Search results for: Blood parameters
10248 The Assessment of the Diabetes Mellitus Complications on Oral Health: A Longitudinal Study
Authors: Mimoza Canga, Irene Malagnino, Gresa Baboci, Edit Xhajanka, Vito Antonio Malagnino
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Background: Diabetes mellitus is regarded as a very problematic chronic disease that has an effect on a considerable number of people around the world and it is straightforwardly associated with the oral health condition of the patients. Objective: The objective of this study is to analyze and evaluate the impact of diabetes mellitus on oral health. Materials and methods: In the present research were taken into consideration 300 patients with an age range of 11 to 80 years old. The study sample was composed of 191 males, respectively 63.7% of them and 109 females 36.3% of the participants. We divided them into seven age groups: 11-20, 21-30, 31-40, 41-50, 51-60, 61-70, and 71-80 years.This descriptive and analytical research was designed as a longitudinal study. Statistical analysis was performed using IBM SPSS 23.0 statistics. Results: The majority of patients participating in the study belonged to the age range from 41 to 50 years old, precisely 20.7% of them, while 27% of the patients were from 51 to 60 years old. Based on the present research, it resulted that 24.4% of the participant had high blood sugar values 250-300 mg/dl, whereas 19 % of the patients had very high blood sugar values 300-350 mg/dl. Based on the results of the current study, it was observed that 83.7% of patients were affected by gingivitis. In the current study, the significant finding is that 22% of patients had more than 7 teeth with dental caries and 21% of them had 5-7 teeth with dental caries, whereas 29% of the patients had 4-5 dental caries and the remaining 28% of them had 1-3 dental caries. The present study showed that most of the patients, 27% of them had lost more than 7 teeth and 22% of the participants had lost 5-7 teeth, whereas 31% of the patients had lost 4-5 teeth and only 20 % of them had lost 1-3 teeth. This study proved that high blood sugar values had a direct impact on the manifestation of gingivitis and there it was a strong correlation between them with P-value = .001. A strong correlation was found out between dental caries and high blood sugar values with P-value ˂.001. Males with diabetes mellitus were more affected by dental caries and this was proved by the P-value= .02, in comparison to females P-value=.03. The impact of high blood sugar values affects missing teeth and the correlation between them was statistically significant with P-value ˂ .001. Conclusion: The results of this study suggest that diabetes mellitus is a possible risk factor in oral health for the reason that Albanian patients over 51 years old, respectively 43% of them have over 5 teeth with dental caries as compared with 49% of the patients who had over 5 missing teeth, whereas the majority 83.7% of them suffered from gingivitis. This study asserts that patients who do not have periodical check-ups of diabetes mellitus are at significant risk of oral diseases.Keywords: dental caries, diabetes mellitus, gingivitis, missing teeth
Procedia PDF Downloads 20510247 Enhanced Functional Production of a Crucial Biomolecule Human Serum Albumin in Escherichia coli
Authors: Ashima Sharma
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Human Serum Albumin (HSA)- one of the most demanded therapeutic proteins with immense biotechnological applications- is a large multidomain protein containing 17 disulfide bonds. The current source of HSA is human blood plasma which is a limited and unsafe source. Thus, there exists an indispensable need to promote non-animal derived recombinant HSA (rHSA) production. Escherichia coli is one of the most convenient hosts which had contributed to the production of more than 30% of the FDA approved recombinant pharmaceuticals. It grows rapidly and reaches high cell density using inexpensive and simple substrates. E. coli derived recombinant products have more economic potential as fermentation processes are cheaper compared to the other expression hosts. The major bottleneck in exploiting E. coli as a host for a disulfide-rich multidomain protein is the formation of aggregates of overexpressed protein. The majority of the expressed HSA forms inclusion bodies (more than 90% of the total expressed rHSA) in the E. coli cytosol. Recovery of functional rHSA from inclusion bodies is not preferred because it is difficult to obtain a large multidomain disulfide bond rich protein like rHSA in its functional native form. Purification is tedious, time-consuming, laborious and expensive. Because of such limitations, the E. coli host system was neglected for rHSA production for the past few decades despite its numerous advantages. In the present work, we have exploited the capabilities of E. coli as a host for the enhanced functional production of rHSA (~60% of the total expressed rHSA in the soluble fraction). Parameters like intracellular environment, temperature, induction type, duration of induction, cell lysis conditions etc. which play an important role in enhancing the level of production of the desired protein in its native form in vivo have been optimized. We have studied the effect of assistance of different types of exogenously employed chaperone systems on the functional expression of rHSA in the E. coli host system. Different aspects of cell growth parameters during the production of rHSA in presence and absence of molecular chaperones in E. coli have also been studied. Upon overcoming the difficulties to produce functional rHSA in E. coli, it has been possible to produce significant levels of functional protein through engineering the biological system of protein folding in the cell, the E. coli-derived rHSA has been purified to homogeneity. Its detailed physicochemical characterization has been performed by monitoring its conformational properties, secondary and tertiary structure elements, surface properties, ligand binding properties, stability issues etc. These parameters of the recombinant protein have been compared with the naturally occurring protein from the human source. The outcome of the comparison reveals that the recombinant protein resembles exactly the same as the natural one. Hence, we propose that the E. coli-derived rHSA is an ideal biosimilar for human blood plasma-derived serum albumin. Therefore, in the present study, we have introduced and promoted the E. coli- derived rHSA as an alternative to the preparation from a human source, pHSA.Keywords: recombinant human serum albumin, Escherichia coli, biosimilar, chaperone assisted protein folding
Procedia PDF Downloads 20710246 Nutritional Composition of Crackers Produced from Blend of Sprouted Pigeon Pea (Cajanus cajan), Unripe Plantain (Musa parasidiaca), and Brewers’ Spent Grain Flour and Blood Glucose Level of Diabetic Rats Fed the Biscuit
Authors: Nneka N. Uchegbu, Charles N. Ishiwu
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The nutritional composition and hypoglycaemic effect of crackers produced from a blend of sprouted pigeon pea, unripe plantain, and brewers’ spent grain and fed to Alloxan induced diabetic rat was investigated. Crackers were produced from different blends of sprouted pigeon pea, unripe plantain and brewers’ spent grain. The crackers were evaluated for proximate composition, amino acid profile and antinutritional factors. Blood glucose levels of normal and diabetic rats fed with the control sample and different formulations of cracker were measured. The protein content of the samples were significantly different (p < 0.05) from each other with sample A having the lowest value and sample B with the highest value. The values obtained showed that the samples contained most of the amino acids that are found in plant proteins. The levels of antinutritional factor determined were generally low. Administration of the formulated cracker meals led to a significant reduction in the fasting blood glucose level in the diabetic rats. The present study concluded that consumption of crackers produced from this composite flour can be recommended for the diabetics and those who are sceptical about the disease.Keywords: crackers, diabetics rat, sprouted pigeon pea, unripe plantain and brewers’ spent grain
