Search results for: blood analysis

Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour, Parisa Hasankhani Tehrani

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Background And Objective: Haematopoietic stem cell transplant is a potentially curative treatment option in various benign and malignant haematological diseases. Patients undergoing stem cell transplant procedure require blood transfusion on a daily basis. Currently, there is paucity of data from developing countries on transfusion practices. This audit was undertaken to determine the consumption of packed red blood cells (PRBCs) transfusion in the bone marrow transplant unit of the Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran. Subjects And Methods: A retrospective audit was conducted for packed red cell transfusion ordering practice over a period from March 2017 to march 2018. All consecutive patients admitted for stem cell transplant procedure for various underlying diseases were included. Outcome measures used in this study were (i) cross match to transfusion (C: T) ratio and (ii) transfusion trigger. Results: During the study period, n=13 patients underwent a haematopoietic stem cell transplant. There were n=10 males and n=3 females. One patient was less than 15 years of age, while rests were adults. Median age±SD was 26.5±14.5 years (12∼54 years). The underlying diagnosis included Aplastic anemia (n=4), Thalassemia major (n=1), Multiple Myeloma (n=3), Acute leukemia (n=3), Hodgkin's lymphoma (n=1), PRCA (n=1). Grand total consumption of PRBCs during the study period was 204, while 258 products were crossmatch. The C:T ratio was 1.26. The transfusion trigger was Hb level of less than 8 gr/dl. Conclusion: The results of our BMT unit indicate that the C:T ratio and transfusion trigger is comparable to the international criteria and pioneer country in BMT transplantation. Also, we hope that our blood consumption become less than it is now.

Keywords: blood consumption, C: T ratio, PRBCs, stem cell transplant, tabriz, Iran

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Authors: B. I. Waziri, M. A. Yahaya

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Background: Practice of shisha smoking involves the use of a multi-stemmed instrument to smoke tobacco or non-tobacco herbal mixture where the smoke is designed to pass through water or other liquid before reaching the smoker. The presence of tobacco content and the use of charcoal when burning the ingredients in this popular practice necessitate for investigation of many physiological parameters of habitual shisha smokers in our environment. Methods: 103 young shisha smokers, regular in the practice for more than three years living in Nasarawa, Kano state, Nigeria, were recruited for the study. The controls were 100 university students (nonsmokers) match for age (18 - 30 years), sex and BMI (20 - 24) with the smokers. Participants with known history of cigarette smoking, cardiovascular or respiratory diseases were excluded. Ethical approval was obtained from the Ministry of Health, Kano Nigeria. Hear rate, blood pressure and percentage oxygen saturation (SPO₂) were measured using stethoscope, sphygmomanometer and pulse oximeter respectively. Data were analyzed using IBM SPSS version 20 and mean values of the measured parameters were compared between the smokers and controls using independent sample t-test. P-values < 0.05 were considered significant. Results: The mean Heart rate was found to be significantly higher (p = 0.01) in the shisha smokers (91.32 ± 0.84) compared to controls (79.19 ± 1.18). Systolic and diastolic blood pressure was also higher (p = 0.00) in the shisha smokers (128.75 ± 1.11 and 85.85 ± 0.78 respectively) compared to controls with the systolic and diastolic pressure of 116.64 ± 0.82 and 80.39 ± 0.83 respectively. SPO₂ was significantly lower (p = 0.00) in the shisha smokers (91.98% ± 0.42%) compared to the controls (97.98 ± 0.18). Conclusion: Habitual Shisha Smoking caused a significant increase in Heart rate, both systolic and diastolic blood pressure and a significant decrease in SPO2 among youth in Kano State, Nigeria.

Keywords: blood pressure, heart rate, shisha, youth

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Authors: Gauri Shankar Shah

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Objectives: The Type I diabetes mellitus in children is frequently a missed diagnosis and children presents in emergency with diabetic ketoacidosis having significant morbidity and mortality. The present study was done to find out the clinical presentation and outcome at a tertiary-care centre. Methods: This was retrospective analysis of data of Type I diabetes mellitus reporting to our centre during last one year (2012-2013). Results: There were 12 patients (8 males) and the age group was 4-14 years (mean ± 3.7). The presenting symptoms were fever, vomiting, altered sensorium and fast breathing in 8 (66.6%), 6 (50%), 4 (33.3%), and 4 (33.3%) cases, respectively. The classical triad of polyuria, polydypsia, and polyphagia were present only in two patients (33.2%). Seizures and epigastric pain were found in two cases each (33.2%). The four cases (33.3%) presented with diabetic ketoacidosis due to discontinuation of insulin doses, while 2 had hyperglycemia alone. The hemogram revealed mean hemoglobin of 12.1± 1.6 g/dL and total leukocyte count was 22,883.3 ± 10,345.9 per mm3, with polymorphs percentage of 73.1 ± 9.0%. The mean blood sugar at presentation was 740 ± 277 mg/ dl (544–1240). HbA1c ranged between 7.1-8.8 with mean of 8.1±0.6 %. The mean sodium, potassium, blood ph, pCO2, pO2 and bicarbonate were 140.8 ± 6.9 mEq/L, 4.4 ± 1.8mEq/L, 7.0 ± 0.2, 20.2 ± 10.8 mmHg, 112.6 ± 46.5 mmHg and 9.2 ± 8.8 mEq/L, respectively. All the patients were managed in pediatric intensive care unit as per our protocol, recovered and discharged on intermediate insulin given twice daily. Conclusions: Thus, it shows that these patients have uncontrolled hyperglycemia and often presents in emergency with ketoacidosis and deranged biochemical profile. The regular administration of insulin, frequent monitoring of blood sugar and health education are required to have better metabolic control and good quality of life.

Keywords: type I diabetes mellitus, hyperglycemia, outcome, glycemic control

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Authors: Mandob Enyegue Damaris, Oko Ndjollo Viviane

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The prevalence of Metabolic Syndrome is increasing throughout the world. The etiology of the metabolic syndrome is dependent on different factors such as ethnic group. This study aimed to evaluate the metabolic syndrome among Mbo ethnic group people leaving in Yaounde, Cameroon. The study conducted on the hundred and thirty two people 40 men and 92 women aged between 18-60 years who were referred to the Andre Fouda Medical Fundation in Yaounde. Metabolic syndrome was diagnosed using Adult Treatment Panel-III (A.T.P-III) 2001 guidelines. The mean of age, high fasting blood glucose, triglycerides levels and total cholesterol levels were significantly (P<0.05) higher in women with metabolic syndrome. High blood pressure level (56.80%), high fasting glucose (20.45%) and high waist circumference (10.60%) were respectively the most frequent characteristics in comparison to others metabolic components. The overall prevalence of MetS was (4.55%) and higher in women (3.03%) than in men (1.52%). The prevalence of MetS is low in originates of Mbo ethnic group of Yaounde. High blood pressure is the most common abnormality.

