Editor(s)

Dr. Win Myint Oo
Associate Professor,
Faculty of Medicine, Sibu Clinical Campus, SEGi University, Malaysia.

ISBN 978-93-90149-94-0 (Print)
ISBN 978-93-90149-95-7 (eBook)
DOI: 10.9734/bpi/idhr/v1

This book covers key areas of health research. The contributions by the authors include  menopause, mammogram, mammographic density, mammograms, breast cancer, micrometrics properties, Bulk density, tapped density, compressibility index, Carr’s index, Hauser’s ratio, sieve analysis, drug excipient interactions, fineness, flow ability and compressibility, placental weight, birth weight, placental-birth weight ratio, electric field, extra-virgin oil, trans fatty acids, undifferentiated carcinoma of nasopharyngeal type, Epstein-Barr virus, IgG/IgA antibody titers, plasma, DNA load, remission, sound pressure levels, reverberation time, speech transmission index, occupational health, voice disorders, hearing disorders, relative frequency, modified Delphi technique, public health nurses, quality care metric development, health promotion, maternal health, metabolic syndrome, infertility, reproductive health. This book contains various materials suitable for students, researchers and academicians in the field of health research.

Media Promotion:

### Chapters

##### Study on Mammographic Breast Pattern in Postmenopausal Women in Ibadan, South-Western Nigeria

O. S. Bassey, T. O. Soyemi, A. T. Adeniji-Sofoluwe, A. O. Adeoye, O. A. Mosuro, T. S. Akingbola, O. O. Osofundiya, G. O. Obajimi, A. O. Oluwasola, M. O. Obajimi, O. I. Olopade

Issues and Development in Health Research Vol. 1, 6 July 2021, Page 1-12
https://doi.org/10.9734/bpi/idhr/v1/2160D

Introduction: Mammographic density is a strong predictor of breast cancer. Menopause has a significant effect on breast pattern and has been documented to have more important influence on the decline in mammographic densities than age. The aim of this study was to describe the breast parenchymal density patterns in postmenopausal women in Ibadan and correlate these with their socio-demographic and anthropometric characteristics.

Methodology: This is a retrospective cross-sectional study of 196 postmenopausal women who had two screening views done on each breast in the Radiology Department of the University College Hospital Ibadan. Data was pulled from completed questionnaire by patient who had mammogram during the period under review. The report of the mammograms were matched with patients’ socio-demographic characteristics and entered into R statistical package for analysis.

Results: The mean age of the women was 55.0±6.8 years while their mean age at menopause was 48.4±4.6 years. The combined BI-RADS 1 and 2 breast parenchymal patterns which are associated with low risk of breast cancer, were found in 82.1% of the women. The mean difference in age at first birth between women with BI-RADS 1 and 2 and BI-RADS 3 and 4 was statistically significant P=0.035. Body mass index, family and personal history of breast cancer also showed correlation with breast parenchymal pattern, though not statistically significant.

Conclusion: The low prevalence of dense breast pattern in this study is consistent with previous findings of relatively lower prevalence of breast cancer in African women. The clustering of low mean age at birth of first child, low mean age at menopause and multi-parity, in association with the low mammographic density in majority of the women in this study further corroborates the relatively reduced risk of breast cancer in our studied population.

##### Preformulation Studies for Generic Omeprazole Magnesium Enteric Coated Tablets: Advance Study

C. O. Migoha, M. Ratansi, E. Kaale, G. Kagashe

Issues and Development in Health Research Vol. 1, 6 July 2021, Page 13-25
https://doi.org/10.9734/bpi/idhr/v1/1525F

Preformulation is an important step in the rational formulation of an active pharmaceutical ingredient (API). Micromeritics properties: bulk density (BD) and tapped density (TD), compressibility index (Carr’s index), Hauser’s ratio (H), and sieve analysis were performed in order to determine the best excipients to be used in the formulation development of omeprazole magnesium enteric coated tablets. Results show that omeprazole magnesium has fair flow and compressibility properties (BD 0.4 g/mL, TD 0.485 g/mL, Carr’s index 17.5%, Hauser’s ratio 1.2, and sieve analysis time 5 minutes). There were no significant drug excipient interactions except change in colour in all three conditions in the mixture of omeprazole and aerosil 200. Moisture content loss on drying in all three conditions was not constant and the changes were attributed to surrounding environment during the test time. Changes in the absorption spectra were noted in the mixture of omeprazole and water aerosil only in the visible region of 350–2500 nm. Omeprazole magnesium alone and with all excipients showed no significant changes in omeprazole concentration for a 30-day period. Omeprazole magnesium formulation complies with USP standards with regards to the fineness, flowability, and compressibility of which other excipients can be used in the formulation. Omeprazole magnesium powder did not change when subjected to stressful conditions of higher temperatures and relative humidity.

