Mc Master Research Articles

Ozone Improves Pain, Function and Quality of Life in Patients with Knee Osteoarthritis: A Prospective Quasi-Experimental Before-After Study

Background: The study was conducted to: 1) demonstrate the effectiveness of a treatment protocol with Ozone therapy in pain, function, and quality of life in patients with knee osteoarthritis; and 2) apply Ozone as a conservative treatment option with a demonstrable level of scientific evidence. Methods: This prospective quasi-experimental before-after study was conducted on 119 patients with knee osteoarthritis, having Kellgren-Lawrence grade 2 or more, who were referred to hospital of Santa Cristina’s University, from January 2012 to April 2016. The protocol consisted of an intra-articular infiltration of a medical mixture of Oxygen-Ozone (95% - 5%) 20mL, at a 20ug / mL concentration, during a total number of 4 sessions (once per week). Pain and quality of life were measured by visual analogical scale (VAS) and Western Ontarion and Mc Master Universities Index for osteoarthritis (WOMAC) at the beginning and end of the treatment. Results: The mean age of participants was 66.29 years. The sample was composed of 70.5% Women (n = 84) and 29.5% men (n = 35). The severity of OA according to Kellgren-Lawrence scale was 2.94°. Post-puncture erythema was 8.4% (n = 10). Pain measured by VAS significantly decreased (P < 0.0001) from the score 7.89 to 2.1. The scores of WOMAC-pain, WOMAC-stiffness, and WOMAC-function subscales decreased significantly (P < 0.0001) from 15.9 to 4.4, 3.5 to 0.9, and 49.5 to 17.6, respectively. The WOMAC total score decreased from 68.9 to 22.9 (P < 0.0001). Conclusions: Ozone is a safe medical treatment that can improve significantly pain relief, stiffness, and function in patients with knee osteoarthritis. The study shows a good level of evidence as well as a good grade of recommendation that allows us to consider Ozone as a conservative therapeutic option in the treatment of osteoarthritis of the knee.

Assessment of Family Functioning and Its Relationship to Quality of Life in Diabetic and Non-Diabetic Women

Introduction: One of the most important components and health indicators, especially among people with chronic diseases is quality of life. One of the possible factors which may impact on quality of life of diabetic patients is family functioning. This study aimed to determine the relationship between family functioning and quality of life of diabetic and non-diabetic women. Methods: In this correlational cross-sectional study, 180 women (diabetics and non-diabetics) who referred to health centers in Mashhad in 2014-2015 were studied. Data were collected using SF-36 questionnaire and Mc Master Family Assessment Device (FAD). Data were analyzed using descriptive and statistical tests by SPSS ver.13 software. Results: The result showed that diabetic women reported family impairment compared with none diabetic women. There was a significant relationship between the family functioning and quality of life in diabetics and non-diabetic women. Based on the results of the stepwise regression model, among factors of family function only the factor of behavioral control was able to predict the quality of life in diabetic women. Conclusion: Regarding the study findings, good family function associated with better quality of life in diabetics and healthy women. Therefore, due to disturbed family function in diabetic’s women implementation of training programs and consulting services could improve their quality of life.

Prevalence of gastrointestinal parasites of baboon (&lt;i&gt;Papio anubis&lt;/i&gt;), warthog (&lt;i&gt;Phacochoerus africanus&lt;/i&gt;) and waterbuck (&lt;i&gt;Kubus deffasa&lt;/i&gt;) in Yankari game reserve, Bauchi state Nigeria

A total of ninety four (94) fresh faecal samples of baboons (Papio anubis), Warthogs (Phacochoerus africanus) and Waterbucks (Kubus deffasa) were collected from different strategic locations within Yankari Game Reserve in August, 2008. Samples were collected in sterilized specimen bottles containing 4% formalin and analyzed by simple floatation, sedimentation and concentration Mc master techniques. The sixty (63) fecal samples of baboons examined; 7(11.11%) had intestinal parasites, comprises of 260 (54.1%) metastrongylus eggs, 180 (37.50%) eggs of mites and 40 (8.33) of adult mites. A total of Seven 7 (28%) of the twenty five (25) fecal samples of warthogs had parasites which comprised of 4960 (98.0%) eggs of hyostrongylus eggs and 100 (2.0%) of monizia eggs. Only 2(33.3%) of the six (6) fecal samples of waterbucks had Hystrongylus eggs 180(1.1%).The infection rate was significantly higher (p&lt;0.05) among Warthogs (98%) fallowed by Baboons (54.1%) and the least Waterbucks (1.1%). Exposure to posture may be the predisposing factor responsible for the prevalence rate recorded in the study area. This may posed a potential danger to visitors in Yankari Game Reserve and other wild animals. Implementation of control policy of helminthes parasites in the Reserve will reducethe prevalence of helminthes diseases.Key words: Baboon, Intestinal parasites, Waterbuck, Warthog, Yankari Game Reserve

