Back Ground Research Articles

Impact of nurse turnover on patient care in a private healthcare facility in UAE

Aim: The aim of this study was to determine the pattern and impact of nurse turnover in a private healthcare facility in United Arab Emirates (UAE) and also to recommend the management strategies that could be adopted to overcome the problem of nurse turnover. Back ground: Global healthcare organizations are in a precarious situation due to the increasing attrition among healthcare professionals. Nurse turnover is an issue of international concern causing widening of supply - demand gaps in the healthcare industry. Despite the acknowledged importance of managing nurse turnover in hospitals, the pattern, causes and consequences of nurse turnover in UAE are poorly understood. Method and analysis: This is an empirical, descriptive, quantitative survey based research conducted in a private healthcare facility in UAE. Results: Hospital witnessed significant nurse shortage secondary to higher nurse turnover. More than two thirds (69.9%) nurses showed intention to leave the organization. Higher nurse turnover intentions were significantly associated with job satisfaction (p<0.01) and workload (p<0.001). Patient fall and medication errors were not significantly associated with nurse turnover however there was significant reduction in patient satisfaction score for nurse services in the hospital. Conclusion: Higher work load, lack of conducive work environment, lack of managerial support mainly contributed to job dissatisfaction and are the key drivers for nurse turnover. Decline in patient satisfaction implied compromised quality of care. However larger trials are needed to effectively implement administrative strategies to overcome the nurse turnover problem.

A novel VCP modulator, KUS121, attenuates atherosclerosis progression by maintaining intracellular ATP and mitigating ER stress in endothelial cells

Abstract Back ground: Endoplasmic reticulum (ER) stress signaling pathways have pivotal roles in atherosclerosis progression. Recently, we have developed Kyoto University Substance (KUS) 121, which selectively inhibits ATPase activities of valosin-containing protein (VCP) and consequently saves intracellular ATP consumption and mitigates ER stress. KUS121 are known to have protective effects on several disease models including ischemic heart disease and heart failure. However, the efficacy of KUS121 against atherosclerosis was still unclear. Purpose To elucidate the effect of KUS121 on atherosclerosis and its mechanisms. Methods and Results The daily treatment of KUS121 reduced atherosclerosis progression by approximately 40% and macrophage burden in the plaques were also significantly decreased in ApoE knockout mice on high fat diet. Interestingly, we found that C/EBP homologous protein (CHOP), an established ER stress marker, was mainly expressed in plaque endothelium. Therefore, we assessed the action of KUS 121 in endothelial cells using the EA.hy926 cell line. Consequently, it was demonstrated that KUS121 attenuated ER stress-induced apoptosis and downregulated the IRE1α-associated inflammatory pathways. Consistent with these in vitro findings, KUS121 treatment also significantly reduced endothelial apoptosis assessed by TUNEL staining and inflammation examined by immunostaining of NF-κB and ICAM1 in atherosclerotic plaques. Moreover, KUS121 treatment attenuated the recruitment of inflammatory Ly6C high monocytes assessed by bead-labeling technique, which could be due to the reduction of endothelial ICAM1 expression. Furthermore, we also demonstrated that maintenance of intracellular ATP levels mitigates ER stress and prevents pathological states in endothelial cells. Conclusion KUS121 can be a new therapeutic option for atherosclerotic diseases by maintaining intracellular ATP levels and attenuating ER stress-induced apoptosis and inflammation in plaque endothelium.

Simple simultaneous analysis of various cardiovascular drug mixtures with vincamine: comparative eco-friendly assessment

