Search results for: acute liver failure

Authors: Lucian Mocan, Flaviu Tabaran, Teodora Mocan, Cristian Matea, Cornel Iancu

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We present method of Gold Nanoparticle enhanced laser thermal ablation of HepG2 cells (Human hepatocellular liver carcinoma cell line), based on a simple gold nanoparticle carrier system, such as serum albumin (BSA), and demonstrate its selective therapeutic efficacy. Hyperspectral, contrast phase, and confocal microscopy combined immunochemical staining were used to demonstrate the selective internalization of HSA-GNPs via Gp60 receptors and the caveolin-mediated endocytosis inside HepG2 cells. We examined the ability of laser-activated carbon nanotubes to induce Hsp70 expression using confocal microscopy. Hep G2 cells heat-shocked (laser activated BSA-GNPs) to 42°C demonstrated an up-regulation of Hsp70 compared with control cells (BSA-GNPs treated cells without laser), which showed no detectable constitutive expression of Hsp70. We observed a time-dependent induction in Hsp70 expression in Hep G2 treated with BSA-GNPs and LASER irradiated. The post-irradiation apoptotic rate of HepG2 cells treated with HSA-GNPs ranged from 88.24% (for 50 mg/L) at 60 seconds, while at 30 minute the rate increased to 92.34% (50 mg/L). These unique results may represent a major step in liver cancer treatment using nanolocalized thermal ablation by laser heating.

Keywords: gold nanoparticles, liver cancer, albumin, laser irradiation

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Authors: Doaa M. Elghannam, Nashwa Khayrat Abousamra, Doaa A. Shahin, Enas F. Goda, Hanan Azzam, Emad Azmy, Manal Salah El-Din

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Background: The pathogenesis of acute myeloid leukemia (AML) involves the cooperation of mutations promoting proliferation/survival and those impairing differentiation. Point mutations of the NRAS gene are the most frequent somatic mutations causing aberrant signal-transduction in acute myeloid leukemia (AML). Aim: The present work was conducted to study the frequency and prognostic significance of NRAS gene mutations (NRASmut) in de novo Egyptian adult AML. Material and methods: Bone marrow specimens from 150 patients with de novo acute myeloid leukemia and controls were analyzed by genomic PCR-SSCP at codons 12, 13 (exon 1), and 61 (exon 2) for NRAS mutations. Results: NRAS gene mutations was found in 19/150 (12.7%) AML cases, represented more frequently in the FAB subtype M4eo (P = 0.028), and at codon 12, 13 (14of 19; 73.7%). Patients with NRASmut had a significant lower peripheral marrow blasts (P = 0.004, P=0.03) and non significant improved clinical outcome than patients without the mutation. Complete remission rate was (63.2% vs 56.5%; p=0.46), resistant disease (15.8% vs 23.6%; p=0.51), three years overall survival (44% vs 42%; P = 0.85) and disease free survival (42.1% vs 38.9%, P = 0.74). Multivariate analysis showed that age was the strongest unfavorable factor for overall survival (relative risk [RR], 1.9; P = .002), followed by cytogenetics (P = .004). FAB types, NRAS mutation, and leukocytosis were less important. Conclusions: NRAS gene mutation frequency and spectrum differ between biologically distinct subtypes of AML but do not significantly influence prognosis and clinical outcome.

Keywords: NRAS Gene, egyptian adult, acute myeloid leukemia, cytogenetics

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Authors: Diana Islam, Juan Fang, Vito Fanelli, Bing Han, Julie Khang, Jianfeng Wu, Arthur S. Slutsky, Haibo Zhang

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Introduction: MSC delivery in preclinical models of ARDS has demonstrated significant improvements in lung function and recovery from acute injury. However, the role of MSC delivery in ARDS associated pulmonary fibrosis is not well understood. Some animal studies using bleomycin, asbestos, and silica-induced pulmonary fibrosis show that MSC delivery can suppress fibrosis. While other animal studies using radiation induced pulmonary fibrosis, liver, and kidney fibrosis models show that MSC delivery can contribute to fibrosis. Hypothesis: The beneficial and deleterious effects of MSC in ARDS are modulated by the lung microenvironment at the time of MSC delivery. Methods: To induce ARDS a two-hit mouse model of Hydrochloric acid (HCl) aspiration (day 0) and mechanical ventilation (MV) (day 2) was used. HCl and injurious MV generated fibrosis within 14-28 days. 0.5x106 mouse MSCs were delivered (via both intratracheal and intravenous routes) either in the active inflammatory phase (day 2) or during the remodeling phase (day 14) of ARDS (mouse fibroblasts or PBS used as a control). Lung injury accessed using inflammation score and elastance measurement. Pulmonary fibrosis was accessed using histological score, tissue collagen level, and collagen expression. In addition alveolar epithelial (E) and mesenchymal (M) marker expression profile was also measured. All measurements were taken at day 2, 14, and 28. Results: MSC delivery 2 days after HCl exacerbated lung injury and fibrosis compared to HCl alone, while the day 14 delivery showed protective effects. However in the absence of HCl, MSC significantly reduced the injurious MV-induced fibrosis. HCl injury suppressed E markers and up-regulated M markers. MSC delivery 2 days after HCl further amplified M marker expression, indicating their role in myofibroblast proliferation/activation. While with 14-day delivery E marker up-regulation was observed indicating their role in epithelial restoration. Conclusions: Early MSC delivery can be protective of injurious MV. Late MSC delivery during repair phase may also aid in recovery. However, early MSC delivery during the exudative inflammatory phase of HCl-induced ARDS can result in pro-fibrotic profiles. It is critical to understand the interaction between MSC and the lung microenvironment before MSC-based therapies are utilized for ARDS.

