Search results for: initiation rites

Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova, Anna Khelkovskaya-Sergeeva

Abstract:

Objectives. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are associated with severe course, increased morbidity and mortality in systemic sclerosis (SSc). The aim of our study was to assess changes in CRP and ESR in SSc patients during long-term RTX therapy. Methods. This study included 113 patients with SSc. Mean age was 48.1±13 years, female-85%. The mean disease duration was 6±5 years. The diffuse cutaneous subset of the disease had 55% of patients. All pts had interstitial lung disease (ILD). All patients received prednisolone at a mean dose of 11.6±4.8 mg/day, and 53 of them - were immunosuppressants at inclusion. Patients received RTX due to the ineffectiveness of previous therapy for ILD. The parameters were evaluated over the periods: at baseline (point 0), 13±2.3 month (point 1, n=113), 42±14 month (point 2, n=80) and 79±6.5 month (point 3, n=25) after initiation of RTX therapy. Cumulative mean dose of RTX at point 1 = 1.7±0.6g, at point 2 = 3±1.5g, and at point 3 = 3.8±2.4g. The results are presented in the form of mean values, delta(Δ)-difference between the baseline parameter and follow-up point. Results. There was an improvement in studied parameters on RTX therapy. There was a significant decrease of ESR, CRP and activity index (EScSG-AI) at all observation points (p=0.001). In point 1: ΔCRP was 6.7 mg/l, ΔESR = 7.4 mm/h, ΔActivity index (EScSG-AI) = 1.7. In point 2: ΔCRP was 8.7 mg/l, ΔESR = 7.5 mm/h, ΔActivity index (EScSG-AI) = 1.9. In point 3: ΔCRP was 16.1 mg/l, ΔESR = 11 mm/h, ΔActivity index (EScSG-AI) = 2.1. Conclusion. There was a significant decrease in CRP and ESR during long-term RTX therapy, which correlated with a decrease in the disease activity index. RTX is an effective treatment option for SSc with an elevation of acute-phase reactants.

Keywords: C-reactive protein, interstitial lung disease, systemic sclerosis, rituximab

Procedia PDF Downloads 29

Authors: A. B. Chehreh, M. Grätzel, M. Klein, J. P. Bergmann, F. Walther

Abstract:

Friction stir welding (FSW) is an advantageous method in the thermal joining processes, featuring the welding of various dissimilar and similar material combinations, joining temperatures below the melting point which prevents irregularities such as pores and hot cracks as well as high strengths mechanical joints near the base material. The FSW process consists of a rotating tool which is made of a shoulder and a probe. The welding process is based on a rotating tool which plunges in the workpiece under axial pressure. As a result, the material is plasticized by frictional heat which leads to a decrease in the flow stress. During the welding procedure, the material is continuously displaced by the tool, creating a firmly bonded weld seam behind the tool. However, the mechanical properties of the weld seam are affected by the design and geometry of the tool. These include in particular microstructural and surface properties which can favor crack initiation. Following investigation compares the dynamic properties of FSW weld seams with conventional and stationary shoulder geometry based on load increase test (LIT). Compared to classical Woehler tests, it is possible to determine the fatigue strength of the specimens after a short amount of time. The investigations were carried out on a robotized welding setup on 2 mm thick EN AW 5754 aluminum alloy sheets. It was shown that an increased tensile and fatigue strength can be achieved by using the stationary shoulder concept. Furthermore, it could be demonstrated that the LIT is a valid method to describe the fatigue behavior of FSW weld seams.

Keywords: aluminum alloy, fatigue performance, fracture, friction stir welding

Procedia PDF Downloads 153

Authors: Francimar Alves, Marcos Castro, Marllus Lustosa

Abstract:

In the context of the teaching of computer programming, the choice of tool to use is very important in the initiation and continuity of learning a programming language. The literature tools do not always provide usability and pedagogical dynamism clearly and accurately for effective learning. This hypothesis implies fall in productivity and difficulty of learning a particular programming language by students. The integrated development environments (IDEs) Dev-C ++ and Code :: Blocks are widely used in introductory courses for undergraduate courses in Computer Science for learning C and C ++ languages. However, after several years of discontinuity maintaining the source code of Dev-C ++ tool, the continued use of the same in the teaching and learning process of the students of these institutions has led to difficulties, mainly due to the lack of update by the official developers, which resulted in a sequence of problems in using it on educational settings. Much of the users, dissatisfied with the IDE Dev-C ++, migrated to Code :: Blocks platform targeting the more dynamic range in the learning process of the C and C ++ languages. Nevertheless, there is still the need to create a tool that can provide the resources of most IDE's software development literature, however, more interactive, simple, accurate and efficient. This motivation led to the creation of Falcon C ++ tool, IDE that brings with features that turn it into an educational platform, which focuses primarily on increasing student learning index in the early disciplines of programming and algorithms that use the languages ​​C and C ++ . As a working methodology, a field research to prove the truth of the proposed tool was used. The test results and interviews with entry-level students and intermediate in a postsecondary institution gave basis for the composition of this work, demonstrating a positive impact on the use of the tool in teaching programming, showing that the use of Falcon C ++ software is beneficial in the teaching process of the C and C ++ programming languages.

