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Journal of Pharmacy and Pharmacology

ISSN(p):2328-2150 | ISSN(e):
Journal Papers (379) Details
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1 Bioactive Compound from Streptomyces sp. KB1 TISTR2504 as Effective Disinfectant against Microorganisms , Monthon Lertcanawanichakul1,2 and Kittisak Chawawisit3
A host environment cleaning using disinfectants is the most effective way to prevent the pathogen’s transmission. This study compared the activity among of commercial liquid disinfectants [3% hydrogen peroxide (HP), and 70% ethyl alcohol (EA)] and bioactive-compounds (BCs) from Streptomyces sp. KB1 on indicating microorganisms: Bacillus subtilis ATCC 6633 as representative of spores; Staphylococcus aureus TISTR 517 and clinical methicillin-resistant S. aureus as representative of gram-positive bacteria, Escherichia coli TISTR 887, Pseudomonas aeruginosa TISTR 1467, and extended spectrum beta-lactamase (ESBL)-Klebsiella pneumoniae 342 as representative of gram-negative bacteria; Candida albicans TISTR 5779 as representative of yeast. Results showed that B. subtilis spores are resistant to 70% EA and BCs from strain KB1—which are biocidal to TISTR strains and clinical isolate MRSA, ESBL—in the free floating microorganism (suspension test). On the other hand, this resistance was not observed with 3% HP. Thus, 3% HP showed more promise for disinfecting microorganisms than that 70% EA and BCs. However, BCs did show the antimicrobial activities equal as 70% EA. The results might be implied that the using of BCs from selected bacterial strain as effective disinfectant against microorganism, especially vegetative cell, is a sustainable application in nearly future, to reduce using the chemical substances and zero wastes.  
2 Milk Nutritional Composition and Its Role in Human Health , Kourkouta Lambrini1, Frantzana Aikaterini2, Koukourikos Konstantinos1, Iliadis Christos3, Papathanasiou V. Ioanna4 and Tsaloglidou Areti1
Introduction: Milk is a nutritious, white or slightly yellowish liquid, which is a biological secretion of mammalian breasts, including the human species, intended for feeding their babies. Purpose: The purpose of this review is to examine the nutritional value of milk and its usefulness in human nutrition. Material and Methods: The study was conducted based on reviewing Greek and international scientific studies on the subject found in Greek and international databases such as “PubMed”, “Scopus” and “Medline”, through the search engine “Google Scholar” and the Hellenic Academic Libraries Association (HEAL-Link). The exclusion criterion for the articles was the language, except for Greek and English. Mostly, only articles and studies accessible to authors were used. Results: Cow’s milk consumption is vital for children, because it is considered one of the most important factors in the structure and development of the skeleton and maintenance of Intestinal microbiota (intestinal flora) aiding digestive processes. Additionally, it promotes the absorption of calcium. As regards the milk consumption by older adults, it meets the needs of the body in the best way because its nutrients are in digestible form. One liter (1 L) of milk provides 700 calories and consuming 2 L of milk per day neutralizes the feeling of hunger from the body, while achieving a satisfactory weight loss diet. Conclusions: Milk, therefore, is an invaluable and irreplaceable liquid that offers considerable long-term benefits to both people of all ages and society.  
3 A Look to the Bioenergetic Medicine from the Human Physiology , Richard Marcelo Álvarez Orbea, Ana Elena Rodríguez Cadalso, Regina de Caridad Rodríguez Muñoz, Viviana Silvia Rodríguez Jímenéz, Marelys Calzada and Jesús Manuel Cadalso Menéndez
Objective: To relate biochemistry of the human physiology with the application of the bioenergetic medicine. Methods: Search about the topic in the last 5 years and present a general view of some biochemical processes that allow to apply the bioenergetic medicine, due to the need to open new alternatives based on holistic methods. Conclusions: It was based on the search of articles in the Virtual Library in Health (Spanish: BVS) and using the key words: bioenergetic medicine, vibration, energy, breathing, chakras, biomagnetism, translated into the quality of life’s improvement and the welfare of human being.  
4 Investigation of the False Positive Results of Dithiocarbamate Pesticides due to Endogenous Nonpathogenic Carbon Disulfide in Organically Grown Plants (Moringa oleifera) , Ahmed Ma’mun
Moringa plant belongs to the family Moringaceae within the order Brassicales.It is a magical plant which contains 7 times the vitamin C content of oranges,4 times the vitamin A content of carrots, 4 times the calcium content of milk ,3 times the potassium content of bananas and 2 times the protein content of yogurt (gram to gram) . The most widely distributed species is Moringa oleifera Lam., referred as drumstick tree for the shape of its seed pods. Leaves of M. oleifera are rich in a unique glucosinolate named glucomoringin. Moringa were found to release CS2 when submitted to experimental conditions of dithiocarbamate residue analysis. Gas chromatography was used to quantitate CS2 and control samples were obtained from Moringa plantations cultivated in experimental areas, in which no treatment with fungicides of the dithiocarbamate group was applied. Endogenous CS2 levels were compared with dithiocarbamate residues measured in Moringa samples from the field trials following applications of the macozeeb fungicide. Use small leaves resulted in an observed decrease in CS2 concentration comparable to the large leaves. Temperature level used has an effect on the concentration of CS2 measured as an indicator for dithiocarbamate pesticide residue. And use of high temperature (100 °C) in drying of Moringa leaves after harvesting may lead to some biochemical changes that caused an observed increase in CS2 concentration comparable to drying at (50 °C). Evidence for formation of dithiocarbamate compound from moringin in moringa leaves are metabolized/detoxified principally by the mercapturic acid pathway. Conjugation with glutathione (GSH) promoted by glutathione transferases gives rise to the corresponding Glucosinolate -. Isothiocyanate conjugates. These undergo further enzymatic modifications to give rise sequentially to the cysteinylglycine cysteine - Isothiocyanate and N-acetylcysteine-Isothiocyanate conjugates, all of which are dithiocarbamates. The detection of an ion with a m/z value 430.40, with the following fragments m/z 165.10 and m/z 121.05 respectively, among the ions analyzed by GC-MS gives a clear evidence for formation of dithiocarbamate by addition of glutathione to the isothiocyanate formed from glucosinolate in moringa plant.  
5 An Example of Apiphytotherapy Studies in Azerbaijan: Hepbal , Elnur Eldaroglu Rahimov and Zumrud Alasgar Ahmedova
Ginger, turmeric, black seed, artichoke leaves, Azerbaijani thistle honey, and BB (bee bread) have a hepatoprotective effect; therefore, they show effective results separately in case of alcohol-dependent and non-alcoholic liver obesity, hepatitis and toxic liver damage. We studied how it can affect liver enzymes and hepatocytes in this group of patients. We took all these natural plants and bee products in the optimal dose required by the body and prepared a paste called Hepbal, so that everyday people could eat comfortably as a food supplement, as well as see the therapeutic and prophylactic results. HEPBAL paste for liver ingredients: flaxseed, ginger, seed of thistle, powder of yellow ginger, black cumin, and honey. Benefits: Herbal paste prepared based on well-tested recipes improves the function of the liver and gallbladder. As a hepatoprotector, it affects the recovery of liver cells in liver diseases (hepatitis and cirrhosis), spleen disease, bile ductinfections, gallstones in gallbladders, inflammatory bowel disease, colitis, cholecystitis. It helps to remove toxic substances while taking medicine (antibiotics, chemotherapy, painkillers, etc.). Side effects: Individual sensitiveness to the contents of the product. Usage: In acute process 1 teaspoon, during chronic diseases 1 dessertspoon twice a day before eating. Results: 48 women and 54 men with the third level of fatty liver dystrophy decreased to the second level (fibrosis did not occur). During the treatment of 114 patients who had an HCV (hepatitis C virus), I used HEPBAL paste as a protector for the liver. After the analyses, 24 patients, who had liver cirrhosis ALT (alanine aminotransferase) and AST (aspartate aminotransferase) in the blood reduced twice. Another 81 patients from 90 who had virus had disappeared in blood analyses and in the exogenous factor of liver and GGT in the blood get normal.  
6 Consideration of Healthy Eating Obsession (Orthorexia Nervosa) for Students Educated in Nutrition and Dietetics Department , Zeynep ÇobanoÄŸlu1 and Mehmet Akman2
Objective: It was conducted to evaluate the susceptibility to ON (orthorexia nervosa) in the students of the nutrition and dietetics department according to the variables of gender, age and BMI (body mass ındex). Subjects and Methods: The research covers the students of Marmara University Faculty of Health Sciences, Department of Nutrition and Dietetics in September-October 2017-2018 academic year. The data were collected by survey method. Socio-demographic characteristics and anthropometric measurements of the participants were questioned. EAT-40 (Eating Attitude Test), ORTO-15 test and MOCI (Maudsley Obsessive Compulsive Inventory) were used in the study. It was evaluated with SPSS (The Statistical Package for The Social Sciences) 21.0 program. Results: 205 people participated in the study. EAT-40 scores were found to be ≤ 20 in 94% of the women and 95.2% of the men in the study. The EAT-40 score is ≥ 21 in 6% of women and 4.8% of men in the study (p = 0.646 > 0.05). The ORTO-15 score of 72.3% of women and 71.4% of men is ≤ 40 (p = 0.934 > 0.05). EAT-40 average is 10.25 ± 1.10 in underweight. It was found to be 9.21 ± 0.42 in normals and 8.23 ± 0.76 in slightly obese subjects (p = 0.758 > 0.05). ORTO-15 average of those with BMI ≤ 18.49 kg/m2 is 39.59 ± 0.54; Those with 18.50-24.99 kg/m2 were found to be 38.30 ± 0.25 and those with 25.00-29.99 kg/m2 were found to be 39.54 ± 0.75 (p = 0.098 > 0.05). As the EAT-40 score increased, the ORTO-15 score decreased. It shows a negative, statistically significant difference between EAT-40 and ORTO-15 scores (p = 0.00 < 0.05). Conclusion: It was concluded that orthorexic tendency is common (72.2%) in nutrition dietetic students, and ON is associated with BMI and EAT-40 scores. In terms of ON, it would be beneficial to conduct comprehensive international studies and determine DSM (Diagnostic and Statistical Manual of Mental Disorders) diagnostic criteria.  
7 A Case of Comorbidity of Complicated Infective Endocarditis and Severe Pneumonia Due to Legionella Pneumophila , Nazmi Gultekin1, Emine Kucukates2, Ilker Inanç Balkan3 and Ismail Haberal4
Legionella pneumophila infection can cause Legionnaires’ disease, a severe form of pneumonia. Extrapulmonary manifestations of Legionella infections include myocarditis, pericarditis, and endocarditis. We present a rare case of pneumonia caused by Legionella pneumophila with a possible etiologic link to a recently recovered culture-negative infective endocarditis.  
8 Justification of Lymphotropic Injection of An Immunomodulator in Odontogenic Osteomyelitis , Bakhyt Sekerbekovna Zhanalina1, Olga Yesenovna Bekjanova2, Mayra Taytoleuovna Kopbayeva3, Anar Djambulovna Sagatbaeva3 and Yelmira Niyazovna Smagulova3
The lymphotropic injection of the drug named “Gamma-plant", which is an extract of potato sprouts (Solanituberosigerminum extract) and has a high therapeutic effect, was proved by pathomorphological studies in the experiment on guinea pigs (n = 18).  
9 Larvicidal Evaluation of Aedes aegypti and Antioxidant, Cytotoxic and Antimicrobial Potential of the Aqueous Acid Extract of Pseudoxandra cuspidata (ANNOACEAE). , Ranggel Carvalho Simões1, Rosany Lopes Martins1, Erica de Menezes Rabelo1, Alex Bruno Lobato Rodrigues1, Ana Luzia Ferreira Farias1, Patrick de Castro Cantuária2, Marlon de Oliveira do Nascimento1 and Sheylla Susan Moreira da Silva de Almeida1
The Anonnaceae family has 2,500 species and 135 genera, which has about 14 representatives of species in Brazil, including Pseudoxandra cuspidata. The objective of this research was to study the aqueous-acid extract of P. cuspidata, evaluating its antioxidant, larvicidal, antimicrobial and cytotoxic potential. In the preliminary phytochemical analysis, there were positivity to organicacids and alkaloids. Inhibitory Activity of EAA was 65% against DPPH. The AAE presented to A. Salina nauplii at LC50% of 600.79 μg/mL for a periodof 24 hours. In relation to larvicidal activity to Aedes aegypti intermediates, AAE presented the LC50% in 24 Hours of 475.91 ppm and 290.73 ppm in 48 Hours. Regarding the antimicrobial action, the EAA presented 50 mg/mL MIC for P. Aeruginosa and MBC at 100 mg/mL, and for S. aureus it presented MIC of 50 mg/mL and did not present MBC. This research characterized the presence of alkaloids and organicacids present in the aqueousacid extract of P. cuspidata. The extract presented lowtoxicity in relation to the microcrustacean A. salina. It also had a relevant antioxidant potential (65% of Inhibition), larvicidalaction considered effective, antimicrobialaction for both P. Aeruginosa and S. Aureus even did not present bacterici dalaction.
10 Development of Granule Composition Based on the Total Evaporated Extract of Bidens Tripartita, Solidago Canadensis and Agrimonia Eupatoria Herbs , Novikova E. K and Kaukhova I. E
The aim of the study is the development and standardization of granules in hard gelatin capsules based on the composition of dry extracts of Bidens tripartita L., Solidago canadensis L. and Agrimonia eupatoria L. Herbs, possessing nephroprotective activity and antifibrotics in toxic nephropathies. Developed the structure and defined the quality indicators of the pellets with dry extracts of Bidens tripartita L., Solidago canadensis L. and Agrimonia eupatoria L. herbs. The quality specification for the drug - granules of the composition of dry extracts in solid gelatin capsules is developed.
11 Determination of Fatty Acid Composition by GC-MS and Potential Antioxidant and Antibacterial Properties of Rumex hastatus and Cytisus scoparius Seeds Grown in Kashmir , Zubair Rehman Nengroo1, Abdul Rauf1, Shayeeb Ahmad Bhat2 and Muzammil Sharief Dar3
Rumex hastatus D. Don and Cytisus scoparius Linn. are medicinally important plants used in Ayurveda and food, are enriched with remarkable nervine, diuretic, sedative and various other therapeutic properties. In this study Soxhlet extraction produces higher yield of seed extracts. Gas chromatography-mass spectrometry was used to determine fatty acid composition of petroleum ether extracts (PE). The major fatty acids were Linolenic acid 53.53% in R. hastatus and linoleic acid 59.42% in C. scoparius. Palmitic acid was also found in significant amount (16.58% and 19.33%) in R. hastatus and C. scoparius respectively. The chloroform (RCF, CCF), ethyl acetate (REA, CEA), acetone (RAT, CAT) and methanol (RMT, CMT) extracts of R. hastaus and C. scoparius respectively, were examined for their antioxidant activity using 2,2-di-phenyl-1-picrylhydrazyl (DPPH), nitroblue tetrazolium (NBT), hydrogen peroxide (H2O2), 2,2ˈ-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) radical scavenging assay and antibacterial activity against Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus by Agar disc diffusion method. All the extracts showed good radical scavenging and antibacterial activities compared to butylated hydroxyltoluene and streptomycin respectively. However, dominant radical scavenging effect was observed at 100 μg/mL and 200 μg/mL concentrations of extracts and dominant zone of inhibition was shown by CAT, CMT, RAT and REA extracts. This study exhibited beneficial properties of these plants as an ingredient (unsaturated fatty acids) for the formulation of various functional foods and a source of natural antioxidant and antibacterial agents for drug, design and development.  
12 Orgasmic Bodies: Do-It-Yourself Sexualities, Pharmaceuticals, and Creative Economy , Diego Santos Vieira de Jesus
Based on bibliographic research, the article examines how pharmaceuticals address people‟s sexual needs and desires, stimulated by creative economy. The main argument indicates that pharmaceuticals create conditions for do-it-yourself sexualities, based on bodily stereotypes disseminated by creative industries, which reflect dominant heteronormative discourses. People shape their bodies, enhance sexual experiences, and foster sexual hygiene and prevention of sexually transmitted infections.  
13 2-aminoethyl Dihydrogen Phosphate as a Modulator of Proliferative and Apoptotic Effects in Breast Cancer Cell Lines , Manuela Garcia Laveli da Silva1,2, Laertty Garcia de Sousa Cabral1,2, Monique Gonçalves Alves1,2, Thais de Oliveira Conceição1,2, Henrique Hesse1,2, Rosa Andrea Nogueira Laiso1, Daniel da Conceição Rabelo1 and Durvanei Augusto Maria1,2
Background: Breast cancer is a type of cancer that affects more women throughout the world, in developing and developed countries. 2-AEH2P is a phospholipid analog of cellular membrane, which makes it different from existing molecules for their absorption, stability and display anti-inflammatory, anti-proliferative and pro-apoptotic properties. Methods: MCF-7 human breast adenocarcinoma cells were treated with 2-AEH2P. The viability and adhesion cells were evaluated by MTT assay. Cell cycle phases, apoptosis, markers and mitochondrial potential were assessed by flow cytometry. Morphological ultrastructural analyzes were performed by laser confocal microscopy. Results: MCF-7 Tumor cells acquired round shapes, lost cytoplasmic expansions, formed clusters in suspension and decreased significantly viability. There were changes in the morphology, membrane fragmentation and loss of cytoplasmic projection. The obtained concentrations for IC50% were 37.2; 25.8; 1.8 mM for periods of 24, 48 and 72 h, respectively. Changes in the distribution of cell population phases of the cell cycle showed an increase in fragmented DNA and an increase in the G2/M phase. The expression β-gal showed proliferative reduction induced by 2-AEH2P. Laser confocal microscopy showed changes in the mitochondrial membrane and alteration in distribution. Proliferative index of MCF-7 tumor cells treated with 2-AEH2P decreased significantly when compared to fibroblast normal cells. The compound 2-AEH2P is a phospholipid with antiproliferative potential and apoptosis modulator.  
14 Essential Oils of Lavandula stoechas subsp. luisieri as Antifungal Agent against Fungi from Strawberry Tree Fruit , Joana Domingues1,2, Fernanda Delgado1,3,4, José Carlos Gonçalves1,3,4 and Cristina Santos Pintado1,3,4  
L. stoechas subsp. luisieri is one of the five spontaneous species of the genus Lavandula that occurs spontaneously in Portugal. The chemical profile and antifungal activity of L. stoechas subsp. luisieri essential oils were investigated. The essential oil of two phenological stages was isolated by hydrodistillation and their chemical components analyzed by GC-FID/GC-MS. The minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) of both essential oils were determinate to verify antifungal activity against different strains of fungi isolated from strawberry tree. The fungi tested were Aspergillus carbonarius, Rhizopus stolonifer, Penicillium brevicompactum, Aureobasidium pullulans and Saccothecium rubi. Essential oils were characterized by a high percentage of oxygenated monoterpenes (46-64%) such as trans-α-necrodyl acetate (12.58%), fenchone (5.97%), 1,8-cineole (4.84%) and 5-methylene-2,3,4,4-tetramethylcyclopenten-2-enone (10.97%) were the major compounds in essential oil from dormancy stage, while the main compounds in flowering stage were trans-α-necrodyl acetate (26.90%), trans-α-necrodol (13.02%), lavandulyl acetate (6.53%) and linalool (5.82%). A strong antifungal activity of the essential oils was found against all strains, with MIC and MFC values ranged from 0.07-0.29 µL/mL and 0.58-9.33 µL/mL, respectively.
15 Those Responsible for the Pharmacological Actions of Plants are the Active Secondary Metabolites   , Regina de Caridad Rodríguez Muñoz, Ana Elena Rodríguez Cadalso, Viviana Silvia Rodríguez Jiménez, Geuny Vázquez Bandomo, Yosimy Seijas Delgado and Reydilexis Forestal Gonzáles
Objectives: To relate the presence of the active secondary metabolites in the pharmacological actions and the therapeutic effects of the plants. Methods: Search about the topic in the last 5 years and present some active secondary metabolites that explain the pharmacological actions and therapeutic effects of medicinal plants. Conclusions: It was based on the search of articles in the Virtual Library in Health (Spanish: BVS) and using the key words: secondary metabolites, phytotherapy, medicinal plants.
16 Establishment of Human Neuroblastoma Cell-Line (SK-N-SH) as An In Vitro Model of Morphine Addiction , Noor Azuin Suliman1, Noor Azlina Abu Bakar1, Mohamad Aris Mohd Moklas2 and Che Norma Mat Taib2
Morphine is a schedule II-controlled substance that used to allow the diminution of intra-operative, post-operative or chronic pain. However, its usage is limited due to addiction and overdose liabilities. Morphine was observed to cause tolerance, dependence and withdrawal in human. Justification: to date lack of scientific evidence of morphine addiction was carried out by using specific single human neuroblastoma cell-line (SK-N-SH). Therefore, this study was performed to establish the morphine addiction model in this cell line. The cells were exposed to morphine for 24 hrs before treatment with methadone, as an anti-withdrawal drug for subsequence 24 hours. The cytosolic fraction of the cell was used in different objectives including receptor affinity, withdrawal properties, endocytic machinery, desensitisation or internalisation and cellular adaptation. The result shows that morphine and methadone bind to the µ-opioid receptor. The morphine-treated cells were observed to increase the expression of addiction markers, have a low rate of the endocytic machinery, cause desensitisation of receptor and reduce cellular adaptation. Those changes by morphine were normalised by the treatment of methadone. As a whole, it is postulated that neuroblastoma cell line, SK-N-SH, can be used as an in-vitro model to demonstrate morphine addiction before animal and human testing.
17 Role of Telemedicine and Mobile Health in Management Covid-19 Pandemic   , Sohrabei Solmaz
Background: Digital health similar Telemedicine and Mobile Health interventions are globally playing a significant role to combat coronavirus disease 2019 (COVID-19), which is an infectious disease caused by Severe Acute Respiratory Syndrome coronavirus19. Here, we present a very brief overview of the multifaceted digital interventions, globally, and in India, for maintaining health and health-care delivery, in the context of the Covid-19 pandemic. Methods: This review was conducted through searching four databases including PubMed, Scopus, Web of Science, and Science Direct. Inclusion criteria included studies clearly defining any use of telehealth (Telemedicine and Mobile Health) services in all aspects of health care during COVID-19 outbreak. Results: 111 research studies published from 2019 to May 2020 were employed to provide theoretical and practical evidence on the significance of using telemedicine and mobile health for remote treatment of patients during the COVID-19 pandemic. Also checked the effects for identify the role of telehealth services in preventing, diagnosing, treating, and controlling diseases during COVID-19 outbreak, result showed used Telemedicine and Mobile Health effective outcome in the prevention and emergency treatment of other patients. Discussion: Major technologies identified included telemedicine and mobile care (for COVID-19 as well as routine care), for monitoring. Telehealth can become a basic need for the general population, health care providers, and patients with COVID-19, especially when people are in quarantine, enabling patients in real time through contact with health care provider for advice on their health problems. Conclusions: The use of telehealth improves the provision of health services. Therefore, telehealth should be an important tool in caring services while keeping patients and health providers safe during COVID-19 outbreak and reduces the use of resources in health centers, improves access to care, while minimizing the risk of direct transmission of the infectious agent from person to person.  
18 Influence of Copper Deficit on Structural and Metabolic Features of Myocardium of Rats in Conditions of Thyroid Hypofunction     , Tetyana Guranych, Nataliya Voronych-Semchenko and Mykola Bagriy  
The research was carried on 60 rats, which were divided into two experimental groups—animals with thyroid hypofunction against iodine deficiency and on the background of combined iodine and copper deficit. The control group included 30 intact rats. For evaluation of copper balance its content was determined in erythrocyte mass and myocardium. Prooxidant-antioxidant system was examined by the level of peroxide oxidation of proteins and lipids and due to the activity of antioxidant enzymes. Structural features of the myocardium were examined by light-optical microscopy with subsequent morphometry. In the result of the experiment in rats with thyroid hypofunction on the background of combined iodine and copper deficit the redistribution of copper content in the studied tissues was established (accumulation in blood). The results of the study confirm the activation of oxygen-dependent processes in the myocardium of experimental animals, primarily due to peroxide oxidation of proteins, which is especially manifested in the context of combined iodine and copper deficiency. Metabolic changes in the myocardium were confirmed by histology. So, the development of thyroid hypofunction on the background of combined iodine and copper deficiency increases the probability of cardiovascular pathology due to disorders of prooxidant-antioxidant balance and structural changes in the myocardium.
19 Spectrophotometric Evaluation of Tannin Content in Domestic Beer Samples with Fe(III) and 1,10-Phenanthroline , Crnkic Mirsad and Klepo Lejla
Tannins are polyphenolic compounds that can be divided into two groups by hydrolyzing and condensing. Tannins are produced in organisms of vascular plants called tannosomes and sequestered in vacuoles. The essential uses of tannins are in leather production, as adhesives, additives for wine, beer and fruit juices, etc. They are most present in the growing tissues of the plant as a crust, so beer that ripens in new oak barrels will contain a higher concentration of tannins. Tannins are extracted from malt during grinding and from the hops during cooking. The objective of this research is to determine the tannins content in twelve domestic beer samples (three samples of dark beer and nine samples of light beer) by spectrophotometric method. The method is based on the reduction of Fe(III) to Fe(II) by tannins. The iron(II) reacts with 1,10-phenanthroline at pH 4.4 to form a color complex. The absorbance measurements were made at 540 nm. As a standard tannic acid was used, tannin content was in range 15.49-1722.05 μg/mL. Tannins are present in all beers, above the threshold of detection. When tannins are present in excess, they negatively impact beer by causing astringency but beer completely devoid of tannins does not taste right.
20 Factors Analysis Related towards Behavior of Nosocomial Infection Control on Family Waiting Patient , Ratnasari Ratnasari1, Anggorowati Anggorowati2 and Madya Sulisno2
World Health Organization (WHO) predicted 1.4 million people infected Health Associated Infection (HAIs). One of the risk factors caused is behavior of nosocomial infection control on patient watcher. The purpose is to know relation behavior of nosocomial infection control on patient watcher patient in Semarang hospital and the number of participants was 61 people. Research method was observation with cross sectional approach. Sampling technique was purposive sampling. Data analysis used univariate and bivariate analysis with Pearson correlation test and chi-square test. Result showed a half of them, mean age of the participants was 45.56. Minimum-maximum values were 20-62 with standard deviation 11.114, gender in the research, most of them was female (83.6%), last education was junior high school (34,4%), most of them worked as maids (45.9%). Category of behavior of nosocomial infection control: less (44.3%), moderate (34.4%), and good (21.3%). There is a meaningful relation between behavior of nosocomial infection control behavior with age (p = 0.000), education (p = 0.000), and occupation (p = 0.000). There is no meaningful relation between behavior of nosocomial infection control with gender (p = 0.186). Conclusion: there is a meaningful relation between behavior of nosocomial infection control on patient watcher with age, education, and job, while gender does not have a meaningful relation with behavior of nosocomial infection control. Based on this research, it is recommended to be done as intervention which is able to increase behavior of nosocomial infection control on patient watcher by improving nursing service.
21 Peculiarities of Morphodensitometric Indices of Epitheliocytes of the Oral Cavity Mucous Membrane in Children with Latent Iron Deficiency and Mild Iodine Deficiency     , Uliana Shalamay, Nataliya Voronych-Semchenko, Larysa Kovalchuk and Mykola Bagriy
The article represents the results of the study of the micronutrient deficiency effect (iron and iodine) on the morphometric and optical indices of the oral cavity mucous membrane (OCMM) in school children. In order to achieve this goal, 99 school children aged 6-18 years with adequate iodine and iron supply (control group), latent iron deficiency, and mild iodine deficiency were examined. The morphodensitometric study included the determination of the perimeter and area of cells and nuclei, the nuclear-cytoplasmic ratio, the state of chromatin condensation of the epitheliocyte OCMM. The study material was: epitheliocytes of the buccal scraping. It was determined that the area of epitheliocytes in girls aged 6-11 has significantly increased in mild iodine deficiency and in latent iron deficiency. Instead, the decrease of nuclei area was more noticeable in boys of this age in mild iodine deficiency. During the analysis of the general level of chromatin condensation of epitheliocyte nuclei in children, a gender peculiarity has been proved, which was manifested by a greater sensitivity of girls to microelementosis (increase of the integrative optical density of nuclei in the latent iron deficiency at 97.9%, p1-3 < 0.05, and cell area at 45.8%, p1-4 < 0.01 relative to control). Among children aged 12-18 years,young men were more sensitive to the deficiency of the studied trace elements. Significant growth of the cell area at 38.7% (p1-2 < 0.05) in adolescents with mild iodine deficiency and total optical density of nuclei at 63.6% (p1-2 < 0.05) was substantiated with respect to control in the decrease of karyoplasmic area.
22 Automatic Detection of Stellate Lesions in Digital Mammograms Using Multi-scale SIFT , A. Hikmat1, K. Afdel2 and I. Bakkouri2
This paper presents a novel automatic mammography recognition approach used to develop computer-aided diagnostic systems that require a robust method to assist the radiologist in identifying and recognizing speculations from a multitude of lines corresponding to the normal fibrous breast tissue. Following this rationale, this paper introduces a novel approach for detecting the speculated lesions in digital mammograms based on multi-scale SIFT (scale-invariant feature transform) orientations. The proposed method starts by estimating a set of key points that best represent the image mammography in a scale space. We then benefit from SIFT algorithm to locally characterize each key point by assigning a consistent orientation. Thereafter, a set of three features are extracted for each pixel in the image mammogram based on these orientations. The extracted features are fed into BDT (binary decision tree) in order to perform per pixel classification and decide whether the pixel is normal or abnormal. We evaluate the proposed system on BCDR (breast cancer digital repository) database and the experimental results show that our method is accurate with 97.95% recognition rate, while it is robust to illumination changes, rotation and scale variations.
23 Identifying High-Risk Medication Prescriptions to Prevent Potentially Severe Adverse Drug Events in Primary-Care Patients with Chronic Multimorbidities: The Polychrome Study , Pascal Clerc1, 2, Virginie Boyer3, Françoise Haramburu4, Annie Fourrier-Reglat4 ,5 and Julien Le Breton2, 6 ,7
Background: The association between multimorbidities and polypharmacy among elderly individuals is well documented, and polypharmacy has been shown to increase the risk of adverse drug events (ADEs). However, little information is available about the risks associated with the lifelong use of medications to treat chronic multimorbidities. Objective: To determine the prevalence and nature of high-risk prescriptions among primary-care patients with chronic multimorbidities. Methods: We studied a weighted stratified random sample of 105 prescriptions for different patients with chronic multimorbidities taken from the Polychrome database established using information from the French primary-care record database (Observatoire de la MédecineGénérale). A medication review was conducted to identify contra-indications and potential drug-drug interactions for each prescription. Results: Contra-indications were identified for 60 (57.1%) prescriptions, potential drug-drug interactions for 70 (66.7%), absolute contra-indications for 9 (8.6%), and inadvisable drug combinations for 11 (10.5%). In all, 19 (18.1%) different patients were at risk for major ADEs. Cardiovascular and nervous-system drugs contributed 66.2% of contra-indications and 69.3% of potential drug-drug interactions. Conclusions: This exploratory study confirms the high prevalence and potential seriousness of prescriptions at risk for ADEs in a population of primary-care patients with chronic multimorbidities. The high prevalence of interactions involving the cardiovascular and nervous systems indicates that efforts to improve prescription practices should target these two categories of conditions and drugs in patients with chronic multimorbidities.
24 Nasal Irrigation Effects towards Nasal Mucociliary Transport Time in Active Smokers , Trikaya Cuddhi1, Dwi Marliyawati2 and Anna Mailasari K. D2
Nasal irrigation is often recommended as an adjuctive therapy for treating many sinonasal conditions. It provides mechanical cleansing of mucus, crust, cell debris and various air contaminants. The study was done to analyze the effect of nasal irrigation on change of nasal mucociliary transport time, in active smokers. This study was experimental using pre and post test controlled group design. Samples were divided into two groups; treatment and control group. The mucociliary transport time were tested with saccharin method for two times; before and fourteen days after treatment. On the day fourteen after nasal irrigation there was a significant decreased of the mucociliary transport time than before (p = 0,000). In the control group on second measurement was significantly longer compared to the first measurement (p = 0,003). In the comparison of mucociliary transport time change between treatment group and control group was found significant differences (p = 0,000).
25 Phytochemical, Antioxidant and Antibacterial Studies of Ethanolic and Methanolic Extracts of Aloe elegans Leaves gel   , Halefom Nigus Adhana1, Solomon Libsu (PhD)2, Kiflom Gebremedhn Kelele3
The study was aimed at investigating the phytochemicals, antioxidant and antibacterial activities of the ethanolic and methanolic extracts of Aloe elegans leaves gel. The phytochemical screening revealed the presence of phenols, flavonoids, anthraquinones, tannins, sapponins and terpenoids in both extracts. The antioxidant activities of both extracts were assayed using ferric reducing antioxidant power (FRAP), conjugated diene (CD) and peroxide value (PV) methods using sunflower oil (SFO) as the oxidizable substrate. The value for methanol and ethanol extracts of Aloe elegans leaves gel and the standard ascorbic acid in the ferric reducing power assay at 20 µg/mL were found to be 65.32%, 62.89%, 59.4% respectively. The peroxide value after 12 days at room temperature for the Sunflower oil (SFO) was found to be 45 mmol/L while the value for the substrate containing methanol, ethanol extract and vitamin E were found to be 36, 38, 43 mmol/L respectively. The value of the absorption coefficients of conjugated dienes resulted from oxidations of the methanol and ethanol extracts and vitamin E were found to be 3.006, 3.387, 4.306 g-1cm-1mL respectively. In all the antioxidant assays used, the methanolic extract was found to inhibit oxidation of sunflower oil to a better extent than its ethanolic counterpart. Relative to vitamin E, both extracts exhibited better antioxidant efficacy. In the antibacterial assay, both the extracts showed potent bactericidal effects against Escherichia coli and Staphyloccus aureus, though to a lesser extent than the standard antibiotic Gentamicin.
26 First Report of Polymelia in a DSH Kitten in Tehran, Iran   , Mahmood Akbarian, Milad Borhani, Noushin Zabihi and Farzaneh Azizi
Congenital malformations are intrinsic structural abnormalities and variations of organs, tissue and/or body systems that can occur during the embryonic development of all animal species, and may be partial or total. Polymelia in humans is a rare condition with little information about its occurrence. There is no categorization of data on its occurrence along with other congenital malformations. There are few reports of this occurring in cows, sheep, amphibians, reptiles, birds, dogs and cats. In Jan 2018, a DSH (Short Hair Domestic) kitten found on a street was referred to a veterinary hospital in Tehran with symptoms of rigid mass and deformity in the pelvic region. With lateral and ventrodorsal positioning, the case was sent to the radiology department and examined under the plain radiograph. Findings included two underdeveloped hindlimbs associated with normal left hindlimb showing the congenital deformity and malformations, deformity and underdevelopment of right hemipelvis, the fusion of first and second lumbar vertebrae and kyphosis due to lumbar vertebrae deformity. Through the radiological examinations, the results show that the rigid mass was actually the third hindlimb and the condition is called polymelia. This is the first reported case of polymelia in a domestic shorthair cat in Tehran, Iran.
27 The First Case of Human Herpesvirus 7-Related Epilepsy in the Republic of Belarus , Katerina Divakova1, Elena Kishkurno2,3, Tamara Amvrosieva2, Oxana Romanova1, Svetlana Belaya4, Igor Zaitsau4 and Yuliya Shilova2
Background: Human herpesvirus (HHV)-7 is usually associated with febrile seizures. Later onset and higher frequency of seizures are characteristic of pediatric HHV-7, compared with HHV-6 infection. The HHV-7-related severe neurological disorders are predominantly observed in immunocompromised individuals. Reports of healthy individuals with HHV-7 infection and diverse neurological disorders are limited. Patient Description: We present a case of HHV-7-related epilepsy in an immunocompetent 11-year old boy and extensive infectious and autoimmune testing positive only for HHV-7 in the cerebrospinal fluid. The patient made a good recovery after treatment with intravenous immunoglobulin and methylprednisolone. Discussion: This is the first reported case of epilepsy associated with HHV-7 in a previously healthy individual. It also demonstrates that intravenous immunoglobulin and steroids may be used in the course of this disorder and may be beneficial for recovery.
28 Staging of Adrenal Gland and Pancreas Neoplastic Cyst with Ultradiluted Viscum album: Case Report , Lopes, D. F1,2, Carvalho, A. C1, Sibata, M. N1, Sibata, A. S. C1 and Silveira, JR. L2
Many animal adrenal lesions are frequently observed at necropsy and most often are asymptomatic with clinical syndromes that cause hypofunction or hyperfunction of the gland. The objective of this report is to demonstrate the staging of cysts and to report the clinical evolution of the dog that presented pathognomonic lesions of Cushing's Syndrome and developed Adrenal Cyst and a mass in the Pancreas. We concluded that the use of ultradiluted Viscum album in this patient promoted the control and staging of cystic tumor disease, pruritus and improved immunity to date, totaling 22 months of injectable therapy.
29 Competencies of Obstetric Caregivers Regarding Hepatitis B in the West Region of Cameroon   , Bintcha Walter1, Essi Marie José3,4, Mayopa Cédric François4 and Njoya Oudou2,3
There are many zones of high prevalence of hepatitis B like Cameroon (10%). Mother to child transmission of hepatitis B is the most common mode of transmission in high prevalence area. Its prevention is assured by the health care staff in charge of pregnant women. We therefore used to assess the level of competence (skills levels) of obstetricians regarding hepatitis B in West region of Cameroon. This was a cross-sectional analytical KAP study. The recruitment took place in 11 hospitals in 5 major departments of West region of Cameroon. The sampling was consecutive and comprehensive. The population was constituted of 148 participants with a sex ratio of 0.51. The mean age was 34 years. The population consisted of 50 physicians (33.78%), 61 nurses (41.22%), and 37 auxiliary staff (25%). Only 4% had a good skills level, 55% had an average skills level, and 41% had an insufficient level. The Skills level was influenced by gender, occupation, seniority in the occupation. The skills level of health care workers was average and insufficient for most. This does not allow them to effectively fight against the mother to child transmission of hepatitis B virus in Cameroon.
30 Theory about Treatments and Morbidity Prevention of Corona Virus Disease (Covid-19)   , Majid Rezaei Basiri1,2,3
Corona virus is an enveloped virus from the category of RNA viruses. The patients are suffering from fever, cough, shortness of breath, and no definitive treatment or vaccine is currently available. The viral disease is gradually self-limiting due to the production of antibodies in the body. CDC has developed a new laboratory test kit for use in testing patient specimens for severe acute respiratory syndrome coronavirus, the virus that causes COVID-19. The test kit is called the Centers for Disease Control and Prevention (CDC) 2019-Novel Coronavirus (2019-nCoV) Real-Time Reverse Transcriptase (RT)-PCR Diagnostic Panel. It seems traditional medicine would be usefulness to helping treatment of corona cuvid-19 patients too. It might be other screening distinguishes rapid tests with high detection limit by designing chines scientists are available [1-12].
31 Efficiency of Propolis and N-acetylcisteine on Reduction in Symptom Severity of Respiratory Infection in Children with Adenoid Hypertrophy   , Miljan Folić, Vladimir Nešić and Nenad Arsović
Introduction. Children with adenoid hypertrophy show a tendency towards recurrent or chronic middle ear infection, acute rhinitis or other infections of the upper airway. The purpose of this study was to examine efficacy and safety of combination of N-acetylcysteine and propolis oral suspension and nasal spray in children with adenoid hypertrophy. Method. The clinical trial included children with adenoid hypertrophy. Children in the experimental group were given oral suspension with combination of N-acetylcysteine and propolis, at the first and the second appointment with otorhinolaryngologist, parents of the children were evaluating the intensity of 6 different symptoms, data on otoscopic status were collected, nose and pharynx were examined, audilogical analysis was carried out and nasal swab was used to carry out a microbiological analysis. The control group included children with enlarged adenoids who used hypertonic nasal spray. Key findings. There was a statistically significant reduce of a nasal discharge intensity (p < 0.001), nasal congestion (p = 0.010), sneezing (p = 0.013), post-nasal drip (p = 0.034), cough (p < 0.001) as well as hearing loss (p = 0.002) in experimental group after treatment. Positive effect on nasal congestion, post-nasal drip and cough, recorded during the second appointment, was significantly higher in the experimental group than in the control one (respectively p = 0.04; p = 0.034; p < 0.001), while in the case of a nasal discharge, sneezing and hearing loss there was no difference in effect between the experimental and the control group. Conclusion. The combination of N-acetylcysteine and propolis has justified use for reduction in symptom severity of respiratory infections in children with adenoid hypertrophy.
32 Drug Use Profile and Mortality in Patients with Diabetes Mellitus   , Mariana M Costa1, Cristiane AM Pádua2, Roberta C Figueiredo1, Bruna G Rocha1, Mateus L de Faria1, Cláudia DL Oliveira1 and Clareci S Cardoso1
Objective: To analyze the medicine use by hospitalized patients with DM diagnosis and its association with mortality in one year follow up. Methods: Surveillance of all hospitalizations was conducted through the public health system in the mid-sized municipality of Minas Gerais, Brazil, for 18 weeks. Patients were interviewed regarding their socioeconomic, demographic, as well as medication use. Additionally, they were monitored regarding death outcomes. Deceased and survivors were compared using Multivariable analysis with Classification and Regression Tree. Results: During surveillance we identified 96 patients with DM diagnosis hospitalized, among these, 63 were interviewed regarding medication use. A total of 16 patients (28.1%) did reported difficulty in finding medication within the public health system, 22 (34.9%) did not use hypoglycemic drugs, and 25 (39.7%) had low medication adherence. We found high death outcomes during follow-up, when 32 patients had died (33.3%). The variables associated with death were: absence of information regarding the effects of discontinuing medication; dispensary location, polypharmacy; legal age of adulthood and number of children. Conclusions: This investigation describes problems related to the correct use of drugs by patients with DM who may be contributing to the frequent hospitalizations besides the high mortality rate in this population. These findings may prove useful in public policy planning for DM and may lead to a significant reduction in premature death.
33 Blood Group Cartography (ABO, RHESUS, KELL and DUFFY) and Hemogram of Icteric Newborn in Sendwe Hospital, Lubumbashi/D.R.C , Monga Kalenga J. J1, Monga Ngoy Davidson2, Matanda Kapend Serge3, Masendu Kalenga Paulin4, Haumont Dominique5 and Luboya Numbi Oscar1
Background: Allo immunization jaundice is a common cause of neonatal jaundice. According to racial group the concerned blood group may not be the same. In our Country people are exposed to high transfusionnal risk because of malaria and sicklanemia and the blood group research in laboratory include only ABO/D. Objective: Our objective was to establish a blood group cartography of this icteric newborn population and their mother; the frequency of rare blood group and the compatibility level between mother and newborn. Our interest was also to study hemogram of this population. Methodology: We studied blood group ABO/D; RH/Kell and Duffy of 56 newborn whom developped an indirect bilirubin and their mothers. We performed bilrubin level and hemogram. Results: The frequency of icteric newborn was 17.17%. The mother blood mapping was O (60.71%), RhD positive (83.9%), C negative (91.07%) E negative (89.29%) c positive (91.07%), epositive (92.86%), kell negative (100%) and duffy null (100%). The most common phenotype was ccDee (67.9%) Neonatal was ex aequo O and B (37.50% respectivly), RH D positive (87.50%), RhC negative (87.50%), Rh E negative (89.29%), Rhc positive (96.43%), Rh e positive (96.43%), Kell negative (98.21%) and duffy null (100%), 75% of newborn had the phenotype ccDee. We noticed 9% of extremely rare blood group in maternal population. Mean level of bilirubin was 11.48 mg% at H48. Analyse of hemogram reveal a normocytic and normochromic anemia. Conclusions: Mapping blood group of this population reveal the importance of extended blood grouping in icteric newborn and their mother. Our population presents a blood group that is widely open to allo immunization in all studied blood group.
34 Connecting Morals and Values to Combat the Spread of HIV/AIDS in Grade 10 School Children , Pelokazi Nqabeni and Nomasomi Matiso
This paper sought to understand the connection of morals and values to combat the spread of HIV/AIDS in Grade 10 school children. HIV/AIDS is a disease that threatens the lives of everybody including school children and their intellectual ability, which may lead to poor performance in their studies, pregnancy, drug abuse and dropout of school. Since there is no cure for it, and it is transmitted by various ways including sexual contact, it is vital that everyone including school children, teachers, parents know about the disease and how to connect morals and values to combat the spread of HIV/AIDS and for halting further spread of the infection. The paper uses a qualitative case study research design by means of phenomenological investigation of Grade 10 school children connecting norms and values to combat the spread of HIV/AIDS in one of the rural Senior Secondary Schools in the Dutywa District. The findings showed two themes, learner behaviors and lack of independent experience, lack of knowledge about the use of drugs. Forthcoming researchers could carry more research on young people’s behaviors to sustain good practices for effective goals about their lives.
35 Hemophilia or “Royal Disease” , Kourkouta Lambrini1, Koukourikos Konstantinos1, Iliadis Christos2, Ouzounakis, P.3 and Tsaloglidou Areti1
Introduction: Hemophilia is an inherited sex-linked and life-threatening disorder of hemostasis, preventing proper blood coagulation due to the absence of a specific coagulation factor. Purpose: The purpose of this study is to review all data related to hemophilia disease. Material and Methods: The study material consisted of recent articles on the topic found mainly in valid databases such as PubMed and the Hellenic Academic Libraries Association (HEAL-Link). Results: For patients with hemophilia there is no damage to the original hemostasis function (where platelets are mainly involved), but the fault lies in coagulation. As such, flow time testing and in vivo monitoring of platelet function are completely normal. Consequently, a simple slip that happens to everyone does not lead to hemarthrosis—since initial hemostasis is normal—the same happens to hemophilic patients. Conclusions: Proper collaboration of the therapeutic team with the patient in conjunction with an individualized treatment program adapted to the needs of each patient and especially the child leads to effective improvement of the hemophilic patient.
36 Lactuca sativa Stems as the Source of Bioactive Compounds as well as the Leaves , Hanin Nafed Mughrbi and Abdurazag Abdussalam Auzi
The stems of Lactuca sativa L. are usually not popular as the leaves in preparing the salads and therefore thrown away. The work is intended to compare the phytoconstituents of the leaves and stems extracts. Gas chromatography-mass spectrometry (GC-MS) is applied for the petroleum ether extracts of the leaf and the stem of the selected varieties (L. sativa var. longifolia L. and L. sativa var. capitata L.). A total of fifty-eight compounds were identified and quantified from the studied extracts. These compounds have belonged to various categories such as fatty acid, volatile compounds, phytosterols, triterpenes, diterpenes, vitamin E isomers, and others. Triterpenes with phytosterols represented the superior percentage among other categories. Diterpenes were quantified only in the leaves of the studied varieties. The stems exhibited a higher percentage of phytosterols, triterpenes, and volatile compounds rather than the leaves of each variety.
37 Holistic System of Prophylactic Medicine against the Covid-19 Susceptibility in India , Kameshwaran Sugavanam, R. Manivannan and M. Sarbudeen    
The discovery and spread of 2019 novel coronavirus (2019-nCoV) or the serious acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is threatening the planet with new public health emergencies. The virus originated in bats and was transmitted to humans in December 2019 through still unknown intermediate animals in Wuhan, Hubei Province, China. As the number of victims continues to expand worldwide, it is clear that these viruses raise a population health risk. This article gives a view regarding the holistic approach of Indian Traditional medicine system i.e AYUSH (Ayurvedic, Yoga and Naturopathy, Unani, Siddha and Homeopathy) system of medicine for the improvement of immunity & producing prophylactic effect from the dangerous new virus Covid-19.
38 A Safety, Cheap and Easy Technique to Perform Endoscopic Procedures on COVID-19 Times     , Augusto Fey1,2, João Vilson Cláudio Teixeira1,2, Gabriela Bernardino Fey3
It is known that endoscopists are strongly exposed to aerolization during endoscopic procedures and therefore subject to high levels of contamination by the Corona Virus. This procedure was developed by an endoscopy team, which works in a referral hospital for dealing with the pandemic, in southern Brazil. The technique consists of using a surgical mask on the patient, during the endoscopic procedure, preventing aerolization, as well as the use of gauze, sealing the mouthpiece, when removing the device. It is important to emphasize that this is a complementary technique to the recommendations of the Brazilian Society of Endoscopy, which already has a specific rule for this condition. All images belong to the authors' collection and are authorized for scientific publication by an informed consent form, signed by the patients.
39 Psychotherapeutic Interventions in a Context of Dementia with Delusional Psychosis Outbreak: Clinical Case , Ana Almeida, Diana Monteiro and João Magalhães
Thinking about specialized care that respects vulnerabilities leads to a high and continuous requirement in quality standards. In this clinical case, dementia and delusional psychosis are addressed from a descriptive, participatory and reflective perspective. The role of nurses who specialize in mental health and psychiatry nursing in the monitoring of the target individual of nursing care, based on the patient’s specific needs and the exploitation of psychotherapeutic interventions to be prescribed in this specific case demonstrates that this therapeutic process is a path of change, presenting itself as a complementary method that compensates for the investments made. This structured process that values the relationship between the professional and the care target allows them to develop skills that allow him to continue his life path.
40 Evaluation of the Anti-hyperglycemic Activity of Three Medicinal Plants Extracts in Agadir Region (South of Morocco)   , A. Hikmat1,2, A. Bouhaimi1, A. Khrrachi1, L. Aboudlou2, S. Bari2, S. Tahrouch3 and A. Kaaya2
Our study was carried out to evaluate the hypoglycaemic and antidiabectic activity of organic extracts of three plants: Argania spinosa (leaves), Ceratonia siliqua (aerial part) and Pistacia atlantica (leaves), traditionally used in herbal medicine in Agadir region. Oral administration of extracts was tested at 50, 150 and 250 mg/kg and the anti-diabetic effect was studied by inducing diabetes by pancreatectomy and by alloxan injected at a dose of 180 mg/kg. Ehanolic extract of Argania spinosa induced a significant transient hypoglycemia with a maximum reduction of 12% for the concentration 250 mg/kg compared to the control. Analyses of the hypoglycemic activity show a very highly significant effect for extracts of Argania spinosa and Ceratonia siliqua at the two concentrations tested (250 and 150 mg/kg). On the other hand, the extract of Pistachia atlantica did not show any remarkable results. In the same sense, the results of the anti-hyperglycemic activity showed a remarkable activity for the extract of Argania spinosa and Ceratonia siliqua and a slight activity for Pistachia atlantica.
41 Epigenetic Mechanisms of Drug Resistance of Non-tuberculous Mycobacteria   , O. I. Alkhovik1, L. S. Evdokimova1, T. I. Petrenko1, M. A. Dymova2 and A. A. Pryhodchenko3
High-performance pyrosequencing of the M. abscessus genome was carried out. The genome contains genes responsible for the functioning of the restriction-modifying system; the HPA2 gene encoding histone acetyltransferase HPA2 and related acetyltransferases; cda gene encoding deoxycytidine triphosphate deaminase that is, a complex of perfect epigenetic mechanisms that can protect mycobacteria from various influences, including drug attack.
42 Analysis of Inhibitory Propensity and Percentage Inhibition of Tecoma stans and Plectranthus vettiveroides Leaves against Escherichia coli ESBL Enzyme in Namakkal District Broilers, Tamil Nadu, India , S. Kameshwaran1, K. Abhenaya2, R. Manivannan3, N. Elavarasan4, D. S. Asok Kumar4, J. Priya2 and V. Priyanka4
On samples phenotypically positive for extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli, the inhibitory potential and percent inhibition of fresh juice from Tecoma stans and Plectranthus vettiveroides leaves on beta-lactamase enzyme of cecal samples of healthy broilers were tested. Two hundred (200) samples of cecal treated for ESBL-producing E. coli were obtained from 38 Namakkal poultry selling outlets. The impacts of T. stans and P. vettiveroides leaves were interpreted as chromogenic substrate by colorimetric assay with CENTA and nitrocefin. The mean absorbance value of the inhibitory potential was inversely propotional. Tecoma stans exhibited 29% and 31% of CENTA and nitrocefin inhibition, respectively. The mean absorbance value of Plectranthus vettiveroides and the 10.0% inhibition of CENTA and nitrocefin in both (p > 0.05) showed no significant difference in CENTA and nitrocefin activity. As normal regulation, tazobactum (100 μM) exhibited a 99.89% and 98.31% inhibition against CENTA and nitrocefin, respectively. The combination of Plectranthus vettiveroides and Tecoma stans showed 14% to 15% inhibition, respectively, with CENTA and nitrocefin. Results showed that beta-lactamase enzyme activity which inhibited with T. stans was higher than P. vettiveroides leaf juice and the combination of the two herbs showed no substantial difference in activity.
43 Frailty of Human Enamel in Dental Pieces with and without Fluorosis: An in Vitro Study   , Yamile Tamuch1, Gabriela Figallo2 and Graciela del Carmen Ruiz1
Hardness is considering an essential physiological property of human dental enamel. Much more serious is the fluorosis, teeth pieces are subject to extensive mechanical failures of the surface. Objective: To compare relationship between force and hardness (F-H) in samples of human dental enamel with and without fluorosis. Material and Methods: In vitro experimental study. Dental pieces of adult humans derived from extractions due to periodontal problems or orthodontic treatment were used. Teeth with fluorosis (n = 11) and without fluorosis (n = 11) were included (beta = 10% and alpha = 5%, maximum error admitted at simple size calculation). From each tooth, 4 blocks were cut, each of one catted parallel to respective tooth surface (vestibular, mesial, palatine-lingual, distal); those little pieces were included into acrylic resin and polished. A Vickers microhardness test was used, consisting in measuring the diagonal length of an indent left by indentation of a diamond pyramid with a given load into the sample material. The F-H relationship was measured with Spearman coefficient (Sp), adjusting by group (fluorosis: yes-no) and by dental surface (palatine/lingual, mesial, distal, vestibular); statistical significance level: p < 0.05. Results: F-H relationship showed statistically associated in the group of teeth with fluorosis (Sp = 0.774, p = 0.009) but not in the group without fluorosis (Sp = 0.249, p = 0.586). Adjusting by dental surface, F-H relationship was statistically significant in fluorosis group (Sp = 0.699, p = 0.024 in mesial side; Sp = 0.964, p = 0.001 in distal side; Sp = 0.701, p = 0.036 in palatine-lingual side and Sp = 0.617, p = 0.077 in vestibular side), but not in the group without fluorosis. Conclusion: Evidence suggested that F-H relationship was statistically significant only in dental pieces with fluorosis, suggesting that dental fluorosis involves a weakening of complete dental structure.
44 Anomalous Magnetic Fields - Corona Virus Disease Cause , Nikola Trifunovic
Introduction: Everything in Earth magnetic field (EMF) gets magnetic properties (MP). Diamagnetic can become paramagnetic. Aim: To prove that living world is an agglomerate of electrical beings. To point body electrical potential generator. Show Anomalous magnetic fields (AMF) enormous pathological force; how does an old organism function and how young one concerning immune system and aging. Methodology: Scientific works published in international journals are methodological leaders of this brief information. Pathological processes in people and medicine are mentioned. Results: Clearly presented are unknown things from physiology, cells division, breathing, heart and central nervous system functioning etc. Also, presented is pathology causing enormous mortality and diseases. Cause is AMF. Virus entering into host cell is explained. Conclusion: Humans are magnetic and electromagnetic beings. All chemicals are products of electric impulses.  Life has appeared according to a magnetic code enabled by EMF and its end will be when EMF disappears, as it happened on Mars. Biology-medical science should consider physical fields in order to prolong life on the planet Earth.
45 Assessment Quality of Life in Patient with Lip Cancer after Radical Surgery and Radiation Therapy , Slipetsky Roman1, Rajesh Pandit1 and Halay Oleh2
Lip cancer is one of the most frequent malignant neoplasms of the oral cavity. It has wide impact on the quality of life for patient and their families. In oncology, assessing quality of life is being used as a primary outcome measure to study the effectiveness of treatment therapy for cancer patient. Material and methods: This study included total of 103 patients affected by lip cancer (stage I-IV) who underwent treatment (surgery and radiation therapy) from 2010-2016 at Lviv Regional Oncological Centre, Department of Head and Neck Oncology, Lviv city. Quality of life (QOL) was assessed by using EORTC QLQ C30 V.30 Questionnaires and Head and Neck Cancer Specific Modules EORTC QLQ H&N35. All patients were divided into two groups, in which group-I consisted of 30 patients after radical surgery and in group-II consisted of 73 patients after radical radiation therapy. The QOL was assessed during one month after treatment of lip cancer. Result: In group-I (radical surgery therapy) 43% of patients had locally advanced disease with local metastasis to neck lymph nodes in 13% of cases. In this group G3 histological differentiation was strongly correlated with advance disease and poor prognosis. In group-II (radical radiation therapy) 88% of patients had mostly local disease (stages I-II). EORTC QLQ C30 and H&N35 score were better in group-II (radical radiation therapy) before treatment, than in group-I (radical radiation therapy). But one month after treatment group-I has better European Organization for Research and Treatment of Cancer (EORTC) score. Kaplan-Meier curve also shows better survival rate in group-I patients. Conclusion: Our results suggest that patient’s quality of life is better when treated with radical surgery therapy and it also improves survival rate as compared with radical radiation therapy.
46 Isolation and Identification of Psychrotrophic Photosynthetic Bacterium from Antarctic Seawater with Antibacterial Activity   , Fatin Syahirah Othman1, Mazlan Hashim2, Abdul Hafidz Omar3, Mohd Nadzri Md Reba2, Mohd Farid Muhamad Said4, Kamaruzaman Soeed3, Shafinaz Shahir5, Mohd Firdaus Abdul-Wahab5, Koji Iwamoto1, Shaza Eva Mohamad1 and Zaharah Ibrahim5
The search for new antibiotics is on the rise because of the growing threat of antibiotic resistance. Once the antibiotics fail to work, people are at risk of dying of common infections, and routine operations become difficult to perform, making millions of lives at risk. In our study, the authors found that a photosynthetic bacterium can provide a good potential source of another group of antimicrobial compounds known as photoantimicrobial compounds. This psychrotrophic bacterium was isolated from the Antarctic and grew well at a temperature ranging from 10 °C to 30 °C in the acetate medium, implying minimum energy usage by the bacteria contributing to energy saving for its bioprocessing. The bacteria identified as Stenotrophomonas sp. via 16S rDNA analysis and coded as SZB2 strain was rod shaped. Gram negative and possessed bacteriochlorophyll a and b are usually found in photosynthetic bacteria. SZB2 was found to produce antibacterial substances from the cocultivation assay with both Gram negative and Gram positive bacteria such as Escherichia coli and Staphylococcus aureus. The growth inhibition was higher in S. aureus than that of E. coli. Hence, it may be concluded the bacteria had the ability to produce a wide spectrum antibiotic.
47 In Vitro Antioxidant and Anti-inflammatory Potential of the Optimized Combinations of Essential Oils from Three Cameroon Grew Ocimum L.   , Jean Baptiste Hzounda Fokou1,2,3,4, Ngene Jean Pierre4, Etame Loe Gisele4, Ngoule Charles Christian4, Jazet Dongmo Pierre Michel1,5, Iuliana Mihaela Laza3,6, Fabrice Fekam Boyom1 and Bassene Emmanuel2
In the best of our knowledge, there is no report on the antioxidant and anti-inflammatory effect of the combination of essential oils from Ocimum genus. In our previous report, the combinations of Ocimum basilicum/Ocimum gratissimum, Ocimum basilicum/Ocimum urticaefolium and Ocimum gratissimum/Ocimum urticaefolium were optimized for their antifungal effect. The present report presents the spectral profile and antioxidant and anti-inflammatory effects of those optimized combinations. The optimized combinations were prepared following our previously described approach and analyzed by Fourier Transformed infrared spectroscopy for fingerprinting of essential oils involved in the combination. The radical scavenging activity was evaluated on diphenyl-picryl-hydrazyle (DPPH) and ferric reducing antioxidant power (FRAP). The antioxidant activity was determined using the protective model of Linseed oil accelerated oxidation. The anti-inflammatory activity was assayed using cyclooxygenase (COX) 1 and 2. The results indicated that the fingerprints of the combination are different from those in the essential oil analyzed alone. This denotes the physical expression of different hydrogen bonds in the mixture. Overall, the optimized combinations exerted a maximum reduction (OD = 4) effect on the ferric ion. As well, they scavenged the DPPH efficiently (90% inhibition). These combinations also successfully inhibited the auto-oxidation of flaxseed oil by reduction of cis double bonds, aldehyde and hydroxyl. The optimized combination of Ocimum basilicum and Ocimum gratissimum showed a lower inhibitory effect in comparison to the control consisting of enzyme without inhibitor. Of note, Ocimum gratissimum alone exerted an inhibitory effect on both isoform of cyclooxygenase with IC50 = 0.23 µL/mL and 0.27 µL/mL for cyclooxygenase 1 and 2 respectively. Also, the essential oil of Ocimum basilicum exhibited a better effect on cyclooxygenase 2 (IC50 = 0.22 µL/mL) but showed less action on cyclooxygenase 1 (IC50 = 0.55 µL/mL). The essential oil of Ocimum urticaefolium presented the best effect on cyclooxygenase 1 (IC50 = 0.06 µL/mL) but appeared to be nonactive on cyclooxygenase 2. Globally, the optimized combinations inhibited efficiently all the isoforms of cyclooxygenase with percentage inhibition of ≥ 67% for cyclooxygenase 2 and ≥ 98% for cyclooxygenase 1.
48 Most Common Psychiatric Disorders as Migraine Comorbidities , Denis Jevdokimov1, Natalija Agejeva1 and Ligita Smeltere2
Last studies have found that migraine is common with other diseases. These cases are called "comorbidities", which means that they occur in parallel and are likely to affect a migraine. There are studies showing a link between migraine and major depression, bipolar disorder, and anxiety disorders. The general aim of the study is to identify psychiatric comorbidities of migraine and its clinical pattern.
49 Comparison of Oral versus Intravenous Tranexamic Acid in Total Hip and Knee Arthroplasty , Jennifer Remington1, Rachana Patel1, William Stanfield1, Karen Kier2 and Amber Baehr1
Objectives: The aim of this study is to compare blood loss from IV (intravenous) TXA (tranexamic acid) to PO (oral) TXA in THA (total hip arthroplasty) and TKA (total knee arthroplasty) at UHSJMC (University Hospitals St. John Medical Center). The primary endpoint is to compare the hemoglobin change (g/dL) in patients using IV versus PO TXA after THA or TKA. The secondary endpoints are to compare the amount of blood loss (mL), amount of transfusions (units), and length of stay (days). Methodology: This is a retrospective chart review of patients who receive IV or PO TXA during a THA or TKA. Inclusion criteria are patients receiving IV TXA between September 1, 2018 and February 28, 2019 or patients receiving PO TXA between September 1, 2019 and February 29, 2020 for a THA or TKA. Patients will be excluded if they are less than 18 years old; patients who have a history of cognitive/psychosocial impairment, dementia, or language barrier, have had a deep vein thrombosis or pulmonary embolism within the past twelve months; have a history of deep vein thrombosis or pulmonary embolism being treated with anticoagulation; known congenital thrombophilia; or cardiac stent or ischemic stroke within one year. Primary endpoint will be analyzed using a standard independent T-test comparing mean change in hemoglobin. Secondary endpoints will be analyzed using descriptive statistics. Results: A total of 357 patients were reviewed for inclusion in the study with a total of 289 patients enrolled, 257 in the IV group and 32 in the PO group. There were 107 THA and 150 TKA included in the IV TXA group. There were 18 THA and 14 TKA included in the PO TXA group. The primary outcome of change in hemoglobin was -2.721 ± 1.04 g/dL for the IV TXA group and -2.513 ± 1.09 g/dL for the PO TXA group (p < 0.001). The secondary outcome of blood loss was 189.35 ± 180.2 mL for the IV TXA group and 89.69 ± 70.7 mL for the PO TXA group (p < 0.001). The secondary endpoint of length of stay was 2.02 ± 1.05 days for the IV TXA group and 1.84 ± 1.05 days for the PO TXA group (p < 0.001). Only one patient received a blood transfusion of 2 units during this study therefore statistical tests could not be performed. A post hoc analysis was preformed comparing THA to TKA. Hemoglobin change, length of stay, and transfusions were non-inferior to each other but amount of blood loss was significantly more for THA versus TKA (p < 0.001). Conclusion: With the ease of use of PO tablets, possible cost savings, and longer half-life, the use of PO TXA may be more beneficial for select patients. Future studies with larger sample sizes, randomization, and lack of surgeon variability are still needed.
