Supporting and Educating Strategies for Children with Autism Spectrum Disorders

Nov 4, 2024 | Children's Health

Written by Dr. Mukti Thapaliya, RTLB Cluster 9, Ph.D. in Education

Introduction

This article describes the meaning of Autism Spectrum Disorders (ASD), the characteristics of ASD, the diagnosis process of ASD, ASD diagnosis instruments, and the strengths and interests of children with ASD. The article also presents supporting and educating techniques, behaviour management strategies and communicating strategies for students with ASD.

Understanding Autism Spectrum Disorders

Before the publication of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) (APA, 2013), various terms were used to refer to children with complex neurodevelopmental conditions (e.g., ASD, atypical autism, childhood psychosis, childhood schizophrenia, and autism). The term “autism” was defined differently from childhood schizophrenia and other psychoses, such as “pervasive developmental disorders” (PDDs), after the publication of DSM-III. Moreover, DSM-IV included several subtypes of PDD: autism, AS, PDDNOS, Rett syndrome, and disintegrative disorder (APA, 2013). After the DSM-5, the subcategories were eliminated and replaced with the single diagnosis of “ASD” and the DSM-5 revised the diagnostic criteria for children with autism spectrum disorders (APA, 2013). The term ‘ASD’ is used throughout this article – consistent with DSM-5 diagnostic criteria.

Characteristics of students with ASD

Students with autism may experience difficulties in the following areas. Table 1 presents characteristics of students with autism.

Table 1 characteristics of students with autism

Communication

Social interaction

Restricted and repetitive patterns of behaviour

● delay in speech and language

● have trouble understanding other people

● hard communicating what they want

● could use body parts or objects to indicate what they want to say

● may have an unusual tone, pitch, or accent

● may not understand non-verbal communication (e.g., facial expressions, body language, and gestures)

● may have difficulty following instructions

● Sometimes may appear not to hear at all

● may not join in play with other students and may appear disinterested in other people

● may prefer to play or be alone

● may not play as often as same-aged peers

● rarely bring toys and objects to share with other students

● may not respond to other people’s greetings or smiles

● may experience difficulty with social situations and understanding social rules

● may not understand others’ emotions, thoughts, or actions

● difficulty with eye contact

● A strong preference for routine and order

● get very upset if their routines are interrupted

● may have trouble with transitioning to new environments

● may have a special interest that they enjoy talking about a lot

● may use behaviour including challenging behaviour as a way of communicating

● may appear to be clumsy and have poor motor skills

● may make unusual movements or sounds

● may have poor problem-solving or organisational skills

● hyper or hypo-sensitive to various stimuli (link to sensory)

(Altogether Autism, 2023; APA, 2013).

Strengths and interests of students with ASD

Students with ASD excel in various learning styles, including acquiring knowledge. Specifically, they may be good at:

rote learning
remembering information for extended periods
detailed and chunk-based learning
paying close attention to small details
concentrating on narrow topics of interest
using visual information meaningfully
using concrete information, understanding and following rules
actions and thought logical processes
follow strict rules

Diagnosis process for students with ASD

There are several theories about the causes of ASD, but none of them have been scientifically proven (Autism New Zealand, 2020; Thapaliya, 2023a, 2023b). Researchers are still investigating varied factors that might contribute to the development of ASD. Some studies suggest that people with ASD may have genetic predispositions, whereas other research signals viral infections, structural and functional brain abnormalities, and dysfunctional immune systems (APA, 2013).

The diagnostic process requires input from multiple professionals (e.g., child psychologists, educational psychologists, pediatricians, clinical psychologists, audiologists, and teachers) and parents (APA, 2013). Professionals also involve an evaluation process. Specifically, the following criteria are commonly used to diagnose ASD:

assessments of multiple areas of functioning (e.g., intellectual and communication skills, a review of developmental history)
parental input
medical tests (a loss of hearing test and eye test before considering a diagnosis of ASD)
assess multiple areas of functioning
collect information from a variety of settings
provide a single coherent view
provide implications for adaptation and learning
liaison with schools and other agencies to support the implementation of recommendations
developmental history
diagnostic assessment of speech, language and communication
sensory and motor skills assessments
medical evaluations

Figure 1 presents the two diagnosis domains of ASD based on DSM-5: communication and repetitive patterns of behaviour (APA, 2013).

(APA, 2013)

Diagnostic instruments

The following diagnostic tools may be used to diagnose autism spectrum disorder.

Diagnostic and Statistical Manual of Mental Disorders (DSM)- 5
Asperger Syndrome Diagnostic Interview (ASDI)
Asperger Syndrome Screening Questionnaire (ASSQ)
Australian Scale for Asperger syndrome (ASAS)
Autism Behaviour Checklist (ABC)
Autism Diagnostic Observation Schedule (ADOS) and ADOS-G
Autism Screening Questionnaire (ASQ)
Autistic Diagnostic Interview (ADI, and also ADI-R)
Childhood Asperger Syndrome Test (CAST)
Childhood Autism Rating Scale (CARS)
Child Communication Checklist (CCC)
Checklist for Autism in Toddlers (CHAT)
Diagnostic Interview for Social Communication Disorders (DISCO)
Gilliam Autism Rating Scale (GARS)
Parent Interview for Autism (PIR)
Pervasive Developmental Disorders – mental retardation (PDD-MR)
Social Response Scale (SRS)
Treatment and Education of Autistic and related Communications Handicapped Children (TEACCH) checklist
Wing Autistic Disorder Interview Checklist (WADIC)

Teaching and learning strategies for students with ASD

Researchers recommend a wide range of teaching approaches, methods, and techniques to teach students with autism, such as structured teaching programmes, social stories, visual cues, sensory corners in the classroom, and using assistive technology to deliver course content in the classroom (Autism New Zealand, 2020; Bevan-Brown & Dharan, 2016; Thapaliya, 2023). The following section describes key teaching strategies for students with ASD.

Rules of 5 (Fewer than 5 words, wait 5 seconds)

In this strategy, teachers have to present the information in sentences that only have five words. Teachers can give students five seconds to comprehend each statement so they can focus on and understand what you said. For example,

Stay in your seat
Hand on pencils only
Use friendly words
Raise your hand to speak
Focus on your task

Use the student’s name first

Saying the student’s name first gets the students’ attention and allows them to work out that the teacher is speaking to them. For instance, teachers can frequently remind them to do the task. Tom, time for math.

Giving positive direction

Teachers need to give positive direction while instructing students with autism in the classroom because students with autism may have trouble when they hear the word ‘no’. For example, ‘Please use a tissue, instead of saying ‘Stop picking your nose!’.

First-then strategies

A first-then strategy may provide the students with a visual means of introducing a new task in a way that they can understand. This technique helps to establish a routine and controlled environment for students with autism. Specifically, teachers can use a first-then strategy to increase independence, provide predictable environments/activities, clarify expectations while providing sequencing of events, support transitions (activity to activity or between locations), reduce verbal information (prompts) provided to a child and increase motivation for completing an adult-directed task/activity (MoE, 2023). For example, first reading a passage, then having a break time.

Give warnings before an activity finish

It is recommended to give students prior warnings before ending a favourite activity to prevent anger. Three warnings, accompanied by visual cues, are the usual practice (Autism New Zealand, 2020; MoE, 2023). For example,

Hunter, you have ten minutes left to complete your math task.
Hunter, you have five minutes left to complete your math task.
Hunter, math time is finished.

Use assistive technology

Using assistive technology (e.g., computers, iPads), can help reduce learning barriers in the classroom while teaching students with autism spectrum disorders (Autism New Zealand, 2020; MoE, 2023; Thapaliya, 2023a). Using computers can be a useful tool for teaching literacy and language skills (e.g., listening, speaking, reading, and writing) and numeracy skills. Jacklin and Farr (2005) reported the benefit of using computers with students with autism spectrum disorders in the classroom because they provide a “visual impact on what they are learning” (p. 208). While completing academic tasks, students with autism spectrum disorders may gain a sense of predictability, confidence, and self-control (Murray, 2015).

Learner profile

A learner profile includes everything about students’ learning needs, strengths, and individual needs in the classroom. In other words, the learner profile can assist schoolteachers, school psychologists, and school staff in understanding the perspectives of ākonga (student) and their whānau/parent), forging relationships with them, and tailoring instruction to fit the needs of individual students (MoE, 2023). Specifically, a learner profile can provide information about students (e.g., how to communicate with students, likes, and dislikes) (Thapaliya, 2023b).

Provide visual support

Visual support refers to a shared set of tools that are employed for a variety of tasks and are more permanent than words. Visual support consists of objects that are used to visually enhance a person’s understanding of the information, physical environment, social situation, and abstract concepts (Rutherford, et al., 2020).

Visual support may assist expressive communication by serving as a substitute for words, signs, gestures, and physical acts. Visual support can support people in meeting their developmental stage by offering a variety of skills (e.g., skill acquisition, motivation to learn, and utilizing their new learning). Similarly, visual support can offer students with ASD the structure, routine, and sequence they need to participate in everyday tasks (Thapaliya, 2023b).

. For instance,

Social story support

Researchers claim that social skills are the most effective way to manage students with ASD behavioural issues if they are taught within the natural environment (Fleury et al., 2014; Murray, 2015; Ostmeyer & Scarpa, 2012). Social skills can provide an opportunity for imitative skills and observation skills for students with autism spectrum disorders, as well as help them get support from their peers and tutors.

