1 Nosocomial Infections at Three Regional Tertiary Hospitals in Trinidad and Tobago , Camille Elliott 1* A Justiz-Vaillant 2
Objective: The main objectives of this research were to conduct and provide accurate and original findings related to the epidemiological study of nosocomial infections at three regional tertiary hospitals in Trinidad and Tobago. Specifically, the researcher determined; the frequency of nosocomial infections (NI), the frequency of multiple drug resistance among bacterial organisms associated with NI, infection control measures practiced at the research hospitals and the cost of such NI in terms of morbidity and mortality Synopsis: This study estimated the rate of nosocomial infections (NI) among patients at three major regional hospitals in Trinidad and Tobago and evaluated the frequency of pathogens associated with nosocomial infections. Approximately 450 of 126, 668 patients had nosocomial infections and the most frequent type of nosocomial pathogens were: Staphylococcus sp. (22.5%), Pseudomonas aeruginosa sp. (12.7%), Acinetobacter (11.8%) and Klebsiella sp. (11.6%). Methods: A one-year prospective cross-sectional study was carried out. The nosocomial pathogens were retrieved from the microbiology laboratory. Antimicrobial susceptibility test by the disk diffusion method were done on all bacterial isolates. Data was analysed using SPSS version 20.0.  Results: This research revealed that 450 inpatients suffered nosocomial infections, with thirty (30) mortalities during the twelve (12) months that the study lasted (June 2013 to May 2014) at three regional hospitals of Trinidad and Tobago. The incidence of nosocomial infections was 5.8% and the nosocomial infection rate was 3.6 per 1000 (450/126,668). The highest rate (30.1%) was observed in the Intensive Care Unit (82/272 admissions). The most frequent type of nosocomial infection was Skin and Soft Tissue Infections 168 (37.3%). Staphylococcus sp. (22.5%), Pseudomonas aeruginosa sp. (12.7%), Acinetobacter (11.8%) and Klebsiella sp. (11.6%) were the most frequently occurring nosocomial pathogens.  Conclusion: Consistency in performing good hygiene practices is vital for reducing the high nosocomial rate found at the research sites. Prediction of these infections is very important as a part of clinical surveillance programs to take preventive measures in advance. The antimicrobial susceptibility pattern rate (ASPR) showed that only 8.3 % (5/60) of the isolates were antibiotic-susceptible strains.    
2 Spatiotemporal Thermal Contours mapping of ex-vivo Bovine Liver Radiofrequency Thermal Ablation utilizing Hyperspectral Image and its Associated K-Mean Clustering Algorithm   , Mohamed Hisham Aref ID 1* Ibrahim H. Aboughaleb 1 Mohamed Rabie 1 Yasser H. El-Sharkawy 1  
Significance: Hepatocellular carcinoma (HCC) is considered as worldwide health problem with a poor diagnosis due to limited detection techniques. Thermal ablation is the dominant modality to treat liver tumors for discriminating patients who are not allowed to have surgical intervention. Knowing that, observing or foreseeing the size of the subsequent tissue putrefaction during the Thermal Ablation techniques is a difficult undertaking. Aim: To examine the impacts of ablation zone volume following Radiofrequency ablation (RFA) of an ex-vivo bovine liver to correlate the impacts of thermal ablation with target organ perfusion; by exploiting the unique properties of Hyperspectral Imaging (HSI).where, Vessels may source cooling in the adjacent tumor target (heat‑sink‑effect) with risk of cancer recurrence and the infiltration profundity estimations consider the lessening of the tissue. Materials and Methods: Radiofrequency ablation was perfused on ex-vivo bovine livers at peripheral and central‑vessel‑adjacent locations, and monitored by HSI with a spectral range from 400 to 1000 nm. The system contains k-means clustering (K=8) algorithms combining spectral and spatial information. Labeled spectral signatures datasets were used as training data. Statistical analysis (10 samples) was computed to calculate the highest variance between six spectral images for determining the optimum wavelength for discrimination between the affected regions after thermal ablation (normal, thermal, and ablated liver tissue regions). Results: The change of the optical properties of ex-vivo liver tissues provides different responses to light transmission, scattering, absorption and particularly the reflection over the spectrum range. The spectral reflectance signatures were measured and evaluated using designed K-mean clustering algorithm after image reconstructed. Trials showed that spectral region 650~650 nm was proposed as optimum spectral range. Where, these results successfully distinguishes the Surface Thermal ablation region (x,y-axis),as well as the Thermal penetration Depth (z-axis) for Tissue characterization and Contour mapping for the unwanted thermal damage. Conclusions: Hyperspectral imaging is a powerful tool in real-time monitoring the thermal ablation and more accurate compared to the conventional imaging modality.  
3 The Missing Link in the Human Thermoregulation Systems , Abyt Ibraimov * Stalbek Akhunbaev Orozali Uzakov                                                        
The study of human thermoregulation is one of the most developed areas of modern physiology and medicine. This is due to the important role of temperature in normal and pathological conditions. Directly or indirectly almost all systems and organs are involved in maintaining of relatively constant temperature in the body, since their normal functioning is closely related to the temperature of the internal environment (temperature homeostasis).  Currently, the existence of two systems of thermoregulation is recognized: a physiological organ-based system with a center in the hypothalamus and a molecular system, which manifests itself in the form of the production of proteins (heat shock- and cold shock proteins) and by activation of RNA thermometers in response to heat or cold shock.  Based on studies of the variability of chromosomal heterochromatin regions in the genome of human populations permanently living in various climatic and geographical conditions of Eurasia and Africa, as well as individuals well adapted to the extreme conditions of the high altitudes of the Pamirs and Tien-Shan (mountaineers) and the Far North (oil drillers of the Yamal Peninsula, Eastern Siberia), we came to the conclusion that, apparently, there is a third system of thermoregulation at the cellular level (cell thermoregulation). By cell thermoregulation, we mean the removal of excess heat from the nucleus of an interphase cell in order to avoid the harmful effects of high temperature on the complex molecular processes occurring in the nucleoplasm.  We believe that some intracellular formations (a dense layer of condensed chromatin around the nucleus, nucleoli, chromocenters and other membraneless bodies) serve as a structural basis for the removal of heat from the cell nucleus, because the material basis of all these temporary structures in the interphase nucleus is the chromosomal heterochromatin regions.  In this review, we discuss a set of data, which indicate that cell thermoregulation, may be a missing link between organism and molecular level in maintaining temperature homeostasis in the human body.  
4 Human Chromosomal Q-heterochromatin Regions as a System , Abyt Ibraimov 1,2* Stalbek Akhunbayev 1 Orozali Uzakov 1
The eukaryotic genome consists of the two forms of chromatin: euchromatin and heterochromatin. The DNA of euchromatin contains the gene portion of the genome, while heterochromatin is represented predominantly from non-coding repetitive nucleotide sequences that do not encode proteins or enzymes. In higher eukaryotes, some part of the non-coding, highly repetitive nucleotide sequences were transformed into complex forms of DNA organization as chromosomal constitutive heterochromatin regions. There are two types of constitutive heterochromatin: C- and Q-heterochromatin. C-heterochromatin is found in the chromosomes of all eukaryotic cells, while Q-heterochromatin is found in the karyotype of only three higher primates (Homo sapiens, Gorilla gorilla and Pan troglodytes). Since the discovery of the position effect variegation phenomenon C-heterochromatin has been attributed to gene silencing effects. Dosage compensation of genes is another epigenetic gene silencing mechanism that makes it possible to equalize the level of expression of sex-linked genes in males and females. In mammals, this is done by inactivating one X chromosome in the cells of females using facultative heterochromatin, which is a heterochromatinized euchromatin. However, no epigenetic gene silencing was found in chromosomal Q-heterochromatin regions (Q-HRs). The question is discussed why human chromosomal Q-HRs does not exhibit gene silencing or other epigenetic effects and what their biological role might be.  
5 Evaluation of Cardiovascular Markers in Normotensive Pregnant Women , Oladapo-Akinfolarin, T. T 1* Bartimaeus, E.S 1 Akinfolarin O.M 2
Pregnancy is associated with series of biochemical changes such as changes in cardiovascular markers. These changes may contribute to risk of developing cardiovascular disease among this group of people. Therefore, this work was aimed at evaluating changes in cardiovascular biochemical markers in pregnancy. This research was a cross-sectional study with 150 female subjects divided into three groups; control (non-pregnant women), 2nd trimester and 3rd trimester. Each of the group had 50 subjects each. Subjects were selected randomly from Rivers State University and Rivers State University Teaching Hospital. Fasting blood was collected using venipuncture technique (WHO, 2010). The collected blood was carefully dispensed into plain vacutainer tubes and assayed for uric acid, Apo A1 and B, CRP, TG, HDL and TC while VLDL and LDL were calculated. The data obtained from the study were analyzed using GraphPad Prism Version 8.0.2.263. ANOVA results revealed that there were significant differences in TC, TG, LDL, HDL, VLDL, CRP, ApoA1, and ApoB levels among non-pregnant, 2nd trimester and 3rd trimester groups of normotensive pregnant women (P<0.05) except for uric acid (UA) that showed no significant difference. Post hoc analysis revealed significant difference in studied parameters between groups except in HDL, TG and VLDL in non-pregnant and 2nd trimester group while UA remained non-significant between compared groups. This study has shown that pregnancy causes significant changes in cardiovascular risk markers in healthy pregnant women.
6 Ayurvedic Formulations for the Treatment of Covid -19 , Abbaraju krishna sailaja 1 M. Suma kanth 1 Jangampally Vedhashree 1* Raynee Kirthi 1* Mallepally Deepa Reddy 1 M. Praveen Kumar 2
Background and objective:  To recognize natural phytochemicals from medicinal plants, in order to reutilize them against COVID-19 by the virtue of molecular dynamics (MD) simulation study and molecular docking study COVID-19 is a transmissible disease that is initiated and propagated through a new virus strain SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2). Since 31st December 2019 in Wuhan city of China and the infection has outspread globally infecting many countries.  Methods: Molecular dynamics MD simulation interaction analysis, Salt bridge analysis, Flexibility analysis, Ace-2- rbd complex electrostatic component of binding energy calculation method. Results: Molecular docking studies has shown to be having two inhibitors against SARS-CoV-2 Mpro (Main protease), from Withania somnifera (Ashwagandha) (Withanoside V [10.32 kcal/mol] and Somniferine [9.62 kcal/mol]). Inconsolably, SARS-CoV-2 infection in patients with pre-existing disease conditions (e.g., hypertension and diabetes) can cause severe complications and, as a result, mortality. Conclusion: Hence from the present study it could be suggested that, the active phytochemicals from medicinal plants could potentially inhibit Mpro of SARS-CoV-2 and further equip the management strategy against COVID-19-a global contagion. Active phytoconstituents of Ayurvedic medicinal plants Withania somnifera (Ashwagandha) predicted to significantly hinder main protease (Mpro or 3Clpro) of SARS-CoV-2.Through molecular docking and molecular dynamic simulation study, Withanoside V, Somniferine were observed to impede the activity of SARS-CoV-2 Mpro.  
7 Covid-19 Vaccine Efficacy on Omicron Variant , Sadique Hussain                                                        
The introduction of coronavirus (CoV) shocked our planet in December 2019, resulting in over five million deaths worldwide over the previous two years [1]. Physical and social separation is required as a precautionary step for this infectious and transmissible pandemic. There are several mutant variations of the original SARS-CoV-2. Because of its striking similarities to SARS-CoV, the new coronavirus was first termed SARS-CoV-2 (2019-nCoV), but was later designated Coronavirus Disease-19, or COVID-19 [2,3]. At the moment, the variety of greatest concern is Omicron, also known as B.1.1.529. Omicron was discovered in South Africa and Botswana in early November 2021 [4]. South African scientists were the first to identify it as a consequence of employing genome sequencing to assess an alarming spike in cases. The most frightening aspect is the large number of mutations [5]. COVID-19 is the seventh CoV discovered to infect humans. Before SARS-CoV-2, six other CoVs strains were identified to infect humans. These groupings also include HCoV229E (229E), HCoV-OC43 (OC43), HCoV-NL63 (NL63), HCoV-HKU1 (HKU1), SARS-CoV, and MERS-CoV [6].
8 Bats: One of the Key Animals for Humanity; A Case Study for COVID 19 ,
Cemil Koyunoğlu
9 Antimicrobial Resistance and Molecular Detection of Extended , Nkene I.H 1
Escherichia coli (E. coli) are common etiological agents of food borne diseases. A study on antimicrobial resistance and molecular detection of Extended-Spectrum β-lactamase resistance (ESBL) in E. coli from road-side suya meat was carried out. Suya meat (50 each from Akwanga, Nasarawa Eggon and Wamba) were collected; and E. coli was isolated and identified using cultural, morphological and biochemical characteristics. Antimicrobial susceptibility testing was carried out using disc diffusion method and interpreted as described by the Clinical and Laboratory Standards Institute. The phenotypic detection of ESBL production in multi-drug resistant isolates was carried using double disc synergy test. Screening for ESBL genes namely blaTEM, blaSHV and blaCTX-M was carried out using polymerase chain reaction (PCR) method. The overall percentage occurrence of the isolates was 11(7.3%), being highest in wamba (10.0%), and lowest in Nasarawa Eggon (4.0%). The isolates were more resistant to amoxicillin/clavulanic acid, cefotaxime, and ceftazidine (54.5%). Percentage occurrence of ESBL producing isolates was 4(36.4%). Multidrug resistance (MDR) isolates (63.6%) occurred more than extensive drug resistance (XDR) (36.4%). The percentage occurrence of ESBL genes namely: blaSHV and blaTEM were 3 (75.0%). The Beta-lactam antibiotics such as amoxicillin/clavulanic acid, ceftazidime and cefotaxime were effective against the isolates and most of the isolates were ESBL resistant.
10 Attitudes and Behaviors of Healthcare Professionals toward HIV Positive Patients in a Tertiary Hospital , Esan Ayodele Jacob 1* Osime E. O 2 Fasakin Kolawole 1 Oyedele Titilayo E 3
Background: In reality, fear of being infected at work has led to stigmatization and discriminatory treatment of HIV/AIDS patients.  The consequence of such negative attitude is poor management of people with HIV/AIDS who need most care, treatment, and support. Aim: To evaluate attitudes and behaviors of healthcare professionals toward HIV/AIDS patients in a tertiary hospital in Nigeria Methodology: This was a cross-sectional study conducted in Federal Teaching Hospital, Ido-Ekiti, Nigeria. 250 healthcare professionals were selected randomly, Participants completed a well-structured, self-administered questionnaire delivered to them at their workplace. Data obtained from the questionnaire was analyzed using SPSS software version 9.  Results: A total of 250 healthcare professionals participated in the study, 148(59.2%) were males and 102 (40.8%) were females. 153(61.2%) of them had been working between 0- 10 years with prevalence age group 30-40 years. Majority of Healthcare professionals (HCPs) in this study demonstrated positive attitude and behaviour toward HIV/AIDS patients. However, minority of HCPs had negative attitudes toward HIV/AIDS patients by agreed to the statements that HCPs should not share office with HIV patients, beds of HIV patients should be marked and HCPs should allow relation to marry HIV patients. Conclusion: Healthcare professionals should have access to up-to-date information on all aspects of HIV/AIDS through effective training on the modes of HIV transmission, prevention, counselling, guidelines for safe practice and the rights of PLWHIV, this would reduce discriminatory attitudes towards PLWHIV and also improve patients' care and access to quality healthcare services.  
11 Measurement of Chlorophyll A and Optical Density by Increasing of Algae Biomass , Wasan Mohammed Mousa                                                        
University College for determine the effects of the nutrient enrichment on growth of algae chroococcus in fresh water. The term enrichment normally has positive connotation nutrient enrichment in our rivers, estuaries and lakes causing economic problems and substantial ecological across the nation. Enrichment ‘chlorophyll A. and optical density’ were estimate quantitatively by using spectrophotometer device at the ‘650 nm’ and ‘533 nm’ respectively results were shows increasing the enrichment of chroococcus.
12 How the artificial intelligence tool iSuc-PseOpt is working for predicting lysine succinylation sites in proteins , Kuo-Chen Chou
In 2016 a very powerful AI (artificial intelligence) tool has been established for predicting lysine succinylation sites in proteins, one of the most important post modifications in proteins.
13 Efficacy and Safety of Tocilizumab in Severe Covid-19 Infection in Second and Third Wave of Epidemics in Myanmar: Multicenter Randomized Controlled Trial , Khin Phyu Pyar 1* Aung Phyoe Kyaw 2 Nyan Lin Maung 2 Zar Ni Htet Aung 2 Thi Han Tun 3 Aung Thu 4 Zin Thu Aung 4 Min Aung Shan 5 Yan Lin Aung 5 Kyaw Zaw Lin 5 Si Phyo Thu 5 Thu Htoo Kyaw 5 Sai Aik Hla 6 Kyaw Swar Win 7
Background: Coronavirus disease 2019 (COVID-19), emerged in China at the end of 2019, became a major threat to health around the world as it caused significant morbidity and mortality. SARS-CoV-2 infection induces a cytokine storm due to dose-dependent production of IL-6 from bronchial epithelial cells; therefore, Tocilizumab, a monoclonal antibody against the interleukin-6 receptor, is one of the recommended drugs for treatment of COVID-19 infection. It may result in better outcomes in patients with severe Covid-19 infection. The efficacy and timing of Tocilizumab therapy in severe COVID-19 infection in Myanmar was not known clearly.  Methods: A hospital based interventional study design (Randomized controlled trial) was conducted in COVID-19 treatment centers in Myanmar -Yangon and Nay Pyi Taw, from February 2020 to August 2021. Supervised treatment was done; and, both clinical and laboratory data were collected by using standardized forms and analysis was done. We conducted a double-blind, randomized, placebo-controlled trial of intravenous Tocilizumab in adults who were hospitalized with severe COVID-19 infection. Patients were randomly assigned to receive either Tocilizumab or placebo for within 5 days. The primary outcome was the time to recovery, defined by either discharge from the hospital or hospitalization for infection-control purposes only. Results: A total of 105 patients (55 in Tocilizumab group and 50 in Standard treatment group) with severe COVID-19 infection were included. Baseline characteristics in Tocilizumab group and Standard treatment group were as follows: (1) mean age 64.4 ± 11.9 years and 59.9 ± 15.8 years; (2) BMI 24.3 ± 3.0 and 23.9 ± 5.0; (3) mean duration of symptom onset to hospital admission was 9.5 ± 4.4 days and 6.5 ± 3.8; (4) mean duration of symptom onset to treatment was 12.8 ± 3.8 days and 7.1 ± 3.8 days; (6) mean duration of hospital stay was 20.1 ± 16.5 days and 11.4 ± 4.8 days; (7) associated co-morbidities was 88% and 70%; and, (8) mean CXR severity score by Braxia was 12.0 ± 2.0 and 9.6 ± 3.4 respectively. The survival rate in early treatment receiving group was 80% in Tocilizumab group and 65.5% in Standard treatment group; that of median treatment receiving group was 40% and 62.5% respectively. The survival rate in late treatment receiving group reduced to 36% in Tocilizumab group; however, no one survived in Standard treatment group.  Inflammatory markers (Ferritin, LDH, D dimer and CRP) dropped significantly at 24 hours and 72 hours after Tocilizumab treatment; the difference was noticeable between survivors and non-survivors. Absolute lymphocyte count, liver enzymes (AST and ALT) and procalcitonin levels became normal by 2 weeks. No significant changes were seen in serum creatinine and blood urea level. Both clinical observation and questioning on experienced side effects from patients on recovery revealed that Tocilizumab therapy was tolerable and safe.  Conclusions: Tocilizumab treatment was associated with a lower risk of mortality than Standard treatment group among patients with severe COVID-19 infection. The chance of survival was 36% if Tocilizumab treatment was given late- more than 15 days of symptom onset unlike Standard treatment. The significant inflammatory markers which could predict survival within 24 to 72 hours were serum ferritin, LDH, D dimer and CRP. Tocilizumab treatment in severe COVID-19 infection was safe and effective particularly it was given early.  
