Search results for: acute liver injury

Authors: Chris Phan, Yong Seok Park

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The Toyota Camry is one of the best-selling cars in America. It is economical, reliable, and most importantly, safe. These attributes allowed the Camry to be the trustworthy choice when choosing dependable vehicle. However, a new finding brought question to the Camry’s safety. Since 1997, the Camry received a “good” rating on its moderate overlap front crash test through the Insurance Institute of Highway Safety. In 2012, the Insurance Institute of Highway Safety introduced a frontal small overlap crash test into the overall evaluation of vehicle occupant safety test. The 2012 Camry received a “poor” rating on this new test, while the 2015 Camry redeemed itself with a “good” rating once again. This study aims to find a possible solution that Toyota implemented to reduce the severity of a frontal small overlap crash in the Camry during a mid-cycle update. The purpose of this study is to analyze and evaluate the performance of various A-pillar shapes as energy absorbing structures in improving passenger safety in a frontal crash. First, A-pillar structures of the 2012 and 2015 Camry were modeled using CAD software, namely SolidWorks. Then, a crash test simulation using ANSYS software, was applied to the A-pillars to analyze the behavior of the structures in similar conditions. Finally, the results were compared to safety values of cabin intrusion to determine the crashworthy behaviors of both A-pillar structures by measuring total deformation. This study highlights that it is possible that Toyota improved the shape of the A-pillar in the 2015 Camry in order to receive a “good” rating from the IIHS safety evaluation once again. These findings can possibly be used to increase safety performance in future vehicles to decrease passenger injury or fatality.

Keywords: A-pillar, Crashworthiness, Design Synthesis, Finite Element Analysis

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Authors: Sweta Pandey, Samridhi Dhyani, Susmita Chaudhuri

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Klebsiella pneumoniae causes a wide range of infections, including urinary tract infections, sepsis, bacteremia, pneumonia, and liver abscesses. The emergence of multi-drug resistance in this bacterium led to a major setback for clinical management. WHO also endorsed a need for finding alternative therapy to antibiotics for the treatment of these infections. Development of vaccines and passive antibody therapy has been proven as a potent alternative to antibiotics in the case of MDR, XDR, and PDR Klebsiella infections. Siderophore receptors have been demonstrated to be overexpressed for the internalization of iron siderophore complexes during infections in most Gram-negative bacteria. For the present study, immune response to siderophore receptors to establish this protein as a potential immunogen for the development of therapeutic leads was explored. Clinical strains of Klebsiella pneumoniae were grown in iron-deficient conditions, and the iron-regulated outer membrane proteins were extracted and characterized through mass spectrometry for specific identification. The gene for identified protein was cloned in pET- 28a vector and expressed in E. coli. The native protein and the recombinant protein were isolated and purified and used as antigens for the generation of immune response in BALB/c mice. The native protein of Klebsiella pneumoniae grown in iron-deficient conditions was identified as FepA (Ferrienterobactin receptor) and other siderophore receptors. This 80 kDa protein generated an immune response in BALB/c mice. The antiserum from mice after subsequent booster doses was collected and showed binding with FepA protein in western blot and phagocytic uptake of the K. pneumoniae in the presence antiserum from immunized mice also observed from the animal studies after bacterial challenge post immunisation in mice have shown bacterial clearance. The antiserum from mice showed binding and clearance of the Klebsiella pneumoniae bacteria in vitro and in vivo. These antigens used for generating an active immune response in mice can further be used for therapeutic monoclonal antibody development against Klebsiella pneumoniae infections.

Keywords: antiserum, FepA, Klebsiella pneumoniae, multi drug resistance, siderophore receptor

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Authors: Youcef Amir

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The consumption of beverages continues to grow worldwide due to increasing demography, but pure fruit juices and high-quality nectars can induce protective effects on human health because of their natural bioactive components. In contrast, sodas and gaseous drinks containing synthetic food additives are considered as responsible for consumers of several pathologies such as obesity, diabetes, and non-alcoholic fatty liver disease. The nutritional and therapeutic virtues of fruit juices are generally a remarkable antioxidant power, anti-cancer activity linked to their richness of indigestible and indigestible sugars, vitamins, mineral salts, carotenoids and phenolic compounds. The main reasons, which led us to produce these fruit derivatives, are the non-availability of the fresh fruits mentioned above all along the year and also the existence of variations in the chemical composition of these different fruits as well as for the major or minor components. We tested, therefore, the physicochemical characteristics of each fruit juice and pulp apart and afterward those of the cocktails formulated. The fresh juices used during our experiments were obtained from the following fruits from north-central Algeria: prickly pear, pomegranate, melon, red oranges. The formulations of these fruit juices were tested after several trials comprising sensorial analysis, physicochemical factors (pH, titratable acidity, Brix degree, formal index, water content, total ash, total and reducing sugars, vitamin C, carotenoids, phenolic compounds) and microbial analysis after a storage period. To the pure juices proportions, citric acid E330, sucrose, and water were added followed by pasteurisation. These products were analysed from the physicochemical, microbial and sensorial viewpoints after a storage period of one month according to national legislation to evaluate their stability. The results of the physicochemical parameters of the prepared beverages had shown good physicochemical results, acceptable sensorial characteristics and microbial stability and safety before and after a storage period. We measured appreciable amounts of minor compounds with health properties.

Keywords: fruit juices, microbial analyses, nectars, physico chemical characteristics, sensorial analysis, storage period

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Authors: Siyabonga Kunene, Calvin Shipley

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Introduction: Despite health benefits that come with running, injuries are common with prevalence ranging between 18.2% and 92.4% worldwide. Differences in gait patterns between barefoot and shod running, can determine traits that could lead to running injuries. The aim was to assess and compare lower limb gait cycle patterns between barefoot and shod running among runners. Methods: An experimental same-subject study design was used. The study population consisted of male and female adult recreational runners who were injury free from a running club in Durban. A convenience sampling method was used and 14 participants were recruited. The study was conducted in the physiotherapy performance laboratory at the University of KwaZulu-Natal. A Woodway Desmo Treadmill and KinePro gait analysis system were used. Descriptive & inferential statistics were analysed using Microsoft Excel and Intercooled Stata. Results: Participants included a greater percentage of females (57.1%, n = 8) than males (42.9%, n = 6). The mean population age was 38.57. A significant difference (p < 0.0009) between barefoot cadence (177.9236steps/min) and shod cadence (171.9445steps/min) was observed. Right (0.261s) and left (0.257s) barefoot stand phase was shorter than right (0.273s) and left (0.270s) shod stand phase. Right barefoot swing phase exhibited less significant (0.420s) results when compared to right shod swing phase (0.427s), whereas left barefoot swing phase was quicker (0.416s) than left shod swing phase (0.432s). Significant differences between barefoot and shod stand (p < 0.009) and swing (p < 0.040) phase symmetry occurred. Conclusion: A considerable difference was found between barefoot and shod running gait cycle patterns among participants. This difference may play a role in prevention of running related injuries.