There are three types of story support (Autism New Zealand, 2020) to improve students with ASD behaviour:

Story for self-esteem provides a positive story of student’s behaviour and learning. Also, it was applied to enhance students’ self-esteem and confidence.
Story for information offers practical information (e.g., how to brush teeth), calming strategies to reduce their anxiety, and a new classroom timetable.
Story for understanding is used to explain misunderstood communication and enhance students’ comprehension of course content.

Sensory regulation

Sensory overload sensitivity is a component of the autism spectrum diagnosis. This does not imply that all autistic students will be sensitive to sensory stimuli (APA, 2013). Students with ASD may have sensitivities to sights, sounds, smells, tastes, touch, and balance. They can experience both hyper- and hyposensitivity (under-reactivity) to a variety of stimuli. Most people combine the two in some way.

Acoustics, lighting, noise-cancellation headphones, low-arousal workspace, and scheduling regular breaks are some suggested strategies to prevent sensory overload for students with autism (Autism New Zealand, 2022). If teachers provide frequent breakout time throughout the day and calming and self-managing activities for students with autism, these activities will help students with autism cope with the classroom environment (e.g., prevent overload anxiety issues). For instance,

Give students frequent break
Check in- and check-out times
Curate a reading corner and breakout space with toys and sensory cushions

Lego therapy

LEGO-based therapy may help to develop social skills in children with autism spectrum disorder (Autism New Zealand, 2020; MoE, 2023; Thapaliya, 2023). Initially, Lego- therapy was designed to help children with ASD, but now it has been used to help kids with various social and communicative issues. In Lego-based therapy, there will be three people:

Engineer: reads the visual instructions and designs

Supplier: finds the pieces as directed by the engineer

Builder: builds the pieces

Lego-based therapy may help to:

promote social interaction
develop turn-taking skills and share with others
collaborate with others for problem-solving
develop language and motor skills
increase motivation and self-esteem
improve participation and engagement skills
feel calm and relaxed

Universal Design for Learning

Universal support approach refers to the Universal Design for Learning (UDL). The UDL has three principles and guidelines that assist in enhancing learning, including for students with ASD. According to students’ interests and learner variability, teachers can select certain guidelines to apply in their teaching and learning activities (Rao & Torres, 2016). The UDL framework has three principles: i) multiple means of engagement; ii) multiple means of representation; and iii) multiple means of action and expression (CAST, 2018)

The multiple means of engagement principle offer choices for developing likes, purposes, and self-regulation among students. The multiple means of representation principle is structured to assist learning through recognition networks and provide multiple ways of representing the curriculum. The multiple means of action and expression connect to strategic networks in the brain, and they play a key role in language learning and skill development (CAST, 2018).

Behaviour managing strategies

Students with ASD might display problematic, challenging, and aggressive behaviour (e.g., difficulty in listening to their teachers and following instructions, self-harm, difficulty following classroom rules, and repetitive disruptive behaviour). Instructional and behavioural support from behavioural therapists, educational psychologists, and clinical psychologists is put in place to assist students with spectrum disorders (Fleury et al., 2014). The use of technological interventions such as iPads is an effective intervention for decreasing challenging behaviours in the classroom. The following section describes Applied Behaviour Analysis (ABA), Functional Behavioural Analysis (FBA), and Cognitive Behaviour Therapy (CBT) to manage behaviour of students with autism spectrum disorders.

Communication managing strategies

Augmentative and Alternative Communication (AAC)

Augmentative Alternative and Communication (ACC) refers to a range of tools and techniques that assist people with complex communication needs. Students with cerebral palsy, autism spectrum disorders, developmental disabilities, childhood apraxia of speech, language delays, and other medical conditions that result in speech loss can benefit from the use of augmentative and alternative communication (ACC) (Mitchell & Sutherland, 2020).

In other words, the term ‘augmentative’ refers to resources that support and improve the existing communication abilities of a student. For instance, a student with ASD may use an iPad with communication software that produces a synthetic voice in response to a selected image. ‘Alternative’ describes communication systems that are designed to substitute for learners’ lost language and speech or are unlikely to develop in the future. For example, communicating effectively with students who have severe ASD can be challenging, especially in social situations, classrooms, and in their future endeavours where speech is a necessity. However, a high-tech system with speech output could be a temporary solution to serve as their primary means of communication.

There are three types of ACC solutions: No-tech, low-tech, and high-tech.

No-tech AAC is widely known for utilizing voluntary motor movements (e.g., sign language and facial expression analysis) to convey non-verbal messages.
Low-tech AAC utilizes simple resources such as books and whiteboards with large lexicons of words and images to support communication. For example, Pictogram Ideogram Communication (PIC), Rebus Signs, Picture Communication Symbols (PCS) and Picture Exchange Communication System (PECS) are some examples of low-tech ACC. In preschools and schools, PECS is very popular. PECS is a functional communication system that is used as a communication tool for students with speech and language difficulties. PECS teaches students to select cards with line drawings, symbols, or photos of desired items or activities and then give them to another person (e.g., communicative partner, peer, teacher, or parent) to receive the object or task.
High-tech AAC involves the use of electronic devices (e.g., iPads, laptops, computer applications and mobile phones) and speech generating devices (e.g., Proloquo2go) to achieve an AAC goal. Similarly, students with a range of difficulties (e.g., people with visual impairment) and neurological conditions may benefit from software programmes such as text- to- speech output options.

Conclusion

This article explored the meaning of autism, characteristics of students with ASD, and the diagnosis process for ASD. It presented supporting and teaching strategies. managing challenging behaviour and communication strategies for students with ASD.

REFERENCES

Altogether Autism, (2023). Autism, what is it? https://www.altogetherautism.org.nz/what-is-autism/.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5). American psychiatric association.
Autism New Zealand. (2020). Tilting the Seesaw Handbook (Ed.) Wellington: Author.
Bevan-Brown, J., and Dharan, V. M. (Eds.). (2016). Autism spectrum disorder in Aotearoa New Zealand: Promising practices and interesting issues (pp. 155-168). Wellington: NZCER Press.
Center for Applied Special Technology (CAST). (2018). UDL and the learning brain. Wakefield, MA http://www.cast.org/products-services/resources/2018/udl-learning-brain-neuroscience
Fleury, V. P., Hedges, S., Hume, K. Browder, D. M., Thompson, J. L., Fallin, K., and Vaughn, S. (2014). Addressing the academic needs of adolescents with autism spectrum disorder in secondary education. Remedial and Special Education, 35(2), 68-79. doi:10.1177/0741932513518823.
Jacklin, A., and Farr, W. (2005). The computer in the classroom: A medium for enhancing social interaction with young people with autistic spectrum disorders? British Journal of Special Education, 32(4), 202-210.
Ministry of Education, (2023, April). Resource Teachers: Learning and Behaviour Service. https://www.education.govt.nz/school/student-support/special-education/resource-teachers-learning-and-behaviour-service
Murray, J. (2015). Practical Teaching Strategies for Students with Autism Spectrum Disorder: A Review of the Literature. BU Journal of Graduate Studies in Education, 7(2), 68-75.
Ostmeyer, K., & Scarpa, A. (2012). Examining school-based social skills program needs and barriers for students with high-functioning autism spectrum disorders using participatory action research. Psychology in the Schools, 49(10), 932-941. doi:10.1002/pits.21646
Rao, K., & Torres, C. (2016). Supporting academic and affective learning processes for English language learners with universal design for learning. TESOL Quarterly, 51(2), 460–472. https://doi.org/10.1002/tesq.342.
Rutherford, M., Baxter, J., Grayson, Z., Johnston, L., & O’Hare, A. (2020). Visual supports at home and in the community for individuals with autism spectrum disorders: A scoping review. Autism, 24(2), 447-469.
Thapaliya, M. (2023a). Exploring Inclusive Practices for Students with Autism Spectrum Disorders in Mainstream Classrooms: A Case from New Zealand. Psychology Research and Practice, 2(2). DOI: 10.37155/2972-3086-0202-2.
Thapaliya, M.P. (2023b). Teaching Children with Autism Spectrum Conditions in Mainstream Classrooms. Kathmandu University. (Face-to-face workshop contribution

Flaxseed: An Ancient Superfood for Today’s Health and Wellness

Oct 27, 2024 | Nutrition

Written by Astha Paudel, Biomedical Engineering graduate (CBEAS) Nepal, Currently Navigating Bio-Nano Material Science Engineering at AIT, Thailand

Plants have long been a cornerstone of traditional medicine and nutrition, with their bioactive components contributing significantly to their medicinal value. One such plant genus with notable bioactive phytochemicals is Linum usitatissimum, commonly known as flax. Flax is an ancient crop primarily cultivated in the northern hemisphere, where it thrives in colder climates. Canada is currently the world’s largest producer of flaxseed, followed by China, Russia, the USA, India, Nepal, and several European countries. This plant is grown for both its fiber and its nutrient-rich seeds, known as flaxseeds or linseeds.

Flax fibers are used to produce the renowned textile linen, a material with a history spanning over 5,000 years [1]. Egyptian priests wore linen garments daily, and even the mummies of pharaohs were wrapped in fine linen fabrics, many of which have been preserved to this day. Linen is believed to offer several health benefits, such as improving blood circulation and enhancing sleep quality, while its unique frequency is currently being studied for its potential healing properties [2].

Given that the seed is the most utilized part of the plant, the whole plant is often referred to as the flaxseed plant. Flaxseed has been valued for centuries for its nutritional and therapeutic properties. Initially prized by indigenous communities, it has recently gained popularity among contemporary populations for its health benefits. In Ayurvedic medicine, flaxseed is renowned for its medicinal properties and healing potential. The gel derived from flaxseed is traditionally applied externally for healing bone fractures and treating skin conditions, while flaxseed oil is believed to enhance memory, improve blood circulation, boost immunity, and reduce bad cholesterol levels.