Procedia PDF Downloads 43710245 Hyponatremia in Community-Acquired Pneumonia
Authors: Emna Ketata, Wafa Farhat
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Introduction: Hyponatremia is defined by a blood sodium level of ≤ 136 mmol/L; it is associated with a high risk of morbidity and mortality in the emergency room. This was explained by transit disorders, including diarrhea and inappropriate antidiuretic hormone secretion (Syndrome of inappropriate antidiuretic hormone secretion). Pneumonia can cause dyspnea, stress-causing SIADH and digestive symptoms (diarrhea and vomiting). Aim: The purpose of this study was to determine the link between pneumonia and hyponatremia as a predictor of patient’s prognosis and intra-hospital mortality. Methodology: This is a prospective observational study over a period of 3 years in the emergency department. Inclusion :patients (age > 14 years), with clinical signs in favor of pneumonia. Natremia was measured. Natremia was classified as mild to moderate with a blood sodium level between 121 and 135 mmol/L and as severe with a blood sodium level ≤ 120 mmol/L. Results: This study showed an average serum sodium value of 135 mmol/L (range 114–159 mmol/L) in these patients. Hyponatremia was observed in 123 patients (43.6%), 115 patients (97,8%) had mild to moderate hyponatremia and 2,8% had severe hyponatremia. The mean age was 65±17 years with a sex ratio of 1.05. The main reason for consultation in patients with hyponatremia was cough in 58 patients (47.2%), and digestive symptoms were present in 25 patients (20.3. An altered state of consciousness was observed in 11 patients (3%). Patients with hyponatremia had greater heart rate (p=0.02),white blood cell count (p=0.009) , plasmatic lactate (p=0.002) and higher rate of pneumonia recurrence (p=0.001) .In addition, 80% of them have a positive CURB65 score (>=2). hyponatremia had higher rates of use of oxygen therapy compared to patients with normo-natremia (54% vs. 45%). The analytical study showed that hyponatremia is significantly associated with intra-hospital mortality with( p=0.01), severe hyponatremia p=0.04. Conclusion: Hyponatremia is a predictor of mortality and worse prognosis. Recognition of the pathophysiological mechanisms of hyponatremia in pneumonia will probably allow better management of it.Keywords: oxygenotherapy, mortality, recurrence, positif curb65
Procedia PDF Downloads 9110244 Study of COVID-19 Intensity Correlated with Specific Biomarkers and Environmental Factors
Authors: Satendra Pal Singh, Dalip Kr. Kakru, Jyoti Mishra, Rajesh Thakur, Tarana Sarwat
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COVID-19 is still an intrigue as far as morbidity or mortality is concerned. The rate of recovery varies from person to person, & it depends upon the accessibility of the healthcare system and the roles played by the physicians and caregivers. It is envisaged that with the passage of time, people would become immune to this virus, and those who are vulnerable would sustain themselves with the help of vaccines. The proposed study deals with the severeness of COVID-19 is associated with some specific biomarkers linked to correlate age and gender. We will be assessing the overall homeostasis of the persons who were affected by the coronavirus infection and also of those who recovered from it. Some people show more severe effects, while others show very mild symptoms, however, they show low CT values. Thus far, it is unclear why the new strain of Covid has different effects on different people in terms of age, gender, and ABO blood typing. According to data, the fatality rate with heart disease was 10.5 percent, 7.3 percent were diabetic, and 6 percent who are already infected from other comorbidities. However, some COVID-19 cases are worse than others & it is not fully explainable as of date. Overall data show that the ABO blood group is effective or prone to the risk of SARS-COV2 infection, while another study also shows the phenotypic effects of the blood group related to covid. It is an accepted fact that females have more strong immune systems than males, which may be related to the fact that females have two ‘X’ chromosomes, which might contain a more effective immunity booster gene on the X chromosome, and are capable to protect the female. Also specific sex hormones also induce a better immune response in a specific gender. This calls for in-depth analysis to be able to gain insight into this dilemma. COVID-19 is still not fully characterized, and thus we are not very familiar with its biology, mode of infection, susceptibility, and overall viral load in the human body. How many virus particles are needed to infect a person? How, then, comorbidity contribute to coronavirus infection? Since the emergence of this virus in 2020, a large number of papers have been published, and seemingly, vaccines have been prepared. But still, a large number of questions remain unanswered. The proneness of humans for infection by covid-19 needs to be established to be able to develop a better strategy to fight this virus. Our study will be on the Impact of demography on the Severity of covid-19 infection & at the same time, will look into gender-specific sensitivity of Covid-19 and the Operational variation of different biochemical markers in Covid-19 positive patients. Besides, we will be studying the co-relation, if any, of COVID severity & ABO Blood group type and the occurrence of the most common blood group type amongst positive patience.Keywords: coronavirus, ABO blood group, age, gender
Procedia PDF Downloads 9710243 Therapeutic Efficacy and Safety Profile of Tolvaptan Administered in Hyponatremia Patients
Authors: Sree Vennela P., V. Samyuktha Bhardwaj
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Hyponatremia is an electrolyte disturbance in which the sodium ion concentration in the serum is lower than normal. Sodium is the dominant extracellular cation (positive ion) and cannot freely cross from the interstitial space through the cell membrane, into the cell. Its homeostasis (stability of concentration) inside the cell is vital to the normal function of any cell. Normal serum sodium levels are between 135 and 145 mEq/L. Hyponatremia is defined as a serum level of less than 135 mEq/L and is considered severe when the serum level is below 125 mEq/L. In the vast majority of cases, Hyponatremia occurs as a result of excess body water diluting the serum sodium (salt level in the blood). Hyponatremia is often a complication of other medical illnesses in which excess water accumulates in the body at a higher rate than can be excreted (for example in congestive heart failure, syndrome of inappropriate antidiuretic hormone, SIADH, or polydipsia). Sometimes it may be a result of over-hydration (drinking too much water).Lack of sodium (salt) is very rarely the cause of Hyponatremia, although it can promote Hyponatremia indirectly. In particular, sodium loss can lead to a state of volume depletion (loss of blood volume in the body), with volume depletion serving as a signal for the release of ADH (anti-diuretic hormone). As a result of ADH-stimulated water retention (too much water in the body), blood sodium becomes diluted and Hyponatremia results.Keywords: Tolvaptan, hyponatremia, syndrome of insufficient anti diuretic hormone (SIADH), euvolemic hyponatremia
Procedia PDF Downloads 25810242 Customized Cow’s Urine Battery Using MnO2 Depolarizer
Authors: Raj Kumar Rajak, Bharat Mishra
