The increasing of the modern technologies requires the setting up of multiple factories and industries that produce smokes and chemicals, which polluted the air, water, and the environment resulting in putting lives in dreaded conditions. In fact, the coming of the modern era and the modern lifestyle gives birth to numerous deadly diseases like cancer and its related diseases, which increasingly takes the lives of many in the country. The cold-blooded killer ‘cancer’ becomes the major public health concern in India as a whole. Among all the problems existed across the world, the problems or the issues associated with cancer or terminal illness becomes the worldwide phenomenon that produces several unwanted worst experiences. Human polluting the water, soil, and the air continued, and the global burden of cancer affected populations rapidly increasing year after year. Unfortunately, India turns out to be the world most densely cancer populated regions and a cancer hub. The reason behind the rapidly increasing of cancer illness and its mortality rates in India is mainly due to people lack awareness on cancerous factors, no proper preventive measures, and the late detection of the symptoms at the advanced stages when cure is not possible.Thus, concerning the helplessness conditions of the cancer effected people of in general, the current analytical study has been forms with an aim to spread awareness on the cold-blooded killer cancer across the country.
Objectives: The aim of this study is to use of available resources effectively and efficiently, to determine the situation of recource allocation, priority setting and to offer an insight into future planning in delivery of health services in Turkish Armed Forces (TAF). Study Design: This study was conducted using qualitative focus group method and it is a descriptive and qualitative study. Questions to be asked in the focus group discussions, the location and the time of discussions and the participants was determined by review of the literature. Methods: Focus group interviews lasted between approximately 90-120 minutes, respectively, to each focus group, 9 chief phsycians, 13 doctors /dentists, 6 nurses, 8 health noncommissioned officers, 7 officers, 6 noncommissioned officers and 6 health administrators were attended. Results: The result of focus group discussions; priority settings in military health services must be done and to preventive health care would be prioritised. The military hospitals in Internal Security Operation Area should be strengthened in terms of medical personnel and medical supplies and be full-fledged hospital. There was found that secondary care should be met from civilian hospitals in the other regions. Conclusion: It is evaluated that the study will be contributed to set of priorities in TAF military health services take the investments in the public or private health sectors and operational requirements into consideration, the studies carried out by TAF Medical Command in order to restructure of the military hospitals, to be employed the recources allocated for health services and health personnel graduated from Gulhane Military Medical Academy such as physicians, health noncommissioned officer and nurses in real requirement positions.
Background and Aim: The CCHF (Crimean-Congo hemorrhagic fever) virus causes a severe disease in human with a case fatality rate of up to 50%. Since, there is no specific treatment or approved vaccine against CCHF viral infections, an accurate and early detection as well as a reliable surveillance and quantitative determination of viral load is necessary for patient improvement and case management. In this research, our aim was to develop a probe based one-step real- time reverse-transcription polymerase chain reaction (rRT-PCR) assay for in-house quantitative detection of CCHF virus. Methods: At first, the highly conserved S-fragment sequence of CCHF virus genome was adapted from GenBank and the specific probe and primers targeting this region were designed. Then, viral RNAs were extracted from 37 blood samples of different patients from east of Iran (Zahedan). The specificity and sensitivity of the probe and primers were also evaluated in positive blood samples, confirmed to have CCHF virus. A standard (PTG19-T vector containing S-fragment) for quantization was also constructed and the viral load was determined in some of positive samples. Results: From a total of 37 suspicious blood samples, 15 samples were confirmed to be positive for CCHF virus by this probe based one-step rRT-PCR assay and no false-positive result was detected according to sequencing data. The predicted fragment of 176 bp was also confirmed in all positive samples by gel-based electrophoresis analysis. The assay was linear between 10 to 103 copy numbers per each microliter of extracted plasmid for this technique and the viral load determined in one of patient blood samples was 55,000 viral particles per each milliliter, for example. Bioinformatics and experimental evaluations approved the specificity of this assay. The LOD of the assay was 10 (or fewer) copy numbers of viral genome per each microliter of the extracted genome. Conclusions: This research showed that the developed probe based one-step rRT-PCR assay is a specific, rapid, sensitive and the simple tool for detection and viral load determination of the CCHF virus.
Aim. The assessment of distribution of supernumerary permanent teeth (SPT) and the disturbances caused by them. Material and method. Cross-sectional study upon a sample of 85 children (58 boys) aged between 3 and 18 years (mean age=9.08±3.09 years) with at least one SPT. Were analyzed: patients’ distribution according to gender, age and number of dental units; SPT distribution according to arch and topography and also the disturbances noticed. Results. a) boys:girls ratio=2.14:1; b) the 85 patients had 107 SPT, mean number=1.25; c) 76.47% of patients had one SPT; d) 89.72% of SPT were on maxillary arch, maxilla:mandible ratio = 8.7:1; d) 92.52% of SPT were localized in anterior region, anterior:posterior region ratio = 12.3:1; e) mesiodens –71.96%, supernumerary lateral incisor – 19.62%; f) disturbances caused by SPT: ectopic eruption of permanent teeth – 36.47%; delay or failure of eruption of permanent teeth – 21.17%; crowding – 20%. Conclusions. 1. Supernumerary teeth were most frequent noticed in boys, in maxillary anterior region. 2. Most often they caused eruption disturbances of permanent teeth.