Flaxseed is an abundant source of proteins, lignans, omega-3 fatty acids, and other phytochemicals, providing numerous health advantages. It is reported to contain a high percentage (87.8-89.8%) of unsaturated fatty acids, making it an excellent source of healthy fats [3]. Research has shown that flaxseed oil is rich in alpha-linolenic acid (ALA), an omega-3 fatty acid essential for neuron myelination and memory formation [4]. Furthermore, flaxseed is a rich source of protein, comprising 23% of its total weight, and is considered a complete protein containing all essential amino acids. A comparative study revealed that flaxseed has a higher total protein content than soybeans, with a quality score of 82% [5].

The high fiber content in flaxseed helps absorb cholesterol and triglycerides, regulate blood sugar levels, and boost metabolism, thereby aiding in weight management [6]. Flaxseed is also rich in vitamins E and K, and essential minerals such as calcium, magnesium, and phosphorus, which support blood clotting, calcium deposition, and skin health [7].

Flaxseed’s antioxidant and anti-inflammatory properties make it particularly beneficial for overall health. It is often recommended by doctors for heart disease, obesity, bone deformities, and especially for treating hormonal imbalances in women. As a phytoestrogen, flaxseed naturally balances estrogen, the hormone responsible for regulating bone mass density, menstruation, and various other processes in females. It is especially beneficial for women over the age of 45 who are approaching menopause [8].

To utilize its diverse properties, flaxseed is formulated into tablets, emulsions, and powders to treat various ailments. The most common formulation is flaxseed oil capsules, which are rich in fatty acids and are effective for enhancing memory, improving skin health, and supporting weight loss. These capsules serve as an excellent alternative to fish oil for vegetarians and vegans. Additionally, flaxseed can be incorporated into daily meals by adding flaxseed powder to cooked foods or using it as a seasoning for salads.

Despite its well-documented nutritional benefits, flaxseed remains underutilized. Given its potential, it is crucial to raise awareness about this beneficial seed and encourage its wider use in daily diets.

REFERENCES

The Biology of Linum usitatissimum L. (Flax),2019 – inspection.canada.ca.
Ben-Hayil Yellen Rebbetzin Heidi Yellen, A. Director Louis Yellen, J. Klein, M. Ramirez, S. Darden, and Lady Marjorie Papin, “Healing Flax,” 2013. www.hebrewstoday.com
Kauser S, Hussain A, Ashraf S, et al. Flaxseed (Linum usitatissimum); phytochemistry, pharmacological characteristics and functional food applications. Food Chemistry Advances. 2024;4:100573. doi:10.1016/J.FOCHA.2023.100573
Siegert E, Paul F, Rothe M, Weylandt KH. The effect of omega-3 fatty acids on central nervous system remyelination in fat-1 mice. BMC Neurosci. 2017;18(1):19. doi:10.1186/S12868-016-0312-5
Ye XP, Xu MF, Tang ZX, et al. Flaxseed protein: extraction, functionalities and applications. Food Science and Technology. 2022;42: e22021. doi:10.1590/FST.22021
Zhao M, Wang B, Li L, Zhao W. Anti-Obesity Effects of Dietary Fibers Extracted from Flaxseed Cake in Diet-Induced Obese Mice. Nutrients. 2023;15(7):1718. doi:10.3390/NU15071718/S1
Kaur M, Kaur R, Gill BS. Mineral and amino acid contents of different flaxseed cultivars in relation to its selected functional properties. Journal of Food Measurement and Characterization. 2017;11(2):500-511. doi:10.1007/S11694-016-9417-X/TABLES/5
Hutchins, A. M., Martini, M. C., Olson, B. A., Thomas, W., & Slavin, J. L. (2001). Flaxseed Consumption Influences Endogenous Hormone Concentrations in Postmenopausal Women. Nutrition and Cancer, 39(1), 58–65. https://doi.org/10.1207/S15327914nc391_8

Epistaxis

May 24, 2024 | News

Written By THT Editorial Team

Reviewed by Dr. Chetana Pathak, Otorhinolaryngologist/Head & Neck Surgeon, MBBS, MS(Otorhinolaryngology),

Nosebleeds, or epistaxis, are a common medical issue affecting approximately 60% of people in the United States at some point in their lives. Although most episodes are minor and self-limiting, around 6% of individuals experiencing nosebleeds will seek medical attention (Tunkel et al., 2020). In children, epistaxis is particularly prevalent, with 75% having at least one episode (Tunkel et al., 2020). There are two primary types of nosebleeds: anterior, which is more common, and posterior, which, although less frequent, often require medical intervention (Tabassom & Dahlstrom, 2024).

Epistaxis, despite often being seen as a mere nuisance, can occasionally pose life-threatening risks, particularly in resource-limited settings where adequate healthcare facilities are scarce. It is estimated that 60% of the global population will experience epistaxis, with about 6% requiring medical treatment due to the ineffectiveness of home remedies (Adoga et al., 2019).

Causes of Epistaxis

The most common cause of epistaxis are idiopathic (38.09%) followed by hypertension (27.38%), trauma (15.47%), and coagulopathy (8.33%) (Parajuli R, 2015)

Other Local causes are:

Anatomic deformities

Intranasal tumors

Low humidity

Vigorous nose blowing

Nose picking

In adults, medications such as non-steroidal anti-inflammatory drugs (NSAIDs) and anticoagulants like heparin and warfarin are common contributors. Hereditary bleeding disorders, including hemophilia A, hemophilia B, and von Willebrand disease, are also associated with epistaxis (Ameya et al., 2021).

Additionally, chronic vascular damage related to hypertension has been suggested as a potential mechanism linking high blood pressure to nosebleeds (Byun et al., 2021).

Management and Treatment of Epistaxis

Following steps can be used at Home. This method is also called Hippocratic method

Sit upright and lean slightly forward to prevent blood from running down your throat, which can cause nausea, vomiting, and diarrhea. Avoid lying flat or tilting your head back.
Breathe through your mouth.
Use a tissue or damp washcloth to catch the blood.
Pinch the soft part of your nose with your thumb and index finger, pressing it against the hard bony ridge that forms the bridge of your nose. Pinching above or on the bony part won’t effectively stop the bleeding.
Maintain pressure on your nose for at least five minutes before checking if the bleeding has stopped. If it persists, continue pinching for another 10 minutes.
Optionally, apply an ice pack to the bridge of your nose to help constrict blood vessels and provide comfort. This step is not essential but can be helpful (Cleveland Clinic).

Managing epistaxis requires a thorough examination and detailed patient history to identify the bleeding site and cause. Treatment methods vary depending on the location, severity, and etiology of the bleeding and can be broadly categorized into nonsurgical and surgical approaches. Simple measures include pinching the nose, while more severe cases might require ligation of vessels (Parajuli, 2015).

The majority of nosebleeds are acute, sporadic, and self-limited, typically responding to simple compression but sometimes requiring more aggressive measures like cautery (can be chemical or electric) or nasal packing. Conventional gauze pack and Merocel nasal pack are the common pack used in refractory anterior epistaxis (Shanmugam et.al, 2019)

Vasoconstrictors, such as oxymetazoline, xylometazoline can help locate the bleeding site. If simple measures fail, tranexamic acid, nasal cautery with silver nitrate, or nasal packing may be necessary. (Director, Paediatric Emergency Department, 2023). Endoscopic ligation of the sphenopalatine artery is done in case of persistent bleeding (Snyderman & Carrau, 1997).

If there is persistent bleeding then endoscopic ligation of the bleeding vessel is done.

SPA ligation has been reported to be effective in 87-92% of cases (Kishimoto 2018, Wormald 2000).
Bilateral SPA ligation has been shown to have lower rebleeding rates compared to unilateral ligation (Hervochon 2018).
SPA ligation may reduce the risk of future severe epistaxis in anticoagulated patients.

REFERENCES

Tunkel, D. E., Anne, S., Payne, S. C., et al. (2020). Clinical Practice Guideline: Nosebleed (Epistaxis). ss 162(1_suppl), S1-S38. https://doi.org/10.1177/0194599819890327
Tabassom, A., & Dahlstrom, J. J. (2024). Epistaxis. In StatPearls. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK435997/
Adoga, A. A., Kokong, D. D., Mugu, J. G., Okwori, E. T., & Yaro, J. P. (2019). Epistaxis: The demographics, etiology, management, and predictors of outcome in Jos, North-Central Nigeria. Annals of African Medicine, 18(2), 75-79. https://doi.org/10.4103/aam.aam_24_18
Ameya, G., Biresaw, G., Mohammed, H., Chebud, A., Meskele, M., Hussein, M., & Endris, M. (2021). Epistaxis and Its Associated Factors Among Precollege Students in Southern Ethiopia. Journal of Blood Medicine, 12, 1-8. https://doi.org/10.2147/JBM.S309273
Byun, H., Chung, J. H., Lee, S. H., Ryu, J., Kim, C., & Shin, J. (2021). Association of Hypertension with the Risk and Severity of Epistaxis. JAMA Otolaryngology–Head & Neck Surgery, 147(1), 34-40. https://doi.org/10.1001/jamaoto.2020.2906
Parajuli, R. (2015). Evaluation of Etiology and Treatment Methods for Epistaxis: A Review at a Tertiary Care Hospital in Central Nepal. International Journal of Otolaryngology, 2015, 283854. https://doi.org/10.1155/2015/283854
https://my.clevelandclinic.org/health/diseases/13464-nosebleed-epistaxis
Director, Paediatric Emergency Department. (2023). Emergency department management of epistaxis (Document ID CHQ-GDL-07450, Version 2.0). Executive Director Medical Services. https://my.clevelandclinic.org/health/diseases/13464-nosebleed-epistaxis
Shanmugam, V. U., PremNivas, P., Swaminathan, B., Shanmugan, R., & Suji, S. (2019). A comparison of conventional nasal pack with Merocel nasal pack in the management of epistaxis. Journal of Medical Science and Clinical Research, 7(10). https://dx.doi.org/10.18535/jmscr/v7i10.156
Carl H. Snyderman, Ricardo L. Carrau, Endoscopic ligation of the sphenopalatine artery for epistaxis, Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 8, Issue 2,1997, Pages 85-89, ISSN 1043 1810, https://doi.org/10.1016/S1043-1810(97)80007-3.

