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World Journal of Advance Healthcare Research

ISSN(p): | ISSN(e):2457-0400
Journal Papers (336) Details
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Indexed Journal

1 COMPARATIVE STUDY ON HEALTH IMPLICATION OF MOTHER PREFERENCE TO EXCLUSIVE BREASTFEEDING AND MIXED FEEDING AMONG NEWBORNS IN ISOBOR , Bright Ewona*, Vivian Takim, Grace Offiong and Okon Etim
The process of nursing babies or young children with milk from their mother‟s breast is well known practice as recommended by health professionals for babies from the first hour of their life on earth until as much as they would need it.Breast milk contains vital nutrients and natural antibiotics that are needed for a child‟s well-being, growth and development. Even if many mothers adopt this practice, a lot of them, especially the rural dwellers are still not fully aware of the best method of breastfeeding for their babies. In this study the researcher compared the health implication of mother preference to exclusive breastfeeding and mixed feeding among newborns in Isobor. Three research questions were formulated to guide the study. Descriptive survey design was adopted. Structured questionnaire was used to gather Data from 120 respondents who were basically nursing mothers from sample communities.Simple random technique was employed to select the sample for the study. The instrument was validated to ensure that items in the questionnaire represent the subject of interest and was accurate. The test-retest method of reliability was used in ensuring reliability of instrument. Simple percentage was used to analyze data obtained. From the study, children who wereexclusively breastfed displayed sound physical and mental attitudes, good skin texture, brilliant dispositions and strong disease resistance abilityat significant levels compared to those nurtured by mixed feeding. These are some of the reasons why most mothers adopt exclusive breastfeeding method. From the findings it was recommended that nursing mothers should prefer exclusive breastfeeding under normal conditions.
2 THE ASSOCIATION BETWEEN THE INCIDENCE OF CONTRAST-INDUCED NEPHROPATHY AND DIABETES IN PATIENTS WITH NORMAL RENAL FUNCTION UNDERGOING CARDIAC CATHETERIZATION , Alaa Raslan, MD*, Hussein Saied, PHD, Akram Jahjah, PHD
Even though diabetic nephropathy is a well-known risk factor for CIN, the tendency of diabetic patients with normal renal function to develop CIN remains controversial Aim: Identifying the possible association between diabetes with normal renal function and the incidence of CIN. Methods: This is a prospective analytical study that has included 111 patients, all underwent an objective exam, hematochemical measurements. The patients were divided into two groups depending on the presence of diabetes. The incidence of CIN (defined as an increase in creatinine level equal or more than 25% from baseline values within 48-72 hours after the coronary procedure) was compared in the two groups. Results: CIN took place in 23 patients, 8 of them were in the diabetic group. No significant difference was noted in the incidence of CIN in the diabetic and non-diabetic group (24% vs 19% respectively with a p value of 0.55) Conclusion: No significant association between the incidence of CIN and diabetes was noted in patients with normal renal function.
3 INCIDENCE OF CONTRAST-INDUCED NEPHROPATHY IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION AS OPPOSED TO CORONARY ARTERY ANGIOGRAPHY , Alaa Raslan, MD*, Hussein Saied, PHD and Akram Jahjah, PHD
Contrast-induced nephropathy (CIN) may sometimes be a serious complication of coronary angiography (CAG) and percutaneous coronary intervention (PCI). Aim: to study the incidence of CIN in patients undergoing PCI as opposed to coronary angiography alone. Methods: This is a prospective analytical study that has included 123 patients undergoing coronary angiography or PCI, all underwent an objective exam, hematochemical measurements. The patients were divided into two groups depending on the type of procedure. The incidence of CIN (defined as an increase in creatinine level equal or more than 25% from baseline values within 48-72 hours after the coronary procedure) was compared in the two groups. Results: CIN took place in 28 patients, 10 of them were in the PCI group. No significant difference was noted in the incidence of CIN in the PCI and CAG group (22% vs 23% respectively with a p value of 0.9) Conclusion: No association was found between PCI and increased incidence of CIN as opposed to coronary angiography.
4 BREEDING OF BIRD FLU ON BREAST CHICKEN AND THE POSSIBILITY OF ITS CONNECTION WITH THE CASE OF BIRD FLU INHUMAN IN PROVINCE OF BALI INDONESIA , Hamong Suharsono and *Sumarno Reto Prawiro
Cases of human bird flu had been reported in Bali province in the middle of August 2007. The two cases, each from Jembrana and Tabanan district were associated with exposure to avian influenza virus H5N1. Death in humans due to the H5N1 virus was strongly associated with the outbreak of avian influenza H5N1 in village chickens in Bali province. Data of poultry bird flu at Balai Besar Veteriner Denpasar showed an increase of bird flu cases in village chickens which occured from January until September 2007. From a total of 105 poultries cadaver necropsied at Pathology Laboratory, 86,66% were village chickens and 5(63,74%) were positive bird flu H5N1. This cadaver came from Kabupaten Badung (38,09%), Tabanan (15,24%), Klungkung (10,47%), Gianyar (8,57%), Jembrana (4,76%), Buleleng (3,81%), Bangli (1,90%) and Kotamadya Denpasar (17,14%) respectively. This paper reported an outbreak of bird flu in village chickens and possibility its relationship to the first evidence of human bird flu in Bali province in the midle of August 2007.
5 ASSESSMENT OF KNOWLEDGE AND ATTITUDE OF PATIENTS TOWARDS HEALTH INFORMATION MANAGEMENT PRACTICE AT ESUT TEACHING HOSPITAL PARKLANE, ENUGU. , *Dr. Mgbe Emeka Kevin MBBS, FWACS and Mgbe Chinenye Glory PhD
Background: The present study was on assessment of knowledge and attitude of patients towards health information management practice at ESUT Teaching Hospital Parklane, Enugu. Objective: To ascertain if patients at ESUT Teaching Hospital Parklane, Enugu have the knowledge of health information management practice, to assess the attitude of patients at ESUT Teaching Hospital Parklane Enugu towards health information management practice, as well as to determine the factors affecting the acceptance of health information management practice by the patients at ESUT Teaching Hospital Parklane, Enugu. Methodology: The study population consisted of 207 patients at ESUT Teaching Hospital Parklane, Enugu. A sample size of 136 patients was derived using “Taro Yamane” formula. Descriptive research design was adopted while structured questionnaire was used as the only measuring instrument and purposive sampling technique was used in selecting 118 adult patients of ESUT Teaching Hospital Parklane, Enugu whose opinion was sampled. Result: Findings revealed that majority of the respondents representing 98.2% have knowledge of health information management profession, who gained their knowledge when they were being admitted. Findings also revealed that 31.5% of the respondents felt health information management practitioners to be those who register and document the patients, 42.9% believing that they lack interpersonal communication skills. Conclusion: The researcher recommended that more students should be trained in the profession of health information management.
6 STROKE: COST TO THE HEALTHCARE SYSTEM IN RIO GRANDE DO SUL STATE, BRAZIL, 2007 – 2017 , Greice de Souza Lenz*, Roger dos Santos Rosa, Ronaldo Bordin and Rita de Cassia Nugem
Stroke is a cerebrovascular disease with a high incidence, ischemic heart disease, and stroke are the leading causes of death and disability worldwide, accounting for a total of 15.2 million deaths in 2016. They have remained the leading cause of death in the world over the past 15 years. Aim: To describe the financial amount paid by the Unified Health System for stroke hospitalizations in the Rio Grande do Sul State (RS, Brazil) from 2007 to 2017. Methods: Secondary data were collected from the Hospital Information System, a database that aggregates data from all hospital admissions paid by the Brazilian national public healthcare system (Unified Healthcare System - SUS). Findings: Considering 2007 as a database, in 2017 there was an increase of 11,9% in the number of hospitalizations for stroke, 26.1% in relation to the total paid by SUS for hospitalizations and 12,7% of the average amount paid. The highest number of hospitalizations (10,119) occurred in 2016, the highest total cost (US$ 5,188,404.28) in 2014, and the average amount paid for hospitalization was higher in 2012 (US $ 612.21). Mortality rates ranged from 16.74% in 2007 to 13.45% in 2017, with a downward trend. Conclusion: The increase of 11.9% in the number of hospitalizations for stroke and 26.1% in relation to the costs total paid for SUS for hospitalizations was expected, considering the ongoing demographic and epidemiological transition.
7 PLACE OF INTERNSHIP AND WORKPLACE PREFERENCES AMONG MEDICAL DOCTORS IN TANZANIA; PERSPECTIVES OF INTERN DOCTORS , Mariam Izengo, Larry Akoko, Elizabeth Ngonyani, Obadia Nyongole and Nathanael Sirili*
Background: Tanzania, like many low and middle-income countries, is suffering from a critical shortage and mal-distribution of doctors favouring the urban areas. By 2015, only 25% of doctors were in rural Tanzania where over 70% of the population lives. This study sought to explore the workplace preferences among intern doctors from three selected regions in Tanzania. Methodology: A cross-sectional study was carried out among intern doctors working at Muhimbili National Hospital, St. Francis referral hospital, St. Joseph Hospital Peramiho and Songea Regional Referral Hospital from July to August 2016. Data analysis was done using SPSS version 21 and statistical significance was set at a p-value of ≤ 0.05. Results: One hundred and fifty-four intern doctors filled in a self-administered questionnaire for this study. Majority of the interns (68.2%) were ready to work in urban setting over rural areas despite the location of upbringing and schooling. Undertaking an internship in a rural setting was statistically associated with readiness to work in rural areas. Furthermore, better urban facilities physical infrastructure and many incentives contributed to the readiness to work in urban areas over rural areas. Conclusion: The findings of this study are in line with many other studies that revealed that many doctors prefer to work in urban areas due to economic and career opportunities over rural areas. Place of internship adds on the potential for rural practices among the newly graduating doctors.
8 MULTILEVEL LOGISTIC REGRESSION ANALYSIS OF FACTORS ASSOCIATED WITH ACUTE RESPIRATORY INFECTION (ARI) AMONG UNDER-FIVE CHILDREN IN ETHIOPIA , Tesfaledet Tsegay Mena*
Acute respiratory tract infection (ARI) is considered as one of the major public health problems and it‟s recognized as the leading cause of mortality and morbidity in many developing countries. The greatest problem for developing countries is mortality from ARI in children less than five years of age. This study is an attempt to identify socio-economic, demographic, health, environmental and nutritional related predictors of ARI among under-five children in Ethiopia. In this study the data source is Ethiopian Demographic and Health survey (EDHS, 2011) conducted by Central Statistics Agency (CSA). From the sampled children, the two weeks prevalence of ARI among under-five children was about 12.3% in Ethiopia. The result of the analysis showed that fuel used for cooking, current age of the child, received vitamin A recently, underweight, wasting, region, had Diarrhea recently, number of under five children, mother currently working and household wealth index are significant risk factors of under five children in Ethiopia. The multilevel analysis showed that the variance of the random component related to the intercept term was found to be statistically significant implying difference in prevalence of ARI among the regions. It also found that fuel used for cooking, current age of the child, received vitamin A recently, underweight, wasting, region, had Diharria recently, number of under five children, mother currently working and household wealth index were significant determinant of variations of prevalence of ARI among regions. However, the significant predictors did not show underlying variation from region to region.
9 FACTORS OF SOCIAL EXCLUSION: A STUDY OF TB PATIENTS IN JAMMU URBAN , Prof. Jasbir Singh and Dr. Neharica Subhash*
Tuberculosis remains a major global health problem. It causes ill-health among millions of people each year and ranks as the second leading cause of death from an infectious disease worldwide, after the human immunodeficiency virus (HIV). Under the facilitation by the Central Government Tuberculosis patients(TB) are registered under Directly Observed Treatment Short-course (DOTS) program in Jammu urban. Initially TB is also one of the major diseases that cause enormous economic crisis in low income countries. But with the initiatives taken by the Government, scenario has been changed. The present field survey indicates that along with number of initiatives taken by the Government, there are other factors like socio-economic which affect the patients and clearly indicates exclusion.
10 AN EXPERIMENTAL STUDY TO DETERMINE THE EFFECTIVENESS OF BEETROOT JUICE ON HEMOGLOBIN AMONG GIRLS OF SELECTED HOSTEL GIRLS, BIDAR, KARNATAKA , Prof. Dr. Senthil Kavitha R.* and Dinesh
Anemia is a condition in which a person lacks sufficient healthy hemoglobin, the substance carrying oxygen in red blood cells. Poor nutrient status was associated with common menstrual problems among adolescent girls from rural area. Objectives of the study were 1) To assess the hemoglobin level among girls in selected college hostel, 2) To determine the effectiveness of beetroot juice to raise hemoglobin level among girls in selected college hostel and 3) To associate the relationship between hemoglobin and selected demographic variables among girls in selected college hostel. Hypotheses were 1) There will be a significant difference between the pre and post hemoglobin value among the girls with anemia among girls in selected college hostel and 2) There will be an association between the hemoglobin and selected demographic variables among girls with anemia. One group pretest post test design selected for the study with a purposive sampling technique. Thirty samples of hostellers were included. Reliability was found to be reliable with the reliability coefficient of 0.92 by test retest method. The freshly prepared beetroot juice was administered to the samples for 20 days in mid morning. Pre and post assessment was done by using cyanmethemoglobin method for checking hemoglobin level. The data analysis was done by using descriptive and inferential statistics. Results proved that after beet-root juice intake it was noted to achieve t value of 15.76 which was significant improvement in overall hemoglobin levels at (P < 0.05). Conclusion: Study concluded that the juice of beetroot is an excellent source of iron and vitamin C, which is considered good for anemia for adolescents’ girls.
11 PSYCHOLOGICAL AUTOPSY ON FARMERS’ SUICIDE VICTIMS: A RETROSPECTIVE STUDY. , Shivappa B. Walikar*, Sunanda Govinder Thimmajja, Sreevani Rentala and Sunanda Govinder Thimmajja
Background: Farming is one of the oldest industries in the world and often portrayed as a happy way of life. Despite this, agriculture has one of the highest rates of suicides than any industry. Aim: Assess the Psychological factors influences on farmer’s suicide victims. Method: A retrospective study conducted for 39 victims who were selected based on inclusive criteria. Semi-structured psychological autopsy questionnaires were used to gather information. Results: Results reports about Psychological factors related that majority of farmers’ suicide victims suffered by before committing suicide are i) stressful factors ii) Victim’s addiction to substances, iii) victim’s personal changes, iv) Victim’s life planning issues, v) Victim’s usual reaction to stress, vi) Victim’s personality type characteristics vii) Victim’s health status findings, viii) Victim’s family related stress factors regarding. Conclusion: The present study results revealed that there were multiple risk factors in causation of farmers’ suicide victims were suffered before committing suicide.
12 MULTIRESIDUE METHOD FOR DETERMINATION OF PESTICIDES IN CAULIFLOWER SAMPLES WITH GAS CHROMATOGRAPHY , S. R. Ananda Gowda, A. Kesava Reddy and H. L. Ramesh
India finds it difficult to suffice the needs of ever growing population and use of pesticides in vegetables has increased several folds in the last several years. In tropical conditions, fruits and vegetables are grown throughout the year and cauliflower is highly nutritious and fibrous, helps in scavenging free radicals from the body to prevent incurable diseases. Vegetable samples of cauliflower collected from Bangalore urban district and subjected to gas chromatography equipped with ECD and FTD. Recovery studies performed at fortification levels of 1.0, 0.5 and 0.01 mg/kg and the average recovery rates ranged from 77.3 to 94.7 %. Variation in acephate, chlorpyriphos, dichlorvos, monocrotophos, phorate, cyfluthrin-β, cyhalothrin-λ, cypermethrin, deltamethrin and fenvalerate residues in cauliflower samples is recorded. It is found that 12.5 % of samples from Bangalore urban were having phorate residue value above the MRL of 0.05mg/kg. Pesticides though present in cauliflower sample in Bangalore urban district and not exceeded the MRL.
13 EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING CERVICAL CANCER AND ITS PREVENTION AMONG PRIMARY SCHOOL TEACHERS IN SELECTED SCHOOLS AT MYSURU CITY , Ambika K.* and Prof. Sheela Williams
Background: Carcinoma of the cervix accounts for malignant tumour of the cervix and 50-65% of malignant tumours of the female reproductive tract and is a close second to carcinoma of the breast among all cancers in women. It is necessary to make the teachers aware about cervical cancer, who can impart knowledge regarding cervical cancer and its prevention to the general public. Aim: The aim of the study is to determine the effectiveness of structured teaching programme on knowledge regarding cervical cancer and its prevention among primary school teachers in selected schools at Mysuru city. Methods: In this study, one group pre-test and post-test, pre experimental design was used and convenience sampling technique was adopted. Data were collected using structured knowledge questionnaire and structured teaching programme was conducted to primary school teachers. Results: The result of the study revealed that the significance of difference between the mean pre test and mean post test score which was statistically tested using paired‘t’ test. The mean difference between the mean pre test and mean post test knowledge score was 8.43 with the standard deviation difference ±2.56. The paired ' t value 18.76 which was found to be highly significant at 0.05 level of significance. The knowledge score of primary school teachers had no significant association with their selected personal variable expect for year of teaching experience and type of family regarding cervical cancer and its prevention. Conclusion The study concluded that the administration of structured teaching programme was effective method for improving the knowledge of primary school teachers regarding cervical cancer and its prevention.
14 EVALUATION OF FEASIBILITY OF BINOCULAR MAGNIFYING LOUPES IN SMALL INCISION CATARACT SURGERY AND ITS COMPARISON WITH OPERATING MICROSCOPE WITH RESPECT TO COMPLICATIONS AND POSTOPERATIVE INFLAMMATION- A PROSPECTIVE RANDOMIZED STUDY , Dr. Vimal Krishna Rajput. MS (Ophthal), FPOS, FICO*, Dr. Shweta Bhalsing. MS (Ophthal), FGNN, FICO, Dr. Snehal Bhalsing. MS (Ophthal), FVR, FICO and Dr. Soni Rajput. MDS
Purpose: To evaluate feasibility of a binocular loupe in performing small incision cataract surgery (SICS) and to compare the intraoperative complications and postoperative inflammation of surgeries performed using operating microscope and binocular loupe. Setting: District government hospital in Western India. Design: Prospective, randomized controlled study. Methods: Three hundred and twenty-six patients undergoing SICS were randomly allocated to microscope (158 eyes) or loupe (168 eyes) magnification. Intra- and post-op complications and signs of inflammation were evaluated on day 1 and day 30. Results: With similar baseline characteristics, postoperative congestion (p 0.05) and reaction in anterior chamber (p 0.53) were comparable in both the groups. The overall incidence of striate keratopathy (SK) was statistically significantly higher in group B (p 0.003), but visually significant SK (grade 3 and 4) was similar in both the groups. Intra operative complications were comparable in both groups (p 0.74). Mean surgery time with loupe magnification was shorter, but not statistically significant (p 0.14). Conclusions: The complications and handling of intraocular tissues using magnifying loupes is comparable to that using a microscope. Loupe is a cheap and effective tool to perform cataract surgery in a camp set up; so, it can play a role in reducing cataract blindness in developing countries of the world.
15 GUIDING MANDIBLE BACK HOME: PROSTHETIC REHABILITATION: CASE REPORT , *Dr. Ajay G. Doni, Dr. Supriya Manvi Professor, Dr. Rajeswari C.L. Professor, Dr. Rohit Mohan Shetty, Dr. Srivatsa G. Professor and Principal, Dr. Deepti Kumar Post Graduate
Surgical resection of the mandible due to presence of benign or malignant tumour is the most common cause of the mandibular deviation. The resection can be total or segmental depending on the lesion. Loss of mandibular continuity results in deviation of the remaining mandibular segment towards the resected side, primarily because of the loss of tissue involved in the surgical resection. The success in rehabilitating a patient with hemimandibulectomy depends upon the nature and extent of the surgical defect, treatment plan, type of prosthesis, and patient co-operation. The earlier the mandibular guidance therapy is initiated in the course of treatment, the more successful is the patient’s definitive occlusal relationship. Prosthodontic treatment coupled with an exercise program helps in reducing mandibular deviation and improving the masticatory efficiency. This case report describes an early prosthodontic management of a patient who has undergone hemimandibulectomy and was rehabilitated using provisional guide flange prosthesis followed by a definitive maxillary and mandibular cast partial denture with precision attachments that was designed to fulfil patient’s needs.
16 ROLE OF VAJIKARANA CHIKITSA IN THE PREVENTION OF DISEASE AND MAINTENANCE OF HEALTH , Dr. Pooja Sharma*, Dr. Anupam Pathak, Dr. Yogesh and Dr. Anshu Sharma
Ayurveda is a comprehensive medical system of body, mind and spirit. It is a science and art of appropriate living, which helps to achieve better long life. Ayurveda is also frequently referred as 'Ashtanga Ayurveda' and Vajikarana chikitsa is also a part of it(Ashtanga Ayurveda). As per Charak Samhita, with the help of Vajikarana formulations, we can get good physique, mentally and physically healthy body, strength, potency and sexually potent. Ayurveda is guided about the prevention of disease and maintenance of health. Vajikarana therapy are said to revitalize all the seven Dhatus (body elements), therefore, restores equilibrium and health.
17 HEMORRHAGIC PERICARDIAL EFFUSION IMPENDING TAMPONADE ASSOCIATED TO BURKHOLDERIA CEPACIA , Dr. Lenah Bashir*, Dr. Shadan Akhtar, Dr. Bashir A. Fomda, Dr. Yawar Nissar
Burkholderia cepacia complex (Bcc) is recognized as an important opportunistic pathogen in immunocompromised, cystic fibrosis (CF), chronic granulomatous disease patients. It is also an important nosocomial pathogen in hospitalized patients, causing life-threatening bacteremia, urinary tract infections and respiratory tract infections because of high intrinsic antibiotic and disinfectant resistance.[1,2] Though there are reports of nosocomially acquired Bcc infection in immunocompetant patients.[3] Pericardial effusion caused by Bcc is rarely reported in literature.
18 MEDICATION ERROR – THE CHALLENGING CONCERN , Dr. P. L. Alekhya*
Medication Error is one of the most common causes of un-intentional harm. Health grades reports suggest that annual deaths attributable to Medication errors are more than 250,000. This number is exceeded by only deaths due to Heart Diseases (700,142) and Cancers (553,768). 37.6 $ Billion costs are directly associated with Medication errors which are preventable. The extra Medical costs of treating medical errors occurring in hospitals alone conservatively amounts to 3.5 $ billion per year. This estimate does not take into account lost Wages and Productivity or additional Health care costs. The impact of these errors on patients includes increased length of the stay in hospitals, disability and mortality. Understanding the magnitude and nature of harm in primary care is important. Ongoing research plays a key role in identifying the works to improve safety and how to implement best practices. The range of opportunities for interventions in terms of reducing error rates, those provided by clinical pharmacists are quite promising.
19 IDENTIFICATION TICK SPECIES DETERMINATION OF THEIR SEASONAL RATE IN THE REPUBLIC OF GUINEA , *Aly K., Alpha Oumar Sily D., Mohamed K., Youssouf S., Mamadou Yero B., Ansoumane S.
Ticks are hematophagous arthropods that parasitize almost all vertebrates and can bite humans occasionally. They transmit many germs which are at the origin of zoonoses. This study concerns the identification of tick species involved in the publication of rickettsioses in the Republic of Guinea. The objective of this study was to collect and identify tick species in order to determine their frequency according to the seasons in two prefectures of the Republic of Guinea. Conventional methods used for catching ticks have been used. Samples were taken in the prefectures of Mamou and Kindia. A total of 200 tick samples were taken from the body of N'dama cattle, one hundred (100) in the Kindia administrative area and one hundred (100) in Mamou. The harvested ticks were packaged in the sterile cotton-clogged sterile tubes, labeled and whose information is given on the specimen card: name of animal, tattoo, dress, locality, owner. The cooler was used to send the samples to the Kindia Research Institute for Applied Biology laboratory. In the laboratory, the dichotomous tick identification key was used to identify all the species contained in a pled sample. It focused on the presence and absence of porous area, chitinized scutum, the number of pair of legs, absence of gonopore, surface of the non-rough scutum, stigma with tail, lateral groove. Eight species were identified, including five at Mamou: Amblyomma variegatum (63.09%); Ripicephalus decoloratus (14.29%); Ripicephalusannulatus (15.43%); Hyalomma tuncatum (5.95%) and Haemaphysalis leachi (1.19%). In Kindia they are Amblyomma variegatum (96.92%); Hyalomma truncatun (2.05%) and Ripicephalus geigyi (1.03%) that have been identified. Ticks were much more abundant in the rainy season. As the localities visited are transit and livestock marketing areas, epidemiological surveillance of tick-borne diseases should be carried out with the ultimate aim of preventing the spread of tick-borne zoonoses in the study areas. In Guinea, ticks are present from May to September however, it is in August that the greatest outbreak is observed. These months are in the rainy season in the regions visited. It should be noted that most known species are sensitive to climate change.This entirely exclusive research is devoted to the identification of ticks in the regions of Mamou and Kindia, because these localities are breeding areas par excellence. They are also placing of transit and marketing, which are factors favoring the transmission of ticks and collaterally rickettsioses. It shows the disparity of tick species according to the area of investigation. Tick-borne disease surveillance programs must be implemented in order to maintain the health of populations.
20 FACTORS AFFECTING PATIENT ACCESS TO PRIMARY CARE FACILITIES IN ADO-EKITI, NIGERIA , Dr. Pius Izundu Okpoko*
Background: Most people access care globally through the Primary health care (PHC) which is the first point of contact with health care professionals. Given that the uptake of PHC in Nigeria is low, this research investigated factors affecting patient access to PHC facilities by analysing patient experience as they access PHC facilities in Ado - Ekiti, Nigeria. Methods: A cross-sectional study design that employed the use of quantitative survey method. The participants were 321 Patients who access PHC facilities in Ado – Ekiti for routine medical care. A questionnaire was administered to each of the participants as they accessed the facilities within the PHC settings in Ado - Ekiti. The questionnaire measured outcome of patient-doctor relationship, barriers and difficulties to access, and accessibility to care. Results: More females (79%) and the age group of 18 to 28 years (51.9%) accessed primary health care facilities more than their counterparts do. ‗Empathy‘ was the only significant and predictive variable associated with ‗improvement in physical and mental state after the visit to the doctor‘. Also, ‗attitude of staff‘ was the only predictive factor that showed significant association with ‗arranging for appointment to the doctor‘. Conclusion: ‗Empathy‘ and ‗attitude of staff‘ were found to be independent predictors of access to care. Therefore, strategies that target improvement in patients‘ experience of PHC, and subsequently, access to PHC facilities should be directed to sensitive issues relating to ‗empathy‘ and ‗attitude of staff‘ in Ado-Ekiti, Nigeria.
21 THE INFLUENCE OF EDUCATION, KNOWLEDGE, AND BEHAVIOR FOR MEDICATION ON DELAYED ARRIVALS OF ACUTE CORONARY SYMPTOMS (ACS) PATIENTS AT EMERGENCY UNIT OF SANGLAH PUBLIC HOSPITAL IN DENPASAR, BALI ISLANDS, INDONESIA , Yustina Ni Putu Yusniawati*
Acute coronary syndrome (ACS) is an emergency condition that requires fast and precise actions, but delayed arrival of the patient at the emergency unit is still imminent. Educational factors, knowledge and behavior of treatment are major causes of the delayed arrival of the patients. The purpose of the study is to determine the relationship between the educational, knowledge and behavior for medication factors with the delayed arrival patients at the emergency unit of Integrated Heart Service at the Sanglah Hospital in Denpasar Bali. This research is a quantitative research by nature with cross sectional design, and data collection technique was using purposive sampling with 292 patients. The result shows that 48.6% of patients have higher education degree, 71,6% of the patients do not have information related to ACS and 191% of patients rest when experiencing ACS. The delayed arrival of the ACS patients might be closely related to the patients’ education, knowledge upon the ACS and the patients’ behavior who prefer to rest when experiencing ACS. Medical staffs need to provide counseling to the patients and families about the symptoms of ACS, healthy lifestyle, and the importance to come to emergency when ACS emerges.
22 CLINICAL MANAGEMENT OF AMLAPITTA WITH KHANDA KUSHMANDA AVALEHA , Dr. Deepika Yadav*
One of the very common diseases caused by unhealthy food habits and lifestyle activities is Amlapitta. A clinical trial was conducted to manage the disease through Khanda Kushmanda Avaleha. 25 patients diagnosed as Amlapitta were selected from OPD and IPD of Ayurveda Mahavidyalaya, Hubli, Karnataka who fulfilled the inclusion criteria. S pecial clinical proforma, based on criteria of selection and parameter, for assessment of subjects was prepared. All 25 patients were given 25 gms of Khanda Kushmanda Avaleha along with Sukhoshna Dugdha as anupana for 30 days. Results were statistically significant. Out of 25subjects, 80% subjects showed excellent response. 12% subjects showed good response. Moderate response was shown by 8% subjects. The study revealed that Khanda Kushmanda Avaleha showed excellent results in the management of Amlapitta.
23 THE INFLUENCE OF SERVICE QUALITY ON BED OCCUPANCY RATE THROUGH PATIENT SATISFACTION IN BALUNG GENERAL HOSPITAL JEMBER REGENCY , Ahmad Aviv Mahda*, Al Munawir and Zarah Puspitaningtyas
Background: Bed Occupancy Rate (BOR) serves as an indicator of the hospital performance. The standard of BOR ideally was in 60-85%. BOR in Balung General Hospital over the past five years never reach the ideal standard by an average was 32,65%. When BOR has not ideal so the quality of inpatient services is predicted has not yet been optimized. The service quality is predicted has an effect on patient satisfaction and patient satisfaction is predicted has an effect on BOR. This study aim to analyze and to know whether there is indirect effect of service quality on BOR through patient satisfaction. Materials and Methods: The instrument of service quality use ServQual questionnaire and the instrument of patient satisfaction refer to PERMENPANRB 14/2017. This study is a quantitative study. The samples are 250 respondents and be elected by combining quota and accidental sampling techniques. Data was analyzed using path analysis with Lisrel 8.70. Result: This study shows that service quality and patient satisfaction have had positive and direct effect on BOR and there are significant indirect effect of service quality on BOR through patient satisfaction. Conclusion: The each direct effects of service quality on BOR, service quality on patient satisfaction, and patient satisfaction on BOR are greater than the indirect effect itself. Balung General Hospital is expected to maintain and improve the quality of inpatient services so patient satisfaction and BOR will rise as well.
24 EMBEDDING GRADUATE EMPLOYABILITY SKILLS INTO HEALTH AND SOCIAL CARE COURSE - A SCOPING REVIEW , *Swapna Williamson, Laila Paulsen-Becejac, Kit Tong, Ramona Minette and Janice Forbes-Burford
This scoping review aimed to explore the graduates' employability skills required for employment in health and social care settings. Electronic literature searches were conducted to identify literature published from 1993 to 2018. The literature reviewed were research papers, educational reports and scholarly papers on graduate employability skills. The literature searches and the review were performed independently by the authors. Out of 121 articles only 42 met the inclusion criteria. The review found the perceptions of graduates, employers and academics who could contribute in developing graduates' employability skills. Service users‟ involvement was not evident in the literature reviewed so inclusion of their views was recommended as essential in identifying desirable graduates' employability skills.
25 BRONCHOPLASTIC PULMONARY RESECTIONS: INDICATIONS, SURGICAL TECHNIQUES AND PROGNOSIS , F. Z. Ammor*, S. Rabiou, M. Lakranbi, L. Bellirej, H. Harmouchi, I. Issouffou, Y. Ouadnouni and M. Smahi
The indications for bronchoplastic pulmonary resections are limited, allowing carcinological resection while preserving good respiratory function, with a highly significant drop in morbidity and mortality rate. It’s about a Retrospective study of 6 cases, There were 6 women, whose average age was 47.3 year. It was 4 cases of endobronchial process (2 the right main bronchus, the middle trunk and the right upper lobar bronchus) and 2 cases of tissue mass (of the right upper lobe, straddling the right upper lobar bronchus and the the middle lobe) ; The resections were: Upper and middle Lobectomy with anastomosis of the inferior right bronchus and the right main bronchus (1case), Upper Lobectomy with anastomosis of the the right main bronchus and the middle trunk (2cases), Middle and Inferior Lobectomy with anastomosis of the right upper bronchus and the right main bronchus (1case), Right pneumonectomy enlarged to the carina with V-plasty (1 case) and Kergin plasty (1 case). The histological types were a typical carcinoid tumor (3cases) and atypical (1case), a lepidic ADK (1case) and a moderately differentiated ADK (1case). The mortality rate was 0% compared to 9.5% for 21 tumor pneumonectomies performed in the same period in our department
26 CARINA RECONSTRUCTION SURGERY: INDICATIONS, TECHNIQUES AND RESULTS , M. Lakranbi*, F. Z. Ammor, S Rabiou, L. Bellirej, H. Harmouchi, Y. Ouadnouni and M. Smahi
Introduction: Indications for carina surgery are rare, limited to tumors of the lower trachea or the main bronchi, offering carcinologic resection R0 and a better prognosis at the expense of a operative tactic specially adapted to each case It’s about a Retrospective study about 5 cases, benefiting from a resection of the hull with or without pulmonary resection, associated with a carinoplasty under different techniques (8 years), 3 men and 2 women, whose average age was 41 years. The radiological assessment objectified a central tumor process (Hilar 2cases, subcarinary 2cases, endobronchial 1case), associated with mediastinal lymphadenopathy in 4cases and an aspect of right lung destroyed in 3cases. By a right postero lateral thoracotomy (4cases) and a sternotomy (1cases), the gestures carried out were: right intrapericardial pneumonectomy enlarged to the carina with reconstruction by a KERGIN type (1case), inverted KERGIN (1case), a V-plasty 1 case); tumor excision enlarged to the carina with angular section and V-shaped plasty (1case); resection of the carina with tracheobronchial anastomosis in double rifle barrel (1 case), associated with radical mediastinal lymph node dissection. The histological diagnosis was : moderately differentiated ADK, poorly differentiated carcinoma, mucoepidermoide carcinoma, typical carcinoid tumor (2cases). During an average follow-up of 4.75 years, an immediate postoperative death and a recurrent cervical lymph node were noted Conclusion: Carinoplasty is technically difficult, requiring perfect collaboration between pulmonologists, surgeons and anesthesiologists, to deal with a problem linked to: approaches, mobilization techniques, type of resection-anastomosis and postoperative.
27 A CASE REPORT OF ACUTE APPENDICITIS DUE TO INTESTINAL SCHISTOSOMIASIS WITH A REVIEW OF THE LITERATURE , *Eke Barnabas, Ojo Babarinde, Bamidele Omolabake, Ugwu Victor, Akpor Issac, Ngbea Joseph, raymond Vhriterhire, Udu Comfort, Umabong Emanso and Ogiator Monday
Schistosomiasis is prevalent in tropical and subtropical regions of which Nigeria is considered as one. Schistosoma appendicitis is a rare manifestation of Schistosomiasis particularly in developed countries compared to endemic regions. Its diagnosis is usually made after histological examination of appendectomy specimen. In endemic regions, Schistosoma appendicitis should always be considered as a differential diagnosis for acute appendicitis, though seldom reported in developed countries, and with recent changes in global migration, schistosoma appendicitis should also be considered as one of the causes for appendicitis, especially for recent migrants in western countries. We present a case of a 43 year old woman with appendicitis due to intestinal schistosomiasis.She was first managed as a case of pelvic inflammatory diseases but not responsive to medication. A review by the surgical team changed the diagnosis to acute on chronic appendicitis. Its diagnosis was made after surgical pathology of the removed appendix.
28 THE PATTERN USE OF ANTI-THROMBOTIC IN ATRIAL FIBRILLATION PATIENTS IN SOUTHEAST ASIA: A SYSTEMATIC REVIEW , Rizaldy Taslim Pinzon* and Niyata Hananta Karunawan
Background: Stroke prevention in AF patients is a very important. One of therapeutic goals is prevention of thromboembolism with anticoagulation. there has been very limited data on pattern of use of antithrombotic therapy for atrial fibrillation patients in southeast Asia. Aim: review the use of antithrombotic therapy pattern for ischemic stroke with atrial fibrillation in in southeast Asia. Methods: We performed a comprehensive search on topic that the pattern of anti-thrombotic use in atrial fibrillation patients with in southeast asia from inception up until November 2019 through PubMed, and Cochrane Central Database. Systematic research process was using various keywords. The keywords were: “anti-thrombotic”, “anti-coagulation”, and “atrial fibrillation', The operator “and” was then used with the name of each country in southeast Asia. The inclusion criteria of the study i.e: patients with AF, was a original papers with observational study, concerned on use of anticoagulation in patients with atrial fibrillation in southeast Asia. Results: Data of using antithrombotic are available in six countries in southeast Asia, a total of the 8 articles identified were from Philippine, Thailand, Vietnam, Singapore, Indonesia, and Malaysia were also represented. The reported The rate of using Anticoagulation for secondary prevention of stroke in southeast Asia is ranged 7.7% to 18.2%. Conclusions: The rate of using Anticoagulation for secondary and primary prevention of stroke in southeast Asia is still low. The Pattern Use of antithrombotic in Stroke Patients with Atrial Fibrillation showed that warfarin is the most widely used Anticoagulation in southeast Asia countries.
29 PREVALENCE OF PROTEINURIA AMONG HIV PATIENTS ATTENDING THE HIV CLINIC AT BENUE STATE UNIVERSITY TEACHING HOSPITAL, MAKURDI, NORTH CENTRAL, NIGERIA , Monday O. Ogiator*, Ochoche O. Ijachi and Okpe Matthew
HIV positive patients are at an increased risk for chronic kidney disease. HIV related renal diseases are common causes of chronic kidney disease globally. Proteinuria is a marker of kidney damage and a risk factor for progression to end stage renal disease. This study aimed to investigate the prevalence of proteinuria among HIV patients seen at Benue State University Teaching Hospital, Makurdi. Objectives: To determine the prevalence of proteinuria among HIV infected patients attending HIV clinic at Benue State University Teaching Hospital (BSUTH), Makurdi, Nigeria. Methods: One Hundred and fifty two HIV patients and 65 age and sex matched non-HIV controls were recruited from the HIV clinic and Medical Outpatient Department of BSUTH, Makurdi respectively. Results: Out of 152 HIV subjects, 43 were males while 109 were females. The mean age of the subjects was 37.02 ± 9.3. Urine protein creatinine ratio > 0.2g/day was present in 69(45.4%) of the HIV patients and 16 (24.6%) of the controls P=0.000. Conclusion: Prevalence of proteinuria is high among HIV infected patients seen at Benue State University Teaching Hospital, Makurdi.
30 EMERGENCY CONTRACEPTION: WHICH ARE THE AVAILABLE TOOLS? , Monterrosa-Castro Alvaro*, Quintana-Guardo Freddy and López-García Angela
The purpose of emergency contraception (EC) is to prevent unplanned pregnancy when there has been unprotected intercourse. It’s a medical strategy that allows birth control, without being a regular method of family planning. Initially was called “morning-after pill”, which was an inadequate definition because it’s not always a pill, it should not be expected the next morning to use it and can be used several days after intercourse. To identify available tool for EC, a literature review was performed in the PubMed, ScienceDirect, EBSCOhost, OvidSP, Embase (English) and Scielo (Spanish) databases. The application of the intrauterine copper device, within the first five days after intercourse, is the most efficient way to perform EC. Similarly, ulipristal acetate is the best way for hormonal EC. The effectiveness rates of levonorgestrel-only pills and those of ethinyl estradiol combined with levonorgestrel (Yuzpe's method) are important, statistically significant and accepted for EC, remembering that dose and timing should be respected when administered. Mifepristone 10 mg, single dose, is approved in Russia, China, Vietnam and Armenia, as EC. Health professionals should advance high quality contraceptive counseling, to offer as plan B any of the above tools to administer EC. Governments should be concerned about the permanent availability of EC. The prescription of EC should be accompanied by sufficient instructions for women to initiate a regular method of birth control.
31 UPPER GASTROINTESTINAL BLEEDING SECONDARY TO ESOPHAGEAL HEMANGIOMA , M. A. Lkousse*, A. El farouki, K. Gharbi, Y. Ismail, J. Atmani, A. Aiterrami, S. Oubaha, Z. Semlani, K. Krati
Hemangiomas are benign vascular tumors, rarely localized in the digestive tract. The positive diagnosis of these lesions is easily made by endoscopy and imaging. These tumors have hemorrhagic potential that may be life-threatening. The treatment is essentially surgical. We report a new case of an esophageal hemangioma revealed by Gastrointestinal hemorrhage.
32 RIFAMPICIN INDUCED HYPERBILIRUBINEMIAS: A CASE REPORT , Rohit Bangwal*, Jagdish Rawat, Dev Singh Jangpani
Anti-tubercular therapy (ATT) induced hepatitis is a major problem which a physician encounters in his clinical practice. A case of 28-year old female, weighing 45 kg was brought to hospital with the chief complains of high grade fever for the past two months, cough with expectoration, shortness of breath and 4-5 kg weight loss in two months. Her Chest X-ray showed right sided bilateral pulmonary TB and sputum acid fast bacilli (AFB) smear was repeatedly positive. Pulmonologist has started Category-I anti-tubercular regimen (Rifampicin, Isoniazid, Pyrazinamide and Ethambutol) under DOTS as per RNTCP guidelines. After 7 days of starting the treatment (DOTS regimen), she noticed yellowish discoloration of sclera, orange discoloration of urine but in spite of this she continued the drug for a further two weeks. Patient was found to be developing hepatotoxicity with the findings of elevated total bilirubin (10.2 mg/dl), conjugated bilirubin (2.5 mg/dl) and unconjugated bilirubin (7.2 mg/dl). Viral markers for hepatitis including hepatitis B viruses (HBsAg), hepatitis C viruses (HCV), human immunodeficiency virus (HIV), were all are non-reactive. Pulmonologist made final diagnosis of anti-tubercular drugs (specially rifampicin) induced hyperbilirubinemias. Pulmonologist initially hold Rifampicin and Pyrazinamide, but started Isoniazid, Ethambutol, Ofloxacin, Pyridoxine along with liver enzyme. She showed gradual improvement as bilirubin after one-week had dropped down to 1.2 mg/dl. Patient continued her drugs and came for review after three months. She was advised to continue and complete the course of anti-tubercular drugs. We have reported this case because of its rarity in clinical practice. As a health care team member clinical pharmacist are need to be made aware of these potentially fatal adverse effects associated with anti-tubercular therapy via conduction of quality-based seminars, published medical literature, conferences, learning programs and health care camps.
33 NEPHROPROTECTIVE POTENTIAL OF THE LEAVES OF URENA LOBATA LINN. IN CISPLATIN INDUCED NEPHROTOXICITY IN ALBINO RATS , P. L. Rajagopal*, A. K. Anjana, K. T. Linsha, K. R. Sreejith, K. Premaletha and S. Aneeshia 
The nephroprotective effect of the methanolic extract of the leaves of Urena lobata was evaluated in cisplatin induced nephrotoxicity in albino rats. The methanolic extract at both the doses (200 and 400mg/kg) reduced the elevated blood urea, serum creatinine and normalised the decreased body weight, which indicates the nephroprotective claim of the leaves of Urena lobata in the curative regimen.
34 EVALUATION OF TWO DIFFERENT DISTRACTION OSTEOGENESIS TECHNIQUES IN TREATMENT OF UNILATERAL ALVEOLAR CLEFT , Marwa T. Ibrahim*, Mohammed S. Khedr, Mahmoud E. Khalifa and Ibrahim M. Nowair
Purpose: This study was planned to compare the use of bone borne distractor versus hybrid distractor in repair of unilateral alveolar cleft. Materials & Methods: A 16 patients with unilateral alveolar cleft were included in this study. They were divided into two equal groups according to the type of distractor used, Group I: in which the bone- borne distractor (Liou cleft distractor) was used for alveolar cleft repair. Group II: in which the custom made hybrid distractor was used. Results: Stage I distraction: after three months, showed significant difference in the width of the cleft side in both groups as P-value was 0.007 in group I and P-value was 0.001 in group II. No significant differences in the vitality and mobility of teeth in both groups. The amount of relapse in the regenerate area at the different observation periods 3 and 6 months between both groups were statistically significant (P-value 0.018). Radiographic finding showed no significant difference of the inclination changes of the transported segment in group I (P-value 0.816), while in group II showed significant difference (P-value 0.001). Stage II alveolar cleft grafting: graft resorption and recurrence of fistula was recorded in one case of group II. The differences of the density of the grafted bone between the first month and six months in each group postoperatively were statistically significant in both groups as P-value 0.001 and 0.001 in group I and Group II respectively. Conclusion: Both types of distractors are suitable for treatment of alveolar cleft with some drawbacks related to each type of distractor which include, that the hybrid distractor was limited as it decreases the width of the alveolar cleft from 9 to 10 mm distance while the bone borne Liou distractor decrease the distance from 11 to 13 mm, also the high cost of Liou distractor compared to hybrid distractor.
35 ASSOCIATION OF CROHN'S DISEASE AND CLOACOGENIC POLYP: ABOUT A NEW CASE REPORT , M. A. Lkousse*, A. El Farouki, K. Gharbi, Y. Ismail, J. Atmani, A. Aiterrami, S. Oubaha, Z. Semlani K. Krati
Cloacogenic inflammatory polyps are a rare and benign form of ano-rectal polyps, first described in 1981 by Lobert and Appelman.[1] They are formed from the epithelial transitional zone at the anorectal junction. They affect the lower rectum and anus, and are characterized by distinct clinical and histopathological features.[2] They can be associated with variety of diseases: haemorrhoidal disease, Crohn's disease, colonic diverticulosis or colorectal adenocarcinoma.[3]
36 SQUAMOUS CELL CARCINOMA OF THE SCROTUM: CASE REPORT , Muthanna Saad Abduljawad*
Squamous Cell Carcinoma of the Scrotum is considered as one of the first occupational malignant tumours of the scrotum. Discovered by Sir Percivall Pott. Long term contact with Tar and coal and petrochemicals and chronic inflammatory scrotal lesions are considered as one of the important inflicting factors. A 70-year-old male presented to the medical clinic with a hard spiky scrotal lesion underwent wide-local excision of the same. Histopathology revealed verrucous hyperplasia with hyperkeratosis and squamous cell carcinoma in situ. Treatment options included wide excision with strict follow up for local and/or lymph node.
37 COMPARATIVE ANALYSIS OF THE IMPACT OF HUMAN IMMUNE-DEFICIENCY VIRUS ON FERTILITY VARIABLES OF COMMERCIAL MOTOCYCLISTS AND NON-CYCLISTS IN NNEWI, SOUTH-EAST NIGERIA , Ochiabuto O. M. T. B.* and Chukwura. E. I.
Background: Human immunodeficiency virus infection (HIV), a global epidemic especially in high-risk occupational groups, impacts negatively on fertility parameters and male- fertility. Methodolgy: A case-control study of thecomparative analysis on the impact of Human Immune-deficiency Virus on fertility variables of commercial motorcyclists and non-cyclists in Nnewi, South-East Nigeriawas conducted. A total of 152 males consisting of 49 commercialmotorcyclists and 103 non-cyclists of age-ranges of 19-79 years old was used. Pre-tested questionnaires and tools were used for data collection for variables; hormones were assessed by immunoassay technique, HIV virus was screened immune-chromatographically using parallel testing, positive samples confirmed with Western-blot technique, semen biomarkers (FSH,LH, prolactin, progesterone, testosterone) by Enzyme Linked Imunosorbent Assay (ELISA), semen qualities with new WHO methods, modified to suit sperm; fertility index and observed fertility index was mathematically-derived. Biologically important semen quality parameters were calculatedwith standard WHO mathematical-deduction method. Results: Results revealed a total of 4(2.6%) were HIV-1 infected; 3(6.1%) from tests and 1(1.0%) from controls. Positive HIV status impacted negatively significantly on observed fertility status (U2 = 136.500; P = 0.049) in all males andsome semen quality variables; (teratozoospermia <50%) in test groups (U2 = 20.500; P = 0.039), sperm concentration in both test and control groups,(U2 = 21.000; P = 0.044); (U2 = 0.000; P = 0.020)and non-significantly though with changes in mean rank values of semen biomarkers and serum hormones in HIV -1 + categories in both groups. Conclusion: HIV- 1 status significantly reduced and affected mean rank of testosterone hormones, teratozoospermia cells and sperm concentration semen qualities and observed fertility status incommercial motorcyclists than in non-cyclists reducing their fertilitypotential. Awareness is needed on the need for early detection and care as it can reduce male fertility.
38 EVALUATION OF THE PROXIMATE COMPOSITION AND SENSORY PROPERTIES OF CAKES AND BISCUITS FORTIFIED WITH AFRICAN YAM BEAN, AND MORINGA OLIFERA FLOUR , Obi Chikosolu*
This research work Evaluated the proximate composition and Sensory properties of Cakes and Biscuits fortified with African yam bean, and moringaoleifera flour. The study tends to address the protein calorie malnutrition by producing cakes and biscuit using African yam bean and moringaoleifera. The research design is experimental design. Cakes and biscuit were produced using African yam bean, moringa and wheat flour in different proportion, the nutrient contentand the sensory properties product were analyzed using statistical package for social science (SPSS), version 17 which was express using one way analysis of variance (ANOVA) and Durcan’s multiple range test was used to separate/compare the means that was obtained after each experiment. Different was considered significant when P<0.05a based on the data collected and analyzed, there is significant difference between fortified and the unfortified terms of fat, moisture, crude fiber, protein, carbohydrate and Ash, at 0.05 level of significance. Also there is significant different between the fortifiedand the unfortified in terms of colour, taste, mouthfeel, Aroma, texture and General acceptability at P<0.05 level of significance. The researcher concluded that there is need for increase in the utilization of food crops, grains and tubers to meet the growing need of Nigeria population, also production of cakes and biscuit using AYB and Moringa leave increases the nutrient content of the snacks. She recommends that food industries should employ graduates of home economics and food science and technology to develop more foods from AYB and Moringa which will reduce unemployment of youths as well the Local food products and also to reduce fatigue uncounted during processing.
39 EVALUATION OF NON-INVASIVE MARKERS OF FIBROSIS AND THEIR CORRELATION WITH THE VIRAL LOAD IN SUBJECTS WITH HEPATITIS B VIRUS IN NNEWI , Obiomah Chinwe Favour*, Amilo Grace, Obeagu Emmanuel Ifeanyi and Vincent C. C. N.
Hepatitis B is an infectious disease of great public health importance. Nigeria is one of the countries with the highest incidence of Hepatitis B Virus (HBV) infection worldwide. However, the accessibility and affordability of HBV DNA quantification (viral load) assay which is the key laboratory test for therapy initiation, and monitoring is a challenge to HBV management. This study was designed to evaluate the non-invasive markers of fibrosis and their correlation with the viral load in subjects with hepatis B virus in Nnewi. Cross sectional study design was used with a total of 264 subjects comprising of 88 HBsAg seropositive treatment naïve subjects, 88 HBsAg seropositive subjects on antiviral therapy as case subjects and 88 age-matched apparently healthy HBsAg seronegative individuals were recruited as control subjects. Hepatitis B virus DNA assay was performed using real time PCR technique, Hepatitis C Virus assay, Human Immunodeficiency Virus testing, Gamma glutamyl transferase, Aspartate transaminase, Alanine transaminase tests were determined using spectrophotometric methods. Non-invasive markers of fibrosis - RDW-Platelet Ratio (RPR), Neutrophil to Lymphocyte ratio, Platelet to Lymphocyte ratio, GGT to Platelet ratio, AST-Platelet Ratio index and AST-ALT Ratio were calculated. The noninvasive markers of fibrosis –GGT to Platelet ratio, AST to platelet ratio and AST to ALT ratio were significantly higher in test subjects (0.06±0.11; 0.44±0.87; 1.49±0.86) compared with control subjects (0.02±0.01;0.11± 0.69;0.89±0.59 respectively, p<0.001). Some Liver function tests studied –gamma glutamyl transferase, alkaline phosphatase aspartate transaminase and alanine transaminase were all significantly higher in test subjects 4.60±1.66U/L, 40.30±14.50U/L, 11.61±5.13U/L and 9.10±2.94U/L) compared with the control group(9.15±1.75μmol/l, 2.33±0.78U/L,28.89±5.17U/L, 5.98±0.11U/L and 7.07±1.49U/L). This study showed that noninvasive markers of fibrosis play significant role in HBV management but should not be used as its alternative.
40 DETERMINANTS OF MATERNAL HEALTH, MATERNAL MORTALITY AND MOBIDITY IN ADO-EKITI, EKITI STATE OF NIGERIA , Okpoko P. I.* and James R.
Maternal health remains a major focus among Public health practitioners. This research aimed at investigating sociocultural determinants of maternal health in Ado-Ekiti in Ekiti State of Nigeria. It was a cross sectional epidemiological study, carried out among 418 female respondents of reproductive age group, which determined the association between maternal educational status, maternal religion, and health care availability/accessibility and the dependent variable (choice of ANC provider which stands as a proxy to maternal health). The modal age group was '51 years and above' (24.4%). The majority of the participants (45.5%) were married. A total number of 130(31.1%) had tertiary education. About 216(51.7%) identified themselves as Christians and 188(45.0%) as Muslims. Traditional faith constituted 14(3.3%). All the variables in this research gave a statistical significant value of p<0.05. Efforts geared towards improving maternal educational status, and encouraging accessibility to health care facilities may make a significant impact at reducing maternal mortality rates in Ado-Ekiti in Nigeria.
41 EMERGENCY MEDICAL TREATMENT AND LABOR ACT , *Dr. Shinu Kuriakose DHSc PA-C
The United States Congress, in 1986, passed the Emergency Medicine Treatment and Labor Act (EMTALA) as part of Consolidated Omnibus Budget Reconciliation Act (COBRA) of the Social Security Act to ensure that emergency care was available to the public regardless of the ability to pay (CMS.gov, 2015). This act required that all hospitals, which accepted Medicare reimbursements from the government with emergency services, to provide emergency medical screenings when requested and offer emergency medical treatment as needed including stabilization of active labor to all needful patients regardless of the financial resources of the patient; although, it does not prohibit the hospital from asking about the patients insurance status or payment method, if any. In cases of active labor, this act insists that hospitals stabilize patients until delivery is complete including discharge of the placenta. The origins of this law was based on practices noticed in Cook County Hospital (a public institution) in Chicago were the physicians noticed that an inordinate number of patients were transferred there from private hospitals in Chicago with the vast majority being minorities and unemployed and 87% of them lacking health insurance (Zibulesky, 2001). Furthermore, only 6% had signed informed consent paperwork and 24% were medically unstable at the time of transfer (Zibulewsky, 2001). The United States Congress took it upon themselves to pass this law (a rare show of bipartisanship) to prevent such outrageous behavior by hospitals for monetary gain. Hospitals were not only obligated to stabilize patients medically but also transfer them to other appropriate venues as medically indicated upon the patients request. In essence, due to the vast majority of hospitals accepting reimbursement from the Centers of Medicare and Medicaid, this act basically applies to virtually every hospital in the United States. There are specific sub-statues in EMTALA: a) a hospital is bound by affirmative duty to treat any existing emergency medical condition b) a hospital is obliged to conduct a medical screening exam to rule out any emergent medical condition c) a hospital is restricted from transferring any patient who presents with active labor or any emergent medical condition (Emtala.com, 2015). Another important mandate, which the EMTALA requires is that no hospital deny transfer of patients to its facility regardless of payment if they have specialized (burn unit, neonatal intensive care unit), services to treat patients needing such services and if there is available capacity at the hospital.