Introduction – With increasing life expectancy and changing trends in diseases, lifestyle diseases come forward and become a major concern. Ischemic stroke is an emerging public health issue leading to significant morbidity and mortality. To improvise positive outcome in acute ischemic stroke (AIS) and optimizing healthcare resources, accurate and timed prognostication of functional outcome is important. Various studies implied derangement of Hypothalamo- pituitary-thyroid (HPT) axis in AIS, thereby advocates neuroprotective properties to these hormones. This is, still, an open field for active research. Thyroid hormones can, therefore, be used as a surrogate tool for outcome predilection in AIS. This prospective observational cohort study aimed to investigate the alteration of levels of thyroid hormones in AIS and simultaneously correlate their levels in assessment of clinical severity and predicting the functional outcome. Materials and methods – We had collected data from 60 patients of, radiologically confirmed new cases of AIS who sought medical help within 72 hours of initiation of stroke symptom and had no previous history of thyroid disease. Blood samples for thyroid function test [TSH, FreeT3 (FT3), and FreeT4 (FT4)] were collected within 24 hours after admission and subsequently at 7th and 30th day of discharge .On admission neurological clinical severity was assessed by using National Institute of Health Stroke Scale (NIHSS). Functional outcome was assessed by Modified Rankin Scale (mRS) at 7th and 30th day of discharge. Result – Out of 60 AIS patients, 40 were having Non thyroidal illness Syndrome (NTIS). Low T3 was most common NTIS observed. Negative correlation was observed between FT3 levels and on admission NIHSS score and mRS score on follow up. Conclusion – This study thereby concludes that low T3 levels were associated with clinical severity and poor functional outcome in AIS.
Of the major threats to contemporary mankind, is the use of very dangerous and lethal biological agents as the biological weapons. The first step in confronting with this serious threat after prevention, is the accurate and rapid detection of this agents and neutralization of them. In this article, the role of molecules known as aptamer, has been studied in biological defense against these menacing biological agents. Traditional methods for detection of these agents are based primarily on immuno-affinity assays and the use of antibody molecules. While the modern methods, based on aptamer-affinity assays, are being replaced with traditional methods, due to the abundant advantages of them. The selection and preparation method of specific aptamer with high binding affinity to these biological agents is known as SELEX and the use of magnetic nanoparticles to perform this procedure (Mag-SELEX) is very common. The isolated aptamers with high specificity can also be used in neutralization and inhibition of menacing agents function, in addition to, quick and accurate diagnosis of these agents, utilizing them in nano-biosensors, based on aptamers (as the nano- aptasensors).
Background Left ventricular ejection fraction (LVEF), the single most important metric in cardiology, is the cornerstone on which prognosis is estimated and costly decisions such as whether to implant an ICD are based. LVEF is most often assessed by 2D echocardiography (2DE), although 3D echocardiography (3DE) has been shown repeatedly to be more accurate. Aim of the study. We set out to assess whether using 3DE would reclassify the severity of LV impairment in patients with LVEF < 35% by 2DE. Setting. Tertiary cardiac centre serving a population of one million, and performing approximately 100 ICD implants/year. Methods. Successive patients in sinus rhythm, with good endocardial border definition and LVEF<35% by 2D Simpson’s method, had scans according to the BSE protocol. 3D loops were acquired from the apical 4-chamber view and were analysed off-line using for regional wall motion abnormalities (RWMAs) and LVEF. The patients were classified in subgroups according to EF value: less than 20%, 20-25%, 25-30%, 35% and more than 35%. Moderate LV systolic was defined as LVEF between 35% and 45% and severe as LVEF ≤35%. Results. We studied 100 patients (78 M, mean age (SD) 69.94 (13.54) years). 2DE had been requested for decision-making regarding ICD implantation in 86 patients (86%) and for LVEF measurement after acute coronary syndromes in 14 patients (14%). Regional wall motion abnormalities (RWMAs) were present in half of patients (55%, 51 pts – 56% in LAD territory, 31% in RCA/CX territory and 12% multiple territories). 3D LVEF regrouped 67% of patients: 10% to a lower EF and 57% to a higher EF subgroup. Twenty nine patients (29%) were reclassified from severe LV systolic dysfunction by to 2DE to moderate LV systolic dysfunction by 3DE. Patients with RWMAs were more often reclassified than patients without RWMAs (p=0.006). The LV dimensions were lower for the reclassified patients. The image quality had no effect on reclassification. Conclusion Measuring LVEF by 3DE reclassifies the severity of LV systolic impairment in a substantial proportion of patients with 2D LVEF<35% and RWMAs, which may have important clinical and financial implications by resetting thresholds for costly interventions such as ICD implants.
