Digestive System Disorders Research Articles

Reasons for mortality in elderly and senile patients with hip osteoporotic fractures

Aim. To identify the causes of mortality in elderly and senile patients with non-traumatic hip fracture during the first year after fracture.Materials and Methods. The reasons for death were analyzed in the cohort consisted of 432 patients with a non-traumatic hip fracture: 328 women aged from 70 to 82 years (mean age 75.4) and 104 men aged from 60 to 80 years (mean age 71.5).Results. It was revealed that in first 6 months after the injury, death occurred in 22.00 % of cases (95 from 432 patients died). After 12 months period, mortality increased to 137 cases (total mortality accounted for 31.80 %). Most of the deaths were due to cardiovascular system diseases. Cardiovascular causes were in 93 cases (21.00 %), without any gender difference: 22 in men (21.10 %) and 71 in women 21.60 %). The ratio of cardiovascular diseases in the total number of fatal outcomes was 93 (67.80 %), comparable for men and women subgroups (66.00 and 68.30 % respectively; p = 0.65). Diseases of respiratory system as a reason for death accounted for 16.80 % in the structure of total mortality: 15.10 % in men subgroup and 17.30 % in women (p = 0.31). Mortality from tumors was defined in 10.90 % from all cases of death: in men 9.09 % cases and in women 11.50 % cases (p = 0.45). The ratio of digestive system disorders as the cause of death accounted for 3.60 %: 6.06 % in men and 2.90 % in women respectively (p = 0.1).Conclusions. Cardiovascular and respiratory diseases were the most common causes of first-year mortality in elderly and senile patients with non-traumatic hip fracture. The gender differences in mortality rates were not found.

An Ethnobotanical Survey of a Dryland Botanical Garden and Its Environs in Kenya: The Mutomo Hill Plant Sanctuary.

Mutomo hill plant sanctuary is a ten-hectare piece of land in Kenya listed as a botanical garden under the Botanical Gardens Conservation International, originally established in 1964 with the aim of conserving indigenous flora from destructive anthropogenic activities. This paper presents ethnobotanical documentation of medicinal plants of Mutomo hill plant sanctuary and its environs. An ethnobotanical survey was carried out in Mutomo hill plant sanctuary and its environs with 48 herbalists aged between 32 and 96 years from July 2018 to February 2019 using a semistructured open-ended questionnaire. The plants were collected through random surveys with each herbalist in different ecotypes around the villages and within the Mutomo hill plant sanctuary. The Relative Frequency of Citation (RFC) for each species reported was calculated to determine the plant species frequently collected. In total, 68 different plant species distributed in 28 families and 54 genera were reported. The frequently used plant families were Leguminosae (13 species), Lamiaceae (6 species), and Euphorbiaceae (6 species). Shrubs (37%) and trees (34%) were the dominant growth habits reported. The most cited plant species were Cassia abbreviata Oliv. (RFC = 0.63), Acacia nilotica (L.). Delile (RFC = 0.54), Strychnos heningsii Gilg (RFC = 0.46), and Aloe secundiflora Engl. (RFC = 0.31). Root (19 species) and bark (19 species) were the frequently collected plant parts. Infectious diseases (33) and digestive system disorders (24) were reported to be managed with the majority of the plant species. This study contributes to safeguarding the traditional knowledge on medicinal plants in the study area, which is useful in appreciating and acknowledging the cultural heritage of the Kamba people from the local perspective of Mutomo area in Kenya. It also adds to the knowledge base and documentation of medicinal plants, which is useful information as potential data for drug development.

