Search results for: blood parameter
Commenced in January 2007
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Edition: International
Paper Count: 4441

Search results for: blood parameter

4231 A Retrospective Cross Sectional Study of Blood Culture Results in a Tertiary Hospital, Ekiti, Nigeria

Authors: S. I. Nwadioha, M. S. Odimayo, J. A. Omotayo, A. Olu Taiwo, O. E. Olabiyi

Abstract:

The current study was conducted to determine the epidemiology and antibiotic sensitivity pattern of bacteria isolated from blood of septicemic patients for improved antibiotic therapy. A three-year descriptive study has been carried out at Microbiology Laboratory, Ekiti State University Teaching Hospital, Ado Ekiti, from April 2012 to April 2015. Information compiled from patients’ records includes age, sex, isolated organisms and antibiotic susceptibility patterns. Three hundred and thirteen blood cultures were collected from neonatology and pediatrics wards, Out Patients’ Department (OPD) and from other adult patients. Forty-one cultures yielded mono microbial growth (no polymicrobial growth), giving an incidence of 13.1% positive blood culture (N=41/313). There were 58.4% Gram-negative bacilli and 41.6% Gram-positive cocci in the microbial growth. Bacteria isolated were Staphylococcus aureus 34%(14/41), Klebsiella species22% (9/41), Enterococci 17%(7/41), Proteus species12%(5/41), Escherichia coli 7%(3/41) and Streptococcal pneumoniae 7%(3/41). There was a (35%) higher occurrence of septicemia in neonates than in any other age groups in the hospital. Bacterial sensitivity to 13 antibiotic agents was determined by antibiotics disc diffusion using modified Kirby Bauer’s method. Gram-positive organisms showed a higher antibiotic sensitivity ranging from 14- 100% than the Gram-negative bacteria (11-80%). Staphylococcus aureus and Klebsiella species are the most prevalent organisms. The third generation Cephalosporins (Ceftriaxone) and Floroquinolone(Levofloxacin, Ofloxacin) have proved reliable for management of these blood infections.

Keywords: blood cultures, septicemia, antibiogram, Nigeria

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4230 Degradation Kinetics of Cardiovascular Implants Employing Full Blood and Extra-Corporeal Circulation Principles: Mimicking the Human Circulation In vitro

Authors: Sara R. Knigge, Sugat R. Tuladhar, Hans-Klaus HöFfler, Tobias Schilling, Tim Kaufeld, Axel Haverich

Abstract:

Tissue engineered (TE) heart valves based on degradable electrospun fiber scaffold represent a promising approach to overcome the known limitations of mechanical or biological prostheses. But the mechanical stress in the high-pressure system of the human circulation is a severe challenge for the delicate materials. Hence, the prediction of the scaffolds` in vivo degradation kinetics must be as accurate as possible to prevent fatal events in future animal or even clinical trials. Therefore, this study investigates whether long-term testing in full blood provides more meaningful results regarding the degradation behavior than conventional tests in simulated body fluids (SBF) or Phosphate Buffered Saline (PBS). Fiber mats were produced from a polycaprolactone (PCL)/tetrafluoroethylene solution by electrospinning. The morphology of the fiber mats was characterized via scanning electron microscopy (SEM). A maximum physiological degradation environment utilizing a test set-up with porcine full blood was established. The set-up consists of a reaction vessel, an oxygenator unit, and a roller pump. The blood parameters (pO2, pCO2, temperature, and pH) were monitored with an online test system. All tests were also carried out in the test circuit with SBF and PBS to compare conventional degradation media with the novel full blood setting. The polymer's degradation is quantified by SEM picture analysis, differential scanning calorimetry (DSC), and Raman spectroscopy. Tensile and cyclic loading tests were performed to evaluate the mechanical integrity of the scaffold. Preliminary results indicate that PCL degraded slower in full blood than in SBF and PBS. The uptake of water is more pronounced in the full blood group. Also, PCL preserved its mechanical integrity longer when degraded in full blood. Protein absorption increased during the degradation process. Red blood cells, platelets, and their aggregates adhered on the PCL. Presumably, the degradation led to a more hydrophilic polymeric surface which promoted the protein adsorption and the blood cell adhesion. Testing degradable implants in full blood allows for developing more reliable scaffold materials in the future. Material tests in small and large animal trials thereby can be focused on testing candidates that have proven to function well in an in-vivo-like setting.

Keywords: Electrospun scaffold, full blood degradation test, long-term polymer degradation, tissue engineered aortic heart valve

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4229 Parameter Estimation of Gumbel Distribution with Maximum-Likelihood Based on Broyden Fletcher Goldfarb Shanno Quasi-Newton

Authors: Dewi Retno Sari Saputro, Purnami Widyaningsih, Hendrika Handayani

Abstract:

Extreme data on an observation can occur due to unusual circumstances in the observation. The data can provide important information that can’t be provided by other data so that its existence needs to be further investigated. The method for obtaining extreme data is one of them using maxima block method. The distribution of extreme data sets taken with the maxima block method is called the distribution of extreme values. Distribution of extreme values is Gumbel distribution with two parameters. The parameter estimation of Gumbel distribution with maximum likelihood method (ML) is difficult to determine its exact value so that it is necessary to solve the approach. The purpose of this study was to determine the parameter estimation of Gumbel distribution with quasi-Newton BFGS method. The quasi-Newton BFGS method is a numerical method used for nonlinear function optimization without constraint so that the method can be used for parameter estimation from Gumbel distribution whose distribution function is in the form of exponential doubel function. The quasi-New BFGS method is a development of the Newton method. The Newton method uses the second derivative to calculate the parameter value changes on each iteration. Newton's method is then modified with the addition of a step length to provide a guarantee of convergence when the second derivative requires complex calculations. In the quasi-Newton BFGS method, Newton's method is modified by updating both derivatives on each iteration. The parameter estimation of the Gumbel distribution by a numerical approach using the quasi-Newton BFGS method is done by calculating the parameter values that make the distribution function maximum. In this method, we need gradient vector and hessian matrix. This research is a theory research and application by studying several journals and textbooks. The results of this study obtained the quasi-Newton BFGS algorithm and estimation of Gumbel distribution parameters. The estimation method is then applied to daily rainfall data in Purworejo District to estimate the distribution parameters. This indicates that the high rainfall that occurred in Purworejo District decreased its intensity and the range of rainfall that occurred decreased.