Background: This study presents the management of patients with war-related injuries and early results of vascular injuries treated at a secondary care hospital neighboring to civil war. Methods: Between December 2013-December 2014 ninety-six war-related injury patients evaluated by a single vascular surgeon and participating disciplines according to components of injury in polytrauma patients. Thirty-six patients who underwent vascular surgery were retrospectively registered to the study. Demographics, treatment and early results of patients reviewed. Results: Mean age was 26.69±11.80 (7-66) years and 91.66% (33/36) were males. Injuries were caused by shrapnel wound due to bombing 61.11% (22/36), stab wound 8.33% (3/36), gunshot wound 30.55 % (11/36). The number of patients with polytrauma was 29, seven patients had isolated vascular injury. Among 42 arterial and 31 venous injuries primary suture repair, autologous vein graft interposition and prosthetic graft interposition performed to 20.54% (15), 28.76% (21), 19.17% (14) respectively. Amputation and all-cause mortality were %8.3 (3/36), 13.8% (5/36) respectively. Conclusions: Vascular injury with concomitant trauma is the main issue of war-related injuries. Surgeons should be cautious about patients who were initially deemed not to need surgery for vascular injury and then were found to need it. Repetitive physical examination is very important in case of any suspicion, especially in limited conditions for diagnostic tools like CT angiography. A rapid, careful multidisciplinary evaluation of experienced surgeons for the diagnosis and the treatment priorities in war-related injury patients may lead to increase life and limb salvage rates with a better quality of life.
Purpose – Combined airway burns with cutaneous burns is a further negative prognostic factor in burn patients. In this study we tried to identify the most relevant negative prognostic factors at admission in a relatively homogeneous population. Methods – In this study, ten young patients who suffered from skin and airway burns following a fire in a club, admitted to our ICU department, were included. At the intake, ABSI and APACHE II scores were calculated, and a series of biomarkers were also collected. The correlation and associations between gravity scores and biomarkers was then calculated using the Spearman correlation and Chi square tests. Results – Based on data analysis, we found very high values of ABSI 8.9 ± 1.4 and APACHE II 25.4 ± 2.79 scores, procalcitonin (46.16 ± 68.18 ng/ml), white blood cells (41.26 ± 15.66 × 103/mm3), hematocrit (51.6 ± 7.31 %), and low corrected albumin values (22.08 ± 4.66 g/l). The statistical analysis revealed a good correlation between gravity scores and values of PCT and low albumin levels (p< 0.05). The mortality was also associated with the need for vasopressor support from the beginning (p < 0.05). Conclusions – Adverse prognostic factors that we have identified in this group of young patients with skin burns and airway include: increased values of the severity scores and PCT, low values of corrected albumin and vasopressor support necessary at admission. INTRODUCTION Burns represent one of the most aggressive injuries of the human body known for high mortality, thus raising major length of public health hospitalization and recuperation, along with psychological and physiological traumas, all these leading to increased costs [1-4]. issues such as increased Burns-induced mortality rate is globally increased, and 1 Clinical Emergency Hospital of Plastic Reconstructive Surgery and Burns, Bucharest, Romania 2 Carol Davila University of Medicine and Pharmacy, Division of Physiology and Neurosciences, Bucharest, Romania 3 The Bucharest University of Economic Studies, Department of Statistics and Econometrics, Bucharest, Romania 22 including surprisingly high in the developing countries, including Europe’s burn centers, where it ranges between 1.4% and 18% [5]. The high mortality is associated with a number of factors, long-term severity of burn driven inflammatory response of the host, secondary human body frailty and abnormal response to further injuries like sepsis [6, 7]. The association of airways’ and cutaneous burns induces a supplemental inflammatory response, difficult to quantify because of the inaccurate evaluation of the burns from the surface of the lungs and burn degree same time [8]. Consequently, in the case of mixed cutaneous-and-airway burns the mortality increases, increase of the Corresponding author: Bogdan I. Pavel, MD, PhD bogdan.pavel@umfcd.ro
Diagnosis of stable coronary artery disease is vital for prognosis, classification and early treatment. Current guidelines show that patients with stable angina who are suspected of CAD need to undergo a certain protocol for classification and further analysis. This review’s aim is to present the most used non-invasive techniques for identification of CAD and to underline the current development of imaging technology and the possible reduction of invasive measures due to non-invasive techniques. Currently, non-invasive techniques used to diagnose stable coronary artery disease have a very high accuracy and newer methods seem to be comparable to the gold-standard. The majority of the methods discussed have an optimal performance for patients with PTP between 15-85%, and the future of diagnosis for these patients seem to involve less invasive measures and less radiation by improving the current devices and by usage of machine-learning algorithms.
