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Cavernous malformation/angioma: plum coloured sponge-like mass composed of a collection of blood filled spaces with no intervening brain tissue medicine quiz 500 mg glucophage sr with mastercard. For those presenting with haemorrhage medicine valley high school generic glucophage sr 500mg on-line, the risk of rebleeding may be higher symptoms nausea buy glucophage sr 500 mg with amex, particularly in the first year. Cranial bruit Auscultation, especially over the eyeball, occasionally reveals a bruit. All risk further damage and a team comprised of the neurosurgeon and neuroradiologist should decide on the optimal method or combination of methods for each patient. Larger lesions (> 6 cm) have a greater risk of postoperative hyperperfusion syndrome and brain swelling and carry a 40% risk of permanent neurological deficit. For lesions greater than 3 cm, the lower dose required to minimise the damaging effect of local tissue destruction, makes obliteration unlikely. Pre-treatment with embolisation helps only if this produces a segmental reduction in size. Despite the delay in action, radiosurgery may prove ideal for small deeply seated lesions. Embolisation: Skilled catheterisation permits selective embolisation of feeding vessels with isobutyl-cyanoacrylate, although this technique is not without risk. A around cavernous cavernous malformation may present malformations in the with epilepsy, haemorrhage or with temporal lobe focal neurological signs. Most lesions show marked signal change around this lesion due to a rim of haemosiderin deposition. The annual risk of haemorrhage is about 1% per year, but this varies depending on whether the lesion lies deeply (i. For deep lesions the risk of a bleed sufficiently severe to cause neurological signs is about 5% per year, whereas for superficial lesions, this is almost zero. Unfortunately the high risk, deep lesions are more hazardous to surgically remove, although this may be the appropriate management in selected patients. Patients present either in the neonatal period with severe high output cardiac failure due to the associated arteriovenous shunt, in infancy with cranial enlargement due to an obstructive hydrocephalus, or in childhood with subarachnoid haemorrhage. In the other groups the treatment of choice is now endovascular obliteration of the feeding vessels followed by ventricular drainage if required. As a result, the high mortality and morbidity experienced with direct operative repair has been considerably reduced. Arterial blood drains directly into either a venous sinus, cortical veins or a combination of both (see carotidcavernous fistula page 301). When retrograde venous flow occurs, venous hypertension results and haemorrhage may follow. For this type, treatment requires ligation and division of the draining vein, often combined with endovascular occlusion. Less often petrosal carotid-cavernous fistulae sinus occur spontaneously, perhaps from rupture of a small intracavernous Inferior meningeal artery or a petrosal saccular carotid aneurysm. Provided symptoms do not progress, for the first few months, treatment should be conservative. Endovascular: with detachable balloon catheterization, either through the transvenous or intra-arterial route, or by stent assisted coil embolisation. Fewer patients with metastatic tumours reach a neurosurgical centre, although the actual incidence must equal, if not exceed that of primary tumours. Adults Children In children, more tumours lie below the tentorium; gliomas and medulloblastomas predominate. A benign astrocytoma may infiltrate widely throughout brain tissue preventing complete removal, or may occupy a functionally critical site preventing even partial removal. A malignant intracranial tumour implies rapid growth, poor differentiation, increased cellularity, mitosis, necrosis and vascular proliferation, but metastases to extracranial sites rarely occur. Pathological classification In 2000, the World Health Organization drew up an internationally agreed classification of intracranial tumours based on the tissue of origin. The cell origin of the highly malignant glioblastoma is now recognizable as astrocytic rather than embryonal as previously classified. Histological features permit Composite diagram showing the separation into four grades characteristic features of a glioblastoma. Grading only reflects Mitosis Vascular the features of the biopsy specimen proliferation and not necessarily those of the whole tumour. Ependymal Ependymoma: Occurs anywhere throughout the ventricular system or cells and spinal canal, but is particularly common in the 4th ventricle and cauda choroid equina. Neurons Ganglioglioma/gangliocytoma/neurocytoma: Rare tumours containing ganglion cells and abnormal neurons occurring in varying degrees of malignancy. Small closely packed cells are often arranged in rosettes surrounding abortive axons. Most are benign (despite their Calcified tendency to invade adjacent psammoma bone) but some undergo bodies sarcomatous change. The haemangio-pericytoma is poorly differentiated, aggressive in nature and of uncertain histogenesis. It involves the spinal nerve roots or peripheral nerves but rarely affects cranial nerves and has a greater tendency to undergo malignant change than schwannoma. Cerebellar hemisphere In 1926, Lindau described a syndrome relating Xanthochromic cerebellar and/or spinal fluid haemangioblastomas with similar tumours in the retina and cystic lesions in the Reddish-brown tumour nodule lying in pancreas and kidney (Von the wall of the cyst. Usually a nodular tumour with cystic areas containing greenish fluid and cholesteatomatous material. Pituitary adenoma: Benign tumour, usually secreting excessive quantities of prolactin, growth hormone, adrenocorticotrophic hormone, thyrotropin or gonadotropin. The tumour invades the petrous bone and may extend into the posterior fossa or neck. Metastatic tumours: May arise from any primary site but most commonly spread from the bronchus or breast. Tumour markers Immunohistochemical techniques permit identification of antigens specific for certain cell or tissue characteristics and aid the histological diagnosis of tumours. Only 5% of patients have a family history of brain tumour and with the exception of tuberous sclerosis (related to the formation of subependymal astrocytomas) and neurofibromatosis (linked to an increased incidence of schwannoma, optic nerve glioma and meningioma) do not fall into an obvious autosomal recessive or dominant pattern. Occasionally tumours present acutely due to haemorrhage or the development of hydrocephalus. Intrinsic brain stem tumours in contrast to extrinsic tumours are more likely to produce long tract (motor and sensory) signs early in the course of the disease. Of particular value in tumours of the skull base, cranio-cervical junction and brain stem.