Psychometric evaluation of the Greek version of Mc Master Family Assessment Device (FAD)

IntroductionThe Family Assessment Device (FAD) is a self-report questionnaire, developed to assess the six dimensions of the McMaster Model of family functioning. It has been translated to the Greek language but never validated.Aims and objectivesTo evaluate the psychometric properties of the Greek version of FAD in a non-clinical sample.MethodsIn a sample of Greek families, FAD was administered together with the already validated Family Adaptability and Cohesion Evaluation Scale (FACES-III). In a subsample of 96 participants, the scales were administered again after 1 month.ResultsA sample of 453 participants (194 children and 259 parents) had completed both questionnaires (151 families). Mean age of children was 23.62 (SD: 6.35), 68 (35%) were males. Mean age of parents was 51.4 (SD: 8.2), 117 (45.2%) males. All subscales of FAD had significant correlation (concurrent validity) with FACES-III (n = 453, P &lt; 0.001). Test-retest reliability range from 0.58 to 0.82 (n = 96, P &lt; 0.001). Internal consistency (Cronbach's alpha) range from 0.47 to 0.94. A model with the 6 factors had a good statistical fit but not all the items were loading in the same components as from the theory assumed.ConclusionsThe Greek FAD has good psychometric properties, although its factor structure might differ from the original version. Further evaluation of the Greek version of FAD in other settings and in different samples especially clinical remains a task for future research.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Status of Helminthes Parasites of Cattle in Dairy Farms of Holleta Agricultural Research Center, Central Ethiopia

A cross-sectional study was under taken at dairy farms of Holleta Agricultural Research Center, Central Ethiopia, which was located at central highland of Oromia special zone surrounding Finfinne, to determine the prevalence of gastrointestinal helminthes parasites of cattle from October 2009 to June 2010. A total of 283 cattle were examined using standard coprological examination on 147 Boran × Fresia and 136 Jersey breed cattle from both farms. The over all prevalence of GI helminthes parasites was found to be 68.2% (193/283) with the predominant eggs of paramphistomum (18.0%) followed by ascaris (9.5%), fasciola (8.5%), strongylus (7.1%), nematodirus (6.7%) and trichuris (1.8%) obtained from the study. There was statistical significant difference between age, breed and body condition with prevalence of parasites (P<0.05). The higher prevalence was recorded from adult animals than in young group. A cross breed of Boran × Fresia had higher prevalence of 57% than that of pure Jersey (43.0%). The level of infections determined by using Mc Master Eggs counting indicated that mild infections accounted for 55.5%, sever 1.1% and 11.7% for sub clinical light infections. Based on the results obtained further study on determinant factors for the occurrence of helminthes parasites and implementation of appropriate control and prevention methods should be applied in study area.

Growth performance parameters in chicken experimental coccidiosis treated with Diclazuril and Clopidol: The need for assessing new anticoccidial resources

Background: Coccidiosis is recognized as the parasitic disease that has the greatest economic impact on poultry production. Modern poultry production is largely dependent upon anticoccidials. Objectives: The aim of the present study was to determine and compare the efficacy of two chemical anticoccidials (Clopidol and Diclazuril) on oocyst shedding and their probable effects on growth performance and feed efficiency of broilers in experimental coccidiosis. Methods: One hundred and twenty Ross 308 one day old broilers were randomly assigned into 4 groups: CON+, infected with Eimeria mixed oocysts but not medicated; CON-, not infected and not medicated; CLO, infected and medicated with Clopidol; DIC, infected and medicated with Diclazuril. Chickens in all groups except negative control were inoculated by mixed sporulated oocysts of pathogenic Eimeria at the end of the 3rd week of age. Oocyst shedding was counted using a Mc Master counting chamber. Body weights, body weight gains, and feed conversion ratio were determined on weekly basis. Results: Obtained results showed that Diclazuril was more effective in reducing oocyst shedding than Clopidol. As expected, mean body weight in the positive control group was lower than other groups. But surprisingly, no significant difference was found between Diclazuril or Clopidol treated birds and positive control group, at the end of the experiment. In comparison of weight gain in different treatment groups except for the 4 and 5th week, no significant difference was found in different groups. In the last week of the experiment, difference in weight gain between groups was not significant. According to feed conversion ratio (FCR) results, anticoccidial supplementation did not have any significant effect on improving FCR. ConclusionS: It is reported that some anticoccidials reduce feed consumption and feed conversion. It seems that neither of the present synthetic anticoccidials is completely satisfactory in controlling coccidiosis economic losses and new strategies are urgently required.

