An Observational Study on the Treatment Pattern of Leprosy

INTRODUCTION: Leprosy is a disease of public health concern mainly because of its potential to cause disability in a small proportion of those affected and is a cause for social stigma and discrimination [1]. The World Health Organization’s (WHO) 2011-2015 global strategy for leprosy control focuses on reducing the rate of new leprosy cases with grade II disabilities per 100,000 people by at least 35% at the end of 2015 taking 2010’s occurrence as reference. Leprosy, also known as Hansen’s disease (HD) is a chronic infectious disease caused by Mycobacterium leprae, principally affecting the peripheral nerve, mucosa of the respiratory tract and the skin of human being. HISTORY AND PREVALENCE: Leprosy has affected humanity for over 4,000 years, and was well-recognized in the civilizations of ancient China, Egypt, and India [3].Leprosy was referred to as “Kushtha” in ancient India. The first authentic description of leprosy and its treatment is given in “Sushruta Samhita”, a treatise written in India in 600 BC [4]. Hansen's disease named after a physician called Gerhad Armaver Hansen who discovered ‘Mycobacterium leprae in 1873 [2]. Till the introduction of the drug Dapsone in 1940s there was no treatment for this disease; patients were kept in isolation. India contributes to more than 50 % of new cases detected globally every year .A total of 1.27 lakh new cases were detected during the year 2011 -2012.A total of 0.83 lakh cases are on record as on 1st April 2012 given the prevalence rate (PR) of 0.68 per 10,000 population. AIM OF THE STUDY: Study the treatment pattern of leprosy in two districts in Kerala OBJECTIVE OF THE STUDY: 1. To study the prevalence of the disease. 2. Monitor presence of adverse drug reaction, 3. To study the treatment pattern of leprosy including lepra reactions 4. Assess adherence to drug therapy DISCUSSION: A prospective observational study was carried out for six months among the leprosy patients in two districts in Kerala (Malappuram and Calicut).The study was carried out to determine the prevalence, treatment pattern and drug related problems among the leprosy patients. During our study period 40 cases were reported from Malappuram district and 64 from Calicut. So the prevalence of leprosy in Malappuram and Calicut district was found to be 0.001 and 0.002 respectively. In the current study among among a total of 104 patients included, 49 (47%) were in the age group of 31-50 years. The mean age was 42.13±18.61 years. Nearly 6% of the patients were aged less than 15 showing the transmission is still going on the community. This high prevalence in younger age group calls for more vigorous means of case detection like active search for cases especially in communities known to be leprosy endemic. 104 patients were enrolled in the study, of them 74(71%) were males and 30(29%) were females, demonstrating male predominance over female population. This result is similar to study conducted by B.L Ajibade et-al (2) in which 79.7% was males. No significant association could be found out between the residential status of patient and disease. Leprosy, an ancient disease, was thought to be confined to rural and underdeveloped geographical areas. But, on the contrary, our study found no such association, as we found an equal prevalence or incidence of the disease in urban and rural regions. According to our study, the most prevalent type of leprosy was found to be multibacillary (MB) with 86 cases (83%) while paucibacillary (PB) type accounted for only 18(17%) cases. Similar results were shown in studies conducted by B.L Ajibade et-al(2) and Sileshi Baye(18) .The definition of PB leprosy has been evolving over the last two decades, with an increasing number of erstwhile PB patients being included in the MB group for the treatment purpose. This might be one of the important reasons for the progressive shrinking of the pool of PB cases in our study (21).Male gender (63%) showed significant association with multibacillary leprosy. Considering clinical form of leprosy Borderline tuberculoid (BT) form (75%) was found to be predominant over other forms. These results showed similarity with the study conducted by S.Karat et-al. CONCLUSION: Leprosy is a chronic disease caused by bacteria Mycobacterium leprae that causes damage to skin and peripheral nervous system. The disease develops slowly and results in skin lesion and deformities, most often affecting the cooler places on the body. A prospective observational study was carried for a period for 6 months among the leprosy patients in two districts in Kerala .The total number of cases collected for the study purpose was 104 and the findings of the study reveals that most of the patients were in the age group of 31-50 years and the male patients were predominant over the female population. The most prevalent type of leprosy was found to be multi - bacillary (MB) and among these MB cases, borderline tuberculoid was most commonly reported. Hypo pigmented patches were the most common type of cutaneous lesions observed in leprosy patients taking multidrug therapy. The finding of the study also illustrates that delay in diagnosis of patients augments the transmission of infection, and allows progression of disease and more severe disability.74% of the Multi - bacillary patients were treated with MDT-MB regimen with Dapsone, Rifampicin and Clofazimine and 16% of the paucibacillary patients were treated with MDTPB regimen with Dapsone and Rifampicin. The most common ADR found by using the MDT regimen was anemia and it was managed by using iron supplements. Adverse effects attributed to MDT are comparable to previous studies and we found that ADR due to Dapsone was very high. If patients are properly informed about the common ADR and are advised to report to their health care provider if and when ADRs occur, and are appropriately motivated about the benefits of MDT, most can be managed by MDT only with supportive treatment, without replacing the suspected drug, except in few cases with serious, complicated or life threatening ADR. The continuing occurrence of new cases means that the first priority is the need for these cases to be detected early and treated effectively to cure leprosy and prevent disability. If we fail to do this then the prevalence of leprosy will start to increase and all that has been achieved will be lost. MDT introduction came with additional benefits such as an intense monitoring of patients, coverage of affected populations, and improvement of the closeness between leprosy patients and medical care, and that leprosy changed into a curable disease. There are three important principles for leprosy work in the future. It includes ;Sustainability (new cases of leprosy are continuing and many of the consequences are lifelong so our approaches need to be sustainable) , the leprosy workers cannot do everything themselves(they need to work in alliances at all levels with other agencies, other health care workers, social services, communities, patients themselves and their families),Anti-leprosy services need to be integrated with general health and social services(this includes training, primary health care, hospital care, and community based rehabilitation) Finally we would like to emphasize the importance of a proper health education, daily ulcer care and shoe adjustments as systemic therapy and also to prevent the development of new ulcers. LIMITATIONS OF STUDY: The study was a cross-sectional study and thus the follow-up of patients was not possible. Due to fear of stigma and discrimination some patients were not willing to cooperate with the study. Immigrant patients were been excluded because of the difficulty in obtaining the relevant information. The questionnaires were filled with the help of Assistant Leprosy Officers of the respective hospitals, because patients visited the leprosy centre one time per month. So it was difficult for us to fill up the questionnaires There is a chance of reporting bias