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Diagnosis Giardiasis can be diagnosed by parasite antigen detection in feces and/or examination of several samples from freshly collected stool specimens medicine 2355 order discount glucophage sr on line, with concentration methods used to medicine 6 clinic purchase generic glucophage sr online identify cysts (oval medicine youkai watch discount glucophage sr online amex, with four nuclei) or trophozoites (pear-shaped, flattened parasites with two nuclei and four pairs of flagella). Person-to-person transmission of infectious oocysts can occur among close contacts and in day-care settings. Disease results from ingestion of contaminated food or water and is rare in developed nations. Nontyphoidal salmonellosis: the incidence of nontyphoidal salmonellosis in the United States is 14. If blood cultures are positive for nontyphoidal salmonellae, highgrade bacteremia should be ruled out by obtaining multiple blood cultures. Transmission to humans occurs via contact with or ingestion of raw or undercooked food products or direct contact with infected animals. The course may be fulminant, with bacterial seeding of many organs, particularly vascular sites. Shigellae survive the low pH of the gastric acid barrier, and as few as 100 organisms can cause infection. Severe cases occur most often in children <5 years of age; disease may progress to toxic dilatation, colonic perforation, rectal prolapse, and death. The syndrome is defined by a triad of microangiopathic, Coombs-negative hemolytic anemia; thrombocytopenia; and acute renal failure due to glomerular capillary thromboses. Rehydration usually is not needed; Shigella infection rarely causes significant dehydration. Septicemia and metastatic focal infections can occur in pts with chronic liver disease, malignancy, diabetes mellitus, and other underlying illnesses. Diagnosis Stool culture studies for Yersinia must be specifically requested and require the use of special media. Yersiniosis Antibiotics are not indicated for diarrhea caused by yersiniae; supportive measures suffice. The incidence is high in developing countries and among travelers, recent immigrants, men who have sex with men, and inmates of institutions in developed nations. Infection follows ingestion of cysts from fecally contaminated water, food, or hands. Most pts are febrile and have right upper quadrant pain that can radiate to the shoulder, point tenderness over the liver, and right-sided pleural effusion. Serologic assays (enzyme-linked immunosorbent assay and agar gel diffusion) are positive in >90% of pts with colitis, amebomas, or liver abscess. Stools usually are not grossly bloody and are soft to watery, with a characteristic odor. Chlamydia is the most common etiologic agent, but this syndrome is also caused by N. Anorectal strains in the latter population tend to be more resistant to antibiotics than isolates from other sites. Painful adenopathy above and below the inguinal ligament presents with the "sign of the groove. Rates among heterosexual African Americans in urban areas peaked in 1990, are now declining, but remain higher than for other racial/ethnic groups. One-third of pts eventually develop tertiary disease (syphilitic gummas, cardiovascular disease, neurologic disease); one-quarter of those pts die. Secondary: diffuse mucocutaneous lesions of variable morphologies, generalized nontender lymphadenopathy. Lesions are widely distributed over the trunk and extremities, including the palms and soles. Less common findings include hepatitis, nephropathy, arthritis, optic neuritis, and anterior uveitis. Late latent syphilis, which develops >1 year after infection, is unlikely to cause infectious relapse. Meningeal findings, including headache, nausea, vomiting, change in mental status, and neck stiffness, often with associated uveitis or iritis, present within 1 year of infection. Tabes dorsalis is a demyelination of posterior columns, dorsal roots, and dorsal root ganglia, with ataxic, wide-based gait and footslap; paresthesia; bladder disturbances; impotence; areflexia; and loss of position, deep pain, and temperature sensations. Source: these recommendations are based on those issued by the Centers for Disease Control and Prevention in 2006. First episodes of genital herpes can be associated with fever, headache, malaise, and myalgias. Local symptoms include pain, dysuria, vaginal and urethral discharge, and tender inguinal lymphadenopathy. Current treatment is not completely effective, and some agents have significant side effects. Different entities affect different skin levels; for example, staphylococcal scalded-skin syndrome and toxic epidermal necrolysis cause cleavage of the stratum corneum and the stratum germinativum, respectively. Crusted lesions are also seen in some systemic fungal infections, dermatophytic infections, and cutaneous mycobacterial infection. Group B streptococcal cellulitis is associated with older age, diabetes, and peripheral vascular disease. Other findings may include (1) renal failure, often preceding shock and hypotension; (2) gas in tissue (in mixed infections but rarely with S. Myonecrosis is usually related to trauma; however, spontaneous gangrene-usually due to C.
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Treatment Venesection with replacement of volume with low molecular weight dextran medications and mothers milk discount glucophage sr 500mg without prescription. Antimitotic drugs may also be used when polycythaemia is due to medicine naproxen buy glucophage sr 500mg otc myeloproliferative disease symptoms 9dp5dt glucophage sr 500mg on line. Haemolytic anaemia, haematuria and thrombocytopenia are the main laboratory features. Treatment Aspirin in mild cases; plasmapheresis and antimitotic drugs if more severe. Infection, pregnancy, malignancy and smoking all raise fibrinogen and may explain in part the increased risk of cerebral infarction. Accumulation of homocystine in blood damages endothelium and induces premature occlusive arterial disease. Thrombotic occlusion of the venous system occurs with - infection (especially ear or sinus infection) Cortical veins - dehydration Straight - pregnancy, puerperium and pill sinus Superior - coagulation disorders sagittal sinus - malignant meningitis Inferior - miscellaneous disorders Great sagittal sinus. Outcome is variable; virtual intracranial hypertension may develop occlusion of (p. Treatment: Correct causative factors (dehydration/infection etc) Anticoagulation with heparin or alternative. Deep cerebral venous thrombosis (10% of cases) this produces venous infarction of the basal ganglion and other subcortical structures. Cavernous sinus thrombosis (5% of cases) Commonly results from infection spreading from the jaw through draining veins or paranasal sinuses. Painful ophthalmoplegia, proptosis and chemosis with oedema of periorbital structures are associated with facial numbness and fever. When the haemorrhage occurs deep in the hemisphere, rupture into the ventricular system is common. In hypertensive patients, degenerative changes weaken the walls of small intraparenchymal perforating vessels. In normotensive patients without any evident underlying pathology the cause remains unknown, but cryptic arteriovenous malformations are suspect especially in younger patients (i. In these patients, the haematoma may temporarily or permanently obliterate the lesion. Reinvestigation following haematoma resolution occasionally reveals previously undetected malformations. In the normotensive elderly patient, subcortical haematomas are commonly associated with amyloid vasculopathy, a degenerative disorder affecting the walls of arteries. The haematoma may continue to expand beyond the first few hours due to continued bleeding. The patient may be aware of limb weakness developing prior to losing consciousness. Supratentorial haematoma There is still no evidence to show that early evacuation of an intracerebral haematoma improves outcome. Relief of brain stem compression may be life saving and operative morbidity is low. A conservative approach is usually adopted although some advocate operative exploration. With a large bleed, death may follow from the pressure transmission from within the ventricular system. Blood in the ventricles does not in itself cause damage and, following clot resolution, complete recovery may occur. Bleeding from these vessels or from an associated Subdural aneurysm occurs primarily into space this space. Some intracranial Subarachnoid aneurysms are embedded within space the brain tissue and their rupture Pia causes intracerebral bleeding with or without subarachnoid haemorrhage. In about 20% of patients detailed investigation fails to reveal a source of the haemorrhage. Small thrombosed or undetected aneurysms or cryptic arteriovenous malformations may account for some. A transient or prolonged loss of consciousness or epileptic seizure may immediately follow. Fundus examination may reveal papilloedema or a subhyaloid or vitreous haemorrhage caused by the sudden rise in intracranial pressure. Pyrexia is also a common finding; if severe and fluctuating, it may reflect ischaemic hypothalamic damage. Lumbar puncture establishes the diagnosis of subarachnoid haemorrhage, but in patients with a mass lesion, lumbar puncture could precipitate transtentorial herniation. With the latest equipment, 3-D rotational techniques are employed, combined with cropping of unwanted data, to permit the radiologist to focus on specific regions. Without this aid, antero-posterior, lateral and oblique views are required for each vessel. Negative angiography Angiography fails to reveal a source of the subarachnoid haemorrhage in approximately 20% of patients. In the presence of arterial spasm, reduction in flow may prevent the demonstration of an aneurysm and repeat angiography may be required at a later date. Inheritance: investigations reveal aneurysms in 10% of relatives with two or more affected 1st degree family members. Neck Fusiform dilatation and ectasia of the carotid and the basilar artery may follow atherosclerotic Blood flow damage. Mycotic aneurysms, secondary to vessel wall infection, arise from haematogenous spread. Aneurysm rupture: usually occurs at the fundus of the aneurysm and the risk is related to size. In some patients, rupture occurs during exertion, straining or coitus, but in most there is no associated relationship. Internal these defects occur at the apex of vessel bifurcation elastic as do aneurysms, but they are also found in many lamina extracranial vessels as well as intracranial vessels; saccular aneurysms in contrast are seldom found outwith Uneven wall Layers of of fibrous the skull.