Saccharomyces Cerevisiae Var. Boulardii Probiotic Yeasts As Etiological Agents Of Oportunistic Infections In Humans

Abstract S. cerevisiae var. boulardii yeasts, historically recognized as a separate species, are now considered a subspecies of S. cerevisiae. Strains of S. cerevisiae var. boulardii are widely used for prevention and treatment of disorders of human digestive system. The use of preparations based on S. cerevisiae var. boulardii impacts the functioning of the intestinal barrier, which leads to a change in the composition of the digestive tract microbiota and alleviates intestinal epithelial defects. Despite the clinically confirmed probiotic properties of these unicellular microorganisms, the number of reports of infections in humans has been increasing. Population studies suggest that S. cerevisiae yeasts are responsible for 0.1–3.6% of all cases of mycoses in patients receiving therapy with probiotics containing S. cerevisiae var. boulardii. The presence of a central venous catheter, parenteral nutrition, immunosuppression and co-morbidities in patients are considered as factors predisposing for infection. This work summarizes the most important information on biology of S. cerevisiae var. boulardii and presents the latest epidemiological data on fungemia caused by these fungi. 1. Introduction. 2. Applications of S. cerevisiae yeasts. 3. Isolation and taxonomy of probiotic yeasts S. cerevisiae var. boulardii. 4. Probiotic features of S. cerevisiae var. boulardii. 5. S. cerevisiae var. boulardii infections. 5.1. Review of S. cerevisiae var. boulardii fungemia cases. 6. Conclusions

Gender as a predictive factor in cholecystectomy - is it true or false?

Cholecystolithiasis is one of the most frequent disorders of the human digestive system in a present population. It is common to point out that male gender is one of strong risk factors for complications during cholecystectomy, however the debate about that seems to be still open. The aim of this study was to compare the values related to the course and treatment effects between gender in patients undergoing cholecystectomy, based on own material. The study encompassed 504 patients who were admitted to General Surgery And Polytraumatic Injury Department of University Hospital in Kraków, Poland between 2013 and 2018, with the initial diagnosis of cholecystolithiasis (scheduled cases) and acute cholecystitis (emergency cases). The patients underwent surgical gallbladder removal. In this group there were 326 (64.7%) female and 178 (35.3%) male patients. Statistically significant differences between both genders were found containing age, type of admission, numeric rating scale of pain during admission, results in American Society of Anesthesiologists physical status classification system, outcomes in Acute Physiology And Chronic Health Evaluation II severity-of-disease classification system, percentage of conversions, mortality, period of time from admission to surgical procedure, mean duration of the procedure, blood tests and histopathological results. Subgroups of the cases where determining factor is gender are strongly heterogeneous. Although treatment results were different for both subgroups and these differences were partly statistically significant, it cannot be clearly determined on the basis of a study with such selection of patients, that gender is an independent risk factor for surgical gallbladder removal.

SOME ASPECTS OF MANAGEMENT OF HIV-INFECTED PATIENTS WITH PATHOLOGY OF DIGESTIVE SYSTEM IN CONTEXT OF FAMILY MEDICINE PRACTICE

Introduction. In the current situation of the HIV-infection epidemic, every 100-th citizen of Ukraine aged between 15 and 49 is infected with HIV. It is one of the highest rates among countries in the European Region. The issue of retaining HIV-positive patients in the medical surveillance system and support for adherence to ART treatment are becoming particularly relevant. At the same time, the comorbidity of HIV-infection with digestive system lesion is one of the main elements of pathological changes, both in the progression of HIV infection and in the occurrence of various complications leading to interruptions or failure to receive continuous antiretroviral therapy (ART). The purpose of the study is to examine the features of the digestive system lesions of HIV-infected patients and their impact on the effectiveness of antiretroviral therapy. Materials and methods. The study was conducted on randomly selected 215 HIV-infected patients in compliance with the bioethical and scientific standards, in accordance with industry standards and clinical guidelines approved by the Ministry of Health of Ukraine. Results and Discussion. Patients were divided into two comparison groups: the main group (MG) had 158 (73.5%) of HIV-infected persons with pathology of the digestive system, the controlled group (СG) had 57 (26.5%) of HIV-infected patients with no signs of gastric lesions of the gastrointestinal tract. Among the lesions of the digestive system in HIV-infected patients, hepatitis of viral and/or toxic genesis, chronic inflammatory diseases of the esophagus and gastroduodenal zone, chronic pancreatitis and cholecystitis were most often observed. In 61.4%, the pathology of the digestive tract was combined. When evaluating the efficacy of ART, no statistical difference was found between MG and CG in the frequency of the virologic response and the level of viral load at the beginning of the study and at 6 months of follow-up. However, MG patients had a worse immunologic response compared to CG, they were significantly more likely to switch the initial ART regimen, have breaks in treatment and development of adverse reactions. Patients treated for comorbid digestive system disorders had ART replacements less frequently and after 6 months of treatment they had an average level of CD4 + lymphocytes, which corresponded to the normal value. Conclusions. A significant majority of the examined patients with HIV-infection had digestive system lesions (73.5%). HIV-infected patients with digestive system pathology had more treatment interruptions, switch of ART regimens, and a worse immunological response, compared with the controlled group. Untreated diseases of the digestive system could be predictors of an increased break rate of ART, switch of treatment regimens, and decreased treatment efficacy. The introduction of an integrated, patient-oriented approach to the management of these nosologies in family medicine practice is proposed.

