Search results for: complete blood count
4520 A Closed Loop Audit of Pre-operative Transfusion Samples in Orthopaedic Patients at a Major Trauma Centre
Authors: Tony Feng, Rea Thomson, Kathryn Greenslade, Ross Medine, Jennifer Easterbrook, Calum Arthur, Matilda Powell-bowns
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There are clear guidelines on taking group and screen samples (G&S) for elective arthroplasty and major trauma. However, there is limited guidance on blood grouping for other trauma patients. The purpose of this study was to review the level of blood grouping at a major trauma centre and validate a protocol that limits the expensive processing of G&S samples. After reviewing the national guidance on transfusion samples in orthopaedic patients, data was prospectively collected for all orthopaedic admissions in the Royal Infirmary of Edinburgh between January to February 2023. The cause of admission, number of G&S samples processed on arrival and need for red cells was collected using the hospital blood bank. A new protocol was devised based on a multidisciplinary meeting which limited the requirement for G&S samples only to presentations in “category X”, including neck-of-femur fractures (NOFs), pelvic fractures and major trauma. A re-audit was completed between April and May after departmental education and institution of this protocol. 759 patients were admitted under orthopaedics in the major trauma centre across two separate months. 47% of patients were admitted with presentations falling in category X (354/759) and patients in this category accounted for 88% (92/104) of those requiring post-operative red cell transfusions. Of these, 51% were attributed to NOFs (47/92). In the initial audit, 50% of trauma patients outwith category X had samples sent (116/230), estimated to cost £3800. Of these 230 patients, 3% required post-operative transfusions (7/230). In the re-audit, 23% of patients outwith category X had samples sent (40/173), estimated to cost £1400, of which 3% (5/173) required transfusions. None of the transfusions in these patients in either audit were related to their operation and the protocol achieved an estimated cost saving of £2400 over one month. This study highlights the importance of sending samples for patients with certain categories of orthopaedic trauma (category X) due to the high demand for post-operative transfusions. However, the absence of transfusion requirements in other presentations suggests over-testing. While implementation of the new protocol has markedly reduced over-testing, additional interventions are required to reduce this further.Keywords: blood transfusion, quality improvement, orthopaedics, trauma
Procedia PDF Downloads 764519 Exercise Training for Management Hypertensive Patients: A Systematic Review and Meta-Analysis
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
Procedia PDF Downloads 2824518 Development of Electrospun Membranes with Defined Polyethylene Collagen and Oxide Architectures Reinforced with Medium and High Intensity Statins
Authors: S. Jaramillo, Y. Montoya, W. Agudelo, J. Bustamante
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Cardiovascular diseases (CVD) are related to affectations of the heart and blood vessels, within these are pathologies such as coronary or peripheral heart disease, caused by the narrowing of the vessel wall (atherosclerosis), which is related to the accumulation of Low-Density Lipoproteins (LDL) in the arterial walls that leads to a progressive reduction of the lumen of the vessel and alterations in blood perfusion. Currently, the main therapeutic strategy for this type of alteration is drug treatment with statins, which inhibit the enzyme 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMG-CoA reductase), responsible for modulating the rate of cholesterol production and other isoprenoids in the mevalonate pathway. This enzyme induces the expression of LDL receptors in the liver, increasing their number on the surface of liver cells, reducing the plasma concentration of cholesterol. On the other hand, when the blood vessel presents stenosis, a surgical procedure with vascular implants is indicated, which are used to restore circulation in the arterial or venous bed. Among the materials used for the development of vascular implants are Dacron® and Teflon®, which perform the function of re-waterproofing the circulatory circuit, but due to their low biocompatibility, they do not have the ability to promote remodeling and tissue regeneration processes. Based on this, the present research proposes the development of a hydrolyzed collagen and polyethylene oxide electrospun membrane reinforced with medium and high-intensity statins, so that in future research it can favor tissue remodeling processes from its microarchitecture.Keywords: atherosclerosis, medium and high-intensity statins, microarchitecture, electrospun membrane
Procedia PDF Downloads 1374517 Implementation of Complete Management Practices in Managing the Cocoa Pod Borer
Authors: B. Saripah, A. Alias
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Cocoa Theobroma cacao (Linnaeus) (Malvales: Sterculiaceae) is subjected to be infested by various numbers of insect pests, and Conopomorpha cramerella Snellen (Lepidoptera: Gracillariidae) is the most serious pest of cocoa in Malaysia. The pest was indigenous to the South East Asia. Several control measures have been implemented and the chemicals have been a major approach if not unilateral, in the management of CPB. Despite extensive use of insecticides, CPB continues to cause an unacceptable level of damage; thus, the combination of several control approaches should be sought. The study was commenced for 12 months at three blocks; Block 18C with complete management practices which include insecticide application, pruning, fertilization and frequent harvesting, Block 17C was treated with frequent harvesting at intervals of 7-8 days, and Block 19C was served as control block. The results showed that the mean numbers of CPB eggs were recorded higher in Block 17C compared with Block 18C in all sampling occasions. Block 18C shows the lowest mean number of CPB eggs in both sampling plots, outside and core plots and it was found significantly different (p ≤ 0. 05) compared to the other blocks. The mean number of CPB eggs was fluctuated throughout sampling occasions, the lowest mean number of eggs was recorded in January (17C) and November (18C), while the highest was recorded in April (17C) and December 2012 (18C). Frequent spraying with insecticides at the adjacent block (18C) helps in reducing CPB eggs in the control block (Block 19C), although there was no spraying was implemented Block 19C. In summary, the combination of complete management practices at Block 18C seems to have some effect on the CPB population at Blocks 17 and 19C because all blocks are adjacent to each other.Keywords: cocoa, theobroma cacao, cocoa pod borer, conopomorpha cramerella
Procedia PDF Downloads 4454516 Effects of the Supplementation of Potassium Humate at Different Levels to the Dairy Cows' Concentrated Mix during Dry Period on Early Lactation Yield Parameters and Dam/Calf Immunity
Authors: Cangir Uyarlar, E. Eren Gultepe, I. Sadi Cetingul, Ismail Bayram