Keywords: barefoot running, shod running, gait cycle pattern, same-subject study design

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Authors: Vikneswaran Murugaiyah, Sultan Ayesh Mohammed Saghir, Kisantini Murugesu, Mohd. Zaini Asmawi, Amirin Sadikun

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Gynura procumbens is a popular medicinal plant used as a folk medicine in Southeast Asia to treat kidney diseases, diabetes mellitus and hyperlipidemia. The present study aims to investigate the antihyperlipidemic potential of phenolic acids rich fraction (PARF) from G. procumbens in chemically-induced acute and high fat diet-induced chronic hyperlipidemic rats. Ethanolic extract of G. procumbens leaves exhibited significant reductions in total cholesterol (TC) and triglycerides (TG) levels (P < 0.01 and P < 0.001, respectively) of poloxamer 407-induced rats compared to hyperlipidemic control after 58 h of treatment. Upon bioactivity guided fractionation the antihyperlipidemic activity was found to be concentrated in the PARF, which significantly reduced the TC and TG levels (P < 0.001). HPLC analysis revealed that 3,5-dicaffeoylquinic acid; 4,5-dicaffeoylquinic acid and chlorogenic acid are the major compounds in the PARF. Likewise, chlorogenic acid (60 mg/kg) exhibited significant reductions in TC and TG levels of hyperlipidemic rats (P < 0.001). Both chlorogenic acid and PARF significantly reduced LDL, VLDL and atherogenic index (P<0.01), while PARF increased the HDL (P < 0.01) compared to hyperlipidemic control. Both were found to be not cytotoxic against normal and cancer cell lines. In addition, LD50 of orally administered PARF was more than 5,000 mg/kg. Further investigation in high fat diet-induced chronic hyperlipidemic rats revealed that chronic administration of PARF dose-dependently restored the increase in lipids parameters. In summary, the phenolic acids rich fraction of G. procumbens leaves showed promising antihyperlipidemic effect in both chemically- and diet-induced hyperlipidemic rats that warrants further elucidation on its mechanisms of action.

Keywords: Antihyperlipidemic, Gynura procumbens, phenolic acids, chlorogenic acid, poloxamer-407, high fat diet

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Authors: Chih-Chung Huang, Po-Hsun Peng

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Ultrasound transient elastography has become a valuable tool for many clinical diagnoses, such as liver diseases and breast cancer. The pathological tissue can be distinguished by elastography due to its stiffness is different from surrounding normal tissues. An ultrafast frame rate of ultrasound imaging is needed for transient elastography modality. The elastography obtained in the ultrafast system suffers from a low quality for resolution, and affects the robustness of the transient elastography. In order to overcome these problems, a coherent plane wave compounding technique has been proposed for conventional ultrasound system which the operating frequency is around 3-15 MHz. The purpose of this study is to develop a novel beamforming technique for high frequency ultrasound coherent plane-wave compounding imaging and the simulated results will provide the standards for hardware developments. Plane-wave compounding imaging produces a series of low-resolution images, which fires whole elements of an array transducer in one shot with different inclination angles and receives the echoes by conventional beamforming, and compounds them coherently. Simulations of plane-wave compounding image and focused transmit image were performed using Field II. All images were produced by point spread functions (PSFs) and cyst phantoms with a 64-element linear array working at 35MHz center frequency, 55% bandwidth, and pitch of 0.05 mm. The F number is 1.55 in all the simulations. The simulated results of PSFs and cyst phantom which were obtained using single, 17, 43 angles plane wave transmission (angle of each plane wave is separated by 0.75 degree), and focused transmission. The resolution and contrast of image were improved with the number of angles of firing plane wave. The lateral resolutions for different methods were measured by -10 dB lateral beam width. Comparison of the plane-wave compounding image and focused transmit image, both images exhibited the same lateral resolution of 70 um as 37 angles were performed. The lateral resolution can reach 55 um as the plane-wave was compounded 47 angles. All the results show the potential of using high-frequency plane-wave compound imaging for realizing the elastic properties of the microstructure tissue, such as eye, skin and vessel walls in the future.

Keywords: plane wave imaging, high frequency ultrasound, elastography, beamforming

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Authors: Annisa Ulfah Pristya, Andi Setiawan

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Indonesia placed in sixth rank total Acute Respiratory Infection (ARI) patient in the world and Riau as one of the province with the highest number of people with respiratory infection in Indonesia reached 37 thousand people. Usually society using a mask as prevention action. Unfortunately the commercial mouth mask only can work maximum for 4 hours and the pores are too large to filter out microorganisms and viruses carried by infectious droplets nucleated 1-5 μm. On the other hand, Indonesia is rich with Titanium dioxide (TiO2) and purple sweet potato anthocyanin pigment. Therefore, offered Bio-nano-mask which is a antimicrobial and antiviral mouth mask with Nano-TiO2 coating and purple sweet potato anthocyanins utilization as an effective solution to high ARI patients in Riau, which has the advantage of the mask surface can’t be attached by infectious droplets, self-cleaning and have anthocyanins biosensors that give visual response can be understood easily by the general public in the form of a mask color change from blue/purple to pink when acid levels increase. Acid level is an indicator of microorganisms accumulation in the mouth and surrounding areas. Bio-nano mask making process begins with the preparation (design, Nano-TiO2 liquid preparation, anthocyanins biosensors manufacture) and then superimposing the Nano-TiO2 on the outer surface of spunbond color using a sprayer, then superimposing anthocyanins biosensors film on the Meltdown surface, making bio nano-mask and it pack. Bio-nano mask has the advantage is effectively preventing pathogenic microorganisms and infectious droplets and has accumulated indicator microorganisms that color changes which easily observed by the common people though.