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Bio-battery represents an entirely new long term, reasonable, reachable and ecofriendly approach to production of sustainable energy. Types of batteries have been developed using MnO2 in various ways. MnO2 is suitable with physical, chemical, electrochemical, and catalytic properties, serving as an effective cathodic depolarizer and may be considered as being the life blood of the battery systems. In the present experimental work, we have studied the effect of generation of power by bio-battery using different concentrations of MnO2. The tests show that it is possible to generate electricity using cow’s urine as an electrolyte. After ascertaining the optimum concentration of MnO2, various battery parameters and performance indicates that cow urine solely produces power of 695 mW, while a combination with MnO2 (40%) enhances power of bio-battery, i.e. 1377 mW. On adding more and more MnO2 to the electrolyte, the power suppressed because inflation of internal resistance. The analysis of the data produced from experiment shows that MnO2 is quite suitable to energize the bio-battery.Keywords: bio-batteries, cow’s urine, manganese dioxide, non-conventional
Procedia PDF Downloads 25910241 Anti-lipidemic and Hematinic Potentials of Moringa Oleifera Leaves: A Clinical Trial on Type 2 Diabetic Subjects in a Rural Nigerian Community
Authors: Ifeoma C. Afiaenyi, Elizabeth K. Ngwu, Rufina N. B. Ayogu
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Diabetes has crept into the rural areas of Nigeria, causing devastating effects on its sufferers; most of them could not afford diabetic medications. Moringa oleifera has been used extensively in animal models to demonstrate its antilipidaemic and haematinic qualities; however, there is a scarcity of data on the effect of graded levels of Moringa oleifera leaves on the lipid profile and hematological parameters in human diabetic subjects. The study determined the effect of Moringa oleifera leaves on the lipid profile and hematological parameters of type 2 diabetic subjects in Ukehe, a rural Nigerian community. Twenty-four adult male and female diabetic subjects were purposively selected for the study. These subjects were shared into four groups of six subjects each. The diets used in the study were isocaloric. A control group (diabetics, group 1) was fed diets without Moringa oleifera leaves. Experimental groups 2, 3 and 4 received 20g, 40g and 60g of Moringa oleifera leaves daily, respectively, in addition to the diets. The subjects' lipid profile and hematological parameters were measured prior to the feeding trial and at the end of the feeding trial. The feeding trial lasted for fourteen days. The data obtained were analyzed using the computer program Statistical Product for Service Solution (SPSS) for windows version 21. A Paired-samples t-test was used to compare the means of values collected before and after the feeding trial within the groups and significance was accepted at p < 0.05. There was a non-significant (p > 0.05) decrease in the mean total cholesterol of the subjects in groups 1, 2 and 3 after the feeding trial. There was a non-significant (p > 0.05) decrease in the mean triglyceride levels of the subjects in group 1 after the feeding trial. Groups 1 and 3 subjects had a non-significant (p > 0.05) decrease in their mean low-density lipoprotein (LDL) cholesterol after the feeding trial. Groups 1, 2 and 4 had a significant (p < 0.05) increase in their mean high-density lipoprotein (HDL) cholesterol after the feeding trial. A significant (p < 0.05) decrease in the mean hemoglobin level was observed only in group 4 subjects. Similarly, there was a significant (p < 0.05) decrease in the mean packed cell volume of group 4 subjects. It was only in group 4 that a significant (p < 0.05) decrease in the mean white blood cells of the subjects was also observed. The changes observed in the parameters assessed were not dose-dependent. Therefore, a similar study of longer duration and more samples is imperative to authenticate these results.Keywords: anemia, diabetic subjects, lipid profile, moringa oleifera
Procedia PDF Downloads 19910240 Prevalence, Awareness, and Risk Factors of Diabetes in Ahvaz: South West of Iran
Authors: Leila Yazdanpanah, Hajieh Shahbazian, Seyed Mahmoud Latifi, Armaghan Moravej Aleali, Saeed Ghanbari
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Introduction: This study was designed to determine the prevalence of diabetes in people aged over 20 years in Ahvaz, Iran. Material and Methods: The study population selected by cluster sampling. Fasting blood sugar (FBS) assessed after minimum 8 hours night fasting. A questionnaire included: age, sex, weight, height, blood pressure, waist circumference and previous history of diabetes were completed for each patient. FBS≥126mg/dl and/or oral hypoglycemic treatment and/or insulin was defined as diabetes, FBS=100-125 mg/dl as impaired fasting glucose (IFG) and FBS<100mg/dl as normal. Results: Study population was 936 persons (47.2 % male and 52.8% female). The mean age of a population was 42.2±14 years. Diabetes was detected in 15.1 % of population. Only 57cases(6.1%) were aware of their disease and 9% had unknown diabetes. Diabetes was detected in 14.5% of male (11.3% unknown and 3.2 % known diabetes) and in 11.7% of female (7% unknown and 4.7% known diabetes). Prevalence of diabetes had no significant difference (P=0.21) in male and female but unknown diabetes was significantly higher in male (P=0.025). Prevalence of diabetes was increased with rising of age between 20-60 years old but decreasing after 60 years old. Diabetes was related to age, waist circumference and systolic and diastolic blood pressure, TG level and BMI in both sex (P=0.0001). Conclusion: More than half of female and three-fourth of male diabetic patients are unaware of their disease in South of Iran. Diabetes screening should be intensified in this population.Keywords: diabetes, prevalence, risk factor, awareness
Procedia PDF Downloads 46410239 Response of Grower Turkeys to Diets Containing Moringa oleifera Leaf Meal in a Tropical Environment
Authors: Augustine O. Ani, Ifeyinwa E. Ezemagu, Eunice A. Akuru
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A seven-week study was conducted to evaluate the response of grower turkeys to varying dietary levels of Moringa oleifera leaf meal (MOLM) in a humid tropical environment. A total of 90 twelve weeks old male and female grower turkeys were randomly divided into five groups of 18 birds each in a completely randomized design (CRD) and assigned to five caloric (2.57-2.60 Mcal/kg ME) and isonitrogenous (19.95% crude protein) diets containing five levels (0, 15, 20, 25 and 30%) of MOLM, respectively. Each treatment was replicated three times with 6 birds per replicate housed in a deep litter pen of fresh wood shavings measuring 1.50m x 1.50m. Feed and water were provided to the birds' ad libitum. Parameters measured were: final live weight (FLW) daily weight gain (DWG), daily feed intake (DFI), feed conversion ratio (FCR), protein efficiency ratio (PER), packed cell volume (PCV), haemoglobin concentration (Hb), red blood cell (RBC) count, white blood cell (WBC) count, mean cell volume (MCV), mean cell haemoglobin (MCH) and mean cell haemoglobin concentration (MCHC), feed cost / kg weight gain and apparent nutrient retention. Results showed that grower turkeys fed 20% MOLM diet had significantly (p < 0.05) higher FLW and DWG values (4410.30 g and 34.49 g, respectively) and higher DM and NFE retention values (67.28 and 58.12%, respectively) than turkeys fed other MOLM diets. Feed cost per kg gain decreased significantly (p < 0.05) with increasing levels of MOLM in the diets. The PCV, Hb, WBC, MCV, MCH and MCHC values of grower turkeys fed 20% MOLM diet were significantly (p < 0.05) higher than those of grower turkeys fed other diets. It was concluded that a diet containing 20% MOLM is adequate for the normal growth of grower turkeys in the tropics.Keywords: Diets, grower turkeys, Moringa oleifera leaf meal, response, tropical environment
Procedia PDF Downloads 14210238 The Technique of Mobilization of the Colon for Pull-Through Procedure in Hirschsprung's Disease
Authors: Medet K. Khamitov, Marat M. Ospanov, Vasiliy M. Lozovoy, Zhenis N. Sakuov, Dastan Z. Rustemov