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This study was conducted to investigate the effect of humic acid (Potassium Humate) at different levels on rations on the effects of both maternal and offspring health, metabolic parameters and immunity levels in transition dairy cows. For this purpose, 50 Holstein dairy cows divided 5 trial groups. Experimental groups were designed as follows: A) Control (0% Humas); B) 0.5 Humas (0,5% in concentrated diet); C) 1 Humas (1% in concentrated diet), D) 1,5 Humas (1,5% in concentrated diet), E) 2 Humas (2% in concentrated diet), respectively. The study lasted from the first day of the dry period to postpartum 30th day. Diets were prepared as isocaloric and isonitrogenic. In the experiment, the day on which the animals gave birth was accepted as ‘0 (zero)’ and blood was taken from tail vein (v. coccygea) at -60, -53, -46, -39, -32, -25, -18, -11, -4, 0, ; Colostrum samples were taken on days 0, 1 and 2; Blood samples were taken on days 0, 1, 2, 15 and 30 from the juguler vein (v. jugularis) of the new born calves. Total blood leukocyte, Lymphocyte, Monocyte, granulocytes, Hemoglobin, Hematocrit, MCV, MCH, MWC, RDW, PLT, MPV, PDW, PCT, NEFA, BHBA, Glucose, Total Cholesterol , Triglyceride, LDL, HDL, VLDL, ALT, AST, ALP, GGT and Total IgG levels and colostrum IgG levels were determined in this experiment. The results suggest that although the supplementation of humic acid at 2% level adversely affected to production parameters, the addition of humic acid (potassium humate) to the concentrate mix during the dry period (particularly 0.5 and 1% levels) may provide an increasing on mother and the offspring immunity, some improving on serum metabolism parameters and enhancing the milk production.Keywords: humic acid, dairy cow, calf, immunity
Procedia PDF Downloads 2074515 Blood Profile, Organs, and Carcass Analysis and Performance of Broilers Fed Cowpea Testa Based Diet
Authors: O. J. Osunkeye, P. O. Fakolade, B. E. Olorede
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Broilers productions depend on the provision of adequate and goo quality feed containing all the nutrients, including proteins, carbohydrate, fats, vitamins, minerals and water. All these nutrients have to be provided at a required amount to support maximum productivity and normal physiological functions and demands. Among these nutrients proteins are particularly important, since they are essential for meat and muscle production, optimum growth and health status. Poultry production industry in the developing countries is been threatened because of the over dependency on Soybean meal as one of the key/major conventional protein stuff for feeding livestock. Even the competition between man and livestock for Soybean and other protein sources made the price of this feed stuff to be on the increase. Hence the needs to seek for an alternative feed stuff which is cheap and less competitive. This study showed the blood profile, organ and carcass characteristics and performance of broilers fed with Cowpea Testa Meal (CTM) based diets. Four diets were formulated with Cowpea Testa replacing Soybean at 0%, 15%, 30%, and 50% graded levels. One hundred and twenty day-old unsexed broiler birds were allotted to these four treatments with 3 replicates of 10 birds per replicate. The results showed no significant differences in all the haematological parameters measured (P>0.05), the serum metabolites analysis revealed significant different in Cholesterol (99.8 mg/dl, 112.84 mg/dl, 131.07 mg/dl and 97.66 mg/dl respectively) (P<0.05) among others. There were significant differences within the diets for average daily weight gain, average feed intake and feed to gain ratio. The birds on control (0%) and CTM gained more weight than those fed with 30% and 50% CTM diets. The organs and carcass primal cuts of the broilers expressed significant different for the spleen (0.12 g, 0.09 g, 0.11 g and 0.14 g respectively), lungs (0.97 g, 0.72 g, 0.77 g and 1.01g respectively) and proventriculus (0.96 g, 0.99 g, 0.81 g and 0.85 g respectively) (P<0.05). For the carcass, there were no significant differences (P<0.05) in the breast, thigh, drumstick, wing and neck except for the Back (21.27 g, 21.04 g, 17.71 g, and 17.89 g respectively). In conclusion, CTM inclusion in broiler’s diet could be used as an alternative feed stuff in replacement of Soybean meal up to 15% without any adverse effects as revealed by the blood profile and to increase the growth performance of the birds.Keywords: physiological functions, cholesterol, blood profiles, CTM and carcass analysis
Procedia PDF Downloads 6134514 Authentication of Physical Objects with Dot-Based 2D Code
Authors: Michał Glet, Kamil Kaczyński
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Counterfeit goods and documents are a global problem, which needs more and more sophisticated methods of resolving it. Existing techniques using watermarking or embedding symbols on objects are not suitable for all use cases. To address those special needs, we created complete system allowing authentication of paper documents and physical objects with flat surface. Objects are marked using orientation independent and resistant to camera noise 2D graphic codes, named DotAuth. Based on the identifier stored in 2D code, the system is able to perform basic authentication and allows to conduct more sophisticated analysis methods, e.g., relying on augmented reality and physical properties of the object. In this paper, we present the complete architecture, algorithms and applications of the proposed system. Results of the features comparison of the proposed solution and other products are presented as well, pointing to the existence of many advantages that increase usability and efficiency in the means of protecting physical objects.Keywords: anti-forgery, authentication, paper documents, security
Procedia PDF Downloads 1334513 The Effects of Passive and Active Recoveries on Responses of Platelet Indices and Hemodynamic Variables to Resistance Exercise
Authors: Mohammad Soltani, Sajad Ahmadizad, Fatemeh Hoseinzadeh, Atefe Sarvestan
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The exercise recovery is an important variable in designing resistance exercise training. This study determined the effects of passive and active recoveries on responses of platelet indices and hemodynamic variables to resistance exercise. Twelve healthy subjects (six men and six women, age, 25.4 ±2.5 yrs) performed two types of resistance exercise protocols (six exercises including upper- and lower-body parts) at two separate sessions with one-week intervening. First resistance protocol included three sets of six repetitions at 80% of 1RM with 2 min passive rest between sets and exercises; while, the second protocol included three sets of six repetitions at 60% of 1RM followed by active recovery included six repetitions of the same exercise at 20% of 1RM. The exercise volume was equalized. Three blood samples were taken before exercise, immediately after exercise and after 1-hour recovery, and analyzed for fibrinogen and platelet indices. Blood pressure (BP), heart rate (HR) and rate pressure product (RPP), were measured before, immediately after exercise and every 5 minutes during recovery. Data analyzes showed a significant increase in SBP (systolic blood pressure), HR, rate of pressure product (RPP) and PLT in response to resistance exercise (P<0.05) and that changes for HR and RPP were significantly different between two protocols (P<0.05). Furthermore, MPV and P_LCR did not change in response to resistance exercise, though significant reductions were observed after 1h recovery compared to before and after exercise (P<0.05). No significant changes in fibrinogen and PDW following two types of resistance exercise protocols were observed (P>0.05). On the other hand, no significant differences in platelet indices were found between the two protocols (P>0.05). Resistance exercise induces changes in platelet indices and hemodynamic variables, and that these changes are not related to the type of recovery and returned to normal levels after 1h recovery.Keywords: hemodynamic variables, platelet indices, resistance exercise, recovery intensity
