Characterization of Novel Cement-Based Carboxymethyl Chitosan/Amorphous Calcium Phosphate

Objective This study aimed to analyze, evaluate, and characterize novel cement-based carboxymethyl chitosan/amorphous calcium phosphate (CMC/ACP). Materials and Methods The three cement groups studied were gypsum (Gyp), and CMC/ACP—gypsum cement-based 5% (5% CAG) and 10% (10% CAG). The groups were characterized using Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), setting time, and scanning electron microscopy (SEM) data. The characterization results were analyzed qualitatively, but the data for setting time were analyzed using SPSS (p < 0.05). Statistical Analysis Data were statistically analyzed. One-way analysis of variance was used to compare numerical (parametric) data between more than two separate groups followed by post hoc Tukey. Results FTIR showed phosphate groups indicate the presence of calcium phosphate in the form of amorphous (ACP) in the CMC/ACP, CMC/ACP post-milled powder, and CMC/ACP cement-based (5% CAG and 10% CAG). XRD showed no difference in the diffraction spectra among the Gyp, 5% CAG, and 10% CAG groups. SEM images revealed that the CMC/ACP cement-based groups (5% CAG and 10% CAG) showed CMC/ACP cluster filled with hollow spaces between the gypsum crystals and aggregations surrounding the gypsum crystals. The CMC/ACP showed envelopes and attached to the crystalline structures of the gypsum. Setting times of 5% CAG and 10% CAG showed significant differences compared with Gyp (p < 0.05). Conclusion The result of our study showed that CMC/ACP cement-based (5% CAG and 10% CAG) demonstrated amorphous characteristic, which can stabilize calcium ions and phosphate group (ACP). In addition, the modification of gypsum using CMC/ACP as cement-based extended the time of setting.

Delivery in water, experiences in a population of Mexican women in Mexico City

Background: Labor is a physiological process during which the fetus, the membranes, the umbilical cord and the placenta are expelled from the uterus and water delivery has become popular, although its prevalence is unknown, it is supported by healthy women with full-term pregnancies, without complications; although there is insufficient evidence to support or discourage it. Objective: To identify obstetric and neonatal outcomes and complications in women who delivered in water and to compare them with traditional deliveries. Material and methods: It is a retrospective, observational and cross-sectional study, where 2486 women were included from a database of 4223 women assisted from 2004 to 2020 in private hospitals; Of the 2486 patients included, 1025 had a water delivery and 1461 had a conventional delivery, discarding 1737 women who underwent caesarean section from the study. The information obtained from the patients, their data obtained for this study were kept in the anonymity of the patients, where they were analyzed: non-parametric data reported in percentages using Chi square; Parametric, perinatal and neonatal data are reported as mean plus standard deviation (±SD) and analyzed using Student's T, using the SPSS version 25 statistical package. Results: A total of 2486 women were included in this study, the birth in 1025 was water delivery (24%) and 1461 was conventional delivery (35%), 1737 caesarean section (41%) were excluded from the study, no difference was observed maternal age; unlike weight, height, body mass index; they were higher in women with water birth compared to conventional. No difference was demonstrated between nulliparous (45.99%) and multiparous (53.86%) when comparing both birth in water and conventional; only increase in previous caesarean sections (9.36 vs 6.5%, p=0.008) and decrease in previous abortions (16.19 vs 20.94%, p=0.002) in water delivery with the conventional one; complications were not different: administration of oxytocin (3.2 vs 3.1) or postpartum hemorrhage (0.29 vs 0.13) in both deliveries; no differences in first degree perineal tears (21.4 vs 18.5%). Conclusion: Water birth reduces stress, pain sensation, second and third degree perineal lacerations and contributes to better newborn outcomes; the selection and inclusion of patients with low-risk pregnancies allows better perinatal results than conventional delivery; but, further studies are required to use it routinely.