Keywords: acute respiratory distress syndrome (ARDS), mesenchymal stem cells (MSC), hydrochloric acid (HCl), mechanical ventilation (MV)

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Authors: Oussama Derdous, Lakhdar Djemili, Hamza Bouchahed

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The consequences of a dam breach can be devastating; both in terms of lives lost and damaged infrastructure and property. Hydraulic modeling provides a clear picture of the possible consequences of partial or complete failure of a dam, which is the key to carry out emergency planning and conduct reliable risk assessments. In this paper, the MIKE11 model developed by the Danish Hydrologic Institute (DHI) was used to simulate the flood wave propagation associated with a potential failure analysis failure of Zardezas dam located in the city of Skikda in the North East of Algeria. MIKE11 results including inundation maps and the representative channel/valley cross-sections depicting flow depth and maximal flow velocities showed that Zardezas reservoir presents a significant risk to downstream areas in the event of a dam failure. These results can be used as the basis of the development of an Emergency Action Plan (EAP).The main objective of this plan is to predict the appropriate steps to avoid or at least decrease the consequences of unexpected failure of Zardezas dam.

Keywords: MIKE11, dam break, inundation maps, emergency action plan

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Authors: Venencia Albert, Arulselvi Subramanian, Hara Prasad Pati, Asok K. Mukhophadhyay

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Acute traumatic coagulopathy in an endogenous dysregulation of the intrinsic coagulation system in response to the injury, associated with three-fold risk of poor outcome, and is more amenable to corrective interventions, subsequent to early identification and management. Multiple definitions for stratification of the patients' risk for early acute coagulopathy have been proposed, with considerable variations in the defining criteria, including several trauma-scoring systems based on prehospital data. We aimed to develop a clinically relevant definition for acute coagulopathy of trauma based on conventional coagulation assays and to assess its efficacy in comparison to recently established prehospital prediction models. Methodology: Retrospective data of all trauma patients (n = 490) presented to our level I trauma center, in 2014, was extracted. Receiver operating characteristic curve analysis was done to establish cut-offs for conventional coagulation assays for identification of patients with acute traumatic coagulopathy was done. Prospectively data of (n = 100) adult trauma patients was collected and cohort was stratified by the established definition and classified as "coagulopathic" or "non-coagulopathic" and correlated with the Prediction of acute coagulopathy of trauma score and Trauma-Induced Coagulopathy Clinical Score for identifying trauma coagulopathy and subsequent risk for mortality. Results: Data of 490 trauma patients (average age 31.85±9.04; 86.7% males) was extracted. 53.3% had head injury, 26.6% had fractures, 7.5% had chest and abdominal injury. Acute traumatic coagulopathy was defined as international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s. Of the 100 adult trauma patients (average age 36.5±14.2; 94% males), 63% had early coagulopathy based on our conventional coagulation assay definition. Overall prediction of acute coagulopathy of trauma score was 118.7±58.5 and trauma-induced coagulopathy clinical score was 3(0-8). Both the scores were higher in coagulopathic than non-coagulopathic patients (prediction of acute coagulopathy of trauma score 123.2±8.3 vs. 110.9±6.8, p-value = 0.31; trauma-induced coagulopathy clinical score 4(3-8) vs. 3(0-8), p-value = 0.89), but not statistically significant. Overall mortality was 41%. Mortality rate was significantly higher in coagulopathic than non-coagulopathic patients (75.5% vs. 54.2%, p-value = 0.04). High prediction of acute coagulopathy of trauma score also significantly associated with mortality (134.2±9.95 vs. 107.8±6.82, p-value = 0.02), whereas trauma-induced coagulopathy clinical score did not vary be survivors and non-survivors. Conclusion: Early coagulopathy was seen in 63% of trauma patients, which was significantly associated with mortality. Acute traumatic coagulopathy defined by conventional coagulation assays (international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s) demonstrated good ability to identify coagulopathy and subsequent mortality, in comparison to the prehospital parameter-based scoring systems. Prediction of acute coagulopathy of trauma score may be more suited for predicting mortality rather than early coagulopathy. In emergency trauma situations, where immediate corrective measures need to be taken, complex multivariable scoring algorithms may cause delay, whereas coagulation parameters and conventional coagulation tests will give highly specific results.

Keywords: trauma, coagulopathy, prediction, model

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Authors: Benjaporn Buranrat, Nootchanat Mairuae

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Cratoxylum formosum (Jack) Dyer (CF) has been used for the traditional medicines in South East Asian and Thailand. Normally, northeast Thai vegetables have proven cytotoxic to many cancer cells. Therefore, the present study aims to explore the molecular mechanisms underlying CF-induced cancer cell death and apoptosis on breast and liver cancer cells. The cytotoxicity and antiproliferative effects of CF on the human breast MCF-7 and liver HepG2 cancer cell lines were evaluated using sulforhodamine B assay and colony formation assay. Cell migration assay was measured using wound healing assay. The apoptosis induction mechanisms were investigated through reactive oxygen species formation, caspase 3 activity, and JC-1 activity. Gene expression by real-time PCR and apoptosis related protein levels by Western blot analysis. CF induced MCF-7 and HepG2 cell death by time- and dose-dependent manner. Furthermore, CF had the greater cytotoxic potency on MCF-7 more than HepG2 cells with IC50 values of 85.70+4.52 μM and 219.03±9.96 μM respectively, at 24 h. Treatment with CF also caused a dose-dependent decrease in colony forming ability and cell migration, especially on MCF-7 cells. CF induced ROS formation, increased caspase 3 activities, and decreased the mitochondrial membrane potential, and causing apoptotic body production and DNA fragmentation. CF significantly decreased expression of the cell cycle regulatory protein RAC1 and downstream proteins, cdk6. Additionally, CF enhanced p21 and reduced cyclin D1 protein levels. CF leaf extract induced cell death, apoptosis, antimigration in both of MCF-7 and HepG2 cells. CF could be useful for developing to anticancer drug candidate for breast and liver cancer therapy.

