Search results for “Adult”

Secondary Hip Fractures among Aging Adults with a Previous Hip Fracture History: Cumulative 50 Year Overview, Analysis, and Possible Antidote as Observed from 1974-2026 Data Sources

Hip fractures, which remain an immense public health concern, have been subject to study and prevention efforts for many decades, but with limited success in averting either incident, second or subsequent hip fractures, commonly attributed to a combination of age related proclivity to fall, low bone and muscle mass. This review examines second hip fracture incidence rates and determinants of this serious functionally debilitating injury as observed over time remains a current 2026 public health concern. It specifically explores if more preventive efforts are currently warranted in this regard, and in what respect, if indeed, more frail older adults are living longer, but may be in excessively poor health, fearful of moving or falling, malnourished, weak with poor balance, or depressed. Based on what is published, it is concluded 1) second hip fracture incidence rates remain considerable, especially among those who are frail with osteoporotic bone disease, poor vision, heart/or cognitive conditions, plus those with muscle deficits of the lower limb, live alone and have a falls history; 2) studies to identify possible mitigation approaches appear promising in this regard, along with more routine efforts to minimize falls risk and bone attrition.

Reduced Tissue Oxygenation and Altered Valsalva Hemodynamics in Young Adults with Type 1 Diabetes

Aims Cardiac autonomic neuropathy is currently an untreatable progressive complication of type 1 diabetes (T1D). Impaired microcirculation is a suspected cause of nerve degeneration in TID. We investigated whether cardiovascular autonomic reflexes often used as indices of nerve functions, are associated with indices of microcirculatory function in young adults with T1D compared with non-diabetic controls. Methods In a cross-sectional study, 15 adults with T1D and 15 age-matched controls (20-40 years) underwent standardized cardiovascular autonomic reflex tests. Continuous recordings of electrocardiogram, cardiac vagal tone, beat-to-beat blood pressure and transcutaneous tissue oxygen (tcpO₂) and carbon dioxide partial pressures (tcpCO2) were done. Results Despite preserved baroreflex, parasympathetic, and sympathetic functions assessed using cardiovascular reflex tests, the individuals with T1D exhibited reduced baseline tcpO2 compared to the controls (37.5±3.75 vs. 49.6 mmHg). During the Valsalva manoeuvre, individuals with T1D exhibited a reduced systolic blood pressure response in phase I (31±10 vs. 43±18 mmHg) and early phase II (-1±15 vs. -18±17 mmHg), and an increased systolic (31±15 vs. 18±14 mmHg) and diastolic (45±11 vs. 33±16 mmHg) response in late phase II compared to controls. The early phase II diastolic response was inversely associated with baseline tcpO2. Conclusion The altered hemodynamic response to the Valsalva manoeuvre is suggestive of possible reduced arterial elasticity, higher vascular resistance, and splanchnic sympatho-vagal imbalance in T1D despite normal autonomic reflex ratios. The concomitant evidence of reduced tissue oxygenation and altered hemodynamics may represent early signs of dysautonomia but require longitudinal validation.  

Loneliness and Bedtime Procrastination: Exploring a Model of Interconnectedness Among Young Adults in Germany

Background/Aim This study aimed to examine the relationship between loneliness and bedtime procrastination in young adults in Germany, offering critical insights into the development and maintenance of both conditions. Specifically, it sought to test a new model that connects these two psychological constructs. Materials and Methods A quantitative online survey was conducted with 500 young adults (Mage = 23.3, 83.6% female). Loneliness was assessed using the UCLA Loneliness Scale, while bedtime procrastination was measured using the Bedtime Procrastination Scale. Results The results show a significant positive correlation between loneliness and bedtime procrastination in young adults. Sleep quality was also found to significantly correlate positively with loneliness as well as with bedtime procrastination. Conclusion The findings provide a crucial framework for understanding the relationship between the two psychological constructs of loneliness and bedtime procrastination. Implications for possible future interventions are discussed.

Exercises Pursued by Older Adults with Osteoarthritis and Their Structural Impacts are Hard to Uncover; a Scoping Review of Selected 1970-2024 Studies

Persons with osteoarthritis often have signs of reduced muscle strength. Some studies suggest that this strength could be improved with exercise. However, does this form of therapy improve the disease status as assessed by improvements in cartilage viability, a hallmark of the disease? This brief describes the possible usage of exercises in general, plus those known to improve strength and function, and reduce pain and whether structural impacts that favor or impede disease regression have been observed in this context among the older osteoarthritis adult population. Since exercise may also do harm, rather than good in osteoarthritis management if excessive, contra indicated, or suboptimal, what is the consensus in this regard in 2024?

Osteoarthritis in Older Adults: Is More Emphasis on Managing and Mitigating its Stressful Ramifications, and Enhancing Coping, and Self Efficacy Cognitions Indicated?

Efforts to mitigate or prevent painful disabling osteoarthritis have been pursued for more than a century with limited success. This current overview briefly summarizes how selected beliefs and behaviors, including coping and stress management approaches are potential mediators or moderators of osteoarthritis pain and its overall common adverse prognosis and outcome. Published data housed predominantly in PUBMED, PUBMED CENTRAL, SCIENCE DIRECT, and GOOGLE SCHOLAR sites and pertaining to selected aspects of the literature of current interest, cumulative results reported as of May 30, 2024, show a modest to strong rationale exists for considering the abovementioned factors in efforts to reduce pain and enable daily functions. Accordingly this line of research should be continued, and translated clinically without undue delay, especially in the face of increases in the aging population and osteoarthritis prevalence and undue suffering.

Tai-Chi Exercise Training and its Promising Therapeutic Impacts Among Older Community Dwelling Adults with Painful Knee Osteoarthritis

Knee joint osteoarthritis, a chronic condition resulting in considerable disability, particularly in later life, not only impacts life quality significantly and severely, but is also strongly associated with the persistence of intractable pain, depression, helplessness, and a high falls injury risk. This narrative overview synthesizes the knowledge base regarding painful knee osteoarthritis and what is known about Tai Chi exercise participation in the context of reducing knee joint disability and its associated risk of one or more injurious falls, as well as pain and depression. To this end, all relevant articles published in the English language on the topic were sought. While most reports rely on Eastern observations, rather than Western medicine studies, collectively, these data reveal that Tai Chi practiced widely in Asia for many centuries may have an enormous positive impact on reducing distress and increasing function and autonomy among older adults living in the community and diagnosed as having knee osteoarthritis. They specifically suggest the increasing numbers of older adults diagnosed as having knee osteoarthritis can safely practice selected Tai Chi exercises with the expectation that consistent applications will enhance mobility, reduce pain and depression, plus instability and possible injurious falls, while reducing fatigue, even if surgery is forthcoming.

Effect of Ultra-Processed Foods Consumption on Sleep Disturbances Among Brazilian Adults’ Population: A Propensity Score Matching Approach

Background Diet, exercise and sleep are three pillars of a healthy life. These lifestyle factors influence one another in complex and dynamic ways. Consistent evidence exists about the bidirectional relationship between sleep patterns and food intake. Objectives We aim to assess the effect of the ultra-processed food(UPF) consumption on sleep disturbances in a sample of the Brazilian adults. Method We analyzed 77,298 persons aged 18 and older from the Brazilian National Health Survey (2019). A Propensity Score Matching (PSM) approach was used to address confounding bias and balance the matched exposed and control groups. The population average treatment effect (PATE) and the population average treatment effect on the treated (PATT) were estimated. Also, the Absolute Risk Increase and the Relative Risk Increase were computed. Results The findings revealed that Brazilian adults who consumed UPF experienced small but statistically significant sleep disturbances compared to non-UPF users. Furthermore, salty UPF showed small but significant worsening of sleep compared to sweet UPF users. Conclusion The consumption of UPF is associated with sleep disturbances in Brazilian adults. The consumption of salty UPF had a more significant effect on sleep disorders than sweet UPF in the overall population. However, among individuals who already consumed sweet or salty UPF, these foods had a more significant effect on sleep disorders. To gain a deeper understanding of the complex relationship between UPF consumption, sleep disorders, and their impact on health and quality of life, further research is needed, including precise measurements and consideration of personality traits using prospective designs.

Self-Efficacy and Smoking Cessation: A Mixed Method Study among Adult Smokers in Fiji

Orthorexia Nervosa and Quality of Life in an Austrian Sample of Young Adults – An Exploratory Study

Young adulthood is a sensitive phase that comes with many developmental tasks. Successful mastery of these challenges is crucial not only for long-term physical and mental health. A positive relationship with one's own body and associated healthy dietary and behavioral patterns are essential building blocks for healthy adolescence and adult life. But being overly concerned with healthy food may lead to decreased quality of life and negative (mental) health outcomes. This study was conducted via a cross-sectional online questionnaire including the Düsseldorfer Orthorexieskala(DOS), the WHO Quality of Life BREF and questions about life style and nutritional habits. We investigated the prevalence of ON and its relationship with different aspects of quality of life and lifestyle factors (sport and nu trtional habits) in a sample of young adults in Austria. No significant difference in the DOS-scores of male and female participants were found and no significant difference between students and non-students. High DOS-scores significantly impair all three domains of QoL. We did not find a significant relationship between high DOS-scores and taking nutritional supplements or being vegan, vegetarian or omnivore. Participants with high DOS-scores spent significantly more hours per week with sport/exercising.

Can Vitamin D Positively Impact Sarcopenia Severity Among Older Adults with Hand Osteoarthritis: A Review of the Evidence

Aim This review examines the research base concerning hand osteoarthritis and changes in muscle mass and quality known as sarcopenia and the possible use of vitamin-D supplementation for reducing this potentially adverse functionally disabling state. Methods Publications detailing a possible link between hand osteoarthritis manifestations and sarcopenia, plus those discussing vitamin D as a possible intervention strategy for minimizing sarcopenia in the older adult were systematically sought and reviewed. Results Collectively, data reveal hand osteoarthritis in the older population is common, and is possibly affected by age as well as disease associated muscle mass declines. Vitamin D, a powerful steroid required by the body to foster many life affirming physiological functions may help reduce the degree of any prevailing sarcopenia and thereby some degree of hand osteoarthritis disability. Conclusions Older individuals with hand osteoarthritis, as well as healthy older adults at risk for sarcopenia are likely to benefit physically from efforts to clarify the extent of this association and if indicated, to examine and intervene thoughtfully to maximize muscle composition as well as safe vitamin D levels where subnormal. Researchers can make highly notable impacts in multiple spheres in this regard and are encouraged to do so.

A review of ultrasound for the diagnosis of acute appendicitis in adults

Acute appendicitis is one of the most common surgical emergencies globally, with a lifetime incidence of 8.6% in men and 6.7% in women. While acute appendicitis should be managed promptly to reduce the morbidity associated with perforated appendicitis, morbidity from negative appendicectomy is similar to morbidity from uncomplicated appendicitis. Computer tomography is widely used to aid in the diagnosis of acute appendicitis, however, is costly, often has a slow turn around time, and is associated with exposure to ionising radiation. In contrast, ultrasound is cheap, widely available, requires minimal patient preparation, and does not require exposure to ionising radiation. Ultrasonography is becoming increasingly used for adult patients in emergency settings. The literature has estimated the sensitivity of ultrasound for acute appendicitis in adult patients as between 39-96.4%. The sensitivity and specificity of ultrasound for the diagnosis of acute appendicitis is significantly increased when the appendix is visualised. In cases of a non visualised appendix, indirect ultrasound signs can improve the sensitivity to 93.9% and specificity to 85.7%. The variation in sensitivity and specificity for ultrasound in the diagnosis of acute appendicitis in adults may be due to multiple factors. Ultrasonographer experience, a retrocaecal appendix and obesity have all been described. Given the availability, cost and potential to reduce the rate of negative appendicectomy, ultrasound should be considered as the first line imaging modality for adult patients presenting with suspected AA.

Osteoarthritis Depression Impacts and Possible Solutions Among Older Adults: Year 2021-2022 in Review

Background Osteoarthritis, a serious joint disease, said to represent a generally declining state of wellbeing and function among many older adults has been shown to be affected to a considerable degree by various negative beliefs and inactions rather than degradation alone. Aim This review examines the case of depression as this pertains to the older adult with osteoarthritis of one or more joints. Specifically, the most up to date information on this topic was sought, as care improvements over the past decade have not shown any impactful population wide results. Method Reviewed were relevant 2021-2022 research and review articles specifically pertaining to what is being observed currently by researchers as far as osteoarthritis-depression linkages goes, as these may reveal opportunities for more profound research, and practice-based endeavors. Results In line with 60 years of prior research, it appears a clinically important role for depression in some osteoarthritis cases cannot be ruled out. It further appears that if detected and addressed early on, many older adults suffering from osteoarthritis may yet be enabled to lead a quality life, rather than a distressing and excessively impaired state of being. Those older osteoarthritis cases requiring surgery who suffer from concomitant depressive symptoms are likely to be disadvantaged in the absence of efforts to treat and identify this psychosocial disease correlate. Conclusion Providers and researchers are encouraged to pursue this line of inquiry and begin to map clinical osteoarthritis measures with those that can track cognitive patterns, musculoskeletal, features and inflammatory reactions along with valid depression indicators among carefully selected osteoarthritis sub groups.

Knowledge, Attitudes and Practices about Cardiovascular Diseases among Adult Patients Attending Public Health Centers in Kigali city, Rwanda

In Rwanda, CVDs accounts around 14% of all death. Studies on knowledge, attitude, and practice (KAP) would be of great value in helping public health professionals develop targeted programs and measure the effectiveness of interventional programs. The main objective of this study was to analyze the KAP about CVDs among adult patients attending public health centers located in the City of Kigali, Rwanda. A total of 384 adult patients were enrolled in this study. A structured questionnaire was used. Data entry and analysis was done using SPSS version 21. Findings were presented as frequencies and percentages in tables. For determining the KAP-levels, the overall scores were determined for each respondent by adding up the scores through the KAP-related questions. The mean age was 36.4 years, primary school (57.3%), married (62.8%), self-employed (40.9%), and females predominated (61.5%). The knowledge mean score was 14.2 and 76% had high level of knowledge of CVD risks and prevention. The average attitude score for all respondents was 17.6 and 22.9% of the respondents showed negative attitude towards CVDs prevention. Research findings revealed that 36.5 % were not practicing physical activity and exercise. The mean practice score for all respondents was 3.9 and 70% of respondents had negative practice towards CVDs prevention. Poor CVDs prevention practices were observed among the study participants. Therefore, it is necessary to establish more effective educational interventions intended to promote positive health behaviors related CVD prevention

Evaluation of Anthelmintic Activities of Fractions of Acanthus Montanus (Acanthaceae) on Adult Heligmosomoides Bakeri (Nematoda, Heligmosomatidae)

Acanthus montanusNees T. Anderson (Acanthaceae) has been employed in folk medicine for treatment of different kinds of ailment, but there is dearth of documented information on its therapeutic activities against parasites. In this study, pulverized Acanthus montanusleaf was subjected to four different extraction techniques. The percentage of yields were 25.58%, 31.42%, 11.58% and 3.00% weight by weight (w/w) of crude ethanol extract (CEE), aqueous (AQ), n-butanol (BUT) and chloroform (CHLO) portions, respectively. All the extracts, excluding the chloroform portion were administered to worm-infested mice per os at dose of 1.2 g/kg, 1.4 g/kg, 1.7 g/kg and 2.0 g/kg each for five days consecutive. Mice were euthanized and the adult worm counted for rates of deparasitization. The aqueous extract did not cause significant deparasitization even at the highest dose of 2.0 g/kg. The CEE caused significant (p<0.05) deparasitization rate of 72.35% at 2.0 g/kg dose. The n-butanol portion caused significant (p<0.05) deparasitization rates at doses between 1.4 mg/kg and 2.0 mg/kg (86.17% and 97.04% respectively) compared to figures from distilled water-treated mice (Control) as well as those from mice treated with the aqueous or crude ethanol portion. The 97.04% deparasitization produced by the 2.0 g/kg dose was not stastistically different (p>0.05) from the 100% deparasitization obtained using albendazole at the manufacturer’s recommended dose of 10 mg/kg. This study has demonstrated that the n-butanol extract of Acanthus montanus leaf has profound anthelmintic activity against experimental Heligmosomoidesbakeri infection in mice. Further phytochemical analysis and evaluation is being advocated in large animals and possibly human subjects.  