50 Mediaeval Quality Assurance of Medicines within the Territory of the State of Burgundy     , Nanno Bolt
The State of Burgundy from Charles the Bold included in 1477 the Low Countries (comprising large parts of present-day Belgium, the Netherlands, Luxembourg and parts of northern France) as well as the counties of Nevers and Burgundy and the duchy of Burgundy. The quality of mediaeval medicines within the territory of the Burgundian State was assured by four themes in the municipal and governmental pharmaceutical regulations: inspection of the pharmacy, surveillance of medicines preparation, quality prescriptions and the professional education. Uniform prescriptions were a key factor in the QA (quality assurance) of medicines. Based on ordinances and on heritage inventories in nineteen Burgundian towns it became evident that between 1310 and 1540 the Antidotarium Nicolai was usually prescribed or present as a formulary and that from 1568 on, the presence of the Dispensatorium Cordis predominated.
51 Indentify a High-Risk Group of Cardiovascular Complications in Hypertensive Patients by Analyzing Heart Rate Variability and Heart Rate Turbulence Parameters , Tetyana V. Aleynikova
Background: Low heart rate variability (HRV) in patients with arterial hypertension (AH) is a prognostic factor that increases the risk of adverse cardiovascular outcomes. There are extreme HRV values (so called “cut-points”), beyond which there is a poor prognosis and a high risk of fatal outcomes: SDNN < 50 ms; SDANNi < 40 ms; SDNNi < 20-30 ms; RMSSD < 15 ms; pNN50 (%) < 0.17. Abnormal heart rate turbulence (HRT), as a baroreflex-mediated short-term oscillation of sinus rhythm cycle length after spontaneous ventricular extrasystoles, also has a high predictive value as a cardiovascular risk factor. The aim of our study was to evaluate HRV parameters by the “cut-points” criteria and to analyze HRT in the patients with AH. Materials and Methods: We have analyzed HRV and HRT parameters in 214 patients with AH of the II-nd degree aged 35 to 70 (57.7 ± 7.6) years: 121 women (56.5%) and 93 men (43.5%). To study changes in HRV and HRT, all patients underwent Holter monitoring (HM). The obtained data were processed using the analytical paskage “Statistics 10.0”. Results: The maximum output of HRV parameters beyond the critical values (17.39%—male, 6.58%—female) was registered at the age of 50-59 years, mainly in male with a reduction of the TS parameter. Conclusions: The analysis of HRV and HRT parameters makes it possible to identify hypertensive patients with a high risk of developing cardiovascular complications and an increased risk of fatal outcomes that should be used for timely modification of treatment measures.
52 Enhancing Spatial Memory Effects of Black Seed, Frankincense, and Ginger Extracts Using Albino Mice , Suhera M. Aburawi1, Manal A. Buabeid2, 4, Abdurazag Auzi3, Manal M. Mahmud1, Mai A. Buabeid1 and Rida A. Altubuly1
Over the years, there has been an escalating interest in the use of herbal medicine worldwide. The use of traditional medicine has provided valuable formulas on the selection, preparation and application of herbal remedies. In this study, the effects of ginger, frankincense, and black seed methanolic extracts, on hippocampal synaptic transmission, plasticity and spatial memory were investigated using albino mice. Five groups of mice (each n = 8) were used, Group I. control, received 1% Tween 80; Group II, control received gum acacia 5%; Group III, received black seed extract; Group IV, received frankincense extract; Group V, received ginger extract. Group VI, received the mixture extract. Sub-acute administration was applied (1, 5 and 24 hrs before scoring). The levels of glutamate and GABA were measured by using HPLC. Western blot was performed to evaluate synaptic proteins expression. The extract increased the glutamate levels without any changes in GABA levels; it also enhanced the hippocampal long-term potentiation. In addition, extracts effectively enhanced the spatial recognition memory (hippocampal-dependenttask) in mice using Y-maze test. The amelioration of LTP and spatial memory in mice caused by extracts treatment was accompanied by improvement in AMPA -mediated synaptic transmission in the hippocampus. Interestingly, the protein levels of GluR1 AMPA subunit and NR1 NMDA subunit expressions were significantly increased in mice hippocampus. Memory enhancing is combined with increased glutamate level. These results provide a support for the potential therapy of ginger, frankincense, and black seed extracts for enhancing cognition.
53 Development and Validation of an LC/MS Method of Glatiramer and Its Sequential Amino Acids, at Pharmaceutical Product     , Patricia Parra Cervantes1, Silvia Romero Medina2, Mario De Santiago Ruíz2, Alfredo Espinoza Brambila2, Ramón Soto Vázquez1, Yurihelem Jacobo Cruz3 and Diana Carolina López Osorio4
Analytical method by liquid chromatography coupled to mass spectrometry (LC/MS) was developed and validated for the quantification of the polypeptide mixture of glatiramer acetate (GA) as an injectable solution, the method was linear, precise, accurate and capable of separating the polypeptide mixture consisting of four amino acids that make up the glatiramer (L-glutamic acid, L-alanine, L-tyrosine and L-lysine), using a Waters Acquity® UPLC BEH300 C18 1.7 µm column, 2.1 × 100 mm, a mobile phase composed of 0.2% formic acid and acetonitrile at a flow rate of 0.2 mL/min, a mass spectrometry detector (WATERS Acquity QDa®). As a result, the fragmented ions related to each molecule were obtained with the following values: 564 m/z for GA, 148 m/z for glutamic acid, 90 m/z for alanine, 182 m/z for tyrosine and 147 m/z for lysine; with retention times of 4.1 min, 11.2 min, 11.3 min, 12.1 min and 10.9 min respectively. The method shows linear and reproducible responses in a range of 128-192 µg/mL GA, with a correlation coefficient (r) of 0.997, recoveries of 99 ± 1.2% and an accuracy of 0.5%.
54 Comparative Study for Determination of Atracurium Besilate in Presence of Its Toxic Degradant (Laudanosine) by Reversed Phase HPLC and by TLC Densitometry , Ahmed Ma’Mun1, Amal M. Abou Al Alamein2, Mohamed K. Abd Elrahman2 and Mohamed Abd El- Kawy3
Two methods are described for the stability indicating determination of Atracurium Besylate in presence of its major degradant (Laudanosine). The first method was based on reversed liquid chromatography, C18 column (150 mm × 4.5 mm, 5 µm packing) was used for separation. The mobile phase consisted of a mixture of 0.075 M potassium dihydrogen: methanol: acetonitrile adjusted to a pH of 3.1 ± 0.2 with o-phosphoric acid (50:30:20, by volume). Flow rate of 1.0 mL/min was applied. Quantitation was achieved with UV detection at 280 nm. Linearity, accuracy and precision were found to be acceptable over the concentration range of (1-8 µg/mL) atracurium besylate (ATR). The second method was based on the thin layer chromatography (TLC) separation of the two drugs followed by densitometric measurements of their spots at 282 nm. The separation was carried out on silica gel plates using methanol: ethyl acetate (3:7, v/v) as developing system. The linear regression analysis data were used for the regression line in the range (2-18 µg/mL) of ATR. The two proposed methods were successfully applied to the determination of ATR in presence of LDS in laboratory prepared mixtures and in commercial vials. The optimized methods proved to be accurate, precise, highly selective and highly sensitive.
55 Hydatid Cyst in Children at Nelson Mandela Academic Hospital: A Five Years Study , Arturo L Delgado, Mfuneko Kopolo, Dumo Bangaza, Luke Yamkela and Thabane
Introduction: Hydatid disease is one of the important health problems in developing countries. It is a parasitic disease that can affect any part in the human body, but it commonly affects lungs and liver. Because of poor data and preventive measures in sub-Saharan Africa, cystic echinococcosis (CE) is regarded as endemic disease. Aim: To assess the behaviour of the Hydatid Cysts and the organs commonly affected in children in our rural population. Method: This is retrospective longitudinal analysis of children between the ages of 3 to 12 years that were admitted in paediatric surgical unit at Nelson Mandela Academic Hospital (NMAH) in Eastern Cape, South Africa. The study was conducted on patients admitted between April 2015 and April 2020. The aim of the study was to assess which age group, sex and organs commonly affected by the hydatidosis in our children. Results: We studied 50 children; the group of age most affected was 3 to 12 years. The females accounted for 58%, and 42% males. In our patients, 38% had hydatid lung cysts, 46% liver cysts only, 6% had both liver and lung hydatid cysts, 4% had liver, lung and spleen, another 4% mesenteric cyst and 2% hamstring muscle hydatid cyst. In 40 (80%) cases, the treatment was surgical: puncture-aspiration-injection and reaspiration (PAIR) removing the endo-cyst layer, followed by medical treatment with Albendazole and Praziquantel, only 10 (20%) cases required medical treatment alone. On the operated cases the endo cyst was taken for histopathology. Conclusion: Females were most affected than males and the liver was the organ most affected with 38%, followed by lung.
56 Scientific Studies on Citrullus Colocynthis with Special Reference to Anti-hyperglycemic Activity , Mohammad Kamil, F. Ahmad and El. T. Abdallah
Citrullus colocynthis is a plant used as a traditional medicine for the treatment of diabetes mellitus, one of the most prevalent endocrine disorder throughout the world with special reference in the Maghreb region and in the Middle East. The present study is based on laboratory experiments for pharmacognostic, physicochemical, phytochemical, elemental analysis, TLC (thin layer chromatography) fingerprinting, pharmacological & toxicological studies with special reference to anti-diabetic activity, along with an exhaustive scientific review on Citrullus colocynthis phytochemical and pharmacological activities described in literature. We investigated the anti-hyperglycaemic effect of aqueous extract of Citrullus colocynthis seeds administered intraperitoneally in normal Wistar rats and streptozotoc in diabetic rats. The toxicity of this extract was also evaluated using lethal dose 50 methods (LD50).
57 Prevalence of Cardiovascular Risk Factor in Elementary School Students , Elias Freitas de Brito1 and Leonardo Lopes do Nascimento1,2,3
Background: CVDs (cardiovascular diseases) are a major cause of death and expenditure on public health in the world. CVRFs (cardiovascular risk factors) have increased in the adult population and in children and adolescents. Objective: To obtain the prevalence of CVRFs in elementary school students. Methods: The cross-sectional and observational study was carried out with 379 schoolchildren aged 10 to 15 years old, in a Brazilian capital. The variables studied were BP (blood pressure), physical activity level (IPAQ-short version) and visceral fat, through the BMI (body mass index), WC (waist circumference) and the WHR (waist-hip ratio). In the statistical analysis a significance level of 5% (p < 0.05) was adopted. Results: The main alterations were related to physical inactivity (31.2%), overweight (29.1%) and high BP (24.5%), the correlation between BMI and WC showed good correlation (r = 0.787, p < 0.001). Conclusion: Physical inactivity was the most prevalent risk factor among school children, followed by overweight and high BP, in the FTS (full-time school) higher prevalence of these factors was observed. The BMI and WC showed a good correlation for the results that had the risk of diverting the probabilities of the altered BMI, evidencing that the BMI and WC measures became more effective in predicting CVD than just a single use of one of them.
58 Influence of Climate on Pneumocystosis Cases in the Eastern Brazilian Amazon   , Camilla da Silva Machado1, Victor Ferreira Abreu1, Pedro Henrique Cunha Fontenelle1, Alessandra Teixeira de Macedo1, Haryne Lizandrey Azevedo Furtado1, Conceição de Maria Pedrozo e Silva de Azevedo2, Rodrigo Assuncao Holanda3 and Julliana Ribeiro Alves Santos1
Here, we evaluated the clinical aspects and environmental factors for five cases of pneumocystosis in the eastern Brazilian Amazon. Pneumocystosis was associated with human immunodeficiency virus (HIV) infection, male sex, age (until 30 years), and treatment with sulfamethoxazole plus trimethoprim in 100%, 80%, 40%, and 80% cases, respectively. Drier months, higher temperatures, and wind speed were favorable variables for pneumocystosis. Overall, this fungal infection may be related to global warming, resulting in an increased occurrence of cases.
59 Vaccine-Preventable Diseases in HIV (+) Persons , Nikolay Todorov Vatev
The article discusses the risk for the origin of vaccine-preventable diseases in HIV (+) people and the possibilities for their prevention. HIV (+) people are with 4-8 times greater risk to be infected with influenza and 1.5 times higher to die. They belong to a risk group of 35-100 times possibility to acquire invasive pneumococcal disease in comparison with non-infected people. The risk for origin of invasive meningococcal disease for them is 5-13 times greater. There is significantly higher risk for HIV (+) persons to be infected with pertussis, hepatitis A, Ð’ and С and also human papilloma virus infection. That is why the HIV-infected have to be immunized with the vaccines for which they have not contraindications. Inactivated, polysaccharide, recombinant vaccines and toxoids may be administered to HIV (+) patients: inactivated poliomyelitis; against diphtheria, tetanus and pertussis (inactivated whole cell or acellular); only diphtheria and tetanus; tetanus toxoid; polysaccharide against typhoid fever; haemophilus influenza type B; hepatitis A and B;  influenza; meningococcal and pneumococcal infections. Passive immune prophylaxis may also be applied to HIV (+): with human normal immune globulin—after contact with infected people from hepatitis A, measles, mumps, rubella, meningococcal infection; or with specific hepatitis B immune globulin, immune globulin against rabies and immune globulin for varicella-zoster virus. Live vaccines have not to be applied to HIV-infected: BCG, MMR, OPV, Vivotif, rotavirus, varicella and yellow fever. In conclusion, as soon as possible after the diagnosis of HIV infection is confirmed, we have to check the immune status of this person for the routine immunizations. The necessary immunizations have to be done if they lack. And then it is appropriate to do the recommended vaccines.
60 Insilico Analysis of Zinc Database to Discover New Potent HIV1 Protease Inhibitors , Mohammad Hossein Heidari1, Neda Adibpour2, Sajjad Gharaghani3 and Mohaddesse Rahimi1
AIDS (Acquired immune deficiency syndrome) is the leading cause of death in modern societies. HIV (human immunodeficiency virus) by binding to CD4 receptors on the surface of lymphocytes, T helper and by preventing the throughput of lymphocytes is due to the severe weakening of the immune system and causes AIDS. One of the most critical enzymes of HIV is named PR (Protease) that converts polyprotein precursor to HIV proteins and enzymes. In the meantime, researchers are also struggling and after extensive researches they succeeded in finding the structure and function of enzymes that are critical for HIV, specially Protease. Scientists reported PR enzyme as a desirable target to achieve therapeutic goals, because by inhibition of PR enzyme virus lifecycle will be disrupted. To now ten effective drugs are approved by the FDA (Food and Drug Administration) for HIV protease inhibition. Today research for designing the inhibitors of HIV PR is increasing. In this respect we are particularly trying in this article to find new compounds with high potential protease inhibition. We finally managed to identify several effective compounds and report them. The methods are based on in silico skills. HIV protease structure was prepared from RCSB protein data bank (4rvj ID protein with amprenavir-an enzyme inhibitor-complex) and the structure of all ten drugs that are approved by the FDA were prepared from PubChem and similar compounds were found by using the zinc online server. After similar compounds passed lipinsky filter, 86 compounds were extracted. After these processes compounds were docked on protease-amprenavir complex by PyRx software and then analysis of medicinal chemistry was done by using ligplot software. We analyzed the interactions between compounds and residues of the active site and we compared these interactions with approved drugs, and then we reported effective compounds. From all similar compounds, those showing best binding affinities are mentioned below: 87402021, 68688069, 90305202, 89150243, 59959863, 53682869, 54691125. After medicinal chemistry analysis we guess that these compounds are potent to being a drug. Medicinal chemistry analysis was done by using ligplot software. We used in silico skills and validated processes to find these compounds and we guess that these compounds inhibit HIV1 protease and are useful in HIV1 drug design process.
61 Assessment of Practice Details and Resource Availability of Community and Hospital Pharmacies in Mogadishu, Somalia , Zainab Sabrie
Introduction: Pharmacy has moved from dispensing to pharmaceutical care; pharmacists have a role in improving patient safety. Community and hospital pharmacy practice has a major impact on the health of the public. Standards of practice are not well defined and details of community pharmacy practice are unpredictable in Somalia and it is doubtful whether the practice is structured and follows prescribed standards. The resource availability profile has serious implications on the pattern of practice. The objectives of the present study were to identify routines activities performed in community and hospital pharmacies in Somalia and to determine the extent to which resource limitations affect the pattern of pharmacy practice. Methods: This study was a cross-sectional study conducted between October and December, 2019. It involved randomly selected 25 community pharmacies and 25 hospital pharmacies including the only 3 available public pharmacies in Mogadishu, Somalia. This study used a modified questionnaire based on current literature and it was designed to assess the respondents’ demographics, resource availability of pharmacies surveyed and practice details of pharmacists. Pretesting of the questionnaire was done on 5 randomly selected pharmacies. Data were analyzed using SPSS (Statistical Package for Social Sciences) version 20.0 software. Descriptive statistics were used to report pharmacy employees’ demographics [frequency and percentages; mean ± standard deviation (SD)]. Results: 50 distributed survey instruments were filled. Data analysis showed that only 12% of the pharmacy employees were pharmacists and that 86% of pharmacy employees give prescription drugs to patients without a prescription. Fifty percent (50%) of pharmacy employees admitted they administer an injection to patients. The rate of incoming prescriptions to pharmacies was generally low with 44% of pharmacy premises claiming that they had never received any prescriptions from private hospitals. Sixty percent (60%) of pharmacists surveyed admitted making drug recommendations to patients irrespective of the nature of the drug. Most pharmacies in the study had equipment to measure blood pressure, check body temperature, screen for diabetes and malaria. However many of them lacked necessary types of equipment required to measure body mass index, weigh patients, screen for high cholesterol levels; also tools that could facilitate more accurate dosing e.g., tablet cutter and tablet crusher were absent in most pharmacies. Conclusion: This study showed that resource availability of surveyed community and hospital pharmacies was average but the pharmacy practice standards were poor. No statistical difference was observed between both facilities. Prescribing and recommending drugs to patients; giving prescription drugs without prescription; not counseling the patients about their medications; practicing pharmacy by non-pharmacists are all activities that could have a negative impact on public health. Continuing education would be essential for pharmacists and pharmacy employees in promoting good pharmacy practice; practicing pharmacy by only pharmacists is recommended to avoid improper pharmacy practice.
62 Morphological Parameters of Bladder Rats with Infravesical Obstruction with the Introduction of Biologically Active Compositions     , Vyacheslav Yu. Globa, Galyna A. Bozhok and Evgeniy I. Legach
The morphological features of the urinary bladder (UB) after administration of biologically active compositions (BACs) containing neurotrophic factors (NFs) in female rats with infravesical obstruction (IVO) were studied. IVO was modeled by the ligature method. A cryo extract of the spinal ganglia (SG), conditioned media from cultures of native and cryopreserved mantle gliocytes (MG), and the drug Cortexin were used as the BACs. The BACs were injected intraperitoneally to the animals for 10 days. The morphometric parameters of the UB were determined by studying all its shells and their structure. The BACs obtained from the SG participated in the remodeling of the UB wall, which was changed during the IVO. Exogenous NFs insignificantly affected the hyperplasia of the transitional epithelium, stimulated regression and progression of the enlarged muscle layer of the detrusor, increased the proliferation of connective tissue, and increased the wall thickness of the UB. Proceeding from the above, NFs reduced the indices of the ratio of the muscle layer/wall of the UB, mediated by IVO.
63 Diagnostic Issues of Polycystic Ovary Syndrome in Manaus, Brazil , Jorge Frank Braga Ferreira and Cleiton Fantin
Polycystic ovary syndrome (PCOS) is prevalent in 6% to 20% in women of reproductive age and is considered the most common pathological endocrine disorder in this population. Its etiology is complex, and it is characterized by a wide spectrum of signs and symptoms arising from the excess of androgens. The diagnosis of PCOS is mainly made by observing the clinical phenotype of the patient, along with the request for laboratory exams. In this study, we analyzed medical records of patients who sought the Gynecology and Obstetrics ward of a university hospital in the city of Manaus, Brazil. Among 523 verified records, 40 PCOS diagnoses were found and related to the period from 1991 to 2018. We also verified the conditions of storage of medical records of patients, since, up until 2018, this reference center did not have digital data storage mechanisms. It was observed in some cases that important clinical data were not requested by the physician or, when requested, were not presented by the patient at the return visit. In other cases, some data were shown to be missing or crossed out. There was also a lack of appropriate data sheets for the collection of clinical data. The medical record is an important document and ensures the quality of continuous patient care and is also useful for data collection and analysis for teaching and research, among other uses. Due to the conditions of storage and recording of the patient’s clinical history, it is possible that significant medical information may have been completely lost.
64 Preclinical Vascular Activity of an Aqueous Extract from Flowers of Calendula officinalis , Loipa Galán Martínez
Various parts of Calendula officinalis have been used as a medicinal herb. This study was carried out to evaluate the effects of an aqueous extract from flowers of Calendula officinalis on vascular smooth muscle of rats. The effects on aortic contraction of the extract of C. officinalis at different concentrations were assessed in endothelium-denuded rat thoracic aortic rings pre-contracted with 60 mmol/L of KCl. The results demonstrated that the extract induced a concentration-dependent relaxation in endothelium-denuded rat aortic rings with an IC50 of 0.5 ± 0.01 mg/mL. In conclusion, this investigation has shown that the mode of action on the vasorelaxant effect caused by this extract is endothelium-independent. The findings from this study provide a scientific basis for the use of this plant in traditional medicine and merits further investigations.
65 Correlation between Serum C-Reactive Protein Levels and CURB-65 in Elderly Patients With Community-Acquired Pneumonia , William Nseir1,2, Amir Amara1, Tamer Said-Ahmad1, Julnar Mograbi1 and Raymond Farah2,3
Background: CURB-65 is an important clinical score for severity of community-acquired pneumonia (CAP). C-reactive protein (CRP) is an acute phase protein marker for bacterial infection or tissue inflammation. Serum CRP levels are well correlated with the severity of CAP. Objective: To investigate whether serum levels of CRP correlates with CURB-65 ranking in hospitalized patients with CAP. Methods: We studied 858 patients aged 18-90 years who were hospitalized with CAP during a period of two years in the departments of Internal Medicine at Ziv Medical Center in Safed, Israel. Five hundred patients who met the inclusion and exclusion criteria were included. CURB-65 and serum levels of CRP within 24 hours of admission were collected for each participant. The correlation between serum CRP levels and CURB-65 was analyzed by Spearman’s rank correlation test presented by correlation coefficient (R). Results: The mean CRP levels and CURB-65 score were 114 ± 100 mg/dL, 1.4 ± 1.1 points, respectively. No significant correlation was found between CRP and CURB-65 for all study group (r = -0.014, p = 0.768). Nevertheless, we found a significant correlation between CRP levels and CURB-65 in 320 patients aged ≥ 65 years (r = 0.126, p = 0.024). Conclusions: In this study we found a significant correlation between CRP levels and CURB-65 among elderly patients aged ≥ 65 years but not among patients below the age 65 years. CRP measurements could be used as adjuvant biomarker to CURB-65 for disease severity assessment in elderly patients with CAP.
66 Identification of Germinal Mutations in Eight Exons of the BRCA1 Gene in Breast Cancer Patients in the State of Amazonas, Using Direct Sequencing , Amanda de Araújo Rocha, Denise Corrêa Benzaquem and Cleiton Fantin
Mutations in the BRCA1 gene are responsible for 50% of cases of hereditary breast cancer. The objective of this study was to perform screening of mutations in the BRCA1 gene in breast cancer patients treated in the state of Amazonas, Brazil. We analyzed 53 patients (51 women and 2 men) ranging from 30 to 71 years of age. Most of these patients were born in the state of Amazonas,and had a family history for predisposition to cancer and evidenced hormonal risk factor. The alterations found in the exons of the gene that were studied were verified in three online databases for this gene (ClinVar, BRCA Exchange and Varsome). A total of four mutations were identified: missense mutation c.4304T > C exon 13 (16 patients), missense mutation c.4837A > G exon 16 (25 patients), frameshift mutation c.5266dupC exon 20 (1 patient) and intronic mutation c.5277+48_5277+59dup (1 patient). Of the 53 patients studied, 26 were carriers of mutations, and only one patient presented the Ashkenazi founder mutation c.5266dupC; a mutation already identified in genetic studies in the Brazilian population. The mutation c.4837A>G occurred in 25 patients ruling out the possibility of being deleterious. Two of the mutations reported in this study do not yet have data on their molecular mechanisms in the literature, and thus demand further study in order to obtain a better understanding of the role of these mutations in the BRCA1 gene in the Brazilian population, as well as for the rest of world.
67 Impact of BaSO4 Particles on the Viability of Eukaryotic and Prokaryotic Cells , Lina Ragelienė1, Rūta Paulauskaitė1, Lina Trečiokaitė1, Rasa Žūkienė1, Rimantas Daugelavičius1, Simona Tučkutė2 and Joana Bendoraitienė3
The process of car stopping is inevitable on a daily basis when driving a car and is related to the BaSO4 particles emission because of friction of brake pads. Barium was determined by EDS (energy dispersive spectroscopy) as the third highest quantity of metals after iron and magnesium in the samples of organic brake pads. Elemental mapping SEM (scanning electron microscope) analysis confirmed the presence of BaSO4. A stable BaSO4 NPs (nanoparticles) suspension has been prepared and described by PI (polydispersity index) and Zeta potential. For the increased stability of suspension Tween80 was used. The impact on viability of prokaryotic cells (gram-positive S. aureus and gram-negative E. coli, P. aeruginosa wild-type bacteria) and eukaryotic cells (CHO (Chinese hamster ovary) cells) was determined by usage of BaSO4 NPs with Tween80 or without. S. aureus bacteria were more sensitive to the exposure of BaSO4 NPs and reached MIC50 when affected with 3.32 mg/mL BaSO4 NPs coated with Tween80. Zeta potential value increases in all examined bacteria and NPs suspensions. The highest increase was observed for the S. aureus, P. aeruginosa bacteria and BaSO4 NPs with Tween80 suspensions. Minimal concentration of BaSO4 NPs with Tween80, which had negative effect on viability of CHO cells, was 0.1 mg/mL.
68 State of Immunity and Methods of Correction in Patients with Ventral Abdominal Hernia on the Background of Chronic Uro-Genital Infection , Isayev Hidayat, Aliyev Yusif and Isayeva Aynur
The article considers resulting materials of examination and treatment of 88 patients (31 men, 57 women, the main group), aged 22-45 who applied to the Scientific Center of Surgery in order to have hernioplasty, in whom, chronic urogenital infections (CUGIs) were detected in various combinations viabacterioscopic, cultural and serological tests addressed to the research center of surgery for application of herniaplasty. Recurrent ventral hernia was diagnosed in 79 patients and umbilical hernia—in 9 patients. The control group consisted of 20 patients with hernias of the anterior abdominal wall, which did not have any chronic infections or concomitant diseases that negatively affect the parameters of immune system. The state of the cellular and humoral link of the immune system in patients with chronic urogenital infections was characterized by the presence of suppression in the T-cell link and an imbalance in the parameters of humoral immunity. The presence of clinical signs of immunodeficiency in patients with hernias of the anterior abdominal wall is a direct indication for the appointment of immune corrective therapy in the preoperative period. In patients with chronic urogenital infections, Likopid has a noticeable immune corrective effect, which is manifested in the form of positive dynamics of indicators of both cellular and humoral immunities; at the same time, Likopid therapy in combination with 0.33% saffron tincture is a more effective method of immune correction.  
69 Production of Vitamin E in Erwinia herbicola Bearing the Vitreoscilla Hemoglobin Gene (vgb+) , Asli Giray
Vitreoscilla hemoglobin (VHb) is bacterial hemoglobin and has beneficial effects on heterologous organisms. The VHb/vgb system, in the advanced phases of the culture, transfers oxygen to the membrane transferases, giving the elderly cells the ability to better oxygen-uptake, grow and proliferate. In this study was investigated the intracellular and extracellular production of vitamin E in Erwinia herbicola and its recombinant strains (vgb- and vgb+). There was a significant increase the production of vitamin E in the vgb+ strain in the LB medium. Production of total vitamin E in the vgb+ recombinant strain had 2-fold higher than its host. The wild strain produced 0.06 μg/mL total vitamin E, whereas the recombinant bacteria carrying the vgb gene produced 0.12 μg/mL the product. In addition, production of vitamin E was investigated in the minimal medium (M9) including 1% concentrations of different carbon resources such as glucose, sucrose and fructose. It was recorded that the vitamin E levels produced by the recombinant strain in the culture containing 1% fructose were higher than with 1% glucose and sucrose cultures. The findings showed that the presence of vgb may provide an effective biotechnological method to increase yield of vitamin E.
70 Frequency and Clinical Characterization of Patients with Immune Thrombocytopenic Purpura Cytogenetically Tested for 22q11.2 Deletion Syndrome , Julia Cavalcante do Carmo1, Vania Mesquita Gadelha Prazeres2, Rafael Fabiano Machado Rosa3 and Cleiton Fantin1
Thrombocytopenia occurs in peripheral blood when the destruction, utilization or sequestration of platelets exceeds medullary ability to produce platelets. Among the causes of thrombocytopenia is ITP (immune thrombocytopenic purpura), which is a condition that was characterized by the formation of autoantibodies against the human platelet antigen system. ITP is considered to be one of the findings described within the broad clinical spectrum of 22q11.2 deletion syndrome (SD22q11.2). Also known as velocardiofacial syndrome or DiGeorge syndrome, SD22q11.2 is an autosomal dominant condition with variable expressiveness, which is caused by a deletion that involves the 11.2 region of the long arm (q) of chromosome 22. Our objective was to evaluate the frequency and clinical characteristics of individuals with SD22q11.2 among patients diagnosed with ITP. A total of 38 patients were analyzed through the application of a standard protocol with collection of clinical and epidemiological data, and the application of the FISH (fluorescent in situ hybridization) technique to study 22q11.2 micro-deletion. No cases of SD22q11 were identified in the sample using the FISH technique.
71 Molecular Cytogenetics Findings in Patients with Clinical Suspicion of 22q11.2 Deletion Syndrome , Natalia Dayane Moura Carvalho1, Suely Regina da Silva Teles2, Ronaldo Castillo Camargo2, Heliana Maria Costa Garcia2 and Cleiton Fantin1
Congenital heart defects are changes in the development of the heart and large vessels. Their exact etiology is unknown, however, they have an association with genetic diseases, such as 22q11.2 deletion syndrome, which is caused by a 22q11.2 deletion. Thus, we report four patients diagnosed with congenital heart disease whose cases are suggestive of 22q11.2 deletion syndrome. Case 1, diagnosed with interatrial communication, pulmonary atresia and restricted intrauterine growth; Case 2, diagnosed with pulmonary atresia, complete atrioventricular septal defect, right isomerism, hypoplastic left heart syndrome and anomalous pulmonary venous drainage; Case 3, diagnosed with transposition of the large arteries; Case 4, diagnosed with interventricular communication, cervical vertebra fusion, left lung hypoplasia and ribcage deformity. The results of the karyotyping were as follows: cases 1 and 2 - 46, XY; case 3 - 46, XX; and case 4 - 47, XY, + 21. The FISH revealed an absence of deletion in the N25 and N85A3 regions. Of the four patients with congenital heart disease suggestive of 22q11.2 deletion syndrome, only one presented chromosomal anomaly, the free trisomy of chromosome 21. Although we have a negative result for FISH (fluorescence in situ hybridization), this does not eliminate the possibility of the presence of deletion in the 22q11.2 region, since patients may present deletions in cregions. Thus, cytogenetic/cytogenomic analysis was essential for the etiological elucidation of patients with congenital heart disease, even if they presented negative results for FISH. Cytogenomic analyses are necessary to elucidate whether there is deletion in the 22q11.2 region in these reported patients.
72 Evaluation of the Translation, Cross-cultural Adaptation and Properties of Measurement of the FACT-BMT Questionnaire , Thalissa Maniaes1, Ana Paula Carraro2 and Indiara Soares Oliveira3
Various questionnaires have been described which evaluate the quality of life in patients undergoing cancer treatment, but most were originally developed in English and have not been adequately validated for other languages. To evaluate the process of translation and cross-cultural adaptation and the measurement properties of the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT) questionnaire, a systematic review was conducted with two independent evaluators. The search for articles was carried out in four databases: MEDLINE, EMBASE, CINAHL and SCIELO, using the terms “questionnaire”, “quality of life”, “oncology”, and “valid” and their descriptors according to MeSH and DeCs. The searches yielded 6,877 studies, of which only three performed the stages of translation, cross-cultural adaptation, and evaluation of the measurement properties of the FACT-BMT questionnaire. The instruments in Arabic, Chinese, Korean and Portuguese showed and presented good methodological quality, but none of the four studies followed all the validation criteria for the questionnaire. The adapted versions of the FACT-BMT have methodological weaknesses in their process of translation and cross-cultural adaptation and evaluation of measurement properties, therefore the questionnaires possibly being used inadequately in other languages.
73 Antimicrobial Resistance of Microorganisms Causing Pneumonia in Patients of a Public Hospital in Brazilian Pre-Amazon Region , Raíssa G. Assunção1, Wellison A. Pereira1, Francisco J. R. Nogueira1, Itaynara L. Dutra2, Tânia M. G. Novais1 and Afonso G. Abreu1,2
Nosocomial infections have been common in health services in Brazil. Among them, pneumonia is very highlighted due to the comorbidity that usually affects intensive treatment unit (ITU) patients, and due to the need for endotracheal intubation. The aim of this study was to determine the resistance profile of bacteria isolated from ITU patients with pneumonia in a public hospital in São Luis, an important city in the Brazilian pre-Amazon region. Bacteria strains were obtained from tracheal aspiration and collected for diagnosis as well for phenotypic characterization. Standards culture media, such as blood and MacConkey agar, were used to isolate clinical strains. Automatized Vitek 2 method was used to identify strains and disc diffusion method (Kirby-Bauer) was performed to determine the antimicrobial susceptibility profile. During study, eighty-eight patients were diagnosed with pneumonia, caused by more than 20 different bacteria. Among them, P. aeruginosa (28%), Acinetobacter baumannii (20%), Coagulase-negative Staphylococci (19%), Staphylococcus aureus (8%) and Klebsiella pneumoniae (7%) were the most prevalent microorganisms. Regarding to the resistance, antimicrobial susceptibility test showed that majority of Gram-negative bacteria presented resistance to ampicillin. In Gram-positive bacteria there was a high resistance to ampicillin, penicillin, ciprofloxacin, clindamycin and erythromycin. This study showed a high prevalence of bacteria resistance in ITU patients in a public hospital. Although P. aeruginosa was the most frequent pathogen, it was possible to find other pathogens that were not recurrent, such as Enterobacter spp., Proteus mirabilis and Providencia stuartii. Regarding antimicrobials, the results showed a high resistance to several antimicrobials.
74 Influence of Tooth Loss and Unmet Treatment Needs on the Social Aspects of Quality of Life and Self-esteem in Adolescents , Pavlovic Maja1, Matijevic Dusanka2, Vukovic Branislava2, Mileusnic Ivan3, Gajic Milica4 and Jevremovic Ana1
Adolescence represents specific period of life and development, when young person is going through physical, emotional and mental changes, risking poor general and oral health outcome that might affect quality of life. Negative effects of poor oral health are various: difficulties with speaking and eating, pain and malfunction. This might cause emotional and mental problems, leading to avoidance of speaking, smiling and socializing with friends. Cross-sectional study included 234 participants (15-16 years old). The research instruments used in the study were questionnaire and clinical examination. Questionnaire referred to socio-demographic characteristics of participants, their oral and general health related habits, self-evaluation of confidence and successfulness and effect of oral impacts on daily performances. Clinical examination was used to determine dental status in terms of tooth loss, need for prosthodontic rehabilitation and presence of dental malocclusion. Results: 24.6% (58) of adolescents had at least one tooth missing. Significant difference between the genders was obtained, as 32.5% girls had at least one tooth extracted compared to 8.1% of boys. Normative need for prosthodontic rehabilitation was present in 22.0% of subjects. Dental problems negatively affected their sleep and emotions (14.4% and 10.2% few times in period of one month). Data analyses pointed one correlation between extracted teeth and psychosocial aspect of participants’ life (difficulties and embarrassment when smiling, talking and spending time with friends, emotional problems). Unmet normative need for prosthodonic or orthodontic treatment affected participants’ ability to sleep and relax. Percentage of adolescents with extracted teeth was high, as well as normative treatment need for prosthodontic rehabilitation. Poor dental status affected quality of life of adolescents, especially emotional and mental well-being. Dental service should provide sufficient information to adolescents about prevention of tooth loss and consequences of teeth extraction, not only within masticatory function but also concerning oral health related quality of life.
75 Lung Hydatid Cyst in Children , Arturo L. Delgado1, Emma Muendo Loko2 and Adupa Dhaffala2
Hydatid infestation of the lung can be primary or secondary. Cystic echinococcosis (CE) is regarded as endemic in Sub-Saharan Africa, however, for most countries only scarce data, if any, exist. This is a retrospective analysis of children below 13 years with lung hydatid cyst admitted in the paediatric surgical ward at NMAH (Nelson Mandela Academic Hospital) in Eastern Cape, South Africa. The study period was from September 2015 to September 2017. The variables studied were age, sex, imagen findings, cysts sizes, treatment and complications. Prevalence and behaviour of lung hydatic cyst in our children were found out. There were 12 children studied, 8 females and 4 males. The age ranges from 5 to 10 years. The 50% of the children were to 10 years. The left lung was more affected, 7 patients constituting 58.3%, bilateral disease was seen in 3 patients. Treatment was surgical: punction, aspiration, injection and reaspiration (PAIR), removal of germinal layer, and partial capitonnage on a drain tube in 8 children (67%). A pharmacological treatment was offered to 4 patients. There was rupture of a cyst into the pleural space before surgery. Postoperatively 7 children developed broncho-pleural fistula. There was no mortality in this study. Hydatid cyst of the lung was most frequent on the left side. The surgical treatment performed was PAIR mostly in cysts more than 6 cm or with complications. Conservative treatment is an option in some cases.
76 Production and Properties Analysis of Honey Nanofibers Enriched with Antibacterial Herbal Extracts for Repair and Regeneration of Skin and Bone Tissues , Esmaeil Shahbazi1 and Kiumars Bahrami1,2
Among the commonly used nanofibers production methods, electrospinning has many advantages such as ease of production, possibility of industrialization, nanofibers dimensional control and repeatability. Many parameters affect the characteristics of the nanofibers produced by this method, the most important of these parameters being the applied voltage, the concentration of polymer solution, the sample injection rate, the distance between the needle and the collector, and environmental factors too. Pharmaceutical properties of nanofibers are determined by their composition and structure at the nanoscale. Therefore, the ultimate goal of identify nanostructure and nanofiber morphology must be searching for an atom to an atom on a surface and under the reaction conditions. Inthis paper, honey nanofibers enriched with antibacterial herbal extracts such as the garlic, mint and edible mushroom are produced by method of electrospinning, by reviewing the effective conditions in preparing them, to achieve nanostructures and optimize conditions. The related nanofibers have ability to repair and regenerate damaged skin and bone tissues as an effective drug, which is especially important for biocompatibility and economics. In this research, nanofibers have been investigated by examining cases affecting structure and performance. The hydroalcoholic extracts and nanofibers are identified by device methods such as GC-Mass (gas chromatography-mass spectrometry), FT-IR (Fourier transform infrared spectroscopy), SEM (scanning electron microscopy) and XRD (X-ray diffraction spectroscopy).
77 Schistosomiasis Mansoni in the Amazon Region: Malacological Surveys of Intermediate Hosts for the Identification of Disease Transmission Areas in Belém, Pará, Brazil , Christiane de Oliveira Goveia1,2, Ricardo José de Paula Souza e Guimarães3, Márcio Roberto Teixeira Nunes4, Isabelle Helena Lima Dias2 and Martin Johannes Enk1
In Brazil, schistosomiasis occurrence is related to the presence of the etiological agent Schistosoma mansoni. The presence of mollusks for Biomphalaria genus is a necessary condition for development of the parasite cycle. In Pará state, the species B. schrammi, B. kuhniana, B. straminea and B. glabrata have already been identified, with reports of the last two occurring in Belém. The aim of this study was to determine the spatial distribution of Biomphalaria species in Belém, Pará, Brazil, identifying risk areas for schistosomiasis transmission. Biannual malacological surveys were carried out between September 2013 and October 2017 in 35 neighborhoods of Belém. The collection points were georeferenced using a Global Positioning System (GPS) receiver and the Kernel Density Estimation (KDE) was used to the spatial analysis. The mollusks, after measurement, were exposed to light to verify the presence of S. mansoni cercariae. Subsequently, mollusks were sacrificed and fixed for dissection and morphological identification of species. The surveys resulted in a total of 10,803 mollusks collected, of which 9,367 (86.70%) specimens were examined. Among the analyzed mollusks, 5,820 (62.14%) were identified as B. glabrata and 3,547 (37.86%) as B. straminea. The presence of the parasite was observed in 208 (2.22%) specimens, all B. glabrata. Positive mollusks were found in six neighborhoods: Guamá (51 mollusks/24.5%), Sacramenta (47 mollusks/22.6%), Telégrafo (47 mollusks/22.6%), Terra Firme (36 mollusks/17.3%), Condor (20 mollusks/9.6%) and Barreiro (7 mollusks/3.4%). This study confirms that B. glabrata species actively participates as intermediate host in the disease maintenance in Belém. The KDE allowed to analyze the spatial distribution of collection sites and consequently to determine possible risk areas of schistosomiasis transmission in Belém. The development of maps identifying sites with schistosomiasis positive snails may support efforts of this municipality by directing activities related to endemic disease control.
78 Analysis of Mortality Rates of the 5 Most Frequent Primary Cancer Sites in Brazil between 1979 and 2015 for Both Sexes , Luiz Carlos de Araújo Souza1, Hugo Oliveira de Figueiredo Cavalcanti2, Vinícius Carvalhêdo Cunha1 and Sandra Lúcia Branco Mendes Coutinho3
Introduction: Global estimates determined that there would be 14.1 million new cases of cancer and 8.2 million deaths from cancer. Objectives: To determine the adjusted mortality rates of the 5 most frequent primary sites of cancer and the mortality rates of the 5 most frequent primary in Brazil, between 1979 and 2015. Method: Epidemiological study between 1979 and 2015 based on data obtained from the Online Atlas of Mortality provided by the National Cancer Institute of Brazil (INCA) using information on cancer deaths obtained within the System of Information on Mortality (SIM) of Brazil Ministry of Health. Results: When analyzing the mortality rate of the 5 most frequent primary sites by type of cancer from 1979 to 2015 for both sexes, we show that in the year 2015 the cancers with the highest rates are: bronchi and lungs, breast, stomach, prostate and unknown primary location. A total of 527,980 deaths from bronchial and lung neoplasms were recorded, 304,546 deaths from breast cancer were recorded, 407,611 deaths from stomach cancer were recorded, 268,061 deaths from prostate cancer were recorded, and 257,357 deaths due to neoplasia of unknown primary location were recorded. When we analyze the world standard rate and Brazil’s standard rate for mortality, we show that Brazil has higher values for the 5 most frequent primary sites by type of cancer. Conclusion: The epidemiological study of these values aims to determine what are the main descriptors and characteristics to determine preventive measures against the increase of this disease.  
79 Biochemical, Enzymatic, and Immunological Study on Antimutagenic Achillea millefolium Methanolic Extract in vivo     , Asmaa A. Hussein, Ruqaya M. Al-Ezzy and Mays T. Abdallah
Traditionally medicinal plants are used for its potential chemotherapeutic action and for safety upon the continued use of these plants. Achillea millefolium (AM) is an ancient herb which is used to treat wounds, headaches, disorder in gastrointestinal and hepatobiliary, pain, and inflammation. This study was aimed to investigate the biochemical parameter of antimutagenic methanolic extract for AM in vivo. Plant extract together with MTX decreased the damage caused by the drug on the concentrations of total cholesterol and triglycerides (160.3±2.26 and 108.7±2.71), significant increase in total protein concentration (8.51±0.17, 9.46±0.19 and 10.8±2.71 g\dL) for 100 and 200 mg\kg was observed. Also plant extracts counteract the damage caused by drug through the reduction for both creatinin and albumin concentrations to 1.57±0.03 mg\dL and 4.56±0.09 g\dL, respectively. On enzymatic level, the results of interactions indicated the ability of plant to modulating harmful effects of the drug (57.1±1.3, 130±3.1 and 111.1±2.1 U\L) for GOT, GPT and ALP, respectively. On the other hand, the plant possesses the ability to enhance the concentrations of all immunoglobulin (IgM, IgA and IgG) in the two doses tested. Therefore, the results of this study indicate the antimutagenic potential of AM extract and encouraging its consumption with MTX as one of the promising therapies.
80 Polypharmacy in Elderly Patients in a Community Pharmacy     , Sónia Lopes, Clara Rocha and Rui Cruz
Introduction: The definition of polypharmacy is not consensual, but all authors refer it as the simultaneous use and the chronic way, of several drugs by the same person. Polypharmacy affects mainly the elderly and it is due to the high number of chronic diseases in this population and consequent need to take medications to control them. Aims: Characterization and quantification of polypharmacy in a rural elderly population. Materials and Methods: It carried out an observational, retrospective, transversal and analytical study in Farmácia Popular (Pombal). Total of 230 individuals aged 65 years old or more were surveyed and the data collection was made through a questionnaire prepared for this purpose, in time between February and April 2017. Results: The elderly took, on mean, 6.20 drugs daily. The prevalence of Major polypharmacy (≥ 5 medications) was 70.4%. The most prescribed pharmacotherapeutics groups were cardiovascular and central nervous system. There were statistically significant differences between age and number of medicaments taken, as well between number of drugs and the way to identify the medication, the knowledge of the therapeutics indications, the occurrence of mistakes or take outside advised time, and the self-perception of health state (p ≤ 0.05). Conclusion: In view of the obtained results, it concludes that polypharmacy is very high in Portuguese population in study. It is the persons most aged who consume a greater number of drugs. The elderly with less academic qualifications are those who have more difficulty in identifying medication and respective therapeutics indications. It is necessary to adopt strategies in order to reduce polypharmacy, with the prescriber and the professionals of pharmacy a preponderant role in this task.
81 Evaluation of Pharmacologic Strategies for Prevention of Venous Thromboembolism in Elective Orthopedic Surgery , Eleanor K. Broadbent1, Andrea Lewin1, Katelyn W. Sylvester1, Betsy Whitfield2 and Danielle Knowles1
Background: Venous thromboembolism (VTE) is a common postoperative complication in orthopedic surgery and warrants the use of pharmacologic thromboprophylaxis. The purpose of this study was to analyze current prescribing practices at our institution and to assess outcomes of pharmacologic strategies used for VTE prophylaxis following major orthopedic surgery. Methods: This was a single center, retrospective analysis at a tertiary academic medical center. Patients were included if they were admitted for total hip or knee arthroplasties and received pharmacologic thromboprophylaxis (warfarin INR goal 1.8-2.3, aspirin at variable doses, low molecular weight heparin (LMWH), DOAC) post-operatively from January 2017 to June 2017. Patients were excluded if they had a history of VTE or were on long-term anticoagulation. Major endpoints included incidence of thrombotic and bleeding events within 30 days post-surgery. Results: A total of 476 patients were screened; 89 were excluded and 387 were included (warfarin = 183, aspirin = 201, LMWH = 2, apixaban = 1). Two patients in the warfarin group experienced a deep vein thrombosis compared with one patient in the aspirin group (p = 0.51). Major bleeding occurred in one patient in the warfarin group and none in the aspirin group. Total bleeding rates occurred in 2.7% and 1.0% in the warfarin and aspirin groups, respectively. Conclusion: There has been an increase in the use of aspirin at our facility in postoperative orthopedic surgery patients without an increase in DOAC use. No difference was detected in safety and efficacy endpoints in our warfarin versus aspirin patients.
82 Coconut Oil Reduces Visceral Adipocyte Size and Improves the Metabolic Profile of Rats Fed a High-Carbohydrate Diet , Valéria Schoffen Romão-Carrascoza1, Rosângela Fernandes Garcia1, Lorena Lima Gargaro2, Maria Montserrat Diaz Pedrosa1, Nilton de Almeida Brito1, Clairce Luzia Salgueiro-Pagadigorria1 and Márcia do Nascimento Brito1
This work aimed to evaluate the effects of the food supplementation with coconut oil (CO) on biometric and metabolic parameters in an animal model of obesity. Wistar rats fed a high-carbohydrate diet (HCD rats) develop metabolic disorders very similar to those found in human metabolic syndrome, including increased adiposity, insulin resistance (IR), non-alcoholic fatty liver disease (NAFLD) and dyslipidemia. Although HCD rats had normal fasting glycemia, they developed IR as revealed by Homa-IR index and, after glucose overload, exhibited higher peaks of insulinemia and glycemia. These alterations were accompanied by a higher formation of advanced glycated end products (AGEs). The supplementation with CO improved IR, reduced AGEs formation and reverted NAFLD. These effects could be due to CO action of reducing visceral adipocyte size and take place without undesirable collateral effects on lipid profile, placing CO as an adjuvant in the treatment of the metabolic syndrome. 
83 Aqueous Extract of Newbouldia laevis Abrogates Cadmium-Induced Ovarian Dysfunction in Adult Wistar Rats     , Adeoye O. Oyewopo1, Kehinde S. Olaniyi2, Adesola A. Oniyide2, Olusola A. Sanya2, Oluwatobi A. Amusa2, Omosola F. Faniyan2 and Olugbenga O. Eweoya3
Background: The extract of Newbouldia laevis has been demonstrated to show antioxidant, antimicrobial, sedative, anticonvulsant, analgesic, anti-inflammatory, antinociceptive, hepatoprotective, anticancer, antiulcer, antihypertensive and antidiarrhea properties. However, its reproprotective effect is not well known. The present study was designed to investigate the ameliorative effect of Newbouldia laevis in cadmium- induced ovarian dysfunction. Method: Adult female Wistar rats were randomly allotted into groups; Vehicle (received distilled water), cadmium-treated (received 5 mg/kg b.w.), N. laevis-treated (received 200 mg/kg b.w.) and cadmium + N. laevis-treated groups. Cadmium sulphate was administered for 3 days (i.p.) followed by oral administration of N. laevis for 28 days. The body weight change was monitored using animal weighing balance (Olympia SCL66110 model, Kent Scientific Corporation, Torrington, CT06790, USA), biochemical assay and histology of ovaries were performed as previously described. Results: The results showed weight loss, severe disruption of ovarian follicles and significant reduction of gonadotropic hormones (FSH and LH) in cadmium-treated group compared with vehicle-treated group. These alterations were not associated with inflammatory response. However, concomitant administration of aqueous extract of N. laevis and cadmium sulphate significantly ameliorated ovarian disruption. Conclusion: The study demonstrates that administration of aqueous extract of N. laevis during treatment with cadmium sulphate preserves ovarian function, suggesting that possibly daily intake of aqueous extract of N. laevis prevents the onset of ovarian disorders. 
84 Ciprofloxacin Residue in Marketed Pork of North-East India   , D. C. Roy, A. Kafle, S. K. Laskar and R. K. Roy
Background: Ciprofloxacin is commonly indicated for treating bacterial infections in dogs and cats and is generally not recommended for large animals like pig. Enrofloxacin on the other hand is specially developed for veterinary use (small and large animals), however the main metabolite of enrofloxacin is ciprofloxacin and the data of ciprofloxacin residue in pork are limited. Objective: To evaluate the residue of ciprofloxacin in pork samples obtained from four different states namely Assam, Nagaland, Manipur and Mizoram of North-East India. Method: 720 samples comprising of Liver, Kidney, and Muscle were collected in clear sterile container and transported to the laboratory in ice packs. The samples were kept at -20 °C till analysis. Ultra High Performance Chromatography (UHPLC) equipped with Diode Array Detector (DAD) was used for screening the samples. Level of detection was 0.001 µ/g. Result: Out of 720 samples, 49 samples were found with detectable level of ciprofloxacin residue however none of the residue levels were above the permissible limit (Maximum Residue Limit). Conclusion and Public Health Importance: This study clearly proved that although the residue has been detected in the marketed pork samples the levels of residue were below the permissible limit hence the pork obtained from these states is safe from public health point of view.
85 Pain Exposure Physical Therapy (PEPT) in Complex Regional Pain Syndrome Type 1: A Systematic Review     , Nicoli Greco Müller1 and Glória Maria Moraes Vianna da Rosa2
Complex regional pain syndrome type 1 (CRPS-1) is a debilitating and progressive pathology in which chronic symptoms affect the functional capacity, and there are discussions about its best form of intervention. The aim of this study was to investigate the effectiveness of pain exposure physical therapy (PEPT) on functional recovery of these patients and to compare with conventional treatment. Systematized bibliographic searches were performed with qualitative and quantitative exploratory objective of scientific articles of the last 10 years in the databases PubMed, EBSCO and PEDro. Three studies were selected to analyze: Ek et al. (2009) conducted evaluations at baseline and 3 months after the last session, with 106 patients. The evaluations by Meent et al.’s paper (2011) realized pre-treatment and 12 months after last session, with 20 patients. In Barnhoorn et al.’s article (2015) the only one to perform controlled and randomized study with 56 patients divided into PEPT and conventional, and evaluations were pre-treatment, 3, 6, and 9 months after the last session; performed 5 treatment sessions of 40 minutes, as well as in the other studies. There were positive and significant outcomes on the intervention of PEPT in CRPS-1, showing that this treatment is effective in functional recovery of these patients.
86 Agnuside Reduces Visceral Adipocyte Size, Improves Insulin Sensitivity and Reverses Hepatic Steatosis in Ovariectomized Rats   , Franciele Neves Moreno1,2, Eduardo Hideo Gilglioni1,2, Rosângela Fernandes Garcia3, Naiara Cristina Lucredi4, Sandra Mara Ferreira5, Nilton Almeida Brito3, Marcia do Nascimento Brito3, Emy Luiza Ishii-Iwamoto1,2 and Clairce Luzia Salgueiro-Pagadigorria3
This study aimed to investigate the effects of agnuside (AGN), a phytoestrogen in Vitex agnus-castus, on cellular and metabolic alterations induced by ovariectomy in rats. Ovariectomized (OVX) Wistar rats were used as an animal model of postmenopausal metabolic syndrome. The visceral and subcutaneous adipocyte sizes, the peripheral insulin sensitivity and the occurrence of nonalcoholic fatty liver disease (NAFLD) and liver oxidative damage were evaluated. The results were compared with those obtained from control rats (sham-operated) and OVX rats treated daily with AGN. Obese OVX rats exhibited visceral adipocyte hypertrophy and developed glucose intolerance, hyperinsulinemia, NAFLD and dyslipidemia. AGN exerted beneficial effects on several metabolic parameters in OVX rats, including the improvement in glucose intolerance, hyperinsulinemia and NAFLD. Besides, AGN promoted a general improvement in the liver redox state. Although the reduction of the mesenteric adipocyte size is very likely to be an important mode of action of AGN, some actions of AGN could also involve the interaction with estrogen receptors.
87 Tibolone Reverses NAFLD in Ovariectomised Rats by Reducing Adiposity and Insulin Resistance     , Lilian Brites Campos-Shimada1,3, Eduardo Hideo Gilglioni1, Danielle Aparecida Munhos Hermoso1, Ana Julia dos Reis Buzzo1, Rosângela Fernandes Garcia2, Elismari Rizato Martins-Maciel1, Emy Luiza Ishii-Iwamoto1 and Clairce Luzia Salgueiro-Pagadigorria2
This study aimed to investigate the effects of tibolone, a synthetic steroid, on several metabolic dysfunctions induced by oestrogen deficiency, in rats. Ovariectomised (OVX) rats were used as animal model of postmenopausal metabolic syndrome. The OVX rats were treated with daily doses of tibolone (0.16 mg/kg) and the results were compared with control (sham-operated) and OVX untreated rats. Tibolone reduced the adiposity and the visceral adipocyte size in OVX rats. The insulin sensitivity was also improved, and a decrease in the activity of the adipose tissue hormone-sensitive lipase enzyme was recorded. The lower lipolysis by visceral adipocytes, associated with the recovery of peroxisomal β-oxidation by tibolone may have contributed to the reversion of NAFLD in treated OVX rats. The reduction of liver lipid contents resulted in a general improvement in the liver redox state. In addition, tibolone reduced the mitochondrial ROS generation and restored the activity of glucose-6-phosphate dehydrogenase. Tibolone also exerted antioxidant effects on inguinal adipose tissue. Tibolone exerted several beneficial effects on cellular and metabolic dysfunctions induced by ovariectomy in rats. One important mode of action of tibolone was the reduction of the visceral adipocyte size, corroborating the relationship between this one and the development and progression of several comorbidities associated with metabolic syndrome.
88 Pharmacokinetic, Physicochemical and Medicinal Properties of N-glycoside Anti-cancer Agent More Potent than 2-Deoxy-D-Glucose in Lung Cancer Cells     , Fidelis Toloyi Ndombera1,2 , Geoffrey K. K. Maiyoh3,4 and Vivian C. Tuei5
Acetylated N-xyloside of 1-naphthylamine (K8A) has been shown to be more potent than 2-deoxy-D-glucose in lung cancer cells and has therapeutic potential for further drug development. In this paper we evaluate and report cytotoxicity, pharmacokinetic, physicochemical and medicinal properties of this D-Xylose derivative (K8A) as a lead anticancer agent with greater therapeutic potential than 2-deoxy-D-glucose (2-DG). 2-DG has been in clinical trials for treatment of solid tumors and other types of cancer. We demonstrate using virtual tools that K8A has better “drug-likeness” than 2-DG and does not violate any Lipinski, Ghose, Veber, Egan or Muegge rules. On the other hand, 2-DG violates Ghose and Muegge rules. A “BOILEDegg evaluation”, predicts that K8A has higher gastrointestinal absorption (HIA) than 2-DG and is not effluxed by P-glycoprotein (P-gp). Additionally, K8A does not penetrate the blood brain barrier (BBB) and is not a substrate of most Cytochrome P450 (CYP) enzymes. Importantly, K8A did not show false positive alert from PAINS screening enabling us to narrow down and rule out false targets. Importantly, K8A is more potent than 2-DG in H1299 and A549 lung cancer cells.
89 Wild-Type and Genetically Improved Strains of Dairy Origin Probiotic as Potential Treatments for Intestinal Mucositis     , Flávia Figueira Aburjaile1,2, Gwénaël Jan3, Yves Le Loir3, Vasco Azevedo1 and Rodrigo Dias de Oliveira Carvalho1
The use of probiotic bacteria derived from fermented foods has been explored by the scientific community as alternative strategies for the treatment of several diseases, mainly regarding intestinal dysfunction. One of the most relevant inflammatory diseases affecting the alimentary tract, for which no current intervention is entirely successful, is mucositis. In this review article, we summarize the most recent proof-of-concept studies dealing with the therapeutic use of dairy origin probiotics, for the treatment of gastrointestinal mucositis. Furthermore, we discuss several approaches for the improvement of the classical therapeutic rationale, such as supplementation with prebiotics and genetic engineering along with the respective translational issues, which may be crucial for the successful transposition of these therapeutic strategies for clinical use. 
90 Antibody-Cytokeratin Marker 34βE12 in Prostate Cancer Detection     , Luiz Carlos de Araújo Souza1, Vinícius Carvalhêdo Cunha1, Hugo Oliveira de Figueiredo Cavalcanti2, João Ricardo Alves3 and Sandra Lúcia Branco Mendes Coutinho4
Introduction: The histological diagnosis of prostate cancer is commonly based on morphological patterns. The presence of malignant tissue mixed with benign tissue, or the presence of carcinoma that mimics benignity may generate difficulty in the diagnostic elucidation. Therefore, the application of immunohistochemistry contributes its diagnostic value. Objectives: To evaluate the 34βE12 marker in the detection of adenocarcinoma (ADn), atypical small acinar proliferation (ASAp), regular prostatic tissue (RPT) and regular prostatic tissue alternated by atrophy spotlights (RPTa) in transrectal biopsy guided by ultrasonography of patients with suspected prostate cancer. Method: Analysis of 34 patients who underwent ultrasound-guided transrectal biopsy with subsequent analysis by H&E staining and 34βE12 labeling for elucidation of neoplasms or diseased tissues with doubtful diagnosis. Results: The marker 34βE12 showed negativity in 100% of the neoplasms ADn, positivity in 100% of the benign prostatic tissues (RPT and RPTa); the patients with ASAp presented positivity (20%) and negativity (80%). The chi-square test (χ²) showed that there is an association (χ² = 29.55 and p < 0.0001) between the groups, that is, the 34βE12 marker has a significant value (p < 0.0001) in the elucidation of patients with prostatic neoplasia and benign prostatic tissues. Discussion and Conclusion: With the early screening of prostate cancer in the modern era, pathologists have become increasingly challenged to diagnose small outbreaks of cancer when only a few atypical glands are present in transrectal biopsy-guided ultrasonography. The 34βE12 marker becomes an important tool in elucidating diagnoses such as ADn and ASAp.
91 Descriptive Study: Congenital Malformations in Pediatric Patients of a Public Maternity Hospital of the City of Manaus, Amazonas     , Cleiton Fantin, Denise Corrêa Benzaquem, Marcelo Lasmar Santos, Carlos Augusto da Silva Araújo Júnior, Lilian Barroso Carvalho, Natanael Martins Gomes, Larissa Nascimento Souza and Gabriela Bentes Sousa
The Pan American Health Organization (PAHO) defines congenital malformation as any functional or structural anomaly in the development of the fetus, due to factors originating before birth, whether genetic, environmental or unknown. The aim of the present study was to identify the frequency of malformations, the type of congenital malformations and to correlate this with risk factors in live-born infants, using SLB data. The data were collected through consultation of the medical records of live-born infants of the Balbina Mestrinho Maternity Hospital, 15,621 live births were reported, of which 248 (1.58%) presented congenital malformations. There was a higher prevalence of malformations among live-born males (49.7%), with Apgar ≥ 7 at the first and fifth minute, gestational age ranging from 37-41 weeks, with 46% being born with appropriate weight between 3,000-4,000 g. The association of two or more defects was observed in 38.7% of the total cases and isolated anomalies in 67.3%, with predominance of alterations of the digestive system (26.3%), followed by malformations of the musculoskeletal system (21.2%), nervous system (20.2%) and cleft lip/cleft palate (9.1%). The results presented here may guide strategic actions to improve care for families of people with congenital malformations.
92 The Levels of Minerals and Vitamins in Some Wild and Cultured Mushroom Species from Turkey     , Aydin Sukru Bengu1, Handan Çinar Yilmaz1, Ä°brahim Turkekul2 and Hakan IÅŸik3
In today’s world, Pleurotus ostreatus (Jacq.) P. Kumm. and Agaricus bisporus (J. E. Lance) Imbach species which are grown both wild and cultured are very popular for humans diet because these species have been used in traditional medicine, economicaly and pharmacology. Two species of edible mushrooms Pleurotus ostreatus and Agaricus bisporus were selected from natural and cultured ones to determine vitamins and mineral contents levels. In this study, total protein levels, vitamin A-E and C levels and some mineral levels such as Fe, Cu, Zn, K, Na and Ni were investigated in both natural and cultured species.
93 Research on Drug Loading Performance of Hydroxiapatite-Gelatin Composites by Co-precipication Method   , N. Erdol Aydin, E. Kahraman and G. Nasun Saygili
Hydroxyapatite/polymer composites are promising materials for drug delivery applications. Studies focusing on the development of such composites are available in recent years, as using these materials as a carrier allows us to overcome the side effects of toxic drugs used especially in cancer treatments and increase treatment efficiency. In this study, hydroxyapatite-gelatin (HAp-GEL) composites are produced in the presence of simulated body fluid (SBF) as a carrier for 5-Fluorouracil (5-FU). Composites are produced by wet precipitation method at pH 7.4 and 37 °C and crosslinked with glutaraldehyde (GA). In order to observe the effect of GA amount on drug loading efficiency, composites cross-linked with different amounts of GA are released in deinozed water, HCl and phosphate bufffer solution (PBS). Composites are analyzed by X-Ray Diffraction (XRD), Thermogravimetric Analyses (TGA), Scanning Electron Microscopy (SEM) and particle size distribution to observe morphology and structure. It is concluded that drug loaded HAp-GEL composites have a potential to be used in drug delivery applications.