##### Determining the Placental-Birth Weight Ratio at Term at the Benue State University Teaching Hospital, Makurdi, North-Central Nigeria: A Cross-Sectional Study

P. O. Eka, T. Z. Swende, A. O. Ojabo, B. T. Utoo, A. A. Ornguze, S. K. Hembah- Hilekaan

Issues and Development in Health Research Vol. 1, 6 July 2021, Page 26-32
https://doi.org/10.9734/bpi/idhr/v1/7484D

Background: The birth weight of a neonate depends mainly on optimal placental growth and function in utero. Measurement of the placental weight, the neonatal birth weight and the placenta-birth weight ratio is an indirect way of assessing this vital relationship. This underscores the significance of placental weight as a major determinant of neonatal weight.

Objective: To determine the placental weight, birth weight and placental- birth weight ratio in a cross-section of subjects attending our antenatal clinic

Methodology: This was a clinic-based cross-sectional study from July 31, 2015 to June 30, 2017. Four hundred and forty-four (444) subjects attending our antenatal clinic were recruited through systematic random sampling. The placental weights and birth weights were measured within one hour of delivery using a table –top beam weighing scale. Statistical analysis was performed with SPSS version 20.0 and significance set at a P-value of <0.05.

Results: Four hundred and forty-four subjects (whose mean age was 28.75 years, mean parity was 1.5 and mean gestational age at delivery was 38.70 weeks) participated in the study. The mean placental weight was 670 g, the mean birth weight was 3300 g and the mean placental-birth weight ratio (PBWR) was 20.3. Two hundred and eighteen (49.1%) of the neonates were male and 226(50.9%) were female. There was a positive correlation between the placental weight and the placental-birth weight ratio(X2 = 108.570; p-value = 0.001). There was a progressive decline in the PBWR with gestational age at term.

Conclusion: The placental weight increased with the birth weight and the gestational age. The placenta-birth weight ratio declined progressively with gestational age.

##### Analysis of the Effect of Long-Term Electric Field Treatment on the Spatial Configuration of Fatty Acids in Raw Avocado Oil (Persea americana Mill var. Hass)

José Alberto Ariza-Ortega, María Reyna Robles-López, Raúl René Robles-de-la-Torre

Issues and Development in Health Research Vol. 1, 6 July 2021, Page 33-37
https://doi.org/10.9734/bpi/idhr/v1/10302D

The main objective of this study was to evaluate the stability of fatty acids in raw avocado oil when the product is subjected to different electric field treatment conditions (voltage: 5 Kilo-Volts cm-1, frequency: 720 Hertz and treatment time: 5, 10, 15, 20 and 25 min). Fatty acids were analyzed by gas chromatography. The raw avocado oil had a higher concentration of unsaturated fatty acid (83.31%), where oleic (60.6%) was predominated. The elaidic fatty acid content was quantified at a lower percentage (0.01%) than reported by the Food Safety Commission of Japan, Tokyo. The electric field treatment did not affect the concentration and quality of fatty acids in the raw avocado oil.

##### Determination of EBV Serology and Plasma EBV DNA Load as a Combined Tool for Nasopharyngeal Carcinoma (NPC) Diagnosis

Ksenia Smirnova, Natalia Senyuta, Anatoly Lichtenstein, Vladimir Gurtsevitch

Issues and Development in Health Research Vol. 1, 6 July 2021, Page 38-53
https://doi.org/10.9734/bpi/idhr/v1/10560D

There is limited information regarding the clinical significance of Epstein-Barr virus (EBV) markers for nasopharyngeal carcinoma NPC diagnoses and monitoring in non-endemic areas.

Low NPC incidence in non-endemic countries made it difficult to form a representative group of patients for research this issue. Moreover, NPC cases are often characterized into morphologically different tumor types based upon the geographic and ethnic variability. Since viral and serological markers reflect the different biological events accompanying the development of NPC, it is important to compare their clinical value in the context of different disease manifestations. The implementation of such a study in a non-endemic region is of particular interest, allowing the investigation of the potential impact of differences in the genetic and ethnic characteristics of the population, versus those in populations from endemic regions.