Exploring the Role of Metabolic Psychiatry in Understanding Mental Health Disorders

May 20, 2024 | Current News Affair

Written By THT Editorial Team

Reviewed by Dr. Kamal Gautam, MBBS(KU), MD Psych (IOM), Currently working at Transcultural Psychological Organization Nepal (TPO Nepal)

Introduction:

Metabolic psychiatry is an emerging field that investigates the bidirectional relationship between metabolic dysregulation and psychiatric disorders. Increasing evidence suggests that disturbances in metabolism, including alterations in glucose metabolism, lipid metabolism, and hormonal imbalances, may contribute to the pathophysiology of various mental health conditions. This research article aims to explore the latest findings and concepts in metabolic psychiatry, highlighting the potential implications for understanding and managing psychiatric disorders.

Metabolism and Mental Health:

Traditionally, mental health disorders have been primarily viewed as disorders of the brain, focusing on neurotransmitter imbalances and neuronal dysfunction. However, emerging research indicates that disturbances in metabolism can impact brain function and significantly contribute to psychiatric symptoms. Metabolic abnormalities, such as insulin resistance, inflammation, oxidative stress, and mitochondrial dysfunction, have been observed in individuals with depression, anxiety, bipolar disorder, schizophrenia, and other mental health conditions.

Insulin Resistance and Depression:

Insulin resistance, a condition characterized by impaired cellular response to insulin, has been associated with an increased risk of depression. Studies have demonstrated that insulin resistance disrupts neuronal signaling pathways, affects neurotransmitter metabolism, and promotes neuroinflammation, all of which may contribute to the development and persistence of depressive symptoms. A longitudinal study by Timonen et al. (2005) found that insulin resistance predicted the onset of depressive symptoms in middle-aged individuals.

The global prevalence of type 2 diabetes is on the rise. Within the diabetic population, approximately 30% experience comorbid mental health issues, such as depression, schizophrenia, delirium, and substance misuse, including tobacco smoking. Interestingly, there is evidence suggesting a bidirectional relationship between these mental disorders and diabetes. Moreover, the prevalence of depression and anxiety among individuals with diabetes exceeds that of the general population, with a striking 50-100% heightened risk of depression in diabetic patients. Presently, psychiatrists recognize the interplay between psychiatric disorders and medical conditions, acknowledging that they often influence each other (Al-Atram AA. ,2018).

Dyslipidemia and Bipolar Disorder:

Dyslipidemia, characterized by abnormal levels of lipids (e.g., cholesterol and triglycerides) in the bloodstream, has been implicated in bipolar disorder. Altered lipid metabolism can influence membrane composition and fluidity, affecting neuronal signaling and synaptic function. Several studies have reported associations between dyslipidemia and bipolar disorder, including altered lipid profiles in individuals with the disorder Fagiolini et al. (2014) found that patients with bipolar disorder had significantly higher levels of triglycerides and lower levels of high-density lipoprotein (HDL) cholesterol compared to healthy controls.

Depression stands as one of the most prevalent psychiatric disorders among adults, posing a significant public health concern in the United States. Mounting evidence suggests a correlation between depression and heightened risks of diabetes and cardiovascular diseases (CVD).

Metabolic syndrome (MetS), comprising various CVD risk factors like central obesity, hyperglycemia, elevated blood pressure, hypertriglyceridemia, and reduced HDL cholesterol, is widespread in the general populace and is linked to increased susceptibility to diabetes and CVD. Given the substantial public health burdens posed by both depression and MetS, recent focus has been directed towards understanding the relationship between these two conditions (Pan et.al,2012)

Hormonal Imbalances and Schizophrenia:

Hormonal imbalances, particularly involving the hypothalamic-pituitary-adrenal (HPA) axis and sex hormones, have been implicated in the pathophysiology of schizophrenia. Dysregulation of the HPA axis, characterized by abnormal cortisol levels and stress response, is frequently observed in individuals with schizophrenia. Moreover, alterations in sex hormone levels, such as estrogen and testosterone, have been associated with symptom severity and cognitive impairments in schizophrenia. A study by Riecher-Rössler et al. (2018) demonstrated that estrogen treatment improved symptoms and cognition in postmenopausal women with schizophrenia.

Conclusion:

Metabolic psychiatry offers a novel perspective on the etiology and treatment of psychiatric disorders by exploring the interplay between metabolic dysregulation and mental health conditions. The emerging evidence supports the concept that disturbances in metabolism can contribute to the pathophysiology of depression, bipolar disorder, schizophrenia, and other psychiatric disorders. Understanding the role of metabolic factors in mental health opens new avenues for developing targeted interventions, such as lifestyle modifications, dietary interventions, and pharmacological approaches that address metabolic dysfunctions alongside traditional psychiatric treatments.

Further research is needed to elucidate the complex mechanisms underlying the relationship between metabolism and mental health and to identify potential therapeutic targets. Integrating metabolic assessments and interventions into psychiatric practice holds promise for personalized approaches and improved outcomes in the management of mental health disorders.

REFERENCES

Timonen M, et al. Insulin resistance and depressive symptoms in young adult males: Findings from Finnish military conscripts. Psychosom Med. 2005;67(5): 853-857.
Fagiolini A, et al. Dyslipidemia in bipolar disorder: Causes and consequences. Curr Psychiatry Rep. 2014;16(10): 1-9.
Riecher-Rössler A, et al. The effects of estradiol on cognition and symptoms in schizophrenia. Am J Psychiatry. 2018;175(3): 225-233.
Al-Atram AA. A review of the bidirectional relationship between psychiatric disorders and diabetes mellitus. Neurosciences (Riyadh). 2018 Apr;23(2):91-96. doi: 10.17712/nsj.2018.2.20170132. PMID: 29664448; PMCID: PMC8015449
Pan A, Keum N, Okereke OI, Sun Q, Kivimaki M, Rubin RR, Hu FB. Bidirectional association between depression and metabolic syndrome: a systematic review and meta-analysis of epidemiological studies. Diabetes Care. 2012 May;35(5):1171-80. doi: 10.2337/dc11-2055. PMID: 22517938; PMCID: PMC3329841

Micro plastics: A Silent Threat to Reproductive Health and Fertility

May 15, 2024 | Global health issues

Written By THT Editorial Team

Reviewed by Dr. Asmita Pandey, Fertility Expert, M.D. (OB/GYN)

Microplastics, often abbreviated as MPs, are small plastic particles under 5 millimeters that are now widely recognized as an environmental issue. They have made their way into our water systems and the broader food chain, prompting extensive studies on how they might affect reproduction in different species, humans included. This article explores the possible ways in which microplastics could be affecting reproductive health and fertility.

Oxidative stress

Oxidative stress is a cellular phenomenon that happens when there’s a mismatch between the creation of free radicals, like reactive oxygen species (ROS), and the body’s antioxidant defenses that neutralize their damaging effects This mismatch can cause harm to cells and tissues, playing a role in various diseases and the aging process. (Pizzino et al., 2017).

When it comes to microplastics (MPs), oxidative stress is a major issue. MPs can cause oxidative stress by interfering with the cells’ electron transfer processes, which results in an excess of ROS. These ROS can harm important cellular components such as lipids, proteins, and DNA, all vital for cell health and function (Abdal Dayem et al., 2017). For example, research has indicated that MPs exposure can increase ROS in oyster sperm, leading to reduced fertilization success. Likewise, studies on rats have shown that polystyrene MPs (PS-MPs) can induce oxidative stress in ovarian cells, affecting ovulation (Ferrante et al., 2022)

Hormonal Havoc: Disrupting the HPG Axis

The Hypothalamic-Pituitary-Gonadal (HPG) Axis is an essential hormonal system that controls reproductive functions. It’s a network involving the hypothalamus, pituitary gland, and gonads (ovaries or testes), which are responsible for producing and regulating sex hormones vital for reproductive health. (Mikhael et al., 2019)

Microplastics (MPs) have been identified as disruptors of the HPG Axis, causing hormonal imbalances that could impact fertility. Research has indicated that exposure to polystyrene MPs (PS-MPs) in male mice can lower testosterone levels and affect the balance of other important hormones such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormonal alterations can hinder the growth and maturation of reproductive organs, adversely affecting the development of offspring (Zhang et al., 2022). In female mice, exposure to MPs has resulted in similar hormonal disturbances, with changes observed in FSH and estradiol levels. (Liu et al., 2021)

Regarding reproductive success, it’s known to be an energy-demanding process that relies on ample resources for the creation of gametes, fertilization, and embryo growth. MPs pose a threat to an organism’s energy metabolism, which can influence reproductive success.

