Lupine Publishers| Is There Any Fluctuation in Normal Blood Pressure While Watching Horror Movies?

 Lupine Publishers| Journal of Medical Sciences

Abstract

Relation between normal body temperature and dimple on the chin is the main objective of this study. A total of 130 undergraduate students participated in this research activity. All the subjects were undergraduate students in Bahauddin Zakariya University, Multan, Pakistan. Normal temperature of the body was calculated by using thermometer. It was concluded from the study that there was no relation of normal temperature of the body with the dimple on the chin.

Keywords:Normal temperature of body; Dimple on chin; Fever; Cleft on chin

Introduction

The “ordinary” body temperature is 98.6°F (37°C). This number is just a normal. Our body temperature might be somewhat higher or lower. A body temperature perusing that is above or beneath the normal doesn’t naturally mean we’re debilitated. Various elements can impact our body temperature, including our age, sex, day time, and movement level. As we grew older, our body becomes less efficient to regulate temperature. Older people have less temperature of body because their bones have less stamina to bear the environmental factors that effect on their body. In babies, the normal temperature of body ranges from 97.9 °F to 99 °F. In adults, the normal temperature of body is 97 to 99 °F and for the adults with age above 65 has body temperature less than 98.6 °F. Remember that ordinary body temperature fluctuates from individual to individual. Our body temperature may be up to 1°F higher or lower than this. The specialists called attention to that our bodies will in general warm for the duration of the day. Thus, a fever in the early morning may happen at a lower temperature than a fever that seems later in the day. The main factor is not the time of the day that can impact temperature. More youthful individuals will in general have higher normal body temperatures. This is on the grounds that our capacity to manage body temperature diminishes with age. Physical action levels and certain nourishments or beverages can likewise impact body temperature. Ladies’ body temperatures are impacted by hormones too and may fall or rise at various focuses during a lady’s menstrual cycle.

Body temperature readings change contingent upon where on the body an individual takes the estimations. An infant’s temperature is higher because they have a bigger body surface region in respect to their body weight. Their bodies are likewise more metabolically dynamic, which creates heat. Infant bodies don’t direct temperature just as grown-up bodies. They sweat less when it is warm, implying that their bodies hold more warmth. It might likewise be progressively troublesome for them to chill them off amid a fever. A region of the cerebrum called the nerve center controls body temperature. On the off chance that body temperature transcends or plunges beneath the 37°F imprint, the nerve center kicks in to control the temperature. In the event that the body is excessively cool, the nerve center sends signs to make the body shudder, which warms the body up. In the event that the body is excessively hot, it sends messages to start perspiring, which gives heat a chance to leave the body. Contaminations cause generally fevers. A fever creates as the body’s normal method for responding to and battling disease. Fever occurs when the normal temperature of the body fluctuates and it reaches to the 100 or above 100°F. Side effects include hunger misfortune, a cerebral pain, touchiness, muscle hurts, shuddering, perspiring, shortcoming. Temperature of the body is a proportion of the body’s capacity to produce and dispose of warmth. There are 4 different methods by which we can take the temperature of the body. These include below armpit (axillary strategy), inside the mouth (oral technique), in the ear (tympanic technique) and in the rectum (rectal technique). The rectal reading or reading taken by ear might be higher than the oral reading but the reading taken by the armpit will be lower than the oral one. The most suitable methods from all of them is the reading taken by the rectum.

The cleft on the chin happens in light of the fact that the muscle that shows up around the jawbone neglects to close at the jaw, subsequently leaving a hole and is in fact viewed as a blemish. Dissimilar to cheek dimples, which speaks to energy and honesty, a jaw dimple is viewed by most ladies as ugly as they think having such is more manly than ladylike. There are various approaches to improve the presence of the profound separated jaw. A standout amongst the most well known and most clear courses is to utilize dermal fillers to fill in the jawline dimple. Dermal fillers can be utilized to fill the hole making a progressively female appearance. In Persian writing, a dimple on the chin or jaw pit is viewed as the characteristic of magnificence. The term ‘chin pit’ or ‘jaw well’ is a similitude alluding to the pit or well into which a head over heels sweetheart has fallen and is caught. The terms split chin, jaw separated, dimple on the chin, or jaw dimple, allude to a dimple on the focal point of the jaw. It is a Y-molded gap on the jaw with a fundamental impossible to miss space on the bone itself. The jawline gap pursues the gap that is on the lower jaw bone that came about because of the inadequate combination of the left and right parts of the jaw bone, or the muscle, amid the embryonal and fetal advancement [1].

For a few people, a cleft on the chin can create after some time, since one portion of the jaw is longer than the other, prompting facial asymmetry. The cleft on chin or separated jaw is an acquired quality in people, where the predominant genes causes a split jawline, while the recessive genotype will display without a cleft on the chin. Everybody acquires two arrangements of genes that decide the state of their jaw, with one from each parent. The accomplice’s hereditary makeup will factor into whether the kids will have a parted jaw or a smooth one. If the two parents have acquired two separated jawline genes, at that point the probability of the youngsters having a cleft on the chin is 100 percent [2]. Relation between normal body temperature and dimple on the chin is the main objective of this study.

Materials and Method

Measurement of Normal Body Temperature

For measuring the normal body temperature eat home, we need a digital thermometer. The digital thermometer showed the body temperature of the individual in points as 97.02 °F. We measured the normal temperature of the body of all the students with thermometer by placing it in the armpit. While some students placed it in the center of the arm. There was an ON button on the thermometer. Press the button and the thermometer will show the reading after one minute. Note down the reading on the thermometer.

Task Design

A total of 130 undergraduate students participated in this research activity. All the subjects were undergraduate students in Bahauddin Zakariya University, Multan, Pakistan. The purpose of research was to correlate the normal body temperature with dimple on the chin.

Data Analysis

MS-Excel was used to done data analysis.