The Right Tool for the Job: Detection of Soil-Transmitted Helminths in Areas Co-endemic for Other Helminths.

BackgroundDue to the recent increased use of the McMaster (MM) fecal egg counting method for assessing benzimidazole drug efficacy for treating soil-transmitted helminth (STH) infections, the aim of the current study was to determine the operational value of including the MM method alongside the Kato-Katz (KK) fecal thick smear to increase the diagnostic sensitivity when STHs are co-endemic with trematode helminths (e.g., Schistosoma mansoni).MethodsA cross-sectional study was conducted in school-aged children aged 4-18 years in the northeastern region of the State of Minas Gerais (Brazil), where Necator americanus, Ascaris lumbricoides, Trichuris trichiura, and S. mansoni are co-endemic. One fecal sample from each participant was collected and transported to the field laboratory for analysis. Coprological diagnosis was performed on each fecal sample by three different methods: Formalin-Ether Sedimentation (FES), KK and the MM technique. The diagnostic sensitivity and negative predictive value (NPV) of each technique was calculated using the combination of all three techniques as the composite standard. In order to determine the agreement between the three techniques Fleiss´ kappa was used. Both the Cure Rate (CR) and the Fecal Egg Count Reduction (FECR) were calculated using the two quantification techniques (i.e., the MM and KK).ResultsFecal samples from 1260 children were analyzed. The KK had higher diagnostic sensitivity than the MM for the detection of both A. lumbricoides (KK 97.3%, MM 69.5%) and hookworm (KK 95.1%, MM 80.8%). The CR of a single dose of mebendazole varied significantly between the KK and MM for both A. lumbricoides (p = 0.016) and hookworm (p = 0.000), with lower rates obtained with the KK. On the other hand, the FECR was very similar between both techniques for both A. lumbricoides and hookworm.ConclusionThe MM did not add any diagnostic value over the KK in areas where both STHs and trematodes were co-endemic. The lower sensitivity of the MM would have an important impact on the administration of selective school-based treatment in this area since if only the MM were used, 36 (13.9%) children diagnosed with A. lumbricoides would have gone untreated.

Effect of intraarticular steroid injection in addition to physical modalities in osteoarthritis knee

Context: Osteoarthritis (OA) is the most common form of arthritis accounting for about 30% of general physician visits. Intrarticular (IA) corticosteroid injections have been used for decades in clinical practice for pain relief and control of local inflammation in OA. In the present study a combined therapy of long acting intra-articular injection in addition to physical modalities of OA knee was given to find out the functional improvement and clinical outcome of the patient. Methods: It was a prospective interventional non-randomized clinical study conducted in the Department of Physical Medicine &amp; Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from October, 2011 to March, 2012. Fifty four patients between 35 and 75 years without consideration of gender with a history of not less than three months knee pain with radiographic confirmation of primary osteoarthritis were selected purposefully. Then they were divided randomly in group A and B, having 27 patients in each group. Group A received NSAID (non steroidal anti-inflammatory drugs) i.e. aceclofenac 100mg twice daily for 10 days + omeprazol 20mg twice daily for 10 days + MWD (micro wave diathermy 20 minutes for 14 days. + therapeutic exercise + ADL (activities of daily living), while Group B received 80mg intraarticular triamcinolon acetonide injection once followed by NSAID i.e. aceclofenac 100mg twice daily for 10 days + omeprazol 20mg twice daily for 10 days + MWD 20 minutes for 14 days. + therapeutic exercise + ADL. In both groups the patients were observed for six weeks. Results: The mean of age of patients in group A and B were 52.33±9.62 years and 52.29±9.67 years respectively. In group A, 9 (33.3%) were male and 18 (66.7%) were female. In group B, 10 (37.0%) were male and 18 (63.0%) were female. Mean visual analogue scale (VAS) during pre treatment in group A and group B were 6.22±1.60 and 7.15±1.56 respectively. Mean range of motion (ROM) during pre treatment in group A and group B were 117.33±13.05 and 112.37±19.01 respectively. Mean time taken to walk 50 feet during pre treatment in group A and group B were 18.22±2.39 and 18.81±2.13 minutes respectively. Mean Western Ontario and Mc Master Universities (WOMAC) index in group A and group B were 60.85±15.86 and 67.33±16.33 minutes respectively. After treatment in both groups visual analogue scale (VAS), range of motion (ROM), time taken to walk 50 feet and Western Ontario and Mc Master Universities (WOMAC) index gradually decreased and range of motion (ROM) gradually increased, which were statistically significant. However, the study conducted with small sample size in a single centre in Dhaka city, which may not be representative for the whole country. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22694 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 48-54