INTERLEUKIN-18 GENE POLYMORPHISM AND SOME RISK FACTORS IN IRAQI PATIENTS WITH BREAST CANCER

Objective: Breast cancer is the most diagnosed cancer in women, which leads to death in a lot of women with breast cancer. The major risk factors associated with breast cancer risk related to family history, age, clinical history, lifestyle factors, long-period hormonal exposure, and single nucleotide polymorphisms in many genes showed possible links with breast cancer incidence risk in different people populations. Our study aimed to figure out the correlation between smoking, lodging and family history, and other factors with the risk of breast cancer.Methods: Blood sample from female patients with breast cancer and healthy individuals were collected and subjected to tetra-amplification refractory mutation system–polymerase chain reaction (T-ARMS-PCR) technique for −607 C/A mutation of an interleukin (IL-18) gene and SPSS 18 software analyzed the results statically.Results: Results showed no association between lodging and smoking with risk of breast cancer, (p>0.05), while the association between the risk and family history were obvious (p<0.05).Conclusion: The results obtained by T-ARMS-PCR technique did not show the association between −607 C/An alternation of IL-18 gene and breast cancer (p>0.05) in the individuals examined in our study.Keywords: Interleukin-18, Gene, Polymorphism, Tetra-amplification refractory mutation system–polymerase chain reaction, Mutations