14 Quantum-Information Processes in Awareness Management , Adam Adamski 1* Julia Adamska 2
Human mental life is a form of existence of information not only electromagnetic, but also acoustic, spin, soliton and bioplasm. That is, the layout the biological human in addition to the biochemical way uses the message of information using energy and information converters in living cells. The human biological system creates the pictorial structure of the world not only through sensory perception, but also on the basis of soliton, spin and bioplasm waves. The action of solitons in the biological system of man gives the basis for seeing the psychobiological structures of man in a different light, as presented in biology, medicine and psychology. The science to date recognizes only the action of an electromagnetic wave on the sense of sight. It can be concluded that we are dealing with a second center that creates the structure of the world image and is responsible for health and the development of diseases in humans. According to the authors, consciousness cooperates with the cosmos and is guided by the laws of quantum mechanics. Under its law, there is room for artificial consciousness. In their deliberations, the authors will understand that it is a dynamic structure of quantum-cybernetic-information team processes taking place in the bioplasm of the brain, which is in synergistic interaction with biocomputer simulation, guided by the emission of coherent light, modulated by a soliton wave.  
15 Level of Agitation of Patient in the Emergency Department , La Vonne A. Downey                                                        
His primary purpose of this study was to determine the level of agitation that psychiatric patients exhibit upon arrival at the emergency department. The secondary purpose was to determine whether the level of agitation changed over time depending upon whether the patient was restrained or unrestrained. Methods: This study was a convenience study of psychiatric patients who presented to a level one trauma center.  The patient’s level of agitation upon arrival and for every 30 minutes for 3 hours was assessed using the Sedation Assessment Tool. A comparison was made of SAT scores using SPSS v25 between patients who were and were not restrained.  Results: This study demonstrating that the most agitated patients were the ones who were restrained.  However, few psychiatric patients in this study were restrained. Additionally, the level of agitation decreased for most subjects whether restraints were used or not within the 90-minute time frame.  Conclusions: This study found that most psychiatric patients were not agitated upon arrival to the E.D. Those that were the most agitated E.D. patients did calm down even when they were not restrained.   These results suggest that we should consider and evaluate the benefits of using alternatives to restraints for psychiatric patients in the E.D.   
16 Comparison of Single-Injection and Multiple-Injection Thoracic Paravertebral Block in Preventing Pain after Video-Assisted Thoracoscopic Surgery , Deniz Turan 1 Fatma Ulus 2 Serdar Epözdemir 1* Ali Alagöz 2
Aim: In our study, we aimed to compare the effect of single and multiple thoracic paravertebral block (TPVB) patients who underwent video asisted thoracoscopic surgery (VATS) on hemodynamic parameters, postoperative visual analog scale (VAS) and sedation scores, and total analgesic consumption.  Materials and Method: The ASA II-III, age between 18 to 65 years, and body mass index lower than thirty, 60 patients who underwent elective VATS were included to this study. Patients were divided into two groups as single (Group S), (n:30) and multiple (Group M), (n:30) TPVB. Block was performed at T6 level in Group S and at T4, T6, T8 levels in Group M by using 21 mL 0.5 % bupivacaine. Intravenous patient controlled analgesia (PCA) was performed for both groups after surgery. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2), Ramsay sedation score (RSS), tramadol consumption during 24 hours, resting and coughing VAS scores were recorded before PCA and at 30th, first, second, 6th, 12th, 20th, and 24th hours of postoperative periods. 50 mg iv dexketoprophene was administered when coughing VAS score above the 4. Despite the iv dexketoprophene, in case of consistent pain 1 gr iv paracetamol was given to the patients, and all additional analgesic requirement was recorded. Results: Hemodynamic parameters were similar in both groups during postoperative period (p>0.05). VAS scores were higher in Group M but there were not statistically significant (p>0.05). Additional analgesic requirement was significantly higher in Group M, (p>0.04). Cumulative tramadol consumption was comparable between the groups, (p>0.05). Conclusion: In TPVB, it was observed that single and multiple injections provided similar postoperative pain scores and postoperative cumulative tramadol consumption, but we observed a high additional analgesic requirement in multiple injection group. Based on this result, we concluded that there would be no need to disturb patient comfort and prolong the procedure by applying multiple injections.  
17 Classification of Absolute Cd4+ T Lymphocytes Count in Immunological, Virological and Erythropoietic Growth Factor among HIV Infected Patients , Esan Ayodele Jacob 1* Osime E. O 2 Ogunbusuyi Bolu Esther 3 Oyegue Kelvin 4 Oyedele Titilayo E 5
Background: HIV-infection resulted in CD4+ T-cell depletion which is accompanied by an increase in CD8+ T-cells resulting in an inverted CD4/CD8 ratio. Low CD4/CD8 ratio has been identified as a hallmark of inmmunosenescence and a surrogate of mortality in HIV infected patients especially in ART-naïve patients Aim: Classification of absolute CD4+ T-lymphocytes count in immunological, virological and erythropoietic growth factor among HIV infected patients Methodology: One hundred samples each was collected from HIV positive subjects on ART and HIV positive subjects ART naïve. Six milliliters of whole blood was collected from each consented subject, 3ml was dispensed into 5ml K2EDTA bottle for immediate analysis of absolute CD4 count, CD8 count, total white cell count and HIV screening. The remaining 3ml of blood was dispensed into plain bottle; serum was extracted for the analysis of erythropoietin and viral load  Results: Mean values of CD8, CD4/CD8, EPO and TWBC in CD4 <200 were significantly (p<0.05) lower compared to CD4 >500 and CD4 200-499. Mean values of VL in CD4 <200 were significantly (p<0.05) higher compared to CD4 >500 and CD4 200-499 among HIV subjects on ART and ART-naïve  Conclusion: Immunological and erythropoetic growth factor assessed in this study were decline while viral load was increasing as HIV infection progresses with depletion in absolute CD4 count, this study shows the efficacy of ART on the treated subjects. However, based on this study, absolute CD8 T cells count, CD4/CD8 ratio and erythropoietin can be used as surrogate makers to ascertain pathogenesis in HIV-infected subjects.  
18 Necrobiosis of a Uterine Fibroid in the Course of a Pregnancy , Eida Moya Hernández 1*
Uterine myoma is a very common benign neoplasm. A 32-year-old patient with 8 weeks of gestation was presented, who came to the emergency room presenting abdominal pain of two days of evolution, vomiting and low-grade fever in the course of an already known and desired pregnancy, with a diagnosis of necrobiosis of a uterine fibroid. The fibroid was resected and the gravid uterus is preserved. The patient is progressing satisfactorily, she being discharged seven days later, she is followed by outpatient consultation and 20 weeks later she maintains a normal pregnancy. Key words: necrobiosis, uterine fibroma, pregnancy.
19 Physico-Chemical Properties of Indigofera Zollingeriana Seed Oil , Alagbe J.O 1* Adedeji M.O 2 Habiba Z 2 Nwosu Gloria 2 Dabara Comfort Wyedia 2
The objective of the present study is to examine the physico-chemical properties of Indigofera zollingeriana seed oil. Physico-chemical parameters of oils are important in the determination of edibility and other industrial applications. All the laboratory analysis were carried out using standard procedures according to AOAC (2000). The acid value, peroxide value, iodine value, saponfication value, refractive index and free fatty acids of cold pressed Indigofera zollingeriana seed oil was found to be 17.11 mg NaOH/g, 23.04 meq/kg, 180.4 gI2/100g, 118.7 mg/KOH/g and 14.10 %. The refractive index (20oC) and specific gravity (25oC) was 2.01 and 1.02 respectively. The extracted oil was Indigo in colour at liquid state. It was concluded the oil has a high acid value, peroxide value and free fatty acid which favours the use of the oil for industrial use such as soap production and cosmetics. 
20 Usage of Mushrooms in Culinary and Medicinal Purposes ,  Mohammad Azizur Rahman * Tawhidur Rahman Moshiur Rahman Mirza Arif                                                        
The present article reviews the history of mushroom uses in culinary, food and medicinal values; current status and future aspect of mushroom research. Mushrooms contain biologically active polysaccharides, lipid and proteins in fruit bodies, each of them has a distinct role in health as either nutritional value or medicinal elements. Immunostimulating polysaccharides found in mushrooms, are most important for modern medicine. Several of the mushroom biomolecules have undergone phase I, II, and III clinical trials and are used extensively and successfully throughout the world for the treatment of various cancers and other diseases. Medicinal functions played by the mushrooms include antitumor, antibacterial, antioxidant, antiparasitic, antidiabetic, detoxification, cardiovascular, antihypercholesterolemia, antiviral, antifungal, hepatoprotective, immunomodulating and free radical scavenging. The present review draws attention to nutritional and medicinal importance of mushroom as well as the problems and opportunity in the future development of mushroom research.
21 Herbal Medicine for the Treatmentof Viral Infections: A Systemic Review ,  Amand Alekhya Abbaraju Krishna Sailaja *
The term “Antiviral agents” has been defined in very wide terms as substances other than a virus or virus containing vaccine or specific antibody which can build either a protective or therapeutic effect to the direct measurable advantage of the virus infected host. Viruses are simple in form which are very tiny germs. They comprise of genetic material inside of a protein coating. Viruses cause amicable infectious diseases like common cold, flu and warts. They also cause severe diseases such as HIV/AIDS, Ebola, avian influenzas, dengue virus and COVID-19. Viral diseases are very complex and are easily spread. Herbs and herbal medicines were the foremost in treating infections from centuries over the world in every civilization. Modern science has narrowed the importance of herbal medicine in the past two centuries. But, the side effects and new varieties of diseases creating challenges to modern science. So, usage of herbal medicines is again attaining interests these days. Herbal products for different treatments have achieved a lot of popularity in the last couple of decades. Thus, discovering novel antiviral drugs is of extremely important and natural products are an excellent source for such discoveries. There are many herbs which are excellent sources for the antiviral properties to treat viral infections. This review provides the verified data on the herbal substances with antiviral activity, and some of the herbal marketed antiviral agents like CORONIL TABLETS from Patanjali and different companies had made an attempt to treat viral infections in this pandemic situation. Therefore, herbal plants proved to be a major resort for the treatment of diseases and sickness by traditional healers in many societies.
22 Intractable/ Persistent Hiccups Due to Acute Subdural Haemorrhage as a Result of Prolonged Inr in a 55 Year Old Man with Rheumatic Mitral Valvular Heart Disease and Atrial Fibrillation: A Case Report , Khin Phyu Pyar 1* Sai Aik Hla 2 Win Myint 3 Win Kyaw Shwe 4 Soe Win Hlaing 5 Zaw Min Tun 6 Han Lin Aung 7 Phyo Htet Oo 7 Kyaw Zayar Lin 7 Moe Tun Zaw 7 Kyaw Zay Ya 8 Myo Thant Kyaw 9 Nay Myo Aung 9 Than Naing Lin 9 Soe Moe Htun 9 Zay Phyo Aung 9
A 58 year old man was brought to hospital in state of deep coma following severe headache for one day. His GCS was 3/15 and had flaccid all 4 limbs with equivocal planter response on both sides on arrival. NECT head showed acute subdural haemorrhage with surrounding cerebral oedema, mid-line shift and corning of brain stem. After giving mannitol and dexamethasone, four hours later, he became fully conscious and orientated; his motor power returned to normal. He was on warfarin 3mg daily for rheumatic mitral valvular heart disease with atrial fibrillation and his INR on arrival was 3.5. He had intractable hiccups once he regained consciousness. Both pharmacological and non-pharmacological measures were tried for distressing hiccups; there was no therapeutic success. His hiccups disappeared completely only after removing the haematoma by burr hole surgery. 
23 Full Validation of A New Formula Estimating The Smoking Economic Burden By Morbidity , Fé Fernández Hernández * Efraín Sánchez González                                                        
Introduction: In the Health Economy research context usually researches are assuming that the probability of the morbidity attributable to smoking is equal to the probability of the health spend attributable to smoking. Also is attributed the whole health spend because of active smokers to smoking. To solve this limitation, the authors suggested a new rate to measure the smoking economic burden by morbidity.  Objective: To evaluate the feasibility from a new rate to measure the smoking economic burden by morbidity.  Methods: Was made a bibliographic research to describe the estimation process from the smoking economic burden by morbidity. Were utilized as theoretical method the analysis and synthesis, the comparative and the systematization. As empiric methods were used the Principle of Multiplication and the bibliographic research.  Results: The rate designed solves the limitation identified during the research about the estimation of the smoking economic burden by morbidity.  Conclusion: The new rate will provide a better estimation from the smoking economic burden by morbidity. It application will may identify the role of active smokers and passive smokers in the formation of the smoking economic burden. However, it application must be agree to the supposes identified.   
24 Reprint: Investigation of Genetic Divergence in Local Sunflower Hybrids and Inbred Lines by Applying Morphological Markers , Uzma Ayaz                                                        
Knowledge of genetic diversity is the basic requisite for any plant breeding program. Seventeen sunflower hybrids and fifteen inbred lines including ten Cytoplasm male sterile lines and five restorer lines were evaluated at the experimental area of National Agriculture Research centre, Islamabad, Pakistan during autumn-2011. The objective of study was to investigate the genetic diversity, categorize the proficient cross combiners and approximate characters association among sunflower hybrids and inbred lines. Data was estimated on i.e. flower initiation days, full flowering days, full developmental days, height of plant, disk diameter, stem thickness, leaves per plant, hundred achenes weight, achenes yield and oil content percentage. The maximum achenes yield was contributed by Hysun-33 2119 kg ha-1. Followed by SMH-0924 and SMH-0925, SMH-1028 and SMH-0926 were suggested as potential significant hybrids for future breeding plans to incorporate maximum achenes yield and oil content percentage. The CMS-11, CMS-25 and CMS-10 were long statured with vigorous stem and all the restorers were early maturing recommended for including in hybridization program to generate high heterotic factions. Cluster diagram based on Euclidean dissimilarity matrix grouped hybrids as well as inbred lines in four groups. The group I and IV consist of four whereas group II and group III have three and five hybrids respectively. All the restores were clustered in III and IV and CMS in I and II groups respectively. According to principle component analysis the first two components contribute 64% and 89% in total variation in hybrids as well as in inbred lines respectively.
25 Re-Print: An Interesting Case of Disseminated Tuberculoma of Brain and Spinal Cord Type of Study: Case Report , Parameshwar Keerthi B H 1 Anil Kumar Sakalecha * 1 Varun S 1 Shivaprasad G Savagave 1  
Tuberculosis is an important public problem worldwide from 19th century. Manifestations of tuberculosis widely classified as pulmonary and extra pulmonary manifestations. Central nervous system (CNS) tuberculosis is a serious condition where patients most often present with seizure. Tuberculoma is one of the CNS manifestations of tuberculosis. The imaging feature of tuberculoma is ring enhancing lesions. Tuberculoma should be differentiated from other diseases with ring enhancing lesions like neurocysticercosis, coccidiomycosis, toxoplasmosis and malignancies. 
26 What We Need to Do to Improve Our Immune System Despite the Use of Vaccination for COVID-19? , Huang Wei Ling * 1  
In our daily practice, we have heard more and more frequent reports of people infected with SARS-CoV-2, even having received one or two doses of vaccine for COVID-19. In the article written by Angel et al. (2021) entitled Association Between Vaccination with BNT162b2 and Incidence of Symptomatic and Asymptomatic SARS-CoV-2 Infections Among Health Care Workers, the authors concluded that the effectiveness of the vaccine in symptomatic SARS-CoV-2 infection reduced the incidence of this infection if you compared with unvaccinated health care worker. But the incidence was not reduced in the asymptomatic health care workers, where they found that vaccinated people were more likely to have SARS-CoV-2 if compared to unvaccinated people.
27 Reprint: Peculiarities of expression of apoptosis markers in the tissues of primary fallopian tubes carcinoma , Franklin Unawunwa * Natalia Hyriavenko Anna Korobchanska Mykola Lyndin Vladyslav Sikora                                                        
Aim: immunohistochemical analysis of apoptosis markers in the tissue of PFTC. Introduction: Primary fallopian tubes carcinoma is a rare case among oncological diseases of female genital organs, but the mortality rate is rather high. Nowadays, the prognostic factors of this neoplasia are not fully determined. The data on the p53 and bcl2 proteins expression and their use as prognostic factors in patients with malignant tumors of many locations are contradictory. Methods: the study was conducted on 66 samples of fallopian tubes tumor tissue. To study the apoptosis peculiarities of tumor cells the mouse monoclonal antibodies for bcl-2 (clone 100/D5) and p53 (clone SP5) were used. Mathematic calculations were done using Microsoft Excel 2010 with AtteStat 12.0.5. Results: The high expression of p53 was found in patients of all clinical stages. Mutations of p53 increased with spreading of the neoplastic process. Strong correlation of p53 presence in tumor samples and clinical stage of the disease was determined (r=0.77). In contrast to the abovementioned protein the study of bcl-2 showed the moderate negative correlation between this protein and the stage of the disease (r=−0.54). Analysis of the dependence of p53 expression with the presence or absence of lymph nodes metastasis showed a direct correlation between the indicators (r=0.25). Thus the level of p53 expression in patients with N1 was 80.6±2.7% compared with the N0 group (29.7±3.6%). The stage of neoplasia differentiation is in moderate direct correlation with p53 expression (r=0.58) and in inverse with – bcl-2 (r=−0.64). Conclusion: Expression of p53 depends on neoplasia spreading and stage of tumor differentiation. The expression of p53 is an independent prognostic marker for N-status and helps to classify the patients into “risk” groups. Acknowledgements: Supervisor: A. M. Romaniuk, prof., doctor of medical sciences, Department of Pathological Anatomy, Medical Institute, Sumy State University.  
28 Why do Patients with Acute Pneumonia Receive Intravenous Infusions? , Igor Klepikov *
Currently, almost all urgently hospitalized patients immediately get access to the venous bed and begin to receive an infusion of solutions. This priority of this procedure is due not only to the need to have the most effective way of administering medications, but also to compensate for the loss of fluid, which in acute diseases has many reasons for this. Further recommendations for the correction of water-electrolyte and volume losses and the choice of the infusion rate are determined by the general criteria for their diagnosis in accordance with the parameters of the large circle of blood circulation. Considering AP, first of all, as a result of infection and not focusing on the localization of the process, modern medicine does not make exceptions in this therapeutic direction for patients with inflammation of the lung tissue.
