Feeling Of Suffocation Research Articles

Cold-associated laryngopharyngeal dysesthesia syndrome after oxaliplatin treatment.

Oxaliplatin is a platinum-group chemotherapeutic agent commonly used in the treatment of colorectal cancer. In addition to hematological and gastrointestinal side effects, laryngopharyngeal dysesthesia associated with cold is reported as a rare side effect. In this article, seven cases with pharyngolaryngeal dysesthesia were presented and the diagnosis and treatment planning were reviewed in the light of literature findings. Patient records of cancer patients with laryngopharyngeal dysesthesia were retrospectively analyzed between 2020 and 2023. Demographic characteristics, presenting complaints, vital signs, physical examination, and laboratory tests of the patients diagnosed with laryngopharyngeal dysesthesia were recorded. Seven patients who had gastrointestinal malignancy and oxaliplatin chemotherapy were diagnosed with laryngopharyngeal dysesthesia. The symptoms most commonly developed due to cold weather. The symptoms of three patients had developed while receiving treatment, while four patients were admitted to emergency service after oxaliplatin infusion. The physical examinations revealed no pathological findings of the allergic reaction at presentation or during follow-up skin. Patients were monitored and nasal oxygen therapy was administered. A 5 mg intravenous infusion was given for anxiety symptoms in three patients. Patients were discharged after 4 hours of follow-up with resolution of all symptoms. Laryngopharyngeal dysesthesia should be kept in mind in patients treated with oxaliplatin and presenting with shortness of breath and a feeling of suffocation after cold exposure.

THE ROLE OF DENTISTRY IN THE DIAGNOSIS AND TREATMENT OF OBSTRUCTIVE SLEEP APNEA SYNDROME (OSAS): literature review

Obstructive sleep apnea syndrome (OSAS) is a chronic, progressive, disabling respiratory disorder with serious systemic repercussions; It is characterized by recurrent events of upper airway obstruction (UA) during sleep. In this way, it directly affects the individual's quality of life, since this occurrence causes daytime hypersomnolence, a feeling of suffocation when waking up, memory failure, sexual impotence, psychological changes such as anxiety and depression and, even, in more severe cases, acute heart attack. myocardial injury (AMI), cerebrovascular accident (CVA), as well as car accidents, which, therefore, constitute a public health problem. The objective of this literature review is to highlight the importance of the dentist's knowledge and conduct regarding the early diagnosis and treatment of OSAS, the request for appropriate complementary exams, their classifications and assertive therapeutic measures according to the individual's peculiarities. As a methodology, several searches were carried out in the SciELO, LILACS, PubMed, MEDLINE and Google Scholar databases from 1999 to 2023, with the following indexing terms: Sleep apnea syndrome, polysomnography, diagnosis, treatment, snoring, sleep. In this sense, it appears that Sleep Dentistry is a new field of activity for dental surgeons as a result of the possibility of conservative, effective and cost-effective treatments favorable to patients through clinically manufactured intraoral appliances (AIO). Therefore, it is expected that, in the medium term, the Federal Council of Dentistry (CFO) will recognize it as a dental specialty.

Brown tumor of the mandible - a possible clinical manifestation of primary hyperparathyreoidism

Introduction. One of the possible manifestations of primary hyperparathyroidism (PHPT) is the appearance of a benign bone tumor. We hereby present a case of a young woman whose first clinical manifestation of PHPT was a brown tumor of the mandible. Case report. A 27-year-old female patient was hospitalized at the Clinic for Endocrinology, Diabetes, and Metabolic Diseases due to problems occurring in the form of nausea, exhaustion, the feeling of suffocation, dysphagia, pain in the right ear and the right half of the cheeks, with suspected PHPT. Initial laboratory findings pointed out the high levels of parathyroid (PT) hormone (PTH) and calcium (Ca2+) ions, low levels of vitamin D, and increased parameters of bone metabolism with signs of osteopenia. Cone beam computed tomography revealed the presence of bilateral radiolucent lesions of the mandible. Scintigraphy verified a retrosternal hot focus consistent with PT adenoma. After parathyroidectomy was performed, there was a normalization of PTH values, bone metabolism parameters, and the Ca2+ values. Four months after parathyroidectomy, a significant regression of the mandibular tumefaction was confirmed, clinically and radiologically. Conclusion. Brown tumors are rare first clinical manifestations of PHPT. Owing to their histological similarities with other giant-cell lesions (GCLs), definitive diagnosis is sometimes difficult and is based on a correlation of pathohistological, radiological, and laboratory findings. Due to the spontaneous regression of bone lesions after treatment of the basic cause of PHPT, brown tumors should be considered in the differential diagnosis of any GCLs in order to avoid unnecessary surgical procedures.