Keywords: ide, education, learning, development, language

Procedia PDF Downloads 445

Authors: Abdul Soofi, Katherine Wolf, Egon Ranghini, Gregory Dressler

Abstract:

Obesity and its associated complications, such as insulin resistance and non-alcoholic fatty liver disease, are reaching epidemic proportions. In mice, the TGF-β superfamily is implicated in the regulation of white and brown adipose tissues differentiation. The Kielin/Chordin-like Protein (KCP) is a secreted regulator of the TGF-β superfamily pathways that can inhibit both TGF-β and Activin signals while enhancing the Bone Morphogenetic protein (BMP) signaling. However, the effects of KCP on metabolism and obesity have not been studied in animal models. Thus, we examined the effects of KCP loss or gain of function in mice that were maintained on either a regular or a high fat diet. Loss of KCP sensitized mice to obesity and associated complications such as hepatic steatosis and glucose intolerance. In contrast, transgenic mice that expressed KCP in the kidney, liver and adipose tissues were resistant to developing high fat diet induced obesity and had significantly reduced white adipose tissue. KCP over-expression was able to shift the pattern of Smad signaling in vivo, to increase the levels of P-Smad1 and decrease P-Smad3, resulting in resistance to high fat diet induced hepatic steatosis and glucose intolerance. In aging mice, loss of KCP promoted liver pathology even when mice were fed a normal diet. The data demonstrate that shifting the TGF-β superfamily signaling with a secreted inhibitor or enhancer can alter the physiology of adipose tissue to reduce obesity and can inhibit the initiation and progression of hepatic steatosis to significantly reduce the effects of high fat diet induced metabolic disease.

Keywords: adipose tissue, KCP, obesity, TGF-β, BMP, hepatic steatosis, metabolic syndrome

Procedia PDF Downloads 353

Authors: Ubaka Chukwuemeka Michael, Ukwe Chinwe Victoria

Abstract:

Background: The use of antipsychotic monotherapy remains the standard for schizophrenic disorders so also a prescription switch from older typical to newer atypical classes of antipsychotics on the basis of better efficacy and tolerability. However, surveys on the quality of antipsychotic drug use and substitution in developing countries are very scarce. This study was intended to evaluate quality and factors that drive the prescription and substitution of antipsychotic drugs among schizophrenic patients visiting a regional psychiatric hospital. Methods: Case files of patients visiting a federal government funded Neuropsychiatric Hospital between July 2012 and July 2014 were systematically retrieved. Patient demographic characteristics, clinical details and drug management data were collected and subjected to descriptive and inferential data analysis to determine quality and predictors of utilization. Results: Of the 600 case files used, there were more male patients (55.3%) with an overall mean age of 33.7±14.4 years. Typical antipsychotic agents accounted for over 85% of prescriptions, with majority of the patients receiving more than 2 drugs in at least a visit (80.9%). Fluphenazine (25.2%) and Haloperidol (18.8%) were mostly given as antipsychotics for treatment initiation while Olazenpine (23.0%) and Benzhexol (18.3%) were the most currently prescribed antipsychotics. Nearly half (42%, 252/600) of these patients were switched from one class to another, with 34.5% (207/600) of them switched from typical to atypical drug classes. No demographic or clinical factors influenced drug substitutions but a younger age and being married influenced being prescribed a polypharmacy regimen (more than 2 drugs) and an injectable antipsychotic agent. Conclusion: The prevalence of antipsychotic polypharmacy and use of typical agents among these patients was high. However, only age and marital status affected the quality of antipsychotic prescriptions among these patients.

Keywords: antipsychotics, drug substitution, pharmacoepidemiology, polypharmacy

Procedia PDF Downloads 475

Authors: Nicole Banton

Abstract:

The maternal and infant mortality rate of Blacks is three times that of Whites in the US. Research indicates that breastfeeding lowers both. In this paper, the researcher examines how the ideas that Black/African American mothers had about breastfeeding before, during, and after pregnancy (postpartum) affected whether or not they initiated breastfeeding. The researcher used snowball sampling to recruit thirty African-American mothers from the Orlando area. At the time of her interview, each mother had at least one child who was at least three years old. Through in-depth face-to-face interviews, the researcher investigated how mothers’ healthcare providers affected their decision-making about infant feeding, as well as how the type of birth that she had (e.g., preterm, vaginal, c-section, full term) affected her actual versus idealized infant feeding practice. Through our discussions, we explored how pre-pregnancy perceptions, birth and postpartum experiences, social support, and the discourses surrounding motherhood within an African-American context affected the perceptions and experiences that the mothers in the study had with their infant feeding practice(s). Findings suggest that the pregnancy and birth experiences of the mothers in the study influenced whether or not they breastfed exclusively, combined breastfeeding and infant formula use, or used infant formula exclusively. Specifically, the interplay of invocation of agency (the ability to control their bodies before, during, and after birth), birth outcomes, and the interaction that the mothers in this study had with resources, human and material, had the highest impact on the initiation, duration, and attitude toward breastfeeding.

Keywords: African American mothers, maternal health, breastfeeding, birth, midwives, obstetricians, hospital birth, breast pumps, formula use, infant feeding, lactation consultant, postpartum, vaginal birth, c-section, familial support, social support, work, pregnancy

Procedia PDF Downloads 86

Authors: Mohammad Jamalabadi, Noemi Zabari, Lukasz Bratasz

Abstract:

Panel paintings -complex multi-layer structures consisting of wood support and a paint layer composed of a preparatory layer of gesso, paints, and varnishes- are among the category of cultural objects most vulnerable to relative humidity fluctuations and frequently found in museum collections. The current environmental specifications in museums have been derived using the criterion of crack initiation in an undamaged, usually new gesso layer laid on wood. In reality, historical paintings exhibit complex crack patterns called craquelures. The present paper analyses the structural response of a paint layer with a virtual network of rectangular cracks under environmental loadings using a three-dimensional model of a panel painting. Two modes of loading are considered -one induced by one-dimensional moisture response of wood support, termed the tangential loading, and the other isotropic induced by drying shrinkage of the gesso layer. The superposition of the two modes is also analysed. The modelling showed that minimum distances between cracks parallel to the wood grain depended on the gesso stiffness under the tangential loading. In spite of a non-zero Poisson’s ratio, gesso cracks perpendicular to the wood grain could not be generated by the moisture response of wood support. The isotropic drying shrinkage of gesso produced cracks that were almost evenly spaced in both directions. The modelling results were cross-checked with crack patterns obtained on a mock-up of a panel painting exposed to a number of extreme environmental variations in an environmental chamber.