Keywords: cratoxylum formosum (jack) dyer, breast cancer, liver cancer, cell death

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Authors: Mohana Babu Amberkar, Meena Kumari K, Ravi, Arjun, Christopher Rockson

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The aim of this research is to evaluate the hepatoprotective activity of Terminalia paniculata (Tp) against ATT induced hepatic damage in rats.Three hepatotoxic ATT drugs Isoniazid + Rifampicin + Pyrazinamide, silymarin as standard hepatoprotective drug and 0.5% carboxymethylcellulose (CMC) as a control were used. Tp extract and silymarin were administered orally with ATT drugs for 90 days. Two doses 250 and 500 mg/kg of Tp extract, ATT drugs and silymarin were administered as suspensions with 0.5% CMC. ATT treated rats showed a significant increase in aspartate transaminase, alanine transaminase, alkaline phosphatase, lactate dehydrogenase, and lipid peroxides in the serum vs. control. Treatment of silymarin and Tp (250mg/kg) extract showed hepatoprotective activity against the hepatic damage by ATT. This was evident from significant reduction in serum liver enzymes levels, and also there was a significant increase in serum proteins, albumin and total liver tissue thiols as compared to the ATT treated groups. Tp was found to possess hepatoprotective property.

Keywords: antitubercular drugs, hepatoprotective, liver enzymes, Terminalia paniculata

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Authors: Assia Haif, Djelloul Achouri, Zineddine Soualili

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Introduction: Laparoscopic treatment of liver echinococcosis cyst has become popular. In parallel, the diagnostic approach of cystic liver lesions is based on the number of lesions and their distribution. The etiologies of cystic masses in children are different, and the role of imaging in their characterization and pre-therapeutic evaluation is essential. The main differential diagnoses of hepatic hydatid cysts can be discovered intraoperatively by minimally invasive surgery. Methods: The clinical data contained seven patients with hepatic cystic who underwent laparoscopic surgery in the Department of Pediatric Surgery, SETIF, Algeria, from 2015 to 2022. Results: Of reported seven patients, five are male, and the remaining two are female. Abdominal pain was the most frequent clinical signs. Biological parameters were within normal limits, Abdominal ultrasound, practiced in all cases, completed by abdominal computed tomography (CT), showed a hydatid cystic. For all patients, surgical procedures were performed under laparoscopy. Total cystectomy in four patients, fenestration or subtotal cystectomy in three patients, respectively. A histopathological feature confirmed the nature of the cysts. During the follow-up period, there was no recurrence. Conclusions: Laparoscopic liver surgery is a safe and effective approach, it is an alternative to conventional surgery and a reproducible method. Laparoscopic surgery approach should follow the same principals with those of open surgery. This surgical technique can rectify the diagnosis of hydatid cyst, the histopathological examination confirms the nature of the cystic lesion.

Keywords: children, cyst, echinococcosis, laparoscopic, liver

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Authors: T. O. Ikpesu, I. Tongo, A. Ariyo

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This study was conducted to assess the effects of an organophosphate pesticide glyphosate formulation on neurological enzymes in the brain, liver and serum of juvenile Clarias gariepinus, and also to examine the antidotal prospect of Garcinia kola seeds extract. The fish divided into five groups were exposed to different treatments of glyphosate formulation and Garcinia kola seeds extract. Acetyl cholinesterase activities in the brain, liver and serum of the fish were estimated in the experimental and control fishes on day -7, 14, 21 and of 28 by spectrophotometrical methods. The enzyme was significantly (p < 0.05) inhibited in glyphosate formulation test. The inhibition percentages of AChE ranged for the brain, liver and serum between 40.7–59.4%, 50-57% and 27.5–51.3%, respectively. The aberrated parameters were recovered in G. kola seeds extract treated aquaria, and was dose and time dependent. The present study demonstrated that in vivo glyphosate formulation exposure caused AChE inhibition in the brain, liver and the serum. The brain tissue, however, might be suggested as a good indicator tissue for aquatic pollutants exposure in the fish and G. kola seeds extract has shown to be a good remedy for neurology restoration in a noxious circumstance. The findings has shown that xenobiotics could be eliminated from aquatic organisms, especially fish, and could be put into practice in areas at risk of pollutants. This approach can reduce the risks of biomagnification of poison in sea food. Hence, formulation of this plant extracts into capsule should be encouraged and supported.

Keywords: glyphosate, Clarias gariepinus, brain, Garcinia kola, acetyl cholinesterase, enzymes

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Authors: Mariam G. Eshak, Ahmed Abbas, M. I. El-Sabry, M. M. Mashaly

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This investigation was conducted to determine the physiological response and evaluate the expression of inflammatory and cell death genes and DNA damage induced by endotoxic shock in laying hens. Endotoxic shock was induced by a single intravenous injection of 107 Escherichia coli (E. coli,) colony/hen. In the present study, 240 forty-week-old laying hens (H&N) were randomly assigned into 2 groups with 3 replicates of 40 birds each. Hens were reared in battery cages with wire floors in an open-sided housing system under natural conditions. Housing and general management practices were similar for all groups. At 42-wk of age, 45 hens from the first group (15 replicate) were infected with E. coli, while the same number of hens from the second group was injected with saline and served as a control. Heat shock protein-70 (HSP-70) expression, plasma corticosterone concentration, body temperature, and the gene expression of bax, caspase-3 activity, P38, Interlukin-1β (Il-1β), and tumor necrosis factor alpha (TNF-α) genes and DNA damage in the brain and liver were measured. Hens treated with E. coli showed significant (P≤0.05) increase of body temperature by 1.2 ᴼC and plasma corticosterone by 3 folds compared to the controls. Further, hens injected with E.Coli showed markedly over-expression of HSP-70 and increase DNA damage in brain and liver. These results were synchronized with activating cell death program since our data showed significant (P≤0.05) high expression of bax and caspase-3 activity genes in the brain and liver. These results were related to remarkable over-inflammation gene expression of P38, IL-1β, and TNF-α in brain and liver. In conclusion, our results indicate that endotoxic shock induces inflammatory physiological response and triggers cell death program by promoting P38, IL-1β, and TNF-α gene expression in the brain and liver.