42 ORBITO-OCULR MALIGNANCIES IN MAKURDI, NIGERIA , *CO. Ojabo, BA. Ojo, I. Ugwu, E, Umabong, J. Ngbea, R., Vhriterhire, I. Akpor, C. Udu
Orbito-ocular malignancies represent a significant cause of morbidity and mortality in Africa. This work set as its objectives as analysis of 38 histologically confirmed malignant tumor of the eye and adnexae in Makurdi, Benue State in North central Nigeria using laboratory bench book of the department of Anatomic Pathology, Benue state University Teaching Hospital, Makurdi, Benue State Nigeria between September and December, 2019. Sixty specimen were from eye and its adnexae and only 38 (63%) were orbito-ocular malignancies. The male:female was 1:1 with a peak age of incidence in the first decade and age range of 1 month to 85yrs. Squamous cell carcinoma accounted for 21 cases (55%), retinoblastoma 8 (21%) and embryonal rhabdomyocarcoma 5 (13%) were the most common malignancies. No case of lacrimal gland malignancy was seen agreeing with its rarity. Orbito-ocular malignances are not uncommon in Benue State of Nigeria. There seem to be an upsurge in the incidents of squamous cell carcinoma of the eye and adnexae region. This may be a reflection of the high incidence and high prevalence rate of HIV/AIDS in this environment. There is an urgent need for awareness to ensure early presentation.
43 PEDIATRIC ORBITAL AND OCULAR MALIGNANCIES IN MAKURDI, NIGERIA. , *C. O. Ojabo, B. A. Ojo, I. Ugwu, E. Umabong, J. Ngbea, R. Vhriterhire, I. Akpor and C. Udu
Pediatrics malignancies are not uncommon in Nigeria and like all other childhood malignancies, differ biologically from their adult counterparts. The aim of this review is to highlight the age, sex and morphological characteristics of orbito-ocular malignancies in Makurdi, North Center Nigeria. A retrospective review of all orbito-ocular specimens received in the department of Anatomic Pathology of Benue State University Teaching Hospital, Makurdi Nigeria between September, 2012 and December 2013. Clinical data obtained included sex, age and histological type. Fourteen (14) children were seen. Retinoblastoma 7(50%) was the most common pediatrics orbito-ocular malignancy with an average age of occurrence of 3.89 years and male preponderance of 1.7:1. Embryonal rhabdomyosarcoma was the second most common pediatric cause of orbito-ocular malignancy with 5(36%) cases and an average age of 6 years and a female preponderance of 4:1. One (1) case of small round blue cell tumor was found in a 10 year old male patient. The average age of pediatric orbito-ocular malignancies in Makurdi are relatively high and maybe a result of late presentation. There is a need to improve on awareness with further work into their clinical behavior and management, coupled with increase accessibility of the patient to different management modality.
44 THE LIPID PROFILE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND CORRELATION WITH DISEASE SEVERITY , Dr. Ali Raheem Ali, Dr. Jaleel Okaish Hadi, Professor Dr. Adnan M. Al, Jubouri and Professor Dr. Mohammed Waheeb Al-Obaidy*
Background: Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by chronic obstruction of air flow that interferes with normal breathing which is not fully reversible. COPD is currently the fourth leading cause of death in the world. And it is projected to be third leading cause of death by 2020. The smoking is major risk factor for COPD. The smoking also affect the lipid profile. Objective: -To assess the lipid profile in COPD patient. To assess the correlation between the lipid profile and disease severity. Method and material: 50 cases of COPD were selected, 50 healthy subjects were selected as control without any chronic illness and not receiving any medication which may affect the lipid profile. The diagnosis of COPD was confirmed by clinical feature, chest x-ray and spirometery following the GOLD guideline (post –bronchodilator forced expiratory volume (FEV1)/forced vital capacity (FVC) ratio <70% predicted). According to that the patient were divided into four groups depending on GOLD guideline which were mild COPD (stage Ι) FEV1 ≥80% predicted, moderate COPD (stage ΙΙ) FEV1 50% - 80% predicted, severe COPD (stage ΙΙΙ) FEV1 30% - 50% predicted and very severe COPD (stage ΙV) FEV1 <30% predicted. The blood sample for fasting lipid profile were sent for cases and control and compare between them then four groups of COPD were compared. Result: according to our result the majority of cases were male (88%), and the majority of the patient within age group above 60 years (the mean age of male 60.09±8.06 while for female 56±2.56) most of our patient have moderate to severe COPD (stage ΙΙ,ΙΙΙ). The serum low density lipoprotein (S.LDL), serum triglyceride (S.TG), Serum cholesterol were significantly elevated in COPD patient comparing to control. The serum high density lipoprotein (S.HDL) was significantly lowering in COPD cases comparing to control (P-value<0.05). There were no statistically significant between the lipid profile and COPD severity (P-value>0.05). Conclusion: there were elevated level of S.LDL, Cholesterol and lower S.HDL in COPD patient compared to control. Also we noticed that S.LDL, S.cholesterole, S.TG are slightly elevated in severe and very severe stage of COPD comparing to moderate stage, but the result was statistically not significant.
45 ACQUIRED TESTICULAR AND EPIDIDYMAL LYMPHANGIOMA: A RARE CASE REPORT AND REVIEW , Muthanna S. Abduljawad*
Scrotal and intrascrotal lymphangiomas are rare pathologic conditions. Mismanagement and hence rapid recurrence occur due to its rarity and similar clinical and imaging findings with other common pathologic conditions.
46 UTILIZATION AND ALLOCATION FOR VILLAGE FUND IN THE PROMOTION OF FAMILY PLANNING VIA UPTAKE LONG ACTING AND PERMANENT METHOD (LAPM) IN WEST NUSA TENGGARA PROVINCE, INDONESIA , Surotul Ilmiyah*, Rita Damayanti, Ede Surya Darmawan, Iwan Ariawan, Hoirun Nisa, Hendri Hartati, Ousman Bajinka
Background: Indonesia has succeeded in driving population growth rates through family planning programs, however, the number of Total Fertility Rate (TFR) is still stagnant, even higher than ASEAN countries. Long Acting and Permanent Method (LAPM) is a very effective method to delay, space pregnancy. West Nusa Tenggara is a province with a high TFR rate, a low contraceptive prevalence rate (CPR) and a low use of LAPM. Decentralization should strenghten institutional support for family planning at the village level. Johns Hopkins University through the Universitas Indonesia (UI) Health Research Center and Cipta Cara Padu Foundation (YCCP) has made an advocacy initiative on Village Law No. 6/2014 for the benefit of family planning programs. Aim: This study aims to look at utilization of village funds allocation for family planning promotion with long acting and permanent method (LAPM) uptake in West Nusa Tenggara Province, Indonesia. Methods:This study was conducted with a cross-sectional design using bivariate chi-square analysis and multivariate analysis using multilevel with individuals as level 1 and villages as level two file, with the secondary data endline survey (YCCP) and UI Health Research Center in 2016. Results:The results showed that village funds increased the use of LAPM with p value of 0.041, and Multilevel Odd Ratio (MOR) 1,162 showed that villages funding for LAPM promotion was 1,162 times greater in increasing uptake of LAPM acceptors compared to villages that did not have village funds for LAPM promotions. In addition, other variables that were very influential; family planning policy in the village, village family planning institutions, and knowledge after controlling for education, time, economic, cost of family planning services, and transportation costs. Conclusion: the study concluded that, there should be advocacy for village health levels in various regions by allocating village funds above Rp.7,500,000 to strengthen family planning programs to support LAPM. Access barriers in LAPM can be overcome by using funds in addition to management activities, counseling, can also be used for transportation, and cadre transportation that allows acceptors to access health services.
47 EFFECT OF CONVENIENCE AND BENEFIT ON THE ATTITUDE OF USING THE HOSPITAL MANAGEMENT INFORMATION SYSTEM IN BALUNG GENERAL HOSPITAL JEMBER REGENCY , Hafis Nur Wicaksono*, Isa Ma’rufi and Dwi Wahyuni
The purpose of this study is to analyze the influence of ease and benefits to the attitude of the use of the Hospital Management Information System in Balung General Hospital Jember Regency. The data used is the primary data obtained from the questionnaire 181 respondents to employees who use the technology in Balung General Hospital Jember Regency. The analysis tool uses Structural Equation Modelling (SEM). The test results of the instrument concluded that: 1) There is an influence perceived ease of use against attitude toward using technology, 2) there is an influence perceived ease of use against perceived usefulness, 3) there is no influence perceived usefulness to attitude toward using technology.
48 ANAESTHETIC TECHNIQUES FOR OPHTHALMIC SURGERIES IN BENUE STATE UNIVERSITY TEACHING HOSPITAL (BSUTH):- A REVIEW OF 100 CONSECUTIVE CASES. , *Efu ME, Ojabo CO, Ojo BA, Chaha K, Eke BA Ozuagu MA, Anefu GO
Background: Historically, ophthalmic surgeries were first performed without anaesthesia and then under local anaesthesia because of the accessibility of the eye and the disastrous effects of coughing under general anaesthesia. Regional anaesthesia in form of retro-bulbar block, peri-bulbar block, sub-conjunctival block, sub-tenon anaesthesia as well as topical anaesthesia has become the most prevalent form of anaesthesia used globally for ophthalmic surgical procedures. In spite of the global trend of preferred use of regional anaesthesia and judging from its advantages, some ophthalmic procedures are carried out under general anaesthesia. The choice of anaesthesia for surgical procedure is influenced by the type of surgery intended, patient related factors and surgeon’s preference. This study was carried out to ascertain the anaesthetic techniques employed for ophthalmic surgeries in the Benue State University Teaching Hospital (BSUTH), Makurdi. Methodology: A total of 100 consecutive case files of eligible patients were retrieved from the records department. Relevant information were extracted from the patients’ folders and transferred into a prepared proforma. Data collected were analyzed using SPSS version 25 using simple statistics. Results: A total of 100 patients were evaluated. There appears not to be dominance by any age group. Nevertheless, the age bracket that recorded the highest number of patients is the one between 61 and 70 years with 17 accounting for 17% of the study population. Fifty-eight males and 42 females were evaluated making up 58% and 42% of the study population respectively. Of 108 indications for sorcery, cataract was observed 36 times accounting for 33.3% of the variables. This was followed by glaucoma with 25 making up 23.1% and pterygium with10, making up 9.2%. Also, of the 111sugrical procedures undertaken, trabeculectomy took place 25 times accounting for 22.5% of the variables. This was followed by the two cataract surgical procedures of small incision cataract surgery + posterior chamber intraocular lens (SICS+PCIOL) and extracapsular cataract extraction+posterior chamber intraocular lens (ECCE+PCIOL) which were undertaken 24 (21.6%) and 12 (10.8%) respectively. Of the 100 patients evaluated, 22 (22%) underwent general anaesthesia with tracheal intubation while the rest, 79 (79%), had their surgeries done under local or regional anaesthesia. Conclusion: This study demonstrates overwhelmingly that in Benue State University Teaching Hospital, the anaesthetic technique of choice for ophthalmic surgery is local/regional anaesthesia. General anaesthesia comes a distant second, being employed mostly in the paediatric age group and in patients with penetrating eye injury where retro-bulbar block is contraindicated.
49 HAEMOSTATIC FACTORS ASSESSMENT AMONG MALE AND FEMALE GERIATRICS IN NNEWI, ANAMBRA STATE NIGERIA. , Onwurah O. W.*, Amilo G. I., Ajuba I., Fasakin K. A., Muhibi M. A. and Ezeugwunne I. P.
Background: Coagulation profiles are very important assay carried out in the assessment of Haemostatic factors. The coagulation factors are present in the blood and helps in regulating the loss of blood through injury, internal bleeding, during surgery, monitoring oral anticoagulant therapy and evaluating the function of the liver. The absent or reduction of these coagulation factors lead to excessive bleeding which may lead to death. Some of these coagulation profiles are Platelet count, Prothrombin Time (PT), Activated Partial Thrombin Time (aPTT), Whole blood Clothing Time (CT) and Bleeding Time (BT) and were carried out among 100 male and 100 female geriatrics residing in Nnewi, Anambra state, Nigeria. Their ages ranges from 65 years to 84 years old. Young adult aged 18-25 years blood samples were used as control. The results showed the geriatrics values higher than the control samples. The PT of female geriatrics significantly (p = 0.03), higher than the male geriatrics, while the aPTT of male geriatrics significantly (p =0.00) higher than the female geriatrics. The platelets values, INR, the clotting and the bleeding time levels did not differ between the male and female geriatrics. With these result, the male and female geriatrics health can be assessed and treated adequately.
50 POST-LOBECTOMY DIFFICULTY IN WEANING OFF THE VENTILATOR-IS IT EDAC? , Dr. Hemant Gopal Bhirud*, Dr. Amit Bodkhe, Dr. Chitra Pitale, Dr. Sanjay Upadhye
Excessive Dynamic Airway Collapse (EDAC) along with tracheobronchomalacia (TBM) constitutes Excessive Central Airway Collapse (ECAC) which presents with a myriad of respiratory symptoms.[1,2,3] In the post-operative period EDAC may be suspected in a patient difficult to wean off the ventilator, when other causes have been excluded.[4] Confirmation of diagnosis is by Fiber Optic Bronchoscopy (FOB) and dynamic CT scanning.[5,6,7] EDAC is an entity characterized by >50% reduction in the lumen of the trachea with anterior bowing of the posterior membranous wall of the trachea.[5] The symptomatology in a non-surgical patient may vary from asymptomatic to wheezing refractory to treatment, dyspnea, stridor and coughing.[8]
51 CARDIOVASCULAR DISEASE - RISE IN INDIA: NURSES ROLE TO CURB THE MENACE , Vinil Upendrababu* and Dr. Prof. S. N. Nanjunde Gowda
Cardiovascular disease is the foremost public health concern, leading to premature deaths and morbidity across all states of India. The increasing burden of cardiovascular diseases is one of the chief threats to sustainable development of the country. Although the incidence of CVD has shown a reverse tendency in developed countries because of the remarkable advances in the health sector, the same cannot be held true for low and middle income countries, which include India. Hence so many researches has been carried out in various parts of the world to find out the most effective and cost efficient way of preventing the rising menace of CVD. Many well-known associations and prominent persons in the health field have illustrated the role of nurses in preventing this growing trend of CVD around the globe as the nurses have been spending much of their working time with patients. As a significant health team member, nurses can play a vital role to reduce the occurrence of CVD as well as to promote the cardiovascular health of patients through a number of ways. Significant evidences exist to support a systematic approach in the reduction of CVD risk through team based, nurse directed case management.
52 IMPACT OF EDUCATIONAL INTERVENTION ON KNOWLEDGE OF UNIVERSAL PRECAUTIONS AMONG HEALTH CARE STAFF OF A TERTIARY CARE HOSPITAL OF SOUTH GUJARAT , Kamlesh Shah*, Baria Hinal, Alka Nerurkar and Diwarkar Sharma
Back ground: Health care workers often exposed to various infections during the course of patient care. Correct and adequate knowledge regarding practice of universal precautions can effectively prevent health care associated infections. Materials and methods: An interventional study done among paramedical and other staff involved in patient care, of tertiary care hospital from 9 may 2016 -10 may 2016. Training on universal precaution was conducted for the participants in two batches. Non-probability convenience sampling technique was used for selection of study sample. total 178 participants before the intervention and 171 participants post training were included in the study to test the knowledge of Universal Precautions, as 7 staff members were drop out in post training sessions. The participants consisted of nurses, lab technician and class four workers. Data was collected before and after the intervention using a semi-structured questionnaire consisting of questions related to demographic characteristics and knowledge regarding Universal precautions. Verbal informed consent was obtained from participants. Questionnaire was administered before and after training sessions. Statistical analysis: Frequency, percentage, mean, and standard deviation were calculated. Results: 1) In our study the mean pretest and post test knowledge score was 9.89 and 11.83 respectively. The difference between pre and post intervention score was 1.94. So after the intervention the knowledge of the health care staff increased by 20%. Conclusion: Educational interventions in form of trainings were found effective in increasing the knowledge of universal precautions and its practices in the paramedical and staff associated with patient care.
53 CASE REPORT OF TWO RARE TUMORS IN THE SPHENOID SINUS , Juvaina P., Priyanka Venu*, Devarajan E, Rajan P., Naufal P. and Saanida M. P.
Sphenoid sinus lesions usually have a late clinical presentation due to the deep seated location of the sinus within the body of the sphenoid bone. Hence mostly there is invasion of the adjacent structures at the time of diagnosis. Here we report two rare tumors arising from sphenoid sinus with invasion of the surrounding structures.
54 ESTHETIC REHABILITATION OF DISCOLORED MAXILLARY ANTERIORS WITH MINIMALLY INVASIVE PORCELAIN LAMINATE VENEERS – A CASE REPORT , *Dr. Param Dev Singh (MDS), Dr. Geetha Bhavani Paluri (MDS), Dr. Geeta Arya (MDS) and Dr. Payal Gumber
Discoloration and the surface defects are the most common challenges encountered by the clinician in a day to day practice. Discolored anterior teeth are an integrated part of facial esthetics and have a major impact on the social, cultural and psychological interaction. Achievement of an optimal long-term esthetic result in such cases needs careful diagnosis, visualization of the final outcome followed by comprehensive treatment planning with minimally invasive technique. It is important to understand the self-perceived opinion of the patient in the treatment planning and sometimes two or more treatment options are combined for a more successful outcome.
55 A RARE CASE OF DIFFUSE INFILTRATING RENAL CELL CARCINOMA WITH EXTENSIVE VENOUS THROMBOSIS , Juvaina P.*, Neema Jaleel, Devarajan E., Rajan P., Naufal P. and Saanida M. P.
Renal cell carcinoma (RCC) is the most common solid renal cancer in adults. Early and accurate imaging plays important role in its detection and staging. Diffuse renal infiltration with global enlargement is usually diagnostic of renal lymphoma. Here we report a rare case of a papillary renal cell carcinoma with diffuse renal enlargement and extensive intravenous tumor thrombus.
56 CONFRONTING THE CHALLENGES OF REDUCING HIV AND OTHER SEXUALLY TRANSMITTED INFECTIONS AMONG IN-SCHOOL ADOLESCENTS IN THE RURAL AREAS OF IMO STATE OF NIGERIA. , Ezeama, M.C. and Enwereji, E. E.*
Introduction: The challenge of minimizing HIV and other sexually transmitted infections among adolescents in the rural areas has been the uttermost concern of many researchers in both developed and developing countries. Studies have shown that most adolescents especially in-school adolescents in the rural areas are exposed to indiscriminate sexual practices due to conditions including rape from opposite sex, desire to have sex after watching pornography, poverty and others. This study investigated the extent to which in-school adolescents in the rural areas of Imo State protect themselves against sexually transmitted infections including HIV as well as the extent to which they are aware of mode of transmission of STIs. Materials and method: Cross--sectional descriptive design was used to collect information for the study. Three community secondary schools populated by both boys and girls were randomly selected for the study. It was assumed that using schools populated by both boys and girls will afford the researchers the opportunity of identifying the extent to which adolescent males and females engage themselves in risky sexual activities. Self-administered questionnaire containing open and closed ended questions served as instrument for data collection. The sample size for the study was 278. The study used all the Senior Secondary School Students in the three schools studied. It was assumed that the students in the Senior Secondary classes constitute the group of students that are sexually active. Result: The finding showed that out of 91 students studied in school number 1, 9(9.9%) males and 22(24.2%) females have had sex. Out of those who have had sex, only 10(8.7%) used condom during sex . In school number 2, out of 94 students studied, 15(16%) of the males and 27(28.7%) of the females have had sex . Out of this number, only 8(7%) used condom. In school number 3, out of 93 students studied, 17(18.3%) of the males and 25(26.9%) of the females have had sex. Out of the number that have had sex, only 12(10.4%) used condom. The main sources of information where the students learnt about STIs were television 50(22.7%), peers in school 45(20.5% and radio 44(20%). A good proportion of the students 159((56.6%) were aware that having unprotected sex with an infected person will expose them to STIs including HIV. As a result, 41.4% of them suggested the use of condom during sex as a protective measure against STIs. Conclusion: As a result of the students’ poor knowledge on STIs and HIV mode of transmissions, there is need to health educate in-school adolescents on the benefits of maintaining abstinence as a sure method for preventing STIs and HIV infections.
57 POST-DIARRHEA HEMOLYTIC UREMIC SYNDROME MIMICKING SEVERE ACUTE COLITIS IN ADULTS: ABOUT A RARE CASE AND REVIEW OF THE LITERATURE , Krati K.*, Lemfadli Y., Jiddi S., Benjelloun Z., Ait Errami A., Oubaha S. and Samlani Z.
Hemolytic uremic syndrome (HUS) is a thrombotic micro angiopathy (TMA) with renal tropism but extrarenal damage is possible. Typical or post-diarrheal HUS is well described in the pediatric population, but its incidence in adults is rare. The classic triad in HUS is hemolytic anemia, acute renal failure and thrombocytopenia. Resuscitation measures with adequate rehydration and dialysis if necessary remain the pillars of treatment. We report the case of a 17-year-old patient who presented with bloody post-diarrhea HUS and discuss the data in the literature.
58 MANAGEMENT OF COMMON POISONING , Dr. Bhartendra Sharma*
Cases of poisoning may be treated in many places, e.g. at the scene of the accident, during transport, in a hospital. The type of care that can be given will depend on whoever makes the initial contact with the patient and in what circumstances. Certain members of the community, such as firemen, policemen, and teachers, may frequently be the first to be faced with poisoning cases. In rural areas, nurses and primary health care workers, and even agronomists and veterinarians, may have to deal with poisoned persons. They all need at least some basic training in first aid as well as in decontamination and measures for their own protection. The treatment of poisoning by ingestion is as complex as is the enumeration of poisoning agents. There are, however, many practical and general principles that may be applied to any case in which a poison has been taken by mouth. The essence of treatment of any type of ingested poison is the often life saving procedure of emptying the stomach as quickly as possible. Unless the patient is comatose or in cases of poisoning due to petroleum distillates and corrosive agents, gastric lavage should be carried out in every instance. Where emesis is impossible, chemical antidotes may be administered in the lavage fluid. While specific treatment and supportive measures are of great importance, prevention through education is the basic means of avoiding these tragedies.
59 EPIDEMIOLOGICAL PARTICULARITY OF ANTHRAX IN RUMINANTS IN KANKAN AND KOUBIA PREFECTURES (REPUBLIC OF GUINEA) , *Mamadou Dian D., Youssouf S., Ekatherina Vladimirovna N., Sanaba B. and Ansoumane S.
This research was carried out in the period from 3 to 30 November 2017 in certain localities of the prefectures of Kankan (district Kankan Koura) and Koubia (Districts: Dayan and Linguere-Katia). The main methods of investigation were: the study of the documentation available and the archives of the veterinary services, the field surveys of breeders and managers of the livestock and health services, the epidemiological study, the health indices, the evaluation of the means of prevention and to fight with their impact on the incidence of the disease and the study of clinical and post mortem features. During the decade 1995 - 2016, there were a total of 1093 outbreaks of anthrax per year, including 6776 patients for 4645 dead and 2176 destroyed corpses of cattle, while in sheep, 690 patients were registered for 597 dead and 529 corpses destroyed whereas, there are 406 patients for 367 dead and 283 corpses destroyed in goats. The symptoms observed on the 6776 sick animals by breeders, livestock and veterinary agents working in the field, have consecrated the existence of anthrax in Guinea. Morbidity and mortality rates vary according to animal species. The highest peak was observed respectively in cattle, sheep and goats in 1997 while the lowest was reported in 2016. This indicates a continuous improvement in vaccination coverage. Lethality ranges from 99% in 2007 to 32% in 2015 in cattle and 100% in small ruminants. This would be the consequence of the resistance of cattle compared to sheep and goats. The incidence of anthrax is linked to the socio-economic conditions of the country and its ability to effectively fight animal diseases. The various unsuitable practices for managing animals, the sick or corpses are the basis of the disease's endemic.
60 DIGESTIVE HAEMORRHAGE: PLACE OF SCINTIGRAPHY COUPLED WITH TECHNICIUM 99 , Jiddi S.*, Jellal S., Lmfadli Y., Bouchrit S., Ait Errami A., Samlani Z., Oubaha S. and Krati K.
The acute gastrointestinal bleeding is associated with a high mortality risk.Thecause of the bleeding is usually identified with an upper gastrointestinal endoscopy and a colonoscopy. Rarely, the etiology of hemorrhage is obscure and not found by endoscopy. The purpose of this work is to evaluate the contribution of single-photon emission computed tomography (SPECT)/CT) in the diagnosis and management of obscure gastrointestinal bleeding, based on a clinical case of a64-year-old patient, presenting with melaenas 10 days prior to her admission, requiring multiple blood transfusions. An upper gastrointestinal endoscopy, a colonoscopy, a capsule endoscopy and an abdominal angio-scan, did not found any active origin of the bleeding. The Tc99m red blood cells scintigraphy showed an active bleeding in the left hypochondrium. The SPECT/CT confirmed the diagnosis and guided the treatment by electrocoagulation. The Tc99m red blood cells scintigraphy is a useful diagnostic tool in objectifying a gastrointestinal bleeding without being able to specify its exact anatomical localization. The Hybrid SPECT/CT imaging can overcome this challenge. This diagnostictool has taken a prominent position as it is non-invasive, easy to perform and able to detect intermittent bleeding.
61 CONCURRENT INFECTION OF DENGUE CHIKUNGUNYA AND SCRUB TYPHUS IN JHARKHAND, INDIA , Dr. Amar Verma*, Dr. Antony Kisku and Dr. Vishwajeet Pratap
It is very unlikely to have multiple concurrent infection such as malaria, dengue, chikungunya and other vector borne disease. Articles reporting concurrent infection of dengue chikungunya and scrub typhus are very few. Our series encompasses 5 proven case of dengue, chikungunya with scrub typhus admitted from November to December 2019 in department of paediatrics, RIMS, Ranchi. This is an observational study. The mean age of presentation is 11 yrs. Most common presenting complains were fever, headache, vomiting, pain abdomen, rashes. The mean duration of hospital stay was 7 days. Only one death was reported in our case series. Rest four cases were cured with no any patient suffered any sequelae. In case of concurrent infection of dengue, chikungunya and scrub typhus vigilant monitoring of vitals platelet transfusion and timely treatment with doxycycline are necessary. High degree of suspicion has to be made for coinfection in patient presenting with febrile illness with thrombocytopenia and deranged lab parameter in post monsoon season in endemic areas.
62 PREVALENCE OF STRESS AMONG PARENTS HAVING HEARING IMPAIRED CHILD IN NORTH INDIA. , Rina Kumari*, Sunita Tiwari and Sunil Kumar
Objective: This study evaluates the level of stress of parents having hearing impaired children and to see the association with degree of hearing loss. Methodology: A cross-sectional (comparative) study conducted at King George’s Medical University, U.P., Lucknow. Hearing-impaired children of age between 1 to 10 years of age and their parents included through convenience sampling method. Quantitative data of subjects recorded were hearing impairment detection age, degree of hearing loss, education level of parents, financial status. Qualitative data recorded were parents stress level through Perceived stress scale, a self-report tool with 36 items measuring the stress of the parent-child relationship and defining their psychological sources of stress. Available data analyzed and Quantitative data were expressed as mean (standard deviation) and qualitative as number (percent). A chi-square test was used to comparing the parenting stress score among studied groups. P < 0.05 was considered as statistically significant level. Results: The study result shows that 88.1% of fathers and 75.86% of the mother were having a severe degree of stress. Degree of stress was more in father compared to the stress of mother and their association was highly significant (<0.0001) Most of the children detected of having a hearing impairment at the age between 1 to 3 years. Association of stress with a degree of hearing loss shows that 66% of parents were severely stressed whose children were having severe to profound hearing loss and 73.33% of parents were severely stressed having children of moderately hearing loss. Conclusions: Severe stress in parents and significant association with the stress of father raises the possibility of a lack of awareness and neglect behavior. The specific resources of parenting stress among parents of different socioeconomic status should be explored in future studies so that appropriate interventions can be planned.
63 FIBER REINFORCED MATERIALS: A NOVEL APPROACH TOWARDS IMPROVED ESTHETIC DENTISTRY , Dr. Anwetakshmi Ray*, Dr. Kundabala M., Dr. Ankita Kanotra, Dr. Ayushi Bajoria, Dr. Janina Loren DSouza and Dr. Afroz
The treatment strategy in the field of dentistry is constantly evolving as a result of innovative therapeutically based solutions for the development of biomaterials, advanced technologies and more successful treatment techniques. One such material is fiber reinforced material. Amongst this Fiber reinforced composites (FRC) are the best example for this. Not only in the field of dentistry, but have shown wide industrial scale application as well (boat hulls, bullet proof jacket, sports equipment). These materials are metal free with light weight having good mechanical properties including high fatigue resistance and fracture toughness. They are cost effective, showed good esthetic results and showed better strength. Because of their excellent adhesive properties and esthetics they have been the main highlight in dentistry for the last two decades. Some of the clinical applications are such as fixed prosthodontics, restorative dentistry, periodontology, orthodontics and in repair of prosthetic devices. In restorative dentistry the applications include repairing fractured porcelain veneers, root canal posts, reinforcement of composites. FRC restoration is a tooth conserving technique which is minimally invasive. It is so, because of the adhesive technique clubbed with physical properties of the restoration, along with the orientation of individual fibers and its position.
64 FACTORS INFLUENCING CONTRACEPTIVE USE AMONG WOMEN OF REPRODUCTIVE AGE IN THE BIA WEST DISTRICT OF GHANA: A COMMUNITY BASED CROSS-SECTIONAL STUDY , Awuni Prosper Mandela Amaltinga*, Mbinta Fenibe James and Abugri Osman Bright
The study looks at the BIA District in the Western Region of Ghana where unmet need of contraceptives is low with fluctuations between 22.4% and 20.8%. The objective of the study was to examine factors influencing contraceptive uptake among women of reproductive age (15 – 49 years) and sexually active women. Methods: A cross-sectional study design was used and 268 participants were selected through simple random and systematic sampling techniques from six sub-districts from January to November 2019. The study adapted the Health Belief Model (HBM) as a conceptual framework to explain and predict behaviors. Chi-square test was used to determine associations between socio-demographic variables and contraceptives use. Results were considered statistically significant if p value was < 0.05. Results: Most (58.6%) of the respondents reported ever using contraceptive method while 41.4% did not use any contraceptive method. 73.5% of respondents agreed that using contraceptives is beneficial to the mother and the family. However, respondents constituting 55.2% agreed that contraceptive use has serious negative side effects on users. Most of the respondents (54.9%) feared using contraceptives because of their partners. There was an association between contraceptive use and religion (p<0.001), culture (p<0.001), fear to use contraceptives (p<0.001), benefit to use (p<0.031), expensive in acquisition (p<0.001), and negative side effect (p<0.001). However, there were no associations between contraceptives use and marital status of the respondents. Conclusion: The finding showed that almost half of the respondents have never used any form of contraceptives. It implies that if this trend continues there will be increased in unplanned pregnancies and high population growth. This may also affect the maternal and child health as there will not be enough spacing between pregnancies. Comprehensive sexual education should be included in the educational curriculum to promote education of contraceptives.
65 ANALYSIS BASIC EMERGENCY OBSTETRIC AND NEONATAL ON THE QA PROGRAM IN PONED PUBLIC HEALTH CENTER X BONDOWOSO REGENCY , Asti Nuris Mida Rahmawati*, Al Munawir and Dewi Rokhmah
Providing quality and satisfactory service to the patient is a claim that must be fulfilled by PONED Public Health Center as one of the government programs to reduce maternal and infant mortality. QA is a form of program to maintain the quality of a health center. The purpose of this research is to analyse the service of obstetric-basic emergency in the use of QA program. The research plan uses a qualitative approach with 4 informants comprising key informant, primary, and additional interviews. The results showed that QA's input variables have not been fulfilled and support the implementation of PONED. Service process variables have not been implemented according to guideline. Performance access output variables not optimal.
66 CONTENT OF SULFUR DIOXIDE (SO2) IN THE AIR ON THE OCCURRENCE OF UPPER RESPIRATORY INFECTION (URI) IN FARMERS IN IJEN DISTRICT WATERSHED, BONDOWOSO , Aditya Sapta Wardana*, Isa Ma’rufi and Ristya Widi Endah Yani
The objective of this research was to analyze the effect of Sulfur Dioxide (SO2) content on Upper Respiratory Infection through individual factors (age, duration of exposure, length of work, smoking habits, nutritional status, independent efforts to reduce exposure (personal protective equipment) and environment factors (temperature, humidity, ventilation). This is an observational analytic research with a cross sectional approach with a sample of 101 respondents. The data used are primary data obtained from SO2 measurements, Upper Respiratory Infection examination, and questionnaires for 101 farmer respondents. The analysis instrument uses SPSS 22.0. The results of data analysis show that: 1) SO2 source of exposure has a significant effect on the incidence of URI. 2) Individual factors (age, length of work, duration of exposure, smoking habits, independent efforts to reduce exposure) and environment factors (temperature, humidity, ventilation) have a significant effect on the occurrence of URI.
67 PERTUSIS: FACTS AND MANAGEMENT , K. Sen*, Dr. B. Ray and Prof. S. K. Mahapatra
Pertussis, or whooping cough, is an acute respiratory infectious disease caused by the bacterium Bordetella pertussis. It can be quite serious, especially for young infants with tiny air passages. Severe cases of whooping cough may require hospitalization, respiratory support, and nutritional and rehydration therapy. Antibiotic are given to control infection followed by other Supportive Therapy.Manytimes Macrolide group of Antibiotic Shows effectiveness. The treatment, however, has no influence on the course of the disease. Human hyper immune pertussis globulin is still used occasionally, but no reliable data support its efficacy. Further treatment is symptomatic. Preventive Vaccinations are many times effective.
68 ANTIBACTERIAL PROPERTIES OF EPILOBIUM AND OTHER PLANT SPECIES: A SYSTEMATIC REVIEW OF THE LITERATURE , *Dr. Wally J. Bartfay RN PhD, Maryam Masood MHSc (C), Julia Green-Johnson PhD
Background and Significance: The emergence of new pathogens and the increase in number of multi-drug resistant strains unaffected by currently available antibiotics is a major growing public health concern globally. The current lack of research into the development of new antibiotics by large pharmaceutical companies is largely due to poor financial returns. Herbal and plant based sources, such as the Epilobium angustifolium, may possess antibacterial properties, and therefore provide a viable and cost effective source for the development of new antibiotics. Methods: A systematic review of the literature was undertaken to locate articles describing potential antimicrobial properties of E. angustifolium and similar plant species. A data extraction template was employed, and three databases were searched: (i) PubMed (January 1992 to November 2018), (ii) Web of Science (January 2008 to November 2018), and (iii) Scopus (January 2000 to November 2018). Results: A total of 84 potential articles were identified; 65 were redundant sources, and a total of 19 studies met the inclusion criteria. These studies consisted primarily of serial dilution, micro dilution, disk diffusion, minimum inhibitory concentration, minimum cytocidal concentration, high performance thin-layer chromatography or zone of inhibition methods. Conclusion: There is preliminary evidence to suggest that E. angustifolium and related plant species may possess both gram positive and gram negative antibacterial properties that warrant further investigation. Specifically, dose-response studies are required as well as the need to isolate and identify the active biochemical compounds present in these plant species.
69 MALE BREAST CANCER: A CASE REPORT AND REVIEW OF LITERATURE , Dr. Akpor I. O.*, Vhriterhire R. A., Ngbea J. A., Ojo B. A., Eke B. A., Nyaga T., Gyenger D.
Carcinoma of the breast in a male is quite a rare occurrence. However, the risk factors, the pathologic features and prognostic factors documented for male breast carcinoma are remarkably similar to what obtains in women affected by the disease. In addition to assessing and confirming the patient-specific risk factors, and clinical presentation, a definitive diagnosis can be made by subjecting a needle core biopsy specimen or even a modified radical mastectomy specimen together with dissected axillary lymph nodes to histopathological evaluation. We report a case of an invasive ductal carcinoma of the breast in a 63 year old male who presented with a recurring and progressive right breast mass on account of the rarity of this diagnosis in males. The patient had a modified radical mastectomy and the mass with dissected lymph nodes was subjected to histopathological analysis upon which a diagnosis of mucinous invasive ductal carcinoma was made. Immunohistochemical tests were done to further characterize the tumour, which was found to be positive for the oestrogen receptor. The patient was placed on tamoxifen post operatively and is alive and symptom free as at the time of this report.
70 THE COMMONEST RESPIRATORY INFECTIONS THAT INDICATE HOSPITAL ADMISSION AMONG CHILDREN IN MOSUL , *Dr. Hajir H. Al-Ridhwany, Khulood J. Mahmood and Farah S. Yonan
Introduction: Acute Respiratory Infections are the most common causes of illness and mortality among under five children. Its severity is greater in developing countries, resulting in a higher case-fatality rate. Aim: The present study is aiming for enumerating the commonest ARIs that indicate hospital admission among children in Mosul, at the north of Iraq. Subjects and method: Administrative agreement was obtained from Nineveh Health Directorate. A design of case series study was achieved over the period from 1st of November 2012 to 30th of March 2013. Inclusion criteria of the studied sample "children between 1-24 months old who were admitted to the pediatric clinics and words in Mosul city. Results: Two hundreds children were studied.More than half of cases (52.0%) were classified as upper ARIs. Among such group, common cold was the most frequent cause of hospital admission (34.5%). While pneumonia was the commonest cause (28.5%) among lower ARIs. Conclusion: Common cold and pneumonia are the commonest ARIs occurring among young in Mosul in order. Recommendation: All capabilities including health education is needed to be harnessed in order to minimize occurrence of ARIs.
71 FACTORS AFFECTING UNMET NEED FOR CONTRACEPTION AMONG REPRODUCTIVE AGED WOMEN IN BANGLADESH: DOES EMPLOYMENT STATUS MATTER? , Ahmed Zohirul Islam*, Mt. Laily Khatun, Md. Nazrul Islam Mondal, Ahmed Eftekharul Islam, Md. Rafiqul Islam and Md. Golam Mostofa
Background: In most of the developing countries, millions of women in their reproductive age do not use contraceptives but prefer to postpone or limit their births. So, the main purpose of this study is to identify the factors influencing unmet need for contraception among employed and unemployed women in Bangladesh. Methods: This study used a cross-sectional data (n=16,596) extracted from the Bangladesh Demographic and Health Survey (BDHS) 2011. The binary logistic regression was used to identify the determinants of unmet need for contraception. Results: This study reports that unmet need for contraception of unemployed women is higher than that of employed women and even the national level. Giving family planning (FP) methods by FP workers contributed the most in lowering the likelihood of having unmet need for contraception among unemployed women followed by non-Muslim religion and having secondary level of education whereas fertility preferences, having more than two children, regional variations and residing in the rural areas of the country increase the likelihood of having unmet need for contraception. Conclusion: Since unmet need for contraception among unemployed women is higher than the national level, different family planning programme initiatives are required for this sub-group of women.
72 PHARMACOGNOSTICAL AND CHEMICAL COMPARISON OF THE SEED AND ARIL OF MYRISTICA FRAGRANS HOUTT. , *Gayathri Devi V., Anitha John, Natarajan M., Neethu Kannan B. and Kanagarajan A.
Myristica fragrans Houtt., commonly known as Jaiphal and Javitri in India, belongs to the family Myristicaceae. Objective of the present study is to generate information based on botanical, physico-chemical and HPTLC data needed for proper identification and authentication of seed and aril of Myristica fragrans. The botanical study comprises of macroscopic analysis and powder microscopic studies of the two plant materials. The physico-chemical parameters such as loss on drying at 105℃, total ash, acid insoluble ash, water soluble ash, water soluble extractive, pH of water extract, alcohol soluble extractive, fibre content, swelling index, foaming index and volatile oil were determined by following standard methods. HPTLC studies of the defatted chloroform extracts of the seed and aril were conducted at 254 nm, 366 nm and 575 nm after derivatisation using vanillin-sulphuric acid reagent and the results were documented. The study shows that macroscopy, powder microscopy and most of the physico-chemical parameters of both the plant materials are different. HPTLC studies reveal that there are so many compounds having the same Rf values and colour indicating the presence of similar compounds in both the plant materials. The bands which are not common indicate that the corresponding compounds are different. It is also observed that larger numbers of phytochemicals are present in seed than aril. The given results help in accurate identification of these medicinally important plant materials by pharmacognostical and chemical methods.
73 GIANT OVARIAN FIBROMA: A CASE REPORT AND REVIEW OF LITERATURE , *Akpor I. O., Vhriterhire R. A., Ojo B. A., Nyaga T., Terkula D. G. and Agwa M.
Ovarian fibroma is the most common sex-cord-stromal tumour of the ovary, with peak incidence occurring in the fourth decade of life. It may occasionally be a component of one of two syndromes, the Meig syndrome and Gorlin-Goltz syndrome. Recurrence is encountered in some cases, but a good number of those reviewed in this work did not come up with any known recurrence of the neoplasm understudied. Therefore, surgery is curative in managing most cases of fibromas of the ovary, even though the cellular fibroma may recur or form peritoneal implants at times. The report of an isolated ovarian fibroma in a middle aged woman without syndromic association has been presented in this material on account of its quite alarming gross size, yet benign histological nature, following an initial impression of suspected malignancy. Marked improvement of the symptoms after surgical intervention was affirmed by the patient on follow up visits.
74 EVALUATION OF C-REACTIVE PROTEIN LEVEL IN PATIENTS WITH RENAL DISEASE IN NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI, ANAMBRA STATE, NIGERIA , Onwurah O. W.*, Ikebido O. C., EZE. H. T., Nkemjika U. N., Ifeanyichukwu M. O, Amilo G. I., Ajuba I., NWACHUKWU E.P
Cardiovascular disease is the major cause of hospitalization and mortality in chronic kidney disease (CKD). C-reactive protein (CRP) is a marker of cardiovascular disease and predictor of mortality in CKD patient. The CKD patients with elevated CRP should be identified on time and treated to avoid cardiovascular risk factors as well as reducing the mortality rate. This study evaluated the level of C -reactive protein in renal disease patients in Nnamdi Azikiwe University Teaching Hospital, Nnewi. A total number of 90 subjects were used for this study (45 patients with CKD and 45 healthy subjects as control), age ranged from 18 year to 65 years. They were grouped as young adults (age 18-35years) and older adults (greater than 35years). Their blood sample was collected and separated; the serum CRP level determined using the biosystem kit procedure. The values obtained were statistical analyzed and P-value of <0.05 taken as significant. The result showed the mean value of C-reactive protein of the renal disease patients (1.44± 0.50) was significantly higher when compared with the control group (1.13± 0.34). This finding concluded a high level of CRP in renal disease patient when compared with the control groups.
75 EVALUATION OF C-REACTIVE PROTEIN LEVEL IN PATIENTS WITH RENAL DISEASE IN NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI, ANAMBRA STATE, NIGERIA , Onwurah O. W.*, Ikebido O. C., EZE. H. T., Nkemjika U. N., Ifeanyichukwu M. O, Amilo G. I., Ajuba I., NWACHUKWU E.P
Cardiovascular disease is the major cause of hospitalization and mortality in chronic kidney disease (CKD). C-reactive protein (CRP) is a marker of cardiovascular disease and predictor of mortality in CKD patient. The CKD patients with elevated CRP should be identified on time and treated to avoid cardiovascular risk factors as well as reducing the mortality rate. This study evaluated the level of C -reactive protein in renal disease patients in Nnamdi Azikiwe University Teaching Hospital, Nnewi. A total number of 90 subjects were used for this study (45 patients with CKD and 45 healthy subjects as control), age ranged from 18 year to 65 years. They were grouped as young adults (age 18-35years) and older adults (greater than 35years). Their blood sample was collected and separated; the serum CRP level determined using the biosystem kit procedure. The values obtained were statistical analyzed and P-value of <0.05 taken as significant. The result showed the mean value of C-reactive protein of the renal disease patients (1.44± 0.50) was significantly higher when compared with the control group (1.13± 0.34). This finding concluded a high level of CRP in renal disease patient when compared with the control groups.
76 AYURVEDIC MANAGEMENT OF AN INFECTED WOUND: A CASE STUDY , Manorma Singh*, Sanjeev Sharma, Rahul Sharma
Wound management is an integral component of principles of surgery. Rational wound management involves consideration of multiple factors like type of wound, its extent, site, cause etc. with due consideration of general condition of the patient as well. In Ayurveda not only the wound but patient as a whole is treated. A wide range of formulations for topical and oral administration, diet and lifestyle regimen have been described in ancient Ayurvedic treatises. Wound management is a major thrust area in Ayurvedic surgical practice. This is a single observational innovative case study where a male patient aged 11years, presented with complaints of pain, blisters formation, discoloration, pus discharge from a wound over dorsal aspect of right foot and ankle. Patient was hypersensitive to local anaesthetic agents. So skin grafting could not be performed despite the wound got healthy and receptive for the same, in the course of treatment. Ayurvedic management culminated in complete wound healing.
77 FREQUENCY AND DURATION OF BREASTFEEDING AMONG CHILDREN HAVING ACUTE RESPIRATORY INFECTIONS IN MOSUL , Dr. Khulood J. Mahmood* and Zaid M. Yassen
Introduction: Breast milk is the ideal feeding for babies. It helps to prevent infections in young children and even in management. Aim: The present study is aiming for evaluate the frequency and duration of breast-feeding among children during the first two years of life in Mosul. Methods: A case series study design was adopted. A sample of 200 cases which was randomly collected from the pediatric word and outpatient clinic in Al-Khansaa and Ebin Sena teaching hospitals during the period from the 1st of November 2012 to the 1st of April 2013. Results: The lowest frequency of ARIs was among children who gave history of 12 months and more of duration of breast-feeding. Children with history of no breast-feeding more frequently had pneumonia (33.3%) and had bronchiolitis (26.6%). Children who gave history of breast-feeding ≥ 12 months had less frequency of otitis media (5.5%) and bronchitis (5.5%). Beside, 14.3% of the cases of otitis media have history of bottle feeding. In this study no significant difference appear between various type of ARIs regarding the short duration of breast-feeding. Short duration of breast-feeding makes child expose to all types of ARIs. Conclusion: Frequency of ARIs, in general, depended on the lactation duration. Recommendations: All capabilities including health education is needed to be harnessed in order to minimize occurrence of ARIs.
78 IMPROPER TECHNIQUE OF USING TURBUHALER IN A SAMPLE GROUP OF IRAQI ASTHMATIC PATIENTS, AFFECTING FACTORS AND ITS EFFECT ON ASTHMA CONTROL , Dr. Mahmood Fouad Mahmood M.B.Ch.B., Dr. Muftafa Ali Al. Sakini M.B.Ch.B., Dr. Ibtihal Shukri Abd Alhaleem M.B.Ch.B, FICMS-FM. and Professor Dr. Mohammed Waheeb. Al-Obaidy*
Background: Improper use of inhaler devices had a major effect on the drug delivery and furthermore associated with uncontrolled asthma and frequent respiratory clinics and emergency units visits. Therefore assessment of the effect of the improper use of turbuhaler device in the control of bronchial asthma, and the factors that have important impact on asthma management and control. Objectives: To evaluate the Turbuhaler technique among asthmatic patients and to investigate the characteristics of these patients and factors associated with improper use of Turbuhaler device and its relationship with asthma control. Methods: A cross-sectional study of 100 patients who visited respiratory clinic at Baghdad Teaching Hospital with bronchial asthma from 1st of March 2018 to 30th of March 2019. Information was collected about demographic data and asthma control and we assessed the inhaler techniques for each patient using an inhaler technique checklist. Results: Among the 100 asthma patients, 50(50%) were male, 50(50%) female. There was a statistically significant association between educational defects with the gender (P value <0.05). There was a statistically significant association between educational defects with the age (P value < 0.01). There was a statistically significant association between educational defects with the education level of patients (P value < 0.01). There was a statistically significant association between educational defects with the duration of disease of the patient (P value = 0.02). There was a statistically significant association between educational defects with the disease education of the patient (P value< 0.01). There was a statistically significant association between educational defects with asthma control test (ACT) (P value< 0.01). Conclusion: Improper inhaler device use was associated with poor asthma control. Many factors was associated with improper technique, the modifiable factor which we improve was the asthma education.
79 COMPARISON OF DEXAMETHASONE AND TRIAMCINOLONE AS EPIDURAL STEROIDS IN LOW BACK PAIN , Harparam Singh Ghuman*, Hardayal Singh Ghuman, Sumera Rahim
Epidural steroids are used in the treatment of radicular and other spinal pain of an inflammatory origin emanating from the cervical, thoracic, and lumbar spine. The use of epidural administration of steroids is to produce higher local concentrations at an inflamed nerve root and other areas of inflammation in the spinal canal area. Different steroid preparations have dissimilar physico chemical properties and these may affect outcomes and side-effects. There is an ongoing debate with regard to the use of particulate and non-particulate steroids for epidural injections for chronic pain patients. Design. One hundred patients were randomized to receive lumbar transforaminal epidural steroid injections (N = 50) with either dexamethasone 7.5 mg, or with triamcinolone acetate 40 mg (N = 50). Measurement were taken before treatment and one month after treatment using ascale, short McGill pain questionnaire, and re vised Oswertry Back Disability Index Conclusion. In this study, dexamethasone and triamcinolone treatments were shown to have different effects on low back pain with sciatica, with triamcinolone being more effective than dexamethsone in lumbar radiculopathy.
80 EFFECTIVITY OF LEECH THERAPY IN VARICOSE VEINS , Md. Anwer Alam, Zarnigar and Md. Tanwir Alam*
Background & Objectives: Varicose vein (Dawali) is a disease in which veins of legs and feet become dilated, tortuous, and greenish in colour due to excess accumulation of blood which is derived from saudavi madda, balgham ghaleez. The aetiology of varicose veins is still incompletely under stood, despite the fact that it is a very common disease affecting all ages from teenagers to elderly people. Prevalence of varicose veins increases with age. The complication of varicose veins like venous eczema, venous pigmentation, lipodermatosclerosis, superficial thrombophlebitis, venous ulceration etc impair health related quality of life significantly. The objective of the study is to evaluate the efficacy of Taleeq for secondary prevention of Dawali and to provide safe & cost-effective alternative treatment. Methods: Randomized controlled clinical open trial was conducted in regimenal unit of National Institute of Unani Medicine (NIUM). 50 patients were divided into 2 groups, 30 in test group & 20 in control group. Test group was treated with Taleeq on alternate day & control group was treated with grade 2 compression stockings & limb elevation for 2 months. Response was measured by assessment of pain / leg discomfort, limb girth, pigmentation colour & area. Ulcer healing was assessed by ulcer depth, pain in ulcer. PUSH Score, Periulcer surface, exudate amount & type on every 15th day. Hb% was assessed on every 15th day to check anaemia. Effect on anatomy of vein was assessed by colour flow Doppler USG in terms of valvular competency. Result: Test group showed significant reduction in pain, limb girth, pigmentation, number of perforators and out of 4 cases of ulcers 3 were completely healed in test group. Control group showed significant reduction in pain & limb girth, but there was no improvement on pigmentation in control group. There was improvement in ulcer parameters but ulcer was not completely healed. Both groups do not show significant improvement on SFJ & SPJ incompetency. Conclusion: Test group has major effects in improvement of all parameters. Study stresses that leech therapy should be administered in combination with compression stockings & other effective treatment modalities like weight normalization for obese patients, physical therapy, dietary modification etc for optimal results.
81 PREVALENCE OF ANEMIA AMONG THE ADOLESCENT FEMALES , Dr. Talat Nahid Ramzan Ali, Prof. S. T. A. Bilgrami, D. Md Razi Ahmad, Dr. Md Najibur Rahman and Dr. Md Tanwir Alam*
Introduction: Su-ul-qinya (anaemia) is a condition of decrease in quantity as well as quality of blood. The quantitative decrement is a condition which resembles anaemia in modern medicine, whereas Unani medicine describes its qualitative approaches too. As far its description, Su-ul-qinya is described in great details in classical Unani literature. The ancient scholars including Ali Ibn-e-Abbas Majoosi (Haly Abbas 930-994 AD), Zakariya Razi (Rhazes 850-925 AD) Ibn Sina (950-1037 AD’), Rabban Tabri (777-850 AD) etc. have mentioned Su-ul-qinya in their different documentation with emphasis on aetiological factors. Various aetiological factors have been described, some of them are related to demography and other are related to sex, age, diet and temperament, some experts have emphasised on its congenital and hereditary etiological spectrum.[1,2] Aims and Objectives: To estimate the prevalence of anaemia among adolescent females, to study pattern symptoms according to Unani parameter and to study the socio demographic factors associated with anaemia. Methodology: The present study (sample size of 50) is a cross sectional, field survey entitled as “Prevalence of Su-ul-Qinya among the adolescent females.” The survey was carried out among students from the primary secondary, higher secondary and junior college and U.G classes. The study was designed on two parameters the first one was questionnaire-based scale (subjective parameter) and second was evaluation of haemoglobin percentage through Sahli’s method as an objective scale.[3] Investigation & Results: Haemoglobin level was assessed by Sahli’s method and prevalence of anemia was found to be 91.8%. Observations: The prevalence of anemia was 91.8% and normal students were 8.2%. The two groups did not differ significantly with respect to personal history, menstrual history, type of diet, symptoms according to Unani parameters and awareness about the various facts concerning anemia. Chi square test done in each category (P > 0.05%).
82 PEDIATRIC AKI - A COMPARISON OF pRIFLE, AKIN, AND KDIGO DEFINITIONS , Dr. Nirranjana Sakthivelu and Dr. Divya Singh*
Background and Objectives: Acute Kidney Injury is synonymous with morbidity and mortality in critically ill children. Lack of standardization of existing definitions has led to the masking of true incidence of AKI. This study was done to compare the incidence of AKI in PICU and non ICU patients by pRIFLE, AKIN and KDIGO criteria. Material and Methods: A prospective observational study of 280 children, aged between 3 months and 18 years, admitted in ICU and general ward of Department of Pediatrics, Rajendra Institute of Medical Sciences, Jharkhand from January to August 2019 was undertaken. Incidence of AKI and staging were defined by pRIFLE, AKIN, and KDIGO definitions. Outcome and duration of stay at each AKI stage between the three definitions were compared by Fisher Exact tests. Results: AKI incidences according to pRIFLE, AKIN, and KDIGO were 37.8%, 27.8%, and 30% respectively. Mortality was alike across all definitions (pRIFLE, 2.3%; AKIN, 2.7%; KDIGO, 2.5%). Significantly longer hospital stay was noted, mean duration of ICU and non-ICU stay being 9 and 15 days respectively. Inter-stage incidence was similar between AKIN and KDIGO criteria. Conclusion: Since the three definitions led to differences in AKI incidence and staging, these results underscore the need to adopt an universal AKI definition.
83 A COMPREHENSIVE REVIEW ON MATRIX TYPE TRANSDERMAL PATCHES , Asheesh Chauhan* and Dr. Kapil Kumar
Transdermal drug delivery system was presented to overcome the difficulties of drug delivery especially oral route. A transdermal patch is a medicated adhesive patch that is placed on the skin to deliver a specific dose of medication through the skin and into the bloodstream. It promotes healing to an injured area of the body. Transdermal drugs are self-contained, discrete dosage form. It also provides controlled release of the drug for extended period of the time. Drug delivery through the skin to achieve a systemic effect without producing any fluctuations in plasma concentration of the drug. This review article covers introduction, outline advantages, disadvantages, skin pathways for transdermal drug delivery systems, various components of transdermal patches, preparation of transdermal patches, factor affecting transdermal patches, evaluation of transdermal system.
84 MODERN CONCEPTS OF THE "MECHANISM OF ACTION" OF THE PHYSICAL FACTOR ON THE WHOLE ORGANISM FROM THE POSITION OF QUANTUM PHYSICS , Dr. Bitsoev Vladimir Dodtievich*
The article attempts to formulate modern concepts of the "mechanism of interaction" of the physical factor and the whole organism on the basis of quantum physics, based on the most recent studies of the universe for their subsequent integration into a single science of physiocorrection and physiostabilization of the surrounding world.