The development of two eco-friendly analytical methods for the simultaneous determination of eight cardiovascular drugs; hydrochlorothiazide (HCT), captopril (CPL), lisinopril (LSP), valsartan (VAL), atorvastatin (ATR), bisoprolol (BSL), amlodipine (AML) and carvedilol (CVL); alongside with the nutraceutical vincamine (VIC) is essential for sustainable pharmaceutical analysis. This study explores the application of Micellar Electro Kinetic Chromatography (MEKC) and High-Performance Liquid Chromatography (HPLC) for this purpose. In MEKC method, the separation was done using fused silica capillary (41.5 cm × 50 µm id) and a back ground electrolyte consisting of 50 mM borate buffer (pH 9) containing 50 mM sodium lauryl sulphate (SLS) and 10% organic modifier (Acetonitrile). In HPLC method, separation was performed on a ZORBAX Extend-C18 (4.6 × 250 mm, 5 µm) column, using a gradient mobile phase consisting of 50 mM phosphate buffer pH 3 and methanol. Both methods attained good linearity (r ≥ 0.9996) with low values of LOD and LOQ. Both methods were successfully applied in the determination of co-administered single, binary and ternary dosage form of the studied drugs. Moreover, application of various combinations of co-administered dosage forms was achieved in rat plasma, confirming the applicability of these methods in different matrices. The use of micellar solutions in MEKC enhances separation efficiency while reducing the need for organic solvents, aligning with green chemistry principles. HPLC methods were optimized using environmentally benign solvents, ensuring reduced toxicity and waste production. The methodologies were evaluated through green, white, and blue metrics to ensure comprehensive sustainability, considering ecological impact, safety, and practical efficiency. These methods were not only cost-effective and time-saving but achieved high efficiency, sensitivity, and reproducibility making them ideal for routine use in pharmaceutical analysis.

779. IMMUNE CHECKPOINT INHIBITOR WITH CHEMOTHERAPY (CISPLATIN+5FU) FOR ADVANCED ESOPHAGEAL CANCER

Abstract Background First-line chemotherapy for advanced esophageal carcinoma results in poor outcomes. Compared with placebo plus chemotherapy, pembrolizumab plus chemotherapy improved overall survival in patients with previously untreated, advanced oesophageal squamous cell carcinoma according to the KEYNOTE-590. We studied 17patients for the unresectable esophageal cancer and gastroesophageal junction adenocarcinoma cases treated with pembrolizumab and chemotherapy at our hospital between November 2023 and May 2024. Methods 17 patients with advanced carcinoma of the thoracic esophagus having either T4 tumor or distant lymph node metastasis were enrolled in this study. pembrolizumab 200mg/m2 and CDDP 80 mg/m2 was administered on days 1 and 5-FU 800 mg/m2 was administered on days 1-5 intravenously 3corse in 3-week cycles. Results Back ground: Averaged Age 76 (55-86), male: female =16:1, location (Ce: Ut: mt: Lt: Jz =1:1:6:6:3), strength 71mm (30-120), Stage (IVA: IVB= 7:10), Pathology (SCC: AD= 16:1), Times (3 courses completed: uncompleted: ongoing=9:3:5), Response PR:SD:PD: unknown=6:1:2:8, Toxicity: iRAE: liver dysfunction: Febrile neutropenia=4:2:6, The incidence of Grade 3 or higher adverse events was 3/15. One toxicity-related death occurred. We performed conversive esophagectomy for 2 patients. After chemotherapy: operation: radiation: observation: death:=2:2:10:3 Conclusion and discussion Due to the small number of cases, it is unclear whether the treatment was safe in a single center. I would like to consider increasing the number of cases. We will show one toxicity-related death and two conversive operation.

Phantom test procedures for a new neuro-oncological amino acid PET tracer: [18F]fluciclovine.

Amino acid positron emission tomography (PET) examinations using anti-1-amino-3-[18F]-fluorocyclobutane-1-carboxylic acid ([18F]FACBC) were allowed for routine clinical use in July 2024. However, phantom test procedures for [18F]FACBC reconstruction parameters have not yet been established. The present study aimed to establish new phantom test procedures for [18F]FACBC brain PET imaging to determine optimal reconstruction parameters. Background (BG) activity as well as hot sphere and target-to-background ratios (TBRs) of [18F]FACBC were estimated based on brain activity and tumor-to-normal tissue ratios (TNR) in a Japanese clinical trial of [18F]FACBC. Phantom experiments proceeded under [18F]FACBC or L-[methyl-11C]-methionine ([11C]MET) conditions. The number of iterations and the Gaussian filter parameters were determined from the reconstruction parameters %contrastmean and coefficients of variation (CVs) in ordered subset expectation maximization (OSEM) and time-of-flight (TOF) with or without point-spread-function (PSF) correction. The amounts of activity in the hot spheres and BG were 1.1 and 5.5kBq/mL, respectively, and the TBR was 5.0 at the start of acquisition. The %contrastmean of all hot spheres was higher with [18F]FACBC than [11C]MET, and %contrastmean converged between 4 and 6 iterations in hot spheres with diameters < 10mm. We used four iterations for OSEM + TOF and five for OSEM + TOF + PSF correction for [18F]FACBC and [11C]MET images. The CV was higher for [18F]FACBC than [11C]MET. The optimal sizes of Gaussian filters for OSEM + TOF and OSEM + TOF + PSF correction of image reconstruction were 5mm for [18F]FACBC, and 4 and 3mm, respectively, for [11C]MET images. We estimated phantom activity and TBR based on brain activity in a Japanese clinical trial and established new phantom test procedures for [18F]FACBC. We recommend that the optimal reconstruction parameters for [18F]FACBC should be set to the same number of iterations as [11C]MET and that the FWHM of Gaussian filter should have a few mm higher than [11C]MET to reduce image noise from brain normal tissue.