Keywords: chicken, DNA damage, Escherichia coli, gene expression, inflammation

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Authors: Nazmul Huda, Ashik Mosaddik, Abdul Awal, Shafiqur Rahman, Rukhsana Shaheen, Mustofa Nabi

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Polyherbal formulation Sharbat Deenar is a very popular unani medicine in Bangladesh. It is usually used for different kinds of liver disorders. In absence of reliable and inadequate hepatoprotective agents in conventional medicine, the herbal preparations are preferred for liver diseases. The present study was designed to evaluate the hepatoprotective activity of Sharbat Deenar on carbon tetrachloride (CCl₄) induced hepatotoxicity in male Long-Evans albino rats. Group I served as normal control and received neither formulation nor carbon tetrachloride. Group II received only CCl₄ 1mL/kg body weight of rat intraperitoneally for consecutive 14 days. Group III received CCl₄ 1mL/kg body weight of rat intraperitoneally and Silymarin, in dose 50mg/kg body weight of rat orally. Group IV received CCl₄ 1mL/kg body weight of rat intraperitoneally and Sharbat Deenar 1mL/kg body weight of rat for the same 14 consecutive days. At the end of the study, hepatoprotective activity was evaluated by the levels of total bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP). Histopathological study of rat liver was also carried out. The results showed that polyherbal formulation Sharbat Deenar exhibited a significant hepatoprotective effect. Such an outcome seems to be the synergistic effect of all ingredients of tested herbal formulation. Although this study suggests that Sharbat Deenar may be used to cure or minimize various liver diseases, it needs further study to attain the clarity of mechanism and safety.

Keywords: polyherbal formulation, sharbat deenar, carbon tetrachloride, silymarin, hepatoprotective

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Authors: M. R. Jokanović, V. M. Tomović, M. T. Jović, S. B. Škaljac, B. V. Šojić, P. M. Ikonić, T. A. Tasić

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Proximate (moisture, protein, total fat, total ash) and mineral (K, P, Na, Mg, Ca, Zn, Fe, Cu and Mn) composition of chicken giblets (heart, liver and gizzard) were investigated. Phosphorous content, as well as proximate composition, were determined according to recommended ISO methods. The content of all elements, except phosphorus, of the giblets tissues were determined using inductively coupled plasma-optical emission spectrometry (ICP-OES), after dry ashing mineralization. Regarding proximate composition heart was the highest in total fat content, and the lowest in protein content. Liver was the highest in protein and total ash content, while gizzard was the highest in moisture and the lowest in total fat content. Regarding mineral composition liver was the highest for K, P, Ca, Mg, Fe, Zn, Cu, and Mn, while heart was the highest for Na content. The contents of almost all investigated minerals in analysed giblets tissues of chickens from Vojvodina were similar to values reported in the literature, i.e. in national food composition databases of other countries.

Keywords: chicken giblets, proximate composition, mineral composition, inductively coupled plasma-optical emission spectrometry (ICP-OES)

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Authors: Akram Khaleghei Ghosheh Balagh, Viliam Makis, Leila Jafari

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In this paper, we present a new maintenance model for a partially observable system subject to two failure modes, namely a catastrophic failure and a failure due to the system degradation. The system is subject to condition monitoring and the degradation process is described by a hidden Markov model. A cost-optimal Bayesian control policy is developed for maintaining the system. The control problem is formulated in the semi-Markov decision process framework. An effective computational algorithm is developed and illustrated by a numerical example.

Keywords: partially observable system, hidden Markov model, competing risks, multivariate Bayesian control

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Authors: Shedy Maharani Nariswari, Prima Agustia Nova, I. Made Kariasa

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Background. Heart Failure (HF) is a chronic and progressive condition associated with significant morbidity, mortality, health care expenditures, and a high readmission rate over the years. Self‐care is essential to manage chronic heart failure in the long term, and it is related to better outcomes and can enhance the quality of life. Objective. The aims of this study were to describe the relationship between self-care behavior and quality of life among heart failure patients in East Jakarta, Indonesia. Methods. This study used a correlational-descriptive design with a cross-sectional study, the sampling method used purposive sampling method. Self-care was measured using Self-care Heart Failure Index version 6.2, and quality of life was measured using The Minnesota Living with Heart Failure. Pearson correlation and Spearman-rho correlations are used to analyze the data. Results. We recruited 103 patients with HF in both outpatient and inpatient ward: mean age 59.26 ± 11.643 years, 63.1% male. Patients with higher levels of education were associated with higher self-care maintenance (p= 0.007). The patient's average quality of life is quite high, with a score of 72,07 ± 16,89. There were a significant relationship among self-care maintenance (r=0,305, p=0,001), self-care management (r=0,330, p=0,001), and self-care confidence (r=0,335, p=0,001) towards the quality of life. Most participants have inadequate self-care maintenance, self-care management, and self-care confidence (score < 70), while the score of quality of life is categorized as poor. Conclusion. The self-care behaviors were limited among patients living with HF in Indonesia yet was associated with better quality of life. It is necessary to promote health related to knowledge and adherence to self-care behavior so that it can improve the quality of life of heart failure patients. This study can be used as a reference to promote self-care among patients with heart failure, it can help to enhance their quality of life.