Study on the expression level of NF-κB and clinical evaluations in spinal tuberculosis patients

Spinal tuberculosis or tuberculous spondylitis is one of the most common types of skeletal tuberculosis. Complications of the spine and spinal cord tuberculosis include destruction of the vertebrae, deformity, and paraplegia. Since in some patients, the clinical manifestations of tuberculosis are unusual and timely diagnosis and treatment of this disease can prevent its serious consequences, so in the present study, some cases of rare manifestations of tuberculosis were investigated. The expression of the NF-κB gene in these patients was also evaluated. In this regard, 36 patients with spinal tuberculosis and 30 healthy individuals (as a control group) were assessed. Clinical symptoms, imaging, laboratory tests, pathology, and response to treatment related to patients with spinal tuberculosis and spinal cord tuberculosis were evaluated. NF-κB expression was also evaluated using the PCR technique in peripheral white blood cell samples. The obtained results were analyzed using SPSS ver. 16, χ2 and T-test statistical methods. Mann-Whitney U test and Kruskal–Wallis non-parametric tests were used to analyze non-parametric data. The results showed that out of 36 cases of spinal tuberculosis, 29 cases had spinal tuberculosis, five cases had tuberculous radiculomyelitis, one case had spinal intramedullary tuberculoma, and one case had syringomyelia. 52.78% of patients were male, and 70% of cases were observed between the ages of 35 and 55 years. Fever and back pain were seen in more than 80% of cases. The study of NF-κB expression in the control and case groups showed that the NF-κB expression in the case group increased compared to the control group. This increase was statistically significant (P = 0.0071). In general, in the present study, the methods of clinical diagnosis of spinal tuberculosis were evaluated. Also, the amount of NF-κB transcription factor was evaluated as an effective genetic factor in the diagnosis of this disease.

Analysis of the efficiency of insurance companies in Indonesia

Financial system stability is not only supported by the banking sector, but also the role of insurance companies that operate efficiently. The study aims to analyze the efficiency performance of general insurance companies using two stages of data envelopment analysis during the 2017 – 2018 period. The first stage of efficiency measurement using a non-parametric data envelopment analysis (DEA) approach shows the efficiency level of general insurance companies experiencing a positive trend. The performance of general insurance companies in 2018 was more efficient than in 2017 based on the value of technical efficiency (CRS) and the value of pure technical efficiency (VRS). This means that in general there has been an increase in the efficiency of general insurance companies in Indonesia from 2017 to 2018. Testing the efficiency determinants in the second stage using the Tobit regression model found that the cost ratio is the only factor that significantly influences the efficiency level of general insurance companies in Indonesia. Meanwhile, company ownership and investment adequacy ratio have no significant effect on the efficiency level of general insurance companies in Indonesia. The results of the study provide recommendations to the management of general insurance companies that efficiency performance has not reached the maximum, and to improve it, it is necessary to control costs without disturbing routine operations and development activities.

Laser Assisted In Situ Keratomileusis (Lasik) Versus Trans Epithelial Photorefractive Keratectomy (T-Prk) In Astigmatic Patients

Purpose: To compare the results of LASIK versus Trans Epithelial Photorefractive Keratectomy (T-PRK) in correcting astigmatic refractive error. Study Design: Quasi experimental study. Place and Duration of Study: Lahore Medicare Hospital from January to October 2018. Methods: One hundred and twenty six eyes of 63 patients, age 18 to 35 years, either gender, presenting with astigmatism were enrolled in this study. Myopes with spherical equivalent (SE) ? -13.0 diopter sphere (DS), hyperopes with SE ? +5.0 DS and astigmatism ? 1.5 D with visual acuity better or equal to 0.3 LogMAR were included. Astigmatic eyes with < 1.5D and with any other ocular pathology were excluded. Refractive status was assessed by Canon Autorefractor and Heine Retinoscope. Average reading of both methods was taken. Patients were divided into two groups (31: LASIK; 32: trans-PRK) by spin of a coin method. Refractive surgery was done in both groups. Data was analyzed by SPSS 20. Normality of quantitative data was checked by Shapiro Wilk test. Mann Whitney-U test was used for non-parametric data. P-value ? 0.05 was taken as significant. Results: Mean age of the patients was 25.83 ± 3.09 years. The difference in residual sphere, amount of cylinder, axis of cylinder and CCT (central corneal thickness) after surgery in two groups was insignificant. P values were as follows; for sphere p = 0.85, amount of cylinder p = 0.22, axis of cylinder P = 0.46 and CCT p = 0.07. Conclusion: Both techniques are equally good in correcting astigmatism (p = 0.22). LASIK or T?PRK can be done alternatively in patients with astigmatism. Key Words: LASIK, Trans epithelial PRK, Astigmatism.