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With a high rectosigmoid transitional zone in children with Hirschsprung’s disease, the upper rectal, sigmoid, left colon arteries are ligated during the pull-through of the descending part of the colon. As a result, the inferior mesenteric artery ceases to participate in the blood supply to the descending part of the colon. As a result, the reduced colon is supplied with blood only by the middle colon artery, which originates from the superior mesenteric artery. Insufficiency of blood supply to the reduced colon is the cause of the development of chronic hypoxia of the intestinal wall or necrosis of the reduced descending colon. Some surgeons prefer to preserve the left colon artery. However, it is possible to stretch the mesentery, which can lead to bowel retraction to anastomotic leaks and stenosis. Chronic hypoxia of the reduced colon, in turn, is the cause of acquired (secondary) aganglionosis. The highest frequency of anastomotic leaks is observed in children older than five years. The purpose is to reduce the risk of complications in the pull-through procedure of the descending part of the colon in patients with Hirschsprung’s disease by ensuring its sufficient mobility and maintaining blood supply to the lower mesenteric artery. Methodology and events. Two children aged 5 and 7 years with Hirschsprung’s disease were operated under the conditions of the hospital in Nur-Sultan. The diagnosis was made using x-ray contrast enema and histological examination. Operational technique. After revision of the left part of the colon and assessment of the architectonics of its blood vessels, parietal mobilization of the affected sigmoid and rectum was performed on laparotomy access, while maintaining the arterial and venous terminal arcades of the sigmoid vessels. Then, the descending branch of the left colon artery was crossed (if there is an insufficient length of the reduced intestine, the left colonic artery itself may also be crossed). This manipulation provides additional mobility of the pull-through descending part of the colon. The resulting "windows" in the mesentery of the reduced intestine were sutured to prevent the development of an internal hernia. Formed a full-blooded, sufficiently long transplant from the transverse loops of the splenic angle and the descending parts of the colon with blood supply from the upper and lower mesenteric artery, freely, without tension, is reduced to the rectal zone with the coloanal anastomosis 1.5 cm above the dentate line. Results. The postoperative period was uneventful. Patients were discharged on the 7th day. The observation was carried out for six months. In no case, there was a bowel retraction, anastomotic leak, anastomotic stenosis, or other complications. Conclusion. The presented technique of mobilization of the colon for the pull-through procedure in a high transitional rectosigmoid zone of Hirschsprung’s disease allows to maintain normal blood supply to the distal part of the colon and to avoid the tension of the colon. The technique allows reducing the risk of anastomotic leak, bowel necrosis, chronic ischemia, to exclude colon retraction and anastomotic stenosis.Keywords: blood supply, children, colon mobilization, Hirschsprung's disease, pull-through
Procedia PDF Downloads 14510237 Effect of Mixture of Flaxseed and Pumpkin Seeds Powder on Hypercholesterolemia
Authors: Zahra Ashraf
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Flax and pumpkin seeds are a rich source of unsaturated fatty acids, antioxidants and fiber, known to have anti-atherogenic properties. Hypercholesterolemia is a state characterized by the elevated level of cholesterol in the blood. This research was designed to study the effect of flax and pumpkin seeds powder mixture on hypercholesterolemia and body weight. Rat’s species were selected as human representative. Thirty male albino rats were divided into three groups: a control group, a CD-chol group (control diet+cholesterol) fed with 1.5% cholesterol and FP-chol group (flaxseed and pumpkin seed powder+ cholesterol) fed with 1.5% cholesterol. Flax and pumpkin seed powder mixed at proportion of (5/1) (omega-3 and omega-6). Blood samples were collected to examine lipid profile and body weight was also measured. Thus the data was subjected to analysis of variance. In CD-chol group, body weight, total cholesterol TC, triacylglycerides TG in plasma, plasma LDL-C, ratio significantly increased with a decrease in plasma HDL (good cholesterol). In FP-chol group lipid parameters and body weights were decreased significantly with an increase in HDL and decrease in LDL (bad cholesterol). The mean values of body weight, total cholesterol, triglycerides, low density lipoprotein and high density lipoproteins in FP-chol group were 240.66±11.35g, 59.60±2.20mg/dl, 50.20±1.79 mg/dl, 36.20±1.62mg/dl, 36.40±2.20 mg/dl, respectively. Flaxseed and pumpkin seeds powder mixture showed reduction in body weight, serum cholesterol, low density lipoprotein and triglycerides. While significant increase was shown in high density lipoproteins when given to hypercholesterolemic rats. Our results suggested that flax and pumpkin seed mixture has hypocholesterolemic effects which were probably mediated by polyunsaturated fatty acids (omega-3 and omega-6) present in seed mixture.Keywords: hypercolesterolemia, omega 3 and omega 6 fatty acids, cardiovascular diseases
Procedia PDF Downloads 41610236 Associations between Physical Activity and Risk Factors for Type II Diabetes in Prediabetic Adults
Authors: Rukia Yosuf
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Diabetes is a national healthcare crisis related to both macrovascular and microvascular complications. We hypothesized that higher levels of physical activity are associated with lower total and visceral fat mass, lower systolic blood pressure, and increased insulin sensitivity. Participant inclusion criteria: 21-50 years old, BMI ≥ 30 kg/m2, hemoglobin A1C 5.7-6.4, fasting glucose 100-125 mg/dL, and HOMA IR ≥ 2.5. Exclusion criteria: history of diabetes, hypertension, HIV, renal disease, hearing loss, alcoholic intake over four drinks daily, use of organic nitrates or PDE5 inhibitors, and decreased cardiac function. Total physical activity was measured using accelerometers, body composition using DXA, and insulin resistance via fsIVGTT. Clinical and biochemical cardiometabolic risk factors, blood pressure and heart rate were obtained using a calibrated sphygmomanometer. Anthropometric measures, fasting glucose, insulin, lipid profile, C-reactive protein, and BMP were analyzed using standard procedures. Within our study, we found correlations between levels of physical activity in a heterogeneous group of prediabetic adults. Patients with more physical activity had a higher degree of insulin sensitivity, lower blood pressure, total visceral adipose tissue, and overall lower total mass. Total physical activity levels showed small, but significant correlations with systolic blood pressure, visceral fat, lean mass and insulin sensitivity. After normalizing for the race, age, and gender using multiple regression, these associations were no longer significant considering our small sample size. More research into prediabetes will decrease the population of diabetics overall. In the future, we could increase sample size and conduct cross sectional and longitudinal studies in various populations with prediabetes.Keywords: diabetes, kidney disease, nephrology, prediabetes
Procedia PDF Downloads 18510235 Room Level Indoor Localization Using Relevant Channel Impulse Response Parameters
Authors: Raida Zouari, Iness Ahriz, Rafik Zayani, Ali Dziri, Ridha Bouallegue
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This paper proposes a room level indoor localization algorithm based on the use Multi-Layer Neural Network (MLNN) classifiers and one versus one strategy. Seven parameters of the Channel Impulse Response (CIR) were used and Gram-Shmidt Orthogonalization was performed to study the relevance of the extracted parameters. Simulation results show that when relevant CIR parameters are used as position fingerprint and when optimal MLNN architecture is selected good room level localization score can be achieved. The current study showed also that some of the CIR parameters are not correlated to the location and can decrease the localization performance of the system.Keywords: mobile indoor localization, multi-layer neural network (MLNN), channel impulse response (CIR), Gram-Shmidt orthogonalization