Variations in Diameter of the Left Coronary Artery and its Main Branches among Adult Population of Khartoum State, Sudan

Themain left coronary artery and its branches have wide variability in its morphology regarding caliber, as seen through angiographic imaging. This study aims to determine the diameters of the left coronary artery and its branches among the Sudanese population & to correlate these diameters and the personal and health data. Angiography of 441 patients of both sexes was used in this study. Personal and health information was obtained from the records. We found that the left coronary artery's diameter was between 2.90- 4.90mm, with an average of 3.96mm. The diameter of the left circumflex artery in the range between 1.70- 4.70mm, with an average of 2.73mm, and that of the anterior descending artery in the range between 1.20- 4.70mm, with an average of 2.78mm. We correlated the diameters of the three arteries and the variables of age, gender, BMI, coronary artery disease, smoking habits, and hypertension. Wefound many correlations to be significant. We concluded that the diameters of the left coronary artery and its branches are affected by age, gender, BMI, coronary artery disease, smoking habits, and hypertension.

Vitamin D, Falls and Balance Capacity Impacts in Older Adults: Update

Background Falls injuries continue to contribute to numerous premature deaths as well as high disability levels, and excess morbidity rates among older adults, worldwide. But can vitamin D account for excess falls injuries among older adults? This review specifically focuses on what is known about vitamin D in the context of postural stability or balance control, both fairly consistent independent predictors of falls among older adults. Methods and Procedures Drawn largely from a review of current relevant English language peer reviewed research publications published over the last 10 years detailing the relationship between vitamin D levels and balance control among the elderly, as this relates to falls injuries, evidence for any emerging consensus on this controversial topic was sought. Used to conduct the search were various key word combinations including: falls injuries and older adults, vitamin D or vitamin D deficiency and balance or postural control. The database used predominantly to provide input into this largely descriptive assessment and narrative overview was PUBMED. Results The prevailing data show falls injuries currently constitute a widespread costly major impediment to successful aging and longevity for many older adults, despite numerous efforts to prevent this disabling set of events over the past two to three decades. However, no consistent association appears to exist between the variables of vitamin D, falls, and balance attributes in the older population-despite years of research, regardless of study approach, and a strong rationale for hypothesizing a clinically meaningful relationahip. Conclusion It is not possible to arrive at any universal recommendation concerning the value of vitamin D supplementation as regards its possible influence on balance capacity among older adults in the realm of falls prevention efforts, as has been frequently proposed. However, until more definitive research is conducted, there still appears sufficient justification for considering the screening of vulnerable aging adults for serum vitamin D levels, along with balance impairments, and intervening as required in the case of deficits in either or both of these possible falls determinants.

Can Vitamin D Mitigate Osteoarthritic Hip Joint Arthroplasty Infections Among Older Adults? A Narrative Overview of the Literature Amidst COVID-19 Lockdowns and Beyond

Background Older adults with hip joint osteoarthritis, a major cause of chronic progressively disabling highly painful functional experiences, may require a surgical joint replacement procedure known as total joint arthroplasty surgery. Objective This review aimed to address the question of whether there an association between hip joint arthroplasty infection rates and prevailing pre or preoperative vitamin D levels that warrants consideration in efforts to prevent or minimize infection related hip arthroplasty complications among older adults particularly during the current ongoing COVID-19 pandemic. Methods PUBMED, SCOPUS, and WEB OF SCIENCE articles related to the topic and published between January 2016-2021 were searched, examined, and summarized. Results Older adults with hip joint osteoarthritis and low vitamin D serum levels who undergo total hip joint arthroplasty surgery may be at higher risk for post-operative infections than those with adequate vitamin D serum levels. Conclusion More research to verify whether efforts to screen for, and maximize vitamin D levels, before and after surgery, as indicated, may be helpful in the context of minimizing total hip joint arthroplasty surgery infection susceptibility and severity among older vitamin D deficient severely disabled hip osteoarthritis cases.

COVID-19, and Vitamin D, and Air Pollution Global Epidemics Impact on Older Adults

Background Most current Corona virus or COVID-19 pandemic deaths have been found to occur among populations older than 65 years of age, who often suffer from the presence of an array of chronic diseases that may be related to a co-occurring vitamin D deficiency. Another factor affecting older adults’ immune response mechanisms is air quality. In turn, air quality can impact the absorption of vitamin D from sunlight sources, a factor which could explain why older people, who are often vitamin D deficient, may be more likely than younger adults or healthy adults to be at risk for COVID-19 and poor outcomes. Aim This work was designed to examine the recent literature on COVID-19, vitamin D and air pollution and what it might imply for public health workers, policy makers, and others. Methods Available data accessed largely from the PUBMED data base for the year 2020 using the key words COVID-19, air pollution, and vitamin D deficiency were sought and selected items were carefully examined and documented in narrative and tabular formats. Results Many publications on COVID-19 prevail, but far fewer focus specifically on vitamin D deficiency and its possible role in explaining COVID-19 global health risk among older adults. A similar, albeit small number of publications, discuss the global pandemics of air pollution and its possible COVID-19 association, as well as its impact on vitamin D production. However, while most related articles support a possible independent as well as a dual role for both factors in COVID-19 the realm of this highly infectious widespread disease, very few actual studies have been conducted to date on any of these topical issues Conclusion More research to examine if vitamin D-based nutrients or supplements may provide some degree of community wide protection against COVID-19 in the older vitamin D populations, especially among those living in highly polluted areas may prove highly valuable. Controlling air pollution emissions globally and locally may also prove to be a highly impactful public health approach to reducing overall COVID-19 risk, and extent, and warrants study.

Can Vitamin D Positively Impact COVID-19 Risk and Severity Among Older Adults: A Review of the Evidence

Background The coronavirus Covid-19 strain that emerged in December 2019, continues to produce a widespread and seemingly intractable negative impact on health and longevity in all parts of the world, especially, among older adults, and those with chronic health conditions. Aim The first aim of this review article was to examine, summarize, synthesize, and report on the research base concerning the possible use of vitamin-D supplementation for reducing both Covid-19 risk and severity, especially among older adults at high risk for Covid-19 infections. A second was to provide directives for researchers or professionals who work or are likely to work in this realm in the future. Methods All English language relevant publications detailing the possible efficacy of vitamin D as an intervention strategy for minimizing Covid-19 infection risk published in 2020 were systematically sought. Key words used were: Vitamin D, Covid-19, and Coronavirus. Databases used were PubMed, Scopus, and Web of Science. All relevant articles were carefully examined and those meeting the review criteria were carefully read, and described in narrative form. Results Collectively, these data reveal vitamin D is a powerful steroid like compound that is required by the body to help many life affirming physiological functions, including immune processes, but its deficiency may seriously impact the health status and well being of the older adult and others. Since vitamin D is not manufactured by the body directly, ensuring those who are deficient in vitamin D may prove a helpful overall preventive measure as well as a helpful treatment measure among older adults at high risk for severe Covid-19 disease outcomes. Conclusions Older individuals with chronic health conditions, as well as healthy older adults at risk for vitamin D deficiency are likely to benefit physically as well as mentally, from efforts to foster adequate vitamin D levels. Geriatric clinicians can expect this form of intervention to reduce infection severity in the presence of Covid-19 infection, regardless of health status, and subject to careful study, researchers can make a highly notable impact in this regard.

Reactive Stepping Responses Mediated by Predictable Manual Waist-Pull Perturbations are Associated with Fall History in Older Adults

Background and Purpose The ability to respond effectively to perturbations is a key element of reactive postural control and is a crucial mediator of falls. Several studies exist in the literature that determine older adults’ responses to perturbations, however those studies typically involve procedures that lack objectivity or applicability outside a laboratory. A study involving waist-pull perturbations with a spring-scale (SS) is an exception. In that study, fall history was most accurately differentiated by a reactive stepping response to a perturbing force of 10% total body weight. Using data from that study, we retrospectively examined the association between fall history and the number of steps accompanying a SS perturbing force of 10% total body weight in older adults. For perspective, the association of fall history with Timed-Up-and-Go (TUG) and single limb stance (SLS) times was also determined. Methods Fifty-eight healthy older adults (mean age = 80.7 years) participated in the study. Their 2-year fall history (yes, no) was recorded. All participants underwent SS testing with one-pound incremental, horizontal sagittal plane manual waist-pull perturbations. The number of steps in response to perturbation with 10% total body weight was recorded; TUG and SLS tests were performed. Associations between variables were examined using Spearman (rank-biserial) correlations. Results The median number of steps for fallers was 5 in both anterior and posterior directions. For non-fallers, the median number of steps was 1 and 2 in the anterior and posterior directions, respectively. The significant correlations between fall status and number of steps were 0.772 and 0.813 for the anterior and posterior directions, respectively. Similarly, the significant correlations between fall status and balance tests were 0.722 and -0.456 for the TUG and the SLS, respectively. Conclusions The number of steps accompanying waist-pull perturbations with forces of 10% of body weight were highly explanatory of experiencing a fall during the preceding 2 years.

Impact of Low Birth Weight on Early Vascular Aging and Cardiometabolic Phenotypes in Later Life Among Cameroonian Adults

Background Evidence suggests that low birth weight (LBW) is associated with increased cardiovascular and metabolic risk in adulthood, including increased arterial stiffness, a marker of early vascular aging (EVA) assessable by pulse wave velocity (PWV), obesity and glucose homeostasis abnormalities. The present study aimed to explore the late impact of LBW on PWV and cardiometabolic phenotypes among young adult Cameroonians. Methods The study evaluated 120 subjects (mean age: 26 ± 5 years; 54% male sex) at the Cameroon Heart Institute, Douala, Cameroon, between January and June 2018. Birth weight (BW) and gestational age, sociodemographic, anthropometrics and fasting capillary blood glucose were recorded in all participants. Blood pressure (BP) and PWV were measured using an automatic oscillometric device (Mobil-O-Graph®). Multiple-adjusted linear regression was used to determine predictive factors for PWV. For assessment of potential impact of BW on EVA, PWV was adjusted for age, sex, body mass index (BMI) and mean arterial pressure (MAP). Results 28 participants (23.3%) of the study sample had LBW (<3000g). There was no gender difference between LBW or normal birth weight patients (NBW; controls). Age- and MAP-adjusted PWV (aPWV) were higher in women with LBW compared to NBW (5.6 m/s and 5.3 m/s respectively, P = 0.038). In men, aPWV was similar in LBW and NBW. In this study population, aPWV was higher (on average +15 cm/s) in LBW than in controls, although the difference was not statistically significant (P=0.083). Multivariate regression analysis showed age, male sex, BMI and MAP were independent determinants of PWV, but not LBW. Compared to NBW controls, the prevalence of overweight/obesity, impaired glucose homeostasis and diabetes was higher in LBW: 42.9% vs 37%; 10.7% vs 3.3%, and 3.6 % vs 1.1%, respectively. Moreover, compared with controls, LBW individuals who were overweight/obese in adulthood had a much higher mean fasting capillary glucose (1.54 ±0.17 g/l vs 0.87 ±0.11 g/l in NBW, p=0.003). Conclusion This study suggests that although LBW is associated with increased aortic stiffness in young adulthood, mainly in women, the association was predominantly driven by aging, MAP, BMI and male sex. In adulthood, LBW subjects exhibited higher obesity indices and altered glucose homeostasis.

Effects of Aluminium Sulphates on Weight and Structure of Adrenal Gland of Adult Wistar Rats

This study evaluated the effects of aluminum sulphate exposure on the histology of adrenal gland of Wistar rats. Thirty adult Wistar rats were used for this study. The Wister rats were divided into three groups; group A was the control animals and tagged C, group B animals received 10g of alum dissolved in 1000cm3 of distilled water and were tagged T1, group C animals received 50g of alum dissolved in 1000cm3of distilled water and were tagged T2, via drinking water for duration of four weeks. Twenty-four hours after the last administration, the rats were sacrificed by cervical dislocation. The adrenal gland was excised and preserved in 10 % formosaline after which it was routinely processed for hematoxylin and eosin staining (H&E). Histological observations showed normal cell distribution in the control group but treated group revealed evidences of cellular obliteration& hemorrhagic necrosis. The results obtained from this study suggest that aluminum sulphate has a damaging effect on the structure of the adrenal gland.

The Intersection of Cultural Characteristics and Genetics on the Prevalence of Delayed Sleep Phase Syndrome in Brazilian and Japanese Adults

Delayed sleep phase syndrome (DSPS) is a circadian rhythm disorder where individuals experience difficulty modifying the time they go to sleep and wake up in response to environmental changes. The circadian rhythm itself is regulated by a variety of clock genes, and various other genes (e.g., AA-NAT gene, CKIϵ gene) code for proteins that regulate clock genes. Various polymorphisms of the clock gene influencers have been shown to increase susceptibility to DSPS. This paper seeks to examine how certain cultural characteristics (e.g., napping, timing of meals, exposure to artificial light) and the presence of the AA-NAT gene (G619A polymorphism) and the CKIϵ gene (S408N polymorphism) influence the prevalence of DSPS amongst Japanese and Brazilian populations.

Structural Equation Modeling to Detect Predictors of CD4 Cell Count Change due to Long Term Antiretroviral Therapy Administered to HIV-Positive Adults at Felege Hiwot Teaching and Specialized Hospital, Bahir Dar, Ethiopia

Background The relationship between predictors and the variable of interest was estimated using a structural equation model which is used to predict latent variables. The main advantage of the SEM is the ability to estimate the direct and indirect pathways of the effect of the primary independent variable on the outcome, given sufficient sample sizes. Despite not directly modeling the mediated pathways, GLMMs excluding mediating variables performed well with respect to power, bias and coverage probability in modeling the total effect of the primary independent variables on the outcome. In longitudinal studies, data are collected from subjects at several time points. The main purpose of longitudinal analysis is to detecting the trends or trajectories of the variables of interest. Methods A longitudinal study was conducted on 792 adults living with HIV/AIDS who commenced HAART. Structural equation modeling was used to construct a model to detecting predictors of CD4 cell count change. The procedure was illustrated by applying it to longitudinal health-related quality-of-life data on HIV/AIDS patients, collected from September 2008 to August 2012 monthly for the first six months and quarterly for remaining study period. Results The result of current investigation indicates that CD4 cell count change was highly influenced by certain socio-demographic and clinical variables. Out of all the participants, 141 (82%) have been considered 100% adherent to antiretroviral therapy. Structural equation modeling has confirmed the direct effect that personality (decision-making and tolerance of frustration) has on motives to behave, or act accordingly, which was in turn directly related to medication adherence behaviors. In addition, these behaviors have had a direct and significant effect on viral load, as well as an indirect effect on CD4 cell count. The final model demonstrates the congruence between theory and data (x2/df. = 1.480, goodness of fit index = 0.97, adjusted goodness of fit index = 0.94, comparative fit index = 0.98, root mean square error of approximation = 0.05), accounting for 55.7% of the variance. Conclusions The results of this study support our theoretical model as a conceptual framework for the prediction of medication adherence behaviors in persons living with HIV/AIDS. Implications for designing, implementing, and evaluating intervention programs based on the model are to be discussed.

Interdisciplinary Orthodontic and Surgical Management of Class III Malocclusion in Adult Patients

The treatment of class III malocclusion differs depending on the age of the patient. In adult patients, alternatives include either orthodontic dentoalveolar compensation treatment or a combined ortho-surgical approach. The aim of this paper is to present the orthodontic and surgical treatment of a 24 year old adult patient with increased anterior face height, a class III skeletal pattern and mandibular asymetry. Previous orthodontic treatment with removable appliances obtained a 1 mm overbite and overjet. Intraorally, class III molar relationship was observed, proclined upper incisors, retroclined lower incisors and a deviated lower midline. The main complaint was facial esthetics which required surgical intevention. After pre-surgical orthodontic preparation the maxilla was repositioned by a Le Fort I osteotomy and the mandible was set back using the Obwegeser-Dal Pont method. Final assesment revealed both functional and esthetic dentofacial results. A combination of orthodontic treatment and orthognathic surgery is often required in adult patients with dental malocclusion and skeletal discrepancies.