Electronic Visualization of Underground Tourist Routes on the Example of the Route in Sandomierz

For many years in Poland, anthropogenic objects constructed underground have been very popular with tourists. In the past they fulfilled various functions (historic mines, underground merchant warehouses, military objects, special objects, caverns and grottoes). Many of them were secured and rebuilt in such a way that a new form was created. They make interesting tourist offers and still more objects can be made available to tourists. An example of strongly modified underground anthropogenic objects of very complex geometry and extremely interesting architectural form is the Underground Tourist Route (Polish: Podziemna Trasa Turystyczna – PTT) in Sandomierz. Owing to much effort and financial means, in 1960s many interesting cellars and merchant warehouses were saved from destruction – and – with the application of mining techniques, they were joint into attractive spatial forms. So far, few publications give the full characteristic and parametric data of this object. Today’s possibilities of available measurement and information technologies allow comprehensive inventory of complicated engineering constructions, as well as the 3D visualization, regarding even tiniest elements of small architecture (doors, lattice, lamps, etc.). The article presents the results of the visualization and parameterization based on the data from integrated surveying (levelling, transects, total stations, laser scanning and other direct measurements). ELEKTRONICZNA WIZUALIZACJA PODZIEMNYCH TRAS TURYSTYCZNYCH NA PRZYKŁADZIE TRASY W SANDOMIERZU W Polsce dużą popularnością turystyczną od lat cieszą się obiekty antropogeniczne wzniesione pod powierzchnią ziemi, pełniące różnorodne funkcje użytkowe w przeszłości (zabytkowe kopalnie, podziemne składy kupieckie, obiekty militarne, obiekty specjalne, jaskinie i groty). Wiele z nich zostało w stopniu istotnym zabezpieczone i przebudowane w taki sposób, by nadać im nową formę. Udostępnione, dziś stanowią ciekawe oferty turystyczne, a ich liczba stanowi dziś zbiór otwarty. Przykładem mocno przetworzonego podziemnego obiektu antropogenicznego o bardzo zróżnicowanej geometrii i niezwykle ciekawej formie architektonicznej jest Podziemna Trasa Turystyczna w Sandomierzu. Dzięki zaangażowaniu wielu środków udało się w latach 60. XX w. ocalić od zniszczenia wiele interesujących piwnic i składów kupieckich i połączyć je z zastosowaniem technik górniczych w atrakcyjne formy przestrzenne. Dotychczas powstało niewiele opracowań, które ukazałyby w pełni ich charakterystykę oraz sparametryzowały obiekt. Możliwości dostępnych dzisiaj technik pomiarowych oraz informatycznych pozwalają na kompleksową inwentaryzację skomplikowanych budowli inżynierskich, a także wizualizację przestrzenną z uwzględnieniem nawet najdrobniejszych elementów małej architektury (drzwi, kraty, lampy itp.). W artykule zaprezentowano wyniki wizualizacji i parametryzacji na podstawie danych zintegrowanych pomiarów geodezyjnych (niwelacji, poligonizacji, tachimetrii elektronicznej, skaningu laserowego i innych pomiarów bezpośrednich).

Evaluation of Plasma Levels of Interleukin 6 and Iron Status of Football Players in a Nigerian University

To determine the levels of interleukin 6 (IL-6) and iron status of football players in Madonna University, Elele, Rivers State, Nigeria. A total number of 100 subjects were recruited for the study, comprising of 50 of football players before playing football (25 males and 25 females) and 50 of football players after playing football (25 males, 25 females) from Madonna University Nigeria, Elele Campus, Rivers State, Nigeria. The data obtained from the study were presented as Mean SD in tables and analysed using student t-test for parametric data using SPSS version 20. The level of significance was set at p<0.05. The results showed significant increase (p=0.004) in interleukin 6 (IL-6) of football players after playing compared to it before playing and no significant change (p=0.505) in the iron level of football players after playing compared to before playing respectively. The results also showed no significant change in interleukin 6 compared among football players based on gender and age groups and no significant change in the iron level of all the subjects. The study showed increase an in interleukin 6 (IL-6) of the football players after playing compared to the level before playing which shows that the physical activity increases the level of interleukin 6 and but has no effect on the iron level after football game.