Correlation between synovial vascular endothelial growth factor, clinical, functional and radiological manifestations in knee osteoarthritis

Aim of the workTo correlate between synovial vascular endothelial growth factor (VEGF), clinical, functional and radiological findings in knee osteoarthritis (KOA) patients. Patients and methodsTwenty patients with primary KOA were clinically examined and the modified Ritchie articular index (RAI) recorded. The knees were examined and knee pain evaluated by the visual analog scale (VAS) and tenderness by the knee subscale of the RAI. The Western Ontario Mc Master scale (WOMAC) was recorded and the Kellgren–Lawrence grading used to assess radiographic severity. The synovial level of VEGF was assessed using ELISA. ResultsThe mean age was 56.15±7.77years and body mass index 28.1±4.04. All patients had knee effusion; 40% were bilateral and 60% unilateral. The mean duration of knee pain was 3.01±1.43years; duration of morning stiffness was 15.75±3.72min. The mean WOMAC was 44.22±11.46 and modified RAI 5.45±2.94. The mean knee subscale of RAI was 2.9±1.16 and VAS for knee pain 5.7±2.92. The mean synovial VEGF level was 693.71±314.63pg/ml. There was a significant increase in the synovial VEGF compared to the reference value (p=0.0001). There was a significant correlation between the synovial VEGF and patients’ age (p=0.04), knee pain duration (p=0.025), morning stiffness (p<0.0001), modified RAI (p=0.0001), knee subscale of RAI (p<0.0001), VAS for knee pain (p<0.0001) and WOMAC (p=0.0001). There was a significant negative correlation between synovial VEGF and muscle strength grading (p=0.0001) and a significant correlation with the radiological assessment (p=0.0001). ConclusionSynovial VEGF significantly correlated with clinical manifestations, functional impact, as well as radiological changes of KOA.

AB1124 The Importance of the Early Rehabilitation after Total Knee Replacement in Osteoarthritis and Rheumatoid Arthritis Patients

BackgroundTotal knee replacement (TKR) revolutionized management of patients with advanced knee osteoarthritis and rheumatoid arthritis, in order to help them overcome pain and functional limitation, with very good long-term results.ObjectivesOur...