94 The Utilisation of Marrow Concentrate in Canine Arthrosis—Case Report     , Busuioc Diana-Alexandra1, Șindilar Eusebiu-Viorel1, Horhogea Cristina1, LăbuÈ™că (Simion) LuminiÈ›a2 and Drugociu Dan1
The use of bone marrow concentrate in the treatment of degenerative joint disese (DJD) in dogs represents an innovative approach, minim invasive, that already has been used with increasing success in the veterinary field. The technique, adapted from human medicine for the quadruped patients is based on the principle of the autologous transplant of mesenchymal stem cells that are included in the bone marrow concentrate. The intervention involves a short anesthesia of the animal for harvesting the marrow. The processing of the marrow is realised in strict aseptic conditions in a laboratory and the inoculation is done in the same day. The results are clinically visible after 2-4 weeks. For an enhanced effect, a part of the concentrate is grown on a flask in specific conditions in order to expand autologous bone marrow stem cells and is inoculated after a sufficient number of cells are achieved, usually 3-4 weeks.
95 Utilization of Polyethylenimine (PEI) Modified Carbon Black Adsorbent Derived from Tire Waste for the Removal of Aspirin   , Dyg Khairunnisa Awg Zaini, Norzita Ngadi, Muhd Asyiq Azman and Khairudin Ahmad
A new adsorbent was synthesized using polyethylenimine (PEI) on the carbon black to remove aspirin from an aqueous solution. In this study, adsorption performance of modified carbon black by polyethylenimine (PEI) on aspirin was investigated. Batch adsorption studies were performed to evaluate the effects of contact time, pH solution, temperature, and initial concentration on the adsorption of aspirin. For this study, the carbon black obtained from the pyrolysis of tire waste was used as a precursor for low-cost adsorbents. The carbon black was treated by 1 M of hydrochloric acid solution to remove ash and sulphur content. Then, the treated carbon black was modified by impregnation with PEI in one to one weight ratio within 24 hours at 65 °C and then cross linked with 1% (w/v) glutaraldehyde solution for one hour. The adsorption rate of aspirin by modified carbon black was rapid from 20 minutes to 60 minutes and reached equilibrium. Hence, the optimum contact time for this study is 60 minutes with 59.96% of aspirin removal and 29.98 mg/g adsorption capacity. The best performance for pH solution, temperature, and initial concentration was observed at pH 3 (26.1 mg/g), 30 °C (26.9 mg/g) and 20 ppm (40.96 mg/g) respectively.
96 Differential Diagnosis between the Gallbladder Cancer and Xanthogranulomatous Cholecystitis by Multiple Percutaneous Biopsies     , Jinju Choi1 and Yong-Tae Kim2
Xanthogranulomatous cholecystitis (XGC) is a rare form of chronic inflammatory disease that is often mistaken for gallbladder (GB) cancer. Differential diagnosis based on clinical features or imaging scan is virtually impossible and pathological confirmation is crucial for diagnosis. A 72-year-old man was referred to an oncologist for suspicion of unresectable GB cancer with liver metastasis. He was admitted and underwent three percutaneous needle biopsies. However, all specimens showed non-neoplastic hepatic parenchyma with the third biopsy indicating xanthogranulomatous inflammation with abscess formation. The final biopsy changed the diagnosis from GB cancer to XGC. He was prescribed oral antibiotics and discharged after multiple ERBD stenting because of benign biliary stricture. He regularly visited an outpatient clinic and a follow-up CT scan showed a decrease of gallbladder mass. In conclusion, xanthogranulomatous cholecystitis should be considered in the differential diagnoses of GB mass and clinical suspicion is very important for a precise diagnosis.
97 Complications due to Endoscopic Retrograde Cholangiopancreatography : A Mini Review of Risk Factors and Diagnosis     , Mehmet Gokceimam1, Nuri Emrah Goret1, Ceren Canbey Goret2, Hasan Ediz Sikar1, Kemal Eyvaz3, BagiÅŸ Tasdogan1, Omer Faruk Ozkan4 and Hasan Fehmi Kucuk1
Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic and therapeutic procedure performed for pancreatobiliary diseases. Procedure has many complications and most frequent is pancreatitis. Knowing the risks of the pancreatitis due to ERCP can reduce the rate of the complication and can affect its consequences. Many studies are performed for describing the risk factors of the procedure and the results are divided in two categories; patient related and endoscopy related. Patient related factors are female sex, young age, sphincter of oddi dysfunction, intraductal papillary mucinous neoplasm and previous pancreatitis, endoscopy related factors are unexperienced center, multiple cannulation, precut sphincterotomy, difficult cannulation, deep wire pancreatic cannulation and pancreatic or main duct contrast injection. Foreseeing the risk of the patient can reduce the complication rate of the endoscopist by selection of patients for new performers or taking precautions for the experienced ones.
98 Antibacterial Activity of Silver Nanoparticles Using Salvia officinalis Extract on Some Pathogenic Bacteria     , Sarah Mohanad Yaseen, Asmaa A. Hussein and Ruqaya M. Al-Ezzy
This study included evaluation for the effects of green synthetic nanoparticles of Salvia officinalis aqueous leaf extract loaded with silver nitrate on antibacterial activity. Green synthetic nanoparticles were synthesized by mixing the plant extract with different AgNO3 concentrations (1 mM, 1.5 mM, 1.75 mM, and 2 Mm) then they were detected by color changing and UV visible spectroscopy, which gave indication for the creation of silver nanoparticles. A characteristic and definite surface plasmon resonance (SPR) band for silver nanoparticles was obtained at around 433 nm. The SPR peak of silver nanoparticles extreme peak intensity was obtained at 1.75 mM of AgNO3. Atomic Force Microscopy analysis was used to characterize silver nanoparticles which declared that the shape of green synthetic nanoparticles had different average size depending on sliver concentrations. Since it was observed that the shape and size of green synthetic nanoparticles were concentrations dependent (89.69 nm, 80.94 nm, 76.98 nm and 60.28 nm) respectively for AgNO3 concentrations tested (1 mM, 1.5 mM, 1.75 mM and 2 mM). The antibacterial activity of green synthetic sliver nanoparticles was studied for all G+ve and G-ve selected isolates (Staphylococcus aureus, Staphylococcus heamolytics, Streptococcus pnemoniae, Enterococcus faecalis) and others G-ve bacterial isolates (Escherichi coli, Klebsiella pneumoniae, Proteus vulgaris, Pseudomonas aeruginosa) and the result showed that different green synthetic nanoparticles concentrations (1, 1.5, 1.75, 2 mM) have the ability to inhibit all bacterial isolates with varying zones of inhibition higher than the inhibition observed by ready to use sliver nanoparticles. Minimum inhibitory concentrations (MIC) of green synthetic nanoparticles were obtained in concentration of (31, 27, 23 and 16 μm/mL) for G+ve (S. auerus) and (187, 125, 125, 109 μm/mL) for G-ve (E. coli) at (1, 1.5, 1.75, 2 mM) respectively. The activity of green synthetic sliver nanoparticles in inhibition S. auerus and E. coli, biofilm formation was studied and the result showed that 2 mM nanoparticles could inhibit 75% of S. auerus biofilm and 50% of E. coli biofilm respectively.
99 Cutaneous Leishmaniasis: Endemic Regions and Epidemiological Characteristics of Cases Declared at University Hospital Center of Tlemcen, Algeria, 2012-2016   , Samira Benbekhti Abdrebbi1,2, Latefa Henaoui1,2, Nafissa Chabni1,2 and Kaouel Meguenni1,2
Cutaneous leishmaniasis (CL) is a widespread parasitic disease and a public health problem worldwide. It is an endemic and notifiable disease in Algeria. Our objective was to know the epidemiological characteristics and to determine the endemic regions of the CL in the town of Tlemcen. A descriptive study was conducted with a prospective collection over five years, from 2012 to 2016, based on the systematic declaration of CL cases received from the various departments of the University Hospital center (UHC) of Tlemcen. Data entry and analysis was done by Epi-info 6 software. Thirty-four cases of cutaneous leishmaniasis, 27 of which are autochthonous were reported at the UHC of Tlemcen during 5 years with a female predominance; sex ratio (h/f): 0.79. The most affected age group was 40-50 years old. Six cases occurred in children under 16 years, 80% of the reports were received by the dermatology department. The highest peak was recorded in 2013; autumnal predominance was noted in 30% of cases. All patients lived or had been in endemic areas. Vector control campaigns must be reinforced to fight against leishmaniasis in the town of Tlemcen, also, the improvement of habitat conditions for populations at risk.
100 Determination of Dihydromyricetin in Cassia ferruginea (Schrad.) DC. by Quantitative 1H NMR (qHNMR)     , Alene Côrtes de Queiroz e Silva, Lilian Cherubin Correia, Lucinéia Vizzotto Marconcini and Alberto José Cavalheiro
Cassia ferruginea (Schrad.) DC. (Fabaceae) is a native plant widely used as an ornamental tree and for the restoration of degraded areas in Brazil. Although no previous ethnopharmacological or chemical information was available, bioprospecting studies on this species found out a high concentration of dihydromyricetin (DHM) in different parts of the plant. DHM, also known as (+)-ampelopsin, is a flavonoid that presents important pharmacological and biological activities, including anticancer, cardioprotective and hepatoprotective effects. The aim of this study was to develop and validate a simple method for the determination of DHM in hydroethanolic extracts of C. ferruginea by quantitative 1H NMR (qHNMR) using the internal standard approach. The parameters as linearity, specificity and selectivity, accuracy, precision (repeatability and intermediate) and robustness showed satisfactory results. Five ethanolic extracts from different stages and organs of C. ferruginea were investigated, the DHM concentration ranges from 52.08 ± 3.95 to 201.83 ± 4.71 mg/g. The proposed method appears to be a suitable tool for fast quality control of herbal extracts, with no need of tedious sample preparation and chromatographic separations increasing the efficiency of natural products analysis. This is the first study reporting the presence and determination of DHM in Cassia ferruginea (Schrad.) DC.
101 Sperm Donation in IUI and Preeclampsia’s Risk: Case of Reoccurrence in Patient with the Same Donor   , C. S. Kamto Fotso1, Saidi S. Dahman2 and K. F. Kenfack3
Preeclampsia remains a major obstetrical problem, affecting 3-5% of pregnancies and can be up to 18% in some African countries. Epidemiological studies based on the immune theory showed the relationship between exposition to sperm and preeclampsia. Repeated exposition to seminal liquid would therefore be a protection against preeclampsia, as observed in women having frequent unprotected sex, or having had a previous normal pregnancy with the same partner. Other publications showed an increased risk of preeclampsia in patients who received sperm during an intrauterine insemination (IUI) or during an in vitro fertilization (IVF). We report a case of reoccurrence of severe preeclampsia in a mixed afro-caucasian couple having had a child delivered normally at term in the past. The couple later went for a sperm donation as a result of a chemotherapeutic treatment for Hodgkin Lymphoma which the man suffered from. The fact that the sperm was gotten from the same donor did not stop the reoccurrence. The first pregnancy gotten from sperm donation ended up into a medical termination of pregnancy (MTP) at 23 weeks 2 days of amenorrhea, and the second pregnancy issued from the same donor ended into a cesarean delivery at 28 weeks of a child with intrauterine growth retardation (IUGR).
102 Histological Effect of Viola Odorata Methanolic Extract and Methotraxate Induced in Albino Male Mice , Farah T. O. Al-jumaili1, Sura Alaa Soud2, Mays Talip Abdalla1, Ruqaya M. Al-Ezzy1 and Mohammed Bdaiwy Hassan3
The objective of this study was to considere as an explorer for in vivo studies on the production of some secondary metabolites from local medical plants named Viola odorata. Viola odorata commonly known as “garden violet or sweet violet” belongs to family Violaceae, is a slow growing perennial, with stout rootstock, grows in hedgerows, rough land and margins of woodland. 200 mg/kg of methanol extract for V. odorata was interacted with methotrexate as a drug in albino mice to see the healing capacity for this extract. Different organs were used such as intestine, kidney, spleen, and testes for this experiment. Each organ response was recorded in this experiment. Histopathological section in the intestine of animal treated with MTX and plant showed hypertrophy and hyperplasia of goblet cells and increased cellularity of lamna properia while Histopathological section in the testes of animal treated with MTX and plant showed no sperm in the seminiferous tubules of epididymis with the round multi-nuclei cell in the lumen accompanied by homogeneous material and cellular debris while Histopathological section in the spleen of animal treated with MTX and plant proliferation of lymphocytes in the periarteriolar sheath and proliferation of mononuclear cells around sinus in red pulp and Histopathological section in the kidney of animal treated with MTX and plant mononuclear cells aggregation in the interstitial tissue mainly around blood vessels and in the adipose tissue and renal tubules. Other sections showed hydropic degeneration of renal tubules.  
103 Effectiveness of Garlic (Allium sativum) as Antimicrobial Agent against Bacteria Causing Urinary Tract Infection , Muhammad Zuhal Darwis, Lisa Yuniati and Arina F. Arifin
Background: Urinary tract infection (UTI), is caused by pathogen bacteria, such as: Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Proteus sp. The emergence of antibiotic resistance, leads to treatment failure in some cases. One strategy to overcome this is using alternative therapies, one of them by using herbal plants, namely garlic (Allium sativum) which has antimicrobial effects. Aim: To determine the effectiveness of garlic extract against bacteria that causes UTI. Methods: The study used experimental in vitro method; Using garlic extract with 50% & 80% (5 & 8 gr garlic extract in 10 mL aquades as a solvent) concentration and amoxicillin as positive control which then dripped on the medium growth of bacteria’s culture, then measured diameter of the minimum inhibit zone that formed. Results: The inhibitory zone diameter of 50% garlic extract showed intermediate results in Pseudomonas aeruginosa with a diameter of 13.17 mm, and is not sensitive to other bacteria. Concentration at 80% showed sensitive results in Pseudomonas aeruginosa and Escherichia coli with diameter 17.27 mm & 15.5 mm, the result is almost equivalent compared with amoxicillin, with diameter 20.38 mm & 24.23 mm. Conclusion: Garlic extracted with 80% concentration has antimicrobial effect against Pseudomonas aeruginosa and Escherichia coli.
104 Change of Blood Composition before and after Implementation of Special Physical Load , Rafiga Mazahir Baghirova
A comparative analysis of changes in the amount of adrenaline in the blood and heart rate in highly skilled athletes, and persons not involved in sports, before and after physical load has been carried out. Revealed amount of adrenaline in the blood and heart rate after physical load were directly dependent from the level of physical preparedness of the subjects.
105 Protective Effects of Tribulus terrestris, Avena sativa, and White Ginseng Powder on Bone Mineral Density in Hypercholesterolemic Rats     , Mehmet AkdoÄŸan1, Huri Tilla Ä°lçe2, Ali Bilgili3 and BaÅŸak Hanedan4
This study investigated the effects of the herbal compounds Tribulus terrestris (TT), Avena sativa (AS), white ginseng (WG), and a triple combination (TC) powder on the serum total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride, and the tibial bone mineral density (BMD) levels in rats fed a high-cholesterol diet. This study comprised Group I (normal pellet feed), Group II (pellet feed with 2% cholesterol), Group III (2% cholesterol plus 15% TT), Group IV (2% cholesterol plus 7.5% AS), Group V (2% cholesterol plus 5% WG) and Group VI (2% cholesterol plus 7.5 TT% + 3.75% AS, 2.5% WG). The serum total cholesterol, LDL-C, HDL-C, triglyceride, and tibial BMD (g/cm2) levels were measured. Significant decrease in the serum HDL-C levels in Group II than Group I, and significant increase in the serum LDL-C levels in Group II than Groups I and VI were determined. The tibial BMD levels were significantly lower in Groups II and IV than Group I. It was determined that WG and TC significantly prevented the serum total cholesterol increase; TC significantly prevented the serum LDL-C increase; and TT, WG, and TC were non-significantly effective in the improvement of tibial BMD levels.
106 Development of Baccharis dracunculifolia (Asteraceae) Essential Oil Nanoemulsion and Its Biological Activity on Pre-pupae of Cochliomyia hominivorax (Diptera: Calliphoridae)     , Jaqueline Seugling1, Shirley Kuhnen2, Giuliano Pereira de Barros1, Maria Beatriz Velerinho2, Letícia Mazzarino3 and Patrizia Ana Bricarello1
Myiasis is considered a serious medical condition in animals and humans that occurs predominantly in tropical countries. Cochliomyia hominivorax is one of the main fly species that causes myiasis and the actual geographic distribution includes the Caribbean and all of South America, except Chile. The use of synthetic insecticides and endectocides in livestock for the myiasis treatment has resulted in insect resistance, while also causing residuals in the environment and contamination of animal food products. Biologically active compounds are considered an alternative for the sustainable management of insects, as they are biodegradable and less damaging to the environment. This study developed a nanoemulsion containing the essential oil of Baccharis dracunculifolia and evaluated its in vitro effects on C. hominivorax larvae. High pressure homogenization was used to develop the nanoemulsion. Larvicidal tests were carried out with the tested products using 15 larvae/repetition, for a total of 150 larvae per treatment. Five different concentrations of the nanoemulsion were tested shortly after preparation and after 120 days of storage. For the fresh formulation, at concentrations of 5, 7.5, 10, 13.5, and 15% (w/v) we found mortality of 28, 48, 70, 84, and 97%, respectively, while for the stored formulation, we found mortality of 17, 36, 51, 81, and 92%. The larvicidal effect was similar, except for the concentrations of 5 and 10% (w/v) (p < 0.05). Our results show that the natural based B. dracunculifolia nanoemulsion can be considered a promising alternative for the treatment and control of myiasis caused by C. hominivorax.
107 Analyze the Dose Results Calculated with AAA Algorithm in Eclipse Software of New Treatment Planning System     , Soai DANG QUOC1, Quang BUI VINH2, Cuong BUI XUAN1, Toan HOANG VAN1 and Truong VU1
In this paper, the authors investigate the differences between the dose results calculated with AAA (Anisotropic Analytical Algorithm) algorithm in Eclipse 13.0 treatment planning system, which has just commissioned, with the measured doses. The AAA algorithm in the Eclipse software is used to calculate the absolute dose, relative dose in profile line, and percent depth dose of some specific field size in Blue Phantom. The calculated dose results were compared with measured dose based on Technical Reports Series No. 430 of International Atomic Energy Agency (IAEA No. 430). The authors have used CC13 ion chamber, Famer Chamber, water phantom, and Omnipro software to measure relative, absolute doses of these fields size. The AAA algorithm was also used to calculate the doses in IMRT (Intensity Modulated Radiotherapy) plan of fifty head and neck cancer patients. These IMRT plans were controlled quality in some points with plastic phantom, and famer chamber FC65. The differences between calculated dose, and measured doses are in the limit of IAEA 430 report. The results of the QA IMRT plan processing are fitting with ESTRO (European Society Therapeutic Radiation Oncology) Booklet No. 9.
108 Fucoidan—New Principle Prevention and Treatment of Diabetes     , Emil Mukhamejanov1, Galina Kon1, Sara Erjanova2, Aray Kirgizbaeva2 and Elizabeth Muhamadieva2
Most of patients with diabetes mellitus are not able to adhere to the basic principles of maintaining glucose homeostasis by decrease consumption of carbohydrates from food and increasing their utilization for physical activity. Pharmacological correction developing disorders are not always effective and have side effects. That is why necessary search for nutraceuticals with high bio-active properties does not have side effects. This review being considered possibility using fucoidan is sulfated polysaccharide of brown algae to maintain glucose homeostasis by reducing the rate absorption of glucose from the intestine and increasing its utilization by muscle fibers as a nutraceutical for patients with diabetes mellitus. In this plan, fucoidan should be considered as a functional food product for the prevention and treatment of diabetes mellitus.
109 Congenital Hypothyroidism: A Report of Two Isolated Cases at National Hospital Abuja     , N. Y. Papka, I. B. Babaniyi and N. Hamza
Background: Congenital hypothyroidism is a disorder of thyroid gland morphogenesis. It is the commonest endocrine disorder in newborns occurring in 1:4,000 to 1:3,000 live births. The incidence in Nigeria has not been well documented probably due to lack of neonatal screening. Aim/objectives: To raise awareness of physicians to have a high index of suspicion for this treatable cause of mental retardation in children presenting with unusual symptoms. Case presentation: Case 1 presented to our hospital at 18 months of age with a respiratory tract infection. She had delayed developmental milestones and coarse facies among other features. This prompted a work up for hypothyroidism. Thyroid function tests done showed a profoundly hypothyroid picture and she was commenced on levothyroxine. Case 2 was referred to our facility at ninth week of age on suspicion of a congenital heart disease. The parents had complained of dry skin to the referring physician. She had a hypothyroid profile on laboratory evaluation. Conclusion: Congenital hypothyroidism should be suspected in children with unusual symptoms as it is a treatable cause of short stature and mental retardation. The introduction of newborn screening will go a long way in identifying the children in need of urgent thyroid replacement to prevent the negative consequences of untreated hypothyroidism.
110 Green Synthesis of CuO Nanoparticles Using Leaf Extract of Catha edulis and Its Antibacterial Activity     , Kiflom Gebremedhn1,2, Mebrahtu Hagos Kahsay1 and Muluken Aklilu2
Copper oxide nanoparticles (CuO NPs) have attracted huge attention due to catalytic, electric, optical, photonic, and antibacterial activity. The use of plant leaf extracts in the biosynthesis of nanostructured materials is an eco-friendly, non-toxic and cost effective approach. Hence, this study aims to provide an updated survey of the main green synthesis method of CuO NPs using leaf extract of Khat, its characterization and studies on antibacterial activities. The synthesis of CuO NPs was done by reducing 1 mM CuSO4∙5H2O with 2% (m/v) aqueous leaf extract of Khat under optimum conditions (pH = 11). The formation of CuO NPs has been confirmed first by the color change from colorless to light green and then to greenish yellow. The kinetics of the reaction was studied using UV-Visible (UV-Vis) spectrophotometer that showed surface plasmon resonance at 333 nm. The CuO NPs exhibit antimicrobial activity against two human pathogens viz. Salmonella typhimurium and Escherichia coli with an average zone of inhibition of 12.5 mm and 8 mm, respectively. Therefore, the current study reveals a convenient utilization of Catha edulis extract as a reducing agent for the successful synthesis of CuO NPs through a green synthesis method to obtain significantly active antibacterial material.
111 Frequency of Congenital Anomalies in the State of Amazonas-Brazil for the Period 2008 to 2017     , Iandara Maíra Lopes de Souza and Cleiton Fantin
There are few studies on the frequency of congenital anomalies in Brazil, particularly in the state of Amazonas. Therefore, the aim of this study was to investigate the number of live births with congenital anomalies in Amazonas, in the period 2008-2017, based on the Live Birth Information System (SINASC), as well as to discuss the relevance of the professionals being trained for the correct completion of the notice of live birth. In the study period, of the 773,313 live births in Amazonas, 4,593 were diagnosed with some type of congenital anomaly, according to DATASUS. This corresponds to a prevalence of 5.9 cases per 1,000 live births. The most frequent cases were congenital deformities of the musculoskeletal system, with 23% of the reports, congenital deformity of the feet, with 16%, and other congenital malformations, with 15% of the registrations. The need for investments in the training and qualification of professionals was observed, so that they can act, in a qualified way, in the cycle of diagnosis, registration and support for families, since they have not been trained to deal with this new reality. The importance is emphasized of continuing the research in the field of genetic diseases in Amazonas, in order to assist the individuals and families affected, as well as supporting the decisions related to the planning and implementation of public policies directed toward the issue.
112 Phytochemical Analysis of Asparagus africanus Root Extracts     , Onyeka Damianfranklin Okolie, Idah Manduna and Samson Mashele
Phytochemicals are the reliable source for the treatment of health complications in Africa and specifically South Africa, which brought forward for the screening of Asparagus africanus root extracts, though this result indicated several bioactive constituents presents, such as alkaloids, carbohydrate, cardiac glycosides, protein, flavonoids, tannins, steroids, terpenoids and saponins contained in A. africanus roots.
113 Punica granatum Leaf Lipophilic Fraction Favours Mortality by Attenuating Inflammation in Mice with Polymicrobial Sepsis   , Nágila Caroline Fialho Sousa1, Isabella Fernandes da Silva Figueiredo1, Mizael Calácio de Araújo1, Elaine Pereira de Andrade1, Thaís Costa Alves1, Bruna Letícia Rosa da Silva1, Domingos Magno Santos Pereira1, Saulo José Figueiredo Mendes1, João Francisco Silva Rodrigues1, Jaqueline Pessoa Pontes1, Simone Aparecida Teixeira2, André Alvares Marques Vale3, Marcus Vinícius Dias-Souza4, Lídio Gonçalves Lima-Neto1, Vera Lúcia dos Santos4, Ana Paula Azevedo-Santos3, Marcelo Nicolás Muscará2, Valério Monteiro-Neto1, 5, Andrea de Souza Monteiro1, Luís Cláudio Nascimento da Silva1 and Elizabeth Soares Fernandes1
Punica granatum L. possesses known antimicrobial and anti-inflammatory actions. Preparations of different parts of this plant have been commonly used in the folk medicine to prevent and treat infections; and studies have supported the use of P. granatum extracts for this purpose. However, little is known of the effects of P. granatum-derived fractions in severe infectious diseases such as sepsis. Here, we investigated the actions of the hexane fraction (HF), rich in lipophilic compounds, obtained from the leaves of this plant, in a murine model of polymicrobial sepsis. Oral pre-treatment with HF increased mortality in septic mice. The same animals presented with lower levels of interleukin-6, nitric oxide and hydrogen peroxide in their peritoneal lavage samples than vehicle mice. HF also increased polymorphonuclear cell accumulation in to the peritoneum of mice with sepsis. Macrophage-derived nitric oxide upon lipopolysaccharide stimuli was markedly reduced by incubation with HF. Diterpenes, triterpenes, phytosterols, vitamin E and ascorbyl palmitate were detected in the HF. These results indicate that P. granatum leaf lipophilic fractions may worsen sepsis outcome. This effect may be associated with its bioactive compounds which act synergistically or not, increasing sepsis mortality in vivo.
114 ID7 Isolated from Bauhinia variegata Stem Inhibits Tumor Progression and Metastatic Mechanisms of Triple Negative Breast Cancer in Vivo     , Kamilla Monteiro dos Santos1,2, Izabela Natalia Faria Gomes3, Renato José Silva Oliveira3, Fernanda E. Pinto4, Bruno Oliveira4, Fabrício P. Batista5, Rafael Cesar Russo Chagas1, Hélio B. Santos6, Ralph G. Thomé6, Wanderson Romão4, Rui Manuel Reis3,7,8, Maria Luiza Vilela Oliva5 and Rosy Iara Maciel de Azambuja Ribeiro1
Background: The breast cancer has been the most common form of cancer among women. The triple negative subtype represents 20% of all breast cancer cases in the world and is standing out by affecting young women and being aggressive. The main cause of death of patients with cancer is due to metastasis, which can reach the liver and lungs. Objective: The activities of ID7 fraction of the stems of Bauhinia variegata L. on breast cancer, lung metastasis and liver inflammatory process were evaluated. Method: ID7 was characterized by mass-spectrometry. The viability of murine mammary cells (4T1) treated with ID7 was assessed by MTT, trypan blue and fluorescence assay and viability of BT-20, MDA-MB-231 and MCF-7 human breast cancer tumor lines by MTS. The cell migration, invasion using matrigel and adhesion were performed. The expression of cell death proteins was quanitified by western blot and the gelatinases by zimogram. The ID7 activity of the tumor (4T1) and metastatic progession in vivo was evaluated. Results: ID7 reduced the 4T1 and MDA-MB-231viability and increased the late apoptosis, inhibited the 4T1 migration and invasion, increased the 4T1 adhesion and decreased the secreted active gelatinases. ID7 also increased the expression of PARP, caspase-7 and caspase-8, RIP and TNF-R1. In vivo, the ID7 decreased the volume and weight of the tumors and decreased lung metastasis and inflammation in the liver. The characterization showed mainly the presence of oleic acid, myricetin, quercetin and kaempferol in ID7. Conclusion: Thus, it was found that ID7 fraction exhibits selective antitumor and on the mechanisms of breast cancer metastasis activity, preventing lung metastasis and inflammation in the liver. It is suggested that fatty acids and flavonoids are correlated with such activities.
115 The Self-inspections (Internal Audits) Process as a Part of the Pharmaceutical Quality System: Formation of a Risk-Based Approach to Internal Audits Planning     , Valeriy Nikityuk1, Tetiana Karamavrova2 and V. Lebedynets2
The quality system of any modern pharmaceutical company is the pharmaceutical quality system (PQS), which extends the GMP standards to all stages of the medicinal productslife cycle, from pharmaceutical development to its withdrawal from production. The principal difference between PQS and GxP rules from other quality systems is that the medicinal product, its safety and efficacy is put at the forefront. At the same time, PQS implies a process approach to all components that should be aimed at achieving the main goal—ensuring and guaranteeing the quality of the medicinal product for the end user (patient)—and should be based on the quality risk management system. An integral part of PQS, as well as the GxP rules adopted in the European Union and PIC/S, is a process for self-inspections and/or quality audits, which regularly appraises the effectiveness and applicability of the PQS. This publication is dedicated to the definition of self-inspections (internal audits) as one of the PQS’s processes. The article defines the main standard stages and develops a model of a risk-based approach to the self-inspections’ planning in relation to processes of the pharmaceutical quality system.
116 Glutamine or Glutamine Dipeptide Supplementation Improves Gluconeogenesis and Liver Glycogenosis in Type 1 Diabetic Rats     , Silvia Carla S. F. Azevedo1, Carlos Vinicius D. da Rosa1, Ana Luiza M. Wunderlich2, Laís A. Yamada2, Isabela R. Mariano2, Camila Bataglini1, Nayra T. D. Branquinho1, Scarlett R. Raposo3, Roberto B. Bazotte4, Edmara A. Baroni5, Maria Raquel M. Natali6, Maria Montserrat D. Pedrosa5 and Vilma A. F. de Godoi5
The effects of the supplementation with L-glutamine (GLN) or L-alanyl-L-glutamine (GDP) on the progression of the systemic and hepatic metabolic status of rats having untreated type 1 diabetes mellitus (T1DM) were investigated. Male Wistar diabetic rats (streptozotocin, 60 mg/kg) were allotted to four groups supplemented by gavage for thirty days as follows: control and diabetic receiving saline; diabetic receiving GLN (248 mg/kg); and diabetic receiving GDP (400 mg/kg). Body weight, plasmatic parameters and kidney function were analyzed. Isolated hepatocytes were used to assess gluconeogenic capacity. Liver and kidney were used for morphological analyses. T1DM decreased the number and increased the area of the hepatocytes, possibly because of the observed enlargement of glycogen stores. Kidney weight, glomerular area and proteinuria increased, and glomerular filtration rate decreased, in non-supplemented T1DM rats. Glomerular area and proteinuria were reversed by both supplementations. The T1DM hepatocytes released less glucose, which could have been diverted to glycogen synthesis and secondary glycogenosis observed in T1DM; this was partially reversed by the supplementations. The results point to a possible beneficial effect of glutamine on the metabolic and hepatic impairments of T1DM.
117 Meclizine Chloridrate and Methyl-β-Cyclodextrin Associated with Monophosphoester Synthetic Phosphoethanolamine Modulating Proliferative Potential in Triple-Negative Breast Cancer Cells     , Manuela Garcia Laveli da Silva, Luciana Bastianelli Knop and Durvanei Augusto Maria
Synthetic phosphoethanolamine (Pho-s) is a monophosphoester ester with anti-inflammatory and pro-apoptotic properties. Meclizine chloridrate (MC) is a histamine H1 receptor blocker that is also able to inhibit cellular respiration. However, MC does not inhibit cellular respiration in isolated mitochondria such as antimycin and rotenone. Methyl-β-cyclodextrin (MβCD) belongs to the β-cyclodextrin family, which is capable of removing cholesterol from the plasma membrane. The aim of this study was to evaluate the proliferative effects of meclizine chloridrate and methyl-β-cyclodextrin compounds associated with synthetic phosphoethanolamine in a triple-negative human breast tumor line, MDA-MB-231 Cell viability of the tumor line and normal cells FN1 was evaluated by MTT colorimetric test; the production of free radicals was determined by lipoperoxidation (LPO) test; and the percentage of cell cycle phases and proliferative index was evaluated by flow cytometry. Cell viability demonstrated a significant decrease with the treatments of MβCD, MC and Pho-s associated with MC. The production of free radicals decreases significantly in all treatments. In addition, a significant increase of DNA fragment and decrease in G0/G1 cell cycle phase were observed in cellular percentage with concentrations of 20 and 30 mM of Pho-s in association with MC and MβCD, respectively.
118 Studies on the Effects of Extracts of Fresh Khat/Catha edulis Leaves on the Oxidation of Niger Seed Oil     , Adugna Nigatu1 and Solomon Libsu2
The methanolic extract of the fresh leaves of khat/Catha edulis was investigated using established procedures for its phytochemical constituents and effect on lipid oxidation. The phytochemical analysis revealed the presence of alkaloids, tannins, phenols, and flavonoids. The effects of the extract on oxidation of locally produced edible NSO (niger seed oil) was assessed through the measurement of peroxide value, iodine value and conjugated diene concentration for a period of sixteen days. Control setup involving NSO without the extract was also kept for the same period of time under similar conditions. It was observed that the peroxide value and conjugated diene value of the oil containing varying concentrations of the extracts of khat leaves increased significantly, relative to the control, showing that the extract of the khat leaves promoted deterioration of the oil. In a similar manner, the iodine value of NSO with and without added khat leaves extract was assessed. It was observed that the iodine value of the oil containing the khat leaves extract decreased more rapidly than the control, suggesting that the double bonds in the fat constituting the oil were diminished by the extract of the khat leaves. It is thus inferred from the present study that methanolic extract of fresh khat leaves leads to deterioration of NSO. It can also be suggested from the results of the present investigation that the health problems khat chewers face may be related to the oxidative damaging effects of these leaves exert on biomolecules found in the body.  
119 Okra (Abelmoschus esculentus L. Moench) as Anti-cholesterol, Anti-diabetic and Anti-obesity in White Male Rats   , Nur Rahayuningsih, Rizka Pratama, Yedy Purwandi Sukmawan and Maritsa Nurfatwa
Hypercholesterolemia is cholesterol elevation condition in blood serum. Type 2 Diabetes Mellitus is a metabolic disorder increasing significantly around the world, associated with obesity and lipid accumulation in the body. Okra (Abelmoschus esculentus L. Moench) is used as anti-obesity and anti-cholesterol empirically. The objective of the study was to determine the anti-obesity, anti-diabetic and anti-cholesterol activity of okra ethanolic extract in animal high-fat diet model. We conduct short- and long-term anti-obesity, anti-diabetic and anti-cholesterol test. The blood sample was collected from all rats after 8 hours fasting previously. Short- (p = 0.000) and long-term test (p = 0.005) showed significantly different parameter between the negative and positive group. Dose III showed no significant differences compared to positive group (p > 0.05) in the short-term test while, Dose I, II and III showed no significant differences compared to positive group in decreasing cholesterol level in the long-term test, Dose III showed the best activity in decreasing cholesterol level in blood serum and was equivalent with the positive group.
120 Phosphomonoester Phosphoethanolamine Induces Apoptosis in Human Chronic Myeloid Leukemia Cells     , Thais de Oliveira Conceição, Manuela Garcia Laveli da Silva and Durvanei Augusto Maria
Background: Leukemia is a type of cancer that starts in the blood or blood-forming tissues. It results from the clonal proliferation of hematopoietic cells in the bone marrow and/or lymphoid tissues, which subsequently reach the peripheral circulation and can infiltrate other systems. There are many different kinds of leukemia, and treatments are different for each one. Chronic leukemia is with a slower growing than acute leukemia but could be just as life-threatening. Phospholipids are antitumor analogs, such as synthetic phosphoethanolamine, which is a phosphorylated compound capable of controlling cellular proliferation and inducing apoptosis in several types of tumor cells. Methods: K562 and K562-Lucena (MDR+) human chronic myeloid leukemia cells were treated with synthetic phosphoethanolamine (Pho-s). The viability was evaluated by sulforhodamine B (SRB) assay and cell cycle phases, apoptosis, markers expression, and mitochondrial potential were assessed by flow cytometry. Results: Tumor cells formed clusters in suspension and decreased significantly viability. The concentrations for IC50% were obtained. Pho-s treated were 43.1 mM (K562) and 145.9 mM (K562-Lucena MDR+) in a period of 24 hours. Pho-s induced changes in the distribution of cell population phases of cell cycle which showed an increase in fragmented DNA and increased markers expression envolved apoptosis pathways a decrease in the G1/G0 phase. Discussion: Treatment of K562 and K562-Lucena (MDR+) chronic myeloid leukemia cells with Pho-s showed dose and time dependent cytotoxic effects. This cytotoxicity induced a decrease in proliferative capacity, mitochondrial electrical potential, and consequently release of cytochrome C; inhibition of Bcl-2 family protein expression, increase in pro-apoptotic family members Bad and Bax, dependent on p53 expression. Conclusion: This study presented a significant therapeutic potential of Phos-s in this type of leukemia through the apoptotic effects on tumor cells independently of the molecular resistance profile (MDR+).
121 Chromosomal Alterations in Patients with Alzheimer Disease in Manaus, Amazonas, Brazil     , Cleiton Fantin1, Kledson Moraes Nunes1, Ernanda Raquel de Queirós Gonçalves de Sousa e Fernandes2,3, Diana Vieira Brito1, Natalia Dayane Moura Carvalho1 and Denise Corrêa Benzaquem1
Alzheimer disease (AD) is a complex neurodegenerative pathology that is characterized by a cognitive decline. Its causes and mechanisms are still largely unknown. It has been suggested that both genetic and life exposure factors can contribute to AD development. There are also evidences that chromosomal alterations can be related to this disease. So far, there is not a precise diagnosis for AD, which is given only after the exclusion of other dementia by clinical and neurological examination. The possible association of AD with chromosomal alterations and the easy access of classical cytogenetics analysis are important aspects to consider, given the difficulties in diagnosis. Due to the lack of similar studies in Brazil and the increasing number of AD cases in the state of Amazonas, the aim of this study was to investigate the presence of chromosomal alterations in patients diagnosed with AD in Manaus, Amazonas, Brazil. Peripheral blood lymphocytes of twelve patients and twelve healthy individuals with the same age were analyzed using conventional karyotyping. All AD patients presented cells with autosomal aneuploidy, while no chromosomal alterations were found in the age-matched controls. Also, rare events of double and multiple aneuploidies are being reported in association with AD for the first time. Our results corroborate that the increase in the frequencies of aneuploidies is not related to the aging process itself, but it might be associated to the disease development. However, no chromosomes were preferentially affected in all AD patients, and no consistent karyotype pattern for AD lymphocytes was found. Therefore, our results do not support the use of standard cytogenetics as a tool for AD diagnosis. Future studies are necessary to understand better the association between chromosomal alterations and AD.  
122 Diagnostic Value between 1984 and 2018 of Transrectal Biopsy Guided by Ultrasonography after Radical Prostatectomy     , Luiz Carlos de Araújo Souza1, Vinícius Carvalhêdo Cunha1, Hugo Oliveira de Figueiredo Cavalcanti2, João Ricardo Alves3, Grimar de Oliveira Paula4 and Sandra Lúcia Branco Mendes Coutinho5
Objectives—to determine correlation between GSs (Gleason scores) on needle biopsy and RP (radical prostatectomy), evaluating diagnostic tests on biopsy and RP within the last years, between 1984 and 2018. Method—analysis of 100 patients, diagnosed with PCa (prostate cancer) needle biopsy using 18-gauge needle, who underwent RP with lymphadenectomy and for which preoperative and postoperative GSs were available. GS group analysis used three categorization schemes for differentiation: mild, moderate and poor for the whole group and we determined SE (sensitivity), SP (specificity), PVPR (positive predictive value), negative predictive value and accuracy. Results—we found that 42% of the patients had no changes between GS on biopsy and prostatectomy, while 20% were overgraded and 38% undergraded by needle biopsy. Graduation of +1 point in GS (32%) or -1 point (17%) was the most common. Most patients were classified as moderately differentiated by biopsies (78 and 35% in scheme 1 and 2 or 3, respectively), while 43% of patients received an intermediate differentiation classification. Biopsy accuracy varied from 44 to 76% for the analysis of all three schemes. Conclusion—there are differences in correlation between GS on biopsy and on surgical specimen, and Gleason’s graduation also depends on the experience of the pathologist. We have shown that sextant biopsies using 18-gauge and a same group of pathologists showed acceptable concordance values (42%) between the GS on biopsy and prostatectomy.
123 Effect of Ciprofloxacin on S. aureus and E. coli Growth in Presence of Vitamin C Using Cup Cut Diffusion Method     , Suhera M. Aburawi1, Bassma M. Doro2 and Ebtisam A. Awad1
Ciprofloxacin is a second-generation of fluoroquinolone, broad-spectrum antibiotic with bactericidal activity against Gram-positive and Gram-negative organisms. It is one of the most widely used antibiotics, because of its efficacy, safety, and relatively low cost. Ascorbic acid (vitamin C) is water-soluble monosaccharide antioxidant; it is essentially required by the body for its various biochemical and physiological processes. S. aureus is Gram-positive cocci; widely distributed in the environment, it is a member of the normal flora of the body. S. aureus is not always pathogenic; it is a common cause of skin infections including abscesses, respiratory infections such as sinusitis, and food poisoning. E. coli is Gram-negative bacteria, found in the environment, foods, and intestines. Most E. coli strains are harmless; it is part of the normal microbiota of the gut. However, some serotypes of E. coli cause serious food poisoning in their hosts; it can cause diarrhea, while others cause urinary tract infections, respiratory illness and pneumonia, and other illnesses. Method: Cup cut diffusion method was applied. Experiment I: is carried out to choose the concentration of vitamin C to be used in experiment II. The negative control is normal saline, added in cup in each plate, vitamin C (100 mg/mL, 200 mg/mL, 400 mg/mL) was added, the volume in each cup was 100 μL. Experiment II: Eight groups of treatments were applied. The first is the negative control (1% normal saline), the second group is the positive control of vitamin C (200 mg/mL). The third, fourth and fifth groups are ciprofloxacin with different concentrations (10 mg/mL, 20 mg/mL, 40 mg/mL); the sixth, seventh and eighth are the combination of vitamin C with each concentration of ciprofloxacin (10 mg/mL, 20 mg/mL, 40 mg/mL). Each group includes six petri dishes. Bacterial plates were incubated at 37 oC for 24 h and 48 h. Zone of inhibition is measured in mm. Results and conclusion: Ciprofloxacin produces dose dependent increase in zone of inhibition of S. aureus and E. coli growth, after 24 and 48 hours incubation. While vitamin C in the concentration used produced inhibitory effect on the growth of S. aureus and E. coli, after 24 hours incubation, vitamin C effect was not changed after 48 hours incubation. After 24 hours incubation, vitamin C potentiated the effect of ciprofloxacin at low concentration (10 mg/mL); while vitamin C antagonized the effect of ciprofloxacin at higher concentrations (20 and 40 mg/mL) on S. aureus growth. In the same time, ciprofloxacin antagonized the inhibitory effect of vitamin C on S. aureus growth. After 48 hours incubation, S. aureus produced resistance against ciprofloxacin alone, and that combined with vitamin C compared to zone of inhibition after 24 hours. Ciprofloxacin produced dose dependent inhibition of E. coli growth after incubation for 24 and 48 hours. Vitamin C potentiated the inhibitory effect induced by ciprofloxacin (additive effect). The inhibitory effect of ciprofloxacin, vitamin C and the combination was not changed after 48 hours compared to 24 hours.
124 Detection of Gram-Negative Bacteria Carrying the blaKPC-2 Gene from Mangrove Sediments     , Wallace Ribeiro Nunes Neto1, Jessica Mayara Mendes Araujo 1, Darlan Ferreira da Silva2, Joveliane de Melo Monteiro1, Wallace Borges Pachêco 1, Jessflan Rafael Nascimento Santos1, Maria Raimunda Chagas Silva2, Maria Rosa Quaresma Bomfim3 and Andrea de Souza Monteiro 1
Mangroves are environments that have fast cycles associated with high concentration of bacterial decomposers. These are impacted by anthropogenic pollution due to contamination of bacterial species carrying resistance genes. This study aims to evaluate the metabolic profile of the microbiota in mangrove sediments, and verify the presence of Gram-negative bacteria resistant to meropenem. The samples were obtained from location along the Anil river and were seeded in medium supplemented with the antibiotic meropenem in increasing concentrations. The DNA was analyzed by multiplex PCR for detecting resistance genes for β-lactam antibiotics. The bacteria were identified by Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS). The genes were sequenced by ABI PRISM 3100, analyzed by MEGA 6.0 program, and the sequence identified was assessed by GenBank using the BLAST algorithm. Ecoplate® the kit was used to determine the metabolic profile of the microbiota. The results of the six bacterial isolates showed the blaKPC-2 gene and were identified as Stenotrophomonas maltophilia and Pseudomonas putida. The samples showed a greater diversity Shannon index, a rich substrate consumption and high equity. There was a metabolic richness such as carbon consumption profiles, being a factor of adaptation of pathogenic bacteria carrying resistance genes to β-lactamics antibiotics.
125 Paediatric Chronic Myeloid Leukaemia in a Tertiary Hospital in Nigeria: A Report of Two Cases     , Udechukwu Ngozi Patricia1, Nwagha Theresa Ukamaka2, Okike Clifford1, Ukoh Uchechukwu Chukwuebuka1 and Oyim-Elechi Oluchi Cecilia1
Background: Chronic myeloid leukaemia (CML) is a myeloproliferative disorder with BCR/ABL mutation characterized by proliferation of granulocytic cell lines at varying stages of development. It is predominantly a disease of the adult population, only accounting for 2-3% of all childhood leukaemia. In our tertiary hospital, we recorded two cases of paediatric CML within three years. Objective: To increase the awareness of physicians on this seemingly rare form of childhood leukaemia. Case reports: We report a 10 year-old boy and a 16 year-old girl who presented to our facility with features suggestive of CML. Both cases had splenomegaly and leucocytosis. Cytogenetic assessment was positive for BCR-ABL in both cases. The first case was in chronic phase (CP) and had an initial therapy of hydroxyurea (HU) before referral for imatinib therapy. The second case received imatinib therapy, however due to blastic transformation to acute myeloid leukaemia (AML), she received treatment comprising of intravenous anthracycline and cytarabine. Conclusion: CML, although one of the rare childhood leukaemia is becoming increasingly noticed, probably due to availability of diagnostic facilities. There is therefore need for increased awareness of the disease among physicians to minimize delays in the diagnosis for improved care and better outcome.
126 Mode of Action and Cytotoxicity of Bioactive Compounds Produced by Streptomyces sp. KB1   , Monthon Lertcanawanichakul1,2 and Kittisak Chawawisit1
Rapid emergence of methicillin-resistant Staphylococcus aureus (MRSA) has led to search of a novel bioactive compounds from natural resources. This study was aimed to determine the mode of action of bioactive compounds produced by Streptomyces sp. KB1 TISTR 2304 against MRSA, including cytotoxicity against mature brine shrimp. The mode of action and cytotoxicity of bioactive compounds were performed by observing the tested MRSA cells with a scanning electron microscope and evaluated by the brine shrimp lethality bioassay, respectively. The results indicated that bioactive compounds had the mode of action at the cell wall and also showed the moderate cytotoxic activity. This study concluded that the bioactive compounds produced from strain KB1 can be used as a model for novel anti-MRSA drug development.
127 Evolution of People Living with HIV and AIDS in Medical Consultation at 17 ESOPE Sites in Mali     , S. Traore1, K. Kayentao2, B. Traore1, I. Coulibaly4, N. Telly1, S. Diop3, S. Doumbia2 and M. Traore5
Despite the efforts made by the Malian government with technical and financial partners in the fight against HIV and AIDS, there are no data on the evolution of people with HIV in medical consultation in antiretroviral treatment sites. The objective of this work is to fill this gap by generating factual data describing the evolution of the number of people with HIV in medical consultation in Mali. To achieve this goal, we conducted a cross-sectional study using data from the Coordination Unit of the Sectoral Committee for AIDS Control of the Ministry of Health and Public Hygiene. Sampling was comprehensive including all people living with HIV. The data collected concerned those of the years 1999 to 2014 by the ESOPE software and analyzed with Stata version 12. A Total of 39,619 people were enrolled in the study. And 26,212 people living with HIV in the 17 ESOPE sites of Mali were female. Patients aged 25-34 and 35-44 years were strongly represented in consultation in the years 2007 and 2011, and those aged 15-24 were the least frequent. HIV1 was the most dominant with 97%. The majority of patients presented for initial consultation were clinical stages 2 and 3 in all years. Cases of lost sites seen in the more common in hospitals are 62.79% at the Hospital of Mopti and 57% at the University Hospital of Point G. The number of cases of people living with HIV in medical consultation has progressively augmented from 1999-2007. Then it dropped from 2008-2010. After this number has increased by 2011, it dropped again in 2012-2014. This study made it possible to note the evolution of the patients in medical consultation in ESOPE antiretroviral treatment sites according to the years and events (safe, subsidized by activities by the global fund). The activities of sensitization and communications, case research should be strengthened by involving the community.
128 Synthesis and Photophysical Properties of Conjugates of Green Fluorescent Protein (GFP) Chromophore and 2'-Deoxy-Uridine Developed as Labelled Building Blocks for Oligonucleotide Probes     , Abed Saady and Bilha Fischer
Fluorescent probes with high signal/background ratio are needed for hybridization assays. Hence, the chromophore of green fluorescent protein (GFP), 4-hydroxybenzylidene-imidazolinone (HBI), was targeted as a potential fluorescent intercalator. For producing a building block for fluorescent oligonucleotide probes, 2'-deoxyuridine (dU) was conjugated with HBI via a flexible carbon-spacer. dUHBI conjugates highly fluoresce in glycerol (λem 460 nm, Φ 0.31), and are 109-fold more emissive than in methanol, implying the potential of dUHBI-labeled oligonucleotides as probes for hybridization assays.
129 The Nutrition Science on Basis of Algae in the Patronage of Neoplastic Processes     , Azhar Zheksenova, Emil Muhamedzhanov, Aiman Kaldybayeva, Roza Nurgaliyeva, Gulbanu Mukyshova, Ainur Amanzholkyzy, Gulaim Taskozhina and Farida Balmaganbetova
In the mechanism of development of the tumor process, a large role is given to the impact on the body of factors causing cell death (apoptosis). Therefore, all technologies aimed at reducing the negative impact are methods of preventing the development of the tumor process. Of great interest in this regard are food compounds with high bioactivity, in particular sulfated polysaccharide brown algae fucoidan. Fucoidan prevents cell death due to antioxidant activity, anti-toxic effects, antibacterial or immunomodulatory effects, normalization of metabolic processes and neuro-endocrine status. In addition, fucoidan has a direct impact on the cancer cell: reduces its survival, improves differentiation and inhibits proliferation, suppresses migration and invasion, or blocks metastasis. This indicates that fucoidan can be used as a functional food product to prevent and treat cancer.  
130 Development of Fast Dissolving Tablets Containing Fexofenadine Hydrochloride Prepared by Lyophilization Technique     , Rajendra Kotadiya1 and Bhavin Bhalani2
Objectives: To improve the aqueous solubility and dissolution of fexofenadine HCl, an attempt was made to prepare its fast dissolving tablets by lyophilization technique. Methods: For the preparation of lyophilized tablets (F1-F32), the drug was dispersed in a hydrated solution of water-soluble polymers (gelatin/maltodextrin/acacia) containing glycine and mannitol. The blend was pelted down into the patches of a blister pack, frozen down and then lyophilized. Different characterization parameters viz. differential scanning calorimetry, hardness, weight variation, X-ray diffraction (XRD), scanning electron microscopy (SEM), mercury porosimetry, solubility, wetting time and water absorption ratio, lyophilization tablet index, drug content, in vitro dissolution and stability were evaluated. Key findings: Tablets (F32) containing acacia were found to have fast disintegration and relatively higher mechanical strength with improved drug solubility. X-ray diffractogram and scanning electron micrograph indicated decrease in crystallinity of drug and a good porous structure property for prepared tablet, respectively. Dissolution study showed complete drug released within 5 min. Moreover, tablets (F32) were found to be stable for one month at 25 ± 2 °C/60 ± 5% relative humidity.
131 Physiochemical Composition of Fig Seed Oil from Turkey     , Nazan Güven1, Ali Gökyer3, AyÅŸenur Koç1, Naime Nur Temiz3, Seher Selvi4, Beril Koparal2, Burçak Deniz DedeoÄŸlu1, Sidika Büyükhelvacigil Öztürk1, Hale Feyza Büyükhelvacigil1, Ramazan Büyükhelvacıgil2 and Ceren Erman1
Fig (Ficus carica Linn (Moraceae)) is a deciduous tree that grows in tropical and subtropical zones [1]. Ficus carica has a broad spectrum of pharmacological activity and is widely used in traditional medicine. Research has found its use in more than 40 areas. Some of these are gastrointestinal, endocrine, respiratory, reproductive system disorders [2]. The fig seed oil contains alpha-linolenic acid (ALA), which is highly beta-sitosterol and herbal omega [3]. It can be used as a supplement in the treatment of diseases such as cardiovascular disorders, gastrointestinal disorders, and diabetes. Fig seed oil can be a good choice for skin hydration when used externally. In our study, the fig seed oil was analyzed by gas and liquid chromatography. In this study where linoleic acid (C18:2) and linolenic acid (C20:0) ratios found in fig seed oil composition were evaluated, the health benefits of two fatty acids were discussed based on the literature.
132 Cost-Effectiveness Analysis of Oral Hypoglycemics for Type-2 Diabetes Mellitus at a Tertiary Care Hospital, Nepal     , Saroj Dhakal, Shrijana Shakya and Shree Krishna Sharma
An observational follow-up study on 63 newly diagnosed Type-II diabetic patients was conducted at Tribhuvan University Teaching Hospital, a tertiary care centre, Kathmandu, Nepal. The aims of the study were to determine demographics, prescribing patterns, drug costs and to analyze the effectiveness of different hypoglycemic therapies. The effectiveness of glucose control was analyzed by Wilcoxon signed rank test. The majority of patients (31%) fell into the age strata of 50-60 years. A total of 63 prescriptions were screened including anti-diabetics drugs and other drugs. The average number of drugs per prescription sheet was 2.72 ± 2.23. Eighty-two percent (82%) of the patients were recommended oral hypoglycemic agents. The prescribing frequency of biguanides was more than sulphonylureas. Biguanides were prescribed more frequently than sulfonylureas. The biguanide monotherapy group (p = 0.001) and the combination of biguanide and sulfonylureas (p = 0.028) were the most effective treatment methods, and the p-value of fasting blood glucose was the lowest at follow-up. Nearly 55% of patients receiving the combination achieved glucose control. In summary, this study reflects the best treatment for patients with diabetes. Future studies of larger patient populations need to evaluate existing treatment models to ensure good practice and quality of care.
133 Identification of a Target Region for Specific Molecular Diagnosis of Human Papillomavirus Subtype 16     , Ketly Rodrigues Barbosa dos Anjos1, Anderson Alves da Silva Bezerra1 and Ana Lisa do Vale Gomes2
Objective: To identify a target region for molecular diagnosis from the E6 region of the Human papillomavirus (HPV). Method: This was a quantitative data research. The sample was composed of sequences from the National Center for Biotechnology Information (NCBI), HPV subtype 16, E6 region, using the following search filters: viruses, genomic DNA/RNA. 3227 sequences were obtained, which were separated according to the country of origin. After selection, the total number of samples consisted of 22 sequences that were aligned in the Clustal/o program, available on the online platform at: https://www.ebi.ac.uk/Tools/msa/clustalo/ and reading it through the Jalview program to identify consensus regions. For the primer design, the FastPCR program was used and the data were attached to a spreadsheet in Microsoft Excel 2010. Results: The consensus sequence among the countries was selected according to the consensus region for the primer design, called the target region, with 95 nucleotides. FastPCR analyzed the sequence and defined 10 pairs of primers, 5 forward and 5 reverse. The primers were selected according to the percentage CG/AT ratio (50%-60%) and the specific temperature of 58 °C, resulting in 3 primer pairs. The pairs were analyzed in the BLAST program, obtaining a 100% identification and query score, identifying other sequences of HPV 16, region E6. Conclusion: The use of a primer with greater specificity will lead to the specific diagnosis of the virus, making possible the early diagnosis and the most effective treatment.
134 Therapeutic Trials of Nigella sativa   , AyÅŸenur Koç1, Nazan Güven1, Sıdıka Büyükhelvacıgil Öztürk1, Burçak Deniz DedeoÄŸlu1, Hale Feyza Büyükhelvacigil1, Ramazan Büyükhelvacıgil1 and Beril Koparal2
Nigella sativa (NS) (Ranunculaceae family) is generally utilized as a therapeutic plant all over the world. The seeds of the plant have a long history of use in different frameworks of medicines and food. N. sativa seeds reveal a broad spectrum of pharmacological activities including immunopotentiation and antihistaminic, antiseptic, antiallergic, anti-hypertensive, anti-inflammatory, and antimicrobial activities. It is known as a source of thymoquinone (TQ), thymohydroquinone, dithymoquinone, p-cymene, carvacrol, 4-terpineol, t-anethol, sesquiterpene longifolene, nigellicimine and nigellicimine-N-oxide, α-pinene and thymol etc. Additionally, this is uncovered that the majority of therapeutic properties of this plant are due to the presence of thymoquinone which is a major bioactive component of the essential oil. The incalculable medicinal properties and therapeutic uses of N. sativa prove its importance as a valuable medicinal plant. The aim of this review is to summarize some important pharmacological studies and phytochemical investigations on N. sativa and isolated principles which can be investigated further to get novel molecules in the search of novel herbal drugs.
135 Some Aspects Affecting the Molecular Mechanisms of Eukaryotic Adaptation under Global Warming , Michael Ivanovich Gill1, Vladimir Pavlovich Novikov2, Lyubov Igorivna Denisyuk3 and Igor Yurievich Gorbatenko4    
Global warming is an irreversible process resulting in the deterioration of living conditions for various organisms, including the most important agricultural species. So-called ς32 factor of Escherichia coli is embedded into the RNA-thermosensor in the λ cIII gene and plays an important role in the regulation of bacterial response to hightened temperatures. Expression of heat/cold-shock genes and some virulence genes in response to temperature changes is coordinated by the genome. There are some known RNA-thermosensors with different structures that provide a functional control of the diversity of cellular processes. The most common RNA-thermosensor is the ROSE-element suppressing expression of heat-shock genes. A common feature is functionally important and it is elimination that makes the RNA-thermosensor insensitive to high temperatures. In this paper we describe molecular sequences (RNA-thermosensor) whose chemical compounds influence on the homeostatic temperature regulation, namely, on the corresponding enzymes. Though the data on RNA-thermosensors we obtained for microorganisms it is maybe possible in the long run to change the animal genome at the molecular level by the insertion of these sequences or cultivation of symbiotic microorganisms, which may be used for production of biologically active compounds. In addition, such insertions would probably be able to reduce the negative effect of high environmental temperatures on living organisms.
136 Spirometric Abnormalities Met among Senegalese Workers Exposed to Chlorine Gas   , Houndjo Salimata Diagne1, Ouattara Rokia1, Mbengue Arame3, Ouedraogo Valentin1, Seck Aissatou1, Sow Abdou khadre1, Diaw Mor1, Toure Maimouna1, Coly Mame Saloum3, Ba Awa4, Sar Fatou Bintou2,3, Ba Abdoulaye1 and Samb Abdoulaye1
Introduction: Chlorine as a disinfectant has many side effects on respiratory function. This respiratory toxicity may be related to the exposure time. Materials and Methods: Measure the impact of the duration of chlorine gas exposure on the respiratory function of Senegalese workers who work in the national water production factory: Senegalaise Des Eaux (SDE), aged 35-54 years. Twenty-four (24) male subjects exposed to chlorine gas were divided into two groups, one (35-44) and the other (45-54). Clinical examinations were performed on each employee, followed by chest x-rays and spirometry. We included all subjects whose first or last two spirometry results were normal. Results: In the 35-44 years group, 50% of subjects had disturbed spirometry including 41.6% of obstructive syndrome (OS), at the second spirometry and 8.3% had a restrictive syndrome FVC at -25%, at the 3rd spirometry 4/12 had a normal spirometry. The duration of exposure was 10 years. For subjects in 45-54 years, 8/12 had persistent OS or accentuated, then at the 3rd spirometry we had 10 subjects. The duration of exposure was 17.5 years. Conclusion: Compared with (35-44) group, older (45-54) subjects had significant OS, which may be related to duration of exposure.
137 Antimicrobial Activities of Desert Truffle Extracts and Their Chemical Identification   , Dib-Bellahouel S. and Fortas Z.
Desert truffles are edible mushrooms and they belong to groupe of ascomycetes. In Algeria, we find them in arid and semiarid area. They are represented by two most genuses: Tirmania (white terfez) and Terfezia (red terfez). The aim of our work is to present extraction technics of the bioactive substances from gleba (ascoms) of Tirmania pinoyi (Maire) Malençon and from the culture filtrate of mycelium of Terfezia claveryi Chatin. Also, we present antifungal and antibacterial activity of these substances in vitro and their identification. There is antifungal activity of different extracts on solid medium, in vitro, against species of Aspergillus, Fusarium, Gliocladium, Candida. Also, there is antibacterial activity against species of Staphylococus, Streptococcus, Bacillus, Enterococcus, Escherichia, and Salmonella. Results show that extracts inhibition varies according to microbial tested species. Bioactive substances of the different extracts were analyzed by GC (gas chromatography)-mass, RMN (Nuclear Magnetic Resonance) and infrared in order to determine the chemical identity. Results show that these substances contain pyrazines and cyclic compounds like quinones.
138 Nectandra acutifolia (Ruiz & Pav.) Mez (Lauraceae) Reduces Oxidative Stress Induced with Rotenone in Drosophila melanogaster     , Lina María González and Oscar Marino Mosquera
The increase in the population of neurodegenerative diseases has made it necessary to search for new drugs and phytopharmaceuticals for the prevention or treatment of these diseases, which is why the exploration of the potential of the plants present in the coffee zone is of great importance. The objective of this study was to determine the possible neuroprotective effect of the species Nectandra acutifolia. The methanolic extract of Nectandra acutifolia was obtained through maceration of the aerial part of the leaves. The phytochemical profile was detected by means of thin layer chromatography. The evaluation of the antioxidant capacity was carried out by means of the colorimetric techniques of DPPH• and ABTS•+. On the other hand, the total content of phenols and flavonoids was determined as well as the neuroprotective activity, by means of the negative geotaxis test and biochemical tests. Finally, the methanolic extract of N. acutifolia showed a high antioxidant capacity through the two colorimetric methods. The negative geotaxis test revealed that the concentration of 0.1% had a greater locomotor effect in D. melanogaster, which was used as a supplement in the feeding of the Drosophilas. The results showed that the methanolic extract of this species has neuroprotective activity using this in vivo model.
139 Tumor-Infiltrating Lymphocytes in Primary Tumor and Bone Marrow in Patients with Gastric Cancer and Overweight   , Larissa Nikitichna Bubnovskaya1, Viktor Michailovich Mikhailenko1, Sergey Pavlovich Merentsev2 and Dmitriy Sergeevich Osinsky2
Immune infiltration in human tumors is a key prognostic factor. In this aspect it has to be noted that the publications concerning the tumor-infiltrating lymphocytes (TILs) under overweight and obesity are limited, especially in the clinical setting in particular concerning gastric cancer. This study has shown that density of TILs consistently associated with body mass index (BMI) and density of cancer-associated adipocytes (CAA) in tumors, decreased significantly in patients with BMI > 30 having high density of CAA. Hypoxia in tumor does not affect this process. Patients with BMI > 30 having high density of CAA with slight infiltrating of TILs in tumors demonstrated better overall survival than the same patients with BMI < 25 whereas the same patients with BMI < 25 but with low density of CAA have shown much longer overall survival. Presence of TILs in BM was not affected by both the high density of CAA and level of hypoxia in primary tumor; moreover it has not been associated with BMI as well as patients survival time. Understanding the metabolic changes that occur in obese individuals may help to pave the way for more effective treatments for patients with gastric cancer having overweight.
