Learning about good nutrition with the 5-color front-of-package label"Nutri-Score":an experimental study

The Nutri-Score is a 5-color front-of-pack nutrition label designed to provide consumers with an easily understandable guideline to the healthiness of food products.The impact that the Nutri-Score may have on consumers'choices is unclear since different experimental paradigms have found vastly different effect sizes.In the present study,we have investigated how student participants change a hypothetical personal 1-daydietary plan after a learning phase during which they learn about the Nutri-Scores of the available food items.Participants were instructed to compose a healthy diet plan in order that the question of whether the NutriScore would improve their ability to compose a healthy dietary plan could be investigated,independent of the question of whether they would apply this knowledge in their ordinary lives.We found a substantial(Cohen's d=0.86)positive impact on nutritional quality(as measured by the Nutrient Profiling System score of the Food Standards Agency)and a medium-sized(Cohen's d=0.43)reduction of energy content.Energy content reduction was larger for participants who had initially composed plans with higher energy content.The results suggest that the Nutri-Score has the potential to guide consumers to healthier food choices.It remains unclear,however,whether this potential will be reflected in real-life dietary choices.

Toxoplasmic Chorioretinitis: About a Case in an Immunocompetent Adult at the Renaissance University Hospital Centre (UHC) in N’Djamena (Chad) and Review of the Literature

Toxoplasmic chorioretinitis also known as ocular toxoplasmosis is a parasitic infection caused by the obligately intracellular multiplying protozoan called Toxoplasma gondii. Active toxoplasmic chorioretinitis is a rare condition in immunocompetent people. We report a case of a 47-year-old patient who received reduced right visual acuity, left hemiparesis and eye pain. Examination of the right anterior segment of the eye is unremarkable. In the fundus of the right eye, there was a focus of active toxoplasmic chorioretinitis located in the macula at 1.5 mm papillary diameter next to old scar lesions. The ophthalmological examination of the left eye was unremarkable. The paraclinical assessment carried out on the patient shows a positive Remington test on two occasions three weeks apart. The clinical outcome after initiation of treatment was favorable with a healing of the active site within four weeks.

Ethnobotanical Study of Medicinal Plants Used for Treating Urinary Tract Infections in N’Djamena (Chad)

Introduction: Infection disease is a real publique health problem. The rise of resistance for modern antibiotic in infections treatment imposed us order alternatives. The study objective was to contribute in the knowledge of medicinal plants uses in urinary infections treatment in N’Djamena (Chad) in view for amelioration the traditional medicine in future. Methodology: The study was conducted in the city of N’Djamena in the Republic of Chad that interviewed 60 traditherapists on using 11 plants for urinary tract infections treatment. The methodology of this study consisted of the knowledge of medicinal plants that used by traditherapists, and the plants identification was done in the laboratory of IRED at Farcha. Results: A total of 60 traditherapists was interrogated on the plants used in the treatment of urinary tract infections among the population of N’Djamena. The majority of traditherapists interrogated in this study were male with the rate of 61.67% against female with the rate of 38.33%. The age range of traditherapists was between 20 to 80 years, 25 (41.67%) from the age range between 30 - 50 years and 35 (58.33%) in age range from 50 to 70 years. For the origin of their knowledge, the study showed that 72% of traditherapists inherited the knowledge from their family, while 15% inherited from the family and from training. The ethnic groups of the traditherapists were Sara (16%), Maraba (12%) and Massa (11%). According to the results, 18.33% were illiterates, 49% attended primary school and 33.34% the secondary school. Our study found that 11 species of plants belonging to 11 families were used in the treatment of urinary tract infection and the Ziziphus spina-christi was the most represented. According to traditherapists the Ziziphus spina-christi, Cassia obovata and Euphorbia hirta were the most frequent plants used in the urinary tract infections treatment. The parts of plants used in the treatment were leaves and bark, grained leaves and entire plants with the proportion of 50%, 16.67 and 15% respectively. Conclusion: This study revealed that the medicinal plants are variously used in the treatment of infection urinary tract in the city of N’Djamena.