"Hwabyeong", a Korean Cultural Syndrome

Hwabyeong is known as a Korean cultural-bound syndrome which is situated at the intersection between depression and anger syndrome. Translated as “anger illness” or “fire illness”, hwabyeong is a mental illness resulted from repressed feelings, which has a specific somatization in middle-aged Korean women: lump in throat or chest, feeling of suffocation, palpitations, heat sensation, burning feeling in the stomach, insomnia etc. While this syndrome is often stressed as a clinical study case, hwabyeong can also be found in Korean literature, proving the power it holds within the society. Two such cases from Korean contemporary literature are The Vegetarian, by Han Kang, and Kim Jiyeong, born 1982, by Cho Nam-joo. Despite the fact that no one mentions hwabyeong, the main characters show clear symptoms of the disorder. They also match the pattern of those who suffer from this disease. At first glance, someone might say they are gone mad, but looking more closely at their background, their symptoms and behavior, they are no different from many other Korean women. Yeong-hye and Kim Jiyeong are two women from South Korea who experience body rebellion because of society’s failure to let them express as individuals with personal needs, ambitions and feelings.

Neuroimmune mechanisms in fear and panic pathophysiology.

Panic disorder (PD) is unique among anxiety disorders in that the emotional symptoms (e.g., fear and anxiety) associated with panic are strongly linked to body sensations indicative of threats to physiological homeostasis. For example, panic attacks often present with feelings of suffocation that evoke hyperventilation, breathlessness, or air hunger. Due to the somatic underpinnings of PD, a major focus has been placed on interoceptive signaling and it is recognized that dysfunctional body-to-brain communication pathways promote the initiation and maintenance of PD symptomatology. While body-to-brain signaling can occur via several pathways, immune and humoral pathways play an important role in communicating bodily physiological state to the brain. Accumulating evidence suggests that neuroimmune mediators play a role in fear and panic-associated disorders, although this has not been systematically investigated. Currently, our understanding of the role of immune mechanisms in the etiology and maintenance of PD remains limited. In the current review, we attempt to summarize findings that support a role of immune dysregulation in PD symptomology. We compile evidence from human studies and panic-relevant rodent paradigms that indicate a role of systemic and brain immune signaling in the regulation of fear and panic-relevant behavior and physiology. Specifically, we discuss how immune signaling can contribute to maladaptive body-to-brain communication and conditioned fear that are relevant to spontaneous and conditioned symptoms of PD and identify putative avenues warranting future investigation.

Automatic diagnosis of sleep apnea from biomedical signals using artificial intelligence techniques: Methods, challenges, and future works

AbstractApnea is a sleep disorder that stops or reduces airflow for a short time during sleep. Sleep apnea may last for a few seconds and happen for many while sleeping. This reduction in breathing is associated with loud snoring, which may awaken the person with a feeling of suffocation. So far, a variety of methods have been introduced by researchers to diagnose sleep apnea, among which the polysomnography (PSG) method is known to be the best. Analysis of PSG signals is very complicated. Many studies have been conducted on the automatic diagnosis of sleep apnea from biological signals using artificial intelligence (AI), including machine learning (ML) and deep learning (DL) methods. This research reviews and investigates the studies on the diagnosis of sleep apnea using AI methods. First, computer aided diagnosis system (CADS) for sleep apnea using ML and DL techniques along with its parts including dataset, preprocessing, and ML and DL methods are introduced. This research also summarizes the important specifications of the studies on the diagnosis of sleep apnea using ML and DL methods in a table. In the following, a comprehensive discussion is made on the studies carried out in this field. The challenges in the diagnosis of sleep apnea using AI methods are of paramount importance for researchers. Accordingly, these obstacles are elaborately addressed. In another section, the most important future works for studies on sleep apnea detection from PSG signals and AI techniques are presented. Ultimately, the essential findings of this study are provided in the conclusion section.This article is categorized under: Technologies > Artificial Intelligence Application Areas > Data Mining Software Tools Algorithmic Development > Biological Data Mining