Keywords: individual components, metabolic syndrome, Mbo ethnic group, Yaounde-Cameroon

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Authors: Ebere Ellison Obisike, Justina N. Adalikwu-Obisike

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Artificial intelligence (AI) is progressively transforming health and social care. With the rapid invention of various electronic devices, machine learning, and computing systems, the use of AI istraversing many health and social care practices. In this systematic review of journal and grey literature, this study explores how the applications of AI might promote the prevention of micro and macrovascular complications in type 1 diabetic patients. This review focuses on the use of a digitized blood glucose meter and the application of insulin pumps for the effective management of type 1 diabetes in low and middle-income countries. It is projected that the applications of AI may assist individuals with type 1 diabetes to monitor and control their blood glucose level and prevent the early onset of micro and macrovascular complications.

Keywords: artificial intelligence, blood glucose meter, insulin pump, low and middle-income countries, micro and macrovascular complications, type 1 diabetes

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Authors: Fahad Raj Khan, Suleman Khan

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There is a lack of consensus about the predictive value of raised blood glucose levels in terms of major adverse cardiac events (MACEs) in non-diabetic patients admitted for acute decompensated heart failure. The purpose of this research was to examine the long-term prognosis of acute decompensated heart failure (ADHF) in non-diabetic persons who had increased blood glucose levels, i.e., stress hyperglycemia, at the time of their ADHF hospitalization. The research involved 650 non-diabetic patients. Based on their admission stress hyperglycemia, they were divided into two groups.ie with and without (SHGL). The two groups' one-year outcomes for major adverse cardiac events (MACEs) were compared, and key predictors of MACEs were discovered. For statistical analysis, the two-tailed Mann-Whitney U test, Fisher's exact test, and binary logistic regression analysis were utilized. SHGL was found in 353 (54.3%) individuals. It was more frequent in men than in women. About 27% of patients with SHGL had previously been admitted for ADHF. Almost 62% were hypertensive, whereas 14 % had CKD. MACEs were significantly predicted by SHGL, HTN, prior hospitalization for ADHF, CKD, and cardiogenic shock upon admission. SHGL at the time of ADHF admission, independent of DM status, may be a predictive indication of MACEs.

Keywords: stress hyperglycemia, acute heart failure, major adverse cardiac events, MACEs

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Authors: Sanaa AM Elgayar, Sohair A Eltony, Maha Mahmoud Abd El Rouf

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Background: Retinopathy remains an important complication of diabetes. Aim of work: This work was carried out to evaluate the protective effects of genistein from diabetic retinopathy in rat. Material and Methods: Fifteen adult male albino rats were divided into two groups; Group I: control (n=5) and Group II: streptozotocin induced diabetic group (n=10), which is equally divided into two subgroups; IIa (diabetic vehicle control) and IIb (diabetic genistein-treated). Specimens were taken from the retina 12 weeks post induction, processed and examined using light, immunohistochemical, ultrastructural techniques. Blood samples were assayed for the levels of glucose. Results: In comparison with the diabetic non-treated group, the histological changes in macro and microglial glial cells reactivity and retinal blood capillaries were improved in genistein-treated groups. In addition, GFAP and iNOS expressions in the retina and the blood glucose level were reduced. Conclusion: Genistein ameliorates the histological changes of diabetic retinopathy reaching healing features, which resemble that of a normal retina.

Keywords: diabetic retinopathy, genistein, glia, capillaries.

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Authors: Mary Anthony Oguike, Ilouno, Amaduruonye

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A completely randomized design experiment with 3 treatments was conducted to study the effects of garlic on intestine characteristics, haematology and serum biochemistry of Marshal broilers. Thirty three (33) broiler chicks were randomly allotted to each treatment designated T1, T2 and T3. The birds in each treatment were replicated 3 times with 11 broilers per replicate. They were fed diets supplemented with garlic at 0, 1.5 and 2.5 % /kg feed for t1, T2 and T3, respectively with T1 as control. Data were collected on intestine parameters, serum biochemical parameters and haematological indices. The results showed significant (P>0.05) dose-dependent decrease in intestine weight and caeca microbial load of the broilers. The intestine of broilers in the treatments showed normal histological architecture in all the treatments. The red blood cell (RBC), white blood cell (WBC), haemoglobin (Hb) and other haematological indices showed no significant differences (P<0.05) among the treatments. Cholesterol, globulin, glucose and alanin aminotransferase (ALT) were significantly different (P<0.05) among the treatment groups. Serum biochemical parameters such as, total protein albumin, bilirubin and others were not significant among the treatments. All the blood parameters studied fall within the normal range for broilers. Garlic supplementation in the diets of broilers did not have any detrimental effects on the treated birds since their serum biochemistry and haematology fall within the normal range for broilers birds. The microbial examination of intestine and caeca, as well as the histopathological studies of the intestine confirmed antimicrobial properties of garlic.

Keywords: broiler, biochemistry and haematology, garlic, intestine

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Authors: Intan Maisarah Abd Rahim, Herlina Abdul Rahim, Rashidah Ghazali

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Diabetes is a medical condition that can lead to various diseases such as stroke, heart disease, blindness and obesity. In clinical practice, the concern of the diabetic patients towards the blood glucose examination is rather alarming as some of the individual describing it as something painful with pinprick and pinch. As for some patient with high level of glucose level, pricking the fingers multiple times a day with the conventional glucose meter for close monitoring can be tiresome, time consuming and painful. With these concerns, several non-invasive techniques were used by researchers in measuring the glucose level in blood, including ultrasonic sensor implementation, multisensory systems, absorbance of transmittance, bio-impedance, voltage intensity, and thermography. This paper is discussing the application of the near-infrared (NIR) spectroscopy as a non-invasive method in measuring the glucose level and the implementation of the linear system identification model in predicting the output data for the NIR measurement. In this study, the wavelengths considered are at the 1450 nm and 1950 nm. Both of these wavelengths showed the most reliable information on the glucose presence in blood. Then, the linear Autoregressive Moving Average Exogenous model (ARMAX) model with both un-regularized and regularized methods was implemented in predicting the output result for the NIR measurement in order to investigate the practicality of the linear system in this study. However, the result showed only 50.11% accuracy obtained from the system which is far from the satisfying results that should be obtained.