Comparison of the effects of high-intensity interval and moderate-intensity continuous training on inflammatory markers,cardiorespiratory fitness,and quality of life in breast cancer patients

Background:As the effectiveness of breast cancer treatment has improved,a growing number of long-term breast cancer survivors are seeking help for unique health problems.These patients may be at increased risk of cardiovascular disease due to the side effects of treatment.The positive impact of most types of exercise has been repeatedly reported in people with cancer,but the most effective exercise approaches for maximum beneficial adaptations remain controversial.Thus,this study aimed to compare the effects of high-intensity interval training(HIIT)and moderate-intensity continuous training(MICT) on inflammatory indices,adipokines,metabolic markers,body composition,cardiorespiratory fitness,and quality of life in breast cancer patients during adjuvant endocrine therapy.Methods:Thirty non-metastatic breast cancer patients during adjuvant endocrine therapy who had been treated with chemotherapy and/or radiotherapy were recruited from Iran and randomized to HIIT,MICT,or control groups for a supervised exercise intervention that took place 3 times a week for 12 weeks.The training intensity was determed based on the peak oxygen uptake(VO2peak),and the volume of training was matched in HIIT and MICT based on the VO2peak.Body composition,functional capacity,cardiorespiratory fitness,metabolic indices,sex hormones,adipokines,and inflammatory markers were assessed before and after the intervention.Results:The VO2peakincreased by 16.8% in the HIIT group in comparison to baseline values(mean difference=3.61 mL/kg/min).HIIT significantly improved the VO2peakcompared to control(mean difference=3.609 mL/kg/min) and MICT(mean differences=2.974 mL/kg/min)groups.Both HIIT(mean difference=9.172 mg/dL) and MICT(mean difference=7.879 mg/dL) interventions significantly increased highdensity lipoprotein cholesterol levels compared to the control group.The analysis of covariance showed that physical well-being significantly improved in MICT compared to control group(mean difference=3.268).HIIT significantly improved the social well-being compared to the control group(mean difference=4.412).Emotional well-being subscale was significantly improved in both MICT(mean difference=4.248)and HIIT(mean difference=4.412) compared to the control group.Functional well-being scores significantly increased in HIIT group compared with control group(mean difference=3.35).Significant increase were also observed in total functional assessment of cancer therapy-General scores in both HIIT(mean difference=14.204) and MICT groups(mean difference=10.036) compared with control group.The serum level of suppressor of cytokine signaling 3 increased significantly(mean difference=0.09 pg/mL) in the HIIT group compared to the baseline.There were no significant differences between groups for body weight,body mass index,fasting blood glucose,insulin resistance,sex hormone binding globulin,total cholesterol,low-density lipoprotein cholesterol,adipokines,interleukin-6,tumor necrosis factor-a,or interleukin-10.Conclusion:HIIT can be used as a safe,feasible,and time-efficient intervention to improve cardiovascular fitness in breast cancer patients.Both HIIT and MICT modalities enhance quality of life.Further large-scale studies will help determine whether these promising results translate into improved clinical and oncological outcomes.

Learning from the Film “Mitorishi (Transition Doula)”—Application to Understanding the End-of-Life in a Gerontological Nursing Practice Course in Japan

Purpose: This study aims to detail what nursing students learned from watching the film “Mitorishi”, which was used among the teaching materials in a gerontological nursing practice course in nursing education in Japan, and demonstrate the applicability of using the film as an element relevant to the teaching of end-of-life care in Japan. Methods: The participants were fourth-year nursing students at University A who had watched the film “Mitorishi” during the course, had submitted a report on what they learned, and provided informed consent to the study participation. The reports submitted by the participants were used as data and analyzed qualitatively using the content analysis approach. Results: The analysis identified the following five categories (number of codes): Characteristics of life during the final days (9), Importance of views on life and death (3), Importance of end-of-life care (3), Assistance in preparation for the final days of life (13), and Understanding the profession of transition doula (9). Discussion: The five categories show that the students have learned about the “role of nurses at the time of end-of-life care” while “visualizing end-of-life care” and learning “preparedness for end-of-life care”. These findings suggest that using the film “Mitorishi” in the teaching curriculum is effective for learning about end-of-life care for older people.