85 DYSLIPIDAEMIA AMONG PATIENTS WITH END STAGE RENAL DISEASE IN MAKURDI, NORTH CENTRAL, NIGERIA , Dr. Monday O. Ogiator*, Joseph E. Ojobi and Ochoche O. Ijachi
Background: Chronic Kidney Disease (CKD) is a common public health problem with increasing prevalence and incidence. Dyslipidaemia is a commonly associated comorbidity in patients with CKD including end stage renal disease (ESRD). It has been shown to increase the risk of cardiovascular events which is a common cause of morbidity and mortality in these patients. In this study we aimed to determine the prevalence of dyslipidaemia among patients with ESRD seen at Benue State University Teaching Hospital, Makurdi. Methodology: This was a retrospective study which analysed data from patients with end stage renal disease managed at Benue State University Teaching Hospital, Makurdi from October, 1st 2012 to 31st December, 2015. Results: Out of the 118 patients studied, 59.3% were males while 40.7% were females. The mean age of the population was 45.9 ± 16.4. Seventy seven patients (65.3%) of the patients had dyslipidaemia. Conclusion: Over half of the Patients with ESRD had dyslipidaemia. Regular measurement of fasting serum lipids is essential in CKD to detect and treat abnormalities early as well as monitor progress of treatment
86 MODERN VIEW ON THE MECHANISM OF "THOUGHT" FORMATION AND ITS IMPLEMENTATION "PROGRAM" AT THE SUPRAMOLECULAR LEVEL , Dr. Bitsoev Vladimir Dodtievich*
The paper considers one of the most important problems of modern medicine: corrective and guiding function of cardiovascular system in all manifestations of vital activity of an organism at the supramolecular level. A "thought" and its implementation "program" simultaneously appear in the left ventricle of the heart. In author's opinion, when a child is born, a place in the information bank of the biosphere is allocated for the constant receipt and storage of data on his or her vital activities, until the death. The author managed to discover a mechanism of information feedforward and feedback between an organism and the biosphere.
87 CLINICAL EFFICACY OF COMPOUND UNANI FORMULATION IN NIQRIS (GOUT) , Md. Kalam Ansari, Md. Razi Ahmad, Md. Najibur Rahman and Md. Tanwir Alam*
Historical background: According to Ibn-e-Habal, Niqris originated from the word „Anquroon’ which means big toe of foot, because this disease usually starts with the involvement of this particular joint and hence the disease has been named after this joint.[1,2,3] Gout comes from the Latin „Gutta‟-which means „Drop‟ (Noxa) - with reference to the mediaeval “flowing down of humour”. Which justify the ancient belief about disease matter i.e. humours falling down drop by drop into the joint.[4,5,6] Incidence of gout is on rise with time and the prevailed mainstream treatment is not effective that mush as required. So, this unani formulation has been decided to testify scientifically and to prove its efficacy on patients of gout; which has been claimed in classical Unani text. Study Design: Present study has been designed to study the efficacy of a compound Unani formulation drug in the management of Niqris (Gout). It is an open clinical trial. The efficacy of this drug has been evaluated on the basis of standard parameters, subjective and objective both. The study was conducted on 60 patients for duration of 60 days. Result: After Intervention, most of the subjective parameters improved significantly, on objective parameters, improvement is very significant. All the biochemical parameters P=0.001. This result suggesting the effect of test drug is very effective in lowering the serum uric acid. Findings of trial were recorded on a specially designed chart and inference was made by appropriate statistical analysis.
88 DAWALI (VARICOSE VEINS): DESCRIPTION IN UNANI SYSTEM OF MEDICINE , Md. Anwer Alam, Zarnigar and Md. Tanwir Alam*
The dilatation of veins due to the accumulation of natural saudavi maadda (atrabilious matter) is known as Dawali (varicose veins).[1] Dilatation of leg veins is known as Dawali. It is caused by pooling of saudavi khoon.[2,3] Tortuous, dilated and prominent veins in legs are known as Dawali.[4,5] Dawali is a disease in which veins of the legs become dilated, tortuous and green due to the accumulation of saudavi khoon.[6,7] In this disease dilated, tortuous veins of different shapes and colour appear in legs.[8] In Dawali the veins in legs become thick due to excess pooling of saudavi or balghami khoon or tabai khoon.[9] It is a disease in which the veins of the legs become dilated, tortuous and green due to the accumulation of saudavi khoon.[6,10]
89 LEECHING: THE ANCIENT ART OF HEALING , Md. Anwer Alam, Zarnigar and Md. Tanwir Alam*
Ibne Sina, Akbar Arzani, Ibn Baitar and Ambroise (1510-90) recommended leeches for bloodletting in cases where cupping glasses could not be used, "to those leeches may for the most part be put to open the coat of the haemorrhoid veins, to the mouth of the womb, the gums, lips, nose, fingers and calf.”.[1,2,3,4] Harvey defended venesection as a major therapeutic tool for the relief of diseases caused by plethora. Long after accepting Harvey’s theory, physicians praised the health promoting virtues of bloodletting with as much (if not more) enthusiasm as Galen.[5] For hundreds of years after the death of Galen, physicians warned their patients about the dangers posed by a plethora of blood. If a plethora of blood caused diseases, venesection was the obvious remedy; thus, spontaneous haemorrhage and venesection were as natural and helpful to the maintenance of life as the menstrual purgation was in healthy women. Bleeding was a perfectly rational means of treatment within this theoretical framework.[5] Leeching had a fixed & relatively modest range of indication in humoral pathology. The dominant paradigm in ancient European and Arabic medicine until the 17th century like bloodletting, leeching as mainly conceived as a means of eliminating the superabundance of blood, or plethora.[5] Roman physician Galen (129-199 C.E) classified leeching as part of the system of elements & temperaments, the healthy balance of which required the drainage of excess corporal substances. Plethoric changes were treated by draining blood from the body, which was achieved by leeching & bloodletting.[6] Leeches have been used medicinally for phlebotomy. They were once used in India and elsewhere for the abstraction of blood from foul ulcers and other congested parts of the body.[7]
90 NEONATAL BILATERAL CHOANAL ATRESIA: A CASE REPORT AND REVIEW OF LITERATURE , Mohammad H.*, Otene AT., Adekwu A., Ochoga M., Eneojo A., Ausha JT., Azih NK., Ijiko BE. and Ojo B., Amodu A.
Bilateral choanal atresia (BCA) is a rare variant of choanal atresia. It presents in neonates with severe respiratory distress. The index case is a full term neonate which presented with acute respiratory distress. Emergency resuscitation was done. Thereafter, the diagnosis was made on choanogram and confirmed on CT scan. The patient had transnasal repair and stenting. This case highlights that BCA is not unusual. It should be considered as a differential diagnosis of severe respiratory distress in the newborn.
91 CASES OF INTERSTITIAL LUNG DISEASE IN WOMEN WITH SYSTEMIC SCLEROSIS AND OTHER CONNECTIVE TISSUE DISORDERS , *Patricia McWalter MD and Mayada Ahmed MD.
Background: Interstitial lung disease (ILD) can be a complication of Systemic Sclerosis (SSc), and other Connective Tissue Disorders (CTDs), and often has a poor prognosis. The cases described here show the association between ILD and SSc/CTDs in two Saudi female patients. Of interest, our first case of a younger patient with SSc, had a more severe form of ILD, whilst the older patient with Mixed Connective Tissue Disorder (MCTD) had a milder case of ILD. In a study looking at ILD in rheumatologic disorders, it was noted that ILD appeared more severe when the patient presented with predominantly SSc symptoms, which is also our observation in this case series. The diagnosis, management and future therapies of ILD are discussed. Design: This case series shows the association between ILD and SSc/MCTDs in two Saudi female patients. The study describes ILD associated with SSc of an advanced nature and the association between ILD and MCTD of a milder severity. Significance: Knowledge about ILD is essential for doctors caring for patients with SSc and MCTDs. The cases remind us to initiate an early evaluation and management of respiratory symptoms in SSc/MCTDs.
92 CALCIPHYLAXIS IN CHRONIC RENAL FAILURE: ABOUT ONE CASE , Ayoub Khanoussi*, Fatima Nachite, Abderahim El Naderi, Hanane Rais, Wafaa Fadili and Inas Laouad
Summary: Calciphylaxis or uremic and calcifying arteriolopathy is a rare, life-threatening condition, mainly affecting dialysis patients or patients with renal insufficiency. It is characterized by the rapid onset of infiltrated, inflammatory, purplish and livid patches of skin, resulting in deepening and necrotic ulcerations, surrounded by livedo purpuricus, sitting on the trunk, in the adipose areas, or on the limbs. Cutaneous histology reveals calcifications of the media of the deep dermal and hypodermal arterioles, intimal hyperplasia and necrotic panniculitis. Images of thrombosis and extravascular calcifications are also reported. The treatment combines several simultaneous strategies aimed at decreasing the phosphocalcic product, dissociating and removing calcium deposits, clearing necrosis and avoiding potentially fatal septic complications. We report an observation of a histologically confirmed calciphylaxis and review the pathogenesis, clinical, biological, therapeutic and evolutionary characteristics of this complication in the literature.
93 ASSESSMENT OF BACTERIAL CONTAMINATION OF COASTAL MARINE WATERS IN FISH LANDING SITES IN URBAN DISTRICT, ZANZIBAR, TANZANIA , Zakia M. Abubakar, Wahida K. Soud, Ali M. Ussi and Rabia A. R.*
Pollution of Zanzibar beaches and coastal marine waters through dumping of domestic wastes, fish processing and disposal of untreated wastewater from local toilets and municipal drainage systems highlights a great health safety concern that may also harm the marine water ecosystem. This study assessed levels of bacterial contamination by evaluating the log cfu/100ml of E. coli, Salmonella and Vibrio spp in coastal marine waters of the four major fish landing sites in the Zanzibar Urban district; Maruhubi, Malindi, Kizingo and Mazizini. The study also investigated the seasonal variability of contamination of the three types of pathogens. Contamination levels of E. coli was highest at Malindi and Kizingo (58%). Malindi also showed highest contamination of Salmonella spp. (46%) whereas Mazizini had highest contamination of Vibrio spp. (44%). The log cfu/100ml levels varied between 1.8 at Mazizini and 3.2 at Malindi for total coliforms and between 0.28 and 0.45 for fecal coliforms. There was a significant zonal variability in contamination levels for coliforms at Malindi relative to other sites, where the levels were higher in inshore zone than offshore. Inter-site comparison for pooled data showed significantly higher level of contamination on average at Malindi inshore for both total coliform (p = 0.0002) and fecal coliform (p = 0.003) than all other sites. There was a significant seasonal variability in coliforms contamination levels in all sites (p = 0.014 to p << 0.0001); higher contamination levels were observed in rainy seasons and low contamination during dry seasons. Isolations of public health related bacterial pathogens in this study might indicate presence of other types of pathogens in Zanzibar coastal waters. There is therefore need for establishment of coastal water monitoring measures and define local standards for beach water quality. Further, the results of the study raise the possibility of contamination of fish catches, hence the need of introduction of fish catch hygiene monitoring schemes.
94 AGE-RELATED HAEMATOLOGICAL VARIATIONS IN RELATION TO SERUM ERYTHROPOIETIN LEVELS OF INDIVIDUALS IN ELELE, RIVERS STATE , *Nwuzor Miriam Daberechi, Okoroiwu Ijeoma Leticia and Obeagu Emmanuel Ifeanyi
Age –Related Haematological Variations in relation to Serum Erythropoietin Levels of Individuals in Elele, Rivers State was carried out amongst children, adolescents and geriatrics at Madonna University Teaching Hospital Elele, Rivers State. A total of 116 Subjects were recruited for the study. It comprised 20 males and 16 females for children, 20 males and 20 females for adolescent’s group, 20 males and 20 females for geriatrics. Erythropoietin level was determined using Enzyme Linked Immuno- Sorbent Assay (ELISA), packed cell volume, haemoglobin level; total white blood cell count, differential white blood cell count, platelet count and red blood cell count were determined using standard method. Results from children showed statistical increase in neutrophil and lymphocytes in male children while serum Erythropoietin and other haematological parameters were statistically insignificant (P>0.05).Children showed significant correlation of serum erythropoietin which was negative for packed cell volume and haemoglobin in children. On the adolescents category, serum erythropoietin increased statistically on the females while packed cell volume, haemoglobin level, total white blood cell counts showed statistical increase in males (P<0.05).Other haematological parameters on the adolescents were statistically insignificant. Correlation of serum erythropoietin with other haematological parameters in adolescents showed significant negative correlation with packed cell volume and haemoglobin level while it showed significant positive correlation with red blood cell count.Geriatrics result displayed that serum erythropoietin,platelet count and neutrophil had statistical increase in the female while packed cell volume, haemoglobin level and lymphocytes of geriatric males showed statistical increase(P<0.05). Correlation of serum erythropoietin with some haematological parameters of geriatrics showed significant negative correlation of serum erythropoietin with packed cell volume and haemoglobin while it was positive for total white blood cell count and neutrophils. In conclusion, serum erythropoietin increases as packed cell volume and Hb decreases in children, adolescents and geriatrics. Among other haematological parametres, packed cell volume and haemoglobin increases at a higher rate in adolescent stage than other stages of life (childhood and geriatric stage). Serum erythropoietin has negative correlation with packed cell volume and haemoglobin in children, adolescents and geriatrics while it has positive correlation with red blood cell in adolescents.
95 NUTRITIONAL POTENTIAL OF THE EDIBLE WILD MUSHROOM TERMITOMYCES LETESTUI FROM BOUAFLE (COTE D’IVOIRE). , *Yoboue Guillaume Arthur Kouassi Loh, Saki Suomion Justin, Sea Tehi Bernard and Karim Kouablan Jean Constant
In order to contribute to food security, wild edible mushrooms Termitomyces letestui from the department of Bouaflé were collected and analyzed. To do this, the usual analysis techniques that are: extraction of fat with Soxhlet, the determination method with HPLC…were used. The salient results obtained reveal that these mushrooms contain 88.50 ± 1.30% moisture; 22.8 ± 0.77% protein; 2.48 ± 0.02% lipid; 54.27 ± 0.12% carbohydrates. With these different nutrient levels, these mushrooms have an energy value of 328.38 ± 2.5 kcal / 100g of dry matter. The mineral elements of the mushrooms have also been determined. Among these, potassium is the most preponderant macroelement (3227.74 ± 10.5mg / 100g). Regarding trace elements, the most important element is iron with a content of 1068.82 ± 0.08 mg / 100g. In view of the proportions of these various important nutrients for consumers, it seems imperative to popularize these wild mushrooms with this study.
96 A REVIEW ON QUALITY OF LIFE IN CORONAVIRUSES PATIENTS: AN INDIAN SCENARIO , Niranjan Sutar* and Ranju Sutar
Coronaviruses are a large family of viruses that can cause illness ranging from the common cold to more severe diseases like Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).The 2019 novel coronavirus, called 'SARS-CoV-2' (previously referred to as 2019-nCoV), is a new strain that has not been identified in humans before. The disease that is caused by SARS-CoV-2 is called 'COVID-19'.Coronaviruses (CoVs), enveloped positive-sense RNA viruses, are characterized by club-like spikes that project from their surface, an unusually large RNA genome, and a unique replication strategy. Coronaviruses cause a variety of diseases in mammals and birds ranging from enteritis in cows and pigs and upper respiratory disease chickens to potentially lethal human respiratory infections.
97 COMBINATORIAL CHEMISTRY AND ITS APPLICATION - A MODERN SYNTHETIC APPROACH , Konda Ravi Kumar and B. Sai Keerthana*
Combinatorial chemistry is defined as the systemic and repetitive covalent connection of asset of different building blocks of varying array of diverse molecular entities. Combinatorial chemistry is a new methodology by which we can simultaneously synthesize a number of possible compounds that could produce simultaneously a very large number of compounds, called libraries. Combinatorial chemistry involves the rapid synthesis or the computer simulation of a large number of different but often structurally related molecules or materials. Combinatorial chemistry is especially common in CADD (Computer aided drug design) and can be done online with web based software, such as Molinspiration. In the past, chemists have traditionally made one compound at a time. For example compound A would have been reacted with compound B to give product AB, which would have been isolated after reaction work up and purification through crystallization, distillation, or chromatography. In contrast to this approach, combinatorial chemistry offers the potential to make every combination of compound A1 to Am with compound B1 to Bn. Although combinatorial chemistry has only really been taken up by industry since the 1990s, its roots can be seen as far back as the 1960s when a researcher at Rockefeller University, Bruce Merrifield, started investigating the solid-state synthesis of peptides.
98 PHYTOCHEMICAL INVESTIGATIONS AND ANTI-CANCER ACTIVITY OF METHANOLIC EXTRACT OF ADINA CORDIFOLIA , Jayshri H. Bairagi* and Dr. R. S. Ghosh
Adina cordifolia is a deciduous tree of subfamily Cinchonoideae, family Rubiaceae, is found Southern Asia, from India and Srilanka east to southern China and Vietnam. It had been also shows anti-ulcer potential, active constituent showed interesting H+/K+ATPase inhibitory activity. The isolated stem of Adina cordifolia were identified as stigmasta-5,22-diene-3P-O-a-rhamnopyranosyl-(1-4)-P-Dxylopyranoside, a-amyrin, octacosanol and naringenin-7-methylether-4’-O-a-rhamnopyranoside on the basis analytical elucidation. Tannins and Phenolic compounds, Flavonoids are significantly present in 70% Hydroalcoholic and methanolic extract whereas the alkaloids, Triterpenoids, Sterols, Amino acids and Proteins presence were found negligible by the colour reactions. TLC profile of the methonolic extract for flavonoids and coumarins showed seven spots after acid spray and heated up to 1100C, whereas six spots were seen, when observed under UV light at 365 nm, before acid spray using n- Butanol: Acetic Acid: water (4:1:5) as mobile phase. Whereas TLC profile of the methonolic extract for coumarins showed three spots after acid spray and heated up to 1100C,whereas single spot was seen, when observed under UV light at 365 nm, before acid spray. using 10% Acetic Acid as mobile phase. Anti-proliferative activity of methanolic extract of Adina cordifolia, was determined using cell lines. Cells (5 × 103) were used various concentrations of Adina cordifolia, extracts (0-100 μg/ml) were added. The IC50 values were calculated by plotting the percentage survival versus the concentration of extract.
99 THE ACHARYA TECHNIQUE AS HEALTH CARE MEASURE FOR LOWER BACK PAIN , Lala Ram Yadav* (Rahul) and Dr. Bhartendra Sharma
Health is the state of complete physical, social, mental and spiritual well being, not merely the absence of disease or deformity. (WHO) But any fluctuation in these states may originate and trigger irritation, lack of interest in work or an obstruction in day to day life practices. Pain is an unpleasant sensory, emotional and subjective experience associated with actual or potential tissue damage. Lower Back Pain (LBP) is defined as discomfort in the spinal area below the level of 12th rib and above the gluteal folds experienced at least once a month, with or without radiation into the leg. The nurses working in ICU and OT experience lower back pain more frequently due to bending forward for long durations, over-forcing /over-loading some body parts while repositioning patients and sparing more time for patient care. From the above risk factors the nurses become less efficient, receive medical leave/retire early. Lower back pain can be treated by medications, mobilization, stretching exercise, stabilization exercise, ergonomic advice and postural advice and home remedies. Exercise plays an important role in preventing and reducing lower back pain by strengthening the back muscles and improving flexibility. Acharya Technique is a simple natural stretching exercises consisting of 5 steps each with half a minute duration to strengthen the lower back muscles and to reduce lower back pain. This exercise can be practiced by nurses for 15 minutes daily for 15 days to strengthen lower back muscles and to reduce lower back pain. Literature reviews proved that stretching exercise were effective in reduction of lower back pain. Acharya Technique is a simple stretching exercises consisting of 5 steps each with half a minute duration to strengthen lower back muscles and to reduce low back pain. This exercise can be practiced by nurses for 3-5 minutes daily for 15 days to strengthen lower back muscles and to reduce low back pain.
100 BURNOUT SYMPTOMS AMONG NURSES: LITERATURE REVIEW , Annu*, Dr. Poonam Sharma and Jyotsna Jacob
The concept of stress in the workplace is of great importance in health care. Among health care professionals especially nurses are generally considered a high risk group regarding work stress and burnout. Burnout is a psychological term for the negative response to chronic job-related emotional stress. In other words, burnout results from people giving too much of their time, energy and effort on the job over a long period of time without adequate time to recover physically or emotionally. When an individual attempts to minimize the negative feelings arising from a negative event, this is considered as coping process. Worldwide, health professionals and the hospital authorities have become concerned about the concept of 'burnout' and have tried to solve this problem.
101 TODAY’S ERA: THE HEALTH BEHAVIOR AND RISK FACTORS WITH DEPRESSIONNeelam Sharma*1 and Lala Ram Yadav (Rahul)2 , Neelam Sharma* and Lala Ram Yadav (Rahul)
Heath is defined as the state of complete physical, mental, social, and spiritual well being and not merely the absence of any disease or infirmity.(WHO) but in today’s busy life style, Mental, behavioral and social health problems are an increasing part of health problems all over the world. Depression is a common mental disorder usually starts in early adulthood that presents with depressed mood loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. It usually occurs as a result of adverse life events, such as: losses of a significant person, object, relationship or health, stressful life, sedentary life and lack of occupation but it can also occur due to no apparent cause. These problems can become chronic or recurrent and lead to substantial impairments in an individual's ability to take care of his or her every day responsibilities As a psychiatric illness, depression exists in all countries across the globe. WHO has identified depression as the number one psychiatric cause of disability in the world and projected that it would rank second in the world as a cause of disability by 2020. (WHO) Depression may affect the person’s socialization, family relations, and performance at school and work place, often with potentially serious long-term consequences. Adolescents with depression are at risk for increased hospitalizations, recurrent depressions, psychosocial impairment, alcohol abuse, and antisocial behaviors as they grow up. Depression is associated with poor academic achievement, social dysfunction, teenage pregnancy and substance abuse. It is also closely linked to attempted and completed suicide. This makes depression not only a burden of disease to the patients who are suffering from it, but also for their family, friends and for society as a whole.
102 A STUDY TO ASESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME 0N KNOWLEDGE REGARDING PREVENTION OF ROAD TRAFFIC ACCIDENT AMONG ADOLESCENTS IN SELECTED PU COLLEGES, MYSURU , Prof. Chandrashekar M.*, Prof. Sheela Williams, Dhanalakshmi N. and Priyadarshini
Road traffic accident (RTA) is any injury due to crashes originating from, terminating with or without involving a vehicle partially or fully on a public road. Road traffic accidents are considered as one of the important public health problem around the world. Road traffic injuries are the biggest killer of teenagers globally, international data released by the WHO reveals in 2015 more than 1.2 million adolescents died. According to the worldwide report more than 3000 die everyday .Currently RTAs are the leading cause of death and are predicted to become the 5th leading cause of death by the year 2020.Accidents are killing more people in India more than terrorism or natural disasters.[1] Research approach indicates the description of plan to investigate the phenomena under study the present study aimed to assess the effectiveness of structured teaching programme on Knowledge regarding prevention of road traffic accidents among adolescents in selected PU colleges in Mysuru. The research design selected for the study was pre experimental one group pre-test post- test design.
103 DOES ORTHOPAEDIC ISSUES INFLUENCE ON STROKE RECOVERY? , *Dr. S. S. Subramanian, M.P.T (Orthopaedics), M.S (Education), M. Phil (Education), Ph.D (Physiotherapy)
Stroke incidences and their treatment are widely recorded. The influence of orthopaedic issues and lack of follow-ups with major surgeries like arthroplasty affecting functional recovery under normal and post stroke remain unaddressed. This research aims to analyse various orthopaedic and neurologic causes for his negative prognosis for lack of functional recovery. 72 year old diabetic businessman of Chennai with THR in 2006 (Left) was ambulant with a quadruped, had a left side stroke in January 2018, getting treated with due medication and rehabilitation but even after 18 months with inadequate functional recovery, necessitates to analyse with evidence as done in this presentation. Outcome of this research analysis insists on regular post operative follow up in arthoplastic surgeries including physiotherapy for enhanced QOL of affected subjects.
104 EVALUATION OF AWARENESS OF CYBERCRIME IN MEDICAL STUDENTS , Sagar Lande* and Sandeep Kadu
Cybercrime is one of the vast growing area of criminality, all over the world. Definitions of cybercrime are variable, depends on purpose of using the term. A limited number of acts against the confidentiality, integrity and availability of computer data or systems represent the core of cybercrime. Aim and objective: 1) To assess the awareness about cybercrime and its related laws.2) Assessment of precautions taken by respondents to prevent from being cyber victim. 3) Evaluation of cybercrime related knowledge. Materials and methods: The cross sectional questionnaire based descriptive study was performed in DVVPF‟s Medical College and Hospital, Ahmednagar (M.S). The structured questionnaire to gather relevant information pertaining to the research topic was designed and distributed among the participants. The data was collected and analysed statistically under expert guidance for number and percentage. Results: In our study 200 individuals were participated of which with 98% response rate 196 individuals responded. Our study reveals that 98(50%) individuals access their social networking account when they get bored. The Majority 140(71.4%) individuals don’t use same password for different accounts while 168(85.7%) don’t share their passwords with friends and relatives. Most of the participants, 153(78.1%) knows about strong password and aware about its use. For security purpose most of individuals 133(67.8%) have installed Antivirus on their devices. Conclusion: The study found that most of the individuals are aware of judicious use of social media, security and of privacy during its use. But the individuals needed to be informed about cybercrime laws and acts and about the various cybercrime related terms.
105 EFFECTS OF NICOTINE AND CHROMIUM (VI) CO-EXPOSURE ON THE FUNCTIONAL STATUS OF LIVER IN MALE ALBINO RAT , Amit Nandi, Soumita Dey, Surachita Das, Sandip Kumar Sinha, Sankar Kumar Dey*
Background: Nicotine is one of the major constituents of different types of smoking and is the more toxic part also. Thirty metals including chromium and some chromium compounds have been detected in tobacco smoke are causally associated with cancer in humans. Objective: In the present investigation, we evaluate the individual and combined effect of nicotine and chromium (VI) on the functional status of liver in animal. Materials and Methods: In this study, a group of male Wistar rats (80-100 g) were induced by intraperitonial injection of vehicle (0.9% NaCl), nicotine tartrate (0.2 mg / 100 g body weight / day), K2Cr2O7 (0.8 mg / 100 g body weight / day) and, combined exposure of nicotine tartrate and K2Cr2O7 at an interval of six hours for a period of 28 days. After the period of treatment the blood samples were collected to measure the liver function test related parameters. Results: It was showed that individual and combined exposure of nicotine and chromium (VI) marked increased the activities of ALP, AST, ALT, LDH and the levels of bilirubins were decreased. On the other hand, there were no significant alterations were observed in the level of total protein and albumin in response to individual and combined exposure of nicotine and chromium. Conclusion: The present study suggests that nicotine and chromium exhibited significant changes during individual exposure whereas co-exposure showed a marked alteration of the functional status of liver in male albino rats.
106 UNDERSTANDING EPIDEMICS WITH SPECIAL REFERENCE TO COVID-19: A REVIEW OF THE AYURVEDIC CLASSICS , Dr. Dilip Kr. Goswami*
The term “Epidemic” means “a sudden outbreak of infectious disease that spreads rapidly through the population, affecting a large proportion of people”. Similarly “Pandemic” is a technical word used to indicate “an epidemic so widely spread that vast number of people in different countries are affected”. These two words cause panic among the common citizen, cause extra ordinary alertness in the administration and raise brain storming situation among the researchers and scientists. In such situations the health workers have to stand as the soldiers to fight for the administration. They have to forget food, rest and sleep. Public co-operation is must to overcome such situations successfully. “COVID-19” the situation caused by the dreadful virus “CORONA” is now standing as the great challenge for the human society. Life of the citizen is in danger irrespective of age,sex,religion, caste , financial condition and profession. Starting from China it has already caused havoc in the developed countries and now affecting India. Looking back to the ancient medical system, specially of India, Ayurveda, it is observed that, there are some facts in Charaka Samhita, Susruta Samhita, Ashtanga Hridaya and Ashtanga Sangraha that have similarity with the present situations viz.endemic and pandemic. The facts mentioned in these ancient books regarding aetiology, diagnosis, treatment and prevention can also be taken in consideration for application in present situation also. A discussion on the descriptions of the ancient Ayurvedic scholars with special reference to the epidemic/pandemic like situations, aetiology, diagnosis, treatment prevention etc. is considered to have great importance in present situation.
107 A DESCRIPTIVE STUDY TO ASSESS THE PERCEIVED BURNOUT SYMPTOMS AND COPING STRATEGIES AMONG STAFF NURSES IN SELECTED HOSPITALS OF DELHI NCR WITH A VIEW TO DEVELOPE INFORMATIONAL GUIDELINES ON BURNOUT MANAGEMENT , Annu*, Dr. Poonam Sharma and Jyotsna Jacob
The concept of stress in the workplace is of great importance in health care. Among health care professionals especially nurses are generally considered a high risk group regarding work stress and burnout. Burnout is a psychological term for the negative response to chronic job-related emotional stress. In other words, burnout results from people giving too much of their time, energy and effort on the job over a long period of time without adequate time to recover physically or emotionally. When an individual attempts to minimize the negative feelings arising from a negative event, this is considered as coping process. Worldwide, health professionals and the hospital authorities have become concerned about the concept of 'burnout' and have tried to solve this problem.
108 EARLY THROMBOCYTOPENIA IN PRETERM NEW BORN AND ITS PROGNOSTIC OUTCOME , Dr. Vishwajeet Pratap, Dr Anil Kumar Chaudhary and Dr Partha Kumar Chaudhuri*
In many Study it has been shown that platelet count beyond 2nd trimester of pregnancy reaches and maintain a level above 150×109.[1-4] Therefore Neonatal Thrombocytopenia is defined as platelet count less than 150×109/l. Its overall prevalence ranges from 1% to 5%.[5-8] It is severe thrombocytopenia when platelet count is less than 50×109/l, which occurs in 0.1-0.5%.[9-11] The prevalence of neonatal thrombocytopenia which develop among the baby who are admitted in NICU is much higher which is 22-35%.[12,13] Among preterm new born admitted in NICU it is 8%, who have severe thrombocytopenia.[14]
109 A RARE CASE REPORT OF LARGE SUBMANDIBULAR DUCT CALCULUS , Dr. Mohammed Israr Ul Khaliq* MDS (Oral & Maxillofacial Surgery) and Dr. Shakiel ur Rehman2 BDS
Sialolithiasis is most commonly found in the submandibular gland and it’s duct (Wharton’s duct). This report describes the case of a patient who had a painless very rare giant Submandibular sialolith visible per orally on the floor of mouth. A 2.5× 1cm sized stone was excised.
110 A DESCRIPTIVE STUDY TO ASSESS THE KNOWLEDGE REGARDING EXCLUSIVE BREASTFEEDING AMONG ANTENATAL MOTHERS VISITING OBG OPD, AIIMS PATNA. , *Hansmukh Jain and Fauzia Jawaid Kazi
Introduction: Breastfeeding is the safest, cheapest and best protective food for infants. Breast milk contains all the nutrients in the right proportion which are needed for optimum growth and development of the baby up to 6 months .It is easily digestible and provide immunity to the baby. Breastfed baby is less likely to develop infection especially gastrointestinal and respiratory tract infections. Breastfeeding promotes close physical and emotional bondage between mother and baby. It also promotes development of higher intelligence and feeling of security in infant. It reduces the chance of PPH and pregnancy for 6 months, risk of breast and ovarian cancer to the mother. Methodology: The research design was non-experimental descriptive design, sampling technique was convenient sampling, sample size was 60, population was the antenatal mothers visiting the OBG- OPD. Tools used for data collection were demographic proforma and self-structured knowledge questionnaires, setting was OBG-OPD of AIIMS. Results: Data presents that the minimum age is 19 years and maximum age is 32 years, Mean is 24.35 and standard deviation is 2.93. Maximum number of subjects 38.3% were qualified up to graduation, majority of the subjects 86.7% were housewives, maximum number of subjects 81.7% belong to hindu religion, maximum number of subjects 58.3% had prior knowledge about breastfeeding. The 5% of subjects had poor knowledge, whereas 32% of subjects had average knowledge and 63% of subjects had good knowledge regarding breastfeeding. There was association between knowledge regarding exclusive breastfeeding and educational qualification of mother is significant at 0.05 level of significance.
111 EVALUATION OF CRP LEVEL AS MONITORING TOOL FOR PATIENT WITH FACIAL SPACE INFECTION , Dr. Sami Faisal Jamdar*, Dr. Aaminah Fatima Jamdar and Zidan Muead Alanazi
Background and Aim Despite greatly improved health services available in present era, severe odontogenic infections still remains leading cause of morbidity and mortality. Thus close monitoring of such patients becomes a necessity and efficient monitoring tools are required for the same. The objectives to assess efficacy of CRP levels as monitoring tools for determining severity of infections, severity of malnutrition and nutritional status, length of hospital stay, and efficacy of treatment regime. Materials & Methods: The blood samples of the patients were taken on Day 0 and Day 5 for measuring serum levels of the markers. Simultaneously clinical parameters like swelling size, mouth opening, pain etc. were also recorded on Day 0 and Day 5. The appropriate treatment was given to each patient. Analyses were done to find correlation between markers and clinical parameters of odontogenic infections using regression and paired t- test. Results: The statistical analysis found strong correlation between lab values of markers and clinical parameters used to measure severity of infection. The analysis also proved that values of markers significantly changed and moved towards normal as the condition of patient improved with effective treatment. Similarly, CRP was also a significant predictor for hospital stay (P<0.001) and 40.11% of the variation in X hospital stay was explained by CRP. (P<0.001) Conclusion: The findings of this prospective analysis indicate C-reactive protein are effective markers for determining severity of infection, efficacy of treatment regime and length of hospital stay for patients with fascial space infections of odontogenic origin. The duration of antibiotic usage, need for intensive care, and use of additional nutritional supplements becomes more rationale if these markers are incorporated in the clinical decisions. Thus we conclude that CRP should be incorporated as monitoring tools for patients with fascial space infections.
112 CARBOHYDRATE TOLERANCE IN PREGNANCY WOMEN, STATUS OF SERUM IRON AND SERUM PHOSPHORUS LEVELS IN GESTATIONAL DIABETES MELLITUS CASES: A CASE CONTROL STUDY IN A DISTRICT, ANDHRA PRADESH, INDIA , *Dr. D.S.R.S. Prakash and M. Kiran Deedi
Gestational diabetes mellitus is defined as any degree of glucose intolerance with the onset of pregnancy or first recognized during pregnancy (Metzger GE, 1991). Women with gestational diabetes mellitus far exceed the number of pregnant women with pre-existing diabetes, the ratio being approximately 10 to 1.clinical recognition of gestational diabetes is important because it can be associated with increased prenatal mortality and increase birth trauma, and maternal hypertension (Magee MS et al.1993). The present study was done to know the incidence of glucose intolerance in pregnant women and to evaluate the relation with serum iron and serum phosphorous. In 50 pregnant women between 24-28 weeks of gestation oral glucose tolerance test (OGTT) with 75-g glucose without regard to recent meal status was done. In the same cases, serum iron and serum phosphorous were measured.
113 DOPAMİNE AGONİST RESPONSİVE ABULİA: A CASE REPORT AND LİTERATURE REVİEW , Hakan Şilek*, Ayça Serap TUNCER, Bahar Erbaş
Abulia is a "syndrome of hypofunction," characterized by apathy, slowness of thought (bradyphrenia), blunting of emotional responses and response to external stimuli decreased or complete lack of initiative , spontaneeity and drive. We describe a case of a socially active 73-year-old male patient who presented with symptoms of abulia which may have occurred due to damage of the frontosubcortical circuits following an cardiac mitral valve replacement. The patient's symptoms improved dramatically following treatment with pramipexole.
114 IMPACT OF COVID-19 ON FOOD SAFETY AND FOOD SECURITY , Shrikrushna Subhash Unhale*, Quazi Bilal Ansar, Vaishnavi Gajghane, Sonaji S. Bharudkar, Priyanka P. Gadekar and Prof. Dr. K. R. Biyani
Food safety and food security is of the forefront of policy making around the globe. To spreading of COVID – 19, world around the globe have enforced cerfew. It has resulted in full closer of most of the industries and carried out on global economy. In this difficult situation, Humans try this best that they do not run out of food supplies The fast spread of COVID- 19 has caused nation and organisations across the world to take emergency auction in the interest of health. The food industry is susceptible to experiencing a fuel impact from the global outbreak and also climate change will have fare- redusing impacts on crop.
115 PHENOMENOLOGY STUDY: CHANGE IN THE PERCEPTION OF CANCER PATIENTS DUE TO FAMILY SUPPORTS , Kristianto Dwi Nugroho* and Ucip Sucipto
Background: Cancer is a cell which abnormally grows in human body and can particularly damage other parts of body. During the healing process of cancer, there will be a physical and psychological changing towards the patients. The psychological exchange could happen directly or can also discharge the patient‟s life quality. Social support can increase the adaptation of patients during the healing period. The smallest social environment that can help the healing process is the family so that family support is needed to refine the patients‟ perception until they have the spirit to recover. Objective: The aim of this study is to analyze changes in the perception of cancer patients start from patients' rejection as far as having spirit to recover. Methods: The research design used in this study is a qualitative study with a phenomenological perspective. This study explains an idea about the symptoms that arise about the subject's experience that gives meaning towards an event. Results: This research proposes three main themes, which are: (1) Family support towards patients during the healing process (2) Acceptance of cancer patients (3) Passion for recovery of cancer patients. Conclusions: The smallest social environment support is needed in changing patients' paradigms from rejection to the emergence of a passion for recovery.
116 THE EFFECTIVENESS OF ORAL CARE USING HONEY AND 0.12% CHLORHEXIDINE ON THE RISK OF ASPIRATION PNEUMONIA IN STROKE PATIENTS WITH DECREASED CONSCIOUSNESS , Dyah Untari* and Nadia Oktiffany Putri
Background: The increase of stroke prevalence is still a big challenge for the world every year. Stroke often requires a prolonged treatment because most stroke patients have decreased consciousness. Hospitalized patients who experience decreased consciousness are at risk of nosocomial pneumonia originating from aspiration pneumonia. Prevention of aspiration pneumonia can be done with adequate oral care. Generally, oral care is performed using chemical materials, including 0.2% chlorhexidine, 0.12% chlorhexidine, 0.9% NaCl, and alcohol-free mouthwash. Oral care with natural ingredients is still rarely used in hospitals. Aim: The aim of this study was to compare the effectiveness of oral care with honey and 0.2% chlorhexidine to the risk of aspiration pneumonia in stroke patients with decreased consciousness. Methods: This study was a quantitative study with a quasi-experimental method. The study design used a pre and post-test with control group. The dependent t-test and independent t-test was used for data analysis. Results: The results showed that there was a significant difference between the effectiveness of oral care using honey and 0.2% chlorhexidine on the risk of aspiration pneumonia in stroke patients with decreased consciousness (p-value. (0.029) < 0.05). Conclusions: In conclusion, the findings highlight that oral care with honey has more significant effect in reducing the risk of aspiration pneumonia in stroke patients with decreased consciousness. The use of honey as an oral care doesn’t only have benefits as an anti-microbial, but also makes the color of the gums and teeth become brighter in stroke patients with decreased consciousness.
117 AN EXPERIENCE OF WEB BASED CLINICAL TEACHING IN FAMILY MEDICINE AT COLLEGE OF MEDICINE IN OMAN, DURING COVID-19 OUT BREAK , Dr. Firdous Jahan*
The ideal clinical teaching and learning is done in patient care but because of COVID-19 pandemic outbreak all clinical and class room teaching is suspended now. Online teaching is an acceptable mode of teaching, online medical teaching is entirely a different story but converting face-to-face teaching into the online mode in this unique situation has allowed each of us to use our ingenuity in planning the road that lies ahead. The teaching methods used in outpatient clinics are different from those used in wards, outpatient clinics in primary care offer more diverse and effective educational opportunities. Medical students in clinical years need effective and conducive learning environment to motivate and facilitates in depth learning, where they can express their opinion, questioning, evaluating own and peer performance with maximum hands on practice (doing). Ambulatory care gives a better opportunity for medical students to acquire appropriate medical knowledge with diversity of cases. There is a serious and disruptive change to medical education worldwide in this pandemic and the use of technology has been rapidly and innovatively used in an attempt to maintain teaching and learning. The aim of this article is to provide guidance how to conduct effective clinical teaching on line and make plan for assessment under current pandemic conditions.
118 RASA AUSHADHIS DOSE SCHEDULE- A REVIEW , Dr. Kashimali Nadaf* and Dr. Mahantesh B. Rudrapuri
Rasashastra deals with Rasa Aushadhis, drugs of metallic and mineral origin. Mercury is mainly used in the Rasaaushadhis. Mineral and metal formulations toxicity is minimized to such a degree by specific Shodhana, Marana, etc. techniques that Mercury turns its intrinsic toxicity property into therapeutic property. Rasa Aushadhis acts easily on the body because, owing to their low particle size, they are consumed by the oral mucosa itself. Drugs are mostly based on the Anupana, i.e. the drug vessel Rasacharayas listed numerous Rasa preparations, such as Bhasmas, Parpati, Pottali, Manduras, Karpooras, etc., along with their doses, dosing plan and Anupana / Sahapana, etc. The concepts of Rasaaushadhi, although applied in modern times, are considered to be scientifically valid. It can be claimed that Rasacharyas has already mastered the science of nanotechnology, purification, function of microbial catalysts, biotransformation and the protection of medicinal goods. Ayurvedic medications can be toxic to our body if they are not delivered in the correct dose as shown in classical literature.
119 THE PHYTOCHEMICAL CONTENT AND ANTIMICROBIAL ACTIVITY OF MUNG BEAN (VIGNA RADIATA L.) EXTRACT AGAINST SOME SELECTED PATHOGENS OF MEDICAL IMPORTANCE , Adeoye John Kayode*, Adewole Sunday Awe, Folasade Banji-Onisile, Adebanke Adeorite Agboola and Olusegun Victor Oyetayo
The current study investigated the phytochemical and antimicrobial characteristics of unsprouted mung bean seed obtained at Igasi Akoko, in Akoko North West Local Government Area of Ondo State, Nigeria. The seed (Vigna radiata L.) was grounded into powder and divided into two equal parts (A and B). Sample A was used as a positive control for bioactive components present in the seed. The crude extract of sample (B) was obtained by soaking in ethanol to extract the bioactive components. Qualitative and quantitative phytochemical analyses of samples (A) and extract of sample B were assessed. The phytochemical assay revealed that alkaloid, saponin, terpenoid, steroid, and cardiac glycosides were present, ranging from 12.47 to 47.25 mg/g and 8.05 to 27.73 mg/g respectively. The antimicrobial activity of the extract was tested against referenced microbial cultures using appropriate microbiological techniques. The antimicrobial activities of the extract vary with different zones of inhibition ranging from 2.85 to 3.10 mm against Salmonella typhi, ATCC6539 (3.05 mm) Pseudomonas aeruginosa ATCC9027 (3.10 mm) and Citrobacter freundi ATCC8090 (2.85mm) but Klebsiella pneumoniae, and Enterobacter aerogenes were resistant. The extract did not exhibit any antifungal effect against Candida albicans, Cryptococcus neoformans and Aspergillus fumigatus. In light of this finding, mung bean seed could be considered as a potential source of natural antimicrobial agent.
120 BIO-DEGRADABLE POLYMER: VARIETY AND APPLICATION , Prof. S. K. Mahapatra, Malay Ranjan Mahanta*, Dr. B. Ray
Polymers have become an indispensable part of the drug delivery systems, be it be conventional drug delivery or novel drug delivery. They have drastically changed the mode of drug delivery by introducing lot of flexibility. Among the different types of polymers, biodegradable polymers have an edge over the non-biodegradable ones because of the advantage of obviating the need to remove the device after its depletion. The present article deals with variety of Such polymer with its Special Application.
121 THE PREVALENCE OF POST-TRAUMATIC STRESS DISORDER AMONG PRIMARY SCHOOLS PUPILS IN BAGHDAD/AL-KARKH , Dr. Ibtihal Shukri Abd Al-Haleem* (FICMS \ FM, MBChB), Assistant Professor Dr. Waleed AT Al-Ani (PhD, MSc, MBChB), Professor Dr. Muhammed Waheeb al Obaidy (FCCP.FRCPE)
Background: The critical current situation in Baghdad and the huge amount of violence affect the whole population causing different degree of distress, anxiety, fear, and depression. The psychological trauma may precipitate post-traumatic stress disorder. In children post-traumatic stress disorder is a common response to community violence with higher rates in youngster’s exposed to life threatening events. Objectives: To estimate the prevalence of post-traumatic stress disorder in primary schools and study different associated factors (demographical, cultural, and social). Subjects and Methods: A descriptive cross-sectional study using random sample (multi-stage sampling) on 25 primary schools (boys and girls) from Al-Karkh sector/ Baghdad for the period of six months of teaching period 2010-2011 involving 2707 pupils from both sexes. A well-structured questionnaire including socio-demographic and post-traumatic stress disorder related factors were filled by the researcher through direct interview with ensured confidentiality. Results: The results obtained from primary schools showed a 29.8% prevalence of post-traumatic stress disorder among such vulnerable group (29.6% in boys and 30.1% in girls), this rate is high enough to cause concern to take preventive and therapeutic measures to deal with it. The prevalence of criteria of post-traumatic stress disorder was 29.8% for reaction to fear or terror or disability and painfully recalls the event, 38.7% for avoidance symptoms, 30.1% for hyper arousal symptoms and 98.1% for study or social activity affected, obvious grief, or stress. Conclusion: A higher proportion of primary school children were affected with post-traumatic stress disorder with main factors associated adversely were female sex, increase failure rate, low family economic status, and if the parents were alive or not. The present study points the importance to be aware of early symptoms, an urgent need for targeted interventions, and the value of special follow-up.
122 THE BAY LEAVES TEA CAN DECREASE CHOLESTEROL LEVELS OF PATIENTS WITH CARDIOVASCULAR DISEASE , Susyani*, Ahmad Zurio and Terati
Background: Cardiovascular disease is the number one cause of death globally. Cardiovascular disease causes 75% of deaths that occur in countries with middle and low earnings in the world, one of them is Indonesia (WHO, 2015). The causes of cardiovascular disease are unhealthy diet, lack of activity, obesity, high cholesterol, age, etc. Bay leaves contain flavonoids, tannins, saponins, and niacin which can reduce cholesterol levels.Objective: The purpose of this study is to know the effect of bay leaves tea to reduce total cholesterol levels of patients with cardiovascular disease. Method: The type of research used is an experiment by pretest and posttest with a control group design. The treated group got 1 gram bay leaves tea twice per day in a week. The research samples were chosen by systematic random sampling with the total of treated group samples and control samples are 30 respondents each. Data analyses of this research are paired sample t-test and independent t-test. Result: The paired sample t-test showed that there was an effect of bay leaves tea towards total cholesterol, HDL and LDL with p-value (<0.05). The Independent t-test showed LDL has a significant difference between treated and control with p-value (<0.05). Conclusion: the bay leaves tea can decrease total cholesterol levels of cardiovascular patients especially the reduction of LDL level.
123 STUDY OF MATERNAL NEAR MISS CASES: SCENARIO AT TERTIARY HEALTH CENTER IN WESTERN MAHARASHTRA , Prachi Sawant*, Maulika Shah and Anita Ijalkar
According to millenium development goals in 2015, the goal number five was to improve the maternal health. In any setting women who develop severe acute morbidity during pregnancy share many circumstantial factors related to their condition. A maternal near miss case is defined as a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy. This concept is relatively new in maternal care, but is increasingly becoming important in areas with low maternal mortality ratios or where the geographic area is small. Our study is conducted at tertiary health care center in Western Maharashtra, state in India. Maternal morbidity is assessed in view of maternal near miss cases. Maternal near miss incidence ratio, obstetric and non obstetric complications, investigations and maternal near miss to mortality ratio calculated.
124 IMPROVING KNOWLEDGE AND ATTITUDES OF WOMEN ATTENDING FAMILY PLANNING UNITE AT AL-BATOOL HOSPITAL\MOSUL , *Alaa Abd-Al-Ghany Younis, Amenah Qasim Yehya and Nahlah Wadullah Hasan
Family planning (FP) refers to limiting or spacing childbirth so one can enjoy a healthy family. Family planning makes benefit for the health and wellbeing of women, children, families and communities and is key component to sexual and reproductive health services. Family planning means deciding when is the right time to have children and what is the appropriate number for couples to have. The right time to have children is: when a woman is between 20-30 years old, when has not been pregnant for the last 2-3 years, when a woman has 2-3 children, when a woman has no illness that would place her or her baby in danger and when a couple wants to have a child.
125 COMPENDIOUS REVIEW ON SOLID LIPID NANOPARTICLES , Deepa M. K.*, Karthikeyan M.*, Abhay A. D., Shruti P. C., Omkar S. D. and Satish R. C.
Nowadays researchers have been focused on solid lipid carriers as colloidal drug carrier systems, which combine the advantages of other smart nanocarriers. Solid lipid nanoparticles (SLN), it remains solid at room temperature, developed a novel pharmaceutical delivery carrier system. This review article focused on various approaches in industrial scale-up techniques of Solid lipid nanoparticles with its advantages and disadvantages. It may help the researcher to select an appropriate method for the development of SLN according to their choice of drug delivery.
126 THE PROGNOSTIC VALUE OF CD10 IN PATIENTS WITH B-ACUTE LYMPHOBLASTIC LEUKEMIA: 10-YEAR EXPERIENCE , Rim Zakaria Alkasem*, Suzanne Alshemali and Firas Hussein
Determination of prognostic factors in patients with acute leukemia is crucial in reducing intensive chemotherapy, decreasing economic costs, and improving the outcome of the patients. We conducted this study to determine the prognostic value of CD10 expression in B-acute lymphoblastic leukemia (studying the relationship between CD10 expression and therapeutic response, overall survival, and event-free survival). Also, we want to study the combined expression of CD10 and CD34, and the effect on overall survival and event-free survival. A retrospective study included 119 patients from 1st January 2010 to 31 December 2016. We monitored the patients until 1st December 2019. In B-acute lymphoblastic leukemia, expression of CD10 was 81.5%. Most patients whose Blasts had CD10+ were children and standard risk stratification. In contrast, patients with CD10- had significantly an increased incidence of B symptoms, fever (infection), and cerebrospinal fluid infiltration. We found that complete remission after 4 weeks and after 18 months of starting treatment was significantly higher in CD10+ patients than CD10- patients and in CD10+ and/or CD34+ patients than CD10-CD34- patients. Death was significantly higher in patients with CD10- than CD10+. The median survival rate was higher in patients with CD10+ than CD10- and in CD10+ and\or CD34+ patients than CD10-CD34- patients but without statistical significance. Our findings suggest that CD10 expression and the combined expression of CD10 and CD34 have a favorable prognosis in patients with B-acute lymphoblastic leukemia.
127 CORONA- COVID 19 , *Parul Saini
COVID-19 is a disease caused by novel coronavirus. Fever, dry cough and breathing difficulties are its common symptoms. Some patients can also have aches, running nose, sore throat or nasal congestion. About 80% of the confirmed cases recovered without developing serious complications. The virus that causes COVID-19 is mainly transmitted through droplets generated when an infected person coughs, sneezes, or exhales. These droplets are too heavy to hang in the air, and quickly fall on floors or surfaces. You can be infected by breathing in the virus if you are within close proximity of someone who has COVID-19, or by touching a contaminated surface and then your eyes, nose or mouth. Frequent handwashing, maintaining social distancing and following respiratory etiquettes can help us to prevent from COVID-19. As of now there is no specific antiviral- medication for treatment of coronavirus.
128 NOVEL CORONAVIRUS (COVID-19) INFECTION AND ITS RADIOGRAPHIC APPEARANCE IN COMPUTED TOMOGRAPHY , Tamijeselvan S.*
Medical Imaging plays a vital role in the diagnostic field. In recent time the corona virus COVID-19 became pandemic as announced by the World Health Organization (WHO). Screening Computed Tomography for the identification of Novel Coronavirus (COVID-19) pneumonia is currently not recommended by most countries. However, the number of Computed Tomography performed in persons under investigation for Novel Coronavirus (COVID-19) has increased. But it is necessary to have the knowledge about the Radiographic appearance of chest CT images. Radiologists recognize findings of Novel Coronavirus (COVID-19) pneumonia and aid their communication with other healthcare providers, assisting management of patients during this pandemic. Typical imaging findings may encourage repeat testing in the cases of initial RT-PCR tested negative patient.
129 KNOWLEDGE AND PERCEPTION REGARDING NOVEL CORONAVIRUS: A SURVEY FOR THE GENERAL PUBLIC , Mohit Sharma* and Dr. Smriti Arora
Introduction: With over three million affected cases, most of the countries in the world are facing the big challenge in the form of the novel coronavirus. Different strategies are adopted by the governments to tackle this pandemic in the form of public awareness, lockdown, etc. The role of the general public is very crucial in the fight with this outbreak. The aim of the study was to assess the knowledge and perception of general public regarding novel coronavirus. Methods: A cross-sectional, web based survey was conducted among the general public of India, including 156 participants with voluntary participation in the last week of April 2020. A survey instrument was used for assessing the knowledge and perception of the participants towards novel coronavirus. Results: Descriptive statistics was used for analysis. Majority of the participants were students and 18-24 years of age. The mostly used sources of information were news, media and government official websites. Majority of the participants (53.20%) were having poor knowledge regarding the disease whereas about two third of the participants (69.20%) showed a good perception towards the disease. Conclusion: There is a need for knowledge improvement in the general public to face the ongoing challenges related to the novel coronavirus when a lot of wrong information is being circulated on various whatsapp groups.
130 A CLINCAL STUDY OF HERPES ZOSTER IN SAMPLE OF IRAQI PATIENTS (SINGLE CENTER STUDY) , Dr. Sawsan Abd Al-Razzaq Taha.M,B,Ch,B.DDV* and Dr. Zuhair Ajjam.M,B,Ch,B.M,Sc(UK)
Background: Herpes Zoster (HZ) it is cutaneous viral infection of the skin characterized by unilateral radicular painful vesicular eruption limited to the dermatome innervated by single spinal or cranial sensory ganglion. Aim of study: The study was especially designated to throw light on and evaluate the clinical picture of Herpes zoster in Iraqi patients attending Al- Yarmook Teaching Hospital. Methodology: A clinical study was carried out on sixty five patients with Herpes Zoster who visited our clinic over six month's period, their ages ranged from 6-85 years with a mean age of 37.4 years. There were 43 males (66.1%) and 22 females (33. 8 %). Result: Thoracic dermatomes where the most common dermatomes involved 40 patients (61 .5 o/o) and T10 was the commonest (12 patients) (1 8. 4 %). The pain was the commonest presenting symptom and was seen in 27 patients (41.5%). The common eruption was clear vesiculobullous in 45 patients (69.2%). There was no recognized precipitating factor noticed in 45 patients (69.2%). Five patients after a mean period of five weeks with PHN with their ages ranged from (50-85 years) representing (7.6%), and two patients of the same group presented with scarring lesion of the scalp representing (3%). Conclusion: The rash and pain usually subside within three to five weeks, but about one in five people develop a painful condition called post herpetic, which is often difficult to manage.
131 IMPACT OF DIFFERENTIAL PATTERN OF APPARENT DIFFUSION COEFFICIENT (ADC) OF ORBITAL TISSUES IN THYROID ASSOCIATED ORBITOPATHY (TAO) , *Dr. Sukriti Ahuja, Apjit Kaur, Vinita Singh, Sandeep Saxena, Madhukar Mittal, Manoj Kumar, Abbas Ali Mahdi and Shailendra Saxena
AIM-To study the Apparent diffusion coefficient (ADC) values in orbital tissues in patients with thyroid associated orbitopathy (TAO). METHODS- 65 TAO patients and data of 65 controls were included. ADC values of extraocular muscles (EOMs) and orbital fat were calculated. The ADC values of mild, moderate-severe and sight threatening stages were compared. RESULTS- A significant statistically difference was present between the ADC values of cases and controls (p<0.001). The mild cases having normal muscle thickness on conventional MRI also showed higher ADC values. CONCLUSION- A differential pattern exists between the various severity stages and activity phases of TAO.