Changes in Adult Rats’ Testis structure Induced by Hypothyroidism and Alleviating Role of L-Carnitine

Background Hypothyroidism is a metabolic disorder affecting the functions of many tissues in the body including the testis. Testis is rich in the polyunsaturated fatty acids content and lacks strong intrinsic antioxidant system making it prone to such oxidative stress. L-carnitine (LC) regulates long chain fatty acids metabolism; and is considered a valuable antioxidant factor. Aim It was to evaluate the effect of hypothyroidism induced by propylthiouracil (PTU) on rats’ testes and the possible protective role of LC. Methods Forty-eight adult male albino rats were used in this work. The animals were divided into three groups with sixteen animals in each. Group 1 (Control): Animals were kept without medications. Group 2 (PTU-treated): was subjected to administration of PTU; while group 3 (PTU and LC) received both PTU and LC. By the end of the experiment “30 days”, blood samples were taken for hormonal assay; then animals were anaesthetized and sacrificed. Specimens were homogenized for biochemical analysis; epididymal content of each rat was obtained immediately for semen analysis. Testes’ specimens were harvested, prepared and examined by light microscope examination. Results Induced hypothyroidism was noticed to cause histopathological, morphometric and biochemical changes in rat’s testes. LC protected the testicular specimens against such changes; it also improved the seminal quality and quantity as well as testicular structure and biochemistry. Conclusion Hypothyroidism could result in hazards to the structure of testis. Fortunately co-administration of LC might reduce such hazards.

Exploring the Occupational Physical Activity Levels in young Adult Restaurant Servers.

Physical activity (PA) decreases in late adolescence and young adulthood when this age cohort enters the workforce with many being employed in the foodservice industry. Daily energy expenditure can be divided between occupational physical activity (OPA) and leisure-time physical activity (LTPA). Although LTPA is known to be associated with positive health benefits, a limited number of studies have investigated the influence of OPA on LTPA in young restaurant servers. This study measured via accelerometry, OPA and LTPA for a 7-day period from a sample of young adult servers (n = 7, 23-29 years old) from two restaurants. Resting metabolic rate was measured via indirect calorimetry and inputted into the AMP 331 accelerometer for energy expenditure calculations. Energy expenditure patterns were compared to age- and sex-specific normative data, occupational classifications, and the Canadian PA Guidelines to Healthy Active Living (CPAG). Energy expenditure results and step count values were higher for working versus non-working days and working versus non-working periods. Daily, working energy expenditure was approximately equal to normative data, while non-working daily energy expenditure was lower. The working period energy expenditure placed this population in the ‘exceptionally active’ OPA classification. Minimum PA levels, based on CPAG were met each day, however 10,000-steps-per-day were only achieved on working days. None of the participants logged LTPA and therefore 100% of their PA came from OPA. More research is needed over a longer duration and at different times in the year to identify the effect OPA has on LTPA in this population.

The Effects of Zanzalacht on the Gonotrophic cycle of the Adult House fly Musca Domestica

Melia azedarach extract were applied by feeding the adult female flies on diets mixed with the extracts at different doses. The concentrations of Melia azedarach utilized were 1.8, 2.4 and 3.6%. The gonotrophic cycles of length of 90, 753, 67.6 and 84, 72, 68 hours were obtained after feeding at age 24 hours with diet mixed with doses of 1.8, 2.4 and 3.6% fruit extract; respectively. 98 & 96 hours were the length of gonotrophic cycle in the control groups. The length of 86.7, 72.3, 57.3 and 89.3, 75, 61 hours were obtained after feeding adults at age 48 hours with diets mixed with different doses of fruit extract of the same plant 97.3 and 98.7 hours were the length of the control groups. Proportions of the egg hatching reached 69, 55.3, 49 and 72.9, 64.2, 52 in groups of eggs obtained from 24 hours adults feeding with diets mixed with doses of 1.8, 2.4 and 3.6% fruit extract; respectively. Also 68.7, 53.3,48 5 and 81 2, 70, 56.3 were the proportions of egg hatching obtained from groups at age 48 hours after feeding with diets mixed with the same doses. 85, 77.6, 62.2 and 92.6, 88.9, 84.9 were the proportions of the egg hatching obtained from groups feeding with diets mixed with doses of 1.8, 2.4 and 3.6% fruit extract of Melia azedarach; respectively. The pupae showed larval-pupal intermediates which failed to complete the pupal period and died after emerging from the third larval instar.

Identification and Quantification of an Adulterant in a Dietary Supplement Marketed for Sexual Enhancement

In recent years, the consumption of dietary supplements (DS) has increased worldwide. In Argentina, approximately 14 million DS units were sold between 2015 and 2017. The adulteration of DS with active pharmaceutical ingredients or their analogues has been reported. This represents an alarming emerging risk to public health. The aim of this work was to detect the possible adulteration of a DS marketed in Argentina for the treatment of erectile dysfunction. Initially, thin layer chromatography analysis of the DS capsules content suggested the presence of a major compound. For the isolation and purification of this compound, an easy method consisted of a liquid-liquid extraction (water/CH2Cl2) followed by re-crystallisation from ethanol, is reported. Spectroscopic techniques such as mono- and bidimensional nuclear magnetic resonance, Fourier transform infrared spectroscopy and mass spectrometry allowed its identification as tadalafil. A rapid and reliable method was developed for the quantification of tadalafil in this DS by high performance liquid chromatography-mass spectrometry (HPLC-MS/MS). The mean content of tadalafil per capsule was 21.2 mg which represents a slightly higher value than that found in approved products in Argentina (5 or 20 mg per tablet). In addition, an undeclared alga was identified in the DS by microscopic techniques.

The Effects of Physical Activity on Sleep among Adolescents and Adults: A Narrative Review

Objective: Examining the correlation between physical activity measures and sleep in normal adolescents and adult population. Methods: A systematic review was conducted on the effects of exercise, its intensity, its frequency and its timing and sleep outcome. Using the databases including MEDLINE, PsycINFO and SPORTDiscus, keywords used were “sleep”, “circadian rhythm”, “exercise”, and “physical activity”. Results: To improve the general quality of sleep amongst adolescents and adults, individuals should engage in physical activity at any time of day. It also appears very advantageous to engage in long-term physical activity to maintain the positive effects on sleep. Nonetheless, it seems that sedentary individuals can also benefit from occasional physical activity to improve the quality of their subsequent sleep period. Conclusion: A virtuous relationship between physical activity and sleep may exist in normal adolescents and adults. People should seek to benefit from this link to improve both the quality of their sleep and of their daily functioning. However, larger scale studies, controlling for variables might help to better delineated this relationship.

Health Literacy and Older Adults: Fall Prevention and Health Literacy in a Midwestern State

Falls continue to be a health concern for older adults. Gender and age are key predictors of falls, particularly for those with low health literacy. Data were collected by a State Health Department using the state-led supplemental question option for the Centers for Disease Control and Prevention (CDC) Behavior Risk Factor Surveillance System (BRFSS) survey. Specifically, trend data for respondents were examined by gender, geographic location and health literacy rate. Results indicated the highest mean number falls occurred with men for those within the metropolitan statistical area (MSA) city code, lowest in suburban areas. Females reported to have a higher estimated mean number of falls and injuries than males. For males, the number of falls and injuries tended to decrease with higher health literacy. The findings support the importance of addressing fall prevention for older adults. Long term implications for improving fall prevention and health literacy for older adults include impact on individual outcomes.

Overcoming Recruitment Challenges for Securing a Survey Sample of Caregivers of Community-Dwelling Older Adults with Multiple Chronic Conditions

This paper discusses the challenges in recruiting a diverse sample of caregivers of older adults with multiple chronic conditions in two Canadian provinces – Ontario and Alberta, as well as the successful strategies to overcome these challenges. Four strategies were employed to overcome the recruitment challenges experienced. These included: (1) using a multi-pronged recruitment strategy with persistence; (2) knowing the location of the sample in the community; (3) weekly reporting by team members primarily responsible for recruitment and data collection, and; (4) regular team meetings to build on successful recruitment strategies while troubleshooting new approaches. These four strategies complemented one another. The most effective strategies in Alberta (recruiting over 50% of participants) were newspaper advertisements and working with the Alberta Caregivers Association and the Alzheimer Society of Alberta/NWT. In Ontario, the most effective strategy was door to door flyers (recruiting 61.5% of participants).

Thymic Hypertrophy and Sudden Unexpected Death In Adults –A Retrospective Study Of 56 Autopsy Cases

Status thymico-lymphaticus had ever been explained as a cause of sudden death usually in children, but few cases were reported in adults. We sought to determine the relationship between thymic hypertrophy and sudden unexpected death in adult (SUDA), and associated macroscopic and microscopic findings. Adult post mortems from 1984 to 2014 were reviewed and 23 thymic hypertrophy patients without SUDA, 33 thymic hypertrophy patients with SUDA and 172 SUDAs without thymic hypertrophy entered. The data of thymus, lymph nodes, spleen, heart, aorta, and adrenal glands were collected for macroscopic and histological analysis. Ten antibodies were used and applied to 3 children and 46 adult thymus specimens. We found, as an independent factor, thymic hypertrophy increased significantly the risk of SUDA (6.9 folds) in both male and female. What’s more, SUDAs associated with thymic hypertrophy were quite younger (22.5 years) than those without it. A majority of patients with hypertrophic thymus had a variable number of accompanied anomalies described as the typical characteristics of status thymico-lymphaticus, but no macroscopic and microscopic findings related to SUDA in patients with thymic hypertrophy. Cytokeratins (CKs) showed distinctly different immunohistochemical expression patterns in individuals who had different death causes and disease background. Instead of a disease entity “status thymico-lymphaticus” is a systematic abnormality with thymic hypertrophy as a feature involving mainly immune and/or cardiovascular system, probably caused by gene mutations.

Sub-Types and Treatment Outcomes of adolescent and Adult Non-Hodgkin Lymphomas in a Resource Poor Setting

Background: The diagnosis and treatment outcomes of Non- Hodgkin Lymphoma’s (NHL) in resource poor countries in the absence of routine molecular studies and immunohistochemistry is challenging. Methods: A retrospective review of case folders of NHL patients aged13 years and above. Information obtained from the case folders included age, sex, histological subtype, subtypes using the Working Formulation and WHO classifications. Treatment given and follow up information were also evaluated. Results: A total of 279 cases of NHL were identified within the study period. The mean age of the patients was 48.8 ± 17.0 years. The male to female ratio was approximately 1.5:1. The majority of cases seen (53%) were diffuse large B- cell lymphoma. Chronic lymphocytic leukaemia/ small lymphocytic lymphoma (22.2%) was the next most common subtype. Other sub types seen, in order of frequency, included diffuse mixed cell lymphoma (6.4%), gastric lymphomas (3.9%), mediastinal B- cell lymphoma (2.9%), Burkitt’s lymphoma (1.8%), splenic marginal zone B-cell lymphoma (1.1%), lymphoblastic lymphoma (1.1%), mucosa- associated lymphoid tissue (MALT) type B- cell lymphoma (0.7%) and follicular lymphoma (0.7%). Conclusion: This study provides an overview of the distribution of NHL subtypes and their outcomes in a resource constrained setting. Immunohistochemistry, cytogenetics and specific molecular studies which are important in characterization of NHLs, should be made affordable and accessible in low income countries.

Prevalence of Impulse Control Disorders among Adult Filipino Patients with Idiopathic Parkinson’s Disease seen at Jose R. Reyes Memorial Medical Center

Background: Impulse Control Disorders (ICDs) are characterized as pathologicalbehavioral patterns of excess impulsivity which may result as part of the non-motor complications of Parkinson’s disease (PD). These significantly affect the patient’s overall quality of life and have impact on their care givers, as well. Currently, the prevalence of ICDs among adult Filipino patients with Parkinson’s disease is unknown and less reported. Objectives: The study is intended to determine the prevalence of ICDs and its severityamong adult Filipino patients with idiopathic Parkinson’s disease seen at Jose R. Reyes Memorial Medical Center. Specifically, this study will identify risk factors and the clinical correlates to these patients. Methods: Adult Filipino patients diagnosed withidiopathic Parkinson’s diseasewhowere seen at the outpatient department from March 2015 – September 2015 are screened for the study. The Modified Hoehn and Yahr staging was utilized to determine the stage of PD. With approval from the author, the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease-Rating Scale (QUIP-RS) was used for detecting the presence of ICDs and corresponding severity. Results: We were able to examine 66 patients (31 males and 35 females) withidiopathic Parkinson disease. Majority of the patients manifested with Tremor Dominant (50%) subtype, followed by Early Disease Onset (34.8%), and Non-Tremor Dominant (15.2%). Sixteen (16) out of 66 patients (24.2%) have ICD symptoms with the following incidence rates: hobbyism/ punding 56.25%, compulsive eating 50%, hypersexuality 18.75%, compulsive shopping 18.75, Dopamine dysregulation syndrome 18.75%, and gambling 12.5%. Overall average QUIP-RS score is 5.42. There is significant association of PD duration with occurrence of ICD symptoms; the longer the PD duration, the higher risk of having ICD symptoms (x2 20.41; p = 0.026). Patients with higher mean modified Hoehn and Yahr stage (2.66±0.94), t 2.735, df 64, p 0.008, have much higher incidence of ICD symptoms. Conclusion: Filipino patients with idiopathic Parkinson disease who are majority onlevodopa + carbidopa therapy may develop impluse control disorders (ICDs). Other contributory factors in development of ICDs include longer duration of PD and higher mean Modified Hoehn and Yahr stage.

Diet and Nutritional Status of the Older Adults in Rural India

Objectives: World has witnessed a considerable increase in the proportion of elderly population.Aging is associated with decreased physical activity and metabolism and thereby the changes in the nutritional requirements of older adults.The objective of this communication was to assess the nutritional status of rural elderly population in India. Methodology: A community based cross-sectional study; adopting multistage stratified random sampling procedure was carried out by the National Nutrition Monitoring Bureau (NNMB), during 2005-06 among the rural population of nine major states of India. A total of 3871 older adults were covered for anthropometry and of them, a total of 2138 older adults were covered for dietary assessment. Key Results: In general, the consumption of all the foods was below recommended daily intakes (RDI), and the in-adequacy (<70% of RDI) of intake was high with respect to leafy vegetables, milk & milk products, fats & oils and sugar & jaggery. Similarly, the in-adequacy of intakes of micronutrients such as vitamin A, iron, riboflavin and free folic acid was high among both genders. The poor intake of diet was reflected in high prevalence of chronic energy deficiency (CED) among the rural elderly in India. Conclusions: In general,the rural elderly were subsisting on inadequate diets in terms of both quantity and quality. Similarly, the prevalence of CED among elderly is a ‘‘very high’’ public health nutrition problem in India. Therefore, the Government of India should initiate appropriate nutrition intervention measures to improve the overall nutritional status and special nutrition policies to address the health and nutritional problems of the aging population.

Healthy lifestyle behaviors and hypertension among older adults in the United States (NHANES 2007-2010): Are there differences by race and ethnicity?

Using NHANES 2007–2010, this cross‑sectional study examines associations between healthy lifestyle behaviors and hypertension among older U.S. adults, stratified by race and ethnicity. It explores how activity, diet, weight, and smoking patterns relate to blood pressure burden across groups. Findings inform tailored prevention strategies and equitable cardiovascular risk reduction.

COLLAGE 360: A Model of Person-Centered Care to Promote Health Among Older Adults

This article describes COLLAGE 360, a person‑centered care model for older adults that integrates comprehensive assessment, goal‑setting, and coordinated community services. The approach seeks to promote health and function while reducing fragmentation across medical and social supports. Early implementation experience outlines feasibility and pathways to measure outcomes and scale within aging networks.