Sydenham’s Chorea: Apropos of Three Observed Cases at the N’Djamena Mother and Child University Teaching Hospital (CHU-ME)-Chad

Introduction: Post-streptococcal chorea is the most common form of acquired chorea in children. Objective: The objective of this study was to contribute to better management of this condition by giving the characteristics of the epidemiological, clinical, biological, etiological, therapeutic and evolutionary aspects. Methodology: This was a retrospective and descriptive study from January 2021 to December 2021 which took place in the pediatrics department of the Mother and Child University Teaching Hospital of N’Djamena (CHU-ME). All the children in whom we observed abnormal involuntary movements whose age was less than or equal to 15 years were concerned. Result: there were three female children. The average age was 7.5, of which the two are 7 years old and the third is 8 years old. Two had a history of angina. A notion of polyarthralgia and dental caries was found in the third. The diagnosis of post-streptococcal chorea was retained on the basis of clinical arguments: observation of abnormal movements of the limbs and the face, which are involuntary, sudden with an insidious and progressive onset, muscular hypotonia, and psychic disorder. Medical imaging, in particular echocardiography, which objectified two cases of associated rheumatic valvular disease. Remission was observed in all three children after two weeks of treatment with haloperidol, penicillin. Those with associated rheumatic valve disease also received corticosteroid therapy. Complete remission of chorea was observed in all three girls. Prophylaxis in two patients based on Penicillin V was instituted. Conclusion: Although less frequent, post-streptococcal chorea is still seen in our country and is still an important health problem that needs more real medical efforts.

Seroprevalence of Chlamydia trachomatis Infection in Women of Procreate Age in the Mayo-Boneye Department in Chad

Introduction: Chlamydia trachomatis infections constitute a major public health problem, particularly in women. The objective of this study is to identify Chlamydia trachomatis to improve the health of women in the Department of Mayo-Boneye. Methodology: This is a prospective observational study that took place from October to December 2021, including 168 patients with their sociodemographic characteristics. The venous blood of the patients was collected in dry tubes and centrifuged to obtain the serum. The Chlamydia IgG Rapid Test Cassette was used for the detection of antibodies to Chlamydia infection. The Epi Info 7TM software was used to perform the statistical analyses. Results: A total of 168 patients were included in this study. The average age was 26.36 ± 9.21 years, the median was 25.5 years with the extremes of 14 years and 70 years. Among these patients, 46.43% were illiterate, 5.95% and 20.83% were primary and secondary school students, respectively, and 26.79% university students. For marital status, 66.67% were single, 16.67% married, 10.71% divorced and 5.95% widowed. Regarding the profession, 26.79% were traders, 8.93% were employees and 64.29% unemployed. In this study, the 168 patients had performed Chlamydia trachomatis serology among whom 02 (1.19%) were excluded for invalid results and 10.71% presented positive cases. The city of Bongor was the most infected with 61% of cases. Among these patients, 54.22% were linked to risk factors for Chlamydia trachomatis. The most infected age group was between 25 and 35 with a seroprevalence of 5.36% of cases. Conclusion: In this study, Chlamydia trachomatis was positive for 10.71% of diagnosed cases. The most affected age groups are young, sexually active women. The State should emphasize the screening of women, the awareness of students and academics.