132 NOVEL COVID 19: A GLOBAL PANDEMIC , Dr. D. S. R. S. Prakash*
The term ―Epidemic‖ means ―a sudden outbreak of infectious disease that spreads rapidly through the population, affecting a large proportion of people‖. Similarly ―Pandemic‖ is a technical word used to indicate ―an epidemic so widely spread that vast number of people globally more than 200 countries are affected‖. These two words cause panic among the common citizen, cause extra ordinary alertness in the administration and raise brain storming situation among the researchers and scientists. In such situations the health workers have to stand as the soldiers to fight for the administration. They have to forget food, rest and sleep. Public co-operation is must to overcome such situations successfully. ―COVID-19‖ the situation caused by the dreadful virus ―CORONA‖ is now standing as the great challenge for the human society. Life of the citizen is in danger irrespective of age, sex, religion, caste , financial condition and profession. Starting from China it has already caused havoc in the developed countries and now affecting India. A novel coronavirus disease (COVID-19), triggered by infection with SARS-CoV-2, has flounced across 31 provinces in China and more than 200 countries worldwide globally. The transition from first symptoms to acute respiratory distress syndrome (ARDS) is extremely probable to be due to unrestrained cytokine release. There is a crucial need to classify safe and active drugs for action. Chloroquine (CQ) exhibitions an inhibitory effect. However, the clinical use of CQ can cause severe side effects. Moreover, hydroxyl-chloroquine (HCQ) also exhibits an antiviral effect highly similar to that of CQ, inhibiting the cytokine storm by suppressing T-cell activation. Coronavirus vaccine will be carry after clinical trials ahead in markets.
133 SEROPREVALENCE OF BARTONELLA HENSELAE IgG AND IgM ANTIBODIES AMONG HIV INFECTED INDIVIDUALS ATTENDING HEART-TO-HEART CLINIC AT FEDERAL TEACHING HOSPITAL IDO-EKITI, NIGERIA , Richard Yomi Akele*, Agu Confidence Chidera, Bernard Oluwapelumi Oluboyo, Janet Funmilayo Akinseye, Emmanuel Jide Akele and Eleojo Grace Itodo
Bartonella henselae (Bh) is a fastidious, zoonotic, Gram-negative bacteria pathogen known to infect both immunocompetent and immunocompromised individuals. It is known to cause a range of clinical symptoms with bacillary angiomatosis and bacillary peliosis hepatitis being the most common complication in HIV patients. The clinical diagnosis of bacillary angiomatosis is readily missed for Kaposi’s sarcoma. The paucity of empirical data of its burden has led to its neglect, thus this cross-sectional study was conducted to evaluate Bartonella henselae infection burden among HIV subjects attending Heart-to-Heart clinic at Federal Teaching Hospital Ido-Ekiti (FETHI). One hundred and eighty-four HIV infected subjects were evaluated for Bartonella henselae IgG and IgM using enzyme-linked immunosorbent assay (ELISA). CD4+ count was collected from the information management system of the facility. The prevalence of Bartonella henselae IgG and IgM was 51% and 38% respectively. The seropositivity rate of Bartonella henselae IgG was higher among females (52%) and subjects who are yet to commence highly active antiretroviral therapy (HAART) [62%]. Prevalence rate of Bartonella henselae IgM was uniform across groups. Prevalence was not significantly influenced by sex, HAART and CD4+ count (p > 0.05). There is a high infection burden of Bartonella henselae among HIV infected patients attending the clinic at Federal Teaching Hospital Ido-Ekiti requiring attention in the management of these patients.
134 DOES ORGANOPHOSPHATE PESTICIDES EXPOSURE BRING OUT NEUROLOGICAL SYMPTOMS IN THE CHILDREN OF AGRICULTURE WORKERS IN RURAL INDIA? , Prachi Sawant* and Neelam Sukhsohale
India.
135 ANALYSIS OF AVAILABLE LABORATORY TESTS FOR DIAGNOSIS OF COVID 19 , Dr. Rajeev Shah*, Reena Mehta, Aarjav R. Shah, Sudesh Kamat, A. P. Gupta
Universal availability of accurate and rapid testing procedures is extremely important in unraveling the complex dynamics involved in Covid 19 infection and immunity. For achieving this, laboratories, universities, and companies around the world have been racing to develop and produce critically needed diagnostic test kits. The pandemic of corona itself is a big challenge for containing the spread of COVID-19 is the ability to identify asymptomatic cases that result in spreading of the virus to close contacts. It has been presumed that actual number of SARS-CoV-2-infected individuals may be much higher than currently accounted for based on positive test results. For getting accurate, convenient, and rapid testing for widespread deployment can aid in eliminating the silent spread of COVID-19 by asymptomatic viral carriers. Because COVID-19 shows a great range of clinical manifestations, from mild flu-like symptoms to life-threatening conditions, it is important to have efficient testing during the early stages of infection to identify COVID-19 patients from those with other illnesses. Which avoids unnecessary quarantines of negative individuals and the spread of infection by positive individuals.
136 ASSOCIATED RISK FACTORS FOR OVERWEIGHT OR OBESITY AMONG YOUNG ADULTS: A COMMUNITY BASED CASE CONTROL STUDY , Shrijana Shiwakoti*, Tara Shah, Surya Raj Niraula, Angur Badhu and Shyam Lamsal
Introduction: Obesity is rapidly establishing itself as a public health problem. It leads to changes in disease structure which is evidenced by increasing non communicable disease related morbidities and mortality which can be observed in Nepalese young adults also. The objective of the study was to determine the factors associated with overweight or obesity among young adults of Dharan, Nepal. Methods: A community based case control study was conducted among 200 respondents (100 cases and 100 controls) on the basis of body mass index (BMI) in age group 21-39 years. Respondents having BMI 18.5 to 22.9 kg/m2 were categorized as control and BMI ≥23 kg/m2 were categorized as case as per Asian criteria after gender matching. Odds ratio, bivariate and multivariate logistic regression analysis was done to examine association of different possible factors with overweight or obesity. Results: The average BMI and standard deviation (SD) among cases and controls were (27.32 ± 2.84) and (21.11 ± 1.28) respectively. Twelve possible risk factors were significantly associated with overweight or obesity in bivariate analysis. Final regression model suggests that age, occupation, frequency of snacks consumption, frequency of vegetable consumption and leisure time with no physical activity were the significant predictors of overweight or obesity after adjusting the effect of all possible risk factors. Conclusions: This study identifies some modifiable risk factors in context of Nepal. Awareness program including importance of physical activity on health should be organized to reduce the problem of overweight or obesity in the community.
137 EVALUATON OF THE EFFECTIVENESS OF MULTI-STAGE SURGICAL TACTICS FOR LIVER DAMAGE , Mustafakulov I. B.*, Umedov Kh. A., Karabaev Kh. K., Djuraeva Z. A.
The authors proposed active surgical tactics as "damage control" in traumatic liver injuries. The method of "damage control" in SFRICAN used since 2009 as the only method of saving the life of patients with traumatic injuries of the liver in the IV and V degree (for E. Moore, 1986). In the departments of emergency surgery STRNCMP 2009–2019 130 operated patients with liver trauma. Of these, 19 (14,61%) patients with severe liver injuries of IV and V degree of damage by E. Moore. The effectiveness of multi-stage tactics was evaluated by the level of mortality and the number of purulent-septic complications. The results of surgical treatment of 19 patients with massive liver injuries, aged 17 to 50 years, were analyzed. The median age was 26±2,0 years. There were 11 men and 8 women. The average assessment of the severity of damage on the ISS scale was 34 points (17-76), E. Moore IV and V degree of damage. The average blood loss was 2850 ml (1750-3850 ml). All patients underwent multi-stage laparotomy with gauze (film) tamponade, the average number of operations per 1 person 2,7 (2-5), suturing of the liver wound with tamponade (13), extensive hepatotomy and vascular ligation (3), atypical resection (2), stitching of large major vessels with taponade (1). The average bed/day in the intensive care unit is 13 (3-16), and the average bed/day in the clinic is 25 (3-28). Mortality was 26,3% (5 out of 19), mainly purulent-septic complications and multiple organ failure. Multi-stage surgical tactics "damage control" in isolated and combined severe liver damage is an effective method in unstable patients with the risk of developing coagulopathy and multiple organ failure. The use of the "damage control" technique helped to reduce the mortality rate from acute abdominal pathology by 26,3%.
138 COMPARATIVE EFFICACY OF AQUEOUS ACALYPHA WILKESIANA LEAVE EXTRACT AGAINST METHICILLIN RESISTANT STAPHYLOCOCCUS AUREU   , Nwankwo L. U., Ovwasa F. T., Uyovwiesevwa A. J., *Omoirri M. A., Agare G. I., Nwagu S. T., Agbamu E.  
Overtime, medicinal plants have been shown to contain intrinsic active ingredients that can be used for curative purpose for some diseases. Acalypha wilkesiana is one of those ethno medicinal plants of reported health benefits. This study compared the efficacy of aqueous A. wilkesiana leaf extract on Methicillin Resistant Staphylococcus aureus. Powdered leaves of this plant was soaked in 100% distilled water for 3 and 7 days respectively. Both crude extracts were filtered, and concentrated distinctively to evaporate the excess solvent. This was reconstituted with distilled water in 6 dilutions (400 mg/mL, 200 mg/mL, 100 mg/mL, 50 mg/mL and 25 mg/L) and used against Methicillin Resistant Staphylococcus aureus (MRSA) which was isolated from different individuals. The mean inhibitions obtained for the aqueous extract at these varying concentrations were; 10.317 mm, 8.426 mm, 5.571 mm, 3.00 mm,1.00 mm, 0.714 mm respectively. Phytochemical analysis was also carried out on the leaf to ascertain the active ingredients present. For each concentration obtained, zone of inhibition and minimum inhibitory concentrations were each determined for Staphylococcus aureus. Comparisons were then made on the efficacy of A. wilkesiana leaf extract on S. aureus resistance. Results showed that the aqueous extract, had a higher antimicrobial effect against MRSA at increasing concentrations of the leaf. Phytochemical analysis also revealed the presence of Saponins, Tannins, Steroids and Terpenoids; active ingredients that may be responsible for the anti-microbial activity. Corroborative studies that consolidate on results of this study is highly recommended.  
139 COVID 19: IMPACT ON PREGNANCY- ANTENATAL INTRANATAL AND POSTNATAL HEALTH , Prachi Sawant*
Impact of novel covid 19 on antenatal and postnatal services to support them during the evolving coronavirus pandemic. This is to implement which elements of routine antenatal and postnatal care are essential and which could be modified.Providing a safe and responsive antenatal and postnatal care service is essential.Where women require a face to face consultation due to the need for physical examination and/or screening, a system should be in place for evaluating whether she has symptoms that are suggestive of COVID-19, or if they meet current ‘stay at home’ guidance.
140 SCHIZOPHRENIA LIKE PSYCHOSIS ASSOCIATED WITH EPILEPSY IN A 14 YEAR OLD- A CASE REPORT , Jagrita Malakar*, Naghma Mobin and Amar Verma
Epilepsy and schizophrenia are both due to altered cerebral functioning. There had been reports of mental health disorders associated with epilepsy. Usually the psychiatric comorbidities in epilepsy is a non-negligible issue with regard to the quality of life of such patient.[1] But still Psychosis associated with epilepsy has been observed in adult and children recently. In this review, the predisposing factors, clinical features and diagnostic approach of schizophrenia like psychosis in epilepsy (SLPE) has been discussed, which is one of the most severe form of comorbidity in epilepsy in children. Here we present a case of epilepsy of generalized tonic clonic type along with schizophrenia like symptoms in a 14 year old male pediatric patient.
141 SURGICAL REPAIR OF URETHROCUTAEOUS FISTULA IN A MALE WITH PREVIOUS ISOLATED EPISPADIAS - A CASE REPORT , Muthanna Saad Abduljawad* and Hajir H Al-Ridhwany Ph.D CM
Introduction: Isolated male epispadias is a rare congenital penile malformation that describes a defect of the dorsal aspect of the penis, leaving the urethral plate open. It may associated with urinary incontinence. Aim: The current case report study is aiming for presenting a successful one stage-surgical repair of a large urethral fistula situated at the dorsum of the penile boy in a patient with a history of isolated epispedis corrected with multiple previous failed attempts. Subject and method: The studied case was a 23 years old male who presented to Urology Department in Medicano Hospital in Erbil, at the north of Iraq, in Jan. 2020 with an evidence of urethral fistula at the dorsum of the penis. The patient had a history of congenital isolated male epispadias with failure of previous surgical repair. Clinical examination revealed a large fistula at the dorsum of the penile body with indurated edges and everted urethral wall. The glandular urethral opening was patent. A Foley catheter was introduced from the glandular urethral orifice bypassing the fistula to the bladder. Closure of the edges of the urethral wall around the Foley catheter. A flap was taken from the dartos fascia to cover the site of the closed urethral incision. Conclusion and Recommendation: Complete excision of the scar tissue and utilization of more than one layer of flap over the closure site are advisable for repair of urethrocutaneous fistula.
142 A NEWLY DIAGNOSED MULTIPLE MYELOMA WITH EXTRAMEDULLARY INVOLVEMENT OF THE LIVER: A RARE CASE REPORT FROM SYRIA , Firas Hussein M. D.* and Zainab Omar M. D.
Multiple myeloma is a malignant clonal proliferation of plasma cells in the bone marrow preceded by monoclonal gammapathy of undetermined significant. Extramedullary myeloma is an uncommon finding refers to the infiltration of neoplastic monoclonal plasma cells in either organs or soft tissues, with a more aggressive clinical course and poorer outcome. We herein describe a case of 65-year-old patient who presented with fatigue and severe low back pain. Ultrasound and CT scan of the abdomen showed multiple liver nodules. Biopsy of the liver nodules showed CD138 and kappa light chain-restricted positive cells consistent with extramedullary spread of multiple myeloma to the live. After 2 cycles of Cyclophosphamide, Revlimid, and Dexamethasone (CRd) the patient showed a partial response. Therefore, we decided to follow-up the same regimen. No controlled prospective studies have defined the standard treatment for multiple myeloma with extramedullary spread particularly to the liver. Treatment of multiple myeloma with extramedullary disease follows guidelines for multiple myeloma.
143 SANITARY ANTECEDENTS AND NUTRITIONAL STATUS OF PREGNANT WOMEN ATTENDING ON CHU OF COCODY-ABIDJAN (COTE D'IVOIRE) , Dr. Essé Sonia-Estelle*, Apkoué N’Zi Ambroise, Kouamé Konan Joel and Amoikon Kouakou Ernest
This survey was conducted to evaluate the sanitary antecedents, and to determine the nutritional status of pregnant women. The target population consisted of 504 pregnant women, aged 15 to 44, who were admitted to the Gynecology and Obstetrics Department of the University Hospital Center in Cocody-Abidjan (Côte d'Ivoire). The results show that one-third of these pregnant women have previously undergone surgery, and that 35.52 % have pathological antecedents. In this study population, 41.27 % are nulliparous, 20.04 % are primigest and 0.99 % of these women are mothers of 2 children under 5 years of age. 60.52 % of respondents never voluntarily interrupted a pregnancy, against 39.48 % who have already had an abortion, at least once in their life. Of those surveyed, 24.8 % had at least one miscarriage, and 20.44 % had cesarean deliveries. With regard to the term of pregnancy, 2.98 % of these women have already given birth prematurely. The inter-reproductive interval concerns 58.73 % of women. The number of prenatal consultations (PNC) was reported each trimester of pregnancy. Thus, the highest rate is for women who received 2 PNC in the first trimester (56.55 %), 3 PNC in the 2nd trimester (46.64 %) and 4 PNC in the 3rd trimester of pregnancy (43.65 %). Anthropometric measurements show that in early pregnancy, 38.89 % of these pregnant women are overweight, 49.21 % are in satisfactory weight and 11.9 % are undernourished.
144 EVALUATION OF SEASONAL PATTERN OF INFECTION IN DRY AND RAINY SEASONS OF 14 MONTHS EACH , Bessie Nonyelum Esimai* and Emmanuel Ifeanyi Obeagu
A parasitologic evaluation of blood samples of 2000 symptomatic malaria patients (1000 males and 1000 females) in some health facilities of Enugu metropolis was conducted to determine the seasonal pattern. The blood was evaluated parasitologically. For seasonal pattern, 830 (67.9 percent) was recorded to coincide with rainy seasons while 390 (50.1%) was recorded in dry seasons. A prevalence of 880 (88.0%) was recorded in males and 340 (34.0%) in females.
145 EVALUATION OF MALARIA INFECTION ACCORDING TO GESTATIONAL AGE OF WOMEN BY TRIMESTERS. , Esimai Bessie Nonyelum*, Obeagu Emmanuel Ifeanyi and Ikeme A.C.C.
Prevalence by gestational age in pregnant women showed 27 (9.6%) in first trimester, 33(25.4%) in second trimester, 80(20.5%) in third trimester. Eight hundred pregnant women of the study population and residents of Enugu who attended antenatal clinics of University of Nigeria Teaching Hospital Enugu (UNTH) and Mother of Christ Hospital both in Enugu Metropolis were assessed parasitologically to determine the presence of Plasmodium infections. The prevalence of malaria was highest in second trimester (25.4%) followed third trimester (20.5%) and low prevalence in first trimester (9.6%). It showed the immunity was stronger in first trimester, and declined abruptly in second trimester which improved little in third trimester. The gestational age of pregnant women should be considered during antenatal visits to hospitals.
146 SOCIO-DEMOGRAPHIC CORRELATES OF HEAVY DRINKING AFTER HOSPITAL DISCHARGE AMONG THAI ALCOHOL-DEPENDENT PATIENTS: 6-MONTH FOLLOW-UP , Soontaree Srikosai*, Ph.D.(Nursing), Sirisak Thitidilokrat, M.D., Hathaichonnee Booncharoen, M.D., Doungduan Chainoy, Ns. M., Napatsorn Rungsiwaroj, Ns. M., Lasita Srithammachart, M.S.
Background: After receiving in-patient treatment for alcohol abuse, alcohol-dependent patients (ADP) are at risk to return to heavy drinking. Little has been known regarding the correlates of socio-demographic and heavy drinking within 6-month after inpatient treatment. Objectives: This study aims to examine the socio-demographic correlates of heavy drinking among Thai ADP after hospital discharge within six-months. Methods: A prospective cohort study of 618 ADP who received inpatient treatment at two tertiary care hospitals in Northern Thailand between July and December 2014. Heavy drinking is defined by the World Health Organization as ≥5 standard drinks for men and ≥4 standard drinks for women per occasion. Heavy drinking data was collected using a Timeline Follow Back Calendar (TLFB) every month after discharge. Other measures included the Alcohol Use Disorder Identification Test (AUDIT), Rosenberg Self-esteem Scale, Alcohol Craving Control (ACC), Severity of Alcohol Dependence Questionnaire (SADQ), and demographic questionnaires. Results: 618 participants present with a mean age of 43.28 (SD=10.01) years, 94.2% male, 216 (35%) reported that family members are drinkers, and 400 (70.7%) continue to exhibit heavy drinking behaviour. The logistic regression model revealed that age at onset of alcohol use was correlated with heavy drinking after hospital discharge within 6 months (p<.01). Conclusions/ Importance: Many socio-demographic factors were analysed as potential correlates of a return to heavy-drinking. The only relevant factor was the age at onset of drinking. This finding suggests that the development of adolescent alcohol prevention intervention is a priority of Thailand alcohol policy.
147 PUBLIC HEALTH INFORMATICS: A RAY OF HOPE FOR PEOPLE AMID PANDEMIC COVID-19 IN BANGLADESH , Dr. Irin Hossain*, Prof. Dr. Manzurul Haque Khan, Dr. Md. Shafiur Rahman, Dr. M. M. Aktaruzzaman and Dr. Ashekur Rahman Mullick*
Never before has health informatics played a greater role in public health than during the COVID-19 pandemic. While the Health IT industry is certainly challenged due to the overall disruption to the healthcare system, the pandemic undoubtedly underscores the opportunity and importance of health informatics, such as telehealth, remote patient monitoring, electronic health record (EHR), online training for health-care provider, online health briefing, health awareness caller tunes. In this study we are trying to review and share emerging science, best-practices and policy shifts that may affect how our communities, healthcare and public health systems, insurers and providers respond to and manage the COVID-19 pandemic. Searching in different types of journal portal like PUBMED, Nature, Hinari, Google Scholar we accumulate total 42 articles regarding public health informatics with different era and also COVID-19. After proper literature review we took only 19 articles and newsletters for this review purpose. This is the time for all public health experts to redouble the efforts to communicate the best information to those seeking a trusted and reliable source. Everyone will try to continue to share emerging science, best-practices and policy shifts related to COVID-19. And, because COVID-19 may intensify other gaps in public health systems and infrastructure, everyone should try continue to share other important public health news, research and policies and help in spreading COVID-19 related information.
148 INFERTILITY AS A COMPLICATION OF ENDOMETRIOSIS , *Farzona Nuriddinovna Ataeva, Larisa Rubenovna Agababyan, Dildora Rakhimovna Khudoyarova
Genital endometriosis among gynecological pathology takes third place after inflammatory diseases and uterine fibroids, and in specialized endoscopic clinics comes first. The frequency of endometriosis among operated patients is from 12% to 50%. Currently, about 176 million women aged 15 to 49 suffer from endometriosis. This causes significant damage to the reproductive health of patients. The question of the causes of endometriosis, as well as the real mechanisms of the development of infertility associated with this disease, is still unclear. There are many causes of infertility in the presence of endometriosis: decreased receptivity of the endometrium, impaired implantation processes, tubal and peritoneal disorders, decreased ovarian reserve, decreased intensity of crushing of embryos, impaired implantation.
149 STRUCTURE & EVOLUTION OF COVID 19 (SARS-COV-2) , Dr. Rajeev Shah*, Reena Mehta, Ashvika Mistry, Manali Patel, Rajendra Choudhary and Vivek Trivedi
Coronaviridae is a family of enveloped, positive-sense, single-stranded RNA viruses. The viral genome is 26–32 kilobases in length. The particles are typically decorated with large (~20 nm), club- or petal-shaped surface projections (the "peplomers" or "spikes"), which in electron micrographs of spherical particles create an image reminiscent of the solar corona. Coronaviruses are a group of related RNA viruses that cause diseases in mammals and birds. In humans, these viruses cause respiratory tract infections that can range from mild to lethal. Mild illnesses include some cases of the common cold (which is also caused by other viruses, predominantly rhinoviruses), while more lethal varieties can cause SARS, MERS, and COVID-19. Symptoms in other species vary: in chickens, they cause an upper respiratory tract disease, while in cows and pigs they cause diarrhea. There are as yet no vaccines or antiviral drugs to prevent or treat human coronavirus infections. Coronaviruses constitute the subfamily Orthocoronavirinae, in the family Coronaviridae, order Nidovirales, and realm Riboviria.[5,6] They are enveloped viruses with a positive-sense single-stranded RNA genome and a nucleocapsid of helical symmetry.[7] The genome size of coronaviruses ranges from approximately 26 to 32 kilobases, one of the largest among RNA viruses.[8] They have characteristic club-shaped spikes that project from their surface, which in electron micrographs create an image reminiscent of the solar corona, from which their name derives.[9]
150 HOW & WHY MISCHIEVOUS CORONA VIRUS TRANSFORM IN TO TERRORIST COVID 19 , Rajeev R. Shah*, Reena Mehta and Minal Patel
Earlier in past the whole family members of family Coronviridae happened to be only mischievous family, among which some genus may cause common cold and flue like very non fetal clinical syndrome. Few years back some of them transform into murders after some mutatoin- causing SARS and MERS, but still both of these viruses do not have capacity to spread fast, so could not cause very big pandemic like Covid 19. The biggest factor making Covid 19, is the development of spike protein which can bind to ACE2 receptor on the some type of human body cells, and may be source of disease China, which like Pakistan hide this micro terrorist and deliberately allow it to spread this virus to whole world, as even American president Mr. Trump raise doubt that why Covid 19 did not spread in China country but spread through out the world.
151 BURDEN AND COPING AMONG CAREGIVERS OF CHRONIC MENTALLY ILL PATIENTS: A HOSPITAL BASED STUDY , Renuka Adhikari*, Sami Lama, Nirmala Shrestha, Kriti Thapa and Nidesh Sapkota
Background: Family caregivers of people with mental illnesses are a key support system. The caregivers suffer substantial burden as a result of the care giving role and need help from the mental health professionals, since it is typically a chronic and long term challenge. Caregivers use different coping strategies to cope with their burden. The objective of the study was to assess the level of burden and coping among caregivers of chronic mentally ill patients attending Psychiatric Department BPKIHS. Methods: A hospital based cross sectional study was adopted among 100 caregivers who had attended OPD and IPD of Psychiatric department with mentally ill patients. Purposive sampling technique was used. Caregivers who were staying with the patient for at least 6 months were interviewed face to face using the Zarit burden Interview scale and Brief Cope Inventory. Results: Majority of caregivers (66%) had severe burden, 28% had moderate to severe burden and six percent of them had mild to moderate burden. Mean score and SD of using Active coping as coping strategies was 6.97±1.167, followed by Acceptance 6.28±1.621 and Religion 6.28±1.471 respectively. Problem focused coping strategies were adopted more than emotion focused coping strategies. There was significant association between patient's position in the family and patient's occupation with the burden. Positive correlation was found between caregiver's burden and coping strategies that are statistically significant. Conclusions: Majority of the caregivers experienced severe burden while caring their mentally ill relatives. Problem focused strategies were adopted by most of the respondents.
152 “DHOOPANA” VIS-À-VIS FUMIGATION: THE MEASURE FOR PREVENTION OF INFECTIOUS DISEASES , *Dr. Dilip Kr. Goswami, B.A.M.S. MD (Ay), Ph.D.
The group of infectious diseases that spread from one person to another through air is termed as “air-borne diseases”. In this case the disease causing agents (organisms like bacteria, virus etc.) first cause pollution of air. Then, since inhalation of air is must for each and every individual, they enter into the respiratory tract and from there spread their effect to the whole body. In modern medical science, for prevention of such diseases “fumigation” is opted in large scale. As a tradition at the very beginning of the rainy season fumigation with mosquito destroyers is done to kill the mosquito which are the vector of malaria, chikungunia, dangue etc. Ayurveda, the well accepted health science of India serving for the mankind selflessly since time immemorial, deals with all types of diseases/conditions that can cause disturbance in peace of the living beings (not only of the human but also of the animal kingdom). The Ayurvedic scholars classify the diseases into two main groups – (1)Nija (that occurs due to disturbance in the normalcy of the body humours viz. Vata, Pitta and Kafa) and (2)Agantuja (that occurs due to invasion of the external agents leading to disturbance in the normalcy of the body humours ). For the “Nija roga” the treatment procedure is mentioned by the authors in detail. But for the “Agantuja roga” there are some additions in the treatment procedure. As the Agantuja roga is considered to occur due to invasion of “krimi (worms)”,”bhuta”, “rakshasa(two examples of invisible harmful agents)” etc. it is said to be mandatory to think about the surrounding environment of the patient. As the direction suggest purification of air is most important to protect the patient from the attack of the external agents as mentioned. “Dhoomaprayoga” or “Dhoopana” (use of smoke by burning some substances) is considered as the most important and beneficial method for purification of air by the Ayurvedic authors. Since even now the human society is facing the problem of spread of disease through air hence the need of discussion, evaluation and application of the process “ Dhoopana”, as mentioned in the Ayurvedic classics, can be considered as the need of the hour. Drawing attention to the concept of application of medicated smoke may be proved to be beneficial for the human society even now, at the time of “CORONA VIRUS OUTBREAK”.
153 MICROBIAL QUALITY CONTROL OF NIGER RIVER WATER IN URBAN AND PERI-URBAN AREAS OF BAMAKO , Yacouba Koumaré, Amadou Hamadoun Babana*, Kangaye Amadou Diallo, Fallaye Kanté and Fassé Samaké
Rivers are the most important freshwater resource for humans. However, because of the high density of populations, the growth and concentration of industrial centers on the banks of rivers favor the pollution of these rivers. Anything that presents a serious threat to human health. In Mali, the Bamako District is one of the major cities, whose water supply is mainly based on the Niger River. Unfortunately, in this city and its surroundings, this river receives a large amount of waste and untreated wastewater, which are likely to degrade the quality of its water, hence the need to regularly monitor the quality of this in the context of sustainable management of this resource. This study aimed to determine the water quality of the Niger River in Bamako and its immediate surroundings (Samaya, Ecole Normale Supérieure (ENSup), Martyrs Bridge and Moribabougou). Specifically, it was intended to (i) quantify the faecal coliforms contained in the water of the Niger River by the most probable number (MPN) method and (ii) determine the physicochemical parameters of the Niger River water, based on international standards established by ISO 7899-1. Results show that the water of the Niger River is heavily polluted in Bamako and in some areas of this city. Indeed, fecal coliforms have found in the water of the river, in particular at ENSup and the Martyrs' Bridge and the defined norm is very strongly exceeded several times. Similarly, nitrates (NO3-) have been encountered for a concentration exceeding the allowed standard.
154 COVID 19 AWARENESS AMONG PEOPLE IN INDIA: A SURVEY REPORT , *Dr. Poonam Sharma
The rapid and extensive spread of the COVID-19 pandemic has become a major cause of concern for the healthcare profession. Given the extensive time needed to conduct a nationally representative household survey and the commonly low response rate of phone surveys, rapid online surveys may be a promising method to assess and track knowledge among the general public during fast-moving infectious disease outbreaks. This study aimed to apply rapid online surveying to determine knowledge of coronavirus disease (COVID-19) among the general public in the India.
155 IMAGING IN PANOPHTHALMITIS WITH A RARE COMPLICATION: A CASE REPORT , Saanida M. P.*, Henna Faizel, Devarajan E., Rajan P., Naufal P. and Juvaina P.
Panopthalmitis is a sight threatening ophthalmic emergency, where clinical diagnosis is often challenging and delayed diagnosis may exacerbate poor visual prognosis1 B scan ultrasound with contrast enhanced CT and MRI help in assessing disease extent, complications and response to therapy.
156 THE DIFFERENCE IN THYROID HORMONE METABOLISM BETWEEN MAMMALIAN FETUSES AND ADULTS AND ITS IMPLICATIONS , Sing-Yung Wu, M.D., Ph.D.
The neonatal screening program for congenital hypothyroidism (CH) implemented nearly half a century ago has helped a lot of neonates with CH. However, judging from the early involvement of thyroid hormone (TH) in brain development, the reliance on the neonatal strategy to reverse 'ALL' of the cerebral and other developmental anomalies may be in question, and there is room for improvement. The study from our group in the past three decades has demonstrated that sulfo-conjugation is the primary pathway for TH metabolism in developing fetuses in utero that is distinctly different from adults. Our studies have also shown that 3,3'-diiodothyronine sulfate (3, 3'-T2S) is a major fetal metabolite in inactivating TH in the developing mammals that do not need the active catabolic hormones. Further, 3, 3'-T2S has been shown to cross the placenta and return to the maternal circulation. The appearance of W-compound, a material detected by3, 3'-T2S-specific antibody in human maternal and fetal circulation has been shown to correlate significantly to fetal thyroid function. It is time to consider a different approach by taking advantage of the difference in TH metabolism between fetuses and adults. Further study on the sulfation pathway may provide an alternative strategy to the current neonatal screening and the "catch-up" therapy after birth.
157 CIRCULATING CD34-POSITIVE STEM CELLS IN PERIPHERAL BLOOD OF PATIENTS WITH HODGKIN LYMPHOMA , Hala Ahmad*, Ghassan AlMassarani, Adnan Ikhtear, Haissam Yazigi, Reem Nadra, Suzan Samra
Hematopoietic stem cells are characterized by the properties of self-renewal and multi-lineage differentiation. Bone marrow residing stem cells are mobilized from their BM niches into peripheral blood in many pathological situations including tissue injury and systemic inflammation. Although the role of non-mutated normal stem cells in cancer progression is still under debate. Circulating normal peripheral blood stem cells may play an important role in the vascularization of the growing tumor. We assessed CD34+ cells from the peripheral blood of 15 patients with de novo Hodgkin Lymphoma using flowcytometry. We found that CD34+ cell counts and CD34+ cell percentages were significantly higher in Lymphoma patients at diagnosis than in controls. After the induction of chemotherapy, CD34+ cell count and CD34+ cell percentage levels were significantly decreased in Lymphoma patients compared with their levels at diagnosis. The mean baseline levels of CD34+ cell count and CD34+ cell percentage in Lymphoma patients who achieved complete response were significantly lower than in those who did not achieve it in response to induction treatment. We concluded that the number and percentage of circulating CD34+ cells in peripheral blood in cancer patients depend on the tumor type, and can be used as a prognostic value for complete response.
158 PREVALENCE AND DETERMINANTS OF WORKPLACE BULLYING AMONG HEALTHCARE WORKERS IN RIYADH , *Mona Yahya Alshareef, Salha yahya Alshareef and Dr. Mohammad Masoud Almasoud
Background: Bullying, or moral harassment in a hospital setting has become a concern of many organizations. Bullying on work place can influence the productivity of employees. However, Information Bullying among health care workers in Saudi is limited. Methods: A cross- sectional study on 666 health care workers during 2019. We will used Negative Acts Questionnaire to measure exposure to negative behaviors identified with bullying, which is a valid and reliable instrument that has been used globally to assess workplace bullying. It is consisting of 21 specific negative behaviors, which has been adapted among healthcare workers in Riyadh. Data was will be entered and analyzed using SPSS. Result: Overall findings harassment Associate in Nursing discrimination of Saudi residents is common with quite three-quarters coverage having had such an expertise. Conclusion: Findings can be used to implement programs to eliminate harassment level which consequently impacts their health care, retention and the health care organizational effectiveness. We also recommend assessing Harassment on regular basis.
159 LINGUAL NERVE INJURIES DURING ORAL SURGERY PROCEDURES: VIEWS AND PERSPECTIVES , Abel Salgado*, Rafael Guedes and Ana F. Vinha
Lingual nerve being one of the most important nerves within the oral cavity, it is very often injured during some oral surgery procedures. The clinical presentation of lingual nerve injury, its epidemiology, predisposing factors, and anatomy are explored to identify those patients at risk for developing neuropathic pain. Moreover, lingual nerve presents a variable anatomical location and is very often injured during mandibular third molar surgery due to trauma from an inferior alveolar nerve injection; incision, intubation in general anaesthesia; lingual flap retraction, bone removal and instrumentation; tooth sectioning; tooth elevation; and suturing. Due to its importance when it comes to guarantee the correct oral surgery procedures, this work aims to identify any factors that could aid the surgeon in preventing or minimizing the risk of lingual nerve injury during some oral surgery. The research which sustains this review was implemented on databases from PubMed (R), PMC and B-on, and the inclusion criteria were papers written from 2000 until 2019, that included clinical trials, case reports and revision articles, and whose subjects were humans and ought to have been written in English language. From the articles gathered, we were able to obtain a general vision of the frequency as well as of the severity of lingual nerve injuries and the most common ways of treating them. Oral surgery, namely third molar removal, is responsible for a high number of lingual nerve injuries. The piezosurgery may be advantageous when doing osteotomy and the raise or retraction of a lingual flap presents no advantage. The coronectomy emerged to avoid lingual nerve injuries. The time to repair the injured nerve should be as quickly as possible and the neurography presented the biggest success percentage, although in the lingual nerve case there may be an association with neuroma formation. Nevertheless, results should be interpreted with extreme caution because of the considerable heterogeneity of the data and the considerable influence of several anatomic and surgical variables that were closely related, but difficult to analyze independently.
160 SHOULD FAMILY DOCTORS MANAGE MULTIMORBIDITIES? , Dr. Patricia McWalter*, Prof. Abdullah AlKhenizan and Dr. Loay Basudan
The Authors work in a large Family Medicine and Polyclinic Department in the Middle East, as Family Medicine Consultants, with training and experience from UK, Canada and USA. With an increasing elderly population worldwide, more people are living with multiple chronic conditions. Multi morbidity is challenging for physicians and health care systems, with family doctors particularly under pressure with complex cases, without appropriate training to deliver healthcare for such patients. Training of family doctors in multimorbidity as part of a multidisciplinary team, using a patient-centered care model, would enhance the care of patients with complex needs. An integrated care approach with more resourcing of primary care is an essential step in managing multimorbibity in the future.
161 DOPAMİNE AGONİST RESPONSİVE ABULİA: A CASE REPORT AND LİTERATURE REVİEW , Hakan Şilek*, Ayça Serap TUNCER, Bahar Erbaş
Abulia is a "syndrome of hypofunction," characterized by apathy, slowness of thought (bradyphrenia), blunting of emotional responses and response to external stimuli decreased or complete lack of initiative , spontaneeity and drive. We describe a case of a socially active 73-year-old male patient who presented with symptoms of abulia which may have occurred due to damage of the frontosubcortical circuits following an cardiac mitral valve replacement. The patient's symptoms improved dramatically following treatment with pramipexole.
162 NEEDS ASSESSMENT FOR DEVELOPING A DOCTORATE OF CLINICAL PSYCHOLOGY PROGRAM IN SAUDI ARABIA , *Dr. Ahmed Mohammed J. Alkhalaf, Prof. Ara Tekian and Dr. Yoon Soo Park
Title: Needs Assessment for Developing a Doctorate of Clinical Psychology Program in Saudi Arabia Introduction: There are a number of challenges in Saudi Arabia regarding developing higher health standards and particularly psychological services. There are challenges in existing psychological training, but also a significant lack of learning from Western standards in psychological work both academically and clinically. Objectives: This study has two primary aims: (1) to examine the attitude of local practicing physicians (who are working with psychologists) towards the current psychologists‟ work and towards establishing a Doctorate of Clinical Psychology program; and (2) to explore the needs for such a program to have culturally relevant content and competencies to meet local needs and enhance general professional competencies. Methods and Participants: The sample of participants consisted of 73 (54 male [74%] and, 19 female [26%]) practicing physicians in Saudi Arabia. Participants ranged from 29 to 59 years of age (M = 38.18 years, SD = 6.94 years), with an average of 5.86 years (SD = 1.37) of clinical experience. All participants completed the questionnaire used in this study. The main tool (the questionnaire and interview) was developed for this study after reviewing the literature, local needs and policies, and asking input from a small sample of clinicians. Results: Belief in the importance of developing a Doctorate of Clinical Psychology program was strong. It was also found to be significantly, positively correlated with the belief that the psychologists should work as part of a multidisciplinary team in particular with family medicine, neurosurgery, neurology, psychiatry, and pediatric(r = .415; p ≤ 0.01). Conclusions: There is a real need to conduct a needs assessment for developing a Doctorate Clinical psychology program in Saudi Arabia to contribute and enhance the healthcare for a good quality of patient, as indicated by the view of local practicing physicians. The study provides high recommendations to develop a curriculum of the global standards in Saudi Arabia which is the need of hour.
163 COMPARISON BETWEEN THE EFFICACY OF PLATELET RICH PLASMA COMBINED WITH FRACTIONAL CO2 LASER VS. LASER ALONE IN THE TREATMENT OF FACIAL ATROPHIC ACNE SCAR SPLIT-FACE STUDY , Hamid B. Suleiman* and Rama M. Okdeh
Introduction: Acne scar is a common distressing complication of acne vulgaris. Many treatments are available for treating post acne scars but optimized treatment still does not exist. Aim of the work: To compare the efficacy and safety of combining autologous PRP with FCL in the treatment of atrophic acne scars with that of FCL alone. Patients and method: This study included 30 patients suffering from post-acne scars. CO2 laser treatment was applied to both sides of the face followed by PRP injection for the right side, each participant received 3 treatments with four weeks interval between the sessions and were followed up for a period of 3 months. Results: The outcome among the study were assessed using Goodman and Baron Scale at different time intervals. Significant reduction in acne scars was observed in both treated sides but better reduction of acne scars was noted at the PRP site, the incidence of adverse effects such as erythema during the procedure was significantly disappeared faster in PRP injected side compared to the other side. Conclusion: Combination of fractional CO2 laser resurfacing and intradermal PRP was superior to CO2 laser alone for acne scar treatment.
164 PAX-5 NEGATIVE HODGKIN LYMPHOMA IN MESENTERIC LYMPH NODE IN A CHILD: A RARE CASE REPORT , *Dr. Juhi Shahab, Dr. Sufian Zaheer, Dr. Sunil Ranga
Introduction: Classical Hodgkin lymphoma (CHL) as per WHO 2016 is a clonal lymphoid neoplasm. CHL contains Reed-Sternberg (RS) cells in a background of a non-neoplastic inflammatory infiltrate including lymphocytes, eosinophils, neutrophils, histiocytes, and plasma cells.The expression of PAX5 is reduced and in rare cases of CHL, PAX5 expression is absent in RS cell. This has been postulated to be caused by compromised B-cell specific transcription machinery and inactivity of immunoglobulin promoters, which results in low levels to absent expression of several B-cell-restricted transcription factors such as PAX5 and OCT2. Hence, the PAX5 negative cases of CHL are extremely rare and pose a major diagnostic challenge for pathologists. Case report: An 8 year old male child presented to the paediatric department with the complaints of prolong fever, loss of appetite, weakness and unexplained weight loss since 3 months. The general examination was non contributory but on CECT child was suspected for mesenteric gastro intestinal stromal tumour( Mesenteric GIST) with no other palpable lymph nodes. The mesenteric lymph node was excised and sent for histopath examination which revealed the findings of a rare case i.e. a PAX-5 negative hodgkin lymphoma presenting solely as mesenteric lymphadenopathy. Discussion: PAX-5 negative Hodgkin lymphoma is itself a rare case which is associated with bad overall prognosis but in our case important point was that, that it solely presented as mesenteric lymphadenitis which made a confusion to clinico-radiological team as a possibility of mesenteric GIST. Conclusion: PAX5-negative CHL may have worse clinical outcomes, when compared to typical PAX5-positive CHL.
165 ANALYSIS OF DETERMINANT FACTORS ABOUT VISITING IN TODDLERS (12 - 59 MONTHS) ON INTEGRATED HEALTH CENTER IN THE WORKING AREAS OF ARJASA COMMUNITY HEALTH CENTER , Andriya Syahriyatul Masrifah*, Ristiya Widi E. Y. and Isa Ma’rufi
Factors that influence toddler visits are predisposing factors (knowledge, attitudes, beliefs, motivation, work), enabling factors (information facilities and distance of residence), and reinforcing factors (the role of health workers, the role of cadres, community leaders). This study aims to analyze the determinants of under-five (12 - 59 months) visits to integrated health centers in the working area of the Arjasa community health center. This type of research used in this study was observational analytic with cross-sectional design. The population is 728 people. 251 people were taken as samples by simple random sampling. Data collection techniques using a questionnaire. Data analysis using logistic regression test shows predisposing factors (knowledge, attitudes, beliefs, motivation, work) enabling factors (means of information and distance) and reinforcing factors (the role of health workers, the role of cadres, community leaders) the significance value is less than α 0.05 which can be concluded there is an influence on the visit of infants to integrated health centers in the work area in the Arjasa community health center.
166 PREDISPOSING FACTORS OF THE VISIT ACTIVITIES TO THE INTEGRATED GUIDANCE POST (POSBINDU) FOR NON-COMMUNICABLE DISEASES (NCD) AT SUMBER SARI HEALTH CENTER, JEMBER , Putri Rizkiyah Salam*, Dwi Wahyuni and Farida Wahyu Ningtyias
Non-communicable diseases (NCD) are the main cause of death in the world, which represents 63% of all annual deaths. NCD kills more than 36 million people every year. The existence of integrated guidance post (POSBINDU) is expected to be able to carry out prevention and control through early detection, monitoring, and early follow-up of risk factors for non-communicable diseases in an integrated and periodic manner. The purpose of this study was to analyze the influence of predisposing factors (age, gender, education level, occupation, knowledge, attitude, level of trust toward POSBINDU) on the activity of visiting POSBINDU in Sumbersari District, Jember Regency. This study used an observational analytic research design with a cross sectional research design. Samples taken in this study were 381 people with age ≥ 15 years. Data analysis in this study used logistic regression. The sampling technique in this study uses purposive sampling method. The results showed that there was an influence of predisposing factors to the activity of visiting POSBINDU, showing a value of p <0.05 so that the seven variables influenced the activity of visiting POSBINDU.
167 BENEFIT OF DYNAMIC MR IMAGES IN EVALUATION CERVICAL SPONDYLOTIC MYELOPATHY PATIENTS , Ebaa Saeed Saleem*, Mohamed Abd Alrahman and Fawaz Badoor
Background: cervical spondylotic myelopathy CSM is the most cause of cervical spinal cord dysfunction in people aged over 55 years. even though , our understanding of the etiology of this clinical problem remains incomplete. Methods: A total of 30 patients (M:F=11:19, 60.1±10.7 years), The study population consisted of 23(76.7%) patients with signs of cervical myelopathy (M group) and 7(23.3%) patients without signs of myelopathy (NM group). All patients examined clinically and neurologically. the static and dynamic cervical MRI done by using a 1.5-T MR unit (siemens magetom essenza A tim + dot system). The dynamic exam was performed with as much neck flexion and extension the patient could achieve alone. On T2-weigthed MRI each level was assessed and Muhle scale was applied. Results: Analysis with extension MR images found an increased number of compression levels posterior position 6 fold than static.Clinical factors for increased compression levels in extension MR images were age (p-value=0.002 , r= 0.4). Conclusions: The evaluation of CSM may be better with dynamic MR images. Dynamic MR imaging may be proposed for elderly patients with signs of myelopathy, but an interpretation for asymptomatic cervical spine compressed based exclusively on extension MR image must be done with caution.
168 EFFECTIVENESS OF IEC PACKAGE REGARDING KNOWLEDGE OF ORAL HYGIENE AMONG THE ADOLESCENT STUDENTS OF HARYANA , Suman Moun Khatkar* and Mohan Soni
Background and aim: The important public health issue among adolescents is Poor oral health. Various studies have noted a high prevalence of dental problems among adolescents. In order to plan successful awareness programme it is essential to evaluate adolescent’s knowledge related to oral hygiene at the school level. The aim of study was to assess the effectiveness of IEC package on knowledge of adolescents regarding oral hygiene in selected schools of Uchand, Jind, Haryana. Materials and Methods: This experimental study included 60 students of Govt. Girls Sr. Sec. School of Uchana selected by probability convenient sampling technique. Data were collected using a semi structured questionnaire and analyzed with Chi-square and student paired t test. Results: In pre-test, majority of the samples 18(60.00%) belongs to average level of knowledge with mean of 13 and 2.1 of standard deviation. Followed by 9(30.00%) with good level of knowledge, 23.77 of mean and 2.657 standard deviation. Followed by 3(10%) of poor knowledge with 9.33 mean and 0.471 standard deviation. In post-test, majority of the samples 27(90.00%) belongs to good level of knowledge with mean of 18.33 and 1.68 of standard deviation. Followed by 3(10.00%) with average level of knowledge, 18.33 of mean and 0.471 standard deviation. Followed by none of the sample belongs to poor level of knowledge. There is a significant association with the obtained knowledge score of adolescents regarding oral hygiene with the selected demographic variables such as Education and Occupation of the parents. Conclusion: This study shown that IEC Package had a significant effect in improving knowledge of adolescents regarding oral hygiene.
169 THE VALIDITY OF STONE CONE AS AN OCCLUSION DEVICE IN LASER ENDOSCOPIC LITHOTRIPSY FOR URETERIC STONE- A RETROSPECTIVE COHORT STUDY , *Muthanna Saad Abduljawad and Hajir HusamAldeen Alridhwani
Introduction: Aim: This study is aiming for evaluating the valuably of the stone cone application during Laser ureteroscopic lithotripsy for ureteric stone. Method: A case-control was adopted in Medicano private hospital, Erbil over the period between Feb. 2018 to Dec. 2019. The included cases were diagnosed as having ureteric stones of variable sizes and locations and managed by Holmium Laser lithotripsy DornierTM Mdilas. Rigid Ureteroscope StorzTM. The 104 patients included in the studied sample were divided into 2 groups; Group A involved 52 patients where ureteric occlusion device (stone cone). The stone cone was introduced via the Ureteroscope in the closed state and opened proximal to the stone. The other 52 patients Laser ureteroscopic lithotripsy was conducted with no utilization of ureteric occlusion device and hence included under the control group (Group B). Results: Mean age for cases was 36 years and more than half of them were male. Residual stone was less frequently reported by using stone cone (p=0.000). It also significantly decreased the mean time consumed for completing the surgery (p<0.0001) and event of retropulsion of stones during lithotripsy (p<0.0001). Conclusion: Using stone cone with ureteroscopy in management of uretric stones is beneficial in many aspects. Recommendations Introduction of stone cone within ureteroscopy procedure is recommended to be routine.
170 URETEROCALICOSTOMY: A BAILOUT PACKAGE FOR KIDNEY PRESERVATION IN SECONDARY PELVIURETERIC JUNCTION OBSTRUCTION , Liaqat Ali*, Mishal Nazim, Muhammad Shahzad, Faiza Hayat, Nasir Orakzai and Qudratullah Wazir
To study the successful outcome of Guillotine method of lower pole Ureterocalicostomy for the treatment of secondary ureteropelvic junction obstruction (PUJO). Methods: It is a descriptive study, conducted in Department of Urology at Institute of Kidney Diseases Hayatabad Peshawar Pakistan from June 2012 till March 2020. Total numbers of 22 patients with secondary PUJO were included in the study. We excluded the adult patients with renal function less than 20% and pediatric patients with renal function less than 10% on DTPA renal scan. After thorough radiological and nuclear imaging, the patients were subjected to lower pole Ureterocalicostomy. All the Preoperative, intra-operative and postoperative data was recorded on structured proforma and was analyzed on SPSS. Results: The Mean age of the patient was 28.5 years ± 9.7 years. The mean Pre operative Glomerular filtration rate (GFR) was 27.3 ± 5.9 ml/minute The mean cortical thickness on Ultrasound was 8.18±1.5. The mean pre operative split renal function on renal scan was 29.95%±5.525. Although Marginal improvement can be observed in postoperative renal scan at 6 month duration by 31 % but not significant (p= 0.140). Lower pole Ureterocalicostomy was found successful in relieving the obstruction and saving the kidney in 20 (90.9%) patients. The multivariate analysis showed poor cortical thickness less than 7mm and spit renal function below 20 % (p 0.001) as independent factors of failure in 2 patients. Conclusion: Ureterocalicostomy proves to be a bail-out package for the preservation of kidney in cases of complicated secondary Ureteropelvic Junction Obstruction
171 DEVELOPMENT OF BASIC LIFE SUPPORT KNOWLEDGE LEVEL AND APPLICATION SKILLS ASSESSMENT FORMS: VALIDITY AND RELIABILITY STUDY , Dr. Tuğba Gültekin* and Melek Ardahan
Background: Basic Life Support (BLS) consists of a series of life-saving actions that improve survival after cardiac arrest. The most important factor that increases the chance of survival is early and correct intervention. Nurses constitute an important group among health personnel in increasing survival rate after cardiopulmonary arrest. Purpose: The aim of the study is to develop basic life support knowledge level and application skills assessment forms, and to investigate their validity and reliability. Methods: This is a methodological study. The population of the study consisted of 302 nursing students studying at Faculty of Nursing. “Content Validity Index (CGI)” and Kendall’s W test were used for expert opinions. Kuder Richardson 20 coefficient was used for the reliability analysis of the forms. Results: The mean age of students participating in the study was 21.06 ± 1.20 years. 21.0% of the students were male and 79.0% were female. The content validity index of the basic life support knowledge level assessment form was above 0.90 and the expert opinions were significantly consistent with each other (p = 0.001). The content validity index of the basic life support application skills assessment form was found to be over 0.80 and the expert opinions were significantly consistent (p = 0.029). Kuder-Richardson 20 coefficient was over 0.80 and the forms was reliable (Kuder-Richardson 20 coefficient > 0.80). Conclusions: According to the results of the validity and reliability analyzes forms were found to be valid and reliable.
172 THE FREQUENCY OF INTIMATE PARTNER VIOLENCE AND SEXUAL VIOLENCE IN YOUNG WOMEN AND THE EFFECT OF THEIR LEVELS ON THE EMOTIONAL THEMES OF SHAME AND GUILT , Fisun Sözen, Canan Tuz, Ergun Oksuz*, Zeliha Özbakir and Ersin Ogus
Background and Aim: The objective was to determine the frequency of intimate partner violence (IPV) and sexual violence (SV) perpetrated by anyone in young women and the distribution of violence according to its types. Materials and Methods: We used a simple random method to select 270 female students attending a university in Ankara, Turkey. The research form consisted the Severity of Violence Against Women Scale (SVAW), the Sexual Experiences Survey–Victimization Version (SES–VV), and the Personal Feelings Questionnaire–2 (PFQ–2). Results: The results show that 56.8% of the participants were exposed to psychological, physical, or sexual IPV or SV; 51.5% of the participants were exposed to IPV; 15.4% of the participants were exposed to SV perpetrated by anyone after the age of 14; and 10.1% of the participants were exposed to both IPV and SV by anyone. Conclusion: Young women have a very high incidence rate both for IPV and SV. The shame and guilt scores of the young women who experienced violence are higher than those who did not. The guilt scores of those who experienced psychological IPV are significantly higher for all levels of psychological violence.
173 CLINICAL EXAMINATION OF AGNIBALA – A REVIEW ARTICLE , S. Shraddha* and M. Subhash Chandra Bose
Ayurveda, the science of life mainly deals with the preventive aspect of diseases along with curative aspect and this is the aim of Ayurveda. Healthy state of body & diseased condition is entirely dependent on Agni. Agni present in the Jatara which digests the food is Bhagawan- Ishwara himself, and that Jataraagni augments other agni to carry out their respective functions. Function of Agni is likely to be compared with gastric juice and different enzymes at gastro intestinal level. In the present era, the diseases related to Annavaha srota and Purishvaha srota (Gastro intestinal system) are commonly found in clinical practice. In the pathogenesis of disease, Dosha, Dusya, Srota, Agni and Ama (Prime causative factors of diseases) are required to be analyzed for fruitful treatment. Bala of Agni or normal condition of Agni is responsible for strength, health, longevity etc. Hence it is necessary to understand the Bala of Agni to manage the health of a healthy individual. In this article attention has given on clinical examination of Agnibala based on classical theories.
174 THE ROLE OF MEAN PLATELET VOLUME IN THE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE , Dima Fatahi*, Malek Hejazie and Firas Hussain
Background: Studies have supported the correlation between mean platelet volume and COPD. However, there are limited data on the relationship between COPD exacerbation and mean platelet volume. Aim: This study was aimed to evaluate the mean platelet volume trend in patients with COPD exacerbation. Materials and Methods: This was a prospective study in which 80 patients with acute COPD exacerbation were enrolled at Tishreen University Hospital, Lattakia during the period between 2019 - 2020 . The levels of mean platelet volume, C-reactive protein, complete blood count, and percent of- predicted FEV1 were measured in subjects at admission (exacerbation period) and after 3 months (stable period). Results: Subjects in the exacerbation period had significantly higher levels of C-reactive protein (P<0.0001), white blood cell count (P<0.0001) and percentage of neutrophils (P<0.0001) and lower percent-of-predicted FEV1 than in the stable period (P<0.0001). Mean platelet volume levels were significantly decreased in the exacerbation period(P<0.0001). Mean platelet volume levels correlated negative significantly with increase of C-reactive protein level in the exacerbation period (r = - 0.342, p<0.001) and in the stable period (r = -0.168, p=0.0347). Conclusion: Mean platelet volume may be an inflammatory marker in exacerbation of COPD.