Risk Factors And Angiographic Profile of Young Adult Less Than 40 Years of Age in Bangladeshi Population

Back ground: : Coronary artery disease (CAD) in young adults under the age of 40 is an increasing medical, social, psychological, and economic concern, owing to the rise of civilization-related diseases and an unhealthy lifestyle. The problem of CAD in young people has not been studied as thoroughly as it has in older people, as current data consists primarily of case reports and small series, which are frequently tied to genetic features and family occurrence of the illness. Aim: To evaluate the risk factors for ischemic heart disease and the angiographic pattern of young adults with CAD who presented with chest pain in the ER. Methods : We conducted this observational study at Ibrahim Cardiac Hospital &amp; Research Institute in Dhaka, Bangladesh, from February 1 to June 30, 2024. Patients with chest discomfort aged 21-40 years who underwent coronary angiography were included in the study. Results: This retrospective analytical investigation was carried out from February 1st to June 30th, 2024, with 110 patients enrolled in the department of cardiology at Ibrahim Cardiac Hospital &amp; Research Institute. Patients aged 21 to &lt;40 years were separated into two groups: 21-30 years and more than 30 to &lt;40 years, with a mean age of 34.28±4.25 years. All patients underwent a coronary angiogram, which revealed that 30% had non-flow limiting coronary arteries, 29.1% had single vessel disease, 22.7% had double vessel disease, 17.3% had triple vessel disease, and 0.9% had left main with or without coronary involvement. Patients aged 30 to under 40 had more coronary artery disease than those aged 21 to 30. Conclusion: Young patients have distinct coronary artery disease patterns, hence the therapeutic plan must be tailored to their demographic. In this vulnerable age group, there should be a stronger emphasis on risk factor identification and management.

Significant Association of Epidemiological Factors with Hypothyroid Patients in Khulna Region: A Cross Sectional Study

Background and Objectives: Thyroid disorder is one of the most common endocrine disorders worldwide. A community‑based investigations showed that; overall occurrence of thyroid disease was 20.43%, highest incidence of diffuse goiter (7.35%), followed by sub-clinical hypothyroidism (6.59%), hypothyroidism (4.97%), hyperthyroidism (0.86%) and sub-clinical hyperthyroidism (0.65%) in Khulna, Bangladesh. High prevalence of hypothyroidism with autoimmunity are also observed in Khulna Region. The aim of this study was to conduct epidemiological survey of hypothyroid patients in Khulna region. Methods: This cross‑sectional study was done on Hypothyroid patients of Khulna Medical College Hospital and Institute of Nuclear Medicine and Allied Science (INMAS), Khulna, from July 2023 to December 2023. After having informed written consent of adult sixty hypothyroid patients, was interviewed and examined the blood sample for relevant information; data recorded in a preformed, semi-structured data collection sheet (Patient particulars form) and analyzed. Results: Out of the sixty hypothyroid patients about fifty percent was obese, eighty percent was female of 30-60 years age group. Ninety percent of them belongs to poor socioeconomic conditions and came from rural area of Khulna district. About 20 percent had positive family history of hypothyroidism, 27 percent patient was associated with other autoimmune diseases and about 80 percent was associated with anti-thyroid antibody. Conclusions: Most of the patients were rural female of low socioeconomic back ground of reproductive age groups. They also associated with other autoimmune diseases. Chronic autoimmune diseases, poverty, anti-thyroid antibody and salinity of environment may play an important role for the causation of hypothyroidism in Khulna region. Keywords: Thyroid disorder, hypothyroidism, dyslipidemia, thyroiditis.