Prevalence, Management and Outcomes of Enterocutaneous Fistulas in Buea Regional Hospital and Laquintinie Hospital of Douala. A Five Years Retrospective Study

Background: An Enterocutaneous fistula (ECF) is an abnormal connection between the intestinal tracts or stomach and the skin. They are a major catastrophe to the patient and surgeons and still have a high incidence of morbidity and mortality which varies between 6% - 33%;their management remains a big challenge. These patients frequently face complications, and a well-organized multidisciplinary approach must be implemented in their management to improve outcomes. Objectives: Our study aims to assess the prevalence, management and outcomes of enterocutaneous fistulas in Buea regional hospital and Laquintinie hospital of Douala over the past 5 years. Methods: This was a hospital-based retrospective study in Buea regional hospital and Laquintinie hospital of Douala. Records of patients who had enterocutaneous fistulas within the period of 1st January 2017 to 31st December 2020 in the surgical departments. Data included demographics, pre-operative diagnosis, comorbidities, type of fistula, management modality and means, the indication of operative treatment, length of stay in the hospital and outcomes. Data was analysed using SPSSv26. Results: The study constituted 1343 medical records of which 83 medical records of patients with enterocutaneous fistulas, giving a prevalence of 6.2%, female predominance at 59% (n = 49), 42.2% (n = 35) were referred cases from the periphery for better management. A vast majority (96.4%) occurred as post-operative complications with appendectomy the most common indication (18.8%). High output fistulas were predominant (43.4%). 59% (n = 47) were managed medically, 6% (n = 5) received both conservative and surgical modalities while 35% (n = 5) were managed surgically. 64.1% (n = 50) were placed on enteral nutrition while 35.9% (n = 28) were placed on parenteral nutrition. Peritonitis/infection 50% (n = 18) was the commonest indication of surgical treatment, followed by failure of medical treatment 25% (n = 9) then high output fistulas 16.7% (n = 6). Resection with end-to-end anastomosis was the preferred repaired work at 61% (n = 22). The mortality rate was 38.5% (n = 32), 29% (n = 24) healed after conservative treatment, 21.7% (n = 18) healed after surgery, 7.2% (n = 6) persisted after surgery while 3.6% (n = 3) persisted after conservative treatment. Anaemia, sepsis, electrolyte imbalance, dehydration and malnutrition were the commonest complications. Conclusion: The prevalence of enterocutaneous fistulas was high, with a female predominance and a mean age of 38 years. Most cases were seen as a referral from the periphery for better management. The greatest majority of fistulas occurred as a postoperative complications. Conservative management with enteral feedings was preferred, they had better outcomes and gave more chances of healing. The commonest indication of surgical treatment was an infection. Resection with end-to-end anastomosis was the preferred repaired work. The mortality rate was high, and anaemia, sepsis and electrolyte imbalance were the commonest complications.

Prevalence, Aetiology, and Clinical Profile of Acute Abdomen in Pregnancy in Southwest Cameroon: A 5-Year Retrospective Study

Background: Acute abdomen is one of the commonest reasons for presentation at the emergency department. The physiologic changes of pregnancy increase the chances of developing acute abdomen. The global incidence of acute abdomen in pregnancy range from 1 in 500 to 1 in 635 pregnant women. In 2018, a study in Azerbaijan reported a prevalence of 25%. However, to the best of our knowledge, very few studies have been carried out on this subject in Cameroon. Objectives: To determine the prevalence, assess the aetiologies, and review clinical profile of acute abdomen in pregnancy in the Southwest Cameroon. Methods: We conducted a 5-year retrospective study at the Obst/Gyn and Surgical units of Kumba, Buea, and Limbe Regional Hospitals. We included all files of pregnant women that were admitted for acute abdomen within the study period (1st Jan 2017 to 31st Dec 2021). Data was collected using a structured checklist adapted from previous studies. Descriptive statistics and statistical testing was done using SPSS version 25.0. Chi-square was used to compare categorical variables. p Results: Over 14,106 pregnant women were admitted to the aforementioned hospitals within the study period. 335 (2.4%) met our inclusion criteria. The patients’ age ranged from 17 to 43 years. The mean age was 27 years. Acute abdomen was more frequent (65%) in the first trimester. Ectopic pregnancy was the commonest obstetric aetiology while appendicitis was the commonest non obstetric surgical aetiology. Abdominal pain and tenderness were the most common presentation. Conclusion: The prevalence of acute abdomen in pregnancy in the Southwest Cameroon is 10 times higher than the global prevalence. Our study also confirmed the numerous aetiologies and varied clinical presentations of acute abdomen in pregnancy. Hence a wake-up call for primary care physicians.