Keywords: parameter estimation, Gumbel distribution, maximum likelihood, broyden fletcher goldfarb shanno (BFGS)quasi newton

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4228 The Short-Term Stress Indicators in Home and Experimental Dogs

Authors: Madara Nikolajenko, Jevgenija Kondratjeva

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Stress is a response of the body to physical or psychological environmental stressors. Cortisol level in blood serum is determined as the main indicator of stress, but the blood collection, the animal preparation and other activities can cause unpleasant conditions and induce increase of these hormones. Therefore, less invasive methods are searched to determine stress hormone levels, for example, by measuring the cortisol level saliva. The aim of the study is to find out the changes of stress hormones in blood and saliva in home and experimental dogs in simulated short-term stress conditions. The study included clinically healthy experimental beagle dogs (n=6) and clinically healthy home American Staffordshire terriers (n=6). The animals were let into a fenced area to adapt. Loud drum sounds (in cooperation with 'Andžeja Grauda drum school') were used as a stressor. Blood serum samples were taken for sodium, potassium, glucose and cortisol level determination and saliva samples for cortisol determination only. Control parameters were taken immediately before the start of the stressor, and next samples were taken immediately after the stress. The last measurements were taken two hours after the stress. Electrolyte levels in blood serum were determined using direction selective electrode method (ILab Aries analyzer) and cortisol in blood serum and saliva using electrochemical luminescence method (Roche Diagnostics). Blood glucose level was measured with glucometer (ACCU-CHECK Active test strips). Cortisol level in the blood increased immediately after the stress in all home dogs (P < 0,05), but only in 33% (P < 0,05) of the experimental dogs. After two hours the measurement decreased in 83% (P < 0,05) of home dogs (in 50% returning to the control point) and in 83% (P < 0,05) of the experimental dogs. Cortisol in saliva immediately after the stress increased in 50% (P > 0,05) of home dogs and in 33% (P > 0,05) of the experimental dogs. After two hours in 83% (P > 0,05) of the home animals, the measurements decreased, only in 17% of the experimental dogs it decreased as well, while in 49% measurement was undetectable due to the lack of material. Blood sodium, potassium, and glucose measurements did not show any significant changes. The combination of short-term stress indicators, when, after the stressor, all indicators should immediately increase and decrease after two hours, confirmed in none of the animals. Therefore the authors can conclude that each animal responds to a stressful situation with different physiological mechanisms and hormonal activity. Cortisol level in saliva and blood is released with the different speed and is not an objective indicator of acute stress.

Keywords: animal behaivor, cortisol, short-term stress, stress indicators

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4227 Off-Line Parameter Estimation for the Induction Motor Drive System

Authors: Han-Woong Ahn, In-Gun Kim, Hyun-Seok Hong, Dong-Woo Kang, Ju Lee

Abstract:

It is important to accurately identify machine parameters for direct vector control. To obtain the parameter values, traditional methods can be used such as no-load and rotor locked tests. However, there are many differences between values obtained from the traditional tests and actual values. In addition, there are drawbacks that additional equipment and cost are required for the experiment. Therefore, it is hard to temporary operation to estimate induction motor parameters. Therefore, this paper deals with the estimation algorithm of induction motor parameters without a motor operation and the measurement from additional equipment such as sensors and dynamometer. The validity and usefulness of the estimation algorithm considering inverter nonlinearity is verified by comparing the conventional method with the proposed method.

Keywords: induction motor, parameter, off-line estimation, inverter nonlinearity

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4226 Effects of Different Processing Methods of Typha Grass on Feed Intake Milk Yield/Composition and Blood Parameters of Diry Cows

Authors: Alhaji Musa Abdullahi, Usman Abdullahi, Adamu Lawan, Aminu Maidala

Abstract:

Abstract 16 healthy lactating cows will be randomly selected for the trial and will be randomly divided in to 4 groups with 4 cows in each. They will be kept under similar management condition (conventional management system). Animals of relatively same weight and age will be used. After 11days for adaptation, feed intake and performance of the experimental animals will be determine. Milk sample will be collected at each milking in the morning and afternoon to determine; Milk yield, Milk fat percentage, Solid not fat percentage, Total solid percentage of milk. Cows dung will be observe to determine; Score 1 very loose watery stool, Score 2 semi solid with undigested raw material, Score 3 semi solid with less undigested raw material, Score 4 solid with very less undigested raw material, Score 5 good dung no undigested raw material. At the end of the experiment, blood samples will be analyzed for full blood counts and differentials {White Blood Cells (WBC), Red Blood Cells (RBC), Hemoglobin (Hb), Packed Cell Volume (PCV), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), Platelets (PLT), Lymphocytes (LYM), Basophils, Eosinophils and Monocytes Proportion (MXD) and Neutrophils (NEUT)} using automated hematology analyzer. Serum samples will be analyzed for heat shock transcription factors, heat shock proteins and hormones (Serum glucocorticoid, prolactin and cortisol). Moreover, biochemical analysis will also be conducted to check for Total protein (TP), Albumen (ALB), Globulin (GBL), Total cholesterol (TCH), glucose (G), sodium (Na+), potassium (K+), chloride (Cl-) and pH. Keywords: Lactating cows, milk composition, dung score and blood parameters.

Keywords: Lactating cows , Milk yield , Dung score , Blood parameters

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4225 Effect of Different SE Diets on Blood SE, TAC Levels in Dairy Cattle and Their Newborn Calves

Authors: Moshfeghi Sogand

Abstract:

Free radicals can be produced during the respiratory oxidation of different cells. These free radicals can damage to various macromolecules as protein ,fat, nucleic acids and … are harmful for body. The natural defence system that can prevent the damage of free radicals and nuteralized them , have tittled under the name total antioxidant capacity (TAC ). Se is one main antioxidant part in TAC , because it is one main part in structure of some body antioxidant enzymes such as GPX(glutathione peroxidase). Blood SE ,GPX and TAC probably can change by feeding of different selenium supplement diet in late pregnancy and also may transport from maternal blood to its fetus or by clostrum after calving. In this respect we have determined 100 pregnant dairy cattle (in the same condition of age , race and number of parturient) then devided them to 4 groups feed them in 3 last pregnancy months by different selenium diets. Group1:controle no se supplementation , group2: recived 0/3 ppm of the daily diet Saccharomyces Cervisiae . group3 :recived selenium _ rich yeast(containing200ppm selenium)was mixed with total daily ration fed. Group4: recived se _rich yeast(containing300 ppm selenium)was mixed with total daily ration fed. Then measured blood SE,GPX and TAC levels in them and in 3 days newborn calves after calving. The results were analysed by Tukey Anova test and the highest level of blood SE ,GPX and TAC was shown in cattle that feed fermented SE_yeast diet and in their 3 days newborn calves.