Keywords: anthocyanins, ARI, nano-TiO2 liquid, self cleaning

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Authors: Atitallah Sofien, Bouyahia Olfa, Attar Souleima, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Ciliopathies are a spectrum of diseases that have in common a defect in the synthesis of ciliary proteins. It is a rare cause of neonatal cholestasis. Clinical presentation varies extremely, and the main affected organs are the kidneys, liver, and pancreas. Methodology: This is a descriptive case report of a newborn who was admitted for exploration of neonatal cholestasis in the Paediatric Department C at the Children’s Hospital of Tunis, where the investigations concluded with a rare genetic mutation. Results: This is the case of a newborn male with no family history of hepatic and renal diseases, born to consanguineous parents, and from a well-monitored uneventful pregnancy. He developed jaundice on the second day of life, for which he received conventional phototherapy in the neonatal intensive care unit. He was admitted at 15 days for mild bronchiolitis. On clinical examination, intense jaundice was noted with normal stool and urine colour. Initial blood work showed an elevation in conjugated bilirubin and a high gamma-glutamyl transferase level. Transaminases and prothrombin time were normal. Abdominal sonography revealed hepatomegaly, splenomegaly, and undifferentiated renal cortex with bilateral medullar micro-cysts. Kidney function tests were normal. The infant received ursodeoxycholic acid and vitamin therapy. Genetic testing showed a homozygous mutation in the DCDC2 gene that hadn’t been documented before confirming the diagnosis of renal-hepatic ciliopathy. The patient has regular follow-ups, and his conjugated bilirubin and gamma-glutamyl transferase levels have been decreasing. Conclusion: Genetic testing has revolutionized the approach to etiological diagnosis in pediatric cholestasis. It enables personalised treatment strategies to better enhance the quality of life of patients and prevent potential complications following adequate long-term monitoring.

Keywords: cholestasis, newborn, ciliopathy, DCDC2, genetic

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Authors: Angelis P. Barlampas

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Purpose of Learning Objective: This case depicts the need for cooperation between the emergency department and the radiologist to achieve the best diagnostic result for the patient. The clinical picture must correlate well with the radiology report and when it does not, this is not necessarily someone’s fault. Careful interpretation and good knowledge of the limitations, advantages and disadvantages of each imaging procedure are essential for the final diagnostic goal. Methods or Background: A patient was brought to the emergency department by their relatives. He was suddenly confused and his mental status was altered. He hadn't any history of mental illness and was otherwise healthy. A computing tomography scan without contrast was done, but it was unremarkable. Because of high clinical suspicion of probable neurologic disease, he was admitted to the hospital. Results or Findings: Another T was done after 48 hours. It showed a hypodense region in both thalamic areas. Taking into account that the first CT was normal, but the initial clinical picture of the patient was alerting of something wrong, the repetitive CT exam is highly suggestive of a probable diagnosis of bilateral thalamic infractions. Differential diagnosis: Primary bilateral thalamic glioma, Wernicke encephalopathy, osmotic myelinolysis, Fabry disease, Wilson disease, Leigh disease, West Nile encephalitis, Greutzfeldt Jacob disease, top of the basilar syndrome, deep venous thrombosis, mild to moderate cerebral hypotension, posterior reversible encephalopathy syndrome, Neurofibromatosis type 1. Conclusion: As is the case of limitations for any imaging procedure, the same applies to CT. The acute ischemic attack can not depict on CT. A period of 24 to 48 hours has to elapse before any abnormality can be seen. So, despite the fact that there are no obvious findings of an ischemic episode, like paresis or imiparesis, one must be careful not to attribute the patient’s clinical signs to other conditions, such as toxic effects, metabolic disorders, psychiatric symptoms, etc. Further investigation with MRI or at least a repeated CT must be done.

Keywords: CNS, CT, thalamus, emergency department

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Authors: Cody Stolle, Mojdeh Asadollahipajouh, Khaleb Pafford, Jada Iwuoha, Samantha White, Becky Mueller

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Battery-electric vehicles (BEVs) are growing in sales and popularity in the United States as an alternative to traditional internal combustion engine vehicles (ICEVs). BEVs are generally heavier than corresponding models of ICEVs, with large battery packs located beneath the vehicle floorpan, a “skateboard” chassis, and have front and rear crush space available in the trunk and “frunk” or front trunk. The geometrical and frame differences between the vehicles may lead to incompatibilities with gasoline vehicles during vehicle-to-vehicle crashes as well as run-off-road crashes with roadside barriers, which were designed to handle lighter ICEVs with higher centers-of-mass and with dedicated structural chasses. Crash data were collected from 10 states spanning a five-year period between 2017 and 2021. Vehicle Identification Number (VIN) codes were processed with the National Highway Traffic Safety Administration (NHTSA) VIN decoder to extract BEV models from ICEV models. Crashes were filtered to isolate only vehicles produced between 2010 and 2021, and the crash circumstances (weather, time of day, maximum injury) were compared between BEVs and ICEVs. In Washington, 436,613 crashes were identified, which satisfied the selection criteria, and 3,371 of these crashes (0.77%) involved a BEV. The number of crashes which noted a fire were comparable between BEVs and ICEVs of similar model years (0.3% and 0.33%, respectively), and no differences were discernable for the time of day, weather conditions, road geometry, or other prevailing factors (e.g., run-off-road). However, crashes involving BEVs rose rapidly; 31% of all BEV crashes occurred in just 2021. Results indicate that BEVs are performing comparably to ICEVs, and events surrounding BEV crashes are statistically indistinguishable from ICEV crashes.

Keywords: battery-electric vehicles, transportation safety, infrastructure crashworthiness, run-off-road crashes, ev crash data analysis

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Authors: Sibel Karacaoglu, Fatma Ç. Kayapinar

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The aim of the study is to investigate the effect of the core training program on physical fitness characteristics and body composition in male volleyball players. 26 male university volleyball team players aged between 19 to 24 years who had no health problems and injury participated in the study. Subjects were divided into training (TG) and control groups (CG) as randomly. Data from twenty-one players who completed all training sessions were used for statistical analysis (TG,n=11; CG,n=10). A core training program was applied to the training group three days a week for 10 weeks. On the other hand, the control group did not receive any training. Before and after the 10-week training program, pre- and post-testing comprised of body composition measurements (weight, BMI, bioelectrical impedance analysis) and physical fitness measurements including flexibility (sit and reach test), muscle strength (back, leg and grip strength by dynamometer), muscle endurance (sit-ups and push-ups tests), power (one-legged jump and vertical jump tests), speed (20m sprint, 30m sprint) and balance tests (one-legged standing test) were performed. Changes of pre- and post- test values of the groups were determined by using dependent t test. According to the statistical analysis of data, no significant difference was found in terms of body composition in the both groups for pre- and post- test values. In the training group, all physical fitness measurements improved significantly after core training program (p<0.05) except 30m speed and handgrip strength (p>0.05). On the hand, only 20m speed test values improved after post-test period (p<0.05), but the other physical fitness tests values did not differ (p>0.05) between pre- and post- test measurement in the control group. The results of the study suggest that the core training program has positive effect on physical fitness characteristics in male volleyball players.