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Pathological tremor occurs at rest or with movement medications and pregnancy order glucophage sr online pills, slow in rate treatment of gout cheap glucophage sr 500mg line, coarse in character medicine ubrania 500 mg glucophage sr visa, proximal or distal and often asymmetrical in distribution. The tremor may progress until handwriting becomes impossible and feeding difficult. Alcohol may temporarily abort the tremor; beta blockers may produce an improvement. Tremor during and maximal at the end of movement Tremor absent at rest; present during movement and maximal on approaching target. Such jerks occur repetitively in the same muscle groups and range from a flicker in a single muscle to contraction in a group of muscles sufficient to displace the affected limb. Several forms exist, some clearly related to epilepsy; others may be associated with damage to inhibitory mechanisms in the brain stem reticular formation. Myoclonus may result from pathological changes affecting a variety of different sites including the motor cortex, cerebellum and spinal cord. The movements may be accentuated or precipitated by visual, auditory or tactile stimulation. Repetitive stimulation may result in a crescendo of myoclonus which resembles a seizure. Physiological myoclonus occurs in sleep (hypnic jerks), with anxiety and in infants when feeding. This disorder is associated with degenerative changes in the olivary and dentate nuclei. Treatment Benzodiazepine drugs such as clonazepam may suppress myoclonic movements. Eyes open Eyes closed Sensory ataxia Stance normal Stance unsteady Vision compensates for proprioceptive loss. In mild cases: Tandem gait (heel-toe walking) is impaired; the patient falling to one or both sides. Sensory Disturbed conscious or unconscious proprioception due to interruption of afferents in peripheral nerves or spinal cord (posterior columns, spinocerebellar tracts). When walking, abduction and circumduction at the hip prevent the toes from catching on the ground. In paraplegia, strong adduction at the hips can produce a scissor-like posture of the lower limbs. Dual innervation from each hemisphere results in sparing of the upper face, muscles of mastication, the palate and tongue with a unilateral upper motor neuron lesion. Combining these findings with other neurological signs enables localisation of the lesion site. Pain and temperature loss in the opposite leg, proprioception loss on the same side. Leg lower motor neuron + upper motor neuron Upper motor neuron signs are important in detecting level of cord damage (since lower motor neuron signs may result from either segmental damage or root damage from a higher level). Second order neurons synapse locally, cross the midline and run up the spinothalamic tract and lateral lemniscus to terminate in the posterolateral nucleus of the thalamus. Throughout its course, the fibres lie in a somatotopic arrangement with sacral fibres outermost. In the brain stem the lateral lemniscus gives off collateral branches to the reticular formation, which projects widely to the cerebral cortex and limbic system and is joined by fibres from the contralateral nucleus and tract of the trigeminal nerve. Fibres enter in the root entry zone and run upwards in the dorsal columns to the lower medulla where they terminate in the nucleus gracilis and nucleus cuneatus. Second order neurons decussate as the internal arcuate fibres and pass upwards in the medial lemniscus. Maintaining a somatotopic arrangement, they terminate in the ventral posterolateral thalamus. Loss of all sensory modalities including pain and temperature in the face, arm, trunk and leg. This involves interneuronal connections within the substantia gelatinosa (a layer of the posterior horn which extends throughout the whole length of the spinal cord on each side). An afferent impulse arriving at the posterior horn in thick myelinated fibres has an inhibitory effect in the region of the substantia gelatinosa. The overall interaction of these inhibitory or excitatory effects determines the activity of second order neurons of the spinothalamic pathway. In addition to these segmental influences, higher centres also control the gate region and form part of a feed-back loop. Electrical stimulation of certain sites, such as the periaqueductal grey matter, can inhibit pain perception. Receptor sites for endogenous opiates have been found in the posterior horns and thalamus as well as at several other sites. The endogenous substances which bind to these sites are called encephalins or endorphins. Substance P, a polypeptide, found predominantly around free nerve ending receptors and in the spinal cord posterior horns, glutamate and calcitonin gene related peptide are the likely primary transmitters of pain.