Keywords: fracture saturation, surface cracking, paintings on wood, wood panels

Procedia PDF Downloads 268

Authors: Radoslav Stojchevski, Leonid Poretsky, Dimiter Avtanski

Abstract:

Proinflammatory cytokines play an important role in cancer initiation and progression by mediating the intracellular communication between the cancer cells and tumor microenvironment. Increased tumor growth causing reduced oxygen concentration and oxygen pressure commonly result in hypoxia. Mechanistically, hypoxia is characterized by stabilization and nuclear translocation of hypoxia-inducible factor 1 alpha (HIF-1α) followed by propagation of molecular pathway cascade involving multiple downstream targets. Cobalt(II) chloride (CoCl₂) is commonly used to mimic hypoxia in experimental conditions since it directly induces the expression of HIF-1α. The aim of the present study was to investigate the in vitro effects and the molecular mechanisms by which hypoxia regulates the cytokine secretory profile of breast cancer cells. As a model for this study, we used several breast cancer cell lines bearing various molecular characteristics and metastatic potential (MDA-MB-231 (clauding low, ER-/PR-/HER²⁻), MCF-7 (luminal A, ER⁺/PR⁺/HER²⁻), and BT-474 (liminal B, ER⁺/PR⁺/HER²⁺)). We demonstrated that breast cancer cells secrete numerous cytokines and cytokine ligands, including interleukins, chemokines, and growth factors. Treatment with CoCl₂significantly modulated the breast cancer cells' cytokine expression in a concentration- and time-dependent manner. These effects were mediated via activation of several signaling pathways (JNK/SAPK1, NF-κB, STAT5A/B, and Erk/MAPK1/2). Taken together, the present data define some of the molecular mechanisms by which hypoxia affects the breast cancer cells' cytokine secretory profile, thus contributing to the development of novel therapies for metastatic breast cancer.

Keywords: breast cancer, cytokines, cobalt(II) chloride (CoCl₂), hypoxia

Procedia PDF Downloads 211

Authors: Aditya Manna, L. K. Khanra, S. K. Sarkar

Abstract:

Aim: Due to financial incapability and the absence of manpower-poor families often fail to carry their advanced cancer patients to the nodal centers. This pilot study will explore whether communication by mobile phone can lessen this burden. Method: Initially a plan was generated regarding management of an advanced cancer patient in a nodal center at District Head Quarter. Subsequently every two week a trained social worker attached to the nodal center will follow up and give necessary advice and emotional support to the patients and their families through their registered mobile phone number. Patient’s family were also encouraged to communicate with the team by phone in case of fresh complain and urgency in between. Results: Since initiation in January 2013, 193 cancer patients were contacted by mobile phone every two weeks to enquire about their difficulties. In 76% of the situation trained social workers could give necessary advice by phone regarding management of their physical symptoms. Moreover, patient’s family was really overwhelmed by the emotional support offered by the team over the phone. Only 24% of cancer patients have to attend the nodal center for expert advice from Palliative Care specialists. Conclusion: This novel approach helped: (a) In providing regular physical and emotional support to the patients and their families. (b) In significantly reducing the financial and manpower problems of carrying patients to the nodal units. (c) In improving the quality of life of patients by continuous guidance. More and more team members can take help of this new strategy for better communication and uninterrupted care.

Keywords: palliative care, terminal care, home based palliative care, rural india

Procedia PDF Downloads 304

Authors: Sayantika Biswas, Dipanshu Sur, Amitoj Athwal, Ratnabali Chakravorty

Abstract:

Title: Impact of serum estrogen and progesterone levels in the outcome pregnancy rate in frozen embryo transfer cycles. A prospective cohort study Objective: The aim of the current study was to evaluate the effect of serum estradiol (E2) and progesterone (P4) levels at different time points on pregnancy outcomes in frozen embryo transfer (FET) cycles. Materials & Method: A prospective cohort study was performed in patients undergoing frozen embryo transfer. Patients under age 37 years of age with at least one good blastocyst or three good day 3 embryos were included in the study. For endometrial preparation, 14 days of oral estradiol use (2X2 mg for 5 days. 3X2 mg for 4 days, and 4X2 mg for 5 days) was followed by vaginal progesterone twice a day and 50 mg intramuscular progesterone twice a day. Embryo transfer was scheduled 72-76 hrs or 116-120hrs after the initiation of progesterone. Serum E2 and P4 levels were examined at 4 times a) at the start of the menstrual cycle prior to the hormone supplementation. b) on the day of P4 start. c) on the day of ET. d) on the third day after ET. Result: A total 41 women were included in this study (mean age 31.8; SD 2.8). Clinical pregnancy rate was 65.55%. Serum E2 levels on at the start of the menstrual cycle prior to the hormone supplementation and on the day of P4 start were high in patients who achieved pregnancy compared to who did not (P=0.005 and P=0.019 respectively). P4 levels on on the day of ET were also high in patients with clinical pregnancy. On the day of P4 start, a serum E2 threshold of 186.4 pg/ml had a sensitivity of 82%, and P4 had a sensitivity of 71% for the prediction of clinical pregnancy at the threshold value 16.00 ng/ml. Conclusion: In women undergoing FET with hormone replacement, serum E2 level >186.4 pg/ml on the day of the start of progesterone and serum P4 levels >16.00 ng/ml on embryo transfer day are associated with clinical pregnancy.