Results

Figure 1: Load vs crack initiation life with only ML.

Table 1: Relation of normal temperature of the body and dimple on the chin (p value).

p>0.1 these are non-significant results.

Relation of normal temperature of the body and dimple on the chin is given in (Figure 1) and (Table 1). These figures showed that there was no significant relation of the normal temperature of the body and dimple on the chin as all the p values were higher than the significant value that was 0.1. The high ratio of presence of chin dimple was in males but there was no significant relation with the normal body temperature.

Discussion

Important advancement had been made by recent researches [3-11]. Levander et al. [10] did an investigation on the temperature of the body in men and women. They observed the rectal, oral, tympanic and axillary temperature of the body. The motivation behind this examination was to research ordinary body temperature in grown-up people. A methodical audit of information was performed. Studies were incorporated that was from 1935 to 1999. Articles were named strong, genuinely strong and weak proof. While condensing contemplates with strong or genuinely strong proof the range for oral temperature was 33 to 38 Celsius, rectal temperature was 34 to 37 Celsius, tympanic temperature of body was 35 to 37 Celsius and axillary body temperature was 35 to 37 Celsius. The range in oral temperature for people, separately, was 35 to 37 Celsius and 33 to 38 Celsius, body temperature in rectal was 36 to 37 Celsius and 36 to 37 Celsius, and temperature of body in tympanic was 35 to 37 Celsius and 35 to 37 Celsius. While surveying body temperature it is critical to happen of estimation and gender orientation into thought. Concentrates with arbitrary examples are expected to affirm the scope of typical body temperature as for gender orientation and age.

Action of Salicylate on the normal temperature of the body in rats was also studied by Satinoff [11]. Rats accepting intraperitoneal infusions of sodium salicylate demonstrated a decrease in rectal temperature of up to 5 degree Celsius when set in a 5 Celsius area. The portion of salicylate was by the body load as 30 to 300mg. Elevated amounts of salicylate brought down the temperatures of rats kept in a 23 Celsius condition. The verdict that salicylate can bring down non-feverish temperature of the body recommends that antipyretic specialists affects routine temperature direction.

Conclusion

It was concluded from the study that there was no relation of normal temperature of the body with the dimple on the chin.

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Lupine Publishers| Is There Any Fluctuation in Normal Blood Pressure While Watching Horror Movies?

 Lupine Publishers| Journal of Medical Sciences

Abstract

  The purpose of recent research was to probe any close linkage concerning the normal blood pressure with viewing scary films. Total 185 subjects contributed in this survey. Blood pressure is the force that transports blood throughout the vascular system. It is expressed by two figures. The systolic blood pressure defines the pressure in blood vines when our heart strokes. The diastolic pressure estimates pressure when the heart relaxes between pumping. The readings are shown in the form of 120 systolic and 80 diastolic. It is the normal blood pressure. We can say “120 over 80” or note “120/80 mmHg.” There is a constructive relation between watching a horror movie and the blood pressure. We encounter some physical situations while watching these events. We detect an increase in heart rate, rise up in blood pressure, stressed muscles and a reduction in body temperature. It activates the release of dopamine and adrenaline hormone. It triggers aggressive behavior and emergency situation. we applied automatic digital device for the precise measurement of blood pressure. We placed the cuff on naked arm on inch above or below the curve of the elbow. We pressed the start button and the cuff began inflating and then slowly deflated. We recorded the measurement of the blood pressure during this period. It was deduced that there is no significant fluctuation in normal blood pressure while watching horror movies.

Keywords: Horror Movies; Blood Pressure; Systolic; Diastolic; Digital Monometer; Dopamine

Introduction

Blood pressure is the power that transports blood throughout the vascular system. It is defined via two figures. The systolic blood pressure determines the pressure in blood vessels when our heart propels the blood. The diastolic pressure evaluates the pressure when the heart relaxes between pumping. The readings are shown in the form of 120 systolic and 80 diastolic. It is the normal blood pressure. We can say “120 over 80” or record “120/80 mmHg.” The fluctuations from normal reading indicates low and high blood pressure which can be dangerous to our health. It reads highest at the beginning from our heart and it is lowest when it enters the minute branches of arteries. It is also significant as the afore mentioned carries leukocytes and antibodies for immunity, hormones i.e. insulin. It is not only vital in delivering O2 and nutrients but also eliminates toxic carbon dioxide and toxins that removes through liver and kidney. It also helps in thermoregulation and prevents bleeding with the help of clotting platelets.

Blood runs across our body because of a variance in pressure. The state of the arteries alters blood pressure and flow. If the arteries become thicker and smaller, it will lead to blockage of the blood circulation and this condition cause stroke and heart attack. In recent age, the majority watch scary movies but they do not know about the facts of watching horror movies. Now a days, the internet source is easily accessible to everyone. So, we can download any type of horror videos. There is a worthy relation between watching a horror movie and the blood pressure. We face some physical situations while watching these events. We observe an increase in heart rate, rise in blood pressure, tense muscles and a fall in body temperature. It activates the release of dopamine and adrenaline hormone. It triggers aggressive behavior and emergency situation. There is a heart attack risk due to high blood pressure during this activity of viewing horror film. When we are habitual to these movies then there is no fear and no anxiety. Hence, low blood pressure or equal to normal BP is observed [1,2]. The target of this project was to investigate the relationship between the normal blood pressure and watching horror movies [3-8]

Materials and Method

we used automatic digital device for the accurate measurement of blood pressure. We positioned the cuff on naked arm on inch above or below the curve of the elbow. We pushed the start button and the cuff began inflating and then slowly deflated. We recorded the measurement of the blood pressure during this period. The screen displayed the blood pressure in the form of ‘120/80’ mm of Hg. In this way, we counted the subjects’ blood pressure.