Keywords: body composition, core training, physical fitness, volleyball

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Authors: Krishnendu Mukhopadhyay, Subhashis Kundu, Mayank Tiwari, Sameeran Pani, Padmapal, Uttam Singh

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Blast Furnace is a counter current process where burden descends from top and hot gases ascend from bottom and chemically reduce iron oxides into liquid hot metal. One of the major problems of blast furnace operation is the erratic burden descent inside furnace. Sometimes this problem is so acute that burden descent stops resulting in Hanging and instability of the furnace. This problem is very frequent in blast furnaces worldwide and results in huge production losses. This situation becomes more adverse when blast furnaces are operated at low coke rate and high coal injection rate with adverse raw materials like high alumina ore and high coke ash. For last three years, H-Blast Furnace Tata Steel was able to reduce coke rate from 450 kg/thm to 350 kg/thm with an increase in coal injection to 200 kg/thm which are close to world benchmarks and expand profitability. To sustain this regime, elimination of irregularities of blast furnace like hanging, channeling, and scaffolding is very essential. In this paper, sustaining of zero hanging spell for consecutive three years with low coke rate operation by improvement in burden characteristics, burden distribution, changes in slag regime, casting practices and adequate automation of the furnace operation has been illustrated. Models have been created to comprehend and upgrade the blast furnace process understanding. A model has been developed to predict the process of maintaining slag viscosity in desired range to attain proper burden permeability. A channeling prediction model has also been developed to understand channeling symptoms so that early actions can be initiated. The models have helped to a great extent in standardizing the control decisions of operators at H-Blast Furnace of Tata Steel, Jamshedpur and thus achieving process stability for last three years.

Keywords: hanging, channelling, blast furnace, coke

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Authors: H. Sebai, M. A. Jabria, D. Wannes, H. Tounsi, L. Marzouki

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We aimed in the present study to investigate the protective effects of Tunisian Rosa canina aqueous extract (RCAE) against ethanol-induced gastric ulceration and oxidative stress in a rat model. In this respect, adult male Wistar rats were used and divided into six groups of ten each: control, EtOH, EtOH plus various doses of RCAE, EtOH plus famotidine and EtOH + gallic acid. Phytochemical and biochemical analysis were performed using colorimetric methods. We found that RCAE is rich in total polyphenols, total flavonoids, and condensed tannins, and exhibited an importance in vitro antioxidant activity on 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical. In vivo, the results showed that oral administration of EtOH caused macroscopic and histological changes in gastric mucosa. These injuries are accompanied by an oxidative stress status as assessed by an increase of lipid peroxidation as well as a decrease of antioxidant enzyme activities such as superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx). Alcohol intoxication also induced intracellular mediators deregulation as assessed by an increase of hydrogen peroxide (H2O2), calcium and free iron levels in gastric mucosa. More, importantly, RCAE pretreatment reversed all macroscopic, histological and biochemical changes induced by EtOH administration. In conclusion, we suggest that RCAE has potent protective effects on acute ethanol-induced gastric ulceration related in part in part its antioxidant properties and its opposite effect on intracellular mediators. Indeed, Rosa canina can be offered as a food additive to protect against alcohol consumption-induced gastric and oxidative damage.

Keywords: alcohol, antioxidant properties, food additive, gastric ulceration, rat model, Rosa canina

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Authors: Shilpa Balan

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Radio Frequency Identification, also popularly known as RFID is used to automatically identify and track tags attached to items. This study focuses on the application of RFID in healthcare. The adoption of RFID in healthcare is a crucial technology to patient safety and inventory management. Data from RFID tags are used to identify the locations of patients and inventory in real time. Medical errors are thought to be a prominent cause of loss of life and injury. The major advantage of RFID application in healthcare industry is the reduction of medical errors. The healthcare industry has generated huge amounts of data. By discovering patterns and trends within the data, big data analytics can help improve patient care and lower healthcare costs. The number of increasing research publications leading to innovations in RFID applications shows the importance of this technology. This study explores the current state of research of RFID in healthcare using a text mining approach. No study has been performed yet on examining the current state of RFID research in healthcare using a data mining approach. In this study, related articles were collected on RFID from healthcare journal and news articles. Articles collected were from the year 2000 to 2015. Significant keywords on the topic of focus are identified and analyzed using open source data analytics software such as Rapid Miner. These analytical tools help extract pertinent information from massive volumes of data. It is seen that the main benefits of adopting RFID technology in healthcare include tracking medicines and equipment, upholding patient safety, and security improvement. The real-time tracking features of RFID allows for enhanced supply chain management. By productively using big data, healthcare organizations can gain significant benefits. Big data analytics in healthcare enables improved decisions by extracting insights from large volumes of data.

Keywords: RFID, data mining, data analysis, healthcare

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Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba

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Introduction: Despite the development of technologies and improvements in the interior of dialysis stations, dialysis remains an unpleasant procedure, difficult to accept by the patients (who undergo it 2 to 3 times a week, a single treatment lasting several hours). Haemodialysis is one of the renal replacement therapies, in Poland most commonly used in patients with chronic or acute kidney failure. Purpose: An attempt was made to evaluate the quality of life in haemodialysed patients using the WHOQOL-BREF questionnaire. Material and methods: The study covered 422 patients (200 women and 222 men, aged 60.5 ± 12.9 years) undergoing dialysis at three selected stations in Poland. The patients were divided into 2 groups, depending on the duration of their dialysis treatment. The evaluation was conducted with the WHOQOL-BREF questionnaire containing 26 questions analysing 4 areas of life, as well as the perception of the quality of life and health self-assessment. A 5-point scale is used to answer them. The maximum score in each area is 20 points. The results in individual areas have a positive direction. Results: In patients undergoing dialysis for more than 3 years, a reduction in the quality of life was found in the physical area and in their environment versus a group of patients undergoing dialysis for less than 3 years, where a reduced quality of life was found in the areas of social relations and mental well-being (p < 0.05). A significant correlation (p < 0.01) between the two groups was found in self-perceived general health, while no significant differences were observed in the general perception of the quality of life (p > 0.05). Conclusions: The study confirmed that in patients undergoing dialysis for more than three years, the quality of life is especially reduced in their environment (access to and quality of healthcare, financial resources, and mental and physical safety). The assessment of the quality of life should form a part of the therapeutic process, in which the role of the patient in chronic renal care should be emphasised, reflected in the quality of services provided by dialysis stations.