Evaluating the tracking e-Files prototype project based on the task technology fit model

Locating files in an exact time is considered one of the greatest problems and the tedious process in universities nowadays. This problem becomes greater when the university has a large number of departments and transactions, as well as the documents are moving from one department to another. Especially, developing countries that have many problems and unstable environment and that may lead to lost or damage the important documents that influence on the decision making. Furthermore, the traditional manner not only wasted the time and energy, but also the paper cost for printing copies of required file. And with the advancement of technology and the increase of Internet users, documents are still being sent in Iraqi universities manually between departments. Although the higher education and scientific research ministry was recommended the public universities for using modern technologies during the daily transactions between the departments or amongst the units.  Therefore, this study sought to design and evaluate the prototype system which tracks movements of the documents from one department to another as well as check the completion rate for each department. For providing opportunities to assess how well the use of e-file tracking system meets the needs of management units in universities. The systems implementation research notes the need to fit between tasks, technologies and users.  Thus, this empirical study utilized the task technology fit model for this purpose. The results from selected participants indicated that all the factors significant effect on the employee’s performance in E-file Tracking System, excepted, task characteristics. This study will be contributed to reduce the corruption and enhance the transparency and help the decision-makers make the right decision at the right time

Attitudes of Palestinian Undergraduate Students Towards Native and Non-Native English Language Teachers and Their Relation to Students’ Listening Ability

The purpose of this study is to investigate the attitudes of Palestinian undergraduate students towards native and non-native English language teachers and their relation to students' listening ability. To achieve this purpose and to answer the research questions and test the hypotheses, the researchers adopted both the descriptive and inferential approaches. For collecting data, a questionnaire and a listening test were designed and distributed among 120 Palestinian undergraduate students to find out their attitudes towards both their NES and NNES and their relation to students' listening ability. After the statistical analysis, the major findings of the study revealed that attitudes of Palestinian undergraduate students towards Native and Non-Native English language teachers were moderate in all items and sections, except for the teaching culture which was found to be with low attitudes for native teachers. The findings also pointed out that the listening ability of Palestinian undergraduate students towards native and non native English language teachers were higher for those who studied with native teachers compared to those who studied with non native teachers. The findings also highlighted that there were significant differences in the mean scores of the listening ability for Palestinian undergraduate students towards native and non native English language teachers due to university. Based on the research findings some recommendations are finally presented. The researchers concluded that students generally have positive attitudes towards both teacher types (Native and Non-Native English language teachers), but the highest degree of the respondents’ preferences and attitudes are for and towards non native. Furthermore, the relation between attitudes towards both teacher types and listening ability isn't found. There is more than one explanation for this, may be students have an innate ability to listen to many types of speakers and comprehend and being guided through the process of listening may lead the students to get rid of the feelings of fear from speakers when they listen

Attitudes of Palestinian Undergraduate Students Towards Native and Non-Native English Language Teachers and Their Relation to Students’ Listening Ability

The purpose of this study is to investigate the attitudes of Palestinian undergraduate students towards native and non-native English language teachers and their relation to students' listening ability. To achieve this purpose and to answer the research questions and test the hypotheses, the researchers adopted both the descriptive and inferential approaches. For collecting data, a questionnaire and a listening test were designed and distributed among 120 Palestinian undergraduate students to find out their attitudes towards both their NES and NNES and their relation to students' listening ability. After the statistical analysis, the major findings of the study revealed that attitudes of Palestinian undergraduate students towards Native and Non-Native English language teachers were moderate in all items and sections, except for the teaching culture which was found to be with low attitudes for native teachers. The findings also pointed out that the listening ability of Palestinian undergraduate students towards native and non native English language teachers were higher for those who studied with native teachers compared to those who studied with non native teachers. The findings also highlighted that there were significant differences in the mean scores of the listening ability for Palestinian undergraduate students towards native and non native English language teachers due to university. Based on the research findings some recommendations are finally presented. The researchers concluded that students generally have positive attitudes towards both teacher types (Native and Non-Native English language teachers), but the highest degree of the respondents’ preferences and attitudes are for and towards non native. Furthermore, the relation between attitudes towards both teacher types and listening ability isn't found. There is more than one explanation for this, may be students have an innate ability to listen to many types of speakers and comprehend and being guided through the process of listening may lead the students to get rid of the feelings of fear from speakers when they listen. Keywords: Attitudes, Palestinian undergraduate students, native and non-native, language teachers, listening abilit