Keywords: diabetes, glucose level, linear, near-infrared, non-invasive, prediction system

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Authors: Valeria T. Dilcheva, Svetlozara L. Petkova, Ivelin Vladov

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Trichinellosis is a food-borne parasitic disease caused by nematodes of the genus Trichinella which are zoonotic parasites with cosmopolitan distribution and major socio-economic importance. Human infection is acquired through consumption of undercooked meat from domestic or wild animal. Penetration of Trichinella larvae into striated skeletal muscle cells results in ultrastructural and metabolic changes. Migration of larvae causes the typical symptoms and signs of the disease. The severity of the symptoms depends on the number of ingested Trichinella larvae and the immune response of the host. Eosinophilia is present, with few exceptions, in most cases of human trichinellosis, inasmuch as it is the earliest and most important host response. Even in human asymptomatic cases, increases in eosinophilia of up to 15% have been observed. Eosinophilia appears at an early stage of infection between the second and fifth weeks of infection. By 2005 it was considered that only two species of Trichinella genus were found in the country. After routine trichinelloscopy procedure disseminated single muscle larvae in samples of wild boars and badger were PCR-identified as T. pseudospiralis. The study aimed to observed hematological changes occurring during experimentally induced infection with Trichinella spiralis, T. britovi and T. pseudospiralis in mice. We performed hematological blood profile, tracking 15 blood indicators. In statistical analysis made by Two-way ANOVA, there were significant differences of HGB, MCHC, PLT, Lymph%, Gran% in all three types of trichinellosis compared to control animals. Capsule-forming T. spiralis showed statistically significant differences in HGB, MCHC, Lymph% and PLT compared to the other two species. Non capsule-forming T. pseudospiralis showed statistically significant differences in Lymph%, Gran% relative to the control and in Gran% relative to T. spiralis. It appears rather substantial the process of capsule formation for prolonged immune response and retention of high content of percentage of lymphocytes(Lymph%) and low of granulocyte(Gran%) in T. pseudospiralis, which is contrary to studies for T. spiralis and eosinophilia. Studies and analyzes of some specific blood profile parameters can provide additional data in favor of early diagnosis and adequate treatment as well as provide a better understanding of acute and chronic trichinosis.

Keywords: hematological test, T. britovi, T. spiralis, T. pseudospiralis

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Authors: Z. C. Dlamini, R. L. S. Langa, A. I. Okoh, O. A. Aiyegoro

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The indiscriminate usage of antibiotics in swine production have consequential outcomes; such as development of bacterial resistance to prophylactic antibiotics and possibility of antibiotic residues in animal products. The use of probiotics appears to be the most effective procedure with positive metabolic nutritional implications. The aim of this study was to investigate the efficacy of probiotic bacteria (Lactobacillus reuteri ZJ625, Lactobacillus reuteri VB4, Lactobacillus salivarius ZJ614 and Streptococcus salivarius NBRC13956) administered as direct-fed microorganisms in weaned piglets. 45 weaned piglets blocked by weight were dived into 5 treatments groups: diet with antibiotic, diet with no-antibiotic and no probiotic, and diet with probiotic and diet with combination of probiotics. Piglets performance was monitored during the trials. Faecal and Ileum samples were collected for microbial count analysis. Blood samples were collected from pigs at the end of the trial, for analysis of haematological, biochemical and IgG stimulation. The data was analysed by Split-Plot ANOVA using SAS statistically software (SAS 9.3) (2003). The difference was observed between treatments for daily weight and feed conversion ratio. No difference was observed in analysis of faecal samples in regards with bacterial counts, difference was observed in ileums samples with enteric bacteria colony forming unit being lower in P2 treatment group as compared with lactic acid and total bacteria. With exception of globulin and albumin, biochemistry blood parameters were not affected, likewise for haematology, only basophils and segmented neutrophils were differed by having higher concentration in NC treatment group as compared with other treatment groups. Moreover, in IgG stimulation analysis, difference was also observed, with P2 treatment group having high concentration of IgG in P2 treatment group as compared to other groups. The results of this study suggest that probiotics have a beneficial effect on growth performances, blood parameters and IgG stimulation of pigs, most effective when they are administered in synergy form. This means that it is most likely that these probiotics will offer a significant benefit in pig farming by reducing risk of morbidity and mortality and produce quality meat that is more affordable to poorer communities, and thereby enhance South African pig industry’s economy. In addition, these results indicate that there is still more research need to be done on probiotics in regards with, i.e. dosage, shelf life and mechanism of action.

Keywords: antibiotics, biochemistry, haematology, IgG-stimulation, microbial count, probiotics

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Authors: M. Titaouine, T. Meziane, K. Deghnouche

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The purpose of this study was to determine reference serum biochemistry values from dromedary (Camelus dromedarius) in Algeria and to evaluate potential sources of physiological variability such as the sex, age and season on serum data. Usual serum biochemistry values were determined in blood samples from 26 apparently healthy dromedaries, 11 males and 15 females, divided into 3 lots (ender 4years), (between 5 and 10 years), (up 10 years). Parametric reference ranges and physiological variations are determined for calcium (Ca), organic phosphate (P), magnesium (Mg), natrium (Na), potassium (K), iron (Fe), glucose, triglycerides (TG), cholesterol, urea, creatinine, total proteins and albumin. The results demonstrate: * Values which agreed with literature * Significant statistically differences (Anova test, p < 0.05) depending on: -the sex for Na, glucose, TG, cholesterol, urea, creatinine, albumin, -the age for Ca, P, K, Mg, glucose, TG, b and g globulin, -and season for Fe, urea, total proteins, TG, cholesterol and glucose. These reference ranges for serum biochemical analysis can be used for metabolic and nutritional disorders detection in dromedary.

Keywords: age, biochemistry, dromadery, season, sex

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Authors: Eqbal M. A. Dauqan, A. Aminah

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The aim of the present study was to evaluate the blood lipid profile and liver lipid peroxidation in normal rat fed with different concentrations of Acacia senegal and Acacia seyal. Thirty six Sprague Dawley male rats each weighing between 180-200g were randomly divided into two groups. Each group contains eighteen rats and were divided into three groups of 6 rats per group. The rats were fed ad libitum with commercial rat’s feed and tap water containing different concentrations of Acacia senegal and Acacia seyal (3% and 6%) for 4 weeks. The results at 4 weeks showed that there was no significant difference (p≤0.05) in the total cholesterol (TC) and triglycerides (TG) between the control group and treated groups while the results for the high density lipoprotein (HDL-C) showed a significant decrease (P≥0.05) at the 3% and 6% of gum arabic treated groups compared to control group. There was a significant increase (P≥0.05) in low density lipoprotein (LDL-C) with 3% and 6% of gum Arabic (GA) groups compared to the control group. The study indicated that there was no significant (p≤0.05) effect on TC and TG but there was significant effect (P≥0.05) on HDL-C and LDL-C in blood lipid profile of normal rat. The results showed that after 4 weeks of treatment the malondialdehyde (MDA) value in rat fed with 6% of A. seyal group was significantly higher (P≥0.05) than control or other treated groups of A. seyal and A. senegal studied. Thus, the two species of gum arabic did not have beneficial effect on blood lipid profile and lipid peroxidation.