Assessment Mother`s Satisfaction of postpartum care

AbstractIntroduction: Nowadays patient’s satisfaction has an important role in medical care. Therefore consideration of patient’s expectation is necessary for improving quality of midwifery care. The aim of this study to assess patients’ satisfaction with postpartum care in teaching and nonteaching hospitals in Tabriz,Iran.Materials and Methods: This was descriptive comparative study in which 270 mothers were recruited from Alzahra, Taleghani and 29 Bahman hospitals in Tabriz. Mother`s satisfaction questionnaire was used to evaluate the satisfaction of four aspects of care (Physical, Providing necessary information, Ethical and Emotional).Results: Overall mother’s satisfaction rate of caregivers during postpartum was 78/5% and 86/3% in teaching and non-teaching maternity hospitals respectively. The results of this study showed that the mother’s satisfaction rate regarding providing necessary information by caregivers were very low. Mother’s dissatisfaction rate was 47% and 37% in teaching and non-teaching maternity hospitals respectively. There were a significant difference between mother’s satisfaction in aspect ethical in teaching and non-teaching maternity hospitals.Conclusion: Satisfaction rate in non teaching-hospitals was higher than teaching hospitals in both labor and delivery phase and one of the reasons for low satisfaction in teaching-hospitals is the presence of students and a large number of care givers in teaching hospitals. So that it is necessary to encourage care givers to give mothers necessary educations. This shows the importance more attention maternity services liable and directors in securing and promotion Mother`s health.Key words: Care, Satisfaction, Normal Vaginal Delivery, postpartum REFERENCES Azari S, Sehhati F, Ebrahimy H (2010).[Mothers’ satisfaction from cesarean cares in Public and Private Tabriz Hospitals in 2010]. Tabriz Nursing &Midwifery faculty, Iran MSc thesis. 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(2000).Women`s Experiences Of Maternity Care: Satisfaction Or Passivity. Social Science & Medicine , (51), 103-113. Mackey MC, Flanders Stepans ME. (1994). Women’s evaluation of their labor and delivery nurses. JOGNN , 23(5) 413-420. Mirmolaei S, Mehran A, Rahimi Ghasbeh S. (2004). [Mothers opinions concerning the importance of and their satisfaction with support received in the labor and delivery rooms]. Hayat . 9 (17) 41-47. (Persian) Mirmolaei S, Khakbazan Z, Kazemnead A, Azari M. (2007). [Prenatal care utilization rate and patients satisfaction]. Hayat . 13 (2) 31-40. (Persian) Ordibeheshti Khiaban M. (1998). [Women`s Expectation of Maternal Care Givers in Education Tabriz Maternity Hospitals].Un published Master`s thesis, Tabriz Nursing &Midwifery faculty, Iran. (Persian)Page LA(2000).The new midwifery science and sensitivity in practice, 1st ed.Churchill Livingstone, London.Peterson W. (2004). Adolescent Mothers`Satisfaction with Postpartum Nursing Care: Quantitative and Qualitative Approaches. Unpublished PhD thesis, Mc Master university. Robledo IJ. (1997). the Impact of Childbirth Preparation and Support on Labor and Birth Outcome. Unpublished PhD thesis, university of Rhode Island. Rudman A, El-Khouri B, Waldenstrom U. (2007).Women’s satisfaction with intrapartum care – a pattern approach. Journal of Advanced Nursing. 59(5) 474–487.Simbar M, Dibazari Z, Abedsaidi J,Alavimajd H(2005). [Assessment of quality of care in postpartum wards of Shaheed Beheshti Medical Science University hospitals,. Pajohande Journal]. 10(43) 49-45.(Persian)Sharami SH, Zahiri H, Zendedel S. (2007). [Assessment the Client satisfaction in Prenatal Unit of Rasht Public Hospitals]. Gilan University of Medical Sciences Journal. 17 (66) 29-37. (Persian)Waldenstrom U,Brown S,Mclachlan H,Forster D,Brennecke S. (2000). Does team midwifey care increase satisfaction with antenatal, intrapartum, and postpartum care? A randomized controlled trial.Birth. 27(3)156-167. Zolfaghari B, Kabiri P, Oveic Gharan SH. (1997). [Development and Validation of an Instrument to measure Patient satisfaction with hospital services]. Esfahan University of Medical Sciences Journal. 3 (2) 136-142. (Persian)

Prevalence and abundance of Eimeria spp. infection in captive vicuñas (Vicugna vicugna) from the Argentinean Andean Altiplano

Two hundred and thirty-five faecal samples from adult and young captive vicuñas from the Abra Pampa Experimental Station of the National Agricultural Technology Institute (Jujuy Province, Argentina) were obtained in May and November 2011 in order to study the prevalence and abundance of Eimeria spp. Faeces were individually assessed by two methods: the modified Mc Master technique for the diagnosis of the smaller Eimeria species: E. punoensis, E. alpacae and E. lamae and the sedimentation–flotation technique for the detection of the bigger Eimeria species: E. macusaniensis and E. ivitaensis. The five species of Eimeria of South American camelids were found in the vicuñas population with prevalence ranging from >65% (E. punoensis and E. alpacae in both ages and also E. macusaniensis in young vicuñas) to <2% (E. ivitaensis in both ages). The juveniles showed both higher prevalence and mean abundance than adults for most coccidian species, except for E. ivitaensis. E. punoensis exhibited the highest prevalence in young and adult vicuñas whereas the highest mean abundance in juveniles was due to E. lamae (May) and E. punoensis (November). In adult vicuñas, smaller Eimeria had a higher prevalence and mean abundance than the bigger ones for both sampling dates. Most (>70%) of adult and young vicuñas were concurrently infected by two to four Eimeria species. Despite the high oocysts’ outputs in some juveniles no clinical signs of coccidiosis were seen in them. The epidemiological patterns of Eimeria spp. infections in vicuñas are discussed.