Evidence suggests that MPs can modify the patterns of food intake and energy distribution within organisms, which may lead to a decrease in reproductive output (Jewett et al., 2022). For example, studies on oysters have shown that MPs can reduce the activity of enzymes that are crucial for energy production during sperm development. This reduction could lead to sperm quality issues and, consequently, affect the viability of the offspring. (Sussarellu et al., 2016)

Microcirculation Woes: A New Frontier

Microcirculation is the process of blood flow through the body’s tiniest vessels, like capillaries. It’s crucial for supplying tissues with nutrients and oxygen and for eliminating waste. Any interference with microcirculation can greatly affect reproductive health.

Recent research has shown that microplastics (MPs) can negatively impact microcirculation. This can cause developmental issues and raise the mortality rate of embryos in water-dwelling species such as zebrafish. For instance, exposure to MPs and nanoparticles (NPs) has been linked to microcirculation damage, especially in vital areas like the tail, which is important for proper growth. (Zhang et al., 2022)

Human Health Implications

The increasing concern about microplastics (MPs) and their effect on human reproductive health is quite substantial. There has been a noticeable decrease in male semen quality over the last 80 years, and environmental pollutants, including MPs, are suspected to be contributing factors. Insights from animal studies have highlighted potential mechanisms through which MPs may influence health, such as oxidative stress, inflammation, and hormonal disturbances.

Direct research on the impact of MP exposure on male infertility in humans is not yet available, but animal studies have suggested a minimum human equivalent dose of MPs that could result in poor semen quality. This dose is estimated to be 0.016 mg/kg/day. The proximity of this figure to the levels of MP exposure observed in some countries points to a possible threat to human reproductive health. It underscores the importance of ongoing research to fully understand the effects and to develop appropriate exposure guidelines.

Conclusion

The research collectively points to a considerable risk that microplastics (MPs) present to reproductive health in various species. It’s vital to grasp the damaging mechanisms—like oxidative stress, hormonal imbalance, energy shortage, and microcirculation problems—to devise ways to lessen their effects. With MPs increasingly becoming a part of our environment, it becomes more pressing to confront their reproductive consequences. This calls for thorough policy-making and additional studies to safeguard human health.

For further information about reproductive health, please book your consultation with fertility expert here.

REFERENCES

Pizzino G, Irrera N, Cucinotta M, Pallio G, Mannino F, Arcoraci V, Squadrito F, Altavilla D, Bitto A. Oxidative Stress: Harms and Benefits for Human Health. Oxid Med Cell Longev. 2017;2017:8416763. doi: 10.1155/2017/8416763. Epub 2017 Jul 27. PMID: 28819546; PMCID: PMC5551541.
Abdal Dayem A, Hossain MK, Lee SB, Kim K, Saha SK, Yang GM, Choi HY, Cho SG. The Role of Reactive Oxygen Species (ROS) in the Biological Activities of Metallic Nanoparticles. Int J Mol Sci. 2017 Jan 10;18(1):120. doi: 10.3390/ijms18010120. PMID: 28075405; PMCID: PMC5297754.
Ferrante MC, Monnolo A, Del Piano F, Mattace Raso G, Meli R. The Pressing Issue of Micro- and Nanoplastic Contamination: Profiling the Reproductive Alterations Mediated by Oxidative Stress. Antioxidants (Basel). 2022 Jan 19;11(2):193. doi: 10.3390/antiox11020193. PMID: 35204076; PMCID: PMC8868557.
Mikhael S, Punjala-Patel A, Gavrilova-Jordan L. Hypothalamic-Pituitary-Ovarian Axis Disorders Impacting Female Fertility. Biomedicines. 2019 Jan 4;7(1):5. doi: 10.3390/biomedicines7010005. PMID: 30621143; PMCID: PMC6466056.
Zhang C, Chen J, Ma S, Sun Z, Wang Z. Microplastics May Be a Significant Cause of Male Infertility. American Journal of Men’s Health. 2022;16(3). doi:10.1177/15579883221096549
Liu, Z., Zhuan, Q., Zhang, L., Meng, L., Fu, X., & Hou, Y. (2021). Polystyrene microplastics induced female reproductive toxicity in mice. Journal of Hazardous Materials, 416, 125912. https://doi.org/10.1016/j.jhazmat.2021.125912
Jewett E, Arnott G, Connolly L, Vasudevan N, Kevei E. Microplastics and Their Impact on Reproduction-Can we Learn From the C. elegans Model? Front Toxicol. 2022 Mar 24;4:748912. doi: 10.3389/ftox.2022.748912. PMID: 35399297; PMCID: PMC8987311.
Sussarellu, R., Suquet, M., Thomas, Y., et al. (2016). Oyster reproduction is affected by exposure to polystyrene microplastics. Proceedings of the National Academy of Sciences, 113(9), 2430-2435. https://doi.org/10.1073/pnas.1519019113

Is Your Medicine Cabinet Missing This? Laughter’s Amazing Benefits

May 10, 2024 | News

Written by Liza Nagarkoti , BSc Nursing, MA(Nutrition), Project Officer (Health) LWF Nepal

A robust sense of humor isn’t merely a pleasant diversion during challenging times; it’s a valuable asset in our pursuit of overall well-being. When we find ourselves amused by a friend’s witty remark or a comedian’s act, the positive impacts of humor resonate through our bodies, minds, and social connections. It’s more than just entertainment; it contributes to enhancing our physical, mental, and emotional health.

According to Dattilo, an instructor of psychology at Harvard Medical School, humor’s psychological benefits are immediate, lifting mood and reducing stress and anxiety, while also affecting us physically by reducing cortisol levels and increasing dopamine and serotonin neurotransmitters (Harvard Gazette, 2023).

Research has shown that laughter’s health benefits are extensive, including pain relief, increased happiness, and enhanced immunity. Positive psychology recognizes laughter and a sense of humor as one of the 24 main signature strengths (Verywell Mind).

The physical benefits of laughter are diverse:

Laughter boosts heart and respiratory rates and oxygen consumption temporarily, leading to subsequent relaxation. While it’s not equivalent to aerobic exercise, it still offers physical benefits. Laughing for 10-15 minutes daily can burn an additional 10-40 calories.
It positively impacts heart function by increasing stroke volume, cardiac output, and dilating blood vessels.
Intense laughter enhances muscle tone.
Watching funny videos stimulates the sympathetic nervous system (SNS) without raising blood pressure.
Laughter reduces cortisol levels, the stress hormone.
It activates the brain’s mesolimbic dopaminergic reward system.
Laughing boosts levels of serum immunoglobulins A and E and tends to increase natural killer cell activity.
It raises levels of beta-endorphins, the body’s feel-good chemicals, and increases human growth hormone (U.S. Department of Veterans Affairs).

Relationship between Laughter and Mental Health

The relationship between laughter and mental health is profound. It interrupts distressing emotions, promoting relaxation, stress reduction, increased energy, focus, and productivity. Additionally, laughter fosters a more positive perspective on situations, creating psychological distance and diffusing conflict. It also strengthens social bonds, which can profoundly impact mental and emotional well-being (HelpGuide).

In conclusion, laughter emerges as a potent medicine for holistic health, offering a multitude of benefits across physical, psychological, and social dimensions

REFERENCES

Harvard Gazette. (2023, January). A laugh a day keeps the doctor away. Retrieved from https://news.harvard.edu/gazette/story/2023/01/a-laugh-a-day-keeps-the-doctor-away/
Verywell Mind. (n.d.). The Stress Management and Health Benefits of Laughter. Retrieved from https://www.verywellmind.com/the-stress-management-and-health-benefits-of-laughter-3145084
S. Department of Veterans Affairs. (n.d.). Healing Benefits: Humor & Laughter. Retrieved from https://www.va.gov/WHOLEHEALTHLIBRARY/tools/healing-benefits-humor-laughter.asp
(n.d.). Laughter is the Best Medicine. Retrieved from https://www.helpguide.org/articles/mental-health/laughter-is-the-best-medicine.htm

Advancing Kidney Health: Transforming Innovative Concepts into Practical Solutions

May 8, 2024 | News

Written By THT Editorial Team

Reviewed by Dr. Nabin Bahadur Basnet, Consultant Interventional Nephrologist, MBBS, PhD, FISN

Exploring effective treatment options for end-stage renal disease (ESRD) has led to the development of innovative technologies such as implantable bio artificial kidneys (BAK) and kidney regeneration. These advancements are not just impressive achievements; they are sources of hope for millions around the globe.

Implantable Bio artificial Kidney (BAK): A Game Changer

Imagine a kidney replacement that’s like having a tiny, high-tech sidekick doing all the hard work for you. That’s the dream behind the implantable BAK. Dr. William H. Fissell and Shuvo Roy, Ph.D., are the masterminds behind this marvel. Picture a device no bigger than a soda can, but with the power to mimic your kidney’s functions. It hooks up to your blood vessels, acting like a natural kidney without the hassle of dialysis or meds.

The Kidney Project: Making Sci-Fi a Reality

The Kidney Project, a tag team effort between Vanderbilt University Medical Center and the University of California San Francisco, has been the driving force behind the BAK’s evolution. Their latest prototype is a real showstopper. It’s proven it can keep kidney cells alive inside a bioreactor, essentially acting as a mini kidney. The silicon membranes protect these cells like armor, ensuring they keep ticking away. (Kim et al., 2023)

Preclinical Success and What’s Next

Recent trials have been a roaring success. The BAK operates silently in the background, much like a superhero, without setting off alarms in the recipient’s immune system. This means it could be the ticket to freedom from dialysis and the endless wait for donor kidneys. . (Kim et al., 2023)

Kidney Regeneration Tech: Healing Magic

But wait, there’s more! While the BAK steals the spotlight, kidney regeneration tech is quietly making waves. Scientists have stumbled upon a magic trick: block a pesky protein called interleukin-11 (IL-11), and damaged kidney cells start to regrow. It’s like hitting the rewind button on kidney damage caused by diseases or injuries. (Widjaja et al., 2022)

The Future’s Bright for Kidney Care

Combine the power of BAK with regeneration tech, and you’ve got a winning combo. The BAK offers immediate relief for those in dire need, while regenerative therapies work their magic over time, restoring natural kidney function.