Keywords: SE, TAC, SE DIETS, FRAP

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4224 Regression-Based Approach for Development of a Cuff-Less Non-Intrusive Cardiovascular Health Monitor

Authors: Pranav Gulati, Isha Sharma

Abstract:

Hypertension and hypotension are known to have repercussions on the health of an individual, with hypertension contributing to an increased probability of risk to cardiovascular diseases and hypotension resulting in syncope. This prompts the development of a non-invasive, non-intrusive, continuous and cuff-less blood pressure monitoring system to detect blood pressure variations and to identify individuals with acute and chronic heart ailments, but due to the unavailability of such devices for practical daily use, it becomes difficult to screen and subsequently regulate blood pressure. The complexities which hamper the steady monitoring of blood pressure comprises of the variations in physical characteristics from individual to individual and the postural differences at the site of monitoring. We propose to develop a continuous, comprehensive cardio-analysis tool, based on reflective photoplethysmography (PPG). The proposed device, in the form of an eyewear captures the PPG signal and estimates the systolic and diastolic blood pressure using a sensor positioned near the temporal artery. This system relies on regression models which are based on extraction of key points from a pair of PPG wavelets. The proposed system provides an edge over the existing wearables considering that it allows for uniform contact and pressure with the temporal site, in addition to minimal disturbance by movement. Additionally, the feature extraction algorithms enhance the integrity and quality of the extracted features by reducing unreliable data sets. We tested the system with 12 subjects of which 6 served as the training dataset. For this, we measured the blood pressure using a cuff based BP monitor (Omron HEM-8712) and at the same time recorded the PPG signal from our cardio-analysis tool. The complete test was conducted by using the cuff based blood pressure monitor on the left arm while the PPG signal was acquired from the temporal site on the left side of the head. This acquisition served as the training input for the regression model on the selected features. The other 6 subjects were used to validate the model by conducting the same test on them. Results show that the developed prototype can robustly acquire the PPG signal and can therefore be used to reliably predict blood pressure levels.

Keywords: blood pressure, photoplethysmograph, eyewear, physiological monitoring

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4223 Optimizing Oxidation Process Parameters of Al-Li Base Alloys Using Taguchi Method

Authors: Muna K. Abbass, Laith A. Mohammed, Muntaha K. Abbas

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The oxidation of Al-Li base alloy containing small amounts of rare earth (RE) oxides such as 0.2 wt% Y2O3 and 0.2wt% Nd2O3 particles have been studied at temperatures: 400ºC, 500ºC and 550°C for 60hr in a dry air. Alloys used in this study were prepared by melting and casting in a permanent steel mould under controlled atmosphere. Identification of oxidation kinetics was carried out by using weight gain/surface area (∆W/A) measurements while scanning electron microscopy (SEM) and x-ray diffraction analysis were used for micro structural morphologies and phase identification of the oxide scales. It was observed that the oxidation kinetic for all studied alloys follows the parabolic law in most experimental tests under the different oxidation temperatures. It was also found that the alloy containing 0.2 wt %Y 2O3 particles possess the lowest oxidation rate and shows great improvements in oxidation resistance compared to the alloy containing 0.2 wt % Nd2O3 particles and Al-Li base alloy. In this work, Taguchi method is performed to estimate the optimum weight gain /area (∆W/A) parameter in oxidation process of Al-Li base alloys to obtain a minimum thickness of oxidation layer. Taguchi method is used to formulate the experimental layout, to analyses the effect of each parameter (time, temperature and alloy type) on the oxidation generation and to predict the optimal choice for each parameter and analyzed the effect of these parameters on the weight gain /area (∆W/A) parameter. The analysis shows that, the temperature significantly affects on the (∆W/A) parameter.

Keywords: Al-Li base alloy, oxidation, Taguchi method, temperature

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4222 The in vitro Effects of Various Immunomodulatory Nutritional Compounds on Antigen-Stimulated Whole-Blood Culture Cytokine Production

Authors: Ayu S. Muhamad, Michael Gleeson

Abstract:

Immunomodulators are substances that alter immune system via dynamic regulation of messenger molecules. It can be divided into immunostimulant and immunosuppressant. It can help to increase immunity of people with a low immune system, and also can help to normalize an overactive immune system. Aim of this study is to investigate the effects of in vitro exposure to low and high doses of several immunomodulators which include caffeine, kaloba and quercetin on antigen-stimulated whole blood culture cytokine production. Whole blood samples were taken from 5 healthy males (age: 32 ± 12 years; weight: 75.7 ± 6.1 kg; BMI: 24.3 ± 1.5 kg/m2) following an overnight fast with no vigorous activity during the preceding 24 h. The whole blood was then stimulated with 50 µl of 100 x diluted Pediacel vaccine and low or high dose of immunomodulators in the culture plate. After 20 h incubation (5% CO2, 37°C), it was analysed using the Evidence Investigator to determine the production of cytokines including IL-2, IL-4, IL-10, IFN-γ, and IL-1α. Caffeine and quercetin showed a tendency towards decrease cytokine production as the doses were increased. On the other hand, an upward trend was evident with kaloba, where a high dose of kaloba seemed to increase the cytokine production. In conclusion, we found that caffeine and quercetin have potential as immunosuppressant and kaloba as immunostimulant.

Keywords: caffeine, cytokine, immunomodulators, kaloba, quercetin

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4221 Prospective Study of the Evaluation of Autologous Blood Injection in the Treatment of Lateral Epicondylitis

Authors: Bheeshma B., Mathivanan N., Manoj Deepak M., Prabhu Thangaraju, K. Venkatachalam

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This study involves the effect of autologous blood injection for patients who had degeneration of the origin of extensor carpi radialis brevis which was confirmed radio logically and by ultrasound examination and failed cortisone injections to the lateral epicondylitis. In this prospective longitudinal series involves pre-injection assessment of grip strength, pain, and function, using the patient-rated tennis elbow evaluation. In this study, blood from the contralateral limb is taken and injected into the affected limb with the help of ultrasound guidance and then the patient wore a customized wrist support for five days, after which they were commenced with stretching, strengthening, and massage programme with an occupational therapist. In these patients assessment was done after six months and then finally at 12 months after injection, using the patient-rated tennis elbow evaluation. 50 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not. Our study thus concludes that autologous blood injection show significant improvement in pain and function in patients with chronic lateral epicondylitis, who did not have relief with cortisone injection.