In present study, we analyzed clinical significance of two EBV markers (serological and molecular) in large group (96 cases) of undifferentiated non-keratinizing carcinoma of nasopharyngeal type (UNPC) Russian patients. It has been shown that IgA/VCA antibody titers elevated on patient's admission and being valuable markers for primary UNPC diagnosis do not allow to adequately assessing patients’ state after the treatment. In contrast to EBV serology, the plasma EBV DNA load was found to be valuable marker for clinical evaluation of UNPC patient’s state, such as remission and relapse. It was also shown that the concentration of viral DNA correlated with the UNPC patients' overall survival.

The proposed study, conducted on UNPC patients from a non-endemic region, for the first time revealed a direct correlation between IgG /IgA antibody titers to EBV virus capsid antigen (VCA) and the levels of plasma EBV DNA load, and the absence of such correlation between plasma EBV DNA burden and serological responses to EBV. t has also been demonstrated that the combined assessment of plasma EBV DNA load and EBV-specific antibody titers provides a reliable approach to UNPC diagnosis, disease monitoring, and therapeutic response assessment.

##### Reaction of Clients and Fitness Instructors to Noise in Fitness Centers

Paulo Henrique Trombetta Zannin, Karyn Lia Hamad Anjelo, Andrei Rei Rodrigues Silveira

Issues and Development in Health Research Vol. 1, 6 July 2021, Page 54-96
https://doi.org/10.9734/bpi/idhr/v1/10018D

Noise is increasingly associated with leisure activities in Brazil, including working out in fitness centers, where thousands of instructors and clients are exposed to high sound pressure levels for several hours a day without using any type of protection. This is a cause of concern for their mental and physical health. This research involved an evaluation of noise levels in fitness centers based on measurements of sound pressure levels – equivalent sound levels (Leq), minimum (Lmin) and maximum (Lmax) levels, simulations of acoustic parameters (reverberation time – RT and speech transmission index – STI), and identification of the effects of noise on instructors and clients. Data were collected during workout sessions using a Brüel & Kjær 2238 sound level meter.

Computer simulations were performed using Odeon Room Acoustics v. 9.2 Combined software. The effects of noise on instructors and clients at fitness centers were identified based on their answers to a questionnaire. The data were analyzed statistically using R version 2.11.1 software, and the level of significance was set at 5% (p $$\le$$ 0.05). The findings indicated that sound pressure levels (Leq) varied from 82 to 100 dB(A), reaching a maximum level (Lmax) of 117.2 dB(A), which exceeds the legally established noise level limits. Modifications made in fitness centers were found to reduce reverberation time and change the classification of the speech transmission index from poor to satisfactory, thereby improving the acoustic properties in these fitness centers. The effects most commonly reported by clients and instructors were tiredness and vocal fatigue. Fitness instructors reportedly underwent several vocal changes by the end of their workday, the most common one being hoarseness. It was concluded that, contrary to expectations, the environments of fitness centers where people seek to improve their health and engage in leisure activities present high sound pressure levels similar to those of industrial environments, causing extreme concern regarding the health of their clients and especially that of their working fitness instructors. The findings of this study clearly indicate the need for measures to minimize and control the harmful effects of noise in fitness centers. This can be achieved by controlling the exposure of fitness instructors and clients through noise reduction measures, such as the installation of noise absorption materials on the ceilings and walls of fitness centers. Another way to control noise is to reduce the sound levels of music played during workout sessions.

##### Focality of Aedes (Stegomyia) aegypti Mosquito (Diptera: Culicidae) from the Chronology to the Trend Analysis in Villa Clara Province, Cuba: A Recent Study

Rigoberto Fimia-Duarte, Ricardo Osés Rodríguez, Idalberto Machado Valenzuela, María Patricia Zambrano Gavilanes, Yamilka Rios Ruiz, Rafael Armiñana García, Frank Manuel Wilford González, Freddy Eli Zambrano Gavilanes

Issues and Development in Health Research Vol. 1, 6 July 2021, Page 97-122
https://doi.org/10.9734/bpi/idhr/v1/11066D