29 Diabetes Ameliorating Effect of Mushrooms , Mohammad Azizur Rahman * Rabeya Akter                                                        
The growing impact of type 2 diabetes in the majority of the population requires the introduction of better and more secure treatments, but also requires the development of new prevention strategies to reduce the incidence and prevalence of the disease. Significantly, type 2 diabetes is an important preventable disease and can be prevented or delayed by lifestyle intervention. Edible and medicinal macrofungi, mushrooms have been reported having diabetes ameliorating effects. Current study reviews the potentiality of both edible and medicinal mushrooms in preventing and ameliorating the diabetic complications as well as the future aspects of mushrooms against this metabolic disorder.
30 The case number 506 of Mostyn Embrey Syndrome: Imaging Studies and Ethics of Naming Syndromes , Aamir Jalal Al Mosawi * 1  
Background: Mostyn Embrey syndrome is a rare disorder associated with unilateral renal agenesis and malformations of the female reproductive tract. Delayed diagnosis is associated with serious diagnostic difficulties that may lead to inappropriate management including harmful surgery. The aim of this paper is to present imaging studies of case number 506 of the syndrome which was the first case of this rare syndrome in Iraq, and was originally reported in 2016. Ethics of naming syndromes relevant to this syndrome is discussed. Patients and methods: An 18-year-old female presented with acute abdominal pain and poor urine output associated with retention of urine; about three years after the onset of menses. The pain was radiating to the back and pelvis. Her menstrual cycles started at the age of fifteen, and were lasting seven days. Cycles were associated with normal flow. The first physician the patient consulted considered the diagnosis of uterine tumor and the need for hysterectomy, but the family of the patient consultedanother physician. Vaginal exam was performed and showed bulging left vaginal wall. The diagnosis of hematocolpos was made. A clotted blood was drained by trans- vaginal approach.  Results: It was difficult to identify the two separate uteri and two separate cervices and to make a diagnosis of didelphys uterus on hysterosalpingography. Abdominal MRI showed left renal agenesis, and two uterine bodies, cervices, and vaginas with normal myometrium and endometrium (uterine didelphys), and normal ovaries. Conclusions: It is recommended that pediatricians, and pediatric nephrologists need to be aware of this syndrome to avoid unexpected presentations which may lead to delayed diagnosis and sometimes to inappropriate management. The imaging modalities that can be used to diagnose Mostyn Embrey syndrome include ultrasonography, hysterosal pingography and MRI. In this case, hysterosal pingography was not of much help. Ultrasound is affordable, non-invasive, widely available imaging modality that contributes to the accurate diagnosis of Mostyn Embrey syndrome. However, there can be difficulties in visualizing the vaginal septum on ultrasound which best shown on MRI. MRI can facilitate early diagnosis and thus help in the prevention of further complications. Syndromes in medicine are often named after the physician or group of physicians that discovered them or initially provided the full clinical picture or the best description of the syndrome. Unfortunately, Mostyn Embrey syndromes has been attributed unfairly and inappropriately to physicians other that those first described them in almost all previous papers.  
31 Highlights on some different Wild Mushrooms Xeromphalina, Cookeina, Gyromitra, Xylaria, Phellodon, Marasmius and Parasola, Description and Ecology , Waill A. Elkhateeb * 1 Ghoson M. Daba 1  
This review provides detailed morphological descriptions of some wild mushrooms of the genus Xeromphalina, Cookeina, Gyromitra, Xylaria, Phellodon, Marasmius and Parasola, including common species for each genus.
32 Re-Print: Developing and then Confirming a Hypothesis Based on a Chronology of Several Clinical Trials: A Bayesian Application to Pirfenidone Mortality Results , Zhengning Lin * 1 Donald A Berry 2  
Designing a study for independent confirmation of a treatment effect is sometimes not practical due to required large sample size. Post hoc pooling of studies including those for learning purposes is subject to selection bias and therefore generally not suitable for confirmation of a treatment effect. We propose a Bayesian approach which calibrates the role of prior information from historical studies for learning and confirming purposes. The amount of prior information to be combined with current study data for the purpose of hypothesis confirmation depends on the overall strength of prior information for hypothesis generation. The method is illustrated in the analysis of mortality data for the pirfenidone NDA. The Bayesian analysis provides a formal method to calibrate the role of information from historical evidence in the overall interpretation of results from both historical and concurrent clinical studies. The increased efficiency of using all available data is especially important in drug development for rare diseases with serious consequences, where limited patient source prohibits large trials, and unmet medical needs demand rapid access to treatment options.  
33 Novel Therapeutic Trends in Pneumonia: Antibiotics and Mesenchymal Stem Cells , Jennifer Ly 1 Qi Chu 2 Li Zhong * 1,2  
Pneumonia remains a major cause of morbidity and mortality. With the significant global health burden that pneumonia poses, it is essential to improve therapeutic and management strategies. The increasing emergence of antibiotic-resistant bacterial strains limits options for effective antibiotic use. New antibiotics for the treatment of pneumonia may address deficits in current antimicrobial drugs, with an ability to cover both typical, atypical, and resistant pathogens. Several of these newer drugs also have structural characteristics that allow for a decreased propensity for the development of bacterial resistance. The potential use of stem cell therapies in place of corticosteroid treatments may also offer an improvement in patient outcomes. Human mesenchymal stem cell treatments have shown efficacy and safety in treating COVID-19 induced pneumonia. Combined treatment with both stem cells and antibiotics in pneumonia in a rabbit model has also shown significantly increased efficacy in comparison to antibiotic treatment alone. This presents yet another possible route for a novel strategy in treating pneumonia, though additional future studies are necessary before clinical implementation. While pneumonia remains a major disease of concern, having newer approved antibiotics as well as novel therapies such as stem cell treatments in the pipeline offers clinicians more options in effectively treating pneumonia.
34 Coronavirus Variants of Concern: An Insight , Timmeka Andrews 1 Quinlin Bisbee 1 Asiah Cheek 1 DeLisa Davis 1 Jada Harvey 1 Armani Hayes 1 Steven Hopkins 1 Jeannette Mack 1 Gianni Narcisse 1 Brianna Pendergrass 1 Janai Poullard 1 Nathaniel Schirmer 1 Caytlin Willis 1 Prabir Mandal * 1
The new coronavirus, SARS-CoV-2, which causes the disease COVID-19, has had a serious worldwide impact on human health. The virus was virtually unknown at the beginning of 2020. Since then, intense research efforts have resulted in sequencing the coronavirus genome, identifying the structures of its proteins, and creating a wide range of tools to search for effective vaccines and therapies. Also, there’s a chance that the COVID-19 contraction rate could get higher than the COVID-19 vaccination rate. In other words, the virus continues to spread while very little people actually get vaccinated. This only makes the job of scientists even harder. In order to stop the spread of COVID-19, citizens must get vaccinated more frequently than citizens are contracting COVID-19. The coronavirus attacks and kills healthy cells, causing detrimental damage to the respiratory system and immune system. It was then discovered that COVID-19 can be terribly fatal for those with already fragile immune systems and preexisting health conditions. Back in March, when COVID-19 was clearly becoming a critical threat to many countries around the world, the evidence indicated that the virus spreads from person to person through small respiratory droplets produced when people cough or sneeze, or even breathe. Surfaces can serve as an intermediary for the virus when looking for a host. Instead of contracting the virus directly from a person, it is possible to receive the virus from touching an object that an infected person sneezed on. It has been discovered that the virus can last up to three 3 days on a surface. Proceeding to rub one’s eyes, mouth, or nose after such contact is also a mode of transmission.  
35 Microgravity Environments: The Physical Exercise in the Space , Dario Furnari * 1,2 Nadya Khan 3 Melissa Delaney 1 Margaret Cerna 1 Khaled Hamlaoui 1 Sebastien Lagree 1,2 Amy Peace 1,2 Megan Owens 1,2 Shanee Lee Scott 1,2 Tonja Latham Gustin 1,2 Tessa Rey 1,2 Susana Sanchez 1 Heather Perren 1,2 Timothy Lee 1 Michael Cochard 1 Sandy Wanna 1 Dayroon Booth 1,2 Jean N Paul 1 Jennifer badger 1 Jim Bermingham 1 San Soulat 1  
Nice to recede a thesis, transformed into a project and then finally into a great and beautiful research. also the "American magazine Biomedical Science & Research" publishes an article of mine which is then only an abstract of a work done during my university training where through physical exercise, applied physiology and rehabilitation in particular environments such as microgravity, we can find new methods to improve the quality of life on earth, for example for all those people who suffer from osteoporosis and arthrosis but not only. Exercise is medicine and when administered appropriately it helps to improve people's quality of life. Core, endurance, strength, neuroscience, the secrets for good longevity: heart health, brain health, muscle and joint health. Neuroscience and lagree method, besides fitness and wellness, neuro complex training. Happy to be part of this family and also to be its ambassador and researcher. also used by astronauts returning to earth.
36 Lung cancer: prevent or treat? , Claribel Plain Pazos * 1 Carmen Rosa Carmona Pentón 1 Anisbel Pérez de Alejo Plain 2 Nereyda Alejandrina Caraballo Moya 3 Alfredo Jiménez Aguiar 4 Ana Bretón Espinosa 5  
Cancer is currently one of the most serious health problems of humanity, it is among the first as a cause of death in developed and developing countries, with a tendency to continue to rise and occupy the absolute first place for the year 2025 also, because its diagnosis is made in advanced stages, it is estimated that its incidence will double by the year 2030 as a result of population growth and aging and that it may affect all ages, even those fetuses. 
37 Tako-Tsubo syndrome. Approach to the subject and Report of 2 cases , Lázaro A Mata Cuevas 1 Jesús J Roque Corzo 2 Modesto González Cortiñas 3 Celibel García Meneses 4 Lídice Corzo González 5 Claribel Plain Pazos * 6  
Takotsubo syndrome, or stress cardiomyopathy, is a relatively rare transient and reversible cardiomyopathy, although its diagnosis has increased in recent years, it presents as an acute coronary syndrome (ACS) or acute heart failure, its incidence is unknown exactly in Latin America and in Cuba. We present 2 cases seen in our hospital, both 63 and 55-year-old women with typical precordial pressure pain, the first triggering psychological stress and the second physical, with electrocardiographic changes consistent with anterior infarction and cardiogenic shock, which were found in the coronary angiographic study observed normal coronary arteries and ventriculography determined apical ballooning of the left ventricle characteristic of the syndrome, with subsequent recovery and favorable clinical evolution at 6 months. 
38 Review Article: The use of fenugreek supplementation in diabetes , Aamir Jalal Al Mosawi * 1
Dietary health supplements have increasingly used in the prevention and treatment of chronic disorders. During the previous decades, fenugreek (Trigonella foenum-graecum) seeds have been reported to have hypoglycemic and cholesterol lowering effects when used in type 1 and type 2 diabetes mellitus patients, and in experimental diabetic animals. The aim of this paper is to review fenugreek research findings relevant to its use in diabetes. There is convincing research evidence suggesting that fenugreek can improve hyperglycemia and has a protective effective against diabetic complications through immunomodulatory, insulin stimulation, and antioxidant effects, enhancing adipocyte differentiation, inhibition of inflammation in adipose tissues, and preventing or lessening pancreatic and renal damage. Many of the beneficial effects of fenugreek in diabetes have been attributed to four bioactive components including diosgenin, 4-hydroxyisoleucine, furostanolic saponins, and the fiber in fenugreek.  
39 The use of pentoxifylline in male reproduction abnormalities , Aamir Jalal Al Mosawi 1  
Pentoxifylline a derivative of methylxanthine and nonspecific inhibitor of the phosphodiesterase with vasodilatory properties and rheological properties on blood that made it useful in the treatment of intermittent claudication. Pentoxifylline also has an immunomodulatory effect which inhibits on the production inflammatory cytokines including tumor necrosis factor-alpha. The aim of this paper is to review the uses of pentoxifylline in male reproduction abnormalities. The available research evidence suggests that the addition of pentoxifylline to the traditional treatment of erectile dysfunction can be helpful, it also beneficial in the treatment of oligo-asthenozoospermia, possibly through stimulation of sperm motility by increasing the intracellular levels of cAMP.  
40 Heart cardiac’s sounds signals segmentation by using the discrete wavelet transform (DWT) , Sid Mohammed ElAmine Debbal ID 1 L.Hamza Cherif ID 1 F.Meziani ID 1
The presence of abnormal sounds in one cardiac cycle, provide valuable information on various diseases.Early detection of various diseases is necessary; it is done by a simple technique known as: phonocardiography. The phonocardiography, based on registration of vibrations or oscillations of different frequencies, audible or not, that correspond to normal and abnormal heart sounds. It provides the clinician with a complementary tool to record the heart sounds heard during auscultation. The advancement of intracardiac phonocardiography, combined with signal processing techniques, has strongly renewed researchers’ interest in studying heart sounds and murmurs. This paper presents an algorithm based on the denoising by wavelet transform (DWT) and the Shannon energy of the PCG signal, for the detection of heart sounds (the first and second sounds, S1 and S2) and heart murmurs. This algorithm makes it possible to isolate individual sounds (S1 or S2) and murmurs to give an assessment of their average duration.  
41 Costs and predictors of early readmissions in patients with Infective Endocarditis. Utilizing the Nationwide Readmission Database ,                                                          Jesan Zaman MD #* 1 Amod Amritphale MD # 1 Christopher Malozzi 1 Nupur Amritphale MD 2 Mukul Sehgal MD 3 Omar Bassam MD, PhD 1  
There have been previous studies detailing the variables involved in readmissions in patients with a primary admission diagnosis of infective endocarditis – however those studies were done prior to the 2015 change in AHA guidelines and introduction to ICD-10 codes.
42 Stigma towards Patients with Chronic Obstructive Pulmonary Disease: To Help or To Judge? , Iqbal Akhtar Khan MBBS DTM FACTM PhD * 1 Hamza Iltaf Malik MBBS 2  
Chronic Obstructive Pulmonary Disease (COPD), the third leading cause of mortality worldwide, is a highly incapacitating irrevocable health problem, with pulmonary and extra-pulmonary manifestations. According to Suzanne Hurd and Claude Lenfant, it is “the only chronic disease for which the finger of blame can be pointed to a single risk factor – tobacco smoking”. However, only 15-20% of smokers are afflicted. Whereas smoking is far from being the only cause, substantial proportion of COPD cases cannot be explained by smoking alone. The visibility of distressing and frightening physical manifestations of symptoms leads to serious ‘‘observable’’ consequences, such as disability or lack of control, public use of oxygen and rescue inhalers.  As a result “they are disqualified from full social acceptance”. However, the stigma is not the only factor responsible for the miseries of those with COPD. In fact, there are many misconceptions in this scenario which have been discussed. The need of a   huge awareness campaign for the public to improve their understanding of lung diseases (notably COPD) has been highlighted. The patient, healthcare professionals and the health services should be prepared to play their new role in the management of a chronic disease like COPD “requiring “ongoing management over a period of years or decades”. The importance of a self-management strategy has been emphasised. 
43 Hematological Parameters in Sudanese Type-2 Diabetes Mellitus , Nassreldeen Khalid Abderahman Adam * 1 Nahla Ahmed Mohamed Abderahman 2 Mohamed Ahmed Ibrahim Ahmed 3 Ibrahim Mohamed Ahmed Eisa 4 Hala Mohammed Wardi 5 Abd Elkareem Abubaker Abdrabo 6  
Background: Diabetes mellitus is a complex concept for a spectrum of disorders characterized by hyperglycemia and a variety of complications, comprising metabolic and cellular disturbances that lead to vascular complications. The objective of this project was to correlate type 2 diabetes patients to healthy controls in aspects of hematological indices and their association with demographic data. Materials and Methods: From May to September 2016, a case-control analysis has been performed in Khartoum, Sudan. 154 participants were enrolled in this study. 104 participant were diabetic type 2 and 50 were apparently healthy as control group to find out any variations in hematological parameters HbA1C and CBC: (Hb, WBCs & differential, RBCs& indices and PLTs, hematocrit (HCT) among type 2 diabetic patients. Blood was gathered in EDTA containers. HbA1C measured using i-CHROMATM and complete blood count using the Sysmex® Kx21-N hematological analyzer. Before samples collection, each participant gave their informed consent, which had been approved by the Ministry of Health's ethical committee. The Statistical Package for Social Sciences (SPSS) SPSS version 20 was used. The meaning of the discrepancies was assessed using the Crosstab test. p- Value is significant at P< 0.05. Results: T2DM patients had a statically significant in white blood cells, neutrophils, and lymphocytes as comparison to the control group P<0.05. There was no considerable difference in red blood cell count, Hb, Hct, MCV, MCH, MCHC, RDW, Platelets count, MPV, and PDW between the two classes P> 0.05. Conclusion: T2DM patients had relatively increased levels of white blood cells, neutrophils, and lymphocytes than the control group (P<0.05).  
44 Evaluation of Negative Inotropic Effects of a Isoquinoline Alkaloid N-14 , Inoyat Z. Jumayev * 1 Pulat B. Usmanov 1 Shavkat Yu Rustamov 1 Sadriddin N. Boboev 1 Eldor B. Ibragimov 1 Adilbay T. Esimbetov 1 Abdisalim A. Zaripov 1 Sherzod N. Zhurakulov 2  
In studies, the alkaloid 1-(2-Chloro-4,5-methylenedioxyphenyl)-2-hydroxyethyl-6,7-dimethoxy-1,2,3,4-tetrahydroisoquinoline (N-14) had a negative inotropic effect on the activity of the papillary muscle contraction of the rat heart detected. Ca2+ ions from SR play an important role in the process of contraction of the heart muscle. With this in mind, the negative inotropic effect of the N-14 alkaloid was investigated with the modification of the accumulation processes of Ca2+ ions to SR. To clarify this, we examined the effects of the alkaloid being studied on SERCA2a and RyR2. To do this, the inhibitor of SERCA2a - cyclopiazonic acid (CPA) and RyR activator caffeine, which provide the accumulation of Ca2+ ions in SR, were used.
45 Infectious Diarrhea, a Public Health Problem in Population , Deac Liana Monica MD PhD ID 1
Infec­tious etiology in acute diarrhea, referred several gastrointestinal diseases, Most are gastroenteri­tis associated with clinical signs and symptoms including: nausea, vomiting, abdomi­nal pain and cramps, bloating, flatulence, fever, passage of bloody stools, tenesmus, and fecal ur­gency disorders. Diarrheal illness is a large worldwide public health problem, with substantial regional variation, in the prevalence of medical signs by being caused by specific pathogens. Infectious diarrheal diseases, are the second leading cause of morbidity and mortality worldwide and can cause real public health concerns. Such diarrhea was studied as a medical disorder, in a 3 years period, 2017 to 2020, in Transylvania a large   region in Romania. It was found there, 3577 number of diarrheal diseases cases, appeared almost during July to August. The case incidence for the disease arrived at 65%, in the entire summer season. The cases data were transmitted by 12 district Sanitary Polices, to the Public Health Center Cluj. Cases were almost diagnosed by the   family doctors of the region, in more then 50%.  Few of this have need some days of hospitalization, because of several disease disorders, in which case it was used a specific adequate fluid and electrolyte replacement as key of the treatment, for managing diarrheal illnesses. Even so, 3 children under 5 years age died, because of severe complications. It was remarked so, organic failed who was estimate to be the cause of their deaths. Clinical and epidemiological evaluations were done and even defined the severity and type of this mentioned illnesses.  The detected infectious etiology for the acute diarrheas, where determined in authorized Microbiology laboratories, where were identified:  Shigella spp, Salmonella spp, Campylobacter spp, Yersinia spp, Rotavirus, Giardia. Most number of cases appeared in children, being suggestive in 63%, followed by elderly or adult people in 17% each. Acute diarrheal illness had to be considered a major public health issue, against which some determined control efforts are needed. Public health surveillance of infectious acute diarrhea, includes obligatory done strategies for a correct infection control.