Procedia PDF Downloads 35310234 Physiological Effects of Myrrh and Ginseng Extracts in Diabetic Rats
Authors: Ismail I. Abo-Ghanema, Faheim E. Wehaish, Rasha M. Saleh , Walaa F. Awadin, Mohamed F. Elshal
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The antidiabetic activity of myrrh and ginseng ethanolic extracts were investigated in streptozotocin (STZ)-induced diabetic rats. Thirty male albino rats were divided into five groups, each consisted of six rats. The first group (G1) is the negative control that was fed basal diet, the second group (G2) was injected with STZ and received no treatment, the third group (G3) injected with STZ and received metformin (50 mg/kg, b.wt) as standard anti-diabetic drug, the fourth group (G4) injected with STZ and ginseng (50 mg/kg, b.wt), the fifth group (G5) injected with STZ and received myrrh (500 mg/kg, b.wt). As compared with G1-group, STZ injection increased blood concentrations of glucose (6.2 fold), glycated hemoglobin (HbA1c) (2.51 fold), aspartateaminotransferase (AST), and alanine aminotransferase (ALT) (2.64, 4.60 fold respectively), creatinine (2.91 fold), cholesterol (1.79 fold), triglycerides (2.06 fold), low density lipoprotein-cholesterol (LDL) (2.92 fold), nitric oxide (NO) (20.18 fold), and malondialdehyde (MDA) (2.25 fold), whereas it decreased blood insulin (0.40 fold), albumin (0.60 fold), high density lipoprotein-cholesterol (HDL) (0.33 fold), and reduced glutathione (GSH) (0.49 fold). Vascular permeability index (VPI as measured by Evan's Blue; EB extravasations test) was significantly increased in the skin of diabetic animals (9.6 fold) when compared with the G1-group. In addition, histological alterations in liver, pancreas, kidneys and heart were observed. After 4 weeks of treatment, rats in G4 and G5 showed significant corrections in the all measured parameters and indices. In conclusions, the ethanolic extracts of ginseng and myrrh exhibited promising and safe anti-diabetic activity especially on peripheral circulation as manifested by decreased vascular permeability and improved histopathological alterations of examined organs and insulin secretion. Hence, it may be pursued for their clinical usefulness in the management of diabetes mellitus (DM) and associated vascular complications.Keywords: diabetic rats, peripheral circulation, natural plants, myrrh, ginseng
Procedia PDF Downloads 64310233 Parameters Tuning of a PID Controller on a DC Motor Using Honey Bee and Genetic Algorithms
Authors: Saeid Jalilzadeh
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PID controllers are widely used to control the industrial plants because of their robustness and simple structures. Tuning of the controller's parameters to get a desired response is difficult and time consuming. With the development of computer technology and artificial intelligence in automatic control field, all kinds of parameters tuning methods of PID controller have emerged in endlessly, which bring much energy for the study of PID controller, but many advanced tuning methods behave not so perfect as to be expected. Honey Bee algorithm (HBA) and genetic algorithm (GA) are extensively used for real parameter optimization in diverse fields of study. This paper describes an application of HBA and GA to the problem of designing a PID controller whose parameters comprise proportionality constant, integral constant and derivative constant. Presence of three parameters to optimize makes the task of designing a PID controller more challenging than conventional P, PI, and PD controllers design. The suitability of the proposed approach has been demonstrated through computer simulation using MATLAB/SIMULINK.Keywords: controller, GA, optimization, PID, PSO
Procedia PDF Downloads 54210232 Fabrication of Optical Tissue Phantoms Simulating Human Skin and Their Application
Authors: Jihoon Park, Sungkon Yu, Byungjo Jung
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Although various optical tissue phantoms (OTPs) simulating human skin have been actively studied, their completeness is unclear because skin tissue has the intricate optical property and complicated structure disturbing the optical simulation. In this study, we designed multilayer OTP mimicking skin structure, and fabricated OTP models simulating skin-blood vessel and skin pigmentation in the skin, which are useful in Biomedical optics filed. The OTPs were characterized with the optical property and the cross-sectional structure, and analyzed by using various optical tools such as a laser speckle imaging system, OCT and a digital microscope to show the practicality. The measured optical property was within 5% error, and the thickness of each layer was uniform within 10% error in micrometer scale.Keywords: blood vessel, optical tissue phantom, optical property, skin tissue, pigmentation
Procedia PDF Downloads 45110231 Improvement of the Q-System Using the Rock Engineering System: A Case Study of Water Conveyor Tunnel of Azad Dam
Authors: Sahand Golmohammadi, Sana Hosseini Shirazi
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Because the status and mechanical parameters of discontinuities in the rock mass are included in the calculations, various methods of rock engineering classification are often used as a starting point for the design of different types of structures. The Q-system is one of the most frequently used methods for stability analysis and determination of support systems of underground structures in rock, including tunnel. In this method, six main parameters of the rock mass, namely, the rock quality designation (RQD), joint set number (Jn), joint roughness number (Jr), joint alteration number (Ja), joint water parameter (Jw) and stress reduction factor (SRF) are required. In this regard, in order to achieve a reasonable and optimal design, identifying the effective parameters for the stability of the mentioned structures is one of the most important goals and the most necessary actions in rock engineering. Therefore, it is necessary to study the relationships between the parameters of a system and how they interact with each other and, ultimately, the whole system. In this research, it has attempted to determine the most effective parameters (key parameters) from the six parameters of rock mass in the Q-system using the rock engineering system (RES) method to improve the relationships between the parameters in the calculation of the Q value. The RES system is, in fact, a method by which one can determine the degree of cause and effect of a system's parameters by making an interaction matrix. In this research, the geomechanical data collected from the water conveyor tunnel of Azad Dam were used to make the interaction matrix of the Q-system. For this purpose, instead of using the conventional methods that are always accompanied by defects such as uncertainty, the Q-system interaction matrix is coded using a technique that is actually a statistical analysis of the data and determining the correlation coefficient between them. So, the effect of each parameter on the system is evaluated with greater certainty. The results of this study show that the formed interaction matrix provides a reasonable estimate of the effective parameters in the Q-system. Among the six parameters of the Q-system, the SRF and Jr parameters have the maximum and minimum impact on the system, respectively, and also the RQD and Jw parameters have the maximum and minimum impact on the system, respectively. Therefore, by developing this method, we can obtain a more accurate relation to the rock mass classification by weighting the required parameters in the Q-system.Keywords: Q-system, rock engineering system, statistical analysis, rock mass, tunnel
Procedia PDF Downloads 7010230 Blood Volume Pulse Extraction for Non-Contact Photoplethysmography Measurement from Facial Images