Complex Discrete Wavelet Transform-Based Image Denoising

Dual tree complex discrete wavelet transform is implemented for denoising as an important image processing application. Two wavelet trees are used, one generating the real part of the wavelet coefficients tree and the other generating the imaginary part tree. A general computer program computing two dimensional dual tree complex wavelet transform is written using MatLab V.7.0. for a general (NxN) two dimensional signal. This paper introduces firstly a proposed method of computing one and twodimensional dual tree complex wavelet transform .The proposed method reduces heavily processing time for decomposition of image keeping or overcoming the quality of reconstructed images. Also, the inverse procedures of all the above transform for multi- dimensional cases verified. Secondly, many techniques are implemented for denoising of gray scale image. A new threshold method is proposed and compared with the other thresholding methods. For hard thresholding, PSNR gives (13.548) value while the PSNR was increased in the proposed soft thresholding, it gives (14.1734) PSNR value when the noise variance is (20). Denoising schemes are tested on Peppers noise image to find its effect on denoising application. The noisy version has SNR equals to (11.9373 dB), the denoising image using WT has SNR equals to (17.4661 dB), the denoising image using SWT has SNR equals to (18.1459 dB), the denoising image using WPT has SNR equals to (19.3640 dB), the denoising image using Complex Discrete Wavelet Transform has SNR equals to (21.9138 dB) using hard threshold and has SNR equals to (22.1393 dB) using soft threshold. Matlab V.7.0 is used for simulation

Antibacterial and Anticancer Properties of Zinc Oxide Nanoparticles: A Review of Current Advances and Future Directions

Zinc oxide Nanoparticles (ZnO-NPs) have a promising potential in antibacterial and anticancer treatments because of their ease of production, low toxicity, and versatility in application. This review encompasses recently developed synthesis, characterizing and biomedical applications of ZnO-NPs. Green synthesis methodologies, sol-gel, and precipitation influence the biological effectiveness of ZnO-NPs, these methods particularly affect key characteristics such as particle size, shape and surface charge. These properties play crucial roles in antibacterial effectiveness, which facilitates their ability to generate reactive oxygen species (ROS) and bacterial cell membrane disruption, leading to bacterial cell death. The efficiency of ZnO-NP in cancer treatment is also reviewed because the nanoparticles selectively affect cancer cells, which generate apoptosis and cease cell proliferation. Additional novel applications of ZnO-NPs further highlight their benefits because they improve the precise delivery of the drug and enhance its bioavailability. Additionally, ZnO-NPs had future uses in photodynamic therapy as their light-triggered ROS generation results in localized and selective bactericidal and anticancer effects without affecting normal cells. This review provides a comparative evaluation of recent findings on the antibacterial and anticancer properties of ZnO-NPs, as well as exploring the possible directions for futural research; in addition, it emphasizes improving the functional characteristics of ZnO-NPs for enhancing the therapeutic impact and reducing the unfavorable influences that may expand the list of possible clinical uses of ZnO-NPs

Phytochemicals, Nutritional and Anti-Nutritional Composition of Aqueous Extracts of White and Red Onions Bulbs