A CASE OF TURBAN PIN INHALATION SYNDROME IN A YOUNG WOMAN

TOPIC: Cultural Diversity TYPE: Medical Student/Resident Case Reports INTRODUCTION: Turban Pin Inhalation Syndrome (TPIS) is mainly reported in countries in the Middle East with increased prevalence in younger females [1]. Incidences can be found in diverse cultural populations such as intercity areas like New York City. CASE PRESENTATION: A 38 year old woman with no past medical history presents to the emergency room an hour after accidentally inhaling a hair pin. Patient sensed something stuck in her throat and admitted to persistent hoarseness. Patient denies radiating pain, shortness of breath, chest pain, or hemoptysis. Physical exam reveals normal vitals. Patient is sitting comfortably with no respiratory distress, wheezing, drooling, or stridor. X-ray reveals a pin in the left main bronchus without pneumothorax or pneumomediastinum. After obtaining informed consent for flexible bronchoscopy, the patient was intubated and the pin was removed with three pronged forceps via flexible bronchoscopy in the emergency room (ER). Patient was discharged directly from the ER after successful extubation. DISCUSSION: Patients with TPIS usually present to the ER after accidentally inhaling pins held in their mouth while adjusting their scarves. Patients experience a brief episode of intense coughing and a feeling of suffocation, which is known as penetration syndrome. Patients are typically asymptomatic shortly afterwards, which leads to delay in seeking treatment. Early intervention is important because of the risk of distal mobilization or penetration through the bronchial wall or lung parenchyma leading to pneumothorax or pneumomediastinum. The average time between inhalation and surgery is 10 days. Longer term complications include granuloma formation into bronchial tree, recurrent pneumonia, obstructive emphysema, pleural effusion, bronchiectasis, and pulmonary abscess. Diagnosis is confirmed via X-ray that shows a linear opacity. In some reports, pins are located in the right main bronchus, but in other studies, there is no predilection for either side [1]. Rigid bronchoscopy is the standard modality to retrieve the pin, but would require removal in the operating room [1, 2, 3]. Flexible bronchoscopy can be used to retrieve the foreign body inhalation at bedside, which saves time and is more efficient in terms of logistics. If physicians are unable to retrieve the pin via bronchoscopy, more invasive measures would be used to retrieve the pin such as thoracotomy or parenchymal resection. CONCLUSIONS: Incidences of TPIS are not only in the Middle East, but also can be found in multi-cultural areas. These patients can present to intercity hospitals where they can undergo pin removal via flexible bronchoscopy and can be discharged the same day from the ER. REFERENCE #1: N. Rizk, N.E. Gwely, V.L. Biron, U. Hamza. Metallic hairpin inhalation: a healthcare problem facing young Muslim females. J Otolaryngol Head Neck Surg, 43 (2014 Aug 2), p. 21 REFERENCE #2: O. Ilan, R. Eliashar, N. Hirshoren, K. Hamdan, M. Gross. Turban pin aspiration: new fashion, new syndrome. Laryngoscope, 122 (4) (2012 Apr), pp. 916-919 REFERENCE #3: O. Dikensoy, C. Usalan, A. Filiz. Foreign body aspiration: clinical utility of flexible bronchoscopy. Postgrad Med J, 78 (2002), pp. 399-403 DISCLOSURES: No relevant relationships by Amanda Eng, source=Web Response No relevant relationships by rattan patel, source=Web Response

Empty nose syndrome pathogenesis and cell-based biotechnology products as a new option for treatment.