Project Designing: Over-all 185 took part around the survey. The participants were the undergraduates getting education in BAHA UD DIN ZAKARIYA UNIVERSITY MULTAN, PAKISTAN. Their blood pressures were gaged through automatic digital sphygmomanometer and cited the blood pressure. A feedback form was supplied to them. Their replies accumulated and explored later in this study.

Statistical Analysis: This process was completed utilizing MS Excel software. T-test was manipulated to examine the following findings. P value (< 0.05) was indicated being substantial.

Results and Discussion

From above Table 1, we can describe that female subjects show the significant result because their actual P* value (0.05) is very equal or similar to original p value (<0.05). Table 2 displays that there are greater actual p values than original value. So, there is non- significant results in situation of diastolic BP. But seeing the averages of 1st Table, greater systolic blood pressure avg for male explains their attraction towards watching horror movies. The same result seeks from the 2nd Table. While in case of female and combined gender, they have greater avg values for hating to watch scary movies.

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Lupine Publishers| Etiological Mirages of Acute Pneumonia

  Lupine Publishers| Journal of Medical Sciences

Abstract

Introduction: Modern AP concepts are focused exclusively on the infectious nature of the disease and the presence of certain pathogens. This belief determines the principles of treatment, the lack of effectiveness of which remains a concern of health professionals. The article presents a fragment of the study devoted to the etiology of АP.994 children aged 4 months to 14 years with various forms of so-called community-acquired pneumonia were examined and treated. Bacteriological examination of the material from the inflammation zone was carried out in 542 patients. Experiments on modeling АP and its pleural complications were performed on 44 animals. The obtained results and critical analysis of the literature data and scientific facts allow us to consider bacteria only as one of the etiological elements of АP, which is not mandatory in all cases of the disease. Scientifically based revision of existing ideas about the causes and mechanisms of AP development leads to the need for a radical change in the principles of treatment and is a strategic direction in solving the problem.

Keywords: Acute Pneumonia; etiology; Symbiotic Microflora; Experimental Model of Acute Pneumonia; Pleural Empyema; New doctrine

Introduction

Acute pneumonia (AP) has been one of the most acute health problems in all regions of the world for many years, occupying a leading position among the causes of morbidity and mortality [1-3]. At the same time, the justified concern of experts is a clear tendency to reduce the effectiveness of treatment of the disease. This concern is due to the increase in the number of cases requiring hospitalization and intensive care, as well as the gradual increase in mortality and the incidence of purulent complications, even in the best health systems of developed countries [4-10]. However, the main reason for deep reflection is not statistical reports, but the lack of reasoned scientific explanations of these negative trends and the lack of proposals for a radical strategic solution to the problem. The idea of the omnipotence of antibiotics as the main means of assistance in inflammatory diseases, which has developed in recent decades, is increasingly refuted by the results of daily practice. Equivalent treatment of patients with inflammatory processes having fundamental differences in localization, mechanisms of development and severity of clinical manifestations, has become a common norm. The increase in the group of strains resistant to antibiotics, and the periodic change of leaders among the pathogens of АP are accompanied only by tactical reforms and the release of more and more new antibacterial drugs, reducing the possibility of such maneuvers in the foreseeable future. There is no doubt that the modern system of medical care for patients with AP requires not only an analysis of the situation, but also a deep and reasoned assessment of existing ideas about the nature of the disease and the scientific validity of the principles of its treatment. The first results of such research experience and clinical testing of the revised principles of AP treatment were obtained about three decades ago, but their relevance is not only not lost, but, on the contrary, in the light of the subsequent trends described above, is becoming increasingly important. In modern conditions, first of all, it is necessary to critically assess the reliability of information about the causative agents of the disease, as these data formed the basis of modern understanding of the nature of АP and they dictate the direction of therapeutic tactics. A small part of the previous work proposed below could be very useful for reflection in this regard and for starting a more in-depth analysis of current views on the issue.

Materials and Method

Studies were conducted in the Clinic of pediatric surgery at The State Institute for Advanced Training of Doctors (Novokuznetsk, USSR) in 1976-1985.During this period, the Department treated 994 children aged 4 months to 14 years with various forms of so-called community-acquired pneumonia and its purulentdestructive complications. Many patients from this number were selectively hospitalized in our Department in the initial period of the most aggressive forms of AP immediately at diagnosis. The reason for hospitalization of the last group of patients is that the surgical clinic was the only place of intensive care in our region with a population of about 2 million people. This group of patients was characterized by high mortality and rapid development of pleural complications. Unsatisfactory results of traditional treatment (massive doses of antibiotics, oxygen supply, methods of bronchial drainage, intravenous infusion) and a large concentration of very severe patients are forced to look for effective solutions. The work began with a review of theoretical ideas about the nature of АP, its causes and mechanisms of development. For this purpose, known scientific data from certain biomedical rules and laws were used. To clarify some of the nuances of the disease and obtain objective evidence of the measures taken, special studies and experiments were conducted. Here are only those materials that are relevant to the topic under discussion. In bacteriological examination of patients, the importance was attached only to the material that was taken directly from the inflammation zone (542 patients). Therefore, the results obtained in patients with purulent complications of the main process were analyzed. It was in this category of patients there was a situation requiring removal of the contents of the lesion (pleural empyema, pleurisy, abscess), followed by microbiological examination.

Experimental Research 4

Series of experiments were carried out on 44 rabbits. The main experimental manipulation in all animals was endobronchial administration of various mixtures. These manipulations were performed under sterile conditions under intravenous thiopental sedation. A 0.6 mm diameter polyvinyl-chloride catheter was inserted using a puncture of the cervical trachea. The distal end of the catheter was moved to small bronchial branches in one of the lungs. After instillation, the catheter was immediately removed. The liquid mixture for instillation in each series of experiments differed in its composition. The following materials were ingredients for the preparation of the basic compound:

a. 1 billion microbial bodies of one-day culture Staphylococcus epidermidis in 1 ml of saline;

b. 2.1 billion microbial bodies of one-day culture Escherichia coli in 1 ml of saline solution;

c. sterile sunflower oil;

d. horse serum is normal, which was not used only in the first series of experiments.