46 The most important animal pest is the possibility of transmitting or reservoirs the Corona virus , Abd El-Aleem Saad Soliman Desoky ID 1*  
Although the bat has unique characteristics compared to other mammals, but it currently enjoys a poor reputation, especially after being linked to being the source of the Corona virus, as international researchers recently published a large-scale research, which is the largest of its kind, about corona viruses in the bat, If this hypothesis is correct, then the Corona virus will be added to other dangerous viruses carried by the bat bird. The bird had caused, years ago, the spread of viruses such as “SARS” and “MERS”, because the bat can carry different viruses without getting sick. The bat is a "reservoir for viruses" that have caused a number of diseases and epidemics in Africa, Malaysia, Bangladesh and Australia. It is not limited to the mentioned viruses, as the bat carries an "Ebola" infection, and the "rabies" virus also carries. Other mammals. It is possible that other animal pests such as rodents may be related to reservoiror transmitting the Corona virus.
47 Why to ignore alternative therapies in human population? , Shah Murad Mastoi Baloch ID 1 Seema Shah Murad ID 2 M Ismail Khoso ID 3 Tarique Ahmed Maka ID 4 Quratulain Saleem ID 5 Saleemullah Abro ID 6 Wajid Abro ID 7 Shah Murad ID 8*  
After having a meal, cholesterol is digested and absorbed in small intestine then the metabolism and storage occurred in the liver. The cholesterol may be secreted by the liver whenever the requirement of cholesterol is needed by the body. Cholesterol is not present in the food which is derived from the plants. We in this study have compared hypolipidemic effects of Fenugreek, Curcuma longa, and Lemon. Study was conducted at Jinnah Hospital Lahore-Pakistan from January 2016 to May 2016. Ninety hyperlipidemic patients of age group 19 to 70 were included in the study. Exclusion criteria were diabetic, alcoholic additives, hypertensive patients and those whose kidney or liver functions were impaired. Consent was taken from all participants. Their base line lipid profile was taken in biochemistry laboratory of the hospital.   They were divided in three groups i.e. 30 patients in each group. Group-I was advised to take 500 mg of Curcuma longa (haldi) mixed in fresh milk without cream, thrice daily for two months. Group-II patients were advised to take 100 grams of Fenugreek leaves mixed with salad in each meal (thrice daily) for the period of two months. Group-III patients were advised to take 40 ml of fresh lemon juice mixed with 40 ml mineral water thrice daily for two months. They all were advised not to take heavy meal rich with any type of fat like junk food etc. One hour daily brisk walk was advised to all participants. 15 days follow up visit was scheduled for them. After two months their lipid profile was re-determined. When results were compiled and statistically analyzed by applying paired ‘t’ test, it revealed that Curcuma longa decreased total cholesterol, TG, LDL cholesterol 16.10, 20.01, and 17.59 mg/dl respectively. Fenugreek decreased total cholesterol, TGs, and LDL cholesterol 14.70, 17.33, and 17.06 mg/dl respectively. Lemon in two months therapy decreased total cholesterol, TGs, and LDL cholesterol 15.45, 10.13, and 11.97 mg/dl respectively. None of the above mentioned herbs raised HDL cholesterol significantly. It was concluded from this research work that Curcuma longa, Fenugreek leaves and Lemon are mild to moderately effective hypolipidemic herbs to lower total plasma cholesterol, triglycerides, and LDL cholesterol but have no potential to raise HDL cholesterol when analyzed.  
48 Biomedical applications of nanoscale tools and nano-bio interface: A blueprint of physical, chemical, and biochemical cues of cell mechanotransduction machinery , Rajiv Kumar * 1  
A dream to have control over the cell behavior by nanoscale tools and nano-bio interface to mimic remodeling of cell mechanotransduction machinery, is an updated approach and the latest theme of current research.[1] To achieve such a goal, the nanofabrication technique plays a key role in designing novel nanoscale tools capable of stimulating the natural extracellular matrix (ECM).  These nano-bio tools can create a valuable nanoscale interface, and finally, these advanced tools control cell behavior. Structurally and compositionally, the cells are too complicated and well equipped with remarkable features. It has a lot of complexity in it. The initial hurdle is the natural composition of cells and the surroundings of the nanoscale. 
49 Strengthening Healthy Saudi-habits Using Ajwain (Trachyspermum ammi) Seeds by In-Vivo Experiment on Digestive-system Bacterial-quantity at High-level Region , Sherifa Mostafa M. Sabra ID 1* Samar Ahamed H. Al-Gehani ID 2 Fatimah Awwadh A. Al-Otaibi ID 3
Ajwain seeds contain 50% thymol, 7% carvacrol, 35% terpinene, 25% para-cymene, pinene, and limonene. They have anti-bacterial and anti-spasmodic effects, also founding usually in healthy Saudi-habits (called Nanakhah) with cheap-price using in different ways. The aim was to prove the health protection quality of Ajwain  it was tested at a high-level region; Taif, KSA to trace its effect on the bacterial quantity of buccal-cavity and digestive-system tract. The seeds samples were collected from original licensed stores, In-Vivo experiments were done twice daily for a week for each step. The bacterial-quantity method was by turbidity and inoculation using "Bacterial Modern Culture". The mean results of bacterial-quantity of buccal-cavity as chewing method at (before, during, and after) were (39.6, 17.5, and 4.6%). The using boiled water extract as a mouthwash was (38.8, 16.7, and 4.1%). The mean results of seeds swallowing on bacterial-quantity of digestive-system were (61.3, 32.5, and 4.5%); the mean results of using boiled water extract on bacterial-quantity of digestive-system were (61.8, 31.6, and 3.9%). It was clear that the effect of bacterial quantity was reduced by about half during the use and to the tenth after the trial period. It was concluded that its use can kill and reduce (bacterial-quantity of both buccal-cavity and digestive-system), that supporting individual health at high-level region. It was recommended that since it is very cheap and get easy, as well to use usually in healthy Saudi-habits at high-level region daily to clean the whole digestive-system that will support public health with cheap price.
50 Our experience of using Hydroxychloroquine and Azithromycin in the treatment of COVID-19: an observational study from Kinshasa, Democratic Republic of Congo , Jean-Marie N. Kayembe ID 1* Daniel Ishoso ID 2 Christian Mbongopasi ID 2 Don Jethro Mavungu ID 2 Jean René Makulo ID 2 Stéphane Mukendi ID 2 Nsengi Ntamabyaliro ID 2 R. Junior Matangila ID 2 Jean-Jacques Muyembe ID 2
Background: Up to now COVID-19 treatment is a matter of great debate. Several trials and observational studies have brought conflicting results regarding the efficacy of some repurposed drugs suggested treating COVID-19, stressing the need for further research. Objective: This study aimed to add to the existing literature, some evidence on the efficacy and safety of hydroxychloroquine (HCQ) and azithromycin (AZ) as suggested drugs for COVID-19 treatment. Materials and Methods: This observational study reports the experience of conventional treatment (CT) combining HCQ plus AZ applied in the Democratic Republic of Congo. We compared epidemiological and clinical data between 1,100 (89%) subjects submitted to the CT and 135 (11%) who did not receive the CT. Survival analyses including Kaplan-Meier and Cox regression were used to determine the clinical progress at day 10 and the survival likelihood at day 15, from the treatment initiation date.  Results: Clinical outcome is much better in the CT group on D10 than in the comparison group (p=0.001). The adverse effects reported are minor and equivalent in both groups (3% vs 3%).  Conclusion: This preliminary observational study suggests a beneficial and safe effect of conventional treatment in our country and justifies the continuation of this therapeutic protocol at this time. However, larger analytical studies with more robust evaluation criteria are needed to strengthen the power of observations.
51 Medical teaching professionalization: quality of training , Claribel Plain Pazos ID 1* Odalis Ruíz Pérez ID 2 Isabel Julia Veitía Orrieta ID 2 Carmen Rosa Carmona Pentón ID 1 Elsa Núñez Escobar ID 3 Anisbel Pérez de Alejo Plain ID 4
University teaching professionalization is a necessity in modern society. The scientific and technical revolution that has been taking place in the world demands a different preparation for teachers. Modern universities need professors adapted to these new times. The professionalization of teachers today constitutes a challenge as well as a social commitment.
52 Prostasomes (Exosomes) Mediate Functional Abilities to Recipient Cells through Transfer of Proteins and Nucleic Acids: A Comprehensive Model for Exosomal Intercellular Communication , Gunnar Ronquist ID 1* Anders Waldenström ID 2
The prostasome is the first described exosome and constitutes the third communication system between cells mediating messages besides gap junctions and soluble compounds such as hormones. Exosomes are nanometer vesicles surrounded by a lipid bilayered membrane and released by most cell types including malignant cells. The exosomal messenger system reaches distant cells even on the other side of the blood brain barrier. In this way they are able to interact with their target cells for delivery of their cargo.  We here describe prostasomal properties in more detail thus exemplifying common exosomal characteristics. Myocardial derived exosomes (cardiosomes), are also described in order to highlight other common biological functions including damaged tissue, i.e. tissue repair. Abnormal tissue such as malignant progression can be driven by cancer cell derived exosomes, believed mainly to be mediated by different forms of short RNAs exerting their action through specific signaling pathways related to metastases, therapeutic resistance and immunosuppression.
53 A Decrease in the Increased Marker of Tissue Hypoxia Pco2> (Av-Gap) in Microcirculatory-Mitochondrial Distress Syndrome in Critical Obstetrics is Achieved by Complex Methods of Recruiting Microcircula , Vasiliev Ilie* ID 1,3,4 Vasilieva Maria ID 1,2 Vasilieva Irina ID 1,2
A retrospective analysis of the 40-year absence of maternal mortality in critical obstetric, in different countries, was due to the timely decentralization of macro-circulation through the recruitment of the microcirculatory-mitochondrial, in the space: capillaries - cell - mitochondria; detoxification; and adequate analgesia.
54 Contraception in Adolescence: Social Necessity , Claribel Plain Pazos ID 1* Carmen Rosa Carmona Pentón ID 1 Anisbel Pérez de Alejo Plain ID 2 Yiset Menéndez Pedraja ID 3 Lilian Ibonne Sosa Martínez ID 1 Lianet Corne Sosa ID 4
Teenage pregnancy is a global health problem. The beginning of sexual life at an earlier age has an impact on the increase in sexually transmitted diseases, unwanted pregnancies, and the number of single mothers. Each year approximately 2 million adolescents under the age of 15 become pregnant and an estimated 16 million girls between the ages of 15 and 19 give birth, 95% of these births occur in developing countries. Adolescent births as a percentage of all births range from around 2% in China to 18% in Latin America and the Caribbean. The global rate of adolescent pregnancy is estimated at 46 births for every 1,000 girls and of the same Thus, the rate for Latin America corresponds to 66.5 births per 1,000 girls between the ages of 15 and 19, ranking second worldwide, only surpassed by Sub-Saharan Africa. Furthermore, complications during pregnancy and childbirth are the second leading cause of death among women 15-19 years of age worldwide.  
55 Erdheim-Chester Disease: Case Report with Aggressive Multiple Organ Manifestations ,  Luís Teles M.D 1* Bernardo Macedo M.D 2 António Marinho M.D. PhD 3  
Erdheim-Chester disease (ECD) is a rare non-Langerhans cell, lipid-laden histiocytosis with specific histological and radiological findings. The diagnosis sometimes is established lately in the course of the disease. We present a case of a 64-year-old female with elevated inflammatory markers for one year and symptoms related with her comorbidities, particularly bone pain and short of breath. Past medical history includes a stage III chronic kidney disease, central diabetes diagnosed when she was 38 years old, Paget Disease, metabolic syndrome and ischemic cardiopathy. Computed tomography in the near past showed a tissue densification in the thoracic vertebral column and kidneys with hairy aspect. X-ray of the arms, legs, skullcap, and demonstrated sclerotic changes. F-fluorodeoxyglucose positron emission tomography showed uptake in the skull, mediastinum, abdomen and long bones from arms and legs. Biopsy of the hairy kidney was consent after 4 years of an unknown disease in progression. Histological findings of the biopsy reported a diffuse infiltration by foamy histiocytes. On immunohistochemical staining, the histiocytes were positive for CD68 and negative for CD1 and S100. Mutation of BRAF V600E was present and ECD was established. Tocilizumab was initiated off label due to psychiatric contra indication for interferon use and no clinical conditions for BRAF inhibitors and symptoms started being controlled. The diagnosis of ECD is usually challenging due to the rarity of the disease and clinical overlapping with many other conditions. The rarity and variable presentation of this disease usually leads to delayed diagnosis and to high morbidity and mortality rates from associated complications.  
56 The Evolving Demand for Negative Pressure Isolation Facilities during COVID 19: Trial of the Negative Pressure Isolation Tent , Fatimah Lateef FRCS (A&E) MBBS FAMS (Em Med) 1* Sunny Chia S H 2 Alan Teo H B 3 Tan Teck Choon 4  
With COVID 19, more than ever before, healthcare institutions are realizing the need to develop, implement, assess, review and revise their infection control policies and guidelines of practice. In many facilities, patients who are known to be or suspected to be infectious are physically isolated from other patients and people. This is the rightful and ethical thing to do. These patients are usually identified through surveillance or using clinical and/ or microbiological criteria. Whilst practices such as personal and hand hygiene,  safe infection control practices, distancing and others are useful, the use of formal isolation in hospitals represent an important step. This is also essential to reduce spread to healthcare workers. In this paper, we describe a Negative Pressure Full Isolation Tent (NPFIT) which we tried out via simulation and the conduct of a simple smoke test to understand more on the concept of negative pressure and what it entails. It is our hope that readers will get a better understanding of this concept, through our simplified demonstration and trial.  
57 Coronavirus Is A Biological Warfare Weapon , Robert Skopec
Dr. Francis Boyle, who drafted the Biological Weapons Act has given a detailed statement admitting that the 2019 Wuhan Coronavirus is an offensive Biological Warfare Weapon and that the World Health Organization (WHO) already knows about it. Francis Boyle is a professor of international law at the University of Illinois College of Law. He drafted the U.S. domestic implementing legislation for the Biological Weapons Convention, known as the Biological Weapons Anti-Terrorism Act of 1989, that was approved unanimously by both Houses of the U.S. Congress and signed into law by President George H.W. Bush.
58 Zinc (?)-immune pediatric virucidal activities for 2019-nCoV prevention and therapeutic effects of COVID-19 bronchitis and pneumonia, Sci. Tsuneo Ishida
Zinc (Ⅱ)-immune pediatric virucidal activities for children with 2019-nCoV prevention and COVID-19 bronchitis and pneumonia are discussed, and these Zn2+-immune pediatric virucidal effects result in the following. Zinc intakes by zinc induced immunity are required 3 mg/day for 7 month to 3 years, 5 mg/day for 4～ 8 years, and 8 mg/day for 9 ～13 years in children. Zinc supplementation have been assessed, from 15 mg to 140 mg/week, with the upper range exceeding the recommended daily infection (RDI) for children of 2 mg/day for children less than one year of age and up to 7 mg/day for children between 1 to 3 years. Zinc induced pediatric preventing respiratory 2019-nCoV is required that supplementation with zinc gluconate 20 mg in Zn deficient children resulted in a nearly twofold reduction of acute lower respiratory infections as well as the time to recovery.  Zinc supplementation in children is associated with a reduction in the incidence and prevalence of pneumonia. Preventing 2019-nCoV pneumonia is required that zinc supplementation alone (10 to 20 mg) for more than 3 months significantly reduces in the rate of pneumonia. Prophylactic zinc supplementation for two weeks may reduce the morbidity due to acute lower respiratory infections.  Zinc gluconate supplement may result in significant reduction in respiratory morbidity among children with acute lower respiratory infections.  In addition. as serum zinc level of Acute Respiratory Infection (ARI)-children was very low, higher zinc concentration treatments as low sociodemographic factors, poor nutritional status and male children were prevalently associated with higher incidence of acute respiratory infections. Adjuvant treatment with 20 mg zinc/day accelerates recovery from severe pneumonia in children.  Primary outcome was recovery from pneumonia and 30 mg/day of zinc supplementation reduces pneumonia in children with chronic kidney disease (CKD).  Zinc supplementation + Chloroquine (CQ)/hydroxychloroquine (HCQ) may be more effective in reducing COVID-19 morbidity and mortality than CQ or HCQ in monotherapy.  The serum zinc level returned to a normal level (median, 53.20 μmol/L) on day 12±2 in the treatment. There was no statistical difference in the pediatric critic illness score, lung injury score, length of hospital stay, and duration of mechanical ventilation between the zinc treatments. The oxidative stress in pediatric diseases causes an oxidative burst that results in a respiratory burst and rapid ROS production. Thus, zinc pediatric intake may be required to be effective range 10～20 mg/d for 2019-CoV prevention, 10～30 mg/d for reduction of COVID-19 bronchitis, and 20～30 mg/d for recovery from COVID-19 pneumonia, in which Zn2+ could bind with viral surface proteins by Zn2+ions-centered tetrahedrally coordination pattern.  