Empty nose syndrome (ENS) is a rare complication that develops after partial or complete turbinectomy. The main feature of ENS is paradoxical nasal obstruction feeling despite objectively wide nasal airway. ENS pathogenesis is multifactorial and includes changes in laminar physiological airflow, disruption of mucosa functions and deficient neural sensation. This leads to the development of ENS symptomatology such as dyspnea, nasal dryness, nasal burning, nasal obstruction, feeling of suffocation and even comorbid psychiatric disorders that significantly impairs life quality. Specific effective treatment of ENS does not exist up to date. In this review we outline existing biomaterial for surgical reconstitution of nasal anatomy and discuss the perspective of stem cell-based technologies in ENS management. The main focus is directed to justification of rationality application of adult mesenchymal stem cells (MSCs) from different tissues origin and neural crest-derived stem cells (NCSCs) based on their intrinsic biological properties. MSCs transplantation may stimulate mucosa tissue regeneration via trophic factors secretion, direct transdifferentiation into epithelial cells and pronounced immunosuppressive effect. From the other hand, NCSCs based on their high neuroprotective properties may reconstitute nerve structure and functioning leading to normal sensation in ENS patients. We postulate that application of cell-based and tissue-engineered products can help to significantly improve ENS symptomatology only as complex approach aimed at reconstitution of nasal anatomy, recovery the nasal mucosa functionality and neural tissue sensation.

Intravenous doxapram administration as a potential model of panic attacks in rats.

Panic disorder can be categorized into the nonrespiratory or the respiratory subtypes, the latter comprising dyspnea, shortness of breath, chest pain, feelings of suffocation, and paresthesias. Doxapram is an analeptic capable of inducing panic attacks with respiratory symptoms in individuals diagnosed with the disorder; however, its neuroanatomical targets and its effects on experimental animals remain uncharacterized. One of the brain regions proposed to trigger panic attacks is the midbrain periaqueductal gray (PAG). Therefore, in this study, we evaluated the effects of doxapram in Fos (c-Fos) protein expression in the PAG and characterized its cardiorespiratory and behavioral effects on the elevated T maze and in the conditioned place aversion (CPA) paradigms. Doxapram increased Fos expression in different columns of the PAG, increased respiratory frequency, decreased heart rate, and increased arterial pressure when injected via intravenous route. Alprazolam, a panicolytic benzodiazepine, injected via intraperitoneal route, decreased respiratory frequency, whereas URB597, an anandamide hydrolysis inhibitor injected via intraperitoneal route, was ineffective. Doxapram injected via intraperitoneal route induced an anxiogenic-like effect in the elevated T-maze model; however, it failed to induce CPA. This study suggests that the cardiorespiratory and behavioral effects of doxapram in rodents serve as an experimental model that can provide insights into the neurobiology of panic attacks.

Heightened affective response to perturbation of respiratory but not pain signals in eating, mood, and anxiety disorders.

Several studies have recently suggested that an abnormal processing of respiratory interoceptive and nociceptive (painful) stimuli may contribute to eating disorder (ED) pathophysiology. Mood and anxiety disorders (MA) are also characterized by abnormal respiratory symptoms, and show substantial comorbidity with ED. However, no studies have examined both respiratory and pain processing simultaneously within ED and MA. The present study systematically evaluated responses to perturbations of respiratory and nociceptive signals across the levels of physiology, behavior, and symptom report in a transdiagnostic ED sample (n = 51) that was individually matched to MA individuals (n = 51) and healthy comparisons (HC; n = 51). Participants underwent an inspiratory breath-holding challenge as a probe of respiratory interoception and a cold pressor challenge as a probe of pain processing. We expected both clinical groups to report greater stress and fear in response to respiratory and nociceptive perturbation than HCs, in the absence of differential physiological and behavioral responses. During breath-holding, both the ED and MA groups reported significantly more stress, feelings of suffocation, and suffocation fear than HC, with the ED group reporting the most severe symptoms. Moreover, anxiety sensitivity was related to suffocation fear only in the ED group. The heightened affective responses in the current study occurred in the absence of group differences in behavioral (breath hold duration, cold pressor duration) and physiological (end-tidal carbon dioxide, end-tidal oxygen, heart rate, skin conductance) responses. Against our expectations, there were no group differences in the response to cold pain stimulation. A matched-subgroup analysis focusing on individuals with anorexia nervosa (n = 30) produced similar results. These findings underscore the presence of abnormal respiratory interoception in MA and suggest that hyperreactivity to respiratory signals may be a potentially overlooked clinical feature of ED.