Fecal calprotectin levels in Helicobacter pylori gastritis in children.

Fecal calprotectin is an important inflammatory marker in intestinal diseases and is not routinely used in the upper gastrointestinal system disorders. The aim of this study was to show whether there is a relationship between fecal calprotectin levels and Helicobacter pylori (H pylori) gastritis in children and to determine the association of fecal calprotectin levels with gastric biopsy results in terms of chronic inflammation and neutrophil activity. Patients with the complaints of the upper gastrointestinal system (epigastric pain, heartburn, nausea and vomiting) who were planned to undergo endoscopy were enrolled prospectively. The presence of H pylori was defined according to the gastric antrum biopsy results. Fecal calprotectin level was tested in the stool sample of the patients. The fecal calprotectin levels, upper gastrointestinal endoscopy and gastric biopsy results of 89 patients were evaluated. H pylori was found to be positive in the gastric biopsies of 51 (57.3%) patients. In the H pylori positive group mean fecal calprotectin level was 74.8 ± 67 μg/g, and in the H pylori negative group mean fecal calprotectin level was 52.7 ± 46 μg/g and the difference was significant (p= 0.039). We also found a significant relationship between fecal calprotectin levels and gastric neutrophil activity grades (p= 0.034). Mean fecal calprotectin levels were found to be higher in H pylori positive subjects in our study. Fecal calprotectin levels were correlated with gastric neutrophil activity grades. Fecal calprotectin represents gastric neutrophilic inflammation. When interpreting a high fecal calprotectin level, H pylori infection should be kept in mind.

Patch Solid Lipid Nanoparticles (SLN) Mengandung Ekstrak Bekatul (Oryza Sativa L.) untuk Pengobatan Diabetes Melitus Tipe 2

a atau sekresi insulin pankreas yang tidak bekerja dengan baik (resistensi insulin) dimana menjadi salah satu prioritas penyakit tidak menular (noncommunicable diseases/NCDs). Dari kasus diabetes yang ada, 90% diantaranya merupakan diabetes melitus tipe 2 (IDF, 2017). Diabetes tipe 2 atau disebut dengan diabetes non-dependen-insulin ini terjadi karena resistensi jaringan terhadap efek insulin dan defisiensi relatif sekresi insulin (WHO, 2016).Diabetes Melitus Tipe 2 lebih sering didiagnosis pada usia yang lebih rendah dan indeks massa tubuh pada pria dibandingkan wanita. Berbagai faktor risiko diabetes adalah usia, aktivitas fisik, indeks massa tubuh (IMT), tekanan darah, stres, gaya hidup, adanya riwayat keluarga, kolesterol HDL, trigliserida, DM kehamilan, riwayat ketidaknormalan glukosa dan kelainan lainnya. Selain itu, faktor resiko yang berpengaruh adalah kebiasaan merokok dan minum minuman beralkohol (Isnaini, 2018). Berdasarkan data Riskesdas pada tahun 2013, prevalensi perokok laki-laki sebanyak 66% dimana sekitar 10 kali lebih tinggi dibandingkan perempuan yaitu sebanyak 6,7% (Pusat Data dan informasi Kementerian Kesehatan RI, 2013).Penderita diabetes melitus tipe 2, selain memerlukan terapi non-farmakologis seperti mengatur pola makan, berolahraga, tidak merokok dan tidak minum minuman beralkohol juga memerlukan terapi farmakologis yang dapat dilakukan dengan menyuntikkan insulin dan/atau meminum obat antidiabetik oral (Neal, 2012). Namun penggunaan terapi pengobatan dengan insulin memiliki masalah pada pasien yang takut dengan jarum suntik, selain itu pengobatan dengan antidiabetik oral juga memiliki beberapa masalah yaitu adanya efek samping seperti penurunan berat badan, hipoglikemia, gangguan sistem pencernaan, dan lain-lain. Biaya pengobatan diabetes sendiri cukup mahal karena pengobatannya dalam jangka panjang dan bahkan bisa seumur hidup. Biaya yang diperlukan untuk memberi terapi pada pasien yang telah terdiagnosis diabetes di seluruh dunia pada 2011 hingga 2030 sebanyak 1,7 triliun US$ (WHO, 2016). Mempertimbangkan biaya pengobatan diabetes yang cukup tinggi dan efek samping yang ditimbulkan oleh obat-obat antidiabetes diperlukan suatu terapi alternatif dengan harga yang relatif murah dan memiliki potensi yang kuat serta memiliki efek samping yang minimal. Hal tersebut dapat dilakukan dengan menggunakan limbah namun berkhasiat dalam terapi pengobatan diabetes melitus, diantaranya adalah bekatul (Sivamaruthi, Kesika and Chaiyasut, 2018).