59 On the Enterprise Dynamic Management in the COVID-19 Pandemic ,    Weihua Zhao 1 Jinming Cao 2 Bin Zhao 3*  
Background: With the worldwide spread of the novel coronavirus (COVID-19), the global economy has entered a cold winter, and the International Monetary Fund predicts that the global economy will shrink by about 3% in 2020. The outbreak of the epidemic has also caused heavy losses to the Chinese economy. In the first quarter of 2020, actual GDP fell sharply for the first time by 6.8% year-on-year for the first time. This is the first decline since record. Then, according to the data from the business survey in March, China's economy has improved compared with February, which shows that the economy has rebounded under the influence of policies. Judging from the current situation, although China has passed the peak period of the epidemic, affected by the high cases abroad, it can only be carried out slowly for the resumption of production. Enterprises, as micro-individuals under the macro economy, need to pass through analyzing the dynamic management of the enterprise to deepen the reform of the commercial system and stimulate the vitality of the enterprise. This will also provide data support for the government formulating relevant policies, which is conducive to the synergy of various policies and enhance the momentum of economic recovery. On the other hand, we choose tourism as our specific research object. Thus, we need to set different scenarios according to the development situation of the epidemic, evaluate the impact of the novel coronavirus epidemic on China's tourism industry, and discuss tourism development and opportunities in the post-epidemic era from the aspects of tourism's response to the epidemic and the development trend of the tourism after the epidemic4. Methods:  This dissertation first discusses the issue of enterprise dynamic management in the post covid-19 epidemic era, establishes the Difference-in-Difference model (DID model), and improves the model reasonably. It puts forward the dynamic management plan of different regions, and judges the effect of the policy on the implementation of the epidemic. At the same time, it also aims at the impact of the epidemic on the tourism industry at the important time points. The elasticity method and linear regression are used to evaluate and forecast. Using transportation data as a leading indicator, the elasticity of the total number of tourists Et1 and the elasticity of total tourism revenue Ei1 during the Spring Festival and Spring Festival are calculated to be 1.39 and 1.60 respectively. The impact of COVID-19 on the Spring Festival tourism market is evaluated through the Spring Festival elasticity; During the period, the elasticity of the International Workers’ Day tourism market relative to the Spring Festival tourism market Et2 、Ei2 is calculated to be 1.14 and 0.9024 respectively through data over the years. Combining the forecast results of the Spring Festival tourism market and the data calibration of different forecast scenarios, the International Workers’ Day is predicted. The total number of tourist trips and total tourism revenue during the period; for the National Holiday, the above ideas are used to calculate the elasticity of the National Holiday tourism market relative to the Spring Festival and International Workers’ Daytourism markets Et3 、 Ei3, which are 0.69 and 0.94, respectively, predicting the total number of tourists and total tourism revenue during the National Holiday period. Findings:  The results based on DID model analysis show that the significance level of the policy to the GDP of Jiangsu Province is 32%. The saliency level in Hubei province is 37%. In the first quarter of the year 2020, the total travel time and total tourism revenue of the first quarter of the year 2020 are predicted, and the logarithmic linear regression equation is established based on the total tourist arrivals and the total tourism revenue in the year 2020 as the explanatory variables of total tourism trips and total tourism revenue in the first quarter. The total number of tourist trips in the first quarter of the year 2020 is 394 million, a decrease of 74.42% over the same period last year, and the total value of tourism revenue is 319 billion 565 million yuan, a decrease of 77.01% over the same period last year. The counter-factual prediction value of the total number of tourists in the first quarter of the year 2020 is 1 billion 676 million, and the counter-factual prediction value of the total tourism revenue is 1 trillion and 580 billion yuan. During the first half of the year 2020, the total number of tourists and the total tourism revenue in the first half of the year are predicted. The total number of tourists in the first quarter and the International Workers’ Day is used as the explanatory variables of the total travel time in the first half of the year. Logarithmic linear regression equations are established respectively and replaced by the estimated values. The predicted value of the total tourist arrivals in the first half of the year 2020 is 1 billion 440 million, which is 53.25% lower than that in the same period last year. The forecast value of total tourism revenue is 1 trillion and 165 billion 98 million yuan, with a decrease of 58.09%. Compared with the same period last year, the potential decline of the total number of tourists in the first half of the year 2020 is 1 billion 911 million, with a decrease of 57.03%, resulting in a potential loss of 1 trillion and 994 billion 902 million yuan and a loss ratio of 63.13% for tourism total revenue. Under the optimistic forecast, the total number of tourist trips in the year 2020 is 4 billion 659 million. A decrease of 23.12% compared with the same period last year, and the total value of tourism revenue is 4 trillion and 807 billion 295 million yuan, 26.27% lower than that of the same period last year. Under the prudent forecast, the total number of tourist trips in the year 2020 is 3 billion 941 million, a decrease of 34.97% over the same period last year, and the total value of tourism revenue is 3 trillion and 922 billion 883 million yuan, a decrease of 39.83%, over the same period of the last year. Interpretation:  China's economy has been affected by the epidemic to varying degrees in all sectors, especially in the tertiary sector. And because the outbreak situation in China did not look good in the first quarter of 2020, almost all companies made a loss in the first quarter of 2020. To address the economic downturn, the Chinese government has taken various measures, such as issuing coupons to stimulate consumption, discounting promotions, etc. And as the domestic epidemic situation in China continues to improve, more and more companies have resumed normal operations in the last two months. It is believed that in the near future, China's economic situation will be significantly better than in the first quarter.  
60 Poor COVID 19 Pandemic Waste Management Outcome in Nigeria: A Possible Potential Public Health Threat and Promoter of Community Transmission , Azuonwu Obioma 1* Ahiakwo Christian 2 Egba Promise Chijioke 1  
Introduction The COVID-19 pandemic outcome which is an emerging infectious disease that potentially originated from Wuhan in China has seen an upsurge of cases and deaths globally over time. One of the consequences found in the course of the management of these viral pandemic involves the massive production and usage of different myriad of medical supplies to meet up the increasing demands by health workers, patients and the public. This trend has resulted in the proliferation of medical wastes against a backdrop of poor waste management outcome especially in Nigeria. Aim The aim of this article borders on bringing to light the effects of improperly managed medical wastes, and the risks it poses to human health and the environment at large. Furthermore also, to outline various types of medical wastes and the guidelines associated with their disposal, especially those associated with management of COVID-19 pandemic saga. Method/Methodology The study approach follows the systematic review of peer-reviewed published articles as well as online publications and articles derived from various databases with search keywords relevant to the topic of discourse. Findings and Results Findings from this study show that the coronavirus disease of 2019 has spread widely globally with massive socio-economic and socio-cultural consequences. Over time there has been a progressive increase in cases and deaths due to Covid-19 in Nigeria and most other countries. The management of COVID-19 pandemic has resulted in the proliferation of medical wastes.  Medical wastes are those generated from the use of medical supplies in the course of healthcare delivery and disease prevention such as hand gloves, facemasks, and hazmat suits etc. Medical wastes legislations that support the proper disposal of medical wastes in Nigeria and most other developing nations have been very weak and have failed to achieve the desired results, with high incidences of infectious diseases such as HIV and Hepatitis still being transmitted through improperly disposed of wastes. Therefore improperly waste disposal may probably serve as a very potent means of community transmission of COVID-19 transmission, if not handled in good time especially the freshly disposed materials Conclusion and Recommendation While the generation of massive wastes is being seen in this COVID-19 pandemic period, it may be unavoidable that there could be re-infection of subjects from improper medical waste disposal strategies. Thus, it is pertinent that relevant regulations are put in place, enforced and monitored to ensure that improperly managed wastes do not form another avenue for widespread of the virus in our communities. It is also very necessary to organize massive campaigns aimed at creating enough public awareness of the risks associated with medical wastes and on the need for proper disposal especially COVID 19 associated waste materials.  
61 Tripartite Mechanism of Neural Memory: Proof-of-Concept with Neuromimetic Impedence Electrodes , Gerard Marx 1* Chaim Gilon   
The idea that neural signaling is the basis of mental processes has a long history. We graphically summarize salient developments in the neurobiology of signaling, as a Timeline. In particular, we review the “tripartite mechanism” of neural memory, which centers on the interactions between a neuron with its surrounding extracellular matrix (nECM) doped with metals and neurotransmitters (NTs). Essentially, the neuron employs the nECM as its “memory material”, wherein it uses dopants to encode cognitive units of information (termed “cuinfo”). The NTs, which elicit bodily reactions (feelings), also encode past feelings as emotions, which “color” mental states in real-time and in memory. In the interest of developing experimental tests of the tripartite mechanism, impedance glass electrodes were covalently coated with an exemplar NT (oxytocin) or a sulfated tetra-saccharide analog of the nECM, were constructed and tested. The two types of coated, neuro-mimetic electrodes, termed “neulectrodes”, were capable of detecting metals, such as Hg+2, Pb+2, Cd+2, Cu+2, and Zn+2 with very high selectivity and sensitivity. The “neulectrodes” demonstrated that the chemodynamic interactions of metal cations with NTs or nECM-saccharide analogues can translate into electrodynamic signals. They experimentally validate the concept of the tripartite mechanism that underlies the chemo-electric encoding of neural memory.  
62 Modelling for prediction of the spread and severity of COVID-19 and its association with socioeconomic factors and virus types , Shreshth Tuli 1 Shikhar Tuli 2 Ruchi Verma 3 Rakesh Tuli 4*  
We report the development of a Weibull based Long-Short-Term-Memory approach (W-LSTM) for the prediction of COVID-19 disease. The W-LSTM model developed in this study, performs better in terms of MSE, R2 and MAPE, as compared to the previously published models, including ARIMA, LSTM and their variations. Using W-LSTM model, we have predicted the beginning and end of the current cycle of COVID-19 in several countries.  Performance of the model was validated as satisfactory in 82% of the 50 test countries, while asking for prediction for 10 days beyond the period of training. Accuracy of the above prediction with days beyond training was assessed in comparison with the MAPE that the model gave with cumulative global data. The model was applied to study correlation between the growth of infection and deaths, and a number of effectors that may influence the epidemic. The model identified age groups, trade with China, air traffic, country temperature and CoV-2 virus types as the likely effectors of infection and virulence leading to deaths. The predictors likely to promote or suppress the epidemic were identified. Some of the predictors had significant effect on the shape parameters of Weibull distribution. The model has been deployed on cloud, taking inputs in real time to handle large data country wise, at low costs and make predictions dynamically. Such predictions are highly valuable in guiding policy makers, administration and health. Interactive prediction curves generated from the W-LSTM model deployed on cloud platform can be seen at http://collaboration.coraltele.com/covid2/ (updated daily). Abbreviations: ML: Machine Learning; SARS-CoV-2: Severe Acute Respiratory Syndrome Coronavirus 2; COVID-19: Coronavirus disease  
63 COVID-19 Pneumonia: A Review of Typical Ct Findings and Differential Diagnosis , Klaus Irion MD, Ph.D 1 Ali Nawaz Khan, MBBS, MRCS, FRCR, FRCP 1 Anthony Kodzo-Grey Venyo. MB, ChB, FRCS2 2  
Pneumonia that is caused by the 2019 novel coronavirus (SARS-CoV-2, which is also referred to as 2019-nCoV recently did break out in Wuhan China has been coined the terminology of COVID-19. With the spread of the disease, similar cases of COVID-19 had been confirmed in various regions of the world. Because COVID-19 is a relatively new global disease, clinicians, and patients across the globe would initially not be conversant with the clinical features and radiology imaging characteristics of SARS-CoV-2 pneumonia. The causes of pneumonia are protein, many secondary to an underlying cardiorespiratory abnormality while some are related systemic disease. Various imaging techniques generally diagnose cases of Pneumonia. In the current climate, COVID-19 Pneumonia has taken center stage; confirmation relies upon microbiological studies such as real-time polymerase chain reaction or sequencing. These investigations are not usually available in an emergency setting. Computed Tomography (CT) can be used as an essential complement for the diagnosis of COVID-19 Pneumonia in the current epidemic context. But the later may be misleading as other cases of Pneumonia, and interstitial lung disease can easily be confused with COVID-19 Pneumonia. Also, Covid19 Pneumonia may be missed if not considered. The attention of clinicians should be alerted to the possibility of COVID-19 to conduct the appropriate tests to confirm or negate the diagnosis of COVID-19. In asymptomatic as well as in symptomatic patients that have COVID1-9 pneumonia, the initial COVID-19 nuclei acid test results could be normal, which upon subsequent repeat testing would become normal. Still, radiology imaging using a CT scan of thorax would tend to demonstrate various non-specific features that affect a variable number of lobes of the lungs, and these features quickly increase in size when a repeat CT scan of the thorax is undertaken. These findings tend to predate positive COVID-19 test results in some cases of COVID-19. The non-specific changes tend to resolve when the patient resolves from COVID-19 pneumonia. A catalog of radiology images that demonstrate various types of cardio-pulmonary lesions which when encountered by clinicians should alert them to exclude the possibility of COVID-19 Pneumonia has been included in the paper as an aid to alerting clinicians to have a high index of suspicion of radiology images of the thorax which should help them to quickly undertake appropriate tests to confirm or negate the diagnosis of COVID-19 pulmonary infection.
64 COVID-19 Pneumonia: A Review of Typical Ct Findings and Differential Diagnosis , Klaus Irion MD, Ph.D 1 Ali Nawaz Khan, MBBS, MRCS, FRCR, FRCP 1 Anthony Kodzo-Grey Venyo. MB, ChB, FRCS2 2  
Pneumonia that is caused by the 2019 novel coronavirus (SARS-CoV-2, which is also referred to as 2019-nCoV recently did break out in Wuhan China has been coined the terminology of COVID-19. With the spread of the disease, similar cases of COVID-19 had been confirmed in various regions of the world. Because COVID-19 is a relatively new global disease, clinicians, and patients across the globe would initially not be conversant with the clinical features and radiology imaging characteristics of SARS-CoV-2 pneumonia. The causes of pneumonia are protein, many secondary to an underlying cardiorespiratory abnormality while some are related systemic disease. Various imaging techniques generally diagnose cases of Pneumonia. In the current climate, COVID-19 Pneumonia has taken center stage; confirmation relies upon microbiological studies such as real-time polymerase chain reaction or sequencing. These investigations are not usually available in an emergency setting. Computed Tomography (CT) can be used as an essential complement for the diagnosis of COVID-19 Pneumonia in the current epidemic context. But the later may be misleading as other cases of Pneumonia, and interstitial lung disease can easily be confused with COVID-19 Pneumonia. Also, Covid19 Pneumonia may be missed if not considered. The attention of clinicians should be alerted to the possibility of COVID-19 to conduct the appropriate tests to confirm or negate the diagnosis of COVID-19. In asymptomatic as well as in symptomatic patients that have COVID1-9 pneumonia, the initial COVID-19 nuclei acid test results could be normal, which upon subsequent repeat testing would become normal. Still, radiology imaging using a CT scan of thorax would tend to demonstrate various non-specific features that affect a variable number of lobes of the lungs, and these features quickly increase in size when a repeat CT scan of the thorax is undertaken. These findings tend to predate positive COVID-19 test results in some cases of COVID-19. The non-specific changes tend to resolve when the patient resolves from COVID-19 pneumonia. A catalog of radiology images that demonstrate various types of cardio-pulmonary lesions which when encountered by clinicians should alert them to exclude the possibility of COVID-19 Pneumonia has been included in the paper as an aid to alerting clinicians to have a high index of suspicion of radiology images of the thorax which should help them to quickly undertake appropriate tests to confirm or negate the diagnosis of COVID-19 pulmonary infection.
65 Effect of aluminum oxide powder reinforcement on degree of conversion, monomer release and flexural strength of heat-cured acrylic resin , Ibrahim M. Hamouda 1* Alaa Makke 2  
Objectives: Effect and correlation of aluminum oxide powder on degree of conversion, residual monomer and flexural properties of heat-cured acrylic resin specimens were studied. Materials and methods: Heat-cured acrylic resin and aluminum oxide powders were used. Specimens of specific dimensions from unreinforced and reinforced acrylic resins using stainless steel plates were prepared. Degree of conversion was determined using FTIR Spectrometer. Released monomer was measured using isocratic high-performance liquid chromatography. Flexural strength was tested using three point-bending test.     Results: Aluminum oxide reinforcement showed increased degree of conversion than that of the unreinforced specimens. Released monomer from reinforced specimens was lower than that of unreinforced specimens. Deflection at fracture of reinforced specimens was lower than that of unreinforced specimens. Flexural strength was increased by addition of 2.5 % and 5% aluminum oxide. There was a positive correlation between degree of conversion and flexural strength. There was a negative correlation between degree of conversion and monomer release. Conclusions: Aluminum oxide powder increased degree of conversion and flexural strength but reduced monomer release and deflection at fracture. There was a positive correlation between degree of conversion and flexural strength. There was a negative correlation between degree of conversion and monomer release. Clinical relevance: Aluminum oxide powder could reinforce the week acrylic resin denture base materials. Degree of monomer conversion during processing of acrylic resin denture base materials is very critical in determination of monomer release and mechanical properties of acrylic resin in service.  
66 Albizia lebbeck Stem Bark Aqueous Extract as Alternative to Antibiotic Feed Additives in Broiler Chicks Diets: Haematology, Serum Indices and Oxidative Status , Alagbe, J.O 1* Ajagbe A.D 2 Attama Jeremiah 3 Philemon K.C 4 Kamoru. A 5  
A total of Three hundred and seventy five (375) one day old (Ross 308) broiler chicks with mixed sex were used to examine the effects of Albizia lebbeck stem bark (ATSM) aqueous extract as alternative to antibiotic feed additives in broiler chicks diets: haematology, serum biochemical indices and oxidative status. Birds were divided to five treatments with five replicates of fifteen (15) birds in a completely randomized design. Treatment 1 (basal diet + 0 % ATSM), treatment 2 (basal diet +1.2 grams Oxytetracycline per litre of water), treatment 3 (basal diet + 10 ml ATSM per liter of water), treatment 4 (basal diet + 20 ml ATSM per litre of water) and treatment 5 (basal diet + 30 ml ATSM per liter of water) and the trial lasted for 56 days. Results on some haematological parameters revealed that red blood cell (RBC), pack cell volume (PCV), haemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), white blood cell (WBC) and its differentials were significantly ((P<0.05) different among the treatments. Total protein, glucose, urea, cholesterol, creatinine, aspartate aminotransaminase (AST) and alanine aminotransferase (ALT) were significantly ((P<0.05) affected by ATSM. Activities of superoxide dismutase (SDA), glutathione peroxidase (GPx), catalase (CAT) and malonyldialdehyde (MLA) were significantly influenced by ATSM (P<0.05). It was concluded that ATSM could be administered to broiler chicks at 30 ml/litre without any negative effect on the general performance of birds.
67 Etiology and Clinical Features of Acute Flaccid Paralysis among Children in Gadarif, Sudan , Mohammed Ahmed A. Ahmed MD 1* Kamal Omer Abdalla PhD 1 Samia O. Masaad PhD 1 Yassir Fadl Abubakar PhD 1 Amar Mohammed Mahjoub MD 2  
Acute Flaccid Paralysis (AFP) is a rare but a serious neurological condition characterized by sudden weakness or paralysis of one or more extremities, the respiratory or bulbar muscles and reduced muscle tone without other obvious cause. Death occurs in about 7.5% of AFP affected patients worldwide. AFP is the most common sign of acute polio. Therefore, AFP studies are important for surveillance during polio outbreaks to differentiate polio cases from AFP cases. There is a lack of information about the clinical features & causative factors of AFP among children in Gadarif, Sudan. The identification of AFP cases and its causative factors are important in the management & prevention of the disease. This study assessed the etiology and the clinical features of AFP among children in Gadarif, Sudan aiming at effective management & prevention of the disease. It was a prospective cross sectional study conducted at Gadarif Pediatrics Teaching Hospital during the period of January 2017-December 2019. It comprised 73 children with confirmed AFP, ages 6 months to < 15 years old. Our study revealed that Poliomyelitis was not the cause of AFP. AFP was significantly affected children with youngest ages 0-5 years old and from the rural areas. Guillain-Barré syndrome (GBS) was the leading cause of AFP followed by meningitis, traumatic neuritis and hypokalemia and we believed that infections were the main triggers of GBS. Gender did not affect the prevalence of the AFP. Fever and paraplegia were the most prevalent clinical signs at onset of the weakness. Over 50% of the AFP victims showed symmetric paralysis. It is obviously that AFP-based awareness, provision of high-quality health services and fighting of illiteracy and poverty in the rural areas of Sudan are urgently needed for effective management of AFP.  