Panic Disorder with Choking Phobia : a Case Report

Abstract
 
 Panic disorder is a form of anxiety disorder characterized by repeated panic attacks and preoccupied with worrying that a panic attack will occur. Panic attacks are characterized by fears of a disaster or loss of self-control even though there is really nothing to worry about. Other symptoms experienced during a panic attack are heart palpitations (similar to a heart attack), shortness of breath, feelings of suffocation, and the body feels weak. If this disorder is not detected early, it will affect the daily life of the patient. This case report presents the case of a 34-year-old woman who experiences symptoms of panic disorder with choking phobia that is managed with antidepressants and cognitive behavior therapy. In addition, there is discussion of differential diagnosis and the role of cognitive behavior therapy in handling this case.

Pain, somatic complaints, and subjective concepts of illness in traumatized female refugees who experienced extreme violence by the “Islamic State” (IS)

BackgroundRefugees with a history of war or sexual violence often experience somatic symptoms along with mental disorders. After being held in captivity by the so-called “Islamic State” (IS), 1100 especially vulnerable Yazidi women and children (around 400 women) received special medical and psychological support. We report on their (psycho-) somatic complaints and concepts of illness. MethodsFemale refugees (N = 116) were surveyed regarding their somatic complaints and concepts of illness. The Impact of Event Scale-Revised (IES-R) and self-developed questionnaire items with ratings on a five-point Likert scale from 0 (“not at all”) to 4 (“extremely”) were used. Subgroup analyses and a multiple linear regression model were computed. ResultsPain (M = 2.43, SD = 1.70) is the main somatic complaint with a moderate rated severity, followed by feelings of suffocation (M = 2.37, SD = 1.53), and movement disorders (M = 1.62, SD = 1.70). In a linear regression model, pain explains variance (R2 = 0.325) in the refugees' self-reported health-related wellbeing. Somatic symptoms are mainly attributed to psychological causes, followed by physical (e.g., physical origin of symptoms), religious, and supernatural causes. Women with pain symptoms attributed their symptoms more to physical causes (M = 1.90, SD = 1.78) than did women without pain symptoms (M = 1.07, SD = 1.59). ConclusionFemale Yazidi refugees being kept in IS captivity mainly suffer from pain, which is attributed to an explanatory psychological model. The study results show the specific psychosomatic and psychotherapeutic needs and demands for specifically tailored psychotherapy.

COPD patients' experiences, self-reported needs, and needs-driven strategies to cope with self-management.

Background: COPD is a common cause of morbidity and mortality. The aim of this study was to explore patients’ experiences, self-reported needs, and needs-driven strategies to cope with self-management of COPD.Patients and methods: In this phenomenological study, 10 participants with mild to severe COPD were interviewed 1–2 times, until data saturation was reached. In total, 15 in-depth interviews were conducted, recorded, transcribed, and analyzed.Results: COPD negatively affected participants’ physical and psychosocial well-being, their family relationships, and social life. They described their experiences of COPD like fighting a war without weapons in an ever-shrinking world with a loss of freedom at most levels, always fearing possible breathlessness. Fourteen needs were identified and eight clusters of needs-driven strategies that participants used to cope with self-management of COPD. Coping with the reality of COPD, a life-threatening disease, meant coping with dyspnea, feelings of suffocation, indescribable smoking addiction, anxiety, and lack of knowledge about the disease. Reduced participation in family and social life meant loss of ability to perform usual and treasured activities. Having a positive mindset, accepting help and assuming healthy lifestyle was important, as well as receiving continuous professional health care services. The participants’ needs-driven strategies comprised conducting financial arrangements, maintaining hope, and fighting their smoking addiction, seeking knowledge about COPD, thinking differently, facing the broken chain of health care, and struggling with accepting support. Procrastination and avoidance were also evident. Finally, the study also found that participants experienced a perpetuating cycle of dyspnea, anxiety, and fear of breathlessness due to COPD which could lead to more severe dyspnea and even panic attacks.Conclusion: COPD negatively affects patients’ physical and psychosocial well-being, family relationships and, social life. Identifying patients’ self-reported needs and needs-driven strategies can enable clinicians to empower patients by educating them to improve their self-management.