175 A GENERAL TREATMENT WHOSE PEOPLES AFFECTED PRIMARILY BY THE COVID-19 WHICH IS RECOGNIZED TO PANDEMIC PHENOMENON , Hasan Billah* and Shariful Islam
Corona virus is a mRNA virus that is so peculiar categories affiliated with virus in the SARS group.[1] This virus already dispersed whole countries in the world but all in all there is any countries are not recovered fully from affected by the COVID-19 which is basically acts on the physiological sector likes as –upper respiratory tract firstly affected, then gradually into our whole physiological system diminished. when corona virus infected upper and lower respiratory tract so that it can show mild or highly acute symptoms of respiratory tract and gradually, release pro-inflammatory cytokines, including interleukin (IL)-1β and IL-6. On the other hand, Toll like receptor (TLR) is importance macromolecule for lung but corona virus easily infected to this types of receptor and break down to the lung cell so that enhancing level of interleukin (IL)-1β and IL-6 that are responsible to such kinds of disease fibrosis, lung inflammation etc.[2] This types of condition recognize to viremia that is recalled to incubation time. In this situation, B-cell gradually decrees but T-cell same for sudden 3-6 days.[3] The burgeon week is next second week that is so serious for affected public because B-cell and T-cell both are decreasing so that patients are recognized to pneumonia and cytokines enhancing simultaneously. At the last moment, the affected public are keep clam easily for perpetually. In this situation, must be recover if we are conscious about pandemic phenomenon from corona virus. A lots of articles suggested that, how to way boost my immune system develop so that we are wined from corona virus.
176 NURSES’ PERCEPTION OF THEORY-PRACTICE GAP AT ALEX EKWUEME FEDERAL UNIVERSITY TEACHING HOSPITAL ABAKALIKI: A QUALITATIVE STUDY , *Chukwu Stella Nchekwubedi, Ezeruigbo C.F.S. and Ibeneme G.
Nursing education which has both theoretical and practical elements is aimed at producing skilled and competent professional practitioners who are able to apply the theoretical knowledge and skills learned in practice at the completion of their academic program. But the gap between theoretical knowledge and practice has continued to be a prevailing problem in nursing. The main aim of the study was to explore the perception of Nurses on the theory-practice gap in Nursing practice using qualitative approach. The study was done at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA). A purposive sampling technique was used to recruit and invite participants for a focused group discussion. 20 Nurses participated in the FDG. Analysis of data was done using thematic coding analysis (Colaizzi method). Four themes were generated from the responses to include: (a) Deficient practical know-how to apply sound theory, (b) TRASI Gap factors: Trainer related factors, Students’-related gap factors and Institutional factors,(c) Motivation and (d) Evidence-based Nursing: (i) Research (ii) Justification of nursing actions (iii) Bracing competence. Regarding the views about theories, it was agreed that classroom learning were adequate but then some of the issues identified to be contributing to the gap include poor clinical skills despite good theoretical knowledge, resistance to reform and learning without indispensable tools. Several reasons described as ‘TRASI gap factors’ were indicated for the presence of the gap. On the possible ways of bridging the gap, motivation of teachers/ clinical instructors by provision of learning tools, understanding the nurse responsibilities by acquainting self with documents that define service/ responsibilities, research, justification of nursing actions, bracing competencies, supervision of student nurses during clinical postings, constructive criticism of the students, review of employment criteria in employing nurse educators and ultimately evidenced based nursing were identified as some of the ways to overcome the theory- practice gap.
177 LITERATURE REVIEW ON SCHOOL BULLYING , Krishna Kumari Paudel Subedi*
It is substantiated that millions of school children have been the victims of bullying every year. Not only does school bullying decrease their academic performance but it also adversely affects their health and increases likelihood of their later life criminality. Prime purpose of this review is to provide an overview of school bullying; its nature, causes, consequences and existing methods of prevention. Additionally, it also supports to detect gaps and guide to develop new synchronized strategy for prevention of school bullying. For this review, bullying related published materials were searched and reviewed by using traditional or narrative literature review method. The raw material as supporting for this review were books, thesis articles, journal and dissertations with online journal and other materials related to school bullying. Basically, reviewer focuses on five types of material such as material related to concepts of traditional bullying and cyber bullying, theoretical concepts of bullying, substantiated material that can reveal preventive strategies and finally researches likes to highlights existing scenarios of bullying in Nepal. This course of literature review reveals that bullying has several negative consequences to school students from poor academic performance to physical and mental disorders, even suicidal tendencies and involvement in crime are high among bullying students in long run. It is substantiated that even bullies and bystanders are equally affected from these negative consequences of bullying. Bullying is the most complicated and multifaceted problems. Therefore, in-depth understanding of its risk factors and socio-cultural effects on bullying must be made to stop bullying in school.
178 THYMULIN – A HOPE OUT OF THE BOX IN COVID-19 DISASTER , Dr. Chavan Vishal, MD*, Kasumbiwal Ajay MD and Kasumbiwal Ripal M.Tech
The COVID-19 pandemic is a challenge to medical science. Till date we do not have any definitive treatment for it nor do we have vaccines available against SARS-CoV-2. Cytokine storm syndrome, through immune dis-regulation is the most important mechanism in the death of serious patients of COVID-19. Regulating the immune system may reduce mortality in COVID-19 cases. In this review, we see Thymulin, a thymic peptide as a modality for treatment of serious COVID-19 cases through control of cytokine storm.
179 A CASE OF CEREBRAL FAT EMBOLISM , Dr. Juvaina P.*, Kavya A., Devarajan E., Rajan P., Naufal P. and Saanida M. P.
Fat embolism syndrome is a serious clinical event occurring following long bone fractures. Although fat embolism syndrome is a triad of hypoxemia, neurologic abnormalities and petechial rashes, isolated cerebral involvement can occur which is rare. Hence, cerebral fat embolism should be suspected in patients presenting with neurologic symptoms even without respiratory and dermatological manifestations. Here, we present a case of cerebral fat embolism which did not have pulmonary or dermatological manifestations.
180 TOBACCO CESSATION: AVAILABLE TREATMENT MODALITIES, LIMITATIONS, AND SOLUTIONS , *Dr. Sanvritti M.
Tobacco use is associated with 5 million deaths per year worldwide and is considered as one of the leading causes of premature death.[1] The few reports of tobacco use in different population groups report its prevalence from about 15% to over 50% among men.[2] Differences in its prevalence are rather wide for the non-smoking forms. Overall, smoking causes 1 in 5 deaths.[1] Long-term effects of smoking include lung and throat cancer due to tar in cigarettes. Carbon monoxide in cigarettes also reduces the amount of oxygen available to the muscles, brain, and blood. Overtime, this causes airways to narrow and blood pressure to rise, which leads to cardiovascular effects.[3] The chance that a lifelong smoker will die prematurely from a complication of smoking is approximately 50%.[1]
181 GLOBAL AND NATIONAL TRENDS AND CHALLENGERS OF UNMET NEED FOR FAMILY PLANNING , Indrani Malwenna*
Unmet need for family planning refers to the percentage of all fecund women who are married or living in union and thus presumed to be sexually active but are not using any method of contraception, either do not want to have any more children or want to postpone their next birth at least for next two years or do not know when or if they want another child. Use of appropriate contraceptive method helps the user to avoid unplanned pregnancies, thus reducing the risk of induced abortion; the number one killer of women in the reproductive age in developing countries. Due to its clandestine nature, most abortions in the developing world are unsafe, thus resulting a series of complications, the most disastrous being a maternal death. Even though abortion is criminalized in Sri Lanka except to save the mother‟s life, average of 700 abortions are carried out daily, which accounts for 75% of live births per day being the second leading cause of maternal deaths in 2006, 2008 and 2010 It has been estimated in Sri Lanka Demographic and Health Survey 2006/07 that 17.2% of births in the previous 5 years were unplanned or unwanted. It has been revealed that, 73% among 365 abortion seekers were found to have unmet need for family planning. Economic burden of induced abortion is unbeareble, because the total cost for management of complications of an abortion has been estimated to be 462 US $, of which 79% is spent by government health expenditure in Sri Lanka.
182 CHARACTERISTICS OF INPATIENTS’ FATALITY DUE TO COVID-19 PANDEMIC: EXPERIENCE FROM MUGDA MEDICAL COLLEGE AND HOSPITAL, DHAKA, BANGLADESH , Dr. Irin Hossain* Prof. Dr. Manzurul Haque Khan, Dr. Sk Akhtar Ahmad, Dr. M. M. Aktaruzzaman, Dr. Shah Golam Nabi Tuhin, Dr. Md. Shafiur Rahman, Dr. Ashekur Rahman Mullick*, Dr. Md. Shahin, Dr. Adnan Yusuf Choudhury, Dr. Md Abdul Hamid, Dr. Md. Utba Bin Rashid
COVID-19 was firstly reported in Wuhan, Hubei Province, China at the end of 2019. As of July 26, 2020, COVID-19 has cause over 16.25 million infections and over 0.65 million deaths around the world. In Bangladesh, more than 0.22 million patients infected with COVID-19 and among them near about three thousand have been died. We aimed to explore risk factors of in-hospital death for patients and describe the clinical course of symptoms, associate baseline risk factors, treatment strategy. We conducted a retro-prospective study of 98 deceased patients who were admitted into COVID-19 dedicated Mugda Medical College and Hospital, Dhaka, Bangladesh for treatment purpose from May 1 to June 30, 2020. Data were obtained from patient charts and the hospitals’ admission records using a structured questionnaire. The overall age of 98 death patients was estimated 57.65 ± 17.597 years with the median of 60 years old. Among the fatal cases, 76 (77.6%) were males. Based on the history of underlying diseases in the dead’s, it was found that most of them had diabetes (55, 56.1%) and hypertension (55, 56.1%). The main clinical symptoms were shortness of breath (90, 91.8%) and fever (72, 73.5%). Among the deceased patient about 49.0% patient need ICU/HDU support for treatment purpose. Patients with coexisting conditions and older age are at risk for severe disease followed by death. Overall, informing people in the community especially the high-risk groups providing the medical supplies, increasing laboratory tests capacity, performing social distance, banning public gathering, and announcing quarantine were panic management strategies which could moderate the death cases.
183 TRACHEAL MALIGNANCY PRESENTING AS TRACHEO OESOPHAGEAL FISTULA , Juvaina P., Tintu A. S.*, Devarajan E., Rajan P., Naufal P. and Saanida M. P.
Malignant tracheo oesophageal fistula though rare, occurs most commonly in association with oesophageal malignancy. Incidence of primary tracheal malignant lesions are extremely rare. Two most common tracheal malignancies known are squamous cell carcinoma involving the lower trachea and adenoid cystic carcinoma involving the upper trachea. Tracheo oesophageal fistulous communication has been described as one of the uncommon complications of tracheal malignancy according to literature. Here we report a rare case of primary tracheal malignancy with invasion of oesophagus causing tracheo oesophageal fistula.
184 EPIDEMIOLOGY OF COVID-19 IN FOUR MAJOR GOVERNORATES IN IRAQ , Dr. Hajir H. Al-Ridhwany*
Introduction: The latest pandemic is COVID-19 as it has been declared by the World Health Organization on March 11,2020. It has a zoonotic source but it continues infecting human. Aim: The current study is aiming for displaying epidemiology of COVID-19 in four major Governorates in Iraq. Method and subjects: A prospective cohort study design was adopted to analyze the epidemiological data that is published officially by the Public Health Department in Iraqi Ministry of Health from February 24 to the end of July 2020. Four major Iraqi Governorates were included in the current study; Nineveh, Erbil, Baghdad and Basra. Inclusion criteria was "infected patients with COVID-19 that confirmed by polymerase chain reaction testing. Results: Baghdad was the first one that reported a confirmed COVID-19 infection among the four studied Iraqi Governorates. Incidence in Iraq was 312 per 100,000 population. The highest incidence was in Baghdad and Al-Basra Governorates (494 and 331 per 100,000 population). Case fatality rate was 3.8%; almost third of deaths in Iraq (35.2%) was in Baghdad. Recommendations: The current study recommends that clinical and radiological presentation should be considered in COVID-19 case-confirmation.
185 DYSLIPIDEMIA IN CHILDREN WITH TYPE 1 DIABETES MELLITUS: CROSS SECTIONAL STUDY , *Leen Jamel Doya, Naya Talal Hassan, Entessar Nasser, Muhammad Imad Khayat
Background: Type 1 diabetes mellitus (T1DM) and dyslipidemia (DLP) are serious metabolic disorders, and their coexistence has been associated with dangerous outcomes. Objective: The purpose of the present study is to investigate dyslipidemia and its association with glycosylated hemoglobin (HbA1c) in Type 1 diabetes mellitus children. Methods: In a cross-sectional study design included 118 patients with Type 1 diabetes mellitus aged between 5-13 years. Serum glycosylated hemoglobin (HbA1C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL), and triglyceride (TG) were measured. Results: The results showed that there was a significant relationship between all lipid profiles expects HDL-C with glycosylated hemoglobin (p=0.0001). Conclusion: The current study concludes that Poor glycemic control plays a role as a risk factor for the development of dyslipidemia in children with Type 1 diabetes mellitus.
186 ANALYSIS ON THE IMPLEMENTATION OF ECOLITERACY-BASED GREEN HOSPITAL PROGRAM POLICIES IN BHAKTI HUSADA GENERAL HOSPITAL OF BANYUWANGI , Warda Arumsari*, Isa Ma’rufi and Sugeng Winarso
Background: The fact shows that the hospital management do not concern on the existence of hospitals in the middle of residence with limited environmental supports, whereas the current paradigm reveals that hospital management and the complexity of its activities do not cause negative burden of environmental pollution. The demands of modern society's needs for hospital services has also shifted to the demands of environmentally friendly health services. Material & methods: A qualitative approach with a case study design is applied in this study. This study uses the Delphi method which aims to formulate, prioritize, and design policy problem solving strategies. Result: The analysis showed that four variables namely environmental conditions, relationships between organizations, organizational resources, and characteristics and capacity of implementing agencies affect the performance and impact of decentralization policies. Studies on these four variables are useful for understanding the implementation of Ecoliteracy-based green hospital program policies at Banyuwangi General Hospital. Conclusion: The policy environment is related to resource constraints and the availability of physical infrastructure. Relationships between organizations are determined by the clarity and consistency of program objectives. Organizational resources are related to the balance between budget sharing and program activities and the support of local political leaders. Characteristics and capabilities of organizing agencies are the commitment of officers on the program and the nature of internal communication.
187 PREVALENCE OF THALASSEMIA TRAIT IN COUPLES TENDING FOR MARRIAGE IN NINAWA CITY , *Zakaria Abdulkhalk Abdal, Saif Waadallah Yonis and Abdulaziz Zouba Mansoor
Thalassemia is a common inherited preventable hematologic disorder by investigating hemoglobin electrophoresis. It is a worldwide disorder with a predominant incidence in Mediterranean countries, North Africa, the Middle East, India, Central Asia, and Southeast Asia. The treatment of affected individuals presents a substantial global disease burden. β-thalassemia is characterized by the reduced synthesis (β+) or absence (βo) of the β-goblin chains in the HbA molecule, resulting in accumulation of excess unbound α-globin chains that precipitate in erythroid precursors in the bone marrow and in the mature erythrocytes, leading to ineffective erythropoiesis and peripheral hemolysis. Our study done on 86027 couple tending for marriage attending to official institutions health facilities In Ninawa governorate in 2019. The result was 0.44 % having thalassemia trait of couples tending for marriage. 7.7% are consanguinity relationship.
188 STRUCTURE AND DIVERSITY OF THE VARIOUS ZOOPLANCTONIC GROUPS IN THE BAY OF TABOUNSOU , *Mamadouba Camara and Ansoumane Keïta
This survey is about the analysis of 468 samples that aims to determine the structure and the diversity of the different group zooplanktonics in the 13 inshore stations in the bay of Tabounsou. They have been studied in succession during one year, that means the year 2014 (March, April, May, June, July, August, September, October, November, December) and 2015 (January, February). Most species are perennial and their maximal abundance is located to the season of rains, when the enrichments of the coasts make themselves through the presence of the terrigènes. The abundance of the zooplankton reached its peak during the rainy season (July) and the evolution coordinated of several species of zooplankton is confirmed by the specific wealth. The following species are considered constants because, they have been met in each of the 13 stations sampled: Paracalanus aculeatus; Eriphia spinifrons; Paracalanus scotti; Nannocalanus minor; Paracalanus parvu; Sagitta hispida; Sagitta friderici. In terms of biomasses the Mysidacés (2433,14mg/m3), and the chaétognathes (1768,38 mg/m3) form the dominant group. Of a station to the other the variations of the biomass can be explained by the presence of the larvas of shrimps of large size.
189 DISPARITY IN COVID-19 MORTALITY RATE AMONG COUNTRIES , Swathi Paleti, Zain A. Sobani and Dr. Tarun Rustagi*
The COVID 19 pandemic continues to rampantly spread across the globe without prejudice and has significantly impacted the health and wellbeing of the entire population of the world. Each country and region has implemented different strategies to mitigate the spread of the virus; with the common underlying theme of social distancing and avoiding unnecessary travel and interaction. The significant healthcare and economic burden of this disease is related to the proportion of infected patients with severe disease and its high mortality. Recent studies have shown older patients (>60 years old) and those with chronic diseases are prone to having a severe and more critical COVID-19 clinical course along with higher mortality rates.[1,2]
190 EFFECT OF AN AYURVEDIC FORMULATION IN THE MANAGEMENT OF VATAJA PRATISHYAYA W.S.R. TO ALLERGIC RHINITIS , Dr. Priyanka Thakur*, Dr. Vijayant Bhardwaj, Dr. Satish Sharma, Dr. Rajika Gupta and Dr. Priya Sharma
Vataja Pratishyaya is a condition characterised by Sneezing, Nasal obstruction, Nasal discharge, Itching in nose etc. and occur mainly due to Vata Kapha Pradhana, alpa Pitta Dosha. As the symptoms of Vataja Pratishyaya are same as that of Allergic Rhinitis this disease was selected for the study. The present study is done on 10 patients of Vataja Pratishyaya and was treated with Vyaghri Haritaki as oral drug. The signs and symptoms were studied before and after treatment. Result of the study showed moderate improvement in 8 patients (80%) & mild improvement in 2 patients (20%).
191 THE CONCEPT OF ECOLOGY IN AYURVEDA , Dr. Ashwini Patil*
Ayurveda, the science of life, is from time immemorial has laid more emphasis on Prakriti, Purusha, Srshti, Desha, Kala, Rutu & its relation with human beings. The interdependency of loka and purusha is wisely explained by Charakacharya. The fundamental principles laid down in Ayurveda are based on Panchamahabhuta concept which says that the shareera, the dravya and the entire existing materials are made out of it. This marks the relation of Ayurveda with nature which aims at prevention of disease rather than cure, by adopting healthy regimens. The healthy regimens include both diet and activities. Acharyas insight towards the effect of Prakriti on human beings is remarkable. We find many scattered references regarding environment in our Samhitas. The concept of Janapadhvamsa clearly indicates the effect of Prakriti on humans. Ayurveda, an Upaveda of Atharvanaveda, includes all the concepts not only to prevent and treat a disease but it shows a path to lead a healthy and contented life by preserving and understanding the relation between human and nature.
192 IN SITU GELLING SYSTEM: FOR TREATMENT OF NEUROLOGICAL DISORDERS , Shreya Parkar*, Rutuja Sawant, Prajakta Kegade and Akshay Gade
Intranasal drug delivery can be visualized as the promising route for the administration of drugs as it has the potential to overcome some major limitations associated with other routes. It is one of the promising approach for the systemic delivery of drugs because concentration time profile of drugs achieved after nasal administration is often similar to that obtained after intravenous administration. Nasal administration has a drawback of poor retention time which is overcome by novel drug delivery i.e. In-situ gelling system. In-situ gelling system is a polymeric solution which can be administered in solution form, and it undergoes sol-gel phase transition into a viscoelastic gel upon exposure to physiological conditions (e.g. pH, temperature and ionic concentration). This system also has a great impact in the treatment of neurological disorders. Neurodegenerative diseases are becoming prevalent as the population ages. Preclinical reports from several researchers have proven that the delivery to the brain via the nose-to-brain route using in situ gels holds great promise. The ‘in situ gel’ system has become one of the best novel drug delivery systems by its special characteristic feature of ‘Sol to Gel’ transition. The treatment of neurological disorders require the delivery of therapeutics to the brain in appropriate amounts to elicit a pharmacological response. Nose-to-Brain delivery has emerged as a powerful strategy to overcome the BBB and deliver drugs to the brain. The present review highlights anatomy of nose, nose to brain delivery and its advances in the treatment of neurological disorders.
193 EMULGEL: IN TREATMENT OF PERIODONTITIS , Prajakta Kegade*, Rutuja Sawant, Shreya Parkar and Akshay Gade
Nano emulgel is the lipid based, thermodynamically stable drug delivery system.It consist of two different systems in which drug containing Nano emulsions incorporated into a gel base. The fusion of this system makes it advantageous in several ways. It is an appropriate candidate for drug delivery because of their dual character. Due to their unique property Nano-emulgel showed various applications over topically used unstable dispersions. For the enhancement of transdermal permeation, Nano-emulgel is great approach in comparison of conventional topical formulations. It also provides controlled and sustained drug delivery and have been undertaken in achieving much better drug product effectiveness, reliability and safety. Nano-emulgel is employed as a promising approach for the treatment of periodontitis. Periodontitis is a chronic inflammatory disease affecting the supporting structure of teeth. Bacteriological studies show that periodontal disease are infections caused by the overgrowth of a Gram-negative anaerobic microorganisms. The diversity of bacterial species, the variation in composition of floras and the variation in host response to bacterial species from individual to individual are some of the major reasons that the specific aetiology of periodontal disease has not been clearly established. The plaque-induced forms of periodontal diseases are the most prevalent chronic inflammatory conditions seen in humans worldwide, affecting nearly half of the adult population. Recent studies have reported that many localized deliveries of drugs such as simvastatin, ornidazole, levofloxacin have been evaluated with positive results for periodontitis.
194 ESTABLISHED LEAF FLAVONOIDS AS PHYTOLIGANDS FROM ANDROGRAPHIS PANICULATA (BURM. F.) WALL. EX NEESFOR ANTIBACTERIAL ACTIVITY AGAINST BACTERIAL DNA-GYRASE B RECEPTOR: AN IN SILICO APPROACH , Debojyoti Roychowdury*, Partha Talukdar and Soumendra Nath Talapatra
The medicinal plant,Andrographis paniculata(Burm. f.) Wall. Ex Neesis a common herbal plant having several medicinal properties in the leaves of plant.The medicinal properties are depending upon by the presence of several phytochemicals. Among different medicinal values,potent antibacterial properties are known as natural antibacterial agents. The objective of the present study was to detect receptor-ligand binding energy and interaction through molecular docking for lead phytocompounds established in the leaf of A. paniculata against bacterial DNA gyrase B protein (PDB ID: 3G7B). Molecular docking was performed by usingsoftware (iGEMDOC, Version 2.1) to detect binding energy and interaction.The interaction with residues was visualized in the AutoDoc tool (Version 1.5.6). Among 9 phytochemicals and 1 antibiotic (Ciprofloxacin), highest binding energy value was obtained in 5-hydroxy-7,8,2',5'-tetramethoxy-flavone (-121.862 Kcal/mol) when compared to Ciprofloxacin (-106.621Kcal/mol). The binding interaction of target protein with this phytocompound found binding at the active site due to competitive inhibition. In conclusion, phytocompound 5-hydroxy-7,8,2',5'-tetramethoxy-flavone can be alternative of synthetic antibacterial drug as per binding energy value and residue interaction. It is suggesting further pharmacological and toxicological assay with this phytocompound after isolation from medicinal plant (A. paniculata).
195 A CLINICAL STUDY ON THE MANAGEMENT OF DANTVESHTA (PYORRHEA ALVEOLARIS) WITH VAJRADANTA MANJANA AND VIDANGADI GUGGULU , Dr. Priya Sharma*, Dr. Satish Sharma, Dr. Vijayant Bhardwaj and Dr. Priyanka Thakur
On evaluating the 65 Mukharogas by Acharya Susruta Dantveshta is described in subtypes of Mukharogas .i.e. under 15 Dantamulagata Rogas. On comparing the symptoms of Dantaveshta with modern side it can be correlated with periodontitis, now a days known as Pyorrhea Alveolaris. So this research work has planned in such a way to see the effect of two herbal formulation named Vajradanta Manjana and Vidangadi Guggulu whose ingredients are proven anti-inflammatory, antimicrobial, antioxidant when combined with authentic principles of Ayurveda. This can show markable relief in the symptoms and that too without any side effects as that of modern surgical therapies. The present study is done on 30 patients of Dantaveshta, who were grouped into three groups with 10 patients in each group. Group A was treated with Vajra Danta Manjana for Pratisarna, Group B with Vidangadi Guggulu for oral use, Group C with both the formulation simultaneously. The signs and symptoms were studied before and after treatment. Results of the study indicates significance of Group C as Group C gives 71.11% relief in the criteria for assessment than Group A which gives 53.07% and 49.36% in Group B.
196 DEVELOPMENT AND IMPLEMENTATION FEASIBILITY OF COST-EFFECTIVE SCHOOL LUNCH PROGRAM , Dr. Mahnaz Nasir Khan, Hira Zia and Noor-e-Huma*
School plays an important role in determining the food choices of the students besides mental and cognitive development. Snacks available at the school premises effect the nutritional status of the children; consumption of fast food is increasing these days in the urban areas due to availability at the school premises that is also posing severe effects on the health of students. The aim of this study was to provide cost effective school lunch to the students within their limited resources. The study also helped them in determining healthy food choices virtually by providing them the school lunch that meet their 1/3rd of the macro-nutrient requirements. The study focused on development of sustainable business model that can be easily implemented in any of the school. Healthy lunch was developed on the basis of their daily money consumed at school; on an average Rs. 75/- to Rs. 100/- were spent on snacking weekly by the students and the lunch was developed within this range. In the second phase the regular lunch available at school was converted to a cyclic menu and its acceptance was checked to further modify the lunch to make it healthy. Students were not very satisfied with the lunch, almost 48% students liked the lunch but there were complaints for diarrhea and abdominal pain. The lunch was than modified and was standardized by the expert panel for sensory evaluation. Students were contented with the healthy lunch and they readily accepted the change; 88% of the students liked the cyclic menu of lunch, only 1% of the students were not happy with the lunch. The female staff in the school started delivering the same lunch thus making this model sustainable. In future, this should be implemented at national level; government should also supply this lunch free of cost to low socioeconomic schools thus securing the future of the children belonging to low and middle socioeconomic status.
197 EPIDEMIOLOGICAL ANALYSIS OF PREGNANT WOMEN WITH COVID-19 IN DHAKA, BANGLADESH: A SINGLE-CENTRE RETROSPECTIVE STUDY , Dr. Irin Hossain*, Prof. Dr. Manzurul Haque Khan, Dr. M. M. Aktaruzzaman, Dr. Ashekur Rahman Mullick
There is a special group in this outbreak, pregnant women, which deserve our great attention because of the physiological changes during pregnancy that make them more susceptible to virus. Pregnant women have a higher risk of serious illness and death from viral infections during pandemics such as influenza and Ebola. We conducted a retro-prospective study of 30 pregnant women with COVID-19 admitted into Mugda Medical College and Hospital, Dhaka, Bangladesh from May 1 to June 30, 2020. This study aims to describe the clinical characteristics, treatment strategies, and outcomes of pregnancy during COVID-19 to aid practitioners in managing these unique patients. The pregnant patients represented 6.4% (30/469*100) of all reported patients with COVID-19 at these hospitals during this time. The median age of the women was 30 years (interquartile range, 28.75 to 35). Women had symptoms at a median of 36 (interquartile range 33-38) completed weeks‟ gestation and about 16.7% (5/30) patients presented without symptoms. The most common symptoms were abdominal pain (19, 63.3%) and cough (16, 53.3%). Fever was present in 13 of 30 patients (43.3%). A total of 14 of 30 women (46.7%) were nulliparous, 14 (46.7%) had previous history of caesarean section. a total of 25 women (83.3%) had been discharged alive, 3 women (10%) transferred to other facilities for treatment purpose of other issues rather that COVID-19. Total 2 women (6.7%) were departed during this time period. In the context of the covid-19 pandemic, ongoing collection of data on the outcomes of infection during pregnancy will remain important.
198 AYURVEDA PREVENTIVE MEASURES FOR URDHVAJATRUGATA VIKARA AND COVID 19 , Sarika Choure*, Pushpa Chhangani and Snehal Garhate
Ayurveda is an ancient science of healthcare. Holistic Ayurveda has proven efficacy for preventive and curative aspect of the diseases. Covid 19 pandemic is widely affecting whole mankind all over the world and till date no effective treatment protocol is available for this viral disease. Ayurveda treatise are written after many years of experienced practice and the pandemic conditions are described as Janapadoddhvansa and many preventive aspects are given for this situation. Sympomatology of Covid 19 starts with respiratory system illness and main entry point for the droplet infection is nose and mouth. Ayurveda perspective of this disease gives a clue regarding Urdhvajatrugata Vikara so preventive measures explained in Shalakyatantra can be helpful to prevent oneself from covid 19. This article is aimed to compile the data related to Urdhvajatrugata Vikara preventive measures mentioned in Ayurveda.
199 UNANI CONCEPT OF THE NEPHROLITHIASIS (HISAT-UL-KULIYAH) , Wasim Ahmad, Md. Razi Ahmad, Md. Najibur Rahman and Md. Tanwir Alam*
Hisat-ul-Kuliyah (Nephrolithiasis) is one of the oldest diseases known to human being & has been documented in ancient Greek literature. Urinary stones have been found in Egyptian mummies dating back as far as 7000 years & the symptoms of the condition were described by Hippocrates who suggested that drinking of muddy river water causes the excretion of sand in urine. Roman physician Galen postulated that factors like diet, climate, heredity, gout, race and some abnormalities cause the stone formation. Hisat-ul-Kuliyah has been described by ancient Unani physicians like, Razi, Ibn Sina have discussed the signs, symptoms & complication of the disease. Nephrolithiasis is a common disease with an increasing incidence and prevalence worldwide. Lifestyle and dietary habit implicated in the complex of the metabolic syndrome are important factors contributing to such developments. So, keeping the fact in mind want to summarized concept of Hisat-ul-Kuliyah in the light of classical Unani literature.
200 FILFIL SIYAH (PIPER NIGRUM); THE SPICE OF MEDICINAL IMPORTANCE , Saziya Sohel, Dr. Md. Razi Ahmad, Md Najibur Rahman and Md Tanwir Alam*
Black pepper (well known as Filfil Siyah in Unani system of medicine) is a flowering vine in the family Piperaceae, cultivated for its fruit, known as a peppercorn, which is usually dried and used as a spice and seasoning. When fresh and fully mature, the fruit is about 5 mm (0.20 in) in diameter and dark red, and contains a single seed, like all drupes. Peppercorns and the ground pepper derived from them may be described simply as pepper, or more precisely as black pepper (cooked and dried unripe fruit), green pepper (dried unripe fruit), or white pepper (ripe fruit seeds).1 The use of Piper nigrum since ancient times in different alternative system of medicine like Unani, Ayurveda etc. for the treatment of Nafakh-e-Shikam (Flatulence in the stomach), Waj-ul-Meda (Gastric Pain), Zof-e-Ishteha (Anorexia) it is also used as Kasir-r-Riyah (Carminative), Mudir-e-Baul (Diuretic), Mudir-e-Haiz (Emmenagogue), Muharrik (Stimulant), Munaffis wa Mukhrij (Expectorant), Muqawwi-e-Medah-wa-Jigar (Liver and Gastric tonic), Daf-e-Humuzat (Antacid), Muqawwi-e-Aasab (Nervine Tonic), Muqawwi-e-Bah (Aphrodisiac) etc. Several studies have been carried out for the therapeutic evaluation of its efficacy and safety. So, I want to compile and summarized all the literature at one space.
201 A COMPARATIVE PHARMACEUTICO ANALYTICAL STANDARDIZATION OF TRIPHALA KASHAYA WITH TRIPHALA ARKA , Dr. Ragini G.*, Dr. Mahantesh B. Rudrapuri and Dr. G. Vinay Mohan
Panchavidhakashayakalpanas are the basic or primary preparations of BhaishajyaKalpana. The different dosage forms like Swarasa, Kalka, Kashaya, Hima, Phanta have shelf life of 24 hours. In order to increase the shelf life these primary preparations are processed and converted into secondary dosage. To meet the need of time and to fulfil the requirements like long self-life, palatability, low dose, quick action, easy dispensing and handling, several upkalpanas were discovered, like Vatikalpana, Avaleha, Sandhan, Sneha, arkaKalpana etc. Arka is a liquid preparation obtained by distillation of certain liquids or of drugs soaked in water using the ArkaYantra. For the present study a critical evaluation on preparation of Triphala Kashaya and TriphalaArka by following the Standard Operating Procedure (S.O.P) was done by considering suitable Analytical parameters. For pharmaceutical standardizing preparation of Triphala Kashaya and TriphalaArka was repeated five times.
202 THE EFFECT OF SERVICE QUALITY TO THE PATIENT SATISFACTION OF PREMIUM RECIPIENT AND NON-PREMIUM RECIPIENT OF NATIONAL HEALTH INSURANCE (JKN PBI AND NON PBI) PARTICIPANTS IN OUT-PATIENT UNIT OF RS X JEMBER DISTRICT , Ahmad Fausi*, Dewi Rokhmah and Hadi Prayitno
This research aimed to identify effects of service quality to the patient satisfaction of premium recipient (PBI) and non-premium recipient (Non-PBI) of National Health Insurance in out-patient unit of RS X, Jember District. The method of this research was quantitative, while based on the research time, it was included into cross sectional research. The total sample of this research were 110 sample, which were taken from purposive sampling. The data was then analyzed through ordinal regression test in order to test the effects with significance value (α > 0.05). The test result on effects of service quality and patient satisfaction on this research showed that the significance level value 0,000 was fewer than T table value 0,005, thus, H0 was approved, which stated that there was effect between service quality and patient satisfaction in the out-patient unit of RS X, Jember District, particularly the total N were 110 respondents. This research concluded the effect between service quality and patient satisfaction of premium recipient and non-premium recipient of National Health Insurance participants in the out-patient unit of RS X, Jember Distrcit.
203 FORMALIN LEVELS IN WHITE TOFU BASED ON DISTRIBUTION CHANNELS AND TIME STORAGE IN JEMBER REGENCY, 2019 , Nur Aini Hardyanti*, Erma Sulistyaningsih and Sri Hernawati
Formalin is one type of hazardous additives that are still often used by tofu traders or other food processors with the aim of improving the color and texture of food and inhibiting the activity of microorganisms so that food products can be stored longer. Storage by soaking tofu using water can reduce formaldehyde levels. The use of formaldehyde in tofu often relates to the distribution channe,[1] of tofu from producers to consumers so the use of these chemicals in food needs to be watched out together, both by producers and consumers. This study aims to determine the presence of formalin in white tofu based on distribution channels and storage time in Jember Regency. This type of research is an experimental laboratory using a cross section approach. Tofu storage time testing of formaldehyde content is carried out by giving treatment to white tofu that has been known to be positive containing formaldehyde from a sample of producers and traders. The sample was divided into four groups, namely one control group (K) and three treatment groups (X1, X2, and X3). The results obtained did not get formaldehyde content in white tofu samples sold at the producer level, while at the merchant level obtained formalin content as much as,[2] samples from 24 samples (8.3%). Formalin levels in white tofu at the trader level varied from 4.2 to 4.8 ppm. There is an opposite relationship between the storage time of white tofu on formalin levels (correlation coefficient of -0.941) and there is the effect of storage time on formalin levels p value = 0,000. There is a difference in formalin tofu storage time to formalin levels p value = 0,000 (p <0.05).
204 CAN LIPID PROFILE BE USED AS BIOMARKER PREDICTORS OF CARDIOVASCULAR RISKS IN MALE AND FEMALE CHILDREN UNDER AGE 11 YEARS, AS IT DOES FOR MIDDLE AGE AND ELDERLY? , Hussain Al – Wandawi, Hadi Mahdi Salih, Ahmad Arak Kamil, Ali Wahad Enad and Mustafa Nazim Rafeek
Heart disease is the most frequent condition in elderly. Within this age group, cardiovascular disease will remain the leading cause of death. Heart failure, coronary heart disease (CHD), artery disease and arterial fibrillation are some of the common sequences and reasons. In the last three decades lot of information emerged to show that middle – age and elderly are not the only groups affected by cardiovascular disease (CVD), but children and adolescents as well. Some children have a higher risk for coronary artery disease than others especially if they have family history of heart disease. Some other children are born with congenital heart disease, a type of heart disease that children are born with, usually caused by heart defect that are present at birth. Still other children acquire some risk factors due to sedentary lifestyle, and unhealthy food. With the exception of aging process and inherited - cardiovascular – problems, many others risk factors can be modified if diagnosed and treated early in life, if not, it can lead to heart and circulatory diseases. Screening for CVD at childhood and adolescence stages is one of the effective measures for modifying risk factors for CVD later in life. The results presented in this study; suggest that lipid profile (lipid panel) measurement of children under age 2 years is not recommended for prediction of cardiovascular risk later in life, although it may be required under certain conditions. However, in children age 2 to 5 years and 5 to 10 years such screening is found to be indicative for highlighting some risk factors which if not treated early in life may lead to health problems later in life. Moreover, such early prediction of CVD risks, may help in chaining unhealthy sedimentary life style related to CVD later in life. This investigation has also been extended to include males and females from the same community to explore the prevalence of cardiovascular risks at mid - aged and in elderly. The results revealed that elderly are at higher risk of CV compared to persons at their middle age persons. Objective: The objective of this study was to find out whether lipid profile measurement of children can be useful for cardiovascular risks prediction later in life, or one that can be used to identify children who benefit from treatment.
205 PHARMACOLOGICAL AND EDUCATIONAL INTERVENTION FOR THE CONTROL OF INTESTINAL PARASITIC INFECTIONS IN PRE-SCHOOL CHILDREN IN LA PLATA, ARGENTINA , Mínvielle Marta*, Zubiri Karina, De Andrea María, Ceccarelli Soledad, Ciarmela María and Pezzani Betina.
This work compares the results of three years of pharmacological and educational intervention (2015-2018) to control intestinal parasites in preschool children from La Plata, Argentina. An exploratory ecological study was carried out. The clinical, socio-clinical-environmental conditions and detection of intestinal parasites were evaluated. After carrying out the therapeutic intervention of the parasitized children, educational workshops were implemented to avoid the return to the disease state and finally, the post-intervention control. In 2015, 45 preschoolers of the 65 enrolled (69.2%) in the Kindergarten completed all stages of the program, in 2018 40 of 62 preschoolers (64.5%) did so. In 2015 we registered 93.3% of parasitized children, of which 60% had helminthes and 93.3% protozoa. In 2018 we registered a decrease of about 51% of parasitized children; the impact being greater in protozoa with a decrease of 63% compared to helminthes whose reduction was 35%. The educational workshops had greater impact on risk behaviors those in children’s hygiene habits. The strategies implemented have had good results with the pharmacological treatment and reduction of risk behaviors, but it has been deficient with respect to the modifications in the personal hygiene of the schoolchildren. Aspects that we must take into account to improve future interventions in the community.
206 UNANI CONCEPT OF THE NEPHROLITHIASIS (HISAT-UL-KULIYAH) , Wasim Ahmad, Md. Razi Ahmad, Md. Najibur Rahman and Md. Tanwir Alam*
Hisat-ul-Kuliyah (Nephrolithiasis) is one of the oldest diseases known to human being & has been documented in ancient Greek literature. Urinary stones have been found in Egyptian mummies dating back as far as 7000 years & the symptoms of the condition were described by Hippocrates who suggested that drinking of muddy river water causes the excretion of sand in urine. Roman physician Galen postulated that factors like diet, climate, heredity, gout, race and some abnormalities cause the stone formation. Hisat-ul-Kuliyah has been described by ancient Unani physicians like, Razi, Ibn Sina have discussed the signs, symptoms & complication of the disease. Nephrolithiasis is a common disease with an increasing incidence and prevalence worldwide. Lifestyle and dietary habit implicated in the complex of the metabolic syndrome are important factors contributing to such developments. So, keeping the fact in mind want to summarized concept of Hisat-ul-Kuliyah in the light of classical Unani literature.
207 FILFIL SIYAH (PIPER NIGRUM); THE SPICE OF MEDICINAL IMPORTANCE , Saziya Sohel, Dr. Md. Razi Ahmad, Md Najibur Rahman and Md Tanwir Alam*
Black pepper (well known as Filfil Siyah in Unani system of medicine) is a flowering vine in the family Piperaceae, cultivated for its fruit, known as a peppercorn, which is usually dried and used as a spice and seasoning. When fresh and fully mature, the fruit is about 5 mm (0.20 in) in diameter and dark red, and contains a single seed, like all drupes. Peppercorns and the ground pepper derived from them may be described simply as pepper, or more precisely as black pepper (cooked and dried unripe fruit), green pepper (dried unripe fruit), or white pepper (ripe fruit seeds).1 The use of Piper nigrum since ancient times in different alternative system of medicine like Unani, Ayurveda etc. for the treatment of Nafakh-e-Shikam (Flatulence in the stomach), Waj-ul-Meda (Gastric Pain), Zof-e-Ishteha (Anorexia) it is also used as Kasir-r-Riyah (Carminative), Mudir-e-Baul (Diuretic), Mudir-e-Haiz (Emmenagogue), Muharrik (Stimulant), Munaffis wa Mukhrij (Expectorant), Muqawwi-e-Medah-wa-Jigar (Liver and Gastric tonic), Daf-e-Humuzat (Antacid), Muqawwi-e-Aasab (Nervine Tonic), Muqawwi-e-Bah (Aphrodisiac) etc. Several studies have been carried out for the therapeutic evaluation of its efficacy and safety. So, I want to compile and summarized all the literature at one space.
208 SARS COV 2- A QUANTITATIVE STUDY ON PREVENTIVE HEALTH BEHAVIOR OF CARETAKERS OF ELDERLY IN NORTHERN INDIA , *Dr. Puri S., Dr Amarjeet Singh, Andrew P. and Sharma D.
Background: SARS COV-2(severe acute respiratory syndrome Corona Virus -2), global pandemic has engulfed the whole world causing major health and economic consequences. All segments of population are affected with Elderly at a higher risk of being susceptible to it due to compromised immune system. In regards to its increased virulence and none vaccine available till date, the only saving modality at present observing safe practices to mitigate its spread. Objectives: To assess the knowledge and preventive health practices of caretakers of elderly regarding SARS COV-2. Study Design: Cross sectional study Methods- This cross sectional web based study was done from June 22nd to 27th. By non probability snow ball sampling technique 208 participants were included. The data was collected online by Google forms. Participants included were those who had some elderly in their house or were taking care of an elderly. The questionnaire on Google forms consisted of socio demographic profile and assessment of knowledge along with practices for managing elderly against Covid. Data was collected and analyzed using percentages. Results: A total of 149 subjects out of 208 (71.6%) were aware of the term ―social distancing‖ and 88.5% knew that elderly are at higher risk of contracting SARS COV-2 infection as compared to others. 91.3% were aware that unnecessary visits to market should not be done. 73.6% caretakers of elderly did not mix their clothes with others and sanitized their door knobs. Only13% were aware of the national emergency helpline numbers (police, ambulance etc.). Conclusion- The caretakers of elderly possessed limited knowledge about the SARS COV-2 and preventive safe practices.
209 AN ETIOLOGICAL CORRELATION OF NIQRIS WITH GOUTY ARTHRITIS , Tabassum Sultana, Md. Razi Ahmad, Md. Najibur Rahman and Md. Tanwir Alam*
Gout, “the king of diseases and the disease of kings”,[1] was one of the earliest disorders to be recognised as a clinical entity. It was first identified by the Egyptian in 2640 BC, and written evidence of disease found to Hippocratic writings dates back to 400BC.[2,3] The most accurate early description of an acute attack of gout was made by Sydenham, an English physician, written about himself in 1683.[1,2] Crystal from tophi were first described during the 18th and 19th centuries, and in the mid-20th century the role of excess urate production and impaired excretion in the pathogenesis of Hyperuricaemia were reported. Finally, McCarty and Hollander showed that crystals from the synovial fluid of patients with gout were composed of monosodium urat.[2] Present study has been designed to study the aetiological correlation of Gout with Niqris.
210 A PROSPECTIVE OPEN LABEL RANDOMIZED CLINICAL STUDY OF LUK MUGHSUL (TACHARDIA LACCCA), AJWAIN DESI (TRACHYSPERMUM AMMI) & ZEERA SIYAH (CARUM CARVI) IN THE CASES OF SAMANE MUFRIT (OBESITY). , Sayyed Juwairiyah, Md. Razi Ahmad, Md. Najibur Rahman and Md. Tanwir Alam*
The emerging epidemics of Samane Mufrit (obesity), cardiovascular disease (CVD) and diabetes form the crux of this phenomenal change. Among these entities, obesity has become a colossal epidemic causing serious public health concern and contributes to 2.6 million deaths worldwide every year.[1] The present study was designed as an open label randomized clinical trial in successive patients with obesity diagnosed on presentation, history and investigations. Sixty diagnosed patients of age between 20-50 years. And Unani formulation (compound of Luk Mughsul (Tachardia Laccca), Ajwain Desi (Trachyspermum ammi) & Zeera Siyah (Carum carvi) is given for 90 days. Subjective, objective and safety parameter recorded. The observation and results obtained in group have been discussed and compared with reference various known variables in the light of the text present in Unani as well as modern literature. distribution of base line characteristics like; Age, Sex, Mizaj, Diet, Anxiety, Habits, Hypertension, Past history, did not differ significantly between two intervention groups in other words groups are well matched and comparable. Objective Parameters: Safoof very effective on all objective parameters like Weight, BMI, WHR, Arm circumference and Thigh circumference. The “P” value of each intervention groups on all parameters is P= 0.001.
211 KNOWLEDGE AND ATTITUDE OF HEALTHCARE PERSONNEL ABOUT COVID -19 PANDEMIC IN INDIA – CROSS SECTIONAL STUDY , *Megha Sharma MSC. Nursing and Sunil Kumar Poonia MSC. Nursing
Purpose: To assess the knowledge and attitude of healthcare personnel (HCP) about COVID -19 in the Indian healthcare scenario. Methods: A cross-sectional study was performed in April 2020 in India. Snowball sampling strategy was carried out and the data was collected through a self-administered questionnaire of the knowledge and attitude of healthcare personnel regarding COVID-19. Descriptive analysis was reported to describe the demographic, mean knowledge, and attitude score of healthcare personnel. Results: A total of 400 healthcare personnel had a mean score of knowledge and attitude of (10.0+ 1.3) and (10.7+ 6.9) respectively. They showed good knowledge and a positive attitude. However, the participants knew the mode of transmission, the isolation period and treatment (92.5%, 92.8%, and 77.5%, respectively), only (30.5%) were coming in direct contact with the patient, 55.5% personnel reported use of hand sanitizer more often than hand washing. Conclusions: The majority of healthcare workers had good knowledge and a positive attitude toward COVID-19. Only a few questions were not answered correctly. Additional education interventions and campaigns are required for healthcare workers.
212 ASSESSMENT OF WATER QUALITY IN RIVER KHAN FOR DOMESTIC USE IN SANWER TOWNSHIP, MADHYA PRADESH, INDIA , Dr. Parag Dalal*
Human exercises along water courses have affected contrarily on water quality finishing in water quality issues. The expansion in contamination load along numerous waterways in the creating nations has diminished the possibilities of these significant water hotspots for an assortment of purposes. The examination evaluated the appropriateness of water in Khan River for homegrown use in Sanwer Township. The stream streams across Sanwer Township giving it the possibilities to an assortment of employments, for example, diversion, homegrown and water system. Despite the fact that the water is broadly utilized for different purposes notwithstanding, little work has been done to decide its reasonableness. Ten water tests were brought the waterway during a solitary summer period of Corona year 2020. Utilizing standard lab methods given by APHA (1979) the water tests were investigated. Properties dissected included, pH, absolute broke up solids, explicit particle harmfulness and E-coli focuses. Discoveries from this examination uncovered the outcomes as pH between 8.2 to 8.90 and add up to broke up solids 1700 to 3200 mg/l were inside the level considered safe for homegrown water use .While calcium carbonate with a mean of 138.75mg/l and alkalinity 173.25mg/l were extremely high as per WHO, (2012) edge limits for homegrown water use, The location of e-coli at significant level in the water of the waterway shows that the water presents medical issues thus alert must be seen in the utilization of the water for homegrown purposes. The investigation suggests that checking of the water quality particularly at the purpose of human exercises into the waterway ought to be paid attention to, elective water sources ought to be given to the occupants of the town to decrease their reliance on the stream and danger they are probably going to look in the utilization of water in the stream and different uses, for example, water system, watering of yards and nurseries that require less rigid quality should be possible with water from the waterway.
213 COMPARISON OF BLOOD PRESSURE BETWEEN ADOLESCENT LIVING IN HILLY AND NON-HILLY AREAS , Dr. Biswajit Paul, Professor Dr. Afroza Begum, Professor Dr. Manzurul Haque Khan, Dr. Md. Shafiur Rahman and Dr. Irin Hossain*
High blood pressure (BP) is a silent killer and the most common risk factor for cardiovascular diseases (CVD), chronic kidney diseases and stroke. A cross sectional comparative study was conducted on school and college going adolescent group (Class 9-12) of both hilly and non-hilly area. A total of 594 students (297 from hilly and 297 from non-hilly area), whose age was in the range of 14-18 years and had consented to be a respondents were included in the study. Bandarban was considered as hilly part of study place and Rajshahi as non-hilly. Data was collected by face to face interview through a semi-structured questionnaire consisting information relating to socio-demographic characteristics and physical activity status of respondents which was adopted from International Physical Activity Questionnaire-Short Form. The sample included 54.4% girls, and the mean age of the respondents was 16.12 ± 1.04 years. The groups were statistically similar in terms of gender composition but dissimilar in terms of age, religion, education status, salt preserved fish consumption, smoking habit, physical activity and BMI. The male respondents from hilly area had significantly higher systolic pressure, diastolic pressure, mean arterial pressure and pulse pressure compared to that for respondents from non-hilly area. In case of females, the respondents from hilly area had significantly higher systolic pressure, diastolic pressure, mean arterial pressure and pulse pressure compared to that for respondents from non-hilly area. If blood pressure screening programs and counselling on blood pressure control is introduced, it may be beneficial to the population in hilly areas.
214 HAND SANITIZERS: CRITICAL EVALUATION OF COMMONLY USED ALCOHOL AND NON-ALCOHOL BASED HAND SANITIZERS IN CONTEXT TO EFFICACY TOWARDS CORONAVIRUS , Sweta Jangra, Nikita Dagar and Priti Agarwal*
The world is facing an emergency for public health due to increasing corona virus infection these days. Hand hygiene is considered as a simple and effective tool to interrupt the transmission chain of virus in normal population and health care settings for mitigation of this pandemic. A range of hand sanitizers are available with various combinations of ingredients and mode of delivery these days. But every disinfectant is working on a different mode of action with different contact periods and efficacies. In this scenario it is important to understand which type of hand sanitizers are preferable against this novel corona virus. This review is a venture to provide an insight on different types of disinfectants that we can use to prevent the spread of COVID-19, an ample literature search was performed to draw enough conclusion on the active ingredients, mechanism of action of sanitizers and comparison between the effectiveness of alcohol based/non alcohol based hand sanitizers against corona virus.
215 UNDERSTANDING THE PAST PERSPECTIVE OF RIVERINE FLOODING IN BANGLADESH; CHARACTERISTICS AND CHALLENGE IN PRESENT ERA , *Dr. Irin Hossain and Dr. Ashekur Rahman Mullick
Flooding is a regular catastrophic event in Bangladesh as it causes severe social and economic losses and damages in the different parts of the country in every year. Bangladesh is a flat delta with many abandoned channels inside the country and many depressions known as beels, baors and haors. The geographic location of Bangladesh with the Indian Ocean to the South, the Himalayas to the North and the prevailing monsoons, has made it one of the wettest countries of the world. The flatness of the land surface gives a minimal gradient to the flood producing rivers. During flood time, the average slope of the Brahmaputra is of the order of 6 cm/km and the Ganges and the Meghna have even smaller gradients. The heavy monsoon downpour and synchronization of flood-peaks of the major rivers are generally considered to be the main causes of the floods. Some primary factors also deserve serious consideration as possible contributors to the recent floods: alteration in the base level of the rivers due to local sea level rise and subsidence, inadequate sediment accumulation on flood plains, a possible increase in the watershed area due to seismic and neotectonic events in the region, river bed aggradation due to siltation and damming of rivers, soil erosion due to imprudent tilling practices, deforestation in the upstream area, and excessive development and population growth. Despite its recurrent nature and devastation, the comprehensive research on flood modelling, forecasting and management in Bangladesh has been limited and less emphasized. This study of research will help the authorities to have an overview of important aspects of flood during planning of mitigation measures and management projects.
216 EFFECT OF HERBAL UNANI FORMULATION ON CHRONIC SINUSITIS , Md. Zahid Arfi, Md. Razi Ahmad, Md. Najibur Rahman and Md. Tanwir Alam*
Sinusitis is the inflammatory condition involving paranasal sinuses. The paranasal sinuses are air filled spaces in certain bone of skull and they are in direct communication with nasal cavity through their opening called ostia. The clinical manifestation of sinusitis is nasal discharge, headache, blocking of nose, changed nasal resonance, post nasal drip and pain with tenderness in affected sinus. It may be associated with fever occasionally. If the symptoms of sinus inflammation lasting >3 months, then the condition is called chronic sinusitis.[1,2,3,4,5] Although there are so many unani single drugs and compound formulation are being claimed and used to treat and manage chronic sinusitis but here we are testing a well known and literary claimed formulation containing ingredients Ustukhuddoos, Filfil Siyah and Aslussoos for managing the various clinical sign & symptoms of chronic sinusitis.
217 MISDIAGNOSIS OF A FULMINANT CASE OF PRIMARY CNS LYMPHOMA DUE TO OF COVID-19 OVERDIAGNOSIS , Kourosh Karimi Yarandi, Ahmad Pourrashidi*, Mohammad Hosseinzade, Hedieh Moradi Tabriz, Mohammad Shirani and Abbas Amirjamshidi
Background: Novel coronavirus disease 2019 (COVID-19) is a pandemic infection that appeared in December 2019, in Wuhan, China. It has been considered as a multi-systemic disease that could involve central nervous system. We intend to report a case of fulminant primary CNS lymphoma (PCNL) misdiagnosed as COVID-19 infection and led to a delay in treatment. Case presentation: A 75-year-old female was admitted in our hospital due to altered mental status and mild fever. She had a history of tiredness, headache, and low-grade fever presented within two weeks. Her chest CT scan was apparently compatible with pulmonary involvement seen in COVID-19 and she was treated accordingly. Brain CT scan and MRI showed periventricular hyper-dense changes, diffuse brain edema and periventricular enhancing lesions. CSF analysis and brain biopsy confirmed the diagnosis of PCNL. Conclusions: It can be concluded that the in the outbreak of COVID-19 some manifestations of other diseases can be confused and assumed as the signs and symptoms of the pandemic disease and overdiagnosis of COVID-19 may result in missing the others. Although this infection has several faces with the ability to involve multiple organs, it always should be differentiated from the other possible illnesses to prevent devastating complications.