68 Reprint-The Effect of Bone Marrow Derived Mesenchymal Stem Cells on the Survival of Random Skin Flap on Sterptozotocin-Induced Diabetic Rats ,                                                          Khadijah Rezazadeh 1 Farzaneh Chehelcheraghi 2* Khatereh Anbari 3  
Background and Objective: Wound dressing and healing in diabetic patients is encountered with many problems. This study aimed to investigate the effect of bone marrow derived mesenchymal stem cells (BM-MSCs) on the survival of random skin flap (RSF) on Streptozotocin-induced diabetic rats (STZ) using an optical microscope. Materials & Methods: In this study, 60 male Albino Wistar rats were used (average weight 250-300 gr). The rats were divided into six groups: 1) Health-Non (HN), 2) Health-Cells (HC), 3) Health-Sham (HS), 4) Diabetic-Non (DN) that were became diabetic by injecting STZ 70 mg/kg intraperitoneally), 5) Diabetic-Sham (DS), and 6) Diabetic-Cell (DC). In all groups, the day of surgery was considered as the zero day, on the back area of animal, the flap was created with a size of 8 × 3 cm and the BM-MSCs were performed. The sampling was performed on day 7 after surgery from the region where Transitional Zone (TZ) necrosis was initiated. Results: BM-MSCs increased the number of blood vessels (P=0.009) and the histology parameters (wound demarcation P=0.0001, granulation tissue P=0.0001) significantly compared to the control group. But this increase was not significant in the area of the survival region. Conclusion: It was concluded that after treatment with BM-MSCs, the wound healing process in both non-diabetic and diabetic groups was increased in accordance with histological characteristics.  
69 Growth Performance, Caeca Microbial Population and Immune Response of Starter Broiler Chicks Fed Aqueous Extract of Balanites Aegyptiaca and Alchornea Cordifolia Stem Bark Mixture , Musa bashir 1* John O. Alagbe 2 Adegbite Motunrade Betty 3 Omokore, E.A 2  
A total of Two hundred and fifty (250), 1-day old (Cobb) broiler chicks with mixed sex were used to evaluate  the the growth performance, caeca microbial population and immune response of starter broiler chicks fed aqueous extract of Balanites aegyptiaca and Alchornea cordifolia stem bark mixture (BACM). Birds were reared on a deep litter system and randomly divided into five treatment with five replicates consisting of 10 birds each in a completely randomized design. Treatment 1 (T1) were given basal diet + 0 % BACM, T2, T3, T4 and T5 were fed 20, 40, 60 and 80 ml/liter BACM respectively. The experiment lasted for 28 during which clean feed and water were offered ad libitum. The results obtained revealed that the average weight gain (AWG), feed conversion ratio (FCR) and mortality were influenced by the dietary treatments (P<0.05). Birds in T5 had the highest AWG and FCR  (1159.3 g, 1.57) followed by T4 (1070.2 g, 1.70), T3 (1047.4 g, 1.74), T2 (981.1 g, 1.86) and T1 (850.7 g, 2.14) respectively. Activities of superoxide dismutase (SDA), glutathione peroxidase (GPx), catalase (CAT) ,malonyldialdehyde (MLA) and antibody titres against Newcastle and gumboro disease were significantly affected by BACM (P<0.05). Caeca microbial population of Escherichia coli and Lactobacilli were significantly different among the treatments (P<0.05). E. coli count in T1 were higher compared to other treatments (P<0.05), Lactobacilli population increased in T2, T3, T4 and T5 compared to T1. It was concluded that BACM can be fed to broiler chicks at 80 ml/litre without any negetive effect on the performance and immune response of birds.
70 Challenges of Pediatric Multisystem Inflammatory Syndrome Associated with Covid-19 - A Series of Clinical Cases , Ninel Revenco 1* Silvia Foca 2 Ala Jivalcovschi 3 Larisa Ziaev 1 Tatiana Turea 1 Dina Bujor 1 Ana-Mihaela Balanuța 1 Ludmila Serbenco 1 Irina Vasilieva 3 Maria Vasilieva 3 Ilie Vasiliev 3  
According to the first SARS-CoV-2 pandemic data, signs and symptoms were less frequently reported among pediatric patients versus adults. Later in April, was described as the multisystem inflammatory syndrome in children (MIS-C) associated with COVID -19. The clinical presentation of MIS-C includes fever, simultaneous involvement of two or more organ systems, altered inflammation parameters and laboratory or epidemiological evidence of SARS-CoV-2 infection. MIS-C features some similar clinical aspects with Kawasaki disease, toxic shock syndrome, and secondary hemophagocytic lymph histiocytosis syndrome / macrophage activation syndrome. This review describes the clinical features of 7 cases of MIS-C treated in the Republic of Moldova.  
71 Differential expression of apoptosis related genes in the peripheral blood mononuclear cells of acute lymphoblastic/lymphocytic leukemia (ALL) patients , Samad Farashi Bonab 1* Maryam Mirakhori 2  
Apoptosis is the cell’s intrinsic death program which plays a crucial role in the regulation of many normal physiological processes in the body’s tissues. In leukemia patients, the extent of cancer cell susceptibility to apoptosis is correlated with clinical responses to chemotherapy and disease prognosis. The aim of this study was evaluation of the expression of apoptosis related genes in the peripheral blood mononuclear cells (PBMCs) of acute lymphoblastic/lymphocytic leukemia (ALL) patients. Peripheral blood samples were obtained from 20 patients with ALL and 20 healthy individuals. PBMCs were isolated using Ficoll-Paque density gradient centrifugation method. After RNA extraction and cDNA synthesis, gene expression levels of apoptosis related genes including caspase-3, 8, 9, BAX, and BAK genes were measured by real-time RT-PCR technique. Gene expression analysis showed that the expression levels of the initiator caspases-8 and -9 are increased in the PBMCs of adult ALL patients when compared with that in PBMCs of healthy individuals. Increased gene expression levels of the proapoptotic protein BAK was also detected in PBMCs of ALL patients. In contrast, decreased expression levels of the proapoptotic BAX and the executioner caspase-3 were observed in the PBMCs of ALL patients. These results suggest that the expression of genes involved in both extrinsic and intrinsic signaling pathways of apoptosis are induced in PBMCs of ALL patients while the gene expression of other proapoptotic molecule, BAK, and the executioner caspase-3 diminished in PBMCs cells of ALL patients. This findings indicate that resistance to apoptosis may be one of the hallmarks of ALL cells.  
72 Debate on the Effectiveness of Hydroxychloroquine for Treatment of Coronavirus Disease 2019 (COVID-19) , Muhammad Ishaq Ghauri MBBS, FCPS, FRCP 1 Muhammad Shariq Mukarram MBBS, MRCP 1* Jibran Sualeh Muhammad MBBS, PhD 2  
The recent outbreak of Coronavirus disease (COVID-19) caused by novel SARS-CoV-2 has raised global health concerns putting many lives at stake. Such condition calls for an urgent demand for effective, available and affordable drugs to control the viral illness. Several different therapies are under study and no definite treatment has yet been approved. Hydroxychloroquine, an antimalarial agent with immunomodulatory and anti-viral properties, remains the hot topic of discussion. The drug has demonstrated potent in vitro activity against SARS-CoV-2. This article presents a review of published literature from the year 2020 (Jan-Apr). This aimed article aimed to review the effectiveness of Hydroxychloroquine in treating patients with COVID-19. Based on the available literature, we recommend the use of this agent in treating patients with active SARS-CoV-2 infection.
73 Full-thickness skin grafts (FTSG) with a new technique , Raphael Staubach M.D 1* Glosse H 1 Fennell S 1 A. Tripp 1 U. Mehlig 1  
Introduction: Full-thickness skin grafts (FTSG) have long been an indispensable and frequently practiced standard procedure in plastic surgery. The defatting and thinning of the grafts with scissors or scalpel to a thickness of 0,8 – 1,2 mm is very time-consuming even for experienced surgeons in the case of large transplants. Devices for full-thickness skin graft defatting are not available on the market. For this reason, we developed a relatively simple device that enables complete and safe degreasing and thinning of the graft in the shortest possible time.  Materials and Methods: The machine has a dimension of 38cm width, 24cm length, 23cm height. The cutting thickness can be set to 0.6mm, 0.8mm, and 1.0mm. The central part is a crimper run manually with a crank to guide the specimen through a cutting blade. The machine is made of stainless steel, can be completely disassembled, and is easy to sterilize.  Results: With this device small and very large skin grafts up to 15 cm in width can get completely defatted within a few seconds.  Discussion: The time for defatting is reduced by many times. Precious operating time is spared. It can be assumed that the healing of the graft is improved due to a more complete defatting, a much shorter manipulating time of the skin and a more even cut surface compared to the manual procedure. The risk of defects in the graft and of injury of the surgeon is minimized compared to manual preparation.
74 Standardized Plant Immunomodulator Increases the Effect of MEK and BRAF Inhibitors with Clinical Benefit. Case Report of a Patient with Carcinoma in Biliary Duct , Tibor Hajto 
Background: Targeting hyperactive mitogen-activated protein kinase (MAPK) signaling cascade has proven to be an effective treatment for a variety of different cancers. Using an important member of this cascade, namely MEK (mitogen-activated extracellular signal regulation kinase) inhibitors, the clinical responses are often transient and complete remission is rarely observed. It was shown that growth factor receptor signaling pathway inhibitors can increase the immune sensitivity of tumor cells but they can’t activate the down regulated immune effectors. Consequently, the combination of MAPK cascade signaling pathway inhibitors and the immune effectors activating immunomodulators may be a promising new strategy. Material and Methods: In a now 59 years old patient with inoperable (BRAF-mutant) low differentiated adenocarcinoma of biliary ducts after 30GY radiotherapy and two cycles (Gemcitabin+ Cisplatin) chemotherapy a rapid progression of lung, liver and brain metastases were by CT and MR established. A treatment was tarted with BRAF+MEK inhibitors (2x150 mg dabrafenib and 1 x 2 mg trametinib). These inhibitors were combined with daily 45 mg/kg rice bran arabinoxylan concentrate (using Biobran/MGN-3) which was shown to be a pathogenic associated molecular pattern (PAMP)-like molecule and can stimulate the type-1 innate immune cells against tumor cells. Results: After the chemotherapy and before the start of second-line treatment, the patient had a nearly terminal state of her rapidly progressive disease. Eight months after the combination of MEK / BRAF inhibitor and immunomodulator therapy nearly complete remissions of all metastases were established in CT and MR.  Conclusion: This case report may support a hypothesis that MEK/BRAF inhibitors and type-1 immune cells activating immunomodulators together may synergistically inhibit the tumor growth. Further clinical investigations are necessary to clarify this question.  
75 Evaluation of the effectiveness of hyaluronic acid for the treatment of seborrheic dermatitis of the face , Gagik Hakobyan DMsC, PhD 1* Irina Komissarova 2 Zoya Evsyukova PhD 3 Elena Ribakova PhD 4 Armen Haruthyunyan 5  
Objectives: The aim of the study was to assess the efficacy of 5% hyaluronic acid crem for the treatment of seborrheic dermatitis of the face. Materials and methods: A total of 49 patients (28 men and 21 women, age from 31 to 64 years) with seborrheic dermatitis of the face were selected for the study. A single-site, prospective observational study of 5% hyaluronic acid cream for the treatment of facial seborrheic dermatitis was conducted from 2016 to 2020. All patients underwent a thorough clinical examination according to the generally accepted scheme. Treatment planning includes a thorough history and physical examination, preoperative laboratory examination. At each visit, degrees of scale, erythema, and pruritus were evaluated. To assess the effectiveness of patients were given a questionnaire to fill out the questions. The questionnaire evaluated the 5% hyaluronic acid crem effectiveness of the treatment.  Outcome was the evolution of the Investigator Global Assessment (IGA) scale, assessing erythema, scale / scaling, seborrhea and pruritus, all measured on a five-point scale, from 0: no signs / symptoms to 4: very severe sign / symptom. Subjects were assessed at baseline after   4 and 8 weeks. Results: Baseline IGA scores (mean ± SD) were 9 ± 3 (range: 5-13). The use of the EDS significantly reduced the IGA score by 67% at 4 week and by 83% at 8 week. The condition improved from baseline in 92.3% of subjects. Conclusion: 5% hyaluronic acid crem has been effective in reducing erythema, scales, seborrhea, and itching.  No local side effects were reported.  
76 Evaluation of the effectiveness of hyaluronic acid for the treatment of seborrheic dermatitis of the face , Gagik Hakobyan DMsC, PhD 1* Irina Komissarova 2 Zoya Evsyukova PhD 3 Elena Ribakova PhD 4 Armen Haruthyunyan 5  
Objectives: The aim of the study was to assess the efficacy of 5% hyaluronic acid crem for the treatment of seborrheic dermatitis of the face. Materials and methods: A total of 49 patients (28 men and 21 women, age from 31 to 64 years) with seborrheic dermatitis of the face were selected for the study. A single-site, prospective observational study of 5% hyaluronic acid cream for the treatment of facial seborrheic dermatitis was conducted from 2016 to 2020. All patients underwent a thorough clinical examination according to the generally accepted scheme. Treatment planning includes a thorough history and physical examination, preoperative laboratory examination. At each visit, degrees of scale, erythema, and pruritus were evaluated. To assess the effectiveness of patients were given a questionnaire to fill out the questions. The questionnaire evaluated the 5% hyaluronic acid crem effectiveness of the treatment.  Outcome was the evolution of the Investigator Global Assessment (IGA) scale, assessing erythema, scale / scaling, seborrhea and pruritus, all measured on a five-point scale, from 0: no signs / symptoms to 4: very severe sign / symptom. Subjects were assessed at baseline after   4 and 8 weeks. Results: Baseline IGA scores (mean ± SD) were 9 ± 3 (range: 5-13). The use of the EDS significantly reduced the IGA score by 67% at 4 week and by 83% at 8 week. The condition improved from baseline in 92.3% of subjects. Conclusion: 5% hyaluronic acid crem has been effective in reducing erythema, scales, seborrhea, and itching.  No local side effects were reported.  
77 Deep Vein Thrombosis and Pulmonary Embolism in Sickle Cell Disease , Priyatham Kumar Satyajit Patra *
American International Medical University, Gros Islet, St. Lucia.
78 Body Composition, Functional Status and Clinical Outcomes in Patients with Chronic Obstructive Pulmonary Disease , González- Correa Clara Helena 1*
Objective: To define the correlation between the Fat Free Mass Index (FFMI), the muscle function, degree of airflow obstruction, the respiratory symptoms and the number of exacerbations during the last year in patients with Chronic Obstructive Pulmonary Disease (COPD).  Methods: Prospective and cross-sectional study of subjects older than 40 years with a clinical diagnosis of COPD who underwent measurement of the FFMI and muscular function to determine if these were correlated with the variables of severe COPD. Results: 55 patients Participated in the study.  The FFMI was below 32.7% (n=18) and the strength diminished in 56.4% (n=31). In the sample, we found a direct and significant correlation between the FFMI and the FEV1* (predicted %), (p= 0,045).  When analyzed by sex, men had a direct correlation between FFMI and the FEV1*(predicted %), (p=0,019), an inverse correlation between FFMI and the spirometric classification of the Global Initiative Obstructive Lung Disease (GOLD) (p=0,008) and between the muscular function and the symptoms (p=0, 03).   In women no significant correlation was found. Conclusions: The conditions in mass and the muscular function were correlated with clinical variables and pulmonary function in men, but not in women.   We did not find a correlation between corporal composition and the number of exacerbations.  
79 In clear water no fish can live. Water purification promote global warming, decline of countries , Shoichiro Ozaki
Carbon dioxide CO2 increasing 2 ppm yearly since developed countries started elimination of NOx and elimination of NP. Global warming is happening by the decrease of CO2 assimilation from insufficient supply of NP fertilyzer. Developed countries hated NOx and NP and are eliminating NOx and NP. Japan is criticized as increasing much CO2. Japan is eliminating NOx,NP completely using much electricity producing 2 billion tone CO2 for the elimination of NOx and NP. Fish production of Japan dropped to 10%. GDP do not increase. If developed countries stop elimination of NOx,NP . CO2 assimilation is activated. Production of grain and fish increase. DGP will increase and global warming will stop.
80 Assessment of the Role of Environmental factors and Associated Plants for the Mass Cultivation of Santalum album L in Nepal and India , Roshan Kumar Yadav 1* Jagatpati Tah 2 Subrata Mukhopadhyay 3  
Sandalwood (White Sandal) is the fragrant heartwood of some species of genus Santalum. The widely distributed and economically important Santalum genus belongs to the family Santalaceae which includes 30 genera with about 400 species, many of which being completely or partially parasitic (John, 1947). The word Sandal has been derived from Chandana (Sanskrit), Chandan (Persian), Savtador (Greek) and Santal (French). There are references of Sandalwood in Indian mythology, folklore and ancient scripts. ‘Chandana’ the Sanskrit name ascribed to Santalum album L. was known and used in India from the earliest historic times and is frequently mentioned in the ancient Sanskrit writings, some of which dated before Christian era. Kautilya’s Arthashastra (320 B.C.) considered Sandal as one of the important forest products to increase royal revenue. Charaka Sanhitha, the major text book of internal medicine in Ayurveda (300 B.C.) quotes uses of Sandal over 160 time in the entire text. In treatment of major diseases like fever, piles, hemorrhagic conditions, diabetes, dropsy, mental disorders, management of poisons & skin disorders wide spread uses of sandal is seen. Susrutha Samhita (150 B.C.) a great text on Indian wisdom on surgical procedures, equally preferred sandal for the management of wounds. Sandal fumigation is indicated in warding off evils and organisms, which contaminate the wounds. Such fumigations hasten the wound healing & surgical wards remain aseptic. Dusting of wounds with sandal for early healing is common. In the Amarkosha (Lexicon 3rd or 4th Century A.D.) sandal is mentioned and it is said that ‘Vina-malayam anyathra chandanam vivarditha’ [Majumdar, 1941].
81 The Role of Mutations on Gene NAGA, in Schindler Syndrome , Shahin Asadi * Amir Houssein Kiani Mohaddeseh Mohsenifar                                                        
Schindler syndrome is an inherited genetic disorder that mainly causes neurological problems. Schindler's syndrome is caused by a mutation in the NAGA gene, which is located in the long arm of chromosome 22 as 22q13.2.  