Food intolerance and the few-foods(or oligoantigenic)diet in children with attention-deficit hyperactivity disorder

The hypothesis that some children with attention-deficit hyperactivity disorder(ADHD)may show sensitivity or allergic reactions to various food items has led to the development of the the few-foods(or oligoantigenic)diet.The rationale of the diet is to eliminate certain foods from the diet in order to exclude potential allergens contained either naturally in food or in artificial ingredients with allergenic properties.The oligoantigenic diet attempts to identify individual foods to which a person might be sensitive.First,ADHD symptoms are monitored while multiple foods are excluded from the diet.Subsequently,if symptoms remit,foods are re-introduced,while observing the individual for the return of symptoms.An advantage of the oligoantigenic diet is that it can be tailored to the individual.A growing body of evidence suggests that behavioral symptoms of subgroups of children with ADHD may benefit from the elimination of certain foods.The effect sizes of an oligoantigenic diet regarding improvement of ADHD symptoms have been found to be medium to large.Available evidence suggests that the investigation of the role of food hypersensitivities in ADHD is a promising avenue worthy of further exploration.Further large-scale,randomized controlled studies including assessment of long-term outcome are therefore warranted.

Delay for Performing Laparotomy for Extra Uterine Pregnancy in N’Djamena Mother and Child University Hospital

Background: Ectopic pregnancy is defined as any pregnancy developed outside the uterine cavity. Objective: to study the relationship between the duration of laparotomy for EP and maternal prognosis. Patients and method. This was a prospective analytical study performed during a period of six (06) months, from May 1st to October 30, 2023, on delay time to perform laparotomy for EP in N’Djamena Mother and child University hospital (NMCUH). We included in this series all patients admitted for EP managed by laparotomy. Data were collected using Word software and analyzed using SPSS 18.0 version 2018. The p value statistical test was used to compare variables (p significant if ≤5%). Results: We recorded 92 cases of EP out of 5751 pregnancies, giving a frequency of 1.6%. Among patients diagnosed with EP, 76/92 (82.6%) had an indication of laparotomy. In 90.8%, the EP was ruptured. On admission, the diagnosis of EP was made within 1 hour in 15.8% of cases. The time to sign the consent allowing doctor to operate was >1 hour in 14.5% of cases. The operating room was unavailable in 34.2% of cases, with an unavailability of >1 hour in 17.1% of cases. Total salpingectomy was performed in 93.4%. Salpingotomy was performed in 6.6%. The lethality rate was 3.9% with significant value when the delay after indication and admission in the operating room is >1 (p value = 0.03). Conclusion: Various factors, such as the search for blood products, the time loss to sign the consent form and the unavailability of the operating room, delay the laparotomy, influence maternal prognosis. Anticipation on these factors is necessary in order to limit the proportion of delays.

Tuberculosis in the Carcinal Environment in Chad Due to the Mycobacterium Tuberculosis Circulante Complex

Tuberculosis (TB) is a serious infectious disease and its control is considered a challenge, particularly among vulnerable populations such as prisoners. The prevalence of TB in prisons is an alarming public health problem in many countries. The aim of this study is to describe the epidemiology of tuberculosis and the strategies for controlling this disease in the Chadian prison population. During the course of our study, the prevalence of tuberculosis in prisons was 9.64%. The age group between 55 years and over (43.33%) was the most represented in this study, and all patients were men with a frequency of 62.66%. The cross-tabulation of Culture_7H9G and Culture_7H9P showed that out of our total positive sample, we found a total of 87 positive strains and 63 negative strains. Our study shows that it is essential to know the prevalence of tuberculosis in all the country’s prisons. Indeed, this can serve as an indication of the need for action in prisons to reduce TB rates, in particular by improving the structure of prison environments, diagnosing new cases quickly and accurately, identifying drug-resistant strains and implementing effective, direct treatment observed in people with tuberculosis.