Onion bulbs have been consumed for foods and nutrition and management of many diseases including infections, diabetes, gastrointestinal disorders, cardiovascular and respiratory disorders. This study aims to evaluate the phytochemicals, nutritional and anti-nutritional composition of the aqueous extracts of white and red onions bulbs. Analytical techniques AOAC and AAS were used in phytochemicals and proximate analysis and determination of minerals, heavy metals, determination of anti-nutrients content of the aqueous extracts of white and red onions bulbs. The findings showed the presence of alkaloids, flavonoids, tannins, glycosides, saponins, steroids, cardiac glycosides, and anthraquinones in the aqueous extracts of red and white onions bulbs. The aqueous extracts of white and red onions bulbs contain significant (p < 0.05) amounts of moisture (89.68 and 87.04%), ash (3.22 and 2.03%), fiber (3.00 and 2.00%), carbohydrates (2.33 and 2.59%), proteins (3.19 and 1.04%), and crude lipids (1.22 and 2.66%), respectively. The aqueous extracts of white and red onions bulbs demonstrated significant (p < 0.05) level of potassium (987.10 and 756.24 ppm), sodium (42.50 and 32.50 ppm), calcium (8.90 and 6.10 ppm), phosphorus (3.87 and 4.04 ppm), zinc (2.32 and 1.13 ppm), magnesium (1.85 and 1.12 ppm), iron (0.62 and 0.58 ppm), and copper (0.47 and 0.17 ppm), respectively. Low concentrations of nickel (0.112 and 0.524 ppm), lead (0.034 and 0.023 ppm), cadmium (0.029 and 0.014 ppm), and chromiun (0.090 and 0.032 ppm) were observed in the aqueous extracts of white and red onions bulbs contain, respectively. The aqueous extracts of white and red onions bulbs exhibited moderate and low amounts of cynogenic glycosides (3.00 and 12.46 mg/100g), saponins (2.02 and 2.07 mg/100g), oxalate (0.63 and 3.75 mg/100g), tannins (0.90 and 1.09 mg/100g), and phytate (0.38 and 1.49 mg/100g), respectively. The aqueous extracts of white and red onions bulbs contain various phytochemicals and significant amounts of important nutrients with trace quantity of certain heavy metals and anti-nutrients

A novel AVR system utilizing fuzzy PIDF enriched by FOPD controller optimized via PSO and Sand Cat Swarm Optimization algorithms

Power system stability is managed through various control loops, including the Automatic Voltage Regulator (AVR), which regulates the terminal voltage of synchronous generators. This study integrated Fuzzy Logic Control (FLC) and a Proportional–Integral–Derivative controller with Filtered derivative action (PIDF) to propose a hybrid Fuzzy PIDF controller enhanced by Fractional-Order Proportional-Derivative (FOPD) for AVR applications. For the first time, the newly introduced Sand Cat Swarm Optimization (SCSO) algorithm was applied to the AVR system to tune the parameters of the proposed fuzzy controller. The SCSO algorithm has been recognized as a powerful optimization tool and has demonstrated success across various engineering applications. The well-known Particle Swarm Optimization (PSO) algorithm was also utilized in this study to optimize the gains of the proposed controller. The Fuzzy PIDF plus FOPD is a novel configuration that is designed to be a robust control technique for AVR to achieve an excellent performance. In this research, the Fuzzy PIDF + FOPD controller was optimized using the PSO and SCSO algorithms by minimizing the Integral Time Absolute Error (ITAE) objective function to enhance the overall performance of AVR systems. A comparative analysis was conducted to evaluate the superiority of the proposed approach by benchmarking the results against those of other controllers reported in the literature. Furthermore, the robustness of the controller was assessed under parametric uncertainties and varying load disturbances. Also, its robustness was examined against disturbances in the control signal. The results demonstrate that the proposed Fuzzy PIDF + FOPD controller tuned by the PSO and SCSO algorithms delivers exceptional performance as an AVR controller, outperforming other controllers. Additionally, the findings confirm the robustness of the Fuzzy PIDF + FOPD controller against parametric uncertainties, establishing its potential for a successful implementation in real-time applications