Keywords: serum estradiol, serum progesterone, clinical pregnancy, frozen embryo transfer

Procedia PDF Downloads 81

Authors: Azza H. El-Medany, Hanan H. Hagar, Omnia A. Nayel, Jamila H. El-Medany

Abstract:

In search for drugs that can target cancer cell micro-environment in as much as being able to halt malignant cellular transformation, the natural dietary phytochemical curcumin was currently assessed in DMH-induced colorectal cancer rat model. The study enrolled 50 animals divided into a control group (n=10) and DMH-induced colorectal cancer control group (n=20) (20mg/kg-body weight for 28 weeks) versus curcumin-treated group (n=20) (160 mg/kg suspension daily oral for further 8 weeks). Treatment by curcumin succeeded to significantly decrease the percent of ACF and tended to normalize back the histological changes retrieved in adenomatous and stromal cells induced by DMH. The drug also significantly elevated GSH and significantly reduced most of the accompanying biochemical elevations (namely MDA, TNF-α, TGF-β and COX2) observed in colonic carcinomatous tissue, induced by DMH, thus succeeding to revert that of MDA, COX2 and TGF-β back to near normal as justified by being non-significantly altered as compared to normal controls. The only exception was PAF that was insignificantly altered by the drug. When taken together, it could be concluded that curcumin possess the potentiality to halt some of the orchestrated cross-talk between cancerous transformation and its micro-environmental niche that contributes to cancer initiation, progression and metastasis in this experimental cancer colon model. Envisioning these merits to a drug with already known safety preferentiality, awaits final results of current ongoing clinical trials, before curcumin can be added to the new therapeutic armamentarium of anticancer therapy.

Keywords: curcumin, dimethyl hydralazine, aberrant crypt foci, malondialdehyde, reduced glutathione, cyclooxygenase-2, tumour necrosis factor-alpha, transforming growth factor-beta, platelet activating factor

Procedia PDF Downloads 298

Authors: Mihai-Ionut Firescu, Mark A. P. Carson

Abstract:

We present a case of inferior vena cava agenesis (IVCA) associated with bilateral deep venous thrombosis (DVT) in a patient with Beckwith-Wiedemann syndrome (BWS). In adult patients with BWS presenting with bilateral lower limb oedema, specific aetiological factors should be considered. These include cardiomyopathy and intraabdominal tumours. Congenital malformations of the IVC, through causing relative venous stasis, can lead to lower limb oedema either directly or indirectly by favouring lower limb venous thromboembolism; however, they are yet to be reported as an associated feature of BWS. Given its life-threatening potential, the prompt initiation of treatment for bilateral DVT is paramount. In BWS patients, however, this can prove more complicated. Due to overgrowth, the above-average birth weight can continue throughout childhood. In this case, the patient’s weight reached 170 kg, impacting on anticoagulation choice, as direct oral anticoagulants have a limited evidence base in patients with a body mass above 120 kg. Furthermore, the presence of IVCA leads to a long-term increased venous thrombosis risk. Therefore, patients with IVCA and bilateral DVT warrant specialist consideration and may benefit from multidisciplinary team management, with hematology and vascular surgery input. Conclusion: Here, we showcased a rare cause for bilateral lower limb oedema, respectively bilateral deep venous thrombosis complicating IVCA in a patient with Beckwith-Wiedemann syndrome. The importance of this case lies in its novelty, as the association between IVC agenesis and BWS has not yet been described. Furthermore, the treatment of DVT in such situations requires special consideration, taking into account the patient’s weight and the presence of a significant, predisposing vascular abnormality.

Keywords: Beckwith-Wiedemann syndrome, bilateral deep venous thrombosis, inferior vena cava agenesis, venous thromboembolism

Procedia PDF Downloads 239

Authors: Bicky Agarwal, Ambika Behl, Rajiv Kumar, Ashish Dhamaniya

Abstract:

India ranks second for having the largest road network in the world after the United States (U.S.). According to the National Asphalt Pavement Association (NAPA), the U.S. produced about 94.6 million tons of Reclaimed Asphalt Pavement (RAP) in 2021. Despite the benefits of RAP usage, it is not widely adopted in many countries, including India. Rising asphalt binder costs and environmental concerns have spurred interest in using RAP material in asphalt mixtures. However, increasing RAP content may have adverse effects on certain characteristics of asphalt mixtures, such as cracking resistance. Cracking is a common pavement issue that affects the lifespan and durability of hot-mix asphalt pavements. Assessing cracking resistance is crucial in pavement design. Various laboratory tests and performance indicators are utilized to evaluate cracking resistance. This study aims to use the Texas Overlay Tester (TOT) to assess the impact of reclaimed asphalt pavement (RAP) on the cracking resistance of Bituminous Concrete (BC-II) mixes. Following the Marshall Mix Design method, asphalt mixes with RAP contents of 0% (Control), 30%, 40%, 50%, and 60% were prepared and tested at their Optimum Binder Content (OBC). The ITS results showed that the control mix had an ITS value of 1.2 MPa, with slight decreases observed in mixes containing up to 60% RAP, although these changes were not statistically significant (p=0.538>0.05). The TSR tests indicated that all mixes exceeded the minimum requirement of 80%. The Texas Overlay Test (TOT) was used to evaluate cracking performance and revealed that higher RAP contents had a negative impact on fatigue resistance. The 50% RAP mix exhibited the highest CFE, indicating that it has the best resistance to crack propagation despite having a lower number of cycles to failure. All mixes were categorized as falling into the Soft-crack-resistant quadrant, indicating their ability to resist crack propagation while being more susceptible to crack initiation.