Standardization of exercise intensity and consideration of a dose-response is essential.Commentary on "Exercise-linked FNDC5/irisin rescues synaptic plasticity and memory defects in Alzheimer’s models”,by Lourenco et al.,published 2019 in Nature Medicine

Over the past decade,several biochemical pathways have been investigated to understand the underlying mechanisms involved in the beneficial effects of physical exercise on cognition.1,2 Lourenco et al.,3 in an elegant study published in Nature Medicine,examined the relationship between exercise training and hippocampal memory function.Mechanistically,the authors showed that FNDC5/irisin is an important mediator of beneficial effects of physical exercise in a mouse model of Alzheimer's disease.

Exploring Potential of REDD+ Readiness with Social Safeguard through Diverse Forest Use Practices in Gunung Palung National Park in West Kalimantan, Indonesia

Implementation is expected to be a measure for sustainable forest management by providing benefit for forest users based on their efforts. Without careful attention for the social safeguard, the mechanism of reducing greenhouse gas emissions from deforestation and forest degradation with forest management (REDD+) might cause negative impact such as depriving of customary forest use rights under unclear tenure and forest use rights typical in Indonesia. This study aimed to explore how REDD+ Safeguard can be applied in readiness activities by analyzing practical forest use situations in a conservation forest, the Gunung Palung National Park as study site. From the results of the questionnaire survey and interviews, characteristics of forest users were identified and compared. The households, mostly Malays, practicing traditional durian collection, were recognized as main forest users depending on on-farm income especially from non-timber forest product (NTFP). Since the income structure is relatively low and unstable, some of them practice farming in forest area or sell their forest use rights to other households. They are inclined to be lack in legal farm land and certain forest use rights. Based on the findings, consideration for diverse forest users and potential readiness activities were discussed and proposed. For achieving REDD+ implementation with sustainable forest management and social safeguard, it will be necessary to respect for customary rights and take comprehensive measures as readiness efforts.

Thai Psychiatric Nurses’ Experiences and Perceptions of the Professional Role When Caring for Older People Displaying Depressive Symptoms

Purpose:?The aim of this study was to describe Thai psychiatric nurses’ experiences and perceptions of their professional role when caring for older people whom displayed symptoms of clinical depression.?Methods:?A qualitative descriptive research design was used. Thirteen psychiatric nurses working in the field of mental health and psychiatric nursing at a rural district hospital were purposively included. The data were collected through in-depth,?face to face interviews and analyzed using qualitative latent content analysis.?Results:?All participants were female, and the mean age was 43 years, and the mean experience of caring for mentally ill patients was 8.3 years. The psychiatric nurses’ experiences and perceptions of their professional role were mirrored in the following themes:?1) managing a central role in the care of the patients;?2) conflicting interests between the professional needs of caregiving and other requests;and?3) being compassionate beyond the profession.?Conclusion: The psychiatric nurses were challenged by the complexity of the caregiving situations and the partners involved in the process of caring for older people with depression. Professionally, the psychiatric nurses played an important role in preventive care and managerial work. They underwent stress under the influence of stakeholders, but they also contributed to the holistic patient care.?Health service authorities may use these results to develop plans for psychiatric nurses in managing a central role and in advocating for holistic care to mitigate the influence of stakeholders to enhance quality of caring for older?individuals with depression.

Estimation of Potential GHG Emission Reduction through Corresponded REDD Plus Activities in Remote Area in Central Kalimantan, Indonesia—Case Study in the Paduran Area