Authors: Ki Moo Lim, Iman R. Tayibnapis
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According to WHO estimation, 38 out of 56 million (68%) global deaths in 2012, were due to noncommunicable diseases (NCDs). To avert NCD, one of the solutions is early detection of diseases. In order to do that, we developed 'U-Healthcare Mirror', which is able to measure vital sign such as heart rate (HR) and respiration rate without any physical contact and consciousness. To measure HR in the mirror, we utilized digital camera. The camera records red, green, and blue (RGB) discoloration from user's facial image sequences. We extracted blood volume pulse (BVP) from the RGB discoloration because the discoloration of the facial skin is accordance with BVP. We used blind source separation (BSS) to extract BVP from the RGB discoloration and adaptive filters for removing noises. We utilized singular value decomposition (SVD) method to implement the BSS and the adaptive filters. HR was estimated from the obtained BVP. We did experiment for HR measurement by using our method and previous method that used independent component analysis (ICA) method. We compared both of them with HR measurement from commercial oximeter. The experiment was conducted under various distance between 30~110 cm and light intensity between 5~2000 lux. For each condition, we did measurement 7 times. The estimated HR showed 2.25 bpm of mean error and 0.73 of pearson correlation coefficient. The accuracy has improved compared to previous work. The optimal distance between the mirror and user for HR measurement was 50 cm with medium light intensity, around 550 lux.Keywords: blood volume pulse, heart rate, photoplethysmography, independent component analysis
Procedia PDF Downloads 32710229 Health Effect of the Central European Diet in Postmenopausal Women with Increased Waist Circumference: A Preliminary Study
Authors: Joanna Bajerska, Agata Chmurzyńska, Agata Muzsik, Patrycja Krzyżanowska, Klaudia Łochocka, Jarosław Walkowiak
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The Mediterranean diet (MED) is regarded as beneficial in the therapy of central obesity-associated metabolic abnormalities. However, in the traditional diet of the Central European countries, food items with positive nutritional profiles (rye bread, oats, buckwheat, herrings, linseed and rapeseed oil, berries, apples, plums, root vegetables etc.) are also used. We hypothesized that the Central European Diet (CED) may be comparatively effective in reducing symptoms of central obesity as MED. We tested the health effects of the CED, which is an environmentally friendly regional diet and the traditional MED diet in a group of postmenopausal centrally obese women. A total 58 with a mean age of 60 y (50-70y), body mass index (in kg/m(2)) of 33.4 (22.6-47.3), and waist circumference of 105 cm (87.5-137 cm) were randomly assigned to receive either the diet based on food items commonly used in Central Europe (the CED group; n = 29) or the Mediterranean diet (the MED group; n = 29) for 15 weeks. Body mass and body composition were measured with a Bod Pod (Cosmed, Italy). A non-elastic flexible measuring tape was used to measure waist circumference. Additionally, blood pressure, plasma lipid and glucose levels were assessed with the use of a biochemical analyzer. A total of 50 subjects [86% (CED 83%; MED 90%)] completed the intervention. A high dietary compliance for both described diets was achieved. The mean (±SEM) weight and waist circumference changes were -7.4 ± 0.7 kg; -8.3 ± 0.7 cm and -8.1 ± 0.5 kg; -7.1 ± 0.6 cm for the CED and MED groups, respectively. Moreover, there were no differences between the effectiveness of the diets used in terms of the influence on fat mass, blood pressure, and biochemical parameters. The preliminary data suggest that both described diets may be successfully used for improving central obesity-associated metabolic abnormalities. The project was financed by the National Science Centre awarded based on the number of decision DEC-013/09/B/NZ9/02365Keywords: central european diet, central obesity, Mediterranean diet, metabolic abnormalities
Procedia PDF Downloads 42710228 Effect of Velocity Slip on Two Phase Flow in an Eccentric Annular Region
Authors: Umadevi B., Dinesh P. A., Indira. R., Vinay C. V.
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A mathematical model is developed to study the simultaneous effects of particle drag and slip parameter on the velocity as well as rate of flow in an annular cross sectional region bounded by two eccentric cylinders. In physiological flows this phenomena can be observed in an eccentric catheterized artery with inner cylinder wall is impermeable and outer cylinder wall is permeable. Blood is a heterogeneous fluid having liquid phase consisting of plasma in which a solid phase of suspended cells and proteins. Arterial wall gets damaged due to aging and lipid molecules get deposited between damaged tissue cells. Blood flow increases towards the damaged tissues in the artery. In this investigation blood is modeled as two phase fluid as one is a fluid phase and the other is particulate phase. The velocity of the fluid phase and rate of flow are obtained by transforming eccentric annulus to concentric annulus with the conformal mapping. The formulated governing equations are analytically solved for the velocity and rate of flow. The numerical investigations are carried out by varying eccentricity parameter, slip parameter and drag parameter. Enhancement of slip parameter signifies loss of fluid then the velocity and rate of flow will be decreased. As particulate drag parameter increases then the velocity as well as rate flow decreases. Eccentricity facilitates transport of more fluid then the velocity and rate of flow increases.Keywords: catheter, slip parameter, drag parameter, eccentricity
Procedia PDF Downloads 52110227 The Effect of Aerobic Exercise on Glycemic Control in Prediabetes and Type 2 Diabetes
Authors: Chun-Chin Huang
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Individuals with prediabetes increase the risk of developing type 2 diabetes. Exercise is a potent stimulator of skeletal muscle glucose uptake and thus good for maintaining glucose homeostasis. That could be a conducive method to improve blood glucose regulation and prevent type 2 diabetes without medication intake. The aim of this study was to summarize mechanisms of insulin resistance and investigate the beneficial effects of acute and chronic aerobic exercise on glycemic control in prediabetes and type 2 diabetes. Aerobic exercise regulates glucose homeostasis and reduces blood glucose, insulin concentrations. Therefore, the type of aerobic exercise brings positive effects to prediabetes and type 2 diabetes.Keywords: insulin resistance, glucose sensitivity, impaired fasting glucose, impaired glucose tolerance
Procedia PDF Downloads 15310226 Modeling and Optimization of Performance of Four Stroke Spark Ignition Injector Engine
Authors: A. A. Okafor, C. H. Achebe, J. L. Chukwuneke, C. G. Ozoegwu
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The performance of an engine whose basic design parameters are known can be predicted with the assistance of simulation programs into the less time, cost and near value of actual. This paper presents a comprehensive mathematical model of the performance parameters of four stroke spark ignition engine. The essence of this research work is to develop a mathematical model for the analysis of engine performance parameters of four stroke spark ignition engine before embarking on full scale construction, this will ensure that only optimal parameters are in the design and development of an engine and also allow to check and develop the design of the engine and it’s operation alternatives in an inexpensive way and less time, instead of using experimental method which requires costly research test beds. To achieve this, equations were derived which describe the performance parameters (sfc, thermal efficiency, mep and A/F). The equations were used to simulate and optimize the engine performance of the model for various engine speeds. The optimal values obtained for the developed bivariate mathematical models are: sfc is 0.2833kg/kwh, efficiency is 28.77% and a/f is 20.75.Keywords: bivariate models, engine performance, injector engine, optimization, performance parameters, simulation, spark ignition