Keywords: haemodialysis, perception of quality of life, quality of services provided, dialysis station

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Authors: Kinga Zebrowska, Maria Falis, Katarzyna Kosinska-Kaczynska, Bartosz Godek, Olga Plaza, Katarzyna Kwiatkowska

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Introduction: According to the ministerial decree of 16 August 2018, each woman in Poland during childbirth has the right to the pharmacological and non-pharmacological labour pain management (LPM). Aim: The aim of the study was to assess the knowledge of Polish mothers about pharmacological and non-pharmacological LPM, to investigate which methods they chose and their satisfaction with chosen ones. Material And Methods: A prospective cross-sectional study was performed among women who gave birth between 2015 and 2018. The self-composed questionnaire was distributed via the Internet in October 2018. Results: 13.727 women participated in the study. 75% have learned about LPM from the Internet. 68% of them did not gain any information on LPM from doctors during their prenatal appointments Safety of the newborn (46%), midwife’s advice (40%) and the chance of the immediate pain relief (39%) were the most important issues while choosing LPM. Respondents used a wide range of non-pharmacological methods, such as the assistance of partner during labour (81%), physical activity (58%), immersion in water (37%), relaxation techniques (15%) and others. 11% of mothers did not use any of the LPM methods. 52% of women declared that they wanted to use the pharmacological anaesthesia, while 49% had it performed (28% epidural, 16% inhaled anaesthesia, 5% parenteral opioids). Pharmacological methods were unavailable due to lack of anaesthesiologist in the maternity ward (41%) or inaccessibility of the chosen methods in the hospital (31%) and too advanced labour (43%). 48% of respondents did not decide to use pharmacological methods, because the pain was bearable (29%), anxiety of child’s health (17%), or belief that the pain is natural and it should not be avoided (16%). 83% of respondents believed that epidural analgesia has no influence on the time needed to gain a full cervix dilatation and 81% of them claimed that serious spinal cord injury is a common side effect of epidural. 51% believed that epidural increases the risk of caesarean section. Conclusions: The knowledge about the methods of LPM is not satisfactory. We should focus on well- maintained education guided by doctors, midwives, and media.

Keywords: childbirth, labour pain management, maternity experiences, obstetrics

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Authors: Sameer A. Pathan, Biswadev Mitra, Zain A. Bhutta, Isma Qureshi, Elle Spencer, Asmaa A. Hameed, Sana Nadeem, Ramsha Tahir, Shahzad Anjum, Peter A. Cameron

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Background: This study aimed to compare epidemiology, clinical presentations, management and outcomes of renal colic presentations in two major academic centers and discuss potential implications of these results for the applicability of current evidence in the management of renal colic. Methods: We undertook a retrospective cohort study of patients with renal colic who presented to the Hamad General Hospital Emergency Department (HGH-ED), Qatar, and The Alfred ED, Melbourne, Australia, during a period of one year from August 1, 2012, to July 3, 2013. Cases were identified using ICD-9-CM codes, and an electronic template was used to record the data on predefined clinical variables. Results: A total of 12,223 from the HGH-ED and 384 from The Alfred ED were identified as renal colic presentations during the study period. The rate of renal colic presentations at the HGH-ED was 27.9 per 1000 ED visits compared to 6.7 per 1000 ED visits at The Alfred ED. Patients presenting to the HGH-ED were significantly younger [34.9 years (29.0- 43.4) than The Alfred ED [48 years (37-60); P < 0.001]. The median stone size was larger in the HGH-ED group [6 (4-8) mm] versus The Alfred ED group [4 (3-6) mm, P < 0.001]. The intervention rate in the stone-positive population was significantly higher in the HGH-ED group as opposed to The Alfred ED group (38.7% versus 11.9%, p<0.001). At the time of discharge, The Alfred ED group received less analgesic prescriptions (55.8% versus 83.5%, P < 0.001) and more tamsulosin prescriptions (25.3% versus 11.7%, P < 0.001). Conclusions: Renal colic presentations to the HGH-ED, Qatar, were younger, with larger stone size, compared to The Alfred ED, whereas, medical expulsion therapy use was higher at the Alfred ED. Differences in epidemiology should be considered while tailoring strategies for effective management of patients with renal colic in the given setting.

Keywords: kidney stones, urolithiasis, nephrolithiasis, renal colic, epidemiology

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Authors: Ali Ayatic, Emad Mozaffari, Bahareh Tanhaei, Maryam Khajenoori, Saeedeh Movaghar Khoshkho, Ali Ayati

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The abuse of antibiotics, such as tetracycline (TC), is a great global threat to people and the use of topical antibiotics is a promising tact that can help to solve this problem. Antibiotic therapy is often appropriate and necessary for acute wound infections, while topical tetracycline can be highly efficient in improving the wound healing process in diabetics. Due to the advantages of drug-loaded hydrogels as wound dressing, such as ease of handling, high moisture resistance, excellent biocompatibility, and the ability to activate immune cells to speed wound healing, it was found as an ideal wound treatment. In this work, the tetracycline-loaded hydrogels combining agar (AG) and κ-carrageenan (k-CAR) as polymer materials were prepared, in which span60 surfactant was introduced inside as a drug carrier. The Field Emission Scanning Electron Microscopes (FESEM) and Fourier-transform infrared spectroscopy (FTIR) techniques were employed to provide detailed information on the morphology, composition, and structure of fabricated drug-loaded hydrogels and their mechanical properties, and hydrogel permeability to water vapor was investigated as well. Two types of gram-negative and gram-positive bacteria were used to explore the antibacterial properties of prepared tetracycline-contained hydrogels. Their swelling and drug release behavior was studied using the changing factors such as the ratio of polysaccharides (MAG/MCAR), the span60 surfactant concentration, potassium chloride (KCl) concentration and different release media (deionized water (DW), phosphate-buffered saline (PBS), and simulated wound fluid (SWF)) at different times. Finally, the kinetic behavior of hydrogel swelling was studied. Also, the experimental data of TC release to DW, PBS, and SWF using various mathematical models such as Higuchi, Korsmeyer-Peppas, zero-order, and first-order in the linear and nonlinear modes were evaluated.

Keywords: drug release, hydrogel, tetracycline, wound healing

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Authors: Hamidreza Hoshyarmanesh, Sanju Lama, Garnette R. Sutherland

Abstract:

In tele-operative robotic surgery, an ideal haptic device should be equipped with an intuitive and smooth end-effector to cover the surgeon’s hand/wrist degrees of freedom (DOF) and translate the hand joint motions to the end-effector of the remote manipulator with low effort and high level of comfort. This research introduces the design and development of a microsurgery-specific end-effector, a gimbal mechanism possessing 4 passive and 1 active DOFs, equipped with a bipolar forceps and haptic feedback. The robust gimbal structure is comprised of three light-weight links/joint, pitch, yaw, and roll, each consisting of low-friction support and a 2-channel accurate optical position sensor. The third link, which provides the tool roll, was specifically designed to grip the tool prongs and accommodate a low mass geared actuator together with a miniaturized capstan-rope mechanism. The actuator is able to generate delicate torques, using a threaded cylindrical capstan, to emulate the sense of pinch/coagulation during conventional microsurgery. While the tool left prong is fixed to the rolling link, the right prong bears a miniaturized drum sector with a large diameter to expand the force scale and resolution. The drum transmits the actuator output torque to the right prong and generates haptic force feedback at the tool level. The tool is also equipped with a hall-effect sensor and magnet bar installed vis-à-vis on the inner side of the two prongs to measure the tooltip distance and provide an analogue signal to the control system. We believe that such a haptic end-effector could significantly increase the accuracy of telerobotic surgery and help avoid high forces that are known to cause bleeding/injury.