218 HIGH COLONIZATION OF MULTIDRUG RESISTANT COAGULASE NEGATIVE STAPHYLOCOCCI (CONS) ON SKIN AT VENEPUNCTURE SITE AMONG ANTENATAL CARE FEMALES FROM A RURAL COMMUNITY ATTENDING BLOOD COLLECTION CENTRE , Sweta Jangra and Debasish Chattopadhya*
Background: Coagulase negative staphylococci (CoNS) being a part of normal flora of skin, intravascular access through venepuncture may be a major point of entry for causing septicaemia. Inadequate disinfection of the venepuncture site may be responsible for rapid recolonization with CoNS that can pose risk for invasion of organism in blood leading to blood stream infections among pregnant women coming for routine antenatal check-up. Aims: Prevalence of multidrug resistant CoNS on skin at venepuncture site and analysis of various associated risk factors in antenatal care females. Material and Methods: A total of 400 antenatal females attending blood collection along with their accompanying husbands were sampled. CoNS were detected by standard bacteriological procedures, speciation was done by multiple sugar fermentation tests using commercially available kits and were subjected to AST by disc diffusion method. Results: Out of total 400 samples 260(65%) showed a positive isolation for CoNS. S.epidermidis was the most common species isolated among the CoNS isolates. The factors positively associated with CoNS carriage were milking of livestock and concomitant nasal and skin carriage of CoNS. Methicillin resistance was found among 177(68%) CoNS isolates with co-resistance towards tetracycline, erythromycin and penicillin. Few isolates were also found to be resistant to vancomycin. Conclusion: The present study suggests monitoring colonization of multi-drug resistant CoNS on venepuncture site to reduce the chances of blood stream infections among pregnant females.
219 MATERNAL MORTALITY IN NINEVEH GOVERNORATE 2018-2019 , *Dr. Marab Younis Abdullah Al-Fathy, Dr. Nahla Wadallah Al-Habbah and Dr. Alaa Abd-Alghany Younis
Background: Maternal death due to pregnancy or labor complications is a tragedic end because it is preventable and treatable. Aim: Describe women death in childbearing age in Nineveh governorate 2018-2019. Methods: A Biometry study used to review a records of 55 deceased mothers during 2018-2019. The study extended from 1st Feb-June 2020, using standardized maternal mortality inquiry forms adopted by Ministry of Health. Result: The study showed that 4(12%) of deceased mothers in age less than 20 years and 13(39%) in age more than 35 years were seen during 2019, death of women in age 20-34 years more frequently seen during 2018. Visit to antenatal care was 18% and 49% and no improvement in provision of health services in health institution during 2018-2019 respectively. Delivery in health institution slightly increase from 73% to 79% with minimum increase in percentage of cesarean section 36% during 2018 and 39% during 2019. Death in health institution more frequent during 2019 than 2018 it was 82 % and 73% respectively, and death during puerprum specially in 1st 24 hrs was decrease in 2019 than 2018. Death can be prevented in 17 (77)% and 31(94%) during 2018- 2019. The most common causes of death were hemorrhage, complication of hypertension and PET and pulmonary embolism. Conclusion: Although there was increase awareness of deceased women to seeking medical advice during pregnancy but the quality of health care services provided to them were unacceptable. Recommendation: Provision of emergency obstetric care in central and remote maternity hospital to reduce maternal mortality.
220 MICROORGANISMS RESISTANCE PATTERN AND ANTIBIOTIC PRESCRIPTIONS IN PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT IN GHAZY AL HARIRI HOSPITAL , Laith G. Shareef*, Ayad Abbas Salman, Fadil Agla Bonyan, Mohammed A. Taher and Ibrahim Mohammed Ameen
Resistance to antibiotics has emerged recently due to the misuse of antibiotics and is a threat to the health‑care system, especially in developing countries like Iraq where there are no antimicrobial stewardship programs in most intensive care units (ICU). Our objective to investigate the antibiotic prescribing pattern in ICU, organisms, and its resistance pattern and its influences on the all-cause mortality as there is sparse data in Iraqi ICUs. This was an observational, cross-sectional study done in the ICU of Ghazi AL Hariri hospital, Medical City/Iraq. All patients getting admitted to ICU from both genders were included in the study. Samples taken for culture and sensitivity tests included blood, urine, tracheostomy tube, sputum, cerebrospinal fluid, central venous line, and bedsore swab. Patients followed until they stabilized or died. 43 patients satisfied the inclusion and exclusion criteria and were included in the study. The mean age of the study population was 50.72 years. The most common isolated pathogens were pseudomonas in sputum and blood samples, Acinetobacter in wounds and operation skin site infection, Klebsiella in central venous line, and bedsore swab, while Candida in the urine. Klebsiella was the most frequently isolated in overall culture results, it was most sensitive to imipenem, meropenem, and amikacin. Ceftriaxone was the most commonly used antibiotic as an empiric treatment followed by meropenem and amikacin. Most of the isolated pathogens (> 90%) had resistance to ceftriaxone. ICU-acquired Klebsiella, P. aeruginosa, and Acinetobacter predominate hospital-acquired infections.
221 LITERARY REVIEW ON GARA VISHA W.S.R. IN AYURVEDIC RESERVE , Dr. Trupti Gupta* Dr. Arun Kumar Gupta and Dr. Swati Garg
Garavishais prepared artificially by mixture of various substances to produce various disease. Kritrimvishais called as garavishaaccording to vagbhatta3GaraVishameans the Dravya(substance) which causes Vishaad(sorrow or depression) is also known as Visha. Laghu, ruksha,aashu, vishad, vyavayi, tikshna, vikaashi, sookshma,ushna, anirdeshya rasa are the ten qualities of poisonous drugs4. Poison is a substance which when administerd, inhaled or ingested capable of acting deleteriously on human body and produces ill health. Poison may be synthetic, mineral, vegetable or of animal origin5, garavisha is one of them.Ayurveda has elucidated Garaviṣhaas non-natural poison. Wonderful concept of Garavishaexplained by Ayurveda. Today man is commonly unprotected to these artificial poisons which are primed by the combination of poisonous and non poisonous substances. Hence it is the need of the hour to appreciate correctly about all the potential toxins which we are exposing unknowingly. Garavisha is often consumed unintentionally hence the person doesn’t feel anything proximately and even delayed onset of symptoms makes treatment bit difficult. Early Diagnosis is better diagnosis so we need to aware the cause, diagnosis, Symptoms & Treatment of GaraVisha.
222 AN OUTLOOK OF ACONITUM FEROX IN CONTEXT OF VATSANABH IN AYURVEDA , Dr. Trupti Gupta*, Dr. Arun Kumar Gupta and Dr. Swati Garg
Vatsanabha or Mahavisha, Aconitum ferox is a species of monk’s hood from the family Ranunculaceae is a deciduous perennial with tall and erect stems crowned by racemes of large eye catching blue, purple, white zygomorphic flowers with numerous stamens. Vatsanabha is also recognized as Vatsanaga, Ksweda, Visa and Amrita. A deciduous perennial plant, two to six feet high, 50 cms wide, belonging to family Ranunculaceae and rising in eastern temperate and sub-alpine areas of the Himalayas, eastwards of Uttarakhand, Nepal, Kashmir and Sikkim. All the parts of the plant are poisonous, the root existence most potent. The root is mostly used for medicinal purpose. As the synonym reveals, this toxic plant can also be useful as Amrita. The root of this plant is enormouslypoisonous but useful in the treatment of various diseases such as fever, rheumatoid arthritis, sciatica, hypertension and also act as a Rasayana after Shodhana. Acharyacharaka told that if vishadrava is taken in proper dose it act as Medicine while if drugs taken in more dose, it Act as poison. Formulations having aconitum roots as an ingredient are extremely effective in various diseases. If we give Vatsanabh or its preparation in the therapeutic dose, it acts as a medicine. Fatal doses of Vatsnabha root- 1gm, Extract or Juice of Vatsanabh- 250 mg & dose of Alkaloid- 4mg. If we are treating the patients by Vatsanabh, We should take care of patients. If any toxic symptom appears, the preparationencompassing vatsnabha should be instantly stopped and medicine to offset the toxic symptoms should be started instantly without any delay. The patient should also conscious and not to buying Ayuvedicmedicine over the counter and start self-medication.
223 OVERVIEW MECHANISM OF SHVAS KRIYA IN AYURVEDIC & CONTEMPORARY SCIENCE , Dr. Trupti Gupta*, Dr. Arun Kumar Gupta and Dr. Satej T. Banne
Description regarding physiology of respiration is available in Ayurvedic and Sanskrit Literature. In Yajurveda it is mentioned that air in the form of Prana and Apana enters the Naasika (Yaj. 15/12). Some times Udana has been mentioned in the place of Apana. Conferring to Chandogyopanishad, one of the supreme ancient Upanishads, a human being can persist without eyes, ears, legs etc. but he cannot do so without breathing and without food, for life originates on these two basics and completely be contingent on them. This is the vital energy (prana) or vital force inside them. Lungs are the organs that benefit in this exchange of gases. The respiratory system is the channel that transmits the gases along with the vital life force, identified as the Prana. The antediluvian Ayurvedic scholars had obviously depicted the method of respiration in parlance of contemporary medical sciences. Maintenance of the respiratory tract is therefore actual significant. Problems in the respiratory tract can retire due to improper diet, seasonal changes, polluted air and lack of exercise Respiratory health can be enriched through controlled diet. Avoid fried food and, having light breakfast and dinner are the best ways to be followed. Drinking luke warm water comforts to break chest congestion. Herbs resembling pippali, guduchi, shati, pushkarmoolaetc are few of the lung supportive herbs. Warming the body through exercise is another way for sustaining respiratory health. Yoga, meditation and pranayama, in specific, purify the respiratory tract; strengthen the lungs and maintenances healthy lung function.
224 COMPREHENSIVE APPRAISAL OF AGEING AN AYURVEDIC & CONTEMPORARY PROSPECTIVE , Dr. Trupti Gupta*, Dr. Arun Kumar Gupta and Dr. Satej T. Banne
A constant reactivity and change in the form and probably functioning is one of the important features of living beings in biosphere. Modern scientists say that biosphere is an open system which constantly reacts with the environment. However, the nature of reactivity varies from one organism to another, which is an inherent phenomenon. This is triggered at the time of conception, runs throughout the life span and when it totally ceases, the organism dies. Within the period of life span, the nature has bestowed two important mottoes. One is growth and other is reproduction or multiplication of the species. After birth, growth and senility ultimately leading to death are inevitable process. It is correctly stated that aging begins before birth and continues through and life at different rates, in different races for different individuals and for different tissues of the body. It involves two opposite processes that simultaneously come into operation i.e. growth and atrophy. By the use of Rasayan therapy we can slow ageing process. Rasaynastands as an answer to solve the problem of healthful longevity containing mental development and resistance beside disease. Susrutaexpresses Rasayanaas a measure which extends longevity, develops positive health and rallies mental faculties and provides conflict and immunity against diseases. It is a specialized type of treatment impelling the fundamental facet of the body viz. Dhatus, Agni and Srotamsiand benefits in the prevention of aging. Rasayanacontains of two words viz (1) Rasa and (2) Ayana. The word Rasa states to the Rasa Dhatusin the context of RasadiSaptaDhatusand to the pharmacodynamic possessions of a drug in the context of Rasa Gunaetc. Ayanameans flow i.e. the measures by which one is proficient of getting the nourishing Rasa. Thus Rasaynais that process by which all the body tissues are nourished. Consequently Rasayanahelps in renewal, revival and revitalization of Dhatus. Rasayandravya is very useful for maintaining to Ageing process. ManshikaVikrati factor like Kama, Krodha, Lobha, Moha & Mada induce the Ageing process so we should avoid these manshikavikratifactor for maintaining to health & slowing Ageing process. Yoga, Pranayam& Healthy diet is very essential part for tumbling Ageing Process.
225 ETIOLOGY AND ENDOSCOPIC FINDINGS OF GASTROINTESTINAL BLEEDING IN CHILDREN , *Maria Adnan Naamah, Zeina Alkilany, Ali Ibrahim and Ali Mohamed
Background: Gastrointestinal (GI) bleeding in children, although uncommon, can be life-threatening. The purpose of the present study is to review the causes of gastrointestinal bleeding in pediatric patients according to age, determine the endoscopic findings in these children, and highlight of the important role of gastrointestinal endoscopy. Methods: A three-year prospective cross-sectional study included 150 children with upper or lower GI bleeding aged between 1 month and 14 years, who had referred to the pediatric gastrointestinal center at Tishreen University Hospital, Lattakia, Syria over 3 years from June 2017 to June 2020.Patients were categorized as infants, pre-school aged, school-aged, and adolescents. Each patient underwent an esophagogastroduodenoscopy and/or colonoscopy and several mucosal biopsies were taken. History and clinical information as well as endoscopy and pathology findings were reported. Results: The results showed that erosive gastritis was the most common upper endoscopic finding, and rectal colon polyp was the most common colonoscopic finding. HP related Gastritis and juvenile polyp were the most common causes of upper and lower gastrointestinal bleeding. Cow’s milk protein intolerance was the most common cause of gastrointestinal bleeding in the younger age group (under 2 years), and Inflammatory Bowel Disease is becoming more common at younger ages. Conclusion: Causes of gastrointestinal bleeding in children are multiple, thus specific etiologies at different age groups should be kept in mind, while assessing pediatric patients with Gastrointestinal Bleeding.
226 DIASTOLIC DYSFUNCTION IN TYPE II DIABETES AND ITS CORRELATION WITH GLYCOSYLATED HAEMOGLOBIN   , Tarfa Abed, MD*, Akram Jahjah, PHD and Munif Al Meri, PHD
Background: The alteration of left ventricular diastolic function is considered to be one of the earliest ultrasonographic signs of diabetic cardiomyopathy, which is a well-known chronic complication of diabetes mellitus. glycosylated haemoglobin (HBA1c) is the standard marker for monitoring the control of glycemic status, although biological studies indicate that HBA1c has a negative effect on the cardiovascular system, this effect has not been sufficiently studied so far. Aim: Highlight the role of HBA1c as not only a marker, but also a risk factor for diabetic cardiomyopathy. Materials and Methods: in this case-control study, a total of 80 patients with type2 diabetes aged between 40-70 years, were selected from Tishreen University Hospital and been included in the case group and been compared with 80 non diabetic participants as a control group, the two groups were matched in terms of: age, gender, blood pressure and BMI, the two groups were scrutinized for Doppler echocardiography, ECG, stress ecg, both groups underwent an objective exam, full biochemistry profile, and Blood pressure measurement. HBA1c analysis was performed for the case group. Results: in the case group Diastolic dysfunction of left ventricle was observed in 66 patients out of 80 (82.5%), the grades of Diastolic dysfunction were 33(50%) for grade I, 22(33.3%) for grade II, 11(16.7%) for grade III, 16(20%) patients of the case group had HBA1c <7,19(23.75%) with HBA1c between 7.1-8, 11(13.75%) with HBA1c between 8.1-9, 20(25%) with HBA1c >9, and 14(17.5%) without diastolic dysfunction all of them had HBA1c <7. in the control group Diastolic dysfunction of left ventricle was observed in 30 participants out of 80 (37.5%), the grades of Diastolic dysfunction grades were 28(93.3%) for grade I, 2 (6.7%) for grade II, 0% for grade III. Conclusion: Diastolic dysfunction of left ventricle is a common finding in patients with type 2 diabetes, elevated levels of HBA1c increase the risk of developing Diastolic dysfunction and with higher grades, Hence, it is a risk factor for diabetic cardiopathy.  
227 EVALUATION OF VACCINE ADHERENCE AND ROLE OF A CLINICAL PHARMACIST IN PAEDIATRIC VACCINATION , Dr. Shiv Dinesh Dyarapogu*, Dr. Ayaz Khan Pattan, Dr. Artham Lavanya, Dr. S. Tejaswini, Dr. M. Sireesha, Dr. S. P. Srinivas Nayak*
Background: Immunization is one of the decisive factors in preventing various life threatening diseases. Vaccines have thrived as one of the most successful healthy intervention on that have diminished the occurrence of various infectious diseases and improved the quality of life in the population. Although the vaccine coverage has been gradually increasing, the average total immunization coverage is far less than desired outcome. Objective: The objective of our study were to enhance the quantity of vaccine delivered in the paediatric care setting, to improve Awareness of vaccination at community level by a more active involvement of clinical pharmacist on vaccination errors and missed opportunities in paediatric care setting, to analyse the extent of knowledge, attitude and practice of parents to minimize vaccination errors and avoid vaccine misconception thereby improving vaccine adherence. Results: It is a prospective observational study was conducted on 253 paediatric subjects upto 3years of age for a period of six months in a secondary care hospital, Hyderabad. The study was divided into Pre- intervention and post-intervention phases and was performed using a KAP questionnaire. The socio- demographic details were collected by using data collection form and their knowledge, Attitude and practice levels were assessed by using KAP questionnaire regarding child vaccination. Out of 253 subjects were enrolled in the study, the percentage distribution of the respondents age showed that the age group of 25-29 were predominant. The respondents with single child were observed to be more with a frequency of 132 out of 253 who received complete awareness about vaccination. Majority of the respondents were under graduates which was the main reason for lack of knowledge on immunization. Of the total 253 study population, male child were 128(50.50%) and female child were 125(49.40%). In the study, the majority of the children were neonates (103) which is 40.71%. majority of children were immunized with polio (75.49%) and least was varicella (3.55%). Of the total population, delayed or missed vaccine was 72 out of 253 i.e. 28.40% which was observed in both the genders. Missed vaccine opportunities were mostly observed for PCV, Rotavirus, and MMR. Conclusion: This study lead to optimal disease prevention through vaccination in multiple population groups while maintaining high levels of Safety and the clinical pharmacist’s interventions certainly will be helpful in providing education on immunization and improving immunization rates in the underdeveloped and developing countries. KAP questionnaire can be used in future researches on immunization and allow for better understanding of relation between mothers knowledge and immunization of children.
228 COMPARATIVE STUDY OF OPEN CYSTOGASTROSTOMY VS LAPAROSCOPIC CYSTOGASTROSTOMY IN THE MANAGEMENT OF SYMPTOMATIC PSEUDOCYSTS OF PANCREAS , *Dr. Vinaya Ambore, Dr. Shraddha Gangawane, Dr. Aditya Marathe, Dr. Nikhil Dhimole, Dr. Gurpreet Singh and Dr. Harshal Padekar
Introduction: Pseudocyst of pancreas is a common sequalae of acute pancreatitis and it might require a surgical intervention for its management. Depending on the site of pseudocyst, various surgical procedures can be performed, cystogastrostomy by both open and laparoscopic approach being one of them. In this series, we aim to compare the efficacy and outcomes of open cystogastrostomy (OCG) and laparoscopic cystogastrostomy (LCG). Materials and Methods: A prospective observational comparative study was designed and carried out over a period of 18 months at a tertiary care centre enrolling cases of symptomatic pancreatic pseudocyst managed surgically. Demographic details, history, clinical findings, radiological findings, operative time, blood loss, post operative pain, and course in hospital was noted. Statistical analysis was done using independent t test as deemed appropriate. RESULTS: We found that LCG when compared with OCG is associated with shorter operative time (135 mins vs 115 mins) with statistically insignificant differences in blood loss. Patients undergoing LCG has lesser pain (3 vs 5.5 on visual analogue scale), required lesser drainage via abdominal drains (0 vs 3 days) and had fewer days of hospital admission (9 days vs 11 days). The postoperative morbidity of these procedures due to complications like surgical site infection was found to be 4.55% (1/22) for LCG and 21.43% (6/28) for OCG, with a p-value of 0.0294. Conclusion: LCG is safe, feasible, effective, requires a shorter hospital stay and enables early resumption of diet with reduced post-operative morbidity and mortality at nearly the same cost and thus is also cost-effective when compared to OCG.
229 INNOVATIVE PHARMACEUTICAL PACKAGING TECHNOLOGY , Priyanka D. Sherkar*, Vaishali K. Ghume and Dr. Ramanlal N. Kachave
The packaging can be defined as an economical means of providing presentation, protection, identification information, containment, convenience and compliance for a product during storage, carriage, display and until the product is consumed. Packaging must provide protection against climatic conditions biological, physical and chemical hazards and must be economical. Pharmaceutical packaging is a multiphase broad process which is classified into primary, secondary and tertiary level. Presently, numerous advancements and changes are taken into consideration for product safety, stability and patient’s compliances. An important role of pharmaceutical packaging is to transform the formulation into an attractive and marketable product. So many issues regarding the pharmaceutical product like stability, sale, patient compliance etc are related with the packaging and in regard to this; present review is done on the various advancements in the packaging techniques and selection of packaging material. The review details several of the recent pharmaceutical packaging trends that are impacting packaging industry, and offers some predictions for the future.
230 PAEDIATRIC SPECIFICITIES OF A RADIOLOGY DEPARTMENT: CASE OF THE GYNAECO-OBSTETRICS AND PAEDIATRIC HOSPITAL OF YAOUNDÉ (GOPHY). , Elsa Brenda Masso Waffo, Serge Honoré Tchoukoua, Anselme Michel Yawat Djogang*, Roméo Talla Fogang, Steve Yannick Ngounou, Diane Mirianne Kapche Fotso, Stève Carole Ditchou Nganso, Pierre René Fotsing Kwetché and Boniface Moifo
Paediatric radiology should be regarded as a specific domain in health management and not as adaptations of practices and materials from adults’. In that, paediatric environment and protocols should be adapted accordingly to enable optimal output in the sector with minimal irradiation. The general objective of the present study was to assess the paediatric peculiarities of the radiology department at the Gynaecological Obstetric and Paediatric Hospital in Yaoundé. A descriptive cross-sectional and analytical study was conducted from October 8th through to November 8th, 2018. Data related to the paediatric peculiarities of the service recorded with questionnaires and observation sheet, then analysed with the EPI Info. Data analysis highlighted a non-conformity of the environmental specificities and the absence of the material. These gaps had high impacts on the daily practice, notably the stress in children characterized by cries and agitation in the examination room, causes for long duration of the examinations and additional irradiation. Developing a room dedicated to paediatric radiography, associating a children playground to the service and acquiring restraint equipment would significantly contribute to improved quality results and safer practices in paediatric radiography at the Yaoundé’s Gynaecological Obstetrics and Paediatric Hospital.
231 PATIENT SATISFACTION WITH SERVICES IN IBN SINA TEACHING HOSPITAL , *Mojahid K.S Alshammaa, Ikram MT Abdulrahman Algadanfary and Hameed MF Altaie
Background: Patient‘ satisfaction represents a good monitoring of the quality of health care delivery and this internationally accepted factor needs to be studied repeatedly for smooth working of the health care systems. Objectives; This study aims to identify the level of quality of health services provided by the health departments in Ibn Sina Teaching Hospital in Mosul and the extent of satisfaction of patients by revealing the dimensions and criteria used to evaluate them. Methodology; The study was a cross-sectional facility-based, the sample comprised 600 patients, and questionnaire in the form of (I agree, I do not know, I disagree) applied to 100 patients lying in the hospital and 100 patients referring to outpatients, from late 6 months of 2018 and two periods, each of 6 months (early 6 months and late 6 months) of 2019, we applied SPSS program for statistics and one way anova kruskal-willis test for analysis. Results: The results in general, showed an improvement in some services, such as the availability of medicines, laboratory and radiology services, while there was no improvement in some of them, such as drinking water. Conclusion: The doctors and nurses performed well over the three periods, while the services provided to the patients improved and other services showed no improvement.
232 A PRE-EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING PARTOGRAPH AMONG NURSING STUDENTS IN SELECTED NURSING COLLEGES OF DISTRICT LUDHIANA, PUNJAB , Kaur Karamjit* and Bhatia Anmol
Introduction:- “A woman, as long as she lives, will remember how she was made to feel at her birth.” Partograph is the part of the Midwifery tool of practice used every day, it is the management tool for the prevention of prolonged labor. The use of a Partograph for the management of labor has been shown to be beneficial in that it clearly differentiates normal from abnormal progress in labor and intervention. Aim:- The Aim of study was To assess knowledge score of nursing students regarding partograph and To compare pre-test & post-test knowledge score by using STRUCTURED TEACHING PLAN among nursing students studying in selected nursing college of district Ludhiana, Punjab. Material and Methods:- Pre-experimental design was selected to carry out the study and data was collected by using purposive sampling technique. Study was carried out on 60 B.Sc. (N) 4th year and GNM interns studying in Kular College of Nursing Kishangarh, Ludhiana in which pre-test was done and post-test was conducted followed by administration of STP. Results:- results reveals that mean difference of Pretest and Posttest was 11.13 and Calculated t value is 11.77 at 59 df i.e. higher than tabulated value. This was found to be statistically significant. It shows that research hypothesis was accepted. Conclusion:- Hence it has been concluded that structured teaching programme was effective as significant mean difference of 11.13 has been computed in pre-test and post-test knowledge score. There is no relationship found between knowledge score and selected sociodemographic variables.
233 MONITORING OF HEAVY METAL IMPACTS BY SMALL MAMMALS , Mojtaba Zamani*, Tahereh Batyari, Fariba Abdolrahmani and Mohammad Rashidi
Environment is continuously polluted with various environmental chemicals, released by anthropogenic activities. Therefore, many species and human communities are exposed to a different contaminant such as heavy metals which lead to adverse health effects in both human and other animals. Over the last decades the production of heavy metals in the world areas substantially increased and the subsequent release of these metals into the environment is of some concern. Acute and chronic effects of heavy metals have been reported on different ecosystems and organisms. Protection of human health and the environment from different pollutants such as heavy metals will be resulted by performing environmental monitoring. Bio-indicator species can provide useful information to monitor the quality of the environment, in particular polluted environment. The distributions of heavy metals in the polluted areas are well reflected in the body of small mammals living in the contaminated areas. Small mammals like rodents have interesting features make them popular as a bio-indicator species in different studies. Therefore, small mammals are suggested to apply in monitoring of heavy metals due to large population, wide distribution, and similarity to human in terms of habitat and internal organs, short life spans, and many other characteristics.
234 STUDY OF DRUG USE PATTERN IN GERIATRIC PATIENTS IN A TERTIARY CARE TEACHING HOSPITAL- A PROSPECTIVE & OBSERVATIONAL STUDY , Manjula G, Bhanu LP*, Kishore KV, Joel K, Sravan S, Priyank T, Kumaraswamy M
Geriatrics is the branch of medicine that deals with the problems and diseases of old age and aging people. Indian elderly constitute 12.8% of the global elderly population. The elderly usually have multiple medical problems, requiring prescription drugs to treat diseases and to prevent complications arising from them. The elderly use more medications than any other age group. This high rate of drug use has been attributed in part to the accumulation of disease with ageing. Objective: Thus the current study aimed to assess the drug use pattern in elderly by understanding age-related changes in pharmacodynamics and pharmacokinetics factors which helps to achieve better health care. Method: This was a prospective and observational study conducted over a period of 6 months from January 2013 to June 2013 by using a well designed and validated patient data collection form to collect the study data. Result: The number of drugs prescribed during this study was 1-2 number of drugs (0.0%), 3-5 number of drugs (22 patients i.e., 24.4%), 6-10 number of drugs (56 patients 62.2%) and >10 number of drugs (12 patients i.e., 13.3%). Conclusion: The current study concluded with an association between the practice of polypharmacy and drug-related problems mainly ADRs and Drug interactions. Clinical pharmacist intervention can help the prescriber in selecting a regimen which contains a lesser number of drugs to prevent the occurrence of drug-related problems.
235 A SURVEY ON COMMON BELIEFS ON NUTRITION THERAPY AND ITS TREATMENT AMONG PEOPLE WITH DIABETES , Deepthi S.*, Shilpa C. and Dr. R Anil Kumar
Medical nutritional therapy in Diabetes is influenced by many beliefs. The study intended to find out the common beliefs followed by individuals with diabetes and to understand the difference of opinion in belief by urban and rural population. A cross sectional study was conducted in KIER Campus involving 200 randomly selected people aged between 21 to 80 years with Diabetes using questionnaire method. The total number of 21 beliefs were identified and analyzed. The belief related to skipping of prescribed anti-diabetic medication which they take regularly on the day of blood test was significantly higher (P=0.007). The participants expressed highest belief related to consumption fruit juices without adding sugar (Mean = 3.57±1.44). The lowest belief was seen in belief related non vegetarian food consumption (Mean value: 2.16±1.16) The respondents belonging to urban population expressed highest belief related to overconsumption of sugar (percentage =62) and the lowest belief related to non-vegetarian food consumption (percentage = 33) The respondents belonging to rural population expressed highest belief related to non-vegetarian food consumption (percentage = 67) and lowest belief related to overconsumption of sugar (percentage = 33):The study concludes that common beliefs which may not be scientifically proven is wide spread irrespective of education and socio-economic status in the study population which calls for a proper address from medical team by educating people in a right path. Educating common people through counselling and handing over printed materials can be considered.
236 NUTRITIONAL ASSESSMENT OF ELDERLY WITH DIABETES VISITING KARNATAKA INSTITUTE OF ENDOCRINOLOGY AND RESEARCH USING MINI NUTRITIONAL ASSESSMENT. , Shilpa C. Parihar*, Deepthi S., Dr. Anil Kumar R.
Malnutrition in the elderly is an under recognized condition that is increasing in prevalence as the population ages. Older adults are more likely to have chronic conditions like diabetes, cardiovascular diseases and cancer, which further puts them at risk of malnutrition and increases the frequency of hospitalization. If identified early, malnutrition can be treated with proper adherence to a nutritional intervention plan. In this present study, 75 elderly aged 65 years and above with diabetes were selected as participants from the outpatient department of Karnataka Institute of Endocrinology and Research, Bangalore. Nutritional status was assessed using Mini Nutritional Assessment tool (MNA). The findings showed that 84% (63) of people were normal, 16% (12) were at risk of malnutrition and none of them were malnourished. Early recognition and treatment of malnutrition are not only beneficial for the people’s health but can reduce overall cost to the healthcare system.
237 A REVIEW ON COVID 19: RESPONSIBLE FOR WORLDWIDE PANDEMIC , Deshpande M. M.*, Khandge N. T. and Chavan M. J.
This review aims to introduce the general information about the Coronaviruses and ongoing pandemic of Coronavirus Disease 2019. From the early 1960’s the different Coronaviruses species was introduced in the human population that cause mild to moderate respiratory diseases. Coronaviruses are a large family of viruses named for their shape protruding spikes that look like a crown. It belongs to the family Coronaviridae and is enveloped with lipid bilayer. From the multiple copies of nucleocapsid (N) protein nucleocapsid is formed which is present inside the envelope. The first case of Novel Coronavirus was reported in Wuhan, Hubei province, China in December 2019 and it was declared the outbreak a public health emergency of International concern by the World Health Organization on 30 January 2020 and declared as pandemic on 11 March 2020. COVID-19 can cause flu-like symptoms that range from mild to severe including cough, fever, and shortness of breathing.
238 ELECTROCARDIOGRAM CHANGES IN PATIENTS WITH ACUTE STROKE IN THE EMERGENCY DEPARTMENT OF BAGHDAD TEACHING HOSPITAL , Bilal Nawfal Abdula, Jawad Ibrahim Rasheed, Fadil Ogla Bonyan, Asaad Abdullah Abbas and Laith G. Shareef*
Strokes are a syndrome of rapidly developing clinical symptoms and signs of focal (or at times global) disturbance of cerebral function enduring more than 24 hours (unless interrupted by surgery or death), with no apparent cause other than of vascular origin. The majority are ischemic, secondary to arterial occlusion by in-situ thrombus or embolus, with the remainder being due to intracerebral haemorrhage or subarachnoid haemorrhage. The electro cardiac irregularities subsequent acute stroke are common and seen in both ischemic and hemorrhagic stroke. This research aims to find the relation of the Electrocardiogram (ECG) changes in patients with acute stroke and its pattern. A cross-sectional study conducted in the emergency department of Baghdad teaching hospital in Baghdad City/Iraq. Purposing sampling adopted, and the sample size were=100 patients. The central part of the sample was male 64. About half of them were 55–64 years old. Various ECG changes observed in the present study including rhythm disturbances (like S-T Depression, T Wave Inversion, Q-T Prolongation, Sinus Tachycardia, Sinus Bradycardia, U Wave, AF etc.) in 79 patients (79%), the association of various factors with mean values with ECG changes (Mean age, BMI, DBP, RBS) was more in patients with ECG changes than patients without ECG changes. However, this difference wasn't found to be statistically significant.
239 THE ROLE AND IMPORTANCE OF AN ELECTROCARDIOGRAM TO REFLECT THE POTASSIUM LEVEL IN DIABETIC KETOACIDOSIS PATIENTS , Mohammed Husam Sadeq, Omar Farooq Al-Azzawi, Fadil Agla Bonyan Asaad Abdullah Abbas and Laith G. Shareef*
Diabetic ketoacidosis is a common cause of morbidity and mortality in the emergency department of Iraqi hospitals. Electrolyte disturbances are frequently accompanying diabetic ketoacidosis, specifically hyper and hypokalemia. Electrocardiography is an easy and available tool for early identification of these electrolyte disturbances. Aim of the study is to assess the role and importance of ECG monitor, which is a simple, quick, non-invasive and readily available tool in the diagnosis and confirmation of hypokalemia and hyperkalemia in patients with DKA in the Emergency Department. A cross-sectional study conducted in the Baghdad Teaching Hospital- Medical Complex Baghdad city /Emergency Department. The duration of the study was through six months from the 1st of January to the 30th of June 2019 on a sample of 88 DKA patients. Interpretation of the ECG was made by the supervisor, the researcher and the physicians in the emergency department. Results: Prevalence of hypokalemia among DKA patients was 75%. Significant ECG changes associated with hypokalemia among DKA patients were prolonged QT interval, flat T wave, U wave and ST depression. A highly significant association was observed between female gender DKA patients and hypokalemia (p<0.001). Mean random blood sugar of DKA patients with hypokalemia was significantly higher than the RBS mean of DKA patients with average K+ level (p<0.001). Mean blood PH of DKA patients with hypokalemia was significantly lower than blood PH mean of DKA patients with normal K+ level (p<0.001).
240 AN APPRAISAL ON AYURVEDA PERCEPTIONS OF FETAL DEVELOPMENT – A LITERARY REVIEW , Dr. Madhuri P. Koche*, Dr. Arpita Shah
Fetal development is the most crucial phase of life. It is the foundation for entire lifespan. Ayurveda is the holistic science and Ayurveda principles have great emphasis over healthy progeny. Many new investigation tools have evolved due to tremendous development in health science so, it has become very easy to get idea about fetal development but in ancient era there were no such techniques; still the description found in Ayurveda treatise is very scientific and somewhat similar to modern science. Acharyas have given a very detailed explanation of per month fetal development.physican and mental both the aspects are described in a scientific manner.So, here an effort has been done to write about Ayurveda perceptions of fetal development.
241 A CRITICAL EVALUATION ON THE ROLE OF MANASIKABHAVA IN THE ETIOPATOGENESIS OF GRAHANI -"AN OBSERVATION STUDY" , Dr. Vinuta Patil*, Dr. Venkatesha S. and Dr. M. Subhash Chandra Bose
Ayurveda explains about both Shareera and Manas concept, If both these are in healthy state the person is said to be Swastha, the Shreera and Manas are interrelated each other .Health is defined as equilibrium of Tridosha, Dhatu, Agni, Mala, Prasannatma, Indriya and Manas.[1] Ayurveda explains about both Shareera and Manas concept, If both these are in healthy state the person is said to be Swastha, The Shreera and Manas are interrelated each other .Grahani as a Tridoshatmaka disorder of digestive system which occurs due to vitiation of Agni.[2] Grahani is the seat of Agni. Grahani and Agni are having Ashraya –Ashrayi Sambanda. When Agni is vitiated Grahani will also be vitiated.[3] Impaired Agni is responsible for the causation of Grahani Dosha. Present lifestyle and unhealthy habits like irregular eating, intake of unwholesome heavy, cold, adulterated food, improper sleep causes indigestion.[4] Improper digestion also occurs due to altered emotional factors like Bhaya, Chinta, Shoka, Kroda which leads to Agni Dushti.[5] Manas and Agni are both Satwa Pradhana these both are interrelated each other state of normal and abnormal conditions. As said earlier Agni Dushti plays a major role in the Grahani and Manasikabhava have a direct impact on Agni Dushti.  
242 EFFECTS OF THERMAL PROCESSING ON FATTY ACIDS PROFILE OF WILD RED MULLET (MULLUS SURMULETUS) FROM THE MEDITERRANEAN SEA COAST OF SYRIA , Rahaf Akel*, Anwar Al-haj Ali, Moufid Yassin
Lipid, moisture and fatty acids profile of wild Red Mullet (Mullus Surmuletus) from Mediterranean Sea (Banias City - Syria) were investigated before and after (deep frying in Sunflower oil, grilling, roasting) to detect the effects of different thermal treatments on fatty acids profile especially Docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA). samples were collected in autumn of 2019 – 2020 and analyzed by Gas Chromatography GC-FID. The results revealed significant differences between control and all heat treatments in both EPA and DHA levels (p.value < 0.05). The average of EPA and DHA estimated by g/100g of fatty acids methyl esters in control samples were 5.80 and 17.88, respectively. Frying process revealed a remarkable decrease in these two fatty acids, as they were 0.63 and 0.59, respectively. The percentage of EPA and DHA in grilling were 10.12 and 6.43 while roasting came up with levels of 11.22 and 5.82 g/ 100g of fatty acids methyl esters, respectively. Both processes were companied with a significant decrease in the percentage of DHA, and with a significant increase of EPA compared with the control samples. However, no significant differences were noticed in DHA percentage between grilled and roasted samples. frying was accompanied by a significant increase in the percentage of C18:2n-6 fatty acid, reaching 59.89 compared with 1.92 for the control samples which lead to very high n6/n3 ratio equal to 45.88.However, grilling and roasting came up with 0.36 n6/n3 ratio which prove their higher nutritional value comparing with frying.
243 EFFECTIVENESS OF BASIC LIFE SUPPORT (BLS) TRAINING ON THE KNOWLEDGE AND SKILLS OF HIGH SCHOOL STUDENTS IN PROVIDING ASSISTANCE TO CARDIAC ARREST VICTIMS , Ayu Wahyuni Lestari* and Zulkarnain
Background: In improving health development the main part is in emergency services. In order to realize the improvement of the quality of services in the treatment of victims or emergency patients is necessary a system of victim care that is carried out in an integrated and integrated manner by engaging several parties because it does not cover the possibility of emergency conditions can occur in areas that are difficult to reach health workers, then in those conditions, the role of the community to help victims before being found by health officials becomes very important. Pulmonary cardiac resuscitation is one of a series of life-saving measures to improve the survival rate of sudden cardiac arrest patients. Objective: The purpose of this research is to find out the effectiveness of BLS training on the knowledge and skills of high school students in providing assistance to cardiac arrest victims. Methods: This study used quantitative pre experimental method with one group pre-post test design. The sampling technique uses simple random sampling technique with a number of samples of 30 respondents. Data collection techniques using paired t-test. Result: The average value of knowledge obtained by respondents before being given training is 1,2667 ± 0,44978 and the average value of knowledge after training is 2,5000 ± 0,68229. The average value of skills obtained by respondents before being given training is 1,1333 ± 0,34575 and the average value of skills after being given training is 2,3667 ± 0,71840. The results of the Wilcoxon Signed Rank Test on the knowledge variable obtained a value of Z of -4,604 with p value = 0,000 and in the skill variable obtained an Z value of -4,344 with p value 0,000. This shows there is a significant influence between BLS training and the knowledge and skills of high school students in providing assistance to cardiac arrest victims. Conclusion: There is an influence of basic life support training on the knowledge and skills of high school students in providing assistance to cardiac arrest victims.
244 ANAEMIA AMONG TERM PREGNANT WOMEN ATTENDING LABOUR UNITS IN TWO MATERNITY HOSPITALS IN MOSUL , Dr. Ruqayah Y. Hasani*, Sedra A. Alnuamy and Duaa I. Al Ahmed
Background: Anemia is one of the most common nutritional deficiency diseases observed globally, the problem is more prevalent among pregnant women and contributes to maternal morbidity and mortality, as well as to low birth weight. Objective: The aim of the present study is to estimate the frequency of anaemia among full term pregnant women attending labour units in two Mosul maternity hospitals. Method and Material: A case series study design which was adopted included 400 full term pregnant women that were taken from both attendance of AL-Batool and AL-Khansaa Teaching Hospitals. A special questionnaire form was prepared using simplified and summarized questions. Data collection started on the 1st of January 2012 and ended on 1st of July 2012. Results: The study results showed that 42.25% of sample were anaemic, majority of them had mild grade of anaemia. Pregnant women with a mean age of 28.17±5.57 years. Primary school educated and illiterate women were highly and significantly observed in anaemic group. It was seen also that 94.25% of women in the sample were taken iron supplement even one time, but only 45.36% of them take supplement on regular basis. Those on regular usage high significant less frequently observed in anaemic group .Pica appeared in 13.75% of studied women where they were more frequently seen in anaemic group. Conclusion: There were 42.75% of full term pregnant women were anaemic, majority (98.22%) had mild grade, no detection of severe grade. Illiterate women more frequently among anaemic group. Employed and urban residing women less frequently among anaemic group. Screening for anaemia in antenatal care was done only in 42.75% of pregnant women.
245 COMPARISON OF PLATELET AGGREGATION RESPONSE IN TYPE 2 DIABETES AND NORMAL SUBJECTS , *Dr. R. Anil Kumar MD, WHO Fellowship in Diabetology. FICP, FCCP
Aims and objectives- To compare the platelet aggregation response in type 2 diabetes subjects and normal subjects. Research methods- 80 subjects with type 2 Diabetes Mellitus and 40 normal subjects were randomly selected. FPG, PPPG, HBA1c and platelet aggregation response were studied. Results - The mean age was 52.16±11.28 in the case group and 41.4±10.43 in the control group. There were 50 and 21 number of male subjects and 30 and 19 number of female subjects in the case and control group respectively. The mean fasting plasma glucose was 150.08±54.52 and 88.70±13.36 in the case and control group respectively. The mean post prandial plasma glucose was 233.98±82.99 and 129.95±15.27, mean HBA1c was 8.08±1.84 and 5.50±.42 in the case and control group respectively. The duration of diabetes ranged from newly detected diabetics to those with disease duration of more than 10 years. Platelet aggregation responses to ADP and epinephrine were measured and results were recorded as percentage for both groups. The difference between the case and control groups in the platelet aggregation responses induced was statistically insignificant. Conclusions- The platelet aggregation responses induced by ADP and epinephrine were similar in type 2 diabetes and normal subjects. So the routine use of anti platelet agents may not be necessary in all type 2 diabetes subjects for primary prevention of cardiovascular diseases. Anti platelet drugs can be used in secondary prevention and high risk patients. This is a small study done in a single centre. So a large multicentre study is necessary to prove this.
246 A REVIEW OF ANTI-DIABETIC ACTIVITY OF TWO MEDICINAL PLANTS USED TRADITIONALLY IN THE MANAGEMENT OF DIABETES MELLITUS FROM THE NORTH EASTERN STATE OF ASSAM, INDIA , Dr. Munmee Das*, Dr. Bishnu Prasad Sarma and Dr. Shubhabrata Das
Diabetes considered as the epidemic of the century, is one of the most challenging global public health threats the world is facing. And India has emerged as one of the epicenters of the diabetes mellitus epidemic as the number of people with diabetes is around 65.0 million in 2016. Type II diabetes is a complex disease to treat and because of the unique challenges in the management of type II diabetes, a renewed interest is being seen globally in traditional medicine including various local health traditions (LHT). Several of indigenous Indian medicinal plants have been found to be effective in the management of diabetes. Dillenia indica and Phlogacanthus thyrsiflorus are two of the traditionally used anti diabetic medicinal plants from north eastern state of Assam,India. The present review explored and consolidated information on the anti diabetic therapeutic potential of Dillenia indica and Phlogacanthus thyrsiflorus. Method: An extensive and relevant literature on the anti diabetic activities of Dillenia indica and Phlogacanthus thyrsiflorus were gathered through search of electronic databases including Goggle scholar, Pubmed and Medline. Results and conclusion: The review demonstrated that Dillenia indica has shown promising effects in controlling hyperglycemia and in control of diabetes-associated complications including diabetic neuropathy and diabetic nephropathy. In case of Phlogacanthus thyrsiflorus only few limited studies are available and these studies have reported good hypoglycemic activities. Considering the results of previous studies Phlogacanthus species warrant further studies on its anti diabetic therapeutic potential.
247 COVID-19 PANDEMIC AND EFFECT OF DELAYED SURGICAL RESPONSE , Dr. Usmani M. S., Khatoon A. and Saad A.*
Objective: To determine the effect of delayed surgical response during COVID19 pandemic. Methodology: This was a case series performed in Hanif hospital Karachi, Pakistan during COVID19 outbreak from 15th March 2020 till 15th May 2020 for two months. The inclusion criteria involved only emergency visceral surgeries, including either gender. The exclusion criteria involved patients with COVID positive reports, bleeding disorders. This was a probability consecutive type sampling. The sample size of the study was n=45. Result: Total 45 cases were enrolled in study. All the patients presented were mostly males i-e; 38 males and 7 females with mean age 38.31±4.38 yrs. Out of 45, Small bowel obstruction with gangrenous loop of ileum secondary to peritoneal band presented in n=4(8.9%) patients, n=9(20%) cases of perforation of appendix, n=15(33.3%) cases of typhoid perforation, n=6 (13.3%) perforated duodenal ulcer, n=9(20%) patient’s perforation of gall bladder, n=2(4.4%) cases were of Internal iliac artery ligation for severe postpartum hemorrhage. Conclusions: Increasing complications with increased morbidity especially during pandemic has affected patients physically and psychologically. Only timely intervention at this time can prevent associated morbidity.
248 THE GLOBAL IMPACTS OF COVID-19 PANDEMIC IN CURRENT ERA , Reshmina Firoz Khan, Ram P. Yadav* and Ajay Singh
The COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing pandemic of coronavirus diseases (COVID-19) caused by severe acute respiratory syndrome (SARS-CoV-2). The disease was first identified in December 2019 in Wuhan, China The outbreak was declared a Public Health Emergency of International Concern (PHEIC) in January 2020, and was recognized as a pandemic in March. As of 13 October 2020, there have been at least 1,080,682 confirmed deaths and more than 37,801,975 confirmed cases in the COVID-19 pandemic. The pandemic and response measures have contributed to social and economic rescission including the largest Global Recession since the Great Depression. Around 100 million people could fall into extreme poverty and global famines. It has led to the postponement or cancellation of events and widespread supply shortages, but also decreased emission of pollutants and greenhouse gases. Educational institutions have been partially or fully closed, with various alternatives used. Misinformation about the virus has circulated through the media. There have been many incidents of xenophobia and racism against Chinese people and against those perceived as being Chinese or as being from areas with high infection rates.
249 ISOLATED MIXED CONJUNCTIVAL HAEMANGIOMA IN A CHILD: A RARE CASE REPORT , Dr. Juhi Shahab and Dr. Sufian Zaheer*
Haemangioma is the most common benign vascular eyelid tumor in childhood.[1] It is present in 1%–4% of all births,[2] and is more common in premature infants and often following chorionic villus sampling.[3] It is usually a cutaneous, subcutaneous, or deep orbital lesion and commonly presents a few weeks after birth and shows no gender predilection in children.[3]
250 RHEUMATOLOGICAL MANIFESTATIONS SECONDARY TO SYPHILIS , *Renata Valente Lisboa, Rafael Moura De Almeida, Ivy Menezes Monteiro, Eduardo Gonçalves Teixeira and Suzana B.O. Ferraz
Syphilis is an infectious pathology caused by the bacterium Treponema pallidum, which can present different signs and symptoms, including the mimicry of other diseases. This infection has increased in incidence since the 1980s, and this fact is related to risk behaviors and the diagnostic evolution of medical practice. This article portrays the case of a 50-year-old patient with fever, purpuric lesion in the lower limbs and bilateral inflammatory low back pain, without other symptoms that suggested an infectious focus. The biopsy of the lesion in the lower limbs revealed findings compatible with leukocytoclastic vasculitis, the performance of a lumbosacral spine tomography revealed bilateral sacroiliitis and the serum evaluation documented syphilis infection, with this clinical presentation described with resolution with the relevant antibiotic administration.
251 A STUDY ON CLINICAL SCENARIO AND MANAGEMENT OF VARICOSE VEINS , Dr. K. Sridharan M. S.*
Introduction: The varicose veins is the most common vascular disorder of the lower extremities. It affects more than 5 % of adult population but in India incidence of varicose veins seems to be far less common because patients come for complications such as pain, oedema, pigmentation and ulceration leading to tip of Iceberg phenomenon. This study will help in finding epidemiology, mode of presentation and effect of surgery on venous ulcers and recurrence. Hence based on this aim of our research is to study the incidence of varicose veins according to age, sex and occupation, to study spectrum of clinical presentation in varicose veins, to study effect of surgery in healing of varicose ulcers if present and also to observe the recurrence upto 6 months Material and Methods: This prospective study involved 50 patients admitted to surgical wad in Government district headquarters hospital, Krishnagiri with varicose veins. The study period was 12 months inclusive of a 6 month follow up period. Patients were evaluated and followed up according to a protocol. Observation and Results: Most patients was between 41 to 50 yrs (26 %.), males (74%), left side involvement in (70%) and farmer by occupation (40%) with pain as most common presenting symptom in (76%). Long saphenous system involvement in (94%). 6 patients out of 50 showed recurrence of varicose veins. 4 patient showed recurrence out of 21 venous ulcer patients. Conclusion: For varicose veins saphenofemoral junction ligation with stripping of vein with perforator ligation showed good outcome. Venous ulcers heal well after surgery with few recurrences.
252 PREGNANT WOMEN’S PERCEPTION OF EQUITABILITY, EFFICIENCY AND PEOPLE-CENTEREDNESS OF ANTENATAL SERVICES PROVIDED BY MIDWIVES, AND THE ASSOCIATIONS BETWEEN THEIR PERCEPTIONS AND SATISFACTION WITH THE SERVICES , Kanikwu Phoebe Nwamaka and *Chiejina Edith Nkechi
Background: Pregnant women’s experiences with the care they receive influence their perceptions and compliance with the care. Assessing Pregnant women’s perception of the care they receive and their satisfaction with the care, can expose the lapses in the quality of antenatal services and necessitate improvement in the services provided by the midwives. Objectives: The objectives of this study were to determine the perception of pregnant women about the equitability, efficiency and people-centeredness of the antenatal services provided by midwives, and the associations between their perceptions and satisfaction with the services in government-owned health care facilities in South-South, Nigeria. Materials and Methods: The study was a cross sectional survey research design carried out in the antenatal clinics of 30 government-owned health facilities in the South-South geopolitical zone of Nigeria. A total of 1500 respondents were selected for the study using multi-stage sampling technique. Questionnaire on Equitability, Efficiency and People-Centeredness of the Antenatal Services Provided by Midwives and Patient Satisfaction Questionnaire were the instruments used for data collection. The reliability of the instruments were established through the test-retest method using Cronbach’s Alpha which yielded co-efficients of 0.806 and 0.709 respectively. Data collected were analyzed using frequencies, percentages, mean and Factorial Analysis of Variance to determine the objectives of the study. Results: The result showed means of 3.67±1.19, 3.89±0.98, 3.52±1.24, for pregnant women’s perceived equitability, efficiency and people-centeredness respectively of the antenatal services provided by midwives. There were significant associations between the satisfaction expressed by pregnant women and their perceived equitability (F = 25.267, p-value=0.000), perceived efficiency (F = 8.501, p-value = 0.000) and perceived people-centeredness (F= 18.763,p-value= 0.000) of antenatal services provided by midwives. Conclusion: Pregnant women had positive perception about the equitability, efficiency and people-centeredness of the antenatal services provided by midwives in health care facilities in South-South Nigeria. Midwives in government-owned health care facilities should organize regular forum with their clients to get feedback from pregnant women regarding their perceptions of the antenatal services provided by midwives.
253 MULTIMEDIA-BASED PRESENTATIONS VERSUS DIDACTIC SESSIONS FOR PICC MANAGEMENT COMPREHENSION IMPROVEMENT IN CANCER PATIENTS: A META-ANALYSIS , Kija Malale*, James Samwel Mundamshimu, Magwa Kiyumbi
Background: It has always been a controversial issue to meet the educational needs of cancer patients living in peripherally inserted central catheter (PICC) by traditional didactic approach. In recent years, some scholars have proposed multimedia-based teaching approaches. However, the potential effectiveness of these approaches is still not reliable in the literature. Objective: This study evaluated the efficacy of multimedia-based presentations on improving the comprehension of PICC management in cancer patients. This study evaluated the efficacy of multimedia-based presentations on improving the comprehension of PICC management in cancer patients. Methods: Systematic searches of the PubMed, Cochrane Library, Embase Ovid, Medline, BioMed Central-cancer (BMC-cancer), ScienceDirect and Google Scholar databases without date constraints till May 31, 2020 were performed. The methodological quality of the eligible studies was appraised by using the Cochrane risk of bias tools. Meta-analysis methods were used to synthesize study results. Results: A total of 4 intervention studies met the inclusion criteria, including three randomized controlled trials and a quasi-experimental study. All studies included 314 subjects, including 151 in the multimedia group and 163 in the control group. The findings demonstrated that the overall comprehension score of the multimedia group was significantly improved after the intervention compared with the baseline data. However, compared with face-to-face interviews or face-to-face interviews plus brochures, multimedia-based presentations had no superiority in improving patients' comprehension. Conclusion: The findings suggest that multimedia-based presentations can be used as an alternative to face-face interviews or face-face interviews plus brochures to educate cancer patients about PICC management.
254 SURGICAL TREATMENT OF TALUS FRACTURES: ANATOMIC AND FUNCTIONAL RESULTS , Charaf Eddine Elkassimi*, Boubker Messoudi, Mohammed Rafai, Abderrahim Rafaoui and Abdelhak Garch
Fractures of the talus are rare and serious and represent a therapeutic challenge for the surgeon. We report a retrospective study of 16 cases of talar fractures treated surgically over a period of 6 years. The objective of our work is to show the peculiarities of this fracture and to report the anatomical and functional results of our study in order to establish therapeutic conclusions. The approach was anterointernal in 75% of cases. The overall results were excellent in 31% of the cases. Complications from these fractures are dominated by bone necrosis and osteoarthritis.
255 PERINEURAL VERSUS INTRAVENOUS DEXAMETHASONE AS AN ADJUVANT FOR PERIPHERAL NERVE BLOCK: A PROSPECTIVE STUDY CONDUCTED IN A TERTIARY CARE INSTITUTION IN SOUTH INDIA , Dr. Naresh Kumar R. and Dr. Rajanbabu P. K.*
Perineural dexamethasone appears to prolong the duration of analgesia after brachial plexus block when combined with local anaesthetics. Several studies have compared intravenous with perineural dexamethasone in upper extremity surgeries, however there is concern regarding potential neural toxicity of perineural dexamethasone; Therefore we aimed to find out whether intravenous dexamethasone compared to perineural dexamethasone had similar or superior effects in prolonging the duration of nerve block, as adjuvant to local anaesthetic brachial plexus block. This randomized, prospective observational study was conducted on 222 patients,in govt.medical college hospital, thiruvananthapuram, posted for upperlimb forearm surgeries under supraclavicular brachial plexus block with duration of analgesia as the primary outcome. The Study period was from December 2016 to June 2018 (1.5 years) after getting clearance from Institutional Ethics Committee and study duration was 1 ½ years. Analysis was done using Excel 2007 worksheet and SPSS 16 statistical software Qualitative data were expressed in proportion and percentage. Quantitative data expressed as mean and SD. Bivariable analysis was done using students t-test and chi-square test. The supraclavicular block lasted significantly longer in patients who received intravenous dexamethasone compared with perineural dexamethasone (p=0.001).With respect to secondary outcomes, there was a reduction in total post operative morphine equivalent administration in perineural dexamethasone compared with intravenous dexamethasone (p = 0.002).We have concluded that 8 mg of intravenous dexamethasone extended the duration of analgesia and reduced pain scores. We suggest that intravenous dexamethasone be preferred, as its use is licensed and the possibility of neurotoxicty is avoided.