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Hoping for further progress in curative management of blood malignancies medications kidney damage generic glucophage sr 500 mg with amex, so the modulation of autophagy is a promising potential strategy to treatment 7th feb cardiff buy glucophage sr 500 mg without a prescription enhance cancer therapy treatment lyme disease buy 500 mg glucophage sr with visa. Ethical Approval: this study was approved by the Institutional Ethics Committee of School of Medicine, Minia University, Egypt, and all patients gave informed consent before participation in this study. During the same period, the serum of 35 apparently healthy individuals collected as a control group. The Microelisa stripplate provided in this kit had been pre-coated with an antibody specific to Beclin 1and S. Their age ranging from 30 to 70 years with 22 of them with no comorbidities but 13 of them had comorbidties. Subjects and Method: A total of 35 newly diagnosed patients with Myelodysplastic syndrome and myeloproliferative disorders collected in a single center, Minia University Hospital. Creatinine level, showed statistically significant difference between two groupswith P value <0. By comparing serum beclin1 and Serum Atg 7in the two groups, there was statistically highly significant difference with P value <0. Recently, many clinical trials using autophagy inhibitors are being applied to multiple blood cancer types together with chemotherapeutic agents to achieve complete cure. So it is the flavour of the moment to try to understand the relationship between autophagic protein markers and various blood malignancies. Numerous recent studies suggest that inhibiting autophagy may be an efficient approach to improve the chemotherapeutic antileukemic regimens, but this was not in agreement with Alessio et al. Therefore, positron emission tomography/computed tomography and magnetic resonance imaging probes for Atg activity are currently being developed. Hoping to come in depth and more detailed informations about the role of autophagy in various blood malignancies, as It is evident that autophagy is more and more emerging as a potential target for cancer therapy. In the current study, there is significant increase 1272Indian Journal of Public Health Research & Development, March 2020, Vol. Limitations of the present study: (1) the number of subjects that was small due to financial issues. Atg 7 levels were not assessed after initiation of treatment which could provide important information about the relation between autophagy and response to chemotherapy. Autophagy in the pathogenesis of myelodysplastic syndrome and acute myeloid leukemia. The Role of Autophagy in Cancer: Therapeutic ImplicationsMol Cancer Ther 2011;10:1533-1541. Hypoxiainduced autophagy promotes tumor cell survival and adaptation to antiangiogenic treatment in glioblastoma. Authors of the manuscript have no financial ties to disclose and have met the ethical adherence. Disclosure of Interest: the authors declare that they have no competing interests. Declaration of Authorship: All authors have directly participated in the planning, execution, analysis or reporting of this research paper. Autophagy in acute leukemias: A double-edged sword with important therapeutic implications. Autophagy in blood cancers: biological role and therapeutic implications haematologica 2013; 98(9) 14. Role of Beclin-1-Mediated Autophagy in the Survival of Pediatric Leukemia Cells Cell Physiol Biochem 2016; 39:1827-1836 18. Clinical Significance of Beclin-1 Dependent Autophagy Induced by Imatinib in Chronic Myeloid Leukemia Patients. East Java was ranked in the second among other provinces in Indonesia with more than 20. Surabaya has the highest number of tuberculosis cases in East Java with the success rate of less than 90%. The key role of a community health center is to support the program of tuberculosis prevention but the organization frequently did not achieve the goal of health program. The sample was taken using stratified random sampling and chose 43 teams of tuberculosis prevention with simple random sampling. Total of participants was 318 people consisted of a doctors, nurses, and health analysts. The findings showed reward influenced significantly toward team cohesion, while communication variable did not influence to team cohesion. The research concluded there was an influence of intrinsic reward toward cohesion in a team. Team cohesion is one of team process enabling to support team performance to achieve program target of tuberculosis prevention so it suggested paying attention to their staff particularly intrinsic reward by the management. Introduction Tuberculosis is a disease caused by anaerobic bacteria living in the lung or any organs that have high oxygen partial pressure(1). The prevention program by the government of Indonesia was launched in Indonesian Ministry of Health Regulation No. The primary health facility in Indonesia includes the community health center as the Corresponding Author: Ratna Dwi Wulandari Departmentof Health Administration and Policy, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia e-mail: ratna-d-w@fkm. A team was a workgroup consisted of people with equal ability and interact with weach other to actuate the task in a organization(7). The problem faced in a team might be overcome easily compared to an individual problem in an organization(8). Mcshanedan Von Glinow (2018) stated that one of the supporting factors for a team was team cohesion to obtain effective performance(10). The team cohesion was influenced by reward and effective communication from an organization toward the team. This study aimed to analyze the influence of reward and communication toward team cohesion. Reward here was intrinsic reward that consisted of trust, responsibility, power, and complimentary. The statistical analysis used linear regression test and descriptive analysis using mean value, with cut off point of 3. The average score of each team is tested using a linear multivariable regression test, which if the p-value is less than value (0,05), it will give significance. The reward not only might come out like money, but also appreciation, giving responsibility, and fully trust to team in decision making(11). The organization offered reward both intrinsic and extrinsic to every staff aiming to improve performance of staffs(12).
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Ethical Permission: None Source of Funding: Personal funds Conflict of Interest: None References 1 symptoms narcissistic personality disorder purchase generic glucophage sr online. The Impact Of Employee Satisfaction On Quality And Profitability In High-Contact Service Industries treatment diffusion order glucophage sr with a visa. Beliefs About Physicians: Their Role In Health Care Utilization medicine rock discount glucophage sr 500mg on line, Satisfaction, And Compliance. Pdf; Evidence From Community Health Centers In South Carolina By Ashley Lynn Barnes Bachelor Of Science North Greenville University, 2002 Master Of Business Administration. A Study Of the Relationship Between Job Satisfaction, Organizational Commitment And Turnover Intention Among Hospital Employees. Is the Professional Satisfaction Of General Internists Associated With Patient Satisfaction? An Investigation Of Job Satisfaction, Organizational Commitment And Role Conflict And Ambiguity In A Sample Of Chinese Undergraduate Nursing Students. Medicare: A Strategy For Quality Assurance, I: A Recapitulation Of the Study And Definition Of Quality Of Care. Interrelating Employee Satisfaction And Customer Satisfaction In the Healthcare Industry Interrelating Employee Satisfaction & Customer Satisfaction In Healthcare Industry. Congruent Satisfaction; Is There Geographic Correlation Between Patient And Physician Satisfaction? Linked References Are Available On Jstor For this Article; Congruent Satisfaction; Is There Geographic Correlation Between Patient And Physician Satisf. The Effects Of Health Worker Motivation And Job Satisfaction On Turnover Intention In Ghana: A Cross-Sectional Study. Is the Job Satisfaction Of Primary Care Team Members Associated With Patient Satisfaction? Impact Of Job Satisfaction On Quality Of Care Among Nurses On the Public Hospital Of Lahore, Pakistan. Relationship Between Job Satisfaction Among Frontline Staff And Patient Satisfaction Indian Journal of Public Health Research & Development, March 2020, Vol. This cross-sectional study was conducted on housewives who lived in Sukadanau Village, West Cikarang Sub-district, Bekasi Regency, West Java. Respiratory symptoms experienced by housewives who live around the steel industry are cough (30. Also, studies conducted around the steel industry show that people who live near the industry with a distance of 3. Sukadanau is a village in West Cikarang District and is the location of steel industry operations. There are several criteria that must be met, namely housewives are predominantly in the home environment, have lived at least 1 year, do not use firewood as cooking fuel, do not have a history of asthma and tuberculosis. One of the measurement points is the point adjacent to Sukadanau Village and the steel industry, which is called "Warung Bongkok T-junction" (Figure 1). This measurement was carried out in 2 periods, namely 14 days each period which was carried out sustainably during 2013 - 2015. This village is the location where the steel industry