Bovine trypanosomosis and gastrointestinal helminthosis in settlement villages of Bedele district, South-western Ethiopia

This cross-sectional study was carried out from October 2011 to March 2012 to assess the concurrent infections of bovine trypanosomosis with gastrointestinal (GI) helminthes in Peasant Associations of Bedele district settlement areas located in Illubabor Zone, Southwestern part of Ethiopia. A total of 500 randomly selected cattle were examined using Buffy Coat Technique and coprological examinations. Faecal examination was done by sedimentation and flotation techniques following the standard procedures to identify eggs of parasitic helminthes. Those faecal samples that were positive for flotation technique were subjected to eggs per gram (EPG) count using Mc Master egg counting technique and the degree of infestation was categorized as light, moderate and severe. Out of total cattle examined, 21(4.2%) were positive for Trypanosoma congolense and 321(64.2%) were found to harbor one or more gastrointestinal helminthes infection. Helminthes identified were Fasciola species (51.4%), paramphistomum species (18.7%), the protozoan Eimeria species (6.2%), Trichuris species (6.85%), Trichostrongyles (11 %) and mixed infections (6%). The overall mean PCV value recorded was 26.7±3.9 and it was 26.8±3.9 in trypanosome negative animals and 22.9±3.3 in trypanosome positive animals. The overall mean EPG recorded was 172±99.6. Among 21 cattle found positive for T. congolense, 18 (85.7%) were concurrently infected with (GI) helminthes particularly Fasciolosis (38.1%) and statistically there was significant association (P &lt; 0.05) between trypanososmosis and GI helminthes infection. Age and sex of sampled cattle were not found to influence GI helminthes prevalence (p&gt;0.05). Infection with T. congolense and Fasciola species is the most prevalent form of co-infection in cattle within study areas. In conclusion, any attempts to control or prevent trypanosomosis or GI helminthes infection through different management approaches, need to address the possibility of concurrent infections especially in trypanosomosis endemic areas to save the losses in advance.Key words: Bedele, Cattle, Concurrent, Ethiopia, GI helminthes, Trypanosomosis

A Study to assess the effectiveness of Video Teaching Programme (VTP) on Non Drug Pain Relief Measures of Osteoarthritis among Elderly in Selected Old Age Homes, Coimbatore, Tamil Nadu

Introduction: Old age cannot be healed or prevented. However much can be done by health workers in helping the elderly to lead a normal life, which is necessary for them to perform their activities of daily living (ADL) smoothly. The commonest obstacle for elderly to carry out ADL is the problem of joint-pain and decreased mobility. Objective: A study to assess the effectiveness of Video Teaching Programme on Non drug pain relief measures of Osteoarthritis (heat and cold therapy and proper body mechanisms) among elderly for improving their knowledge and practice towards non drug pain relief measures. Design: Quasi Experimental Design- One group Pre test and Post test design Setting: The study was conducted at Old Age Home in Coimbatore. Participants: 27 Elderly clients with Osteoarthritis. Measurements and tools: A assessment tool to identify the clients with Osteoarthritis and WOMAC (Western Ontario and Mc Master Universities) tool for identifying the severity of Osteoarthritis. Structured Interview Schedule and Observation Checklist to assess the knowledge and practice of Non drug pain management of clients with Osteoarthritis. Descriptive and inferential statistics were used to analyze the data. Findings: The findings of the study revealed that among 27 clients, the highest percentage (45%) of patients were in the age group of 60-65 years. 59% of clients are male. Most of the clients (33%) were educated up to primary education and had a history of previous occupation like semi manual work respectively. Highest percentage of clients (70%) were non vegetarians. 89% of clients were obese. 15% of clients have medical illness of CAD and 33% of clients not having any health problems. 74% of clients have joint pain more than 5 years. 89% of clients not using any assistive devices for mobilization. In pre test knowledge mean score was 2.778±1.706, the mean percentage is 34.73, whereas in post test it was 7.519±0.625, the mean percentage is 94, it shows that after implementation of VTP the clients gained excellent knowledge on non drug pain relief measures. Whereas in pre test practice mean score was 5.44±1.387 and mean % was 30.22 where as in post test it was 14.33±4.094 and mean % was 79.61, it shows that clients had fully adoptive practice after the video teaching programme. There was highly significant difference was found between pre test and post test knowledge and practice. Whereas there is a significant association between knowledge score and osteoarthritis clients education, previous occupation, type of diet and usage of any assistive devices for ambulation. There is significant association between the practice score with the demographic variables of age and duration of joint pain. There was highly significant difference between severity of osteoarthritis pre and post test practice scores. Positive correlation was found between pre and post test knowledge and practice scores. Conclusion: It concluded that the education on Non drug pain relief measures through demonstration will improve the elderly client's knowledge and practice of self care.