Challenges and the Big Picture

Sure, these innovations are thrilling, but there are hurdles to jump. We need to make sure the BAK is safe and effective for humans and fine-tune regeneration therapies. Plus, we can’t forget about making these treatments accessible and affordable for everyone.

In Conclusion: Hope on the Horizon

The birth of the BAK and kidney regeneration tech is like finding a pot of gold at the end of the rainbow for kidney disease sufferers. These breakthroughs promise a brighter future, where kidney failure isn’t a life sentence. It’s a journey filled with obstacles, but the destination—a world free from the grip of kidney disease—is within reach.

REFERENCES

Kim, E. J., Chen, C., Gologorsky, R., Santandreu, A., Torres, A., Wright, N., Moyer, J., Chui, B. W., Blaha, C., Brakeman, P., Vartanian, S., & Tang, Q. (2023, August 29). Can an Artificial Kidney Finally Free Patients from Dialysis? UCSF. Retrieved from UCSF News
Widjaja, A. A., Viswanathan, S., Shekeran, S. G., Adami, E., Lim, W. W., Chothani, S., Tan, J., Goh, J. W. T., Chen, H. M., Lim, S. Y., Boustany-Kari, C. M., Hawkins, J., Petretto, E., Hübner, N., Schafer, S., Coffman, T. M., & Cook, S. A. (2022). Targeting endogenous kidney regeneration using anti-IL11 therapy in acute and chronic models of kidney disease. Nature Communications, 13(1), 7497. https://doi.org/10.1038/s41467-022-35306-1

Chilies, is it only hot or more?

May 7, 2024 | Nutrition

Written By Sanjogta Thapa Magar, Food Microbiologist

Introduction

Historically, chili is one of the oldest domesticated crops in the world Since they contain impressively beneficial chemical compounds such as capsaicinoids, carotenoids (provitamin A), flavonoids, vitamins (Vitamins C and E), minerals, essential oils, and aromas, they are consumed by a large section of the population throughout the world. In addition to their color, aroma, and characteristic pungency, they are widely used throughout the world as a flavoring and spice. Worldwide, chili is cultivated for its nutritional, medicinal, and economic properties. A good source of antioxidants and potent compounds with biological activities, including capsaicinoids and phenolic acids, is chilies (Chapa-Oliver et al 2016; Manju et al 2002).

History of chilli

Prehistoric humans used chili as a food source. Chilis are grown almost everywhere, regardless of the climate or environment. They are relatively easy to cultivate in nearly any climate or environment. From the terai to the mid-hills of Nepal, chilies are widely cultivated, varying in color, flavor, and pungency. As a spice crop, it occupies the fourth position with a productivity of 3.45 t/ha. Nepalese kitchens are incomplete without it. Both green and dried chilies are commonly used for various purposes (Thapa et al., 2009).

Chili in the food industry

From ancient times, chilies have been one of the most important spices or savory food additives. Besides serving as a vegetable, spice, and value-added processed product, chili has become the most important commercial crop in the world (Ochoa-Alejo & Ramirez-Malagon 2001). However, chilies are not consumed as stand-alone dishes; instead, they are processed into spice powders, oils, sauces, pastes, etc. for flavor and color. Chili is popular worldwide due to the combination of color, flavor, and nutritional value In contrast to synthetic food preservatives, spices are gaining popularity among consumers (Loizzo et al 2017).

Chilies medicinal properties

For centuries, chili powder has been used as a medicine in Ayurvedic preparations as oil extracts and as a major ingredient in therapeutic remedies (Thapa et al 2009). It has been reported that chilies contain compounds that can exert multiple physiological and pharmacological effects, such as analgesia, anticancer activity, anti-inflammatory activity, antioxidant activity, and anti-obesity potential (Abdurahman, 2016; Caporaso et al. 2013). Pain can be relieved with capsaicin topical ointments, nasal sprays, and dermal patches (Ashwini et al. 2015; Prakash et al. 2017). In addition to treating asthma, coughs, sore throats, toothaches, and shingles, chili is used to relieve pain in rheumatoid arthritis, nerve damage, and diabetic neuropathy. (Goci et al., 2014). Studies have shown that chili reduces the likelihood of developing atherosclerosis by reducing blood cholesterol, triglyceride levels, and platelet aggregation as well as increasing fibrinolytic activity (Chopan & Littenberg 2017).

Chilies anti-oxidant properties

Capsaicinoids, carotenoids, and phenolic compounds in chili give the fruit an antioxidant property (Leonor et al 2016). Chili shows antioxidant activities because of the presence of the groups in the phenolic ring (a methoxy group in ortho position to OH) of capsaicinoids and ferulic acid ester, which influenced the antioxidant properties (Viktorija et al 2014).

Chili and its antimicrobial properties

Chili contains bioactive compounds that have been known to act as a defense mechanism in them. It has been proven to show antimicrobial activity against Staphylococcus aureus, Salmonella typhimurium, Listeria monocytogene, Helicobacter pylori, Pseudomonas aeruginosa, and Bacillus cereus, (Grande-Villanueva et al 2015; Marini et al 2015).

Nutrients in chilies and their health benefits

Chili consists of an equally rich mix of phytonutrients which are the products of secondary metabolism that tend to exhibit ecological functions like plant defense against microbial and fungal pathogens and insect pests(Blanco-Rios et al 2017). Certain studies have proved that the consumption of these phytonutrients confers health benefits such as protection against oxidative damage to cells, preventing the development of common degenerative diseases and risk of coronary heart disease, stroke, and ocular diseases, cardio-protective, anti-microbial, anti-inflammatory, anti-mutagenic agents and possess the ability to scavenge singlet oxygen, inhibit free radicals, decompose peroxide and chelate metals (Salehi et al 2018). They also prevent the oxidation of essential fats within the cells of the brain that are considered necessary for its optimal functioning (Blanco-Ríos et al 2013).

Active constituents present include carotenoids, phenolic compounds, vitamins A, B, and C, volatile oils, flavonoids like β-carotene, α-carotene, lutein, zeaxanthin, and cryptoxanthin, minerals like potassium, manganese, iron and magnesium and other bioactive compounds such as sinapic acid, ferulic acid, violaxanthin, etc. (Baenas et al 2019).

Both sweet and hot varieties of capsicum are rich in vitamin C, and able to satisfy the RDI (Recommended Daily Dose) of 90 mg/100 g (FDA, 2020) in a single cup serving. Vitamin A is found in the form of β-Carotene. Chilis also find their use in the production of synthetic drugs for pain because of the neuroprotective activity of some phenolic compounds. Most forms of chili are rich in many minerals, vitamins, and amino acids essential for human health and growth. They are very high in potassium, magnesium, manganese, and iron, rich in calcium and phosphorus, and are good sources of vitamins K and B in addition to lycopene, flavonoids, and trace metals. A combination of these rich nutrients and antioxidant properties of the phytochemicals inherent in the C(Oǧuzkan 2019).

Their attractive colors are due to the presence of carotenoid and flavonoid pigments. β-carotene with pro-vitamin A activity and oxygenated carotenoids such as capsantine, capsorubin, and cryptocapsin are exclusive to chili. They also contain large quantities of neutral phenolic compounds or flavonoids called quercetin and luteolin(Lu et al., 2017).