140 Pentalogy of Cantrell with Total Ectopia Cordis and a Major Omphalocele—A Case Report     , Arturo Leonardo Delgado, Kopolo Mfuneko Matongo, Bangasa Dumo, Ntsikelelo Mzayiya and Busisiwe Mrara
Ectopia cordis (EC) is a rare malformation due to failure of maturation of the midline mesodermal components of the chest and abdomen. It can be defined as 0.1% of congenital heart diseases, and it could present isolated or could belong to the spectrum of the Pentalogy of Cantrell (PoC), which is a rare congenital disorder first described in 1958 by Cantrell. We are reporting a rare case of total ectopia cordis, associated to a major omphalocele, total agenesis of the sternum, anterior diaphragmatic deficiency, absence of pericardium, and persistence of the Ductus arteriosus, making therefore these features compatible with a full spectrum of the Pentalogy of Cantrell, encouraging us to report this case.
141 Myxoid Degeneration of Ovarian Tumor in Young Patient, Laparoscopic Approach     , Sofoudis Chrisostomos1, Dedoulis Evaggelos2 and Zioris Konstantinos2
Myxoid degeneration of ovarian tumors represents a rare distinctive benign ovarian stromal neoplasm that occurs predominantly in young women and is hormonally inactive. According to recent bibliography, pathogenesis remains controversial. Many conducted studies express the strong belief adjusting myxoid ovarian tumors with genetic abnormalities. Therapeutic mapping is associated with histologic confirmation of the lesion. In cases of premenopausal patients, fertility preservation consists of ultimate scope. Abdominal MRI (magnetic resonance imaging) along with transvaginal ultrasound can differentiate and depict all preoperative imaging findings. Myxoid degenerated ovarian tumors can be malignant transformed into myxoid leiomyosarcomas with extremely metastatic possibilities. Meticulous atomic history, proper laboratory and imaging findings reflect successful key concerning ultimate diagnosis and treatment.
142 Assessment of Laryngeal Mask Airway in General Anesthesia during Thyroidectomy without Applying Miorelaxants     , Aynur Isayeva
The selective approach of anesthesia has a crucial role in the surgical treatment of thyroid diseases. Anesthesia during the insertion of a laryngeal mask airway is an alternative instead of endotracheal tube, hence this is a novel period in anesthesiology.
143 Analysis of Calcium and Phosphorus in Pregnant Women’s Oral Fluid in the Republic of Belarus   , Butvilovsky Alexsander1, Bulatova Victoriya1, Volchok Anastasia2 and Huzei Iryna3
A change of the saliva biochemical components during pregnancy affects on enamel and it’s resistance to microorganisms of the oral cavity. It is necessary to prevent an increase of pathological processes. Determining the concentration of calcium and inorganic phosphorus in oral liquid by photometry is the rational method of mineralization potential. The concentration of calcium and phosphorus in pregnant women’s oral fluid was not measured in the republic of Belarus nor compared with standard indicators. In this case, we should take appropriate actions related with calcium and inorganic phosphorus concentration in oral fluid of pregnant women to avoid oral diseases such as caries and sanitize oral cavity in time.
144 Postpartum Maternal Mortality and Pulmonary Embolism: A Case Report     , Neda Dodange
Introduction: Pregnancy and postpartum are very high-risk periods for venous thromboembolism events (VTE), which seems to extend far beyond the classical 6-8 weeks after childbirth. Case presentation: The patient was a 33-year-old, 158 cm, and 70.5 kg 2 gravida on the sixth day of the 40th week of pregnancy, and she was hospitalized on the 7th day before vaginal delivery for gestational diabetes mellitus (GDM). Vital signs were normal at the time of hospitalization. The results of the blood test and urinalysis during hospitalization were all normal. Only sign of the patient during the hospitlization was pale. Unfortunately, the patient 3 days after discharge referred to the health facility with dyspnea and died. Other patient was 28-year-old,155 cm, and 72 kg 1 gravida, and he was hospitalized on the 3rd day before vaginal delivery for thrombocytopenia. Last complete blood count (CBC) plt was 118,000. She had no personal or family history of thromboembolism. Unfortunately, the patient 2 days after discharge referred to the health facility with dyspnea and died. Conclusion: The diagnosis of PE was confirmed by autopsy. The maternal mortality of PE during pregnancy and postpartum period is quite high. Whenever there is any doubt, objective examinations for PE should be started early in order to strive for the chances of the anticoagulant therapy. Essentials: The evidence on how to manage life-threatening pregnancy-related pulmonary embolism (PE) is scarce.
145 Allosteric Regulation of Dual Function of Thrombin , Preetpal Singh Sidhu
Thrombin is the most important and highly targeted protease in coagulation cascade to develop anticoagulation therapy. It has dual function in coagulation system and highly regulated by allosteric mode. Based on binding by various protein and peptides in exosite 1 and 2, it can act as pro-coagulant or anti-coagulant. The fine regulation of these two conflicting actions of thrombin is required to maintain the homeostasis. Besides exosites, binding of single sodium ion at sodium binding site can also modulate the dual action of thrombin. Various single point mutations can convert pro-coagulant to anti-coagulant thrombin and vice versa. Dual nature an dallostery of thrombin makes it the most important regulator of coagulation cascade.
146 Indoleamine-2,3-Dioxygenase Activity in Pulmonary Tuberculosis , Kamlesh Kumar Swami
TB (Tuberculosis) continues to be a major health problem and there are few biomarkers for predicting prognosis. IDO (indoleamine-2,3-dioxygenase) is a potent immunoregulatory molecule that catalyzes the rate-limiting step of Trp (tryptophan) degradation in the Kyn (kynurenine) pathway. An increased SIDO (serum Indoleamine-2,3-dioxygenase) activity can be determined by serum Trp: Kyn ratio. In recent years, tryptophan metabolism and its rate limiting enzyme IDO have attracted increasing attention in the diagnosis and prognosis of infectious diseases. These studies suggest that serum IDO activity can be used as a novel prognostic maker in PTB (pulmonary tuberculosis).
147 Comparison of the Carbon Nano Tube Field Effect Transistor Based Immunosensor and ELISA for Detecting BRCA1 from Mouse Serum     , Moon-Jun B. Kim1, Soohyun Woo2, Ji Won Kim3, Yeonsuk Kim4, Michelle E. Kim5 and Sung-Jae Chung6
We investigated the applicability of using CNT-FET (carbon nanotube field effect transistor) based biosensor as a diagnostic instrument in transgenic mice that are a preclinical model of human BRCA1-related breast cancer. The important factors for the development of effective biosensors were high sensitivity and simplification of the pretreatment process. We were able to lower the detection limit to a protein concentration of 1.0 ng/mL, without cutting antibody or labeling the target proteins. Both the IGF-1 (insulin-like growth factor 1) immunoassay and the CNT-FET gave comparable results; however, the CNT-FETs were much faster than the immunoassay. Additionally, the low sample volume required by CNT-FETs can be especially advantageous for studies constricted by limited amount of human clinical samples and for mouse studies, since animals often need to be sacrificed to obtain enough serum for biomarker evaluation.
148 Development of 166Ho Poly Lactic Acid Microspheres for Radiosynovectomy     , Kamal Yavari1, Khodabandehloo Hadi2, Taghikhani Mohamad2, Majid Mazidi1, Kalantari Bagher1, Reza Solhifam Asl1 and Mohammad Ghannadi Maragheh1  
Microsphere and particle technology with selective transport of radiation represents a new generation of therapeutics in radiosynovectomy. 166Ho-PLLA-MS (Poly L-lactic acid microspheres loaded with holmium-166 acetylacetonate) are novel microdevices for intra-cavital radiosynovectomy in this work. 166Ho- PLLA agent was developed and quality controls of the compound were described. 165HoAcAc-PLLA microparticles were prepared by dissolving holmium acetylacetonate and incorporating into PLLA spheres by the solvent evaporation technique. Microspheres were irradiated at TRR (tehran research reactor). The diameter and surface morphology were characterized by particle sizer and SEM (scanning electron microscopy) before and after irradiation. The complex stability, radiochemical purity and in vivo biodistribiotion were checked in the final solution up to 3 days. In this study, 166Ho-PLLA spherical particles with a smooth surface and diameter of 5-10 µm were obtained, which were stable in vitro and in vivo studies. Neutron irradiation did not damage the particles, and heightened activity stimulated radiosynovectomy. No significant leakage of dose from injection site and its distribution in organs was observed up to 3 days for 166Ho-PLLA. The ease with which the PLLA spheres could be made in the optimal size range for later irradiation and their ability to retain the 166Ho made them attractive agents for radionuclide synovectomy.
149 (Z)-Butylidenephthalide Restores Temozolomide Sensitivity to Temozolomide-Resistant Malignant Glioma Cells by Downregulating Expression of the DNA Repair Enzyme MGMT   , Horng-Jyh Harn1, 2, Syuan-Rong Chen3, Mao-Hsuan Huang4, Po-Cheng Lin5, Fong-Jia Syu3, Dean-Kuo Hsieh6, Ssu-Yin Yen3, Shinn-Zong Lin7, 8, 9, 10 and Tzyy-Wen Chiou3
Temozolomide, an alkylating agent against high-grade astrocytomas such as GBM (Glioblastoma Multiforme), is the leading compound in a new class of antitumor drugs. Altered methylation by MGMT (O6-methylguanine-DNA-methyltransferase) leads to temozolomide-resistant GBM. Thus, inhibition of MGMT activity is necessary for temozolomide effectiveness. Here we show a synergistic cytotoxic effect on the GBM cell line 8901 with a low dose of (Z)-butylidenephthalide combined with temozolomide. Using CalcuSyn software to analyze the combination index of (Z)-butylidenephthalide and temozolomide, we observed significant synergism in decreasing MGMT expression. We next investigated the effect of (Z)-butylidenephthalide on a temozolomide-resistant cell line GBM22-TMZ and examined changes in MGMT. The combination of 50 μM or 100 μM (Z)-butylidenephthalide with 1,600 μM temozolomide yielded a combination index of 0.649 or 0.581 (an index < 1 indicates synergism), indicating that increasing (Z)-butylidenephthalide enhanced the synergism. In addition, (Z)-butylidenephthalide enhanced MGMT promoter methylation and decreased MGMT expression in a dose-dependent manner. Using a GBM22-TMZ xenograft tumor model, (Z)-butylidenephthalide combined with temozolomide showed significant antitumor effects compared with a single drug. Finally, a survival study with Kaplan-Meier statistical analysis demonstrated a significant benefit of the (Z)-butylidenephthalide/temozolomide combination compared to temozolomide alone. In summary, the combination of (Z)-butylidenephthalide and temozolomide shows potential clinical relevance for treating temozolomide-resistant GBM.
150 Annexin II Proteins: An Evaluation for Type 1 Diabetes Mellitus   , Filiz Bakar1, UÄŸur Ünlütürk2, Nilgün BaÅŸkal2 and Serpil NebioÄŸlu1
Annexin II (AnxII) has diverse functions including anti-coagulant activity. The studies have suggested that antibodies against annexin II (aAnxIIs) might induce thrombosis by inhibiting plasmin generation in the course of autoimmune diseases. Type 1 diabetes mellitus (DM) is also an autoimmune condition that related with thrombotic complications, but there is no study regarding aAnxII/AnxII in this disease setting. The aim of this study was to evaluate the status of AnxII and aAnxII in patients with type 1 diabetes mellitus. One hundred twenty-five patients with type 1 DM and 92 healthy controls were enrolled to the study. Serum AnxII and aAnxIIs levels were quantified by enzyme-linked immunosorbent assays. The AnxII gene expression analysis was performed by Real Time PCR. As compared to controls, patients with type 1 DM had significantly higher serum AnxII levels. There were no significant differences in terms of aAnxII levels and AnxII gene expression between patients with type 1 DM and healthy controls. The present study shows that AnxII levels are increased in patients with type 1 DM. Further studies are required to determine the clinical importance of AnxII protein in type 1 diabetes.
151 Ameliorative Effect of Tecoma stans Extract on Diabetic Cardiomyopathy against Streptozotocin-Induced Diabetes in Wistar Rats   , Kameshwaran Sugavanam1, Raju Senthilkumar2 and Thenmozhi Shanmugam2
The pathogenesis of diabetic cardiomyopathy (DCM) is complex, and the therapeutic options available to treat DCM are limited. The present study was designed to investigate the effect of ethanolic extract of Tecoma stans on diabetic cardiomyopathy against streptozotocin-induced diabetes in wistar rats. Diabetes was induced by a single intravenous injection of (Streptozotocin 45 mg/kg) in male wistar rats. Blood pressure, serum lactate dehydrogenase (LDH), glucose apolipoprotein B and lipids as well as heart weight, caspase-3, sodium potassium adenosine triphosphatase (Na + -K + ATPase) and DNA laddering were determined. The obtained result showed that the administration of ethanolic extract of Tecoma stans (120 mg/kg/p.o.) significantly ( P < 0.01) reduced myocyte loss by suppressing the levels of cardiac caspase-3, DNA laddering; mean arterial blood pressure and heart rate as well as serum LDH, glucose, apolipoprotein B and lipids levels. Further, it augmented the heart weight and cardiac Na+ K+ ATPase activity in diabetic rats. Finally it was concluded that the ethanolic extract of Tecoma stans posses significant anti-apoptotic potential on Streptozotocin induced diabetic cardiomyopathy.
152 Protective Effect of Taurine in the Induction of Genotoxicity by Mutagenic Drugs , Priscila Longhin Bosquesi, Cauê Benito Scarim, José Ricardo Soares de Oliveira, Ednir de Oliveira Vizioli, Jean Leandro dos Santos and Chung Man Chin
Genotoxicity is a toxic action of several drugs, such as anti-neoplastic and nitro-related compounds. TAU (Taurine, 2-aminoetano sulfonic acid) is an important and potent antioxidant amino acid involved in the maintenance of homeostasis in many systems like leukocytes, skeletal muscle, the heart, the kidney, the liver, the bowel, the brain and the retina. The aim of this work was evaluated by the protective effect of TAU co-administered with mutagenic drugs such as benznidazole, cyclophosphamide, hydroxyurea, metronidazole, and nitrofurazone in an in vivo model using a micronucleus assay, evaluatation for the ability of different substances to promote DNA injury. The results showed that TAU decreased genotoxic activity of all drugs suggesting that the protective action of TAU supplementation can be beneficial to reduce genotoxicity of drugs. In this context, we propose one possible mechanism for how TAU blocks the chromosomal aberrations caused by the action of genotoxic substances.
153 Recent Advances in Therapeutics for B-Cell Lymphoma , Yasuhito Terui
Objectives: The molecular targeting drugs for the treatment of B-cell lymphoma have been dramatically developed. Recently, novel drugs of monoclonal antibodies and small molecules are approved by US FDA (Food and Drug Administration). Key Findings: This review summarizes characteristics, mechanisms, and results of the trials in the novel molecular targeting drugs for B-cell lymphoma such as obinutuzumab, polatuzumab vedotin, ibrutinib, idelalisib, and venetoclax. Summary: As a novel anti-CD20 antibody, obinutuzumab has been clinically developed on going. ADC (antibody drug conjugate) against CD79b molecules is also developed for B-cell lymphoma. BCR pathway is one of the most crucial pathways, and ibrutinib is a BTK (Bruton’s tyrosine kinase) inhibitor that is under development for the treatment of B-cell malignancies, including CLL (chronic lymphocytic leukemia), MCL (mantle cell lymphoma), and DLBCL (diffuse large B-cell lymphoma), as well as FL (follicular lymphoma). BCL-2 family dysfunction and impairment of apoptosis are common in most B-cell lymphoid malignancies. Venetoclax, which is a highly selective BCL-2 inhibitor, a mimic for its BCL2 homolog 3-domain to induce apoptosis, is also reported to be active against B-cell malignancies. Conclusions: Mechanism-based combination regimens including these drugs may be required in the future. 
154 Magnetic Resonance Imaging in the Acquired Demyelinating Disorders: A Pediatric Cohort Study , Santa Ignêz L. J.1, Silveira de Souza A.2, Amâncio A. P. R. L.1, Almeida J.V.1, Gamarano G. M. F.1, Costa A. A. B. P1, Tovar-Moll F.2, 3 and Saad T. R. D.1
Objective: Describing the characteristics of the MRI (magnetic resonance imaging) of patients with ADD (acquired demyelinating disorder) followed in a specialized pediatric clinic. Methods: Descriptive and retrospective study of the MRIs of a pediatric ADD cohort. The included images were acquired in machines with 1.5 or 3T magnets. Low-quality images were excluded. The radiological characteristics of the lesions were described using the 2010 Revised McDonald Diagnostic Criteria regarding localization, contrast enhancement and optic nerve alterations. Results: Twenty-three patients were included (55% female). The mean age of the first clinical event was 7.7 years. Most common diagnosis was Clinically Isolated Syndrome (35%), followed by Multiple Sclerosis (30%), Neuromyelitis Optica (17%) and Acute Disseminated Encephalomyelitis (17%). Mean time elapsed until diagnosis was 1.8 years. Follow-up MRIs of ADEM patients showed complete or partial resolution of lesions; MS lesions were mostly localized in the brain and four patients had contrast enhancement of lesions in their last available MRI. All NMO (neuromyelitis optica) patients had extensive spinal lesions, and two had optic neuritis. All patients with CIS (clinically isolated syndrome) had focal spinal lesions and evolved with radiologic improvement. Conclusions: ADEM and CIS patients’ MRIs showed lesion reduction, while MS and NMO patients developed new lesions during follow-up.
155 The Usage of Laser Doppler Flowmetry for Evaluation of the Efficiency of Ozone-Containing Drugs for External Use , O. Grechkanyova, O. Bitkina, S. Peretyagin, P. Peretyagin, I. Gabasov and P. Razheva
Ozone-containing drugs for external use are the new trend in applying of medical ozone-oxygen mixture. For the last few years the majority of manufacturer countries have produced wide lines of ozone-containing cosmetics, which were presented in various ozone therapeutic congresses. Its properties are used in dermato-cosmetology for correction of the changes associated with aging, promoting regeneration, shortening the recovery period after surgeries or chemical peelings. The article presents the results of LDF (laser Doppler flowmetry) study of skin’s blood dynamics in response to applying cosmetic gels containing different amounts of active oxygen in the form of ozonides, Comparative analysis of the three-patient groups allowed us to draw a conclusion about the accumulating stimulating effect of the “Ozodermis” 10% cream on skin’s microcirculation, which makes it perspective for use as in healthy people for improving one’s skin condition, as well as in people suffering from diseases, the key roles in pathogenesis of which are disorders in the skin’s microcirculation (exampli gratia: vasculitis, severe forms of atopic dermatitis). 
156 Studies on Cardiac Cytoarchitectonic and Biochemical Indices in Pregnant Streptozotocin-Induced Diabetic Rats Treated with Gliclazide and Insulin , Olojede Samuel Oluwaseun1, Lawal Sodiq Kolawole2, Medubi Leke Jacob1, Adekoya Abimbola Julius1, Esubi Juan Uche1 Dauda Feyikemi Funmilayo1, Buhari Muhammed Olanrewaju3 and Osinubi Abraham Adewale1
Introduction: GDM (gestational diabetes mellitus) is a common complication of pregnancy, and prevalence has become alarming. Insulin remains the cornerstone in management of diabetes mellitus but oral agents have been increasingly viewed as potential alternatives to insulin because it’s economically low in cost, easier to administer and affordable to monitor compare to insulin. Aim: This study aimed to determine the effects of Gliclazide on the heart cytoarchitectonic and some biochemical indices of pregnant STZ (streptozotocin)-induced diabetic rats compare with insulin. Methods: Twenty (20) pregnant Sprague Dawley rats weighing between 130 g and 150 g were used for the experiments. The rats were divided into four (4) groups: Group 1 (Non-diabetic), Group 2 (Diabetic), Group 3 (Diabetic + Gliclazide) and Group 4 (Diabetic + Insulin). The glucose levels and body weights were monitoring daily. The experimental rats were sacrificed on the 19th on gestational period, blood samples and organs were collected for biochemical and histo-morphological examinations. Results: Gliclazide group rats showed significant increase in body weight compared with diabetic group (p ≤ 0.05). The blood glucose level of rats in gliclazide group was significantly reduced compared with other groups. There was significant increase in reduced GSH (glutathione) of gliclazide and insulin groups compared with diabetic group. MDA (malondialdehyde) and CAT (catalase) levels activities were significantly increase in diabetic group compared with other groups. Hormonal profiles and hematological parameters are significantly increased in gliclazide, and insulin group compared with diabetic group. There were distortions in the structural organization of heart of diabetic group while gliclazide and insulin groups showed remarkable improvements of the degenerative changes of the myocardium. Conclusions: Gliclazide glycemic control has shown beneficial effects on the cardiomyocytes damage in STZ-induced diabetic rats by maintaining the histological integrity of the heart leading to reduced degenerative changes in the myocardium.
157 Liver Histology after Chronic Use of Alcohol and Exercise Training in Rats , Marina Silva de Lucca1, 2, Eveline Torres Pereira2, Thamires Righi3, Camilo Amaro de Carvalho1, Clayton Israel Nogueira1, Daise Nunes Queiroz da Cunha4, Antônio José Natali2 and Luciana Moreira Lima1, 2
Objectives: To investigate the effects of physical training on the liver morphology and morphometry after chronic use of alcohol in rats. Methods: Twenty-four Wistar rats were housed in cages with controlled environment and randomly divided into four groups according to treatment received. In the initial treatment, alcohol was administered to SA (sedentary alcohol) and EA (exercise alcohol) groups. After four weeks, physical training program was held on a treadmill with EA and EC (exercise control) groups. Area, perimeter, maximum and minimum diameter and form factor of nucleus and cytoplasm of hepatocytes were analyzed. Key findings: Micro-vesicular fatty degeneration, predominantly pericentrolobular, of mild to moderate intensity, was found especially in animals treated with alcohol. EC group showed nucleus area greater than the nucleus area of EA and SA groups. The form factor was lower in the EC group than in the EA group. EA group showed maximum cytoplasm diameter is smaller than in SC (sedentary control) group. Conclusions: Physical training for two weeks was not enough to suppress histopathologic changes in the liver caused by chronic use of alcohol in rats. Chronic use of alcohol seems to have minimized the beneficial effect of physical training in the nucleus area of hepatocytes.
158 Basic Knowledge and Attitudes to Promote Safe Behaviours to Grade 8 Learners Concerning Burden of Diseases Including HIV/AIDS , P. Nqabeni
This paper focuses on knowledge and attitudes of Grade 8 pupils about HIV/AIDS and opportunistic diseases. In particular, people need to know what it is, how it is transmitted, how to protect themselves from it, and how to relate to people with the disease. According to the National policy for HIV/AIDS, schools are key settings for educating children about HIV/AIDS and for halting further spread of the infection. It has been noticeable that Grade 8 pupils in the rural areas around Mthatha district are particularly at risk of getting HIV. The focus is often more on Grade 11 and 12 pupils, so female Grade 10 pupils look for boys for attention. This resulted for the female pupils to fall pregnant. The fact that some of them are falling pregnant means they are also more vulnerable to contracting HIV. This shows that little information is available for them and this paper is contributing to that body of knowledge. Prevention therefore is the most effective strategy to combat pregnancy and against the spread of HIV/AIDS in schools. Measures should be taken to remove the social, cultural and political barriers that might block access to HIV/AIDS services and programmes. The results showed that while some Grade 8 pupils are aware of HIV/AIDS, there are others who said it does not exist. It has also been highlighted that the phenomenon of pupils having unprotected sex with older men for money, as well as pupils saying they did not have time to use condoms. It is therefore recommended that pupils need to have role models, people they can look up to. In the absence of parents, it should be teachers’ responsibility to advise the pupils and inform them about Sexually Transmitted Infections (STIs) and HIV/AIDS in schools.
159 Evaluation of Abuse Drugs and Clinical Laboratory Tests Variations in Whole Blood & Urine Samples of Abusers , Majid Rezaei Basiri1, 2, 5, Mojgan Behshid2, 3, Alireza Najafi4, Saleh Alilou5, Haniyeh Mohebbi-Kamali5, Fatemeh Hosseindoust5, Marziyeh Mokhtari5, Valiyollah Watani5, Ladan Aminzadeh5, Fatemeh Seyed Nejad5, Ashraf Razavi5 and Ligha Saadat5
In this study, five hundred urine samples and five hundred blood samples of abusers were examined for the presence of alkaloid substances and abuse drugs in urines and bloods. These numbers of blood and urine samples of addicts in clinics of welfare organization, during detoxification treatment or maintenance treatment were screened for abuse drugs presence. The all of samples were tested through as a view of clinical laboratory methods. Age ranges of female patients were 35 ± 15 and age range of males patients were 45 ± 15. All patients filled questionnaire and satisfy forms too. First, all fresh urine and blood samples were examined to confirm presence drugs abuses, depend on their addiction and treatment, so all samples were confirmed by two tests. Then they were examined to other clinical laboratory tests. All data were analyzed by t-test and were Anova one way and two ways of Anova Turkey, and p < 0.05 was considered significant. The p-value of this study was p = 0.0001. The results of this study were showed that 4% of abusers had mild increase in hematocrite level and 2% of narcotic drugs abusers had mild lower level of blood sugars than normal range and 4% of participants had increase liver enzymes such ALT (alanine transferase), AST (aspartat transferase), ALP (alkaline phosphatease) and 1% of them had renal failure. Although blood level BUN (blood urea nitrogen) and creatinin were examined to evaluation of their renal failure .The results in Tabriz/Iran undrevision of welfare organization clinics were approximately showed that positive results of addiction are in each of urine and blood samples. Because some of abusers directly consumed full long time agonist or partial agonists’ drugs such as methadone and buprenorphine for their maintenance therapy in clinics. Also doing test on blood samples has high importance in distinguishing and confirmation of drugs abuse in samples. Also in this study we conclude that among all drug analytical methods the cheapest and easiest test to screening opioids and other abuse drugs in urine and blood samples is strip test for rapid diagnosis, also tests on blood samples have high importance as a view point of accuracy to distinguishing of drugs abuse, and serum levels of some other parameters showed all abusers patients situation such as liver and renal dysfunction through clinical laboratory tests.
160 Analysis of the Technical and Sanitary Constraints of the Traditional Breeding of Guinea Fowl in “Région des Savanes” of Northern Togo , Yao Lombo 1, 2, Kokou Tona 2 and Bèdibètè Bonfoh 1
A survey to determine the causes of mortality of guinea fowl and the technical and sanitary constraints of the traditional breeding of guinea fowl was carried out among 106 poultry farmers from the Savannah Region in North Togo. The survey also made it possible to identify the breeding constraints and the endogenous practices of rearing of the guinea fowl. The results obtained from the investigations are: (i) the high rate (69.81%) of illiterates is not conducive to the definition or control of plans for prophylaxis and rationing. (ii) Breeders are unaware of disease-resistant strains of guinea fowl. (iii) Guinea fowl breeding starts with traditional methods, with 33.96% of the breeders who leave the guinea fowl in the wilderness and 13.21% who breed them in conflagration pell-mell. (iv) The formulations of food rations in order to satisfy the nutritional requirements of guinea fowl are virtually non-existent. The sources of proteins sometimes supplemented are only termites. However, food imbalance leads to growth lags. (v) Prophylaxis plans are not followed by breeders. Fifty two percent (52%) of the breeders self-medicate and other breeders (9.43%) do not treat. Several plants are used alone or in combination to control poultry diseases. (vi) biosecurity measures are non-existent in the farms (48.11% of the farmers give the dead guinea fowl to the children for consumption and 66% of the breeders throw the dead guinea fowl in the wild). (vii) The major constraints identified in this investigation are the remoteness of the veterinary supply centers, the lack of access to quality veterinary services, the low rate of training of farmers, the inadequate support of pastoralists livestock equipment; (viii) the problem of predators (93.40%) and the problem of access to effective veterinary products (79.25%) were noted.
161 Evaluation of the Effectiveness of Three Methods of Protecting Guinea Fowl from Mortalities Used in Traditional Breeding in Northern Togo , Lombo Yao1, 2, Tona Kokou2 and Bonfoh Bèdibètè1
A study on the evaluation of the effectiveness of three traditional methods of protecting guinea fowl from mortality was carried out at CRA-SS (Centre de Recherche Agronomique de la Savane Sèche) in northern Togo. Guinea fowl were divided into 5 batches, of which 3 batches received prophylactic medical treatment including plant decoctions, the 4th batch was followed by a medical prophylaxis program as a control group and the 5th batch considered as a negative control, has not received any prophylactic treatment. The results showed that a mortality rate of 25% for the reference lot and two other batches which received plant decoctions (Euphorbia poissonii or Khaya senegalensis) were recorded against a rate of 87.5% in the batch of guinea fowl which received the decoction of Pteleopsis suberosa. Meanwhile, regardless of weight growth, daily average gain (GMQ) or food consumption, no significant difference was observed (p > 0.05) between the guinea fowl that received a baseline health monitoring and those having taken the decoction of E. poissonii. On the other hand, the values recorded in these two batches of guinea fowl differed statistically from those in the guinea fowl that received the decoction of K. senegalensis. Although the decoction of K. senegalensis has a protective effect in guinea fowl, the growth of guinea fowl has been slowed down. On the basis of these results, it appears that two endogenous practices tested (K. senegalensis or E. poissonii) have positive effects. However, it would be desirable to carry out a toxicity test in order to determine the recommended doses.
162 Excessively High Urinary Beta 2-Microglobulin Level: A Sign of Pathology or Laboratory Error? , Gulsum Feyza Altas¹, Pinar Akan¹ and Erkan Cagliyan²
Measurement of urinary β2M (beta 2-microglobulin) is a sensitive and reliable assay for detecting tubular injury, renal toxicity, lymphomas, leukemia, or myeloma. Some chemical substrates may increase the level of β2M in-vivo. Elevated β2M level in urine is unusual because it rapidly degrades when pH is below 6. The level of β2M in the bladder can also be used as a marker to assess renal tubular maturation in neonates. β2M in the bladder could be a result of fetal megacystis, which is an abnormally enlarged bladder appearing after 10 weeks of gestation, when the fetus begins to produce urine. Identification of the pregnant women instead of the fetus is a common pre-analytical error with samples sent from the gynecology clinic to the laboratory. Here we present the case of a 24-year-old pregnant woman whose urine analysis results indicated excessively high β2M level in the urine. The present study could improve the understanding of urinary β2M analysis, laboratory errors, and the interpretation of test results.
163 Pharmaceutical Care in Homeopathic Treatment , Luciana Ferreira Mattos Colli and Palloma Valle Napolitano
Homeopathy is a therapy based on the principle of similarity. This therapy was proposed by the father of medicine, Hippocrates for almost 3000 years, thus developing the principle “Similia similibus curantur”. Therapy with homeopathic medicines is widely used in therapeutics, but the patient often has difficulty in understanding how the treatment should be conducted. The Pharmaceutical Care, one pact relationship between patient and pharmacist, presents itself as an appropriate tool to assist in obtaining positive results in homeopathic therapy. Objectives: to demonstrate how the pharmacotherapeutic follow—AFT assists in detecting and solving problems related to homeopathic medicine and promotes improvements in response to treatment. Methodology: we performed literature review of the portals: SCIELO, MEDLINE and Google academics. Patients were interviewed by pharmacotherapeutic monitoring that was conducted—AFT employing the Dader method adapted to pharmaceutical care in homeopathic medicines in a pharmacy, this place was located in Rio de Janeiro, from November-December 2010 and January 2011. The research was previously approved by the Research Ethics Committee of the Unigranrio (CAAE: 4531.0.000.317-10). Results: the first of three interviews were identified DRM (drug related problem), having been required to apply IF—pharmaceutical intervention to adjust the behavior of the patient regarding the treatment and improvement of the results. Conclusions: the pharmacotherapeutic follow—AFT—introduced himself as appropriate methodology for managing patients on therapy with homeopathic medicines, and an improvement factor in the outcome of treatment of the patients.
164 Adipose Derived Stem Cell on the Regeneration of Irradiated Mandible of Adult Rabbit Submitted to Distraction Osteogenesis , M. M. Soares, H. Segreto, A. Aloise, and L. M. Ferreira  
Purpose: To evaluate the effect of adipose derived mesenchymal stem cell (ADSC) on the regeneration of irradiated mandible submitted to distraction osteogenesis on adult rabbits. Methods: Ten adult rabbits were selected and the dorsal fat was harvested for isolation, dissociation and culture of adipose derived adult mesenchymal stem cells. The mandibles were irradiated on a single dose of 20 Gy. After 30 days the animals underwent mandibular lengthening by distraction osteogenesis. After 10 mm of lengthening, the animals were distributed into two groups. Saline solution (1 mL) was injected the control group, and supplemented with ADSC, on the study group. After 4 weeks the mandibles were removed and evaluated by tomography and histomorphometric analysis. Histomorphometric was obtained and statistical analysis done by Mann-Withney test (p > 0.05). Results: The tomography shows a significant improvement on the Hounsfield scale for lateral fibrovascular zone (114.5 ± 9.7 control group to 148 ± 24,       p = 0.0045) and central fibrovascular zone (37 ± 13.4 control group to 96 ± 41.8 on study group p = 0.0045). The Histomorphometric analysis demonstrated an increase area of new bone formation. The mineralized area was of 61.2 ± 9.9% in the study group and    31.3 ± 10.6% in the control group (p = 0.0045) for the central fibrovascular zone, 79.1 ± 9.1% in the study group and 39.1 ± 14.7 on control group for anterior fibrovascular zone (p = 0.0001) and 67.7 ± 12.9% in the study group and 38.4 ÷ 12.9% in control group for posterior fibrovascular zone (p = 0.0001). Conclusions: The injection of adipose derived mesenchymal stem cell was effective to improve bone regeneration distraction callus on the irradiated mandible.
165 Non-paraneoplastic Anti-NMDAR Encephalitis: First Confirmed Adult Case Report in Latvia     , Dace Ziemele1, 3, Marija Litviņenko2, Guntis Karelis3, Viktorija Ķēniņa3, Lana Vainšteine3 and MārÄ«te Karlovska3
Anti-NMDAR (Anti-N-Methyl-D-aspartic acid) encephalitis is a rare autoimmune condition mainly affecting young women. It is associated with an underlying tumor in about 50% of reported cases. Antibodies directed against the GluN1 subunit of the NMDA receptor are responsible for the disease pathogenesis and their detection in the patient’s serum and cerebrospinal fluid are required to make a definite diagnosis. Classical clinical presentation consists of flu-like symptoms, followed by psychiatric disturbances and impaired consciousness, epileptic seizures and movement disorders. During the past decade, it has become an emerging area of research and discussion as more than 1,000 cases have been reported since the first description of this specific disease entity in 2007. Despite a rather typical clinical course it is frequently diagnosed and treated with a delay up to many months. Overall prognosis tends to be favorable. However, it strongly depends on early diagnosis and rapid treatment initiation. While diagnostic criteria for probable and definite anti-NMDAR encephalitis have been proposed, there are no evidence based guidelines for specific treatment strategies. Glucocorticoids, plasma exchange and IVIG are generally used as 1st line treatment, in patients who do not respond, 2nd line treatment with Cyclophosphamide or Rituximab is used. We report a case of a confirmed non-paraneoplastic anti-NMDAR encephalitis with a rather classical manifestation in a Latvian woman who is first hospitalized in a psychiatric clinic then transferred to an ICU   (intensive care unit), treated with glucocorticoids, plasma exchange and later Cyclophosphamide with a good outcome.
166 Colonic Bleeding Due to Histoplasma and Mycobacterium Coinfection in Renal Transplant Patient     , Arthur Ivan Nobre Oliveira, Luiz Ricardo Pinheiro de Santana, Cicelys Andreina Malave, Flair Jose Carrilho and Andre Zonetti de Arruda Leite
Introduction: Histoplasmosis is a rare infectious condition caused by the fungus Histoplasma capsulatum that can be presented from asymptomatic to severe forms. Tuberculosis, still an endemic infection in some developing countries, can also have variable clinical presentations. Both diseases involve the lungs mostly, but in immunocompromised patients, especially those with advanced HIV infection and transplant patients, disseminated forms are more frequently found. Gastrointestinal involvement is unusual, and digestive bleeding is an even rarer complication. Case presentation: We report the case of a 39-year-old female who was diagnosed with a Mycobacterium tuberculosis and Histoplasma capsulatum coinfection occurring 11 years after a living-donor-related renal transplant. The patient presented a severe gastrointestinal bleeding caused by an ulcer in the ascending colon. She improved after a combined treatment with tuberculostatic and fungicidal drugs. Conclusions: Simultaneous gastrointestinal involvement by histoplasmosis and tuberculosis, presenting as severe digestive bleeding, with minimal respiratory symptoms associated, make this an extremely rare case and a diagnostic challenge. Therefore, it is important to keep a high clinical suspicion of opportunistic infection, especially in immunocompromised patient who presents with LGB.
167 Turner Syndrome and Inflammatory Bowel Disease: Case Report     , Priscilla Pereira dos Reis¹, Ricardo Fortes Monteiro de Castro², Rafaela Costa Vieira³ and Carolina de Paula Guimarães Baía³
Summary: TS (Turner syndrome) is a genetic disease which affects women caused by complete or partial absence of one of the X chromosomes. This condition is related to an increase in autoimmune diseases incidence like, IBD (inflammatory bowel disease). Material and Methods: a case report of a 31 years old woman with TS hospitalized with two months of prostration, fever, rashes, nausea, vomit and diarrhea. Investigations have shown colonic mucosa inflammation, besides chronic colitis with cryptic microabscess in the anatomopathological evaluation, suggesting IBD as etiology. Treatment with mesalazine was effective in symptoms improvement. Conclusions: TS is a condition frequently associated with autoimmune diseases, including diseases of the gastrointestinal tract, such as IBDs. Recognition and early treatment of this condition leads to an improvement in the quality of life of these patients and reduces the chances of future complications.
168 Use of a Simple Fabrication Process to Produce a Biosensor: The 3-Hydroxybutyrate Dehydrogenase Case     , I. Ribau and E. Fortunato
This study was aimed to construct a biodegradable but reliable 3-β-hydroxybutyrate biosensor. In this context a versatile paper based biosensor, quickly, easily and cheaply fabricated is reported. The procedure of fabrication is based on the assumption that the introduction of the enzyme in the carbon ink will allow enzyme stabilization and facilitate the study of the catalysis of enzymes and the detection of substrates. To prove this concept we use the enzyme 3-hydroxybutyrate dehydrogenase, in aqueous solution. This enzyme was chosen because it catalyzes the 3-β-hydroxybutyrate, which results from ketoacidosis. The quantification this substance in the diabetics’ blood is very important as it can increase the reliability of the diagnosis of glycaemia. To prove the multi-use of this biosensor we not only study the redox process in steady state and during the catalytic process, but also detected and quantify the 3-β-hydroxybutyrate. Our results showed that it was possible to study the redox process that occurred during the catalysis and to confirm the amino acid residues that participate in it. It was also observed that glucose and ascorbic acid can interfere in the detection and quantification of the 3-β-hydroxybutyrate, what should be in mind when the quantification of the 3-β-hydroxybutyrate is made in blood samples.
169 The Role of Pharmacist in Treatment of Depression     , Z. Binakaj1, S. Stojkov2, B. Angelovska3, 4 and E. Drakalska4
One of the most significant health issues is the disorders of mood according to the fact that they have a significant effect on the quality of life of the patients, their families, their working and wider social surroundings. According to the World Health Organization, mood disorders are the fourth cause of morbidity and mortality with a tendency to move to the second place by the 2020. The prediction of higher number of patients diagnosed with depression in the future comes from the facts that the main factor of risk, like stress, is in constant rise. Furthermore, the demographic image (ageing of the population) is changing, associated with the effect of comorbidity of depression, also attributed with increase of the number of genetically predisposed patients with this mood disorder. The aim of this study is to define, describe and question the role of pharmacists in the treatment of patients suffering from depression. Therefore, we measured the impact of pharmaceutical care on significant parameters in treatment of depression due to the selection of appropriate therapy according to the guidelines, adherence of the patient, quality of life, work capability, anxiety, side effects and interactions with other medicines.
170 Epithelioid Hemangioendothelioma of the Liver—Case Report     , Julio Cesar Razera1, Carla Alessandra Smiderle1, Felipe Luzzatto2, Rui Luzzatto2, Julio Carlos Pereira Lima3, Gabriela Perdomo Coral3 and Claudio Augusto Marroni3
EH (Epithelioid hemangioendothelioma) is a rare vascular malignant neoplasm. Only 434 cases had been reported until 2006. Symptoms may be nonspecific, but it also can involve hepatic veins resulting in Budd-Chiari syndrome. The main differential diagnosis is cholangiocarcinoma, sometimes only distinguishable through immunohistochemistry study. We report a case of a young woman diagnosed with hepatic EH and listed for liver transplantation.
171 Internal Hernia of Broad Ligament: A CT Scan Suspicion and Laparoscopic Treatment     , E. Diémé1, I. Sall1, A. R. Ndiaye2, M. Diouf1, S. M. Seck1, B. Ndiaye1, O. Fall1, A. Sow1, I-C. Diakhaté2, and M. Ogougbemy1
Internal hernia of the broad ligament is rare. Computerized tomography is the key tool of the diagnosis. The treatment is surgical and takes advantage of the use of laparoscopy. We report a case of internal hernia of right broad ligament suspected on computerized tomography and treated by laparoscopy. The following was uneventful.
172 The Elderly Health Office—Public Health Respond to the Ageing Challenge     , Irena Dzeletovic Milosevic, Dusanka Matijevic and Svetlana Mladenovic Jankovic
Introduction: Demographic structure in Belgrade is regressive biological type with 16.4% of the Elderly in whole population. Addressing this fact Public Health Institute of City of Belgrade in 2008 established the EHO (Elderly Health Office). Aim: This paper emphasizes the importance of Public Health response to ageing population challenges. Method: This public health study is retrospective review based on work of EHO from 2008 to 2017 year. Results: Numerous health promotion activities were performed by EHO: development guidelines for elderly care services coordination as well as for effective communication within health care system; development of age-friendly web portal; cooperation with the mass media; building partnership with representatives of the state- and private-owned facilities and NGOs (non-governmental organizations); support to strengthening inter-generation cooperation; promotion of elderly age-friendly phone line; organizing and participation in public health events, meetings and conferences. EHO participated in evaluation capacities of healthcare in Belgrade, regarding human resources, equipment and facilities, and monitoring elderly health status. Conclusions: The role of the EHO of IPHB is: (1) support to active, healthy, productive ageing of the citizens of Belgrade; (2) strategic planning of the Elderly health care; (3) strengthening of intersectional cooperation. Measures suggested: Public Health approach of EHO is response to challenges of ageing population and potential model for age oriented program management.
173 Double Problem—Clostridium difficile and Diabetes     , Ioana Florina Iordan1 and Carmen Manciuc1, 2  
Considered to be the most common cause of nosocomial diarrhea, Clostridium difficile infection is a daily clinical reality, and its incidence is increasing globally. Many factors have been implicated in causing this infection, including glucose metabolism disorder. Aim: to evaluate the prevalence of diabetes among patients with C. difficile colitis and assessing the risk of disease relapse and extension of the disease, in combination with diabetes mellitus infection. Materials and methods: were included in the study 102 patients known to have diabetes type 1 or type 2 admitted to our clinic between January 2016 and June 2017, from a total of 648 patients diagnosed with C. difficile colitis. We used data from observation charts of patients. Results: 98% were suffering from type 2 diabetes, mostly female, respectively from urban areas, 29.4% being at the second hospitalization in our clinic for the same symptoms. Studying the average length of hospitalization, compared with a control group, we noticed the prolongation of hospitalization for patients with metabolic pathology associated with approximately 7 days. Conclusions: Diabetes is a risk factor for the occurrence and recurrence of C. difficile infection, an additional risk factor being the age.
174 A Simple Procedure to Fabricate Paper Biosensor and Its Applicability—NADH/NAD+ Redox System     , Isabel Ribau and Elvira Fortunato  
A simple device which incorporates three electrodes (working electrode, counter electrode and reference electrode) was constructed to be used currently in laboratories without elevated cost. It does not need more than 2 µL of electrolyte, sample or working solution, his support material is paper, and the working electrode which is based on carbon ink can incorporate enzymes and cofactors. To test this concept we started this investigation using the NADH/NAD+ redox couple which is an omnipresent coenzyme in living systems but is also a challenge to electrochemistry. The paper sensor fabrication was simple, rapid and cheaper. NADH was incorporated in the carbon ink by mixing both and, this mixture was used to print the working electrode. The direct electrochemical system NADH/NAD+ signal obtained, using this device, appeared at low potentials. A quasi-reversible diffusional redox process was achieved and regeneration of the NADH after oxidation was reached. This small paper device was not only used to study the redox process of NAD+/NADH, but also its behavior in the presence of electroactive (ascorbic acid) and non-eletroactive species (glucose).
175 Achieving Enzyme Stability Using a Simple Fabrication Procedure: The Alcohol Dehydrogenase Example     , I. Ribau and E. Fortunato
The use of screen-printing biosensors has been updated in this article as a tool to analyze the electron transfer process involving redox proteins or enzymes. The aim of this research was to fabricate a simple apparatus which allowed the use of the enzymes (in the solid state) to maintain their stability. To prove this concept an enzyme in the solid state was mixed with the carbon ink and this mixture was used to print the working electrode. We choose as proving the alcohol dehydrogenase. The first reason is because it metabolizes the alcohol, which can be present in biological samples of blood, saliva and urine and also in the beverage; the second is that this enzyme is still a challenge to electrochemistry due to having lower stability in sensors. The results show that in this device the enzyme was active and stable during all the experiments and in the experimental conditions that could catalyze the ethanol to acetaldehyde. These devices have the advantage of being disposable, cheap and are easy to fabricate. And also, they do not need expensive tools to be fabricated, they only need 2 µL of electrolyte or sample, and they need lower amounts of enzyme to permit electrochemical studies.  
176 Evaluation of Opioid Reversal with Naloxone before and after Implementation of a Computerized Physician Order Entry System at a Tertiary Medical Center     , Shannon Inglet1, Michael Curcio2 and Lada Radetic3  
Objectives: Opioid medications consistently rank among the drugs most frequently associated with adverse events. We reviewed cases of naloxone administration to assess our opioid prescribing and administration practices before and after implementation of a computerized provider order entry (CPOE) system. Our primary measure was the rate of opioid reversal with naloxone in the two time periods. Methods: We systematically reviewed all cases of naloxone administration at our institution from March 2016 through May 2016 (before period) compared with cases from October 2017 through December 2017 (after period). Results: In the before period, 0.58% of patients who received an opioid required reversal with naloxone compared with 0.16% in the after period (p < 0.001).  Subject demographics such as age, sex, BMI, and serum creatinine were not significantly different between the two groups. Similarly large proportions of patients in the before and after groups had at least 2 risk factors for over-sedation (79.5% and 75%, respectively, p = 0.17). More than 84% and 61% of patients in the before and after groups, respectively, did not have documentation of an opioid on the admission medication history, suggesting they were opioid-naïve (p = 0.10). Per our institution’s policy on range orders, nurses should begin with the lowest prescribed opioid dose; this policy was followed in 58.3% in the before period and 69.2% in the after period (p = 0.36). Conclusions: Doses of naloxone that were required for opioid reversal were significantly reduced after implementation of a CPOE system. Our opioid-reversal rate was comparable to similar studies; however, secondary endpoints indicate that opioid prescribing and administration habits may not account for patient-specific risk factors for over-sedation.
177 Extraction of Essential Oils from Afghanistan Medicinal Plants Using Microwave and Conventional Methods     , Nazifa Faqeryar and Yoshihito Mori
Afghanistan has many kinds of volatile-oil-rich and not-fully-utilized flora. This article represents a review on Afghanistan medicinal plants contain essential oils. Lamiaceae, Asteraceae and Apiaceae are the most important botanical families which are widely found and used as traditional medicines, food and spices in Afghanistan. Over 215 plants which are used in traditional therapy in Afghanistan, 93 plants contain essential oils. Twenty-two plants contain essential oils applied to microwave extraction techniques and forty-nine plants contain essential oils applied to conventional extraction techniques. Totally 41 extracted species belong to above mentioned botanical families that could be found in Afghanistan too. But still there are some species of these families which are endemic in Afghanistan and not studied yet. 
178 Postoperative Complications and Patient’s Satisfaction after Harvesting of the Radial Artery for Coronary Artery Bypass   , Aleksandar V. Milutinovic1, Miodrag S. Peric1, Andja M. Cirkovic2, Petar M. Vukovic1 and Predrag S. Milojevic1
Objectives: There is a paucity of data regarding wound-site complications and patient’s satisfaction after harvesting of a radial artery. This study is conducted to evaluate the frequency complications and the level of patient’s satisfaction after myocardial revascularization in our setting. Methods: From April 2009 to October 2013, 97 patients had radial artery (RA) used as a graft in myocardial revascularization. The graft was harvested using open technique. This was retrospective study. Telephone questionnaire was used to evaluate: arm pain, swelling, mobility, sensory changes, patient’s contentment with a cosmetic result and the general health state. Results: Pain of limited duration was reported by 24 patients (24.7%), none of them reported permanent pain. Some problems in performing everyday’s activities were reported by 8 pts (8.2%). Sensory changes were permanently present in 5 pts (5.2%), and frequent arm fatigue was reported by 4 pts (4.1%). Positive opinion regarding the cosmetic result was reported by 95 pts (97.9%). State of the health after surgery, 81 pts (83.5%) described as excellent or good. Patients who had more mobility problems, also had more sensory and neurological discomfort respectively. Patients with better self-reported general health state were also more satisfied with the esthetic effect of the intervention. Conclusions: Using the open technique resulted in excellent cosmetic effect. This gives us credit to point out that exclusive need of the endoscopic as a supreme method might be under the question mark. Our study suggests that individual attitude of the particular patient plays extremely important role in his/her overall satisfaction with the end effect of the procedure. 
179 A Clinical Trial of Mediterranean Diet Enriched with Fatty Fish in Pediatric Asthma: Study Protocol     , Maria Michelle Papamichael1, Charis Katsardis3, Dimitris Tsoukalas4, Bircan Erbas2 and Catherine Itsiopoulos1
Background: Considerable interest exists in the therapeutic potential of dietary omega 3 fatty acids in asthma, due to anti-inflammatory and immune-modulating effects. The aim of this Randomized Controlled Trial is to investigate the efficacy of fatty fish consumption in the context of the Mediterranean diet in ameliorating symptoms in pediatric asthma. Methods: Children aged 5-12 years with physician-diagnosed “mild asthma” will be recruited from a pediatric asthma clinic in Athens and randomized to two groups. The intervention group will consume two meals of fatty fish (≥ 150g cooked fish) per week over a period of 6 months as part of the Greek Mediterranean diet. The control group consumes their usual diet. Questionnaires will be used to collect data on socio-demographics, medical history, dietary habits, adherence to the Mediterranean dietary pattern, asthma control and quality of life. Pulmonary function will be assessed using spirometry and exhaled nitric oxide analysis. In addition, blood tests will be undertaken to assess metabolic profile, biomarkers of nutritional status and dietary intake. Discussion: This clinical dietary intervention will evaluate the therapeutic potential of a Mediterranean diet enriched with fatty fish on pediatric asthma and assist in devising dietary guidelines for the management of pediatric asthma.
180 Effects of a Carbonated Soft Drink on Epitheial Tumor Incidence in Drosophila melanogaster   , Paula Marynella Alves Pereira Lima1, 2, Priscila Capelari Orsoli2, Thaise Gonçalves Araújo1, Douglas Brandão Cardoso1 and Júlio César Nepomuceno1  
Diet represents an important risk factor for tumor development and numerous food dyes have been tested for their carcinogenic potential. Caramel IV colorant and its byproduct, the 4-methylimidazole (4-MI), are part of the composition of cola soft drinks, although in undefined concentration. Considering that this concentration depends on the manufacturing place, we aimed to evaluate the potential carcinogenic activity of cola soft drinks from Brazil, Canada, Egypt and Netherlands, through the test for detection of epithelial tumor clones (warts) in somatic cells of Drosophila melanogaster. We used 72-hour larvae resulting from the crossing of wts/TM3, Sb1 virgin females and mwh/mwh males. Larvae were exposed to the media containing the cola soft drinks for 48 hours and the analysis was performed in adults after transformation. Cola soft drinks from Brazil significantly induced epithelial tumor in D. melanogaster, while those from Canada, Egypt and Netherlands did not. In fact, the concentration of 4-MI is higher in cola soft drink commercialized in Brazil. Our results highlight the importance of investigating the toxic potential of current drinks, which may correlate with the rising incidence of malignant diseases.  
181 Stress Related Takotsubo Cardiomyopathy: A Case Report     , Ana Beatriz Boamorte Cortela1, Franciele Silva Bernardo2, Marcos Tadao Kavanishi1, Vilmar Queiroz de Menezes3 and Nivaldo Cortela3  
First described in Hiroshima City Hospital in 1990, Takotsubo Cardiomyopathy emerged as an important differential diagnosis for acute coronary syndrome, since this disease mimics some commemoratives presentations of acute coronary syndrome such as chest symptoms, electrocardiographic changes and cardiac injury biomarker alteration. Also, it’s important to emphasize that, although it commonly occurs among woman, TCC can happen in males, as demonstrated in other studies which 10% of the cases occurred in male sex. In this way, this study shows the importance of Takotsubo Cardiomyopathy as a differential diagnosis for acute coronary syndrome.
182 Cecum Dieulafoy’s Lesion Presenting with Recurrent Lower Gastrointestinal Bleeding: Case Report     , Ludmila Resende Guedes, Silas Castro de Carvalho, Vitor Nunes Arantes, Arthur Manoel Braga de Albuquerque Gomes, Daniel Antônio de Albuquerque Terra, Nathália da Silva Braga and Nicoly Eudes da Silva Dias  
Introduction: Gastrointestinal Dieulafoy’s lesion is a rare entity, of unknown etiology, and corresponds to an arterial malformation at the submucosal space that can be a source of life-threatening hemorrhage. We report a case of a Cecum Dieulafoy’s bleeding lesion that was managed endoscopically with a favorable outcome. Case report: Female, 70-year-old, diagnosed with type 2 diabetes, hypothyroidism, and chronic heart failure associated with rheumatic mitral stenosis, submitted to biological valve replacement in 2006 and with permanent atrial fibrillation using vitamin K antagonist anticoagulant for thrombosis prophylaxis. Her background includes a stroke in 2004 without any permanent disability. In 2016, the patient experienced voluptuous and painless lower gastrointestinal bleeding with severe acute anemia, requiring hospital admission, fluid resuscitation and blood transfusion. Urgent colonoscopy revealed a small reddish vascular malformation at the cecum with oozing active bleeding, about 3 mm in size. Initially argon plasma coagulation was performed with satisfactory and immediate hemostasis. One week later, she recurred with hematochezia. The lesion at the cecum was reassessed and it was possible to notice a large caliber vessel surrounded by a normal appearance mucosa, compatible with Dieulafoy’s lesion and it was treated with an endoscopic clip placement with a good long-term response. Conclusion: Endoscopy is the method of choice for diagnosis of Dieulafoy’s lesion and may provide efficient treatment with mechanical hemostasis such as endoclip placement with a high success rate.
183 Using Moringa oleifera Extracts to Control Blackrot (Xanthomonas campestris) in Field Grown Rape (Brassica napus)     , Maria Goss1, 2, Paramu. L. Mafongoya1, Augustine Gubba1 and Obert Jiri2
The leaf, bark and seed extracts of Moringa oleifera were evaluated for their efficacy under field conditions in suppressing Xanthomonas campestris pv. campestris in rape (Brassica napus. L.). Xanthomonas campestris pv. campestris is an important bacterial pathogen of agricultural importance causing devastating black rot disease of Brassicas. Three extracts concentrations of 60, 100 and 140% were sprayed as foliar applications weekly and the antibacterial activity was evaluated by recording number of totally defoliated plants. The three extracts showed significant effect against the test pathogen (p > 0.05). The antibacterial activity of seed extract demonstrated higher activity against the Xanthomonas campestris pv. campestris as evidenced by lower mean leaf defoliation of 1.59 cm followed by bark (2.58 cm) and lastly leaf extracts (2.96 cm) (p < 0.05). There were no significant differences based on the concentration levels used. Observations revealed that 100% and 140% levels were not significantly different from each other on enhancing growth of the stem diameter. Moringa seed at 60% concentration level can be used to enhance growth of rape. The conclusion is that Moringa seed extracts can be effectively implemented to suppress Xanthomonas campestris pv. campestris pathogen in field grown rape in an integrated disease control program.
184 Plum Pox Virus (PPV) Dispersion in Plum Trees (Prunus domestica. L) CV. D’Agen , Laura Porcel, Cecilia Picca, Carlos Fuentes and Eva Ojeda  
Sharka, it is considered one of the most serious diseases of stone fruits worldwide. It is transmitted long distances by propagating material and by aphids close to an infection focus. In San Rafael, Mendoza, Argentina, it made a study of dispersion’s degree of the disease in a plum plantation CV D’Agen. Samples were taken in the spring of the basal part of open leaves. A DAS-ELISA test was made using a protocol in agreement with SENASA and INASE (2007) on 750 plants. Infection percentages found were 4.4%; 6.4%; 8.53% and 10.1%; between the first until last year of study. These numbers indicate a degree of dissemination of the disease similar than described by the Chileans and slower than described by the Spanish and French. Several factors can be responsible for the speed of dispersion of diseases like Sharka: vector quantities, presence of parasites and predators, closeness to inoculants sources, different degree of susceptibility of the species or cultivar to the disease or insect or others. This work can serve as a base for further studies on the incidence of diverse factors in the process of disease dispersion.
185 Formulation and Solid-State Characterisation of a Novel Benzanilide Co-crystal of the Anti-HIV Drug Efavirenz     , Maryam Amra Jordaan and Michael Shapi  
HIV/AIDS has had a crippling socio-economic effect on developing countries in Africa. EFV (Efavirenz) is generally used to treat this pathology. However, its clinical efficacy is reduced by its limited water solubility. Our recent efforts were to discover new multicomponent molecular crystals of EFV to further enhance the solubility of EFV, which has led to the formulation of a novel BZA (benzanilide) CC (co-crystal). The molecular complex was characterized by X-ray Powder Diffraction (XRD) and FTIR (Fourier transform infrared) spectroscopy. FTIR data showed a shift in the N-H stretch of the amide group of EFV from 3,312.39 cm-1 to 3,299.71 cm-1 and the C = O frequency from 1,749.70 cm-1 to 1,739.87 cm-1 suggesting that the N-H and C = O functionalities of EFV are participating in hydrogen bonding with the N-H and C = O moieties of BZA in the EFV-BZA complex, indicative of improved water solubility. Both the XRD patterns of BZA and EFV show characteristic peaks, however, in the XRD pattern of EFV-BZA CC, one unique peak appeared which is absent in both EFV and BZA at 30.8005° (100% intensity) suggesting the formation of a new solid phase. The results from this study are significant in understanding the complexity of these scarce EFV based CCs and can be used to advance the development of new solid-state structures with improved physicochemical properties.
186 Antidepressant Drugs Modulate Differentially Anti-inflammatory Lithium’s Property: An in Vitro and in Vivo Study     , Fernanda Barbisan1, Pedro Antônio Schmidt do Prado-Lima2, Verônica Farina Azzolin3, Maiquidieli Dal Berto4, Claudia Giuliano Bica5, Cibele Ferreira Teixeira6, Dianni Capeleto7, Ivo Emílio da Cruz Jung8, Euler Esteves Ribeiro9, Marta Maria Medeiros Frescura Duarte10 and Ivana Beatrice Mânica da Cruz11  
Li (lithium), a mood stabilizer has anti-inflammatory effect. However, in clinical practice, Li can be administered together with other antidepressants drugs, such as FLX (fluoxetine), IMI (imipramine), NOR (nortriptyline) and ESC (escitalopram). As interaction between Li and these antidepressant drugs on inflammatory modulation has not been investigated yet, we performed an in vitro protocol using a non-human macrophage cell line. Oxidative and inflammatory markers, as well as cell cycle analysis and cytokine gene expressions were compared among treatments. An IR (inflammatory ratio) was calculated based on the following oxidative-inflammatory variables: nitric oxide, superoxide anion, reactive oxygen molecules, cytokines IL-1β, IL-6, TNF-α and IL-10. The in vitro calculated IR data were validated through an in vivo analysis of 154 human subjects with similar IR. Li and control cells presented similar IR values. FLX, NOR and IMI increased slightly IR values indicating some proinflammatory effect, whereas ESC decreased IR values indicating some anti-inflammatory effect. However, cells exposed to Li + ESC triggered a proinflammatory response on macrophages. Thus, IR comparison results suggest that the Li anti-inflammatory effect is not universal and could be influenced by both basal macrophage-inflammatory state and interaction of other psychiatric drugs. These results could be useful to understand some inconsistencies observed in human studies involving Li and other psychiatric drugs.
187 Cytotoxic Effect of Chitosan Based Nanocomposite Synthesized by Radiation: In Vitro Liver and Breast Cancer Cell Line     , A. Abaza1, G. A. Mahmoud2, E. A. Hegazy2, M. Amin3, E Shoukry3 and B. Elsheikh3  
A silver nanoparticle (AgNP) is likely to provide an attractive object for combining a variety of biochemical properties with great therapeutic potential by using radiation. The present study explores the IC50 value of chitosan-poly (vinyl alcohol) hydrogel (Cs/PVA) and Ag-doped chitosan-poly (vinyl alcohol) (Cs/PVA/Ag) nanocomposite in view of their anticancer application. The aim was to develop (Cs/PVA) based hydrogel synthesized by gamma radiation which could behave both as a nanoreactor for Ag nanoparticle with promising anticancer applications. The (Cs/PVA/Ag) nanocomposite was confirmed by FTIR (Fourier transform infrared) spectroscopy, XRD (X-ray diffraction) and EDX (energy dispersive X-ray) analysis. The anti-cancer activity of the prepared nanocomposites was demonstrated in human liver cancer cell line (HEPG2) and breast cancer cell lines (MCF7). It has significant effects against human liver cancer cell line HEPG2 compared to breast cancer cell line MCF7. Further quantitative analysis on the molecular and protein levels is still required to confirm the impact of chitosan on genotoxic effect before reaching a final conclusion and starting its biomedical application.
188 O-Acetylated (1→6)-β-D-Glucan (Lasiodiplodan): Chemical Derivatization, Characterization and Antioxidant Activity     , William N. Sanchez Luna1, Vidiany A. Q. Santos1, Sirlei D. Teixeira1, Aneli M. Barbosa-Dekker2, Robert F. H. Dekker3 and Mário A. A. da Cunha1
β-Glucans are biomacromolecules that present biological properties of medical and pharmacological interest. The chemical modification of the primary structure of these carbohydrate biopolymers is a way to enhance or achieve new biological properties. Acetylated derivatives of (1→6)-β-D-glucan (lasiodiplodan) with different degrees of substitution (0.48, 0.66, 1.03 and 1.26) were obtained and characterized by infra-red and NMR (nuclear magnetic resonance) spectroscopy, thermal analysis, X-ray diffraction and antioxidant capacity. Acetylation was confirmed by FT-IR, and 13C NMR spectroscopy. Thermal analysis indicated that unmodified lasiodiplodan and the O-acetylated b-glucan derivative of degree of substitution 0.48 presented three stages of mass-loss, whereas acetylated derivatives of DS (degree of substitution) of 0.66, 1.03 and 1.26 presented four stages of mass-loss. X-ray diffractograms demonstrated that both native and acetylated lasiodiplodan presented crystalline regions in an amorphous polymeric matrix. Scanning electron microscopy revealed that O-acetylation promoted morphologic changes in the biopolymer according to the DS. Acetylation also contributed to improve antioxidant capacity.