The culture of the above-mentioned microorganisms was chosen specifically for experiments, since these bacteria do not appear in the list of dangerous pathogens of АP and belong to the group of “harmless” symbionts. Therefore, the experiment had the following objectives:

a. check the possibility of AP development involving trivial symbionts;

b. to clarify the role and importance of microbial factors in the occurrence of nonspecific pneumonia.

Only the experimental conditions in series 1 and 4 are of interest for the topic of this article and the discussion below. Therefore, descriptions of 2 and 3 series of experiments are not given. In the first experimental series (11 animals), a liquid mixture (1 ml of Staphylococcus epidermidis, 0.5 ml of Escherichia coli and 1 ml of sterile sunflower oil) was injected through a catheter into the bronchial tree. On the second and third day of the experiment, seven animals carried out jet slow intravenous infusion of rheomacrodex (30 CC/kg body weight).

All animals were put to sleep on the fourth day. All 15 rabbits 4 series of experiments received seven days before the main part of the experiment subcutaneous injection of 5 CC conventional horse serum. A week later, the above-mentioned composition of the mixture of ingredients, in which 0.05 CC of ordinary horse serum was added, was introduced into the bronchial tree. Later the animals were divided into 2 groups. Seven animals (series 4a) did not undergo additional procedures. The remaining 8 animals (series 4b) was obtained [3-4] hours after endobronchial procedures) intravenous slow infusion rheomacrodex and 0.9% sodium chloride (30 CC/kg body weight). These infusions were repeated once a day. Six animals from the last group (4b) received solutions with the addition of a dye (methylene blue). Euthanasia of all animals was performed on the fourth day after endobronchial instillations. After euthanasia, the lungs of all animals were subjected to macroand microscopic examination. Statistical evaluation of the study was carried out according to successive test plans, as well as by the method of controlling the average dispersion in pairs (Sachs L. “Statistische Auswertungsmethoden”. Springer. Berlin, Heidelberg, New-York, 1972). These statistical methods made it possible to limit the amount of experiments to obtain reliable results.

Results and Discussion

My generation grew up in fear of Staphylococcus aureus. Even at University, I received the first revelations that any pneumonia, accompanied by purulent and destructive complications, has a staphylococcal etiology. This was a period when in such situations the diagnosis of “staphylococcal lung destruction” was made confidently and without much thought. However, if the student had to take on faith the information provided, the practitioner could already critically evaluate the sources of such information. Treatment and monitoring of patients with АP allowed to note that the results of bacteriological examination of the material taken directly from the inflammation zone in some cases showed the presence of other microorganisms instead of the expected Staphylococcus aureus. In some cases, bacteria were not found in the purulent fluid at all. Yes, Staphylococcus aureus at that time was the leader among bacteriological findings in pleural empyema, but, as it turned out, he was not the only causative agent of the process. Statistics of such bacteriological data we carried out a little later in the period when there was a decrease in the frequency of detection of staphylococci. Analysis of the results of bacteriology of the material from the inflammation zone in 542 patients showed that Staphylococcus was detected in 32.7% of studies, other microorganisms-in 33.0%, and microbial flora-in 34.3% of studies was not revealed.

The results of clinical observations and statistics of bacteriological studies contradicted scientific explanations of the causes of purulent-destructive complications of AP. The main stimuli for the development of these complications were interpreted exclusively by the whole complex of pathogenic qualities of Staphylococcus. This microorganism was considered to be the main culprit of all troubles in AP. It is interesting to note that in the above analysis of bacteriological studies, pneumococcus was found only in 12.7%. Then it was difficult to imagine that in just a couple of decades the staphylococcal catastrophe will go down in history and not every certified specialist will be focused on these events, and pneumococcus will repeat the fate of Staphylococcus and will be presented at all levels as another Scarecrow. But in fairness it should be noted that among the bacteriological findings of the pleural empyema were found other microorganisms (Proteus, Е.coli, Klebsiella and others), which were considered less dangerous than staphylococci .However, purulent complications of АP still developed in the presence of less aggressive microflora, and their clinical and radiological signs had no fundamental differences. When the failure of treatment of АP and the development of its severe complications are trying to associate only with the presence of a certain pathogen, but in fact such a monopoly is not confirmed, then inevitably the question arises whether the value of certain properties of a microbe in the development and negative dynamics of the inflammatory process is not exaggerated.

Finding an answer to this question becomes even more relevant if you try to explain the reason for the lack of microbes in the study of pus, which was extracted from patients with complications of АP. But patients with this result of bacteriological studies were no more and no less than a third of our observations. The cause of the so-called sterile empyema of the pleura can be two possible factors. First, this circumstance can be a consequence of effective antibacterial therapy. Antibiotics are known to torpedo the microflora, but are not a means of direct impact on the mechanisms of the current inflammatory process. Second, it is now estimated that about a third of all АP cases worldwide have viral etiology [3]. If these data are true, antibiotics as the main modern means of treatment of АP have no reasonable application in such situations. Some clarity in this discussion may be provided by the results of experimental studies on modeling АP and its complications. Such studies are usually resorted to in situations where it is not possible to clarify the details of the disease in clinical conditions, and animal experiments allow you to recreate a close panorama of the observed phenomenon.