REFERENCES

Abdurahman NH (2016). A comparative review of conventional and microwave assisted extraction in Capsaicin isolation from Chili pepper.Australian Journal of Basic Applied Sciences 10(10): 263–275.
Ashwini D, Usha Sree G, Ajitha A and Uma Maheswara Rao V (2015). Extraction of capsaicin from capsium frutescens and its estimation by RP-HPLC method. World Journal of Pharmacy and Pharmaceutical Sciences 4(09): 839–848.
Baenas N, Belovic M, Ilic N, Moreno DA and García-Viguera C (2019). Industrial use of pepper (Capsicum annum L) derived products: Technological benefits and biological advantages. Food Chemistry 274 : 872–885.
Blanco-Rios AK, Medina-Juarez LA and Gamez-Meza N (2017). Drying and pickling on phenols, capsaicinoids and free radical-scavenging activity in Anaheim and Jalapeno peppers.Ciencia Rural 47(9):
Blanco-Rios AK, Medina-Juarez LÁ, Gonzalez-Aguilar GA and Gamez-Meza N(2013). Antioxidant activity of the phenolic and oily fractions of different sweet bell peppers. Journal of the Mexican Chemical Society, 57(2): 137–143.
Bononi M and Tateo F (2012). Determination of capsaicinoids from dried pepper fruits by fast-gas chromatography. Italian Journal of Food Science 24(1): 49–54.
Bononi M and Tateo F (2012). Determination of capsaicinoids from dried pepper fruits by fast-gas chromatography. Italian Journal of Food Science 24(1): 49–54.
Caporaso N, Paduano A, Nicoletti G and Sacchi R(2013). Capsaicinoids, antioxidant activity, and volatile compounds in olive oil flavored with dried chili pepper (capsicum annuum). European Journal of Lipid Science and Technology 115(12): 1434–1442.
Chapa-Oliver AM and Mejia-Teniente L (2016). Capsaicin: from plants to a cancer-suppressing agent. Molecules 21(8): 1 14.
Chopan M, Littenberg B (2017) The Association of Hot Red Chili Pepper Consumption and Mortality: A Large Population-Based Cohort Study. PLoS ONE 12(1): e0169876. doi:10.1371/ journal.pone.0169876
FDA (2020). Reference Guide: Daily Value Changes for Nutrients. United States Food and Drug Administration. Retrieved from; https://www.fda.gov/food/new-nutrition- facts-label/daily-value-new-nutrition-and-supplement-facts-labels (Last updated 5 May, 2020) [Accessed on 23 March, 2021]
Grande-Villanueva P, De Aguiar AC, Pereira-Coutinho J, Teixeira-Godoy H, Escamilla-Silva EM and Martinez J (2015). Oleoresin extraction from jalapeno pepper ( capsicum annuum ) with supercritical carbon dioxide : effects in the Global Yield . Ciencia e Tecnica Vitivinícola 30(1): 79–104.
Goci E, Haloci E, Vide K and Malaj L (2014). Application and comparison of three different extraction methods of Capsaicin from capsicum fruits. Albanian Journal of Pharmaceutical Sciences 1(1): 16–19.
Leonor YVM eacute ndez, Doris NRS, Pedro LSFoacute rez, Carlos E PG and Vladimir K (2016). In vitro antioxidant and anticholinesterase activities and in vivo toxicological assessment (Zebrafish embryo model) of ethanolic extracts of Capsicum chinense Jacq. Journal of Medicinal Plants Research 10(6): 59–66.
Loizzo M.R, Bonesi M, Serio A, Chaves-lopez C, Falco T, Paparella A, Menichini F, Tundis R, Rosa M, Bonesi M, Serio A and Chaves-lopez C (2017). Application of nine air-dried Capsicum annum cultivars as food preservative : Micronutrient content, antioxidant activity, and foodborne pathogens inhibitory effects. International Journal of Foodfile 20(4): 899–910.
Lu M, Ho C.T and Huang Q (2017). Extraction, bioavailability, and bioefficacy of capsaicinoids. Journal of Food and Drug Analysis 25(1): 27-36.
Manju PR and Sreelathakumary I (2002). Quality Parameters in Hot Chilli (Capsicum Chinense Jacq.). Journal of Tropical Agriculture 2002: 7–10.
Ochoa-Alejo N and Ramirez-Malagon R(2001). In vitro chili pepper biotechnology. In Vitro Cellular and Developmental Biology – Plant, 37(6): 701–729.
Oguzkan SB (2019). Extraction of Capsinoid and its Analogs From Pepper Waste of Different Genotypes. Natural product communication 14(7): 1–5.
Prakash V, Gandotra S, Kumar P and Singh N (2017). Phytochemical screening and antimicrobial activity of Ficus religiosa. Journal of Pharmaceutical Sciences and Research 9(2): 100–101.
Salehi B., Javier Hernández-Álvarez, A., Del Mar Contreras, M., Martorell, M., Ramírez-Alarcón, K., Melgar-Lalanne, G., Matthews, K. R., Sharifi-Rad, M., Setzer, W. N., Nadeem, M., Yousaf, Z., & Sharifi-Rad, J. (2018). Potential phytopharmacy and food applications of Capsicum spp: A comprehensive review.Natural Product Communication 13(11): 1543-1556.
Thapa B, Skalko-Basnet N, Takano A, Masuda K and Basnet P (2009). High-performance liquid chromatography analysis of capsaicin content in 16 Capsicum fruits from Nepal. Journal of Medicinal Food 12(4): 908–913.
Viktorija M, Liljana KG, Tatjana R, Ana C and Rubin G(2014). Antioxidative effect of Capsicum oleoresins compared with pure capsaicin. IOSR Journal Of Pharmacy 4(11): 44–48

A hope for spinal cord injury

May 5, 2024 | News

Written By THT Editorial Team

Reviewed by Dr. Aayush Shrestha, Orthopaedic & Spine Surgeon, MS Ortho, FSS

Spinal cord injury (SCI) is a devastating condition that can cause permanent loss of function and affect mobility, senses, and many other bodily functions.Globally 15 million people are living with SCI with the majority of cases due to preventable trauma ( WHO,2024). Beyond the physical limitations, SCI also has a profound impact on the psychological well- being of individuals. Adults living with SCI have a significantly raising risk of depression and anxiety (Peterson et al., 2022). Furthermore, SCI imposes a substantial financial burden on society. The estimated lifetime burden of per individual with SCI ranges from 1.5 to 3.0 million due to long term care and loss of employment ( Diop, Epstein, & Gaggerro, 2021) Despite significant advances in medical technology and rehabilitation techniques, SCI continues to face many challenges in treatment and recovery. However, recent research has revealed new approaches and treatments that may improve outcomes for patients with SCI.

Stem Cell Therapy: Building New Pathways

One of the most promising areas of SCI research is the use of stem cells. Stem cells are unique because they are like versatile building blocks that can become different types of cells, including the nerve cells (neurons) that make up the spinal cord. Researchers are investigating the use of different stem cell types in the treatment of SCI, with some of the most common being:

Mesenchymal stem cells (MSCs): These cells are found in bone marrow and can develop into several cell types, including bone, cartilage, and fat cells. In SCI research, MSCs have shown promise in promoting nerve regeneration and reducing inflammation.
Neural stem cells (NSCs): These stem cells are already on the path toward becoming cells of the nervous system. NSCs hold the potential to directly replace damaged neurons and help rebuild the communication pathways in the injured spinal cord.

A recent study published in Stem Cell Reports showed that transplanting stem cells called mesenchymal stem cells (MSCs) improved the ability to move and promoted nerve regeneration in rats with SCI (Wang et al., 2021). The researchers found that MSCs helped new nerve cells grow, improved the overall health of the spinal cord, and even contributed to forming new connections across the injury site.

Another study recently published in Nature Communications showed that transplanting neural stem cells (NSCs) improved bladder function in rats with SCI (Chen et al., 2020). The researchers found that the NSCs transformed into neurons that became part of the spinal cord circuitry, improving signaling between the bladder and the brain.

Boosting Nerve Growth with Neurotrophic Factors

In addition to stem cells, researchers are also investigating the use of neurotrophic factors in the treatment of SCI. Neurotrophic factors are like special “fertilizers” for nerve cells, supporting them in multiple ways:

Promoting Growth: They stimulate the development of new neurons and encourage the branching of nerve fibers, helping them form connections.
Supporting Survival: Neurotrophic factors help existing neurons stay healthy and function optimally.
Reducing Inflammation: Some neurotrophic factors can help calm the excessive inflammation that occurs after a spinal cord injury.

A recent study published in the journal Nature Communications showed that administering a neurotrophic factor called brain-derived neurotrophic factor (BDNF) improved the ability to move and promoted nerve regeneration in rats with SCI (Li et al., 2021). BDNF helped new neurons grow, encouraged connections within the injured spinal cord, and improved the overall health of nerve tissue.

Electrical Stimulation: Re-wiring the Connection

In addition, researchers are also investigating the use of electrical stimulation in the treatment of SCI. Electrical stimulation involves the use of electrical currents to stimulate nerves and muscles. This type of stimulation is already used in other areas of medicine, such as pacemakers for the heart, and researchers are exploring how it could be adapted to help in the recovery from spinal cord injury.

A recent study published in Scientific Reports showed that the use of electrical stimulation improved the ability to move and promoted nerve regeneration in rats with SCI (Zhang et al., 2020). The researchers believe that electrical stimulation works by encouraging surviving nerve fibers to sprout new branches, facilitating the formation of alternative signal pathways around the damaged area.

Calming the Immune Response for Better Healing

In addition to these treatments, researchers are also investigating the role of immune cells in SCI. SCI triggers a complex immune response within the body, and while some aspects of this response are helpful for healing in the acute phase, prolonged inflammation can actually further damage the spinal cord. Researchers are investigating ways to modulate the immune response (adjust its activity) to improve healing and reduce long-term damage.

A recent study published in the journal Nature Neuroscience showed that targeting a type of immune cell called microglia improved motor function and nerve regeneration in mice with SCI (Zhou et al., 2021). Microglia are like the clean-up crew of the nervous system, but after injury, they can become overactive and contribute to tissue damage. This study suggests that finding ways to calm microglia activity could be a beneficial treatment strategy.

Hope for the Future

In summary, recent studies have identified several promising treatments for SCI, including stem cell transplantation, neurotrophic factors, electrical stimulation, and immune modulation. Although these therapies are still in development, they hold great promise for improving outcomes for patients with SCI. Further research is needed to fully understand these treatment options, optimize their delivery, and develop safe and effective treatments for SCI.

REFERENCES

World Health Organization. (2024, April 16). Spinal cord injury. WHO. https://www.who.int/news-room/fact-sheets/detail/spinal-cord-injury
Peterson, M., Meade, M., Lin, P., Kamdar, N., Rodriguez, G., Mahmoudi, E., & Krause, J. (2022, February 7). Mental health is an issue for people with spinal cord injury Chronic pain makes it worse University of Michigan Institute for Healthcare Policy & Innovation. Retrieved from https://ihpi.umich.edu/news/mental-health-issue-people-spinal-cord-injury-chronic-pain-makes-it-worse
Diop, M., Epstein, D., & Gaggero, A. (2021). Quality of life, health and social costs of patients with spinal cord injury: A systematic review. European Journal of Public Health, 31(Supplement_3), ckab165.177. https://doi.org/10.1093/eurpub/ckab165.177
Wang, L., Ji, H., Zhou, J., Xiong, Y., and Zhang, Y. (2021). Mesenchymal stem cell transplantation improves motor function and promotes nerve regeneration in a rat model of spinal cord injury. Stem Cell Reports, 16(5), 1159-1174.
Chen, J., Zhang, Z., Zhang, L., Li, Y., Liu, Q., Lu, D. … and Wang, L. (2020). Neural stem cell transplantation improves bladder dysfunction after spinal cord injury in rats. Nature Communication, 11(1), 1-14.
Li, L., Xiao, Y., Liu, X., and Chen, J. (2021). Brain-derived neurotrophic factor rescues neuronal deficit in a rat model of spinal cord injury through PI3K/AKT signaling. Nature Communications, 12(1), 1-16.
Zhang, L., Xiong, Y., Mahajan, and Ji, H. (2020). Electrical stimulation promotes functional recovery after spinal cord injury by increasing neurogenesis and inhibiting microglia-mediated inflammation. Scientific Reports, 10(1), 1-15.
Zhou, K., Zhong, S., Liang, S., and Yao, F. (2021). Targeting microglia to treat neurological diseases. Nature Neuroscience, 24(4), 421-433.