Medicinal Plants of the Maasai of Kenya: A Review.

The use of medicinal plants for treatment of humans and animals is entrenched in the Maasai culture and traditional knowledge related to it is passed on from one generation to the next. A handful of researchers have in the past decades documented this knowledge. No single study has documented medicinal plant uses of the Maasai community as a whole. This review provides a consolidated database of the diversity and uses of medicinal plants among the Maasai in Kenya. The study will help conserve traditional medicinal plant knowledge that is valuable for the development of modern medicine. Relevant information on medicinal plants used by the Maasai of Kenya was extracted from journals, books, M.Sc., and Ph.D. dissertations. We found evidence of 289 plant species used by the Maasai of Kenya in traditional medicine. Most species were used to treat health conditions in the categories gastrointestinal and respiratory system disorders. The most used families were Leguminosae, Asteraceae, Malvaceae, Euphorbiaceae, and Lamiaceae. Medicines were commonly prepared as a decoction and administered through oral ingestion, with roots reported to be the preferred plant part for medication. The Maasai preference for roots compared to other plant parts may be unsustainable and could threaten species availability in the future.

Folk medicine in Düzce Province (Turkey)

The present study was conducted to collect, record, and document local knowledge of medicinal practices in Düzce, a northwestern Anatolian province. To the best of our knowledge, no comprehensive ethnobotanical study has been reported from this province. Information was acquired through semistructured interviews and personal conversations using a questionnaire and numerous guided field trips with local knowledgeable people. For quantitative analyses and comparisons, recorded data such as informant consensus factor (FIC) and use value (UV) were calculated, respectively. As a result of extensive field studies, 122 taxa were determined as folk medicines; 76 of were wild and 46 were cultivated. The identified medicinal plants were mainly from the family Rosaceae, followed by Compositae, Apiaceae, Lamiaceae, and Solanaceae, respectively. Among the preparations used, liquid forms such as infusions (30.2%) or decoctions (16.4%) represented the most favored ways to administer medicinal plants. Dermatological disorders had the highest FIC score with a value of 0.75 followed by skeletomuscular (FIC = 0.7466), gastrointestinal (FIC = 0.6666), immunological (FIC = 0.6615), and respiratory (FIC = 0.6292) system disorders, among others. The most prominent medicinal plants were Urtica dioica (UV = 0.4352), Plantago major (UV = 0.3056), Rubus ulmifolius (UV = 0.2279), and Sambucus ebulus (UV = 0.2279). According to the present study, the number of people who recognize and use the wild plants of Düzce, and those of the rest of Anatolia, is steadily decreasing. The ethnobotanical knowledge cannot be passed to the next generation in its entirety if it is not properly recorded. In addition to this gradual loss of knowledge, modern information pollution and contamination via the popular media highlight the urgent need to record this precious knowledge before it is lost.