Epidemiology of stroke in the elderly in the Nordic countries. Incidence, survival, prevalence and risk factors

Objective: To review what is known at present with respect to incidence, survival, risk factors and prevalence among the elderly stroke patients in the Nordic countries.Method: This article is based mainly on literature identified through search engines (Mc Master Plus, Cochrane Library, Medline and PubMed), restricted to first-ever stroke in Nordic population-based studies and having applied to the standard WHO definition, a prospective study design and no upper age limit.Results: Data from the Nordic countries show an incidence rate of 1250 to 1796/100 000 in the age group 75-84, and 1628 to 2234 in those above 85 years. The incidence rates are higher among men, but women are expected to contribute more to incident cases due to their higher life expectancy. If the age-specific incidence of stroke remains stable, the proportion of stroke patients aged 80 years and older may reach 50% in a few decades. The elderly stroke patients have a higher 30-days case fatality, and a higher risk of dependency. Better treatment of stroke patients has improved the survival over the last two decades. The prevalence is expected to increase due to the decrease in lethality, a slower fall in incidence and a higher proportion of elderly. Cardiovascular risk factors increase with age. Hypertension is a major risk factor for stroke mortality in the elderly. Cardioembolic stroke due to atrial fibrillation is the most common stroke subtype in the elderly. Lifestyle risk factors are less prevalent in the older stroke patients.Conclusion: The growing proportion of elderly stroke patients is a major challenge for future stroke care. The elderly stroke patients have a different risk factor profile compared to younger stroke patients. Treatment should focus on regaining independency. The age-specific epidemiology of stroke needs to be studied further in large studies in order to plan for future health care.

Functional exercise after total hip replacement (FEATHER) a randomised control trial

BackgroundProlonged physical impairments in range of movement, postural stability and walking speed are commonly reported following total hip replacement (THR). It is unclear from the current body of evidence what kind of exercises should be performed to maximize patient function and quality of life.Methods/designThis will be a single blind multi centre randomized control trial with two arms. Seventy subjects post primary total hip arthroplasty will be randomized into either an experimental group (n=35), or to a control group (n=35). The experimental group will attend a functional exercise class twice weekly for a six week period from week 12 to week 18 post surgery. The functional exercise group will follow a circuit based functional exercise class supervised by a chartered Physiotherapist. The control group will receive usual care. The principal investigator (BM) will perform blinded outcome assessments on all patients using validated measures for pain, stiffness, and function using the Western Ontario and Mc Master Universities Osteoarthritis index (WOMAC). This is the primary outcome measurement tool. Secondary outcome measurements include Quality of life (SF-36), 6 min walk test, Visual Analogue Scale, and the Berg Balance score. The WOMAC score will be collated on day five post surgery and repeated at week twelve and week eighteen. All other measurements will be taken at week 12 and repeated at week eighteen. In addition a blinded radiologist will measure gluteus medius cross sectional area using real time ultrasound for all subjects at week 12 and at week 18 to determine if the functional exercise programme has any effect on muscle size.DiscussionThis randomised controlled trial will add to the body of evidence on the relationship between muscle size, functional ability, balance, quality of life and time post surgery in patients following total hip arthroplasty. The CONSORT guidelines will be followed to throughout. Ethical approval has been gained from the Ethics committee Health Services Executive Dublin North East.Trial registrationThis trial is registered with ClinicalTrials.gov (a service of the United States National Institutes of Health) identifier NCT01683201

RESISTENCIA A ANTIHELMÍNTICOS Y PREVALENCIA DE FASCIOLOSIS BOVINA EN LA GANADERÍA LECHERA DE JAUJA, PERÚ.