Procedia PDF Downloads 1434512 Membrane Technologies for Obtaining Bioactive Fractions from Blood Main Protein: An Exploratory Study for Industrial Application
Authors: Fatima Arrutia, Francisco Amador Riera
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The meat industry generates large volumes of blood as a result of meat processing. Several industrial procedures have been implemented in order to treat this by-product, but are focused on the production of low-value products, and in many cases, blood is simply discarded as waste. Besides, in addition to economic interests, there is an environmental concern due to bloodborne pathogens and other chemical contaminants found in blood. Consequently, there is a dire need to find extensive uses for blood that can be both applicable to industrial scale and able to yield high value-added products. Blood has been recognized as an important source of protein. The main blood serum protein in mammals is serum albumin. One of the top trends in food market is functional foods. Among them, bioactive peptides can be obtained from protein sources by microbiological fermentation or enzymatic and chemical hydrolysis. Bioactive peptides are short amino acid sequences that can have a positive impact on health when administered. The main drawback for bioactive peptide production is the high cost of the isolation, purification and characterization techniques (such as chromatography and mass spectrometry) that make unaffordable the scale-up. On the other hand, membrane technologies are very suitable to apply to the industry because they offer a very easy scale-up and are low-cost technologies, compared to other traditional separation methods. In this work, the possibility of obtaining bioactive peptide fractions from serum albumin by means of a simple procedure of only 2 steps (hydrolysis and membrane filtration) was evaluated, as an exploratory study for possible industrial application. The methodology used in this work was, firstly, a tryptic hydrolysis of serum albumin in order to release the peptides from the protein. The protein was previously subjected to a thermal treatment in order to enhance the enzyme cleavage and thus the peptide yield. Then, the obtained hydrolysate was filtered through a nanofiltration/ultrafiltration flat rig at three different pH values with two different membrane materials, so as to compare membrane performance. The corresponding permeates were analyzed by liquid chromatography-tandem mass spectrometry technology in order to obtain the peptide sequences present in each permeate. Finally, different concentrations of every permeate were evaluated for their in vitro antihypertensive and antioxidant activities though ACE-inhibition and DPPH radical scavenging tests. The hydrolysis process with the previous thermal treatment allowed achieving a degree of hydrolysis of the 49.66% of the maximum possible. It was found that peptides were best transmitted to the permeate stream at pH values that corresponded to their isoelectric points. Best selectivity between peptide groups was achieved at basic pH values. Differences in peptide content were found between membranes and also between pH values for the same membrane. The antioxidant activity of all permeates was high compared with the control only for the highest dose. However, antihypertensive activity was best for intermediate concentrations, rather than higher or lower doses. Therefore, although differences between them, all permeates were promising regarding antihypertensive and antioxidant properties.Keywords: bioactive peptides, bovine serum albumin, hydrolysis, membrane filtration
Procedia PDF Downloads 2004511 Examining the Effects of Exercise and Healthy Diet on Certain Blood Parameter Levels, Oxidative Stress and Anthropometric Measurements in Slightly Overweight Women
Authors: Nezihe Şengün, Ragip Pala
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To prevent overweight and obesity, individuals need to consume food and beverages according to their nutritional needs, engage in regular exercises, and regularly monitor their body weight. This study aimed to examine the effects of exercise, diet, or combined intervention on changes in blood lipid parameters (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides) and the level of malondialdehyde (MDA), a marker of oxidative stress, in parallel with the increase in body weight due to poor nutrition and sedentary lifestyle conditions. The study included a total of 48 female students aged 18-28 years with a BMI between 25.0 and 29.9 kg/m². They were divided into four groups: control (C), exercise (Ex), diet (D), and exercise+diet (Ex+D). Those in the exercise groups received aerobic exercises at 60-70% intensity (10 minutes warm-up, 30 minutes running, 10 minutes cool-down), while those in the diet groups were provided with a diet program based on the calculation of energy needs considering basal metabolic rate, physical activity level, age, and BMI. The students’ body weight, body fat mass, Body Mass Index (BMI), and waist-hip ratios were measured at the beginning (day 1) and end (day 60) of the 8-week intervention period. Their total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and MDA levels were evaluated and analyzed, considering a statistical significance level of p<0.05. As a result, female students in the Ex+D group had the largest difference in body weight, body fat mass, BMI, and waist-hip ratios, and this difference was statistically significant. Except for those in the C group, those in the other groups experienced a decrease in their total cholesterol, LDL cholesterol, and triglyceride levels and an increase in their HDL cholesterol levels. The decrease in total cholesterol, LDL cholesterol, and triglyceride levels was statistically significant for those in the D group, and the increase in HDL cholesterol level was statistically significant for those in the Ex+D group (p<0.05). A decrease in MDA level was found in all groups except those in the C group, and this decrease was significantly higher in the Ex group. In conclusion, our study revealed that the most effective way to achieve weight loss is through a combination of exercise and diet. The application of Ex+D is considered to balance blood lipid levels and suppress oxidative stress.Keywords: obesity, exercise, diet, body mass index, blood lipids
Procedia PDF Downloads 784510 Radiation Induced DNA Damage and Its Modification by Herbal Preparation of Hippophae rhamnoides L. (SBL-1): An in vitro and in vivo Study in Mice
Authors: Anuranjani Kumar, Madhu Bala