Keywords: RAP, BC-II, HMA, TOT

Procedia PDF Downloads 32

Authors: Liang Ning, Chung Hau Yin

Abstract:

Angiogenesis is the process of new blood vessel development. It has been recognized as a therapeutic target for blocking cancer growth four decades ago. Vascular sprouting is initiated by pro-angiogenic factors. Vascular endothelial cell growth factor (VEGF) plays a central role in angiogenic initiation, many patients with cancer or ocular neovascularization have been benefited from anti-VEGF therapy. Emerging approaches impacting in the later stages of vessel remodeling and maturation are expected to improve clinical efficacy. TIE receptor as well as the corresponding angiopoietin ligands, were identified as another endothelial cell specific receptor tyrosine kinase signaling system. Much efforts were made to reduce the activity of angiopoietin-TIE receptor axis. Two eudesmane-type sesquiterpenes from laggera alata, namely, 15-dihydrocostic acid and ilicic acid were found with strong anti-angiogenic properties in zebrafish model. Meanwhile, the mRNA expression levels of VEGFR2 and TIE2 pathway related genes were down-regulated in the sesquiterpenes treated zebrafish embryos. Besides, in human umbilical vein endothelial cells (HUVECs), the sesquiterpenes have the ability to inhibit VEGF-induced HUVECs proliferation and migration at non-toxic concentration. Moreover, angiopoietin-2 induced TIE2 phosphorylation was inhibited by the sesquiterpenes, the inhibitory effect was detected in angiopoietin-1 induced HUVECs proliferation as well. Thus, we hypothesized the anti-angiogenic activity of the compounds may via the inhibition of VEGF and TIE2 related pathways. How the compounds come into play as the pathways inhibitors need to be evaluated in the future.

Keywords: Laggera alata, eudesmane-type sesquiterpene, anti-angiogenesis, VEGF, angiopoietin, TIE2

Procedia PDF Downloads 210

Authors: Barbara Torres Rives

Abstract:

Uveitis. Non-infectious anterior uveitis is a polygenic inflammatory eye disease, and it is suggested that mediated processes by the immune system (autoimmune or not) are the main mechanisms proposed in the pathogenesis of this type of uveitis. A relationship between infectious processes, digestive disorders, and a dysbiosis of the microbiome was recently described. In addition, alterations in the immune response associated with the initiation and progression of the disease have been described. Objective: The aim of this study was to identify factors related to the immune system associated with complicated non-infectious anterior uveitis. Methods: A cross-sectional observational analytical study was carried out. The universe consisted of all patients attending the ocular inflammation service of the Cuban Institute of Ophthalmology Ramón Pando Ferrer. The sample consisted of 213 patients diagnosed with non-infectious anterior uveitis. Results: Of the 213 patients with non-infectious anterior uveitis, the development of ophthalmologic complications predominated 56.3% (p=0.0094). In patients with complications was more frequent the presence of human leukocyte antigen-B27 allele (49.2%) (p<0.0001), decreased immunoglobulin G (24.2%, p=0.0124), increased immunoglobulin A (14.2%, p=0.0024), history of recurrent sepsis (59.2%, p=0.0018), recurrent respiratory infections (44.2%, p=0.0003), digestive alterations (40%, p=0.0013) and spondyloarthropathies (30%, p=0.0314). By logistic regression, it was observed that, for each completed year, the elevated risk for developing complicated non-infectious anterior uveitis in human leukocyte antigen-B27 allele positive patients (OR: 4.22, p=0.000), Conclusions: The control of recurrent sepsis at mucosal level and immunomodulation could prevent complications in non-infectious anterior uveitis. Therefore, the microbiome becomes the target of treatment and prevention of complications in non-infectious anterior uveitis.

Keywords: non-infectious anterior uveitis, immune system disorders, recurrent mucosal infections, microbiome

Procedia PDF Downloads 93

Authors: Sameer Gupta, Prant Gupta

Abstract:

Context: Fractures in the distal humerus are complex and challenging injuries for orthopaedic surgeons that can be effectively treated with open reduction and internal fixation. Aims: The study analyses clinical outcomes in patients with intra-articular distal humerus fractures (AO type 13 C3 excluded) treated using a different method of fixation ( LCPMS). Subject and Methods: A study was performed, and the author's personal experiences were reported. Thirty patients were treated using an intercondylar screw with lateral column plating and percutaneous medial column screw fixation. Detailed analysis was done for functional outcomes (average arc of motion, union rate, and complications). Statistical Analysis Used: SPSS software version 22.0 was used for statistical analysis. Results: In our study, at the end of 6 months, Overall good to excellent results were achieved in 28 patients out of 30 after analysis on the basis of MEP score. The majority of patients regained full arc of motion, achieved fracture union without any major complications, and were able to perform almost all activities of daily living (which required good elbow joint movements and functions). Conclusion: We concluded that this novel method provides adequate stability and anatomical reconstruction with an early union rate observed at the end of 6 months. Excellent functional outcome was observed in almost all the patients because of less operating time and initiation of early physiotherapy, as most of the patients experienced mild nature of pain post-surgery.