Quality of Life of Mothers of Children with Intellectual Disability in Relation to Mother Empowerment Program

Background: The present study investigated the quality of life of 100 mothers of children with intellectual disability in selected special schools of Kottayam district, Kerala. Materials & methods: A descriptive survey was conducted among 100 mothers of children attending special schools of Kottayam district from February 2020 to September 2020. The Quality of Life was measured by using WHO QOL Malayalam questionnaire, after obtaining Institutional Ethics Committee Approval and after seeking informed consent from the participants. . The purpose of the study was explained, socio demographic data collected by interview and the data recorded. The mothers filled up the instrument and returned back to the investigator. Data were analyzed with descriptive statistics such as mean and standard deviations and appropriate parametric test such as independent t test for parametric data. Results: Out of the 100 mothers studied, educational status of the mothers showed that 10 had primary education, 37 had high school education, 32 had higher secondary education and 21 graduates.; occupation of the mothers showed that , 18(18%) had Government job, 20 (20% ) had private job ,15(15%) were self employed and 47 (47%) were not employed. It was found that 95(95%) of children obtained financial assistance and other benefits from local self governing bodies. The Overall quality of life scores of mothers and financial assistance obtained from the local self governing bodies was studied .The overall QOL scores of mothers is influenced by the financial assistance obtained from local self governing bodies.(P=0.01, t= 2.51). The Overall QOL Score ranged from 2 to 130 with a mean of 69.93 and Standard Deviation of 20.13 Results shows that the highest mean value was obtained for Psychological Domain with a standard Deviation of 19.85 , the lowest mean value was obtained for social relationships domain with a mean value of 39.55 and a standard deviation of 26.30.

Comparative effectiveness of topical lignocaine nebulization and airway nerve blocks for awake fiber-optic nasal intubation in TM joint ankylosis

Background: Awake fiber-optic nasal intubation is a gold standard management of difficult airway in temporal mandibular (TM) joint ankylosis. Aims and Objectives: We compared topical lignocaine nebulization with airway nerve blocks for awake fiber-optic nasal intubation in TM joint ankylosis. Materials and Methods: Fifty patients of either gender were randomly allocated into two groups of 25 each. Group I received 10 ml of 2% lignocaine nebulization over a period for 20 min. Group II received bilateral superior laryngeal nerve block and transtracheal recurrent laryngeal nerve block (each with 2 ml of 2% lignocaine). Awake fiber-optic bronchoscopy-guided nasal intubation was done in all patients. All the patients received sedation during the procedure. The intubation time, intubating conditions, vocal cord position, cough severity, and degree of patient satisfaction were recorded. Student’s t-test was used to analyze parametric data, while the Mann–Whitney U-test was applied to non-parametric data and Fisher’s test to categorical data. P<0.05 was considered statistically significant. Results: The time taken for intubation was significantly shorter in Group II [110.2 (14.6) s compared with Group I (211.0 [22.3] s) (P=0.028 ss). The intubating conditions and degree of patient comfort were better in Group II compared with Group I. Although all patients were successfully intubated, patient satisfaction was higher in Group II. Conclusion: Airway nerve block is a better way of anesthetizing airway as compared to nebulization for awake fiber-optic nasal intubation. However, nebulization with lignocaine may be an alternative in situations where nerve blocks are not feasible or may be used as an adjuvant to nerve blocks.

P-P25 Hot Axios stent removal following endoscopic pancreatic necrosectomy

Background Symptomatic pancreatic pseudocysts or walled off necrosis following pancreatitis can be drained via a stoma from the collection to the GI tract, this is typically facilitated by endoscopic stents. These stents are left in-situ until the area has drained, this can take several months. The stent is then ideally removed endoscopically. Little is known about the consequences of failed endoscopic stent removal or factors contributing to this failure. Methods Retrospective analysis of prospective data at LUHFT between 1st January 2018 and 31st December 2019 of patients receiving at least one Hot Axios stent for management of pancreatic collection. Normally distributed data were compared using Student’s two tailed T test, with non-parametric data compared using Mann-Witney U test, categorical data were analysed using Chi2 test Results 131 patients were included in analysis, of which 74 were male with a median age of 56 years (IQR 46-66.5). Failure of endoscopic removal (14 patients) was associated with a longer time to removal; 101 days (IQR 78-121) to first attempt vs. 49 days (IQR 19-104) to first endoscopic attempt where the stent was successfully retrieved endoscopically (p &lt; 0.01). Surgical removal was undertaken in 6 patients, with significant morbidity in 2 of 6 patients. Overall 90-day mortality in patients undergoing Hot Axios stent placement was 8 of 131 (6%). Conclusions Endoscopic stent removal fails more frequently in patients where the stent has remained in situ for a long time before removal is attempted. Surgical removal of Hot Axios Stents is associated with significant morbidity, and this should be balanced against the as yet unknown consequences of leaving Hot Axios stent in-situ permanently.