REDD plus activities corresponded in Central Kalimantan Province, Indonesia and their GHG emission reductions potential were analyzed. Target area is located in a remote area from Pa-langkaraya, Capital of Central Kalimantan Province and consisted of immigrating people mainly from Java Island. In the target area, most of local people conducted unsustainable land use activities (e.g. slash-and-burn agriculture). From analysis of past land use in the target area, there were drastic changes in land use from 1989 after migration began. Natural secondary forest with high density was greatly reduced (2010 levels are approximately 80% of 1996 levels) and converted to cropland and settlement. Also, the reduction in natural secondary forest with high density allowed Melaleuca cajuputi Powell forest to rapidly increase in size (2010 levels are approximately 3.7 times as 1996 levels). Additionally, as marked point, there was an increase in oil palm plantations from 2008 and onwards. From results of land use change in the past, mean annual GHG emissions of 5450 Gg CO2e year-1 had been continued until year 2010. To consider counter-measure for reducing GHG emissions in the target area, the relationship between past land use changes and human activities was analyzed through workshops with stakeholders of 6 different groups (village authorities, forest fire fighting team, members of farmers group, large landowners, workers outside of village and oil palm plantation and mother having small children). The results of the workshops showed that the core problem of unsustainable land use faced by 4 of the 6 groups of stakeholders was the lack of job opportunities (means to earn a living) in the target area. Also, it was learned that core groups considered oil palm plantations is to alleviate the problem and provide a source of alternative income. Furthermore, the workshops indicated that future land use scenario (reference scenario) will be based on income from oil palm plantations and, to prevent such land conversion, counter-measures (REDD plus project scenario) of indirect activities of local people’s lifestyle improvement (e.g. A new forestry system which uses abundant resources of M. cajuputi forest) and reducing pressures on forest resources should be introduced. This study indicated, by implementing REDD plus project in the target area, potential reduction in GHG emissions is quite large and such GHG reduction will be essential as mitigation activities under the new mitigation mechanism, the Joint Crediting Mechanism (JCM) between Indonesia and Japan.

Clinical Case: Place of Cardiac Stimulation in Asymptomatic Significant Chronic Aortic Insufficiency Associated with Sinus Dysfunction

The association between aortic insufficiency and sinus dysfunction is rare. We reported a case of significant chronic degenerative aortic insufficiency associated with sinus dysfunction. This was a 66-year-old patient on follow-up for asymptomatic chronic aortic insufficiency who was referred to us for a preoperative invasive hemodynamic assessment. The indication for surgery was based on the left ventricular dilation criteria. The echocardiography and cardiac catheterization showed a disappearance between the aortic insufficiency and the left ventricular repercussion. Upon discovery of the sinus bradycardia, the patient received a single chamber pacemaker set at a base rate of 70 seconds in AAIR at first and then the patient was measured remotely. At five months, cardiac pacing resulted in a significant reduction in the left ventricular diameter and volume on the echocardiography and magnetic resonance imaging;therefore surgery was postponed.

Sexual Perception of Young Lebanese Students

This article presents the sexual perception of young Lebanese students. We hypothesized that, in Lebanon and the Arab countries, premarital sex is forbidden by most cultures because of conservative societies and backgrounds. Sexuality lives as a “myth” in these conservative societies. We examined the influence of demographics and genders among a group of 706 Lebanese university students, from public and private universities, as well as the fluctuation of sexual beliefs and practices, based on their gender, demographics and social pressure. The method used was a questionnaire collected form n = 706 students, 446 females and 260 males. The female population of our sample is 62.9% of the total volunteers while the male population is 36.7%. They come from different religions (Christian, Muslim, Druze and Other), between May 2015 and December 2015. Quantitative significant results: 1) A non-conformity with the social and demographic pressure and an openness of the new generations. Similarly, it shows more permissiveness in flirting. Even though, parts of the negative answers were significantly linked to understanding the rules of prohibited sex (NO 32.4% for belief and NO 34.5% for practice);2) the reality of Lebanese youth, their integrity in engaging in a relationship, and their true daily happening of social and peer pressure;3) An opening to a natural outlook of sexual life, (25.5%) with reluctance on dating (51.1%);4) An important significance is showed in the percentage between beliefs and practice: 18% in belief and 78.3% in practice (Q1) and 34.2% in belief and 60.8% in practice (Q2) emphasizing on the reality of sexual engagement within Lebanese youth;5) However, reluctance in engaging in sexual activity and attachment and fear to social sanctions toward premarital sex and agreeing on abstinence before marriage. Quantitative findings supported the lack of sexual education and the prevalence of religious and social norms. This article examines Young Lebanese adolescents do not always have the same views neither the same patterns of sexual behaviors between men and women. Education and awareness are the keys to a healthy sexual life. Specifically, it considers the way they receive their sexual education, the acceptance and refusal of differences between genders, beliefs and practices. It becomes a real challenge when it comes to early learning and education, openness, and real communication of sexual life, being a natural part of life, with honesty and transparency.

