Professional Secrecy and Privileged Communication in Medical Practice

A medical professional has the faith and confidence of society in him/her. It is his utmost duty and responsibility to uphold the ethical standards of confidentiality, set forth in the Hippocratic Oath, the Declaration of Geneva, the International Code of Medical Ethics and the World Health Organization. Communication between the physician and his patient is privileged. This information can only be divulged, in part, under special circumstances

Lived experiences, self-perceived health and sense of coherence

It includes 4 articles 2 studies published and two papers submittedABSTRACT The overall aim in this thesis was to describe the lived experiences of children with spina bifida (SB) and their mothers while living under specific social and cultural conditions in West Bank, Palestine. A further aim was to gain knowledge about the impact of SB on self-perceived health and sense of coherence (SOC) among a group of children and adolescents with SB in comparison to their healthy peers. Study I and II involved narrative interviews with 20 mothers and 10 children, respectively, which were analysed with the phenomenological-hermeneutical method. Study III and IV involved selfreported questionnaires. The Pediatric Quality of Life Inventory (PedsQLTM 4.0) was used in Study III to assess self-perceived health in 50 children with SB in comparison with 150 healthy children. In Study IV, the PedsQLTM 4.0 and SOC scales were used to assess self-perceived health and SOC in 50 adolescents with SB in comparison with 150 healthy adolescents. The association between self-perceived health, SOC and levels of impairment in children and adolescents with SB was also investigated. The findings in this thesis show that children with SB, their mothers and other family members were struggling with negative sociocultural beliefs about the disability. Stigmatisation, political conflict and consequent poor health care services were shaping the daily life experiences of the children and their families. The lack of knowledge about health care needs of the child with SB had a true effect upon the mothers’ well-being, and increased their burden. Children with SB were struggling with social exclusion and seemed to possess a negative self-concept. Children and adolescents with SB perceived their health to be worse than the health of their peers. SOC was lower in adolescents with SB than it was in their healthy peers. Levels of impairment in mobility and hydrocephaly associated negatively with self-perceived health in children and adolescents with SB, while bladder dysfunction was negatively associated with SOC only among the adolescents. In conclusion, stakeholders, policy makers, health care providers and educators in Palestine must be aware of the extent of the burden and suffering experienced by children with SB and their families. Health promotion and social support for this group of children and their families can be achieved through the development and implementation of effective policies and strategies, such as a family-centred care (FCC) approach, within health care systems and rehabilitative practices in the Palestinian context.Not funde

Physical Activity and Obesity Indicators: National Cross Sectional Study on Lebanese Adults

Association between higher levels of physical activity and lower rates of obesity has been shown. The aim is to assess the relation between the prevalence of physical activity and the Physical Activity Index (PAI) of 300 Lebanese healthy adults, with age, gender, occupation, body mass indices and waist circumferences (WC). The cutoff points of WC for both genders were determined using the values of Body Mass Index (BMI). A cross-sectional study using self-reported valid questionnaire was conducted randomly on 150 men and 150 women, between 18 and 74 years, from Beirut region. Association between variables was performed using chi2, T-Test and ANOVA. Linear regression determined the WC cutoffs based on BMI. 22% of the population was obese with WC mean level of 92.47±14.4cm (87.71±14.4 cm for women and 97.24±12.96 cm for men). The prevalence of physical activity was 34% in overall population (27% in women and 40% in men).There was no significant association between BMI values and PAI (p< 0.085 for men and p< 0.300 for women). However there was an inverse association between WC values and PAI in both genders (p<0.043 in men and p< 0.036 in women). Linear regression showed WC cut-off point in Lebanese women with BMI ≥25 kg/m2 and ≥30 kg/m2 of 86 cm and 100 cm respectively, whereas for men it was 92.12 cm and 105 cm respectively. The prevalence of physical activity in Beirut is low with differences among genders. The highest physical activity index is associated with the decreased values of waist circumference