Keywords: lateral epicondylitis, autologous blood injection, conservative treatment, plasma-rich proteins (PRPs)

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4220 Isolation and Classification of Red Blood Cells in Anemic Microscopic Images

Authors: Jameela Ali Alkrimi, Abdul Rahim Ahmad, Azizah Suliman, Loay E. George

Abstract:

Red blood cells (RBCs) are among the most commonly and intensively studied type of blood cells in cell biology. The lack of RBCs is a condition characterized by lower than normal hemoglobin level; this condition is referred to as 'anemia'. In this study, a software was developed to isolate RBCs by using a machine learning approach to classify anemic RBCs in microscopic images. Several features of RBCs were extracted using image processing algorithms, including principal component analysis (PCA). With the proposed method, RBCs were isolated in 34 second from an image containing 18 to 27 cells. We also proposed that PCA could be performed to increase the speed and efficiency of classification. Our classifier algorithm yielded accuracy rates of 100%, 99.99%, and 96.50% for K-nearest neighbor (K-NN) algorithm, support vector machine (SVM), and neural network ANN, respectively. Classification was evaluated in highly sensitivity, specificity, and kappa statistical parameters. In conclusion, the classification results were obtained for a short time period with more efficient when PCA was used.

Keywords: red blood cells, pre-processing image algorithms, classification algorithms, principal component analysis PCA, confusion matrix, kappa statistical parameters, ROC

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4219 Boundary Layer Flow of a Casson Nanofluid Past a Vertical Exponentially Stretching Cylinder in the Presence of a Transverse Magnetic Field with Internal Heat Generation/Absorption

Authors: G. Sarojamma, K. Vendabai

Abstract:

An analysis is carried out to investigate the effect of magnetic field and heat source on the steady boundary layer flow and heat transfer of a Casson nanofluid over a vertical cylinder stretching exponentially along its radial direction. Using a similarity transformation, the governing mathematical equations, with the boundary conditions are reduced to a system of coupled, non –linear ordinary differential equations. The resulting system is solved numerically by the fourth order Runge – Kutta scheme with shooting technique. The influence of various physical parameters such as Reynolds number, Prandtl number, magnetic field, Brownian motion parameter, thermophoresis parameter, Lewis number and the natural convection parameter are presented graphically and discussed for non – dimensional velocity, temperature and nanoparticle volume fraction. Numerical data for the skin – friction coefficient, local Nusselt number and the local Sherwood number have been tabulated for various parametric conditions. It is found that the local Nusselt number is a decreasing function of Brownian motion parameter Nb and the thermophoresis parameter Nt.

Keywords: casson nanofluid, boundary layer flow, internal heat generation/absorption, exponentially stretching cylinder, heat transfer, brownian motion, thermophoresis

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4218 Comparative Antihyperglycemic Activity of Serpentina (Andrographis paniculata) and Papait (Mollugo oppositifolia linn) Aqueous Extracts in Alloxan-Induced Diabetic Mice

Authors: Karina Marie G. Nicolas, Kimberly M. Visaya, Emmanuel R. Cauinian

Abstract:

A comparative study on the antihyperglycemic activity of aqueous extracts of Serpentina (Andrographis paniculata) and Papait (Mollugo oppositifolia linn) administered at 400mg/kg body weight per orem twice daily for 14 days was investigated using 24 alloxan-induced diabetic male, 6-8 weeks old ICR mice and Metformin as standard control. The blood glucose levels of all the animals in the treatment groups were not reduced to < 200mg/dl so as to consider them as non-diabetic but Papait showed a consistent blood glucose lowering effect from day 0 to 14 causing 36.07% reduction as compared to Serpentina which was observed to cause a fluctuating effect on blood glucose levels and a reduction of only 22.53% while the Metformin treated animals exhibited the highest reduction at 45.29%. The blood glucose levels at day 14 of animals treated with Papait (322.93 mg/dl) had comparable blood glucose levels (p<0.05) with the Metformin treated groups (284.50 mg/dl). Also, all the animals in the three treatment groups were still hypercholesterolemic with an observed consistent weight loss and a decrease in feed intake except for Serpentina which recorded a slight increase. Results of the study showed a superior antihyperglycemic activity of Papait compared with Serpentina.

Keywords: antihyperglycemic, diabetes, hypercholesterolemic, papait, serpentina

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4217 A Study to Identify Resistant Hypertension and Role of Spironolactone in its Management

Authors: A. Kumar, D. Himanshu, Ak Vaish, K. Usman , A. Singh, R. Misra, V. Atam, S. P. Verma, S. Singhal

Abstract:

Introduction: Resistant and uncontrolled hypertension offer great challenge, in terms of higher risk of morbidity, mortality and not the least, difficulty in diagnosis and management. Our study tries to identify the importance of two crucial aspects of hypertension management, i.e. drug compliance and optimum dosing and also the effect of spironolactone on blood pressure in cases of resistant hypertension. Methodology: A prospective study was carried out among patients, who were referred as case of resistant hypertension to Hypertension Clinic at Gandhi memorial and associated hospital, Lucknow, India from August, 2013 to July 2014. A total of 122 Subjects having uncontrolled BP with ≥3 antihypertensives were selected. After ruling out secondary resistance and with appropriate lifestyle modifications, effect of adherence and optimum doses was seen with monitoring of BP. Only those having blood pressure still uncontrolled were true resistant. These patients were given spironolactone to see its effect on BP over next 12 weeks. Results: Mean baseline BP of all (n=122) patients was 150.4±7.2 mmHg systolic and 92.1±5.7 mmHg diastolic. After promoting adherence to the regimen, there was reduction of 4.20±3.65 mmHg systolic and 2.08±4.74 mmHg Diastolic blood pressure, with 26 patients achieving target blood pressure goal. Further reduction of 6.66±5.99 mmHg in systolic and 2.59±3.67 mmHg in diastolic BP was observed after optimizing the drug doses with another 66 patients achieving target blood pressure goal. Only 30 patients were true resistant hypertensive and prescribed spironolactone. Over 12 weeks, mean reduction of 20.62±3.65 mmHg in systolic and 10.08 ± 6.46 mmHg in diastolic BP was observed. Out of these 30, BP was controlled in 24 patients. Side effects observed were hyperkalemia in 2 patients and breast tenderness in 2 patients. Conclusion: Improper adherence and suboptimal regimen appear to be the important reasons for uncontrolled hypertension. By virtue of maintaining proper adherence to an optimum regimen, target BP goal can be reached in many without adding much to the regimen. Spironolactone is effective in patients with resistant hypertension, in terms of blood pressure reduction with minimal side effects.