Prevalence Rates of the Incubus Phenomenon: A Systematic Review and Meta-Analysis.

The incubus phenomenon is a paroxysmal sleep-related disorder characterized by compound hallucinations experienced during brief phases of (apparent) wakefulness. The condition has an almost stereotypical presentation, characterized by a hallucinated being that exerts pressure on the thorax, meanwhile carrying out aggressive and/or sexual acts. It tends to be accompanied by sleep paralysis, anxiety, vegetative symptoms, and feelings of suffocation. Its prevalence rate is unknown since, in prior analyses, cases of recurrent isolated sleep paralysis with/without an incubus phenomenon have been pooled together. This is unfortunate, since the incubus phenomenon has a much greater clinical relevance than isolated sleep paralysis. PubMed, Embase, and PsycINFO were searched for prevalence studies of the incubus phenomenon, and a meta-analysis was performed. Of the 1,437 unique records, 13 met the inclusion criteria, reporting on 14 (k) independent prevalence estimates (total N = 6,079). The pooled lifetime prevalence rate of the incubus phenomenon was 0.19 [95% confidence interval (CI) = 0.14-0.25, k = 14, N = 6,079] with heterogeneous estimates over different samples. In selected samples (e.g., patients with a psychiatric disorder, refugees, and students), prevalence rates were nearly four times higher (0.41, 95% CI = 0.25-0.56, k = 4, n = 1,275) than in the random samples (0.11, 95% CI = 0.08-0.14, k = 10, n = 4,804). This difference was significant (P < 0.001). This review and meta-analysis yielded a lifetime prevalence of the incubus phenomenon in the general population of 0.11 and, in selected samples, of 0.41. This is slightly higher than the prevalence rates in previous analyses that included cases of recurrent isolated sleep paralysis without an incubus phenomenon. Based on the condition's robust clinical presentation and the relatively high prevalence rates, we advocate inclusion of the incubus phenomenon as a diagnostic category in major classifications such as the International Classification of Diseases and Related Health Problems and the Diagnostic and Statistical Manual of Mental Disorders. Recommendations are also made for clinical practice and future research.

Cognitive Impairment and Psychological Distress at Discharge from Intensive Care Unit.

This study aimed to investigate cognitive impairment and psychological distress of critically ill patients at discharge from intensive care unit (ICU). This study included 30 critically ill patients who had neither pre-existing dementia nor ongoing delirium. At ICU discharge, they performed a screening test for cognitive impairment (Mini-Cog test) and completed questionnaires for depression (Patient Health Questionnaire-2, PHQ-2) and for 4 stressful experiences during ICU stay including nightmares, severe anxiety or panic, severe pain, and trouble to breathe or feeling of suffocation (Post-Traumatic Stress Syndrome 14-Question Inventory, PTSS-14 Part A). Thirteen patients (43.3%) screened positive for cognitive impairment and 18 patients (60.0%) exhibited depressive symptoms. Twenty three patients (76.7%) recollected one or more stressful in-ICU experiences. Female patients (88.9%) was more likely to feel depressed at ICU discharge, compared to male patients (47.6%) (χ2=4.47, p=0.03). To the best of our knowledge, this is the first report on cognitive and psychological outcomes of ICU survivors in Korea. In this study, we observed that a considerable number of critically ill patients had experienced cognitive impairment or psychological distress at ICU discharge.