Arm Span is an Alternative to Standing Height for Calculation of Body Mass Index (BMI) amongst Older Adults

Objectives: Accurate measurement of height is difficult in older adults because of the reduction in height that occurs during the ageing process. Therefore, several western studies have demonstrated the arm span as an alternative anthropometric measurement to height among older adults, as the length of arm span is less affected by aging. The aim of the study was to use arm span as an alternative to standing height for calculation of body mass index (BMI) amongst older adults. Methodology: A community-based cross sectional study was carried out during 2011-12 among 400 (Men: 180; Women: 220) urban geriatric population (age 60-years and over)of the town of Khammam. Weight, height and arm span were measured with standard procedures. Nutritional status of older adults was calculated by body mass index (BMI) classification using both height and arm span. Key Results: The mean (SD) height and arm span among men were 164.5 cm (6.6) and 175.3cm (7.9), respectively, while among women were 149.5cm (5.8) and 158.7cm (8.6). The mean difference between arm span and height was 10.8cm (10.1,11.4)in men and 9.2cm (8.3,10.0) in women (p<0.001). Similarly, significant (p<0.001) differences were observed between the BMIs derived using both height and arm span among both the genders. Conclusion: The conventional height is not a reliable anthropometric measurement for the assessment of nutritional status of older adults, where the BMI-height model over estimated the nutritional status of older adults compared to the BMI- arm span model. Therefore, arm span is the best alternative to height for calculation of body mass index (BMI) in older adults.

Depression and Executive Dysfunction in Young Adults; Implications for Therapy

The prevalence of young adults endorsing depressive symptomatology is thought to peak during late adolescence. While there has been a wealth of research assessing the relationship between decline of the prefrontal cortex and how this process impacts depression and therapy in older adults, very little is known about the relationship on the younger end of the continuum. The current study sought to explore whether there is also a significant relationship between executive functioning and depression in younger adults. In addition, different types of executive dysfunction were assessed to better understand the possible implications for therapy in younger adults with depressive symptomatology. Data from 1,730 college-aged participants were collected on measures of depression (Center for Epidemiological Studies-Depression, CES-D) and executive dysfunction (Dysexecutive Questionnaire, DEX). In addition, three factors of the DEX were assessed; Executive cognition (EC), emotional/ behavioral control (EMO), and metacognition (MC). Correlations between CES-D scores and the full DEX survey were statistically significant (R = .45, p < .001) as were correlations between CES-D scores and scores on each individual factor (p< .001). A multiple linear regression was run to demonstrate the predictive value of each individual DEX factor as a function of CES-D scores (p < .001). Results suggested that there was a clear relationship between depressive symptoms and executive dysfunction and that all factors of the DEX appeared to be affected by depressive symptoms in this population. The implications of these results for therapy, particularly the use of problem-solving therapy or complimentary executive functioning training are discussed.

Influence of Education Sources on Osteoporosis Knowledge and Calcium Intake in Adult Women: A cross sectional Study

Osteoporosis prevention among women requires obtaining proper knowledge early in life about the disease, risk factors and treatments. This study compares specific education sources to osteoporosis knowledge and calcium intake. Online survey usinga convenience sampling was performed with women between ages 18 and 40. The survey measured osteoporosis knowledge, calcium consumption, and specific education source within categories of age, school classes, television, radio, newspaper, magazine, Internet, and in-person. Multiple regression analysis determined influential education sources for osteoporosis knowledge and calcium intakes. Osteoporosis knowledge was suboptimal (13.8 ± 3.3, as a score higher than 16 defined as “adequate”) and average daily calcium intake was 1315.1 ± 609.9 mg. Age and newspaper had greatest contribution towards osteoporosis knowledge, while Internet, school classes and radio were most influential resources on calcium intakes. Creating an osteoporosis education initiative utilizing these sources is imperative for increasing disease knowledge and preventive behavior among young women.

Cognitive Functioning in Adults Aging with HIV: A Cross-Sectional Analysis of Cognitive Subtypes and Influential Factors

Objective: This cross-sectional study examined cognitive subtypes and influential factors in HIV-positive (HIV+) adults. Method: Two-step cluster analysis was conducted on a neurocognitive test battery in a sample (N = 78) of adults and older adults with HIV (Mage = 46.1). Next, cognitive, functional, and mental and physical health differences were compared between the HIV+ clusters and an HIV- reference group (N = 84; Mage = 47.9). Results: A two-cluster solution emerged, with a lower performing cluster exhibiting poorer performance across all domains except psychomotor speed, and a “normal” cluster displaying similar performance as the HIV- group. The most influential factors to classification in the lower performing cluster were older age and presence of stroke and hypertension. There were trends for longer duration of HIV-infection, higher unemployment rates, and greater prevalence of Hepatitis C co-infection in the lower performing cluster. Conclusions: These findings suggest that there are not unique cognitive subtypes in HIV, but rather a subset of individuals who exhibit globally normal performance and those with below average performance. Older age and the related cardiovascular comorbidities of both aging and HIV medications may be key influential factors to variability in neurocognitive functioning in this population and thus should be considered in future studies. Implications for research and practice are provided.

Implementing Evidence-Based Occupational Therapy for Multiple Sclerosis Rehabilitation: Exploring Knowledge on Barriers, Facilitators and Strategies

Background A persistent gap remains between evidence-based health care and its application in routine practice. This challenge is particularly prominent in allied health professions like occupational therapy (OT), where interventions are complex, individualized and centred on patients' daily functioning. Objective To identify barriers, facilitators, and implementation strategies for integrating evidence-based OT interventions in multiple sclerosis (MS) rehabilitation. Methods A mapping review was conducted using searches in five databases. Eligible studies included adults with MS, examined OT interventions, and reported on factors influencing implementation. Data were extracted and categorized using Grol’s framework for barriers/facilitators and Mazza’s taxonomy for implementation strategies. Results Fifteen studies met inclusion criteria. Barriers and facilitators were identified at multiple levels of Grol’s framework: 1-Innovation-level: accessibility, feasibility, and perceived attractiveness supported implementation, particularly when interventions incorporated holistic approaches, gamification, or printed manuals. 2-Professional-level: therapists’ competencies and alignment between interventions and patients’ priorities. 3-Patient-related: facilitators included motivation, readiness to change, and peer support, whereas fatigue, pain, and cognitive challenges served as barriers. 4-Social and organizational: effective teamwork, resource availability, and flexible scheduling facilitated successful adoption. 5-Economic or political: no studies. Implementation strategies focused on using manuals, patient empowerment, gamification, and organizational supports. No financial or structural policy-level strategies were identified. Conclusion Successful implementation of evidence-based OT for MS requires multifaceted, context-sensitive strategies addressing innovation, professional, patient, and organizational determinants. Practical approaches enhance uptake, while substantial gaps persist at economic and policy levels. Strengthening these areas may improve longterm integration and sustainability of evidence-based OT in MS rehabilitation.

Efficacy and Safety of Pulsed Magnetic Therapy in Sleep related Disorders: A Remote, Randomized, Double-Blind, Placebo-Controlled Trial

Background/Aim Sleep disturbances are common and are associated with impaired daytime functioning, reduced quality of life, and increased health risks. Non-pharmacological neuromodulatory interventions have gained interest as alternatives to hypnotic medication. Pulsed electromagnetic field (PEMF) therapy has been proposed as a non-invasive approach to improve sleep quality and recovery, but evidence from large, well-controlled trials remains limited. The objective of this study was to evaluate the efficacy and safety of pulsed magnetic field therapy (PMT) on sleep quality, sleep-related symptoms, daytime functioning, and well-being in adults with heterogeneous sleep complaints.  Materials and Methods In this remote, randomized, double-blind, placebo-controlled trial, 217 adults reporting non-restorative sleep, difficulties initiating sleep, or frequent nocturnal awakenings were assigned to active PMT using a PEMF device (Night Harmony Female/Male protocol) or a sham application for three weeks. Primary outcomes were changes in the Pittsburgh Sleep Quality Index (PSQI) global score and self-rated sleep satisfaction, restfulness, and sleep initiation difficulties. Secondary outcomes included sleep diary measures, daytime functioning, well-being (WHO-5), symptom burden (MYMOP), and daytime sleepiness (Epworth Sleepiness Scale). Analyses followed the intention-to-treat principle using ANCOVA with baseline values of the respective parameter as covariate.  Results Both groups showed significant improvements over time in global sleep quality and most secondary outcomes (p < 0.001). Between-group differences in PSQI global score were not significant (p = 0.314). However, active PMT resulted in significantly greater improvements in subjective sleep satisfaction (p = 0.02) and restfulness (p = 0.02), particularly among participants with moderate to severe baseline sleep disturbances (p < 0.001 for both). Sleep continuity measures improved similarly in both groups. No serious adverse events were reported.  Conclusions PMT produced modest but significant improvements in subjective restorative aspects of sleep beyond placebo effects and was well tolerated. Further studies using objective sleep measures and longer follow-up are warranted.

Retrospective Evaluation of Well Differentiated Thyroid Cancer Treatment Outcomes: 50 year experience at the University of Puerto Rico

Our study gathered information on the diagnosis, treatment, and long-term outcome in adult and pediatric Hispanic patients with Well Differentiated Thyroid Cancer. Methods We performed a retrospective review of the clinical and imaging nuclear medicine records of cases of WDTC evaluated and treated in the Nuclear Medicine CLINICc. Evaluation included the clinical PROFILE, histology, radioiodine (RAI) therapies and treatment response, long-term outcome and survival. The data was ASSESED using the 2015 ATA Risk level guidelines and recommendations. Results Three hundred eleven cases were reviewed, 81% females, 19% males, median age of 41 years. Eleven percent (34 patients) of the patients were in the pediatric group and 49% were between 16-45 years. The tumor histology was 60.5% Papillary, 28.2% Papillary-Follicular variant and 11.3% Follicular type. All patients had a total thyroidectomy. A total of 287 (92%) of the patients were treated with RAI. The median RAI dose was 128 mCi. Patients in the low risk group received a dose range of 25-105 mCi, 73 cases in the intermediate RISK group received 106-160mCi and 104 cases in the high-risk group received doses greater than 160 mCi. The overall median cumulative dose was 151 mCi (55-926 mCi). Annual follow up was done in all cases , WITH A median follow-up OF 5-10 years. Residual functioning tissue in the neck was found in 52% of the cases by US and/or RAI imaging. of those, 43% belonged to the low risk group, while 57% were in the intermediate and high-risk groupS. The mean treatment dose received by those with persistent functional thyroid tissue in the neck was 157 mCi. Recurrent disease was found in 15% of the patients, 85% of them belonged to the intermediate and high-risk GROUPS. Forty-seven percent of the patients with recurrent disease had residual disease. Conclusion We believe ablative and/or adjuvant RAI treatment early in the disease is important to decrease residual thyroid tissue and/or residual disease, and to improve disease-free survival. We recommend total thyroid surgery in all tumors above 1 cm, post-operative evaluation with RAI Whole Body (with 123-I or 131-I), planar and SPECT/CT imaging and RAI ablation to remnant tissue. Follow-up post treatment evaluation is also recommended.

Electromagnetic Fields and Osteoarthritis 2025

This mini review examines the potential efficacy of applying electromagnetic field therapy for purposes of reducing osteoarthritis pain and other related disease features such as frailty, muscle sarcopenia, obesity, bone loss and fragility, and cartilage derangements and degradation in the older adult. Based on selected English language literature published largely on PUBMED between January 2000 and October 2025, papers describing the impact and potential synthetic and disease modifying impact of electromagnetic stimuli are explored. These data reveal a high degree of promise in fostering joint tissue reparative efficacy trends post electromagnetic stimulation. Its usage may allay the extent of the disease and its degree of disablement, while facilitating function.

Prevalence of Hypertension Among Adolescents in Benue South, Nigeria

Background Hypertension in adolescents has been shown to tracks into adulthood, as well as causing premature cardiovascular and renal diseases. Objectives To determine the prevalence of elevated blood pressure and hypertension among adolescents of ages 10-19 years old attending secondary schools in Benue South, Nigeria; characterise their demographics and determine factors associated with the development of high blood pressure. Materials and Methods A cross-sectional descriptive study of secondary school adolescents selected through multistage sampling from across three Local Government Areas of Benue South, Nigeria. All the participants had their blood pressure measured using mercury sphygmomanometer and their height and weight taken for the calculation of their body mass index. A dipstick urinalysis with was carried out on their urine samples. Data analysis was with SPSS version 25. Results Atotal of 260 adolescents were studied, males were 132 (50.8%) and the mean age was 13.65 ±2.01 years. The prevalence of elevated blood pressure and hypertension was 5.4% and 2.3% respectively. Fifteen females (75.0%) had elevated blood pressure/hypertension as against five males (25%) and it was statistically significant. Adolescents in mid-adolescence age (60.0%) and lower social class (70.0%) had higher rate of high blood pressure. Significant proteinuria (+) was found among eleven (55.0%) of those with high blood pressure. Conclusion The prevalence of elevated blood pressure and hypertension among the adolescents was 5.4% and 2.3% respectively; being female, within mid-adolescence age and from lower social class are associated factors. Recommendation Regular blood pressure measurement should be part of school health programme.

Trading on Impulse: The Role of ADHD, Impulsivity, and Gender in Financial Risk and Investment Outcomes

Background Attention-deficit/hyperactivity disorder (ADHD) in adulthood is increasingly recognized not only as a psychiatric condition but also as a trait with behavioral and occupational implications—particularly in high-stakes, fast-paced financial environments. Traits such as impulsivity, sensation seeking, and altered reward sensitivity may influence decision-making among individuals engaged in stock trading or high-risk investment professions. Objective This systematic review and meta-analytic synthesis aims to investigate the relationship between ADHD, impulsivity, gender differences, and financial risk behavior, with a particular focus on decision-making outcomes in real or simulated trading contexts. Methods Seventeen peer-reviewed studies published between 2008 and 2025 were included. Studies employed behavioral experiments, fMRI paradigms, neurochemical analysis (e.g., glutamate levels), and ecological financial assessments to examine impulsive traits and investment behaviors among adults with and without ADHD. Both clinical samples and occupational cohorts (e.g., brokers, retail investors) were analyzed. The analysis followed PRISMA 2020 guidelines. Results ADHD symptoms—particularly impulsivity and reward hypersensitivity—were associated with increased delay discounting, higher risk-taking, and diminished cognitive control in financial tasks. Neuroimaging data revealed hypoactivation in prefrontal control regions and hyperactivation in reward-related circuits (e.g., ventral striatum). Gender-stratified analyses showed that males with ADHD displayed stronger preference for immediate rewards, higher portfolio turnover, and greater volatility. Preliminary evidence also suggests an overrepresentation of ADHD traits in high-frequency trading roles. Conclusion ADHD-related impulsivity significantly modulates financial risk behavior, particularly in high-stakes and fast-paced contexts such as trading. A convergence of behavioral, neurobiological, and ecological findings suggests that males with ADHD are disproportionately prone to rapid, high-risk financial decisions, whereas females may demonstrate greater regulatory control. These insights underscore the need for gender-sensitive interventions, occupational screening, and tailored psychoeducation. As financial environments become increasingly automated and fast-paced, understanding the neurocognitive vulnerabilities of individuals with ADHD may not only protect personal outcomes but also enhance systemic financial stability.

Osteoarthritis Depressive, Loneliness and Social Isolation in Later Life and the Robotic Companion

Background Older adults with disabling osteoarthritis may be severely impacted by negative emotions and pain, especially if they feel isolated. Review Aims 1) To summarize the research base concerning the presence of depression in older adults suffering from osteoarthritis; 2) To examine the degree to which mitigating loneliness is desirable in this regard and may be helped by one of the many emergent robotic social devices offering companionship; and 3) To provide directives for professionals who work or are likely to work with this population in the future. Methods Reviewed were current publications detailing some aspect of osteoarthritis in the older adult, depression, emergent loneliness and social isolation, and the role and impact of robotic personal ‘friends’ in this realm. Results Collectively, these data reveal efforts to reduce and mitigate different degrees of depression in older adult osteoarthritis cases are needed and that social robots may help quell isolation. Implication Those older adults with osteoarthritis suffering from depression and emergent loneliness and social isolation may benefit from robotic human or pet like contacts and interactions regardless of cause and overall health status, but the key is still loneliness prevention.

Intramuscular Fat Deposition and Osteoarthritis Pathology: A Possible Overlooked Pathogenic Correlate?

Osteoarthritis, the most prevalent joint disease and one affecting many aging adults is strongly associated with various degrees of disability and high health costs. Commonly deemed largely incurable and progressive, it appears muscle fat deposition and its encroachment on muscle tissue may account for multiple adverse health outcomes, especially the osteoarthritic disease process. This mini review examines whether contemporary evidence supports a role for efforts towards preventing excess fat infiltration into vulnerable muscles as one means of reducing osteoarthritic pain and disability. To this end, research on this theme and reported as of June 2025 on this issue was sought. We found that with few exceptions and regardless of joint examined a role for muscle mass infiltration in osteoarthritis disability appears of high clinical significance.