Keywords: heart failure, self-care maintenance, self-care management, self-care confidence, quality of life

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Authors: Zong Yan Cai, Wen-Chyuan Chen, Chih-Min Wu

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The purpose of this study was to investigate the acute effects of local vibration on muscle activation, metabolic and hormone responses. Totally 12 healthy, physically inactive, male adults participated in this study and completed LV exercise session. During LV exercise session, four custom-made vibrations (diameter: 20 mm; thickness: 8 mm; weight: 0.022 g) were locally placed over the belly of the thigh of each subject’s non-dominant leg in supine lying position, and subjects received 10 sets for 1 min at the frequency of 35-40Hz, with 1–2 min of rest between sets. The surface electromyography (EMG) were obtained from the vastus medialis and rectus femoris, and the subjects’ rating of perceived exertion (RPE) and heart rate (HR) were measured. EMG data, RPE values as well as HR were obtained by averaging the results of 10 sets of each exercise session. Blood samples were drawn before exercise, immediately after exercise, and 15min and 30min after exercise in each session for analysis of lactic acid (LA), growth hormone (GH), testosterone (T) and cortisol (C). The results indicated that the HR did not increase after LV (63.18±3.5 to 63.25±2.58 beat/min, p > 0.05). The average RPE values during the LV exposure were at 2.86±0.39. The root mean square % EMG values from the vastus medialis and rectus femoris were 19.02±2.19 and 8.25±2.20 respectively. There were no significant differences after acute LV exercise among LA, GH and T values as compared with baseline values (LA: 0.68±0.11 to 0.7±0.1 mmol/L; GH: 0.06±0.05 to 0.57±0.27 ng/mL; T: 551.33±46.62 to 520.42±43.78 ng/dL, p>0.05). However, the LV treatment caused a significant decrease in C values after exercise (16.56±1.05 to 11.64±1.85 nmol/L, p<0.05). In conclusion, acute LV exercise only slightly increase muscle activation which may not cause effective exercise response. However, acute LV exercise reduces C level, which may reduce the catabolic response. The probable reason might partly due to the vibration rhythmically which massage on muscles.

Keywords: cortisol, growth hormone, lactic acid, testosterone

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Authors: B. Lee, B. H. Choi

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The loss of safety for reservoirs brought about by climate change and facility aging leads to reservoir failures, which results in the loss of lives and property damage in downstream areas. Therefore, it is necessary to provide a reservoir failure alert system for downstream residents to detect the early signs of failure (with sensors) in real-time and perform safety management to prevent and minimize possible damage. 10 case studies were carried out to verify the water level management criteria of four levels (attention, caution, alert, serious). Peak changes in water level data were analysed. The results showed that ‘Caution’ and ‘Alert’ were closed to 33% and 66% of difference in level between flood water level and full water level. Therefore, it is adequate to use initial water level management criteria of reservoir failure alert system for the first year. Acknowledgment: This research was supported by a grant (2017-MPSS31-002) from 'Supporting Technology Development Program for Disaster Management' funded by the Ministry of the Interior and Safety(MOIS)

Keywords: alert system, management criteria, reservoir failure, sensor

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Authors: Arpit K. Shrivastava, Nirmal K. Mohakud, Subrat Kumar, Priyadarshi S. Sahu

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Acute diarrhea is one of the major causes of morbidity and mortality among children less than five years of age. Multiple etiologies have been implicated for infectious gastroenteritis causing acute diarrhea. In our study fecal samples (n=165) were collected from children (<5 years) presenting with symptoms of acute diarrhea. Samples were screened for viral, bacterial, and parasitic etiologies such as Rotavirus, Adenovirus, Diarrhoeagenic Escherichia coli (EPEC, EHEC, STEC, O157, O111), Shigella spp., Salmonella spp., Vibrio cholera, Cryptosporidium spp., and Giardia spp. The overall results from our study showed that 57% of children below 5 years of age with acute diarrhea were positive for at least one infectious etiology. Diarrhoeagenic Escherichia coli was detected to be the major etiological agent (29.09%) followed by Rotavirus (24.24%), Shigella (21.21%), Adenovirus (5.45%), Cryptosporidium (2.42%), and Giardia (0.60%). Among the different DEC strains, EPEC was detected significantly higher in <2 years children in comparison to >2 years age group (p =0.001). Concurrent infections with two or more pathogens were observed in 47 of 160 (28.48%) cases with a predominant incidence particularly in <2-year-old children (66.66%) compared to children of 2 to 5 years age group. Co-infection of Rotavirus with Shigella was the most frequent combination, which was detected in 17.94% cases, followed by Rotavirus with EPEC (15.38%) and Shigella with STEC (12.82%). Detection of multiple infectious etiologies and diagnosis of the right causative agent(s) can immensely help in better management of acute childhood diarrhea. In future more studies focusing on the detection of cases with concurrent infections must be carried out, as we believe that the etiological agents might be complementing each other’s strategies of pathogenesis resulting in severe diarrhea.

Keywords: children, co-infection, infectious diarrhea, Odisha

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Authors: Srinivasan Chandrasekaran, Manda Hari Venkata Ramachandra Rao

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Increase in the oil and gas exploration in ultra deep-water demands an adaptive structural form of the platform. Triceratops has superior motion characteristics compared to that of the Tension Leg Platform and Single Point Anchor Reservoir platforms, which is well established in the literature. Buoyant legs that support the deck are position-restrained to the sea bed using tethers with high axial pretension. Environmental forces that act on the platform induce dynamic tension variations in the tethers, causing the failure of tethers. The present study investigates the dynamic response behavior of the restraining system of the platform under the failure of a single tether of each buoyant leg in high sea states. Using the rain-flow counting algorithm and the Goodman diagram, fatigue damage caused to the tethers is estimated, and the fatigue life is predicted. Results shows that under failure conditions, the fatigue life of the remaining tethers is quite alarmingly low.