189 Effectiveness of Hypertension Therapy by Using Fixed Combinations and Monocomponent Drugs—A Prospective Study from Croatia   , Antonija Banic1, Vanesa Benkovic2 and Aleksandar Knezevic3, 4
Arterial hypertension is the leading risk mortality factor in the world according to the report by the World Health Organization. The aim of this research was to compare fixed-dose combination with free-drug combination therapy and prove that fixed-dose combination improve patient compliance and persistence, measuring blood pressure among hypertensive patients in a Croatian Adriatic city. Methods: The study included 202 patients, 101 women and 101 men, mean age 66.8 ± 9.4 with previous diagnosis of hypertension. Results: Mean blood pressure was 152.8 ± 18.8/87.3 ± 10.3 mmHg. Blood pressure control (≤ 140/90 mmHg) was achieved in 24.8% of patients, 13.9% of women and 10.9% of men. Mean blood pressure in the group with fixed-dose combination was 149.2 ± 17.9/86.2 ± 8.5 mmHg, and 156.7 ± 18.9/88.4 ± 11.8 mmHg in the group with free-drug combination therapy. Conclusions: Results suggest that blood pressure control was better in patients with fixed-dose combinations than in patients with free-drug combinations. Fixed-drug combination improved compliance and adherence in patients with antihypertensive therapy. Results of the study indicate that fixed-drug combination should be considered in patients with hypertension according to the guidelines.
190 Approach by Health Professionals to the Side Effects of Antihypertensive Therapy: Strategies for Improvement of Adherence     , Grazia Maria Guerra1, 2, Heno Ferreira Lopes1, ELizangela Oliveira Freitas2, 3, Fernanda Marciano Consolim-Colombo1, Patricia Silva Lessa4, Dante Marcelo Artigas Giorgi1, Luiz Aparecido Bortolloto1 and Eduardo Moacyr Krieger1
The aim was to determine whether complaints about side effects made by stage III hypertensive patients undergoing antihypertensive therapy lead to adequate blood pressure control. Forty-eight patients were monitored by a nurse every 15 days over the course of 180 days. At baseline, both groups presented similar SBP (systolic blood pressure) (GA, 196 (5)) mm Hg and GB, 189 (6) mm Hg) and DBP (diastolic blood pressure) (GA, 122 (3) mm Hg and GB, 121 (4) mm Hg). On day 165, after a progressive decline in blood pressure levels, the two groups differed significantly from each other regarding SBP (GA, -16.9 (24) mm Hg and GB, -40.8 (31) mm Hg). At the final follow-up, the patients were allocated to two groups: without complaints (GA) and with (GB) complaints about side effects. Complaining about side effects was a decisive factor for immediate nursing intervention and improved control over BP.
191 Genotyping and Antifungal Susceptibility Profile of Sequential Candida albicans Isolated from the Oral Cavity of HIV-Infected Individuals     , Daniela Vanessa Moris1, 2, 3, Joyce Marinho de Souza3, Márcia Souza Carvalho Melhem4, Marilena dos Anjos Martins4, Caroline Lucio Moreira3, Lenice Rosario de Souza1, Gioconda San-Blas5, Maria Walderez Szeszs4, Lidia Raquel Carvalho6, Marcus Vinícius Pimenta-Rodrigues2, 3 and Rinaldo Poncio Mendes1
Objective: The study aimed to evaluate the genotypic profiles of C. albicans (Candida albicans) sequentially isolated throughout the course of HIV infections, and to determine its MIC (minimal inhibitory concentrations) to AMB (amphotericin B), FLC (fluconazole), KTC (ketoconazole), and ITC (itraconazole). Design: samples were collected from the oral cavity of HIV-positive individuals during 4 years, with a sterilized swab. MIC was performed by using the microdilution method AFST/EUCAST. The genetic similarities within and between sequential clones of C. albicans were assessed by DNA fingerprinting using the random amplification of polymorphic DNA technique. Results: A total of 142 oral samples were isolated from 59 HIV-infected individuals who attempted up to five visits each, with or without symptoms of oropharyngeal candidiasis. Profile analysis revealed that yeasts isolated over sequential visits from symptomatic or asymptomatic individuals showed 78% or 87% relatedness, respectively. The degree of similarity among C. albicans was higher for isolates from colonization than for those from infection. Genetically identical C. albicans samples also formed connected subclusters in sequential visits. In regard to susceptibility profile, all isolates were susceptible to AMB, FLC, KTC, and ITC and maintained this pattern all along, no differences in MICs of any given antifungal compound were observed for sequential C. albicans isolates. Conclusions: These data suggest that genotype and susceptibility to antifungal drugs were maintained over time in sequentially isolates of C. albicans colonization and a diverse evolutionary genetic trend in C. albicans sequentially isolated from the oral candidiasis of HIV infected individuals. 
192 Caloric Restriction and Litter Size Do Not Compromise Renal Function of Male Wistar Rats     , Nayra Thais Delatorre Branquinho1, Letícia Diniz Crepaldi2, Vilma Aparecida Ferreira de Godoi3, Maria Montserrat Diaz Pedrosa3 and Edmara Aparecida Baroni3
This work had the purpose of comparing some renal parameters of Wistar rats raised in small litters either freely-fed (G3L) or subjected to 30% caloric restriction (G3R) with those of rats from normal litters (G9) at the age of 90 days. The results showed that the relative weight of the kidneys and urinary flow were not significantly different. All the groups had GFR (glomerular filtration rate) and proteinuria within normal values, despite group G3R having values statistically lower. However, group G3R had diminished glomerular area and increased numbers of renal corpuscles. Group G3L did not exhibit differences compared with controls (G9). The effects of caloric restriction did not compromise kidney structure and function in 90-day-old rats.
193 Responses of the Adult Rat Glucose Metabolism to Early Life Feeding, Caloric Restriction and Refeeding     , Nayra T. D. Branquinho1, Mônica S. M. Loiola2, Leticia D. Crepaldi1, Laís A. Yamada2, Silvia C. S. F. Azevedo1, Camila Bataglini1, Márcia N. Brito3, Vilma A. F. de Godoi3, Maria Montserrat D. Pedrosa3 and Maria Raquel M. Natali4
Early life overfeeding in the rat can be experimentally induced by reducing litter size. This investigation assessed the consequences of this manipulation on glucose metabolism in vivo and in isolated hepatocytes in 150-day old rats. Additionally, after body growth, the effects of caloric restriction and refeeding were tested. Adult rats from control (G9) and reduced litters (G3L) did not differ in body and fat weights, glucose tolerance or insulin resistance (insulin-induced hypoglycemia), or hepatocyte glucose release under basal or gluconeogenic conditions. Caloric restriction (G3R) reduced body and fat weights, decreased glucose decay after insulin injection and decreased hepatocyte gluconeogenic glucose release. Refeeding after caloric restriction reversed these parameters to those of the freely-fed groups (G9 and G3L). Taken together, these results suggest that the liver glucose metabolism is not programmed by lactational overfeeding, but rather is responsive to the current nutritional condition of the animal. 
194 Short Term Evaluation of a Novel Eletronic Transanal Irrigation System in Patients with Neurogenic Bowel Dysfunction Previously Exposed to Transanal Irrigation Systems   , Passananti V.1, Emmanuel A.1, Nordin M.2, Storie J.1, Gripenland J.2, Astrom M.3 and Hultling C.2  
Introduction: Neurogenic bowel dysfunction is one of the most distressing consequences of the spinal cord injury. Transanal irrigation has proven to be a treatment for many such individuals, but there are some patients with sub-optimal response to it. Our aim was to evaluate the satisfaction, safety, perception and compliance of a new transanal irrigation device, Navina Smart system featuring an electronically driven pump with a digital control. Material and methods: Twenty-eight patients who had previously used, or were currently using transanal irrigation were enrolled. They were trained to use the Navina Smart system and were thereafter treated for four weeks. Patient perception, compliance and level of satisfaction were assessed at baseline and at the end of treatment. Results: At the end of treatment 68% of patients were still using the system and 50% of ITT (intended to treat) wished to continue using the system. Navina Smart was well tolerated with no adverse effects in the cohort. Patient perception of the Navina Smart system was positive in 67%. Conclusions: Navina Smart system was shown to be safe, tolerable and effective in two-thirds of patients who were unsatisfied with their previous bowel care and was associated with an increase in the patient’s independence.
195 Analysis of Carbamates Pesticides: Immunogical Technique by Local Development of Enzyme-linked Immuno-Sorbent Assay , N. Bellemjid1, 2, A. Iddar1, A. Moussaif1, N. El Abbadi1 and A. Mesfioui2
Carbamates insecticides are used increasingly in agriculture as a replacement for environmentally more persistent organochlorine insecticides for the control of insect pests. It was the most used pesticides in Loukkous-Morocco. Conventional methods employed to detect/analyze carbamates residues are time consuming and require sophisticated equipment only available in well-equipped laboratories. In addition, the conventional methods usually require a lot of complex pre-treatment of samples. Therefore, convenient and rapid pesticide detection system is urgently needed. In this order, we aimed to develop a rapid ELISA (enzyme-linked immuno-Sorbent Assay) for detection of some carbamates such as carbendazim [methyl 2-benzimidazole carbamate] and carbofuran [2,3-dihydro-2,2-dimethyl-7-benzofuranylmethyl carbamate]. To develop an immunoassay for carbendazim and carbofuran we have synthesized molecules with acid function (haptens with 4 and 5 carbons) that are coupled with BSA protein and injected to the rabbits, collected antibodies are used for the achievements of the immunoanalytical assay.
196 Use of Intragastral Balloon and Increase in Fertility: Case Report     , Leite Letícia Torres1, Araújo Anna Bárbara Ribeiro1, Souza Luma Lorraine dos Reis1, Sander Bruno Queiroz2 and Lopes Joanilva Ribeiro3  
The IGB (intragastric balloon) is a silicone device, inflated by endoscopy in the gastric cavity, with physiological saline and a blue dye, up to the volume of 700 mL, and used for a maximum of 6 months. It is indicated for patients with BMI ≥27 kg/m² that have not undergone previous gastric surgery. In obese women there is a decrease in peripheral resistance fertility, and the weight loss achieved in bariatric surgery improves fertility due to reduced subcutaneous fat, with lower insulin resistance. Similar results could be achieved through the use of IGB, a less invasive method. The objective of the article is to report the case of a patient who became pregnant using IGB, considering the hypothesis that the increase in fertility was due to weight loss and/or due to the improvement in the self-esteem (and sexual life) of patient. We selected 13 articles from PubMed, UpToDate, JAMA and a case report. Results: Balloon with drawal occurred on 05/02/16 after positive pregnancy test with final weight 65.5 kg and BMI 25.91 kg/m². Conclusions: Weight loss actually favors fertility, but self-esteem may have been instrumental in improving the sex life, enabling conception.
197 Cardiac Complications in Maroteaux-Lamy Syndrome: Case Report     , Ricardo Siqueira Gonçalves¹, Claudia Aparecida Marques Landim², Jesuíta Mendes Cornélio³ and Joaquim Tomaz da Silva4  
MLS (Maroteaux-Lamy syndrome) or MPS VI (mucopolysaccharidosis VI) is an autosomal recessive pathology in which there is absence or low activity of the enzyme N-Acetylgalactosamine-4-Sulfatase, which hydrolyzes GAGs (glycosaminoglycans) in the body (mainly dermatan sulfate). Consequently, there occurs lysosomal deposition of GAGs in connective tissue multisystemic. Myocardium and heart valves are frequently affected structures, presenting a direct correlation with the reports of complications and deaths. Case report: RGS, male, 3 years and 2 months, diagnosed with MPS VI from the first month of life, in weekly ERT (enzyme replacement therapy) since 4 months of age (inconstant). At physical examination: normotensive, with holosystolic heart murmur 3+/6+ in mitral focus. Complementary tests: normal electrocardiogram, echocardiogram with pronounced mitral regurgitation, concentric left ventricular hypertrophy of moderate degree and mild aortic insufficiency. Discussion: Mitral valve disease is common in patients with MLS. Conditions such as cardiomyopathy, fibroelastosis, aneurysm and pulmonary hypertension may occur in these patients, indicative of morbidity and mortality. Early and constant ERT may be useful in slowing a progression of heart disease. Conclusions: follow-up with a cardiologist is important to evaluate the progression of cardiac complications in MPS VI. Constant and early ERT provides better prognosis for these patients.
198 Groove Pancreatitis: A Case Report     , Luciana Leony Valente, Mariama Alves Dantas Fagundes, Camila Medrado Pereira Barbosa, Hélio Miguel de Azevedo Bião Veiga and Maria Helena da Silva Borges  
We report a case of groove pancreatitis in which clinical and endoscopic findings improved with conservative treatment. Most authors suggest more aggressive management, such as Whipple’s surgery because of its similar findings to pancreatic carcinoma. Groove pancreatitis is a rare condition that requires more studies to establish diagnostic criteria to better classify the disease’s stage and direct appropriated therapy for the patient, improving morbidity and survival of this disease.  
199 Massive Pericardial Effusion as the First Manifestation of Hypothyroidism in a Male Patient     , Lívia Maria Carvalho Costa1, Flávia Lunardelli Negreiros de Carvalho2 and Wagner Leão Leite Tostes3  
This article intends to report a rare case of massive pericardial effusion as the first manifestation of hypothyroidism. A 45-year-old male patient, accompanied by a cardiology department, suddenly started to present signs of dyspnea and tiredness. He was submitted to an echocardiogram and diagnosed with dilated cardiomyopathy associated with a moderate pericardial effusion and low ejection of fraction. The laboratory tests showed elevated TSH levels (13.20 mIU/L), what leads to the hypothyroidism diagnose and enable to start the treatment with levothyroxine. The patient has not followed correctly the treatment, reason why he has not showed any improves. He was admitted in the hospital to cardiology monitoring and the chest radiography confirmed an intense pericardial effusion. Then, the patient was submitted to the pericardiocentesis procedure, which was capable of remove the pericardial fluid for laboratory analysis and fragment of the pericardial sac for neoplastic cell research. After the hospital discharge, he was maintained in outpatient follow-up, when showed an important improvement in the clinical state.
200 The Discussion of Peritoneal Dialysis Patients Taking Proper Portion of Valacyclovir     , Wan-shan Chiang1, Charn-ting Wang2, Wei-Chih Kan3 and Hui-Chen Huang4  
Dialysis patients have risk in Zoster virus because of low immune. Valacyclovir, used for Zoster virus, is digested in kidney and it has side effect of nerve virus on patients with malfunction kidneys. This article reviews 8 dialysis cases and discusses the proper Valacyclovir portion for peritoneal dialysis patients.  
201 Mobility after Heart Surgery: What Are Influential Factors?     , Gabriela Lago Rosier1, Gleide Glícia Gama Lordello1, Marcela Araujo de Moura1, Larissa Santana Correia1, Luana Lais Silva Polte1, Giulliano Gardenghi2, Luis Cláudio Correia1, Patricia Alcântara Doval de Carvalho Viana1  
Objective: To analyze postoperative mobility after cardiac surgery. Methods: Observational study in patients, aged ≥ 18 years, undergoing myocardial revascularization and/or valvular heart surgery, hospitalized in a Brazil hospital. The data collection took place between April 2016 and March 2017. On admission to the ward, patients received a calibrated pedometer. They were asked to use the device during five consecutive days, yet only three days of full use were analyzed. Results: Analyzed were data of 87 individuals with mean age of 58.70 ± 12.59 years, 52 (59.8%) of them were males. Regarding surgery, 53 (60.9%) underwent myocardial revascularization. The median number of steps was 738 (185-1,557), which showed a weak and inverse correlation with the length of stay in the intensive care unit (r = -0.3 / p = 0.02), however, it was not statistically significant when related to clinical and surgical data. Male patients had a better mobility when compared to patients of the female sex (p = 0.04). Conclusions: Individuals who had a longer stay in the intensive care unit, as well as females, had a lower mobility in the ward. The mobility did not show a relation with intra- and postoperative factors.
202 Stabilization of Alliinase from Garlic by Osmolytes and the Mannose-Specific Lectin ASAI   , Irina Shin1, David Mirelman2, Lev Weiner3, Enrique Villar4, Valery L. Shnyrov4 and Aharon Rabinkov1  
Objectives: Alliinase is a pyridoxal-5’-phosphate (PLP)-dependent enzyme responsible for the production of diallyl thiosulfinate (allicin), the biologically active component of garlic, from alliin. The use of allicin for treatment of various diseases has been proposed but it is very unstable in the blood stream. This difficulty can be overcome by administration of alliin, together with a conjugate of alliinase directed towards the target cells. This, in turn requires a stable and active form of the enzyme. In this study we evaluate the stability of alliinase itself, in the presence and absence of osmolytes, as well as that of its catalytically active complex with a mannose-specific lectin, ASAI (Allium sativum agglutinin I), also presents in garlic. Methods: Alliinase, and ASAI were both purified from garlic cloves. Thermal stability of alliinase itself, and of its complexes with PLP and ASAI, in the presence and absence of osmolytes, was analyzed by monitoring enzymic activity, and using DSC (differential scanning calorimetry). Key  findings: PLP exerts only a minor influence on alliinase structure and stablity. But both osmolytes and ASAI stabilize the enzyme considerably. Conclusions: The principle finding is that ASAI greatly stabilizes alliinase. Thus, the lectin-enzyme complex, which can be lyophilized and stored until used, provides an effective formulation of alliinase for generation of allicin from alliin in vivo. 
203 LC-MS/MS Method Applied to the Detection and Quantification of Ursodeoxycholic Acid Related Substances in Raw Material and Pharmaceutical Formulation , Boscolo Oriana1, Flor Sabrina1,2,4, Dobrecky Cecilia1,3, Martinefski Manuela1,2, Tripodi Valeria1,4 and Lucangioli Silvia1,4  
Objective: To develop a highly sensitive LC-MS/MS (liquid chromatography-mass spectrometry/mass spectrometry) method applied to the detection and quantitation of UDCA (ursodeoxycholic acid) related substances such as CA (cholic acid), DCA (deoxycholic acid), CDCA (chenodeoxycholic acid) and LCA (lithocholic acid) in raw material and pharmaceutical formulation. Methods: The method was validated for specificity, linearity, accuracy, precision, robustness. A triple quadrupole mass detector was employed, equipped with an ESI (electrospray ionization) source operated in the negative ion mode. The chromatographic system consisted of a Symmetry C18 column (150 mm × 4.6 mm, id; particle size 5 µm) and methanol-acetonitrile-ammonium acetate (pH 7.6; 10 mM) (40:40:20, v/v/v) as the mobile phase. The chromatographic conditions were 25 uL injection volume, flow rate of 0.4 mL/min and column temperature set at 35 °C. Key findings: The method requires a minimum sample amount and presents very low LOD (limits of detection) for CA (0.29 ng/mL), DCA (0.59 ng/mL), CDCA (0.13 ng/mL) and LCA (0.44 ng/mL) in comparison to LC methods coupled to different detectors like UV (ultraviolet), fluorescence and refractive index. Conclusions: The developed and validated LC-MS/MS method for the determination of UDCA and related substances in raw material and in a suspension was advantageous since it required a minimum sample amount. In turn, it could be used as a stability indicating method.
204 Changes of Liver Glucose Metabolism in C57BL/6 Mice Transgenic for Human Apolipoprotein ApoCIII     , Vilma Aparecida Ferreira de Godoi1, Guilherme Brescancin Mamus2, Diego Gustavo Linhares de Rezende3, Marcos Aguiar Primo3, Maria Montserrat Diaz Pedrosa1 and Jairo Augusto Berti1  
Mice overexpressing the human apolipoprotein apo CIII are a model of dyslipidemia. They become hypertriglyceridemic, hypercholesterolemic and have high blood levels of free fatty acids. Blood glucose is normal, but as the liver integrates lipid and carbohydrate metabolism, conditions of high inter-tissue circulation of energy substrates, such as fasting, may reveal hepatic alterations of glucose metabolism in these (CIII) mice. This hypothesis was explored by in situ liver perfusion in this investigation. The NTG (non-transgenic) animals showed liver and muscle glycogen content changes compatible with the fed or fasted state. In contrast, glycogen in group CIII was much lower in the fed state. The liver glucose release in group CIII after overnight fasting and adrenaline-stimulated was lower than in group NTG. Total glucose production under gluconeogenic conditions was not different between groups NTG and CIII, but glucose production from alanine was decreased in group CIII. Therefore, dyslipidemia caused by overexpression of apoCIII in mice alters the liver glucose metabolism, particularly compromising glycogen synthesis and degradation. This profile might have adverse outcomes during metabolic challenges that are more severe than fasting.
205 Altered Expression in Patients with Heart Failure of Circulating MicroRNAs Related to Lipoprotein Metabolism   , Priscila O. Carvalho1, Fatima R. Freitas1, Ana Elisa M. Martinelli1, Bruna M. O. Silva1, Milena N. C. Curiati2, Roberto Kalil-Filho1, Antonio C. Pereira Barretto3 and Raul C. Maranhão1,4  
Objective: This study aimed to investigate, for the first time, the expression of circulating miRNAs (microRNAs) related to lipoprotein metabolism in patients with HF (heart failure). Methods: Twenty patients with HF and 10 controls without HF were included. BNP (brain natriuretic peptide), a marker of HF severity, plasma lipid parameters and the expression of circulating miRNAs were determined. Key findings: Total, LDL-, non-HDL- and HDL-cholesterol, triglycerides, and apo A-I did not differ between both groups, but apo B was lower in the HF group compared to controls (p = 0.007). In respect to miRNAs, miR-33a, miR-144, miR-125, miR-30c, miR-122, miR-26a, miR-185, miR-758 and miR-106b were higher, from ten- to 25-fold, and miR-10b was lower about 4-fold, in HF group compared to controls. In HF patients a negative correlation between miR-26a and BNP, the marker of disease severity, was found (r = -0.552; p = 0.041). Conclusions: Plasma levels of miRNAs involved in HDL and LDL metabolism regulation were strikingly changed in HF patients. The negative correlation between miR-26a and BNP values may suggest the possibility of the rise of a novel biomarker or therapeutic target in HF. 
206 Distal Jejunal Intussusception from Melanoma Metastasis: Case Report , Renata Bruna Garcia dos Santos Gatelli1, Charles Nilton Gatelli1, Isabella Kern Arendt2 and Leonardo Werner Rasche2
Introduction: The invagination of one intestinal loop within another rarely occurs in adults and it is usually caused by a polyp or another intraluminal lesion. Intussusceptions occur mostly in children; an organic lesion is not necessary, and colic pain syndrome, rectal bleeding, and a palpable mass (the intussuscepted segment) are characteristics. Justification: To compare data from a tertiary reference hospital with data described in the literature, considering the evolution of such patients is unknown in our field. Objective: To report the case of a patient with distal jejunal intussusception from melanoma metastasis. Method: Information was obtained through medical record reviews, patient interviews, photographic records of the diagnostic methods and the surgery to which patients were subjected, and literature review. Final considerations: The case reported and the publications surveyed bring to light the discussion on the therapeutics of the complex condition that is melanoma metastasis, showing that some patients may present satisfactory and lasting results regarding symptom relief and improvement of quality of life.
207 Anemia as a Predictor of Mortality in Patients with Decompensated Heart Failure     , Paulo Átila da Silva Viana1,Vanessa Tavares Aragão1, Esther Carneiro Vasconcelos1, Bianca Ratts Freitas dos Santos1, Joaquim David Carneiro Neto2, Leandro Cordeiro Portela2 and José Antônio de Lima Neto2  
Objective: To correlate the presence of anemia with mortality in hospitalized patients with decompensated HF (heart failure). Methods: A total of 148 patients hospitalized for HF compensation were analyzed from April 1 to December 31, 2017 in a tertiary referral hospital for cardiovascular diseases. The diagnosis of anemia was established according to the Brazilian Ministry of Health criteria, considering a serum hemoglobin value of < 13 g/dL for men and < 12 g/dL for women. Data were collected through medical and physical attendance records. Statistical analysis was performed using the Epi Info program, version 7.0 for Windows, with Student’s t test for unpaired variables, Chi-square test and Fischer test. The significance of p < 0.05 was considered. Results: Of the 148 selected patients, 63.5% were male, 60.1% were over 65 years old, 50.74% were enrolled in the first grade, and 93.2% were self-declared white. The prevalence of anemia observed in the study population was 72 (56.25%), of which 49 (68%) were male and 23 (32%) were female. The mortality rate of the anemic patients was 19.4%, a total of 14 patients, whereas the non-anemic patients rate was 7.9%. It was observed that patients with worse outcome had hemoglobin < 12mg/dL (p = 0.045) and Functional Class (FC IV) by the New York Heart Association (NYHA) (p = 0.0001) at hospital admission. Conclusions: It is noticed that anemia is a frequent finding in patients with HF and that it interferes in the clinical manifestations, with worsening of the prognosis. Anemia treatment is not yet standarized in the HF approach, but patients without anemia appear to evolve with more favorable outcomes than anemia.
208 Association between Ebstein Anomaly and Coronary Artery Disease: A Report Case , Larissa Biolchini, Fabio Gouvêa, Isabela Furtado, Walter Gusmão, Henrique Veiga and Bruno Paolino  
The intention of this article is to report a case of a 26 years old man presenting a rare combination of congenital heart disease (Ebstein anomaly) and coronary artery disease. EA (Ebstein anomaly) has a prevalence of 1% of all congenital heart diseases, as CAD (coronary artery disease) has a little evidence in literature’s registries when occurred in individuals with 40 years old or less. Therefore, this case report rises attention to the rarity of those patologies, which individually are already considerably rare and, in this case, it comes associated what turns this diagnosis excepcional, highlighting the complexity of the treatment.
209 Coronary Artery Vasospasm with Acute Myocardial Infarction in a Male Patient: Case Report     , Angelo Alencar Mello Savoldi1, Alexandre Mello Savoldi2, Gustavo Alexandre Dutra1, Shirley Katherine Tinajero Enriquez1 and Gregue Marques Leite Costa1  
We present a 48-year-old male patient with a history of classic precordialgia, ST-segment elevation in inferior leads (II, III and aVF), with troponin and CK-MB (creatine kinase-MB) elevated on the day of admission that received conventional anti-ischemic treatment. Hemodynamically stable, symptom-free, is referred to cardiac catheterization. In the selective catheterization of the left coronary artery, a moderate lesion was observed in the middle third of the anterior descending coronary  artery; in the right coronary artery, a subocclusive proximal lesion with TIMI (thrombolysis in myocardial infarction) II. We performed a single projection and opted for angioplasty. Before, it was decided to re-evaluate the left coronary artery, and it was observed in the contrast test that anterior descending artery was occluded. Intra-coronary nitroglycerin and new contrast injection were performed, which showed totally open descending artery with TIMI III, without obstructive lesions as initially suggested, and improvement of  pain. It was a severe coronary vasospasm. When a new contrast injection was performed in the right coronary, with a therapeutic catheter, the disappearance of the subocclusive lesion and the presence of a normal coronary flow were observed, although there was a moderate plaque in its proximal third, which motivated the maintenance of angioplasty with stent placement in a proximal third of right coronary artery. During the passage of the intracoronary guidewire it was once again evident that diffuse coronary artery vasoreactivity was present; the procedure was successfully completed.
210 Tricuspid Valve Endocarditis in a Patient with Congenital Heart Disease     , Bárbara Liss de Sousa Freire, Suyane Gomes Leite, José Antônio de Lima Neto, Eduardo Ferreira Almeida, Joaquim David Carneiro Neto, Bruna Theresa de Sousa Freire  
The present study reports a case of a young patient who presented for 3 months dyspnea, edema of lower limbs, fever and important weight loss. She evolved with acute fever, hematemesis and focal seizures. An echocardiogram was performed demonstrating the presence of interventricular, interatrial, and extensive echogenic imaging and of poorly defined borders throughout the septal cusp of the tricuspid valve, suggestive of vegetation, chest tomography that observed several foci of pulmonary abscess and blood culture evidencing the presence of Staphylococcus aureus. She was treated with Vancomycin, Meropenem and Amphotericin, along with clinical support. She underwent surgery to exchange the tricuspid valve for a biological prosthesis, evolving with clinical improvement and receiving discharge from hospital.  
211 Endovascular Repair of Symptomatic (Non-ruptured) Abdominal Aortic Aneurysm in the University Hospital Centre Split     , S. Penović1, L. Cambj-Sapunar2, T. Batinić2, T. Borić1, I. Ribičić1, A. Kanjer1, R. Opačak1, F. Šimić1, and D. Meštanek1  
The aim of this study is overview of endovascular sAAA (symptomatic abdominal aortic aneurysm) treatment in the University Hospital Centre Split. The sAAA refers to a number of symptoms associated with aneurysm. EVAR (endovascular aortic repair) is increasingly used as an alternative to an open method that carries a number of advantages. Between January 2016 and February 2017, eight patients were admitted to the University Hospital Centre Split due to sAAA, following clinical and diagnostic treatment by a team of vascular surgeons and emergency radiologists, and ultimately treated with EVAR. Two patients had femoral endarterectomy. One patient had fistula of the right external iliac artery with left common iliac vein. After EVAR with embolization of the right internal iliac artery, the fistula was resolved. Also, one patient had occluded left external iliac artery and femoral-femoral bypass graft was made. After the procedure, two patients had endoleak of type II. Perioperative mortality was zero. On control examinations, all patients were with good general condition and without complications. A prompt diagnosis of sAAA and good team working will result of emergency endovascular procedure and resolve the risk for abdominal aortic aneurysm rupture. 
212 Percutaneous Implantation of Mitraclip® Device: First Case Report in the West of Paraná     , Cassiana Tomazoni, Evandro L. Q. Flores, Laura G. Flores, Leandro S. I. Ueda, Micheli G. Signor, Patrícia F. Ferreira and Vanessa C. Trentim  
MI (mitral insufficiency) is the most common valvulopathy currently, with surgery being the gold standard treatment. However, about half of patients with severe MI have a high surgical risk because of their age or comorbidities, therefore surgery is contraindicated. In this context, Mitraclip® appears, a device that allows the percutaneous treatment of MI and which is presented as a safe alternative and able to improve the quality of life for these patients. This work describes the first procedure performed at a referral hospital in western Paraná-Brazil. It is a male patient with mitral valve insufficiency due to mitral prolapse, submitted to endovascular therapy due to the high surgical risk because of his advanced age, presence of comorbidities and left ventricular dysfunction. From this modality, partial regurgitation improvement and intense symptomatic relief were obtained, demonstrating the great potential of the MitraClip® device to improve the quality of life of its patients.
213 Gonadal Steroid Hormones Levels in a Bitch with True Bilateral Hermaphroditism     , M. S. Araujo, O. L. O. H. Paulo, L. S. Camargo, C. S. Paranzini, F. N. Marqui, H. S. Oliveira, F. F. De Souza, and E. Oba  
Intersexualism occurs in all species of mammals and the pathogenesis of abnormal development of the gonads is still unclear. Thus, the aim of this report is to describe the hormonal and histopathological findings from a case of bilateral true hermaphroditism in a mixed-breed bitch due to the few case reports published involving hormonal levels in dogs with intersexuality. Serum was obtained from the animal before surgery and was submitted to hormone measurements. Progesterone and testosterone were evaluated by radioimnunoassay and estrogen by ELISA (immune-enzymatic assay). The values of progesterone, testosterone and estrogen concentrations were 2.26 ng/mL, 0.05 ng/mL and 9.7 pg/mL, respectively. The proportion of ovarian tissue found in the ovotestes after histopathological examination was higher in relation to seminiferous tubules, which may explain the low level of serum testosterone. Low concentration of serum testosterone may have contributed to the partial virilization of external genitalia, since the animal only had clitoral hypertrophy. Estrogen and progesterone levels found were compatible with the initial stage of estrus (preovulatory LH (luteinizing hormone) surge), which shows that ovarian follicles found in the bilateral ovotestes contributed to the occurrence of the estrous cycle before surgery. Quantitation of serum hormones may also shed light on the cause of disturbances in sex differentiation in canine species. More studies are needed to elucidate the real cause of intersex in dogs.
214 Effects of Supplementation of Dries Bio-Floc as Immuno-Stimulants on Survival Rate of Tilapia Infected with Flavobacterium columnare, VETSV01     , Sulaiman Madyod1, Suwanna Madyod2, Suwit Wuthisuthimethavee3, Jittawat Rodpun1, Rujira Makechumphon1 and Paweera Thonglaw1  
Objective: The aim of the research was to investigate efficacy of dried bio-floc supplemented with immuno-stimulants as beta-glucan and nucleotide on mortality rate and relative percent survival (RPS) of tilapia infected with Flavobacterium columnare, VETSV01. Materials and Methods: A research was performed in 1-inch long tilapia stimulated its immunity by infection with Flavobacterium columnare, VETSV01. Pathogenesis of 0.2 mL Flavobacterium columnare, VETSV01 in the range of 102-108 mL-1 fish-1 was injected into its intraperitoneal injection and intramuscular injection and suitable concentrations were screened to obtain for further experiment in a late restage. Based on data of minimal concentration, 50% mortality rate was caused and it was found the concentration of 108 mL-1 fish-1 caused 100% mortality rate and no lethal rate was found in other concentrations. Afterwards, efficacy of bio-floc sediment on survival rate of Tilapia infected with Flavobacterium columnare, VETSV01 was examined. Completely randomized design was employed and experiments were divided into 4 treatment: (1) control-commercial feed only, (2) commercial feed attached with dried bio-floc, (3) commercial feed attached with bio-floc and beta-glucan and (4) commercial feed attached with bio-floc and nucleotide. Experiment design was performed as 3 replicates with 10 fishes/replicates in 24 inch glass aquarium. Analysis of difference was performed and determination of mean differences of mortality rate and relative percent survival was done through Duncan’s Multiple Range Test (p < 0.05). Results and Discussions: It was demonstrated feeding tilapia with commercial feed in combination with dried bio-floc with or without supplementation of 2 immuno-stimulants could lead to 100% survival rate and 100% relative percent survival rate and it was statistically significant different (p < 0.05) compared to control group. Bio-floc product supplemented with beta glucan or nucleotide could effectively stimulate immunity against Flavobacterium columnare, VETSV01 and such high effective performance is viewed as a promising potential product to be further developed and practically employed for sake of aquaculture industry in the near future. 
215 Recombinogenic Effect of the Ternary Complex of Copper(II) with Doxycycline and 1,10-Phenanthroline on Somatic Cells of Drosophila melanogaster   , Jeyson Césary Lopes1,2, Luísa Mariana Melo Guimarães1, Júlio César Nepomuceno1,2, Sandra Morelli1 and Robson José de Oliveira Júnior1  
In the search for new anti-tumor agents, exploiting features such as the flexibility of coordination modes of metals have become an alternative strategy for synthesizing pharmaceuticals. It has been shown that the CuDP (copper(II), doxycycline, and 1,10-phenanthroline) complex cleaves DNA strands by an oxidative mechanism and by intercalating the major groove, resulting in a cytotoxic action. The objective of this study was to assess the mutagenic/recombinogenic effects of the CuDP complex in vivo using the SMART (Somatic Mutation and Recombination Test) in Drosophila melanogaster. Treatments were carried out with third instar larvae at the standard cross and high bioactivation cross using three concentrations of CuDP (6.92, 13.84 or 27.67 mM). The mutagenic doxorubicin (0.4 mM) was used as a positive control and reverse osmosis water as a negative control. For each compound, marked trans-heterozygous and balanced heterozygous individuals were analyzed to determine the mutational and recombinogenic events occurring in the cells. We found that CuDP significantly increased the frequencies of mutant cells in both standard and high bioactivation crosses, mostly by induction of recombination. These data show that CuDP is a direct recombinogenic agent that is independent of bioactivation.
216 Mechanical Circulatory Support in Patients with Sepsis: A Case Series , Helmgton José Brito de Souza, Henrique Louzan Machado, Thiago do Amaral Cavalcante, Leonardo Jadyr Santos Rodrigues Alves, Diogo Assis Souza, Rafael Ramos Amaral, Felipe Bruno Santos da Cunha, Marcus Vinícius Nasimento dos Santos, Glauco Kalil da Silva Pina, Isaac Azevedo Silva and Ricardo Barros Corso  
MCS (mechanical circulatory support) has shown great efficacy in treatment of respiratory and cardiovascular diseases when conventional therapy is insufficient. The use of ECMO (extracorporeal membrane oxygenation) for the treatment of cardiogenic shock secondary to sepsis is still controversial. Studies have shown that ECMO should be considered as a valuable therapeutic option in cases of refractory cardiovascular dysfunction in severe septic patients, although more studies are needed to consolidate its efficacy. We report the case of two patients, without previous history of cardiopathy, subjected to temporary MCS, with use of ECMO for the treatment of refractory cardiogenic shock secondary to sepsis.  
217 Three Cases of Familial Clavicular Hypoplasia     , Hui Ye and Lian-jia Li
CCD (cleidocranial dysplasia) is a kind of rare congenital skeletal dysplasia and deformity. It has rare clinical syndrome, such as forehead radius, small maxilla ofa cial, wide long distance eye, collapse nose, widening cranial suture, incompleted closure of the frontal, clavicle hypoplasia, increased range of shoulder motion and other abnormalities. Often accompanied by teeth hypoplasia or impacted, through a careful observation of the clinical morphology, case history and X-ray examination can confirm the diagnosis.  
218 Casearia sylvestris Improved Cutaneous Burn Repair in Diabetic Rats     , Anderson Martelli, Viviane Theodoro, Fernanda O. G. Gaspi, Maria E. C. Amaral, Rodrigo A. Dalia, Andrea A. Aro, Marcelo A. M. Esquisatto, Fernanda A. S. Mendonça, Thiago A. M. Andrade and Gláucia M. T. Santos  
Objectives: The burn repair associated with diabetes complications showed considerable changes in the healing process and the development of alternative therapies to favor the repair is important. This study investigated the efficacy of the Casearia sylvestris in the burn repair in diabetic and non-diabetic rats. Methods: The animals were divided into four groups (n = 20): (C) non-diabetics treated with carbopol gel; (G) non-diabetic treated with C. sylvestris extract in carbopol gel; (DM-C) diabetics treated with carbopol gel; (DM-G) diabetics treated with C. sylvestris extract in carbopol gel. Burn was induced using a metal plate (2 cm diameter/120 °C/20 sec). Samples were collected on the 3rd, 7th, 14th and 21st days after the injury for histomorphometric analysis (inflammatory infiltrate, fibroblasts, blood vessels and collagen), MPO (Myeloperoxidase) and NAG (N-Acetilglicosaminidase) dosage, hydroxyproline, glycosaminoglycans, TGF-β1, VEGF, collagen I and III. Key findings: C. sylvestris decreased the inflammatory process during the experimental period in diabetic and non-diabetic animals which has been demonstrated by MPO, NAG quantification, and TGF-β1 expression. C. sylvestris also increased blood vessels and decreased VEGF expression during the studied period in non-diabetic animals. Fibroplasia and collagenase were increased in all experimental periods in the DM-G group by means of de hydroxyproline quantification, collagen I, collagen III and glycosaminoglycans. Conclusions: C. sylvestris application can modulate favorably the time of inflammation and collagenous process in the repair of burn injuries in diabetic rats.  
219 Assessments of Immunological Activity of Achillea Millefolium Methanolic Extract on Albino Male Mice     , Ruqaya Mohammed Al-Ezzy1, Rafal S. A. Al Anee2 and Niran A. Ibrahim3
Achillea millefolium (Asteraceae) is a permanent herb highly recognized in traditional medicine for its anti-oxidant and anti-inflammation properties. However, studies on phytochemical constituents of A. millefolium underlying these properties are scarce. The present work focuses on examining the effect of methanol extract of A. millefolium L. on total and differential blood cells account on albino male mice. The results showed the methanol extract increased the account of lymphocyte, and monocyte cells, and total account as well as this extract showed high decrease in the oxidative stress of MTX after the interfere between the extract and MTX due to increase in the leucocyte cells compared with controls. Concluded from these results that methanol extract of A. millefolium has ability enhancement in leucocyte cells in the blood and it has detoxification effect of MTX.
220 Prognostic Biomarkers in Patients with Ischemic Stroke Who Received Thrombolytic Therapy   , Aleksandrs Fjodorovs  
Background: The aim of the research was to evaluate the association between CRP (C-reactive protein), troponin I, d-dimer, creatinine, glucose, GFR (glomerular filtration rate) and LDL-C (low-density lipoprotein cholesterol) levels at the admission and the results of thrombolytic therapy. Materials and methods: 113 patients who underwent thrombolytic therapy for acute ischemic stroke in Pauls Stradins Clinical University Hospital from 01.01.2015 to 01.01.2016 were studied retrospectively. Blood samples were collected in the emergency department. The neurological status was estimated using the NIHSS (National Institute of Health Stroke Scale). The efficacy of thrombolytic therapy was assessed by comparing NIHSS score at the admission and after treatment. Afterward all patients were divided into three groups—the major improvement (NIHSS > 4), minor improvement (NIHSS ≤ 4) and without any clinical effect. Results: Only the median levels of GFR were significantly (p = 0.015) lower in patients who did not have any clinical improvements after thrombolytic therapy as compared to patients with the major or minor improvements (60.0, IQR (interquartile range) 42.4-72.3 mL/min/1.73m2; 83.2, IQR 65.3-98.3 mL/min/1.73m2 and 75.9, IQR 59.2-94.6 mL/min/1.73m2). Based on the ROC (receiver operating characteristic) curve, the optimal cut-off value of GFR level as an indicator for prediction of worsen clinical outcome after thrombolytic therapy was projected to be 61.65 mL/min/1.73m2, which yielded a sensitivity of 71.4% and a specificity of 24.5%, the area under the curve was 0.788 (95% CI (confidence interval), 0.648-0.928). According Spearman rank correlation test was founded statistically significant indirect correlation between GFR level and NIHSS score after treatment   (r = -0.410, p = 0.020) in patients with severe stroke (NIHSS > 14). Conclusions: GFR level lower than 61.65 mL/min/1.73m2 at the admission could predict as a worse outcome, especially in patients with severe stroke.  
221 Heart Valve Injury Induced by Mediastinum Radiotherapy in Cancer Treatment , Patricia Fraga Paiva1, Alice Assumpção Soares1, Guilherme Sotto Maior do Valle Pinheiro1, Carolina Fraga Paiva2, Gisele Maria Campos Fabri3, Emanoel Guimarães Paiva4, Carlos M. Campos5,6 and José Fabri Junior1  
Radiotherapy as monotherapy or in combination with chemotherapy, has contributed to the drop in mortality rates related to neoplasms in the last 60 years. However, irradiation may promote heart damage and involvement is very common. As a result, VHD (valvular heart disease) is one of the earliest cardiovascular events post-radiotherapy. What it concerns to valve disease induced by chemotherapeutics, there are still only few studies. However, patients treated with chemotherapy in combination with radiotherapy had twice the risk of developing the disease when compared to those treated by radiotherapy alone. The heart injury caused by radiotherapy begins with damage to the endothelium and results in fibrosis and diffuses calcification primarily of the mitral and aortic valves. The echocardiography is the tool of choice to the patient’s assessment and follow-up after exposure. Prevention is the best option to face the valve damage induced by radiation. 
222 Case Report: Myxoid Liposarcoma in Retroperitoneum , Janaina Gomes da Silva Cirqueira, Jefferson Luiz Rodrigues Nascimento and Paulo Henrique de Sousa Fernandes  
Liposarcoma is a malignant neoplasm of mesodermal origin, which among sarcomas, 10% to 20% are located in the retroperitoneum. The case presented shows a 50-year-old male patient who initially presented weight loss and abdominal pain in the left iliac fossa. A tumor mass of hardened consistency was palpated in virtually all the abdomen. An abdominal ultrasound and a computed tomography of the abdomen were performed and confirmed the tumor mass. An exploratory laparotomy was performed, with removal of bulky abdominal mass of greasy consistency. A histopathological study of the piece reported myxoid liposarcoma. Clinical and prognostic features, as well as oncologic outcomes, are well known in this group of patients. The patient has been in the outpatient clinic for 7 years without tumor recurrence. Computed tomography is the fundamental study for the diagnosis of imaging. The treatment of choice consists in an aggressive approach aiming the complete resection, which is a major predictor of local and distant recurrence and survival.
223 Total Occlusion of Anterior Descending Artery (AD) without ST-Segment Elevation: DE Winter Pattern     , Ana Carolina Brito de Alcantara1, Francisco Marcelo Sobreira Filho2, Danielli Oliveira da Costa Lino2, Lúcia de Sousa Belem2 and Carlos José Mota de Lima2  
The recognition of the presence of ST-segment elevation in the context of ACS (acute coronary syndrome) is fundamental for the good outcome of the case. However, some electrocardiographic patterns have been highlighted by the fact that there is no elevation, but they represent a severity similar to ACS with ST elevation. Hence, it is necessary that doctors who do the first service recognize these standards promptly.The electrocardiographic pattern of association between the ST-segment depression and the hyperacute T waves representing myocardial infarction in the anterior wall, localizing more specifically in the anterior descending artery, now known as the De Winter pattern, was first described by Dressler, and then described by Winter six years later. Winter observed that, out of a series of 1,452 cases, 2% of patients with anterior wall infarction had the pattern of ST-segment depression, positive and symmetrical T waves, and occasionally mild ST-segment elevation at AVR derivation. Those patients are admitted to the emergency room with a typical chest pain. However, because the electrocardiographic findings of this syndrome are not known to many health professionals, in many cases the patients do not receive adequate care and have fatal outcome, since mortality is relevant in these cases. Thus, the rapid recognition of this pattern is extremely necessary for the correct and effective intervention.
224 Patients’ Level of Knowledge of State-Funded Screening Programs in Family Physician’s Practice     , Alevtina Hanturova1, Aiva Doroško1, Anastasija Tomilova1 and LÄ«ga Kozlovska2
Introduction: Screening tests have been shown to find cancer early and to reduce the risk of dying from cancer. In Latvia from 2000-2015 registered oncological patients had increased. At the end of year 2015, the 74,540 patients with oncology were registered. Aim: To evaluate respondents’ knowledge about screening and the reasons for non-use screening. Materials and methods: A cross-sectional study uses a survey of family physician’s patients. Responded data were summarized and processed with IBM SPSS 23 descriptive and analytical statistics. Results: In this study 102 patients’ survey data are used, at age group from 50 to 74 years. And 67% (n = 68) from of overall respondents were women, and 33% (n = 34) of respondents were men. The 35% of respondents visited family doctor 5 to 10 times per year, 29%—2-5 times per year, 19%—more than 10 times per year and 17%—once per year. Knowledge about screening programs of all respondents: 21% (n = 21) rated it as good, 26% (n = 27) rated it as bad and 53% (n = 54) rated it as average. And 49% of respondents said that screening includes colorectal cancer test, 65% that screening includes cervical cancer test, and 62% noted that screening includes mammography. Respondents identified the following reasons why they cannot use screening: 22% lack of informative material, 11% fear that diagnosed oncology, 14% do not feel that this is important, another 53% of respondents always use screening. Correlation was found between the number of family doctor’s visit per year and respondent’s knowledge about screening programs (p = 0.015, r = 0.24). Conclusions: Despite the increased number of health improvement campaigns, lack of knowledge about screening programs still exists. The results show that half of respondents still do not use screening. Population health and knowledge can be improved by regular health check through family physician.
225 Endoscopic Classification of Esophagic Eosinophilia , Augusto Fey1,2, Lorete Maria da Silva Kotze2 and Mônica Serapião1  
Introduction: EoE (eosinophilic esophagitis) is an inflammatory condition characterized by a dense eosinophilic infiltrate in the esophageal epithelium. In Brazil, it remains a poorly diagnosed disease due to the lack of interaction between the clinician, the endoscopist, and the pathologist. The diagnosis is performed by histological study of esophageal biopsies, with at least fifteen eosinophils per high-power field (EOS/HPF). Some doubts remain with respect to patients with a clinical picture and symptoms compatible with the disease (EoE), but who have a lower number of eosinophils than established. The main objective of this study was to create an endoscopic classification for EsEo (esophageal eosinophilia), which pointed the way to the endoscopist towards the diagnosis. Methods: This study was a prospective, two-year study, at a gastrointestinal endoscopy center where all patients with endoscopic symptoms and/or endoscopic findings suggestive of EsEo were biopsied for histological examination of EOS/HPF. After the study and compilation of the results, a retrospective study was performed, based on a review of electronic medical records, where the same diagnosis was searched, although at a period when this classification was not adopted. Results: A total of 4,251 endoscopies were performed between September 2011 and September 2013. Two biopsies were performed, aimed at lesions, in 133 patients with clinical picture or imaging suggestive of EsEo. Eosinophils were found in 55 patients, corresponding to an incidence of 1.29% of the total population studied and 41.35% of the suspected cases of the disease. EoE was diagnosed in 24 patients during the period of this study. In the two-year retrospective study, only two cases of EoE were found. Conclusions: The results of this study demonstrate that the endoscopic standardization of esophageal lesions, suggestive of eosinophilia, in this case by classification, alerts the endoscopist for the diagnosis of EoE, prompting him to perform targeted biopsies. Further, it was observed that two samples of esophageal tissue were sufficient for the diagnosis. The relationship between the clinical picture, endoscopy, and histology was not evident in this study.
226 A Concept Analysis of Continuity of Care in Nursing     , Yao Liao1, Qiaomiao Zeng2, Yu Xu3 and Qian Yang4  
Purpose: This paper is a report about the concept analysis of continuity of care, to get further understanding of continuity of care. Methods: The Walker and Avant concept analysis approach was applied in this paper. Results: The three attributes include: seamless transfer, flexible reaction and effective interaction. The antecedents were changed needs and patient centred care. In addition, the continuity of care had a significant effect on patients’ outcome, satisfaction and costs. Conclusions: This analysis provides nurses an understanding about continuity of care in both patient’s and care provider’s perspective. Continuity of care is a tailored services provided by care givers, which is an essential element of healthcare system. 
227 Primary Scientific Project in Evaluating the Quality of Life and Healthy Factors in Medical Students of a Private Brazilian University     , Gabriela Carvalho Monnerat Magalhães, Carolina Padilha Tavares, Fernanda Tebaldi Henriques de Queiroz, Jéssica Barone Sangineto Rocha, Camilla Soares Moreira, Mariana Montenegro Banharo and Lílian Soares da Costa  
Introduction: Limited data are available regarding medical students’ habits related to long duration shifts and graduation classes that could negatively impact on their academic performance. The objective of this study is to identify the profile factors related to life quality and cardiovascular risk on medical students of a private university in Brazil. Methods: This study is based on a descriptive analysis of cross-sectional cohort of a sample of 490 students from the first to sixth year of medical school. The data were collected through an anonymous questionnaire. Results: Some of the data were: 81.6% of students reported alcohol ingestion, 5.9% are smokers and 13.9% reported use of illicit drugs, 27.9% informed adding salt to the food, 78.4% reported stress/anxiety. Conclusion: After observing all the collected data, a project was built for a longitudinal analysis of the influence of life style during the medical school years on mental and cardiovascular health, short and long term.
228 Computational Intelligence-Based System in the Support of the Diagnosis of Brain Tumors: An Approach through Fuzzy C-Means Method     , Rodrigo Gondim Miranda  
Brain tumor is a major cause of an increased transient between children and adults. This article proposes an improved method based on magnetic resonance (MRI) brain imaging and image segmentation. Automated classification is encouraged by the need for high accuracy in dealing with a human life. Detection of brain tumor is a challenging problem due to the high diversity in tumor appearance and ambiguous tumor boundaries. MRI images are chosen for the detection of brain tumors as they are used in the determination of soft tissues. First, image preprocessing is used to improve image quality. Second, the multi-scale decomposition of complex dual-wavelet tree transformations is used to analyze the texture of an image. Resource extraction draws resources from an image using gray-level co-occurrence matrix (GLCM). Therefore, the neuro-fuzzy technique is used to classify brain tumor stages as benign, malignant, or normal based on texture characteristics. Finally, tumor location is detected using Otsu threshold. The performance of the classifier is evaluated on the basis of classification accuracies. The simulated results show that the proposed classifier provides better accuracy than the previous method.
229 Study of Effectiveness of Combined Antiallergic Drug Dualler-G     , T. Tchumburidze1, N. Alavidze2, T. Chikviladze1, N. Nemsitsveridze1, N. Dugashvili1, N. Kvizhinadze1 and T. Zarkua1  
The secretory granules of mast cells contain several mediators, some of which, such as histamine and serotonine, are known to participate in many immune reactions and allergic diseases. Allergic reactions play the leading role in pathogenesis of dermatitis and mechanism of such reactions is based on release of histamine and serotonin. Due to this, the development of drug with both antihistamine and antiseritinine activity was the goal of this study. Drugs with close chemical structure and pharmacological activity were selected from derivates of quinuclidin carbinols. This difference in pharmacological activity of different compounds makes Dualler-G, a new antiallergic drug with antihistamine and antiserotonine activity. The goal of the study was clinical trial of Dualler-G in patients with allergic dermatosis. Obtained data shows that Dualler-G shows high effectiveness in treatment of different types of dermatosis. The effect of Dualler-G, an original antiallergic drug, was evaluated in patients displaying different kinds of dermatosis (urticarea, eczema). A total of 22 patients diagnosed with dermatosisis were randomized to receive in an open fashion 40 mg of Dualler-G per day, for 2 weeks. Efficacy was assessed according to the common improvement of pathological elements on skin or itching as symptom. Clinical course of patients treated with Dualler-G tended to be significantly better than the patients treated with other antiallergic preparations and the symptoms were significantly correlated in the Dualler-G treated group. These data suggest that Dualler-G provides direct efficacy on the symptoms (skin elements and itching) in patients with different kinds of dermatosis.
230 Electromagnetic Stimulation Combined with Aloe vera Increases Collagen Reorganization in Burn Repair , Sofia Poletti1, Letícia D. Lucke1, Fernanda O Bortolazzo1, Renata M. Acunha1, Marcos G. Mattos1, Fernanda O. G. Gaspi1, Thiago A. M. Andrade1, Maria Esméria C. Amaral1, Andrea A .Aro1, Edson R Pimentel2, Marcelo A. M. Esquisatto1, Fernanda A. S. Mendonça1, Gláucia M. T. Santos1
Objectives: Burns are shown as a clinical problem for their severity and multiple complications due to the time required to heal. Therapies that improve their healing are of great importance, especially for being minimally invasive, of low cost and best performance, all related to the speed and quality of healing. This study investigated the effects of the magnetic electro stimulator Haihuá CD9 isolated or in association with Aloe vera in rats skin burns. Methods: Experimental groups (n = 30/group) were: (C) Carbopol gel; (F) A. vera/Carbopol gel; (H) Haihuá+Carbopol gel; (H+F) Haihuá+A. vera/Carbopol gel. Samples were collected on the 7th, 14th, and 21st experimental days for structural and morphometric analysis, hydroxyproline and glycosaminoglycans quantification, zymography for MMP-2 and MMP-9 and Western Blotting for TGF-β1, VEGF, Collagen I and III. Key findings: The expression of TGF-β1 in H+F was increased on the 7th day and of MMP-9 on the 7th and 14th days. The expression of VEGF increased in the first experimental periods and decreased in the last for the treated groups. There was an increase in the fibroblasts and birefringent collagen fibers in groups treated with Haihuá isolated or in association with A. vera in all periods. The quantification of collagen I increased, while collagen III decreased in H+F. The higher amount of GAGs and MMP-2 active isoform was detected in H and H+F during all periods. Conclusions: Considering the results of the present study, electromagnetic stimulation in association with the A. vera extract promoted an increase in the number of fibroblasts, GAGs content, MMP-2 activity, the deposition and organization of collagen fibers, favoring the repair of injuries to second degree burns, and may also present therapeutic potential in this injury type. 
231 Lasertherapy as A Strategy for Treatment Healing under Caloric Restriction – Study in Rats   , Leandro C. Moscardi, Talita P. Espíndola, Amanda A. Ferreira, Naiara Alves, Maria Esméria C. Amaral, Andréa A. Aro, Rodrigo A. Dalia, Marcelo A. M. Esquisatto, Fernanda A. S. Mendonça, Gláucia M. T. Santos and Thiago A. M. Andrade
Complications in the healing process are challenging, especially in clinical situations of caloric restriction (CR). The lasertherapy becomes an important strategy that aids the repair, especially in CR. Thus, it is important to investigate the InGaAlP-660 nm laser as an strategy to repair cutaneous wounds in rats submitted to 30% of CR and to understand the tissue repair in clinical situations of CR. Thirty-six male Wistar rats were used, of which half were fed with 30% less ration, and half with ad libitum diet, for 21 days. Then, punch lesions of 1.5 cm in diameter were made on the animals backs, which were divided into: NR (no-restricted), R (restricted)—both before lesion; C (control), RC (restricted-control), L (laser), RL (restricted-laser)—after lesion. Samples of the skin/lesion/scar were collected on the 2nd, 7th and 14th days post-injury for histological, biochemical and molecular analyses. The R group showed reduction of body mass, epidermal/dermal thickness, inflammation, angiogenesis, fibroplasia and collagenesis. The RL group showed control of inflammation, oxidative damage and increase of antioxidants than RC, which probably favored angiogenesis, collagenesis and reepithelialization, similar to C and L. Thus, 30% of CR impaired the skin (before lesion). In the lesion, lasertherapy has shown to be effective in tissue repair mainly in CR status, being thus, the laser clinically important strategy to tissue repair in critical situations of caloric restriction.
232 Characterization and Antitumor Activity of Chitosan/Poly (Vinyl Alcohol) Blend Doped with Gold and Silver Nanoparticles in Treatment of Prostatic Cancer Model , A. Abaza1, E. A. Hegazy2, Ghada. A. Mahmoud2 and B. Elsheikh3
The application of nanotechnology in various fields of science has earned a great concern over the past decades. The natural products and surface-modified polymers and metallic nanoparticles (NPs) have evolved as promising nanomaterials for targeted prostate cancer treatment. In the present study, Chitosan/poly (vinyl alcohol) (Cs/PVA) blend was synthesized by gamma radiation which could behave a nanoreactor for silver (Ag) and gold (Au) nanoparticle with promising anticancer applications. (Cs/PVA/Ag) and (Cs/PVA/Au) nanocomposites were confirmed by SEM (scanning electron microscope) and TEM (transmission electron microscope) analysis. The swelling properties have been investigated as a function of time and pH. The anti-cancer activity of the prepared nanocomposites was demonstrated in prostatic cancer cell line. It has a significant effect against prostatic cancer. However, metal nanoparticles have shown a good experimental success in the field of nanomedicine especially in cancer treatment, which has always been an area of high concern. The collaboration of biomedical research in the identification and characterization of biomedical strategies using the interesting metal nanocomposite will impact the future nanomedicine greatly.
233 D-Transposition of Great Arteries in a Primigravida of 35 Years Old—Case Report and Literature Review     , Ali Kassen Omais1, Camila Martines Mello1, Nathalia Suzan Camarão Martins1, Natália Regina Alécio Mettelo Diehl1, Alethéia Carpine Favini Schefer1, Felipe Amorim Zarour1, Julio Cesar de Oliveira1, Janice Lanzarin1 and Gisele do Couto Oliveira2
This is a case report with discussion of the maternal-fetal outcome of pregnant women with uncorrected transposition of the great arteries (TGA) associated with pulmonary arterial hypertension and a large ventricular septal defect. This case draws attention to the severity of the pathology and maternal symptoms prior to gestation, and how an adequate clinical management of both obstetrics and cardiology can provide a favorable outcome for mother and fetus.
234 Right Ventricular Perforation after Pacemaker Implantation in an Elderly Woman: A Case Report     , Fernando S. Montenegro  
Background: Cardiac pacing is a proven and effective treatment used worldwide with a low incidence of complications depending on the patient group. Late lead perforation is a rare complication without a standard treatment. Case summary: We report a case of a 98-year old woman submitted to pacemaker implantation due to symptomatic second-degree atrio-ventricular block. After two days she returned to the hospital with thoracic pain and was diagnosed with RV (right ventricular) lead perforation. She was submitted to cardiac surgery with lead extraction and RV repair. Discussion: There are two major types of complications after pacemaker implantation, mechanical and infection. Reported perforation rates after pacemaker implantation range from 0.1%-0.8%. While acute lead perforation is very well described, late lead perforation is only described in case reports with a low rate of tamponade or death. Management of subacute or delayed RV lead perforation is not well defined due to very limited data. Question remains on whether to extract the lead or not.
235 Left Ventricular Myxoma: Case Report   , Holanda Filho Luiz1, Arruda Filho Mauro², Martins Isabela³, Gomes Hugo4, Siqueira Mariana4 and Brito Evandro5,6
Male, 22 years old, hospitalized in a reference hospital, was diagnosed with a left ventricular myxoma, and underwent into surgical removal of the tumor. The left ventricular myxoma is a rare condition where very few hospitals in the world have experienced in its resolution, making the advancement on its management studies difficult. This article’s goal is to promote an update about this subject. 
236 Diagnosis of Hypophosphatasia     , Cleiton Fantin1, Denise Correa Benzaquem1 and Vânia Mesquita Gadelha Prazeres2
Objective: HPP (Hypophosphatasia) is a congenital disease characterized by a deficiency of tissue-specific ALP (alkaline phosphatase), which causes the generation of abnormal bone and tooth tissue. The clinical manifestations are variable, from neonatal forms with high mortality to milder adult forms with fractures and osteomalacia. The present study reports a clinical case of HPP, with emphasis on the physical characteristics and laboratory tests. The patient was attended at the medical genetics outpatient clinic of the Association of Parents and Friends of the Exceptional of Manaus (Associação de Pais e Amigos dos Excepcionais-APAE/Manaus). Methodology: For the case report, anamnesis, peripheral blood G-band karyotyping, Vitamin and ALP dosage and resonance examination were performed. Results: A.M.M.S, 9 years, non-consanguineous parents, no bone disease in the family, with one sister from the mother. Birth weight AGA without intercurrence. The patient presented a slight delay in psycho-motor development and was diagnosed with craniostenosis through CNS imaging examination. The physical examination, in addition to a short stature, showed dolichocephaly, frontal bossing, curved tibias and great dental compromise with many early cavities and loss of teeth. Laboratory evaluation: ALP dosage: 63/L (N = 69-325); Vitamin B6 dosage: 27.4 (5.2-34.1). The mother and the younger sister also had an ALP result below that expected for the age. Conclusions: The clinical phenotype and laboratory diagnosis of the patient were compatible with ICD Q78 HPP.
237 Spontaneous Coronary Artery Dissection with Clinical Presentation of Acute Myocardial Infarction     , Taísa Godoy Guzzela1, Luciano de Siqueira Bracci Júnior1, Mauro Rogério de Barros Wanderley Júnior2, Sandra Helena Gonsalves de Andrade2, Mauro Cosme Gomes de Andrade2, Raony Previtali Paniquar2, Izabela Guimarães Falcão Alves2, Nayrelle de Alencar Ferreira Gomes2, Jandir Ferreira Gomes Júnior2, Marcela Lopes Muniz de Andrade2, Renata London Rodrigues2, Diego Silveira da Costa2, Lucila Buriasco de Oliveira2, Amanda Ribeiro2, Letícia Trad Martins Costa2, Diego Braga Filartiga2 and Reiby Caetano Mustafá2
SCAD (spontaneous coronary artery dissection) proves to be a pathology of several manifestations, whose clinical diagnosis is a challenge for emergency departments. Therefore, their early identification and knowledge of the various forms of presentation are mandatory for optimal medical therapy. We present a case report of a 45-year-old patient who was admitted to the coronary unit showing symptoms and laboratory tests compatible with myocardial infarction. Complete diagnosis was obtained only with more specific exams. The manifestations of the disease in the case described and the main features of the disease are discussed.
238 In vitro reproduction of Kidney Tea (Orthosiphon stamineus Bents)     , Nana Zarnadze, Inga Diasamidze, Natela Varshanidze, Ketevan Dolidze and Tsiala Bolkvadze
The stages of introduction in vitro culture of the local population of the kidney tea (Orthosiphon stamineus Bents) cultivated in the Georgia’s medicinal plant farm and the microclonal propagation, in particular, have been elaborated. The cultivation of explants was carried out on the Gamborg (B5) feeding area. The hormonal (BAP; Zn; NAA) composition of the feeding area and their concentrations have been selected; proliferation of buds in the basal part of the sprout has been achieved from the formed morphogenic tissue. The microclones by activating axillary meristem have been received. 