PERBEDAAN VOLUME PERDAGANGAN SEBELUM DAN SESUDAH PEMECAHAN SAHAM

Pemecahan saham adalah memecah selembar saham menjadi beberapa lembar saham. Peristiwa pemecahan saham ini menjadikan harga saham lebih rendah dibandingkan dengan sebelumnya sehingga menimbulkan minat beli investor dan meningkatkan trading volume activity saham. Bank BCA memanfaatkan peristiwa pemecahan saham agar harga sahama menjadi lebih rendah sehingga dapat dijaungkau semua investor. Penelitian ini bertujuan untuk melihat perbedaan trading volume activity terhadap pemecahan saham pada bank BCA. Penelitian ini menggunakan metode studi peristiwa, yaitu mempelajari pengaruh pemecahan saham terhadap pasar saham. Hasil penelitian menunjukkan bahwa tidak ada perbedaan trading volume activity sebelum ataupun sesudah pemecahan saham

Biology of pink stem borer, Sesamia inferens (Walker) on maize, Zea mays

Biology of pink stem borer, Sesamia inferens (Walker) (Lepidoptera: Noctuidae) was conducted during 2015-16 in laboratories of CCS Haryana Agricultural University, Regional Research Station, Karnal on HQPM 1 (hybrid) and HKI 1128 (inbred) for two generations at room temperature. Results on biology of S. inferens in the first generation revealed that incubation period varied from 10-14 days on HQPM 1 and 11-15 days on HKI 1128. The larval duration lasted for 21-37 days on HQPM 1 and 24-39 days on HKI 1128. The adult longevity of male and female ranged from 6-7 days and 7-8 days on HQPM 1 and 5-7 days and 6-7 days on HKI 1128, respectively. The total life span ranged from 63-72 days for female and 45-58 days for male on HQPM 1 and 65-74 days for female and 49-62 days for male on HKI 1128, respectively in the first generation. The total life span in second generation ranged 94-107 days for female and 83-96 days for male on HQPM 1 and 98-112 days for female and 86-101 days for male on HKI 1128. The biology of an insect pest is a condition precedent to find out its management strategies. The biology of S. inferens on maize has not yet been studied in north western part of the country. Having regards to the fact that no systematic work on this aspect has been carried out, studies were conducted on biology of this pest for developing efficient pest management strategies

Approximate Regular Modules

There are two (non-equivalent) generalizations of Von Neuman regular rings to modules; one in the sense of Zelmanowize which is elementwise generalization, and the other in the sense of Fieldhowse. In this work, we introduced and studied the approximately regular modules, as well as many properties and characterizations are considered, also we study the relation between them by using approximately pointwise-projective modules

THE HDAC INHIBITOR SODIUM PHENYLBUTYRATE ENHANCES THE CYTOTOXICITY INDUCED BY 5-FLUOROURACIL, OXALIPLATIN, AND IRINOTECAN IN COLORECTAL CANCER CELL LINES

Objective: The main objective of this study was to evaluate the ability of sodium phenylbutyrate (NaPB) to enhance the cytotoxicity of 5-fluorouracil, oxaliplatin, and irinotecan against colorectal cancer cell lines expressing wild-type and mutant p53.Methods: The antiproliferative effect of NaPB alone or in combination with 5-fluorouracil, oxaliplatin, or irinotecan in HCT-116 and HT-29 colorectal cancer cell lines was investigated using the MTT cell proliferation assay. IC50 values were calculated using Compusyn Software 1.0 (Combosyn Inc.). Synergy values (R) were calculated using the ratio of IC50 of each primary drug alone divided by combination IC50s. For each two pairs of experiments, student's t-test was used for analysis. In combination studies, one-way ANOVA test; Tukey post-hoc testing was performed using R 3.3.2 software. P-value<0.05 was considered significant.Results: NaPB inhibited the growth of HCT-116 and HT-29 cell lines in a dose-dependent manner (IC50s 4.7 mmol, and 10.1 mmol, respectively). HT-29 cell lines (mutant p53) were more sensitive to NaPB at low concentrations (<4 mmol). Moreover, the addition of NaPB to HCT-116 and HT-29 with 5-fluorouracil, oxaliplatin, or irinotecan synergistically induced the antiproliferative effect (R>1.6, p-value<0.05).Conclusion: NaPB enhanced the cytotoxicity of conventional chemotherapy against colorectal cancer cell lines harboring wild-type or mutant p53. Thus NaPB is a promising potential adjuvant chemotherapy in colorectal cancer