The objective of this study was to determine the prevalence of Fasciola hepatica through coprological analysis in dairy cattle in the district of Huertas, province of Junin, Peru and to evaluate the efficacy of two anthelmintics frequently used in the region: triclabendazol (TBCZ) and albendazol (ABZ). Faecal samples were collected from 387 cows in 30 farms. Samples were analysed by the spontaneous sedimentation test and the modified Mc Master test. The prevalence of F. hepatica was 38.2%, with a mean of 16 eggs per gram of faeces (epg) and a range of 1 to 197 epg. Furthermore, 26 farms (86.7%) were positive to F. hepatica. The faecal egg count reduction test (FECRT) was used for evaluating the parasite resistance to the two anthelmintics. For this, 75 animals with more than 12 epg were selected and randomly allocated to two groups: a) TCBZ, 12 mg/kg body weight (n=39) and b) ABZ, 10 mg/kg body weight (n=33). Both drugs were orally administered. The efficacy of TBCZ on days 7, 14, 21, and 28 was 53.4, 53.3, 36.4, and 34.9% respectively, whereas ABZ was zero in all cases. It is concluded that dairy cattle in Huertas, Jauja has a high prevalence of F. hepatica and the parasite shows resistance to albendazol and triclabendazol.

The comparison of parasite eggs and protozoan cysts of urban raw wastewater and efficiency of various wastewater treatment systems to remove them

One of the most important quality characteristics associated with wastewater reuse in agriculture is the microbial quality. This study aimed to determine the efficiencies of Ghasreshirin (constructed wetland), Islamabadgharb and Gilangharb wastewater treatment plants (stabilization ponds), Sarpolezahab and Paveh (extended aeration activated sludge) and Kermanshah (conventional activated sludge) in the removal of protozoan cysts and parasitic eggs.This study was carried out during six months and samples were collected at weekly intervals from influent and effluent of the wastewater plants. In order to determine the concentration of ova, 288 samples were analyzed by Mc Master Slide according to Bailenger method.No parasite eggs or protozoan cysts were detected in the effluents of the constructed wetland or stabilization ponds systems. The extended aeration activated sludge system of Sarpolezahab removed 99–100% of parasite eggs and ≥99% of protozoan cysts. The respective values for extended aeration activated sludge system of Paveh were 97.5–100% and ≥99%. However, the conventional activated sludge of Kermanshah removed 97–99% and 99–100% of parasite eggs and protozoan cysts, respectively.According to the results, removal efficiency for cysts and parasite eggs in natural systems (constructed wetland and stabilization ponds) is better than mechanical systems (extended aeration activated sludge and conventional activated sludge). The effluent quality of all systems in terms of nematode eggs is consisted to Engelberg index (nematode eggs count: 1≥counts per liter).

Prevalence and intensity of gastro-intestinal helminths in horses in the Sudano-Guinean climatic zone of Cameroon

Background:It is important to understand the biology and health impact of parasites affecting horses in the Western highlands of Cameroon.Aim:to evaluate the prevalence and intensity of infection of gastrointestinal helminths in these animals.Materials and Methods:A total of 894 horses (367 males and 527 females), and aged ≤1 to ≥7 years old were examined. A parasitological investigation of faeces was carried out using two techniques: concentration method of Full Born Willis (flotation in saturated solution of sodium chloride) and Mc Master Technique.Results and conclusions:From the results the overall prevalence was 100%. Nine species of nematode (Parascaris equorum, Oxyuris equi, Habronema sp., Strongyloides westeri, Dictyocaulus arnfieldi, Trichostrongylus axei, Cyathostome sp., Triodontophorus sp., Strongylus sp.) were identified with the prevalence of 18.48%, 16.94%, 2.99%, 6.05%, 5.22%, 7.75%, 12.49%, 1.09%, and 22.26%, respectively, and one species of cestode (Anoplocephala magna) with a prevalence of 6.73%. Strongylus sp. had the highest mean intensity of infection (1270±942) in female horses. Poly-parasitic infections (92.28%) were more common than mono-parasitic infections (7.72%).

Effect of Antihypertensive Drugs on Quality of Life in Elderly Patients

The use of drugs to increase human happiness and to improve the quality of life physically, mentally and socioeconomically is a serious matter of concern. Chronic disabling conditions become common in old age and affect the quality of life. Quality of life (QOL) is an important measure of health care, which measures the gap between expectations and achievements. Effect of Drug use on quality of life in elderly Indian population with hypertension was studied using Mc Master Health Index. The study population was divided into test group (hypertensive patients on regular treatment) and control group (Not on any treatment or on treatment for less than 3 months). All three parameters of QOL namely physical, emotional and social were studied using Mc Master Health Index questionnaire. The results were statistically compared using ANOVA and chi square. Our results point toward better overall QOL in patients on regular treatment.