Causes that Contribute to the Excess Mortality Risk in Multiple Sclerosis: A Population-Based Study

Background: Lifespan is 6–10 years shorter in multiple sclerosis (MS), but the reasons remain unclear. Using linked clinical- and population-based administrative health databases, we compared cause-specific mortality in an MS cohort to the general population. Methods: MS patients in British Columbia (BC), Canada, were followed from the later of first MS clinic visit or January 1, 1986, to the earlier of death, emigration, or December 31, 2013. Comprehensive mortality information was obtained by linkage to BC’s multiple-cause-of-death mortality data. Causes were grouped using International Classification of Disease codes. Standardized mortality ratios (SMRs) were calculated for underlying cause, and relative mortality ratios (RMRs) for any mention cause, by comparison to mortality rates in the age-, sex-, and calendar year-matched general population. Cause-specific relative mortality was explored by sex and disease course (relapsing onset and primary progressive). Results: Among 6,629 MS patients with 104,236 patient-years of follow-up, 1,416 died. The all-cause mortality risk was increased relative to the general population (SMR 2.71; 95% CI 2.55–2.87). MS was the underlying cause in 50.4%, and a mentioned cause in 77.9%, of deaths. Mortality by underlying cause was higher than expected for genitourinary disorders/infections (SMR 3.55; 95% CI 2.25–5.32), respiratory diseases/infections (SMR 2.69; 95% CI 2.17–3.28), suicide (SMR 2.40; 95% CI 1.61–3.45), cardiovascular disease (SMR 1.57; 95% CI 1.36–1.81), and other infections/septicemia (SMR 1.83; 95% CI 1.15–2.78). Risks of death due to overall cancer, accidents, digestive system disorders, and endocrine/nutritional diseases as underlying causes were similar to the general population. However, mortality with any mention of accidents (RMR 2.71; 95% CI 2.22–3.29) or endocrine/nutritional diseases (RMR 1.75; 95% CI 1.46–2.09) was greater. Bladder cancer mortality was increased in women (SMR 3.87; 95% CI 1.42–8.42) but not men. No notable differences were observed by disease course. Conclusions: MS itself was the most frequent underlying cause of death. Infections (genitourinary, respiratory, and septicemia), suicides, cardiovascular disease, and accidents contributed significantly to the increased risk of death. Some findings differed by sex, but not disease course. Multiple-cause death data offer advantages over “traditional” use of underlying cause only.

PEMANFAATAN TUMBUHAN OBAT UNTUK MENGATASI GANGGUAN SISTEM PENCERNAAN OLEH SUKU DAYAK IBAN: STUDI KASUS DI KABUPATEN KAPUAS HULU KALIMANTAN BARAT

Penelitian ini bertujuan untuk menganalisis pola pemanfaatan tumbuhan obat suku Dayak Iban di Kapuas HuluPutussibau Kalimantan Barat terutama penggunaannya untuk mengatasi gangguan sistem pencernaan. Metode penelitian yang digunakan adalah purposive sampling dengan teknik wawancara semi terstruktur dengan target 100% responden KK. Lokasi penelitian di desa Lanjak Besar (dusun Tekalong dan Bejabang) dan Desa Sepandan (dusun Tematu 1 dan Tematu 3). Analisis data berupa pola pemanfaatan tanaman (Use value/UV, Informant concensus factor/ICF dan fidelity level/FL), dan hubungan antara karakteristik responden dan level pengetahuan tumbuhan obat (chi square test). Sebanyak 21 species tanaman obat digunakan oleh 60% responden untuk mengatasi masalah pencernaan. Jenis-jenis tanaman yang memiliki nilai penggunaan (UV) yang tinggi adalah bawang merah (0.53), pisang (0.5) dan jambu batu (0.44). Nilai tertinggi dari ICF antara lain untuk mengobati maag (1,00), sariawan (1,00), pencahar (1,00), susah buang air besar (9,98), dan masuk angin (0,98). Jenis-jenis tanaman yang memiliki nilai fidelity level (FL) tertinggi (100) adalah salam (diare), langsat (flatulence), leban (maag), jeruk sambal (sariawan), durian (sakit lidah), pisang dan papaya (susah buang air besar), sahang putih, sugan dan rumput cupak (sakit perut), bawang merah (masuk angina), putri malu (sakit gigi), japa dan bawang lembak (ambein/wasir), temulawak dan kencur (penambah nafsu makan), serta kucai sebagai obat pencahar. Penggunaan tertinggi adalah famili Zingiberaceae (4 species), habitus herba (43%), bagian daun (29%), dan dengan cara diminum (59%).