Knowledge and Attitude Towards Pre-Exposure Prophylaxis for HIV/AIDS and its Associated Factors Among Health Care Workers in Debretabor Compressive Specialized Hospital 2023

Back ground: Human immunodeficiency virus infection is a severe public health issue that claims the lives of numerous people, including medical professionals. The effectiveness of daily oral pre-exposure prophylaxis for HIV prevention among at-risk individuals has thus been repeatedly shown in clinical trials. An important public health opportunity to reduce HIV incidence is presented by pre-exposure prophylaxis. Objective: The purpose of this study is to evaluate health care workers' knowledge, attitudes, and factors related to pre-exposure prophylaxis against HIV/AIDS at Debretabor comprehensive specialized hospital in Debretabor, Ethiopia. Method: A cross-sectional study was conducted among 322 health care workers in Debretabor comprehensive specialized hospital from June to July, 2023. The data were collected by trained data collectors using a structured questionnaire with self-administered questioners. The collected data were entered, and the data were checked, coded, data cleaning and analysis using SPSS version 23. Result: The level of attitudes of pre-exposure prophylaxis was analyzed among all 322 respondents. Overall attitudes of health care workers were 68% [95% CL: 62.7-72.7].Off 322 study participants were participated with a response rate of 100%. About 134(41.6%) health care workers had six to ten year clinical experience in their profession, and almost half, 63(51.6%) health care workers in this study were Nurses followed by 62(19.3%) doctors. Majority of 203(63%), and 127(39.4%) were male, and educational status were BSc degree, Prior to conduct this survey, 273 (84.8%) the respondents were aware of the concept of HIV pre-exposure prophylaxis. but only half of, 171 (53.1%) Previously took training on pre-exposure prophylaxis. And 37 (11.5%) of participants had self-rating poor knowledge about HIV- pre-exposure prophylaxis. Variables which had P value less than 0.25 in bivariable analysis would be adequate for multivariable logistic regression analysis, and then in the final stage of multivariable analysis two variables such as marital status [AOR:.211(0.048-0.932],educational status[AOR:.032(.003- .365],[AOR:.181(0.054-0.600)],[AOR:.112(0.027-0.469)],[AOR: .084(0.025-0.286)], and [AOR: .204(0.058-0.720)] of health care workers had significantly associated with the attitudes of pre-exposure prophylaxis.. Conclusion and Recommendation: Our study shows that, inadequate knowledge, and attitude towards pre-exposure prophylaxis, and its management comparing to previously conducted researches, but the current study shows low levels of attitudes, there is suboptimal knowledge about PrEP. So concerned bodies expected to give training to health care workers to increase knowledge, and attitude of health care workers, and researchers expected to conduct research in the area of pre-exposure prophylaxis.

Knowledge, Attitude and Practice of Parents of Children with Childhood Asthma in a Tertiary Care Hospital

Back ground: Asthma is one of the most common reasons that children visit doctors, miss days at school or are admitted to hospital. If asthma is well managed, child should be able to lead a healthy and active life. Methods: The study aims to investigate parental knowledge, attitudes about childhood asthma, and practices regarding the management of their children’s asthma. An observational cross-sectional study was conducted among parents of children aged between 2 and 12 years with asthma who had visited the outpatient or inpatient department of Pediatrics at Dhaka Medical College Hospital over a period of approximately 6 months. Data were collected using a preformed Knowledge, Attitude, and Practice (KAP) questionnaire. Results: Total 110 parents of children with childhood asthma were interviewed in this study. There were 63 (57.3%) male and 47 (42.7%) female with M:F ratio 1.34:1 (Slightly male predominance). Most of the patients 57(87.6%) visited in out-patient department (OPD). Almost half of the parents (52.7%) knew their children had asthma. Most of the parents (80.9%) thought oral form of drug (syrup/ tablet) is better than inhaler. Almost two-third parents believed asthma can be cured and they did not know the importance of adherence with asthma medications. The overall parental knowledge was poor (49.09%). Nearly half of them (49.09%) had negative attitude about childhood asthma &amp; 50.9% parents had poor practice about avoidance of allergens, use of asthma medications and regular follow up of their children. Knowledge, attitude and practice are significantly associated with education, socioeconomic condition and living area. Statistically significant positive correlation has been found between knowledge and practice, but knowledge and attitude has not showed significant positive correlation. J Dhaka Med Coll. 2022; 31(2) : 194-200