Procedia PDF Downloads 32310225 Concentrations of Cortisol and Progesterone after Dexamethasone Challenge in Egyptian Stray Bitches
Authors: K. A. El-Battawy
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This investigation was done to evaluate cortisol secretion in bitches following dexamethasone administration as well as its impact on progesterone levels during four days trail. Five bitches were used as their own pre-challenge control in a 4-day trial. On the control day, saline was injected intravenous (i.v.) and on the treatment day, 15 mg / animal of dexamethasone-21-disodiumphosphate (Dexa-TAD) was injected i.v. Blood samples were collected for four days then the analysis of cortisol and progesterone (P4) were done. Levels of cortisol decreased sharply within 24 h after dexamethasone administration. These low levels of cortisol remained for approximately 24hour then started again to reach normally back. Progesterone concentrations did not differ than pre-treatment one. In conclusion, this study confirms that single injection of dexamethasone lowered significantly the cortisol concentrations for approximately 24hour and did not affect the progesterone levels in bitches.Keywords: dexa, progesterone, cortisol, blood, bitch, concentration
Procedia PDF Downloads 30510224 Physical Characterization of a Watershed for Correlation with Parameters of Thomas Hydrological Model and Its Application in Iber Hidrodinamic Model
Authors: Carlos Caro, Ernest Blade, Nestor Rojas
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This study determined the relationship between basic geo-technical parameters and parameters of the hydro logical model Thomas for water balance of rural watersheds, as a methodological calibration application, applicable in distributed models as IBER model, which represents a distributed system simulation models for unsteady flow numerical free surface. There was an exploration in 25 points (on 15 sub) basin of Rio Piedras (Boy.) obtaining soil samples, to which geo-technical characterization was performed by laboratory tests. Thomas model has a physical characterization of the input area by only four parameters (a, b, c, d). Achieve measurable relationship between geo technical parameters and 4 values of hydro logical parameters helps to determine subsurface, underground and surface flow more agile manner. It is intended in this way to reach some solutions regarding limits initial model parameters on the basis of Thomas geo-technical characterization. In hydro geological models of rural watersheds, calibration is an important process in the characterization of the study area. This step can require a significant computational cost and time, especially if the initial values or parameters before calibration are outside of the geo-technical reality. A better approach in these initial values means optimization of these process through a geo-technical materials area, where is obtained an important approach to the study as in the starting range of variation for the calibration parameters.Keywords: distributed hydrology, hydrological and geotechnical characterization, Iber model
Procedia PDF Downloads 52010223 Mutagenesis, Oxidative Stress Induction and Blood Cytokine Profile in First Generation Male Rats Whose Parents Were Exposed to Radiation and Hexavalent Chromium
Authors: Yerbolat Iztleuov
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Stochastic effects, which are currently largely associated with exposure to ionizing radiation or a combination of ionizing radiation with other chemical, physical, and biological agents, are expressed in the form of various mutations. In the first stage of the study, rats of both sexes were divided into 3 groups. 1st - control group, animals of the 2nd group were exposed to gamma radiation at a dose of 0.2 Gy. The third group received hexavalent chromium in a dose of 180 mg/ l with drinking water for a month before irradiation and a day after the end of chromium consumption and was subjected to total gamma irradiation at a dose of 0.2 Gy. The second stage of the experiment. After 3 days, the males were mated with the females. The obtained offspring were studied for peroxidation, cytokine profile and micronucleus in the nuclei. This study shows that 5-month-old offspring whose parents were exposed to combined exposure to chromium and γ-irradiation exhibit hereditary instability of the genome, decreased activity of antioxidant enzymes and sulfhydryl blood groups, and increased levels of lipid peroxidation. There is also an increase in the level of inflammatory markers (IL-6 and TNF) in the blood plasma against the background of a decrease in anti-inflammatory cytokine (IL-10). Thus, the combined effect of hexavalent chromium and ionizing radiation can lead to the development of an oncological process.Keywords: hexavalent chromium, ionizing radiation, first generation, oxidative stress, cytokines, mutagenesis, cancer
Procedia PDF Downloads 2210222 Correlation Between Cytokine Levels and Lung Injury in the Syrian Hamster (Mesocricetus Auratus) Covid-19 Model
Authors: Gleb Fomin, Kairat Tabynov, Nurkeldy Turebekov, Dinara Turegeldiyeva, Rinat Islamov
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The level of major cytokines in the blood of patients with COVID-19 varies greatly depending on age, gender, duration and severity of infection, and comorbidity. There are two clinically significant cytokines, IL-6 and TNF-α, which increase in levels in patients with severe COVID-19. However, in a model of COVID-19 in hamsters, TNF-α levels are unchanged or reduced, while the expression of other cytokines reflects the profile of cytokines found in patients’ plasma. The aim of our study was to evaluate the relationship between the level of cytokines in the blood, lungs, and lung damage in the model of the Syrian hamster (Mesocricetus auratus) infected with the SARS-CoV-2 strain. The study used outbred female and male Syrian hamsters (n=36, 4 groups) weighing 80-110 g and 5 months old (protocol IACUC, #4, 09/22/2020). Animals were infected intranasally with the hCoV-19/Kazakhstan/KazNAU-NSCEDI-481/2020 strain and euthanized at 3 d.p.i. The level of cytokines IL-6, TNF-α, IFN-α, and IFN-γ was determined by ELISA MyBioSourse (USA) for hamsters. Lung samples were subjected to histological processing. The presence of pathological changes in histological preparations was assessed on a 3-point scale. The work was carried out in the ABSL-3 laboratory. The data were analyzed in GraphPad Prism 6.00 (GraphPad Software, La Jolla, California, USA). The work was supported by the MES RK grant (AP09259865). In the blood, the level of TNF-α increased in males (p=0.0012) and IFN-γ in males and females (p=0.0001). On the contrary, IFN-α production decreased (p=0.0006). Only TNF-α level increased in lung tissues (p=0.0011). Correlation analysis showed a negative relationship between the level of IL-6 in the blood and lung damage in males (r -0.71, p=0.0001) and females (r-0.57, p=0.025). On the contrary, in males, the level of IL-6 in the lungs and score is positively correlated (r 0.80, p=0.01). The level of IFN-γ in the blood (r -0.64, p=0.035) and lungs (r-0.72, p=0.017) in males has a negative correlation with lung damage. No links were found for TNF-α and IFN-α. The study showed a positive association between lung injury and tissue levels of IL-6 in male hamsters. It is known that in humans, high concentrations of IL-6 in the lungs are associated with suppression of cellular immunity and, as a result, with an increase in the severity of COVID-19. TNF-α and IFN-γ play a key role in the pathogenesis of COVID-19 in hamsters. However, the mechanisms of their activity require more detailed study. IFN-α plays a lesser role in direct lung injury in a Syrian hamster model. We have shown the significance of tissue IL-6 and IFN-γ as predictors of the severity of lung damage in COVID-19 in the Syrian hamster model. Changes in the level of cytokines in the blood may not always reflect pathological processes in the lungs with COVID-19.Keywords: syrian hamster, COVID-19, cytokines, biological model