A Case of Postoperative Hematoma Mimicking Giant Hydrocele

Background In adult males, non-communicating hydroceles are non fluctuant scrotal swellings that are formed when there is an imbalance of fluid secretion and absorption between the parietal and visceral layers of the tunica vaginalis. Giant hydroceles are a rare manifestation and have previously been classified as hydroceles that drain more than 1000 mL of fluid. In this report, we describe a case of a giant hydrocele requiring surgical management and highlight a review of the literature. Case Presentation A 34-year-old male presented with complaints of large right-sided scrotal swelling, accompanied by scrotal discomfort. Ultrasound of the right testicle revealed a large hypoechoic space with a complex collection and posterior displacement of the testicle, indicating a possible hydrocele. The patient was taken to the operating room for a right hydrocelectomy. Approximately 2 liters of fluid were drained from the sac.  Discussion Hydroceles are defined as straw-colored fluid collections within the parietal and visceral layers of the tunica vaginalis. Giant hydroceles, defined as fluid collections within the tunica vaginalis exceeding 1000 mL, are rare and the management of such cases is sparsely documented in the literature. While most asymptomatic fluid collections resolve spontaneously, larger collections with inflammatory changes within the testicular wall may require surgical intervention, either laparoscopic or open. 

Health-Related Quality of Life Perception Among Older Persons with Non-Communicable Diseases in Primary Healthcare Facilities: A Qualitative Inquiry

Background The understanding of older persons with non-communicable diseases (NCDs) regarding health well-being is paramount and can translate to increased self-efficiency, independence, and enhanced well-being. However, little is known about older persons' understanding of the concept of health-related quality of life (HRQoL) in Uganda. The study explored perceptions and unveiled understanding of older persons with NCDs on HRQoL in central Uganda. Methods This exploratory qualitative study design involved 23 participants recruited from selected Primary healthcare facilities in Central Uganda. Thematic analysis using an inductive approach generated themes that informed the study's qualitative findings. Results The study highlighted the physical domain as a key component of HRQoL, encompassing holistic well-being, lifestyle modification, and financial stability. To promote well-being and support a healthy aging journey, it is essential to adopt a person-centered approach that aligns with the perceptions of older adults on HRQoL.

Ethics of Modern Stem Cell Research and Therapy: Current Critical and Interdisciplinary Perspectives

From an academic and clinical point of view, stem cell therapy represents one of the most promising advances in modern medicine, with the ability to partially induce the regeneration of acutely injured or chronically damaged tissues. Stem cell research provides new opportunities for the treatment of various conditions, among them diabetes mellitus, HIV, cardiovascular diseases, and neurodegenerative illnesses. Stem cell therapy is currently not FDA-approved in the US (except for certain blood cancers). While bioethics and religion have mostly discussed the source of cells, i.e., embryonic cells that require the destruction of embryos versus adult tissue for research purposes, we also discuss the controversies with regard to currently offered therapies, and marketing of unapproved procedures from a scientific, clinical, and religious viewpoint.

A 12-week, Multicenter, Randomized, Double-blind, Placebo-controlled Clinical Trial Evaluating the Efficacy and Safety of DKB-131 in Knee Arthritis

In this study, the efficacy and safety of DKB-131 (extract of Siraitiagrosvenorii) in adults of both genders presenting mild symptoms of knee arthritis were evaluated in comparison to a placebo. This clinical trial was randomized, double-blind, multicenter, and lasted for 12 weeks. A total of 120 participants with Visual Analogue Scale (VAS) scores of 30 mm or higher in the knee area and Kellgren & Lawrence Grade I or II knee arthritis on X-ray were enrolled, with 60 subjects randomized to receive DKB-131 and 60 subjects receiving placebo. Following 12 weeks of consumption, the change in K-WOMAC total score assessed in the per protocol (PP) set revealed a reduction of 21.86±15.98 points in participants who received DKB-131 (p<0.0001), whereas those in the placebo group exhibited a reduction of 14.92±16.66 points (p<0.0001). This demonstrated a statistically significant difference between the test groups (p=0.0389). Additionally, significant differences were observed between the DKB-131 and placebo groups in the changes in K-WOMAC pain (p=0.0157) and physical function (p=0.0447). For the secondary efficacy endpoint, the change in Visual Analogue Scale (VAS) scores, analyzed in the PP set after 12 weeks of consumption, the test group showed a reduction of 17.82±13.80 mm (p<0.0001), while the control group exhibited a reduction of 11.81±13.99 mm (p<0.0001), indicating a statistically significant difference between the test groups (p=0.0359). Safety evaluations including hematological tests, biochemical tests, and urinalysis revealed no clinically significant differences between the consumption groups. Additionally, vital signs (pulse, blood pressure) and anthropometric measurements (body weight) did not exhibit clinically significant differences between the consumption groups, confirming the safety of DKB-131. We propose that the consumption of DKB-131 is safe for humans and may contribute to joint health. Trial registration (CRIS.NIH.go.Kr): KCT0008527

Unveiling Gender Disparities in ADHD: A Literature Review on Factors and Impacts of Late Diagnosis in Females (2010-2023)

This exploratory study investigates factors and consequences of underdiagnoses or late diagnoses of attention deficit hyperactivity disorder (ADHD) in females favoring males in the referral, diagnosis, and treatment processes resulting in  gender disparities. A literature review in PubMed, PsychINFO, PsychArticles, and PsychiatryOnline from 2010 to 2023 underscores significant implications of delayed ADHD diagnosis in females, hindering timely access, support, and interventions during critical developmental years. Factors associated with underdiagnosis of ADHD among girls include gender differences in symptomology presentation, comorbidity, and gender bias among parents, teachers, and healthcare providers. We highlight the role of ethnicity and cultural factors. This bias prevents girls from receiving necessary ADHD support and treatment, impacting their health, social, and economic outcomes into adulthood. We summarize strategies to urgently address gaps in ADHD research and practice. Raising awareness among communities, healthcare providers, educators, and parents is vital to alleviate these gender disparities. By illuminating factors contributing to delayed diagnoses, the study informs policymakers and stakeholders, facilitating targeted interventions to improve early detection and treatment outcomes for females with ADHD.

Exploring HIV Self-Testing: Barriers and Facilitators among Undergraduate Students

Introduction Globally, 36.7 million individuals live with HIV/AIDS, with 2.5 million new cases annually. Youth (14-25 years) account for 45% of these new infections. Those aged 15-24 years are less likely to be aware of their HIV status and engage in HIV care compared to older adults. This study explores the use of HIV self-testing to improve access to HIV care among Kenyatta University undergraduates. Objective To identify barriers and facilitators to HIV self-testing in this group. Methodology Employing multistage cluster sampling, 398 students were surveyed using a self-administered questionnaire. Results Of the participants (median age 21 years, 1:1.03 male-to-female ratio), 91.7% understood HIV's seriousness, with sexual intercourse as the primary transmission mode. Self-testing usage was 28.8%. Key barriers included fear of partner reaction, stigma, and lack of confidence. Significant facilitators were being female, knowledgeable about HIV, and sexually active. Conclusion Only 24% had prior HIV testing experience. The study highlights the importance of addressing fears and misconceptions while leveraging knowledge and sexual activity awareness to promote HIV self-testing.

Morphological Variations and Morphometric Analysis of Foramen Ovale in South Indian Population

Introduction The foramen ovale is located in the area where intracranial and extracranial structures meet. Procedures involving trigeminal neuralgia and mandibular nerve anaesthesia require an understanding of the foramen ovale's morphometry and anatomy. Our present study was conducted to define mean values and anatomical variations in foramen ovale. Aims 1. To establish the mean length, breadth and the Area of the foramen ovale. 2. And also to study different shapes and special features of the foramen ovale. 3. To compare the values of the present author with the previous studies. Methodology The study was carried out on100 foramen ovale using 50 dry adult human skull bones of unknown sex. Maximum transverse diameter, antero-posterior diameters of the foramen were measured with the help of vernier calipers. and the different shapes of foramen were noted. The data was analysed by using unpaired T test. Results The mean anteroposterior diameter on left side was 6.59±1.37 mm and on right side was 6.99±1.44 mm. The mean transverse diameter on the left is 4.09±0.74 mm and 4.17±0.76 mm on the right side. Incidences of various shapes of the foramen ovale were oval 70%, almond 11%, round 9%, elongated 6%, pear shaped 2 % and irregular 2%. Conclusions The findings from the current study may be useful for understanding the variations of these foramina for interventions in middle cranial fossa.

The Potential Usefulness of Peripheral Somatosensory Stimulation in Improving Sleep Quality in Patients with Insomnia

Background Insomnia and other sleep disorders represent a major cause of disability and impaired productivity. We evaluated the impact of peripheral somatosensory stimulation (PSS) on sleep quality in 12 patients with varying degrees of insomnia. Methods Twelve adult patients underwent daily PSS therapy for a 4-week period and were evaluated using the Insomnia Severity Index at baseline (prior to initiation of therapy) and then at the conclusion of the treatments. All data were obtained through a self-reported 7-question survey evaluating overall severity of insomnia symptoms and the impact of sleep patterns on satisfaction with sleep, daily functioning, and overall quality of life. Changes from baseline insomnia scores were analyzed using cumulative link mixed models (CLMMs). Results Seven men and five women completed one month of PSS therapy. Mean age was 55.1 (range 29 to 80 years). No adverse events were described by the patients. The average total change from baseline score was -10.3 points (baseline: 16.5 vs. week 4: 6.2). Patients had statistically significant improvements for every individual survey question by week 4. The median composite score was improved from baseline, with an overall median score of 2 (IQR: 1.25 – 2.75, min-max: 1-4) at baseline compared to 0.5 (IQR: 0 – 0.25, min-max: 0-2) by week 4 (MD = -1 95% CI: , p < 0.001), signaling typically moderate insomnia at baseline vs. typically minimal to no symptoms by week 4. The predicted probability of obtaining the best outcome (score=0) was 9% at baseline vs. 53% by week 4. The overall cumulative odds ratio was 11.9 (p < 0.001), suggesting that on average, the odds of moving from one score to a lower (improved) score at week 4 compared to the baseline are approximately 12 times higher than moving to a neutral or worse score. Conclusions PSS stimulation appeared to have a significantly favorable effect on sleep quality in this group of patients. Symptoms related to ability to fall asleep, remain asleep, and overall quality of sleep were all improved with PSS therapy. We suggest that further investigation into the potential usefulness of PSS therapy in patients with sleep disorders is warranted.

Ebstein's Anomaly With Right Atrial Thrombus in 23 Years Old Man at Reference National Teaching Hospital of Ndjamena: A Case Report.

Ebstein’s anomaly is a rare congenital heart disease. It is usually associated with other congenital defects, particularly atrial septal defect/patent foramen ovale (PFO). We report here the case of Ebstein's disease revealed in a 23-year-old adult admitted for palpitations and exertional dyspnoea. He was in heart failure. The EKG showed atrial flutter . Cardiomegaly was present with a cardiothoracic index of 0.7. On echocardiography, the apical displacement of the tricuspid septal leaflet was 15 mm/m2 , the Celermajer index was Grade 3.  There was a large thrombus floating in the right atrium. While awaiting surgical management, the patient was being treated with diuretics, digitalis and anticoagulants.

Rheumatic Heart Disease In Chad: Clinical, Paraclinical, Therapeutic And Progressive Aspects

Introduction Rheumatic heart disease is mostly common in low-income or developing parts of the world, such as Sub-Saharan Africa, with a high morbidity and mortality rate. There are few data that are available in Chad on rheumatic heart disease. Our objective was to study the clinical, echocardiographic, therapeutic, and progressive aspects of rheumatic heart disease at the Renaissance University Hospital Center and the National Reference Teaching Hospital in N’Djamena, Chad. Patient and methods This was a prospective, multicenter and observational cohort study, covering a consecutive series of patients consulted and/or hospitalized for rheumatic heart disease, documented by an echocardiogram from January 2015 to January 2021. Results Among the 4456 patients consulted and/or hospitalized, 398 cases of rheumatic heart disease (8.9%) were collected, and 364 patients had met the inclusion criteria. The mean age was 31.2 ± 14.4 years, and 193 patients (53%) were female. On admission, heart failure was present in 214 patients (58.8%), ischemic stroke in 10 patients (2.7%) and supraventricular arrhythmias such as atrial fibrillation in 94 patients (25.8%) and atrial flutter in 6 patients (1.6%). Mitral regurgitation was observed in 49.7% (n=181) of cases, aortic regurgitation in 33.2% (n=121), mitral stenosis in 31.3% (n=114), and aortic stenosis in 7.7% (n=28). At least two valvular disorders were combined in 48.4% of cases. A surgical intervention such as a heart valve replacement and/or valvuloplasty was performed in 80 patients (22.2%). At least one rehospitalization was noted in 56.9% of patients. Forty-two of the 150 patients free of heart failure at inclusion (28%) had experienced the first episode of decompensated heart failure during follow-up. On the other hand, in 119 patients (55.6%), it was the second episode of decompensated heart failure. Other progressive complications included atrial fibrillation (13.8%), thromboembolic complications (6.3%), infective endocarditis (6.0%) and prosthetic valve dysfunction (1.4%). Altogether, the mortality rate was 10.4%. It was 9.9% in non-operated patients compared to 12.5% in operated patients (p=0.49). Conclusion The present study shows that morbidity and mortality of rheumatic heart disease remain high in our context and often affect children, young adults, and women. Treatment is essentially based on cardiac surgery which is not available in Chad.

Human Immunodeficiency Virus Drug Resistance (HIVDR) and Baseline Characteristics among Antiretroviral Therapy (ART) experienced Children and Adolescents under the care of Chidamoyo Christian Hospital in Hurungwe, Zimbabwe

Introduction Human Immunodeficiency Virus (HIV) remains a persistent global public health challenge. In 2020, approximately 37.9 million individuals were living with HIV globally, including 1.7 million children <15 years old, with a global HIV prevalence of 0.8% among adults. A larger portion of people living with HIV are found in low-and middle-income countries, and Sub-Saharan Africa (SSA) is home to about 68% of people living with HIV in the world. Strikingly, with increased uptakes in PMTCT, challenges in ART programs, and high viremia among children and adolescents in SSA, the success rate of ART might be quickly compromised, with possible HIVDR emergence, particularly after years of paediatric ART exposure. Therefore, monitoring ART response in children and adolescents in terms of HIVDR patterns and other socio-economic determinants of disease progression might help achieve better treatment outcomes at individual levels. At a programmatic level, this can guide further optimization of treatment options for SSA especially Zimbabwean rural where there is paucity of information on HIVDR prevalence in children and adolescents. Methods We enrolled 89 children and adolescents experiencing virologic failure from Chidamoyo Christian Hospital in Hurungwe. We managed to amplify all the 89 using nested PCR and 32.5% (29) had resistance to at least one ART drug and analysis was done using the 29 samples. Results Among the 89 participants with virologic failure,29 were resistant to at least one of their ART drugs. 39.2% of males and 23.07% of females had HIV-1 with resistance to at least one medication. Among 29 participants with HIVDR mutations, the prevalence of at least one HIVDR mutation to protease inhibitors (PIs), Nucleotide Reverse Transcriptase Inhibitors (NRTI), and Non-Nucleotide Reverse Transcriptase Inhibitors (NNRTI) were 6.47% ,46.76% and 46.76% respectively. Of the 29 participants who had HIVDR 19 (65.5%) had resistance to a drug they were currently taking and they needed to be switched to a better effective ART regimen Conclusion Use of HIVDR testing in guiding and monitoring development of HIVDR at the start of ART or at 1st failure can be very important in treatment options and patient management.

Building on Success in Tobacco Control: A Roadmap Towards Tobacco-Free Oman (Perspective Review)

Tobacco use remains a leading cause of harm to public health. Despite nearly two decades of ratifying the WHO Framework Convention on Tobacco Control (FCTC), Oman is still striving to achieve the best practice approach in different FCTC measures. Current epidemiological data shows that the prevalence of tobacco use among adults in Oman is steadily increasing with time. This review highlights the progress that has been made in the various FCTC measures, as well as how Oman has the possibility to attain the best practice approach in the various FCTC measures, and even go beyond that by implementing policies that have the potential to achieve a tobacco-free Oman by 2040.