operates and has a maximum distance of 2000 m from the industry. The population of housewives in Sukadanau Village is around 7083 which is spread over 13 residents. The sample size is obtained by estimating proportions14, then by using the Stratified Proportional Random Sampling technique, the sample is divided based on the distance of the house from the steel industry. The distance consists of <500 m (n = 30), 500-1000 m (n = 30), and>1000 m (n = 54), so that a sample of 114 housewives is obtained. And weight measurements were taken to calculate the amount of intake for each subject. Then, the multivariate analysis in this study uses a multivariable logistic regression test. The first model looked at the effect of intake on respiratory symptoms by controlling age, length of stay, and passive smoking. While the second model controls age, length of stay, passive smoking, body weight, insufficient ventilation, and interactions between intake and weight. The interaction between these variables is considered because weight is used in calculating the amount of intake. Most of them aged 2184Indian Journal of Public Health Research & Development, March 2020, Vol. About 75% of coal is used in blast furnaces and 25% is used in the process of sintering and coking19,20. In this study, the amount of intake is used to see its effect on respiratory symptoms. This is because the concentration used in the calculation is only based on measurements at the same point for all housewives in 13 resident of Sukadanau Village. While the intake of each person will be different, this is influenced by the concentration of chemical agents as the formula used15,16. The amount of intake is also influenced by other factors such as body weight and activities17,25. Thus, the use of concentration values also causes subjects not to be compared based on distance from industry, statically (p> 0. However, after controlling for confounding factors both in models 1 and 2, only shortness of breath was statistically significant. Source of Funding: We would like to thank the Directorate of Research and Community Service for financial assistance in the International Indexed Publications program for Student Final Assignments. Ethical Approval: this study was approved by the Research and Community Engagementof Faculty of Public Health Universitas Indonesia. Primary Air Pollutant Emissions and Future Prediction of Iron and Steel Industry in China. Effects of environmental air pollution on pulmonary function level of residents in Korean industrial complexes. Respiratory symptoms, asthma and levels of fractional exhaled nitric oxide in schoolchildren in the industrial areas of Estonia. Impact of air pollution on pulmonary function and respiratory symptoms in children. Contribution of nitrogen oxide and sulfur dioxide exposure from power plant emissions on respiratory symptom and disease prevalence. Review on Effects of Particulates; Sulfur Dioxide and Nitrogen Dioxide on Human Health. Chronic Obstructive Pulmonary Disease in Iron-Steel and Ferrochrome Industry Workers. Comparison of the Fractional Exhaled Nitric Oxide Levels in Adolescents at Three Schools Located Three Different Distances from a Large Steel Mill. Patients: From January 2017 to January 2019, 12 patients with unilateral/bilateral pure orbital blow out fractures were equally assigned to study endoscopic transantral and control transorbital groups. Intervention: In the study group, fractures were repaired with the endoscopic transantral approach while the control group, fractures were repaired via the transconjuctival surgical approach.
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The operative risk increased with age medications similar to abilify purchase discount glucophage sr online, aneurysm size and a site on the posterior circulation medications prescribed for depression order 500 mg glucophage sr with mastercard. For those undergoing a conservative approach medicine lake mt glucophage sr 500 mg otc, it is essential to ensure that they do not smoke, since this doubles the risk of aneurysm rupture. A negative screening investigation will fail to provide the reassurance that a subarachnoid haemorrhage from a ruptured aneurysm will never occur. Arteriovenous malformations occur at any site but are commonest in the middle cerebral artery territory. Coronal and sagittal scanning provide additional information, showing the exact anatomical relationship of the tumour to the sulci and gyri, the ventricles, the falx and the tentorium cerebelli. Paramagnetic enhancement: intravenous gadolinium increases sensitivity of detection and clarifies the site of origin, i. Useful to exclude if proposing conservative management or in planning stereotactic biopsy. After several days treatment, gradual dose reduction minimises the risk of unwanted side effects. In these patients, steroid cover is an essential prerequisite of any anaesthetic or operative procedure. If necessary, combined with image guidance to aid positioning the flap and to give accurate lesion localisation (see page 386). Transphenoidal route: through the sphenoid sinus to the pituitary fossa Burr hole: for stereotactic or hand-held, ultrasound guided biopsy Transoral route: removal of the arch of the atlas, odontoid peg and clivus provides access to the anterior aspect of the brain stem and upper cervical cord. The infiltrative nature of primary malignant tumours prevents complete removal and often operation is restricted to biopsy or tumour decompression. Prospects of complete removal improve with benign tumours such as meningioma or craniopharyngioma; if any tumour tissue is overlooked, or if fragments remain attached to deep structures, then recurrence will result. It is possible to perform a craniotomy and tumour resection with the frame in place, but the frame tends to impede access and after opening the bone flap, the brain may shift introducing errors of localisation. Neuronavigation: this technique requires rigid fixation of the head in a standard three pin head holder, but avoids the use of a cumbersome frame (see page 386). The system accurately detects the position of the handheld probe in relation to the skull and allows the surgeon to see where the probe tip lies in relation to pre-operative imaging. Although often routinely used, this technique also fails to take into account brain shift which can occur on opening the bone flap or if cerebrospinal fluid is drained off thus limiting accuracy. Although costly, this real-time imaging overcomes problems encountered with brain shift and not only helps to locate the tumour, but also shows the extent of tumour resection as the operation progresses. Ultrasound has also been combined with neuronavigation to provide real-time imaging at a more realistic expense. Surgery in Eloquent Areas When intrinsic tumours lie adjacent to or within eloquent areas within the brain, i. When these images are incorporated into the neuro-navigation system it enables the surgeon to avoid extending the tumour resection into these areas and causing irreversible neurological deficits. The reliability of each technique, however, is still in question and benefits remain uncertain. Studies show that patients tolerate the technique well and maximal tumour resection is possible with a low risk of deficit. In contrast to older methods, these modern techniques produce greater tissue penetration and avoid radiation damage to the skin surface. Treatment aims to provide the highest possible dose to a specified region whilst minimising irradiation to adjacent normal brain. Interstitial techniques where the tumour is treated from within (brachytherapy) by the implantation of multiple radioactive seeds. It allows the delivery of high doses of radiation to very localised regions adjacent to vital structures such as the skull base. Oedema, demyelination and radionecrosis may involve the spinal cord after irradiation of spinal tumours. Other harmful effects include hair loss, skin reactions and endocrine disturbance. Temozolomide, an oral alkylating agent with excellent blood brain barrier penetration and modest toxicity is established as an alternative treatment for patients with recurrent high grade gliomas. It has also been shown to improve survival for patients with newly diagnosed glioblastoma when given concomitantly with radiotherapy. A combination of maximal safe surgery followed by combined chemoradiotherapy is now the standard of care for good performance patients with glioblastoma. Carmustine impregnated wafers (Gliadel) may also be considered both as a primary treatment or for tumour recurrence (see below). Patients with anaplastic oligodendrogliomas and oligoastrocytoma with loss of heterozygosity on chromosomes 1p and 19q have a good prognosis and respond well to both radiation and to alkylating agent based chemotherapy (nitrosoureas, Temozolomide). Chemotherapy may be used either at initial diagnosis or at relapse in these patients. Traditionally, chemotherapy has had a lesser role in low grade glial tumours but current studies are examining its use in both astrocytomas and oligodendrogliomas as an alternative to radiation in newly diagnosed patients. Problems of drug administration Toxicity: the ideal cytotoxic drug selectively kills tumour cells; but tumour cell response relates directly to the dose. High drug dosage frequently causes bone marrow suppression which may limit cytotoxic activity before an adequate therapeutic dose is reached.