Vitamin D levels in Children with Gastrointestinal System Disorders

Gastrointestinal sistem hastaliklarinda D vitamini eksikligine farkli nedenlerle sik rastlanmaktadir. Bu calismanin amaci gastrointestinal sistemi ilgilendiren hastaliklari olan cocuklarin D vitamini duzeylerini incelemek ve D vitamini izlemi gerektiren hastalik gruplarini belirlemektir. Mart 2015–Aralik 2016 tarihlerinde Cocuk Gastroenterolojisi polikliniginde en az 3 aydir izlenen ve D vitamini duzeyi belirlenen hastalarin dosyalari retrospektif olarak incelendi. Calismaya toplam 294 hasta dâhil edildi. Hastalarin 138’i (%47) erkek, 156’si (%53) kiz idi. Hastalarin ortalama yasi 80,04 ± 65,24 (1-225) ay idi. Otuz bir hastada (%10) D vitamini eksikligi (<12 ng/ml) ve 57 hastada (%20) D vitamini yetersizligi (12-20 ng/ml) tespit edildi. D vitamini eksikligi ve yetersizligi en fazla kis mevsiminde (sirasiyla %18 ve %29) yapilan analizlerde tespit edildi. D vitamini eksikligi ve yetersizligi en sik inflamatuvar bagirsak hastaligi, Gastroozofageal reflu hastaligi ve Colyak hastaligi olan hastalarda tespit edildi. Yas gruplarina gore en dusuk D vitamini duzeyleri adolesan yastaki hastalarda izlendi. Sonuc olarak cocuk gastroenterolojisi polikliniginde adolesan yastaki hastalar ile inflamatuvar bagirsak, colyak ve gastroozofageal reflu hastaligi olan cocuklarin D vitamini eksikligi acisindan izlenmesinin yararli olacagi kanisina varildi.

Medicinal plants and their uses recorded in the Archives of Latvian Folklore from the 19th century.

The records of folk medicine present historical evidence of medicinal plant usage in the territory of Latvia and describe native and imported plants and plant products that were used as medicine. To collect and analyse the ethnobotanical knowledge found in records of Latvian folk medicine available in the Archives of Latvian Folklore. Following the International Classification of Primary Care, plant uses were grouped into one of the 17 categories based on the body systems and psychological and social problems. Each plant was identified by its scientific name according to The Plant List website. Additionally, the plant parts used, dosage forms of herbal medicines and routes of administration were analysed. In total, 211 genera belonging to 71 families were mentioned in the analysed materials. The most common health conditions were digestive system disorders, respiratory system disorders and skin disorders. The plant families with the largest number of taxa were Asteraceae, Rosaceae, Lamiaceae, and Apiaceae. The most frequently mentioned native plant taxa were Achillea millefolium L., Matricaria chamomilla L., Allium cepa L., Artemisia absinthium L., and Plantago sp. L. Leaves and flowers were the most commonly used parts, and herbal tea was the most common dosage form. Only 59 out of 211 taxa mentioned in this study are included in the official herbal monographs of the European Medicines Agency. One hundred and fifty-two plant taxa mentioned in the records of Latvian folk medicine are not included in the European Union herbal monographs providing scientific information on the safety and efficacy and deserve further exploration as traditional herbal medicines.