Keywords: Acacia senegal, acacia seyal, lipid profile, lipid peroxidation, malondialdehyde (MDA)

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Authors: I-Hui Hsieh, Yu-Hsuan Hu

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The powerful effect of music is often associated with changes in physiological responses such as heart rate and respiration. Previous studies demonstrate that Mayer waves of blood pressure, the spontaneous rhythm occurring at 0.1 Hz, corresponds to a progressive crescendo of the musical phrase. However, music contain dynamic changes in temporal and spectral features. As such, it remains unclear which aspects of musical structures optimally affect synchronization of cardiovascular rhythms. This study investigates the independent contribution of spectral pattern, temporal pattern, and dissonance level on synchronization of cardiovascular rhythms. The regularity of acoustical patterns occurring at a periodic rhythm of 0.1 Hz is hypothesized to elicit the strongest coherence of cardiovascular rhythms. Music excerpts taken from twelve pieces of Western classical repertoire were modulated to contain varying degrees of pattern regularity of the acoustic envelope structure. Three levels of dissonance were manipulated by varying the harmonic structure of the accompanying chords. Electrocardiogram and photoplethysmography signals were recorded for 5 minutes of baseline and simultaneously while participants listen to music excerpts randomly presented over headphones in a sitting position. Participants were asked to indicate the pleasantness of each music excerpt by adjusting via a slider presented on screen. Analysis of the Fourier spectral power of blood pressure around 0.1 Hz showed a significant difference between music excerpts characterized by spectral and temporal pattern regularity compared to the same content in random pattern. Phase coherence between heart rate and blood pressure increased significantly during listening to spectrally-regular phrases compared to its matched control phrases. The degree of dissonance of the accompanying chord sequence correlated with level of coherence between heart rate and blood pressure. Results suggest that low-level auditory features of music can entrain coherence of autonomic physiological variables. These findings have potential implications for using music as a clinical and therapeutic intervention for regulating cardiovascular functions.

Keywords: cardiovascular rhythms, coherence, dissonance, pattern regularity

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Authors: Fedili Benamar, Belloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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Introduction: Perioperative blood loss is a frequent cause of complications in total hip replacement (THR). The present prospective study assessed the efficacy of tranexamic acid (Exacyl(®)) in reducing blood loss in primary THR. Hypothesis: Tranexamic acid reduces blood loss in THR. Material and method: -This is a prospective randomized study on the effectiveness of Exacyl (tranexamic acid) in total hip replacement surgery performed on a standardized technique between 2019 and September 2022. -It involved 154 patients, of which 84 received a single injection of Exacyl (group 1) at a dosage of 10 mg/kg over 20 minutes during the perioperative period. -All patients received postoperative thromboprophylaxis with enoxaparin 0.4 ml subcutaneously. -All patients were admitted to the post-interventional intensive care unit for a duration of 24 hours for monitoring and pain management as per the service protocol. Results: 154 patients, of which 84 received a single injection of Exacyl (group 1) and 70 patients patients who did not receive Exacyl perioperatively : (Group 2 ) The average age is 57 +/- 15 years The distribution by gender was nearly equal with 56% male and 44% female; "The distribution according to the ASA score was as follows: 20.2% ASA1, 82.3% ASA2, and 17.5% ASA3. "There was a significant difference in the average volume of intraoperative and postoperative bleeding during the 48 hours." The average bleeding volume for group 1 (received Exacyl) was 614 ml +/- 228, while the average bleeding volume for group 2 was 729 +/- 300, with a chi-square test of 6.35 and a p-value < 0.01, which is highly significant. The ANOVA test showed an F-statistic of 7.11 and a p-value of 0.008. A Bartlett test revealed a chi-square of 6.35 and a p-value < 0.01." "In Group 1 (patients who received Exacyl), 73% had bleeding less than 750 ml (Group A), and 26% had bleeding exceeding 750 ml (Group B). In Group 2 (patients who did not receive Exacyl perioperatively), 52% had bleeding less than 750 ml (Group A), and 47% had bleeding exceeding 750 ml (Group B). "Thus, the use of Exacyl reduced perioperative bleeding and specifically decreased the risk of severe bleeding exceeding 750 ml by 43% with a relative risk (RR) of 1.37 and a p-value < 0.01. The transfusion rate was 1.19% in the population of Group 1 (Exacyl), whereas it was 10% in the population of Group 2 (no Exacyl). It can be stated that the use of Exacyl resulted in a reduction in perioperative blood transfusion with an RR of 0.1 and a p-value of 0.02. Conclusions: The use of Exacyl significantly reduced perioperative bleeding in this type of surgery.

Keywords: acid tranexamic, blood loss, anesthesia, total hip replacement, surgery

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Authors: Alireza Gholipour, Mergen H. Ghayesh, Anthony Zander, Stephen J. Nicholls, Peter J. Psaltis

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A three-dimensional numerical model of an atherosclerotic coronary ‎artery is developed for the determination of high-risk situation and ‎hence heart attack prediction. Employing the finite element method ‎‎(FEM) using ANSYS, fluid-structure interaction (FSI) model of the ‎artery is constructed to determine the shear stress distribution as well ‎as the von Mises stress field. A flexible model for an atherosclerotic ‎coronary artery conveying pulsatile blood is developed incorporating ‎three-dimensionality, artery’s tapered shape via a linear function for ‎artery wall distribution, motion of the artery, blood viscosity via the ‎non-Newtonian flow theory, blood pulsation via use of one-period ‎heartbeat, hyperelasticity via the Mooney-Rivlin model, viscoelasticity ‎via the Prony series shear relaxation scheme, and micro-calcification ‎inside the plaque. The material properties used to relate the stress field ‎to the strain field have been extracted from clinical data from previous ‎in-vitro studies. The determined stress fields has potential to be used as ‎a predictive tool for plaque rupture and dissection.‎ The results show that stress concentration due to micro-calcification ‎increases the von Mises stress significantly; chance of developing a ‎crack inside the plaque increases. Moreover, the blood pulsation varies ‎the stress distribution substantially for some cases.‎

Keywords: atherosclerosis, fluid-structure interaction‎, coronary arteries‎, pulsatile flow

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Authors: Chakrapani Pullagummi, Arun Jyothi Bheemagani, B. Chandra Sekhar Singh, Prem Kumar, A. Roja Rani