Keywords: resistant, hypertension, spironolactone, blood pressure

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4216 A Study of the Effect of Early and Late Meal Time on Anthropometric and Biochemical Parameters in Patients of Type 2 Diabetes

Authors: Smriti Rastogi, Narsingh Verma

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Background: A vast body of research exists on the use of oral hypoglycaemic drugs, insulin injections and the like in managing diabetes but no such research exists that has taken into consideration the parameter of time restricted meal intake and its positive effects in managing diabetes. The utility of this project is immense as it offers a solution to the woes of diabetics based on circadian rhythm and normal physiology of the human body. Method: 80 Diabetics, enrolled from the Out Patient Department of Endocrinology, KGMU (King George's Medical University) were randomly divided based on consent to early dinner TRM(time restricted meal) group or not (control group). Follow up was done at six months and 12 months for anthropometric measurement, height, weight, waist-hip ratio, neck size, fasting, postprandial blood sugar, HbA1c, serum urea, serum creatinine, and lipid profile. The patient was given a clear understanding of chronomedicine and how it affects their health. A single intervention was done - the timing of dinner was at or around 7 pm for TRM group. Result: 65% of TRM group and 40 %(non- TRM) had normal HbA1c after 12 months. HbA1c in TRM Group (first visit to second follow up) had a significant p value=0.017. A p value of <0.0001 was observed on comparing the values of blood sugar (fasting) in TRM Group from the first visit and second follow up. The values of blood sugar (postprandial) in TRM Group (first visit and second follow up) showed a p-value <0.0001 (highly significant). Values of the three parameters were non- significant in the control group. Hip size(First Visit to Second Follow Up) TRM Group showed a p-value = 0.0344 (Significant) (Difference between means=2.762 ± 1.261)Detailed results of the above parameters and a few newer ones will be presented at the conference. Conclusion: Time restricted meal intake in diabetics shows promise and is worth exploring further. Time Restricted Meal intake in Type 2 diabetics has a significant effect in controlling and maintaining HbA1c as the reduction in HbA1c value was very significant in the TRM group vs. the control group. Similar highly significant results were obtained in the case of fasting and postprandial values of blood sugar in the TRM group when compared to the control group. The effects of time restricted meal intake in diabetics show promise and are worth exploring further. It is one of the first studies which have been undertaken in Indian diabetics, although the initial data obtained is encouraging yet further research and study are required to corroborate results.

Keywords: chronomedicine, diabetes, endocrinology, time restricted meal intake

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4215 Pollution by Iron of the Quaternary Drinking Water and its Effect on Human Health

Authors: Raafat A. Mandour

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Background; Water may be regarded as polluted if it contains substances that render it unsafe for public use. The surface, subsoil waters and the shallow water-bearing geologic formation are more subjected to pollution due to its closeness to the human daily work. Aim of the work; determine the distribution of iron level in drinking water and its relation to iron level in blood patients suffering from liver diseases. Materials and Methods; For the present study, a total number of (71) drinking water samples (surface, wells and tap) have been collected and Blood samples were carried out on (71) selected inhabitants who attended in different hospitals, from different localities and suffering from liver diseases. Serum iron level in these patients was estimated by using IRON-B kit, Biocon company (Germany) and the 1, 10-phenanthroline method. Results; The water samples analyzed for iron are found suitable for drinking except two samples at Mit-Ghamr district showing values higher than the permissible limit of Egyptian Ministry of Health (EMH) and World Health Organization (WHO).The comparison between iron concentrations in drinking water and human blood samples shows a positive relationship. Conclusion; groundwater samples from the polluted areas should have special attention for treatment.

Keywords: water samples, blood samples, EMH, WHO

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4214 Evaluation of Osteoprotegrin (OPG) and Tumor Necrosis Factor A (TNF-A) Changes in Synovial Fluid and Serum in Dogs with Osteoarthritis; An Experimental Study

Authors: Behrooz Nikahval, Mohammad Saeed Ahrari-Khafi, Sakineh Behroozpoor, Saeed Nazifi

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Osteoarthritis (OA) is a progressive and degenerative condition of the articular cartilage and other joints’ structures. It is essential to diagnose this condition as early as possible. The present research was performed to measure the Osteoprotegrin (OPG) and Tumor Necrosis Factor α (TNF-α) in synovial fluid and blood serum of dogs with surgically transected cruciate ligament as a model of OA, to evaluate if measuring of these parameters can be used as a way of early diagnosis of OA. In the present study, four mature, clinically healthy dogs were selected to investigate the effect of experimental OA, on OPG and TNF-α as a way of early detection of OA. OPG and TNF-α were measured in synovial fluid and blood serum on days 0, 14, 28, 90 and 180 after surgical transaction of cranial cruciate ligament in one stifle joint. Statistical analysis of the results showed that there was a significant increase in TNF-α in both synovial fluid and blood serum. OPG showed a decrease two weeks after OA induction. However, it fluctuated afterward. In conclusion, TNF-α could be used in both synovial fluid and blood serum as a way of early detection of OA; however, further research still needs to be conducted on OPG values in OA detection.