Our experiments yielded the following results. In the first series of experiments, where the transbronchial infection of pulmonary tissue was combined with a violation of bronchial patency, the АP-model could not be obtained. Macro-and micro-studies of pulmonary tissue showed the presence of a stable pattern of atelectasis without signs of inflammatory reaction. Intravenous infusions carried out during this series did not make any changes to the final picture. A fundamental change in the results was achieved in the fourth series of experiments. Preliminary sensitization of animals with horse serum and subsequent administration of a small dose of the same drug with simultaneous infection of lung tissue provoked an acute inflammatory reaction. Typical pattern of АP were detected in all observations of the series 4a. The addition of intravenous infusions (series 4b) to such animals shortly after the start of the experiment showed the development of pleural changes. The dye, which was added in several cases, gave a color change in the area of inflammation. The presence of changes in the affected area against the background of infusions further emphasized the inflammatory nature of the observed tissue transformation. The increase in blood flow to the zone of inflammation by infusion stimulated an increase in edema and infiltration in conditions of increased vascular permeability. The results of the experiments were marked by obtaining a certificate for the invention [11].

It is necessary to emphasize a very important, in our opinion, element of experiments. Despite the strict observance of the conditions for the set of materials and performing manipulations, the degree of inflammatory changes in the lungs and the severity of the pleural reaction in each case had their differences. Inflammatory changes in pulmonary tissue ranged from infiltrative changes to small foci of necrosis or abscess. Both fibrin and purulent exudate accumulations were found in the pleural cavity. In one of the observations at the autopsy was found pyopneumothorax. Thus, the results of the experiments allowed us to draw the following conclusions. First, the presence of a microbe is not the only condition for starting АР. Bacteria can be one of the components of the etiology of the process, and severe forms of damage can develop with the participation of representatives of the symbiotic microflora. Secondly, an important condition for the beginning of the inflammatory process in the lungs is the immune response of the sensitized organism to the repeated penetration of the allergen. Third, the development of an inflammatory reaction has individual characteristics and can differ in a wide range of manifestations.

The above data of our own research were only one part of all the work done, which was aimed at clarifying the nature and mechanisms of the development of АP and improving the results of treatment. Despite significant achievements in solving this problem, the results remained little known, as they were published only in Russian [12]. The past years have shown that the current understanding of the causes of the problem has not changed, but has focused even more on one narrow area. Currently, all efforts in the process of diagnosis and treatment, and all proposals for the future are aimed at quickly checking the pathogens of АP for a more accurate choice of antibiotic. It should be noted that for many years all the troubles and failures in the treatment of patients with АP are considered as a result of the presence of infectious and dangerous pathogens. At the same time, the real and objective results of determining the AР agent in the early stages of the disease have not yet been obtained. The exception is a small group of patients with pleural complications, in which the material for bacteriological examination is extracted directly from the area of inflammation. In all other cases of this disease, the nature of the pathogen is tried to be judged indirectly.

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Lupine Publishers| Determination of Knowledge, Attitude and Behaviors of Pesticide Dealers and Applicators in Different Cities of Turkey

 Lupine Publishers| Journal of Medical Sciences

Abstract

Introduction: Biocidal products refer to the general name of substances used in order to prevent, control or reduce the harmful effects of hazardous organisms present in all areas of public health describing human settlements, working areas, physical places and environment related to daily living [1]. The use of biocidal product around the world is, on average, 3 million tons per year; this amount is 13.000 tons in Turkey.

Objective: Objective this study is to measure the knowledge, attitude and behaviors of Pesticide sellers and Pest Control Companies during February-May 2017 in the cities of Antalya (Aksu), Denizli (Center), Isparta (Center) and Ankara (Center).

Materials and Methods:This study was conducted in the cities of Antalya, Denizli, Isparta and Ankara during the months of February-May 2017 by means of surveys prepared to measure knowledge, attitude and behaviors of pesticide sellers and home pest control companies. In the survey study, 37 questions in total were addressed to pesticide sellers while 48 questions were directed to managers and workers in home pest control companies. Statistical significance value was accepted as p< 0.05. For statistical analyses and calculations, IBM SPSS Statistics 21.0.

Results:The average age of respondents was 36.77±10.73 years for home pest dusters and 37.50±9.74 for pesticide sellers. Pesticide sellers (86.7% was university graduate) were found to have higher education level in comparison to home pest dusters (53.3% was university graduate). When the questions of surveys were evaluated, average score of home pest dusters were defined as 64.69±7.79 whereas pesticide sellers scored 64.18±9.74 on average.

Keywords: Biocidal product; Pest control; Biocide poisoning; Agriculture

Introduction

Biocidal products refer to the general name of substances used in order to prevent, control or reduce the harmful effects of hazardous organisms present in all areas of public health describing human settlements, working areas, physical places and environment related to daily living unknown [1]. Although the concepts of biocidal product and pesticide are usually substituted for each other, pesticides are used as a general term involving all kinds of chemical substances used in implementations of agricultural pest control [2]. Rapidly growing world population and unchanging world acreage point out that the yields from cultivated areas should be increased [3]. Illness and detrimental weeds lead to product losses up to 25-30% in cultivated plants. In order to minimize or prevent this loss, chemical control is the most preferred method as it is easy to implement and quickly yields solution [4]. Hazardous chemicals started to be widely used in pest control during mid 1940s [5]. 75 % of all biocidal and pesticide usage in the world occur in developed countries. However, in developing countries, both biocide and pesticide usage have been increasing [6]. Besides, 95% of poisoning and mortality related to biocide and pesticide takes place in developing countries.

Whereas the use of biocidal product around the world is, on average, 3 million tons per year; this amount is 13.000 tons in Turkey. With the aim of maximizing productivity of agricultural lands, use of pesticide in pest control has been increasing more each year due to ease of implementation and quick solution [7]. In pesticide use against pests, illnesses and weeds leading to yield loss; only 0.015%-6.0% of pesticides reach the target organism and the remaining 94.0%-99.9% reach non-target organisms and soil or meddle with other ecosystems as contaminant [8]. Inappropriate use of biocidal products can lead to acute and chronic intoxication, food and environment pollution and development of resistance against these products in target organisms [9,10]. It is quite hard to evaluate the impacts of biocidal products on human since there are many unknown factors related to the exact nature of problem. Socio demographic attributes such as age, gender, race, economic situation change the extent and results of influence considerably [11,12].