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Diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion and its action. The objective of present study was alloxan induced diabetes in S.D (Sprague Dawley) rats, treated with leaf extract of Andrographis paniculata and bark extract of Erythrina indica. Plant extract treated rats were analyzed biochemically and molecularly. on normal and diabetic rats. The changes in MDA (lipid peroxidation) and glucose (by GOD method) levels in blood of both normal and diabetic rat were analyzed. Diabetes induced rats were treated with methanolic extracts of Andrographis paniculata leaf and Erythrina indica bark which are of medicinal importance. Later after inducing diabetes the rats were treated with medicinal plant extracts, Andrographis paniculata leaf and Erythrina indica bark which are well known for their anti diabetic and antioxidative property in order to control the glucose and MDA levels. The blood plasma of diabetic and normal rats was analyzed for the levels of MDA (lipid peroxidation) and glucose levels. Results of this study suggested that the Andrographis paniculata leaf and Erythrina indica can be used as a potential natural antidiabetic agent for treating and postponing the appearance of complications that arise due to Diabetes. Molecular study deals with the analysis of binding mechanism of 2 selected natural compounds from Andrographis and Erythrina extracts against the novel target for type T2D namely PPAR-γ compared with Rosiglitazone (standard compound). The results revealed that most of the selected herbal lead compounds were effective targets against the receptors. These compounds showed favorable interactions with the amino acid residues thereby substantiating their proven efficacy as anti-diabetic compounds.

Keywords: andrographis paniculata, erythrina indica, alloxan, lipid peroxidation, blood glucose level, PPAR-γ

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Authors: Avirup Chowdhury, Angus K. McFadyen, Linsey Batchelor

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Blood cultures (BCs) are an important aspect of management of the septic patient, identifying the underlying pathogen and its antibiotic sensitivities. However, while the current literature outlines indications for initial BCs to be taken, there is little guidance for repeat sampling in the following 5-day period and little information on how antibiotic use can affect the usefulness of this investigation. A retrospective cohort study was conducted using inpatients who had undergone 2 or more BCs within 5 days between April 2016 and April 2017 at a 400-bed hospital in the west of Scotland and received antibiotic therapy between the first and second BCs. The data for BC sampling was collected from the electronic microbiology database, and cross-referenced with data from the hospital electronic prescribing system. Overall, 283 BCs were included in the study, taken from 92 patients (mean 3.08 cultures per patient, range 2-10). All 92 patients had initial BCs, of which 83 were positive (90%). 65 had a further sample within 24 hours of commencement of antibiotics, with 35 positive (54%). 23 had samples within 24-48 hours, with 4 (17%) positive; 12 patients had sampling at 48-72 hours, 12 at 72-96 hours, and 10 at 96-120 hours, with none positive. McNemar’s Exact Test was used to calculate statistical significance for patients who received blood cultures in multiple time blocks (Initial, < 24h, 24-120h, > 120h). For initial vs. < 24h-post BCs (53 patients tested), the proportion of positives fell from 46/53 to 29/53 (one-tailed P=0.002, OR 3.43, 95% CI 1.48-7.96). For initial vs 24-120h (n=42), the proportions were 38/42 and 4/42 respectively (P < 0.001, OR 35.0, 95% CI 4.79-255.48). For initial vs > 120h (n=36), these were 33/36 and 2/36 (P < 0.001,OR ∞). These were also calculated for a positive in initial or < 24h vs. 24-120h (n=42), with proportions of 41/42 and 4/42 (P < 0.001, OR 38.0, 95% CI 5.22-276.78); and for initial or < 24h vs > 120h (n=36), with proportions of 35/36 and 2/36 respectively (P < 0.001, OR ∞). This data appears to show that taking an initial BC followed by a BC within 24 hours of antibiotic commencement would maximise blood culture yield while minimising the risk of false negative results. This could potentially remove the need for as many as 46% of BC samples without adversely affecting patient care. BC yield decreases sharply after 48 hours of antibiotic use, and may not provide any clinically useful information after this time. Further multi-centre studies would validate these findings, and provide a foundation for future health policy generation.

Keywords: antibiotics, blood culture, efficacy, inpatient

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Authors: Mahdokht Sadeghvishkaei, Azizah Abdul-Hamid, Amin Ismail, Nazamid Saari

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Hypertension is a common and serious chronic health problem and known as the most important risk factor for development of many diseases such as stroke. Since angiotensin I-converting enzyme (ACE) is the key enzyme involved in blood pressure, one of the well accepted mechanisms to control hypertension is through ACE inhibition. The ACE inhibitory effect of Actinopyga lecanora (stone fish) proteolysate in vitro had been reported. Hence, this study aimed to evaluate the ACE inhibitory potential of Actinopyga lecanora proteolysate in vivo in normotensive rats. Therefore the ACE inhibitory capability of the proteolysate to prevent increasing systolic blood pressure, after inducing hypertension by angiotensin I was examined. The pre-fed rats with the proteolysates at various doses (200, 400, 800 mg/kg body weight) revealed the significant (p ≤ 0.05) suppression effect compared with control groups. Furthermore, different doses of the proteolysate (200, 400, 800 mg/kg body weight) were examined to find its optimum effective dose. Results depicted that 800 mg proteolysate/kg body weight significantly reduced systolic blood pressure without negative effect on normal blood pressure (p ≤ 0.05). Furthermore, Sub-acute toxicity study based on OECD guideline demonstrated the safety of the proteolysate in vivo. The present study indicated that the proteolysate at a dose of 1000 mg/kg daily for 14 days did not cause toxicity signs such as death, changes in activity, or piloerection. Since there are no significant differences between treated groups and control groups, hematological and biochemical analysis confirmed safety of the proteolysate (p > 0.05). In addition, there were no significant differences between organs weights of the treated groups and the control groups. Morphologically, neither histopathological changes, nor gross abnormalities were observed. However, the proteolysate caused significant decrease in body weight in relation to the control groups (p ≤ 0.05) probably due to appetite stimulation by the proteolysate, leading to decreased food consumption in sub-acute group. It is concluded that the proteolysate generated from Actinopyga lecanora possess a significant anti-hypertensive effect and would be potentially used as natural alternative of ACE inhibitors.

Keywords: ACE inhibition, Actinopyga lecanora, anti-hypertensive activity, bioactive peptides, normotensive rats

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Authors: Khalid Mehmood, Riaz Hussain, Rao Z. Abbas, Tariq Abbas, Abdul Ghaffar, Ahmad J. Sabir

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Blood born diseases such as trypanosomiasis have negative impacts on health, production and working efficiency of camels in different camel-rearing areas of the world including Pakistan. In present study blood samples were collected from camels kept at the desert condition of cholistan to estimate the prevalence of trypanosomiasis and hemato-biochemical changes in naturally infected cases. Results showed an overall 9.31% prevalence of trypanosomiasis in camels. Various clinical signs such as pyrexia, occasional shivering, inappetence, urticaria, swelling, lethargy, going down in condition and edema of pads were observed in few cases. The statistical analysis did not show significant association of age and sex with trypanosomiasis. However, results revealed significantly decreased values of total erythrocyte counts, packed cell volume, hemoglobin concentration, mean corpuscular hemoglobin concentration, serum total proteins and albumin while increased values of mean corpuscular volume was recorded in infected animals as compared to healthy. A significant (P<0.01) increased values of total leukocyte count, monocyte, lymphocyte, neutrophils, and eosinophils was recorded in infected animals. Moreover, microscopic examination of blood films obtained from naturally infected cases showed the presence of parasite and various morphological changes in cells such as stomatocyte, hyperchromasia, and polychromasia. Significantly increased values of different hepatic enzymes including alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were also recorded.