Hypothyroid Patients Show Significant Association with Antithyroid Antibodies: A Cross Sectional Study in Khulna

Background and Objectives: A high prevalence of thyroid disorder is found worldwide and it is a serious public health problem. A community‑based investigations showed that; overall occurrence of thyroid disease was 20.43%, highest incidence of diffuse goiter (7.35%), followed by sub-clinical hypothyroidism (6.59%), hypothyroidism (4.97%), hyperthyroidism (0.86%) and sub-clinical hyperthyroidism (0.65%) in Khulna, Bangladesh. Antithyroid autoantibodies are one of the most important causes of thyroiditis resulting hypothyroidism. The aim of this study was to investigate the prevalence of antithyroid antibody to hypothyroid patients in Khulna region. Methods: This cross‑sectional study was done on Hypothyroid patients of Khulna Medical College Hospital and Institute of Nuclear Medicine and Allied Science (INMAS), Khulna, from July 2023 to December 2023. After having informed written consent of adult sixty hypothyroid patients, was interviewed and examined the blood sample for relevant information; data recorded in a preformed, semi-structured data collection sheet (Patient particulars form) and analyzed. Results: About 20 percent had positive family history of hypothyroidism, 27 percent patient was associated with other autoimmune diseases and about 80 percent was associated with anti-thyroid antibody. Out of the sixty hypothyroid patients about fifty percent was obese, eighty percent was female of 30-60 years age group. Ninety percent of them belongs to poor socioeconomic conditions and came from rural area of Khulna district. Conclusions: Most of the patients were rural female of low socioeconomic back ground of reproductive age groups. There was very significant association of anti-thyroid antibody with these patients. They also associated with chronic autoimmune diseases and poverty.

Adapting to the skies: evolution of qualified personnel in airline operations amid technological advancements

PurposeThis study investigates the evolution of skilled personnel in airline operations driven by technological advancements. It aims to elucidate the changing personnel demands necessitated by technological innovations in the ground and flight services.Design/methodology/approachThe impact of technological advancements on aviation services has been broadly outlined. Secondary sources were used to identify the relationship between technology and human resources in aviation and categorize the current situation. However, the main narrative was based on the author’s observations.FindingsThe progression of technology in air transportation has led to a reduction in the number of personnel involved and the time spent on human interactions. Technological advancements in aviation have predominantly affected three crucial domains: back offices, ground services, and flight services. A future trend foresees a substantial shift toward self-service in ground services, contributing to streamlined processes with minimal errors.Practical implicationsAirlines must consider candidates' ability to adapt to technological changes during the hiring process to enhance operational efficiency and customer satisfaction. The current staff should be supported by training programs to facilitate their adaptation to technology.Social implicationsThis study provides a theoretical framework regarding changes in personnel requirements due to technological applications in aviation, the integration of technology into the sector, and the adaptation of current personnel to these technologies.Originality/valueThis perspective resonates with scholars engaged in the realms of aviation and tourism. This study assesses technological progress from both managerial and customer perspectives.

Virtual reality traffic prioritization for Wi-Fi quality of service improvement using machine learning classification techniques

The increase in the demand for eXtended Reality (XR)/Virtual Reality (VR) services in the recent years, poses a great challenge for Wi-Fi networks to maintain the strict latency requirements. In VR over Wi-Fi, latency is a significant issue. In fact, VR users expect instantaneous responses to their interactions, and any noticeable delay can disrupt user experience. Such disruptions can cause motion sickness, and users might end up quitting the service. Differentiating interactive VR traffic from Non-VR traffic within a Wi-Fi network can aim to decrease latency for VR users and improve Wi-Fi Quality of Service (QoS) with giving priority to VR users in the access point (AP) and efficiently handle VR traffic. In this paper, we propose a machine learning-based approach for identifying interactive VR traffic in a Cloud-Edge VR scenario. The correlation between downlink and uplink is crucial in our study. First, we extract features from single-user traffic characteristics and then, we compare six common classification techniques (i.e., Logistic Regression, Support Vector Machines, k-Nearest Neighbors, Decision Trees, Random Forest, and Naive Bayes). For each classifier, a process of hyperparameter tuning and feature selection, namely permutation importance is applied. The model created is evaluated using datasets generated by different VR applications, including both single and multi-user cases. Then, a Wi-Fi network simulator is used to analyze the VR traffic identification and prioritization QoS improvements. Our simulation results show that we successfully reduce VR traffic delays by a factor of 4.2x compared to scenarios without prioritization, while incurring only a 2.3x increase in delay for background (BG) traffic related to Non-VR services.