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Ionising radiation exposure induces generation of free radicals and the oxidative DNA damage. SBL-1, a radioprotective leaf extract prepared from leaves Hippophae rhamnoides L. (Common name; Seabuckthorn), showed > 90% survival in mice population that was treated with lethal dose (10 Gy) of ⁶⁰Co gamma irradiation. In this study, early effects of pre-treatment with or without SBL-1 in blood peripheral blood lymphocytes (PBMCs) were investigated by cell viability assays (trypan blue and MTT). The quantitative in vitro study of Hoescht/PI staining was performed to check the apoptosis/necrosis in PBMCs irradiated at 2 Gy with or without pretreatment of SBL-1 (at different concentrations) up to 24 and 48h. Comet assay was performed in vivo, to detect the DNA strands breaks and its repair mechanism on peripheral blood lymphocytes at lethal dose (10 Gy). For this study, male mice (wt. 28 ± 2g) were administered radioprotective dose (30mg/kg body weight) of SBL-1, 30 min prior to irradiation. Animals were sacrificed at 24h and 48h. Blood was drawn through cardiac puncture, and blood lymphocytes were separated using histopaque column. Both neutral and alkaline comet assay were performed using standardized technique. In irradiated animals, alkaline comet assay revealed single strand breaks (SSBs) that showed significant (p < 0.05) increase in percent DNA in tail and Olive tail moment (OTM) at 24 h while at 48h the percent DNA in tail further increased significantly (p < 0.02). The double strands breaks (DSBs) increased significantly (p < 0.01) at 48 h in neutral assay, in comparison to untreated control. The animals pre-treated with SBL-1 before irradiation showed significantly (p < 0.05) less DSBs at 48 h treatment in comparison to irradiated group of animals. The SBL-1 alone treated group itself showed no toxicity. The antioxidant potential of SBL-1 were also investigated by in vitro biochemical assays such as DPPH (p < 0.05), ABTS, reducing ability (p < 0.09), hydroxyl radical scavenging (p < 0.05), ferric reducing antioxidant power (FRAP), superoxide radical scavenging activity (p < 0.05), hydrogen peroxide scavenging activity (p < 0.05) etc. SBL-1 showed strong free radical scavenging power that plays important role in the studies of radiation-induced injuries. The SBL-1 treated PBMCs showed significant (p < 0.02) viability in trypan blue assay at 24-hour incubation.Keywords: radiation, SBL-1, SSBs, DSBs, FRAP, PBMCs
Procedia PDF Downloads 1544509 Micro-Rest: Extremely Short Breaks in Post-Learning Interference Support Memory Retention over the Long Term
Authors: R. Marhenke, M. Martini
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The distraction of attentional resources after learning hinders long-term memory consolidation compared to several minutes of post-encoding inactivity in form of wakeful resting. We tested whether an 8-minute period of wakeful resting, compared to performing an adapted version of the d2 test of attention after learning, supports memory retention. Participants encoded and immediately recalled a word list followed by either an 8 minute period of wakeful resting (eyes closed, relaxed) or by performing an adapted version of the d2 test of attention (scanning and selecting specific characters while ignoring others). At the end of the experimental session (after 12-24 min) and again after 7 days, participants were required to complete a surprise free recall test of both word lists. Our results showed no significant difference in memory retention between the experimental conditions. However, we found that participants who completed the first lines of the d2 test in less than the given time limit of 20 seconds and thus had short unfilled intervals before switching to the next test line, remembered more words over the 12-24 minute and over the 7 days retention interval than participants who did not complete the first lines. This interaction occurred only for the first test lines, with the highest temporal proximity to the encoding task and not for later test lines. Differences in retention scores between groups (completed first line vs. did not complete) seem to be widely independent of the general performance in the d2 test. Implications and limitations of these exploratory findings are discussed.Keywords: long-term memory, retroactive interference, attention, forgetting
Procedia PDF Downloads 1324508 [Keynote Talk]: Mathematical and Numerical Modelling of the Cardiovascular System: Macroscale, Mesoscale and Microscale Applications
Authors: Aymen Laadhari
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The cardiovascular system is centered on the heart and is characterized by a very complex structure with different physical scales in space (e.g. micrometers for erythrocytes and centimeters for organs) and time (e.g. milliseconds for human brain activity and several years for development of some pathologies). The development and numerical implementation of mathematical models of the cardiovascular system is a tremendously challenging topic at the theoretical and computational levels, inducing consequently a growing interest over the past decade. The accurate computational investigations in both healthy and pathological cases of processes related to the functioning of the human cardiovascular system can be of great potential in tackling several problems of clinical relevance and in improving the diagnosis of specific diseases. In this talk, we focus on the specific task of simulating three particular phenomena related to the cardiovascular system on the macroscopic, mesoscopic and microscopic scales, respectively. Namely, we develop numerical methodologies tailored for the simulation of (i) the haemodynamics (i.e., fluid mechanics of blood) in the aorta and sinus of Valsalva interacting with highly deformable thin leaflets, (ii) the hyperelastic anisotropic behaviour of cardiomyocytes and the influence of calcium concentrations on the contraction of single cells, and (iii) the dynamics of red blood cells in microvasculature. For each problem, we present an appropriate fully Eulerian finite element methodology. We report several numerical examples to address in detail the relevance of the mathematical models in terms of physiological meaning and to illustrate the accuracy and efficiency of the numerical methods.Keywords: finite element method, cardiovascular system, Eulerian framework, haemodynamics, heart valve, cardiomyocyte, red blood cell
Procedia PDF Downloads 2524507 The Determination of Sodium/Potassium Ion Ratio in Selected Edible Leafy Vegetables in North-Eastern Nigeria
Authors: Raymond D. Uzoh, Philip K. Shallsuku, Christopher S. Vaachia
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Selected edible leafy vegetables from North-eastern Nigeria were analysed for their sodium and potassium content in mg/100 g and the ratio Na+/K+ worked out. From experimental results, Venonia amydalina (bitter leaf) contained 150 mg (0.15 g) of sodium and 20500 mg (20.5 g) potassium with a ratio of 0.007, Brassica oleracea var capitata (cabbage) contained 300 mg (0.3 g) of sodium and 19000 mg (19 g) of potassium with a ration of 0.012. Others are Telfairia occidentalis (fluted pumpkin) with 400 mg (0.45 g) of sodium and 19500 mg (19.5 g) of potassium with a ratio of 0.020; Hibiscus sabdriffa (sorrel) has 200 mg (0.2 g) of sodium and 600 mg (0.6 g) of potassium with a ratio of 0.300; and Amarantus caudatus (spinach) contained 450 mg (0.45 g) of sodium and 23000 mg (23 g) of potassium with a ratio of 0.020. The presence of sodium and potassium in foods has become increasingly important as recent studies and dietary information gathered in this research has shown that sodium intake is not the sole consideration in elevated blood pressure but its considered as a ratio Na+/K+ fixed at 0.6. This ratio has been found to be a more important factor, suggesting that our diet should contain 67 % more potassium than sodium.Keywords: vegetables, sodium, potassium, blood pressure, diet, foods
Procedia PDF Downloads 4794506 Potential Therapeutic Effect of Obestatin in Oral Mucositis
Authors: Agnieszka Stempniewicz, Piotr Ceranowicz, Wojciech Macyk, Jakub Cieszkowski, Beata Kuśnierz-Cabała, Katarzyna Gałązka, Zygmunt Warzecha