Osteoarthritis and Depression Update: 2023-Can the Stress and Coping Model Help?

Background Osteoarthritis and depression are both key barriers to healthy aging and greatly heighten the risk for many negative health issues that seriously impact life quality. When combined what are the implications? Aim This mini review examines 2023 data pertaining to osteoarthritis and depression and older adults and a possible theoretical framework of stress that may direct our approaches in the future. Methods and Procedures Articles published between January 1 and August 15 2023 that addressed the current topic of interest and that were extracted from PUBMED, PubMed Central, Science Direct, and Google Scholar were carefully read and their key points arepresented in narrative form. Results As in the past, very few tangible theory-based prospective analyses that employ valid measures of depression and examine any association of any form of osteoarthritis longitudinally and in a consistent manner prevail. Several reports use the same or similar large cohort to draw upon, and find various degrees of clinical implications, but this may not embrace the need for more inclusivity, sampling strategies, control and diversity issues, as well as embracing the role of cognitions positive and negative. Conclusion Without efforts to develop sound research designs of diverse and carefully differentiated osteoarthritis substantive samples it is impossible to delineate the origin or implications of the osteoarthritis-depression linkage reported currently or arrive at a deep understanding of its relevance, to life quality and public health costs. What is needed to protect against or minimize either or both these clinically related disabling correlates in the aged population warrants timely study.

Deficiency of Adenosine Deaminase Type 2 (ADA2) DADA2 Masquerade as Lupus

DADA2 (deficiency of adenosine deaminase type 2) is an autoinflammatory autosomal recessive disease resulting from biallelic loss of function mutations in ADA2 gene. Clinical presentation and age of onset vary widely even among related patients, and variability of symptoms and severity manifestations include bone marrow failure, autoinflammation, immunodeficiency and vasculitis. Here, we report a case of young male with adult onset DADA2, who presented with fever, lower limbs skin rash, joint pain, and anemia resembling systemic lupus erythematous (SLE). DADA2 has an extremely variable clinical phenotype. It was described into three categories: inflammatory/vascular, immune dysregulation, and hematologic. However, the data is scant in describing autoimmunity phenotype in DADA2 and further studies are required to investigate the clinical correlation and presence of autoantibodies. We recommend genetic testing in cases with lupus-like disease especially if there is consanguinity between parents and family history of vasculitis.

Improving Effective Screening and Management of Obesity in an Urgent Care Clinic

Background Nearly 40% of the adult population in the United States are considered obese by current standards, which equates to approximately 93 million people. Obesity is a chronic disease that is linked to more than 40 other diseases, including hypertension, heart disease, stroke, diabetes, and at least 13 distinct types of cancers. The direct and indirect costs of obesity have been estimated at up to $210 billion annually. Local Problem In Cumberland County, North Carolina, 34% of the adult population was considered obese. The aim of this quality improvement study was to increase effective care (screening, patient engagement, and referral to treatment) in adult patients with a BMI greater than 30 kg/m2 to 75% within 90 days. Methods A rapid cycle plan-do-study-act framework was used to evaluate four focus areas concurrently over 8 weeks with a small test of change completed in each 2-week cycle. Interventions An expanded screening with a checklist, shared decision-making tools (SDMTs), and a referral to treatment checklist were implemented. Activities from the team engagement plan were initiated. Results The effective care of patients increased by 42 percentage points while engaging both the patients and the staff. Conclusions Utilizing standardized communication, SDMTs, checklists, and management plans improved effective care while motivating and enabling patients to take control of their care and make sustainable lifestyle changes that enhance overall health.

A Newer Approach in the Management of Cough: A Review on Levodropropizine

Safe and effective antitussive therapy remains a significant area of unmet need for cough management. Antitussive drugs are commonly used cough suppressants and include centrally acting (opioids and non-opioids) cough suppressants and peripherally acting antitussives. Authors searched PubMed, Google Scholar and additional studies from reference lists via cross-referencing to identify studies assessing levodropropizine for the treatment of cough. Of the 748 studies identified, 13 were included. Recent clinical evidence, guideline recommendations and findings from this review suggest that levodropropizine is a peripheral antitussive which reduces cough intensity, frequency, and nocturnal awakenings in children and adults and provides better efficacy outcomes with a more favourable risk/benefit ratio compared to centrally acting antitussive agents which pose greater safety concerns and present an unacceptable risk–benefit profile. This review is aimed at Indian primary care physicians for making effective cough management decisions where the clinical evidence needs to be translated to clinical practice. Key Messages The usage of currently available centrally acting antitussive agent is greatly limited by their central depressing action and frequent side effect. The findings of this review indicate that levodropropizine is an effective antitussive agent and well tolerated in the management of cough in patients of all ages.

Stemming The Tide Of Hypertension In Women: Optimal Age For Obstetric Debut

Objective Women have continued to bear a heavy burden of cardiovascular disease morbidity and mortality with hypertension as the flagship. This is partly because as the modifiable cardiovascular disease risk factors are falling in rate, gender specific risk factors have persisted. One of them is age at first pregnancy and delivery. Methods In order to contribute to this discourse, we secondarily analysed data generated in a previous field study on risk factors for cardiovascular diseases in free living adults in Plateau State, Nigeria. The women were divided into four groups and we looked at blood pressure at the time of study from the perspective of age at first pregnancy. Reults It was found that those who had their first pregnancy in the late teenage years had the lowest mean arterial blood pressure many years down the line; better than those who started child bearing earlier and those who started later. There was also significant within and between group differences in the blood pressures (p = 0.000). Conclusion To stem the tide of female hypertension later in life, child bearing should not start in the early teenage years nor be unnecessarily delayed. Sociocultural conditions that promote early teenage marriage and pregnancy should be discouraged.

Assessment of Oral Health-Related Quality of Life Among a Sample of Yemeni Population

The study aimed to assess the oral health condition and its impact on the quality of life (QoL) among a sample of Yemeni population. The study including 256 individuals who responded to the Oral Health Impacts Profile (OHIP) through completing a face-to-face survey of the OHIP-14 Arabic version. The data were collected by one dentist trained in the terms of oral health-related quality of life (OHRQoL). The study revealed that the impact of OHRQoL among the study sample was found with a weighted OHIP-14 score of 1.1 (±0.9). Physical pain (3.7±2.3), followed by physical disability (2.4±2.2), and psychological disability (2.1±2.3) were the highest scoring. A significantly higher effect (p < 0.05) was found for the adults (18-44 years old) compared to those elderly individuals (> 64 years). The OHRQoL was better in male than in female and in employees than in both pensioners and un-employees. Females had a significantly higher effect when compared to males in the OHRQoL (p < 0.05). The unemployed subjects were significantly higher than those pensioners and employees in the OHRQoL (p < 0.05). The OHRQoL was also better in subjects with higher income and education than those participants with low. However, there were no significant differences for OHRQoL with respect to the educational level and monthly income of participants (p > 0.05). Conclusion, the quality of life is greatly affected by the oral health conditions of the elderly. This impact of oral health on quality of life has an association with individual and contextual variables.

Long COVID-19 Syndrome and Frailty: Cause or Consequence or Both?

Background Many older adults remain vulnerable to COVID-19 infections. They are also often at risk for frailty and poor health outcomes.  Aim This exploratory review examines the correlates of long COVID and frailty and their association insofar as the older adult’s wellbeing may be jeopardized.  Methods and procedures Articles that emerged between January 1 2022 and 2023 in major electronic data bases that addressed the current topic of interest were sought using the key words: Long COVID and Frailty. Those deemed relevant were duly downloaded, analyzed and summarized in narrative form.  Results A high proportion of older adults can be expected to remain vulnerable to COVID-19 long term impacts, plus new variants of infection, along with frailty as both an outcome and mediator. Many too are at risk for persistent long COVID-19 complications and a low life quality if more concerted preventive and rehabilitation efforts to avert frailty early on are not forthcoming in a timely manner.  Conclusion Prompt and continuing frailty assessments of older adults at risk for COVID-19 or recovering from this disease, especially those with long COVID manifestations who are frail or may become frail are strongly indicated.

Effect of Extracts of Dialium guineense Stem Bark on Lipid Profile and CCl4- Induced Histological Changes in Liver of Wistar Rats

The present study investigated the effect of aqueous and ethanol extracts of Dialiumguineense stem bark on lipid profile and CCl4- induced histological changes in liver of Wistar rats. Adult male Wistar rats (n = 25) weighing 160 – 180 g (mean weight = 170 ± 10 g) were randomly assigned to five groups (5 rats per group): normal control, CCl4 control, silymarin, aqueous extract and ethanol extract groups. With the exception of normal control, the rats were exposed to CCl4 (single oral dose of 1.0 mL/kg body weight, bwt). Silymarin group rats were administered standard hepatoprotective drug, silymarin, at a dose of 100 mg/kg bwt, while those in the two treatment groups received 1000 mg/kg bwt of aqueous or ethanol extract orally for 28 days. Lipid profile parameters were determined in plasma, while rat liver was subjected to histopathological examination. The results showed that the levels of total cholesterol (TC), triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C), very-low density lipoprotein cholesterol (VLDL-C), low-density lipoprotein cholesterol (LDL-C) as well as atherogenic index of plasma (AIP) were significantly lower in CCl4 control group than in normal control group, but they were increased by extract treatment (p < 0.05). However, there were no significant differences in atherogenic coefficient (AC) and cardiac risk ratio (CRR) among the groups (p > 0.05). Carbon tetrachloride (CCl4) markedly disrupted the structure of hepatocytes and induced steatosis (intra-hepatocyte fat in-growth and inflammation) which was predominantly microvesicular. However, treatment with aqueous and ethanol extracts of D. guineense stem bark showed marked regeneration of hepatocytes (unremarkable hepatic lobular architecture). The toxic hepatic injury induced by CCl4 was significantly blocked by the plant extracts.

Characterization of The Oncogeriatric Population Attended at the Arturo López Perez Foundation (Falp) Cancer Institute

This study characterizes an oncogeriatric cohort at a cancer institute, reporting tumor types, comorbidities, geriatric assessments, and treatment patterns. Findings inform service planning and individualized care for older adults with cancer.

Histo-Morphological Effect of The Small, Large Intestines and Stomach of Animal Models Treated With Aqueous Extract of Abelmoschus Esculentus

This study investigates the effect of Aqueous extract of abelmoschus esculentus on the microanatomy of the small, large intestine and stomach and the body weight of Wister rats. Twenty-one adults male wistar rats weighing between 100-120 grams were assigned into three groups consisting of seven rats each; Group A (control), Group B (low dose), and Group C (high dose). The rats in the control group were fed with fed with feed and water only while the rats in groups B and C were treated with 0.1mg/kg body weight and 3.0mg/kg body weight of abelmoschus esculentus respectively for 14 days. At the end of administration, the final weights of all rats were recorded before sacrifice using cervical dislocation and the small, large intestine and the stomach were harvested, processed and stained using H&E stain. The results were revealed as significant (p<0.05) increased in the mean body weight compared with the weight in the control groups and experimental groups. The treated animal groups revealed increased cellularity, focal metaplasia of the mucosal cells with villous disruption in the small intestine and dysplasia of the mucosal with loss of epithelial shape in large intestine. The stomach histology showed gastric pits with goblet cells smooth muscles layer and surface epithelium in the control group. Sections from the low dose treated group showed deep epithelical gastric pit areas with marked depletion of pits and goblet cells while the high dose treated group revealed dysplasia of gastric pits, goblet cells and smooth muscles appear mildly eroded.

Osteoarthritis Literacy and Equity Issues: A Post COVID-19 Analysis and Update

Background Osteoarthritis, the most common joint disease and one affecting a large number of older adults is not always amenable to the use of passive interventions such as surgery or pharmacologic interventions, but even then, to maximize any desirable intervention approaches, a trustworthy and supportive partnership with the sufferer is strongly indicated. Complicating this process are emerging equity and persistent health literacy issues, as well as post COVID-19 service associated ramifications and persistent disease risks. Aim This mini review was designed to examine what current data reveal as regards the presentation of osteoarthritis and its pathology among the older adult as of the current post COVID-19 pandemic period in 2022, and how health literacy and equity issues are likely implicated in some degree with the disease presentation and its outcomes and will be likely to continue, unless remediated. Methods Peer reviewed published articles on this topic were sought from multiple data bases using the key words- osteoarthritis, health equity, health literacy, prevention, and intervention. Results As in prior years, osteoarthritis continues to induce considerable physical disability and consistently impedes the attainment of a high life quality for many older adults. Although not studied to any degree, attention to health equity and literacy issues appear to pose additional osteoarthritis intervention challenges, especially among the long COVID affected older adults and those with low income and educational levels. Conclusions Many behaviourally oriented and necessary osteoarthritis management approaches and interventions may fail to reduce the functional disability and pain experienced by older people with any form of osteoarthritis to any meaningful degree if a) the provider does not tailor their recommendations in light of possible prevailing health literacy, economic, and educational challenges; b) the patient does not understand how their health behaviours impact joint disease as well as COVID-19 risk status, and are not empowered to undertake these.

Common Clinical Presentations of GBV Survivors Seen Between 2020-2022 at a GBV Clinic in a Tertiary Care Referral Facility in South East Nigeria

Background Gender based violence (GBV) refers to any violence targeted at an individual or group on the basis of their gender. It could occur in different forms with several clinical manifestations. The authors have described several clinical manifestations of GBV in a tertiary health centre, knowledge of which would help in case identification and early clinical management. Methods Retrospective descriptive study of all clients seen at a gbv clinic over a sixteen months period.Data was obtained from case records and clinical presentations were entered into excel. Data analysis was done usingIBM SPSS Statistics for Windows, version 25. The results were presented in frequency tables and graphs Results Of 86 clients studied, 56(65.1%) were of pediatric age (< 18years) while 30(34.9%) were adults with a mean age of 18.33+11.64(range 1-64years).72(82.6%) belonged to the low social class. Physical abuse in the forms of battering, human bite, walking and sitting disturbances, hearing loss possibly from slapping or hitting and red eye possibly from trauma on the eye, constituted 37.6% of the clinical presentations. Other presentations were; sexual abuse in the form of forced sex which constituted 34.9%, while gynaecological / obstetrics presentations in the forms of bleeding per vagina, pregnancy due to forced sex and vaginal pain made up 13.9%. Emotional/psychological abuse was observed in all clients irrespective of their different presenting complaints. Conclusion While various forms of physical abuse were common, emotional abuse was present in all clients but masked probably due to prioritization of physical injuries. Therefore we recommend that all GBV survivors be screened for psycholocal abuse and psychotherapy given.

COVID-19 and Hip Osteoarthritis Disability-Linkages and Emerging Practice Implications

Older adults suffering from chronically painful disabling osteoarthritis of one or more joints such as the hip joint continue to experience multiple health issues, commonly progressive debility, and excess disability. This mini review strove to examine current perspectives in the realm of hip joint osteoarthritis, a widespread disabling disease affecting many older adults in the face of the possible repercussions of the multiple COVID-19 restrictions in response to the SARS-CoV-2 pandemic that emerged in late 2019, along with the persistence of multiple evolving COVID-19 variants that remain lethal to many older adults, especially among the older chronically impaired population. Using multiple data bases, results reveal that very little progress has been made in recent times to mitigate hip osteoarthritis, along with very few innovative treatment approaches when severe, other than surgery and medication. Moreover, a multitude of non-pharmacologic approaches have not reduced numbers of cases requiring surgery to any extent, even when employed. In addition, outcomes of hip joint replacement surgery, and other treatments for ameliorating unrelenting pain remain largely suboptimal, especially where those undergoing surgery may now be more impaired than in pre pandemic times, and where high rates of opioid related deaths prevail in this regard. As such, it is concluded that whether in the community or being treated in hospital, exposure to COVID-19 remains risky especially in cases who are now weaker and frail, plus suffering from excess chronic disease manifestations, thus warranting more attention and protection of this high risk group, plus insightful preventive efforts to avert multiple interacting COVID-19 effects in the realm of osteoarthritis suffering, especially where patients are willing to risk infection by undergoing surgery.