Keywords: fatigue life, pm spectrum, rain flow counting, triceratops, failure analysis

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Authors: Sally A. El Awdan, Gehad A. Abdel Jaleel, Dalia O Saleh, Manal Badawi

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Background: Diabetes is a metabolic disease that affects a wide range of people worldwide and results in serious complications. Streptozotocin (STZ) causes selective cytotoxicity in the pancreatic β-cell, and it has been extensively used to induce diabetes mellitus in rats. The present study investigated the effects of diosmin and chrysin alone or in combination with each other on glucose level and on liver in STZ diabetic rats. Methods: In this study, rats were divided into six experimental groups (normal, untreated STZ-diabetic (60 mg/kg B.W., IP), treated STZ-diabetic with glycazide (10 mg/kg B.W, oral), treated STZ-diabetic with diosmin (100 mg/kg B. W., oral), treated STZ-diabetic with chrysin (80 mg/kg B.W., oral), treated STZ-diabetic with diosmin (50 mg/kg B.W, oral) + chrysin (40 mg/kg B.W., oral). After 2 weeks blood samples were withdrawn and glucose was measured. Animals were anaesthetized with an intraperitoneal injection of sodium pentobarbital (60 mg/kg), and sacrificed for dissecting liver. Results: Throughout the experimental period, all treatments significantly (P<0.05) lowered serum glucose, AST, ALT, triglyceride, cholesterol, IL-6, TNF-α and IL-1β. Moreover, the treated diabetic rats showed higher levels of reduced glutathione (P<0.05) in the liver compared to the diabetic control rats and inhibited diabetes-induced elevation in the levels of malondialdehyde in liver. The results of this study clearly demonstrated that diosmin and chrysin possess several treatment-oriented properties, including the control of hyperglycemia, antioxidant effects and anti-inflammatory effects. Conclusion: Considering these observations, it appears that diosmin and chrysin may be a useful supplement to delay the developmentof diabetes and its complications.

Keywords: diabetes, streptozocin, chrysin, rat, diosmin, cytokines

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Authors: Laura Acevedo-Pacheco, Janet Alejandra Gutierrez-Uribe, Lucia Elizabeth Cruz-Suarez, Segio Othon Serna-Saldivar

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Seaweeds can generate changes in the metabolism of lipids; as a consequence, this may diminish cholesterol and other lipids in the blood. However, the consumption of marine algae may also alter the functions of other organs. Therefore, the objective of this research was to study the effect of two different sorts of algae (Ecklonia arborea and Silvetia compressa) in the metabolism of lipids, as well as, in the physiology of the liver. Wistar male rats were fed for two months with independent diets composed of 20% of fat and 2.5% of E. arborea and S. compressa each. Blood parameters (cholesterol, lipoproteins, triglycerides, hepatic enzymes) and triglycerides in the liver were quantified, and also hepatic histology analyses were performed. While S. compressa reduced 18% total cholesterol compared to the positive control, E. arborea increased it 5.8%. Animals fed with S. compressa presented a decrement, compared to the positive control, not only in low density lipoproteins levels (53%) but also in triglycerides (67%). The presence of steatosis in the histologies and the high levels of triglycerides showed an evident lipid accumulation in hepatic tissues of rats fed with both algae. These results indicate that even though S. compressa showed a promising resource to decrease total cholesterol and low-density lipoproteins in blood, a detrimental effect was observed in liver physiology. Further investigations should be made to find out if toxic compounds associated with these seaweeds may cause liver damage especially in terms of heavy metals.

Keywords: brown algae, Eisenia arborea, hepatic metabolism, lipidemic metabolism, Pelvetia compressa, steatosis

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Authors: O. Soji-Omoniwa, N. O. Muhammad, L. A. Usman, B. P. Omoniwa

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This study was conducted to investigate the effect of the leaf essential oil of C. sinensis harvested at 7.00a.m and 4.00p.m on some Liver and Kidney function indices of diabetic rats as well as investigate the effect of time of harvest on the observed effect. Experimental animals were divided into 4 groups (A, B, C and D). Diabetes mellitus was induced in all animals, except the normal control group (Group A), by injecting 150mg/kg body weight of alloxan monohydrate intraperitoneally. Group A received distilled water while group B (diabetic control group) was not treated. Group C and D were treated with leaf essential oil of C. sinensis harvested at 7.00 a.m and 4.00 p.m respectively at a dose of 110 mg/kg body weight every other day for 15 days. Alkaline phosphatase (ALP), Alanine Transaminase (ALT) and Aspartate Transaminase (AST) activity was evaluated in the serum, Liver and Kidney of studied animals. Total and Direct Bilirubin level, Total Protein and Globulin, Creatinine and Urea level were also evaluated. Result showed that creatinine and urea, serum ALP, AST and ALT levels was significantly reduced (p < 0.05), while the levels of total Protein and Globulin increased significantly (p < 0.05) for the treated animals compared to the diabetic control group. In conclusion, the leaf essential oil of Citrus sinensis ameliorated the impaired renal and liver function; however, the time of harvest of the leaf does not significantly affect its ameliorative effect.

Keywords: C. sinensis, function indices, harvest time, leaf essential oil.

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Authors: John Rothrock

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Background: The role of transthoracic echocardiography (TTE) in the diagnosis and management of patients with acute ischemic stroke remains controversial. While many stroke subspecialist reserve TTE for selected patients, others consider the procedure obligatory for most or all acute stroke patients. This study was undertaken to assess the cost vs. benefit of 'routine' TTE. Methods: We examined a consecutive series of patients who were admitted to a single institution in 2019 for acute ischemic stroke and underwent TTE. We sought to determine the frequency with which the results of TTE led to a new diagnosis of cardioembolism, redirected therapeutic cerebrovascular management, and at least potentially influenced the short or long-term clinical outcome. We recorded the direct cost associated with TTE. Results: There were 1076 patients in the study group, all of whom underwent TTE. TTE identified an unsuspected source of possible/probable cardioembolism in 62 patients (6%), confirmed an initially suspected source (primarily endocarditis) in an additional 13 (1%) and produced findings that stimulated subsequent testing diagnostic of possible/probable cardioembolism in 7 patients ( < 1%). TTE results potentially influenced the clinical outcome in a total of 48 patients (4%). With a total direct cost of $1.51 million, the mean cost per case wherein TTE results potentially influenced the clinical outcome in a positive manner was $31,375. Diagnostically and therapeutically, TTE was most beneficial in 67 patients under the age of 55 who presented with 'cryptogenic' stroke, identifying patent foramen ovale in 21 (31%); closure was performed in 19. Conclusions: The utility of TTE in the setting of acute ischemic stroke is modest, with its yield greatest in younger patients with cryptogenic stroke. Given the greater sensitivity of transesophageal echocardiography in detecting PFO and evaluating the aortic arch, TTE’s role in stroke diagnosis would appear to be limited.