Keywords: osteoarthritis, osteoprotegrin, tumor necrosis factor α, synovial fluid, serum, dog

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4213 Identification of Vehicle Dynamic Parameters by Using Optimized Exciting Trajectory on 3- DOF Parallel Manipulator

Authors: Di Yao, Gunther Prokop, Kay Buttner

Abstract:

Dynamic parameters, including the center of gravity, mass and inertia moments of vehicle, play an essential role in vehicle simulation, collision test and real-time control of vehicle active systems. To identify the important vehicle dynamic parameters, a systematic parameter identification procedure is studied in this work. In the first step of the procedure, a conceptual parallel manipulator (virtual test rig), which possesses three rotational degrees-of-freedom, is firstly proposed. To realize kinematic characteristics of the conceptual parallel manipulator, the kinematic analysis consists of inverse kinematic and singularity architecture is carried out. Based on the Euler's rotation equations for rigid body dynamics, the dynamic model of parallel manipulator and derivation of measurement matrix for parameter identification are presented subsequently. In order to reduce the sensitivity of parameter identification to measurement noise and other unexpected disturbances, a parameter optimization process of searching for optimal exciting trajectory of parallel manipulator is conducted in the following section. For this purpose, the 321-Euler-angles defined by parameterized finite-Fourier-series are primarily used to describe the general exciting trajectory of parallel manipulator. To minimize the condition number of measurement matrix for achieving better parameter identification accuracy, the unknown coefficients of parameterized finite-Fourier-series are estimated by employing an iterative algorithm based on MATLAB®. Meanwhile, the iterative algorithm will ensure the parallel manipulator still keeps in an achievable working status during the execution of optimal exciting trajectory. It is showed that the proposed procedure and methods in this work can effectively identify the vehicle dynamic parameters and could be an important application of parallel manipulator in the fields of parameter identification and test rig development.

Keywords: parameter identification, parallel manipulator, singularity architecture, dynamic modelling, exciting trajectory

Procedia PDF Downloads 265
4212 Using the Nonlocal Theory of Free Vibrations Nanobeam

Authors: Ali Oveysi Sarabi

Abstract:

The dimensions of nanostructures are in the range of inter-atomic spacing of the structures which makes them impossible to be modeled as a continuum. Nanoscale size-effects on vibration analysis of nanobeams embedded in an elastic medium is investigated using different types of beam theory. To this end, Eringen’s nonlocal elasticity is incorporated to various beam theories namely as Euler-Bernoulli beam theory (EBT), Timoshenko beam theory (TBT), Reddy beam theory (RBT), and Levinson beam theory (LBT). The surrounding elastic medium is simulated with both Winkler and Pasternak foundation models and the difference between them is studies. Explicit formulas are presented to obtain the natural frequencies of nanobeam corresponding to each nonlocal beam theory. Selected numerical results are given for different values of the non-local parameter, Winkler modulus parameter, Pasternak modulus parameter and aspect ratio of the beam that imply the effects of them, separately. It is observed that the values of natural frequency are strongly dependent on the stiffness of elastic medium and the value of the non-local parameter and these dependencies varies with the value of aspect ratio and mode number.

Keywords: nanobeams, free vibration, nonlocal elasticity, winkler foundation model, Pasternak foundation model, beam theories

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4211 Enhancing of Biogas Production from Slaughterhouse and Dairy Farm Waste with Pasteurization

Authors: Mahmoud Hassan Onsa, Saadelnour Abdueljabbar Adam

Abstract:

Wastes from slaughterhouses in most towns in Sudan are often poorly managed and sometimes discharged into adjoining streams due to poor implementation of standards, thus causing environmental and public health hazards and also there is a large amount of manure from dairy farms. This paper presents solution of organic waste from cow dairy farms and slaughterhouse the anaerobic digestion and biogas production. The paper presents the findings of experimental investigation of biogas production with and without pasteurization using cow manure, blood and rumen content were mixed at two proportions, 72.3% manure, 21.7%, rumen content and 6% blood for bio digester1with 62% dry matter at the beginning and without pasteurization and 72.3% manure, 21.7%, rumen content and 6% blood for bio-digester2 with 10% dry matter and pasteurization. The paper analyses the quantitative and qualitative composition of biogas: gas content, the concentration of methane. The highest biogas output 2.9 mL/g dry matter/day (from bio-digester2) together with a high quality biogas of 87.4% methane content which is useful for combustion and energy production and healthy bio-fertilizer but biodigester1 gave 1.68 mL/g dry matter/day with methane content 85% which is useful for combustion, energy production and can be considered as new technology of dryer bio-digesters.

Keywords: anaerobic digestion, bio-digester, blood, cow manure, rumen content

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4210 Effect of Acute Ingestion of Ice Water on Blood Pressure in Relation to Body Mass Index

Authors: Savitri Siddanagoudra, Shantala Herlekar, Priya Arjunwadekar

Abstract:

Background: The physiological response to water drinking in healthy subjects is an integrated response with an increase in sympathetic vasoconstrictor activity with induced bradycardia. Obesity is a modern pandemic, implicated in the pathogenesis of cardiovascular disease. In autonomic failure patients, water drinking has been shown the increased high blood pressure and bradycardia. Acute effects of ice water ingestion on blood pressure (BP) in relation to body mass index (BMI) is not addressed in literature. Objectives: Objective of this study is to evaluate BP before and after ingestion of cold water in all the three groups. Methods and Material: 60 healthy subjects between the age group of 18-24 yrs were selected and assigned into 3 groups based on BMI. BMI less than and equal to 25 kg/m2 is selected as Normal BMI group ,between 25- 29 kg/m2 as Overweight and BMI more than and equal to 30 kg/m2 as Obese. Procedure: Basal and after ingestion of 250 ml of cold water (7 0C ± 0.5 0C)BP was recorded in all the 3 groups. Results: Basal and after ice water ingestion BP increased statistically in all 3 groups. Conclusion: On acute ingestion of ice water overweight, obese may have more sympathoexcitaion compared to normal subjects.

Keywords: blood pressure, body mass index, ice water, symathoexcitation

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4209 Haemobiogram after Intramuscular Administration of Amoxicillin to Sheep

Authors: Amer Elgerwi, Abdelrazzag El-Magdoub, Abubakr El-Mahmoudy

Abstract:

There are many bacterial infections affecting sheep that necessitates antibiotic intervention. Amoxicillin is among commonly used antibiotics in such case for its broad spectrum of activity. However, the side alterations in blood and organ function that may be associated during or after treatment are questionable. Therefore, the aim of the present study was to assess the possible alterations in blood parameters and organ function bio markers of sheep that may occur following intramuscular injection of amoxicillin. Amoxicillin has been administered intramuscularly to 10 sheep at a dosage regimen of 7 mg/kg of body weight for 5 successive days. Two types of blood samples (with and without anticoagulant) were collected from the jugular vein pre- and post-administration of the drug. Amoxicillin significantly (P < 0.001) increased total leukocyte count and (P < 0.05) absolute eosinophilic count when compared with those of the control samples. Aspartate aminotransferase, alkaline phosphatase and cholesterol were significantly (P < 0.05) higher than the corresponding control values. In addition, amoxicillin significantly (P < 0.05) increased blood urea nitrogen and creatinine but decreased phosphorus level when compared with those of prior-administration samples. These data may indicate that although the side changes caused by amoxicillin are minor in sheep, yet the liver and kidney functions should be monitored during its usage in therapy and it should be used with care for treatment of sheep with renal and/or hepatic impairments.