Keywords: camel, hematological indices, serum enzymes, Trypanosomiasis

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Authors: Waad Al Saleemi, Badriya Al Adawi, Zaaima Al Jabri, Sahim Al Ghafri, Jalila Al Hadhramia

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Objectives: Using standard lab methods, a positive blood culture requires a minimum of two days (two occasions of overnight incubation) to obtain a final identification (ID) and antimicrobial susceptibility results (AST) report. In this study, we aimed to evaluate the accuracy and precision of identification and antimicrobial susceptibility testing of an alternative method (direct method) that will reduce the turnaround time by 24 hours. This method involves the direct inoculation of positive blood culture broths into the Phoenix system using serum separation tubes (SST). Method: This prospective study included monomicrobial-positive blood cultures obtained from January 2022 to May 2023 in SQUH. Blood cultures containing a mixture of organisms, fungi, or anaerobic organisms were excluded from this study. The result of the new “direct method” under study was compared with the current “standard method” used in the lab. The accuracy and precision were evaluated for the ID and AST using Clinical and Laboratory Standards Institute (CLSI) recommendations. The categorical agreement, essential agreement, and the rates of very major errors (VME), major errors (ME), and minor errors (MIE) for both gram-negative and gram-positive bacteria were calculated. Passing criteria were set according to CLSI. Result: The results of ID and AST were available for a total of 158 isolates. Of 77 isolates of gram-negative bacteria, 71 (92%) were correctly identified at the species level. Of 70 isolates of gram-positive bacteria, 47(67%) isolates were correctly identified. For gram-negative bacteria, the essential agreement of the direct method was ≥92% when compared to the standard method, while the categorical agreement was ≥91% for all tested antibiotics. The precision of ID and AST were noted to be 100% for all tested isolates. For gram-positive bacteria, the essential agreement was >93%, while the categorical agreement was >92% for all tested antibiotics except moxifloxacin. Many antibiotics were noted to have an unacceptable higher rate of very major errors including penicillin, cotrimoxazole, clindamycin, ciprofloxacin, and moxifloxacin. However, no error was observed in the results of vancomycin, linezolid, and daptomycin. Conclusion: The direct method of ID and AST for positive blood cultures using SST is reliable for gram negative bacteria. It will significantly decrease the turnaround time and will facilitate antimicrobial stewardship.

Keywords: bloodstream infection, oman, direct ast, blood culture, rapid identification, antimicrobial susceptibility, phoenix, direct inoculation

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Authors: Aman Ullah Khan, Muhammad Younus, Aqil Ijaz, Muti-Ur-Rehman Khan, Sayyed Aun Muhammad, Asif Idrees, Sanan Raza, Amar Nasir

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Dengue fever and malaria are important vector-borne diseases of public health significance affecting millions of people around the globe. Dengue fever is caused by Dengue virus while malaria is caused by plasmodium protozoan. Generally, the consequences of Malaria are less severe compared to dengue fever. This study was designed to differentiate dengue fever and malaria on the basis of clinical and laboratory findings and to compare the changes in both diseases having different causative agents transmitted by the common vector. A total of 200 patients of dengue viral infection (120 males, 80 females) were included in this prospective descriptive study. The blood samples of the individuals were first screened for malaria by blood smear examination and then the negative samples were tested by anti-dengue IgM strip. The strip positive cases were further screened by IgM capture ELISA and their complete blood count including hemoglobin estimation (Hb), total and differential leukocyte counts (TLC and DLC), erythrocyte sedimentation rate (ESR) and platelet counts were performed. On the basis of the severity of signs and symptoms, dengue virus infected patients were subdivided into dengue fever (DF) and dengue hemorrhagic fever (DHF) comprising 70 and 100 confirmed patients, respectively. On the other hand, 30 patients were found infected with Malaria while overall 120 patients showed thrombocytopenia. The patients of DHF were found to have more leucopenia, raised hemoglobin level and thrombocytopenia < 50,000/µl compared to the patients belonging to DF and malaria. On the basis of the outcomes of the study, it was concluded that patients affected by DF were at a lower risk of undergoing haematological disturbance than suffering from DHF. While, the patients infected by Malaria were found to have no significant change in their blood components.

Keywords: dengue fever, blood, serum, malaria, ELISA

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Authors: Noor F. Ilias, Mazlifah Omar, Hashbullah Ismail

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Exercise training has been shown to improve functional capacity and is recommended as a therapy for management of blood pressure. Our purpose was to establish whether different exercise capacity produces different effect size for Cardiorespiratory Fitness (CRF), systolic (SBP) and diastolic (DBP) blood pressure in patients with hypertension. Exercise characteristic is required in order to have optimal benefit from the training, but optimal exercise capacity is still unwarranted. A MEDLINE search (1985 to 2015) was conducted for exercise based rehabilitation trials in hypertensive patients. Thirty-seven studies met the selection criteria. Of these, 31 (83.7%) were aerobic exercise and 6 (16.3%) aerobic with additional resistance exercise, providing a total of 1318 exercise subjects and 819 control, the total of subjects was 2137. We calculated exercise volume and energy expenditure through the description of exercise characteristics. 4 studies (18.2%) were 451kcal - 900 kcal, 12 (54.5%) were 900 kcal – 1350 kcal and 6 (27.3%) >1351kcal per week. Peak oxygen consumption (peak VO2) increased by mean difference of 1.44 ml/kg/min (95% confidence interval [CI]: 1.08 to 1.79 ml/kg/min; p = 0.00001) with weighted mean 21.2% for aerobic exercise compare to aerobic with additional resistance exercise 4.50 ml/kg/min (95% confidence interval [CI]: 3.57 to 5.42 ml/kg/min; p = 0.00001) with weighted mean 14.5%. SBP was clinically reduce for both aerobic and aerobic with resistance training by mean difference of -4.66 mmHg (95% confidence interval [CI]: -5.68 to -3.63 mmHg; p = 0.00001) weighted mean 6% reduction and -5.06 mmHg (95% confidence interval [CI]: -7.32 to -2.8 mmHg; p = 0.0001) weighted mean 5% reduction respectively. Result for DBP was clinically reduce for aerobic by mean difference of -1.62 mmHg (95% confidence interval [CI]: -2.09 to -1.15 mmHg; p = 0.00001) weighted mean 4% reduction and aerobic with resistance training reduce by mean difference of -3.26 mmHg (95% confidence interval [CI]: -4.87 to -1.65 mmHg; p = 0.0001) weighted mean 6% reduction. Optimum exercise capacity for 451 kcal – 900 kcal showed greater improvement in peak VO2 and SBP by 2.76 ml/kg/min (95% confidence interval [CI]: 1.47 to 4.05 ml/kg/min; p = 0.0001) with weighted mean 40.6% and -16.66 mmHg (95% confidence interval [CI]: -21.72 to -11.60 mmHg; p = 0.00001) weighted mean 9.8% respectively. Our data demonstrated that aerobic exercise with total volume of 451 kcal – 900 kcal/ week energy expenditure may elicit greater changes in cardiorespiratory fitness and blood pressure in hypertensive patients. Higher exercise capacity weekly does not seem better result in management hypertensive patients.