Keywords: cardioembolic, cost-benefit, stroke, TTE

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Authors: Piyas Palit, Urbi Pal, Jitendra Mathur, Santanu Das

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Bearing is an important machinery part in the industry. When bearings fail to meet their expected life the consequences are increased downtime, loss of revenue and missed the delivery. This article describes the failure of a gearbox bearing in rolling contact fatigue. The investigation consists of visual observation, chemical analysis, characterization of microstructures using optical microscopes and hardness test. The present study also considers bearing life as well as the operational condition of bearings. Surface-initiated rolling contact fatigue, leading to a surface failure known as pitting, is a life-limiting failure mode in many modern machine elements, particularly rolling element bearings. Metallography analysis of crack propagation, crack morphology was also described. Indication of fatigue spalling in the ferrography test was also discussed. The analysis suggested the probable reasons for such kind of failure in operation. This type of spalling occurred due to (1) heavier external loading condition or (2) exceeds its service life.

Keywords: bearing, rolling contact fatigue, bearing life

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Authors: Soudabeh Shemehsavar

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In this paper, we consider the situation under a life test, in which the failure time of the test units are not related deterministically to an observable stochastic time varying covariate. In such a case, the joint distribution of failure time and a marker value would be useful for modeling the step stress life test. The problem of accelerating such an experiment is considered as the main aim of this paper. We present a step stress accelerated model based on a bivariate Wiener process with one component as the latent (unobservable) degradation process, which determines the failure times and the other as a marker process, the degradation values of which are recorded at times of failure. Parametric inference based on the proposed model is discussed and the optimization procedure for obtaining the optimal time for changing the stress level is presented. The optimization criterion is to minimize the approximate variance of the maximum likelihood estimator of a percentile of the products’ lifetime distribution.

Keywords: bivariate normal, Fisher information matrix, inverse Gaussian distribution, Wiener process

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Authors: Tareq Oshan

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Facility location and size decisions are important to any company because they affect profitability and success. However, warehouses are exposed to various risks of failure that affect their activity. This paper presents a mixed-integer non-linear mathematical model that can be used to determine optimal warehouse locations and sizes, which warehouses to fortify, and which branches should be assigned to specific warehouses when there is a risk of warehouse failure. Every branch is assigned to a fortified primary warehouse or a nonfortified primary warehouse and a fortified backup warehouse. The standard method and an introduced method, based on the average probabilities, for linearizing this mathematical model were used. A Canadian case study was used to demonstrate the developed mathematical model, followed by some sensitivity analysis.

Keywords: supply chain network design, fortified warehouse, mixed-integer mathematical model, warehouse failure risk

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Authors: Nondumiso Lushozi, Busisani Lembede, Eliton Chivandi

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Consumption of fructose increases the risk of obesity, nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome in children. Zingerone which is found in ginger has antidiabetic and antiobesogenic properties. Therefore, the aim of the study was to investigate the potential of orally administered zingerone to protect growing Sprague-Dawley rats (mimicking growing children) against high-fructose diet-induced metabolic derangements. Forty, 21-day old female Sprague-Dawley rats were randomly allocated and administered the following four treatments for 12 weeks: group I: standard rat chow (SR) + plain water (PW) + plain gelatine cube (PC). group II: SR + 20% (w/v) fructose solution (FS) + PC. group III: SR + FS + 100 mg/kg/day of fenofibrate in gelatine cube. group IV: SR+ FS + 20 mg/kg/day of zingerone in gelatine cube. The rats’ triglyceride, cholesterol, insulin & adiponectin concentration, visceral fat liver lipid content, homoeostasis model assessment of insulin resistance (HOMA-IR) and ability to handle glucose were determined. Oral administration of zingerone significantly increased (P<0.001) visceral fat and liver lipid content (P<0.001), respectively. Results from the study revealed that administration of 20% fructose solution did not induce metabolic dysfunction, however the zingerone treatment increased visceral fat and liver lipid content, all these lipid abnormalities are typical features of the metabolic syndrome, therefore the current study suggests that zingerone has no effect on metabolic dysfunction in adolescent females.

Keywords: antidiabetic, metabolic syndrome, zingerone, antiobesogenic

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Authors: Maryam Rafraf, Aida Ghaffari

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Objectives: Nonalcoholic fatty liver disease (NAFLD) is considered as an independent risk factor for cardiovascular disease (CVD). Dyslipidemia contributes to the enhanced risk of CVD in persons with NAFLD. This study aimed to investigate the effects of turmeric supplementation on serum lipids levels in patients with NAFLD. Methods: In this double-blind, randomized, controlled clinical trial, 46 NAFLD patients (21 males and 25 females; age range, 20 – 60 years) were randomly assigned in the two groups. The intervention and control groups received 3g of turmeric (n = 23) and placebo (n = 23), daily for 12 weeks. Fasting blood samples were collected at baseline and at the end of the trial. Results: Turmeric supplementation significantly increased serum levels of HDL-C compared with the placebo group at the end of the study (by 12.73%, P < 0.05). Serum levels of triglyceride, total cholesterol, and low-density lipoprotein cholesterol were significantly reduced within turmeric group at the end of the study (P < 0.05). Conclusions: Turmeric consumption had beneficial effects on serum lipids levels of subjects and may be useful in controlling of CVD risk factors in NAFLD patients.