Keywords: intra arricular distal humerus fracture, percutaneous medial screw, lateral column plate, arc of motion

Procedia PDF Downloads 61

Authors: Rishabh Hans, Saksham Sharma

Abstract:

Drying of a sessile droplet imbibed with colloidal solution is a complex process in many aspects. Till now, most of the work revolves around; conditions for buckling onset, post-buckling effects, nature of change of droplet shape etc. In this work, we are determining the shape of daughter cavity (DC) formed during post-buckling onset, a less explored stage, and its relationship with experimental parameters. We have introduced solid angle as a special parameter that can quantify the shape of DC at any instant. It facilitates us to compare the shape while experimenting across different substrate types, droplet sizes and particle concentration. Furthermore, the angular location of ‘weak spot’ on the periphery of droplet, which marks the initiation of cavity growth, varies in different conditions. To solve this problem, we have evaluated the deflection angle of weak spots w.r.t. the vertical axis going through the middle of droplet. Subsequently, the solid angle subtended by DC is analyzed about that inclined axis. Finally, results of analysis allude that increasing colloidal concentration has inverse effect on the growth rate of cavity’s shape. Moreover, the cap radius of DC is observed lower for high PLR which makes the capillary pressure higher and thus tougher to expedite cavity formation relatively. This analysis can be helpful in further studies to relate the shape, deflection angle, growth rate of daughter cavity to the type of droplet crust formed in the end. Examining DC stage shall add another layer to nano-colloidal research which aims to influence many industrial applications like patterning, coatings, drug delivery, food processing etc.

Keywords: buckling of sessile droplets, daughter cavity, droplet evaporation, nanoporous shell formation, solid angle

Procedia PDF Downloads 270

Authors: Swati Tomar, Sunil Kumar Gupta

Abstract:

The start-up of anammox (anaerobic ammonium oxidation) process in hybrid reactor delineated four distinct phases i.e. cell lysis, lag phase, activity elevation and stationary phase. Cell lysis phase was marked by death and decay of heterotrophic denitrifiers resulting in breakdown of organic nitrogen into ammonium. Lag phase showed initiation of anammox activity with turnover of heterotrophic denitrifiers, which is evident from appearance of NO3-N in the effluent. In activity elevation phase, anammox became the dominant reaction, which can be attributed to consequent reduction of NH4-N into N2 with increased NO3-N in the effluent. Proper selection of mixed seed culture at influent NO2-/NH4+ ratio (1:1) and hydraulic retention time (HRT) of 1 day led to early startup of anammox within 70 days. Pseudo steady state removal efficiencies of NH4+ and NO2- were found as 94.3% and 96.4% respectively, at nitrogen loading rate (NLR) of 0.35 kg N/m3d at an HRT of 1 day. Analysis of the data indicated that attached growth system contributes an additional 11% increase in the ammonium removal and results in an average of 29% reduction in sludge washout rate. Mass balance study of nitrogen indicated that 74.1% of total input nitrogen is converted into N2 gas followed by 11.2% being utilized in biomass development. Scanning electron microscope (SEM) observation of the granular sludge clearly showed the presence of cocci and rod shaped microorganisms intermingled on the external surface of the granules. The average size of anammox granules (1.2-1.5 mm) with an average settling velocity of 45.6 m/h indicated a high degree of granulation resulting into formation of well compacted granules in the anammox process.

Keywords: anammox, hybrid reactor, startup, granulation, nitrogen removal, mixed seed culture

Procedia PDF Downloads 186

Authors: Loïc Chrislin Nguedjio, S. Jerome Afoutou, Rostand Moutou Pitti, Benoit Blaysat, Frédéric Dubois, Naman Recho, Pierre Kisito Talla

Abstract:

The safety and durability of structures remain challenging fields that continue to draw the attention of designers. One widely adopted approach is fracture mechanics, which provides methods to evaluate crack stability in complex geometries and under diverse loading conditions. The global energy approach is particularly comprehensive, as it calculates the energy release rate required for crack initiation and propagation using path-independent integrals. This study aims to extend these invariant integrals to include path-independent integrals, with the goal of enhancing the accuracy of failure predictions. The ultimate objective is to create more robust materials while optimizing structural safety and durability. By integrating the real and virtual field method with the virtual crack closure technique, a new formulation of the M-integral is introduced. This formulation establishes a direct relationship between local stresses on the crack faces and the opening displacements, allowing for an accurate calculation of fracture energy. The analytical calculations are grounded in the assumption that the energy needed to close a crack virtually is equal to the energy released during its opening. This novel integral is implemented in a finite element code using Cast3M to simulate cracking criteria within a wood material context. Initially, the numerical calculations are focused on plane strain conditions, but they are later extended to three-dimensional environments, taking into account the orthotropic nature of wood.

Keywords: energy release rate, path-independent integrals, virtual crack closure, orthotropic material

Procedia PDF Downloads 13

Authors: Ejazulhaq Rahimi

Abstract:

The development of techniques evaluating deterioration on concrete structures is vital for structural health monitoring (SHM). One of the main reasons for reinforced concrete structure's deterioration is the corroding of embedded rebars. It is a natural process that begins when the rebar starts to rust. It occurs when the protective layer on the rebar is destroyed. The rebar in concrete is usually protected against corrosion by the high pH of the surrounding cement paste. However, there are chemicals that can destroy the protective layer, making it susceptible to corrosion. It is very destructive for the lifespan and durability of the concrete structure. Corrosion products which are 3 to 6 times voluminous than the rebar stress its surrounding concrete and lead to fracture as cracks even peeling off the cover concrete over the rebar. As is clear that concrete shows limit elastic behavior in its stress strain property, so corrosion product stresses can be detected as strains from the concrete surface. It means that surface strains have a relation with the situation and amount of corrosion products and related concrete fractures inside reinforced concrete. In this paper, a comparative study of surface strains due to corrosion products detected by strain gauges and acoustic emission (AE) testing under periodic accelerated corrosion in the salty environment with 3% NaCl is reported. From the results, three different stages of strains were clearly observed based on the type and rate of strains in each corrosion situation and related fracture types. AE parameters which mostly are related to fracture and their shapes, describe the same phases. It is confirmed that there is a great agreement to the result of each other and describes three phases as generation and expansion of corrosion products and initiation and propagation of corrosion-induced cracks, and surface cracks. In addition, the strain on the concrete surface was rapidly increased before the cracks arrived at the surface of the concrete.