Explainable localization of premature ventricular contraction using deep learning-based semantic segmentation of 12-lead electrocardiogram.

Predicting the origin of premature ventricular contraction (PVC) from the preoperative electrocardiogram (ECG) is important for catheter ablation therapies. We propose an explainable method that localizes PVC origin based on the semantic segmentation result of a 12-lead ECG using a deep neural network, considering suitable diagnosis support for clinical application. The deep learning-based semantic segmentation model was trained using 265 12-lead ECG recordings from 84 patients with frequent PVCs. The model classified each ECG sampling time into four categories: background (BG), sinus rhythm (SR), PVC originating from the left ventricular outflow tract (PVC-L), and PVC originating from the right ventricular outflow tract (PVC-R). Based on the ECG segmentation results, a rule-based algorithm classified ECG recordings into three categories: PVC-L, PVC-R, as well as Neutral, which is a group for the recordings requiring the physician's careful assessment before separating them into PVC-L and PVC-R. The proposed method was evaluated with a public dataset which was used in previous research. The evaluation of the proposed method achieved neutral rate, accuracy, sensitivity, specificity, F1-score, and area under the curve of 0.098, 0.932, 0.963, 0.882, 0.945, and 0.852 on a private dataset, and 0.284, 0.916, 0.912, 0.930, 0.943, and 0.848 on a public dataset, respectively. These quantitative results indicated that the proposed method outperformed almost all previous studies, although a significant number of recordings resulted in requiring the physician's assessment. The feasibility of explainable localization of premature ventricular contraction was demonstrated using deep learning-based semantic segmentation of 12-lead ECG.Clinical trial registration: M26-148-8.

Major Psychological Factors Affecting Short Distance Athlete’s Performance in Hadiya Zone Athletics Projects

This study is explored the major psychological factors like personality and anxiety affects short distance athlete’s performance of Hadiya Zone athletics projects. The researcher was used both probability and non-probability sampling technique. Used stratified sampling techniques for athletes and available / census for all coaches and sport experts. The population of the study consisted of athletes (n=83), coaches (n=4) and all sport experts (n=8). The study employed the Cross-sectional survey design. Data were analyzed by both descriptive and inferential statics methods were employed. Personality and anxiety psychological factors were assessed by using the Inventory, standard questionnaire. Athlete’s athletic performance was assessed by document analysis. Descriptive Statistics percentage, standard deviation, mean were used for assessing back ground information, the current anxiety level and influence personality factors. Multiple regression coefficients from inferential statics were used to show the influence of major psychological factors on athlete’s performance. The finding of this study indicates the current anxiety level with aggregate mean (M=3.147) implies moderate, and influence of personality factors on this study with aggregate mean (M=3.142) shows that moderate. And, also athletic anxiety and personality factors on performance of athletes’ multiple regression coefficient results indicates, by 40.1% of variance (R&amp;lt;sup&amp;gt;2&amp;lt;/sup&amp;gt;=.165, F = 8.194, *p &amp;lt;.05) predict athletes’ performance.

Profile and predictors of outcome for code blue cases in a tertiary care hospital in Mangalore

Back ground Code Blue is a common emergency code used in cases of cardiac arrest in hospitals to alert trained emergency response teams. The use of codes is mainly to convey essential information quickly to staff while preventing misunderstandings and panic among hospital visitors. This study aimed to determine the profiles and outcomes of patients with activated code blue calls. Methods This retrospective record-based study included all patients who had a code blue declared in the year 2022. Data was collected from the patient files from medical records department and analyzed with descriptive and inferential statistical methods. Results A total of 86 code blue calls were analyzed in this study. In terms of age distribution, the age group 60-80 years had the highest percentage of code blue cases. Code blue cases were more announced in males in the study (55.8%). For the announced code blue cases, it was identified that CPR if initiated by the staff on scene before the arrival of the code blue team had higher survival chance (60.0%). Asystole was the most common rhythm detected initially (66.3%) upon arrival of the code blue team. It was found that if the response time was lesser than 2 min, the patients had a higher chance of survival (53.3%). Conclusions In conclusion, CPR performed by a trained code blue team in a hospital can help improve outcomes. The initiation of bystander CPR has been proven to have favorable outcomes. Better training of staff can result in better outcomes.