In this study, “home pest dusters” refer to the people who actually do the pest control with biocidal products used in public health areas and natural or legal persons who sell these products are stated as “pesticide sellers”. The study evaluates knowledge, attitude and behaviors of pesticide sellers and staff working in pest control companies in four selected cities as well as investigates the factors that might have an impact [13]. The amount of pesticide consumption per hectare is lower in Turkey than European Union Countries yet there is not any tracking and control system regarding the implementation of standards and procedures in preparation, application and sales of these pesticides. In addition; health education as well as education about the pre-and post-processes of pesticide application are necessary to perform balanced and conscious application and to avoid adverse effects of pesticides. The safety of workers applying pesticides is protected by some regulations with active participation of health, environment and business sector. Regulations for workers mainly include components such as the update of acts related to employee and employer, employee protection standard development, extending risk benefit analysis, guidance and training certification [14]. Although there are limited studies about attitude and behaviors of agricultural laborer in use of pesticide, there is no study done regarding pesticide dealers and home pest dusters.

Materials and Method

This study was conducted in the cities of Antalya, Denizli, Isparta and Ankara during the months of February-May 2017 by means of surveys prepared to measure knowledge, attitude and behaviors of pesticide sellers and home pest control companies. Four provinces have been selected in the agricultural sector, which have export licenses and are important in the country of agriculture. While the ratio of the total agricultural area of Ankara to Turkey is about 5%, the ratio of the fruit area of Ankara to Turkey is 8.46%; the ratio of vegetable area of Ankara to Turkey is 5.93% and the ratio of cultivated area to Turkey is 5.01% [15] (Ankara Kalkınma Ajansı, 2017). The city of Antalya constitutes 28.41% of cucumber production; 27.28% of orange production and 78.15% of avocado production in Turkey Antalya İl Gıda Tarım ve Hayvancılık Müdürlüğü [16] and takes the first place in Turkey in Isparta apple production Bashimov [17] (20.2% of total Isparta apple production) Yaman et al. [18].

The share of agricultural production in Denizli South Aegean production basin in 2010 was 30%. According to 2011 data, about 99% of Denizli’s agricultural production is wine grapes. When agricultural products exported in Denizli in 2013 are examined, 11.081 tons of fresh grapes are in the first place; and they are exported to countries such as Russia, Ukraine, Germany, Bulgaria and Azerbaijan. Denizli meets 90% of thyme production in Turkey, 15% of sunflower seeds and 80% of chickpea production in Turkey. Denizli is the world’s top producer in thyme, Turkey’s top producer in sunflower seed and opium, Turkey’s second producer in grape production and in milk production, it is the largest fourth producer of Aegean region and the largest ninth producer of Turkey Öselmiş [19]. The main materials of study include the pesticide sellers in the cities mentioned, pest control company executive, employees and survey questions addressed to these people. Lists of Pesticide dealers were obtained from Directorates of Provincial Food Agriculture and Livestock in the cities of Ankara, Antalya, Denizli and Isparta. Based on the obtained data; 57.69 % of pesticide dealers within the study were reached and 37-question surveys were applied.

Furthermore, lists of home pest control companies were obtained from environmental health units of Ankara, Antalya, Denizli, Isparta Municipalities. 48 question surveys were applied to 10 out of 14 companies in Antalya, 3 out of 4 in Denizli, 3 out of 5 in Isparta and 14 out of 22 companies in Ankara. Selection of companies were made randomly in both survey studies. Distribution of continuous variables such as age, working years was reviewed with Shapiro-Wilk Test and graphs of normality. Kruskal- Wallis test was used in comparison of points of knowledge by cities whereas Mann-Whitney U test and t-test based on the distribution of knowledge point were used in comparison of points of knowledge by education level. In comparison of categorical variables such as education level etc. depending on poisoning, chi square test was applied. The relations between education point and age, working years were assessed by Spearman’s correlation analysis. Statistical significance value was accepted as p<0.05. For statistical analyses and calculations, IBM SPSS Statistics 21.0 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.)

For 35 knowledge measurement questions in the survey measuring the knowledge, attitude and behaviors of home pest dusters and 25 questions in the survey measuring the knowledge, attitude and behaviors of pesticide sellers, “knowledge score” was calculated out of 100 points. During the calculation of knowledge score, every question measuring knowledge level was evaluated in equal weight. Multiple answer questions were scored by adding the number of correct answers for related question. The main professions of home pest dusters and pesticide sellers were divided to two categories as area and non-area for statistical analyses. Professions such as Agricultural technician, agricultural engineer, environmental engineer, health personnel and chemist were regarded as in area while accountant, tradesman, business manager, teacher and other professions were accepted as non-area.

Results

In this study, survey questions were applied to 150 people in the group of pesticide sellers and to 30 people in the group of home pest dusters. In the survey study, 37 questions in total were addressed to pesticide sellers while 48 questions were directed to managers and workers in home pest control companies. Average ages of home pest dusters in study were 36.77±10.73. 53.3% of the 30 home pest dusters within the scope of research were university graduate and 46% were high school graduate. 70.8% of the home pest dusters were among area professions. Average time spent in professional life was 6.03±4.85 years. As for pesticide sellers, average age was 37.50±9.74. 86.7% of them was university graduate, 12.7% high school graduate and 0.7% of them was primary school graduate. 92.1% of pesticide sellers were within the group of area professions. Average time spent in working for pesticide sellers were 9.27±7.02 years. Average knowledge level of home pest dusters was 64.69±7.79 while that of pesticide sellers was 64.18±9.74. Knowledge level of home pest dusters was seen to be higher than that of pesticide sellers. There was no statistically meaningful difference between the knowledge levels of pesticide sellers and home pest dusters (z=0.207, p=0.836).