AECONOMICAL EVALUATION OF AIR POLLUTION INDICATORS BY EXHAUST OF MOTOR VEHICLES WITH TAX MODEL PROPOSAL AN APPLIED STUDY OF CAIRO GOVERNORATE

Introduction: Pollution resulting from human-induced Environmental conditions, thus affecting the balance of elements and components. Transportation is a major cause of air pollution in private cars powered by diesel cities. Where resulting from car exhausts of Greenhouse gases, a group characterized as colorless and with a high degree of toxicity composed. Carbon monoxide gas is (CO) of more air pollutants in urban areas, a highly toxic gas for Humans and Animals, increase its impact on congestion and Rash-hours, which is very dangerous and cause accidents due to breathing over the years. It is also carbon dioxide (CO2) one of the most important causes difficulty breathing and a feeling of suffocation, and the occurrence of problems to the mucous membranes and bronchitis. The Nitrogen oxides (No) It increases lung sensitivity to different diseases breathing is also working on the mucous membrane irritation to the eyes. Hydrocarbons (HC), a fuel is completely burned. These materials are considered toxic substances and carcinogens. Sulfur dioxide (SO2) affects the respiratory tract, high concentrations of this gas lead to spasm and suffocation and the occurrence of pulmonary sclerosis. The lead molecules causing pain in the joints and muscles, Anemia, inflammation of the peripheral nerves and kidney disease, and affects many functions of the brain. The goal of the study:The transport and communications sector on the issue with him and what kinds of exhaust smoke source of about 70 per cent of the existing polluting gases in the air. This high rate caused by the massive increase in the production and use of cars and vehicles. Thus, the growing number of cars means an increase in the amount of exhaust gases emitted by these vehicles and determine the amount of gas emissions from the transport sector, according to the mechanisms and the size of the engines and the quality of the used fuel type. The most important air pollutants released from the transport sector are carbon monoxide and oxides of nitrogen (NO) gas and hydrocarbon (HC) and lead. Methodology of the study:The study relied on the theoretical method that office to gather facts and information about the nature of the problem at hand is based on, and then completed in a way that the analytical description of this information in order to reach results pertaining to this matter, and which help to reach the desired goal of the research. Results: •Air pollution resulting from motor vehicle exhaust is one of the most important environmental risks to health. •Whenever the air pollution from car exhaust levels decreased mental health and cardiac vascular population has improved in the long term and the short. •Air pollution causes, every year in a large number of premature deaths due to pneumonia, which affects children under the age of five. •Air pollution in urban areas kills, each year, the lives of 1.3 million people around the world. • There is a high risk to health from exposureto PM and ozone.

Exploring barriers to and facilitators of preventive measures against infectious diseases among Australian Hajj pilgrims: cross-sectional studies before and after Hajj.

For reasons that have yet to be elucidated, the uptake of preventive measures against infectious diseases by Hajj pilgrims is variable. The aim of this study was to identify the preventive advice and interventions received by Australian pilgrims before Hajj, and the barriers to and facilitators of their use during Hajj. Two cross-sectional surveys of Australians pilgrims aged ≥18 years were undertaken, one before and one after the Hajj 2014. Of 356 pilgrims who completed the survey (response rate 94%), 80% had the influenza vaccine, 30% the pneumococcal vaccine, and 30% the pertussis vaccine. Concern about contracting disease at Hajj was the most cited reason for vaccination (73.4%), and not being aware of vaccine availability was the main reason for non-receipt (56%). Those who obtained pre-travel advice were twice as likely to be vaccinated as those who did not seek advice. Of 150 pilgrims surveyed upon return, 94% reported practicing hand hygiene during Hajj, citing ease of use (67%) and belief in its effectiveness (62.4%) as the main reasons for compliance; university education was a significant predictor of hand hygiene adherence. Fifty-three percent used facemasks, with breathing discomfort (76%) and a feeling of suffocation (40%) being the main obstacles to compliance. This study indicates that there are significant opportunities to improve awareness among Australian Hajj pilgrims about the importance of using preventive health measures.