Keywords: amoxicillin, biogram, haemogram, sheep

Procedia PDF Downloads 458
4208 Changes in Blood Pressure in a Longitudinal Cohort of Vietnamese Women

Authors: Anh Vo Van Ha, Yun Zhao, Luat Cong Nguyen, Tan Khac Chu, Phung Hoang Nguyen, Minh Ngoc Pham, Colin W. Binns, Andy H. Lee

Abstract:

This study aims to study longitudinal changes in blood pressure (BP) during the 1-year postpartum period and to evaluate the influence of parity, maternal age at delivery, prepregnancy BMI, gestational weight gain, gestational age at delivery and postpartum maternal weight. A prospective longitudinal cohort study of 883 singleton Vietnamese women was conducted in Hanoi, Haiphong, and Ho Chi Minh City, Vietnam during 2015-2017. Women diagnosed with gestational diabetes mellitus at 24-28 weeks of gestation, pre-eclampsia, and hypoglycemia was excluded from analysis. BP was repeatedly measured at discharge, 6 and 12 months postpartum using automatic blood pressure monitors. Linear mixed model with repeated measures was used to describe changes occurring during pregnancy to 1-year postpartum. Parity, self-reported prepregnancy BMI, gestational weight gain, maternal age and gestational age at delivery will be treated as time-invariant variables and measured maternal weight will be treated as a time-varying variable in models. Women with higher measured postpartum weight had higher mean systolic blood pressure (SBP), 0.20 mmHg, 95% CI [0.12, 0.28]. Similarly, women with higher measured postpartum weight had higher mean diastolic blood pressure (DBP), 0.15 mmHg, 95% CI [0.08, 0.23]. These differences were both statistically significant, P < 0.001. There were no differences in SBP and DBP depending on parity, maternal age at delivery, prepregnancy BMI, gestational weight gain and gestational age at delivery. Compared with discharge measurement, SBP was significantly higher in 6 months postpartum, 6.91 mmHg, 95% CI [6.22, 7.59], and 12 months postpartum, 6.39 mmHg, 95% CI [5.64, 7.15]. Similarly, DBP was also significantly higher in 6 and months postpartum than at discharge, 10.46 mmHg 95% CI [9.75, 11.17], and 11.33 mmHg 95% CI [10.54, 12.12]. In conclusion, BP measured repeatedly during the postpartum period (6 and 12 months postpartum) showed a statistically significant increase, compared with after discharge from the hospital. Maternal weight was a significant predictor of postpartum blood pressure over the 1-year postpartum period.

Keywords: blood pressure, maternal weight, postpartum, Vietnam

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4207 Evaluation of Transfusion-Related Acute Lung Injury

Authors: Hossein Barri Ghazani

Abstract:

Transfusion-related acute lung injury is the main reason of transfusion-related death, and it’s assigned to white blood cell reactive antibodies present in the blood product (anti-HLA class I and class II or anti granulocyte antibodies). TRALI may occur in the COVID-19 patients who are treated by convalescent plasma. The rate of TRALI’s reactions is the same in both males and females and can happen in all age groups. TRALI’s occurrence is higher for people who receive plasma from female donors because the parous female donors have multiple HLA antibodies in their plasma. Patients with chronic liver disease have an augmented risk of transfusion-related acute lung injuries from plasma containing blood products like FFP and PRP. The condition of TRALI suddenly starts with a non‐cardiogenic pulmonary Edema, often accompanied by marked systemic hypovolemic and hypotension. The conditions occur during or within a few hours of transfusion. Chest X-ray shows a nodular penetration or bats’ wing pattern of Edema which can be seen in acute respiratory distress syndrome as well. TRALI can occur with any type of blood products and can occur with as little as one unit. The blood donor center should be informed of the suspected TRALI reactions when the symptoms of TRALI are observed. After a review of the clinical data, the donors must be screened for granulocyte and HLA antibodies. The diagnosis and management of TRALI is not simple and is best done with a professional team and a specialty skilled nurse experienced with the upkeep of these patients.

Keywords: TRALI, transfusion-related death, anti-granulocyte antibodies, anti-HLA antibodies, COVID-19

Procedia PDF Downloads 162
4206 Comparison of Serological and Molecular Diagnosis of Cerebral Toxoplasmosis in Blood and Cerebrospinal Fluid in HIV Infected Patients

Authors: Berredjem Hajira, Benlaifa Meriem, Becheker Imene, Bardi Rafika, Djebar Med Reda

Abstract:

Recent acquired or reactivation T.gondii infection is a serious complication in HIV patients. Classical serological diagnosis relies on the detection of anti-Toxoplasma immunoglobulin ; however, serology may be unreliable in HIV immunodeficient patients who fail to produce significant titers of specific antibodies. PCR assays allow a rapid diagnosis of Toxoplasma infection. In this study, we compared the value of the PCR for diagnosing active toxoplasmosis in cerebrospinal fluid and blood samples from HIV patients. Anti-Toxoplasma antibodies IgG and IgM titers were determined by ELISA. In parallel, nested PCR targeting B1 gene and conventional PCR-ELISA targeting P30 gene were used to detect T. gondii DNA in 25 blood samples and 12 cerebrospinal fluid samples from patients in whom toxoplasmic encephalitis was confirmed by clinical investigations. A total of 15 negative controls were used. Serology did not contribute to confirm toxoplasmic infection, as IgG and IgM titers decreased early. Only 8 out 25 blood samples and 5 out 12 cerebrospinal fluid samples PCRs yielded a positive result. 5 patients with confirmed toxoplasmosis had positive PCR results in either blood or cerebrospinal fluid samples. However, conventional nested B1 PCR gave best results than the P30 gene one for the detection of T.gondii DNA in both samples. All samples from control patients were negative. This study demonstrates the unusefulness of the serological tests and the high sensitivity and specificity of PCR in the diagnosis of toxoplasmic encephalitis in HIV patients.