256 INFLUENCE OF GSTP1 Ile105Val POLYMORPHISM AND PROTEIN EXPRESSION ON CLINICAL OUTCOME IN PATIENTS WITH COLORECTAL CANCER , Dr. Kinjal K. Gajjar, Dr. Toral P. Kobawala, Dr. Hemangini H. Vora and Dr. Nandita R. Ghosh*
Background: GSTP1 plays a central role in the inactivation of toxic and carcinogenic electrophiles, including platinum compounds. In colorectal cancer (CRC) patients treated with oxaliplatin-based therapy, GSTP1 polymorphism and protein expression found to play significant correlation with prognosis but showed conflicting results. Present study assessed the association of GSTP1 Ile105Val polymorphism and protein expression with survival as well as clinicopathological parameters in CRC patients. Materials and Methods: GSTP1 polymorphism was examined by PCR-RFLP and protein expression was studied by immunohistochemistry in 143 untreated CRC patients. Results: GSTP1 Ile105Val polymorphism showed 51% A/A wild type, 42% A/G heterozygous and 7% G/G variant genotypes. Significant association of GSTP1 polymorphism was noted with family history (P=0.020) and tumor site (P=0.036). Variant G/G genotype was associated with unfavorable prognosis in total CRC, advanced stage and rectal cancer patients. The subgroup of patients having variant genotypes treated with combined 5-FU/oxaliplatin drug had a significant higher incidence of disease relapse and death as compared to those treated with single 5-FU drug. In relation to protein expression, GSTP1 cytoplasmic and/or nuclear immunoreactivity was noted in 95% CRC patients. Cytoplasmic GSTP1 expression was significantly associated with age (P=0.042) and histologic type (P=0.017). Low cytoplasmic as well as low nuclear GSTP1 expression correlated with worse survival in early stage, whereas showed better prognosis in advanced stage patients. Conclusion: GSTP1 Ile105Val polymorphism as well as its protein expression could be useful prognostic biomarkers in CRC patients.
257 THE EFFECT OF AGE, PARITY, AND INCOME ON LOW BIRTH WEIGHT (LBW) IN BONDOWOSO, EAST JAVA, INDONESIA , Sherly Indira Purnama Dewi*, Isa Ma’rufi, Ristya Widi Endah Yani
Low Birth Weight (LBW) is the strongest predictor of mortality in the first few months of life and is a major determinant of mortality, morbidity and disability in infancy and childhood. Until now, low birth weight is still a public health problem in many countries, because it is considered to be one of the factors causing infant mortality. Some of the factors that influence the occurrence of LBW are the socio-demographic characteristics of the mother (age less than 20 and more than 34 years old), socioeconomic status, education level. Maternal medical risks before pregnancy also play a role in the incidence of LBW including maternal parity, maternal weight gain during pregnancy, whether or not she has delivered a baby with LBW, and birth spacing. The reproductive health status of the mother at risk of LBW includes the nutritional status of the mother during pregnancy, the status of antenatal care includes the frequency and quality of antenatal care, the health worker at the place for pregnancy examination, the age of the womb at the first pregnancy check-up can also be at risk of giving birth to LBW (Sistriani, 2008). This study aims to analyze the effect of age, parity and income on the incidence of low birth weight in Bondowoso Regency, East Java, Indonesia. This research is categorized into quantitative research using a case control approach, while data analysis uses bivariate data analysis with logistic regression analysis. The research sample was taken by cluster random sampling as many as 192 respondents. The results of data analysis showed the parity variable, and the income showed a value of p <0.05 so that the two variables had an effect on the incidence of LBW.
258 A PROSPECTIVE STUDY OF ADVERSE DRUG REACTIONS AND DRUG UTILIZATION PATTERN IN DERMATOLOGY DEPARTMENT , *Dr. J. Femi Retna and Dr. Amudavalli K.
Introduction: Dermatological diseases are long-lasting in nature and they need lifelong treatment mostly. Prescription pattern echoes dermatologists‟ attitude towards the disease and part of drugs in its treatment. Hence the study of drug utilization pattern and related adverse effect profile is important to make medical management balanced. Objective: To evaluate drug prescribing pattern and adverse drug reaction profile in Dermatology department of tertiary care hospital. Results: In our study 350 patient‟s treatment were analyzed which include various drugs which account for around 1408. Majority of drugs prescribed were antihistamines (25.23%), antibacterial (18%), antifungal (12%), and corticosteroids (9%). Forty patients were reported with ADR. Most of ADRs are reported with Antimicrobials & common ADR was Maculopapular rash, on severity assessment by modified Hartwig and Siegel‟s scale, out of 40 ADRs, 22 (55%) were mild, 14 (35%) were moderate and 4 (10%) were severe in nature. Based on Naranjo scale analysis 32 were possible 7 was probable and one was definite. Conclusion: The present study showed antihistaminic were commonly prescribed class & antibiotics were responsible from majority of ADR. Maculopapular rash was most common ADR.
259 CYBERCHONDRIA , Priyadarshini*, Chandrashekar M. and Dhanalakshmi N.
Internet gives verity of health information for improving the knowledge of general population, however often people misuse it for self analysis and taking treatment. The current trend is, clients access internet for health issues and they try to self diagnose, treat themselves with some medications based on the symptoms they have.Often,they tend to relate with one or the other disorder and gets worried with the acquiring illness which causes more psychological disturbance and anxiety. The client is preoccupied with acquired information and it may hinder healthy communication between patient and health professionals. This article high lights the consequences of excessive reliance of web-based contents on health.
260 PRIMARY NON-HODGKIN’S LYMPHOMA OF THYROID REPORT OF TWO CASES , Dr. Priyanka Anand*, Dr. Poonam Sahni
Primary thyroid lymphoma (PTL) is a rare entity comprising 1-5% of thyroid malignancies and 1-2% of extra nodal lymphomas.[1] Its annual incidence account for about 2 cases per million per year.[2]
261 A STUDY ON CATHETER ASSOCIATED UTI IN ICU PATIENTS IN A TERTIARY CARE HOSPITAL , Dr. D. B. Shanthi MD*
Introduction: Catheter associated urinary tract infection is an important healthcare associated infection. More than 80% of nosocomial UTIs are catheter- associated. Patients in intensive care unit have more risk of acquiring catheter associate UTI. Based on this our aim is to determine the incidence rate of symptomatic catheter associated urinary tract infection in intensive care unit set-up, to isolate the organisms involved in symptomatic catheter associated UTI, to determine the antimicrobial sensitivity pattern of the isolates. Materials & Methods: A total of 200 patients admitted in medical ICU and put on Foley’s catheter were included in the study and followed up for the development of symptomatic CAUTI. The urine samples from the catheter were collected on day 1 and then on day 3,5,7 and every weekly till the patient is in hospital. The samples were processed as per standard guidelines. Results: Total 52 patients developed Symptomatic catheter associated UTI, thereby the incidence being 26 %. Pseudomonas aeruginosa was the commonest isolate followed by Klebsiella pneumoniae, Escherichia coli, Enterococcus faecalis and Candida spp. each. High degree of antibiotic resistance was observed. On the whole the bacterial isolates were more sensitive to piperacillin-tazobactam, imipenem and meropenem. Conclusion: Development of catheter associated UTI is common in critically ill patients Emphasis should be placed on good catheter management and reducing the duration of catheterization to reduce its incidence. Knowledge of resistant pattern can help in implementing proper antibiotic therapy and infection control policy.
262 ANALYSIS OF DYSLIPIDAEMIC PATTERN OF INDIAN TYPE 2 DIABETES INDIVIDUALS USING AMERICAN DIABETES ASSOCIATION GUIDELINES , R. Anil Kumar*
Aims and Objectives-To analyse the lipid parameters of type 2 diabetes individuals not on any anti lipid drugs using American diabetes association guidelines. Methods --200 type 2 diabetes individuals attending out-patient department of Karnataka institute of endocrinology and research were randomly selected. They should not be taking any anti lipid medications. Fasting plasma glucose, post prandial plasma glucose, HBA1c, lipid profile, BMI, waist circumference and BP of these subjects were measured. Results- Diabetes subjects were in the age range of 20 to 70 years and 67.5% were males. The duration of diabetes was between new to 20 years. Family history was positive in 47% of the subjects. Hypertension was present in 37% of the subjects. LDL was <100, 100-129, 130-159, 160-189 and >190mg/dl were present in 23%, 34%, 20%, 9% and 2% of the diabetes subjects. HDL was less than 40 mg/dl in 67%, 40 to 60 mg/dl in 32.5% and more than 60 mg/dl in 0.5% of the diabetes subjects. Triglycerides were <150, 150-199, 200-499 and more than 500 mg/dl in 40%, 21.5%, 31.5% and 7% of the diabetes subjects. So the LDL and Triglyceride targets were achieved in 23%, 40% of the individuals respectively. HDL levels of 45 mg/dl in men and 55 mg/dl in women were achieved in only 12.6% and 7.7% respectively. Conclusions- The proportion of type 2 diabetes patients with lipid levels outside of clinical target values was high. Patients with established dyslipidaemia will require advice regarding diet, exercise and improvement in glycaemic control. This study suggests that an active strategy of early detection and drug treatment for dyslipidaemia is needed for 80 to 90% of type 2 diabetic patients.
263 THE ADMINISTRATION OF N-ACETYLCYSTEINE AS PREVENTION OF NEPHROPATHY IN HIGH RISK PATIENTS UNDERGOING CORONARY ANGIOGRAPHY IN TERTIARY CARE HOSPITAL, KARACHI, PAKISTAN , Dr. Syed Meerab Javed, Dr. Afifa Saulat and *Dr. Anwar Nabeel Jafri
Introduction: Contrast induced nephropathy is reported to be the third most common cause of in hospital acute kidney injury. There are enormous impacts of the development of this complication in terms of hospital stay, morbidity, mortality and long term dialysis dependence. Since there are no appropriate treatments to this complication much of the focus has been on prevention. N-acetylcysteine is one of the most common drugs used in this perspective; however, there are a number of studies with conflicting results regarding the efficacy of this compound. Hence the need to evaluate the significance of this compound in prevention of contrast induced nephropathy in our population. Objective:To determine the frequency of contrast induced nephropathy in patients undergoing coronary angiography and intervention receiving N-acetylcystein as a prophylaxis at Aga Khan University Hospital. Study design: Cross sectional study. Settings: Department of Medicine, Aga Khan University Hospital. Materisls and Methods: Patients admitted in coronary care unit, Aga Khan university Hospital, receiving N-acetylcysteine as a prophylaxis for contrast induced nephropathy before coronary angiography and intervention were included in this study provided they meet the inclusion criteria. Serum creatinine were noted at the baseline and then at 48 hours post contrast exposure. An increase of 0.5 mg/dl above the baseline creatinine was labeled as contrast induced nephropathy. Comorbid conditions including diabetes and chronic kidney disease were noted, so were the age of the patient. Results: The frequency of contrast induced nephropathy in patients receiving N-acetylcysteine as a prophylaxis for coronary angiography and intervention was found to be 19.6%. The frequency was observed to increase with increase in age of the patients, mean serum creatinine of all patients on presentation was 1.557 (+/- 0.5539) mg/dl. All of these patients received N-acetylcysteine as a prophylaxis for contrast induced nephropathy and the mean serum creatinine 48 hours post exposure to contrast was found to be 1.632 (1.2001) mg/dl. Conclusion: Prophylactic administration of N-acetylcysteine for the prevention of contrast induced nephropathy fail to show a benefit in terms of prevention of contrast induced nephropathy, since, the frequency observed in this study was significantly higher to the incidence of contrast induced nephropathy reported in the earlier studies.
264 NUTRITIONAL VALUE OF CHAPATI PRODUCED FROM THREE WHEAT VARIETIES , Hauwa Hajjagana Laminu*, Ameh Deborah O., Garald Maimuna, Nicholas Paul and Aishatu Abdullahi Shettima
Flat breads predate pan bread and its spread is universal. Chapati is the oldest and most consumed flat bread in the world which contributes to a substantial amount of dietary energy intake. The objective of this study is to determine the nutritional value of Chapati prepared from three improved varieties of wheat Atila Gan Atila, Cetia and Seri M82 produced in Maiduguri, Borno State, Nigeria. Chapatis were prepared from three varieties of wheat Atila Gan Atila, Cetia and Seri M82.Proximate composition, mineral element composition, antinutrients, in vitro carbohydrate and in vitro carbohydrate digestibilities were determined using standard laboratory procedures. All determinations were carried out in triplicates. Data obtained from the research were analysed using Analysis of Variance (ANOVA). Duncan multiple range test was used to compare the differences between the means using SPSS 11.0 software. Significance was accepted at p≤ 0.05. The results showed that the chapati prepared from Atila Gan Atila had significantly P≤0.05 higher protein (9.48±0.03%) and fiber (5.74±0.15%) contents and a significantly P≤0.05 lower metabolisable energy (347.36±0.07%) while the chapati prepared from Seri M82 had the lowest protein (7.76±0.14%) and fiber (4.56±0.03%) contents and a significantly P≤0.05 higher metabolisable energy (357.22±0.33%). All the three chapatis showed significant P≤0.05 reduction in the level of antinutrients: phytic acid and tannins. Significant P≤0.05increases in in vitro protein digestibilities and in vitro carbohydrate digestibilities were exhibited by the chapatis. Chapati prepared from the three wheat varieties did not show any significant P ˃ 0.05 difference in the levels of iron, magnesium and calcium while Atila Gan Atila chapatti exhibited the highest level of phosphorus (481.33±0.11%). The results of the sensory evaluation showed that the chapati prepared from Atila Gan Atila (7.8 ± 0.75%) was preferred followed by that produced from Cetia (5.5 ± 0.99) and Seri M82 (5.5 ± 1.34). In conclusion, the results showed that the result showed that the chapati prepared from Atila Gan Atila is superior to that prepared from Cetia and Seri M82.
265 ROLE OF TECHNICAL, BEHAVIORAL, AND ORGANIZATIONAL FACTORS IN PERFORMANCE OF THE DISTRICT HEALTH INFORMATION SYSTEM IN DISTRICT NOWSHERA, PAKISTAN , *Prof. Dr. Rab Nawaz, Prof. Dr. Shahzad Ali Khan, Prof. Dr. Shafiq ur Rahman, Dr. Shah Nawaz Dr. Tayyaba and Dr. Fatima Nasir
Objective: To assess the role of technical, behavior, and organizational factors in performance of the District Health Information System in the district Nowshera, Pakistan. Methodology: The study was conducted at district Nowshera, Khyber Pakhtun, Pakistan between the years 2015 and 2016. The questionnaire called Organizational and Behavior Assessment Tool (OBAT) has been modified and applied to gather data from the health care providers who were involved in the District Health Information System in District Nowshera. The SPSS version 25 was used to enter and analyze the data. Results were presented in tabular form. Results: The score on punctuality of staff was 1.7 while on the record keeping by staff it was 2.37. When asked if staff can develop appropriate criteria for selecting interventions for a given problem, develop appropriate outcomes for a particular intervention, evaluate whether the targets or outcomes have been achieved, the scores were 2.33, 2.07, and 1.93 respectively. The mean scores for self-efficacy items, "I can explain findings & their implications" and "I can use data for making various types of decisions and providing feedback" were 1.67 each. Conclusion: The main issues were lack of enthusiasm about the job, inability to understand the significance of the HIS, lack of proper skills to decrypt data or findings, and uncooperative attitude of the authorities. It should be noted that adequate leadership, appreciative attitude,regular training and practice can help make DHIS a more efficient system.
266 CHEMICAL ENGINEERING IN HUMAN BODY FLOWS THROUGH ION CHANNEL , *Kushal Nandi, Dr. Dhrubo Jyoti Sen, Dr. Dhananjoy Saha, Dr. Sampa Dhabal and Dr. Beduin Mahanti
Ion channels are pore–forming membrane proteins that allow ions to pass through the channel pore. Their functions include establishing a resting membrane potential, shaping action potentials and other electrical signals by gating the flow of ions across the cell membrane, controlling the flow of ions across secretory and epithelial cells, and regulating cell volume. Ion channels are present in the membranes of all cells. Ion channels are one of the two classes of ionophoric proteins, the other being ion transporters. The study of ion channels often involves biophysics, electrophysiology, and pharmacology, while using techniques including voltage clamp, patch clamp, immunohistochemistry, X–ray crystallography, fluoroscopy, and RT–PCR. Their classification as molecules is referred to as channelomics. The fundamental properties of currents mediated by ion channels were analyzed by the British biophysicists Alan Hodgkin and Andrew Huxley as part of their Nobel Prize–winning research on the action potential, published in 1952. They built on the work of other physiologists, such as Cole and Baker's research into voltage–gated membrane pores from 1941. The existence of ion channels was confirmed in the 1970s by Bernard Katz and Ricardo Miledi using noise analysis. It was then shown more directly with an electrical recording technique known as the "patch clamp", which led to a Nobel Prize to Erwin Neher and Bert Sakmann, the technique's inventors. Hundreds if not thousands of researchers continue to pursue a more detailed understanding of how these proteins work. In recent years the development of automated patch clamp devices helped to increase significantly the throughput in ion channel screening. The Nobel Prize in Chemistry for 2003 was awarded to Roderick MacKinnon for his studies on the physico–chemical properties of ion channel structure and function, including x–ray crystallographic structure studies.
267 INTERESTING CASES OF DIABETES VERY OLD TYPE 1 DIABETES LIVING LONG LIFE AND VERY YOUNG TYPE 2 DIABETES , Dr. R. Anil Kumar*
CASE 1 - Type 1 diabetes patient living long life Type 1 diabetes is accompanied by long-term microvascular, neurologic, and macrovascular complications. Although the daily management of type 1 diabetes is burdensome and the spectre of metabolic decompensation ever-present, long-term complications, including retinopathy, nephropathy, neuropathy, and cardiovascular disease, have caused the most morbidity and mortality since the introduction of insulin therapy.[1,2] The prevention and amelioration of these complications have been major goals of recent research.
268 WASTE MAPPING STRATEGY BASED LEAN MANAGEMENT IN OUTPATIENT INSTALLATION AT HOSPITAL X BANYUWANGI DISTRICT , Martagela Kamahayo*, Farida Wahyu Ningtyias and Ristya Widi Endah Yani
Lean management is a method used to eliminated or reducing waste. In the outpatient installation at the hospital X Banyuwangi. There are several waste that must be addressed immediately so that service ccan run optimally. The purpose of this study is to map waste based on lean management in outpatient installation. The research is a qualitative research with a type of phenomenology. The informans of this research results, there are 8 categories of the waste contained in outpatient installation, namely defect, overproduction, waiting, non-utilized talents, transportation, inventory, motion, and extra processing. There are 3 waste that must be resolved quickly due to their very serious impact namely extra processing in the form of hospital management information system (SIMRS) which not integrated, waiting in the form of the patient waiting time, and inventory in the form of mismatched drug stocks. Improvements were made using the failure mode and effect analysis (FMEA) method in the form of solution and the resulting impact. One form of the solution is the kanban design.
269 BARRIERS TO REPORTING OF MEDICATION ADMINISTRATION ERROR AMONG NURSES WORKING IN A TEACHING HOSPITAL, KATHMANDU , S. Shrestha* and S. Sharma
Introduction: Medication administration error reporting has been accepted as a basic attempt for the improvement of patient safety. The main objective of the study is to identify the perceived barriers to reporting of the medication administration error among nurses. Methods: Descriptive cross sectional research design was used. All the registered nurses working on various inpatient units of Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu were taken as study population. Proportionate stratified random sampling technique was used to select 228 nurses. A structured questionnaire was used to collect data. The collected data were entered into EPI DATA3.1 and transferred onto the statistical package for social science 16 version. Data was analyzed and interpreted by descriptive; mean, median, standard deviation, frequency and percentages and inferential statistics; independent t test. Results: Possible medication administration error was wrong dose (66.7%). Fear (1.76±0.36) and administrative response (1.46±0.39) related barrier was major barrier to reporting of medication administration error among nurses. It was observed that nurses who had less than five years of work experience present higher perception level regarding administrative response barriers in reporting MAEs. There was significant difference between disagreement over error related barrier and socio-demographic characteristics such as age (p=.02, marital status (p=.01), work experience (0.006). Conclusion: In this study, fear and administrative response related barriers are present as influential barrier to reporting of Medication Administration Error. So it is necessary to establish communicative environment in inpatient unit to reduce fear and provide positive reinforcement to encourage reporting.
270 LABOR OUTCOME IN EPIDURAL ANALGESIA - A RETROSPECTIVE COHORT STUDY IN A TERTIARY CARE FACILITY IN CENTRAL KERALA , Dr. Namitha Subrahmanyam* and Mrs. Jisha Joseph
There are controversial view about adverse effects of Epidural analgesia in labour .This study was conducted to examine the effect of epidural analgesia on selected labour outcomes. In this retrospective cohort study 175 newborns whose mothers received epidural analgesia were compared with 175 newborns whose mothers did not receive epidural analgesia during labour. The data were obtained from the hospital records. The rate of caesarean delivery and instrumental delivery were significantly higher in epidural cases (p<0.001).No difference was observed between the groups with regard to the rate of PROM , duration of active phase of labour, neonatal APGAR score at 5th minute and respiratory distress (p >0.05). Epidural analgesia does not prolong the duration of active phase of labor and incidence of PROM. Neonatal outcome was satisfactory while only the rate of instrumental deliveries was found increased with epidural analgesia.
271 NUTOOL / DHARA: A CLASSICAL APPROACH FOR THE MANAGEMENT OF NEUROGENIC DISORDERS , *Ahmad Nadim Khan
Life style disturbance play a pivotal role in the genesis of CNS disturbances like headache, facial pain, dizziness, sleep disturbances, sensory disturbances and spinal muscular atrophies etc. Allopathic drugs are costly and bear many adverse effects. So, for the manage the neurologic disorders, there is need of such alternative approaches which is cost effective and bear less adverse effects. In the Unani system of medicine, Nutool is an easy and, cost effective traditional therapy for the management of neurologic disorders. Different drug's decoction and oils are used in the therapy. Few of them are as follows: Drugs for decoction: Sandal, Gulab, Kahoo, Khashkhash, Neelofar and Kishneez etc. Oils for application: Roghan Laboob Saba, Roghan Sheer Bala, Olive Oil, jkoghan Malkangani, and Roghan Kahoo etc. Details of therapy and drugs used will be discussed in presenting paper.
272 REPURPOSING BCG VACCINE FOR COVID19 IMMUNITY , Mrudula Phadke* and Sujata Saunik
Covid 19 pandemic has created havoc in the world. As on 20th September 2020,the virus has reached 216 countries affecting nearly 31711237 people and 960826 have lost their lives. Various modes of treatment with the use of Hydroxychloroquine, Doxycycline, Ivermectin, VitaminC, Zinc, Favipiravir, Remdesivir, Dexamethasone, Itolizumab, inhahed interleukins and others are being tried with varying degrees of success. Randomized clinical trials are being undertaken in many countries. Vaccines against Covid19 are in different phases of clinical trials and development. Scientists are also attempting to repurpose other vaccines that may offer protection against Covid 19. BCG is one such vaccine, available in the armamentarium for use. Preliminary reports suggest that BCG will offer nonspecific heterologous protection to decrease the occurrence of Corona virus SARS CoV2 infection or may help in decreasing the severity of the disease. This effect is likely to be mediated through ‘trained immunity’ offered by cells responsible for innate immunity.
273 THE ANALYSIS OF DISASTER PREPAREDNESS SYSTEM IN MULTI-STOREY BUILDING AT AL QODIRI ISLAMIC BOARDING SCHOOL, JEMBER , Achmad Afifil Afton*, Isa Ma’rufi and Hadi Prayitno
Al Qodiri led by KH. Muzakki Syah is one of the largest Islamic boarding schools (Pesantren) in Jember Regency. The number of students is 3000, with details of 1000 male and 2000 female, while the board of boarding schools itself is 101 people with 51 male administrators and 50 female administrators (Ponpes Al Qodiri, 2019). The number of students, which is almost a thousand people, makes Al Qodiri Islamic Boarding School build a multi-storey building or flats to facilitate the activities of its students. This 3-storey building which is inhabited by a large number of students needs to be implemented as a means of saving lives for its residents because it has potential dangers and emergencies. In addition, the lack of knowledge about disaster emergency response makes the risk of security and safety problems even greater. This study aims to analyze the needs of an emergency preparedness and response system in a multi-storey building at the Al-Qodiri Islamic Boarding School, Jember. This research is categorized as qualitative research with case studies, while the data analysis uses the Colaizzi technique. The research sample was taken by purposive sampling of 5 respondents. The results of data analysis show that there are several potential hazards of multi-storey buildings in the Al-Qodiri Islamic Boarding School, including the potential for physical hazards in the form of a humid room, lack of lighting, and lack of ventilation and feels stuffy. The potential chemical hazards that exist in the form of smoke from burning various kinds of waste, especially clothes, of course, this can cause air pollution and can endanger health and is a potential chemical hazard.
274 STANDARD OPERATIVE PROCEDURE & PROBABLE MODE OF ACTION OF KARNAPOORANA , Dr. Arun Kumar Gupta*, Dr. Trupti Gupta and Dr. Satej T. Banne
Karnapooran is the best modality for karna roga (Diseases of Ear). Karana purana is the process in which warm, medicated oil or medicated liquid is gently, slowly poured into the ears. This lubricates the delicate filaments of the ear canal which sharpens hearing and removes impurities. The treatment begins with an ear and partial head massage. The ear is then gently filled with drops of warm medicated oil. Karnapuran is a unique procedure mentioned in the context of Vicharna Sneha, Which is explained by Acharya charak. Karnapoorana is made up of two words Karna and Poorana. Karna means ear and Poorana mean filling. So it is a process in which the ear is filled with medicated Taila, Mutra, and Svarasa, etc. for treatment of various Vyadhis. The classic Ayurvedic treatment for the ears is an essential part of a healthy quotidian routine. It is called Karnapoorana – where medicated oil is dribbled into the ears and the ears are then thoroughly massaged. We also know there are small bones in the internal ear called ossicles, which vibrate when hit by sound waves. These bones excite nerve endings that communicate signals to the brain to be inferred. From the Ayurvedic perspective, the ear skin and the ossicles can dry out and function can be cooperated. In Karnpooran , medicines are absorbed by ear and perform the action so Karnapoorna cures the diseases of Ear & maintain the health of Ear.
275 COMPREHENSIVE APPRAISAL KARNA ROGA W.S.R. KARNASHRAVA IN AYURVEDA & CONTEMPORARY SCIENCE , Dr. Arun Kumar Gupta*, Dr. Trupti Gupta and Dr. Satej T. Banne
There is difference of opinions among the Acharya about the total number of karna rogas. In this set of disorders of karna, the diseases belong to Shabdendriya have also been included. Acharya Charaka has described karna rogas in a separate chapter. There is an explanation of these disorders belonging to karna in trimarmiya chikitsa chapter of Charaka Samhita. According to Charaka there are four types of karna rogas based on doshas. They are Vataja, Pittaja, Kaphaja & Sannipataja. In these four types, all the karna rogas are included. Since Charaka belongs to Kayachikitsa School of thoughts, it is natural that a very short description of these disorders of urdhwa jatrugata rogas is found. Charaka has also mentioned a short method of treatment for karna rogas. One, among the treatments is karna purana. Interestingly, there is no mention of disorders of karna pali. (Ch. Chi. 26/71). 1. Vatika Karnaroga 2. Paittika Karnaroga 3. Shalaishmika Karnaroga 4. Sannipatika Karnaroga. According to Sushruta there are 28 types of karna roga as explained in 20th chapter of uttara tantra. Karnashrava is the disease of Karnaroga, it is well described by acharya Sushruta. Karnashrava can compare with Otorrhoea. Avashyaya (Dew), Pratishyaya (Common cold), Jalakrida (water entry in the ear), Karnakanduyana, Mithyayogen shastrasya, Shirobhighata and Prapakat vidradhe are is the main causes of Karnashrava. There are not any specific purvarupa of karnasrava. But increase of wax formation, itching sensation heavyness of the ear can be taken as purvarupa. (A. H. Su. 11/14). Acharya Madhavakara say, that Avyakta lakshana is the purvarupa of vyadhi. Nasya, Dhumapana, Karnapuran, Karna prakshalan and Karna Aschyotan are best modality to treat Karnashrava.
276 IMPORTANCE PATHYA KALPANA IN AYURVEDA CLASSICS , *Dr. Tanvi Singh
Diet is mentioned as the one major causative factor for every disease manifestation. Nidana Parivarjana (restriction for causative factors) is also a major treatment protocol for pacifying the disease. Yogaratnakara has mentioned diet according to present era and also gives Pathya and Apathya diet in every diseases condition. Here, an attempt is made to enlighten the dietary regimen described in Yogaratnakara.
277 IMPORTANCE OF AGNI IN CHIKITSA , *Dr. Nitin Tale, Dr. Ankush Mankar and Dr. Kanchan Khond
Agni means fire. Agni is basic essential of life. Agni is a invariable agent of human being which is important factor for the digestion & transformation. Ingested food is to be digested, absorbed & assimilated & this process performed by agni. Agni converts the food in the form of energy, which is responsible for all vital functions of our body. While stating the importance of agni, acharya charaka has mention that after stoppage the function of agni, the individual dies. Also states that if the agni is in samavastha the individual would be absolutely healthy & lead to happy, healthy life. But if the agni of a person is vitiated the whole metabolism in his body would be disturbed, resulting in many diseases. Hence agni is said moola of life in charak samhita chikitsasthan. While diagnose the disease, have to focus on agni, which may pathological factor for the disease. While treating a patient with ayurvedic principles the agni is important factor.
278 COMPARATIVE STUDY BETWEEN SURGICAL TREATMENT AND DILTIAZEM 2% GEL APPLICATION IN THE MANAGEMENT OF CHRONIC ANAL FISSURE , *Ammar Khiatah, Ahmad Saad and Sajieh Massoud
Introduction: The surgical intervention on chronic anal fissure is still the first line of treatment for this disease. The importance of this research lies in finding a new treatment for one of the most common anal lesions, and to choose a safe and effective method in the treatment of chronic anal fissure, avoiding the risks of anesthesia and surgery. Objective: To compare the surgical treatment (Lateral Internal Sphincterotomy) and topical treatment (Diltiazem Gel 2%), in terms of the ability to heal, studying the degree of symptoms regression after the treatment (bleeding/pain), and studying the incidence of gas / fecal incontinence. Materials and Methods: A prospective pilot study, which included 60 patients divided into two groups equally, Group A (30 patients who underwent surgical treatment), Group B (30 patients who underwent topical drug treatment with Diltiazem 2% gel), and the study was conducted at Tishreen University Hospital in Latakia – Syria, in the period between 2019-2020. Results: In group A, complete recovery occurred in 29 patients (96.6%), anal bleeding decreased in all patients (100%), pain feeling decreased in all patients (100%), and gas incontinence occurred only in 4 patients (13.3%). Fecal incontinence didn't occur. In group B, complete recovery occurred in 17 patients (56.6%), anal bleeding decreased in 17 patients (68%), pain feeling decreased in 17 patients (65.3%), and gas / fecal incontinence didn't occur at all. Conclusion: Lateral internal Sphincterotomy is still the first line of treatment in patients with a chronic anal fissure, but drug therapy with (Diltiazem 2% gel) can be applied to patients who refuse surgical treatment, or for those who have contraindications for surgical intervention.
279 INFLUENCE OF SYSTEM QUALITY, INFORMATION QUALITY, AND SERVICE QUALITY ON ORGANIZATION AT PUBLIC HEALTH CENTER PASURUAN CITY , Nita Dwi Nur Aini*, Farida Wahyu Ningtyias and Dewi Rokhmah
Health policy in Indonesia requires every public health center to organize a Puskemas Management Information System (SIMPUS). SIMPUS implementation in Pasuruan City aims to improve the quality of health services, but in its implementation SIMPUS still faces many obstacles so that it has not run optimally. The purpose of this study is to identify and determine the effect of system quality, information quality and service quality on the organization. This type of research used analytic observational with cross sectional design. Total population 268 officers with a sample of 160 officers at the public health center. The results showed that the quality of the system had no effect on the organization. Meanwhile, information quality and service quality have an effect on the organization. Suggestions that can be given are improving network quality, holding training and technical guidance, evaluating and maintaining devices.
280 PREVALENCE OF OBESITY AMONG CHILDREN UNDER 5 YEARS ATTENDED TO PRIMARY HEALTH CARE CENTERS IN MOSUL CITY , Duaa Ismael I. Al-Ahmed*, Humam Ghanim I. Zubeer, Sedra Ahmed O. Al-Nuamy
Background: Childhood obesity is a "condition in which excess body fat negatively affects a kid's health or wellbeing". Due to expanding the occurrence of Childhood obesity and its various health impacts, it is considered as a serious general wellbeing concern. Aim: To determine the prevalence of overweight and obesity among children under 5 years attended primary health care centers in the Mosul city. Methods: Study Setting: Primary health care centers were chosen as three centers from both right & left sectors of Mosul City. Study Design: Cross-section study, which is a descriptive observational study. Sample Size: Three hundred and ten (310) children of both sexes aged under 5 years attended primary health care centers were examined, this sample was distributed by multistage stratified simple random technique. Data Analysis: Descriptive and analytic statistical tools were applied. For comparison between two means, independent t-test was used and chi-square test was applied for comparison between two categorical variables. Questionnaire form was arranged utilizing summarized questions. Results: In the present study, prevalence of overweight and obesity was 10.32%, 56.4% of the study sample were males, the rest were females and 59.4% of obese children were males while 40.6% of them were females. Mean age was 24.6 months with a range of 2 – 60 months, mean weight was 11.6 kg with arrange of 4.5 – 25.5 kg, mean height 83 cm with a range of 58 – 120 cm. All of obese children ate jam and only 9.5% of normal children ate jam, 40% of obese children moderately active and 27% of normal children moderate active, whereas 40% of obese not active and 26% of normal also not active. About half of normal children were active (47%) and only 20% of obese child were active. Conclusion: The present study concludes that there was a powerful association between eating some items of feeds like jam, also there was a reverse relationship between obesity and physical activity.
281 PROGNOSIS OF HYPERREFLECTIVE FOCI (DOTS) ON OPTICAL COHERENCE TOMOGRAPHY IN PATIENTS WITH DIABETIC MACULAR EDEMA: ABOUT 30 CASES , *M. Bouchaar, S. Bajjouk, M. Bouazza, S. Haddougui, F. El Asri, K. Reda and A. Oubaaz
Diabetic macular edema (DME) is a thickening of the macular retina secondary to a rupture of the internal blood-retinal barrier. It is the leading cause of low vision in diabetic patients.[1] The functional prognosis depends on several anatomical factors. The spectral domain optical coherence tomography (SD-OCT) is an important tool for the diagnosis, therapeutic indication and monitoring of diabetic macular edema.
282 THE PROGNOSTIC VALUE OF PERIPHERAL BLOOD ABSOLUTE LYMPHOCYTE TO MONOCYTE RATIO AT DIAGNOSIS IN HODGKIN’S LYMPHOMA PATIENTS , Oula Yousef Nfelah*, Tagrid Kaddar and Firas Hussein
Determination of prognostic factors in Hodgkin’s Lymphoma patients plays an important role in reducing intensive chemotherapy, decreasing economic costs, and improving the outcome of the patients. We conducted this study to determine the prognostic value of [lymphocyte/monocyte ratio (LMR)] in Classical Hodgkin’s Lymphoma patients (cHL) [trying to establish a relationship between it, overall survival (OS) & progression free survival (PFS)]. Also, we wanted to study the relationship between LMR and other variables such as age, sex, histological type, white blood cells, absolute lymphocyte count, absolute monocyte count, hemoglobin, serum albumin, Ann Arbor Staging, B-Syptoms, early or advanced stages, bulky mediastinal mass, type of primary treatment if chemotherapy alone or radiochemotherapy and the effect of these variables on OS and PFS. A retrospective study included 242 patients with cHL admitted to the center of radiochemotherapy in Tishreen University Hospital in Lattakia from January 2011 to December 2015. We monitored the patients until 1st September 2020. An LMR at diagnosis of 2.9 or more was the best cut-off value for survival. In univariate analysis, patients with LMR < 2.9 had inferior OS and PFS. LMR had an important prognostic value in patients with limited or advanced stages. In multivariate analysis, LMR was an independent prognostic factor for survival and to predict clinical outcomes in patients with classical Hodgkin’s lymphoma. In conclusion, LMR provides a simple model to assess clinical outcomes in cHL.
283 DEMOGRAPHIC AND SOCIOECONOMIC FACTORS INFLUENCING ITNS USE AMONG THE JAGGERY AND TEA WORKERS IN THE PREVENTION OF MALARIA IN SOUTH MUGIRANGO SUB COUNTY, KISII COUNTY, KENYA , *Masta Ondara Omwono, Justus O. S. Osero and Taratisio Ndwiga
Background; This study interviewed about 209 respondents working at the Jaggery and Tea farms. More than half of respondents understudy were at risk of contracting malaria infection due to the demographic and socioeconomic factors influencing ITNs use. Published literature on demographic and socioeconomic factors that influence ITNs use among the Jaggery and tea workers in South Mugirango Sub County, Kisii County, Kenya is limited. Purpose; This study aims to establish the demographic and socio-economic factors influencing ITNs use among the Jaggery and tea workers. Methods; A descriptive cross sectional study design was used and South Mugirango was purposively selected. The study systematically and randomly selected and interviewed 209 Jaggery and tea workers on demographic and socioeconomic factors influencing ITNs use. Qualitative methods were used to investigate their demographic and socioeconomic factors on use of ITNs. Data was collected using structured questionnaire, focused group discussion and key informants interviews to obtain views. Results; A total of 209 Jaggery and tea workers were selected and interviewed; 116 (56%) males and 93 (44%) female. Over 100% of non users of ITNs were male aged between 18-28 years and singles with no formal education. Also 64.7% by occupation were tea workers and among the non users of ITNs who were found using them as tea carrying baskets. About 94.1% of non users lived in grass thatched houses this led to low level of ITNs use due to their low level of income. Education and gender were found to be positively related with ITNs use (P<0.001) respectively. Accessibility, cost and house structure were significantly related with ITNs use. Conclusion and recommendations; the study concludes that demographic and socioeconomic factors influence use of ITNs among the Jaggery and Tea workers. Therefore, the study recommends; (a) Policy review on housing so that the government can give subsidies to low income earners to improve their living conditions within their communities. (b) Education as one of the socio pillar should be enhanced as this will impart knowledge to improve ITNs use among the Jaggery and Tea workers of various age groups with emphasis on proper use.
284 THIS ARTICLE TO EXAMINES SOME OF THE MAJOR IMPACT OF COVID-19 PANDEMIC IN NIGERIA , Ahmed Abdullahi*
Corona virus (Covid-19) is a globally public health problem, Nigeria is first in Africa in terms of people living with covid-19 pandemic.
285 THE MOST FREQUENT PRESCRIBED ANTIMICROBIAL IN HOSPITALS OF NINEVEH, IRAQ – 2019 , Shaymaa H. Saeed, Haimn A. Tawfiq, Nada Jabir Abdullah, Bushra M. Yaseen and *Dr. Hajir H. Al-Ridhwany
Context: Antimicrobials are one of the most successful forms of chemotherapy in the history of medicine. It saves many lives and significantly contributes to the control of infectious diseases. Aim: The current study is aiming for determining the most frequent prescribed antibiotics in hospitals in Nineveh governorate at the north of Iraq. Method and Subjects: A cross-sectional study design was adopted to analyze data that were collected from statistics which were referred formally from hospitals to the Department of Pharmacy in Nineveh Health Directorate during the period from January 1st to the end of December 31st, 2019. Results: The current study had found that penicillin group was the most frequent antibiotic that was prescribed to hospitalized patients (66.42%); followed by Cephalosporin Group (13.32%) and Quinolones Group. Conclusion: Antibiotic that are belong to penicillin, cephalosporin and quinolones groups are the most frequently prescribed to hospitalized patients in Nineveh Governorate. Recommendation: The use of all antibiotics in general, and penicillin group in particular is recommended to be balanced.
286 ANTIBIOTICS CONSUMPTION IN IBN AL-ATHEER PEDIATRIC TEACHING HOSPITAL IN NINEVEH, IRAQ , Shaymaa H. Saeed, Mahmood A. Khattab, Wail M. Mohammed, Haimn A. Tawfiq, Bushra M. Yaseen and Dr. Hajir H. Al-Ridhwany*
Context: Antibiotics are among the most commonly prescribed drugs in pediatrics. They are mostly are started on an empirical basis, without proof of a bacterial infection. Aim: The current study is aiming for enumerating antibiotics that are frequently consumed by Ibn-Alatheer pediatric teaching hospital in Mosul, Iraq. Method and Subjects: A cross-sectional study design was adopted. Data was collected from the formal statistics of Ibn-Alatheer Pediatric Teaching Hospital over the last year from January 1st to the December 31st, 2019. Results: It was found that the most frequent consumed antibiotics (56.6%) were grouped as penicillin, cephalosporin (17.1%) and aminoglycoside (10.1%). Conclusion: It is concluded that penicillin is the most frequent prescribed antibiotics in Ibn-Alatheer Pediatrics Teaching Hospital. Recommendation: The current study suggests that antibiotics are needed to be prescribed carefully for pediatrics.
287 FEMALE GENITAL MUTILATION AND SOCIO-CULTURAL IMPLICATIONS ON BINI TRADITION   , *Akintoye Emily Obaide, Akintoye Onome Pearl and Adjene Josiah Obaghwarhievwo
Female circumcision, also known as female genital mutilation [FGM] is a common practice in many countries across the globe, especially Africa. Current study investigated the social and cultural implications of FGM on the natives of Bini, Southern Nigeria. A 150 open ended questionnaire was carefully structured, validated and distributed (n = 150) to selected Bini indigenes of the target area in Oredo Local Government Ares of the ancient city of Benin, Edo state of Nigeria. This prospective study was based on female children and parents who presented on account of FGM in the past. The questionnaire was designed to obtain relevant cultural and traditional norms of the Bini tribe as it relates to FGM. Sociodemographic data of sampled respondents were also collected. In the end, various sections of the questionnaire were subjected to statistical analysis, while expressing results in simple percentages to extrapolate the effect of FGM on the socio-cultural well-being of the people. Following careful observation, study found that about 74.5% of the respondents supported that till date, the Bini’s support cultural norms than global best practices on FGM as stipulated by the World Health Organizations (WHO). Whereas, about 55.7% of the subjects opposed to this. Study also observed that the social implication of FGM on the girl child within captured area is evident in their sexual life as about 40.6% of the respondents posited that the average Benin girl who underwent FGM is likely to lost control of their libido with time; even in their matrimony, while 29.2% however opposed to this. planned health education campaigns are recommended to elude the drawbacks of FGM and hazards of continuation of this practice in current communities that practice FGM.  
288 DENGUE FEVER RISK ASSESSMENT BASED ON BEHAVIOUR PREVENTION ON FOUR SUB DISTRICTS IN JEMBER DISTRICT , Bhisma Satya Dharma, Dewi Rokhmah* and Isa Ma’rufi
Dengue fever is one of the main problems of public health in the world. Dengue Fever has reached a hundred countries from Afrika up to Western Pacific. Indonesia was the first rank of dengue cases for the Asia Region in 2010. Jember District is one of the highest bestower dengue cases with changes risk areas. A surveillance system can be applied as a new solution tool that is used to monitor area conditions for dengue cases based on prevention as a factor that influenced dengue fever accidents. The purpose of this study is to assess dengue fever risk based on behaviour prevention. This research method is quantitative research, with a crossectional design. Four sub-districts that become research area. This research population is all of the householder on 4 sub-districts in Jember District, and the sample is 100 householders in 4 sub-district. The research tool are documentation, questioner, and observation sheet. The data analysis are univariate analysis to multivariate analysis. Based on research results, only environmental factor which not influence dengue case. The most influential factor for dengue incidences in Jember District is the health behavior for the prevention. The Risk assessment showed that Pakusari subdistrict with score 44 and Mumbulsari subdistrict with score 42 are in the medium risk, meanwhile Panti subdistrict with score 56 and Arjasa subdistrict with score 48 are in the low risk.
289 PROGNOSTIC FACTORS OF ACUTE RENAL FAILURE IN PATIENTS ADMITTED TO INTENSIVE CARE UNIT , Thaer Mohamed Alahmad*, Ibrahim Suliman and Maissa Barakat
Background: Acute renal failure(ARF) has been recognized as common condition in patients admitted to intensive care unit(ICU) and it is associated with increased risk of morbidity and mortality. Objective: the present study aims to determine incidence, risk factors, and outcome of acute renal failure in patients admitted to ICU. Materials and Methods: This is prospective, observational study conducted in ICU in Tishreen University Hospital-Lattakia -Syria from November 2018 to December 2019. Patients aged 18 to 70 years were screened for ARF according to (RIFLE) criteria. Results: During study period, of 152 patients, 49 (32.2%) developed ARF. Independent predictors of ARF were age older of 65 year(OR=3.8 [1.9 – 7.8], p:0.008), presence of infection on admission(OR=3.3 [2.1–8.9], p:0.002), history of diabetes mellitus(OR=2.4 [1.1–4.9], p:0.001), MAP<65(OR=4.1 [1.4–12.2], p:0.003) as well as hypertension(OR=5.4 [2.4 –11.8], p:0.001). The average length of stay in ICU for patients with ARF was longer than those without ARF(17.6 vs 10.5, p:0.002) with high rate of mortality(45% vs 22.3%, p:0.02). Conclusion: Acute renal failure in critically ill patients is associated with worsening prognosis, so identification risk factors of ARF and initiate preventive measures should be part of the management.
290 ETNOCARING: RECOVERY METHOD FOR CHILD FEVER SEIZURES BASED ON BAJO TRIBE TRADITION IN THE NORTH BUTON, INDONESIA , Adi Try Wurjatmiko*, Risnawati and Muhammad Syahwal
Introduction: Children who experience febrile seizures are very important to be given proper treatment from the beginning to after the seizure period. The success of recovering from a child's febrile seizure will determine the degree of health and quality of life in the future. The Bajo tribe has its method of recovery which is still being carried out and is believed to be able to overcome the health problems of children with fever seizures. Purpose: to find out the method of restoring child febrile seizures based on the traditions of the Bajo Tribe in the North Buton. Method: The research design used was qualitative: ethnography. The number of participants was 16 shamans from the Bajo Tribe in the North Buton and 4 women as triangulation participants. The sampling technique used was snowball sampling. The data analysis used was thematic. Result: The findings in this study are described in the theme of herb therapy and seawater splash therapy. Conclusion: The method of restoring pediatric febrile seizures based on the North Buton tradition consists of herb therapy and seawater splash therapy.
291 RENAL MANIFESTATIONS OF SICKLE CELL DISEASE , Jiyan Qasem*, Ibrahim Suliman and Firas Hussein
Background: Patients with sickle cell disease (SCD) are at increased risk of serious morbidity and mortality. Renal abnormalities in SCD are well known but renal involvement in Syrian patients with SCD has not been studied. Aim: We sought to identify the renal manifestations of sickle cell anemia among patients attending Tishreen University Hospital in Lattakia. Materials and Methods: This descriptive observational study included 76 patients (42 males, 34 females) diagnosed with sickle cell anemia confirmed by hemoglobin electrophoresis, and followed at Tishreen University Hospital in Lattakia, during the period between 2019 - 2020. The glomerular filtration rate was estimated (eGFR) using the ‘modification of diet in renal disease’ (MDRD) formula. All patients underwent evaluation by urine examination to detect hematuria, and 24- hour urine collection to measure to quantitate proteinuria. We constructed a multivariate logistic regression model to assess the association between hydroxyurea and proteinuria. Results: The renal manifestations of sickle cell anemia were as follows: glomerular hyperfiltration (9.2%), impaired renal function (31.6%), proteinuria (39.5%), and hematuria (19.7%). Patients with impaired renal function had a greater mean age and a higher prevalence of proteinuria compared with patients with normal renal function. A statistically significant inverse linear relationship was found between age and eGFR values (r = -0.547, p <0.001). The mean age of patients with proteinuria was greater compared to patients without proteinuria (P <0.05). Use of hydroxyurea is associated with a lower prevalence of proteinuria in patients with sickle cell anemia. The mean eGFR in patients treated with hydroxyurea was significantly greater compared to patients not treated with hydroxyurea (P <0.05). Conclusion: Renal abnormalities are present in a significant number of Syrian patients with SCD and proteinuria is the most common abnormality. Hydroxyurea use may prevent development of overt nephropathy or the progression of sickle cell disease nephropathy to end- stage renal disease.
292 QURAN, SCIENCE AND HIFZAN-E-SEHAT , *Prof. Ahmad Nadim Khan
What may be your reaction if I tell you that the Holy Quran and Islam plays an important role in preventing nearly all kind of diseases? Some of you must be surprised but believe me this is truth. Islam, indeed teaches us how to effectively control many faecal borne, air borne and water borne diseases.
293 NANOPARTICLES: A NOVEL DRUG DELIVERY FOR CANCER THERAPY , *Rushikesh Eknath Tupe and Aparna Shantaram Kale
The word nano comes from Greek νᾶνος,which means"dwarf".[1] Having particles of size 1 billionth of a meter (<100 nm).The main advantage is that at this size range, nano-particles having a maximum surface:volume ratio, which makes them appropriate for surface functionlization and incorporation of a chemotherapeutic load.[2] In last years different types of nano-particle technologies developed for cancer treatment to improve the therapeutic efficacy and safety for anticancer drugs.[3] Nano technology has the potential to major change the early diagnosis, treatment, and monitoring the progress of the disease.By using nano-techniques the possibility to work at the same scale of several biological processes, cellular mechanisms, and organic molecules. The nano particle like nano-meters and nano-tubes, technologies could be used to administer drugs more precisely.this techniques target specific cells in a patient suffering from cancer or other life-threatening conditions. This review paper describes the role of multi-functional nano-particle in diagnosis and treatment of different types of cancer.[4]
294 THE EFFECT OF HELICOBACTER PYLORI ON METABOLIC SYNDROME , *Anandkumar S., Akila V., Aksa Ann Joy, Akshayasre G. and Aleena Baiju Varghese
H. pylorus is the main cause of various gastric diseases such as peptic ulcer, duodenal ulcer, and gastric cancer. Cardiovascular diseases like congestive heart disease, metabolic disorders like DM, lipid metabolism disorders like atherosclerosis are also caused by H. pylori. H. pylori infection causes secretion imbalance of pro-inflammatory cytokines and CRPs, angiotensinogen, leptin hormone, and free fatty acids, however, the exact association of metabolic syndrome and Helicobacter pylori infection is not clear. The main mechanism of a metabolic syndrome caused by H. pylori is that the bacterium causes a disturbance in the host’s immunological response which leads to the production of proteins such as CagA, VacA, BabA, and SabA. This mechanism is seen in the association of H. pylori infection and gastrointestinal diseases, diabetes mellitus, lipid profile changes as well as cardiovascular diseases. The inflammation and production of inflammatory cytokines along with different hormonal imbalances is caused by the bacterium. Since there are no specific treatment guidelines for the management of metabolic syndrome associated with HP infection, total eradication of the infection is the goal to be achieved done by the standard triple therapy. H. pylori eradication must be done as early as possible for the management of gastro- and extra gastrointestinal diseases caused by the bacterium.
295 UNANI ADJUVANT THERAPY FOR CORONAVIRUS DISEASE 2019 (COVID-19): A REVIEW , Mariyam Ahad, Mohd Aleemuddin Quamri, *Fasihur Rehman Ansari and Kunwar Alam Chaudhary
The pandemic of coronavirus disease (COVID-19) caused by the novel coronavirus severe acute respiratory syndrome 2 (SARS-CoV-2) poses an unparalleled difficulty in the evaluation of appropriate drugs for prevention and treatment. Due to the unavailability of vaccine and antiviral medicine, there is an urge to look for the scope of traditional therapy for this fatal disease. Despite rigorous global containment and quarantine efforts, the incidence of COVID-19 continues to rise. Currently, no antiviral medication is recommended to treat COVID-19. Treatment is directed at relieving symptoms so a formulation after a comprehensive literature review of Unani literature is being hypothesized as adjuvant therapy for the management of coronavirus disease based on the symptoms associated.
296 A REVIEW ON MYRISTICA FRAGRANS HOUTT. WITH UNANI PERSPECTIVE AND MODERN PHARMACOLOGY , Kunwar Alam Choudhary, Azhar Jabin, *Mohd Aleem, Fasihur Rehman Ansari
Myristica fragrans (M. fragrans) Houtt is an evergreen tree indigenous to India, Indonesia and, Srilanka. It is the main source of spices; nutmeg and mace. Mace used as a tropical spice having a pleasant aromatic fragrance, for this property it has been used widely as flavoring agent in cakes, pudding, beverages, meat, and sausages. Besides this, it has a special ability to enhance the taste of food. Myristicin (5-allyl-1-methoxy-2,3 (methylenedioxybenzene) constituent is responsible for flavoring property and also been known to produce important psychopharmacological responses. It has been known to provide many medicinal properties due to its complex molecular structure. The chemical constituents of M. fragrans have been studied for hypocholesterolemic hypolipidemic, antidepressant, aphrodisiac, antimicrobial, memory enhancer, antioxidant and hepatoprotective properties. A thorough literature review reveals that M. Fragrans deserves more attention from the scientific community and public health specialists to explore its full array of benefits to society's welfare.
297 DEVELOPMENT AND VALIDATION OF STABILITY INDICATING RP-HPLC METHOD FOR THE SIMULTANEOUS ESTIMATION OF DAUNORUBICIN AND CYTARABINE IN BULK AND PHARMACEUTICAL DOSAGE FORMS , A. Suneetha*, V. Mounika and S. Bindu Venkata Sravani
This present work describes a new validated Reverse Phase High Performance Liquid Chromatography (HPLC) method for the simultaneous determination of anti-cancer drugs, Daunorubicin and Cytarabine. A simultaneous determination method saves cost and time as both drugs can be injected into a single HPLC system without the need to change or re-equilibrate with a new mobile phase. The objective of the study is to develop a simultaneous estimation of two anti-cancer drugs in Pharmaceutical Dosage forms. The mobile phase consists of a mixture (50:50 v/v) of 0.1% Octane sulphonic acid: acetonitrile at a flow rate of 1 ml/min, with a PDA detector at 238 nm. Separation was achieved on a Xbridge C18 (150 x 4.6mm) maintained at 30°C temperature in a column oven. The method was linear between 22μg/ml – 110μg/ml for Daunorubicin and 50μg/ml - 250μg/ml for Cytarabine. The limit of detection was 2.98μg/ml for Daunorubicin, and 3.00μg/ml for Cytarabine and the limit of quantification was 10.00μg/mL for Daunorubicin and 9.98μg/mL for Cytarabine. The developed RP-HPLC method achieved good precision and accuracy. The developed and validated method was suitable to be used for routine analysis of Daunorubicin and Cytarabine.