Keywords: nonalcoholic fatty liver, serum lipids, supplementation, turmeric

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Authors: Magda I. Hassan

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This paper aims to investigate the health effects of aspartame on weanling male hamsters. 20 Golden Syrian hamsters drank only water (control) or water with 6, 11, and 18 mg aspartame/kg of body weight per day for 42 days. Food intake, weight gain, glucose blood level, and lipid profile were determined at the end of the experiment. The animals were sacrificed and histopathological examination of organs (liver, brain and heart) was done. Results revealed that animals in Asp.groups consumed significantly larger amount of food than the control (13.4±5.9, 8.6±2.5 and 8.8±3.0 vs 4.2±2.5 g/day, in succession). Hamsters in the control group showed higher total cholesterol and HDL levels than hamsters in aspartame 6, 11, 18 groups (160±19 vs 101±13, 130±22, 141±15 mg/dl & 144±9 vs 120±12, 118±13, 99±17 respectively (P<0•05)). The control group showed a glucose concentration below those of aspartame groups, indicating no effect of aspartame on glucose blood level. While, there were no significant differences in the triglycerides and LDL levels between control group and Asp.groups. Histopathological changes were observed, especially in brain and liver cells. Aspartame increases appetite and weight gain of young hamsters. Therefore, FDA should reconsider the acceptable daily intake (ADI) of aspartame for children.

Keywords: aspartame, brain, food intake, hamsters

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Authors: Chalermsri Sorasit, Siriporn Mongkhonthawornchai, Darawan Augsornwan, Sudthanom Kamollirt

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Background: Although knowledge of pain and pain management is improving, they are still inadequate to patients. The Nursing Division of Srinagarind Hospital is responsible for setting the pain management system, including work instruction development and pain management indicators. We have developed an information technology program for monitoring pain quality indicators, which was implemented to all nursing departments in April 2013. Objective: To study outcomes of acute pain management in process and outcome indicators. Method: This is a retrospective descriptive study. The sample population was patients who had acute pain 24-48 hours after receiving a procedure, while admitted to Srinagarind Hospital in 2014. Data were collected from the information technology program. 2709 patients with acute pain from 10 Nursing Departments were recruited in the study. The research tools in this study were 1) the demographic questionnaire 2) the pain management questionnaire for process indicators, and 3) the pain management questionnaire for outcome indicators. Data were analyzed and presented by percentages and means. Results: The process indicators show that nurses used pain assessment tool and recorded 99.19%. The pain reassessment after the intervention was 96.09%. The 80.15% of the patients received opioid for pain medication and the most frequency of non-pharmacological intervention used was positioning (76.72%). For the outcome indicators, nearly half of them (49.90%) had moderate–severe pain, mean scores of worst pain was 6.48 and overall pain was 4.08. Patient satisfaction level with pain management was good (49.17%) and very good (46.62%). Conclusion: Nurses used pain assessment tools and pain documents which met the goal of the pain management process. Patient satisfaction with pain management was at high level. However the patients had still moderate to severe pain. Nurses should adhere more strictly to the guidelines of pain management, by using acute pain guidelines especially when pain intensity is particularly moderate-high. Nurses should also develop and practice a non-pharmacological pain management program to continually improve the quality of pain management. The information technology program should have more details about non-pharmacological pain techniques.

Keywords: outcome, pain management, acute pain, Srinagarind Hospital

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Authors: Sheikha Turki Alketbi

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Objectives: 1. Documenting the spontaneous resolution of AML following the initiation of anti-TB therapy. 2. Presenting an uncommon type of relapse in Acute Myeloid Leukemia. 3. Highlighting the role of immune markers in the diagnosis of Leukemia cutis. 4. Exploring and highlighting the possibility of skin relapse as the exclusive manifestation, even when skin involvement is known secondary manifestation in AML. Background: Spontaneous remission of Acute Myeloid Leukemia (AML) is a rare phenomenon that has only been reported in some case reports, usually following severe infections. Some studies have described the occurrence of tuberculosis (TB) infection with AML, usually after starting chemotherapy. Spontaneous resolution of AML after starting anti TB therapy (ATT), without starting chemotherapy has never been described in the literature. Moreover, Leukemia cutis is another rare skin manifestation of Acute Myeloid Leukemia as a result of infiltration of the skin or subcutaneous tissue by leukemic cells, in which can present during, precedes, after or independently of systemic leukemia. Methods: Here, we present a case of a 13-year-old male who presented with fever, weight loss, lethargy, epistaxis, bruising and dry cough and was later diagnosed with AML. Before initiating leukemia treatment, the patient was tested for TB and was found to have active TB infection. His leukemia treatment was postponed to clear the TB infection and he was commenced on ATT. Two months later, repeat blood film and bone marrow biopsy showed resolution of his AML. The patient remained in remission for 1 month, after which he presented with symmetrical blue purple well-defined round indurated plaques on the chest and thighs. Our differentials were leukemia cutis and Kaposi sarcoma. Results: Skin Biopsy with immune markers done, showed a picture of Acute Myeloid Leukemia. Immunohistochemistry (IHC) showed neoplastic cells diffusely and strongly positive for LCA, CD2, CD31, MPO, CD117, Lysozymes and TDT, and moderately positive for CD34, CD99, CD43 and CD6 And patchy for CD68. Ki67 showed 60% proliferation index. They were negative for the remaining markers. This suggested acute myeloid leukemia (AML). Conclusion: In summary, we present a rare case of TB with AML that resolved after treatment of TB with ATT but relapsed later as leukemia cutis. While skin involvement might occur as a secondary manifestation of AML, Skin relapse could be the only one.

Keywords: Leukemia cutis, Leukemia relapse, Acute Myeloid Leukemia, spontaneous resolution of AML

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