239 Comparison of Standard Elution and Displacement Modes in Centrifugal Partition Chromatography for an Efficient Purification of Four Anthocyanins from Hibiscus sabdariffa L.     , Nor Syaidatul Akmal Mohd Yousof1, Nikos Xynos3, Evanthia Dina2, Maizatul Hashima Omar1, Choong Yew Keong1, Mohd Isa Wasiman1 and Nektarios Aligiannis2
The increasing demand for natural food antioxidants has hastened research to extract the biologically active substances from a variety of raw materials. The consumption of anthocyanin-rich food promotes health by contributing to cardio protection, lowering high blood pressure and by helping to protect against cancer. In this study, centrifugal partition chromatography (CPC) was studied for anthocyanin separation from Hibiscus sabdariffa L. (HS). A simple elution and two displacement protocols were implemented. The displacement modes were strong ion-exchange (SIX) and pH-zone refining (pHZR) method. Among the three protocols, SIX CPC using trioctylmethylammonium chloride (Aliquat 336 ®) as a strong exchanger was the most successful in purifying four anthocyanins from an ethanolic extract of HS, identified as delphinidin-3-O-sambubioside (DS), cyanidin-3-O-sambubioside (CS), delphinidin-3-O-glucoside (DG) and cyanidin-3-O-glucoside (CG). The purification process was carried out on a gram scale using the ternary biphasic system ethyl acetate:n-butanol:water (mobile organic phase: 4.0/4.6/1.4; aqueous stationary phase: 0.5/0.5/9.0) in the ascending mode. Aliquat 336® was used as the anion extractant in the aqueous stationary phase and sodium iodide (NaI) as the cation displacer in the organic mobile phase. From 1 g of crude HS extract, 80 mg of DS, 40 mg of CS, 15 mg of DG, and 4 mg of CG were obtained after 75 minutes. High performance liquid chromatography (HPLC-UV and LC-MS) analysis revealed the identity and the purity of the isolated compounds: 88% for DS, 92% for CS, 93% for DG and 70% for CG. This new methodology for the isolation of anthocyanin mixtures successfully increased the purity and efficiency especially for DG and CG, while maintaining excellent recovery rate and being relatively low cost. The availability of high purity anthocyanin mixtures will facilitate anthocyanin testing studies and will widen the use of anthocyanins in the food, supplements and pharmaceutical industries.
240 How Spines Cross-Talk: Compartmental Model of Heterosynaptic Plasticity     , Zhang Zhong1 and Li Yinyun2,3
This study addresses the fundamental principle of inter-synaptic interactions in synaptic cross-talk through homosynaptic and heterosynaptic plasticity by studying the intrinsic calcium signaling dynamics in spines. Beyond the calcium influx into synapse through voltage gated calcium channels (VGCCs) and N-methyl-D-aspartate (NNMDA) receptors, the function of calcium released from internal store in mediating inter-synaptic cross-talk has barely been modeled. This work investigates how different sources of calcium contribute to inter-synaptic cross-talk and synaptic clustering. Based on experimental observations, we developed a mathematical model in one dimensional system with uniform distribution of spines with the connected dendrite. We modeled the biophysical process of calcium induced calcium release (CICR) in the dendritic smooth endoplasmic reticulum (SER). Our model compared distinct roles of calcium diffusion, back propagated action potentials (bAPs) and CICR played in synaptic clustering and inter-synaptic cross-talk. The simulation result demonstrated that calcium signal extruded from spine into dendrite requires amplification by CICR before invading neighboring spines to induce plasticity. Our model predicted that initial calcium concentration in SER may discriminate between different types of neuronal activity and induce completely different synaptic potentiation and depression.
241 Effect of Gold Nanocomposite on the Cytotoxicity of Human Cancer Cell Lines     , A. M. H. Abaza1, G. A. Mahmoud2 and B. B. Elsheikh3
Gold nanoparticles (AuNPs) have a biological property that have attracted significant attention in this decade, especially in the field of biomedical application with great therapeutic potential. Additionally, the chitosan molecule appears to be a suitable polymeric complex used in this field. The aim of the current study is to explores the cytotoxicity and the IC50 value of Au-doped chitosan-poly (vinyl alcohol) (Cs/PVA/Au) nanocomposite that was developed by gamma irradiation with promising anticancer activity. The anti-cancer activity of the prepared nanocomposites was demonstrated in human liver cancer cell line HEPG2 and MCF7 breast cancer cell lines. It has significant effects against both cancer cell line. Concluding that, the future nanomedicine will be impacted greatly by the collaboration of biomedical research and developing nanoparticle therapy in the right directions, which will improve the outcome of cancer patients. It is expected that the next decade will reveal real potential for metal nanoparticles to cross the regulatory barrier into clinical use as effective therapeutics.
242 Importance of the Pharmaceutical Council in the Dispensation of Laxants and Probiotics   , Pablo Lopez Veiga Juana Benedi González and Irene Iglesias Peinado  
The goal of pharmaceutical care is to improve the patient’s quality of life, and it must do so by maximising its effectiveness and reducing the risks of the treatment. Therapeutic protocols are an important tool for encouraging the correct use of drugs. The aims of this work are: to analyse the type of patients who visit the pharmacies in the study; to determine the importance of pharmaceutical advice in dispensing; and to identify the most commonly used strains of probiotics and laxatives. A transversal descriptive and observational study was conducted with 500 patients in five pharmacies. The population taking part in the study is predominantly female, aged over 61, of Spanish nationality, actively employed and with middle or higher educational studies. Over 90% of the patients followed the advice of the pharmacist over the advice of their doctors. The most widely used probiotics were Lactobacillus acidophillus and Saccharomyces boulardii for gastrointestinal protection and treatment of diarrhoea. The most commonly used laxatives are bulk-forming and contact laxatives. The pharmacist’s opinion is increasingly important in the treatment of pathologies that may be considered as minor. Therapeutic protocols are an aid to correct dispensing.
243 The Impact of a Clinical Pharmacist in the Emergency Department of an Academic Hospital in the Kingdom of Saudi Arabia     , Waad H. Al-Kathiri1,2, Hossam A. H. Abdelrazek3 and Hisham S. Al-Jadhey4
Introduction: The department of emergency medicine (DEM) has a high-risk environment due to its unique and complex workflow. Many high-risk medications are ordered and administered at patients’ bedsides without being checked by a pharmacist first, which may lead to an increase in the incidence of patient medication errors (MEs). Objective: The current study evaluated the needs of the clinical pharmacy service in the DEM at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. Methods: A cross-sectional retrospective study was conducted between Jan 2016 to Dec 2017 and the documentation of clinical pharmacist interventions was extracted from Esihi database. Results: A total of 2,255 interventions for 862 patients were documented. The recommended interventions were as follows: 645 (dose adjustments), 108 (therapeutic substitutions), and 354 interventions (initiating drug therapy). Adverse drug reactions (ADRs) were reported in 16 patients, and drug interactions were managed in 26 patients. The DEM responded to 713 information inquires and 290 pharmacokinetic consultations. Drug discontinuations included 39 incidents (where unjustified drug prescription occurred), 37 (where contraindications were involved), and 19 (where duplicate therapy was involved). The most common interventions were related to the following drugs: antibiotics (34%), anticoagulants (15%), and anticonvulsants (10%). The acceptance rates for the EM clinical pharmacist recommendations increased from 93.9% in 2016 to 99% in 2017. The most common outcome for interventions was to optimize the therapeutic effects of the drugs that were administered (73%). Reconciliation was done in 796 patients. Conclusions: The clinical pharmacy service plays a critical role in the management of patients in the emergency department (ED). 
244 Evaluation of Continuous Peripheral Nerve Block in Total Knee Arthroplasty Post-Operative Pain Management     , James Hillman
Total knee arthroplasty (TKA) can contribute to significant pain for the patient. Continuous peripheral nerve blocks (CPNBs) have been shown to be efficacious in treating post-surgical pain. The objective of this study is to determine the efficacy of a bupivacaine 0.2% solution administered via CPNB plus standard of care (SOC) compared to SOC alone. SOC for this institution includes the use of opioid analgesics, non-opioid analgesics, regional anesthesia, and other adjuncts. The primary outcome is the overall use of post-operative pain medication. Secondary outcomes include the average length of stay and average pain scores. Methods: A data surveillance system was used to retrospectively identify all patients who underwent TKA with and without the use of CPNB. To be included, patients must have been male or female ≥ 18 years of age who underwent TKA from September 2016 through September 2017. And 70 patients were included in both the CPNB and SOC groups. A retrospective chart review determined the following data: The types and amounts of pain medications used, the length of stay, and patient-reported pain scores. Results: There was an increase in the amount of as needed pain medication use in the CPNB + SOC vs. SOC group with 12.97 administrations vs. 12.67 administrations respectively. Length of stay was increased in the CPNB + SOC vs. SOC group with 3.65 days in the CPNB + SOC group vs. 3.5 days in the SOC group. Pain scores were increased in the CPNB + SOC group with a patient average pain score of 4.5 vs. the SOC groups average pain score of 4.4. Conclusions: The use of a 0.2% bupivacaine solution administered via CPNB in addition to SOC resulted in increased utilization of as needed pain medication administration, increased average length of stay, and increased average pain scores when compared to SOC alone. 
245 Hematopoietic Stem Cell Transplantation in Vietnam: Current Status and Future Directions   , Phu Duc Vinh Huynh1, Man Van Huynh2, Nam Duy Hoang1, Ngon Thien Huynh1, Tuan Xuan Ma1, Thu Hanh Nguyen1, Dung Chi Phu1 and Binh Tan Nguyen1
In recent years, there have been an increasing number of hematologic patients in Vietnam. Hematopoietic stem cell transplantation (HSCT) is fast becoming an effective method to cure many benign and malignant blood disorders. Nine transplant centers are operating throughout Vietnam. HCMC Blood Transfusion Hematology Hospital (BTH) is one of these centers where bone marrow, peripheral blood and cord blood stem cell transplantation were first conducted in our country. At BTH, half of the patients received allogeneic HSCT, mainly from matched sibling donors due to lack of a national bone marrow donor registry. While acute myeloid leukemia was a common indication of allogeneic HSCT, most of the patients undergoing autologous HSCT had multiple myeloma. One major issue we encountered concerned bacterial and fungal infections during neutropenia period. Because of an endemic area, CMV reactivation frequently occurred. Five-year overall survival (OS) and event-free survival (EFS) were 47% and 46%, respectively. To create more opportunities for patients, our future directions will focus on some new transplant procedures, such as haploidentical, unrelated and cord blood transplantation.
246 Sanitary Regulation of Pharmaceutical Products in Mexico (Sanitary Registration-Board Arrangement-Patent)—Monoclonal Antibody Case Study     , Patricia Parra Cervantes, Felix Lugo Trejo, Ramón Soto Vázquez and Alma Herrera Márquez
The Federal Commission for Protection against Health Risks in Mexico (COFEPRIS) is responsible for the regulation and health promotion of the production, commercialization, import, export, publicity or involuntary exposure of medicines and technologies for health. For its part, the Mexican Institute of Industrial Property (IMPI) is a decentralized public body with legal personality, own property and legal authority to administer the industrial property system in our country. In the year 2000, on September 19, the official journal published the linking of patents related to allopathic medicines and the sanitary registry. Objectives: To publicize the process of linking the Sanitary-Patent Registry as a case study to delimit the scope of the new pharmaceutical products. Methodology: Request the information to COFEPRIS for the registration of a new pharmaceutical product; Establish flow diagrams for the registration of: innovative products, generic products, biotech products and bio similar products; Integrate the documents in the dossier of the pharmaceutical product for sanitary registration; Elaborate sworn letter of non-invasion of patents and study of patents; Submit the Health Registry; Intergovernmental consultation. Sanitary Registry Results: Search of patents in databases to elaborate state of the art, to write letter under protest to say truth that is not invading any patent, when developing a composition of cetuximab, as generic product since the patent molecule expired in 2016 and 11 patents related to compositions, preparations and finished product preparation processes. Conclusions: COFEPRIS will determine through intergovernmental consultation with the IMPI whether or not a patent is invaded, according to the case it will grant the registration or send the corresponding prevention for cetuximab, in case that invading can also be a refusal of grant.  
247 Development and Validation of Proximal Chemistry Analytical Procedure in Semi-automated Equipment     , Patricia Parra Cervantes M.1, Tonantzin Rios Rodríguez2, Janet Edith Santamaría Víquez2, Ramón Soto Vázquez1 and Joaquin Tlatempa López2
The proximal chemical analysis (AQP) includes 5 fundamental tests, which are: determination of crude protein, determination of crude fiber, determination of humidity, determination of ashes and determination of fat. This last determination can be made in two different ways, which will depend on the type of sample being treated, as well as the amount of fat expected to be obtained in the food to be analyzed. For foods with low amounts of fat the hydrolysis technique is used, which is divided into 3 phases. All the methods before being taken to the daily practice in a laboratory of food analysis either internal control, verification or third authorized must be validated, in order to obtain consistent, robust and reliable results. In those cases in which the method that will be tested differs with the method that is reported in the literature, a comparison of both methods should be made in order to ensure that both are compatible and the results will be equally reliable. In the validation, the acceptance parameters will be established for each one of the tests that are carried out in it, while at the end of it the acceptance criteria for the general method will be established. The objective of this work was to carry out the development of analytical methodology that was validatable in order to reduce analysis time by using semi-automated equipment. In the case of semi-automated equipment, this comparison of methods is carried out, as it was the case of the analysis of fat with hydrolysis, which used a hydrolysis unit and the extraction equipment using samples of finished food for animal consumption. The results obtained in the validation using the traditional method correspond to a CV less than 2%, while the results obtained using semi-automated equipment correspond to a CV less than 2% for the case of fat determination with hydrolysis.
248 Investigation of the Mutagenic Potential of Immunomodulator Arglabin Native in Tablets in the Ames Test , Khorlan I. Itzhanova, Roza B. Seidakhmetova and Sergazy M. Adekenov  
The mandatory preclinical safety evaluation is an essential prerequisite to obtain the qualitative and effective medicines. Due to the fact that drugs may reveal genotoxic properties, the investigation of their mutagenic activity is an obligatory part of the preclinical drug safety program. The aim of the research is to study mutagenic properties of a new original immunomodulator Arglabin native in tablets in the induced test of gene mutations (the Ames test) on Salmonella typhimurium strains. Materials and methods: Four strains of S. typhimurium TA98, TA100, TA1535, and TA1537 were used to assess the mutagenicity in the Ames test. Results and conclusions: No statistically reliable dose-dependent increase in the number of revertant colonies of Salmonella typhimurium has been observed in the presence of the given drug within the investigated dose ranges from 5.0 to 100.0 μg/mL for strains TA100 and TA1535, and from 5.0 to 250 μg/mL for strains TA98 and TA1537 against the baseline of spantaneous mutations. Arglabin native in tablets does not reveal a mutagenic activity within the studied dose ranges on Salmonella typhimurium strains TA98, TA100, TA1535, TA1537.
249 Association of HbA1c Level with Lipid Ratio in Diabetic Patients     , Lizete Klavina1, Beate Ulmane1, Lāsma Milgrāve1 and GuntaTÄ«cmene1,2
Introduction: Diabetes mellitus is a common disease in the world and the number of diabetes patients is rapidly increasing. Dyslipidemia is one of the most risk factors for cardiovascular disease which is more prevalent among adults with diabetes than in the general population. Aim: To study the correlation of diabetes patients glycated hemoglobin (HbA1c) with lipid ratios. Materials and methods: Samples were collected from 101 diabetic patients (aged 19-86 years; male 51, female 50). Retrospective study included data such as age, gender, type of diabetes, HbA1c, total cholesterol, LDL cholesterol and triglyceride from two family medicine doctor’s practices. According to the HbA1c level, the patients were divided into three groups, group A (HbA1c < 7%, n = 58), group B (7% ≤ HbA1c < 10%, n = 37) and group C (HbA1c ≥ 10%, n = 6). The correlations of HbA1c with lipid ratios were analyzed. Results: In the group A the mean HbA1c was 6.1 ± 0.5%, mean age—60.6 years, total cholesterol—4.7 mmol/L, LDL—2.8 mmol/L, triglycerides—1.6 mmol/L. In the group B the mean HbA1c was 7.7 ± 0.6%, mean age—64.0 years, total cholesterol—5.7 mmol/L, LDL—3.1 mmol/L, triglycerides—2.2 mmol/L and in the group C the mean HbA1c was 11.2 ± 1.0%, mean age—48.7 years, total cholesterol—4.9 mmol/L, LDL—2.7 mmol/L, triglycerides—1.7 mmol/L. Conclusions: From all groups highest total cholesterol, LDL cholesterol, triglycerides were patients in the group B. In others two groups lipid profile changes were without any significant differences and there was no association with HbA1c.
250 Assessment of Dietary Exposure and Health Risk to Multiple Heavy Metals amongst Some Workers in Yaoundé, Cameroon   , Angèle N. Tchana1, Nina D. Kamnang1, Arielle T. Maliedje1, Faustin T. Manfo2, Frederic N. Njayou1, Wilfred A. Abia1, Edouard A. Nantia3 and Paul F. Moundipa1
This study reports on the dietary exposure of people in Yaoundé, Cameroon to heavy metals: lead (Pb), cadmium (Cd), mercury (Hg), copper (Cu) and zinc (Zn). One hundred and fifty table-ready food, water and soft drink samples were collected from households and street restaurants in Yaoundé and analyzed for heavy metals contents using atomic absorption spectrophotometer. Lead (93%, range 0.019-1.77 ppm), Cd (70%, range 0.01-4.68 ppm), Hg (81%, range 0.03-10.56 ppm), Cu (90%, range 0.004-40.32 ppm) and Zn (87%, range 0.014-2,447.04 ppm) were detected in studied samples. Maximum level of each metal exceeded its corresponding European Commissions legislative limits. Samples from street restaurants were most tainted with heavy metals. The highest average daily intakes (ADIs) of Pb (0.96 mg/day) and Hg (1.84 mg/day) were through tap water, while Cd (1.15 mg/day), Cu (5.42 mg/day) and Zn (601.6 mg/day) were through rice/peanut sauce mixed food. The ADI for Cd and Hg was each higher than its respective PTDI (provisional tolerable daily intake) as defined by JECFA (Joint FAO/WHO Expert Committee on Food Additives) and EVM (Expert Group on Vitamins and Minerals). The estimated average daily exposure dose of each detected metal significantly (p = 0.001) exceeded its corresponding PTDI. However, the health risk index was < 1 for all studied samples and it was found to be safe, indicating there is a relative absence of health risks associated with the ingestion of contaminated foods, water and soft drinks. Notwithstanding, the detected levels and ADI being higher than legislative limits and PTDI respectively speculates need for awareness raising towards reducing exposure levels to heavy metals in Cameroon.
251 Photoprotection-UV Filters: Properties, Use and Safety in Sun Products   , Antonina Agolzer
Sunscreen application is a common strategy used to prevent the damage induced by UV radiations. In the last 30 years a variety of protective agents against UV exposure have been developed: physical filters, chemical filters and organic filters. Physical filters are the safest: they scatter and reflect UV rays, but are difficult to apply on the skin. Chemical filters are capable of absorbing these rays, they are cosmetically pleasant, but recent studies suggest a toxicological nature for some of these agents. Organic filters are the newest advance in sun products. Since 2003 the COLIPA Index [Europe] has regulated sun product availability on the market. In the USA, the FDA establishes the classification and the safety of sun products, which are considered topical medical drugs. This article summarizes the dermatologist’s point of view, according to the patient’s request, professional ethics and increasing offer of sun product. 
252 Reliability of Rapid Diagnostic Test (RDT) for Malaria among Pregnant Women in Ido-Ekiti, Western Nigeria     , Ibrahim A. O.1, Bello I. S.2, Shabi O. M.3, Gabriel-Alayode E.M.3, Agboola S. M.3 and Elegbede O. T.3
Background: Malaria is the commonest cause of anemia in pregnancy with severe consequence on the developing fetus. Recent clamor by the WHO for testing before treatment has driven a need to assess the effectiveness of available Rapid Diagnostic Tests (RDTs). Objective: To determine the reliability of Rapid Diagnostic Tests (RDTs) for malaria among pregnant women booking in Federal Teaching Hospital, Ido-Ekiti, Nigeria. Materials and Methods: A cross-sectional study of 240 pregnant women were recruited at booking over a period of twenty weeks. A semi-structured questionnaire sought information about socio demographic data. Blood samples were taken for malaria and diagnosis was done using RDT and Microscopy. Results: Prevalence of malaria was 22.1% by microscopy and 27.5% by RDT. The sensitivity of RDT was 88.7% and specificity was 89.8%. The positive predictive value (PPV) of RDT was 71.2%, the Negative predictive value (NPV) of RDT was 96.6% and accuracy was 89.6%. The reliability of RDT was good (Kappa statistics = 0.731). The reliability of RDTs when compared with that of Microscopy was also good (Kappa statistics = 0.722). Conclusions: RDTs was an effective screening test for malaria among the respondents. Hence, primary care physician should utilize this resource by advocating for its availability.
253 Lyme Disease: Features of Diagnostic and Management Strategies amongst Latvian General Practitioners , Viktorija Kutuzova1, Vladimirs Ivanovs2 and Gunta TÄ«cmane3
Introduction: Lyme disease (LD)—disease caused by bacteria, spread by ticks. The most common sign is an erythema migrans that begins at the site of a tick bite about a week after it has occurred. LD has been treated by antibiotics. Aim: To figure out the most common LD diagnostic and treatment strategies among general practitioners (GPs) in Latvia and evaluate it basing on worldwide guidelines. Materials and methods: Quantitative cross-sectional study. Main material: GPs of different gender and age. Respondents (R) completed the survey voluntarily, anonymously. Data analysis done by using Microsoft Office Excel 2010 and SPSS 22.0. Results: In total, 126 R were included. 32—Riga, 46—other cities and 48—rural areas. Analysis has shown dependence between percent of using guidelines and location of GP’s practice. And 70% of FD in Riga use LD guidelines in their practice, 20% use lecture materials and   10% use their previous experience. Among GPs in other cities of Latvia 46.4% use guidelines, 50%—lecture materials and only 3.6% use their previous experience. And 70.6% of GPs from rural areas base on lecture materials, 18.5% on guidelines and 11.1% on their previous experience. Analysis of knowledge about early symptoms of LD has shown that 30-45 years old GPs orient themselves in it better, then elder colleagues. Conclusions: GPs in cities use guidelines more often. Elder colleagues much worse orient themselves in theoretical information. I’m looking forward to creation of united LD diagnostic guidelines for Latvian GPs.
254 Vaccum Extraction—Maternal and Neonatal Complications   , Diana Stepanova-Mihailova  
The purpose of this research was to evaluate the complications for the mother and newborn, using vacuum extraction, and to compare them with spontaneous delivery. This study included group of vacuum-assisted deliveries in time period 2014-2016 (n = 726) in Riga Maternity Hospital, and it was compared to the group of spontaneous vaginal deliveries (n = 726). Data statistically processed in Microsoft Excel and SPSS Statistics 22.0. Results of the study: in vacuum-assisted deliveries vaginal lacerations was 13.8% more, cervical lacerations was 9.8% more than in group of spontaneous vaginal deliveries, perineal lacerations were 25.6% less in group with vacuum extraction, neonatal cephalohematomas was 26.9% more, and clavicle factures was 3.3% more in vacuum-assisted deliveries. Vacuum extraction was used for the first delivery in 86.9% of cases, for the second delivery 10.9% of cases. Vacuum-assisted deliveries in comparison with spontaneous vaginal deliveries are associated with higher risks for maternal soft tissue ruptures and neonatal cephalohematomas, clavicle factures. It is important to evaluate the indications for use of vacuum extractor. Staff skills, using vacuum extraction method, should be at a high level.
255 Storage and Management for Medicines in the Home of University Students of the Health Area of Espoch, Ecuador , John Ortiz-Simbaña1,3, Paola Villalón-Muñoz1,2, Elizabeth Escudero-Vilema1, Sandy Toapanta-Rivera1,4 and Adriana Rincón-Alarcón1
This work collects the characteristics of the family kits of students from the careers related to health in the Espoch, by identifying their knowledge and habits to determine the relationship between self-medication and the possession of medicines contained in the first-aid kit. This is related to the most outstanding frequency (48.1% bedroom) with the use of medicines in the home (48.5% when the treatment ends). Taking into account that 63.6% do not have a kit, they stored them in inadequate places to control their stability and quality for the use they were made, being analgesics and antibiotics those commonly found during the inspection that took place in the home. This determines that storage habits are not adequate for the proper storage of medications, including having knowledge of health and the importance of proper use by students, being essential to know that medicines must be stored in fresh places and dry, to avoid damage and problems associated with its stability.
256 Caregivers’ Perceptions of Causes and Treatment of Fever and Diarrhea among Under-Fives in Ile Ife , T. E. Babalola1, K. T. Ijadunola2, T. T. Oyetoke1, K. O. Oyeniyi3, A. A. Shittu4 and S. A. Salawu5  
Introduction: Fever and diarrhoea account for a significant portion of under-five mortality in Nigeria. This might be related to the perceptions of caregivers on the causes, which could influence the treatment they proffer. The study was conducted among caregivers in Ife central Local Government. Results: Most mothers perceived that fever could be caused by malaria, teething, hot weather, cough and that diarrhea could be caused by teething, eating contaminated food, drink and water, dirty environment and feeding bottles. Illness behavior was poor, as most waited at least one day after the onset of symptoms before taking any action. Choice of treatment was mostly influenced by health education messages received from health workers and mass media. Discussion and conclusions: Caregivers had a fairly correct perception of the causes of fever, but had incorrect perceptions of the causes of diarrhea. There is need to educate caregivers on the causes of diarrhea, and appropriate treatment measures.
257 The Application of X-STR: Two Case Reports     , Zhengliang Yu1, Jing Sun1, Guangshu Ding1, Xi Wang1, Hong Liu2, Xingchun Zhao1 and Wanshui Li1
The usefulness of the X-chromosomal STRs (short tandem repeats) for forensic purposes seems to be restricted, but may be valuable in some paternity cases. Due to the particular mode of inheritance, X-chromosomal X-STR has the advantage in female traces identification against male contamination and in complex kinship cases, such as deficiency cases (mother-son or father-daughter), grandparent-grandchild comparisons, half-sisters testing, etc. In this study, 4 blood samples from two paternity cases without father were examined with TYPER19 Amplification kit first, from the result, it is hard to judge the relationship between the mother-sons, then TYPERX19 kit was conducted to obtain the full profiles of the two pairs of the mother-son, from the genetypes of the samples, it can be inferred that neither of the two pairs of mother-son were in line with the kinship, which provides important evidence for the two paternity cases. All together, the X-chromosome marks included in the TYPERX19 kit can offer the possibility to solve complex kinship cases where autosomal STR markers cannot provide the information needed. 
258 In Vitro Study of Photodynamic Therapy for Treatment of Bacteremia in Whole Blood , Jennifer Machado Soares1, Thaila Quatrini Corrêa1,2, Natalia Mayumi Inada1, Vanderlei Salvador Bagnato1,2 and Kate Cristina Blanco1
Antibiotic resistance has been compromised hospitalized patients with serious infections. The main cases of bacteremia can be caused by antibiotic resistant pathogens. Photodynamic therapy (PDT) has been shown as an alternative for inactivation of microorganisms in blood. In this therapy photochemical mechanisms occur that may prevent the development of bacteria. This study aims optimization of PDT parameters for blood decontamination. Concentration of photosensitizer (PS), light dose (LD) and incubation time (IT) were studied for hemolysis and cell toxic effects. It was observed that PDT can be used for microbial inactivation in total blood reducing 0.85 log10 CFU/mL of S. aureus at 15 J/cm2 and 50 μg/mL of Photogem®.
259 Cancer in the Elderly     , Kourkouta Lambrini1, Iliadis Christos2, Koukourikos Konstantinos1 and Tsaloglidou Areti1  
The transition to old age involves a series of events, including those that are objectively defined and others that individuals evaluate subjectively. The aim of this review study is the investigation, highlighting and information about the multiple effects of cancer on the elderly. An extensive review of the relevant literature was performed via electronic databases (Medline, PubMed, CINAHL and Google scholar) and Greek and international journals. The exclusion criterion for the articles was the language other than Greek and English. The risk of cancer increases with age, resulting in an increased number of older people seeking treatment. Caring for elderly people with cancer differs from that of adults because of the biological differences in tumor, coexistence of morbidity, as well as various psychosocial issues that can affect the effectiveness of treatment. Despite the reduction in the mortality rate of cancer, the aging of the population is accompanied by a significant increase in the overall number of cancer patients. The main nursing care goal is the limitation of biological and atomic forces and characteristics’ loss and the adjustment of the elderly to the different phases of the disease. Finally, in the later stages of the disease, the nurse often provides just palliative care.
260 Goji Berry (Lycium barbarum) Extract Improves Biometric, Plasmatic and Hepatic Parameters of Rats Fed a High-Carbohydrate Diet     , Letícia Diniz Crepaldi1, Isabela Ramos Mariano1, Anna Julia P. C. Trondoli1, Franciele Neves Moreno2, Silvano Piovan3, Maysa Formigoni4, Clairce L. Salgueiro-Pagadigorria1, Vilma A. Ferreira de Godoi1, Márcia do Nascimento Brito1 and Rosângela Fernandes Garcia1
GB (goji berry) has bioactive components capable of reversing the metabolic syndrome. This work investigated systemic, biometric and metabolic parameters of male rats fed with standard diet (group CD) or high-carbohydrate diet (group HC). At 90 days of age the HC group was subdivided: one was given vehicle solution (HCD) and the other was given GB extract (HCDGB), for 60 days. The vehicle was also given to the CD group. At 150 days of age, glucose tolerance test, tissue collection, plasmatic determinations, lipid content, in situ perfusion and oxidative stress of the liver were carried out. The GB supplementation improved the parameters of the metabolic syndrome caused by the HC diet, including decreased body weight gain, adiposity index, dyslipidemia, hyperinsulinemia, NAFLD, liver oxidative stress and gluconeogenesis. Together with the diminished insulin resistance, these results indicate the GB extract is an important adjuvant in the treatment of the metabolic syndrome.
261 Inactivation of Protein Tyrosine Phosphatase 1B (PTP1B) Activity by the Aqueous Partition of Guava Leaf Extract     , Wan-Jung Wu1, Wei-Li Yan1, Shiou-Cherng Yu1, Gerry Gunawan1, Chien-Yih Lin1, Chih-Yan Huang1, Chia-Ting Chang2, Haw-Wen Chen2, Chong-Kuei Lii2, Alice L. Yu3, Ching-Chu Chen4, 5, Yu-Ting Chung6 Jeng-Dau Tsai7,8 and Henry J. Tsai9
Guava leaf tea has been used as a folk medicine for treating hyperglycemic conditions in Asia and Africa. The hypoglycemic efficacy of guava leaf has been documented by many scientists in these regions, but the hypoglycemic mechanism is poorly understood. Guava leaves were extracted with methanol and the crude extract was partitioned against hexane, ethyl acetate, and butanol in sequence. The leftover in water is defined as the aqueous partition. A second smaller batch was extracted with hot water directly. Oral glucose tolerance test was carried out on healthy mice instead of diabetic mice that lack endogenous insulin. Glucose uptake was examined with 3T3-L1 adipocytes. Oxidative effect on PTP1B (protein tyrosine phosphatase 1b) was carried out with real-time PTP1B enzymatic assay. The aqueous partition of guava leaf extract possesses a potent inhibitory effect on PTP1B enzymatic activity and this PTP1B inhibition is through a slow oxidative but reversible inactivation on the enzyme. The reversible inactivation would suggest guava leaf extract may augment PTP1B inhibition alongside the endogenous H2O2 which itself is induced by insulin. In addition, our study confirmed the hypoglycemic efficacy being associated with guava leaf and found the most effective molecules reside in the aqueous partition which is also less cytotoxic to Chinese hamster ovary cells when compared to other less polar partitions. The guava leaf extract can modulate insulin activity through a redox regulation on PP1B enzymatic activity. It is speculated that a compound similar to gallocatechin in the aqueous partition can reduce an oxygen molecule to hydrogen peroxide which in turn oxidizes the catalytic residue Cys in PTP1B. Therefore, the guava leaf tea can serve as a functional hypoglycemic drink that is suitable for either healthy or diabetic subjects.
262 Synthesis and Anti-tumor Activity Study of Shogaol Analogues   , Song Lei, Duan Yu, Xu Da and Mao Yu
As one of the largest global public health problems, cancer greatly endangers human health. Researchers have been committed to discovering anticancer drugs with high efficiency and low toxicity. Shogaol, a kind of ingredient from ginger with high anti-tumor activity, has attracted our attention. This study was an investigation on the composition and structure-activity relationship of different analogues of shogaol, with the purpose to screen for shogaol compounds which had higher anti-tumor activity and could be easily synthesized. We chose zingerone as the starting material to synthesize shogaol through four-step reactions without protective group, as a result, 31 analogues were synthesized for anti-tumor activity detect. The biological test results showed that: the missing of the unsaturated ketone and the phenolic hydroxyl group reduced the anti-tumor activity of shogaol; the site of phenolic hydroxyl had no significant influence on the anti-tumor activity, the indicating that the larger the steric hindrance of substituent, the lower the activity, but the higher the activity of cyclobutyl substituted derivatives.
263 Reproductive Parameters and Characteristics of Labrador Breed   , Carlos Sorribas1, Mónica Pirles 1, Laura Schiaffino 1 and Carlos Pagni 2
For a period of two years, a survey of 110 parturitions of Labrador breed bitches was carried out in Rosario City to determine the average number of puppies per litter, percentage of dystocia of all parturitions, percentage of males and females born and causes of dystocia, as well as the incidence of clinically detectable congenital pathologies. Over a total of 110 parturitions ninety three (84.5%) parturitions were normal and 17 (15.5%) were dystocic ones, it was established that atony 1 was the most numerous cause of dystocia (53%), followed by atony 2 (23%), dystocia by fetal disorders (6%), hydramnios (6%), uterine rupture (6%) and vagina fibrous band (6%). The whole puppies born was 866, 7.9 puppies per litter, if comparison between normal parturitions and dystocic ones is made, numbers are 7.05 and 8.02 respectively. When sex evaluation percentage is made 51.5% are males and 48.5% are females. When viability of puppies born is calculated it is established that in ones born by normal parturition perinatal death was 9.3%, while in those born by dystocia it was 10.9%. Among clinically verifiable congenital disorders low weight at birth was the most frequent congenital alteration, followed by cleft palate, lethal congenital edema or walrus syndrome and hare lip.
264 Antimicrobial Activity of the Methanolic Fraction of Bamboo Pyroligneous Liquor   , Luciana Jankowsky1,2,3, Simone Possedente de Lira2, Francisco André Ossamu Tanaka3, Ivaldo Pontes Jankowsky1 and José Otávio Brito1,4
Considering that the pyroligneous liquor obtained from pyrolysis of various types of biomass has antiviral activity, the main objective of the present study was to evaluate the antimicrobial action of the methanolic fraction extracted from bamboo (Dendrocalamus asper) pyroligneous liquor in relation to Escherichia coli and Staphylococcus aureus bacteria. The pyroligneous liquor was recovered by laboratorial bamboo pyrolysis at 350 °C and then fractioned by liquid-liquid separation with methanol and hexane. After solvent evaporation, we collected the methanolic extract, which was later diluted in methanol and used in the diffusion disc assay of E. coli and S. aureus at concentrations of 0.125, 0.500, 0.750 and 1.000 mg. Through GC/MS analysis, it was possible to qualitatively identify 92 chemical compounds in the methanolic fraction. Treatment with the methanolic fraction inhibited cellular growth and caused a variety of morphological variations in size as well as deformities in the bacterial cell walls, establishing an antimicrobial activity profile. This finding supports the National Policy for Incentives for Sustainable Management and Cultivation of Bamboo (PNMCB) and has benefits to the society and environment as a whole, as it demonstrates the possibility of adding value to a byproduct of pyrolysis.
265 Assessment of Heart Rate Variability and Heart Rate Turbulence Parameters in the Patients with Arterial Hypertension of the II Degree , Tetyana V. Aleynikova  
Background: AH (Arterial hypertension) due to the extremely high incidence is the most important risk factor for development of myocardial infarctions, strokes and lethal outcomes. It is very important to identify a group of patients with increased risk of adverse outcomes to modify treatment and prevention. Significant assistance in resolving this problem is to provide a method of HM (Holter monitoring) which allows estimating the HRV (heart rate variability) and HRT (heart rate turbulence) parameters that are independent risk predictors of sudden cardiac death. The aim of our study was to assess HRV and HRT parameters in patients with AH of the II degree. Materials and methods: We have studied parameters of HRV and HRT in 214 patients with AH of the II-nd degree aged 35 to 70 (57.7 ± 7.6) years: 121 women (56.5%) and 93 men (43.5%). All patients underwent electrocardiography and echocardiography. Statistical analysis of the results has been made using the analytical package Statistics 10.0. Results: The parameters of HRV and HRT in patients with AH of the II degree were studied. Statistically significant correlations of the HRV parameters with the age of patients, average HR, circadian index, and EF (ejection fraction) were revealed. Statistically significant correlations of the HRT parameters with the LVMI (left ventricular mass index), EF, HR average were received. High level of the statistical significance of the interrelation of HRT parameters (TO and TS) has been revealed. Conclusions: The received results can be used during the selection of the group of patients with AH having high risk for unfavorable outcomes. Taking into account the features of the HRV and turbulence parameters and factors associated with them this will enable the individualization of the assessment of the risk in AH as much as possible and prescription of adequate treatment for each patient.
266 A New Model for a New Central Purchasing Unit for Health Products to Support Reaching the Objectives of a Lasting Development and Facing Sanitary Crisis     , Alassane Ba1 and Karl HOUNMENOU2
Medicines are a global, strategic and diplomatic issue [1]. The UN General Secretary’s High Level Task Force [2] on Access to Medicines calls for a new approach to reduce the gap between medical innovations and access to medicines. Inequality in access to quality pharmaceutical products in a framework of global health democracy poses a threat to the ethical and equitable management of the provision of quality health care, particularly during global health crises. In French-speaking Africa, the lack of a unified production of pharmaceutical medicines forces wholesalers (public and private) to import almost all of their medicine demands resulting in a risk of dependence and major pharmaceutical quality defects. These central purchasing units are therefore often faced with the major challenge of guaranteeing the performance of their services and the security of their supplies. In order to achieve component 3 (“Access to Health”) of the SDOs (sustainable development goals), in particular the access to affordable medicines, it is essential for a country to have a strategy of pharmaceutical independence [3] by anticipating the epidemiological transition and the management of health crises. This strategy of pharmaceutical independence is based in the short and medium term on the strengthening of central purchasing units and the establishment of a public-private partnership between central purchasing units and wholesalers, and in the long term on the establishment of competitive production units that comply with international standards. However, recent health crises have shown the fragility of public central purchasing units and make it difficult to anticipate health crises.
267 Limen, Non-Toxic Recombinant Plant Defensin and Its Effect against Pathogenic Yeast and Fungi     , Katerina Rehorova1, Jitka Viktorova1, Barbora Macuchova2, Tomas Vlcko2, Lucie Stankova1, Nikola Jelenova1, Ludmila Ohnoutkova2 and Tomas Macek1
Limen is a small cysteine-rich peptide that was originally isolated from lima beans, and its activity against Micromycetes was described. Recombinant expression of limen in both a prokaryotic and plant system was performed to demonstrate a wide selection of its activities with potential for further use. At first limen was expressed in E. coli cells and after purification steps, its antimicrobial activity was tested on pathogenic fungi. This showed that limen can significantly eliminate the growth of several pathogenic yeasts such as Candida albicans, while its hemolytic activity was not recognizable. To confirm limen’s activity in vivo, transformation of the barley Hordeum vulgare L. was chosen. Transgenic barley was obtained using Agrobacterium-mediated transformation and the production of limen peptide in plant tissues was verified by molecular techniques. Young barley plants were repeatedly exposed to Fusarium oxysporum spores. Increased resistance to the most important pathogen was followed using chlorophyll measurements as indicators of fusariosis. Focusing on the food safety aspect of the use of GM plants, cytotoxicity was followed in extracts from transgenic stressed plants. No or a lower cytotoxic effect was found on human keratinocytes and human embryonic kidney cells than extracts from the non-transformed plants.
268 Obesity and Protein Metabolism     , Emil Mukhamejanov and Sara Erjanova
A conceptual model of the interdependence between the metabolism of proteins, fats and carbohydrates taking into account the transport of the carbon skeleton and the stages of the relationship between the processes of formation and utilization of ATP (Adenosine Triphosphate) energy, which demonstrates the key role of protein metabolism and the maintenance of glucose homeostasis with different organism availability in energy was proposed. In supporting the processes of vital activity of the body, two periods should be analyzed. The first one is absorptive period, which is for providing rehabilitation processes, the expression of which is the “food pyramid” and the second one is postabsorptive period, which is for the energetic provision of physical and mental work, the expression of which is the “energy pyramid”. These pyramids differ in the ratio of macronutrients, and in their composition, which must be taken into account when developing the principles of human nutrition. Although obesity is seen as a simple discrepancy between the amount of intake of food calories and their utilization for physical activity, however, do not take into account the large energy expenditure on volatile processes, in particular, the process of protein synthesis. The process of protein synthesis depends on the availability in the substrate (amino acids), the intensity of mRNA expression (transcription) and the speed of reproduction (translation), so the violation at each of these stages will affect the energy balance and promote the development of obesity. Half of the protein mass is muscle, so it largely determines the homeostasis of glucose and the development of energy balance, which is presented in the form of an interdisciplinary model for the development of diabetes, obesity and cardiovascular diseases. In conclusion, technologies were proposed to support the process of protein synthesis and ways of preventing and treating obesity.
269 Performance of the Multiprofessional Team in Cytoreductive Surgeries with Intraperitoneal Hyperthermic Chemotherapy: Experience Reporting , Cecília da Silva Angelo, RN, Ademar Lopes, PhD, Catharina Ferreira de Meira Pachioni, MSc, Eduardo Henrique Giroud Joaquim, MSc, Samuel Aguiar Junior, PhD, Gustavo Cardoso Guimarães, PhD, Glauco Baiocchi Neto, PhD, Felipe José Fernandez Coimbra, PhD, Isabel Miranda Bonfim, MSc, Rita de Cassia Burgos de Oliveira, PhD, and Tailine Ligia Tadini, RN  
Purpose: This study aims at reporting the experience of a cancer hospital’s multiprofessional team with surgery patients in performing cytoreductive surgeries associated with hyperthermic intraperitoneal chemotherapy. Methods: It is a reporting about the experience of the multiprofessional team at AC Camargo Cancer Center’s surgery center, which operates in cytoreductive surgeries with hyperthermic intraperitoneal chemotherapy, thus guaranteeing the surgery patient’s safety. Results: No safety report for the surgery patient subjected to intraperitoneal hypothermic chemotherapy was found in the literature. Therefore, the surgery center’s multiprofessional team’s practice was based on standards for manipulating chemotherapeutic agents and for safely administering medication. A checklist was elaborated for cytoreductive surgeries with hyperthermic intraperitoneal chemotherapy based on the surgery patient safety protocol and the institution’s multiprofessional team’s experience. Conclusions: From the multiprofessional team’s experiences in cytoreductive surgeries with hyperthermic intraperitoneal chemotherapy, the importance of elaborating a checklist to promote the quality of assistance and guarantee patient safety during the entire intraoperative phase became evident.
270 Cutaneous Melanoma: A Single Center Experience in Brazil , Emilly Neves Souza1 and Maria Carmen Ferreira Lopes Silva Santos2,3  
The aim is to evaluate the profile of cutaneous melanoma in rural and urban areas of the State of Espírito Santo and compare the results between them. The information collected included gender and age at diagnosis, city of residence, tumor morphology, anatomic site, histological subtype, level of invasion, tumor thickness and staging. A retrospective observational study was conducted, using the Pathology Department’s database of Hospital Universitário Cassiano Antonio de Moraes (HUCAM). Statistical analysis was performed using SPSS Statistics. A total of 258 histopathological reports of Cutaneous Melanomas were identified between 2003 and 2016. This skin cancer was more common among women, in the age group from 50 to 79 years. The majority of lesions was localized in the malar region of the face, usually classified as in situ or with superficial invasion and presented Breslow’s thickness less than 1 mm. Regarding the diagnosis, the male population was older and had more aggressive melanomas with higher rates of Clark’s levels IV and V and Breslow’s thickness when compared to the female group. There was a great concentration of patients in the central mesoregion (173 cases—67.06%), probably because this is the most populous regional area of Espírito Santo. The prevalence of melanoma between 2003-2016 was higher in the rural area (21.52 cases/100,000 habitants) when compared to the urban area (4.15 cases/100,000 habitants).
271 Chemical Characterization and Biological Potential of the Essential Oil of Eucalyptus globulus Labill , Nayara Soares de Mendonça Braga1, Monizy da Costa Silva2, Amanda Lima Cunha2, Antônio Euzebio Goulart Sant’Ana3, Luana Luzia Santos Pires4 and Aldenir Feitosa dos Santos3,4,5
Oxidation of lipids in various products, along with the growth of medically important pathogens, has led to a search for medicinal plants with antioxidant and antimicrobial activities. As a result, the aim of this study was to evaluate the antioxidant and antibacterial activity of the essential oil of Eucalyptus globulus (EO-Eg). Antioxidant activity was assessed by using the 2,2-diphenyl-1-picrylhydrazyl hydrate (DPPH) assay method. Existing components were identified through gas chromatography-mass spectrometry (GC-MS) analysis. Antibacterial activity and minimum inhibitory concentration (MIC) were assessed by using the broth microdilution method with standard multidrug-resistant bacterial strains. The main EO-Eg compounds identified by GC-MS were isopulegol, citronellal, and citronellol, which are primarily used in the industrial sectors. EO-Eg demonstrated excellent antioxidant activity with an effective concentration (EC50) of 4.48 µL/mL owing to the presence of phenolic compounds. Regarding antibacterial activity, the EO-Eg displayed a broad antimicrobial spectrum of antimicrobial activity across the different resistance phenotypes analyzed. The most notable antibacterial activity was observed against Staphylococcus aureus 169 MRSA (MIC = 0.0625%). As a result, our findings suggest that EO-Eg has antioxidant and antibacterial potential against hospital-acquired multidrug-resistant pathogens, which may be correlated with its major components.
272 Schiff Bases as Important Class of Pharmacological Agents , Aliaksandr Dzeikala and Anna Sykula  
Therapeutics are compounds, which do not always exhibit healing powers. They sometimes prevent or control roles. Many compounds, well known or less are treated as the therapeutic agents. Among them, there is a specific group of molecules named commonly as Schiff bases, chemically imines. Schiff bases are aldehyde- or ketone- like compounds in which the carbonyl group is replaced by an imine -HN=СН- or azomethine -NHN=СН- group, they are an important class of compounds for new drug development. Schiff base modifications so far proved to be very effective with increased efficacy and reduced toxicity. Therefore, many researchers have synthesized these compounds as target structures and evaluated their biological activity. The aim of this work was to present some interesting and promising examples of Schiff bases which exhibit biological activity.
273 The Role of a Pharmacist in the Analysis of Adherence Rates and Associated Factors in HIV-Patients Registered on Centralized Chronic Medicines Dispensing and Distribution (CCMDD) Programme in the Public Sector in South Africa , N. L. Katende-Kyenda  
The study assessed adherence rates and associated factors in Human Immunodeficiency Virus (HIV) patients registered on the Chronic Medicines Dispensing and Distribution (CCMDD) programme in the public Primary Health Care (PHC) set in South Africa (SA) and the role a pharmacist could be played in ARV adherence. Data were collected from 100 HIV-infected patients during a descriptive cross-sectional study using a standardized-questionnaire and face-to-face-exit interviews. Pill-counts technique was performed and adherence-rate of 95% considered acceptable. Data were analyzed using SPSS 22.0. Univariate factors associated with poor-adherence to Highly Active Antiretroviral Therapy (HAART) were assessed using ANOVA and a p ≤ 0.05 is considered statistically significant. Of 100 HIV-infected, 74 were females and 26 males with mean-age (± SD) of 38.98 (± 9.24) years enrolled on HAART for more than 36 months. Of these, 26 and 36 were on WHO stages 2 and 3 respectively. Adherence-rates computed from 76 patients revealed 43 (56.6%) having poor adherence-rate and 33 (43.4%) with acceptable adherence rate. Of the demographic factors analyzed age and educational background had an influence on adherence rates with p = 0.087 and 0.097 respectively. Other factors associated with acceptable adherence were: WHO staging (p = 0.016), recent CD4 count (p = 0.07), adverse effects (p = 0.073), stigma (p = 0.027). Of the different areas with waiting times, reception and pharmacy were statistically significant with p = 0.095 and 0.042 respectively.
274 Transforming Practice through Reflection in Patient Education , Yao Liao1, Qiaomiao Zeng2, Yu Xu3, Qian Yang1 and Junrong Ye4  
Objective: This paper is a report about transforming patient education practice, to get further transformation of patient education. Method: Smyth’s critical emancipatory reflective framework was used to guide the reflective practice. Results: Many reasons influence the patient education practice including nurses’ worldview, historical, economic and social reasons. Conclusion: Nurses should empower themselves as well as patients, and patient education should be based on patients’ needs and their belief, the responsibility of nurses should be guiding and teaching. 
275 Transforming Practice through Reflection in Patient Education , Yao Liao1, Qiaomiao Zeng2, Yu Xu3, Qian Yang1 and Junrong Ye4  
Objective: This paper is a report about transforming patient education practice, to get further transformation of patient education. Method: Smyth’s critical emancipatory reflective framework was used to guide the reflective practice. Results: Many reasons influence the patient education practice including nurses’ worldview, historical, economic and social reasons. Conclusion: Nurses should empower themselves as well as patients, and patient education should be based on patients’ needs and their belief, the responsibility of nurses should be guiding and teaching. 
276 Evaluation of the Ability to Apply Near-Infrared Spectroscopy on Direct Assay of Acyclovir in Tablets     , Le Dinh Chi1, Tran Viet Hung2, Bui Van Trung3 and Doan Cao Son4
This paper aimed at developing a simple and fast approach using chemometrics processing for direct assay of acyclovir in tablets by NIR (near infrared) spectroscopy in diffuse reflectance mode. In making trials with 5 different tablet matrices, the experimental results showed that regardless the matrix variation, it was always possible to construct a quantitative model with suitable linear range, accuracy and precision for direct assay of acyclovir in tablet from NIR spectra. Therefore, the approach used in this study was suitable for on-site fast assay of APIs in tablets during manufacturing process or in post-marketing surveillance of drug quality.
277 Sulfonation of (1→6)-β-D-Glucan (Lasiodiplodan) and Its Antioxidant and Antimicrobial Potential   , Gabrielle C. Calegari1, Vidiany A. Q. Santos1, Sirlei D. Teixeira1, Aneli M. Barbosa-Dekker2, Robert F. H. Dekker3 and Mário A. A. da Cunha1
The objective of this study was to investigate the sulfonation of (1→6)-β-D-glucan (lasiodiplodan) as a potentiating mechanism for biological functionalities. Lasiodiplodan was sulfonated by the chlorosulfonic acid-pyridine method. The modified exopolysaccharide was characterized by FT-IR and 13C NMR spectroscopy, X-ray diffraction and SEM. Antioxidant activity was assessed by the methods of H2O2 and OH radical removal and reducing power. Antimicrobial potential was evaluated by the broth-microdilution method. Sulfonation resulted in a derivative with DS of 0.24. FT-IR analysis indicated the introduction of sulfonyl groups in the macromolecule structure through specific bands in the regions of 1,240 cm-1 and 810 cm-1. 13C NMR analysis suggested that sulfonation occurred at carbon 2 of the glucose residue. Sulfonation led to morphological changes in the structure of the biopolymer resulting in a heterogeneous structure with the presence of fibrils. Derivatization promoted an increase in the antioxidant ability of the macromolecule, with a high OH removal potential (74.32%). Bacteriostatic activity against E. coli (Escherichia coli) and S. enterica (Salmonella enterica) typhimurium and fungicidal activity against C. albicans (Candida albicans) and C. tropicalis (Candida tropicalis) were found in the sulfonated sample. Sulfonation potentiated the antioxidant and antimicrobial activities of the biomacromolecule, suggesting that it is a potentiating mechanism of biological functions.
278 Fourteen Days Post-Ovariectomy Estrogens Decline Is Associated with Anxiogenic Effects on Wistar Rats     , Zemo Gamo Franklin1, Djiogue Sefirin1, Ketcha Wanda Germain Jean Magloire2, Seke Etet Paul Faustin3, Yonkeu Tatchou Floriane Gaëlle1, Djikem Tadah Rudig Nikanor1, Awounfack Charline Florence1 and Njamen Dieudonne1  
On study of the effects of estrogen deficiency on anxiety disorder by using ovariectomised animals, one discrepancy was the difference in behavioral testing delay following ovariectomy and the paradigms used. Thus, the aim of this study was to evaluate the anxiogenic effects of fourteen-day estrogen decline subsequent to ovariectomy on Wistar rats using EPM (elevated plus-maze) and open field tests. As results, fourteen days of estrogens decline has induced an increase of anxiety-related behaviour by a reduction of the percentage of the number of entries into the open arm (p < 0.01) and an increase of the percentage of the number of entries into the closed arm (p < 0.01) during the elevated plus-maze test. This anxiety-like behaviour was confirmed on the open field test by a reduction of time spent in the centre of the arena (p < 0.05) as well as a reduction of crossing (p < 0.05) and an increase of the weight of faecal boli (p < 0.05) and grooming (p < 0.01). Meanwhile, the administration of diazepam or estradiol valerate (1 mg/kg BW each) has corrected the anxious-like behaviour in both tests paradigms. These results suggest that fourteen days of estrogens decline was associated with an anxiety-related behaviour. This experimental model can constitute an excellent tool for the study of anxiolytic substances in menopause-related anxiety.  
279 Bioequivalence of Two Brands of Omeprazole 20 mg Gastro-Resistant Capsules in 18 Healthy Algerian Volunteers: A Pilot Study     , K. Mansouri, M. Ghozal, S. Behloul, L. Adda abbou, A. Makhlouf, K. Nekhoul, I. Hadjaz and M. B. Mansouri
A randomized, two-way, crossover study was conducted in 18 fasting, healthy, algerian volunteers to compare the bioavailability of two brands of Omeprazole 20 mg Gastro-Resistant Capsules where MOPRAL (Astra Zeneca) was the reference product. The study was performed at the bioequivalence center of the national control laboratory for pharmaceuticals product. The drug was administered on two treatment days separated by one week washout period. After dosing, serial blood samples were collected for a period of 12 h. A reliable and robust LC-MS/MS (liquid chromatography-tandem mass spectrometry) method has been developed and validated for the estimation of Omeprazole in human plasma. The assay was found to be linear over the range of 5-1,000 ng/mL. The pharmacokinetical and statistical analysis was conducted with Kinetica 4.4.1. AUC0-t, AUC0-∞ and Cmax were tested for bioequivalence. No significant difference was found based on ANOVA; 90% confidence interval ([97.14%-117..85%] for AUC0-t, [97.17%-117.67%] for AUC0-∞) of test/reference ratio for these parameters were found within bioequivalence acceptance range of 80%-125%. But for the Cmax, it was not in this acceptance range [73.5%-100.54%]. The results of PK analysis suggested that the reference and test formulations of Omeprazole 20 mg Gastro-Resistant Capsules were not bioequivalent during fasting state in these healthy Algerian volunteers.
280 Antioxydant Activity of Some Algerian Olive Oil Samples in the Eastern and Center of Algeria     , Metlef Sarra1, Dilmi-Bouras Abdelkader2, Zidane Azdinia3 and Benali Mohammed4  
This study aimed to evaluate the antioxidant activity of five Algerian olive oil samples from Chlef, Jijel, Tissemsilt, Bejaia and Tizi Ouzou regions. Thus the following results were found physicochemical caracterisation revealed that the samples are conform to standards prescribed by IOC (2013) as they are type-oleic and linoleic varies between virgin and extra virgin Chlef, Djijel and Bejaia oils are richer in carotenoids than those of Tizi Ouzou and Tissemsilt. Chlef and Tissemsilt oils are richer in phenolic compounds than other oils and have revealed very important antioxidant activity and the largest inhibitory power of peroxidation.
281 Prevalence of Decreased Susceptibility of Cryptococcus spp. Isolates to Fluconazole in Urban Sources of Presidente Prudente     , Camila Marçon, Caroline Lucio Moreira, Daniela Adélia Fernandes Inocencio, Larissa Rodrigues de Oliveira, Mariana Polidorio Kato, Joyce Marinho de Souza, Marcus Vinícius Pimenta Rodrigues and Daniela Vanessa Moris  
The genus Cryptococcus is composed of encapsulated yeasts that have the ability to infect and cause disease in humans, as Cryptococcus gattii/Cryptococcus neoformans species complex. Facing the current research panel, few studies about cryptococcosis and epidemiological data have been carried out in the western region of Sao Paulo state. This study aimed to verify the occurrence of Cryptococcus spp. In public areas of the city of Presidente Prudente, using pigeon droppings and tree hollows as an environmental source. The samples were identified by conventional mycological methods. Were collected 54 samples from pigeon droppings and 62 samples from tree hollows of the genus Licania. And of these samples, 47 (87.0%) and 14 (22.5%) had positive growth of yeast from pigeon droppings and tree hollows, respectively. Cryptococcus was identified in 11 (20.4%) of the samples from pigeon droppings and 3 (21.4%) of those from tree hollows. The following species were identified: Cryptococcus neoformans (7.15%), Cryptococcus laurentti (14.28%), and Cryptococcus albidus (78.57%). Decreased susceptibility to fluconazole was observed for some isolates. Fluconazole exhibited a limited in vitro activity, particularly against Cryptococcus albidus and Cryptococcus laurentii. Identification and susceptibility testing of Cryptococcus spp. should be performed on a routine basis in view of their unpredictable susceptibility profiles.
282 Immune Complex Formation Involving Etoricoxib in a Patient with Acute Severe Anemia     , C. Domingues1, V. Teixeira2, S. Rocha1, N. Oliveira3, A. Ruivo2 and M. Dias1
Background: DIIHA (Drug-induced immune hemolytic anemia) is rare, and a specialized laboratory is often required to provide optimal serological tests to confirm diagnosis. There have been few cases reported of etoricoxib-induced immune hemolytic anemia. Immune complexes formed between some drugs and their respective antibodies attach weakly or strongly in a nonspecific way to RBCs (red blood cells). The bound immune complex activates complement, which may lead to hemolysis in vivo. Aims: Demonstration of immune complex formation involving etoricoxib in vitro.
Methods: A 46-year-old woman developed acute severe anemia one day after a single dose of etoricoxib 90 mg per os with a strong positive DAT (direct anti-globulin test) and a weak positive IAT (indirect anti-globuline test). For investigation diagnosis, we used the American Association of Blood Banks Technical Manual protocol using patient serum collected in three different moments (at patient admission, one month after and one month after stopping steroids). Results: The authors found strong positive IAT reactions when the patient serum was tested with the drug. Conclusions: The strong agglutination that occurred in the mixture of the drug and the patient serum indicates a drug/antidrug interaction and may lead to DIIHA. This was the first case reported in Portugal of DIIHA induced by etoricoxib.
283 Correction of Factitious Hyperkalemia in Hemolysed Specimens from Adult Emergency Department Using the Beckman Coulter Unicell DxC 880i® Analyzer Derived Factor     , C. Domingues, R. Carneiro and M. Dias  
Hemolysis in ED (emergency department) patients is common due to difficult blood draws. Values of serum potassium (K+) become falsely elevated secondary to release of intracellular contents. Objective: The aim of the study was to establish a correction factor for factitious elevated K+ in samples for de adult ED. Methods: We used samples from 125 adult ED patients, in which the 2nd sample was drawn due to hemolysis of the first tube. Results: Firstly, we derived a correction factor expressing an increase in potassium concentration in 0.21 mmol/L (95% confidence interval, 0.17-0.24 mmol/L with p < 0.01) for each hemolysis index increment. Conclusions: A reliable correction factor for factitious hyperkalemia in a clinical relevant range exists. 
284 Antioxidant Characterístics of Red Wines from Calchaquíes Valleys in Salta     , Berta M. Di Carlo1, Natalia P. Pérez1, Rosario Gómez de Díaz1, Felicidad Navia1, Raquel Salomón2, Facundo Moyano1, Silvana S. Peñaranda1, Georgina Zerpa1, Patricia Rabus1 and Ricardo Buttazzoni1
Objectives: We analyzed polyphenol and antioxidant capacity in red wines Malbec, Cabernet Sauvignon, Tannat and Syrah varieties from wineries Calchaquíes Valleys, in Salta, Argentine. Methods: The total polyphenols was determined by UV absorption at 280 nm evaluating the D280 index. The antioxidant capacity was analyzed by absorbance measured at 520 nm and 420 nm and the color intensity and the hue was calculated by its summation by its relation. Key findings: The results presented indexes D280 (phenolic content) that ranged from 43.3 to 55.7. The antioxidant capacity is evaluate by the color intensity of red wines measuring absorbance values at 420 and 520 nm that ranged from 0.60 to 1.09. There is correlation between phenolic content and antioxidant capacity with a correlation coefficient of 0.974. Conclusions: The total polyphenol content in red wines is correlated with their antioxidant capacity. It is beneficial to health if the wine is consumed in low quantities. The Cabernet Sauvignon variety has more phenolic content than Malbec, Tannat and Syrah varieties.
285 Portal Gas Embolism with Acute Liver Ischemia: Case Report     , Gabriela Delatore Gomes1, Bruno Hafemann Moser1, Rafaela Orikba1, Ricardo Panico Rizzo Luiz1, Lucas Baptista da Slva1 and Augusto Fey1, 2
Portal gas embolism is a rare entity and considered a sign of poor prognosis in abdominal diseases, its mortality rate is about 75%. This case report is about a 61-year old patient with portal gas embolism and acute liver ischemia, evolving to death within 24 hours. Some cases reported in the literature demonstrate the severity of this dramatic condition. It is necessary to have a higher level of suspicion in the vascular structures of the abdomen in order to allow a timely treatment.
286 Kell Blood Group Maternal-Fetal Incompatibility in Lubumbashi (D. R. Congo), Case Report     , Joséphine Monga Kalenga1, Albert Nyembo1, Mimi Mwange1, Nathalie Ngoie1, Judith Sinanduku1, Yaba Antonika1, Ngwej Tshikwej1, Xavier Ngoie Kinenkinda2, Eric Kassamba3 and Serge Matanda Kapend4, Haumont Dominique5 and Luboya Numbi Oscar 6  
Introduction: The anti Kell is a major cause of hemolytic disease of the newborn; the third cause after ABO and Rhesus in frequency; and the second in terms of severity after rhesus type incompatibility. In Africa, 60% of the population is Kell negative. In Congo, Kell blood group determination is not systematically performed and almost non-existent in perinatology. We aimed to report a case of this immunization in routine practice. Method: This study is a clinical report of Kell immunization. Physical examination was performed and blood group determined. Clinical and biological follow up of the case: a review of the literature of Kell immunizations is included. Result: A female newborn on day 4 of life with weight of 3,250 g born at term admitted to Sendwe’s Hospital emergency for pallor and respiratory distress. History reveals jaundice at birth. The mother is P1G4A3D0, blood group Orh+. Clinically the child is pale, jaundiced, present tachycardia, hepatomegaly, polypnea Brh+. The diagnostic orientation is a maternal-fetal incompatibility. The realization of blood grouping Kell, Duffy and irregular antibodies research Kell type confirms the diagnosis of Kell hemolytic disease of the newborn. We discharged him after 14 days. Conclusions: The Kell type IFME is a purveyor of grave hemolytic disease of the newborn. His knowledge, prevention and proper care by a multidisciplinary team can prevent dramatic situations.