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Objectives: There are numerous strategies for the prevention or treatment of oral mucositis. However, their effectiveness is limited and does not correspond to expectations. Recent studies have shown that obestatin exhibits a protective effect and accelerates the healing of gastrointestinal mucosa. The aim of the present study was to examine the influence of obestatin administration on oral ulcers in rats. Methods: lingual ulcers were induced by the use of acetic acid. Rats were treated twice a day intraperitoneally with saline or obestatin(4, 8, or 16 nmol/kg/dose) for five days. The study determined: lingual mucosa morphology, cell proliferation, mucosal blood flow, and mucosal pro-inflammatory interleukin-1β level(IL-1β). Results: In animals without induction of oral ulcers, treatment with obestatin was without any effect. Obestatin administration in rats with lingual ulcers increased the healing rate of these ulcers. Obestatin given at the dose of 8 or 16 nmol/kg/dose caused the strongest and similar therapeutic effect. This result was associated with a significant increase in blood flow and cell proliferation in gingival mucosa, as well as a significant decrease in IL-1β level. Conclusions: Obestatin accelerates the healing of lingual ulcers in rats. This therapeutic effect is well-correlated with an increase in blood flow and cell proliferation in oral mucosa, as well as a decrease in pro-inflammatory IL-1β levels. Obestatin is a potentially useful candidate for the prevention and treatment of oral mucositis. Acknowledgment: Agnieszka Stempniewicz acknowledges the support of InterDokMed project no. POWR.03.02.00- 00-I013/16.Keywords: oral mucositis, ulcers, obestatin, lingual mucosa
Procedia PDF Downloads 734505 Back Stepping Sliding Mode Control of Blood Glucose for Type I Diabetes
Authors: N. Tadrisi Parsa, A. R. Vali, R. Ghasemi
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Diabetes is a growing health problem in worldwide. Especially, the patients with Type 1 diabetes need strict glycemic control because they have deficiency of insulin production. This paper attempts to control blood glucose based on body mathematical body model. The Bergman minimal mathematical model is used to develop the nonlinear controller. A novel back-stepping based sliding mode control (B-SMC) strategy is proposed as a solution that guarantees practical tracking of a desired glucose concentration. In order to show the performance of the proposed design, it is compared with conventional linear and fuzzy controllers which have been done in previous researches. The numerical simulation result shows the advantages of sliding mode back stepping controller design to linear and fuzzy controllers.Keywords: bergman model, nonlinear control, back stepping, sliding mode control
Procedia PDF Downloads 3824504 The Implantable MEMS Blood Pressure Sensor Model With Wireless Powering And Data Transmission
Authors: Vitaliy Petrov, Natalia Shusharina, Vitaliy Kasymov, Maksim Patrushev, Evgeny Bogdanov
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The leading worldwide death reasons are ischemic heart disease and other cardiovascular illnesses. Generally, the common symptom is high blood pressure. Long-time blood pressure control is very important for the prophylaxis, correct diagnosis and timely therapy. Non-invasive methods which are based on Korotkoff sounds are impossible to apply often and for a long time. Implantable devices can combine longtime monitoring with high accuracy of measurements. The main purpose of this work is to create a real-time monitoring system for decreasing the death rate from cardiovascular diseases. These days implantable electronic devices began to play an important role in medicine. Usually implantable devices consist of a transmitter, powering which could be wireless with a special made battery and measurement circuit. Common problems in making implantable devices are short lifetime of the battery, big size and biocompatibility. In these work, blood pressure measure will be the focus because it’s one of the main symptoms of cardiovascular diseases. Our device will consist of three parts: the implantable pressure sensor, external transmitter and automated workstation in a hospital. The Implantable part of pressure sensors could be based on piezoresistive or capacitive technologies. Both sensors have some advantages and some limitations. The Developed circuit is based on a small capacitive sensor which is made of the technology of microelectromechanical systems (MEMS). The Capacitive sensor can provide high sensitivity, low power consumption and minimum hysteresis compared to the piezoresistive sensor. For this device, it was selected the oscillator-based circuit where frequency depends from the capacitance of sensor hence from capacitance one can calculate pressure. The external device (transmitter) used for wireless charging and signal transmission. Some implant devices for these applications are passive, the external device sends radio wave signal on internal LC circuit device. The external device gets reflected the signal from the implant and from a change of frequency is possible to calculate changing of capacitance and then blood pressure. However, this method has some disadvantages, such as the patient position dependence and static using. Developed implantable device doesn’t have these disadvantages and sends blood pressure data to the external part in real-time. The external device continuously sends information about blood pressure to hospital cloud service for analysis by a physician. Doctor’s automated workstation at the hospital also acts as a dashboard, which displays actual medical data of patients (which require attention) and stores it in cloud service. Usually, critical heart conditions occur few hours before heart attack but the device is able to send an alarm signal to the hospital for an early action of medical service. The system was tested with wireless charging and data transmission. These results can be used for ASIC design for MEMS pressure sensor.Keywords: MEMS sensor, RF power, wireless data, oscillator-based circuit
Procedia PDF Downloads 5894503 Antidiabetic and Antihyperlipaemic Effects of Aqueous Neem (Azadirachta Indica) Extract on Alloxan Diabetic Rabbits
Authors: Khalil Abdullah Ahmed Khalil, Elsadig Mohamed Ahmed
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Extracts of various plants material capable of decreasing blood sugar have been tested in experimental animal models and their effects confirmed. Neem or Margose (Azadirachta Indica) is an indigenous plant believed to have antiviral, antifungal, antidiabetic and many other properties. This paper deals with a comparative study of the effect of aqueous Neem leaves extract alone or in combination with glibenclamide on alloxan diabetic rabbits. Administration of crude aqueous Neem extract (CANE) alone (1.5 ml/kg/day), as well as the combination of CANE (1.5 ml/kg/day) with glibenclamide (0.25 mg/kg/day) significantly, decreased (P<0.05) the concentrations of serum lipids, blood glucose and lipoprotein VLDL(very low-density lipoproteins) and LDL(low-density lipoproteins) but significantly increased (P<0.05) the concentration of HDL(high-density lipoprotein). The change was observed significantly greater when the treatment was given in combination of CANE and glibenclamid than with CANE alone.Keywords: neem, hypoglycemic, hypolipidemic, cholesterol
Procedia PDF Downloads 2654502 Inflammatory Markers in the Blood and Chronic Periodontitis
Authors: Saimir Heta, Ilma Robo, Nevila Alliu, Tea Meta