When the knowledge levels and professions of home pest dusters are compared, it was seen that there was no statistically meaningful difference between the knowledge level of participants with in-area (n=17) and non-area (n=9) professions (Z=1.647, p=0.107). In comparison of professions and knowledge levels in pesticide sellers, there was also no meaningful difference between the knowledge level of participants with in-area (n=137) and nonarea (n=13) professions (Z=0.164 p=0.870). In addition, there was no meaningful relation found between ages and knowledge levels of home pest dusters and pesticide sellers (p>0.05). Also, there was no meaningful relation between daily working period and knowledge levels (p>0.05). A moderate negative linear relation was detected in working years and knowledge levels of home pest dusters (p=0.026). As working period of home pest dusters decreased, their knowledge levels increased. According to this result, it can be deducted that as working years of home pest dusters increased, they could not sufficiently keep up with current issues and they supposed that the knowledge they possess is enough for them. On the other hand, when working years and knowledge levels of pesticide sellers are compared, there was no meaningful linear relation found between working period and knowledge level (p>0.05).

According to results, there was no meaningful difference between education level and knowledge level of home pest dusters (t=1.081, p=0.289). Also, when pesticide sellers’ education level and knowledge level are compared, there was no meaningful difference in score between high school and university graduates (z=0.515, p=0.607). When knowledge levels and the cities home pest dusters live are compared, there was again no meaningful difference (x2=0.343, p=0.952). On the other hand, knowledge level and the cities of pesticide sellers are compared, knowledge levels were detected to show meaningful difference based on the cities (x2=18.706, p<0.001). As a result of pair comparisons, it was determined that pesticide dealers from Denizli had higher scores than the participants from Antalya and Isparta (p<0.05) and pesticide sellers in Denizli was found to be more knowledgeable in terms of professional knowledge when compared to other cities.

It was detected in this study that average daily working hours of home pest dusters were 9.47±1.28, there was first aid kit and medicine chest in all workplaces, safety measures were being taken against fire in 90% of the workplaces, there was a separate changing room for the workers in 50% of the workplaces. 40% of companies participating the survey were detected to prepare biocidal products for application in workplace; 13.3% of companies in vehicle and the remaining percentage in application area. However, it was well known that preparation for application should be done in workplaces. Maintenance and calibration of the equipment used in pesticide application was being done regularly by all home pest dusters or through outsourcing. All home pest dusters were using back pomps for spraying and no treatment was done with living things that have died after pesticide use. Yet it is laid down by laws that these dead animals should be disposed properly.

Based on the answers of surveys, it was observed that all home pest dusters think that an ideal biocidal product should be harmless to humans and other organisms, 16.7 % of them think that biocidal product has influence over more than one species, 10% of them think it has influence over only one species, 10% that it should be easy to use and 10% believe that it should be cheap. As for pesticide sellers; it was determined that 53.3% supposed that an ideal biocidal product should be harmless to human and other organisms, 24.0% that it should be easy to use, 21.3% that it has influence over more than one species, 21.3% that it should be cheap and 20.7% that it should impact only one type of species. The main characteristic of an ideal biocidal product is that it should be affectless to human and other organisms. While all home pest dusters have knowledge of this, only 53.3 of pesticide sellers have it.

According to research results, 36.7% of home pest dusters and 79.3% of pesticide sellers believe that even small doses of biocidal products are harmful to other organisms. Among home pest dusters, 93.3% of suppose that biocidal products leave residues in the environment after being used. 100% of participants answering this question believe that residues remain in air, 3.6% believe they remain in rain and there was no one thinking that residues stay in earth, water, food, household goods and clothing. As for pesticide sellers, 75.2% think that residues stay in earth, 37.6% in food, 24.0% in water, 20.0% in air and 4.8% in rain. While pesticide sellers think that after use of biocidal products, residues remain mostly in earth, food and water; home pest dusters believe that they stay in air and rain at most. According to the results obtained, all of home pest dusters were seen that they think biocidal products are not hazardous to human health while 78% of pesticide sellers think they are. As a result, pesticide sellers think they are harmful to human health at a higher rate than home pest dusters. 96.7% of home pest dusters consider that biocidal products enter the human body via inhalation, 16.7% think they enter orally while no one thinks that they enter via skin, touch, eye contact or other ways. 67.3% of pesticide sellers state that biocidal products penetrate the human body via inhalation, 27.3% orally, 52.7% via skin contact, 13.3% via another way, 12% via eye contact. While pesticide sellers consider that biocidal products enter the human body via inhalation and skin contact at most; home pest dusters believe that they do through inhalation and mouth.

All of home pest dusters stated that they know the symptoms of biocide poisoning. Having looked at the distribution of answers; we saw that 100% is nausea and vomiting, 13.3% dizziness, 13.3% weakness, 6.7% fainting and 6.7% excessive perspiration. However apart from these signs, no one considered encopresis, seizures, lachrymation, dyspnea, stomachache, being unable to urinate are among the symptoms of poisoning. As for pesticide sellers, 98.7% stated that they know the symptoms of biocide poisoning. 86.5% marked nausea and vomiting, 48% dizziness, 28.4% excessive perspiration, 23% weakness, 18.2% fainting, 14.2% lachrymation, 14.2% dyspnea, 6.8% stomachache, 11.5% seizures and 10.8% marked encopresis among the symptoms of biocide poisoning. These results showed that although pesticide sellers stated that they are less informed about the symptoms of biocide poisoning than the home pest dusters, they could count the signs more comprehensively.