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The presentation of actual findings (rather than simple statements that the heart examination and the serum sodium were normal) reflects what will be seen in actual clinical practice symptoms ear infection cheapest generic glucophage sr uk. More importantly brazilian keratin treatment purchase 500 mg glucophage sr free shipping, listing both normal and abnormal findings requires students to symptoms 6 year molars order glucophage sr with visa carefully assess the complete database and identify the pertinent positive and negative findings for themselves. A valuable portion of the learning process is lost if students are only provided with findings that are abnormal and are known to be associated with the disease being discussed. The patients described in this casebook have fictitious names in order to humanize the situations and to encourage students to remember that they will one day be caring for patients, not treating disease states. However, in the actual clinical setting, patient confidentiality is of utmost importance, and real patient names should not be used during group discussions in patient care areas unless absolutely necessary. To develop student sensitivity to this issue, instructors may wish to avoid using these fictitious patient names during class discussions. In this casebook, patient names are usually given only in the initial presentation; they are seldom used in subsequent questions or other portions of the case. When ethnicity is pertinent to the case, this information is presented in the social history or physical examination. Patients in this casebook are referred to as men or women, rather than males or females, to promote sensitivity to human dignity. The patient cases in this casebook include medical abbreviations and drug brand names, just as medical records do in actual practice. The advent of biotechnology has led to the introduction of unique compounds for the prevention and treatment of disease that were unimagined just a decade ago. Each year the Food and Drug Administration approves approximately two dozen new drug products that contain active substances that have never before been marketed in the United States. Although the cost of new therapeutic agents has received intense scrutiny in recent years, drug therapy actually accounts for a relatively small proportion of overall health care expenditures. Appropriate drug therapy is cost-effective and may actually serve to reduce total expenditures by decreasing the need for surgery, preventing hospital admissions, and shortening hospital stays. Several studies have indicated that improper use of prescription medications is a frequent and serious problem. Based on a decision analytic model, one study estimated that the cost of drug-related morbidity and mortality was more than $177 billion in 2000. Schools of pharmacy have implemented innovative instructional strategies and curricula that have an increased emphasis on patient-centered care, including more experiential training, especially in ambulatory settings. Many programs are structured to promote self-directed learning, develop problem-solving and communication skills, and instill the desire for lifelong learning. In its broadest sense, pharmaceutical care involves the identification, resolution, and prevention of actual or potential drug therapy problems. A drug therapy problem has been defined as "any undesirable event experienced by a patient which involves, or is suspected to involve, drug therapy and that interferes with achieving the desired goals of therapy. These drug therapy problems are discussed in more detail in Chapter 4 of the casebook. Because this casebook is intended to be used in conjunction with the Pharmacotherapy textbook, one of its purposes is to serve as a tool for learning about the pharmacotherapy of disease states. For this reason, the primary problem to be identified and addressed for most of the patients in the casebook is the need for additional drug treatment for a specific medical indication (problem 1. Other actual or potential drug therapy problems may coexist during the initial presentation or may develop during the clinical course of the disease. After the drug therapy problems are identified, the clinician should determine which ones are amenable to pharmacotherapy. Alternatively, one must also consider whether any of the problems could have been caused by drug therapy. In some cases (both in the casebook and in real life), not all of the information needed to make these decisions is available. These questions are applied consistently from case to case to demonstrate that a systematic patient care process can be successfully applied regardless of the underlying disease state(s). The questions are designed to enable students to identify and resolve problems related to pharmacotherapy. Determination of therapeutic alternatives After the intended outcome has been defined, attention can be directed toward identifying the types of treatments that might be beneficial in achieving that outcome. The clinician should ensure that all feasible pharmacotherapeutic alternatives available for achieving the predefined therapeutic outcome(s) are considered before choosing a particular therapeutic regimen. Useful sources of information on therapeutic alternatives include the Pharmacotherapy textbook and other references, as well as the clinical experience of the health care provider and other involved health care professionals. There has been a resurgence of interest in dietary supplements and other alternative therapies in recent years. The public spends billions of dollars each year on supplements to treat diseases for which there is little scientific evidence of efficacy. On the other hand, scientific evidence of efficacy does exist for some dietary supplements. Health care providers must be knowledgeable about these products and prepared to answer patient questions regarding their efficacy and safety. Identification of real or potential drug therapy problems the first step in the patient-focused approach is to collect pertinent patient information, interpret it properly, and determine whether drug therapy problems exist. Some authors prefer to divide this process into two or more separate steps because of the difficulty that inexperienced students may have in performing these complex tasks simultaneously. In the case of preexisting chronic diseases, such as asthma or rheumatoid arthritis, one must be able to assess information that may indicate a change in severity of the disease. This portion of the casebook contains 10 fictitious patient vignettes that are directly related to a patient case that was presented earlier in this casebook. Each scenario involves one or more questions asked by a patient about a specific remedy. Eleven different dietary supplements are included in this section: garlic, omega-3 fatty acids, Ginkgo biloba, St. Monitoring for adverse events should be directed toward preventing or identifying serious adverse effects that have a reasonable likelihood of occurrence. For example, it is not cost-effective to obtain periodic liver function tests in all patients taking a drug that causes mild abnormalities in liver injury tests only rarely, such as omeprazole. On the other hand, serious patient harm may be averted by outlining a specific screening schedule for drugs associated more frequently with hepatic abnormalities, such as methotrexate for rheumatoid arthritis. Design of an optimal individualized pharmacotherapeutic plan the purpose of this step is to determine the drug, dosage form, dose, schedule, and duration of therapy that are best suited for a given patient. Individual patient characteristics should be taken into consideration when weighing the risks and benefits of each available therapeutic alternative. For example, an asthma patient who requires new drug therapy for hypertension might better tolerate treatment with a thiazide diuretic rather than a -blocker. On the other hand, a hypertensive patient with gout may be better served by use of a -blocker rather than by use of a thiazide diuretic.