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Background: Plasma levels of inflammatory markers are the expression of the infectious wastes of existing periodontitis, as well as of existing inflammation everywhere in the body. Materials and Methods: The study consists of the clinical part of the measurement of inflammatory markers of 23 patients diagnosed with chronic periodontitis and the recording of parental periodontal parameters of patient periodontal status: hemorrhage index and probe values, before and 7-10 days after non-surgical periodontal treatment. Results: The level of fibrinogen drops according to the categorization of disease progression, active and passive, with the biggest % (18%-30%) at the fluctuation 10-20 mg/d. Fluctuations in fibrinogen level according to the age of patients in the range 0-10 mg/dL under 40 years and over 40 years was 13%-26%, in the range 10-20 mg/dL was 26%-22%, in the 20-40 mg/dL was 9%-4%. Conclusions: Non-surgical periodontal treatment significantly reduces the level of non-inflammatory markers in the blood. Oral health significantly reduces the potential source for periodontal bacteria, with the potential of promoting thromboembolism, through interaction between thrombocytes.Keywords: chronic periodontitis, atherosclerosis, risk factor, inflammatory markers
Procedia PDF Downloads 1264501 Blood Flow Simulations to Understand the Role of the Distal Vascular Branches of Carotid Artery in the Stroke Prediction
Authors: Muhsin Kizhisseri, Jorg Schluter, Saleh Gharie
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Atherosclerosis is the main reason of stroke, which is one of the deadliest diseases in the world. The carotid artery in the brain is the prominent location for atherosclerotic progression, which hinders the blood flow into the brain. The inclusion of computational fluid dynamics (CFD) into the diagnosis cycle to understand the hemodynamics of the patient-specific carotid artery can give insights into stroke prediction. Realistic outlet boundary conditions are an inevitable part of the numerical simulations, which is one of the major factors in determining the accuracy of the CFD results. The Windkessel model-based outlet boundary conditions can give more realistic characteristics of the distal vascular branches of the carotid artery, such as the resistance to the blood flow and compliance of the distal arterial walls. This study aims to find the most influential distal branches of the carotid artery by using the Windkessel model parameters in the outlet boundary conditions. The parametric study approach to Windkessel model parameters can include the geometrical features of the distal branches, such as radius and length. The incorporation of the variations of the geometrical features of the major distal branches such as the middle cerebral artery, anterior cerebral artery, and ophthalmic artery through the Windkessel model can aid in identifying the most influential distal branch in the carotid artery. The results from this study can help physicians and stroke neurologists to have a more detailed and accurate judgment of the patient's condition.Keywords: stroke, carotid artery, computational fluid dynamics, patient-specific, Windkessel model, distal vascular branches
Procedia PDF Downloads 2154500 Increase of Sensitivity in 3D Suspended Polymeric Microfluidic Platform through Lateral Misalignment
Authors: Ehsan Yazdanpanah Moghadam, Muthukumaran Packirisamy
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In the present study, a design of the suspended polymeric microfluidic platform is introduced that is fabricated with three polymeric layers. Changing the microchannel plane to be perpendicular to microcantilever plane, drastically decreases moment of inertia in that direction. In addition, the platform is made of polymer (around five orders of magnitude less compared to silicon). It causes significant increase in the sensitivity of the cantilever deflection. Next, although the dimensions of this platform are constant, by misaligning the embedded microchannels laterally in the suspended microfluidic platform, the sensitivity can be highly increased. The investigation is studied on four fluids including water, seawater, milk, and blood for flow ranges from low rate of 5 to 70 µl/min to obtain the best design with the highest sensitivity. The best design in this study shows the sensitivity increases around 50% for water, seawater, milk, and blood at the flow rate of 70 µl/min by just misaligning the embedded microchannels in the suspended polymeric microfluidic platform.Keywords: microfluidic, MEMS, biosensor, microresonator
Procedia PDF Downloads 2234499 Identifying the Mindset of Deaf Benildean Students in Learning Anatomy and Physiology
Authors: Joanne Rieta Miranda
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Learning anatomy and physiology among Deaf Non-Science major students is a challenge. They have this mindset that Anatomy and Physiology are difficult and very technical. In this study, nine (9) deaf students who are business majors were considered. Non-conventional teaching strategies and classroom activities were employed such as cooperative learning, virtual lab, Facebook live, big sky, blood typing, mind mapping, reflections, etc. Of all the activities; the deaf students ranked cooperative learning as the best learning activity. This is where they played doctors. They measured the pulse rate, heart rate and blood pressure of their partner classmate. In terms of mindset, 2 out of 9 students have a growth mindset with some fixed ideas while 7 have a fixed mindset with some growth ideas. All the students passed the course. Three out of nine students got a grade of 90% and above. The teacher was evaluated by the deaf students as very satisfactory with a mean score of 3.54. This means that the learner-centered practices in the classroom are manifested to a great extent.Keywords: deaf students, learning anatomy and physiology, teaching strategies, learner-entered practices
Procedia PDF Downloads 2314498 The Second Smallest Eigenvalue of Complete Tripartite Hypergraph
Authors: Alfi Y. Zakiyyah, Hanni Garminia, M. Salman, A. N. Irawati
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In the terminology of the hypergraph, there is a relation with the terminology graph. In the theory of graph, the edges connected two vertices. In otherwise, in hypergraph, the edges can connect more than two vertices. There is representation matrix of a graph such as adjacency matrix, Laplacian matrix, and incidence matrix. The adjacency matrix is symmetry matrix so that all eigenvalues is real. This matrix is a nonnegative matrix. The all diagonal entry from adjacency matrix is zero so that the trace is zero. Another representation matrix of the graph is the Laplacian matrix. Laplacian matrix is symmetry matrix and semidefinite positive so that all eigenvalues are real and non-negative. According to the spectral study in the graph, some that result is generalized to hypergraph. A hypergraph can be represented by a matrix such as adjacency, incidence, and Laplacian matrix. Throughout for this term, we use Laplacian matrix to represent a complete tripartite hypergraph. The aim from this research is to determine second smallest eigenvalues from this matrix and find a relation this eigenvalue with the connectivity of that hypergraph.Keywords: connectivity, graph, hypergraph, Laplacian matrix
Procedia PDF Downloads 4894497 Transcriptome Analysis Reveals Role of Long Non-Coding RNA NEAT1 in Dengue Patients
Authors: Abhaydeep Pandey, Shweta Shukla, Saptamita Goswami, Bhaswati Bandyopadhyay, Vishnampettai Ramachandran, Sudhanshu Vrati, Arup Banerjee