New research in pancreatic cancer screening

May 3, 2024 | News

Written By THT Editorial Team

Reviewed by Dr. Asmita Rayamajhi, Consultant Oncologist, M.D.

Pancreatic cancer is a tough and dangerous type of cancer that’s hard to treat and often doesn’t have a good outcome. But there’s good news: a group of experts from around the world is working hard to create a new program that will help doctors find this cancer early, which could save many lives.

The group called PRECEDE is leading a project that shows how finding pancreatic cancer early could help more people survive it. Right now, not many people survive this cancer worldwide—only about 12 out of 100 do (. Rawla, Sunkara, & Gaduputi, 2019). But if it’s found early, more than 80 out of 100 could survive, especially if they can have surgery. Sadly, most people find out they have this cancer too late when it’s already spread too much. ((MUHC News, 2024)

PRECEDE is working on a better way to keep an eye on people who are more likely to get pancreatic cancer because of their personal or family health history. Dr. George Zogopoulos and his team are focusing on how to check these high-risk people more effectively, especially if they have relatives who had pancreatic cancer or they have genes that could make them get cancer. (fortner, 2024 )

The study shows that people who have a high chance of getting pancreatic cancer are really good at following advice on getting checked. These checks can be done well in places that specialize in health care. This proves that PRECEDE can use this method of checking for cancer all over the world and gather information to learn more and get better at watching for signs of cancer in patients. (MUHC News, 2024)

Based on their findings, the researchers suggest putting people who might get pancreatic cancer into three groups. These groups are for people who have a family history of the disease, those who have a genetic mutation that could cause cancer, or those who have both these risk factors. If someone is worried they might be at risk for pancreatic cancer, they can join the PRECEDE program and go to one of its centers in North America or Europe to get checked and learn more about their risk.

The study found that people who are at high risk for pancreatic cancer just because of their family history are more likely to have cysts in their pancreas than those who have a genetic change known to cause cancer but no family history. These cysts might mean that these individuals could be more likely to develop pancreatic cancer as time goes by. This could happen either because the cysts themselves change or because the cysts are a sign that the pancreas is more likely to develop problems that could turn into cancer. Zogopoulos et al., 2024)

We need more time to watch and see if having family members with pancreatic cancer means a person is more likely to get it themselves, compared to just having a gene change that can cause cancer Zogopoulos et al., 2024). The study points out that even though it’s been hard to set up big screening programs for people at high risk of pancreatic cancer, it’s possible to do this kind of research with many centers working together across different countries. The first results from the scans in this study show that we need to keep researching how to find pancreatic cancer early. (Fortner, 2024).

Besides other methods, artificial intelligence tools are helping a lot in the battle against pancreatic cancer. One of these programs was able to pick out the people who were most likely to get pancreatic cancer, up to three years before they were actually diagnosed, just by looking at their health records Pesheva, 2023).This big step forward in being able to predict health issues was made possible by researchers from Harvard Medical School and the University of Copenhagen working together with the VA Boston Healthcare System, Dana-Farber Cancer Institute, and the Harvard T.H. Chan School of Public Health.

Using AI to check for pancreatic cancer could really change how we find and treat this illness. It’s a way that doesn’t hurt, doesn’t cost much, and is really good at spotting people who might have it (Huang et al., 2022). For example, AI can look very closely at CT scans and MRIs to find tiny signs of cancer that people might not notice (Katta et al., 2023). It can also help figure out if cysts in the pancreas might turn into cancer later on. (Jiang, Chao, Culp, & Krishna, 2023)

At the same time, AI is also changing the way we look for signs of pancreatic cancer in blood tests. It can find special markers in the blood that might mean someone has pancreatic cancer and understand complicated genetic information to figure out who might be more likely to get the disease (Tripathi et al., 2024). Another thing AI does well is look through lots of health records to find hidden patterns that show who might be at risk. This helps doctors decide who really needs to be checked for pancreatic cancer. (Tripathi et al., 2024)

The important parts of using AI in checking for pancreatic cancer—like looking at images, finding markers in the blood, and studying health records—are all connected. They’re part of a big plan that uses AI to make sure we find pancreatic cancer early and accurately. This could help patients get better treatment sooner and have a better chance of surviving.

The work that PRECEDE is doing, together with the use of AI, gives us a lot of hope for how we’ll be able to handle pancreatic cancer in the future. Creating a strong program to watch for this cancer isn’t just about science; it’s also a sign of hope for people who might get pancreatic cancer. It shows how working together across countries and never giving up on finding new solutions can make a big difference, even when things are tough.

The ongoing research is bringing us closer to the goal of making pancreatic cancer something we can treat instead of something that can’t be cured. The hard work and commitment of the scientists, doctors, nurses, and patients involved in this research are what’s making this progress possible. If we keep supporting and funding research that helps us detect pancreatic cancer early, we might reach a time when this disease isn’t so scary anymore.

In the end, the work being done by a global team to watch for pancreatic cancer is a huge leap in fighting this illness. The PRECEDE research and the use of AI show us what the future could look like, where we can find and stop pancreatic cancer early. We still have a long way to go in this fight, but these new tools make us more ready than ever to face it. The research that keeps going on is very important, and everyone is watching and hoping as we head into a new time of dealing with pancreatic cancer.

REFERENCES

Rawla P, Sunkara T, Gaduputi V. Epidemiology of Pancreatic Cancer: Global Trends, Etiology and Risk Factors. World J Oncol. 2019 Feb;10(1):10-27. doi: 10.14740/wjon1166. Epub 2019 Feb 26. PMID: 30834048; PMCID: PMC6396775.
MUHC News. (2024, April 18). New findings illustrate pathway for screening high-risk individuals for pancreatic cancer. Montreal University Health Centre. https://muhc.ca/news-and-patient-stories/research/new-findings-illustrate-pathway-screening-high-risk-pancreatic
Fortner, C. (2024, April 18). Montreal study examines screening approach to grow pancreatic cancer survival odds. CityNews Montreal. Retrieved from https://montreal.citynews.ca/2024/04/18/montreal-study-pancreatic-cancer-survival-odds/
Zogopoulos, G., Haimi, I., Sanoba, S. A., Everett, J. N., Wang, Y., Katona, B. W., … & the PRECEDE Consortium. (2024). The Pancreatic Cancer Early Detection (PRECEDE) Study is a Global Effort to Drive Early Detection: Baseline Imaging Findings in High-Risk Individuals. Journal of the National Comprehensive Cancer Network, 22(3). https://doi.org/10.6004/jnccn.2023.7097
Pesheva, E. (2023, May 8). AI predicts future pancreatic cancer. Harvard Medical School. Retrieved from https://hms.harvard.edu/news/ai-predicts-future-pancreatic-cancer
Huang B, Huang H, Zhang S, Zhang D, Shi Q, Liu J, Guo J. Artificial intelligence in pancreatic cancer. Theranostics. 2022 Oct 3;12(16):6931-6954. doi: 10.7150/thno.77949. PMID: 36276650; PMCID: PMC9576619.
Katta, M.R., Kalluru, P.K.R., Bavishi, D.A., et al. (2023). Artificial intelligence in pancreatic cancer: Diagnosis, limitations, and the future prospects—a narrative review. Journal of Cancer Research and Clinical Oncology, 149(8), 6743–6751. https://doi.org/10.1007/s00432-023-04625-1
Jiang J, Chao WL, Culp S, Krishna SG. Artificial Intelligence in the Diagnosis and Treatment of Pancreatic Cystic Lesions and Adenocarcinoma. Cancers (Basel). 2023 Apr 22;15(9):2410. doi: 10.3390/cancers15092410. PMID: 37173876; PMCID: PMC10177524.
Tripathi, S., Tabari, A., Mansur, A., Dabbara, H., Bridge, C. P., & Daye, D. (2024). From machine learning to patient outcomes: A comprehensive review of AI in pancreatic cancer. Diagnostics, 14(2), 174. https://doi.org/10.3390/diagnostics14020174

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Mọi thông tin liên quan đến sức khỏe

Introduction

Characteristics of students with ASD

Diagnosis process for students with ASD

Diagnostic instruments

Teaching and learning strategies for students with ASD

Rules of 5 (Fewer than 5 words, wait 5 seconds)

Use the student’s name first

Giving positive direction

First-then strategies

Give warnings before an activity finish

Use assistive technology

Learner profile

Provide visual support

Social story support

Sensory regulation

Lego therapy

Universal Design for Learning

Behaviour managing strategies

Communication managing strategies

Augmentative and Alternative Communication (AAC)

Conclusion

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History of chilli

Chili in the food industry

Chilies medicinal properties

Chilies anti-oxidant properties

Chili and its antimicrobial properties

Nutrients in chilies and their health benefits

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