82 Chemical Evaluation of Proximate, Vitamin and Amino Acid Profile of Leaf, Stem Bark and Root of Indigofera Tinctoria , Alagbe, J.O 
Medicinal plants contain substances with high therapeutic value because they contain multiple bioactive chemicals. Chemical analysis of Indigofera tinctoria leaves, stem bark and roots was evaluated. The result revealed that proximate composition of Indigofera tinctoria leaves contained 12.49 % moisture content (M.C), 87.51 % dry matter (DM), 30.53 % crude protein (CP), 19.02 % crude fibre (CF), 2.44 % ether extract (EE), 13.86 % ash, 36.59 % carbohydrate (CHO) and 254.1 kcal/100g energy (ME). Indigofera tinctoria stem bark contained M.C (6.40 %), DM (93.60 %), CP (5.11 %), CF (54.49 %), EE (2.00 %), ash (10.42 %), CHO (29.98 %) and ME (156.0 kcal/100g). Indigofera tinctoria roots contained MC, DM, CP, CF, EE, ash, CHO and ME at 10.04 %, 89.60 %, 8.22 %, 40.88 %, 1.21 %, 8.43 %, 42.47 % and 210.0 kcal/100g respectively. Vitamin analysis showed that Indigofera tinctoria leaves, stem bark and roots contained β- carotene (8.45, 2.88 and 5.11 mg/100 g), Vitamin B1 (1.94, 0.33 and 1.00 mg/100 g), Vitamin B2 (0.71, 0.21 and 0.50 mg/100 g), Vitamin B3 (0.66, 0.34 and 0.48 mg/100 g), Vitamin B6 (0.32, 0.21 and 0.30 mg/100 g), Vitamin B7 (0.63, 0.01 and 0.16 mg/100 g), Vitamin B9 (0.26, 0.10 and 0.18 mg/100 g), Vitamin B12 (0.21, 0.03 and 0.10 mg/100 g), Vitamin C (14.0, 3.56 and 9.44 mg/100 g), Vitamin D (0.10, 0.01 and 0.06 mg/100 g) and Vitamin K (0.17, 0.07 and 0.12 mg/100 g). Amino acid analysis revealed the presence of threonine, leucine, lysine, valine, tryptophan, glycine, phenylalanine, histidine, methionine, alanine, serine, proline, aspartate, glutamic acid, tryrosine and cysteine in Indigofera tinctoria leaves, stem bark and roots at (7.65 %, 1.22 % and 3.03 %), (5.76, 1.09 % and 2.46 %), (3.11 %, 1.21% and 2.00 %), (7.21 %, 3.53 % and 4.09 %), (1.45%, 0.03% and 1.00 %), (4.76 %, 0.08 % and 2.33 %), (6.33 %, 2.45 % and 3.49 %), (7.42 %, 2.00 % and 3.00 %), (3.49 %, 0.01 % and 2.00 %), (2.41 %, 0.56 % and 1.20 %), (5.23 %, 1.22 % and 1.76 %), (2.87 %, 0.57 % and 1.00 %), (5.32 %, 2.11 % and 3.56 %), (9.66 %, 4.21 % and 5.11 %), (2.45 %, 0.57 % and 1.67 %) and (1.85 %, 0.81 % and 0.89 %) respectively. It was concluded that Indigofera tinctoria leaves, stem bark and roots are loaded with significant quantity of nutrients, vitamins and amino acid (leaves ˃ roots ˃ stem bark).  
83 The Morpho-Genetic Estimation of Drought Stress in Sunflower Seedlings under Laboratory Conditions , Uzma Ayaz 1* Sanam Bashir 1 Shahid Iqbal Awan 2 Muhammad Ilyas 2 Muhammad Fareed Khan 3 Hameed-ur-Rehman 4  
Drought stress directly affects the growth along with productivity of plants by altering plant water status. The present study was carried out to characterize the genetic variability for seedling and morpho-physiological parameters in different sunflower genotypes under water stressed conditions. A total twenty seven genotypes including two hybrids, eight advanced lines and seventeen accessions of sunflower (Helianthus annuus L.) were tested against drought stress at seedling stages by applying Polyethylene glycol (PEG). Significant means were calculated among traits using analysis of variance (ANOVA) whereas, correlation and principle component analysis also confirmed that germination percentage, root length, shoot length, chlorophyll content, stomatal frequency are positively linked with each other hence, these traits were responsible for most of variation among genotypes. The cluster analysis showed that genotypes Ausun, line-1, line-2, line-3, 17578, 17570, line-6, line-7 and 17562 are more diverse among all the genotypes.  
84 Ecological Analysis of the COVID-19 Pandemic , Chrysanthus Chukwuma Sr
Economic, sociological, natural, anthropogenic constructed systems and associated ambients have been enmeshed in the untoward impacts of the COVID-19 pandemic. Environment, health and quality of life should remain of immediate concern in governmental policy and governance. In this COVID-19 era, the diminished introduction of pollutants and the decreased exacerbation of contaminants in the ecosystem due to drastic reduction in economic and industrial production have perspicuously posed less threat and aberration to biodiversity, ecological and environmental systems. The conceptual ecological analysis of the COVID-19 trajectories exposes the dire consequences of the unpreparedness of nature and humans in this pandemic era. It is important to elucidate the functionalities of anthropogenic activities in environmental degradation and the inextricable-linkage between pandemics, ecosystem deterioration and health as pertinent to animal, human, plant, land usage, water and biodiversity. The conspiracy theories, ecological fallacy and mass hysteria of COVID-19 emergence stem from perspicuous extensive shirking of responsibilty regarding domestic and global environmental health by the public and private sectors of production, consumption, administration and governance.  
85 Final proof Starling’s law wrong and G tube hydrodynamic is the correct replacement: New results and critical analytical criticisms of landmark articles , Ahmed N. Ghanem MD (Urology), FRCS Ed 1*
Substantial evidence demonstrating Starling’s law is wrong currently exists. This article presents the final definitive proof that Starling’s law is wrong, and the correct replacement is the hydrodynamic of the G tube. The presented evidence is based on reported and new results of the G tube hydrodynamic and critical analytical criticism of landmark and contemporary impactful articles. The objectives of this article are to affirm applicability to capillary; crossing the editors’ barrier to convince the hardest of critics that the new theory is correct. The new results presented here further affirm this and the critical analytical criticisms reveal many errors that has misled authors into reporting erroneous results and conclusions affirming Starling’s law and its equations are wrong. The new results show the difference between the hydrostatic pressure and the two components of dynamic pressure: Flow and Side pressures. The side pressure is a negative pressure gradient exerted on the wall of G tube built on a scale to capillary ultrastructure of precapillary sphincter and the wide intercellular cleft pores in its wall. This affirms Starling’s law and its equation are wrong and its correct replacement is the magnetic field like phenomenon of the G tube that explain the fast capillary interstitial fluid transfer necessary for viability of cells at rest and during strenuous exercise.  
86 Fluid Therapy (FT) Complications: Volumetric Overload (VO) in the patho-Aetiology of VO Shocks (VOS) and the Acute Respiratory Distress Syndrome (ARDS) , Ahmed N. Ghanem MBChB, MD (Urology), FRCSE d, 1*
Fluid therapy (FT) was introduced during WW2. Ever since its complications have been frequently reported but notably some serious complications have been overlooked. The role of volumetric overload (VO) in inducing VU shocks (VOS) and causing the acute respiratory distress syndrome (ARDS) has remained overlooked, unrecognized, and underestimated till recently. The role of FT complications in inducing VOS and causing ARDS is hard to detect because VOS is a shock that complicates another existing shock seamlessly and un-noticed. The author attributes this to the faulty rules on FT dictated by the wrong Starling’s law that causes many errors and misconceptions of FT which mislead physicians into giving too much fluid during shock resuscitation. The research findings on the wrong Starling’s law and how it has been corrected based on the hydrodynamic of the porous orifice (G) tube and the newly recognized VOS and the new patho-aetiology and therapy of ARDS are summarized here. Other authors in support of this contention are quoted. The errors on current FT and its corrections are given. Finally, a new prospective cohort study on FT and ARDS is recommended and a call for new guidelines on FT is urgently needed.  
87 Evaluation of Thyroid Hormones Levels in Libyan Patients with Chronic Renal Failure Before and AFTER Maintenance Hemodialysis , Riad M Abughali 1 Milad A. Arzeni 1 Karima R. Zarug Edawib 1 Aisha A Muhammed 1*  
Data from recent studies revealed that kidney diseases might affect the thyroid function in various ways. A variety of alterations in thyroid hormone levels and metabolism have also been reported in patients with chronic renal failure (CRF) in some studied population. In addition, it was reported that serum levels of both T3 and T4 might altered immediately after a hemodialysis (HD) treatment than before. Therefore, this study was aimed to investigate the level of triiodothyronine (T3) and thyroxine  (T4) in CRF Libyan patients before and after HD. This study was carried out on 46 CRF patients (30 male and 16 female) with a mean age of 47.46 ±15.75 years. These patients were treated at the hemodialysis unit of Educational Central Zelitin Hospital, Zelitin, Libya. None of these patients apparently have any thyroid problems and no history of drug intake that may affect thyroid function. Blood samples were taken from each patient to measure serum levels of T3 and T4, before and after HD. In addition, the effect of several variables include age, gender, body mass index (BMI), presence of both hypertension and, diabetes mellitus and duration of kidney dialysis on serum levels of T3and T4 before and after HD were also studied. After HD, there was a statistically significant increase in the serum levels of T3, T4. The age, gender, BMI, duration of kidney dialysis and the presence of hypertension and diabetes mellitus did not have any significant effect on the serum level of T3 and T4 before and after HD. However, the serum levels of T3 and T4 were still in the normal range in these examined patients either before or after HD. From these findings, it can be concluded that these CRF patients may be in a euthyroid state, because the serum levels of T3 and T4 were in the normal range. In addition, HD was seem to improve the T3 and T4 thyroid hormone concentrations, suggesting that HD might activate the secretion of thyroid glandand catabolism. The other variables did not play any role in thyroid hormone levels in these patients either before or after HD. It is highly recommended that large scale evaluation of thyroid hormone levels in Libyan CRF patients is performed more patients, especially elderly patients.  
88 Biochemistry, Medicinal Properties & Toxicity of Acacia Nilotica Fruits , Kamal Omer Abdalla PhD
Acacia nilotica tree is native to Africa, the Middle East and the Indian subcontinent. Due to its wide medicinal properties & uses this plant attracted the attention of many scientists. Its fruits are rich in more than 16 classes of different bioactive molecules & elements very beneficial for human health. These molecules & elements include tannins, saponins, phytosterols, cyclitols, alkaloids, anticoagulant agents, regulatory molecules, amines, mucilage, fibers, gums, proteins, various classes of amino acids, carbohydrates, terpenses, crude fats, oils, fatty acids & minerals. The fruits are used to treat various human disorders including cancers, heart & liver diseases, diabetes mellitus, malaria, asthma, arrhythmias, acquired immune-deficiency syndrome, coronavirus disease 2019, spleen disorders, for weight loss, colds, congestion, coughs, diarrhea, dysentery, fever, gallbladder, hemorrhage, hemorrhoids, leucorrhea, ophthalmia, sclerosis, tonsillitis, pharyngitis, skin eruptions smallpox and tuberculosis. Acacia nilotica fruits are very beneficial for human health, safe & effective to treat various human diseases if it is used in appropriate dose & period. It has been in use in Sudan & in other parts of Africa widely & safely for generations to treat various diseases without any reports of toxicity or adverse effects. Moreover, human body has efficient detoxification mechanisms to process and detoxify toxic substances and toxicity in human occurs only from known high toxic substances, overdose, regular and long period of using of herbs or medicines with known side effects. It is apparent that toxicity of acacia nilotica fruits comes from over dosage & longer than required duration of uses or regular consumption and the solvent/s as well. However, further works are needed by pharmaceutical industries to authentically formulate various components of the of acacia nilotica fruits to be used as medicines & supplements to enhance the therapy of several human diseases.  
89 Biochemical Assessment of Fertility-Enhancing Effect of Aqueous Extract of Symphonia globulifera (Linn. F.) In Adult Male Wistar Rats , Adedugbe O. F 1 Odesanmi O. S 2 Ilesanmi O. S 1*  
The present study investigated the effect of oral administration of aqueous extract of Symphonia globulifera root on fertility in addition to its effect on some biochemical indices in adult male Wistar rats. After the aqueous extraction, phytochemical screening was carried out. Twenty-four (24) mature and healthy adult male wistar rats of weights between 150-220 g were used. The rats were randomly divided into four (4) groups each containing six (6) rats. Group 1 rats were gavaged with distilled water which served as control group. Group 2, 3 and 4 rats were orally treated with 100, 200 and 400 mg/kg body weight of the aqueous extract of S. globulifera respectively for 21 days. After the treatment, the rats were sacrificed and their organs (heart, liver, kidney and testes) were excised. Hormonal analysis which include seminal fluid analysis (SFA), follicle stimulating hormone (FSH), leutenizing hormone (LH), testosterone and prolactin were carried out following standard procedures. The data were analysed using students t-test and ANOVA with the aid of SPSS with P < 0.05 level of statistical significance. The phytochemical screening of the extract revealed presence of major phytochemicals. There was dose-dependent decrease in the body weight of the rats after the treatment. In hormonal analysis, SFA increased significantly when compared to that of the control rats. The analysis also revealed that the blood level of follicle stimulating hormone (FSH) was significantly increased whereas; there was decrease in testosterone level when compared with the control animals. In conclusion, aqueous extract of S. globulifera was found to be safe and showed significant fertility enhancing effects.  
90 An Ankle Sprain or Calcaneal Ewing Sarcoma A case report of a 9 year old boy , Luis Salazar 1 Abdullah Ghali 1* David Momtaz 1 Jacob Malmquist 1 Saad Masud 2 Gautham Prabhakar 1 Anil Dutta 1  
Ewing Sarcoma of the calcaneus is a very rare presentation of the tumor. In this case report, we present a 9 year old Hispanic male who presented with a limp in the right ankle, thought to be secondary to a football injury. We also discuss treatment options and various presentations of the tumor.  
91 Psychiatric Stigma in Developing Societies , Saeed Shoja Shafti
Stigmatizing attitudes toward persons with mental syndromes are prevalent in the general population and even among mental health professionals, a problem that may result easily in public avoidance, constant discrimination, and declined help-seeking behavior. The effect of stigma is twofold: Public stigma is the response that the public has to people with mental disorder. Self-stigma is the bigotry which persons with mental disorder turn against themselves. The WHO has advised that stigma is one of the largest barricades to treatment engagement, even if management is operative, even in low-income nations. While before and according to a series of researches the outcome of severe mental illness is generally better in developing societies than in developed countries, and it has been suggested that stigma is less severe or non-existent in unindustrialized nations, the current studies and observations do not confirm such an optimistic hint and the idea that stigma attached to mental illness is a global phenomenon seems a reasonable inference. In the present article, the issue of stigmatization, deinstitutionalization, national goal setting, and real situation of various modules of psychiatric rehabilitation, in the context of social or public psychiatry, especially in developing countries, is discussed, from a practical point of view.  
92 Utility of telemedicine in ophthalmology clinic during COVID-19 era , Sajid Iqbal 1 Umair Syed Mahmud 2 Hamza Yunus 3 Maarij malik 4 Sunil Shah 5 Hana Raza 6 Sohaib Tousif 7 Zehra Sohail 8 Sharef Fawzy Mohamed Hasaneen 9 Shivani M Mehta 10 Vishal Natarajan 11 Aisha Hasan 12 Nadeem Iqbal 13*  
Due to safety concerns to health care workers and the patients alike, hospitals are have been in a desperate search for medical supplies and physicians in the face of overloaded hospitals. The need for social distancing to safeguard the health care personnel and patients have warranted new tools for running an ophthalmic clinic. Before the implementation of social distancing measures, most patients were ignorant of a telemedicine option in clinical visits. Also, leading telehealth platforms have reported a tremendous increase in virtual patient visits. This rise has been proportional to the regional impacts brought by coronavirus infection. In this review article, we tried to highlight the challenges faced by healthcare providers and patients in the ophthalmology clinic.  
93 COVID-19 Cases and Deaths: A Comparison among Bangladesh, India and Pakistan. , Shipra Banik 1 B. M. Golam Kibria 2*
This paper compares the number of infected cases and deaths of an ongoing pandemic of COVID-19 outbreak for Bangladesh, India and Pakistan for the period of March 8, 2020 to September 21, 2020. Comparisons among countries using absolute numbers are not comparable due to different factors, such as population sizes, rates of per 100,000 and also because not all countries are affected equally and at the same time. Following Middelburg and Rosendaal (2020), we graphically compare the number of cases and deaths expressed as a percentage of the cases and deaths on the reference day 25 after the first reported death. To see the impact of reference days, several later reference days are also considered in this study. From these comparisons, clear differences were observed among countries. Among these three countries, it is observed that Bangladesh had the most extreme flattening of the curve, followed by Pakistan and then India. We observed that the epidemic developed in India much more rapidly as compare to Bangladesh and Pakistan.  
94 Precision Engine for Nanobiomedical Research , Afonin SM                                                        
The transfer function and the transfer coefficient of a precision electromagnetoelastic engine for nanobiomedical research are obtained. The structural diagram of an electromagnetoelastic engine has a difference in the visibility of energy conversion from Cady and Mason electrical equivalent circuits of a piezo vibrator. The structural diagram of an electromagnetoelastic engine is founded. The structural diagram of the piezo engine for nanobiomedical research is written. The transfer functions of the piezo engine or are obtained.  
95 First Approach to the Management of Orthopedic Injuries of the Hindfoot , Lázaro Martínez Aparicio 1 Lázaro Martín Martínez Estupiñan 2 Juan Carlos Cedré González 3 Sergio Morales Piñeiro 4 Claribel Plain Pazos 5* Leonardo Domínguez Plain 6  
Hindfoot pain is a common clinical problem that can be due to multiple alterations, it can appear due to bone or soft tissue causes, it is established in a small anatomical area. There are different methods of treatment for these conditions, ranging from simple guidelines in lifestyle to surgery. In this work, patients are divided into four groups with different treatment methods, each group was assigned a different therapeutic option, which will increase its degree of invasion as the number of the group increases. Infiltration with platelet-rich plasma (PRP) is a new technique of cell regenerative therapy and was applied in one of the groups, taking advantage of the regenerative, healing and anti-inflammatory properties of the mentioned therapy.  
96 Evidence of osteomyelitis in Cuban aborigines , Sergio Morales Piñeiro 1 Raúl Villavicencio Finalet 2 Lourdes Morera Estévez 3 Olivia Clavero Machado 4 Claribel Plain Pazos 5* Leonardo Domínguez Plain 6  
Paleopathology is the branch of science that is responsible for the study of diseases suffered by our ancestors, in Cuba some studies have been carried out on pathologies suffered by the aborigines. The objective is to present a specimen of human diaphyseal bone found in the funerary site of the "Cueva de los Chivos" in the Sumidero de Jibacoa Valley, Guamuhaya mountain massif, municipality of Manicaragua, Villa Clara province, Cuba in excavations carried out between the years 2000 and 2002 by the archeology group of the Center for Environmental Studies and Services of CITMA in Villa Clara. Presentation: It is a tibia fragment due to its thickness and triangular shape with periosteal thickening, cortical irregularity and a large number of crypts, whose radiography shows the presence of bone sequestration with the corresponding involvement and signs of periostitis. The skeletal remains found show evidence of having suffered from chronic osteomyelitis. Based on the archaeological materials found at the funerary site, it was determined that these belonged to pre-agricultural pottery groups that populated the island between 2000 and 6000 years ago. Conclusions: The Cuban aboriginal groups had elementary knowledge of orthopedic conditions such as bone infections and their treatment in all probability, evidenced by the chronicity of osteomyelitis presented in this specimen which survived for a period of time.  
97 Attacks on the precious truffles by useful and harmful invadors , Waill A. Elkhateeb 1* Ghoson M. Daba 1  
Truffles are ectomycorrhizal mushrooms that grow in specific climates. They are rare and famous for their secondary metabolites and their promising biological activities. Truffles are considered from the most expensive macrofungi all over the world. Understanding the rare and uncommon types of interaction between truffles and their different invadors is of high significance. However, studies describing such relation are very limited. In this review, we describe general description and ecology of truffles. Examples on microbes attracted to colonize fruiting bodies of truffles were mentioned. Finally, factors causing truffles damage such as pathogenic fungal attacks, truffles rot, and insects’ invasion were highlighted.    