RELATIONSHIP OF SLEEP-DISORDERED BREATHING, EMOTIONAL COMPLAINTS AND ANTROPOMETRIC MEASUREMENTS (THE RESULTS OF SCREENING SURVEY AMONG SAINT-PETERSBURG CITIZENS)

Aim. To assess the prevalence of sleep-disordered breathing (SDB), their relation to emotional complaints, antropometric measures and life-style factors in representative cohort of a large city inhabitants (Saint-Petersburg). Material and methods. Using structured interview and antropometric methods we studied 358 citizens of Saint-Petersburg at the age of 21-68 y.o. The presence/absence of the following were evaluated: dyssomnias, SDB (snore, breathing pauses), emotional complaints, body mass index, life-style characteristics. 21,5% of respondents could not respond definitely about the sleep breathing quality, of those mostly women (25,9% vs 14,2%; p<0,05). Finally we analyzed 281 respondents 115 men and 166 women. Results. Regular snore do confirm 29,6% men and 22,9% women. Proportional increase of snoring with the age was found only in women (r=0,21; p<0,01). Apnea episodes are reported by 14,3% respondents. Clear differences by this parameter in men and women in different ages are not found. Not depending on gender and age the snore prevalence was related to obesity markers: body mass index (r=0,26; p<0,001) and waist circumference (r=0,24; p<0,001). There was no relationship of apnea prevalence and obesity markers. There was connection between snore prevalence with sleepiness level (r=0,21, p=0,001), emotional tension (r=0,24, p<0,001) and despondency (r=0,20, p<0,01), prevalence of bruxism (r=0,18, p<0,01) and awake with the feeling of suffocation/ heaviness in the chest (r=0,17, p<0,01). Apnea prevalence correlated with typicality of fatigue after night sleep (r=0,16, p<0,01), awake with the feeling of suffocation / heaviness in the chest (r=0,17, p<0,01), and with bruxism prevalence (r=0,16, p =0,01). There was no clear evidence of SDB with lifestyle connections. Conclusion. Every fourth adult of Saint-Petersburg shows the signs of SDB, which are linked with overall sleep quality decrease, dyssomnias and emotional complaints, and with obesity values.

Evaluation of the use and reasons for not using a helmet by motorcyclists admitted to the emergency ward of shahid bahonar hospital in kerman.

Background:Motorcycle crashes are the cause of severe morbidity and mortality especially because of head injuries. It seems that wearing a helmet has an effective role in protection against head injuries. Nevertheless, motorcyclists usually have no tendency to wear a helmet when driving in cities and have several reasons for this behavior.Objectives:This study aimed to evaluate the use and reasons for not using a helmet by motorcyclists admitted to an emergency ward of a trauma hospital due to accident in Kerman, Iran.Patients and Methods:This study was carried out by recoding the opinions of motorcyclists who had been transferred to the emergency ward of Shahid Bahonar Hospital (Kerman/Iran). Since no data was available on the frequency of the use of helmets, a pilot study was carried out and a sample size of 377 was determined for the main study. Then a researcher-made questionnaire was used to investigate the motorcyclists’ reasons for not using a helmet.Results:Only 21.5% of the motorcyclists had been wearing helmets at the time of the accident. The most frequent reasons for not using a helmet were the heavy weight of the helmet (77%), feeling of heat (71.4%), pain in the neck (69.4%), feeling of suffocation (67.7%), limitation of head and neck movements (59.6%) and all together, physical discomfort was the main cause of not wearing a helmet during motorcycle rides.Conclusions:In general, it appears that it is possible to increase the use of helmets by eliminating its physical problems, and increasing the knowledge of community members in relation to the advantages of helmet use, which will result in a significant decrease in traumas resulting from motorcycle accidents.

Diagnostic Challenge of a Deep Minor Salivary Gland Neoplasm

Core needle biopsy represents a safe and cheap alternative diagnostic method to open biopsy and fine-needle aspiration cytology in head and neck tumors. There is little evidence in the literature about the use of core needle biopsy in minor salivary gland lesions. This single case report presents a 60-year-old woman with a painless swelling in the soft palate, breathing and swallowing difficulties, and a feeling of suffocation. Two open biopsies had inconclusive diagnosis and the lesion could only be assessed and diagnosed as pleomorphic adenoma through core needle biopsy. Recognizing the correct indication of core needle biopsy can benefit both health professionals and patients; thus, it is important to consider the possibility of performing this method to diagnose minor salivary gland tumors.