Herbal supplement products used by mothers to cope with the common health problems in childhood

ObjectivesThis descriptive and cross-sectional study was conducted to determine the herbal supplement products used by mothers for their children to cope with some frequently encountered health problems in childhood. MethodsThe study sample consisted of 202 mothers who applied to family health centers between January and March 2017 and agreed to participate in the study. A questionnaire was used for data collection. ResultsIn this study, 41.5% of mothers used herbal supplement products for sore throat, 37.1% for nausea and vomiting, 28.2% for gas pain and indigestion, 26.7% for constipation, 17.8% for cough, and 12.3% for sleeping problems and calming their children down. Mothers used mint-lemon, fennel, linden, chamomile, apricot leaf, and anise teas, ginger, lemon balm (Melissa officinalis), cumin water, rosemary, rosehip, and sage to cope with childhood age health problems. One half of mothers had chosen to use herbal products based on recommendations from their family members or close relatives. Doctors recommended herbal supplement products at a lower rate. Four-fifths of mothers obtained herbal supplement products from herbal sellers, markets, and gardens; only 17.3% of mothers bought the products from the pharmacy. ConclusionMothers used mint-lemon, fennel, linden, chamomile, apricot leaf, and anise teas, ginger, lemon balm, cumin water, rosemary, rosehip, and sage to treat children’s symptoms of upper respiratory tract infection, gastrointestinal system disorders, and sleep problems. Very few of the mothers used herbal supplements with the advice of doctors.

Performance Enhancement of an Achalasia Automatic Detection System Using Ensemble Empirical Mode Decomposition Denoising Method

High-resolution manometry, a non-invasive tool for examination of esophagus, has been utilized in order for automatic detection of achalasia as one of the most recognized disorders of digestive system especially in the esophagus. Before designing any digestive system malfunction detection technique, it is necessary to pre-process the original recorded esophageal manometry signals in order to reject noise for further analysis since it is affected by a considerable amount of artifacts with different origins. Employing ensemble empirical mode decomposition for noise rejection, an artificial neural network is applied to detect achalasia automatically and classify the multi-channel esophageal manometry signal. Results of this study show that the raw esophageal manometry signal requires a filtering step in order to provide accurate assessments. This approach is able to increase the accuracy of disorder diagnosis by more than 7% that is a quite significant amount. The accuracy of achalasia diagnosis in this study is 96.6%, which corresponds well in comparison with the other similar studies in the literature. It is highly recommended to attenuate the noise by a reliable technique such as the ensemble empirical mode decomposition method as a pre-processing step.

Ethnobotanical study of medicinal plants in the Adrar Province, Mauritania.

Mauritania is a country in which few ethnobotanical studies have been conducted and consequently the ethnomedical data is scarce. Since the geographical region reflects the transition between tropical and Northern Africa, influenced by the Mediterranean floristic region, the traditional knowledge was influenced by several cultures from tropical Africa as well as Arab, Berber and Islamic societies. This paper aims to explore and compile the diversity of ethnomedical knowledge in one of the regions of Mauritania and to compare the data with similar studies from surrounding territories. Surveys and interviews were carried out in 11 villages of Adrar province in northern Mauritania. Data were collected through open, semi-structured interviews (with individuals and focus groups). A sample of 120 people aged between 20 and 70 years, including 24 herbalists and 28 traditional healers was included. Ethnomedical data for 68 plant species belonging to 27 families were obtained. They are used to treat 50 health conditions grouped in 14 pathological groups. Remedies for digestive system disorders, skin problems and respiratory ailments were among the most frequent indications. Leaves were the most frequently used plant part and remedies generally used as a powder for the various applications and a total of 2'317 use reports were gathered. About 55% of the reported species were not cited previously in the literature focusing on Mauritania and neighbouring countries. Moreover, only 6 species are also cited by Ibn al-Baytar (13th century CE). This work shows a promising perspective for future studies, shedding light on the richness and the risk for conservation of traditional knowledge of herbal medicine in Mauritania.