98 A Congolese infant of 4 months and 8 days presenting a severe form of Covid-19 , Joseph M Bodi 1* Makulo JRR 2 Monkoti MM 1 Aketi LP 1 Matula IK 1 Mankenda FM 1 Lumaya VV 1 Mandina MN 2 Odio GO 2 NSiatuyizatadi B M 2 Tshibasu FT 3 Lelo MT 3  
To date, only a few rare cases of severe forms of Covid-19 in children, especially infant, have been described in other parts of the world. So far no case reported in sub-Saharan Africa (SSA). We report the case in the Democratic Republic of Congo of an infant of 4 months and 8 days old, who presented after   malaria disease, a picture of bronchopneumonia with  severe respiratory failure (Pa O2 :49 mmHg). The RT-PCR made it possible to diagnose a Covid-19 of severe form. The infant had probably been infected by his mother and had no other co-morbidities that could induce a decrease in immunity. The CT scan injuries were comparable to those described in adults. Under oxygen, anticoagulation, hydroxychloroquine and Azythromycin, the outcome was good. Pediatricians in SSA countries should be careful and not miss cases of COVID19 in infant population with severe respiratory syndrome usually observed in most of lung infectious disease.  
99 COVID-19 Cases and Deaths: A Comparison among Bangladesh, India and Pakistan , Shipra Banik 1 B. M. Golam Kibria 2*  
This paper compares the number of infected cases and deaths of an ongoing pandemic of COVID-19 outbreak for Bangladesh, India and Pakistan for the period of March 8, 2020 to September 21, 2020. Comparisons among countries using absolute numbers are not comparable due to different factors, such as population sizes, rates of per 100,000 and also because not all countries are affected equally and at the same time. Following Middelburg and Rosendaal (2020), we graphically compare the number of cases and deaths expressed as a percentage of the cases and deaths on the reference day 25 after the first reported death. To see the impact of reference days, several later reference days are also considered in this study. From these comparisons, clear differences were observed among countries. Among these three countries, it is observed that Bangladesh had the most extreme flattening of the curve, followed by Pakistan and then India. We observed that the epidemic developed in India much more rapidly as compare to Bangladesh and Pakistan.  
100 A Patient-Centric Care Approach to Facilitate the Design of an Artificial Intelligence Application in Geriatric Care Management of Heart Failure Readmissions , Thomas T.H. Wan Ph.D, MHS 1* Varadraj Gurupur Ph.D 2 Bing Long Wang Ph.D., MPH, MBA 3 Sarah Matthews Ph.D 4  
The examination of human factors’ role in moderating medical interventions and hospitalizations and/or rehospitalization of heart failure (HF) patients.  Objectives: The primary purpose of this study is two-fold: 1) to show relevant human factors influencing the rehospitalization of persons with heart failure by developing a systematic algorithm generated from the cited randomized trials; and 2) to examine how the self-care principles, such as choice/efficacy, restfulness, healing environment, activity, trust, interpersonal relationships, outlook, and nutrition, may reduce heart failure readmissions. Methods: The meta-analytic approach generated a theoretically relevant and empirically validated self-care management decision support protocol for HF. Statistical modeling of the effects of eight human factors for the reduction of HF readmissions was presented.  Findings: The systematic review and meta-analysis approach documents the results of randomized clinical trials that affect heart failure hospitalization by selected human factors. A patient-centered decision support system was developed to facilitate the self-care management of heart failure.  Discussion: Our research generates systematic knowledge about the importance of human-factor principles in the provision of geriatric care for heart failure. Using shared decision-making strategies under the population health management approach could enhance the quality of care and reduce costly readmissions of heart failure, particularly for elderly patients.  
101 Using Telemedicine for Providing Supportive and Palliative Care Patients with Advanced Cancer during the COVID?19 Pandemic in Ukraine , Hojouj Mohammad I M 1* N Bondarenko, Zavizion V F 1 Procach A, Hojouj T Elhaj M 1  
COVID‐19 has overwhelmed the capacity of health care systems, limiting access to supportive and palliative care for patients with advanced cancer. Telemedicine has emerged as a tool to provide care continuity to patients while limiting the risk of contagion. However, implementing telemedicine in resource‐limited settings is challenging. We report the results of a multidisciplinary patient‐navigator‐led telemedicine supportive care program in Dnipro City. One‐hundred sixty‐five telemedicine interventions were provided to 50 patients (median age 67, 47% female). A quarter of the patients had less than or equal to elementary school education, and 18% lived in a rural area. The most common interventions were psychological care (30%), pain and symptom control (27%), and nutritional counseling (10%). Half of the interventions were provided by video conferencing. The most common patient‐reported barrier was limited experience using communication technology. Our results demonstrate the feasibility of providing supportive and palliative care interventions using telemedicine in resource‐limited settings.  
102 Effective, timely use of Intravenous Immunoglobulins for management of Pediatric multisystem inflammatory syndrome associated with COVID-19 (PMIS-COV19) in a 9 years old boy: Case report , Nidal O. Al-Hashaykeh 1 Mona M. Faramawy 1 Khaled H. Atwa 1 Aiman Rahmani 1*  
Coronavirus disease 2019 (COVID-19) is arguably the most socially and economically disruptive pandemic since the 1918 influenza pandemic. Although pediatric COVID-19 shares features with the adult disease, there are several differences. Children produce virus in amounts at least equal to adults, if not higher and can transmit the virus just as adults can. School-aged children are generally less severely affected than infants or adults, but some children without significant underlying disease become ill or die in a disease process analogous to the one most commonly seen in adults as severe pulmonary disease and respiratory failure. Children and adults appear to have different humoral immune responses to COVID-19.  
103 Diagnosis and Therapy of an Autistic Child , Adam Adamski
Knowledge of autism is growing tremendously, since the first formulation of the phenomenon of autism in 1943, there is still no cure for the cure of changes in the brain that create the symptoms of autism. I still find better ways of understanding the disease and help patients adapt, but does not give a full understanding of what autism. There are different types of therapy in the field of speech, behavior, vision, hearing, as well as drugs and dietary recommendations, but they are often ineffective. Treatments should be tailored to the individual needs of the patient. The author of that work will pay attention to corrective therapy movement, and the mechanism of imitation, these two factors in autism do not exhibit synchronization, because the child did not received during the birth. Autistic children from the area have movement disorders, and the lack of a mechanism to follow. My research results confirm the view that the movement disorder and the mechanism of imitation are inherent in the phenomenon of autism. The study of movement disorders in children, and the mechanism of imitation, may serve as an early indicator of autism diagnosis methods. They point to the need for the development of therapies to be used from the first months of life in autism.  
104 Fracture Toughness, Hardness, and Microstructure of Ceramic Modified Versus Resin Modified Glass Ionomer Restorative Materials , Ibrahim M. Hamouda 1* Noha N. Mohamed 2
The aim of this study was evaluation and comparison of fracture toughness, hardness and microstructure of ceramic-modified versus resin-modified glass ionomer restorative materials. For fracture toughness, 20 specimens from both materials were fabricated in a stainless-steel split mold (25mm length, 2.5mm thickness and 5mm width). Fracture toughness was measured using Lloyd universal testing machine with cross head speed 2 mm/min. For hardness testing, 20 specimens from both materials were fabricated in a disc-shaped stainless-steel mold (5mm diameter and 2mm height). All specimens were stored in distilled water at 37°C for 24 hours. Hardness was measured using Vickers micro hardness tester with 50 g load. The microstructure of both materials was examined using scanning electron microscopy. The results of this study showed there wasn’t significant difference between both materials in fracture toughness. The hardness of ceramic-modified glass ionomer was higher than that of the resin-modified type. The addition of ceramic filler to the glass ionomer didn’t improve its fracture toughness. The microstructure of resin-modified glass ionomer showed tight packing between the matrix and the resin filler, while the ceramic-modified glass ionomer showed separated matrix from the ceramic filler.  
105 Deodar Cedar (Cedrus Deodara): Efficacy for Potential of Secondary Metabolites and Antibacterial Activity , Vibha Bhardwaj
The setback of microbial resistance is growing and the use of antimicrobial drugs in the future is still uncertain. Infectious diseases are accountable for millions of global deaths annually. Therefore, necessary steps need to be taken to reduce this problem. In the present study, crude extracts of leaves, bark and resins of Cedrus deodara in methanol was investigated for secondary metabolites (flavonoids, glycosides, phenols, saponins, tannins, terpenoids) and antibacterial effect of Cedrus deodara was evaluated on multidrug resistant (MDR) strains of Bacillus subtilis (ATCC 6633), E. coli (ATCC 8739), Salmonella enterica (ATCC 14028), Staphylococcus aureus (ATCC 6538), Pseudomonas aeruginosa (ATCC 27853) by agar well diffusion method. Ciprofloxacin was used as standard.  The methanolic extracts of leaves of C. deodara tested positive for glycosides, flavonoids, phenol, tannins and terpenoids. The Bark was tested positive for glycosides, flavonoids, phenol, tannins but resins was tested positive for terpenoids. Leaves of C. deodara showed zone of inhibition with all the five strains of microorganisms, which were used. C. deodara resin methanolic extract showed maximum zone of inhibition with Bacillus subtilis which are 25 ± 0.1 mm and bark showed maximum zone of inhibition with Staphylococcus aureus 21 ± 0.6 mm. The potency shown by these extracts recommends their use against multidrug resistant microorganisms. Time-kill curve showed a fast and sharp antimicrobial activity. Based on the research experiments, it was identified, that the methanol extract of Cedrus deodara exhibited quite high antimicrobial activity as well as secondary metabolites and this quality together with lots of other values must be considered in green landscape planning of contemporary urban environment and for the other purposes too.   
106 Application of the Diagnostic Tool Efa-4 in Dementia , Erkotidou Sofia 1* Grigorios Nasios 1 Tafiadis Dionisios 5 Magda Tsolaki 4 Eleni Erkotidou 6
Speech is a brain function that includes virtual, mobile and sensory part for the understanding and the production of spoken and written language. The aim of this study was to present the adaptation of the diagnostic tool Examining for aphasia – 4th edition (EFA -4) in the Greek language. In dementia and especially in Alzheimer’s disease (AD), the speech and language disorders are the main diagnostic features, along with the worsening impairment of memory. The diagnostic tool EFA-4 is a standardized, reliable and valid measure of speech and language disorders. The test was administered to 50 adults separately. The sample selection, although it had uniformity in age, was regardless of origin, marital status and socioeconomic status. According to the results of the research, the EFA-4 is perceived to be particularly useful in the setting of language deficits of the patients with AD, who participated in the survey.   
107 Risk Factors for Increasing of the Cancer Developing , Nagham M Aljamali 1* Alaa Hamza Jaber Al-jelehawy 2 Aryaf Mahmood Sabea 3
The current informational review or survey addresses the risk factors for increasing the risk of developing malignance, tumors have several causes that lead to the occurrence of a tumor. There are a group of interrelated factors, including the genetic factor, the hormonal factor, environmental factors, social biology, and physiology of organs, which can affect its development, in addition to other risk factors, such as: disorders of breast proliferation that are related to the development of Breast malignance, especially if the biopsy shows A typical hyperplasia. However, 70% of malignance patients cannot identify risk factors. Advanced-stage malignance s can erode the skin to cause open sores (ulcers), but they are not necessarily painful. Women with non-healing wounds in the breast should have a biopsy. Breast malignance may spread to other places in the body and lead to other symptoms. The most common first site of spread is often the lymph nodes under the arm, although malignance -carrying lymph nodes may be imperceptible. Over time, malignance cells may spread to other organs, including the lungs, liver, brain and bones. Once in these places, new symptoms related to the malignance, such as bone pain or headaches, may develop.  
108 Relationship between Food Type and Increased Risk of Cancer , Nagham M Aljamali 1* Ammar Nabil Mujjed 1 Doaa AbdulWahid Jasim 1
The type and nature of food affect the increase or decrease in the risk of developing cancerous tumors and the speed of their spread, as the type of food has a significant impact on increasing the risk of cancer.About a third of deaths from cancer are attributed to tobacco use, high body mass index (BMI), alcohol use, low intake of fruits and vegetables, and lack of physical activity. Cancer-causing infections, such as hepatitis and HPV, are responsible for 30% of cancer cases in low- and lower-middle-income countries. It is common for late-stage cancer symptoms to be unavailable for diagnosis and treatment, especially in low- and middle-income countries. Universal treatment is reported to be available in more than 90% of high-income countries, but only less than 15% of low-income countries. In 2019, only 1 in 3 countries reported high-quality data on cancer rates. Cancer is a general term that includes a wide range of diseases that can affect any part of the body. Other terms used are malignant tumors and neoplasms. A hallmark of cancer is the rapid generation of abnormal cells that grow outside their usual boundaries and can then invade neighboring parts of the body and spread to other parts of the body. The last operation is called metastasis, and metastases are the most important cause of death from cancer. Currently, between 30% and 50% of cancer cases can be prevented by avoiding disease risk factors and implementing existing, evidence-based strategies for prevention. The burden of cancer can also be reduced by detecting the disease early and providing patients with adequate treatment and care, knowing that the chances of recovery from many types of cancer increase if they are diagnosed early and treated appropriately.  
109 Review on Applications of Dendrimer-Chemical Compounds in Pharmaceutical and Industrial Fields , Dr. Nagham Mahmood Aljamali 1* Safaa Mohammad Jawad Radhi 2 Nawfel Muhammed Baqer Muhsin 3
This review involved Dendrimer in pharmaceutical applications. Dendrimers are the most important medical nano-polymers in the fields of chemistry and pharmacology, which have been used in many pharmaceutical applications. Many technical applications of many biological elements such as proteins, viruses, or bacteria, including applications of chromatography, optical information technology, sensors, stimulation and drug delivery, require immobilization or immobilization of these biologicals. Here, carbon nanotubes, gold particles and synthetic polymers can be used for such purposes. Here we note that this immobilization process can be achieved mostly through adsorption or chemical bonding or to a lesser extent by incorporating these elements as guests in the host matrices. We also note that in the case of guest and host systems, an optimal method for immobilizing the bio-elements as well as incorporating them into a serial structure based on the nanoscale must be established to facilitate the interactions of the bio-nano-elements within their own environment. This is due to the large number of synthetic or natural polymers available and the advanced and developed methods for processing such systems for nanofibers, rods or tubes etc., this makes the polymers a good base for immobilizing different biomaterials.  
110 The Case Number 112 of Congenital Chylous Ascites and Its Successful Treatment , Aamir Jalal Al-Mosawi   
Background:Congenital chylous ascites is a very rare condition that has been well recognized as early as the 1950s, and was mostly called “Congenital chyloperitoneum” during that time. Few cases have been reported during the 1960s, and in 1967, Craven et al attributed the development of congenital chylous ascites to obstruction of the cisterna chyli and chylous reflux into the peritoneal space and small intestine and they demonstrated lymphangiographically.  Patients and methods: The use of a unique dietary therapy for the treatment of congenital chylous ascites is briefly described and the relevant literature is described. Results:An infant with congenital chylous ascites was seen at about the age of two and half months. He was initially treated with intravenous somatostatin infusion, and thereafter by repeated paracentesis, and continued to receive breast and bottle milk feedings. However, when he was first seen, ultrasound was still showing moderate ascites. The boy was successfully treated a combination of a unique form of very low-fat diet and octreotide acetate subcutaneous injections. Treatment was not associated with a negative effect on growth or development, and no evidence of nutritional deficiency was observed.  Conclusion: The case number 112 of congenital chylous ascites is reported and its unique therapeutic approach is described.  
111 The Case Number 112 of Congenital Chylous Ascites and Its Successful Treatment , Aamir Jalal Al-Mosawi                                                        
Background:Congenital chylous ascites is a very rare condition that has been well recognized as early as the 1950s, and was mostly called “Congenital chyloperitoneum” during that time. Few cases have been reported during the 1960s, and in 1967, Craven et al attributed the development of congenital chylous ascites to obstruction of the cisterna chyli and chylous reflux into the peritoneal space and small intestine and they demonstrated lymphangiographically.  Patients and methods: The use of a unique dietary therapy for the treatment of congenital chylous ascites is briefly described and the relevant literature is described. Results:An infant with congenital chylous ascites was seen at about the age of two and half months. He was initially treated with intravenous somatostatin infusion, and thereafter by repeated paracentesis, and continued to receive breast and bottle milk feedings. However, when he was first seen, ultrasound was still showing moderate ascites. The boy was successfully treated a combination of a unique form of very low-fat diet and octreotide acetate subcutaneous injections. Treatment was not associated with a negative effect on growth or development, and no evidence of nutritional deficiency was observed.  Conclusion: The case number 112 of congenital chylous ascites is reported and its unique therapeutic approach is described.  
112 A new combination of surgical techniques for the treatment of 1st carpometacarpal joint arthritis , Konstantinos C Xarchas 1* Zoe Dailiana 2
Up till now, many different techniques have been used for the treatmentof 1st carpometacarpal (cmc) joint arthritis. Here we present a new combination of well- known techniques and surgical approaches that gave excellent results in a five year follow up.  
113 The Effect of Various Genetic Diseases and Eye Surgeries on Iris Discoloration , Sina Moradi 1 Sobhan Sina 1 Shahab Chavoshi Thanil 2 Habibeh Ramezanpour 2 Danial Rahimi 1 Ali Ahmadi 2*  
The color of human eyes is often the same as the iris of the eye, which itself consists of two parts: the anterior layer of iris stroma and the posterior layer or posterior pigment epithelium. Based on experiments, it is believed that iris color is determined based on four factors: pigment granules in the posterior pigment epithelium, pigment concentration in iris stromal melanocytes, melanin pigments in iris melanocytes, and the scattering and absorption of light from the extracellular matrix properties of the stroma. Becomes. In general, melanocytes in the iris stroma have a greater effect on iris color. These types of cells contain a biopolymeric and inert substance called melanin, which itself has two types: brown-black or Eumelanin and red-yellow or Pheomelanin. Eye color in infants varies by race and genetics, st in whites it is often blue and in non-whites it is gray.
114 A Mathematical Model of Middle Ear Ventilation. Controlled Valvular Tympanostomy Tube , Fücsek M 1* Molnárka GY 2
BAKGROUND The middle ear (tympanic cavity and mastoid process) is a closed cavity. It is filled with a special gas mixture and at the same pressure as atmospheric air, the composition of the gas is similar to the surrounding tissues. Its change in pressure is compensated by the occasional opening of the Eustachian tube. If the tube does not open, a persistently high negative pressure develops in the middle ear, the clinical consequences of which are well known. The negative pressure is eliminated by a tympanostomy tube implanted in the tympanic membrane. Inserting the tube instead of one abnormal condition (permanently closed middle ear) creates another abnormal condition (permanently open middle ear). Prolonged insertion of the tube may cause irreversible damage. / eardrum atrophy, tympanosclerosis, permanent perforation, auditory bone damage, cholesteatoma /.  AIM  We are looking for a solution that is similar to the original, i.e. the middle ear should be closed and open from time to time.  METHOD We studied middle ear ventilation based on literature data, our own research, and our computer model. RESULTS We concluded that the original function can be restored with the valve tube. In our case, the opening and closing of the valve is controlled by a change in volume caused /diethyl ether/ by a change in body temperature.  CONCLUSION A more advanced solution would be a nanotechnology valve controlled by a change in total pressure, a partial pressure change in oxygen or carbon dioxide. However, a valve that can be opened at different intervals or even individually adjusted is conceivable.