Beneficial Impacts of Solanum aethiopicum L. in Diabetes Control

Garden egg nutritional values are numerous. However, few nutritional and epidemiological data exist on the impacts of garden egg consumption on diabetes control. In this experimentally-control designed nutritional study, the effects of scarlet garden egg species (Solanum aethiopicum L.) on lipoglycemic profile, weight control and, pancreas histoarchitecture in diabetic male Wistar rats were examined. Twenty-One adult male Wistar rats inducted with diabetes were randomly categorized into three groups (n = 7, each): Diabetic control (DC); Diabetic treated with aqueous extract of garden egg (DEE) and Diabetic fed with garden egg-supplemented diet (DSE). Animals were fed for six weeks according to the experimental design. Glycemic status and body weights were assessed twice weekly while lipid analysis was conducted at the entry and 6th week of the study. Oral glucose tolerance (OGT) test was conducted. Gross analysis and tissue histology of the pancreas were assessed by Hematoxylin and Eosin (H&E) staining technique. Statistical analysis was done using analysis of variance, and the results were expressed as mean ± S.E.M. at P < 0.05. Garden egg reduced mean body weight gain (DSE: 14.53%; DEE: 10.58%; P value = 0.04) and decreased blood glucose concentrations (DEE: 37.33%; DSE: 18.68%; P = 0.03) with corresponding improved lipid profile, glycemic tolerance and control (DEE > DSE) and, preserved pancreas histoarchitecture in diabetic Wistar rats. Solanum aethiopicum (garden egg) consumption (as fresh fruit or supplemented diet) preserves pancreatic tissue histoarchitecture and improves lipoglycemic profile and weight control in diabetic Wistar rats.

Osteoarthritis and Neuromuscular Deficits: Can a Causative Role be Discounted- Key 2017-2022 Observations

Background The origin of osteoarthritis, the most common disabling disorder of older adults remains uncertain. Aim This mini review examines the possible role played by various neuromuscular deficits in the osteoarthritis etiopathogenic process. Methods and Procedures Articles that haveaddressed the current topic of interest and were located in the PUBMED,Google Scholar, and Web of Science electronic data bases as of 2017-2022 were carefully sought and examined. Results Various neuromuscular mechanisms may have a bearing on the development and progression of osteoarthritis, but the data are largely unrelated and observational in nature. Conclusion More research to examine this issue is sorely needed and could have considerable merit in light of the growing populations of older adults at risk for disabling osteoarthritis in the face of few intervention options to help them to achieve an optimal functional level.

Dose Response of Total Saponins Isolated from the Stem Bark of Dialium Guineense

The safety of plant-derived bioactive compounds has become a global concern. The present study investigated the dose response of total saponins isolated from the stem bark of Dialiumguineense. Adultmale Wistar rats (n = 15) weighing 170 – 190 g (mean weight = 180 ± 10 g) were randomly assigned to three groups (5 rats per group). The rats received varied doses of total saponins isolated from the stem bark of the medicinal plant (50 - 150 mg/kg body weight, bwt) orally for a period of 9 days. The concentration of fasting blood glucose (FBG) was used as the therapeutic index.The results of the analysis revealed that total saponins isolated from the stem bark of D. guineense significantly reduced the Fasting Blood Glucose (FBG) levels of normal Wistar rats (p < 0.05). The graded and quantal dose-response curves showed that150 mg/kg bwt was effective in reducing the blood glucose of rats (produced the best hypoglycemic effect). The study concluded that total saponins isolated from the stem bark of D. guineense possesses hypoglycemic effect at a relatively good dose.

Review on Public Health Effects of Aflatoxins in Milk and Milk-Based Foodstuffs of Dairy Cow

Aflatoxins are toxigenic metabolites that are definitely occurring by lethal strains of Aspergillus parasiticus and Aspergillus flavus that commonly dwell and colonize in feed components and various nutritive foodstuffs particularly milk and milk based products. This Review has three main objectives; those are causes of aflatoxin, effects and methods of control in milk and milk products. Drinking of cow milk polluted with aflatoxin may overwhelm immunity and subsidize to stunting in young children, as the young children are not immune-competent during early stage. It has been internationally assessed that aflatoxin is possibly accountable for 30% of the annual cases of liver cancer. Generally, control approaches of aflatoxin can be applied during pre-harvest, cautious management in the time of harvest and postharvest decontamination. Moreover, choosing breed for aflatoxin impervious crop diversities, prevention of aflatoxin production through biological decontamination by microorganisms and their metabolites, rejection of aflatoxin by physical means in addition to inactivation by chemicals are the typical approaches that have been described in different studies. For the reason that cow milk is the most important and principal diet of children, but the risk of exposed to the cancer are more in infants. In addition, according to various investigations it also well thought that young animals are also found to be more vulnerable to aflatoxin than adults. Thus; the contamination of cow milk and milk products by AFM1 should understood as undesirable for young human and animals.

New Classification for Bifurcated Mandibular Neural Canal

Objectives To analyze the occurrence rate of bifurcated mandibular canal (BMC) by cone beam CT(CBCT) and summarise a new classification for further clinical work and academic communication. Method Randomly collected the CBCT images of 350 adult patients. Firstly, we analysed and summarized the BMCs into four types by the position of bifurcation point in the mandible. Second, we did statistics about occurrence. Then we have measured three kinds of distance of Type I and Type II. At last, we compared the advantages and disadvantages about different classifications. Results Among these 350 patients, we found 110 adult people with BMC which indicated the occurrence rate of BMC was 31.43%. The most common type was Type I, especially Type IB, and the least was Type III. Vertical distance between the apex of the second molar, the third molar and mandibular canal are 4.36±2.51 mm and 2.45±2.23 mm. Distance from the apex of two molars to the bifurcated spot are 15.87±6.82mm and 9.32±5.37mm. And the distance between the apex and retromolar foramen in Type I are 22.19±5.97mm and 15.82±4.68mm. Conclusion Comparing with former typing theory, we summarized a new classification which is simpler and more convenient, which should attach scholars’ attention to BMC during clinical work.

Osteoarthritis and Frailty: Associations, Relevance, and Counter Solutions

Background Many older adults, including those who have acquired painful disabling osteoarthritis of one or more joints may be frail rather than obese as is often reported. Those older adults who are frail may acquire osteoarthritis in turn if they encounter excess joint stresses and injury. Aims This report sought to examine what has been published to date on both of these debilitating health states, namely osteoarthritis and frailty. Methods Reviewed were relevant articles published in ACADEMIC SEARCH COMPLETE, PUBMED, WEB OF SCIENCE, SCOPUS and GOOGLE SCHOLAR regardless of time period but that focused on osteoarthritis and frailty related topics. The focus was on ascertaining how these two conditions might interact among community-dwelling older adults and whether more should be done specifically to mitigate any potentially preventable ‘frailty’ induced negative health impact among this group. Results Older adults with osteoarthritis living in the community may suffer from both osteoarthritis and frailty. Those that do are at high risk for disability and injury and should be targeted more effectively. Conclusion Timely and concerted efforts are needed to offset frailty correlates as well as excess osteoarthritis disability among community dwelling older adults.

Fear of Falls and Frailty: Cause or Consequence or Both?

Background Many older adults are vulnerable to becoming frail. They are also often at risk for falling and serious injuries and poor health outcomes. Aim This exploratory review examines the correlates of frailty, and fear of falling and their association insofar as older adults wellbeing may be jeopardized.   Methods and Procedures Articles extracted from major electronic data bases that addressed the current topic of interest were used. Key findings regarding the syndromes of frailty and fear of falling were duly downloaded, analyzed and summarized in narrative form. Results A high proportion of older adults can be expected to exhibit frailty or become frail as they age. Many too are at risk for falls and fear of future falls, regardless of frailty status. A persistent fear of falls may however, heighten frailty risk or manifestations if not duly addressed in a timely manner. Conclusion Prompt comprehensive assessment of at risk older adults, as well as the frail and pre frail older adult, plus those who have fallen may avert serious injury and long term disability plus excess frailty and its deleterious impacts this syndrome has on aging older adults as well as societies.

Anthropometric Study of Nasal Index Among the Youth of Madheshis Community of Nepal

Introduction The nose is one of the important component of the face which is considered as the major clue for the ethnic origin. The proportion of the nose is determined on the same principal as that of the skull.The external nose extends the nasal cavities onto the front of the face and positions the nares so that they point downwards. The shape of the nose is pyramidal with its apex anterior in position. The upper angle of the nose between the openings of the orbits is continuous with the forehead. Materials and Methods This study was carried out among residents of Ramnagar Gaupalika-7, Sarlahi,Nepal, one of the core region of Madhesh Nepal dated Jan 2021 to April 2021.The cohort consists of independent adults of age group 17-45 and consenting adults from the metropolis. Ethical approval was sought prior to conducting the study from the supervising ethical committee of the Nobel Medical College Teaching Hospital, Biratnagar, Nepal. Written consents were taken from the subjects for the recruitment in the study. Results The present study involved 100 subjects of equal males and females subjects of age groups 17-45 years from Madheshis community of Nepal. The table 1, table 2, table 3 below shows the values obtained for different parameters for males and females. The mean value of nasal height for male and female is 52.59±1.89 and 50.27±2.16 mm and the nasal width for male and female is 37.64±1.72mm and 35.42±2.04mm and the value of mean nasal index for both the sexes are 71.59±2.31and 70.58±3.04 respectively. The dominant type of the nasal morphology in both the sexes are the mesorrhine type and the leptorrhine type as well. Conclusion The human nose is a dominant feature in facial region which differs in anatomy and morphology among racial groups and of the most characteristic differences during the analysis of ethnic and racial differences. The dominant type of the nasal index is the mesorrhine type in both the male and female of the Madheshis community. Hence the data obtained here will be useful for the differentiation of different ethnic groups of Nepal as well as in the field of forensic science and rhinoplastic surgery.

Aging and Positive Psychology

Background Aging, a state often associated with poor emotional health status greatly impedes life quality and independence for many. Aim This mini review examines the potential of the concept of positive psychology as an active approach to fostering successful or more successful, rather than suboptimal aging. Methods and Procedures Articles that addressed the current topic of interest and were located in the PUBMED, Medline, Web of Science, PsycINFO and Google Scholar electronic data bases were carefully sought and analyzed and presented in narrative form. Results Various forms of positive psychology appear to provide a safe efficacious evidence based approach for purposes of ameliorating various degrees of anxiety and depression and for improving cognition, life quality, and health well-being in diverse subgroups of older adults Conclusion More research to examine who might benefit most from this highly promising form of intervention, and in what respect appears to have considerable merit in light of the growing populations of older adults and few intervention options to help them to age optimally and as successfully as possible.

RETRACTED: Profile of Children with Covid 19 Infection in our Set Up

This article has been retracted on July 20, 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2692-1537.ijcv-25-5866) In December 2019, a novel coronavirus, now named as SARS-CoV-2, caused a series of acute atypical respiratory diseases in Wuhan, Hubei Province, China. The disease caused by this virus was termed COVID-19. The virus is transmittable between humans and has caused pandemic worldwide. The number of death tolls continues to rise and a large number of countries have been forced to do social distancing and lockdown. In humans, COVIDs mostly cause respiratory and gastrointestinal symptoms. Clinical manifestations range from a common cold to more severe disease such as bronchitis, pneumonia, severe acute respiratory distress syndrome, multi-organ failure and even death. Preliminary evidence suggests children are just as likely as adults to become infected with SARS-CoV-2 but are less likely to be symptomatic or develop severe symptoms. in our study , we consider the symptomatology , complications and mortality patterns of this disease in children.

Photobiomodulation, Depression, Anxiety, and Cognition

Background Anxiety and depression are key barriers to healthy aging and greatly heighten the risk for many negative health issues that seriously impact life quality. Aim This mini review examines the potential of low level laser treatments or photobiomodulation therapy for ameliorating severe anxiety and depression in older adults. Methods and Procedures Articles that adressed the current topic of interest extracted from PUBMED and Google Scholar were carefully and presented in narrative form. Results Photobiomodulation therapy appears to be a safe efficacious modality for ameliorating various degrees of anxiety and depression and for improving cognition, and is supported by several well established mechanisms of action at the molecular, cellular, and tissue levels. Conclusion More research to examine who might benefit most from this form of therapy, and in what respect in this area of growing global concern and few intervention options is strongly warranted.

The Biology of Fall Army Worm (Spodopterafrugiperda. J. E. Smith) in Sudan

The Fall armyworm (Spodoptera frugiperda) is considered among the economic important pests in Sudan. Therefore, it became necessary to study and understand its biology and find out the appropriate control measure (s). To achieve the above objective, experiments based on Randomized Complete Block Design (RCBD) were carried out during the period from September 2018 to August 2019, where the Fall armyworm (FAW) was reared in the laboratory and fed on a nutrient médium composed of Corn leaves. The results displayed the ranges of eggs laid by a female was 890–1169. The egg incubation period ranged between 3-13 days. The larval duration ranged between (13-50) days and the pupal duration was between (7-20) days under a temperature of 21-300c and a Relative Humidity (RH) of 65 ± 5%. The longevity of the adults was 1-20 days, and the range of the full lifecycle was (24-100). However, six generations of FAW were obtained within one year. This study concludes that in Sudan FAW breeds continously throughtout the year and it recommends further studies on the biology and effective management of this invasive pest

Successful Aging, Social Isolation, and COVID-19: Do Restrictions Help or Hinder?

Background Aging, a commonly accepted time period of declining heath has been shown to vary in terms of its impact on function and independence. Aims This mini review examines the current impact of COVID-19 on the goal of ‘successful aging’, a conceptual model and outcome variable deemed desirable, but hard to attain. Methods Peer reviewed articles published between March 1 2020 and April 15 2021 focusing on ‘successful aging’ and COVID-19 secondary impacts, as located in the PUBMED data base were specifically sought. Results Despite a lack of consensus on the concept of ‘successful aging, and whether this can be achieved or not, ample evidence points to a severe secondary impact on efforts to age as successfully as possible by older adults, especially those isolated in the community as a result of lockdowns. Conclusion Pursuing more efforts to counter predictable harmful cognitive as well as physical impacts of lockdowns, resource and movement restrictions is urgently needed.

Characterization of the Consciousness Energy Healing Treated Cholecalciferol Using LC-MS and GC-MS Spectrometry

Vitamin D3 (cholecalciferol) is a fat-soluble vitamin, which widely used for the prevention and treatment rickets, osteoporosis, arthritis, Parkinson’s and Alzheimer’s diseases, autoimmune disease, dementia, glucose intolerance, etc. The impact of the Trivedi Effect®-Consciousness Energy Healing Treatment on the structural properties and the isotopic abundance ratio of cholecalciferol were evaluated using LC-MS and GC-MS spectroscopy. The test sample cholecalciferol was divided into control and treated parts. Only, the treated cholecalciferol was received the Trivedi Effect®-Consciousness Energy Healing Treatment remotely by a renowned Biofield Energy Healer, Dahryn Trivedi. The LC-MS spectra of both the samples at retention time (Rt) ~22 minutes exhibited the mass of the molecular ion peak at m/z 385.25 (calcd for C27H45O+, 385.35). The LC-MS based isotopic abundance ratio of PM+1/PM in the treated cholecalciferol was increased by 0.74% compared with the control sample. But, the GC-MS based isotopic abundance ratio of PM+1/PM and PM+2/PM in the treated cholecalciferol was significantly increased by 66.39% and 62.69%, respectively compared with the control sample. Hence,13C, 2H, 17O, and 18O contributions from C27H44O+ to m/z 386 and 387 in the treated cholecalciferol were significantly increased compared with the control sample. The isotopic abundance ratios of PM+1/PM (2H/1H or 13C/12C or 17O/16O) and PM+2/PM (18O/16O) in the treated cholecalciferol were significantly increased as compared to the control sample. The increased isotopic composition of the Trivedi Effect®-Consciousness Energy Healing Treated cholecalciferol might have altered the neutron to proton ratio in the nucleus via the possible mediation of neutrino. The increased isotopic abundance ratio of the treated cholecalciferol may increase the intra-atomic bond strength, increase its stability. The new form of cholecalciferol would be better designing novel pharmaceutical formulations that might be more stable and more efficacious for the prevention and treatment of various diseases such as vitamin D deficiency, rickets, osteoporosis, arthritis, multiple sclerosis, cancer, diabetes mellitus, mental disorders, cardiovascular diseases, hypertension, infections, influenza, cognitive impairment in older adults, Parkinson’s and Alzheimer’s diseases, autoimmune disease, dementia, glucose intolerance, multiple sclerosis, etc.