Keywords: end-effector, force generation, haptic interface, robotic surgery, surgical tool, tele-operation

Procedia PDF Downloads 118

Authors: Farzaneh Tahmoorian, Bijan Samali, John Yeaman

Abstract:

Road networks are expanding all over the world during the past few decades to meet the increasing freight volumes created by the population growth and industrial development. At the same time, the rate of generation of solid wastes in the society is increasing with the population growth, technological development, and changes in the lifestyle of people. Thus, the management of solid wastes has become an acute problem. Accordingly, there is a need for greater efficiency in the construction and maintenance of road networks, in reducing the overall cost, especially the utilization of natural materials such as aggregates. An efficient means to reduce construction and maintenance costs of road networks is to replace natural (virgin) materials by secondary, recycled materials. Recycling will also help to reduce pressure on landfills and demand for extraction of natural virgin materials thus ensuring sustainability. Application of solid wastes in asphalt layer reduces not only environmental issues associated with waste disposal but also the demand for virgin materials which will subsequently result in sustainability. Therefore, this research aims to investigate the feasibility of the application of some of the waste materials such as glass, construction and demolition wastes, etc. as alternative materials in pavement construction, particularly flexible pavements. To this end, various combination of different waste materials in certain percentages is considered in designing the asphalt mixture. One of the goals of this research is to determine the optimum percentage of all these materials in the mixture. This is done through a series of tests to evaluate the volumetric properties and resilient modulus of the mixture. The information and data collected from these tests are used to select the adequate samples for further assessment through advanced tests such as triaxial dynamic test and fatigue test, in order to investigate the asphalt mixture resistance to permanent deformation and also cracking. This paper presents the results of these investigations on the application of waste materials in asphalt mixture for production of a sustainable asphalt mix.

Keywords: asphalt, glass, pavement, recycled aggregate, sustainability

Procedia PDF Downloads 236

Authors: Julie Connelly, Tanvi Toprani, Xin Xie, Dhinoth Kumar Bangarusamy, Kris C. Gunsalus

Abstract:

The overuse of antibiotics worldwide has contributed to the development of multi-drug resistant (MDR) pathogenic bacterial strains. There is an increasing urgency to discover antibiotics to combat MDR pathogens. The microbiome of the Arabian Gulf is a largely unexplored and potentially rich source of novel bioactive compounds. Microbes that inhabit the Abu Dhabi coastal regions adapt to extreme environments with high salinity, hot temperatures, large temperature fluctuations, and acute exposure to solar energy. The microbes native to this region may produce unique metabolites with therapeutic potential as antibiotics and antifungals. We have isolated 200 pure bacterial strains from mangrove sediments, cyanobacterial mats, and coral reefs of the Abu Dhabi region. In this project, we aim to screen the marine bacterial strains to identify antibiotics, in particular undocumented compounds that show activity against existing antibiotic-resistant strains. We have acquired the ESKAPE pathogen panel, which consists of six antibiotic-resistant gram-positive and gram-negative bacterial pathogens that collectively cause most clinical infections. Our initial efforts of the primary screen using colony-picking co-culture assay have identified several candidate marine strains producing potential antibiotic compounds. We will next apply different assays, including disk-diffusion and broth turbidity growth assay, to confirm the results. This will be followed by bioactivity-guided purification and characterization of target compounds from the scaled-up volume of candidate strains, including SPE fraction, HPLC fraction, LC-MS, and NMR. For antimicrobial compounds with unknown structures, our final goal is to investigate their mode of action by identifying the molecular target.

Keywords: marine bacteria, natural products, drug discovery, ESKAPE panel

Procedia PDF Downloads 75

Authors: Marta Skwarecka, Patrycja Bloch, Rafal Walkusz, Oliwia Urbanowicz, Grzegorz Zielinski, Sabina Zoledowska, Dawid Nidzworski

Abstract:

Upper respiratory tract infections are one of the most common reasons for visiting a general doctor. Streptococci are the most common bacterial etiological factors in these infections. There are many different types of Streptococci and infections vary in severity from mild throat infections to pneumonia. For example, S. pyogenes mainly contributes to acute pharyngitis, palatine tonsils and scarlet fever, whereas S. Streptococcus pneumoniae is responsible for several invasive diseases like sepsis, meningitis or pneumonia with high mortality and dangerous complications. There are only a few diagnostic tests designed for detection Streptococci from the infected throat of patients. However, they are mostly based on lateral flow techniques, and they are not used as a standard due to their low sensitivity. The diagnostic standard is to culture patients throat swab on semi selective media in order to multiply pure etiological agent of infection and subsequently to perform antibiogram, which takes several days from the patients visit in the clinic. Therefore, the aim of our studies is to develop and implement to the market a Point of Care device for the rapid identification of Streptococcus pyogenes and Streptococcus pneumoniae with simultaneous identification of antibiotic resistance genes. In the course of our research, we successfully selected genes for to-species identification of Streptococci and genes encoding antibiotic resistance proteins. We have developed a reaction to amplify these genes, which allows detecting the presence of S. pyogenes or S. pneumoniae followed by testing their resistance to erythromycin, chloramphenicol and tetracycline. What is more, the detection of β-lactamase-encoding genes that could protect Streptococci against antibiotics from the ampicillin group, which are widely used in the treatment of this type of infection is also developed. The test is carried out directly from the patients' swab, and the results are available after 20 to 30 minutes after sample subjection, which could be performed during the medical visit.

Keywords: antibiotic resistance, Streptococci, respiratory infections, diagnostic test

Procedia PDF Downloads 129

Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee

Abstract:

Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.

Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis

Procedia PDF Downloads 130

Authors: Piotr Muzyk, Beata Morawiec, Mariusz Opara, Andrzej Tomasik, Brygida Przywara-Chowaniec, Wojciech Jachec, Ewa Nowalany-Kozielska, Damian Kawecki

Abstract:

Background: Coronary bifurcation is one of the most complex lesion in patients with coronary ar-tery disease. Provisional T-stenting is currently one of the recommended techniques. The aim was to assess optimal methods of treatment in the era of drug-eluting stents (DES). Methods: The regis-try consisted of data from 1916 patients treated with coronary percutaneous interventions (PCI) using either first- or second-generation DES. Patients with bifurcation lesion entered the analysis. Major adverse cardiac and cardiovascular events (MACCE) were assessed at one year of follow-up and comprised of death, acute myocardial infarction (AMI), repeated PCI (re-PCI) of target ves-sel and stroke. Results: Of 1916 registry patients, 204 patients (11%) were diagnosed with bifurcation lesion >50% and entered the analysis. The most commonly used technique was provi-sional T-stenting (141 patients, 69%). Optimization with kissing-balloons technique was performed in 45 patients (22%). In 59 patients (29%) second-generation DES was implanted, while in 112 pa-tients (55%), first-generation DES was used. In 33 patients (16%) both types of DES were used. The procedure success rate (TIMI 3 flow) was achieved in 98% of patients. In one-year follow-up, there were 39 MACCE (19%) (9 deaths, 17 AMI, 16 re-PCI and 5 strokes). Provisional T-stenting resulted in similar rate of MACCE to other techniques (16% vs. 5%, p=0.27) and similar occurrence of re-PCI (6% vs. 2%, p=0.78). The results of post-PCI kissing-balloon technique gave equal out-comes with 3% vs. 16% of MACCE in patients in whom no optimization technique was used (p=0.39). The type of implanted DES (second- vs. first-generation) had no influence on MACCE (4% vs 14%, respectively, p=0.12) and re-PCI (1.7% vs. 51% patients, respectively, p=0.28). Con-clusions: The treatment of bifurcation lesions with PCI represent high-risk procedures with high rate of MACCE. Stenting technique, optimization of PCI and the generation of implanted stent should be personalized for each case to balance risk of the procedure. In this setting, the operator experience might be the factor of better outcome, which should be further investigated.

Keywords: coronary bifurcation, drug eluting stents, long-term follow-up, percutaneous coronary interventions

Procedia PDF Downloads 204

Authors: Sahar M. El-Gowilly, Mai M. Helmy, Hanan M. El-Gowelli

Abstract:

Methotrexate (MTX) is widely used in treatment of cancers and autoimmune diseases. However, nephrotoxicity is one of the most important side effects of MTX. The peroxisome proliferator-activated receptor gamma agonist, pioglitazone (PIO), is known to exert anti-inflammatory and reno-protective effects in various kidney injuries. The purpose of this study was to investigate the potential involvement of endothelial damage in MTX-induced renal injury and to elaborate the possible protective effect of PIO against MTX-induced nephropathy. Compared with saline-treated rats, treatment with MTX (7 mg/kg for 3 day) caused significant elevations in serum levels of urea and creatinine, increased renal nitrate/nitrite level and impaired renovascular responsiveness of isolated perfused kidney to endothelium-dependent vasodilations induced by acetylcholine (0.01-2.43 nmol) and isoprenaline (1µmol). These effects were abolished by concurrent treatment with PIO (2.5 mg/kg, for 5 days starting two days before MTX). Alternatively, MTX treatment did not affect endothelium-independent renovascular relaxation induced by sodium nitroprusside (1-30 μmole). The possibility that alterations in renal antioxidants, circulating cytokine and apoptotic factor (Fas) levels contributed to MTX-PIO interaction was assessed. PIO treatment abrogated renal oxidative stress (decreased reduced glutathione and catalase activity and increased malondialdehyde), elevated serum cytokine (interleukin-6, interleukin-10, tumor necrosis factor-alpha and transforming growth factor-beta1) and Fas induced by MTX. Histologically, MTX caused defused tubular cells swelling and vacuolization associated with endothelial damage in renal arterioles. These effects disappeared upon co-treated with PIO. Collectively, PIO abolished MTX-induced endothelium dysfunction and nephrotoxicity via ameliorating oxidative stress and rectifying cytokines and Fas abnormalities caused by MTX.

Keywords: methotrexate, pioglitazone, endothelium, kidney

Procedia PDF Downloads 312

Authors: Matthew Lee Turnbough

Abstract:

In 2007 Spain began to experience the effects of a deep economic crisis, which would generate a situation characterised by instability and uncertainty. This has been an obstacle, especially acute for the youth of this country seeking to enter the workforce. As a result of the impact of COVID-19, the youth in Spain are now suffering the effects of a new crisis that has deepened an already fragile labour environment. In this paper, we analyse the discourses that have emerged from a precarious labour market, specifically from two companies dedicated to operating job portals and job listings in Spain, Job Today, and CornerJob. These two start-up businesses have developed mobile applications geared towards young adults in search of employment in the service sector, two of the companies with the highest user rates in Spain. Utilizing a discourse analysis approach, we explore the impact of individualization and how the process of psychologization may contribute to an increasing reliance on individual solutions to social problems. As such, we seek to highlight the expectations and demands that are placed upon young workers and the type of subjectivity that this dynamic could foster, all this within an unstable framework seemingly marked by chance, a context which is key for the emergence of individualization. Furthermore, we consider the extent to which young adults incorporate these discourses and the strategies they employ basing our analysis on the VULSOCU (New Forms of Socio-Existential Vulnerability, Supports, and Care in Spain) research project, specifically the results of nineteen in-depth interviews and three discussion groups with young adults in this country. Consequently, we seek to elucidate the argumentative threads rooted in the process of individualization and underline the implications of this dynamic for the young worker and his/her labour insertion while also identifying manifestations of the goddess of fortune as a representation of chance in this context. Finally, we approach this panorama of social change in Spain from the perspective of the individuals or young adults who find themselves immersed in this transition from one crisis to another.

Keywords: chance, crisis, discourses, individualization, work, youth

Procedia PDF Downloads 117

Authors: Reham Hajomer, Ikram Elsiddig, Amna Hamad

Abstract:

Lepidium sativum (Garden Cress) belonging to Brassicaceae family is an annual herb locally known as El-rshad. In Ayurveda it is an important medicinal plant, traditionally used for the treatment of jaundice, liver problems, spleen diseases, gastrointestinal disorders, menstrual problems, fracture, arthritis, inflammatory conditions and for treatment of hypothyroidism. Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormones (Triiodithyronine T3 and Thyroxine T4) which are commonly caused by iodine deficiency. It’s divided into primary and secondary hypothyroidism, the primary caused by failure of thyroid function and secondary due to the failure of adequate thyroid-stimulating hormone (TSH) secretion from the pituitary gland or thyroid -releasing hormone (TRH) from the hypothalamus. The disease is most common in women over age 60. The objective regarding this study is to know whether Lepidium sativum would affect the level of thyroid hormones. The extract was prepared with 96% ethanol using Soxhlet apparatus. The anti-hypothyroidism activity was tested by using thirty male Wistar rats weighing (100-140 g) were used in the experiment. They were grouping into five groups, Group 1: Normal group= Administered only distilled water. Then 10 mg/kg Propylthiouracil was added to the drinking water of all other groups to induce hypothyroidism. Group 2: Negative control without any treatment; Group 3: Test group= treated with oral administration of 500mg/kg extract; Group 4: treated with oral administration of 250mg/kg of the extract; Group 5: Standard group (positive control) = treated with intraperitoneal Levothyroxine. All rats were incubated for 20 days at animal house with room temperature of proper ventilation provided with standard diet. The result show that the Lepidium sativum extract was found to increases the T3 and T4 in the propylthiouracil induced rats with values (0.29 ng/dl T3 and 0.57 U T4) for the 500mg/kg and (0.27 ng/dl T3 and 0.517 U T4) for the 250mg/kg in comparison with standard with values (0.241 ng/dl T3 and 0.516 U T4) so that Lepidium sativum can be stimulatory to thyroid function and possess significant anti-hypothyroidism effect with p-values ranges from (0.000006*-0.893472). In conclusion, from results obtained, Lepidium sativum plant extract was found to posses anti-hypothyroidism effects so its act as an agent that stimulates thyroid hormone secretion.