Procedia PDF Downloads 9010221 Arterial Line Use for Acute Type 2 Respiratory Failure
Authors: C. Scurr, J. Jeans, S. Srivastava
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Introduction: Acute type two respiratory failure (T2RF) has become a common presentation over the last two decades primarily due to an increase in the prevalence of chronic lung disease. Acute exacerbations can be managed either medically or in combination with non-invasive ventilation (NIV) which should be monitored with regular arterial blood gas samples (ABG). Arterial lines allow more frequent arterial blood sampling with less patient discomfort. We present the experience from a teaching hospital emergency department (ED) and level 2 medical high-dependency unit (HDU) that together form the pathway for management of acute type 2 respiratory failure. Methods: Patients acutely presenting to Charing Cross Hospital, London, with T2RF requiring non-invasive ventilation (NIV) over 14 months (2011 to 2012) were identified from clinical coding. Retrospective data collection included: demographics, co-morbidities, blood gas numbers and timing, if arterial lines were used and who performed this. Analysis was undertaken using Microsoft Excel. Results: Coding identified 107 possible patients. 69 notes were available, of which 41 required NIV for type 2 respiratory failure. 53.6% of patients had an arterial line inserted. Patients with arterial lines had 22.4 ABG in total on average compared to 8.2 for those without. These patients had a similar average time to normalizing pH of (23.7 with arterial line vs 25.6 hours without), and no statistically significant difference in mortality. Arterial lines were inserted by Foundation year doctors, Core trainees, Medical registrars as well as the ICU registrar. 63% of these were performed by the medical registrar rather than ICU, ED or a junior doctor. This is reflected in that the average time until an arterial line was inserted was 462 minutes. The average number of ABGs taken before an arterial line was 2 with a range of 0 – 6. The average number of gases taken if no arterial line was ever used was 7.79 (range of 2-34) – on average 4 times as many arterial punctures for each patient. Discussion: Arterial line use was associated with more frequent arterial blood sampling during each inpatient admission. Additionally, patients with an arterial line have less individual arterial punctures in total and this is likely more comfortable for the patient. Arterial lines are normally sited by medical registrars, however this is normally after some delay. ED clinicians could improve patient comfort and monitoring thus allowing faster titration of NIV if arteral lines were regularly inserted in the ED. We recommend that ED doctors insert arterial lines when indicated in order improve the patient experience and facilitate medical management.Keywords: non invasive ventilation, arterial blood gas, acute type, arterial line
Procedia PDF Downloads 42710220 Muscle and Cerebral Regional Oxygenation in Preterm Infants with Shock Using Near-Infrared Spectroscopy
Authors: Virany Diana, Martono Tri Utomo, Risa Etika
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Background: Shock is one severe condition that can be a major cause of morbidity and mortality in the Neonatal Intensive Care Unit. Preterm infants are very susceptible to shock caused by many complications such as asphyxia, patent ductus arteriosus, intra ventricle haemorrhage, necrotizing enterocolitis, persistent pulmonal hypertension of the newborn, and septicaemia. Limited hemodynamic monitoring for early detection of shock causes delayed intervention and comprises the outcomes. Clinical parameters still used in neonatal shock detection, such as Capillary Refill Time, heart rate, cold extremity, and urine production. Blood pressure is most frequently used to evaluate preterm's circulation, but hypotension indicates uncompensated shock. Near-infrared spectroscopy (NIRS) is known as a noninvasive tool for monitoring and detecting the state of inadequate tissue perfusion. Muscle oxygen saturation shows decreased cardiac output earlier than systemic parameters of tissue oxygenation when cerebral regional oxygen saturation is still stabilized by autoregulation. However, to our best knowledge, until now, no study has analyzed the decrease of muscle oxygen regional saturation (mRSO₂) and the ratio of muscle and cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Purpose: The purpose of this study is to analyze the decrease of mRSO₂ and ratio of muscle to cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Patients and Methods: This cross-sectional study was conducted on preterm infants with 28-34 weeks gestational age, admitted to the NICU of Dr. Soetomo Hospital from November to January 2022. Patients were classified into two groups: shock and non-shock. The diagnosis of shock is based on clinical criteria (tachycardia, prolonged CRT, cold extremity, decreased urine production, and MAP Blood Pressure less than GA in weeks). Measurement of mRSO₂ and cRSO₂ by NIRS was performed by the doctor in charge when the patient came to NICU. Results: We enrolled 40 preterm infants. The initial conventional hemodynamic parameter as the basic diagnosis of shock showed significant differences in all variables. Preterm with shock had higher mean HR (186.45±1.5), lower MAP (29.8±2.1), and lower SBP (45.1±4.28) than non-shock children, and most had a prolonged CRT. The patients’ outcome was not a significant difference between shock and non-shock patients. The mean mRSO₂ in the shock and non-shock groups were 33,65 ± 11,32 vs. 69,15 ± 3,96 (p=0.001), and the mean ratio mRSO₂/cRSO₂ 0,45 ± 0,12 vs. 0,84 ± 0,43 (p=0,001), were significantly different. The mean cRSO₂ in the shock and non-shock groups were 71,60 ± 4,90 vs. 81,85 ± 7,85 (p 0.082), not significantly different. Conclusion: The decrease of mRSO₂ and ratio of mRSO₂/cRSO₂ can differentiate between shock and non-shock in the preterm infant when cRSO₂ is still normal.Keywords: preterm infant, regional muscle oxygen saturation, regional cerebral oxygen saturation, NIRS, shock
Procedia PDF Downloads 9010219 Sensitivity Analysis of Pile-Founded Fixed Steel Jacket Platforms
Authors: Mohamed Noureldin, Jinkoo Kim
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The sensitivity of the seismic response parameters to the uncertain modeling variables of pile-founded fixed steel jacket platforms are investigated using tornado diagram, first-order second-moment, and static pushover analysis techniques. The effects of both aleatory and epistemic uncertainty on seismic response parameters have been investigated for an existing offshore platform. The sources of uncertainty considered in the present study are categorized into three different categories: the uncertainties associated with the soil-pile modeling parameters in clay soil, the platform jacket structure modeling parameters, and the uncertainties related to ground motion excitations. It has been found that the variability in parameters such as yield strength or pile bearing capacity has almost no effect on the seismic response parameters considered, whereas the global structural response is highly affected by the ground motion uncertainty. Also, some uncertainty in soil-pile property such as soil-pile friction capacity has a significant impact on the response parameters and should be carefully modeled. Based on the results, it is highlighted that which uncertain parameters should be considered carefully and which can be assumed with reasonable engineering judgment during the early structural design stage of fixed steel jacket platforms.Keywords: fixed jacket offshore platform, pile-soil structure interaction, sensitivity analysis
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