Keywords: acoustic emission, monitoring, rebar corrosion, reinforced concrete, strain

Procedia PDF Downloads 180

Authors: Hasan Izhar Khan, Naiqiang Zhang, Hong Xu, Zhongliang Zhu, Dongfang Jiang

Abstract:

Inconel 625 is a nickel-based alloy having outstanding corrosion resistance and developed for use at service temperatures ranging from cryogenic to 980°C. It got a wide range of applications in nuclear, petrochemical, chemical, marine, aeronautical, and aerospace industries. Currently, it is one of the candidate materials to be used as a structural material in ultra-supercritical (USC) power plants. In the high-temperature corrosive medium environment, metallic materials are susceptible to corrosion fatigue (CF). CF is an interaction between cyclic stress and corrosive medium environment that acts on a susceptible material and results in initiation and propagation of cracks. For the application of Inconel 625 as a structural material in USC power plants, CF behavior must be evaluated in steam and supercritical water (SCW) environment. Fatigue crack growth rate (FCGR) curves obtained from CF experiments are required to predict residual life of metallic materials used in power plants. In this study, FCGR tests of Inconel 625 were obtained by using compact tension specimen at 550-650 °C in steam (8 MPa) and SCW (25 MPa). The dissolved oxygen level was kept constant at 8000 ppb for the test conducted in steam and SCW. The tests were performed under sine wave loading waveform, 1 Hz loading frequency, stress ratio of 0.6 and maximum stress intensity factor of 32 MPa√m. Crack growth rate (CGR) was detected by using direct current potential drop technique. Results showed that CGR increased with an increase in temperature in the tested environmental conditions. The mechanism concerning the influence of temperature on FCGR are further discussed.

Keywords: corrosion fatigue, crack growth rate, nickel-based alloy, temperature

Procedia PDF Downloads 132

Authors: Karthik K. R, Viswanath V, Asraff A. K

Abstract:

The first stage of a new-generation launch vehicle of ISRO makes use of large pressure vessels made of Aluminium alloy AA2219 to store fuel and oxidizer. These vessels have many weld joints that may contain cracks or crack-like defects during their fabrication. These defects may propagate across the vessel during pressure testing or while in service under the influence of tensile stresses leading to catastrophe. Though ductile materials exhibit significant stable crack growth prior to failure, it is not generally acceptable for an aerospace component. There is a need to predict the initiation of stable crack growth. The structural integrity of the vessel from fracture considerations can be studied by constructing the Failure Assessment Diagram (FAD) that accounts for both brittle fracture and plastic collapse. Critical crack sizes of the pressure vessel may be highly conservative if it is predicted from FAD alone. If the J-R curve for material under consideration is available apriori, the critical crack sizes can be predicted to a certain degree of accuracy. In this paper, a novel approach is proposed to predict the integrity of a weld in a pressure vessel made of AA2219 material. Fracture parameter ‘J-integral’ at the crack front, evaluated through finite element analyses, is used in the new procedure. Based on the simulation of tension tests carried out on SCT specimens by NASA, a cut-off value of J-integral value (J?ᵤₜ_ₒ??) is finalised. For the pressure vessel, J-integral at the crack front is evaluated through FE simulations incorporating different surface cracks at long seam weld in a cylinder and in dome petal welds. The obtained J-integral, at vessel level, is compared with a value of J?ᵤₜ_ₒ??, and the integrity of vessel weld in the presence of the surface crack is firmed up. The advantage of this methodology is that if SCT test data of any metal is available, the critical crack size in hardware fabricated using that material can be predicted to a better level of accuracy.

Keywords: FAD, j-integral, fracture, surface crack

Procedia PDF Downloads 187

Authors: Perdana Rakhmana Putra, Hansen Wijaya, Sri Budiyani, Muhamad Natsir, Alexis badai Samudra

Abstract:

The Palembang Sub-Basin (PSB) located in southern part of South Sumatera basin (SSB) consist of half-graben complex trending N-S to NW-SE. These geometries are believe as an impact of strike-slip regime developed in Eocene-Oligocene. Generally, most of the wells in this area produced hydrocarbon from late stage of syn-rift sequences called Lower Talang Akar (LTAF) and post-rift sequences called Batu Raja Formation (BRF) and drilled to proved hydrocarbon on structural trap; three-way dip anticline, four-way dip anticline, dissected anticline, and stratigraphy trap; carbonate build-up and stratigraphic pinch out. Only a few wells reached the deeper syn-rift sequences called Lahat Formation (LAF) and Lemat Formation (LEF). The new interpretation of subsurface data was done by the tectonostratigraphy concept and focusing on syn-rift sequence. Base on seismic characteristic on basin centre, it divided into four sequences: pre-rift sequence, rift initiation, maximum rift and late rift. These sequences believed as a new exploration target on PSB mature basin. This paper will demonstrate the paleo depositional setting during Paleogene and exploration play concept of syn-rift sequence in PSB. The main play for this area consists of stratigraphic and structure play, where the stratigraphic play is Eocene-Oligocene sediment consist of LAF sandstone, LEF-Benakat formation, and LAF with pinch-out geometry. The pinch-out, lenses geometry and on-lap features can be seen on the seismic reflector and formed at the time of the syn-rift sequence. The structural play is dominated by a 3 Way Dip play related to reverse fault trap.