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Background: Long non-coding RNAs (lncRNAs) are the important regulators of gene expression and play important role in viral replication and disease progression. The role of lncRNA genes in the pathogenesis of Dengue virus-mediated pathogenesis is currently unknown. Methods: To gain additional insights, we utilized an unbiased RNA sequencing followed by in silico analysis approach to identify the differentially expressed lncRNA and genes that are associated with dengue disease progression. Further, we focused our study on lncRNAs NEAT1 (Nuclear Paraspeckle Assembly Transcript 1) as it was found to be differentially expressed in PBMC of dengue infected patients. Results: The expression of lncRNAs NEAT1, as compared to dengue infection (DI), was significantly down-regulated as the patients developed the complication. Moreover, pairwise analysis on follow up patients confirmed that suppression of NEAT1 expression was associated with rapid fall in platelet count in dengue infected patients. Severe dengue patients (DS) (n=18; platelet count < 20K) when recovered from infection showing high NEAT1 expression as it observed in healthy donors. By co-expression network analysis and subsequent validation, we revealed that coding gene; IFI27 expression was significantly up-regulated in severe dengue cases and negatively correlated with NEAT1 expression. To discriminate DI from dengue severe, receiver operating characteristic (ROC) curve was calculated. It revealed sensitivity and specificity of 100% (95%CI: 85.69 – 97.22) and area under the curve (AUC) = 0.97 for NEAT1. Conclusions: Altogether, our first observations demonstrate that monitoring NEAT1and IFI27 expression in dengue patients could be useful in understanding dengue virus-induced disease progression and may be involved in pathophysiological processes.Keywords: dengue, lncRNA, NEAT1, transcriptome
Procedia PDF Downloads 3104496 Evaluation of Solid-Gas Separation Efficiency in Natural Gas Cyclones
Authors: W. I. Mazyan, A. Ahmadi, M. Hoorfar
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Objectives/Scope: This paper proposes a mathematical model for calculating the solid-gas separation efficiency in cyclones. This model provides better agreement with experimental results compared to existing mathematical models. Methods: The separation ratio efficiency, ϵsp, is evaluated by calculating the outlet to inlet count ratio. Similar to mathematical derivations in the literature, the inlet and outlet particle count were evaluated based on Eulerian approach. The model also includes the external forces acting on the particle (i.e., centrifugal and drag forces). In addition, the proposed model evaluates the exact length that the particle travels inside the cyclone for the evaluation of number of turns inside the cyclone. The separation efficiency model derivation using Stoke’s law considers the effect of the inlet tangential velocity on the separation performance. In cyclones, the inlet velocity is a very important factor in determining the performance of the cyclone separation. Therefore, the proposed model provides accurate estimation of actual cyclone separation efficiency. Results/Observations/Conclusion: The separation ratio efficiency, ϵsp, is studied to evaluate the performance of the cyclone for particles ranging from 1 microns to 10 microns. The proposed model is compared with the results in the literature. It is shown that the proposed mathematical model indicates an error of 7% between its efficiency and the efficiency obtained from the experimental results for 1 micron particles. At the same time, the proposed model gives the user the flexibility to analyze the separation efficiency at different inlet velocities. Additive Information: The proposed model determines the separation efficiency accurately and could also be used to optimize the separation efficiency of cyclones at low cost through trial and error testing, through dimensional changes to enhance separation and through increasing the particle centrifugal forces. Ultimately, the proposed model provides a powerful tool to optimize and enhance existing cyclones at low cost.Keywords: cyclone efficiency, solid-gas separation, mathematical model, models error comparison
Procedia PDF Downloads 3934495 Beneficial Effect of Biotin in Combination with Canagliflozin on High Fat Diet Induced Diabetes in Rats
Authors: Rayhana Begum, HongBin Wang, Nur Alam Siddiquee, Md.Yasin Ahmed
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Biotin treatment has significant effects on blood glucose, and pharmacological doses of biotin improve hyperglycemia. The present study was aimed to investigate the efficacy and safety of biotin in combination with canagliflozin in improving glycemic control on High Fat Diet-induced diabetes in Rats. Thirty male rats were divided into five groups (six rats /group): control, high fat diet (HFD), canagliflozin (CAG), biotin (BIO), and CAG + BIO. The treatments with CAG and /or BIO significantly reduced the body weight gain, blood glucose and HbA1c levels, whereas CAG in combination with BIO revealed greater glycemic improvement than CAG monotherapy. The treatment with CAG and /or BIO causes significant change in lipid profile and CK level while the treatment with CAG in combination with BIO showed better results as compared with CAG monotherapy. Furthermore, combination of biotin with CAG improved the pancreatic and cardiac damage when compared with other treated groups.Keywords: canagliflozin, biotin, HbA1c, lipid profile
Procedia PDF Downloads 1604494 Exploring the Optimum Temperature and Diet for Growth and Gastric Emptying Time of Juvenile Malabar Blood Snapper (Lutjanus malabaricus)
Authors: Sabuj Kanti Mazumder, Mazlan Abd Ghaffar, Simon Kumar Das
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In this study, we analyzed the effects of water temperature and diet on the growth properties and gastric emptying period of juvenile Malabar blood snapper (Lutjanus malabaricus) over a 30day experimental period. Fish were collected from a local hatchery of Pulau Ketam, Selangor, Malaysia and immediately transferred to flow-through sea water system and subjected to four different temperatures (22, 26, 30, and 34 °C) and two diets (formulated pellet and shrimp). Body weight gain, food consumption, food conversion ratio, food consumption efficiency, specific growth rate, relative growth rate, daily growth rate, and gastric emptying period were significantly influenced by temperature and diet (P<0.05). The best food conversion ratio was with the shrimp group recorded at 30°C (1.33±0.08). The highest growth rate was observed in the shrimp group at 30°C (3.97±0.57% day-1), and the lowest was observed in the formulated pellet group at 22°C (1.63±0.29% day-1). No significant difference was observed between the groups subjected to temperatures of 26 and 30°C. Similarly, the lowest gastric emptying period was detected in the shrimp group at 30°C (16h), where the proportion of meal residues in the stomach decreased from 100% to less than 8% after 12h of starvation. A significantly longer gastric emptying period was observed in the formulated pellet group at 22°C (28h). Overall, the best results were observed on shrimp group subjected to a 30°C temperature. The data obtained from this study suggest that a shrimp diet fed on L. malabaricus at 30°C will optimize the commercial production of this commercially important fish species.Keywords: aquaculture, diet, digestion rate, growth, Malabar blood snapper
Procedia PDF Downloads 2864493 Assessment of Sex Differences in Serum Urea and Creatinine Level in Response to Spinal Cord Injury Using Albino Rat Models
Authors: Waziri B. I., Elkhashab M. M.