Receiving The COVID-19 Vaccine and Its Correlation with Post COVID-19 Long Term Morbidity

Back ground: Long-coronavirus disease is the long-term consequences of COVID-19 infection experienced by individuals who are infected with the virus. Signs, symptoms, and problems that persist or worsen following an acute COVID-19 infection are collectively referred to as long COVID. This study tries to determine the correlation between vaccination status and the post-COVID long-term effects in vaccinated versus non-vaccinated infected individuals. Methodology: It was a cross-sectional descriptive design, encompassing 416 individuals. Study cases represented vaccinated individuals who were infected and were suffering from the long-term consequences of COVID-19, as opposed to non-vaccinated infected individuals. Individuals who were neither infected, vaccinated, or unvaccinated considered as a reference group for estimating the correlation utilizing Odds ratio (OR). Result: This study revealed that vaccinated individuals were more commonly affected by weakness (OR= 0.93; 95% CI 0.49-1.7), joint pain (OR= 0.7; 95% CI 0.41-1.4), and concentration problems (OR= 0.87; 95% CI 0.44-1.7) so that present study didn’t notify significant statistical findings for post-COVID conditions risks regarding to vaccination status. Conclusion: The correlation between vaccinated and non-vaccinated individuals who develop post-COVID-19 conditions showed that risk factors for developing these conditions were independently associated with vaccination status among infected participants.

Failure Of Second Line ART Demands Third -Line Options For HIV-Infected Patients In Telangana, India

Back ground: The research was carried out with the aim of detecting instances of second-line antiretroviral therapy (ART) failure and exploring the potential of third-line ART treatment for individuals with HIV, incorporating the utilization of HIV viral load (VL) testing. Beginning in 2016-17, individuals living with HIV are directed to government ART centers and ART plus centers for treatment. Patients who have experienced treatment failure with second-line therapy and have been exposed to multiple NRTIs, in accordance with the Indian National ART Guidelines, are referred to the SACEP Clinic for further evaluation. If deemed eligible according to the Indian National 3rd Line ART Guidelines, these patients are enrolled and followed up for the initiation of 3rd Line ART at our center. Throughout the duration of the study, a collective of 55 individuals diagnosed with Human Immunodeficiency Virus (HIV) were identified as potentially experiencing a lack of efficacy with regards to their secondary line antiretroviral therapy (ART). Two patients in the cohort were diagnosed with both HIV and multi drug resistant tuberculosis (MDR-TB). Method: Fifty-four and a half percent of the patient sample was classified as being in WHO stage I, while 32.8% were categorized as being in stage II, and the remaining 12.7% were identified as being in WHO stage IV. Fifty-five patients who were suspected of experiencing second-line treatment failure were transitioned to third-line antiretroviral therapy. Results: All 55 patients underwent VL follow-up, with 53 of them attaining viral suppression within a median period of 6 months. However, two patients were unable to achieve viral suppression. Conclusion: However, this study describes HIV-positive patients who need third-line ART due to probable second-line ART failure.

The influence of self-efficacy and experience of Sri Lankan teachers on their experience of occupational stress and resilience

Back ground: The study focussed on the teaching community of Sri Lanka which examined, sense of efficacy, stress, years in service and resilience. Aims: There were two objectives in the study. First objective was to examine whether there was a relationship between a teacher’s sense of efficacy and the perceived occupational stress. Second objective was to understand whether a teacher’s years in service had an impact on their resilience. Method: A questionnaire with few demographic questions and three scales which assessed their sense of efficacy, occupational stress and resilience were presented via Qualitrics. Participants were attracted through a social media advert. Approval was granted to conduct the study under reference number UG7496 by the ethics panel of Cardiff School of Sport and Health Sciences. A quantitative research was conducted and the collected data was analysed using SPSS. Results: A total number of 113 responses were collected where 89 responses were used for analysis. Spearman’s correlation tests were carried out, and the computed results indicated a moderate negative relationship between teacher’s sense of efficacy and occupational stress, r=-0.56, n=89, p&lt;.001. Further, a strong positive relationship was indicated between years in service and resilience of a teacher, r=0.70, n=89, p&lt;.001. Conclusions: Both hypotheses which were tested were supported by the obtained results. Therefore, it was suggested that teachers with greater sense of efficacy perceived less occupational tress and teachers with more work experience had higher levels of resilience.