96.7% of home pest dusters stated that it is necessary to use protective material to avoid biocide poisoning while 83.3% of pesticide sellers confirmed the necessity of protective material, 30% stated that long term exposure should be avoided, 28.7% that unconscious use should be restrained, 26% that they should be kept under safety conditions, 21.3% that their mix with water and food should be avoided and 1.3% that other ways should be done to avoid biocide poisoning. When these answers were analyzed, it was detected that the pesticide sellers knew the ways of protection from biocide poisoning more comprehensively than home pest dusters. Based on the survey answers, it was seen that all of home pest dusters stated they use personal protective equipment; gloves, mask and boots. 20% of survey participants mentioned they use apron, 6.7% goggles and 3.3% safety helmet. On the other hand, only 85.3% of pesticide sellers were using personal protective equipment. 93% of those who use prefer gloves, 26% mask, 18.8% goggles and 3.1% another personal protective equipment. All in all, while pesticide sellers use gloves and mask more as personal protective equipment, home pest dusters mostly use gloves, mask and boots. Surveys showed that all of home pest dusters believe that biocidal products are not harmful to human health while 78% of pesticide sellers thinks they are. 78% of pesticide sellers mentioned that they believe biocidal products cause respiratory system disease, 47% dermatological disorders, 24.8% cancers, 12.8% gastrointestinal and 7.7% cardiovascular, 4.3% blood diseases and 0.9% other diseases. It was found out that the home pest dusters in study did not know the phone number of National Poisons Information Center (UZEM) while only 46.7% of pesticide sellers did know it.

While 76.7% of home pest dusters think that insecticides have antidote, 6.3% think they don’t. As for pesticide sellers, 70% mentioned that they believe biocidal products have antidote and 75.3% definitive treatment of biocide poisoning can be carried out. The study revealed that none of the home pest dusters got examined in regular intervals whereas 100% had no health complaint during or after the application of biocides. 19.3% of pesticide sellers got poisoned while no one among home pest dusters had biocide poisoning. 89.7% of pesticide sellers who had been poisoned consulted a medical institution. This situation can result from the fact that usage ratio of personal protective equipment among home pest dusters is 100%. All the home pest dusters see themselves at no risk of biocide poisoning while only 26% of pesticide sellers see themselves under risk. It was observed that pesticide sellers see themselves under risk of biocide poisoning at a higher rate than home pest dusters. It is considered that awareness level of pesticide sellers was higher than that of another group. All home pest dusters mentioned that they stored biocidal products in accordance with safe storage conditions while only 3.3% of pesticide sellers informed that they did not keep them safely.

According to survey results, 70% of home pest dusters were eating at work. All the workers were washing their hands before meal and after contact with biocides. On the other hand, 96% of pesticide sellers were washing their hands before meal and 86.7% were washing hands after contact with biocides. It was observed that behavior of pesticide sellers about this issue is less conscious when compared to home pest dusters. The study revealed that 93.3% of home pest dusters were following the related legal developments. 73.3 of them took part in training programs about biocidal products and 100% participated courses about preparation and application of biocides. 100% of home pest dusters were making arrangements at home before application and giving information to the hosts about the application. In Turkey, trainings for pest controllers are arranged in two categories: responsible manager trainings and operator trainings. Operator training programs are arranged by authorized relevant occupational organization, university or directorate for minimum 24 hours not to be less than 3 days and more than 10 days [20]. Pesticide sellers were found to follow up legal developments about biocidal products at a higher rate (99.3%) than home pest dusters. Again, the participation rate of pesticide sellers in education programs related to biocidal products (91.3%) was higher than that of home pest dusters.

According to the results of the research, 63.3% of home pest dusters read the contents of biocides. 70% of home pest dusters think that biocidal products are used consciously while %40 of pesticide sellers think so. 98.7% of pesticide sellers stated that they informed buyers about the biocidal products. It was determined that 76.4% of the survey participants gave information about dose, 65.5% about how to apply, 39.9% about the content, 5.4% about side effects of exposure, 4.7% about the symptoms of poisoning, 4.1% about immediate first aid in case of poisoning, 4.1 % about actions to be avoided in case of poisoning, 2.7% about other issues apart from these.

93.3% of home pest dusters pointed out that they knew the necessary immediate actions in case of biocide poisoning. 92.9% of home pest dusters believe that things to do in urgent cases include helping to enable regular breathing, according to 7.1%, it is to get one out of the scene, according to 7.1%, it is to wash the person, according to 3.6% it is to help the person vomit. Among pesticide sellers, the ratio of those who know the necessary immediate actions in case of biocide poisoning is 96%. 37.5% of pesticide sellers stated that in case of biocide poisoning, the person poisoned should be made to vomit immediately, 36.1% stated that the poisoned person should be get out of the scene, 34.7% that the clothes of the poisoned person should be removed, 36.6% that he/ she should be helped to breath regularly, 18.1% that the person should be washed, 7.6% that another action apart from these must be taken. According to 26.7% of home pest dusters, the poisoned person must not be made to drink water and according to 46.7%, movements of the person should not be hindered during seizures. As for pesticide sellers, 44.7% of them stated that to make one drink water was wrong and 33.3% that to hinder the movements during seizures and 22.7% that to make one eat yogurt is wrong.

The rate of biocide poisoning in pesticide sellers is 25.0% in Ankara (n=8), 28.6% in Antalya (n=20), 0.0% in Denizli (n=0) and 5.6% in Isparta (n=1). Distribution of poisoning varies across the cities (p=0.003). Poisoning rate in Denizli is lower than Ankara and Antalya. This meaningful low level in poisoning rate of Denizli is accordant with the high level of knowledge in the participants from Denizli. Pesticide sellers who did not have biocide poisoning had a higher rate of not using personal protective equipment (p=0.008). Among pesticide sellers who had biocide poisoning, the ratio of those who thought biocides were used consciously was higher (p>0.001). It has been determined that the persons who had biocides poisoning were not using biocidal products consciously although they thought themselves conscious user. It was detected that the ratio of those who were aware that biocidal products might enter human body via skin contact was lower among those who had biocide poisoning than those who did not get poisoned (p=0.017). The poisoned people were not aware that the biocides might enter through skin. Similarly, the ratio of those who knew that biocidal products might enter human body via eye contact was lower among those who had biocide poisoning than those who did not get poisoned (p=0.024).

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