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Background: One of the most serious consequences of spinal cord injury (SCI) is progressive deterioration of renal function mostly as a result of urine stasis and ascending infection of the paralyzed bladder. This necessitates for investigation of early changes in serum urea and creatinine and associated sex related differences in response to SCI. Methods: A total of 24 adult albino rats weighing above 150g were divided equally into two groups, a control and experimental group (n = 12) each containing an equal number of male and female rats. The experimental group animals were paralyzed by complete transection of spinal cord below T4 level after deep anesthesia with ketamine 75mg/kg. Blood samples were collected from both groups five days post SCI for analysis. Mean values of serum urea (mmol/L) and creatinine (µmol/L) for both groups were compared. P < 0.05 was considered as significant. Results: The results showed significantly higher levels (P < 0.05) of serum urea and creatinine in the male SCI models with mean values of 92.12 ± 0.98 and 2573 ± 70.97 respectively compared with their controls where the mean values for serum urea and creatinine were 6.31 ± 1.48 and 476. 95 ± 4.67 respectively. In the female SCI models, serum urea 13.11 ± 0.81 and creatinine 519.88 ± 31.13 were not significantly different from that of female controls with serum urea and creatinine levels of 11.71 ± 1.43 and 493.69 ± 17.10 respectively (P > 0.05). Conclusion: Spinal cord injury caused a significant increase in serum Urea and Creatinine levels in the male models compared to the females. This indicated that males might have higher risk of renal dysfunction following SCI.Keywords: albino rats, creatinine, spinal cord injury (SCI), urea
Procedia PDF Downloads 1394492 Leuprolide Induced Scleroderma Renal Crisis: A Case Report
Authors: Nirali Sanghavi, Julia Ash, Amy Wasserman
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Introduction: To the best of our knowledge, there is only one case report that found an association between leuprolide and scleroderma renal crisis (SRC). Leuprolide has been noted to cause acute renal failure in some patients. Given the close timing of the leuprolide injection and the worsening renal function in our patient, leuprolide likely caused exacerbation of lupus nephritis and SRC. Interestingly, our patient on long-term hydroxychloroquine (HCQ) with normal baseline cardiac function was found to have HCQ cardiomyopathy highlighting the need for close monitoring of HCQ toxicity. We know that some of the risk factors that are involved in HCQ induced cardiomyopathy are older age, females, increased dose and >10 years of HCQ use, and pre-existing cardiac and renal insufficiency. Case presentation: A 34-year-old African American woman with a history of overlap of systemic lupus erythematosus (SLE) and scleroderma features and class III lupus nephritis presented with severe headaches, elevated blood pressure (180/120 mmHg) and worsening creatinine levels (2.07 mg/dL). The headaches started 1 month ago after she started leuprolide injections for fibroids. She was being treated with mycophenolate mofetil 1 gm twice a day, belimumab weekly, HCQ 200mg, and prednisone 5 mg daily. She has been on HCQ since her teenage years. The examination was unremarkable except for proximal interphalangeal joint contractures in the right hand and sclerodactyly of bilateral hands, unchanged from baseline. Laboratory findings include urinalysis, which showed 3+ protein, 1+ blood, 6 red blood cells, and 14 white blood cells ruling out thrombotic microangiopathy. C3 was 32 mg/dL, C4 <5 mg/dL, and +dsDNA increased >1000. She was started on captopril and discharged once creatinine and blood pressure was controlled. She was readmitted with hypertension, hyperkalemia, worsening creatinine, nephrotic range proteinuria, complaints of chest pressure, and shortness of breath with pleuritic chest pain. Physical examination and lab findings were unchanged. She was treated with pulse dose methyl prednisone followed by taper and multiple anti-hypertensive agents, including captopril, for presumed lupus nephritis flare versus SRC. Renal biopsy was consistent with SRC and class IV lupus nephritis and was started on cyclophosphamide. While cardiac biopsy showed borderline myocarditis without necrosis and cytoplasmic vacuolization consistent with HCQ cardiomyopathy, hence HCQ was discontinued. Summary: It highlights a rare association of leuprolide causing exacerbation of lupus nephritis or SRC. Although rare, the current case reinforces the importance of close monitoring for HCQ toxicity in patients with renal insufficiency.Keywords: leuprolide, lupus nephritis, scleroderma, SLE
Procedia PDF Downloads 954491 The Dependency of the Solar Based Disinfection on the Microbial Quality of the Source Water
Authors: M. T. Amina, A. A. Alazba, U. Manzoor
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Solar disinfection (SODIS) is a viable method for household water treatment and is recommended by the World Health Organization as cost effective approach that can be used without special skills. The efficiency of both SODIS and solar collector disinfection (SOCODIS) system was evaluated using four different sources of water including stored rainwater, storm water, ground water and treated sewage. Samples with naturally occurring microorganisms were exposed to sunlight for about 8-9 hours in 2-L polyethylene terephthalate bottles under similar experimental conditions. Total coliform (TC), Escherichia coli (E. coli) and heterotrophic plate counts (HPC) were used as microbial water quality indicators for evaluating the disinfection efficiency at different sunlight intensities categorized as weak, mild and strong weathers. Heterotrophic bacteria showed lower inactivation rates compared to E. coli and TC in both SODIS and SOCODIS system. The SOCODIS system at strong weather was the strongest disinfection system in this study and the complete inactivation of HPC was observed after 8-9 hours of exposure with SODIS being ineffective for HPC. At moderate weathers, however, the SOCODIS system did not show complete inactivation of HPC due to very high concentrations (up to 5x10^7 CFU/ml) in both storm water and treated sewage. SODIS even remained ineffective for the complete inactivation of E. coli due to its high concentrations of about 2.5x10^5 in treated sewage compared with other waters even after 8-9 hours of exposure. At weak weather, SODIS was not effective at all while SOCODIS system, though incomplete, showed good disinfection efficiency except for HPC and to some extent for high E. coli concentrations in storm water. Largest reduction of >5 log occurred for TC when used stored rainwater even after 6 hours of exposure in the case of SOCODIS system at strong weather. The lowest E. coli and HPC reduction of ~2 log was observed in SODIS system at weak weather. Further tests with varying pH and turbidity are required to understand the effects of reaction parameters that could be a step forward towards maximizing the disinfection efficiency of such systems for the complete inactivation of naturally occurring E. coli or HPC at moderate or even at weak weathers.Keywords: efficiency, microbial, SODIS, SOCODIS, weathers
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