High spatiotemporal resolution scintillation imaging of pulsed pencil beam scanning proton beams produced by a gantry-mounted synchrocyclotron.

A dosimeter with high spatial and temporal resolution would be of significant interest for pencil beam scanning (PBS) proton beams' characterization, especially when facing small fields and beams with high temporal dynamics. Optical imaging of scintillators has potential in providing sub-millimeter spatial resolution with pulse-by-pulse basis temporal resolution when the imaging system is capable of operating in synchrony with the beam-producing accelerator. We demonstrate the feasibility of imaging PBS proton beams as they pass through a plastic scintillator detector to simultaneously obtain multiple beam parameters, including proton range, pencil beam's widths at different depths, spot's size, and spot's position on a pulse-by-pulse basis with sub-millimeter resolution. A PBS synchrocyclotron was used for proton irradiation. A BC-408 plastic scintillator block with 30 × 30 × 5 cm3 size, and another block with 30 × 30 × 0.5 cm3 size, positioned in an optically sealed housing, were used sequentially to measure the proton range, and spot size/location, respectively. A high-speed complementary metal-oxide-semiconductor (CMOS) camera system synchronized with the accelerator's pulses through a gating module was used for imaging. Scintillation images, captured with the camera directly facing the 5-cm-thick scintillator, were corrected for background (BG), and ionization quenching of the scintillator to obtain the proton range. Spots' position and size were obtained from scintillation images of the 0.5-cm-thick scintillator when a 45° mirror was used to reflect the scintillation light toward the camera. Scintillation images with 0.16mm/pixel resolution corresponding to all proton pulses were captured. Pulse-by-pulse analysis showed that variations of the range, spots' position, and size were within±0.2% standard deviation of their average values. The absolute ranges were within±1mm of their expected values. The average spot-positions were mostly within±0.8mm and spots' sigma agreed within 0.2mm of the expected values. Scintillation-imaging PBS beams with high-spatiotemporal resolution is feasible and may help in efficient and cost-effective acceptance testing and commissioning of existing and even emerging technologies such as FLASH, grid, mini-beams, and so forth.

Biomarker Evaluation in Toxoplasma gondii-infected Patients

Back ground: This study used Toxoplasma IgG/IgM Antibody Rapid test to detect Toxoplasmosis in pregnant women and evaluate their lipid profile compared to a healthy control group. The aim of the study: Serodiagnosis of parasite infection in aborted pregnant women using the rapid detection method. Evaluating the level of some immunological parameters in infected women such as IL17-A, TNA-, lactoferrin, shedding light on the lipid profile of parasite-infected women. Patients and Methods: blood samples 240 were collected from aborted pregnant women attending some governmental hospitals and private medical clinics in some areas of Salah al-Din Governorate during the period from 1/7/2022 to 1/2/2023 and the required information was recorded according to a special questionnaire form. The results: were analyzed statistically using the IBM SPSS Statistics (version 23) program, according to the t-test, at a significant level of p≤0.05. The results of Rapid Test (93 positive samples) 38.7% (divided into 80) 86.02% (positive samples for IgG, while 13 sample) 13.97% (positive for IgM and 147 negative samples) 61.25%. (There is a positive correlation between (LTF, IL-17A, TNF-a) (highly significant). The lipid profile analysis revealed a non-significant increase for each of cholesterol and high-density lipoprotein (HDL) in infected women, as Mean ± S.E concentration was (168.4±8.2 Pg/ml); (33±1.5pg/ml) respectively, compared to the control group, where the Mean ± S.E concentration was (141.6±15.5 Pg/ml); (28±3.09Pg/ml) respectively. While there was a non-significant decrease in each of LDL, very low-density lipoprotein (VLDL), and triglycerides in pateints group, as Mean ± S.E concentration was (80.6±3.7pg/ml); (45.4±1.07 pg/ml); (159.7±4 pg/ml), respectively, compared to the control group, where the average concentration was (84.3±5.3pg/ml); (48.6±2pg/ml) 161.3±6.7pg/ml) respectively.