298 EVALUATION OF ANTIOBESITY PROPERTIES OF AYURVEDIC INTERVENTION VACHA KUTAKI YOGA- “AN OBSERVATIONAL STUDY”EVALUATION OF ANTIOBESITY PROPERTIES OF AYURVEDIC INTERVENTION VACHA KUTAKI YOGA- “AN OBSERVATIONAL STUDY” , Dr. Anil Mangal*, A. D. Jadhav, Uma Mangal and Pratap Makhija
Obesity has become an increasing global health problem among all socio-economic groups and leading to various complications like diabetes, cardio vascular diseases and osteoarthritis knee which are responsible for morbidity & mortality. Ayurvedic approach to pathogenesis of medoroga or sthaulya can provide solution in managing rising cases of obesity among population by using various preparations. Vacha kutaki yoga is one of such Ayurvedic preparations. An observational study was design with the aim to assess the clinical efficacy and safety of Vacha kutaki yoga in the management of obesity through clinical symptoms, Body Mass Index (BMI), measurement of abdomen, chest, thigh, arm circumference and laboratory investigation on 100 patients of obesity (medoroga or sthaulya). Vacha kutaki yoga 1 gm (two capsules of 500 mg) thrice daily with lukewarm water for 12 weeks were used in all study participants. Clinical symptoms, BMI and circumference of body parts reduced significantly from baseline to the end of the treatment in completed 84 subjects aged between 12-60 years of both sexes. This study demonstrated the effectiveness of Vacha kutaki yoga in the management of obesity (medoroga or sthaulya).
299 A STUDY TO EVALUATE THE EFFECT OF CARDIAC REHABILITATION PROGRAM ON HEALTH STATUS AND TREATMENT COMPLIANCE AMONGST POST MYOCARDIAL INFARCTION PATIENTS IN A CARDIAC CENTRE , Diksha Biswal* and Deepa Chugh
Efforts are constantly being made, mostly aimed at improving behavioral patterns and poor lifestyle habits. As for all cardiovascular diseases, it is recognized that the cardiac rehabilitation program is the principal method of lifestyle modification to minimize and avoid the recurrence of heart attacks. After the completion of the cardiac rehabilitation program, it revealed that its effect on health status was statistically effective in terms of BMI and blood pressure, and treatment compliance in terms of medication, diet, exercise and follow-up compliance. Substantial decline in hospitalization was observed after completion of cardiac rehabilitation program. Among two dependent variables, health status was found to be statistically non-significant in terms of blood pressure and BMI and treatment compliance in terms of medication, diet, exercise and follow-up, indicating that there is no association between them.
300 A STUDY TO ASSESS THE EFFECTIVENESS OF ICE PACK APPLICATION ON PAIN AND PHYSIOLOGICAL PARAMETERS DURING REMOVAL OF INVASIVE LINES IN A TERTIARY CARE CARDIAC CENTRE, NEW DELHI , Jayanti* and Deepa Chugh
Nowadays many efforts are being done to decreasing cardiovascular diseases which is expeditiously increasing owing to physiological constraints and unhealthy lifestyle. Many patients undergo cardiothoracic surgery, following a cardiothoracic surgery invasive lines are inserted which gives worst experience of pain during removal. The need for pain relief is an important concern today in the society. Hence it is better to add up a non-pharmacological therapy along with medical treatment to maximize the pain control. Ice pack application has a significant short term analgesic effect on pain and physiological parameters of reducing the painful nerve conductions by acting on the gate control system. The nonpharmacological therapies always have its own merits with less side effects which the nurses by their standing orders can implement to the post- surgical patients to lesion the severity of pain.
301 EFFECTIVENESS OF VIDEO ASSISTED TEACHING PROGRAMME ON KNOWLEDGE REGARDING CARE OF CHILDREN ON MECHANICAL VENTILATOR AMONG STAFF NURSES WORKING IN PEDIATRIC INTENSIVE CARE UNITS OF SELECTED HOSPITALS AT BELGAUM , Dr. Sanjay Shinde*, Dr. Nagarajappa D. Jiiu’s, Sarah Ezhil Kelna Edwin and Pritam Kabade
Background: Mechanical ventilation is a method to mechanically assist or replace spontaneous breathing. This may involve a machine called a ventilator or the breathing may be assisted by a physician or other suitable person compressing a bag or a set of bellows. Traditionally divided into negative-pressure ventilation, where air is essentially sucked into the lungs, or positive pressure ventilation, where air (or another gas mix) is pushed into the trachea. Owing to the anatomy of the human pharynx, larynx, and esophagus and the circumstances in which ventilation is required then additional measures are often required to "secure" the airway during positive pressure ventilation to allow proper passage of air into the trachea and avoid air enters into the esophagus and stomach. Method: This was pre-experimental study a total of 500 subjects was selected through non-probability convenient sampling technique. Pre-experimental one group pre-test, post-test design was used. Data was collected by structured knowledge questionnaire. Data collected under the 2 sections (socio-demographic data, knowledge questionnaires). The reliability of the tool was established by spilt half method formula. The reliability result of knowledge was r = 0.902829. Video assisted teaching programme was developed effective for staff nurses regarding the care of children on ventilators, Content validity of the tool was established by six experts. Data was analyzed by using descriptive statistics and inferential statistically in terms of frequency, percentage, mean, standard deviation, Chi-square values. Results: With regard to the pre-test knowledge assessment, the mean percentage of response was 66.97 %, with mean and SD of 17.62±2.43, which increased to 91.67% with mean and SD of 29.43±1.82 in the post-test. Further effectiveness of planned video assisted teaching programe was tested by inferential statistics using paired „t‟ test [(„t‟= 90.4970, P< 0.05)]. On the whole, the analysis revealed that the video assisted teaching programme was very effective in increasing the knowledge of staff nurses on care of children on ventilator. Conclusion: Video assisted teaching programme was effective in increasing the knowledge of staff nurses regarding care of children on ventilator
302 NASOTRACHEAL INTUBATION USING LIGHTWAND IN A PATIENT WITH ANTICIPATED DIFFICULT LARYNGOSCOPY: A CASE REPORT , Ravindra Kr. Gehlot*, Lalit Kr. Raiger, Ritu Verma
Introduction: Oral cancer is sixth most common cancer worldwide and the most common cancer among males in India. Anaesthetic concerns during surgical treatment of which includes airway difficulty, mainly because of restricted mouth opening and less interincisor gap. Case presentation: Here we are reporting a successful nasotracheal intubation using light wand in a case of carcinoma of buccal mucosa (mallampatti grade 4 and mouth opening 1 finger breadth) posted for reconstructive surgery for removal of dead bone. Conclusion: The light wand is a durable, portable, atraumatic and cost-effective option for difficult tracheal intubation. Therefore, the teaching and practice of light wand intubation should be encouraged in learning period. It will be particularly useful in hospitals without adequate facilities of fibre-optic bronchoscope, video laryngoscope or Intubating LMA.
303 FORMULATION AND EVALUATION OF DENTAL GEL CONTAINING CLOVE OIL FOR THE TREATMENT OF PERIODONTAL DISEASE- A REVIEW , Prashant Kumar Katiyar*, Dr. Smita Takerkhade, Madhavi Ashika Lahu, Masne Mangala Ambanna, Mhatre Prajkta Bhagvan, Mishra Mithilesh Kumar Rakesh, Mishra Saurabh Mangalprasad
The study was aimed to formulate and evaluate dental gel containing clove oil as the chief constituent for the treatment of periodontitis. Clove oil has a wide spectrum of antibacterial activity against a number of periodontal pathogens, hence it is selected for the treatment of periodontitis. Clove oil gel is formulated by using carbopol 934 as gelling agent, clove oil as medicinal agent, polyethylene glycol as co-solvent, methyl paraben and propyl paraben as preservative and required quantity of distilled water as vehicle. The periodontal disease commonly refers to inflammatory diseases that are plaque induced i.e. gingivitis and periodontitis. Gingivitis, the moderate stage of disease caused by an accumulation of supragingival plaque and characterized by swelling, light bleeding and redness of the marginal gingival. Gingivitis is associated with a change in the microflora, shifting from a Gram-positive anaerobic flora to a more Gram negative one. Periodontitis, a more severe stage of periodontal disease, results in the resorption of the alveolar bone and detachment of the periodontal ligament supporting tooth. This study was aimed to formulate dental gel containing clove oil for the treatment of periodontal diseases and then was evaluated for their physicochemical properties including drug content, spreadability, extrude ability, in-vitro antibacterial activity.
304 CONTROLLING COVID-19 PANDEMIC THROUGH HORMONE CALCITRIOL , Sunil J. Wimalawansa* MD, PhD, MBA, FACP, FRCP, FRCPath, DSc
The elderly and those with underlying chronic pulmonary, cardiovascular, metabolic, and renal diseases are at a higher risk for experiencing COVID-19 infection and more prone to serious clinical complications, such as cytokine storm and acute respiratory distress syndrome leading to death. In addition to pulmonary cells, COVID-19 also impairs endothelial cells, thus could initiate intravascular haemolysis and microvascular thrombosis, and consequent pulmonary microembolisation. These can lead to multiorgan failure and death. Vitamin D adequacy has a potent effect in prevent or minimise the mentioned harmful outcomes. Sufficient exposure to ultraviolet B rays from sunlight or adequate doses of oral vitamin D supplements enhances the immune system. In vitro and in vivo data suggest that increase expression of anti-inflammatory, antioxidant, and antimicrobial related genes together with the suppression of excessive inflammatory and oxidative process that not only minimize contracting symptomatic COVID-19 infection and associated complications and deaths but also enable rapid recovery. The weaker innate immune system is responsible for complications and deaths from COVID-19. Administration of higher doses of vitamin D can rapidly boost the immune system. It is the most cost-effective way to keep the immune system at high alert and prevent complications and deaths from COVID-19. Therefore, a combination of safe sun exposure and oral vitamin D supplements should be considered proactively to prevent and manage COVID-19. Hydroxychloroquine and ivermectin are two other cost-effective agents that can use in those who have exposed to a person with COVID-19, immediately after PCR positivity, and in early stage of the disease before developing complications.
305 EFFECT OF EMPAGLIFLOZIN ON HR VARIABILITY AND QT DISPERSION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS T2DM , Abdulaziz Jomaa Almohammad Alissa*, Houssam Balleh and Rouba Salman
Background: Individuals with type 2 Diabetes Mellitus(T2DM) are at high risk for development of cardiovascular complications. Treatment with empagliflozin may affect on impaired heart rate variability and impaired ventricular repolarization heterogeneity which associated with the risk of sudden cardiac death(SCD). Objective: the present study aims to assess the effects of empagliflozin on QT dispersion(QTd) and HR variability (HRV) in patients with T2DM. Materials and Methods This is prospective study conducted in the department of cardiology in Tishreen University Hospital-Lattakia -Syria from September 2019 to September 2020. Patients with T2DM who aged 42 to 80 with indication for treatment with empagliflozin were enrolled in the study. QT dispersion, HR variability were recordered before starting empagliflozin and at the end of follow up. Results: A total of 40 patients were included, Median age was 52.5 years, 22 (55%) were male, hypertension was detected in 28(70%) of the patients. Empagliflozin reduced glycemia (186.10±54.9 vs125.72±33.3. p:0.0001), systolic blood pressure SBP(132.3±12.7vs 124.9±9.8, p:0.001),QTd (62.22±21.4 vs52.15±22.6, p:0.003), and increased SDNN(89.15±22.2 vs96.40±21.2,p:0.03) in the study participants. Spearman's correlation analysis revealed positive correlation between changes in SBP and QTd(Spearman's =0.6, P=0.0001) and negative correlation with SDNN(Spearman's =-0.3, P=0.02). Reduction in glycemia was correlated with increased in QTd(Spearman's = -0.2, P=0.07) and decreased in SDNN(Spearman's = 0.1, P=0.3). Conclusion: Empagliflozin alters ventricular repolarization indices and impaired HRV, and this could be the mechanism by which empagliflozin reduced cardiovascular events.
306 EFFECT OF SACUBITRIL/VALSARTAN ON HEART RATE VARIABILITY HRV AND QT DISPERSION IN HEART FAILURE WITH REDUCED EJECTION FRACTION , Waleed Shehab Aladib* and Houssam Balleh
Background: Treatment of heart failure with reduced ejection fraction(HFrEF) by using Sacubitril/Valsartan reduces sudden cardiac death, but the precise mechanism underlying the beneficial effect on reducing cardiovascular mortality is still not clear. Objective: the present study aims to assess effects of Sacubitril/Valsartan on QT dispersion and HR variability in symptomatic patients with HFrEF. Materials and Methods: This is prospective study conducted in the department of Cardiology in Tishreen University Hospital-Lattakia -Syria from September 2019 to September 2020. Patients with HFrEF classified according to the NYHA in II-IV who aged 39 to 82 years were enrolled in the study. QT dispersion, SDNN were reordered before starting Sacubitril/Valsartan and after one month of the therapy. Results: A total of 22 patients were included, Median age was 50 years, 13 (59.10%) were female, hypertension was present in 15(68.2%) of the patients. Sacubitril/Valsartan reduced QTd (65.09±25.3 vs 51.72±21.7, p:0.004), OTc(435.04±27.6 vs 425.40±27.1.p:0.1), QRS(94.54±19.22 vs 93.40±16.39,p:0.6), and increased SDNN(93.22±24.7 vs 111.81±37.2,p:0.01) in the study participants. Spearman's correlation analysis revealed negative correlation between changes in SDNN and dyspnea degree (Spearman's = -0.2, P:0.04) and a positive correlation between changes in QTD and dyspnea degree (Spearman's = 0.3, P:0.01). Increased dose of drug was correlated with decreased QTd(Spearman's = - 0.1, P:0.5) and increased SDNN(Spearman's = 0.1, P:0.4). Conclusion: Based on our results, Sacubitril/Valsartan alters ventricular repolarization indices which associated with clinical improvement, so it could be an effective approach in treating patients with HFrEF.
307 OUTCOME OF IMMUNE THROMBOCYTOPENIC PURPURA (ITP). EXPERIENCE IN A TERTIARY CARE CHILDREN HOSPITAL OF BANGLADESH , *Md. Belayet Hossain and M. Selimuzzaman
Background: The pathogenesis of Childhood ldiopathic Thrombocytopenic Purpura(ITP), a common hematological disease involves antibody-mediated platelet destruction and reduced platelet production. Though in large number of cases it resolve spontaneously but we the pediatricians very frequently use steroid or IV Immunoglobulin due to lack of experience. Object: The objective of this study was to review the presenting features, natural history and remission rate of ITP cases spontaneously or to therapy. Method: This is a retrospective study conducted in the Department of Pediatric Haematology & Oncology of Dhaka Shishu (Children) Hospital during the period January 2018 to December 2019 and there was review and analysis of natural history and treatment response in children diagnosed with ITP age ranged of 9 months to 14 years. Results: Of 64 patient with ITP with a age range of 9 months to 14 years (mean age 6.1 ± 1.6 yrs) and female predominance 36 (56 %) female and 28 (44 %) male. Male female ratio was I: 1.3. Ten (15.6%) children had major hemorhage. The platelet counts were 6,000/cmm to 1.25,000/cmm (mean 19,000/cmm). Bone marrow study was done in 14 (22%) cases with no alteration in diagnosis. Regarding outcome, 25 (39%) patients had been achieved spontaneous remission and 39 (61%) needed intervention with corticosteroid. Among the patients treated with corticosteroid 26 (67%) patients responded to corticosteroid and 13 (33%) had gone to chronic stage. Out of 13 chronic ITP patients 6 had received Anti D Ig: of these 6 patients 100% patients maintained platelet count >30,000/cmm for variable periods, and 7 patients received oral Eltrombopag-a newer drug of ITP treatment: of these 7 patients 5(71%) had responded and maintaining platelet count >50,000/cmm for longer duration than Anti D and 2(29%) did not respond. These 13 of 64 (20%) patient remained as chronic ITP. Chronic ITP developed in older children. Conclusion: The overall prognosis in childhood ITP is excellent. Spontaneous remission occurred in good number of cases (39 %) and overall about 90% cases resolved with therapy or observation. Anti-D Immunoglobulin and Eltrombopag are promising in chronic ITP though further larger study is needed.
308 EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE OF WOMEN REGARDING MENOPAUSAL CHANGES IN SELECTED RURAL AREAS OF MYSURU, KARNATAKA , *Ambika K. and Prof. Sheela Williams
Background: Menopause is a unique stage of female reproductive life cycle, a transition from reproductive to non-reproductive stage. It is characterized by cessation of menstruation and women may view menopause as a transition from middle age to old age. Various problems which women experience are depression, anxiety, irritability, low self-esteem, lack of confidence, memory changes, and difficulty in concentration, fatigue and inferiority feelings, vasomotor, instability, hot flashes, headaches, dizziness, diaphoresis, sleeplessness, wrinkling and dying of the skin and loss of hair. Thus women may be hesitant and ignore the unusual and hormonal related symptoms may go undetected resulting in a delay in diagnosis and treatment. Awareness about menopausal symptoms is necessary for women as she is vulnerable to physical and psychological stress and ability to manage and cope up with those symptoms effectively. Methods: The main objective of the study was to determine the effectiveness of structured teaching program on knowledge of women regarding menopausal changes. The research design selected for this study was Pre-experimental - One group pre test post-test design. 30 women were selected from rural areas of Mysuru through convenience sampling technique. Personal proforma was used to assess the selected personal variables of rural women and structured knowledge questionnaire to assess the knowledge of women regarding menopausal changes. Results: The structured teaching programme was effective in increasing the knowledge of rural women regarding menopausal changes as the computed paired„t‟= 19.2 p<2.045) is found to be significant at 0.05 level of significance. Conclusion: The study reinforces the need to organize teaching programs which sensitize the rural women to enhance the knowledge regarding menopausal changes.
309 CLINICAL PROFILE OF DENGUE FEVER IN A PEDIATRIC POPULATION IN A TERTIARY CARE CENTRE , *Bharti Bhandari, Nitesh and Ragini Singh
Background: Dengue viral infection is a global health threat and it is the most rapidly spreading mosquito-borne viral disease in the world. Symptomatic dengue infection causes a wide range of clinical manifestations, from mild dengue fever (DF) to potentially fatal disease, such as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Objective: To assess the clinical and laboratory profile of the dengue infection in children less than 18 years of age from july 2018 to November 2019 at the Pediatric Department. Results: A total of 119 cases were classified into 114 (95.7%) non severe and 5 (4%) severe dengue cases. The mean age of admission was 11.5 years. The most common presenting symptom was fever seen in 100%, rash 100%, vomiting 61%, pain abdomen 37% and hepatomegaly (25%), the most common physical finding. Elevation in aspartate transaminase (SGOT) was found in 66.42% and thrombocytopenia in 28%. Conclusion: In children, if symptoms like fever, pain, rashes, and vomiting are associated with hepatomegaly and elevated SGOT in context of low Platelet Count, a strong possibility of dengue fever is present, especially in an epidemic setting. Early suspicion and effective management can reduce the severity.
310 IMPORTANCE OF ANALYSIS OF PRAKRUTI IN CHIKITSA , *Dr. Nitin Tale MD., Dr. Ankush Mankar and Dr. Kanchan Khond
Vata, pitta & kapha are the three basic component of body. According to ayurveda all the physiological processes are controlled by shareerika & manasika doshas. Main goal of ayurveda is to maintain the health of healthy individual & to cure the disease of diseased person. Prakruti is defined as individual state in natural form. According to ayurveda prakruti is formulate at the time of union of sperm & ovum inside the uterus. Predominance of either one or two or three dosha determines the prakruti of individual. Prakruti is the natural state of body on other hand vikruti is unbalanced state of body. While diagnose the disease acharya has explained the dashavidha pareeksha. Prakruti analysis is an first while next one is vikruti analysis. Prakruti analysis is an important factor to understand the nature & severity of disease as well as treatment point of view.
311 VOLUNTARY SCREENING FOR HYPERTENSION AMONG NON-HYPERTENSIVE ADULTS ATTENDING MWINGI LEVEL IV HOSPITAL, KENYA , Janice Mukwayu Mulei and Francis Matheka Muoki*
Hypertension is a serious medical condition that significantly increases the risks of heart, brain, kidney and other disease causing premature death. An estimated 1.13 million people worldwide have hypertension. Screening for hypertension helps detect elevated blood pressure so that treatment can begin as required to prevent complications of late diagnosis. Persons at increased risk for hypertension should voluntarily be screened every year while those with lower risk screening every 3 years. The main objective for the study was to determine voluntary screening for hypertension among non-hypertensive adults attending Mwingi Level IV Hospital. This focused on awareness and uptake of screening for hypertension. A cross-sectional hospital-based design was used. The area of study was Mwingi Level IV Hospital. Included non-hypertensive adults, aged above 18 years who consented for participation. Simple random sampling method and a sample of 50 subjects was selected. Data collection was by a questionnaire and was analyzed using Microsoft excel and SPSS Version 21. Descriptive statistics computed included frequencies, proportions and percentages. A very small proportion (5%) of the respondents had screened for hypertension and was motivated by their sick status (60%) from other illnesses since it was a compulsory check their blood pressure checked before consultation. More than half (60%) of the respondents were females aged 40-50 years and majority of them were married (70%). Majority of the respondents (95%), were knowledgeable on hypertension. The main source of information on hypertension was the school (50%). In conclusions, there is low uptake of voluntary screening for hypertension among the respondents. Thus a need to promote awareness on hypertension at community levels through campaigns on screening for early detection and timely management.
312 ADOLESCENT SMOKING HABITS IN REVIEW OF EXPERIENCE WITH THERAPY SPIRITUAL EMOTIONAL FREEDOM TECNIQUE (SEFT) , *Narmi and Mien
Background: All over the world, the impact caused by smoking continues to increase until it reaches 6 million people who are active or passive smokers, resulting in health problems and death In Indonesia, the prevalence of smokers at the age of 15 years and over has increased, namely in 2010 as much as 34.7%, 2013 to 36.3% while in 2017 it returned to from 34.2% ( Dasar Riset Kesehatan , 2013) . Riskesdes 2018, the prevalence of smokers aged > 15 years reached 62, 9% for men and women as much as 4.8%. Whereas in Kendari City, based on a study by the Central Statistics Agency, the percentage of the population aged > 15 years in 2017 who has the habit of smoking tobacco, especially men, reaches 38.17%. To reduce smoking intensity, one method that will be used is SEFT therapy (Spiritual Emotional Freedom Tecnique). Objective: To find out the smoking habits of adolescents from the experience of undergoing SEFT therapy in Punggaloba Village, Kendari City. Method: This type of research is quantitative with a descriptive design and was conducted in August-September 2020. The total population of adolescents aged 15-25 years was 39 respondents using the Saturated Sample Technique. Results: There was a change in smoking habits in adolescents, namely a decrease in smoking intensity in terms of the respondent's experience after undergoing SEFT therapy 4 times with an average of 10.33 cigarettes a day, whereas before undergoing therapy the average respondent smoked 18.23 cigarettes. Conclusion: Adolescent smoking habits have changed with the reduced smoking intensity of respondents in the moderate category, namely by consuming enough cigarettes with an interval of 31-60 minutes starting to wake up in the morning and changing to the light category, namely consuming cigarettes rarely with an interval of 60 minutes from wake up in the morning.
313 HYDROSTATIC REDUCTION OF INTUSSUSCEPTION IN CHILDREN: PROGNOSTIC MATHEMATICAL SCALE BASED ON INDEPENDENT RISK FACTORS FOR FAILURE OF CONSERVATIVE REDUCTION: A SINGLE CENTER STUDY FROM SYRIA. , Kumait Issa*, Wajeeh Ali and Basel AL-Abbas
Objective: The aim of this study is to design prognostic scale for predicting the probability of failed conservative reduction of intussusception in children. Patient and Methods: Four independent risk factors of failure reduction have been retrospectively defined, we have made of them a scale of 7 grades as following: Bloody defecation:1, free peritoneal fluid:1, length>5 cm:1, and duration of symptoms:0- 4grades. and devided it into two areas: low risk <4, and high risk when the grade ≥4. Then we applied it on the prior sample off 99 patients, and by a prospectively study on a sample of 15 patients, to evaluate its accuracy. Results: According to the ROC curve, patient with chance of failure more than 60% will be a real failure in 94% of cases. On the other hand, patient with chance less than 19% will be a real success in 89% of cases, We have retrospectively applied our scoring system on patients excluded from our earlier sample and treated with primary surgery to evaluate its accuracy and found that 5/7: 71.4% of them are considered as high risk of failure. When we prospectively applied this scoring on the 15 patients intussusception prepared to hydrostatic reduction, we found that it had a high degree of sensitivity and specificity, that 80% 0f high risk group was a real failure. Conclusions: These scores can be used as a guide to promote the referral of the cases to tertiary centers with facilities for conservative reduction if possible.
314 DENTAL CARIES AND RISK OF STUNTING AMONG UNDER FIVE-YEAR CHILDREN AT KLABANG DISTRICT BONDOWOSO REGENCY INDONESIA: A NESTED CASE-CONTROL STUDY , Titah Rahayu*, Isa Ma’Rufi and Ristya Widi Endah Yani
Teeth and oral cavity have an important role in nutritional intake. Pain and discomfort associated with untreated caries can decrease the ability to chew, resulting in inadequate nutritional intake and thus linear growth. Increased pro-inflammatory cytokines as the body's response to chronic infection to the consequences of untreated caries can affect bone growth during the prenatal and postnatal periods. This study aimed to investigate the effect of dental caries on the stunting occurrence in under five-year children who were registered in the birth cohort born from 2014-2015 at Klabang Public Health Center using a case-control nested in cohort study design. 42 stunting and 42 normal children were matched age and gender, obtained by purposive sampling from a total of 317 children. The distribution of respondents showed that more than half were male (66.7%), and have a high caries level 54,8%. The def-t index of case and control groups were 7.40±2.84 and 4.52 ± 2.04, respectively. The result of Mc Nemar test showed that dental caries were a risk factor for stunting (COR = 1.222; 95% CI=0.263-5.682; p=0.000). After being controlled with confounders in multivariable logistic regression analysis, high caries level was the most dominant risk factor for stunting (AOR = 5.4; 95% CI=1.95-14.95; p=0.001). It could be concluded that healthy teeth and mouth are important for general health. Dental procedures as the curative and rehabilitative efforts in Integrated Health Post for Child (Posyandu) are recommended to reduce the negative impact of dental caries in linear growth.
315 SEROLOGICAL SURVEY OF SWINE BRUCELLOSIS IN NORTHERN CÔTE D’IVOIRE: PRELIMINARY ASSESSMENT , Guillaume B. Gragnon, Benjamin K. M’Bari*, Azoumana Timitey and Emmanuel Couacy-Hymann
A serosurvey was conducted in northern Côte d’Ivoire to determine the prevalence of pig brucellosis in 2018. For this purpose, blood was taken from peripheral veins on the ear the ear basis of 600 pigs from 6 months of age and regardless of sex. Pigs were randomly selected from 60 herds herds in four districts. The serological analysis performed was Rose Bengal Test. Brucellosis appeared to be a major problem in the study area, with an overall seroprevalence of 10.2% (61/600). Moreover brucellosis was diagnosed in all the selected localities; and only one from the 60 selected herds did not give positive results in the District of Korhogo, pigs appeared to be most exposed to brucellosis (18.2%). Sex and age did not affect the prevalence of this disease. The high seroprevalence observed shows the urgent need to sensitize pig breeders to improve the biosecurity and pig farms management techniques. In-depth studies are needed to better understand the epidemiology of porcine brucellosis in northern Côte d'Ivoire.
316 OXYGEN SATURATION AT ADMISSION – PREDICTION OF FETO - MATERNAL OUTCOME AMONG PRE-ECLAMPSIA MOTHERS , *Dr. N. Muthulakshmi and Dr. Vanitha
Introduction: Pre-eclampsia is an pregnancy complication affecting 10% of pregnant mothers. It affects both maternal and fetal outcome adversely. In preeclampsia, hypoxemia may result from a number of mechanisms. Preeclampsia remains a complex and poorly understood disease. Currently, there are no reliable predictor of preeclampsia for early diagnosis to avoid adverse maternal or perinatal outcomes. Objective: To evaluate the incremental value of SPO2 in prediction of maternal and fetal outcome in women with preeclampsia. Methodology: We conducted the cross-sectional study on 50 pre eclamptic women who were hypertensive after 20 weeks of gestation with proteinuria with variable severity, were selected on admission at labor ward of OBG department of Tirunelveli medical college hospital. Results: After statistical analysis, it was seen that the women having SPO2 ≤ 95% was 18 and with normal SPO2 was 32 mothers. The mean age of low and normal group was 30.3 and 26.8 years. The mean gestational age of two groups was 34.6 and 35.8 weeks respectively. The Systolic BP was 161.7 and 145.3 in both groups and Diastolic BP was 103.9 and 95.9 mmHg respectively, the difference was statistically significant in both groups. There was proteinuria in 55.6% in low spo2 group and 43.6% in normal spo2 group. MGSO4 administration was required in 83.3% in low SPO2 group and 12.5 in normal SPO2 group. LSCS was bit higher in low SPO 2 group. Thrombocytopenia, blood transfusion, parenteral antihypertensives and acute renal dysfunction was more in low SPO2 group. Whereas the incidence of cortical blindness, pulmonary edema, hepatic dysfunction, placental abruption and PPH was not statistically significant. The fetal outcome like IUD, Birth asphyxia, neonatal death, MAS and NICU admission between two groups was not statistically significant. Conclusion: In mothers SpO2 ≤ 95% had more adverse outcomes in comparison to SpO2 ≥96% along with systemic dysfunction.
317 VISUAL INSPECTION OF CERVIX WITH LUGOL’S IODINE AND ACETIC ACID FOR EARLY DETECTION OF PREMALIGNANT AND MALIGNANT LESIONS OF CERVIX WITH COLPOSCOPY AND HPE CORRELATION , Dr. S. Lujim Mala and *Dr. M. Keerthana
Background: Globally, carcinoma cervix is the fourth most common malignancy and second most common after breast carcinoma in women. In India, new cases of carcinoma cervix are 96,922 every year and the deaths due to cervical cancer is 60,078/year, according to 2018 statistics. Previously there was routine screening with cytology namely pap smear for all women who was and is sexually active. But due to the need for expertise in cytopathological studies, there came another alternative for screening. Now visual inspection with acetic acid and lugol's iodine is mostly recommended in low resource settings like India. Based on this our objective is to find out the incidence of cervical lesions in asymptomatic lady with visual inspection methods. Also, to compare the efficacy of Visual inspection methods with colposcopy and guided biopsy and to analyze the readiness in using Visual inspection methods as effective screening procedure in low resource setting Methods: This prospective study conducted in a tertiary care hospital for 1 year. This study comprises study subject of 620 women who were attending general and gynecology OPD. All 620 patients were subjected to visual inspection and magnification (VIA/VILI), colposcopy and biopsy was done in the positive patients. Results: Of 620 cases studied, colposcopy was positive in 80. Among 80 cases who were colposcopy positive, VIA/VILI was positive in 59 cases. Colposcopy guided biopsy was positive in 80 cases. The sensitivity of VIA/VILI in detecting preinvasive lesions was 91.88% and specificity was 100% when compared with colposcopy which has sensitivity 98.9% and specificity 100%. Conclusions: Hence the screening method of visual inspection methods came into action. This was very easy to perform and very useful for mass screening. The results are available readily so that the patients need not visit the health center twice. Thus, for low resource setting, VIA VILI is a great impact on the mass screening.
318 PREPARATION AND EVALUATION OF ALGINATE BEADS: A REVIEW , *Akbal Ahmad, Abadhesh Niranjan, Kanchan Gangwar, Nikhil Ranjan
The objective of this review is to elaborate the potential of alginate beads as a biopolymer within the formulation development and its applications. There is a growing trend in pharmaceutical in food industry to avoid the tough condition within the preparation for administration to the body or for the storage purpose because it induce the side effects, instability or loss of therapeutic effect of the medicament. The alginate beads could also be a flexible functional biomaterial for viscosity enhancement, stabilizer, matrixing agent, encapsulation polymer, bioadhesive and film former in transdermal and transmucosal drug delivery. This review includes the preparation, properties, compendial standards, methods utilized for preparation of drug delivery systems using sodium alginate and its applications.
319 THE DIAGNOSTIC ROLE OF BRAFV600E MUTATION AND ULTRASOUND FEATURES IN INDETERMINATE THYROID CYTOLOGY , Alaa Al-Maaitah*, Moaath Alsmady, Mira Younis, Ahmad Al-Alwan, Dana Alsmady, Shatha Dmour, Handan Ankaralı, Malek Zihlif, Mohammad Al-Shehab, Heyam Awad, Nader Albsoul, Orhan Alimoglu
Background: Fine needle aspiration biopsies of thyroid nodules are indeterminate in approximately 30% of the cases, so several preoperative molecular markers have been studied to improve the diagnostic utility of such nodules. We aimed to study the role of BRAF V600E mutation and ultrasonography to predict malignancy preoperatively for indeterminate thyroid nodules. Methods: This is a retrospective study that included 78 indeterminate nodules. DNA was extracted from formalin-fixed paraffin-embedded tissues and BRAFV600E mutation was analyzed by direct sequencing. Neck ultrasound records were evaluated for the major sonographic features including size, margin, halo, echogenicity, calcifications, vascularity and cervical lymphadenopathy. A “p” value less than 0.05 was considered statistically significant. Results: Seventy-eight indeterminate nodules were distributed in Bethesda categories III, IV and V as 38, 17, 23, respectively. Malignant cases in each category were 6/38, 5/17, 12/23, respectively. All of them were diagnosed with papillary thyroid cancer. Four cases out of 78 harbored BRAFV600E mutation (1 in category III, 3 in category V). Accordingly, malignancy was significantly predicted by cytology (p=0.009) and BRAFV600E mutation (p=0.001). The latter exhibited 100% specificity. However, the overall sensitivity of BRAFV600E mutation was 17.4% and increased only to 25% in category V. Sonographic features that corresponded significantly to malignancy were microcalcifications and cervical lymphadenopathy (p=0.026 and p=0.017, respectively). But only ill-defined margin was associated with BRAFV600E mutation (p= 0.032). Ultrasound features had low sensitivity (15.4%-84.6%), but higher specificity (9.7%-93.9%) of which microcalcifications and ill-defined margin were the most specific signs. Conclusions: BRAFV600E mutation was a significant predictor of malignancy for indeterminate thyroid nodules. However, it was most useful in Bethesda category V. Microcalcifications, ill-defined margin and cervical lymphadenopathy were the most suspicious sonographic features of malignancy.
320 STUDIES ON THE AIR POLLUTION AND AQI OF BENGALURU CITY, INDIA , Shobitha Sunil, Maria Thomas, Ramesh B. S. and Dr. Jayarama Reddy*
Background: Air pollution has become one of the most hazardous global concerns, killing an estimated 7 million people worldwide every year. Bengaluru, the city of India‟s high-tech industry has been developing economically scaling up the luxuries of living lifestyle. Due to the rapid development of this metropolitan city, it has been facing deteriorating environmental conditions. Aim: The sole objective of this paper is to critically analyze the air pollution trend from 2011-2018 at various industrial, residential, sensitive and moderate locations in Bengaluru on various factors that contribute to air pollution. Methods: The data for this study was retrieved from KPSCB website. To perform the statistical analysis, R-program and Microsoft Excel were utilised. Results: The results show that, the particulate matter is increasing drastically every year, beyond the standard controllable limit, hence leading to increased incidences of respiratory diseases every year.
321 ANALYSIS OF PERINATAL AND MATERNAL OUTCOMES IN ANTENATAL WOMEN WHO HAD TWO HOUR PLASMA GLUCOSE BETWEEN 6.7 MMOL/L AND 7.8 MMOL/L WITH 75G OGTT , A. Geethalakshmi*, Mohana Priya, C. Anjalakshi and V. Seshiah
Objective: To ascertain the maternal and fetal outcome in antenatal women (ANW) whose 2 hr PG is < 7.8 mmol/dl. Materials And Methods: This is a retrospective study performed in a tertiary care hospital, Institute of Social Obstetrics at Govt Kasturba Gandhi Hospital (ISO-KGH), Chennai after obtaining ethical committee approval. This study analysed age, trimester and BMI of n = 1902 ANW who have undergone ―A Single Test Diagnostic Procedure‖ of Diabetes in Pregnancy Study Group India (DIPSI) for diagnosing GDM with 2hr PG ≥ 7.8 mmol/l. ANW were categorized into three group: Group I < 6.7 mmol/dl Group II 6.7 – 7.8 mmol/l and Group III > 7.8 mmol/l. The study compared the incidence of polyhydramnios in the ANW and macrosomia in the new-borns whose birth weight > 3.5 kg. Result: Polyhydramnios in the antenatal woman and macrosomia in the new-borns were statistically significant in Group II *p value- 0.0001. Conclusion: ANW who had 2hr PG between 6.7mmol/l and 7.8 mmol/l had adverse pregnancy outcomes in all trimesters. Hence this category requires cognisance.
322 THE ANALYSIS OF INFANT MORTALITY RATE (IMR) REDUCTION POLICY IN TUBAN HEALTH DEPARTMENT , Bhakti Aryani*, FX Ady Soesetijo and Farida Wahyu Ningtyias
 The Infant Mortality Rate (IMR) report can be a benchmark for determining the quality of a nation's Human Resources (HR) because the creation of a healthy, intelligent and quality future generation will start from the time when the baby is born to adulthood. In the last five years, namely 2014 to 2018, Tuban Health Department reported that the Infant Mortality Rate was still fluctuating. The IMR in 2014 was 186 cases, in 2015 there were 225 cases, in 2016 there were 219 cases, in 2017 there were 109 and in 2018 there were 158 cases. The success of development in the health sector is influenced by various aspects, one of which is the political aspect. The existence of policies, programs, implemented innovations, monitoring and evaluation will be several factors that influence the political aspect. Researchers conducted a policy analysis of reducing IMR at the Tuban Health Office Department using the Dunn method (1998). Forecasting data and recommendations are obtained through a questionnaire with 59 respondents and a recommendation questionnaire based on the criteria for effectiveness, efficiency, political feasibility, economic feasibility, and administrative feasibility that will be assessed by the main research respondents. The result was that there was a lack of effective communication between health workers who could be at risk of fluctuating IMR.
323 ADVANTAGES OF ADIPOSE DERIVED STEM CELLS (ADSC’S) OVER BONE MARROW - MESENCHYMAL STEM CELLS AND UMBILICAL CORD- MESENCHYMAL STEM CELLS IN REGENERATIVE THERAPIES-A SYSTEMATIC REVIEW , *Dr. Kulvinder Kochar Kaur, Dr. Gautam Allahbadia and Dr. Mandeep Singh
With the gradual work on stem cells via bone marrow(BM)or umbilical cord human mesenchymal stem(UC-MSCs) cells finally it has been found that the Human adipose-tissue(AT) constitutes the best source of stem cells in view of its acceptance presence in plenty and much less pain during retrieval as compared to other sources. Adipose derived stem cells(ADSC’s)can get maintained as well as expanded within culture for long time without getting rid of their capacity to differentiate and hence yielding great cell quantities that are getting used exceedingly for cell therapy reasons. A lot of outcomes of ADSC’s-based cell therapies products showed sufficient effect as well as lot of efficiency in certain clinical reasons for autologous as well as allogenic settings. Thus being thought of as potential ways of replacement, repair as well as regeneration of injured cells. Here we have reviewed these advantages and probable uses like wound repair, cardiac problems, Neurodegenerative problems, radiation injuries, autoimmune diseases after having reviewed MSC’s earlier from other sources and embryonic totipotential stem cells.
324 ROLE OF YASHTIMADHU RASAYANA ON AGNI W.S.R.T. JARA , Dr. Punit Dongre*, Dr. Sunil Hariram Pal and Dr. Salil Jain
In Ayurveda the term ‘Jara Vyadhi’ i.e. Geriasis is coined as a natural phenomenon. Acharya Sushruta has classified it as a Swabhava Pravritta Vyadhi. Rasayana therapy is specifically advocated for the management of Jara i.e. Geriasis. In fact Rasayana is defined as a Jara Vyadhi vidhvamsaka i.e. a drug destroying the Jara Vyadhi. The present article takes review of study of Yashtimadhu Rasayana therapy in the light of Agni.
325 STUDY OF PROGNOSTIC FACTORS OF ABDOMINAL WOUND DEHISCENCE AFTER MIDLINE LAPAROTOMY , Taha Sino Ali*, Aktham Kanjarawy and Ali Alloush
Background: Abdominal Wound dehiscence (WD) following laparotomy is a surgical emergency with high morbidity and mortality. Objective: the present study aims to determine the incidence and important risk factors for WD after laparotomy. Materials and Methods: This is analytical study conducted in the Department of General surgery in Tishreen University Hospital –Lattakia- Syria from November 2019 to November 2020. Patients aged 18 to 85 years who underwent to laparotomy were included in the study. Results: 88 patients were included in the study. The median age was 66 years, 57(64.8%) were male, abdominal WD was developed in 22 patients (25%). Abdominal WD was more frequently in patients using corticosteroid, with a history of chemotherapy or radiotherapy, and in the presence of wound infection (P<0.05). Independent predictors for abdominal WD were wound infection (OR=10 [2.7 – 22.9], p:0.0001), hypoalbuminemia (OR 4.5 [1.9 – 19.2],P:0.006), and prolonged use of corticosteroid(OR=3.3 [0.6 – 17.8], p:0.01). Conclusion: Abdominal WD is a serious complication which associated with worsening prognosis, so identification the risk factors for abdominal (WD) may be useful in guiding perioperative management.
326 NON-INVASIVE PREDICTORS OF ESOPHAGEAL VARICES IN PATIENTS WITH CIRRHOSIS , Dr. Khaldoun Hatem*, Hassan Zaizafoun and Ismael Hammad
Background: Esophageal varices (EVs) is one of the main complications of liver cirrhosis which carries a significant risk of hemorrhage, the leading cause of morbidity and mortality in cirrhotic patients. Objective: The aim of this study was to evaluate various biochemical and ultrasonographic parameters in predicting the presence of EVs in cirrhotic patients compared to Esophagogastroscopy, the method of choice for identifying the varices. Materials and Methods: This is Cross sectional study conducted in the department of Gastroenterology in Tishreen University Hospital-Lattakia -Syria from September 2019 to September 2020. Patients with liver cirrhosis who aged 14 years and older were evaluated for presence EVs. Results: 88 patients were included in this study, median age :57(range:21-83 years).65.9% were male with a male/female ratio of 1.9/1.The etiology of liver cirrhosis was unknown in 36.4% of cases, 83% of patients were found to have EVs. Portal diameter and spleen size were greater in patients with EVs in comparison with those without EVs (p<0.05), whereas platelet count and platelet count/spleen size ratio were lower in patients with EVs. Platelet count/spleen diameter ratio had the highest accuracy(77.3%) in comparison with the other parameters. ROC curve showed an area under curve of 0.78, a cut off of 902 with sensitivity 77% and specificity 75% Conclusion: Platelet count/spleen diameter ratio has the best diagnostic accuracy for presence EVs in cirrhotic patients. It might be useful in clinical practice by decreasing the use of invasive Esophagogastroscopy.
327 VALORIZATION OF WATERMELON FRUIT (CITRULLUS LANATUS) BYPRODUCTS: PHYTOCHEMICAL AND BIOFUNCTIONAL PROPERTIES WITH EMPHASIS ON RECENT TRENDS AND ADVANCES , Ana S. Vinhas, Carla Sousa, Carla Matos, Carla Moutinho and Ana F. Vinha*
Watermelon (Citrullus lanatus) a fruit crop, is an herbaceous creeping plant belonging to the family Cucurbitaceae. It is a tropical plant, mainly propagated by seeds and thrives best in warm areas. While the fruit pulp is consumed, seeds are often discarded. The continuously growing global market for the main tropical fruits is currently estimated at 85 million tons, of which approximately half is lost or wasted throughout the whole processing chain. Developing novel processes for the conversion of these byproducts into value‐added products could provide a viable way to manage this waste problem, aiming at the same time to create a sustainable economic growth within a bio‐economy perspective. Given the ever‐increasing concern about sustainability, complete valorization through a bio‐refinery approach, that is, zero waste concepts is therefore most important. This paper aims to report the status on the valorization of tropical fruit byproducts, more specifically in watermelon seeds and their content in bioactive compounds, such as phenolic acids, flavonoids, carotenoids, alkaloids. Moreover, the bioactivity of the different types of phytochemicals and their possible application as a resource for different sectors (food, pharmaceutical, and environmental sciences) is discussed. Consequently, this review presents the concepts of tropical fruit byproducts recovery, and the potential applications of the isolated fractions.
328 COVID-19 AND “NEW NORMAL” , Dr. Kawaljit Kaur*, Dr. Sargun Singh and Dr. Angad Singh
Covid- 19 pandemic is hitting the world at different paces in different parts. It has not only caused mammoth amount of deaths but also devastated the economy of the world. In May 2020, the Asian Development Bank announced that this pandemic could cost the global economy between $5.8 and $8.8 trillion. Countries are making efforts to reopen the businesses and other institutions but parallel to it, the spread of Covid-19 is accelerating at skyrocket pace. New strain of corona virus found recently in UK has been reported as having 17 mutations in the genome and is 56 % more transmissible. More than 50 vaccines for Covid-19 are being tested around the world with at least 80 others in earlier stages of development. The leading vaccines have already been approved fully or for emergency use in some countries. As Covid-19 is expected to stay for long, life has to be managed along with it but with a difference. This difference would be our new normal where we would have to continue wearing masks, sanitizing our hands and our surroundings repeatedly. People would come to rely on the concept of ―work from home‖ and ―online learning‖. When there is still no sure shot cure or treatment for Covid-19, the importance of Ayurveda has emerged as people are trying to find out some respite in the form of Tulsi, Giloy and other natural remedies. People have learnt the importance of good health and started prioritizing home-made foods to ensure the strengthening of their immune system.
329 SOCIO-DEMOGRAPHIC RISK FACTORS FOR COMORBIDITY OF TYPE 2 DIABETES MELLITUS-PRIMARY OPEN ANGLE GLAUCOMA IN IMO STATE NIGERIA , Eberendu Izuchukwu Francis*, Abanobi Okwuoma Chi. and Ozims Stanley James
Comorbidity is a major health concern all over the world with a huge number of people diagnosed each day. This research work studied the demographic risk factors for comorbidity of type 2 diabetes mellitus-primary open angle glaucoma(T2DM-POAG) in Imo state, South Eastern Nigeria through a population based case-control study design. The subjects concerned in this study were 198 adults aged, 40 years and above, diagnosed of T2DM-POAG comorbidity (99 cases and matched 99 controls). Variables taken into consideration were: age, sex, educational background, marital status, occupation. Data analyses were performed using IBM-SPSS statistics version 23 for data analyses. Weighted test such as Wald test was used to test for significant factors in the model. The factors were considered significant at 5% level. Odds ratio were computed so as to measure the strength of the association between each of the exposures (the risk factors of interest) and the outcome. Confidence interval (CI) at 95% level was also calculated for each odds ratio. Results showed Occupation such as office clerk and teaching were found to be significant factors of T2DM-POAG comorbidity in both the univariate and the multivariate analysis with higher odds attached to both factors compared to farmers. Age was not found as a significant demographic factor which is quite a surprise, considering the fact that age is an established separate risk factor of diabetes and glaucoma, as well as in both combinations. Educational level was also found to be significant in the adjusted analysis (p=0.011, 95%CI= 0.071 – 0.0708) and the adjusted odds ratios (AOR =0.22) rather indicates lower risk of T2DM-POAG comorbidity compared to the participants with non-formal education. Implications for the control of the comorbidity were discussed in line with the research questions. Research work like this, tend to broaden the perspectives related to factors that play a vital role during the designing of preventive procedures and development of public health interventions regarding T2DM-POAG comorbidity.
330 INDIGENOUS POLYPHENOLS OF CASHEW: THE ALMA MATER IN NATURAL NUTRITION , *Kushal Nandi, Dr. Dhrubo Jyoti Sen, Dr. Dhananjoy Saha and Dr. Sudip Kumar Mandal
The cashew tree (Anacardium occidentale) is a tropical evergreen tree that produces the cashew seed and the cashew apple. The tree can grow as high as 14 m (46 ft), but the dwarf cashew, growing up to 6 m (20 ft), has proven more profitable, with earlier maturity and greater yields. The cashew seed is often considered a nut in the culinary sense; this cashew nut is eaten on its own, used in recipes, or processed into cashew cheese or cashew butter. Like the tree, the nut is often simply called cashew. The species is native to Central America, the Caribbean, and northern South America, including north-eastern Brazil. Portuguese colonists in Brazil began exporting cashew nuts as early as the 1550s. In 2017, Vietnam, India, and the Ivory Coast were the major producers. The shell of the cashew seed yields derivatives that can be used in many applications including lubricants, waterproofing, paints, and, starting in World War II, arms production. The cashew apple is a light reddish to yellow fruit, whose pulp can be processed into a sweet, astringent fruit drink or distilled into liquor.
331 A COMPARISON OF THE EFFICACY AND SAFETY OF COLD VERSUS HOT SNARE POLYPECTOMY FOR SMALL COLORECTAL POLYPS , Alaa Marshan*, Hassan Zaizafoun and Rana Issa
Background and Aim: Adenomatous colorectal polyps are precancerous lesions, although most have benign course, some of them might develop into colorectal cancer which is the third common diagnosed cancer in USA. Thus, detection and resection of such lesions is very important. Recently, cold snare polypectomy (CSP) has increasingly been used over hot snare polypectomy (HSP) for the removal of colorectal polyps (3 – 10mm in size). However, the optimal technique (CSP vs. HSP), in terms of the complete resection and complications, is uncertain. The aim of our study was to compare cold with hot snare polypectomy in the complete resection and in the occurrence of post polypectomy complications in small colorectal polyps which range (3–10) mm in size. Materials and Methods: The study began from May 2019 to April 2020, in GI Endoscopy Unit in Tishreen University Hospital. 80 polyps from 54 patients were randomly assigned to either CSP or HSP (40 polyps in each group). Total resection was studied and post Polypectomy adverse events (AEs) were monitored. Results: Complete resection was achieved in 92.5% of polyps in (CSP) group (37/40) compared with 95% of polyps in (HSP) group (38/40) (p value = 0.646). Three patients developed delayed bleeding in (HSP) group while no AEs were seen in (CSP) group (p value = 0.048). Conclusion: CSP is effective and safe in removing colorectal polyps range in size 3-10 mm.
332 THE NEED OF MODERNISATION IN AYURVEDIC EDUCATION NEED AND LIMITATIONS , Dr. Neha J. Kothari* and Dr. Amit Barbudhhe
Background: Education is the best investment as it gains best returns. Ayurvedic system of education has a ten folds history from centuries Nalanda, Takshila are the ancient examples of universities imparting quality Ayurvedic education.With time the way of looking diseases have changed due to advent of new sets of micro organisms but the Principles of Ayurveda are firm and unshakable. Modernising Ayurveda in education platform is the challenge as to what and which extend modernisation will benefit the education system. This article discuss the loopeholes of understanding the requirement of modernising the proud tradition of our country to the extend we don’t lose our pride principles.With the discussion of the needs and limitations of modernisation, this article gives new vision to think about our traditional system with utmost respect and to understand the the potency of our medicines to fight all odds. Aim: To discuss need of modernisation in Ayurveda with its limitations. Objectives: To think about globalising Ayurveda and need for reform in current scenario for becoming full fledged educating system. Method: Various vedic texts,electronic articles from journals,interviews of reknowned scholars in Ayurveda helped to compile all thoughts Conclusion: Modernisation to the limit where Ayurvedic principles are unharmed is the requirement of Ayurvedic Education System.
333 CERVICAL CANCER SCREENING METHODS , *Bhavya S. V. and Ambika K.
Cervical Cancer is the second most common cancer among women in developing countries world wide. It causes 12% of all cancers in women. About half a million new cases each year and more than one fourth million deaths each year occur due to cervical cancer, the condition of cervical cancer can be preventable and curable.
334 THE EXTENT OF ADHERENCE TO THE PRECAUTIONARY MEASURES AMONG UNIVERSITY STUDENTS IN PALESTINE DURING COVID-19 PANDEMIC , Mustafa Mohammad Shouli*, Hemat Abd Elmoneem Elsayied, Rebhi Matar Bsharat and Ahmad Adel Hanani
(COVID-19) pandemic has rapidly spread across the globe causing massive disruptions to everyday life. This study aimed to assess the extent of adherence to the precautionary measures among university students in Palestine during COVID-19 Pandemic. Research design: A cross-sectional sample survey consisted of 2094 male and female university students. Setting: the study was conducted at Modern University College, An-Najah National University, Palestine Polytechnic University, Al-Quds Open University, Ibn Sina College of Health Sciences and Arab American of University /West Bank / Palestine. The data collected was from the participant university students and started in first November 2020 to late November 2020 Subjects: A convenience sample consisted of 2094 female and male students with different Bachelor degree programs. Tools: A self-designed questionnaire was used for data collection and included the following parts. part1: demographic particulars of the university students, Part II. Knowledge of university students about Coronavirus, knowledge among isolation for patient with Covid-19 at home, also their knowledge regarding following for Precautionary measures outside home, Part III: precaution practices were assessed for university students outside home Part IV: assessed University student attitude toward Covid-19. Results: the current study reveals that 80.2% of the studied sample of students had a satisfactory total knowledge regarding precaution measures outside home, 91% of them had a satisfactory total knowledge regarding precaution measures inside home among patient with Covid-19, and 95.5% of them had a satisfactory total knowledge regarding Covid-19 disease. There was a statistically highly significant relation between total knowledge and total practices outside home (p-value<0.001), and statistically significant relation between total knowledge and total attitudes (p-value0.005). Conclusion: based on the current study, students were observed to have substantial knowledge, practices for precautionary measures, and a positive attitude toward COVID-19. Recommendation: continuing Government programs should aim to educate individuals from other sectors of the society to ensure the proper dissemination of knowledge on preventive safety measures, as this will help restrict and control the pandemic.
335 ONLINE LEARNING EXPERIENCES IN ACHIEVING THE MATERNITY NURSING COMPETENCY IN THE COVID-19 PANDEMIC: PHENOMENOLOGICAL ANALYSIS , Emy Sutiyarsih* and Yafet Pradikatama Prihanto
Background: Lectures that are carried out online sometimes cause obstacles in the learning process. Lectures at Panti Waluya College of Health Sciences during the pandemic are carried out by online. Sometimes this process is constrained by signals where students live. The purpose of this study was to determine student experiences in online learning to achieve maternity nursing competency in the COVID-19 pandemic. Objective: The study provided an overview of how participants interact with their environment in participating at online learning. Methods: Qualitative method with an interpretive phenomenological approach are used as the research design. The research also used in-depth interview technique with semi-structured interview guidelines as a data collection strategy. The researcher conducted data analysis using Intepretative Phenomenological Analysis (IPA). Results: The results of this study stated that there was 1 main theme, which was The Need of Preparation in Online Learning. Conclusion: The suggestion from this research is that it is recommended to conduct a further study with quantitative methods regarding to factors that influence student readiness in participating online learning.
336 MEDICATION ADHERENCE AMONG TYPE 2 DIABETES MELLITUS PATIENTS IN MANDALAY CITY, MYANMAR , Moe Oo Thant*, Pa Pa Soe, Myo Tun and Win Myint Oo
Context: The prevalence of diabetes mellitus and its related disability and premature death are high all over the world, including Myanmar. It is important to understand the perception on medication adherence among type 2 diabetes mellitus patients to design effective interventions and to ultimately improve adherence rate of diabetes mellitus patients in Myanmar. Objective: To study medication adherence among type 2 Diabetes Mellitus patients in Mandalay city, Myanmar. Methods: A cross-sectional study was done among 180 type 2 diabetes mellitus patients who were recruited by simple random sampling from the eight charity clinics in Mandalay. Face to face interviewing was done at participants’ homes by using a semi-structured questionnaire. Medication adherence was measured by Medication Assessment Questionnaire. Results: Among the participants, 63.3% of patients had good adherence to antidiabetic therapy. Level of perception was strongly associated with level of medication adherence (p<0.001). Conclusion: In this study, medication adherence of type 2 diabetes mellitus patients was good. However, knowledge concerning etiology and pathophysiology of diabetes was poor. Therefore, the health education programs should emphasize not only on the risk factors and complications of the disease but also on etiology and pathophysiology and importance of drug adherence.