287 Multiple Sclerosis and Treatment: Drug Management and Nutrition with Exercise     , Hector Melissinos
MS (multiple sclerosis) is a chronic inflammatory disease of the CNS (central nervous system), characterized by the degeneration of the insulating caps of the brain and spinal nerve cells. Most axons are surrounded by an insulating lipoprotein, myelin, which helps in the transmission of nerve impulses. Myelin destruction disrupts the ability of parts of the nervous system to communicate, resulting in a wide range of symptoms, including physical, mental, and sometimes psychiatric problems. Multiple sclerosis affects more than 2.1 million people worldwide, but its incidence has increased in the last five decades among young people and women, with a 3: 1 ratio compared to men. Latitude is associated with a variety of environmental factors, most notably exposure to solar radiation. The risk of developing MS is inversely proportional to solar exposure and vitamin D, particularly the 1,25-(OH)2D3 derivative that has anti-inflammatory and immunomodulatory activity, is probably the responsible protective agent. There are various therapies that are targeting the treatment of the disease, yet MS is considered an uncurable disease. Available medicines are aimed at relieving symptoms and improving the progression of the disease. In the present study, we will present the disease with reference to the pathogenesis and epidemiology of the disease. We will analyze the environmental factors that influence the development by reference to the etiology and pathophysiology, as well as reference to existing therapies. The ultimate aim of this study is to examine to what extent physical exercise and nutrition, in conjunction with pharmaceutical treatments and mainly intake of vitamin D, can contribute drastically to the fight against the disease and at the same time improve areas that make up the quality of life of the patient.
288 Regression of Barrett’s Esophagus: Is There a Difference between Clinical and Surgical Treatment?     , Ramon Rawache Barbosa Moreira de Lima, Fernando Antônio Siqueira Pinheiro, João Odilo Gonçalves Pinto, Marcos André Araújo Accioly Filho, Mateus Alves de Araújo and Paulo Henrique Araújo Parente  
Objective: To evaluate the response to clinical and surgical treatment of Walter Cantídio University Hospital patients who were diagnosed with Barrett’s esophagus between 2012 and 2016. Methodology: From the database analysis of Walter Cantídio University Hospital’s pathology service, we identified all patients with a diagnosis of Barrett’s esophagus between 2012 and 2016. We analyzed the patients’ medical records and collected epidemiological and clinical data. Results: 22 patients were included in the study, 13 of whom were surgically treated and 9 were clinically treated. The regression was 33.3% in the clinical group and 30.7% in the surgical group, with no statistical difference between these two groups. Conclusions: The results show synchrony with data from the medical literature regarding the response of Barrett’s esophagus to clinical and surgical treatment.
289 Trichoblastic Fibroma of the Skin Mimicking Primary or Secondary Breast Cancer     , Prvulović Bunović Nataša1, 2, Boban Jasmina1, 2, Šveljo Olivera2, 3, Djilas Dragana1, 2, Mihailović Jasna1, 4 and Nikin Zoran1, 5  
We report a case of a 71-year- old female with trichoblastic fibroma, a rare benign tumor of the skin, found in the left breast, associated with an invasive contralateral breast cancer. On clinical examination, a solitary, firm nodule was found in the subcutaneous tissue of the left breast with no changes in the overlying skin. Radiological examination showed disconcordant results. Conventional mammography and ultrasound suggested benign nature, while magnetic resonance mammography and spectroscopy raised the presumption of the malignant nature of the lesion. After performing excisional biopsy, the diagnosis of trichoblastic fibroma was established. Microscopically, it was composed of fibrous stroma, basaloid germs and strands and lace-like epithelial components, with no obvious connection with overlying epithelium or adjacent adnexal structures.
290 IS There A Role of 18F-FDG PET/CT for Initial Staging of Rectal Cancer?     , J. Mihailovic 1, 5, O. Ivanov 2, 5, N. Prvulovic Bunovic3, 5 and D. Ivanov 4, 5  
Background: The management of the rectal cancer requires accurate initial staging. Besides routinely performed conventional imaging, during the last decade 18F-FDG PET/CT became a popular whole-body metabolic imaging for preoperative TNM classification. The purpose of the study was to evaluate the role of 18F-FDG PET/CT in the rectal cancer staging. Patients and methods: 45 patients with rectal cancer who preoperatively underwent 18F-FDG PET/CT imaging in the period from 2011 to 2014 were analyzed. All patients were referred to the surgery afterwards. Histopathologic findings were used as a standard of reference. Descriptive techniques were used for frequency analyses and sensitivity calculations. The χ2 test was used for significance calculation of the contingency tables while Monte Carlo simulation and Fisher’s exact test were used for the table fields where number of cases was smaller than demanded. Results: The average SUVmax value of the primary tumor for all T stages was 26.02 gm/mL. The average SUVmax values of the lymph nodes in N1 stage and N2 stage were 6.04 gm/mL and 6.33 gm/mL, respectively. PET/CT detected benign lesions in 17 (28.3%) patients with average SUVmax of 15.4 mg/mL. The vaginal wall infiltration was detected in 2 (4.4%) patients. Penetration of mesorectal fascia was detected in 21 (46.7%) of patients. Four patients (8.9%) had liver metastases identified by 18F-FDG PET/CT. The overall sensitivity, specificity and accuracy of 18F-FDG PET/CT in T staging was 90.7%, 91.9%, and 90.5%, respectively. The overall sensitivity, specificity and accuracy of 18F-FDG PET/CT in detection of metastatic lymph node was 85.8%, 89.8%, and 89%, respectively. PET/CT shows low sensitivity (77.3%) and specificity (25%) in analyzing mesorectal fascia involvement. The overall sensitivity of 18F-FDG PET/CT in M staging was 100%. Conclusions: 18F-FDG PET/CT is highly sensitive for initial T staging of rectal cancer especially in advanced disease. This imaging modality is highly accurate in detection of metastatic lymph nodes and liver metastases, but it has no role in defining of mesorectal fascia involvement. Therefore, 18F-FDG PET/CT should be incorporated routinely in preoperative staging together with conventional imaging.
291 Possible Mechanism of Action of Neurokinin-1 Receptors (NK1R) Antagonists     , Özüm Öztürk1, Esin Aki-Yalcin1, Tugba Ertan-Bolelli1, Kayhan Bolelli1, Andry Nur-Hidayat2, Ozlem Bingol-Ozakpinar3, Filiz Ozdemir4 and Ismail Yalcin1
Recently, NK1R (Neurokinin-1 receptors) take attention as new and promising target in anticancer drug development area. It has been proved that non-peptide NK1R antagonists L-733,060, aprepitant and L-732,138 inhibited tumor growth in several cancer cell lines. For the development of novel NK1R antagonists as antitumor agents, heterocyclic compounds which were previously synthesized by our team, tested for their cytotoxic activities in several cancer cell lines in this study. Among the tested compounds, a benzothiazole derivative BSN-009 inhibited colon cancer cell lines growth by 57.53% by comparing the activity to the control drug aprepitant. Molecular modeling studies such as molecular docking and pharmacophore generation were performed with known NK1R antagonists and BSN-009 by using Discovery Studio 3.5 in order to explain their binding modes to NK1R. BSN-009 may be a good anticancer drug candidate as a possible NK1R antagonist and is worthy to carry on the anticancer studies.
292 The Protective Role of β-Carotene and Hesperidin on Some Hematological and Myocardial Measurements against Imidacloprid Toxicity in Albino Rats , M. A. Bashandy 1, E. I. El Zawahry 1, S. A. Bashandy 2 and M. F. Abdel Naby 1
Neonicotinoids including IM (Imidacloprid) are widely used as plant systemic insecticides. Several studies have indicated that pesticide toxicity may be associated with the enhanced production of ROS (reactive oxygen species). Both β-carotene (βC) and hesperidin (H) have an antioxidant property and quench free radicals. This study aimed to clarify the protective role of β-carotene and hesperidin as natural antioxidants on IM induced toxicity in hematological parameters and markers of cardiac muscle activity in male albino rats. The treatment of rats with IM showed a significant decrease in hemoglobin (Hb %), MCH (mean corpuscular hemoglobin), MCHC (mean corpuscular hemoglobin concentration), HCT (hematocrit) values and RBCs count comparing with control group. On the other hand, MCV (mean corpuscular volume), WBCs (white blood cells) and Plts (platelets) count pronounced a significant increase in IM group comparing to control. Also, αFP (plasma alpha fetoprotein), CEA (carcinoembryonic antigen), CK (creatine kinase), CK-MB (creatine phosphokinase myocardial band) and LDH (lactate dehydrogenase) clarify a significant increase in IM group comparing to control. Both β-carotene and hesperidin mitigate the deleterious effects of IM on previous parameters. β-Carotene and hesperidin may protect hematopoietic system and heart muscle against toxicity of IM. These improvements of the results clarify the protective effect of the used antioxidants. Conclusion: β-carotene and hesperidin, natural antioxidants, have a protective effect against IM evoked hematological and biochemical changes.
293 Rare Side Effects of Propofol Administration—Case Report and a Brief Literature Review     , Ersin Ismail1, Plamen Dimitrov2, Dimana Mitsova1, Svetoslav Dobrev1, Snezhana Stancheva1 and Natasha Ivanova3
Introduction: Propofol is an intravenous general anesthetic and sedation drug for use in the induction and maintenance of anesthesia or sedation. It is included in WHO Model List of Essential medicines and approved by the FDA (food and drug administration) in 1989. The side effects of Propofol have been studied widely in the last 25 years. They can be easily managed and that is why Propofol has become a first choice drug for the most of the anesthesiologists worldwide. This paper presents a case report of Propofol induced pulmonary edema and also a review of some of the rarest and unusual manifestations of Propofol side effects. Some of them are urine discoloration, tissue necrosis, rhabdomyolysis and postoperative pancreatitis. Methods and materials: A case summary of 18-years old woman with unusual postoperative pulmonary reaction was considered along with other documented cases. Several full-text articles were briefly analyzed for estimating the role of Propofol for a number of strange and potentially life threatening conditions. Results: Despite the low incidence rate, the presented case could be determined as a pulmonary edema due to its clinical features. Furthermore, rare drug reactions such as rhabdomyolysis, tissue necrosis, postoperative pancreatitis etc. may remain unrecognized and create diagnostic and therapeutic issues. Conclusions: Although the officially reported dangerous reaction, Propofol remains one of the best hypnotic and sedative agents. The better knowledge of the full list of drug reactions considered as rare and very rare is a guarantee of an adequate and a better therapeutic behavior.  
294 Cytogenetic Diagnosis and Analysis of the Clinical Profile of Individuals with Non-down Syndrome Intellectual Disability     , Fantin, C.1 , Prazeres, V. G. M.2, Benzaquem, D. C.1, Fernandes, E. R. Q. G. S.3, Oliveira, D. P.3 and Ribeiro-Lima, J. C.1
Chromosomal alterations are the main causes of genetic diseases. One of the characteristics of certain genetic syndromes is ID (intellectual disability) presented by the individual in varying degrees. The study of the ID, its etiology, association or not with chromosomal abnormalities and a clinical diagnosis associated with the examination of karyotype are important aspects to consider when providing genetic counseling for families. Due to the lack of similar studies and of easy access to cytogenetic services for the Amazonian population, this study aimed to contribute to the advancement of this line of study in the state, analyzing the karyotype of individuals with ID, not Down Syndrome treated at the APAE-Manaus and identifying the main types of chromosomal alterations in the individuals analyzed. Analyzes were performed of the clinical diagnosis through investigation of the data from the interview and medical records as well as analysis of the karyotype of 31 patients with non-Down syndrome ID, attended in the APAE-Manaus. Of these subjects, 20 were female and 11 male. The results showed only 2 cases of chromosome abnormalities are detectable by classical cytogenetics, one of mosaic Turner syndrome and one a heterochromatic variant. It is therefore necessary to complement the study with the addition of molecular techniques for the investigation of microdeletions and/or other alterations not detectable through the banding technique, mainly for individuals whose dysmorphisms indicate a suspected syndrome.
295 Bread and Health     , Kourkouta, L.1, Koukourikos, K.2, Iliadis, C.3, Ouzounakis, P.4, Monios, A.5 and Tsaloglidou, A.6  
Introduction: Bread is a food full of flavors and nutrients and continues to be the basis of our daily diet. Aim: The aim of this review was the investigation of bread’s usefulness in our daily dietary chain and health in general. Material-Method: Extensive review of the recent literature was conducted in electronic databases (Medline, Scopus, and Google Scholar) through the Association of Hellenic Academic Libraries (HEAL-Link) using the appropriate key words: bread, health, disease as well as a combination of them. Results: Bread is an excellent source of complex carbohydrates that provide the body with the energy needed. Although bread is a basic food of everyday human nutrition, it is implicated in a variety of situations that burden the human body, such as obesity. However, this happens only when it is consumed in very large quantities and when it is part of an unbalanced diet. Conclusions: Bread, when is consumed in balanced quantities can give the body plenty of nutrients essential for its good function.
296 The Infectious Tricuspid Endocarditis in ICU: Clinical Features, Management and Outcome     , A. Jamoussi1, 2, T. Merhebene1, 2, K Ben Ismail1, 2, S. Ayed1, 2, A Ben Jazia1, 2, J. Ben Khelil1, 2 and M. Besbes1, 2  
Objectives: Infectious tricuspid endocarditis is known to simply require antibiotherapy and to have good prognosis in most cases. Few studies focused on severe episodes managed in ICU. We aimed to describe clinical and microbiological features, and final outcome of infectious tricuspid endocarditis managed in ICU. Methods: From 1 January 2009 to 31 August 2017, all patients hospitalized in intensive care unit with infectious tricuspid endocarditis were enrolled. Key findings: We collected 15 episodes of infectious tricuspid endocarditis. Median age was of 39 years. Risk factors were: intravenous drug users (n = 10), pace maker (n = 1), vascular device (n = 2), none (n = 2). Median SAPS II, APACHE II and SOFA on admission were 21, 10 and 2 respectively. Organ failures on admission were: acute respiratory failure (n = 10), sepsis (n = 7), coma (n = 1) and acute kidney injury (n = 8). The most frequent causative pathogen was Staphylococcus Aureus. Antibiotherapy failure happened in 10 patients from whom 8 underwent cardiac surgery (53.3%). Most frequent complications were acute kidney injury (n = 14) and withdrawal syndrom. Infectious tricuspid endocarditis relapse on bioprosthesis occurred within 2 intravenous drug users after hospital discharge. Overall in-hospital mortality was 40%. Conclusions: Infectious tricuspid endocarditis in ICU is fitted with poor prognosis and high need to cardiac surgery. Special care should be provided to intravenous drug users to prevent relapse.
297 A Novel Therapy of Eosinophilic Esophagitis-Treatment of Eosinophilic Esophagitis Using a Single Dose of Intramuscular Corticosteroid and Proton Pump Inhibitor , Augusto Fey1, 2, Lorete Maria da Silva Kotze2 and Mônica Serapião1
Background: Ee (Eosinophilic esophagitis) is an inflammatory condition characterized by a dense eosinophilic infiltrate in the esophageal epithelium. Its pathophysiology mimics that of allergic esophagitis, and evolves clinically as a chronic disease with periods of exacerbation. Symptoms and endoscopic findings are usually non-specific and similar to those of other esophageal illnesses. The mainstay of treatment of Ee is with corticosteroids and/or specific diets, which have been shown to cause symptom remission and histological improvement. Aim: The objective of this study was to demonstrate the efficacy of a novel and promising treatment protocol for Ee. Materials and methods: We prospectively evaluated 24 patients with Ee over two years. Patients were treated with a single intramuscular injection of betamethasone sodium phosphate associated with betamethasone dipropionate and a PPI (proton pump inhibitor) (rabeprazole 20 mg PO). After 4 weeks of treatment, patients underwent endoscopy and biopsy. We evaluated patients’ clinical response as well as the results of endoscopic and histological examinations. Results: After 4 weeks of treatment, all patients (100%) are reported significant clinical improvement, which was corroborated by the findings on endoscopy and histology. There were no complications or adverse reactions. Conclusions: In this cohort of patients with eosinophilic esophagitis, treatment with a single intramuscular dose of corticosteroids led to complete remission of symptoms and improvement in endoscopic and histological findings.
298 Anti-inflammatory Activity and Antioxidant Potential of Aqueous Extracts from Stem Bark of Geoffroea decorticans     , María Jofré1, María Fusco1, Laura Favier2, Mauricio Teves1, Alejandra Rotelli1, Ana Pedernera1, Lilian Pelzer1, Claudia Ortega2 and Diego Cifuente2
In the present work we investigated, for the first time, the anti-inflammatory activity and the antioxidant properties of aqueous and ethanolic extracts, obtained from stem bark of Geoffroea decorticans (Gill. ex Hook. et Arn.) Burk. (Fabaceae). G. decorticans, commonly known as “chañar” or “chañarcillo”, is a traditional argentinean plant used as emollient, balsamic, antitussive, expectorant and anti-inflammatory. The stem bark was collected from San Francisco del Monte de Oro, San Luis, Argentina. Anti-inflammatory activity was evaluated by carrageenan-induced paw edema in rats. Antioxidant activity was tested using 1,1-Diphenyl-2-picrylhydrazyl radical-scavenging activity (DPPH), 2,2´-Azino-bis(3-ethylbenzthiazoline-6-sulphonic acid) radical scavenging activity (ABTS) and ferric ion-reducing power (RP-Fe) assays. Aqueous extract 10% p/v showed anti-inflammatory activity (3h, 48% inhibition, 5h 37% inhibition and 7h 17% inhibition) and antioxidant activity (DPPH, IC50 (mg/mL) = 0.098 ± 0.032; ABTS, IC50 (mg/mL) = 0.022 ± 0.343, RP-Fe IC50 (mg/mL) = 1.124 ± 0.146). In the other hand, the ethanolic extract 5% p/v, presented anti-inflammatory activity (3h, 34% inhibition, 5h 38% inhibition and 7h 35% inhibition) and antioxidant activity (DPPH, IC50 (mg/mL) = 0.133 ± 0.027; ABTS, IC50 (mg/mL) = 0.086 ± 0.262, RP-Fe IC50 (mg/mL) = 7.089 ± 0.104). These results suggest that, also fruits, the aqueous and ethanolic extracts from the stem bark of G. decorticans present significant anti-inflammatory activity and antioxidant properties.
299 Protective Effects of Vitamin E on Diabetes-induced Oxidative Stress Status and Homocysteine in the Rat Heart , Mojtaba Beyramzadeh1, Mohammad Hassan Khadem Ansari2, Kaveh Azimzadeh3 and Siamak Salami4  
Objective: We aimed to investigate protective effects of vit E on oxidative stress status and homocysteine (Hcy) in cardiac tissue of diabetic rats. Methods: Sixteen Wistar male rats were treated with STZ (streptozotocin) (60 mg/kg) to induce diabetes. Diabetic rats were divided into two groups: NTD (non-treated diabetic) and VETD (vit E-treated diabetic) rats. The VETD group received 300 mg/kg vit E with daily feeding. Eight normal rats of the same age were used as the control group. After 6 weeks, the rats were anesthetized, their cardiac tissue was removed, and homogenated supernatant was separated. Samples were assayed for TAC (total antioxidant capacity), LPO (lipid peroxidation), nitrite (NO2-), nitrate (NO3-), and Hcy. Key Findings: The contents of LPO, NO3- and Hcy in NTD compared to control group indicate a significant increase, but the levels of these parameters decreased in VETD (p < 0.05). There was a significant decrease in the amount of TAC in the NTD group but in VETD group, that significantly increased (p < 0.05). The amount of NO2- in NTD and VETD groups, compared to the control group, did not show any significant changes (p > 0.05). Conclusions: Significant decrease of oxidative stress and Hcy in the cardiac tissue caused by vit E supplementation strongly indicated that this radical scavenger may promote a protective effect on diabetic cardiomyopathy through the attenuation of oxidative stress and increase antioxidant defense mechanism.
300 Attributional Styles in Adolescents with Transfusion-dependent Thalassemia, Lerlugsn Suwanthol1, Tuangrath Sangpaypan1, Phetcharat Naknum2 and Kleebsabai Sanpakit1
This study focused on the way that Adolescents with Transfusion- dependent thalassemia explained negative or positive events in their life (Attributional Styles). It is defined by three dimensions describing the cognitive appraisal of the events: internal-external, stable-unstable, and global-specific. With cross-sectional research design, the observations consist of 102 adolescents (48 males, 54 females) who diagnosed with Transfusion-dependent thalassemia (more than 50 times for blood transfusions) completed the measure of Attributional Styles and Anxiety Questionnaires. The correlations in the predicted directions among variables examine with Pearson product-moment correlation coefficients, t-test, and One-way ANOVA to ascertain a significant between the group differences on attributional factors and levels of anxiety symptoms. The results show that Adolescent samples with higher levels of anxiety revealed statistically significant relationship among three negative attributional dimensions (overall composite F = 4.5, p < 0.05; negative composite F = 4.99, p < 0.01; negative-internality F = 4.99 p < 0.01; negative-stability F = 3.42, p < 0.05 and negative-globality F = 3.77, p < 0.05). In addition, significant age- group differences were found for the total negative-globality (t = 2.05, p < 0.05) and negative- globality (t = -2.22, p < 0.05). These data are consistent with the reformulated learned helplessness model of depression. In finding, the individuals who attribute negative life events to internal, stable, and global causes will be more vulnerable to anxiety than those who make external, unstable, and specific attributions. Most interestingly, those adolescents more than 17 years evidence more negative-globality attributional style than group less than 16 years, and female adolescents may influence this pattern. These results suggest that targeting Adolescents with Transfusion-dependent thalassemia may be important for improving aspect of coping on psychological adjustment to their chronic illness.
301 Profile of Patients Attended at the Genetic Service of a Special Care Institution in Brazil     , Cleiton Fantin1, Denise C. Benzaquem1, and Julia Cavalcante do Carmo1 and Vânia Mesquita Gadelha Prazeres2  
Objective: To analyze the main etiological diagnoses of patients attended at a genetics outpatient clinic of the Association of Parents and Friends of Exceptional Children/APAE in the state of Amazonas, Brazil. Methods: retrospective study of patients seen in the period 2005-2016, with review of medical records. The following data were recorded: sex, origin of referral and etiological diagnosis. Results: 362 patients were attended, 94.7% of them from Manaus, and 5.3% from the interior of the state. The etiological diagnosis was defined in 262 (72.3%) of the sample, of which 254 (70.2%) were of genetic etiology and 8 (2.2%) non-genetic. Of the genetic etiologies, 46 (12.7%) cases were monogenic syndromes, 136 (37.6%) were chromosomal aberrations and 72 (19.9%) had multifactorial causes, however, 100 (27.6%) cases remained unclear. There were several syndromes found, with Down syndrome being the most frequent and correlating significantly with the sex of the patient (male predominance, p < 0.05). Conclusions: The study carried out in the APAE/Manaus genetics outpatient clinic allowed the profile of the patients being attended to be traced. It was verified that the majority of the patients were male and that the diagnosis of chromosomal alterations was the most frequent.
302 Bioequivalence of Two Brands of Metformin 850 mg Coated Tablets in 12 Healthy Algerian Volunteers: A Pilot Study     , Mansouri, K., Aissa, L., Bounab, A. H., Hadjaz, I. M., Nekhoul, K., Djellouli, S., Kheddouci, L., Cherait, I., Behloul, S. and Mansouri, M. B.
A randomized, two-way, crossover study was conducted in 12 fasting, healthy, algerian volunteers to compare the bioavailability of two brands of metformin hydrochloride 850 mg coated tablets. The present study aimed to appreciate the bioequivalence of the generic product and to evaluate the intra-subject variability of this active substance in the Algerian population. The test brand was compared to Glucophage (Merck UK) as the reference product. The study was performed at the bioequivalence center of the national control laboratory for pharmaceuticals products from 03 to 04, 2011, in joint venture with specialized medical hospital center of El Hadi Flici, Algiers, Algeria. The drug was administered with 200 mL of water after a 10 h overnight fasting on two treatment days separated by one week washout period. After dosing, serial blood samples were collected for a period of 12 h. A reliable, simple, and robust liquid chromatography-tandem mass spectro-metric (LC-MS/MS) method has been developed and validated for estimation of metformin in human plasma using propranolol as internal standard. The analytes were extracted from plasma by using the protein precipitation extraction technique. The assay was found to be linear over the range of 50-3000 ng/mL with a lower limit of quantitation of 50 ng/mL. Various pharmacokinetic parameters including AUC0-t, AUC0-∞, Cmax, Tmax, and T1/2 were determined from plasma concentrations of both formulations and found to be in good agreement with reported values. The pharmacokinetical and statistical analysis was conducted with Kinetica 4.4.1. AUC0-t, AUC0-∞ and Cmax were tested for bioequivalence after log-transformation of data. No significant difference was found based on ANOVA; 90% confidence interval ([91.62 %, 115.66%] for AUC0-t, [92.07 %, 115.53 %] for AUC0-∞; [94.58%, 119.58 %] for Cmax) of test/reference ratio for these parameters were found within bioequivalence acceptance range of 80-125%. Based on these statistical inferences, it was concluded that Metformin hydrochloride test is bioequivalent to Glucophage.
303 Evaluation of the Effect of Citrus Lemon L. “Enter” on Blood Pressure in Hypertensive Patients , Zeynep GüneÅŸ Özünal1, Iliriana Alloqi Tahirbegolli2 and Ali Yağız Üresin2  
This study aimed to evaluate the effectiveness of lemon juice to lower blood pressure. Twenty nine patients were included. Blood pressure measurements were done before (basal) and 5th, 15th and at 30th minute after lemon juice or equal volume of water intake. When compared with the basal values, patients who were given lemon juice had lower systolic blood pressure at 5th, 15th and 30th min. Control patients who were given water had lower systolic blood pressure at 5th and 15th, and diastolic blood pressure at 15th min. When compared with the basal values, patients who were given lemon juice had lower heart rate at 15th and 30th and control patients who were given water had decreased heart rate at 5th, 15th and 30th min. Both lemon juice and water decreased systolic blood pressure within first 15th minutes possibly due to doctor and environmental silent effect. These results do not support lemon juice intake.
304 Diversity of Entomopathogenic Fungi in Argane Forest Soil and Their Potential to Manage Mediterranean Fruit Fly (Ceratitis capitata)     , A. Hallouti1, A. Zahidi2, R. Bouharroud3, A. El Mousadik2, A. Ait Ben Aoumar1 and H. Boubaker1  
The present study forms a part of biological control against the medfly (Ceratitis capitata) and seeks to isolate and determine the diversity of the medfly-associated entomopathogenic fungi in soil samples collected from Argane (Argania spinosa) forest, in different localities of Souss-Massa region. Search and isolation of the indigenous populations of Ceratitis capitata entomopathogenic fungi was carried out by using larvae of this pest as baits. After trapping, isolation and identification of fungal isolates, a pathogenicity test was used to select fungal strains that have significant virulence potential against the Mediterranean fruit fly. The degree of virulence was estimated by the ability of the fungus to induce the disease and/or the death in the insect and also by calculating the lethal time 50 (LT50). The obtained results were clearly demonstrated the sensitivity of medfly to tested fungal strains and particularly to strains of Fusarium sp., Aspergillus niger and Scopulariopsis sp. that have shown high mortality rates (more than 84%) and to Trichoderma harzianum, Scedosporium sp., Epicoccum sp. and Ulocladium sp. with more than 70% mortality for the two tested concentrations. Furthermore these strains showed short LT50 (less than 83 hours). All these results confirm the presence of entomopathogenic fungi of Ceratitis capitata in Argane soil, and prove the potential of entomopathogenic fungi for biocontrol of the Mediterranean fruit fly under laboratory conditions.
305 Crizotinib: From Chemical Entity to Anticancer Agent     , Xiaonan Jiang, Weihua Song, Qi Yang and Zhangqun Yang
Crizotinib is a mesenchymal-epithelial transition/anaplastic largecell kinase (MET/ALK) multi-targeted receptor tyrosine kinase inhibitor and has been rapidly and successfully developed as an inhibitor in ALK-rearranged NSCLC (non-small cell lung cancer). Lung cancer is the major cause of cancer-related mortality, accounting for over one quarter of cancer deaths. Lung cancers are generally divided into two main categories: SCLC (small cell lung cancer) and NSCLC. NSCLC accounts for approximately 85% of all lung cancers. ALK gene rearrangements are identified and targeted resulting in promising response rates for NSCLC in early studies. Considering the significance of Crizotinib in the treatment of NSCLC, the synthesis, pharmacodynamics, pharmacokinetics, therapeutic trials and adverse events are briefly overviewed in order to make more scholars, medical workers and patients have a more clear and comprehensive recognition on Crizotinib.
306 Evaluation of the Regulation of Antibiotics Consumption in Bujumbura, Burundi     , Havyarimana, C.1, Makuraza, F.2, Nyandwi, J. 2, 5, Manirakiza, M.2, Muneza, F.3 and Nkengurutse, D.4  
Background: Antibiotic self-medication is highly prevalent in the developing countries. The objective of the study was to evaluate self-medication with antibiotics and the regulation of antibiotics consumption in the private and public pharmacies of the urban area of Bujumbura. Methods: A cross sectional study using self-administered questionnaire was conducted in private and public pharmacies of Bujumbura. 460 clients were randomly chosen and 32 sellers randomly selected from January to September 2015 and interviewed. Results: Of the 460 participants, 186 (40.43%) practiced self-medication to antibiotics. The average age was 34.89 years. Abdominal pain was the first motivation to practice self-medication (20.8%). Amoxicillin was the antibiotic most commonly used (47.3%). Inaccessibility to health care facilities due to the lack of financial resources was cited to be the root of this phenomenon (62%) and these antibiotics were mostly acquired from community pharmacies without prescriptions (84.4%). Conclusions: The high cost of care and the low level of study of the patients are factors favoring this phenomenon. A national policy for regulation use of antibiotics without a medical prescription and an educational program to general population on the effective use of antibiotics are therefore needed.
307 The Process of Immobilization of ZnO Nanorods Surface with Galactose Oxidase     , La Phan PhÆ°Æ¡ng Ha, Ngo Van Chi Quang and Tran Quang Trung  
ZnO nanorods, with the c-axis orientation used for transparent conductors, solar cells, sensors…, especially the functionalized ZnO nanorods with some kinds of enzymes have been used for biosensor. In this work, we describe the process immobilization of galactose oxidase on ZnO nanorods surface with glutaraldehyde as a cross-linker molecule to make the working electrode in electrochemical biosensor. ZnO nanorods were grown on FTO (Fluorine-doped tin oxide) substrate by solution method at low temperature. The crystalline phase and orientation of ZnO nanorods were identified using X-ray diffraction. The efficiency of the immobilization was calculated by Braford method showed that about 36% enzyme content was immobilized on ZnO nanorods surface. The working electrode based on the immobilized ZnO nanorods was tested in galactose solution by CV (cyclic voltammetry) method indicated the value of current intensity is about 0.14 µA. These results clearly demonstrate the potential of galactose sensor based on ZnO nanorod.
308 Staff Management Aspects in Tbilisi Pharmacies , Nino Nemistsveridze
The main purpose of the research was to study a role and place of managers in maintaining staff policy at pharmaceutical companies. It was interesting to see how Georgian pharmaceutical companies are getting new employees at work, what is the priority of the new recruits? What methods are used for selection and recruitment? There were made inquiries by the way of filling applications, which (the applications) were given to the managers of Aversi, PSP, GPC, Pharmadepot and Pharmaceutical House. 50 managers were interviewed totally. It was established that pharmaceutical company management appoints people on the position of pharmacist-managers mainly on the basis of contract (90%). At present, the pharmacist education does not comply with the competence, so 55% of interviewed managers are bachelors, 45% are masters. In order to increase the management’s qualifications, pharmaceutical companies are conducting seminars (50%), trainings (30%), and testing (20%). Staff administration in the pharmacies is mainly carried out by the company administration (75%), rarely by managers (25%), but very often the administration takes into consideration the manager’s opinion; employees are accepted by testing-interview (70%) or CV (30%). Professional career and experience of the newly employed staff are not highly important (50/50), and the company prefers to educate and share practice to the personnel itself. It is possible to conclude that today the pharmacist-managers of the pharmacies are working in accordance with the contractual rights and obligations signed with the employers and pharmaceutical activities regulated under non-governmental institutes. As a result, it is important to be included special features of pharmaceutical management and the recommendations offered by the World Health Organization and the International Pharmaceutical Federation in the articles of regulatory laws.
309 Difficult Endotracheal Intubation—Scales and Causes   , Dejan Stojanovic  
The aim of the study is to assess the possibility of intubation in each patient, the lyche to be difficult intubation, to find all the causes of the difficult intubation, to find and apply appropriate scales for difficult intubation, to estimate the frequency of difficult intubation. Endotracheal intubation is the basic reanimation procedure performed both in hospital and out-of-hospital settings. It is carried out whenever chest movements and spontaneous respiration are compromised. Respiratory arrest may occur for a variety of reasons (such as cardac arrest, coma of any origin, poisining) or direct damage to the airways, e.g. in various traumas (damages to the face, oropharynx, larynx, trachea, chest). The basic endotracheal intubation kit contains: laryngoscope, endotracheal tubes, connectors (tube and Ambu bag connectors), complete Ambu kit (face mask and bag), 20 mL syringe for cuff inflating, suction apparatus, stylete, and Magill forceps. In order to assess the successfulness of endotracheal intubation, it is necessary first to identify patients who need to be intubated. With the aim of identifying such patients, numerous screening tests and scales have been created to predict difficult intubation. The best known and most commonly used are the Mallampati and Wilson classifications as well as the LEMON airway assessment method. Nevertheless, difficult intubation accounts for 1% of cases. It usually occurs when manipulation of the laryngoscope blade is not possible in obese patients and patients with short neck, in congenital restricted mouth opening, limited neck movement as well as limited temporomandibular joint mobility; in cases of edema, fibrosis and lesions of the tongue, pharynx and larynx; when there are anatomical variations and congenital malformations of the oral cavity, pharynx, larynx, head, neck and chest.
310 Comparative Evaluation of Pharmacist-Managed Vancomycin Dosing in a Community Hospital Following Implementation of a System-Wide Vancomycin Dosing Guideline     , Kathryn Koliha 1, Julie Falk 1, Rachana Patel 1 and Karen Kier 2
Purpose: Evaluate the implementation of a large hospital system vancomycin dosing guideline in a community hospital with pharmacist vancomycin management. Design: Single center, retrospective and prospective quality assessment study. Methods: Pharmacist-managed vancomycin therapy was evaluated pre and post-implementation of a new dosing guideline in a study population of 586 from one community hospital. Results: Of the study population, 274 patients evaluated pre-implementation were compared to 312 patients post-implementation of the large hospital-system guideline (46.8% and 53.2%, respectively). There was no significant difference in demographics between both patient populations. Days of vancomycin therapy was shorter in the post-implementation group (4.32 ± 2.241) versus the pre-implementation group [(4.81 ± 2.764), p = 0.018]. Days to goal trough was longer in the post-implementation group (3.51 ± 1.622) compared to the pre-implementation group [(3.09 ± 2.046), p = 0.054]. A post-hoc regression analysis was conducted, showing that age, days of vancomycin therapy and goal trough are predictors for 77% of cases within the post-implementation group. Conclusion: The implementation of a new vancomycin dosing guideline significantly impacted days of vancomycin therapy and days to goal trough in patients on vancomycin managed by pharmacists. Our results encourage completion of future studies utilizing the regression analysis data, which may impact the future care of patient on vancomycin managed by pharmacists. 
311 Investigation of Some Possible Mechanisms Involved in the Anticonvulsant Activity of Tulbaghia violacea Harv, K. A. A. Masoud1, Okobi E Ekpo1 and G. J. Amabeoku2
Even though Tulbaghia violacea has been used to treat and manage epilepsy in South Africa by traditional medicine practitioners, no evidence in any literature has shown any scientific scrutiny of the effectiveness of the plant species in therapy. This study was intended, therefore, to investigate the anticonvulsant effect of the leaf methanol extract of Tulbaghia violacea by studying its effect against tonic convulsion induced by either PTZ (pentylenetetrazole), bicuculline, picrotoxin, strychnine or NMDLA (N-methyl-DL-aspartic acid) in mice. Qualitative phytochemical analysis, acute toxicity and HPLC studies were also carried out on the plant species. Leaf methanol extract of Tulbaghia violacea, phenobarbitone, diazepam or muscimol significantly antagonised PTZ, bicuculline or picrotoxin-induced convulsion. Combined treatment of sub-effective doses of T. violacea and muscimol significantly antagonised tonic convulsion induced by PTZ. T. violacea or phenobarbitone significantly antagonised strychnine-induced tonic convulsion. T. violacea or LY233053 significantly antagonised NMDLA-elicited tonic convulsion. Phenytoin or DMSO (dimethylsulfoxide) did not significantly affect the tonic convulsion produced by PTZ, bicuculline, picrotoxin, strychnine or NMDLA. The phytochemical qualitative analysis of the plant species showed the presence of alkaloids, saponins, reducing sugars, flavonoids, cardiac glycosides, triterpene steroids, quinones and tannins. The LD50 value obtained following oral administration of the plant extract was over 4000 mg/kg. The data in the present study indicate that the leaf methanol extract of T. violacea has anticonvulsant activity which is probably underpinned by GABAergic, glutaminergic and glycinergic mechanisms.
312 Over Exposure to Efavirenz Plasma Concentrations among Beninese HIV Patients Treated by A 600 mg Daily Dose, Allabi Aurel Constant1, 2, Kiki Mikal1, 2 , Zannou Marcel3, Onifade El-Fataï1 and Alvarez Jean Claude4
Therapeutic plasma concentrations of EFV (efavirenz) are between 1,000 ng/mL and 4,000 ng/mL. Concentrations below 1000 ng/mL are associated with higher risk of treatment failure, and concentrations above 4,000 ng/mL are associated with toxicity. The aim of the study was to appreciate EFV plasmas concentrations profile and the association between plasma levels and various characteristics in Beninese patients treated by a 600 mg standard daily-dose. Blood samples were collected and EFV plasma levels were measured by liquid chromatography coupled with mass spectrometry detection in HIV-infected patients receiving EFV in combination with other antiretroviral drugs for at least 14 days. Adverse effects occurring during treatment were collected through a questionnaire. An over-exposure to EFV among Beninese HIV patients were observed, with 46.4% of patients presenting EFV concentration above 4,000 ng/mL, although adverse effects were tolerated indicating that antiretroviral treatment is safe. The measurement of plasma concentration at the steady-state could contribute to early detection of treatment failure and adapt treatment in subjects presenting serious adverse effects within context of therapeutic drug monitoring.
313 Temporary Dysarthria Induced by Irinotecan-Case Report of This Rare Adverse Event     , Mayndra Mychelle Landgraf1, Cinthia Leite Frizzera Borges Bognar2, Raquel Bezerra Guerra2, Andrea Morais Borges1, Fernando Silva Picon1, Gislaine Fernandes Silva1, Pamela Carvalho Muniz1, Pedro Nazareth Aguiar Junior3, Gilberto de Lima Lopes Junior2 and Michelle Samora de Almeida1  
This report describes the case of a patient with dysarthria during the administration of the third cycle of Folfiri for the treatment of metastatic colon cancer. After a thorough neurological examination and neuroimaging, structural causes were excluded and thus the dysarthria was attributed to the irinotecan infusion. A slowing down of the infusion rate to 180 min during the 15 subsequent cycles led to the cessation of the episodes of dysarthria. In 2016, it was estimated there will be 134,490 new cases of colorectal cancer with a five-year survival rate of 21% among patients with metastatic disease. As Irinotecan is often part of the therapeutic regimen in such cases, both in the first and second-line setting, there is a need to report rare adverse outcomes in order to find out ways to better manage of these events. The mechanism by which Irinotecan causes dysarthria is unknown and further research in this area is warranted.
314 Impact of a Pilot, Pharmacy-Led Tobacco Cessation Medication Protocol at Discharge in a Community Hospital     , Carly M. McKenzie, Rachana Patel and Kaitlyn R. Eder  
Purpose: To evaluate the implementation of a pharmacy-led tobacco cessation medication education protocol at discharge in a community hospital. Design: Single center, retrospective quality assessment study. Methods: A retrospective review of a pharmacy-led protocol was completed from November 2016 through April 2017. Data from one year prior to implementation of the protocol was analyzed against the study group. Results: A total of 607 tobacco cessation medication education interventions were made during the study period, 379 patients (62.4%) were given an OTC (Over The Counter) NRT (Nicotine Replacement Therapy) recommendation upon discharge and 148 (24.4%) were referred to the Ohio Tobacco Quit Line. TJC (The Joint Commission) TOB-3/3a measure was met in 44.1% of patients during the study period compared to 0% in the comparator group. Of the 75 patients who were reached via follow-up phone call, 23 (30.7%) purchased an OTC NRT and 22 (29.3%) completely quit using tobacco. Conclusions: Pharmacy-led tobacco cessation interventions during hospitalizations have a positive impact on TJC TOB-3/3a quality measure results and quit rates post-discharge. Our results encourage future studies in this area to further establish the importance of pharmacist involvement in tobacco cessation, specifically in the hospital setting. 
315 On the Role of Intestinal Microbiota in Patients with Cognitive Decline   , Friedrich Leblhuber1, Barbara Strasser2, Kostja Steiner1, Johanna Gostner2, Burkhard Schuetz3 and Dietmar Fuchs4  
Objective: The association between gut microbiota composition and biomarkers of immune activation and inflammation was assessed in the elderly. Patients: Serum inflammation markers of fifty-five outpatients (29 females, 26 males, aged 78 ± 8.5 years) were analyzed. Stool specimens and thus data on gut microbiota were available from a subgroup of 23 individuals (9 females and 14 males). Results: Global cerebral atrophy was found in all magnet resonance tomography scans. Mean mini-mental-score examination in Alzheimer’s disease patients was 18.8 ± 7.1, in patients with mild cognitive impairment 27.8 ± 1.5. Serum neopterin concentrations correlated with concentrations of fecal S100A12 (p < 0.001) and a1-antitrypsin (p < 0.05). Faecalibacterium prausnitzii correlated with MMSE (p < 0.05), with Akkermansia muciniphila (p < 0.01) and with serum neopterin (p < 0.05). Fecal zonulin correlated inversely with Clostridium cluster I (p < 0.02). Conclusions: Our results underline earlier in vitro and animal studies that cognitive decline associates with age-related changes in the intestinal microbiota and neuroinflammation. However, only correlational evidence can be reported, and a causative relationship still has to be demonstrated.
316 Anti-promastigote Activity of the Amazon Plants     , Silva-Silva, J. V.1, Monteiro, R. C. S.1, Brigido, H. P. C.1, Vale, V. V.2, Silvestre, J. V.3, Silva, N. C. S.3, Silveira, F. T.4, Marinho, A. M. R.5 and Dolabela, M. F.1, 2
This study evaluated in vitro activity of ethanol extract, fractions, and isolated substance from Amazon species against promastigotes of L. amazonensis. The ethanol extracts were concentrated and fractionation. The anti-promastigote activity was evaluated through the cell viability assessment method (MTT). The ethanol extract, fractions, and isolated substance from Himatanthus articulatus and Parahancornia fasciculata were inactive in promastigote of L. amazonensis, as the ethanol extract of Physalis angulata. The hexane fractions from different parts of Montrichardia linifera showed anti-promastigote activity probably due to the presence of steroids and terpenes. All species in studies were inactive, except of M. linifera. The few polar constituents can be responsible for the activity. Therefore, the isolation and purification of the active on L. amazonensis promastigotes are urgently required.
317 Bioequivalence of Two Brands of Valsartan 80 mg Coated Breakable Tablets in 15 Healthy Algerian Volunteers: A Pilot Study     , Mansouri. K., Behloul. S., Cherait. I., Nekhoul. K., Hadjaz. I. M. and Mansouri. M. B.
A randomized, two-way, crossover study was conducted in 15 fasting, healthy, Algerian volunteers to compare the bioavailability of two brands of Valsartan 80 mg coated breakable tablets. The present study aimed to evaluate the intra-subject variability of this active substance in the Algerian population. The test brand was compared to TAREG (Novartis) as the reference product. The study was performed at the bioequivalence center of the national control laboratory for pharmaceuticals products, in joint venture with University Hospital Center Ibn Badis, Constantine, Algeria. The drug was administered with 200 mL of water after a 10 h overnight fasting on two treatment days separated by one week washout period. After dosing, serial blood samples were collected for a period of 24 h. A reliable, simple, and robust liquid chromatography-tandem mass spectro-metric (LC-MS/MS) method has been developed and validated that employs protein precipitation (or denaturation) for the estimation of valsartan in human plasma using losartan as internal standard. The assay was found to be linear over the range of 50-5,000 ng/mL, with a lower limit of quantitation of 50ng/mL. Various pharmacokinetic parameters including AUC0-t, AUC0-∞, Cmax, Tmax, and T1/2 were determined from plasma concentrations of both formulations and found to be in good agreement with reported values. The pharmacokinetical and statistical analysis was conducted with Kinetica 4.4.1. AUC0-t, AUC0-∞ and Cmax were tested for bioequivalence after log-transformation of data. No significant difference was found based on ANOVA; 90% confidence interval ([85.82%, 118.76%] for AUC0-t [86.09%, 118.83%] for AUC0-∞) of test/reference ratio for these parameters were found within bioequivalence acceptance range of 80-125%. But for the Cmax, the 90% confidence interval of test/reference ratio wasn’t in this acceptance range [90.18%, 131.07%] .The results of PK analysis suggested that the reference and test formulations of valsartan 80 mg coated breakable tablets weren’t bioequivalent during fasting state in these healthy algerian volunteers.
318 Justicia insularis Improves the in vitro Survival and Development of Ovine Preantral Follicles Enclosed in Ovarian Tissue   , Gildas Tetaping Mbemya1, Denise Damasceno Guerreiro1, Nathalie Jiatsa Donfack1, Luciana Mascena Silva1, Luis Alberto Vieira1, Geovania Francisca Canafistula de Sousa1, Benner Geraldo Alves1, Aryele Pinto Izaguirry2, Francielli Weber Santos2, Phelix Bruno Telefo3, Otília Deusdênia Loiola Pessoa4, Johan Smitz5, José Ricardo de Figueiredo1 and Ana Paula Ribeiro Rodrigues1
Objectives: Evaluating the addition effect of J. insularis extract and FSH on the survival, activation and ROS production after in vitro culture of ovine preantral follicles enclosed in ovarian tissue. Methods: In the first experiment, ovarian fragments were fixed (non-cultured control) or in vitro cultured in α-MEM+ (cultured control), α-MEM+ supplemented with FSH 50 ng/mL, or in α-MEM+ supplemented with J. insularis (JUS0.3; 1.25 or 5 mg/mL) for 1 or 7 days, at 39ËšC, 5% CO2. In the second experiment, fragments were fixed or cultured in α-MEM+ supplemented with anethole 300 µg/mL + FSH 50 ng/mL or in α-MEM+ supplemented with anethole 300 µg/mL + 0.3 mg/mL JUS. Key findings: JUS0.3 was the only treatment that maintained the percentage of morphologically normal follicles similar to non-cultured control even after 7 days of culture. After 7 days of culture, a higher      (p < 0.05) percentage of developing follicles was observed in JUS5 treatment compared with the other treatments except JUS1.25. In the second experiment, FSH maintained the percentage of normal follicles and promoted activation of primordial follicles. A reduction (p < 0.05) of stromal cell density was observed in MEM++ANE supplemented with JUS or FSH. Conclusions: J. insularis in a concentration-dependent manner maintained the levels of ROS and improved in vitro follicular survival and activation of ovine primordial follicles. 
319 Erythropoietin: From a Biosimilar to Innovative Products Protected by Industrial Property Assets     , Lien López Matilla1, Pedro Bárzaga Fernández2 and Sonia González Blanco3
Aim: EPO (erythropoietin) is a hormone that stimulates the erythropoiesis and is mainly produced by the kidneys. In the early 1990s among the emerging biotech drugs, the recombinant human EPO (rhEPO) was the best-selling product worldwide, reaching nearly three billion dollars annually. The CIM (center of molecular immunology) produced and sold the rhEPO as commercial strategy to recover the investment made in its new facilities. This work summarizes the inventions that protect the innovative products developed by three Cuban institutions, starting from rhEPO, and the industrial property strategy followed by them. Methods: The information was obtained from the United States Patent, Trademark Office (USPTO) database, Patentscope, Espacenet, patent databases of Center for Pharmaceutical Research and Drug Development (CIDEM) and Cuban Industrial Property Office. Conclusions: The manufacturing process of CIM’s EPO has its own patent family. From a manufacturing by product an innovative formulation protected by patent was obtained. There is a patent family around the nasal formulation and it continues enlarging. From a biosimilar pharmaceutical innovative products impacting on human health have been obtained.
320 Mandibular Reconstruction with Autogenous Fragment of Previous Iliac Crest Associated to Hyperbaric Oxygen Therapy: Case Report     , João Fernando Veiga Pires1, Claudio Lessa2, Renata Pittella Cancado2, Filipe Barcellos Caldas2 and André Alberto Camara Puppin2
Early efforts at mandibular reconstruction are described from ancient China and the Etruscans to even Hippocrates, involving wooden, terracotta and metal prostheses attached to bone or teeth. Since then, modern surgery has developed more effective techniques, including no vascularized bone grafts, better alloplastic materials, vascularized loco regional grafts, soft and hard tissue compounds, bone fixation and stretching materials, and mechanisms for study models. These components have become indispensable in the surgeon’s arsenal with regard to reconstructive surgery. A gold standard for mandibular bone reconstruction is the use of autogenous grafts. The objective of this study was to describe a clinical case of mandibular reconstruction with autogenous graft associated with adjuvant hyperbaric oxygen therapy. The clinical case presented shows the treatment performed for after-effects correction due to the non-consolidation of sagittal mandibular osteotomy performed for correction of standard III dentofacial deformity, resulting in a pseudoarthrosis with bite deviation and facial asymmetry. As a treatment plan, mandibular reconstruction was instituted with autogenous graft of anterior iliac crest associated with the use prototyping biomodel and hyperbaric oxygen therapy. After a control of 1 year and 6 months, no signs of recurrence were identified and the radiographic image showed excellent positioning, good volume and maintenance of the mandibular contour.
321 Pharmacovigilance and Toxicovigilance Development in Dentistry     , María Renée Romero  
Patient safety has become a priority for the health system, including dentistry. Several studies showed that health care meant to improve people’s health is an important source of disease. Good clinical practices aim to maximize effectiveness and therapeutic compliance, minimize risks and costs, respecting the patient’s choice from generic drugs, also from the moment of prescribing, the supervision of drug-related events must be taken into account, not only on the patient but also in the environment. Pharmacovigilance and pharmacoecovigilance have to be conceived as a clinical practice in dentistry. There is no established culture of drug induced reaction reports by dentists in Uruguay, and awareness of environmental care is incipient. The pharmacy of faculty of dentistry, (Universidad de la República), an institutional project that has been developed since 2006, is in a transformation process. The pharmacovigilance dentistry Node is in full development. The toxicovigilance and pharmacoecovigilance activities are recent. The general aim of this project was to establish the pharmacovigilance, toxicovigilance and pharmacoecovigilance clinical practice in dentistry. The widespread use of cosmetic as toothpastes, or mouth rinses, drugs and dental materials, as well as exposure to chemical contaminants through the population’s living habits and the environmental damage caused by drug wastes requires comprehensive and up-to-date information to establish rational strategies.
322 New Phytochemical Profile of Ethanolic Extract from Talipariti elatum (Sw.)     , José González1, Armando Cuéllar1, Loïk Sylvius2, Frédéric Verdeau2, Frantz François Haugrin3, Juliette Smith-Ravin2 and Odile Marcelin2
Genus Talipariti has long history of use in various traditional medicine therapeutic applications in Cuba, especially in treatment of bronchial asthma and flu. Petals of genus Talipariti are rich source of secondary metabolites and most of these metabolites are reported to possess expectorant, antasthmatic, appetitive, antioxidant, and antibacterial properties. Hence, in our study, we present a validated, sensitive, reliable, and cheap narrow-bore UHPLC-UV-ESI-MS/MS coupled to PDA (photodiode array detectors) method for the simultaneous isolation and identification of flavonoids and their glycosidic derivatives in this flower drug. In addition, about twelve compounds were identified in this specie based on chromatography retention time (tR), UV and MS/MS spectra and compared with those of isolated authentic compound and literature data. About eighth constituents were reported for the first time from Talipariti elatum. Our results demonstrated the developed method could be employed as a rapid and versatile analytical technique for identification of chemical constituents and quality control of Talipariti elatum. 
323 DNA Damage after Ozone-Photodynamic Therapy in Cancer Animals: Experimental Research   , Shcherbatyuk Tatiana, G., Chernigina Irina, A., Plekhanova Evgeniya, S., Shakhov Boris, E.  
Objectives: To assess the genotoxic effect of a new antitumor ozone-photodynamic therapy using the improved modification of the COMET assay. Methods: Xenograft cancer models on 58 rats were used. The sarcoma RA was transplanted subcutaneously, and after increasing of tumor volume from 0.5 to 4.2 cm3, rats were divided into the four groups: “Intact”—healthy, “Control”—with xenografted tumors and no treatment, “PDT”—the rats treated with the photodynamic therapy, “PDT + ozone”—the rats were treated with both photodynamic therapy and injections of ozonated saline solution. The toxicity of treatment was assessed by DNA damage in leukocytes using the new modification of the COMET assay. The analysis of the “COMETs” was performed following the percentage of DNA in the tail of the “COMET” (% TDNA). Results: A combination of PDT and ozone makes the strongest negative impact on tumor growth. The tumor growth inhibition is associated with low genotoxic exposure of ozone-photodynamic therapy on whole blood leukocytes of cancer rats. Conclusions: A new modification of the COMET assay can provide the assessment of the genotoxic effect of the antitumor therapy in experimental neoplasia.
324 Antimicrobial Efficacy of Curcumin Formulations by Photodynamic Therapy , Kate C. Blanco, Natalia M. Inada, Fernanda M. Carbinatto and Vanderlei S. Bagnato
URTI (upper respiratory tract infections) are caused by acute, chronic or recurrent infections including pharyngitis and tonsillitis. The etiologic agents involved are bacteria, virus, and fungi. The standard treatment for bacterial infections is the use of antibiotics. The antibiotic resistance, side effects of drugs and URTI complications indicate the importance of new therapies. PDT (photodynamic therapy) is a treatment option with a fast onset of action, low side effects, and easy administration of PS (photosensitizer) based on this study. The main aim of this study was to develop a new modality for the treatment of infectious pharyngotonsillitis by photodynamic therapy. In addition, this study aims to evaluate components of the therapy as the PS, curcumin, in two formulations and irradiation conditions in the effectiveness of treatment. The procedure consists of two steps: oral administration of CFs (curcumin formulations) containing a PS and illumination (450 nm and 0-60 J/cm2). Bacterial isolates were obtained from patients in a routine clinical pratice. The new methodology has been developed from the principle of PI (photodynamic inactivation). The strain identification number of colony forming units determined the efficacy of PI using each component, lighting and PS. The use of curcumin formulations in PI presented microbial reduction of 5 log..
325 Oxygen-Ozone Autohaemotherapy and Intravescical Oxygen-Ozone Insufflations in Treatment of Recurrent and Interstitial Cystitis: Preliminary Results, Muzi, F., and Tati, G.
Introduction: Cystitis has high incidence in female population. Inflammation is responsible of irritative symptoms; it is supposed the existence of an arterial obstructive disease connected with bladder ischaemia. Direct bacterial damage and/or inflammation are responsible of the activation of ROS (radicals of oxygen) and consequent cell damage. NF-kB protein is protagonist in ROS synthesis. High levels of O2 in periphereal tissues reduce ischaemia, responsible of recurrent inflammation and increase antioxidant effects in presence of controlled oxidation. The aim of this study is the essay of anti-inflammatory effects of OOT (oxygen-ozone therapy) in chronic cystitis, employed in combined subministration. OOT properties could decrease bacterial concentration and eliminate dysuriac disturbances, reducing ischaemic effects. Methods: This study proposes a combined treatment for cystitis with oxygen-ozone AHTM (autohaemotherapy) and intravescical insufflations. It has been selected 8 Women aged 40-55 years with recurrent cystitis, associated with pain and urge incontinence. We have used certified medical OOT generator. Results: After therapies, all patients showed sterile urine and progressive reduction of symptoms with a sensible improvement of quality of life. Conclusions: Nevertheless, in a little group of patients, preliminary results could suggest the use of OOT for recurrent cystitis after failure of conventional therapies.
326 Regenerative Properties of Fetal n. Raphe Cells in Modeling Injuries of Serotonergic Neurite-Glial Fibers in Vitro   , Vasylyeva I. G., Oleksenko N. P., Chopyk N. G., Galanta O. S., Shuba I. M., Tsyubko O. I. and Snitsar N. D.  
It is considered that renewal of growth in serotoninergic caudal fibers their sprouting to injury site and formation of outgrowth net is factor for locomotion recovery. The aim of our work was to study the influence of rat fetal neural cells enriched with serotonin-producing cells, on morphogenesis, gene expression of serotogenesis (Pet1, Nk2.2, Lmx1b, Tph1, Tph2, Sert) and serotonin level in organotypic n. raphe cultures in injury of neurite-glial fibers in vitro. Injury was modeled by the way of crossing neurite-glial fibers after their formation under long-term culture. The cell accumulation was observed in the injury zone when fetal n. raphe cells, previously enriched with serotonin-producing cells were added into organotypic culture of n. raphe with crossing fibers under the culture conditions. As a result, crossing site was filled with these cells after 14 days of culture. The activation of expression in cascade of regulatory genes-regulators of serotogenesis Pet1, Lmx1b, Tph1, Tph2, Sert and increased serotonin content in the culture material were also observed. The activation of gene expression of serotogenesis Pet1 and Sert, and increased serotonin content by 1.7 times were revealed when conditioned medium from culture of fetal rat cells was used. An eviction of single cells was observed in control samples of organotypic n. raphe culture after injury. Crossing site was remained without signs of cell filling in these samples at day 14 after culture. The activation of regulatory gene expression of serotogenesis Pet1, Nkx2.2, Lmx1b, Tph1, Tph2, Sert and restoration of serotonin content were also absent in the culture material.
327 Influence of Heavy Metals from the Flooded Areas of Tuzla Canton on the Growth of Stomach Adenocarcinoma , Indira Mehmedagić1 and Mirza Mešić2
The aim of this study is to determine the relationship between food contaminated with heavy metals and growing number of stomach adenocarcinoma patients in Tuzla Canton after flooding of the river Spreča catchment area. The scope of work is retrospective and prospective five-year study (2010-2015) of 1,000 patients, who had stomach adenocarcinoma surgery in the department of surgery, University Clinical Centre Tuzla, and answered questions about diet. The patients were predominantly male, aged 60 to 70 (1.5: 1). The data on heavy metal contamination in farmlands in the river catchment area were provided by the Federal Department of Agropedology. The malignity was reported to the department of public health in Tuzla Canton. The results showed an increase in number of patients with stomach adenocarcinoma in the industrially developed municipalities who consumed vegetables contaminated with heavy metals after the floods. The smallest number of patients who underwent stomach adenocarcinoma surgery comes from the municipalities situated out of the flood plain, where farmland was not contaminated. It is concluded that most of the patients having stomach adenocarcinoma came from the municipalities with contaminated agricultural soil. The diet included vegetables, meat, and dairy products. 
328 Study of Variation in Phosphocalcic Metabolism during Pregnancy and Postpartum in the Holstein Cow of Constantine Region, Selma Benhizia1, Mohamed Amir Boudhene2, Sara Benayache1, Nadjoua Arzour1 and Abdeslam Mekroud1
Pregnancy, parturition, and lactation represent physiological changes of organism, which activates adaptation mechanisms dedicated to maintain homeostasis during peripartum period. Despite of the appropriate input of calcium and phosphorus, the homeostasis of phosphocalcic metabolism is sometimes faulty, in particular among animals with high production potential. The aim of this study is to define usual values of calcium and phosphorus during pregnancy and postpartum period. This paraclinic tool will serve to a good interpretation when used by veterinarians. A second goal is to study the influence of physiological stage on phosphocalcic metabolism in milch cow. The hereby study was conducted on 17 Prim’ Holsteins cow breed from 3 to 5 years old, clinically healthy, multiparous and derived from two dairy farms located in the wilaya of Constantine. Blood samples were taken from the jugular vein using dry tubes at different physiological stages (early gestation, mid gestation, late gestation, pre-partum, one day after parturition, and one month postpartum). All of the samples correctly identified were transported to a specialized laboratory where specific kits were used. Blood calcium and phosphorus levels have significantly varied depending on physiological stage (p < 0.01). They showed a high pre-partum variation, with a rate of 94.71 mg/mL and 61.99 mg/mL, respectively. These results can be used as means of follow-up reproduction for a better management of dairy farming.
329 Economic Impact of a Dispensing Analog Insulin Strategy to Diabetic Patients   , Jose Jaime Giraldo Rojas1, Zoraida Andrea Ocampo Saldarriaga2, Luis Carlos Sánchez Rojo3 and Edwin Alejandro Ospina Marulanda4
Objective: Assess the economic impact of the dispensing control strategy implementation on analogue insulin dosage in diabetic patients of the subsidized system of Antioquia. Methodology: A retrospective cohort study compares the units of analogue insulin consumed with the expense per patient during the periods of December/14-May/15 versus December/15-May/16. Statistical treatment is applied to data obtained and the results are analyzed. Results: The expense per patient during the period of December/15–May/16 was statistically less than the one during the same period on the year before (December/14-May/15), having a state dispensing saving per patient of US$ 1.34 per month. And a saving per patient in the pharmaceutical care is approximately US$ 2.82 per month. Conclusions: Cost savings in care of insulin-dependent diabetic population enrolled in the subsidized plan was possible due to the development of cost/effective dispensing strategies that allowed access and safety of insulin therapy. 
330 Effectiveness of the Service Mapping Method in Re-designing the Bariatric Surgery Clinical Pathway of a Public Hospital , Loreggian Lara1, Sartor Maria Elisa2, Strohmenger Laura3 and Rovati Marco Pietro Lucca4  
Background: Nowadays obesity is the world’s common disease. Bariatric surgery is the only therapy that provides significant cost savings within Public Health Service, but the lack of diagnostic paths universally accepted causes enormous waste of resources and disruptions. Service Mapping is the ideal methodology to describe work’s organization and to plan a new service model. Methods: The Service Mapping has been used to represent the actual state of the bariatric surgery service and starting from the critical aspects found, we have developed a desirable state of the service. Results: Experience-based design has given centrality to the beneficiary, making the bariatric service sensitive to patient’s needs and expectations. The micro-organization of work has improved professionals’ integration, avoiding the creation of new operational entities or additional costs. The service has been simplified both for clinicians and hospital managers. The strategic repositioning of the dietician and general practitioner’s recognition within the bariatric path allowed us to achieve better clinical outcomes. Conclusions: Service Mapping has highlighted clinicians’ difficulties in providing the service, emphasizing the importance of the beneficiary. The iconic representation is a powerful explicit framework, fundamental for management purposes, to understand the role of every subject involved in the service, to rationalize work’s organization, and integrate healthcare activities. 
331 Health Seeking Behavior among Medical Students in the University of Sharjah     , Sawalha, K., Sawalha, A., Salih, E., Aldhuhori, N., Aboukalam, N., Bakie, R., Alkilani, H., and Hussein, A.  
Background: Medical students have different perception of symptoms and illness. Moreover, medical students report barriers to seeking help about their health, and are more likely to seek advice informally from friends and/or family. It is important to identify health seeking behaviors among medical students to be able to modify and interfere accordingly. Objectives: To describe the health seeking behavior of medical students in UOS and identify the factors affecting those behaviors. Methods: A cross-sectional study was conducted at the University of Sharjah during the spring semester of the academic year 2012-2013. Self-administered questionnaires were distributed to all medical students from all 5 years. Questions were related to physical health seeking behaviors only. Data was analyzed using the SPSS21 software. Results: We have found that self-prescription was the most common practiced health seeking behavior among 91.8%-96.6% of UOS medical students (CI of 95%) followed by the order ignoring a health problem, seeking immediate care, using the internet, reading more about the problem and self diagnosis & management. All are practiced by more than 50% of the students. A set of other behaviors was identified as well. Factors affecting these behaviors mainly included: self-care orientation & medical education. Other factors that had a role as well were: gender, stage of studying, having a chronic illness and lack of knowledge about the health services available. Conclusions: Medical students in the University of Sharjah have a high level of self-care orientation and accordingly, tend to react to their illness in a variety of ways. The most common of these is self-prescription. Studying medicine is the 2nd major factor that influences their health seeking behaviors. Sufficient guidance about the consequences associated with certain behaviors may be required.