Application of unified protocol as a transdiagnostic treatment for emotional disorders during COVID-19: An internet-delivered randomized controlled trial

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has been an emotionally challenging time,especially for young adults.It is associated with a substantial increase in the prevalence of mental health problems,negative symptoms,and stressful experiences that compromise well-being.In low-income countries,internet-delivered psychological services could have a remarkable impact on the population’s mental health,given the lack of mental health professionals.AIM To investigate the efficacy of internet-delivered cognitive-behavior therapy(CBT)-transdiagnostic intervention for adults with emotional disorders.METHODS In this internet-delivered randomized controlled trial,102 students with an emotional disorder(mean age=28.20 years,standard deviation=5.07)were randomly allocated to receive unified protocol(UP)(n=51)or treatment as the usual intervention.Following a semi-structured clinical interview,participants completed an online survey including the Overall Anxiety Severity and Impairment Scale,Overall Depression Severity and Impairment Scale,Difficulties in Emotion Regulation Scale,Positive and Negative Affect Schedule,and Emotional Style Questionnaire.RESULTS The participants showed a high degree of adherence.In total,78%(n=40)of the experimental group participants completed the UP treatment.Considering the intention to treat procedure,the results of the analysis of covariance indicated that participants who received UP showed statistically significant changes in depression symptoms[Cohen’s d=-1.50 with 95%confidence interval(CI):-1.90 to-1.10],anxiety(Cohen’s d=-1.06 with 95%CI:-1.48 to-0.65),difficulties with emotion regulation(Cohen’s d=-0.33 with 95%CI:-0.7 to-0.06),positive affect(Cohen's d=1.27 with 95%CI:0.85 to 1.68),negative affect(Cohen’s d=-1.04 with 95%CI:-1.46 to-0.63),and healthy emotionality(Cohen’s d=0.53 with 95%CI:0.09 to 0.13)compared with the control group.CONCLUSION This study’s findings highlight the potential value of transdiagnostic internet-delivered programs for young adults with an emotional disorder during the COVID-19 pandemic,and expand the research examining emotional well-being improvements resulting from CBT-transdiagnostic interventions.The findings suggest that UP,which generally concentrates on reducing negative effects,can increase positive effects.

The Effectiveness of Cognitive Rehabilitation on Improving the Selective Attention in Patients with Mild Cognitive Impairment

Purpose: The aim of the present study is to evaluate the effectiveness of cognitive rehabilitation on improving selective attention in patients with mild cognitive impairment. Methods: It was a quasi-experimental study with pre-test and post-test. The population in this study was all individuals referred to a neurology clinic in Tehran in 2012. The group was comprised of 40 patients with mild cognitive impairment who were evaluated with early detection and assessment by a medical psychologist (MMSE score lower than 25 and Wechsler memory test) and were selected by available sampling. They were also older than 55 years and had a minimum education at degree level, together with a lack of neurological and psychiatric comorbidities and impaired sensory and motor retardation, according to their nursing history and medical records. They were randomly divided into experimental and control groups (20 patients in each group). The experimental group was given 12 sessions (two hours each section) of cognitive rehabilitation with Neurocognitive Joyful Attentive Training Intervention (NEJATI). The control group, as expected with this group, did not receive any trial period. The selective attention of both groups was evaluated, before and after receiving intervention, by a Strop computer programme. Data were analysed using the covariance statistical test, MANCOVA. Results: The results show an increase in selective attention scores in the experimental group compared with the control group. Therefore, we can conclude that cognitive rehabilitation leads to improvement in the performance of selective attention (F = 4/97;