Evaluation of the Isotopic Abundance Ratio of Consciousness Energy Healing Treated L-Tryptophan Using LC-MS Spectrometry

L-tryptophan is an essential α-amino acid, necessary for the normal growth in newborns, nitrogen balance in adults, protein synthesis, precursor of serotonin, melatonin, niacin, and albeit inefficiently in human, also the precursor of indole alkaloids and auxins in plants. This current study was designed to investigate the impact of the Trivedi Effect®-Biofield Energy Healing Treatment (Blessing) on the structural properties and the isotopic abundance ratio of L-tryptophan using LC-MS analytical technique. L-tryptophan sample was divided into two parts, one part of L-tryptophan was considered as the control sample (no Biofield Energy Treatment was provided), while the second part was treated with the Trivedi Effect®-Consciousness Energy Healing Treatment/Blessing remotely by a renowned Biofield Energy Healer, Dahryn Trivedi and termed as the treated sample. The mass spectra of both the control and treated samples with respect to the chromatographic peak at retention time (Rt) 2.1 minutes exhibited the mass of the molecular ion peak adduct with hydrogen ion at m/z 205.08 (calcd for C11H13N2O2+, 205.1), along with low molecular fragmented mass peaks at m/z 188, 159, and 102 for C11H12N2O2+, C10H11N2+, and C8H6+, respectively were also observed. The isotopic abundance ratio of PM+1/PM (2H/1H or 13C/12C or 15N/14Nor17O/16O) in the treated L-tryptophan was significantly increased by 35.93% compared with the control sample. Hence,the 13C, 2H, 15N, and 17O contributions from C11H13N2O2+ to m/z 206.08 in the treated L-tryptophan was significantly increased compared to the control sample. It could be hypothesized that the changes in the isotopic abundance and mass peak intensities due to the modification in nuclei possibly through the interference of neutrino particles using the Trivedi Effect®-Consciousness Energy Healing Treatment. The Biofield Energy Treated/Blessed L-tryptophan with increased stable isotopic abundance ratio might have changed the physicochemical properties with higher force constant in the molecule. The new form of treated L-tryptophan would be a better and more stable in the supplements, nutraceutical, and pharmaceutical formulations, which would be advantageous for the prevention and treatment of pellagra, depression, kynurenine. It could also maintain the normal label of tryptophan and avoid increase of its metabolite, lower the neurotoxin and a metabotoxin behavior, glutaric aciduria type I (glutaric acidemia type I) disorder, eosinophilia-myalgia syndrome (EMS), incurable and sometimes fatal flu-like neurological condition, etc. As tryptophan is the precursor for the plant hormones like indole alkaloids and auxins, hence, this treated L-tryptophan would be advantageous for the improvement of yield, productivity, and quality of crops and other plants.

The Influence of Siblings on Young Children’s Understanding of Fluid Intake

Background Children need to drink enough water (1.1-1.3 litres) throughout the day to stay hydrated and for health benefits1. Wellbeing and cognitive function benefits have been identified for children who are hydrated2. Yet there is a dearth of research focusing specifically on children’s perceptions of their own fluid intake levels and who helps support them in ensuring they are drinking enough water, this is a novel area to investigate. Previous research3 identified that 44.2% of young children’s fluid intake were influenced the strongest by a family member. This paper will explore in further detail the influence of siblings on children’s fluid intake, in particular older versus younger siblings. Methods 130 children (67 girls and 63 boys, of which 45 had a younger sibling (s) and 85 having an elder sibling(s), from 4 primary schools in the South East of England, were questioned between January and April 2019 using an adapted version of Coppinger and Howells’ (2019)4 questionnaire, on their understanding of fluid intake, how much they perceived they drank and who supported them in prompting them to drink. Physical visual representations were used to aid question comprehension and to ensure the questions were appropriate for young children. The data was analysed using SPSS 24.0 using MANOVAs (P < 0.05) to consider statistical variance in gender and older sibling status. Results The most significant results were linked to elder siblings influence younger siblings in drinking too little fluids within a school day (F=0.530, p<0.05), whilst those without an elder sibling, thought they drank beyond the daily recommended guidelines and reported they drank over 2 litres. This illustrates that children misunderstand fluid intake recommendations regardless of whether they have an elder sibling or not. Children named adults, both parents and teachers as well as elder siblings as the key influencers of them drinking (F=3.67, p<0.05) and the data indicated that girls were more influenced by siblings than boys, whilst twins were not influenced by each other. Conclusion It is concluded that siblings do have an influence on the consumption of water, as siblings act as role models and other siblings follow their habits, therefore the whole family unit is important to ensure that the right fluid intake is consumed. It is recommended that further education, curriculum and community development is needed to continue to support young children’s knowledge and understanding of fluid intake.

Culture of Cyclops for Use the First Intermediate Host in Experimental life Cycle of SpirometraSpecies

Background In natural conditions Cyclops are the first intermediate hosts in the life cycle of Spirometra species. In this paper we describe simple method of culturing Copepod of the genus Cyclops for use the first intermediate host in experimental life cycle of Spirometra species. Methods Paramecium was first cultured to be used as food for Cyclops. Sample of water was collected from a pond within Sokoine University. About 100 ml of water and pre-boiled wheat grains were transferred in a Petri dish and kept under laboratory conditions for 7 days, a swarm of Paramecium was formed. An adult female egg sacked Cyclops from a natural water pond in Tarangire National Park, Tanzania was added in a new Petri dish containing tap water, 0.3 ml of Paramecium suspension and 4 pre-boiled wheat grains. The mixture was kept under laboratory conditions temperature 26-29⁰C and observed daily. Results Eggs from the single Cyclops hatched to nauplius. The average time of developing to nauplius I was 1.2 days, nauplius I to copepodite I was 6.9 days, and copepodite I to adult female Cyclops was 26.3 days. The average measurements of naupliusI were 120.2µm length and 80.0µm width while the adult female was 846.3µm length and 284.6µm width. The adult female produced 1 to 8 broods (mean 4.3). The life span of Cyclops averaged 43.1 days. Conclusion The Cyclops cultured in the laboratory were fed Paramecium and used as first intermediate host in the experimental life cycle of Tanzanian Spirometra species.

Osteoarthritis, COVID-19 Social Isolation-Impacts, and Counter Solutions

Background to the Issue Many older adults, including those already suffering from chronically painful disabling osteoarthritis of one or more joints remain more susceptible than healthy age and gender matched adults to the COVID-19 corona virus. Aims This report sought to examine what has been published in 2020 on this health condition from the perspective of the variable of widely imposed social isolation strategies designed to mitigate the spread of this highly infectious disease, and to especially keep older community dwelling adults ‘safe’ from infection. Methods Reviewed were all articles published in 2020 in PUBMED from January 1-December 24, 2020 on osteoarthritis and COVID-19 isolation impacts, plus relevant past osteoarthritis and isolation literature among older adults. The focus was on ascertaining how social isolation and distancing strategies might impact current community-dwelling adults diagnosed with osteoarthritis and whether more should be done specifically to mitigate any potentially preventable ‘socially’ induced negative health impact among this group, in spite of the laudable goals of this public health strategy. Results Older adults with osteoarthritis living in the community who are asked to self-isolate, may incur more osteoarthritis pain and disability than would otherwise be encountered if actions taken to counter this possibility are not forthcoming. Advocated over and above basic care approaches are several psychosocial strategies including the role of mobilizing various forms of social support. Conclusion Data indicate a need for concerted thoughtful and immediate attention to offset isolation, fear, and anxiety and depression effects as part of a carefully devised integrated plan of management to reduce excess osteoarthritis disability, as well as excess COVID-19 risk among otherwise free living older adults already compromised by osteoarthritis.

Studies on Current Status of Hypertension Prevalence, Awareness, Treatment in Jiangxi Province, China

Objective To understand the present status of high blood pressure in Jiangxi adults including the prevalence rate, overall awareness, and hypertension treatment. Methods a total of 7,200 adult participants (over 18 years old) lived in Jiangxi were recruited using a stratified sampling method. Blood pressure was measured for all the participants and a questionnaire survey was conducted. A 24-hour urine sample was also collected to understand urine sodium and potassium levels. Results Our findings revealed that the measured systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 125.9 mmHg (95% CI, 124.85-126.95) and 79.2 mm Hg (95% CI, 78.15-80.25). The prevalence of hypertension among the enrolled adults was 27.43% (95% CI, 26.38%–28.48%). Among the affected participants, less than 30% of them (95% CI) were aware of their hypertension condition, and only 28.56% (95% CI) were under anti-hypertension medications. The mean salt intake converted from urinary sodium was 10.92±4.07 g and the mean±SD of 24-h urinary sodium and potassium excretion were 185.51±65.44 mmol and 25.98±9.16 mmol, respectively. The high-salt condiments was determined to be the main source of sodium in the region. Conclusion Findings from this study form the baseline information to understand the hypertension condition in the region and indicate a possible solution for hypertension prevention through avoiding high-salt condiments.

Prevalence and Risk Factors of Metabolic Syndrome Among Teaching Staff of Engineering Colleges in Central India

Background Prevalence of Metabolic syndrome is high among Asians including Indians, and is high among those having sedentary occupations. Teaching is one of the important occupations, which demands no strenuous physical activity. However, there is little information available about the prevalence of metabolic syndrome among teaching staff of engineering college. Hence, the present study was conducted to study its prevalence, certain risk factors and co-morbidities among teaching staff of engineering institutes. Methods Teachers from engineering colleges of Nagpur city were the study subjects. Data was collected by interview technique. Clinical examination and laboratory investigations like Fasting blood glucose, High Density Lipoproteins and Serum Triglycerides were done. National Cholesterol Evaluation Programme (NCEP) Adult Treatment Panel Three (ATPIII) criteria were used to study Metabolic syndrome. Blood pressure and anthropometric measurements like height, weight and waist circumference were obtained by standard methods. Results The prevalence of metabolic syndrome was found to be 20.5%. It was 25.32% in females and 19.31% in males. It was more common in subjects of higher age group, muslim religion, and among widows and separated. Alcohol consumption, smoking and sedentary life style was found to be significantly associated with presence of metabolic syndrome. Frozen shoulder, fungal infection and stroke were common co morbidities found among subjects having metabolic syndrome.

Digital Planning for Mini-Implant Supported Palatal Expander in Open-Bite Treatment

Open bite malocclusion, due to it’s multifactorial etiology, has always been considered a difficult problem to treat. Often associated with transverse maxillary deficiency, this is a real challenge in the field of orthodontics. The traditional approach, for this type of anomaly, in adult patients, is orthognathic surgery and RME (rapid maxillary expansion). There are several approaches to the treatment of adult patients using digital technology. Mini-implant supported palatal expander limits the side effects of the conventional RME and is less invasive compared to orthognathic surgery. Precise and predictable mini-implant insertion, using a customized surgical guide, provides a safe therapeutic approach. This case report combines Cone-beam computed tomography (CBCT), laser scan superimposition, computer-aided design (CAD) and 3D printing in order to design and print a customized surgical guide for orthodontic mini-implant insertion. A CBCT scan was performed to determine the optimal site for mini-implants’ placement. Using the 3Shape Trios Intraoral Scanner the maxilla and the mandible were laser-scanned. Blue Sky Plan 4 software was used to design the surgical guide, and RayWare software was used for printing it. 4 mini-implants were inserted using a safe and predictable technique. The 3D technology represents the future of orthodontics, reducing the risks, chair-side time while providing the best treatment plan for the patient.

Quercetin Attenuates Manganese-Induced Neurotoxicity in Mice Hippocampus by Regulation of Oxidative Stress and Tumour Necrosis factor Alpha Expression 

The hippocampus is involved in learning and memory processes, an integral component of cognitive function. The aim of this study is to assess the efficacy of quercetin on manganese-induced neurotoxicity in the hippocampus of the adult mice. In this study, 40 adult mice of average weight of 18 –29g were randomly distributed into five groups of eight each. The brain was harvested and the region of the hippocampus was grossed for histological and immunohistochemical analysis. The results revealed a significant increased level of oxidative stress markers of manganese treated mice when compared with the normal control and quercetin treated animals (p<0.05). Immunohistochemical analysis also showed a decrease expression of Tumour necrosis factor alpha (TNFα) with quercetin treated animals when compared with manganese treated animals indicating its neuroprotective function. In addition, quercetin treated animals all had an improved working spatial memory in Y-maze test. The histological results also revealed a degeneration of pyramidal cells with a characteristic pyknotic activities at the granular layer of the hippocampus leading to neuronal integrity damage following chronic exposure to manganese but normal architectural design was however maintained with quercetin. Conclusively, exposure to manganese in excess may have adverse effect on extensive neuronal degeneration that could affect the learning, memory and possibly spatial navigation ability of miceand quercetin attenuates this induced neurotoxicity via inhibition of oxidative stress and reduction of TNF expression.

The Minimalistic Malignancy- Low grade Fibromyxoid Sarcoma

Low grade fibromyxoid sarcoma (LGFMS) is an exceptional, low grade, soft tissue sarcoma  with indolent biological behaviour, extensive preclinical stage, enhanced localized tumour reoccurrence and delayed, distant metastasis. As the deceptively benign neoplasm was initially scripted by Evans in 1987, the tumefaction is nomenclated as “Evan’s tumour”. Incidence of sarcomas is nearly 1% of adult malignancies wherein low grade fibromyxoid sarcoma represents roughly beneath <5% of soft tissue sarcomas 1.

Coprological Examination of Ovine Fasciolosis in Horro District Community Based Sheep Breeding Program, Horro Guduru Wollega Zone, Western Ethiopia

A cross-sectional study was conducted from November 2017 to March 2018 to determine the prevalence of ovine fasciolosis in the Community Based Horro Sheep Breeding site at Horro district, Horro Guduru Wollega zone, Ethiopia. Coprological examination was performed on a total of 390 sheep at the study area. Age, sex, body condition score and peasant association were taken into consideration as rik factors. An overall prevalence of fasciolosis 45.4% 95% CI (40.41 50.36 was found on the basis of coprological examinations. The prevalence of fasciolosis findings according to PAs were (41.5%) in Laku Ingu and (48.2%) in Gitilo Dole. Statistical analysis of the prevalence among study site (PAs) showed insignificant difference P=0.102 (P>0.05), but significant difference (P<0.05) was observed between animal age groups (P=0.032, with a prevalence of 37.2% in young and 49.8% in adult) and body condition scores (P=0.001, with a prevalence of 57.9%, 43.5% and 29.9% in sheep with poor, medium and good body condition score, respectively. There was insignificance difference (P>0.05) in sex group of study animals in which the prevalence was 47.6% in female and 38.8% in male. Therefore further studies on the epidemiology, seasonal dynamic of the disease, the snail intermediate host and impacts of the infection in animal production with implementations of strategic intervention is necessary.

Childhood Overweight, Social Media, and Osteoarthritis: Is there a Possible Emergent, yet Unrecognized Linkage?

Background Osteoarthritis, a serious and increasingly prevalent disabling global health condition found largely among older adults, has been linked to the presence of excess body weight. But what contributes to this growing health epidemic of excess weight, which is increasingly observed in children? Moreover, can a case be made for predicting a possible negative linkage between the pervasive use of social media from the earliest point in time and possible subsequent childhood overweight or obesity and late life osteoarthritis that may be amenable to intervention? Methods To examine the most probable answers to these questions, the EBSCO, Scopus and PUBMED data bases were sourced for relevant data. The extracted data were carefully reviewed, categorized and documented in narrative format. Results While one cannot readily carry out research to answer the above questions, prevailing data imply that there is more risk of being overweight in childhood, as well as acquiring possible later life disabling osteoarthritis, or a more serious manifestation of this disease, through the prolonged, unfettered and frequent use of social media in early and middle childhood. Conclusion Those in the realm of developing preventive strategies against childhood overweight or obesity as well as osteoarthritis are strongly encouraged to examine the role of the media environment and messages children are exposed early on in this regard. Alternately, children who already have disabilities, joint pain due to arthritis or other health conditions, and who may have to rely more on social media than others who are active- may suffer more readily from an energy imbalance and become overweight if due precautions against this are not taken.