332 Orthognathic Surgery Combined with Partial Lipectomy of the Buccal Fat Pad: Case Report on Optimization of Esthetic Outcome     , Daniel Amaral Alves Marlière1, Caio Bellini Lovisi1, Alan Robert Moreira Schmitt2, Bruno Salles Sotto-Maior3 and Henrique Duque de Miranda Chaves Netto3  
Orthognathic surgery involves correction of functional and often esthetic disharmonies. The purpose of this case report is to present the case of a 22 years-old female with class III dentofacial deformity that required orthognathic surgery to treat her malocclusion and buccal fat pad excision for optimizing soft-tissue facial contour. Treatment planning involved a counterclockwise rotation of the maxilomandibular complex with genioplasty based on digital 3D surgical planning using the Dolphin Imaging® 11.7 3D Premium software. Prototyping splints allowed surgical procedures (bilateral sagital mandibular osteotomy associated to a Le fort I osteotomy) that corrected position of the gnathic bones. In the same surgical procedure, the buccal fat pad was partially removed for a sharp cheek contour giving a slimmer appearance to her face. After 5 months, the patient was reassessed and reported no complaints regarding esthetics or function. This case illustrates that a combination of orthognathic surgery and an esthetic procedure can result in a stable and harmonious facial as well as occlusal outcomes.
333 Effect of Furfuraldehyde on the Polymerization of Acrylonitrile Initiated by Benzoyl Peroxide     , Gyan Singh and R.K.S. Dhakarey  
PAN (polyacrylonitrile) is a synthetic, semicrystalline organic polymer resin, with the linear formula (C3H3N)n. PAN is one of the versatile polymers that is widely used for making membranes due to its good solvent resistance property. It has been used as a substrate for NF (nanofiltration) and RO (reverse osmosis). The thermosetting characteristic offered by PAN makes it suitable as a carbon membrane precursor. It usually does not liquefy or soften during any stage of pyrolysis and preserves its morphology upon the pyrolysis. In the present study, effect of Furfuraldehyde on the polymerization of acrylonitrile initiated by benzoyl peroxide has been studied. The different techniques like, FT-IR and UV-VIS were used for characterization. The UV-VIS study showed that the rate of polymerization of acrylonitrile decreases with increase in the concentration of furfuraldehyde. The FT-IR study proves the successful interaction of polyacrylonitrile with Furfuraldehyde. 
334 Aflatoxin and Fumonisin in Corn Production Chain in Bafia, Centre Cameroon: Impact of Processing Techniques   , E. Nguegwouo1, 4, E. E. Njumbe2, P. B. Njobeh3, G. N. Medoua4, Z. Ngoko5, M. Fotso4, S. De Saeger2, E. Fokou1 and F. X. Etoa6
Food safety is to be a vital component of food security, with mycotoxin contamination, a major contributing factor. In line with this, this study aimed at investigating the effect of maize maturity at harvest, and processing techniques on the aflatoxin and fumonisin levels in maize and maize products. Three maize maturity stages (80, 85, and 90 days after sowing), two drying processes (sun and barn drying), three storage periods (one, two and three months) and subsequent maize derivatives under these conditions were sampled. These were analysed for total aflatoxins and total fumonisins using quantitative ELISA and samples with total aflatoxins and total fumonisins exceeding regulated levels were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) to determine the sub-types of toxins present. Results obtained showed that all analyzed samples were contaminated with total aflatoxins (range: 0.8 to 20 µg/kg) and total fumonisins (range: 10 to 5990 µg/kg). Sun or barn drying for one week followed by one month usual storage resulted in significant total fumonisins contamination, emphasizing the need of at least two weeks of drying maize. It was also observed that processing techniques partly reduced the levels of toxins, mainly in maize products that have a sieving step.
335 A New Model of Drug-Disease Interaction in Rabbits   , Sahar K. Hegazy1, Noha A. Hamdy2, Ahmed G. Adam3 and Nawal M. Khalafallah4  
Background: Drug-infection interaction should be considered in drug prescribing, particularly if potentiated by co-occuring drug-drug interactions. The effects of Candida and e-coli infections separately, and fluconazole administration were tested on cyclosporine blood level in rabbits. Methods: Three study designs were carried out, crossover single-dose-fluconazole-cyclosporine study testing fluconazole-cyclosporine interaction, multi-dose candida-fluconazole-cyclosporine and multi-dose escherichia coli-cyclosporine study designs involving each rabbit acting as its control; cyclosporine was given daily in both studies. Candida and e-coli infections were inoculated on day 5. In the Multi-Candida-Fluc-CyA, fluconazole-cyclosporine interaction was also considered, and fluconazole was administered daily from day 9-18. In all three studies, Cyclosporine trough levels and serum creatinine were measured by CMIA and enzymatic assay respectively, pre, during, post-infection and after fluconazole administration in the Candida study. Results: Both infections resulted in significant rise in cyclosporine trough level (p = 0.018) and (p = 0.005) in fungal and bacterial studies, respectively. The median rise in CyA level reached 52% (range 9-426%) in the Candida infection and reached 60 ± 47.5% (mean) with the e-coli infection. Fluconazole also increased mean cyclosporine trough levels in the single-dose study by 70.3 ± 45.3 and the concomitant rise in the multi-dose study reached 76% (median, range 22-665%). Conclusions: Cyclosporine trough levels increased during Candida and e-coli infections and also during fluconazole administration in the single and multi-dose studies. Fluconazole exerted an additive effect to the Candida inhibitory effect. Type of infection and inoculum size affected CyA levels differently. Monitoring cyclosporine level during episodes of infection as well as in therapy regimen involving interacting drugs is advisable. 
336 Isolation of Cell-Free DNA from Seminal Fluid , Tina Draškovič  
Cell-free DNA (cfDNA) is small short double stranded molecule that is also found in seminal fluid. It is a product of apoptotic cells in different developmental stages during spermatogenesis. To final concentration of total cfDNA in semen contributes also cfDNA secreted from living cells and cfDNA that is result of different diseases e.g. prostate cancer or infertility. Amended concentration (high or low) can be connected to prostate cancer or male infertility and can represent important non-invasive diagnostic biomarker for detection and prognosis of these pathological conditions. In this paper, I will discuss different approaches for isolation of cfDNA from seminal fluid, which includes selection of the samples, separation, isolation, extraction, purification and analysis. Today’s most popular approach for isolation is the use of commercial kits based on selective binding and elution on silica-membrane technology, magnetic-bead technology or extraction with organic solvents and salting out procedure. Furthermore I will present that I tried to isolate cfDNA from semen with QIAamp DNA Mini Kit to confirm the presence of cell-free DNA in our samples. In the end I will describe problems we are facing during cfDNA measurement which are mainly associated with low concentration of cfDNA in samples.
337 Biotechnology and Nanotechnology Drug Delivery: A Review , Tenderwealth Clement Jackson1,4, Nkem Mercy Obiakor1, Irene Nkwachi Iheanyichukwu2, Obo Okokon Ita3 and Adaeze Salome Ucheokoro4  
Nanobiotechnology is a blend of biotechnology and nanotechnology. Nanotechnology, as a field, has been tapped into in recent years, in search of alternatives to overcome challenges associated with drug delivery. Various techniques have been put together in order to fabricate nanoparticles with improved therapeutic efficacy enhanced drug stability, specific targeting of the cells and controlled release inside the cell. This review tends to look at the concepts involved in nanobiotechnology, the application of nanobiotechnology in nanomedicine, diagnosis, cancer treatment and drug delivery approaches.
338 Efficiency of Esmolol in Treating Postoperative Arterial Hypertension in Patients with Ischemic Heart Disease , Abbasov Fazil, Mahmudov Reshad, Musayev Seymur, Kurbanov Emil and Isayeva Aynur
To investigate the efficiency and safety of (β+α)-adrenoblocker esmolol for postoperative arterial hypertention (PAH) in patients with ischemic heart disease. The study included 25 patients (45-65 years, mean age 51.5 ± 7.3) who underwent coronary artery bypass grafting surgery with continuous blood purification (CPB). PAH developed during first post-op hours, all patients were ventilated with 2-4 scale sedation by RASS. All patients had arterial hypertension and were on constant therapy. Esmolol was administered IV push 20 mg within a minute. When required, injection was repeated in 5 min until full required effect. Maximum dose was 100 mg. For intraoperative treatment of hypertension 80 mg bolus within 30 sec was injected followed by 150 mg/kg/min infusion when required. Post-op dosage was administered similarly. Esmolol treatment was efficient in 82.6% of cases. Most frequent target AH was achieved using up to 40 and 60 mg in 20% and 36.9% of cases accordingly. Antihypertension effect maintained within 24 hours after injection. Esmolol cause moderate reduction of heart rate (4-7%), making it possible to use in case of hypertension without tachycardia. It is well tolerated and safe as no side effects were observed. The study showed high efficiency and safety of using esmolol to manage post-op arterial hypertension in cardiac surgery patients.
339 Chromium (III) Biosorption of Deinococcus radiodurans and Its Vitreoscilla Haemoglobin (vgb) Gene-Transferred Recombinants   , Elif Ozbey1 and Dilek Asma2
Objectives: This study used Deinococcus radiodurans, which is extremely resistant to oxidative damage, genotoxic chemicals, high levels of ionising and ultraviolet radiation and drying, and its Vitreoscilla haemoglobin (vgb) gene-cloned recombinant with the vgb− recombinant strain as a control. In addition to the conditions wherein bacteria have an optimum Cr (III) biosorption capacity, the contribution of the vgb gene to the biosorption ability of the bacteria has been investigated by providing the organism with a more oxygenic environment. Methods: Bacteria were produced and metal stock solution was prepared. To determine the Cr (III) removal capacities of wild and recombinant D. radiodurans strains, the residual metal concentration in aqueous media at the beginning and after biosorption was determined in Atomic Absorption Spectrophotometer. Some optimal conditions were created for the biosorption conditions to occur. Conclusions: The optimisation tests showed that Cr (III) reached the highest biosorption capacity within 15 minutes at a metal concentration of 2,000 ppm, 30 °C, pH 5.0 and 150 rpm stirring speed in all the three bacteria. The vgb gene had no significant contribution to the biosorption capacity.
340 Medicinal Plants, Precautions for Their Use in the Elderly     , Geuny Vázquez Bandomo, Ana Elena Rodríguez Cadalso, Regina de la Caridad Rodriguez MuñozI, Eduardo Rafael Aguila Turiño, Viviana Silvia Rodríguez Jiménez and Reimundo Eugenio Fernández Abril
Objective: To relate physiologic changes and presence of illnesses in older adults, with the risk of appearance of adverse reactions and pharmacological interactions as consequence of the use of medicinal plants. Methods: To carry out a search in the last 5 years and to present a general vision about what have been published related to the use of medicinal plants with risk of appearance of adverse reactions and interactions in older adults. Conclusions: Technological prevision based on the search of articles in the Virtual Library in Health (BVS) and using the words key “medicinal plants”, “older adult”, “pharmacokinetics”, “adverse reactions”, “elderly”, “pharmacological interactions”, and the association among them.
341 The Antiproliferative and Pro-apoptotic Role of 2-aminoethyl dihydrogen Phosphate in Triple-negative Breast Tumor Cells , Antenor Pereira Bonfim Neto1, Laertty Garcia de Sousa Cabral2,3, Thalles Anthony Duarte Oliveira3,4, Julio Carlstron Pacheco1,2, Monique Gonçalves Alves1,3, Mercedes Reyes Hernández1, Rosa Andreia Nogueira Laiso1 and Durvanei Augusto Maria1,2,3
Antineoplastic phospholipids are a new class of antitumor agents. These molecules interact with the plasma membrane, changing numerous pathways that induce cell death, with high selectivity for cancer cells. A representative of this class of antineoplastic agents is 2-aminoethyl dihydrogen phosphate (2-AEH2P). It is present in high intracellular concentrations in various tissues and organelles with antitumor, antiproliferative and pro-apoptotic action. Therefore, 4T1 triple-negative tumor cells were treated in different concentrations in order to assess the cytotoxic potential and its effects on the modulation of cell death pathways in association with the chemotherapeutic drug Paclitaxel. 2-AEH2P promoted cytotoxicity in tumor cells and significant morphological changes, however, it did not cause these effects in normal cells. There was positive regulation of proteins involved in the intrinsic pathway of cell death by apoptosis and regulation of the phases of cell cycle progression. Furthermore, structural and distribution changes in mitochondria, as well as decreased cell density and regression of the cytoskeleton were observed. The 2-AEH2P demonstrated a modulatory potential of apoptotic pathways inducing cell death, being a new compound with antitumor properties.
342 Mineral Medicine: Chinese Medical Stone , Haoxuan Yu1,2, Yan Deng3 and Zhiping Yu3
A simple experiment of rat gastric ulcer was carried out to study the medical effect of Chinese Medical Stone which is a kind of Mineral Medicine of mines in China on gastric ulcer in rats. The purpose of this study was to investigate the effect of the Chinese Medical Stone on the prevention and treatment of experimental gastrointestinal disease, especially gastric ulcer.
343 11C-choline PET/MRI for Characterization of Primary High-Risk Prostate Cancer: Correlations between Positron Emission Tomography Imaging Parameters and Clinical Features , Jing-Ren Tseng1, See-Tong Pang2, Kang-Hsing Fan3, Ji-Hong Hong3, 4, Po-Hung Lin2, 5, Lan-Yan Yang6, Hsiu-Ya Chang6, Hou-Ting Yang1, Kwai-Fong Ng7, Li-Jen Wang8, 9 and Tzu-Chen Yen1  
Purpose: The aim of this study was to determine whether PET (positron emission tomography) imaging parameters from simultaneous 11C-choline PET/MRI (magnetic resonance imaging) could be used to characterize primary prostate cancer. Methods: Forty-six patients with biopsy-proven high-risk prostate cancer (clinical T stage ≥ cT2c, a Gleason score ≥ 8, or PSA (prostate-specific antigen) level > 20 ng/mL) were prospectively enrolled. A SUV (standardized uptake value) histogram analysis including maximum SUV, mean SUV, SUV variance, SUV entropy, MTV (metabolic tumor volume), and UVP (uptake volume product) was applied for the calculation of PET imaging parameters. Correlations between the PSA level and Gleason score were then evaluated. Results: Maximum SUV, mean SUV, MTV, UVP, and SUV variance were significantly correlated with PSA level, whereas SUV variance was the only parameter negatively correlated with the Gleason score. Multivariate logistic regression analysis demonstrated that MTV and PSA level at diagnosis were independent predictors of positive distant metastasis status. Conclusions: PET imaging parameters from simultaneous 11C-choline PET/MRI were correlated with PSA level. However, 11C-choline metabolic tumor heterogeneity was not associated with biospecimen-derived Gleason scores in prostate cancer. To apply PET texture quantification analysis to prostate cancer, a more specific PET radiotracer is required.
344 Subchronic Administration of Linalool Decreases Depressive-Like Behaviour in Restrained Rats     , Somrudee Saiyudthong1, Dawrung Srijittapong1and Chantana Mekseepralard2  
Objectives: The aim of this study was to investigate the effect of linalool in chronically stressed rats on their behaviour as related to depressive disorders and BDNF (brain-derived neurotropic factor) protein in the hippocampus. Methods: Either Tween 80 or linalool (50, 160, 500 mg/kg) was intraperitoneally administered to rats, daily, for two weeks. Some rats were housed in home cages but the others were induced with chronic restrained stress (15 min daily). At the end of the treatment, the rats were assessed for depressive-like behaviour using the forced swimming test. At the end of the behaviour test, the animals were immediately decapitated and the hippocampus of each animal was removed for the measurement of the BDNF protein by ELISA. Result: The immobility time was significantly increased (p < 0.05) but time of climbing was significantly decreased (p < 0.05). The restrained rats treated with linalool, 500 mg/kg, displayed immobility times less than those of their controls (p < 0.05) while these rats showed significantly more climbing than in the control rats (p < 0.05). Linalool showed no effect on the BDNF protein in the hippocampus. Conclusions: linalool decreases behaviour related to depressive disorders but it has no effect on the BDNF protein in chronic restrained stress.
345 Rat Hepatocyte Glucose Metabolism Is Affected by Caloric Restriction but not by Litter Size Reduction     , Nayra Thais Delatorre Branquinho1, Gabriel Henrique de Paula Cruz2, Arielle da Cunha Silvério3, Letícia Diniz Crepaldi1, Laís Akemi Yamada2, Isabela Ramos Mariano2, Vilma Aparecida Ferreira de Godoi4 and Maria Montserrat Diaz Pedrosa4
This work aimed at investigating whether the liver glucose metabolism could have a role in any change of glucose homeostasis that might exist in the reduced-litter rat at the age of 60 days. Additionally, post-weaning caloric restriction and its hepatic effects were explored, as this intervention is reported as a useful measure against obesity and its related disturbances. The animals were raised in litters of nine (control, CG) or three pups during lactation. These small-litter pups were FG (fed freely) or subjected to 30% RG (caloric restriction) after weaning until 60 days of age. The increased adiposity induced by lactational overfeeding was not reversed by caloric restriction. Hepatocyte glucose metabolism and glucose tolerance test were not affected by litter size, but caloric restriction increased liver basal glucose release, diminished gluconeogenesis and retarded the glycemic decay during the insulin tolerance test. Liver glucose metabolism of young adult rats was not affected by lactational overfeeding. Up to this age, however, moderate caloric restriction had a potent influence that might compromise whole-body glucose homeostasis and prompt to insulin resistance.
346 The p38-MAPK Pathway Is Involved in Neuroprotection of Artemisinin against H2O2-induced Apoptosis in PC12 Cells     , Liu Linlin, Zhiwen Zeng, Uma Gaur, Fengxia Yan and Wenhua Zheng  
Oxidative stress, owing to the excessive production of ROS (reactive oxygen species), is one of the leading causes for the progression of AD (Alzheimer’s disease). Increasing evidences suggested that oxidative stress insult impaired the physiological functioning of neuronal cells by inducing cell apoptosis. The search for drug candidates that can effectively protect neurons from oxidative stress insult might hold therapeutic potential for AD. In the present study, we tested the neuroprotective effects and the related action mechanisms of artemisinin, a FDA-approved anti-malarial drug, against H2O2 induced oxidative damage in PC12 cells. It was found that artemisinin reduced cell viability loss caused by hydrogen peroxide (H2O2) in PC12 cells. In addition, data from Flow cytometry displayed that artemisinin significantly decreased the apoptosis of PC12 cells induced by H2O2. Furthermore Western blot analysis displayed that artemisinin stimulated the p38MAPK signaling, while treatment of PC12 cells with specific p38MAPK pathway inhibitor SB203580 blocked the neuroprotective effect of artemisinin. These results together indicated that artemisinin is a potential protectant, and it protects PC12 cells against H2O2 injury through activation of the p38MAPK pathway.
347 Effectiveness of Disinfection of Anesthetics Tubes in Oral Surgery—An in Vitro Study   , José Kayque Neves1, Mayke Felipp de Araújo Martins2, Josefa Elaine Silva Germinio2, Maria Cristina de Andrade1 and Sibele Ribeiro de Oliveira2  
Context: Anesthetic tubes are always on the surgical table, for this reason, it’s necessary to perform its disinfection, generally by chemicals. Aim: Was to analyze the effectiveness of tubes decontamination made by disinfectant substances used in a clinical setting and to identify the microorganisms found on their surface. Materials and Methods: 14 anesthetic tubes were collected from dental clinic, on 5 groups. 01 plastic and 01 glass tubes that were not submitted to any disinfection process composed the control group and they had been sown in Agar Blood. Experimental groups underwent immersion and fixation with the proposed chemicals for 1 minute, laminar flow hood was used to seed it in Agar Blood and then it was transferred to incubator for 24 hours at 37°C. Tests were used to identify the main Gram positive pathogenic genera. Gram-negative pathogenic colonies isolated were seeded in biochemical means of identification. Results: It was possible to identify the presence of Staphylococcus coagulase negative, Staphylococcus aureus, Streptococcus viridans, Staphylococcus saprophyticus, Escherichia coli and Acinetobacter spp, as well as the effectiveness of chemical solutions proposed in this study. Conclusions: All chemical solutions proposed in this study were effective for the surface disinfection process of anesthetic tubes.
348 Toxicity of Chemotherapy in a Patient with Bloom Syndrome’s Diagnosis     , Candido Priscila B. M., Anjos Caroline S., Rosa Victor D. L., Rapatoni Liane and Peria Fernanda, M.  
Bloom’s syndrome is a rare disease that is related to an increased risk of developing malignant neoplasm. The patient reported was followed up with several hospital staff when she was diagnosed with gastric cancer, but unfortunately, she had already peritoneal implants in moment of the surgery approach. It has been reported in the literature that patients with this syndrome present greater toxicity to the chemotherapeutic treatment, however due to the rarity of the disease, it is not known exactly how the adjustment of these drugs should be performed and which is the better protocol to use. Palliative chemotherapy was proposed, but after receiving one dose of the initially treatment, she developed severe and limiting toxicity.
349 Undifferentiated Sinonasal Carcinoma—Case Report   , Miroljub Todorovic1 and Tanja Boljevic2  
SNUC (undifferentiated sinonasal carcinoma) is a rare tumor. The exact cause of this cancer is not known. Patients usually have signs and symptoms of bleeding from the nose, runny nose, duplicate photos, symptoms of chronic sinus infections and nose, nasal obstruction, or facial pain. We reported a case of seventy year old patient with sinonasal undifferentiated carcinoma in the right maxillary sinus. Six months ago, the patient was conducted operations polyp in the right nasal hall. He had pain in the right side of his face and swelling in the mouth in the area of the upper jaw on the right side. The patient was operated tumor of the right maxillary sinus, with expansion in the ethmoid sinus, nasal cavity and infratemporal space. The neck dissection was done on the same side. Postoperatively, he received radiation therapy and chemotherapy. SNUC is very rare aggressive cancer that requires aggressive therapy. This cancer is considered in need of modified maxillary sinuses, as well as for modified sinus in polyps or after the operation of the same. Despite extensive surgery, radio therapy and implemented chemotherapy, the prognosis of these tumors is very poor.  
350 Therapeutic Efficacy of Quinapyramine Sulphate with Freund’s Complete Adjuvant in Wistar Rats Infected with Trypanosoma Congolense     , Ehizibolo, P. O.1, Karaye, G. P.2, Kadima, K. B.3, Lawal, I. A.4, Okubanjo, O. O.4 and Aliu, Y. O.1  
Therapeutic efficacy of QS (quinapyramine sulphate) and FCA (Freund’s complete adjuvant) combination was studied. The aim of the study was to evaluate therapeutic efficacy of QS using FCA in Trypanosoma congolense infection. Groups treated with QS and FCA had parasite disappeared in peripheral circulation 2 days pi, relapse was observed one week later. Effect of treatment on rectal temperature shows no significance (p < 0.05), normalization of rectal temperature occurred in QS and FCA treated groups (34.1oC) than untreated (42.8 oC), QS (37.4 oC) and FCA (35.92 oC) treated groups. Mean body weight was significant (p < 0.001) in QS and FCA, QS, and FCA groups. Packed cell volume and hemoglobin concentration for untreated groups were lower, but increased in QS, FCA, QS and FCA treated groups, indicating anemia amelioration. White blood cell counted in untreated, QS and FCA treated groups showed no significance (p < 0.05), however, there was leukocytosis due to lymphocytosis in QS and FCA treated group (6.79 × 103/µl) compared with untreated and other groups. There was comparative decrease in serum liver enzymes in QS and FCA treated group than other groups. Therefore, QS at lower recommended dose with FCA may enhance efficacy of QS in trypanosomiasis.
351 Eptifibatide Induced Severe Thrombocytopenia in an Asymptomatic Patient     , M. Adnan Raufi, Ayesha S. Baig, Rama Siddiqui, Nouman Akbar, Shakaib Jaffery  
GP (glycoprotein) IIb/IIIa inhibitors are routinely used in patients with acute coronary syndromes. There have been reported platelet counts of below 20 × 10^9/L within hours of administering the drug. We present a case of a 44 years old man with inferior wall myocardial infarction and third-degree heart block who was admitted for cardiac catheterization. The patient successfully underwent percutaneous intervention to right coronary artery and eptifibatide was given per protocol. 6 h post-eptifibatide initiation, platelets dropped from 288 × 10^9/L to 24 × 10^9/L. Eptifibatide was stopped and a CBC (complete blood count) was repeated after 2 hours. The platelets had further dropped to undetectable levels showing 0 × 10^9/L. The patient remained completely asymptomatic. Pseudo-thrombocytopenia was ruled out on peripheral smear. Platelet transfusion was considered, however, platelets started to rise few hours after stopping of Eptifibatide. Twelve hours later, platelet count reached 4 × 10^9/L. It continued to show a positive trend and reached up to a level of 293 × 10^9/L after 5 days. Patient was discharged in a stable condition. Due to this rare but significant phenomenon, patients on these drugs should have their platelet count closely monitored. It is also very rare not to have any symptoms after such critically low platelet levels.
352 The Recovery of Complicated Upper Limbs Movement Functions of Poststroke Patients   , F. V. Bondarenko, M. R. Makarova and E. A. Turova  
In chronic stage of stroke, it is necessary to pay attention to the complex spatial movements training along with the traditional restoration of balance, strength of particular muscles, and paretic limb joints mobility. The aim of the study was to evaluate the effectiveness of robotic therapy in the recovery of upper limb function in the chronic stage of stroke. The study involved 52 patients with ischemic stroke in the middle cerebral artery. The patients were divided randomly into 2 groups. All patients      (5 days/wk × 3 wk) got gymnastics by the standard technique, massage, laser, and pulsed currents therapy. Main group patients    (n = 36) extra received complex spatial movements, speed, fluidity, precision and agility training by the robotic electromechanical device Multi Joint System (MJS) (40 minutes, 5 days/wk × 3 wk). Analysis of the results of the study showed a statistically significant difference in improving ROM of the elbow and shoulder joints, speed and accuracy of movement in the main group compared with the control. Hardware recovery of complex spatial upper limb movements in the chronic stage of stroke increases the functionality and independence of the patient’s domestic skills.  
353 Bilirubin Lowering Potential of Aqueous Carica Papaya Extract in Induced Jaundice in Rats     , M. I. Ayeni1, M. A. Akanmu2, O. O. Bolaji3, S. A. Osasan4, G. Olayiwola1, M. O. Afolabi1, A. M. Morohunfola5  
Background: The mature unripe fruit of aqueous Carica papaya (ACP) is used in Nigerian traditional medicine for the treatment of jaundice. Work done on aqueous extract of the unripe C. papaya in an acute oral toxicity study in rats showed the LD50 to be 2,520 mg/kg in rats. Current study evaluated the bilirubin-lowering potential of ACP extract in phenylhydrazine (40 mg/kg) induced jaundice in adult rats. Method: Jaundice was assessed by measuring the levels of TB (total bilirubin) and DB (direct bilirubin) in phenylhydrazine-treated animals with or without drug treatment, with CUR (curative), PRO (prophylactic study), and in animals with RLC (reduced liver capacity). Results: Result demonstrated that TB level of 24.0 µmols/L, 22.0 µmols/L and 45.0 µmols/L in the jaundiced group of the CUR, PRO and RLC respectively was significantly lowered (p < 0.05) to 10.0, 13.0, and 17.0 respectively by 400 mg/kg of the extract. Total bilirubin level of 24.0 µmols/L, 22.0 µmols/L and 45.0 µmols/L in the jaundiced group of the CUR, PRO and RLC respectively was significantly lowered (p < 0.05) to 7.0, 10.0, and 17.0 respectively by 800 mg/kg extract. Conclusion: The study concluded that ACP fruit extract has ability to lower elevated bilirubin level and confer hepatoprotective effect as seen from the liver function test indices thus justifying its ethnomedicinal use.  
354 An Assessment of the Level of Knowledge of HIV-Infected Patients about Highly Active Antireteroviral Therapy and Waiting Times and Their Influence on Antiretroviral Therapy Adherence at a Primary Healthcare Centre of South Africa     , N. L. Katende-Kyenda and T. Apalata  
Objectives: The study assessed if the level of knowledge of HIV-infected about HAART and waiting-times in the PHC (primary healthcare) clinic have an influence on antiretroviral adherence. Methods: A descriptive-cross-sectional study was conducted in South Africa. Data collected uses a standardized-questionnaire and face-to-face-exit interviews. Pill-count technique was performed and a value of ≥ 95% acceptable. Data were analysed using SPSS. Univariate-factors associated with poor-adherence to knowledge about HAART and waiting times were assessed using ANOVA and p ≤ 0.05 considered statistically significant. Key findings: Of 86 enrolled, 63(73.3%) were females and 23(26.7%) males, with mean-age (± SD) of 35.6(±9.6) years and on HAART for 35.5(± 31.8) months ranging from 1-137. Of these, 27(31.40%) and 25(29.07%) were on WHO stages 2 and 3 respectively. Adherence-rates computed from 32 patients, 23(71.9%) revealed poor adherence-rates. The level of knowledge about HAART in terms of names of tablets, correct-dose, frequency, adverse-effects had no influence on ARV-adherence (p ≥ 0.05). Of 23 non-compliant, 10 (40%) gave the reason of drugs-unavailability, 7(30%) adverse-effects, 5(20%) drugs’ complexity, and 1(10%) too busy to take them. Waiting areas associated with poor ARV-adherence were reception (p = 0.028), doctors (p = 0.027), while nurse’s station (p = 0.29) and pharmacy (p = 0.43) revealed acceptable ARV-adherence.  
355 Effect of ABCB1 C3435T Polymorphism on Clinical Outcomes in Kenyan HIV Patients on Lopinavir-Based Regimens     , Kagia Richard1, 2, Okalebo Faith1, Oluka Margaret1, Njoroge Anne 3 and Bulimo Wallace4  
ATP Binding Cassette sub-family B member 1 (ABCB1) affects disposition of many drugs and thus affects the pharmacokinetics of drugs and ultimately treatment response. Polymorphisms of ABCB1 especially ABCB1 C3435T polymorphism may thus affect pharmacokinetics of antiretroviral drugs and hence CD4 treatment response and other clinical outcomes of HIV patients. Methods: The study design was a historical cohort study and entailed collection of patient data. PureLink® genomic DNA extraction mini kit was used for the extraction and purification of genomic DNA. TaqMan® drug genotyping assay and protocol was used in the DNA amplification and genotyping. Data analysis was done using STATA software version 10. Results: Study participants with the CT genotype had lower creatinine levels after 6 months on lopinavir-based regimens compared with those with the CC genotype        (p = 0.001). In addition, the study participants with the CT genotype had consistently higher CD4 cell counts compared with those with the CC genotype from the time of ART switch but this was not statistically significant. However, there was no significant association between the ABCB1 C3435T genotypes and haemoglobin and ALT levels. Conclusion: There was a significant association between ABCB1 C3435T polymorphism and creatinine levels 6 months after therapy on lopinavir-based regimens.  
356 Clinical Oncology Translational Study Phase-1 with Antitumor Phosphorylethanolamine (2-AEH2P) in Dogs with Neoplasms , Olivia Gonçalves de Almeida Leitão da Cunha1,2, Lucas Campos de Sá Rodrigues3 , Daniel da Conceição Rabelo1 , Rosa Andrea Nogueira Laiso1 , Sergio Mestieri Chammas1,2 , Laertty Garcia de Sousa Cabral1,4 and Durvanei Augusto Maria1,2
The animal has the potential to serve as a clinical model for human disease, due to striking similarities and homologies in diseases. Early clinical development of a new drug may influence its final destination, and a careful and thoughtful approach to Phase-1 clinical trials is essential. Phosphorylethanolamine (2-AEH2P) is a new cytostatic phospholipid agent that, unlike most chemotherapeutic drugs used today, does not target DNA or cytoskeleton, but act on the cell membrane. Studies carried out by our group have shown several effects of 2-AEH2P controlling the progression of the cell cycle, in the alterations of the mitochondrial electrical potential capable of inducing apoptosis and autophagy in several types of human and animal tumor cells. The aim of this study is to establish the recommended safety dose of a 2-AEH2P monophosphoester, in dogs with tumor following the Phase 1 study model proposed by Fibonacci. The Phase-1 study following the Fibonacci model, 2-AEH2P was safe at all staggered doses up to 150 mg/Kg for 8 weeks. Intravenous administration in staggered doses according to the Fibonacci model, showed that the drug is safe, no advent of mortality during the study period or acute toxicity were observed. It is not a drug with hemolytic properties or that induces anemia. It does not lead to changes in liver and renal functions and was able to modulate leukocyte production. 2-AEH2P is new compound with antitumor potential, being useful for future veterinary and human tumors, as a combination of chemotherapeutic agents.
357 Release Profile of Lansoprazole Encapsulated in Sodium Alginate Beads , Jair Pereira de Melo Junior1 , Vicente Guerra Filho2 , Márcio Rosa3 , Jeová David1 , Vinicius Cozadi de Souza3 and Vergílio Pereira Carvalho4
Symptomatic gastroesophageal reflux disease (GERD) affects 11% of the population worldwide. Lansoprazole was the second commercially available proton pump inhibitor, recommended for healing and symptomatic relief of reflux esophagitis. This work presents the encapsulation of lansoprazole in sodium alginate beads, generating a controlled release system of the encapsulated drug. The quantification of lansoprazole contents from the encapsulated raw material was carried out, using the methodology prescribed in the Brazilian Pharmacopoeia 5th edition, with adjustments, the encapsulation efficiency and the release profile. Experimental tests were performed using scanning UV-Vis spectrophotometry. Encapsulation efficiency was 100%, obtained from the measurement of the absorbance of the filtrate. Release profile shows the concentration of lansoprazole in the external environment was 4 µg/mL (16%) immediately after 10 min. Concentration of lansoprazole released by the beads follows a linear dynamic as a function of time, with a maximum release equivalent to 25 µg/mL after 210 min (100%). The rate of release is influenced by pH, being higher by 7.4. Beads subjected to heat treatment have a higher release rate at a temperature of 30 °C when compared to a temperature of 60 °C. Increase in temperature decreases the diameter of the beads. The presence of lansoprazole affects the release curve. The absorption rate of the microbeads with lansoprazole is 0.83, and the absorption rate of the microbeads without lansoprazole is 0.58. Sodium alginate beads have a good controlled release effect on lansoprazole.
358 A Study of Attitudes toward Pharmaceutical Care during COVID-19 Pandemic in Tbilisi (Georgia) , Eka Pruidze1 , Tamaz Chumburidze2 , Nino Nemsitsveradze1 , Tamar Chikviladze1 and Mariam Chrdileli2
Background: After the outbreak of COVID-19 in Georgia, the number of patients visiting pharmacies has increased. It became relevant to research the importance of Pharmaceutical Care inprevention of COVID-19. The aim of the study was to understand the attitudes of patients and physicians regarding the involvement of pharmacists in prevention of COVID-19, after the spring and autumn waves of pandemic; also, what role can pharmacists take in the future and whether they can transfer Good Pharmaceutical Practice (GPP) to Georgia. Study also tried to capture overall attitudes towards involving pharmacists in healthcare projects such as population rapid testing and vaccinations. Methods: 522 patients, 1289 pharmacists, and 200 physicians were surveyed regarding their attitudes toward pharmaceutical care during COVID-19 pandemic. Results: The study found that 82.2% of surveyed patients who visited pharmacy during pandemic bought medication and COVID-19 preventive items (face mask, disinfectants, etc.). Out of the surveyed participants, 66.9% of patients and 77.1% of pharmacists believe that recommendations given by pharmacists play an important role in the prevention of COVID-19. Study also revealed that 76.6% of pharmacists and 79.3% of patients agree with the statement, the pharmacist should be able to decide whether to choose over-the-counter medications for a patient or refer the patient to a physician. 91.8% of patients and 78.3% of pharmacists believe that during a pandemic pharmacist should provide patients who visit pharmacies with complaints of flu, cold, and fever with Pharmaceutical Care; which is agreed by 41.7% of physicians. 63.1% of patients, 52% of pharmacists, and 45% of physicians have a positive attitude towards administering rapid testing of COVID-19 by pharmacists. The desire for pharmacists to be involved in vaccination was expressed most in patients (43.6%), followed by pharmacists (38.7%), and physicians (36.7%). Conclusions: The study showed similar attitudes of patients and pharmacists - Pharmaceutical Care plays an important role in pandemic prevention. The attitude of patients and pharmacists is positive regarding administering Pharmaceutical Care for patients who come in pharmacies with symptoms of flu and cold. Physicians had more cautious attitude towards the issue, indicating that they may see risks of spreading the virus and aggravating patients’ conditions. Most patients who participated in the study believe that pharmacists should be involved in pandemic prevention activities – COVID-19 tests and vaccinations. It is recommended that Georgian healthcare system develops projects that support collaboration of medical professionals and bring us closer to Good Pharmacy Practice (GPP). Training of pharmacists along with physicians in scope of pandemic prevention projects should be planned.
359 Evaluation of Aluminum Levels in Drinking Water of Nouakchott , Brahim Ahmed Dick1,2,3 , Mohamed Bouna Ammar 4 , Yahya Maham Ould Sidi1 , H. Y. Learoussy2,5 and Mohamed Elkory Cheikh1
The drinking water of Nouakchott, the capital of Mauritania, comes from the Senegal River. The current water treatment is done with aluminum sulfate. In order to monitor the aluminum content, from September 2015 to August 2016, three samples were taken monthly for each water source: pretreated water (from Beni Naji treatment station), treated water (from PK17 treatment station) and the water tower. The analysis results of the aluminum content of the treated water (full treatment) and pretreated water (first treatment) showed that the aluminum content of all samples was between 0.03 mg/L and 0.09 mg/L, with an average value of 0.07 mg/L. The World Health Organization stipulates that the normal content of aluminum between 0.1 mg/L and 0.2 mg/l. In the course of the study, the changes of aluminum content in samples from different places were observed. This change can be explained by coagulation-flocculation of aluminum sulfate. The aluminum content of the samples met the World Health Organization standards for drinking water
360 Application of Virtual Reality in Rehabilitation of Disabilities: A Mini Review , Solmaz Sohrabei1 and Alireza Atashi2
Introduction: Information and communication technology has provided new opportunities for countries' health care systems. Improving the outcome of health treatments in different groups of disabled and disabled patients is one of the benefits of using this tool. Virtual reality has emerged as a powerful backup tool in the field of rehabilitation of the disabled in life and treatment. The purpose of this study is to review the published research on the application of virtual reality in the rehabilitation of the disabled. Method: In order to conduct a review research, PubMed, Scopus database was searched with the keywords “virtual reality, virtual reality and disability, virtual reality and electronic health” and its equivalent. The documents retrieved from the search were sent to Endnote software and evaluated according to the set criteria. Results: 70 articles that met the inclusion criteria constituted the research sample. The results showed a significant effect of using virtual reality in the rehabilitation of the disabled and improving patient care in the health system of countries. Conclusion: Virtual reality can be used in the health system for the rehabilitation of the disabled due to the effectiveness of routine methods of medical rehabilitation interventions. According to the results of the study, the use of virtual reality in mobile health, especially in educating patients and the disabled to self-care and reduce fear and anxiety, will be very effective.
361 Child Neglect and Perspectives of Nurses Specializing in Mental Health and Psychiatry in Family Violence: Clinical Case , Ana Almeida and João Magalhães
We live in a changing society in which the family plays a role in fostering close relationships among family members, as well as the responsibility to pass on values and principles to them. When the actions of parents and other families impair the child‟s rights and needs in terms of psychomotor, intellectual, moral, emotional or relationship development, we will face situations of neglect, abuse or violence. Since these behaviors can be active (sexual, physical or psychological violence) or passive (by default, to ensure the well-being of the child). Neglect is a form of abuse that leaves the child feeling ostracized and guilty.
362 Multidisciplinary Approach to Drug-Drug Interactions between Tacrolimus and Sofosbuvir/Velpatasvir and Glecaprevir/Pibrentasvir in Kidney Transplant Patients during Hepatitis C Treatment: A Case Series Report     , Tung Huynh1, Uttam Reddy2 and Ke-Qin Hu3
The direct acting antivirals (DAAs) are now the standard of care for hepatitis C virus (HCV) treatment with high and effective sustained virologic responserate (SVR) and great safety profile, including solid organ transplant patients. There are increasing reports showing DAAs are effective with high SVR rates and safety profile in kidney transplant recipients. There are reports on drug-drug interaction (DDI) between tacrolimus with DAAs. However, data remain lacking on potential DDIs between tacrolimus and DAA regimens and the management process. This case series reports three kidney transplant patients on tacrolimus who were successfully treated for HCV with multidisciplinary approach, although there was DDI between tacrolimus with sofosbuvir/velpatasvir and glecaprevir/pibrentasvir, which required tacrolimus dose adjustment to maintain therapeutic level during and after DAA treatment. Such DDIs should be aware of and closely monitored by pharmacist and physicians with tacrolimus dose adjustment as needed during and right after DAA treatment in post-kidney transplant patients.
363 The Importance of Molecular and Clinical Laboratory Tests in Diagnosis and Treatment of Coronavirus Disease   , Majid Rezaei Basiri1, 2, 3, Ghazi-Khansari, M.2, Sahhaf-Ebrahimi, F.3 and Alilou, S.3  
900 abusers were tested for the presence of drug abuse and coronavirus disease. In the early stage, the throat and noise samples of these patients were examined by polymerase chain reaction (PCR). The mean age of the study group is 42 ± 23. Hematological and serological examinations were performed on 131 patients. All data were analyzed by t-test and one-way analysis of variance (ANOVA). Therefore, P < 0.05 is considered as the significance of the test results. The results showed that 131 patients in the study group had positive results of PCR tests and nearby they had Covid-19. Approximately 90% of patients with coronavirus disease showed positive serological tests and lymphopenic condition. All of urine or blood samples in the 131 patients were positive for the presence of abuse drugs. C-reactive protein (CRP) is one of important serologic test that detected on these patients. This study showed the importance of molecular genetics test such as PCR and also hematology and serology tests in distinguish of coronavirus diseases.
364 Principles of Diagnosis and Treatment of Patients with Diagnosis of Covid-19 and Developing Viral Pneumonia , Kamala Namazova1, Hasanov Hafiz2, Hasanov Fuad1, Muradov Nizami1, Guliev Rashad1, Abasova Machruch1, Karimov Qeys1, Asgerov Gunel1, Mamedova Gunel1 and Shirinova Lala3  
The article provides information on our achievements in the application of modern diagnostic methods and modern methods of treating patients with viral pneumonia, confirmed by covid-19. For this, statistical data of 2,000 patients were used. Of the 2,000 patients treated, 920 were men, 1,070 were women and 10 were children. Viral pneumonia-glaucoma syndrome in 1650 out of 2,000 patients with 10-20% damage; In 350, the diagnosis of viral pneumonia-frostbite syndrome with 50-85% damage, CRDS, respiratory failure was confirmed. Thus, 50 out of 350 patients treated at the intensive care unit (ICU) out of 2,000 were intubated and connected to artificial ventilation. The research was carried out in 3 stages: I stage- admission to the intensive care unit; II stage- from the day of intubation to spontaneous breathing (7-14 days); and III stage – covers the period of extubation and recovery. The results of clinical, functional, hemodynamic and echocardiographic studies of the patients participating in the examination were analyzed. Also, the patients underwent bacteriological research studied the sensitivity to antibiotics. In addition, the composition of blood gases and the oxygenation index – Carrico were studied.
365 Application of Medicinal Plants on Menopause Symptoms     , Yosvany Urquiola Martínez, Ana Elena Rodríguez Cadalso, Regina de Caridad Rodríguez Muñoz, Viviana Silvia Rodríguez Jiménez, Marelys Medina Barroso and Ramón Florencio Duarte Chaviano  
Objectives: To relate the symptoms of menopause and the use of medicinal plants. Methods: it was carried out a study that applied the qualitative method, by means of a bibliographical and documental revision in sources of digital data of wide reach (Google, SciELO, DOAJ, Latindex and SCOPUS). It was kept in mind the quality and the present time. Conclusions: It was based on the search of articles in Virtual the Library in Health (Spanish: BVS) and using the key words: menopause, medicinal plants, phytotherapy, menopause symptoms.
366 Application of Medicinal Plants on Menopause Symptoms , Yosvany Urquiola Martínez, Ana Elena Rodríguez Cadalso, Regina de Caridad Rodríguez Muñoz, Viviana Silvia Rodríguez Jiménez, Marelys Medina Barroso and Ramón Florencio Duarte Chaviano
Objectives: To relate the symptoms of menopause and the use of medicinal plants. Methods: it was carried out a study that applied the qualitative method, by means of a bibliographical and documental revision in sources of digital data of wide reach (Google, SciELO, DOAJ, Latindex and SCOPUS). It was kept in mind the quality and the present time. Conclusions: It was based on the search of articles in Virtual the Library in Health (Spanish: BVS) and using the key words: menopause, medicinal plants, phytotherapy, menopause symptoms.
367 Prevalence of Flatfoot and Its Correlation with Age, Gender and BMI among Undergraduates at the Faculty of Allied Health Sciences, General Sir John Kotelawela Defence University , Anjana Jayabandara, Dileni Rodrigo, Shaminda Nadeeshan, Chathuri Wanniarachchi, Prasad Rajathewa, Thamasi Makuloluwa and Dilani Perera
Pes planus or flatfeet is a postural deformity which leads the entire sole of the foot to completely or near-completely touch the ground. Pes planus deformity occurs due to collapse of foot arches which can be congenital or pathological. The objective of this study was to determine the prevalence of flatfoot condition among undergraduates at the Faculty of Allied Health Sciences (FAHS), General Sir John Kotelawala Defence University (KDU) and its correlation with age, gender and BMI. A cross sectional study was conducted among 533 participants (Male = 131, Female = 402). Interviewer-administered questionnaire was used to collect the demographic data.BMI was calculated by obtaining height and weight measurements. Arch index method was used to determine the foot type taken using the Modified Harris Mat. The data analysis was done using SPSS software version 23. P value of less than 0.05 was considered as statistically significant. The study was done among people aged 19 to 26. The prevalence of flatfoot among this age group was 34.7% (n = 185). Most of them are bilateral flat feet (73.5%), only 26.5% are unilateral flat feet. The proportion of patients with flat footedness was significantly higher in women (75%) than in men (25%).BMI in the overweight and obese categories (BMI > 23) was statistically significant (p < 0.05), which is 164 (52.4%). Study shows a statistically significant association between flatfoot and increasing BMI beyond normal (p < 0.05). There is no significant association between flatfoot with age and gender. Prevalence of flatfoot among allied health undergraduates was seemingly high requiring screening for early detection and appropriate referral for corrective measures.
368 Finding New Ways to Improve the Heal of the Physical and Mental Wounds—An Overview , Mahira Amirova Firudin, Sabrin Azim Ali Mohammad, Ellada Huseynova Eldar, Gulnara Dashdamirova Sabir and Rena Rahimova Rufat
The war imposed on Azerbaijan by the Armenian invaders claimed thousands of lives, but even more young guys were left crippled by the war. Today, Azerbaijan faces 2 major tasks of strategic importance: (1) To preserve the lands reclaimed from the enemy and (2) to ensure the maximum preservation of the viability of the military personnel who suffered in this war, because the prospects of the patriotism of our people, fighting spirit, and their combat effectiveness depend on the timely solution of these tasks. Many problems arise for servicemen undergoing rehabilitation after complex injuries. In general, veterans find it difficult to restore old social ties and physical activity, so they also need a positive attitude from society, because they are already the people with disabilities. At the first stage of medical intervention, the doctor is faced with the main task: saving the life and health of the soldiers, so he has little time to study in detail the psychosocial factors that can affect the final results. At the first stage of treatment, unnecessary questions to the patient may even lead to an ineffective result. However, some observations have revealed significant differences in the response to rehabilitation treatment, even in geographically close countries. Therefore, in the subsequent stages, it is important to take into account spiritual factors that will certainly affect recovery and rehabilitation. Thus, to better support the recovery and rehabilitation of people with injuries, more research is needed to organize human-centered care. Some of the organizations in our country, such as «Witness Support» and «LifeSupport», study the interests of servicemen, the needs of the families of those who lost loved ones in the war, and try to solve these problems as soon as possible, helping them not only and not so much materially, but also morally. They arrange meetings of civilians with veterans, help veterans to support their families. If during this period the wounded recover from physical and mental illnesses interacting with the civilian population, they are more successful in overcoming difficult problems. To summarize all of the above, we can conclude that health and well-being depend on more factors than just medical care, and we must continue to look for the best ways to rehabilitate people with disabilities who saved our lives.
369 Acute Tonsillopharyngitis: Photosensitizer Fluorescence-Guided in Topical Therapy , Kate Cristina Blanco, Camila Paula D’Almeida, Priyanka Joshi and Vanderlei Salvador Bagnato
Background: As is observed in acute respiratory pandemics characterized by inflammation of the oropharynx, microbial transmission caused by viruses and bacteria through the upper respiratory tract can quickly affect the lower respiratory tract due to its ease of transmission, The challenges are presented in the development of an adequate lighting system to prevent infections of the upper respiratory treatment and highlight the importance of following the procedure due to fluorescence decay from the given light dose. Methods: for this purpose, our study evaluated the lighting distribution on the oropharynx established and determined under simulation by TracePro software. The photobleaching (PB) is obtained by different fluorescence analysis methods of photosensitizer (PS) in formulation located in the oropharynx and tonsils. A blue light emission system at 450 nm was studied to improve the distribution, uniformity, and ray’s incidence. The PB of the PS was investigated using two different methods for detecting fluorescence in the oropharynx by quantifying the active portion of the PS assessed by fluorescence spectroscopy for patients with pharyngotonsillitis by consuming 2.25 mg of curcumin in formulation after applying light by analysis of images in Software MatLab. Results: The lighting device showed a uniformity of 82% in the oropharynx. In healthy volunteers, the minimum energy of photodegradation of curcumin is 0.2 and the maximum energy is 17.4 J/cm2. We observed intensities of blue and green emission of the analyzed fluorescence images related to PS through fluorescence measurements. Conclusions: We conclude that the pharyngotonsillitis infections can be treated by using an adequate distribution of light in the oropharynx and by activating photosensitizing agents in the infection sites supported by the fluorescence of the compound.
370 Evolution of Mortality Due to Parkinson’s Disease in the Capitals of the Brazilian States in the Period from 2010 to 2019 , Luciana dos Santos Viana and Cleiton Fantin
After Alzheimer’s disease, Parkinson’s disease (PD) is the most common neurodegenerative disease. According to WHO data, about 1% of the world’s population over 60 years of age is affected by PD, and its incidence increases with age. Information about mortality plays a relevant role in the planning and distribution of financial resources in the areas of public health, social assistance and the like. Thus, this article aims to describe the evolution of PD mortality in the Brazilian state capitals, in the period from 2010 to 2019. A descriptive and retrospective study was conducted, based on data collection (number of deaths and estimated resident population), by sex and age group, available in the DATASUS SIM. Mortality rates were calculated per 100 thousand inhabitants; and statistical tests of linear regression, the t-test, ANOVA and the Tukey test, using the R program, were performed to evaluate the significance of the data. The number of deaths and mortality rates were higher in males compared to females and the incidence of mortality was higher in the over 80s. Notably, the southeastern region presented the highest mortality rates, which is to be expected because it concentrates the highest proportion of elderly people. It is hoped that such data will aid the implementation of public health policies and adequate social assistance for those affected by PD, in order to improve their quality of life.
371 New Treatment Options in Rare Diseases , Işıl Özer
The term rare disease is used for diseases with a prevalence of Ë‚ 1 per 2000 people in the community. For the first time in 1990, Sweden became the country that established an information center on rare diseases. Turkey has made the relevant legal arrangements in 2020. The largest group under this common roof is “Hereditary Metabolic diseases”. The number of inherited metabolic diseases has reached a remarkable scope in the light of the rapidly accelerating developments in biochemistry, genetics, pharmacology, electronics sciences in 1902, when this name was first used, “Alkaptonuria” disease. In the light of the information obtained, 4 separate subgroups were created according to their common characteristics in order to produce solutions for this large group. Treatment options for metabolic disorders are both simple and complex. Diet therapy, cofactor therapy, enzyme replacement therapy (ERT), Substrate reduction therapy, chaperone therapy, tissue - organ - stem cell transplantation and gene therapy can be listed as these treatment options. Preimplantation genetics has been a rational solution to preventing disease formation, also supported by our ministry of health.
372 Comparative Study of Solubility of Tranquilizers (Alternative Date Rape Drugs) in Stomach Acid , Aditya More, Smitesh Nalage and Anita Mali
Date Rape Drugs are the members of tranquilizers and sedative class of drugs. These are the substances that make it easier for someone to rape or assault sexually. The person who is administrated by these drugs can cause sleepiness, slow breathing, slow heartbeat rate, trouble in muscle coordination, loss of consciousness. GHB (gamma-hydroxybutyric acid), Rohypnol (flunitrazepam), Ketamine are generally considered as date rape drugs. As Food and Drug Administration Department of Central Government of India considered this issue and placed these drugs under the schedule of Narcotic Drugs and Psychotropic Substances Act. Thereafter it is nearly impossible to get these drugs easily. But criminals have been searched new way through it. Normal tranquilizers and sedatives are also being used for committing such crimes. These drugs are also scheduled, but one can get them with prescription from a registered medical practitioner. So we carried out a comparative study of 3 tranquilizers from the benzodiazepine class that are Diazepam, Alprazolam, and Librium to check their dissolving rate in stomach acid. Estimation of action time of drug can help an investigator to identify the class of drug and time of drug injected (early phase). In our study, we found that the dissolving period of Diazepam and Alprazolam is more than conventional drugs.
373 Prevalence of Flatfoot and Its Correlation with Age, Gender and BMI among Undergraduates at the Faculty of Allied Health Sciences, General Sir John Kotelawela Defence University , Anjana Jayabandara, Dileni Rodrigo, Shaminda Nadeeshan, Chathuri Wanniarachchi, Prasad Rajathewa, Thamasi Makuloluwa and Dilani Perera
Pes planus or flatfeet is a postural deformity which leads the entire sole of the foot to completely or near-completely touch the ground. Pes planus deformity occurs due to collapse of foot arches which can be congenital or pathological. The objective of this study was to determine the prevalence of flatfoot condition among undergraduates at the Faculty of Allied Health Sciences (FAHS), General Sir John Kotelawala Defence University (KDU) and its correlation with age, gender and BMI. A cross sectional study was conducted among 533 participants (Male = 131, Female = 402). Interviewer-administered questionnaire was used to collect the demographic data.BMI was calculated by obtaining height and weight measurements. Arch index method was used to determine the foot type taken using the Modified Harris Mat. The data analysis was done using SPSS software version 23. P value of less than 0.05 was considered as statistically significant. The study was done among people aged 19 to 26. The prevalence of flatfoot among this age group was 34.7% (n = 185). Most of them are bilateral flat feet (73.5%), only 26.5% are unilateral flat feet. The proportion of patients with flat footedness was significantly higher in women (75%) than in men (25%).BMI in the overweight and obese categories (BMI > 23) was statistically significant (p < 0.05), which is 164 (52.4%). Study shows a statistically significant association between flatfoot and increasing BMI beyond normal (p < 0.05). There is no significant association between flatfoot with age and gender. Prevalence of flatfoot among allied health undergraduates was seemingly high requiring screening for early detection and appropriate referral for corrective measures.
374 Finding New Ways to Improve the Heal of the Physical and Mental Wounds—An Overview , Mahira Amirova Firudin, Sabrin Azim Ali Mohammad, Ellada Huseynova Eldar, Gulnara Dashdamirova Sabir and Rena Rahimova Rufat
The war imposed on Azerbaijan by the Armenian invaders claimed thousands of lives, but even more young guys were left crippled by the war. Today, Azerbaijan faces 2 major tasks of strategic importance: (1) To preserve the lands reclaimed from the enemy and (2) to ensure the maximum preservation of the viability of the military personnel who suffered in this war, because the prospects of the patriotism of our people, fighting spirit, and their combat effectiveness depend on the timely solution of these tasks. Many problems arise for servicemen undergoing rehabilitation after complex injuries. In general, veterans find it difficult to restore old social ties and physical activity, so they also need a positive attitude from society, because they are already the people with disabilities. At the first stage of medical intervention, the doctor is faced with the main task: saving the life and health of the soldiers, so he has little time to study in detail the psychosocial factors that can affect the final results. At the first stage of treatment, unnecessary questions to the patient may even lead to an ineffective result. However, some observations have revealed significant differences in the response to rehabilitation treatment, even in geographically close countries. Therefore, in the subsequent stages, it is important to take into account spiritual factors that will certainly affect recovery and rehabilitation. Thus, to better support the recovery and rehabilitation of people with injuries, more research is needed to organize human-centered care. Some of the organizations in our country, such as «Witness Support» and «Life Support», study the interests of servicemen, the needs of the families of those who lost loved ones in the war, and try to solve these problems as soon as possible, helping them not only and not so much materially, but also morally. They arrange meetings of civilians with veterans, help veterans to support their families. If during this period the wounded recover from physical and mental illnesses interacting with the civilian population, they are more successful in overcoming difficult problems. To summarize all of the above, we can conclude that health and well-being depend on more factors than just medical care, and we must continue to look for the best ways to rehabilitate people with disabilities who saved our lives.
375 Exclusive Hormonal Therapy in Breast Cancer in Elderly Women: Clinical Response and Survival over 10 Years , Bintcha Walter, Schmitt Andy, Dangbemey Patrice, Tadrist Brahim, Minsili Hervé, Adje Yves and Bagnan Tonato
Breast cancer is the first cancer of women in the world and in France. In very elderly patients, the treatment options are often very limited. Neoadjuvant hormone therapy has shown similar or even better results than chemotherapy. This is why we decided to evaluate the clinical response following exclusive hormonal therapy and the 5, then 10 years survival in these very elderly women. This was a retrospective, longitudinal cohort-type study with descriptive and analytical purposes. The study population consisted of 59 patients, with an average age of 85 years. Fifteen (15, 25%) of our patients had a complete clinical response after two years of treatment, 16 (27%) a partial clinical response, 23 (39%) lesion stabilization and 5 (9%) cancer progression. The presence of metastasis at diagnosis increased the risk of cancer progression by 2.84. Overall 5-year survival was 72.5%, and breast cancer mortality 5.88%. The 10-year survival was 27.5% and breast cancer mortality 15%. In the age group 85 and over increased the risk of death by 3.25 in the first 10 years of treatment. The clinical response after 2 years was marked by a low rate of cancer progression. Mortality over 5 and 10 years was mostly related to patient comorbidities.
376 Morphological Characteristics of the Artery of the Atrioventricular Node by Congenital Heart Defects , Spirina Galina and Metelkina Christina
The objective of the work is to study the topographic and anatomical characteristics of the atrioventricular node’s artery in complex congenital heart defects. The material for the work was the following: 44 specimens including hearts of fetuses and children of the first three years having congenital defects and 50 specimens of the hearts of a similar age with normal development as the control. A complex of generally accepted morphological methods was used to identify the conductive system of the heart, its blood supply. According to the data obtained given congenital heart defects, the artery of the atrioventricular node arises from an artery, that determines the type of blood supply to the heart. With the full form of the common atrioventricular canal, the presence of the “U” – shaped bend of the coronary artery at the point of departure of the atrioventricular artery from it is inconstant, which is apparently due to the localization of the atrioventricular node in the embryonic position. The intensity of the lateral branches from the artery of the atrioventricular node to the heart partitions is determined by the hemodynamic features with congenital heart defects.
377 Immunostimulator Api-Phototherapy for the Treatment of Upper Respiratory Tract Infection and Chronic Bronchitis   , Dr. Elnur Eldaroglu Rahimov and Dr. Zumrud Alasgar Ahmedova
Throughout history, respiratory tract infections due to viruses, especially influenza viruses, continue to cause serious diseases, up to death, all over the world, as a result of the inability to develop effective treatment methods or vaccines. Due to changes in the antigenic structures of respiratory viruses, especially RNA viruses, there are difficulties in the production of effective vaccines. The World Health Organization estimates 150,000 hospitalizations and 30,000 to 40,000 deaths due to the flu epidemic in the United States alone, with a total of 25 to 50 million cases each year. Respiratory viruses are a major cause of influenza-like illness symptoms in children and adults, causing significant illness and death each year. Various herbal remedies have been used for the prevention and treatment of viral respiratory diseases in many parts of the world. Among those found to be effective are propolis, licorice root, ginger, black cumin, carob, but there is also scientific evidence for the effectiveness of several complementary treatments for the common cold. For example, oral zinc intake can reduce the severity of the common cold. Regular intake of vitamin C supplements can reduce the duration and severity of viral infections. Various herbs are widely used as medicine to clear viral respiratory infections. Influenza control and treatment mainly depend on chemical or biochemical agents isolated from plants. These agents include various polyphenols, flavonoids, saponins, glucosides, and alkaloids. We added such plants, propolis, and licorice honey to the content of bronxbal paste, which is a combination of supportive therapy, bronchial dilator, immunomodulator, mucolytic, and born antiviral and antibacterial effects during coronavirus and other bacterial-virus-caused pneumonia. We prepared it as a paste and used it in patients who do not have allergies. The plant and bee products in the bronxbal content we have prepared are natural pastes to solve problems that need ongoing rehabilitation, such as coronavirus pneumonia and chronic bronchitis caused by other viruses and bacteria, or Covid-19.
378 Spleen: Histomorphological Changes of the White Pulp during Fetal Development , Jovana Rajković1, Branko Baljak1, Matilda Đolai1,2 and Jelena Amidžić1,2    
For a long time spleen has been an important field of study for researchers. However, details about changes of microscopic structure in spleen during the fetal period are far less available in literature. Our goals were to determine distribution of white pulp as well as its relationship with blood vessels and to observe development and distribution of blood vessels and arrangement of CD4+ and CD8+ lymphocytes. The study was carried out on 16 specimens of fetal spleens. After standard histological hematoxylin and eosin (H&E) staining, the specimens were stained with immunohistochemical methods. Antibodies for CD4+, CD8+ and vascular endothelial cells were used. Qualitative, semi-quantitative and quantitative analyses were performed. The results were statistically analyzed and graphically presented. By the 19th week of gestation lymphocytes can be found in spleen. The 24th week of gestation is the period of the formation of a white pulp of the spleen with centrally placed blood vessels in the follicles. Also, during this week the arterioles were completely surrounded by the CD4+ lymphocytes. The number of arterioles in spleen increases during fetal development. With the increase of gestational age of the fetus, lymphatic tissue in the parenchyma of the spleen increases, as well as the number of the arterioles, while the number of capillary blood vessels decreases.  
379 Study of Consistency of Needs and Attitudes of Pharmacists towards Consumers/Patients in Retail Pharmacies in Georgia     , Eka Pruidze, Tamaz Chumburidze and Nana Dugashvili
The demand for the pharmaceutical services in retail pharmacies has increased over the last decade. The aim of the study is to study the requirements of patients/customers in a modern changing environment to ensure that appropriate pharmaceutical care is provided to increase customer loyalty while taking into account the concept of pharmaceutical care. The study also examined the competence and attitudes of pharmacists in pharmaceutical care to meet the patient’s requirements. Methods: The study was conducted in December 2020. 526 patients/pharmacy customers and 1,309 pharmacists participated in the study, via the online questionnaire. Participants were presented with questions such as “I visit pharmacy to buy products” and used 3 or 5-point scale to indicate their response. Results: When choosing a pharmacy, the costumers/patients prioritize: the quality of pharmaceutical services, speed of service, assortment, competence of the pharmacist and the price of the products; while receiving pharmaceutical care, customers want pharmacists to be oriented on them, to be professional and communicate in an understandable language. In pharmaceutical care, the pharmacists’ visions and attitudes are consistent and meet with costumers’ requirements. Conclusions: In Georgia, the pharmacy is no longer perceived as just a place to buy a medication, but 50% of customers go to the pharmacy to purchase cosmetic and hygiene products. Modern patient/costumer expectations tend to increase the speed and quality of pharmaceutical services. Considering the risks of the patients, it is recommended to expand the modern approaches - new technologies and online services to improve/accelerate the processes in retail pharmacies.