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Planning will influence the control of actions which can ultimately affect behavior4 medicine bg purchase cheap glucophage sr. High Blood Pressure and Its Association with Body Weight among Children and Adolescents in the United Arab Emirates treatment yeast diaper rash cheap 500 mg glucophage sr with mastercard. Action control bridges the planningbehavior gap; A longitudinal study on physical exercise in young adults medications you can give dogs order generic glucophage sr online. The influence of peer health education toward the decreasing risk of heart disease. The effects of age and body mass index on blood glucose, blood cholesterol, and blood pressure in adult women. Conclusion Overweight and obesity are risk factors that can increase the occurrence of adolescent hypertension. Other risk factors are family history, high salt consumption, cigarette consumption and low physical activity. To reduce these risk factors, efforts to lose weight and make a healthy lifestyle such as consuming healthy foods, increasing physical activity and preventing consumption of cigarettes are very important things. Conflict of Interest: None Ethical Clearance: Not required Source of Funding: Self-funded 9. SugarSweetened Beverage Consumption and Risks of Obesity and Hypertension in Chinese Children and Adolescents; A National Cross-Sectional Analysis. Predictors of early 1068Indian Journal of Public Health Research & Development, March 2020, Vol. Peraturan Menteri Kesehatan Republik Indonesia Nomor 39 Tahun 2016 Tentang Pedoman Penyelenggaraan Program Indonesia Sehat Dengan Pendekatan Keluarga. Prevalence and risk factors for hypertension i n Hong Kong Chinese adolescents; waist circumference predicts hypertension, exercise decreases risk. Positive association between waist-to-height ratio and hypertension in adolescents. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents. Prevalence of prehypertension and hypertension among adolescent high school girls in Tabriz, Iran. The role of action control and action planning on fruit and vegetable consumption. Associations of multiple unhealthy lifestyle behaviors with overweight/obesity and abdominal obesity among Brazilian adolescents; A country-wide survey. Bagus Qomaruddin2, Rachmat Hargono2 1 Health Promotion and Behavioral Sciences, Master Program of Public Health Sciences, 2Department of Health Promotion and Behavioral Sciences, Faculty of Public Health, Airlangga University, Surabaya, Indonesia Abstract Background: Bullying problem which happened to students in schools continues occur and increasing every year throughout the world. Bullying is unpleasant behavior with intentional to hurt others and occurs repeatedly and it shows difference power between bullied and victims. Adaptive coping strategies can contribute to generating positive emotional well-being for victims of bullying at school. Bullying happened at Senior High School 11 Surabaya can cause emotional problems in students. This study aims to analyze the influences of coping strategies on emotional well-being of victims of verbal bullying in Senior High School 11 Surabaya. Material and Method: this type of research was observational analytic with cross sectional design and used a quantitative approach. The sample of the study was 94 students who were victims of verbal bullying in Senior High School 11 Surabaya. Result: Coping strategies were significantly influence on emotional well-being victims of verbal bullying in Senior High School 11 Surabaya were dispositional coping style (p = 0. Introduction Bullying is an aggressive behavior with intentional to repeated this action from time to time, and combined Corresponding Author: Rosdiana Mahardika Putri Health Promotion and Behavioral Sciences, Master Program of Public Health Sciences, Faculty of Public Health, Airlangga University, Surabaya, Indonesia-60115 e-mail: rosdiana. The Center for Urban Education Success was reported that the prevalence of students involved in bullying, which were as a perpetrator, victim or perpetrator as well as a victim were 20-29% per year. The results of previous studies showed that bullying in Senior High School 11 Surabaya happened in four forms, which were physical, verbal, social and cyberbullying3. Victims of bullying were generally adherent and unconfident teens 4, physically weak, and rejected by peers5. Victims of bullying were often feeling insecure and unhappy at school, which causes victims of bullying experienced difficulty concentrating, regulating attention that affects academic achievements, and tend to absent from school, and dropped out of school7. Victims of bullying were associated with various interpersonal difficulties such as refusal of friends, low friend acceptance, few or no friends, and negative friendship quality8. Bullying in schools have been associated with poor student well-being and had an effect on student education, which were decreased academic grades, and can cause mental health problems such as symptoms of depression, anxiety, internalization, loneliness and withdrawal from the social environment, had suicidal thoughts, self-harm, and violent behavior in adulthood 9. Victims of verbal and physical bullying were more likely to engage in maladaptive behavior and experienced internal pressure 9. Students who were faced bullying adopted different coping strategies depends on age and gender 10. Coping strategies are the processes to reduce stress by using all efforts and self-regulation in order to influence stressors, which are considered as burdens that exceed the ability of individuals. Coping strategies aim to reduce the impact of stressful situations or increase resources and efforts to deal with stress. The results of previous longitudinal studies showed that support from peers and family have been associated with decreased depression while firm coping strategies such as meeting or contacting bullies has been associated with increased depression 12. The aim of the study was to analyze the influences of coping strategies on emotional well-being of victims of verbal bullying in Senior High School 11 Surabaya. Materials and Method this research was an observational analytic study with cross sectional design and used a quantitative approach. The research sample were 94 students who were victims of verbal bullying in Senior High School 11 Surabaya. Frequency distribution of coping strategies in Senior High School 11 Surabaya Coping Strategies Problem management Good Poor Dispositional Coping Style Good Poor Social Support Good Poor Positive Reappraisal Good Poor Positive Events Good Poor 53 41 56,4 43,6 56 38 59,6 40,4 54 40 57,4 42,6 57 37 60,6 39,4 63 31 67,0 33,0 N % Table 1 showed that the majority of victims of verbal bullying had good coping strategies in overcoming verbal Indian Journal of Public Health Research & Development, March 2020, Vol. The majority of victims of verbal bullying had good problem management were 67%, good dispositional coping style were 60. Frequency distribution of emotional wellbeing in Senior High School 11 Surabaya Emotional Well-Being Good Poor N 43 51 % 45,7 54,3 on performed dispositional coping styles to produce good emotional well-being. Optimism is a cognitive construct that has been linked with motivation, so individual who have an optimistic will exert effort to get the desired results15. The results showed a positive reappraisal have been influences on emotional well-being of victims of verbal bullying. This is consistent with previous research that showed positive reappraisal used by caregivers to create positive emotional feelings in dealing with difficult situations to resolve and it significantly correlates with positive influence in interpreting the experience of caring for a sick partner and facing the death of a partner being treated 16. Positive reappraisal encourages victims of verbal bullying to interprets the experience of verbal bullying behaviors at school as a lesson to improve the ability to deal with difficult situations which can contributes to creating positive emotions that will influences on emotional well-being of victims of verbal bullying. The results also showed that positive events have been influences on emotional well-being of victims of verbal bullying.