Keywords: blood Pressure, exercise, hypertension, peak VO2

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Authors: Y. Abdul Aziz, E. L. K. Osafo, S. O. Apori, A. Osman

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A sixteen week trial was conducted at the Research Farm (Technology Village) of the Department of Animal Science, School of Agriculture, University of Cape Coast, Cape Coast, Ghana. This study sought to investigate the effects of Probiotic (RE3) on growth performance, diarrhea incidence and blood parameters of N’dama calves. Sixteen N’dama calves aged 3 months of an average initial weight of 44.2 kg were randomly assigned to one of four dietary treatments according to their body weight, age, and sex. Treatment 1 (T1) serve as a control animal (No RE3 supplementation). Treatment 2 (T2) receives 0.03 ml RE3 per kg body weight. Treatment 3 (T3) receives 0.06 ml RE3 per kg body weight, and Treatment 4 (T4) also receives 0.09 ml RE3 per kg body weight in a Completely Randomize Design (CRD). There were 4 replicates per treatment. The calves were allowed access to feed and water ad libitum. The body weight of the calves was recorded at the start of the experiment and thereafter regularly at two weeks interval. Weighing was done early morning before the calves are allowed to access feed and water and were also observed in their pens for occurrence of diarrhea and faecal scores recorded. Blood samples were obtained from each calf at the end of the study through jugular vein puncture. Supplementation of RE3 to calves had showed a beneficial effect by reducing the incidence of diarrhea. The highest faecal score was recorded in T1 and the least faecal score was recorded in T3. There was significant difference (P < 0.05) in the faecal score between the treatment group and the control after two weeks of the experiment. There was no significant difference (P > 0.05) in the average daily gain of the animals. Hematological and biochemical indices of calves were all within the normal range except in treatments (1, 3 and 4) which recorded high White Blood Cell (WBC) count with no significant difference (P > 0.05).

Keywords: probiotics (RE3), diarrhea incidence, blood parameters, N’dama calves

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Authors: Harini Chakkera

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Background: Inpatient hyperglycemia is an established independent risk factor among several patient cohorts with hospital readmission. This has not been studied after kidney transplantation. Nearly one-third of patients who have undergone a kidney transplant reportedly experience 30-day readmission. Methods: Data on first-time solitary kidney transplantations were retrieved between September 2015 to December 2018. Information was linked to the electronic health record to determine a diagnosis of diabetes mellitus and extract glucometeric and insulin therapy data. Univariate logistic regression analysis and the XGBoost algorithm were used to predict 30-day readmission. We report the average performance of the models on the testing set on five bootstrapped partitions of the data to ensure statistical significance. Results: The cohort included 1036 patients who received kidney transplantation, and 224 (22%) experienced 30-day readmission. The machine learning algorithm was able to predict 30-day readmission with an average AUC of 77.3% (95% CI 75.30-79.3%). We observed statistically significant differences in the presence of pretransplant diabetes, inpatient-hyperglycemia, inpatient-hypoglycemia, and minimum and maximum glucose values among those with higher 30-day readmission rates. The XGBoost model identified the index admission length of stay, presence of hyper- and hypoglycemia and recipient and donor BMI values as the most predictive risk factors of 30-day readmission. Additionally, significant variations in the therapeutic management of blood glucose by providers were observed. Conclusions: Suboptimal glucose metrics during hospitalization after kidney transplantation is associated with an increased risk for 30-day hospital readmission. Optimizing the hospital blood glucose management, a modifiable factor, after kidney transplantation may reduce the risk of 30-day readmission.

Keywords: kidney, transplant, diabetes, insulin

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Authors: Sharmin Sultana, Palash Chandra Banik, Shirin Jahan Mumu, Liaquat Ali

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Santals are one of the oldest indigenous groups of South Asia who, according to anthropological evidence, are thought to be the origins of the Bengali race. The aim of the study was to explore, according to our best knowledge for the first time, the prevalence and determinants of hypertension in this relatively isolated and marginalized indigenous group who still live mostly in a traditional style. Under a cross-sectional analytical design, the study was conducted on the adult (age≥18 years) Santals (n=389, M/F 184/205, age in years, 38±15.3) of a village located in a remote rural area of northern Bangladesh. Subjects were selected by purposive sampling, and data were collected by interviewer-administered pretested questionnaire. Blood pressure was measured by following the WHO guideline of JNC-7 has been used to classify the blood pressure. The prevalence of hypertension was 4.9% among the respondents. Females had a much higher prevalence (5.4%) of hypertension compared to males (4.3%). Among the risk indicators of hypertension, more than half (50.9%) of the study population took extra salt in their meals, whereas 10.5% of respondents used extra salt occasionally, which is an important risk factor for high blood pressure. High waist circumference was found in 19% of the study subjects in terms of central obesity. Older age group (p=0.003, OR=1.1, 95%CI-1.02-1.10), respondents who completed more than primary school (p=0.038, OR=7.1, CI-1.11, 44.6), overweight and obesity (p=0.004, OR=17.1, CI-2.5, 118.1), were the major determinant for hypertension as found from the binary logistic model. None of the respondents received any medication, neither they visit any doctor ever for their hypertension control. The prevalence of hypertension was found to be low but not ignorable. Pre-hypertension in the case of systolic blood pressure needs attention among Santal indigenous population.