The objective of the study was to characterize the time series and trends for the focality of the Aedes aegypti mosquito, by both months and years (2007- 2017) in Villa Clara province, Cuba. In Cuba, the incidence of these entities, both parasitic and viral, is undoubtedly a health problem , with a tendency to increase the number of cases, as well as the populations of vector organisms.  The research covered the 13 municipalities of the province, as well as the number of breeding sites reported by them in the different months of the analyzed period. An observational, descriptive, ecological, retrospective and statistical study was conducted, for which all the information was collected from the work cycles established for vector surveillance and control in the universe of houses and buildings in the urban areas of the 13 municipalities. The data were organized by years and months with the Excel application of Windows. The SPSS statistical package version 19.0 (the ENTER and the ERROR methods) was used to process the data. Santa Clara, Ranchuelo, Placetas, Manicaragua, Santo Domingo, and Sagua la Grande municipalities were found to have the highest absolute frequency (Fi), something very similar for the case of the cumulative relative frequency (fai), with slight changes in relation to the position of the municipalities. The focality of the Ae. a vector, reported by months, showed a direct proportional correspondence with the one reported provincially, July through November being the months with the greatest focality. It is concluded that there are environmental and anthropic conditions that favor the establishment and maintenance of the Ae. a vector focality throughout the year in Cuba.

##### Progressing Quality Care Process Metrics for Public Health Nursing: An Approach towards Modified Delphi

L. O’Connor, E. McAuliffe, M. Casey, L. Rogers, A. Gallen, M. E. Glasgow, C. White, C. Buckley, M. Giltenan, A. Lane, M. Barnard

Issues and Development in Health Research Vol. 1, 6 July 2021, Page 123-142
https://doi.org/10.9734/bpi/idhr/v1/2788F

Background: Nursing plays a central role in facilitating care in the community setting, yet there is no consensus of public health nurses contribution to care, and how to measure what hidden or explicit things they do to provide high quality and safe care. A modified Delphi approach with an expert panel was established with the purpose of identifying quality care process metrics for public health nursing care, and respective indicators that could measure their unique and multidimensional contribution to care.

This modified Delphi study integrated a four round survey of 218 nurses, face-to-face meetings with a patient representative and key stakeholder holders within public health nursing services, with a final consensus meeting inclusive of a panel of 29 expert nurses in the community setting.

Results: Delphi rounds 1-4 led to a consensus on fourteen quality care process nursing metrics and sixty-nine associated indicators incorporating expert panellists’ suggestions for the community care setting. Notwithstanding the rating of ‘critical’ in the Delphi rounds, in depth discussions were conducted on all proposed metrics and indicators at the final consensus meeting, and in particular emphasising the key role performed by public health nurses in the context of ‘Maternal Health’, ‘Care Plan Development and Evaluation’ and ‘Health Promotion’.

Conclusion: This paper describes through the lens of public health nursing the development of a set of 14 quality care metrics using a modified Delphi technique aligned with a set of 69 corresponding indicators. The challenge now is the implementation of these quality care process metrics so that public health nurses’ unique and multidimensional contribution to patient-centered care is measurable in the community setting.

##### Study on Reproductive Disorders in Patients with Metabolic Syndrome and Obesity: Pathogenesis, Clinical Manifestations and Prevention

O. Yelizarova, E. Omelchenko, B. Nykula, O. Lynchak, O. Procuk, O. Polka

Issues and Development in Health Research Vol. 1, 6 July 2021, Page 143-155
https://doi.org/10.9734/bpi/idhr/v1/10703D

The metabolic syndrome (MetS) increase prevalence leads to the growing attention of medical scientists. Studying the aetiology, consequences and prevention of MetS is necessary to improve medical care for patients with this disease and is also an important social issue.

The purpose of the study is to light the basic reasons for the development of reproductive disorders in patients with metabolic syndrome and lifestyle role in the prevention of negative reproductive events.

Methods: Contextual searches were performed in Cochrane Library, PubMed as well as WHO recommendations and leading European and American associations on the management of patients with Mets. Inclusion criteria were both review articles and single studies reporting the analysis of modern ideas about the pathogenesis of reproductive health in patients with Mets.

Results: The issues of pathogenesis, clinical manifestations, outcomes and prevention of reproductive disorders and infertility in patients with MetS and obesity studied. It was found that the main reproductive disorders of men with MetS were decreased testosterone levels, decreased sperm fertility and erectile dysfunction. In women with MetS, metabolic disorders also lead to reproductive disorders such as infertility, menstrual irregularities, premature birth, births of children with congenital anomalies.

Conclusions: Reproductive disorders in patients with MetS can have negative consequences for individuals as reduced quality of life, depression and increasing metabolic disorders, and for the countries as depopulation. Normalization of basal metabolic rate by exercise and a diet improves reproductive health in patients with MetS. However, despite the proven positive impact of lifestyle adjustment, the search for the best treatment for reproductive disorders of patients with MetS remains open.