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To eliminate binding in the simulating canal treatment for shingles order cheap glucophage sr, the files were created to medications knowledge buy 500 mg glucophage sr amex be slightly wider than those used in the test (0 treatment 0f osteoporosis generic 500mg glucophage sr. The cyclic fatigue testing apparatus utilized in this study, as shown in Figure 2. The apparatus consists of a wood main frame attached with an electric hand piece and a simulating canal carved in a stainless-steel block. The electric hand piece is supported to a movable apparatus, allowing accurate and repeated placement of each instrument inside the simulating canal. A glass cover was fixed by the clipper to faciliate file insertion inside the canal and to prevent the instrument from slipping out, thus also providing a clear view of the instruments. Instrument rotation was monitored by the operator until the file fractured, the corresponding time was recorded. The electric motor button was pressed again once to stop rotation during fracture of the instrument. The time needed for instrument fracture from the begining of the rotation was recorded in seconds then transformed into minutes. A separate t-test was performed to assess the significance of variance between a pair of instruments. Using t-test, further comparisons among groups were conducted to determine where the significant difference occurred (Table 3). Discussion: the fracture of rotating NiTi instrument is one of the most critical complications that develop during canal preparation . Diverse classes of rotary NiTi instruments show variation in resistance to fatigue failure owing to differences in numerous factors, such as their manufacture [19&20]. In this study, the resistance of rotary files to cyclic fatigue was tested under simulating conditions to reduce the effect of other failure mechanisms. As other studies, the test was evaluated using stimulating canals made of stainless steel Considering that this study aimed to examine the physical properties of NiTi rotary files, the extracted teeth were unsuitable models as no two root canals are exactly identical . One operator has examined the files, whereas the other has operated the stopwatch . Comparisons were conducted with files of similar curvature and diameter to minimize the confounding variables. The Blue R3 files were the most resistant to cyclic fatigue, followed by F6 SkyTaper, One Curve, and Wave One Gold files. The files are manufuctured with NiTi, which undergoes an innovative heat treatment, altering its molecular structure, to achieve an increase in cyclic fatigue resistance; surface treatment of the file involves chemical polishing, and additional flexibility and a distinct blue color are also added . The F6 SkyTaper instruments showed more cyclic fatigue resistance compared with the One Curve and Wave One Gold instruments. This observation may be related to the decreased crosssectional area associated with the unique double S-shaped cross-section design of F6 SkyTaper. This result agrees with that of a study concluding that Wave One Gold shows low resistance to cyclic fatigue[26&27]. This difference in the cross-section between files might also contribute to their cyclic fatigue resistance. Wave One Gold instruments were less resistant to cyclic fatigue and were fractured within a short period possibly due to their cross-section design (parallelogram-shaped cross-section), which should be regarded for conclusions of this study. The thermal processing increased the temperature of austenitic transformation of nickel-titanium alloy and improved its crystal structure arrangement [28 & 29]. One Curve files are manufactured with a C-wire by applying controlled heat treatment with the property of regulated memory, thus improving file resistance to cyclic fatigue. Cyclic fatigue of different nickel-titanium rotary instruments: a comparative study. Current challenges and concepts in the preparation of root canal systems: a review. Current challenges and concepts of the thermomechanical treatment of nickeltitanium instruments. Root canal anatomy preservation of WaveOne reciprocating files with or without glide path. Cyclic fatigue resistance of WaveOne Gold, ProDesign R and ProDesign logic files in curved canals in vitro. Cone-beam computed tomography assessment of root canal transportation by neoniti and reciproc single-file systems. Further research is advised to assess the resistance to cyclic fatigue of these files by using different canal lengths and curvatures. Source of Funding: Self Ethical Clearance: Not required Conflict of Interest: None 8. Testarelli L, Grande N, Plotino G, Lendini M, 1380Indian Journal of Public Health Research & Development, March 2020, Vol. Cyclic fatigue resistance of two variable-taper rotary file systems: ProTaper universal and V-Taper. Cyclic fatigue and torsional resistance of two new nickel-titanium instruments used in reciprocation motion: Reciproc versus WaveOne. Cyclic fatigue and fracture characteristics of ground and twisted nickel-titanium rotary files. Fatigue resistance of engine-driven rotary nickel-titanium instruments produced by new manufacturing method. Is the reciprocating movement per se able to improve the cyclic fatigue resistance of instruments? Cyclic fatigue of ProFile Vortex and Vortex Blue nickel-titanium files in single and double curvatures. Metallurgical characterization of M-Wire nickel-titanium shape memory alloy used for endodontic rotary instruments during low-cycle fatigue. In vitro Evaluation of Cyclic Fatigue Resistance of Reciprocating and Rotary Single-file System. Evaluation of the Cyclic Fatigue of WaveOne Gold and Reciproc Blue using Different Irrigating Medium. Cyclic fatigue resistance of Reciproc, WaveOne, and WaveOne Gold nickeltitanium instruments. Metallurgical characterization of controlled memory wire nickel-titanium rotary instruments. Blue treatment enhances cyclic fatigue resistance of vortex nickel-titanium rotary files. Factors influencing defects of rotary nickel-titanium endodontic instruments after clinical use. Alsayegh2,3 Faculty of Education, Physical Education Department, Umm Al-Qura University, Makkah, Saudi Arabia, 2Faculty of Social Sciences and Humanities, School of Education, University Technology Malaysia, Johor Bahru, Malaysia, 3 Faculty of Education, Physical Education Department, Taibah University, Almadinah Almonawarah, Saudi Arabia 1 Abstract the purpose of this study is to investigate dietary habits in retired athletes in Saudi Arabia.