Comparative Histological Study on The Effect of Bone Marrow-Derived Mesenchymal Stem Cells Versus Wheat Germ Oil on Acute Pancreatitis in A Rat Model

Background: Acute pancreatitis (AP) is a common inflammatory disorder of digestive system. Mesenchymal stem cells (MSCs) and Wheat germ oil (WGO) could improve AP through their anti-inflammatory and antioxidant effects.Objective: Evaluate and compare the possible therapeutic effects of Bone marrow derived Mesenchymal Stem Cells (BMSCs) versus WGO on AP. Materials and Methods: 47 adult male albino rats were divided into 4 groups. Control group I (no.=12). AP was induced in the remaining 35 rats by a single intra peritoneal (I.P) injection of L-arginine (250 mg/100g). 5 rats died within the 1st hour after AP induction, the rest were divided randomly into group II (AP group; no.=10) that received no treatment, group III (BMSCs group; no.=10) and group IV (WGO group; no.=10). One hour after AP induction, group III was injected I.P. by 1ml of PKH26 labeled BMSCs (1x106 cells/ml) and group IV received WGO in a dose of 3 ml/kg body weight by oral gavage every 24 h for 3 successive days. Blood samples were collected 24 hours and on the 4th day after AP induction for biochemical assessment of serum amylase, lipase, interleukin-1β and interleukin-10. Then, animals were sacrificed and specimens from the pancreas were prepared for Hematoxylin and eosin (HandE) stain and immune-histochemical staining using inducible Nitric Oxide Synthase (iNOS) and insulin antibodies. Morphometric measurements using image analyzer were done. Results: Group II showed extensive pancreatic damage associated with increase in serum amylase, lipase and interleukin-1B levels and reduction in interleukin-10 level. A significant increase in the area % of iNOS immunostaining and non-significant change in insulin immunostaining were detected. On the other hand, BMSCs group and WGO group showed improvement in the biochemical, histological and immunohistochemical results with better results in BMSCs group. Conclusion: BMSCs possess better therapeutic efficacy in treating AP compared with WGO.

Web-based E-diagnostic for Digestive System Disorders in Mumans using the Demster Shafer Method

Web-based E-diagnostic for Digestive System Disorders in Mumans using the Demster Shafer Method

Status of Geriatric Patients with Abdominal Pain Presented To Emergency Department

Background: As the development of better health facilities with advanced tools for diagnosis and management our country is not away from global trend. Nepal’s life expectancy at birth is increasing at its pace, it has in­creased in about 30 years in last 4 decades. Among the various problem presenting to ED abdominal pain is one of the common complain elderly patients are greater risk of missing life-threatening causes during evalua­tion and investigation. The aim of the study wasEdit to identify the frequency, cause and outcome of patient presenting in Emergency department with abdominal pain.&#x0D; Methods: It is a retrospective study conducted in tertiary care center at Chitwan, Nepal during the period from 01/09/2017 to 30/08/2018. Elec­tronic data entered by medical officer were retrieved and analyzed. Statis­tical analysis of the record was done using SPSS 16 software.&#x0D; Results: Elderly population who presented with chief complaints of ab­dominal pain was 1160 (21.79%). Among the patient presented with ab­dominal pain 605(52.2%) were male and 555(47.8%) were female. Mean age of patients was 71.72±8.50 years. Most common system involved was gastrointestinal and biliary problem 730(62.93%). Most common diagno­sis was Urinary tract infection 269 (23.2%) among them, 487(41.98%) re­quired hospital admission.&#x0D; Conclusions: Abdominal pain is one of the common presentations of el­derly to emergency department. Disorders of Gastrointestinal and biliary system were among leading causes of emergency visit. Emergency phy­sician should be tactful to identify life threatening conditions and emer­gency management.

Web-Based Expert System to Diagnose Gastroenteritis in Children in Pariaman District Hospital using the Forward Chaining Method

Gastroenteritis is a digestive system disorder in the form of inflammation of the digestive system involving the stomach and small intestine. Gastroenteritis is usually called a stomach bug, gastro, or stomach virus. Although it has no connection with influenza, it is often referred to as stomach flu. Gastroenteritis is the most common digestive problem in children. Severe gastroenteritis will cause dehydration and electrolyte imbalance, this is caused by body fluids lost through diarrhea or vomiting. This system is a prototype and made as simple as possible, so that users can easily use it and redesign this expert system for other types. Because Because there are still many parents who do not know the symptoms of a disease. So an expert system was made that could diagnose early in gastroenteritis. By using a web-based forward chaining method, using this expert system, Gastroenteritis can be identified by looking at symptoms that can explain and describe whether a child is suspected of having a Gastroenteritis.