Keywords: cerebrospinal fluid, HIV, Toxoplasmosis, PCR

Procedia PDF Downloads 376
4205 Study of a Cross-Flow Membrane to a Kidney Encapsulation Engineering Structures for Immunosuppression Filter

Authors: Sihyun Chae, Ryoto Arai, Waldo Concepcion, Paula Popescu

Abstract:

The kidneys perform an important role in the human hormones that regulate the blood pressure, produce an active form of vitamin D and control the production of red blood cells. Kidney disease can cause health problems, such as heart disease. Also, increase the chance of having a stroke or heart attack. There are mainly to types of treatments for kidney disease, dialysis, and kidney transplant. For a better quality of life, the kidney transplant is desirable. However, kidney transplant can cause antibody reaction and patients’ body would be attacked by immune system of their own. For solving that issue, patients with transplanted kidney always take immunosuppressive drugs which can hurt kidney as side effects. Patients willing to do a kidney transplant have a waiting time of 3.6 years in average searching to find an appropriate kidney, considering there are almost 96,380 patients waiting for kidney transplant. There is a promising method to solve these issues: bioartificial kidney. Our membrane is specially designed with unique perforations capable to filter the blood cells separating the white blood cells from red blood cells. White blood cells will not pass through the encapsulated kidney preventing the immune system to attack the new organ and eliminating the need of a matching donor. It is possible to construct life-time long encapsulation without needing pumps or a power supply on the cell’s separation method preventing futures surgeries due the Cross-Channel Flow inside the device. This technology allows the possibility to use an animal kidney, prevent cancer cells to spread through the body, arm and leg transplants in the future. This project aims to improve the quality of life of patients with kidney disease.

Keywords: kidney encapsulation, immunosuppression filter, leukocyte filter, leukocyte

Procedia PDF Downloads 201
4204 The Effectiveness of Transcranial Electrical Stimulation on Brain Wave Pattern and Blood Pressure in Patients with Generalized Anxiety Disorder

Authors: Mahtab Baghaei, Seyed Mahmoud Tabatabaei

Abstract:

Aim & Background: Electrical stimulation of transcranial direct current is considered one of the treatment methods for mental disorders. The aim of this study was to evaluate the effectiveness of transcranial electrical stimulation on the delta, theta, alpha, beta and systolic and diastolic blood pressure in patients with generalized anxiety disorder. Materials and Methods: The present study was a double-blind intervention with a pre-test and post-test design on people with generalized anxiety disorder in Tabriz in 1400. In this study, 30 patients with generalized anxiety disorder were selected by purposive sampling method based on the criteria specified in DSM-5 and randomly divided into an experimental group (n = 15) and a control group (n = 15). The experimental group received two sessions of 30 minutes of electrical stimulation of transcranial direct current with an intensity of 2 mA in the area of the lateral dorsal prefrontal cortex, and the control group also received artificial stimulation. Results: The results showed that transcranial electrical stimulation reduces delta and theta waves and increases beta and alpha brain waves in the experimental group. On the other hand, this method also showed a significant decrease in systolic and diastolic blood pressure in these patients (p <0.01). Conclusion: The results show that transcranial electrical stimulation has a statistically significant effect on brain waves and blood pressure, and this non-invasive method can be used as one of the treatment methods in people with generalized anxiety disorder.

Keywords: transcranial direct current electrical stimulation, brain waves, systolic blood pressure, diastolic blood pressure

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4203 A Matched Case-Control Study to Asses the Association of Chikunguynya Severity among Blood Groups and Other Determinants in Tesseney, Gash Barka Zone, Eritrea

Authors: Ghirmay Teklemicheal, Samsom Mehari, Sara Tesfay

Abstract:

Objectives: A total of 1074 suspected chikungunya cases were reported in Tesseney Province, Gash Barka region, Eritrea, during an outbreak. This study was aimed to assess the possible association of chikungunya severity among ABO blood groups and other potential determinants. Methods: A sex-matched and age-matched case-control study was conducted during the outbreak. For each case, one control subject had been selected from the mild Chikungunya cases. Along the same line of argument, a second control subject had also been designated through which neighborhood of cases were analyzed, scrutinized, and appeared to the scheme of comparison. Time is always the most sacrosanct element in pursuance of any study. According to the temporal calculation, this study was pursued from October 15, 2018, to November 15, 2018. Coming to the methodological dependability, calculating odds ratios (ORs) and conditional (fixed-effect) logistic regression methods were being applied. As a consequence of this, the data was analyzed and construed on the basis of the aforementioned methodological systems. Results: In this outbreak, 137 severe suspected chikungunya cases and 137 mild chikungunya suspected patients, and 137 controls free of chikungunya from the neighborhood of cases were analyzed. Non-O individuals compared to those with O blood group indicated as significant with a p-value of 0.002. Separate blood group comparison among A and O blood groups reflected as significant with a p-value of 0.002. However, there was no significant difference in the severity of chikungunya among B, AB, and O blood groups with a p-value of 0.113 and 0.708, respectively, and a strong association of chikungunya severity was found with hypertension and diabetes (p-value of < 0.0001); whereas, there was no association between chikungunya severity and asthma with a p-value of 0.695 and also no association with pregnancy (p-value =0.881), ventilator (p-value =0.181), air conditioner (p-value = 0.247), and didn’t use latrine and pit latrine (p-value = 0.318), among individuals using septic and pit latrine (p-value = 0.567) and also among individuals using flush and pit latrine (p-value = 0.194). Conclusions: Non- O blood groups were found to be at risk more than their counterpart O blood group individuals with severe form of chikungunya disease. By the same token, individuals with chronic disease were more prone to severe forms of the disease in comparison with individuals without chronic disease. Prioritization is recommended for patients with chronic diseases and non-O blood group since they are found to be susceptible to severe chikungunya disease. Identification of human cell surface receptor(s) for CHIKV is quite necessary for further understanding of its pathophysiology in humans. Therefore, molecular and functional studies will necessarily be helpful in disclosing the association of blood group antigens and CHIKV infections.

Keywords: Chikungunya, Chikungunya virus, disease outbreaks, case-control studies, Eritrea

Procedia PDF Downloads 162
4202 The Efficacy of Pre-Hospital Packed Red Blood Cells in the Treatment of Severe Trauma: A Retrospective, Matched, Cohort Study

Authors: Ryan Adams

Abstract:

Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.

Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine

Procedia PDF Downloads 393