Keywords: hypertension, indigenous group, Santals, Bangladesh

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Authors: Shervin Rashidinia, Sara Shahmoradi, Seyyed Shahin Eftekhari, Mohsen Talebizadeh, Mohammad Saleh Sadeghi

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Background: Beta-thalassemia Major (BTM) is a kind of hereditary hemolytic anemia which depended on regular monthly blood transfusion. However, iron deposition into the organs leads to multi-organ damage. The present study is the first study which aimed to evaluate the average of five-years serum ferritin level and compared by the prevalence of short stature and hypocalcemia. Materials/Methods: A cross-sectional retrospective study which a total of 140 patients with beta-thalassemia who were referred to Qom Thalassemia Clinic between February 2011 and July 2016 were enrolled to be reviewed. The exclusion criteria were consisting of incomplete medical records, diagnosis less than 2-years-ago and the blood transfusion less than every 4 weeks. The data including age, gender, weight, height, age of initial blood transfusion, age of initial chelation therapy, ferritin, and calcium were collected and analysis by SPSS version 24. Results: A total of 140 patients were enrolled. Of them, 75 (53.4%) were female. The mean age of the patients was 13.4±4.6 years.The mean age of initial diagnosis was 20.2±7.4 months. Hypocalcemia and short stature were occurred in 41 (29.3%) and 37 (26.4%) patients, respectively. The mean five-years serum ferritin level was significantly higher in the patients with short stature and hypocalcemia (P<0.0001). However, rise in serum ferritin level significantly increases the risk of short-stature and hypocalcemia (1.0004- and 1.0029 fold, respectively). Conclusion: We demonstrated that prevalence of short stature and hypocalcemia were significantly higher in the BTM.However, ferritin significantly increases the risk of short stature and hypocalcemia.

Keywords: beta-thalassemia, ferritin, growth retardation, hypocalcemia

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Authors: Shivam Patel, Abdullah Y. Usmani

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Physiological flow under rest and exercise conditions in patient-specific cerebral aneurysm models is numerically investigated. A finite-volume based code with BiCGStab as the linear equation solver is used to simulate unsteady three-dimensional flow field through the incompressible Navier-Stokes equations. Flow characteristics are first established in a healthy cerebral artery for both physiological conditions. The effect of saccular aneurysm on cerebral hemodynamics is then explored through a comparative analysis of the velocity distribution, nature of flow patterns, wall pressure and wall shear stress (WSS) against the reference configuration. The efficacy of coil embolization as a potential strategy of surgical intervention is also examined by modelling coil as a homogeneous and isotropic porous medium where the extended Darcy’s law, including Forchheimer and Brinkman terms, is applicable. The Carreau-Yasuda non-Newtonian blood model is incorporated to capture the shear thinning behavior of blood. Rest and exercise conditions correspond to normotensive and hypertensive blood pressures respectively. The results indicate that the fluid impingement on the outer wall of the arterial bend leads to abnormality in the distribution of wall pressure and WSS, which is expected to be the primary cause of the localized aneurysm. Exercise correlates with elevated flow velocity, vortex strength, wall pressure and WSS inside the aneurysm sac. With the insertion of coils in the aneurysm cavity, the flow bypasses the dilatation, leading to a decline in flow velocities and WSS. Particle residence time is observed to be lower under exercise conditions, a factor favorable for arresting plaque deposition and combating atherosclerosis.

Keywords: 3D FVM, Cerebral aneurysm, hypertension, coil embolization, non-Newtonian fluid

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Authors: Ho Seong Shin

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Introduction: A research in relation to wound healing also showed that platelet-rich plasma (PRP) was effective on normal tissue regeneration. Nonetheless, there is no evidence that when platelet-rich plasma was applied on diabetic wound, it normalize diabetic wound healing process. In this study, we have analyzed matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) expression to know the effect of PRP on diabetic wounds using Reverse transcription-polymerase chain reaction (RT-PCR) of MMP-2, MMP-9 mRNA. Materials and Methods: Platelet-rich plasma (PRP) was prepared from blood of 6 rats. The whole 120-mL was added immediately to an anticoagulant. Citrate phosphonate dextrose(CPD) buffer (0.15 mg CPDmL) in a ratio of 1 mL of CPD buffer to 5 mL of blood. The blood was then centrifuged at 220g for 20minutes. The supernatant was saved to produce fibrin glue. The participate containing PRP was used for second centrifugation at 480g for 20 minutes. The pellet from the second centrifugation was saved and diluted with supernatant until the platelet concentration became 900,000/μL. Twenty male, 4week-old OLETF rats were underwent operation; each rat had two wounds created on left and right sides. The each wound of left side was treated with PRP gel, the wound of right side was treated with physiologic saline gauze. Results: RT-PCR analysis; The levels of MMP-2 mRNA in PRP applied tissues were positively related to postwounding days, whereas MMP-2 mRNA expression in saline-applied tissues remained in 5day after treatment. MMP-9 mRNA was undetectable in saline-applied tissues for either tissue, except 3day after treatment. Following PRP-applied tissues, MMP-9 mRNA expression was detected, with maximal expression being seen at third day. The levels of MMP-9 mRNA in PRP applied tissues were reported high intensity of optical density related to saline applied tissues.

Keywords: diabetes, MMP-2, MMP-9, OLETF, PRP, wound healing MMP-9

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Authors: Eunhye Cho, Hyuk-Hoon Kim, Sieun Lee, Minjung Kathy Chae

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Introduction: I-gel is a commonly used supraglottic advanced airway device in prehospital out-of-hospital cardiac arrest (OHCA) allowing for minimal interruption of continuous chest compression. However, previous studies have shown that prehospital supraglottic airway had inferior neurologic outcomes and survival compared to no advanced prehospital airway with conventional bag mask ventilation. We hypothesize that continuous compression with i-gel as an advanced airway may cause insufficient ventilation compared to 30:2 chest compression with conventional BVM. Therefore, we investigated the ventilation efficacy of i-gel with the initial arterial blood gas analysis in OHCA patients visiting our ER. Material and Method: Demographics, arrest parameters including i-gel insertion, initial arterial blood gas analysis was retrospectively analysed for 119 transported OHCA patients that visited our ER. Linear regression was done to investigate the association with i-gel insertion and initial pCO2 as a surrogate of prehospital ventilation. Result: A total of 52 patients were analysed for the study. Of the patients who visited the ER during OHCA, 24 patients had i-gel insertion and 28 patients had BVM as airway management in the prehospital phase. Prehospital i-gel insertion was associated with the initial pCO2 level (B coefficient 29.9, SE 10.1, p<0.01) after adjusting for bystander CPR, cardiogenic cause of arrest, EMS call to arrival. Conclusion: Despite many limitations to the study, prehospital insertion of i-gel was associated with high initial pCO2 values in OHCA patients visiting our ER, possibly indicating insufficient ventilation with prehospital i-gel as an advanced airway and continuous chest compressions.

Keywords: arrest, I-gel, prehospital, ventilation

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