Keywords: anti-hypothyroidism, extract, lepidium, sativum

Procedia PDF Downloads 205

Authors: Sahar M. El-Gowilly, Mai M. Helmy, Hanan M. El-Gowelli

Abstract:

Methotrexate (MTX) is widely used in treatment of cancers and autoimmune diseases. However, nephrotoxicity is one of its most important side effects. The peroxisome proliferator-activated receptor gamma agonist, pioglitazone, is known to exert antiinflammatory and reno-protective effects in various kidney injuries. The purpose of this study was to investigate the potential involvement of endothelial damage in MTX-induced renal injury and to elaborate the possible protective effect of pioglitazone against MTX-induced endothelial impairment. Compared with saline-treated rats, treatment with MTX (7 mg/kg for 3 day) caused significant elevations in serum levels of urea and creatinine, increased renal nitrate/nitrite level and impaired renovascular responsiveness of isolated perfused kidney to endothelium-dependent vasodilations induced by acetylcholine (0.01-2.43 nmol) and isoprenaline (1µmol). These effects were abolished by concurrent treatment with pioglitazone (2.5 mg/kg, for 5 days starting two days before MTX). Alternatively, MTX treatment did not affect endothelium-independent renovascular relaxation induced by sodium nitroprusside (0.001-10 μmole). The possibility that alterations in renal antioxidants, circulating cytokine and apoptotic factor (Fas) levels contributed to MTX-pioglitazone interaction was assessed. Pioglitazone treatment abrogated renal oxidative stress (decreased reduced glutathione and catalase activity and increased malondialdehyde), elevated serum cytokine (interleukin-6, interleukin-10, tumor necrosis factor-alpha and transforming growth factor-beta1) and Fas induced by MTX. Histologically, MTX caused defused tubular cells swelling and vacuolization associated with endothelial damage in renal arterioles. These effects disappeared upon co-treated with pioglitazone. Collectively, pioglitazone abolished MTX-induced endothelium dysfunction and nephrotoxicity via ameliorating oxidative stress and rectifying cytokines and Fas abnormalities caused by MTX.

Keywords: methotrexate, pioglitazone, endothelium, kidney

Procedia PDF Downloads 500

Authors: Zahra Abdi, Roghayeh Alipour, Babak Farahi Ghasraboonasr

Abstract:

Introduction: Diabetes is a serious medical condition that requires constant care. People with type 2 diabetes may also be likely to experience dry, itchy skin and poor wound healing. Some people with diabetes will have a skin problems at some time in their lives and for those not yet diagnosed with diabetes, a skin problem can be an indication of the disease. our purpose was to assess the capability and knowledge of students of Shiraz University of Medical Sciences about prevent from skin complications in diabetes type 2. Methods: In this descriptive cross-sectional study, knowledge of 360 students of Shiraz University of Medical Sciences was evaluated about different ways to avoid skin complications in diabetes type 2. Data were analyzed by spss19.(P<0.05) was considered significant. Results: 360 students of Shiraz University of Medical Sciences participated in this study. 45% of students agree with the effect of Moisturize skin daily, If Diabetics have sensitive skin, choose a fragrance-free, dye-free moisturizer that won’t irritate skin. 52% believe that Protect skin from sun can be so useful, Sun exposure is drying and aging. Use sunscreen with SPF 30 or higher whenever you’re outside. Wear gloves when doing yardwork to protect the skin on your hands. 62% of students strongly agree with Carefully clean any cuts and scrapes, If diabetics notice any sign of infection skin that’s red, swollen, or warm to the touch, or has a foul-smelling drainage or pus should consulting with a doctor immediately. Diabetics should be careful about any injury that takes longer than normal to heal and they should consulting with doctor about them too. 72% of students believe that diabetics should be diligent about daily foot care. Clean and moisturize feet each day and check each foot closely, top and bottom, for wounds even a tiny cut, blisters, or cracked skin. Conclusions: The risk of getting these diabetes complications can be lessened by controlling blood sugar. Skin complications can cause serious consequences. Taking care of skin is so important and using these tips are remarkable effective and help diabetics to look after their skin easier.

Keywords: skin complications, diabetes type 2, Shiraz University of Medical Sciences, diabetics

Procedia PDF Downloads 355

Authors: Ratnakar Rao, Subair Khan, Hari Haran

Abstract:

Posterior cruciate ligament (PCL) avulsion fractures is a rare condition and commonly mismanaged.Surgical reattachment has been shown to produce better result compared with conservative management.Only few techniques are reported in arthroscopic fixation of PCL Avulsion Fracture and they are complex.We describe a new technique in fixation of the PCL Avulsion fracture through a posterior trans septal portal using button fixation device (Mini Tight Rope). Eighteen patients with an isolated posterior cruciate ligament avulsion fracture were operated under arthroscopy. Standard Antero Medial Portal and Antero Lateral portals made and additional Postero Medial and Postero Lateral portals made and trans Septal portal established. Avulsion fracture identified, elevated, prepared. Reduction achieved using PCL Tibial guide (Arthrex) and fixation was achieved using Mini Tight Rope,Arthrex (2 buttons with a suture). Reduction confirmed using probe and Image intensifier. Postoperative assessment made clinically and radiologically. 15 patients had good to excellent results with no posterior sag or instability. The range of motion was normal. No complications were recorded per operatively. 2 patients had communition of the fragment while drilling, for one patient it was managed by suturing technique and the second patient PCL Reconstruction was done. One patient had persistent instability with poor outcome. Establishing trans septal portal helps in better visualization of the posterior compartment of the knee. Assessment of the bony fragment, preparation 0f the bone bed andit protects from injury to posterior neurovascular structures. Fixation using the button with suture (Mini Tight Rope) is stable and easily reproducible for PCL Avulsion fracture with single large fragment.

Keywords: PCL avulsion, arthroscopy, transeptal, minitight rope technique

Procedia PDF Downloads 258