Keywords: syn-rift, tectono-stratigraphy, exploration play, basin center play, south sumatera basin

Procedia PDF Downloads 199

Authors: Mekni Sabrine, Nouira Mariem

Abstract:

Background and aim: Allogeneic hematopoietic stem cell transplantation is a curative treatment for several hematological diseases; however, it has a non-negligible morbidity and mortality depending on several prognostic factors, including pre-transplant hyperferritinemia. The aim of our study was to estimate the impact of hyperferritinemia on survivals and on the occurrence of post-transplant complications. Methods: It was a longitudinal study conducted over 8 years and including all patients who had a first allograft. The impact of pretransplant hyperferritinemia (ferritinemia ≥1500) on survivals was studied using the Kaplan Meier method and the COX model for uni- and multivariate analysis. The Khi-deux test and binary logistic regression were used to study the association between pretransplant ferritinemia and post-transplant complications. Results: One hundred forty patients were included with an average age of 26.6 years and a sex ratio (M/F)=1.4. Hyperferritinemia was found in 33% of patients. It had no significant impact on either overall survival (p=0.9) or event -free survival (p=0.6). In multivariate analysis, only the type of disease was independently associated with overall survival (p=0.04) and event-free survival (p=0.002). For post-allograft complications: The occurrence of early documented infections was independently associated with pretransplant hyperferritinemia (p=0.02) and the presence of acute graft versus host disease( GVHD) (p<10-3). The occurrence of acute GVHD was associated with early documented infection (p=0.002) and Cytomegalovirus reactivation (p<10-3). The occurrence of chronic GVHD was associated with the presence of Cytomegalovirus reactivation (p=0.006) and graft source (p=0.009). Conclusion: Our study showed the significant impact of pre-transplant hyperferritinemia on the occurrence of early infections but not on survivals. Early and more accurate assessment iron overload by other tests such as liver magnetic resonance imaging with initiation of chelating treatment could prevent the occurrence of such complications after transplantation.

Keywords: allogeneic, transplants, ferritin, survival

Procedia PDF Downloads 66

Authors: Abdulmohsen Alruwaili

Abstract:

A partial differential system featuring momentum and energy balance is often used to describe simulations of flow initiation and thermal shifting in boundary layers. The buoyancy force in terms of temperature is factored in the momentum balance equation. Buoyancy force causes the flow quantity to fluctuate along the streamwise direction 𝑋; therefore, the problem can be, to our best knowledge, analyzed through nonsimilar modeling. In this analysis, a nonsimilar model is evolved for radiative mixed convection of a magnetized power-law nanoliquid flow on top of a vertical plate installed in a stationary fluid. The upward linear stretching initiated the flow in the vertical direction. Assuming nanofluids are composite of copper (Cu) and alumina (Al₂O₃) nanoparticles, the viscous dissipation in this case is negligible. The nonsimilar system is dealt with analytically by local nonsimilarity (LNS) via numerical algorithm bvp4c. Surface temperature and flow field are shown visually in relation to factors like mixed convection, magnetic field strength, nanoparticle volume fraction, radiation parameters, and Prandtl number. The repercussions of magnetic and mixed convection parameters on the rate of energy transfer and friction coefficient are represented in tabular forms. The results obtained are compared to the published literature. It is found that the existence of nanoparticles significantly improves the temperature profile of considered nanoliquid. It is also observed that when the estimates of the magnetic parameter increase, the velocity profile decreases. Enhancement in nanoparticle concentration and mixed convection parameter improves the velocity profile.

Keywords: nanofluid, power law model, mixed convection, thermal radiation

Procedia PDF Downloads 35

Authors: Heru Al Amin

Abstract:

Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology that can affect multiple different organ systems. Isolated cardiac sarcoidosis is a very rare condition that causes lethal arrhythmia and heart failure. A definite diagnosis of cardiac sarcoidosis remains challenging. The use of multimodality imaging plays a pivotal role in the diagnosis of this entity. Case summary: In this report, we discuss a case of a 50-year-old woman who presented with recurrent palpitation, dizziness, vertigo and presyncope. Electrocardiogram revealed variable heart blocks, including first-degree AV block, second-degree AV block, high-degree AV block, complete AV block, trifascicular block and sometimes supraventricular arrhythmia. Twenty-four hours of Holter monitoring show atrial bigeminy, first-degree AV block and trifascicular block. Transthoracic echocardiography showed Thinning of basal anteroseptal and inferred septum with LV dilatation with reduction of Global Longitudinal Strain. A dual-chamber pacemaker was implanted. CT Coronary angiogram showed no coronary artery disease. Cardiac magnetic resonance revealed basal anteroseptal and inferior septum thinning with focal edema with LGE suggestive of sarcoidosis. Computed tomography of the chest showed no lymphadenopathy or pulmonary infiltration. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) of the whole body showed. We started steroids and followed up with the patient. Conclusion: This case serves to highlight the challenges in identifying and managing isolated CS in a young patient with recurrent syncope with variable heart block. Early, even late initiation of steroids can improve arrhythmia as well as left ventricular function.

Keywords: cardiac sarcoidosis, conduction abnormality, syncope, cardiac MRI

Procedia PDF Downloads 92

Authors: Jegede Kehinde Jacob, Ola Akeem Bayonle, Adewale Yemi Yekeen

Abstract:

The rapid rate of urban growth in most developing countries of the world in recent times is alarming. Mass movement of people from rural areas to the urban centres, the consequence of the uncontrolled rapid urbanisation resulting to many un-conforming environmental challenges such as inadequate infrastructure, land, water and air pollution, poor environmental sanitation, poor and inadequate housing, urban degradation, sprawl and slums, urban violence, crime, robbery and prostitution as well as many other social vices that make the cities unsustainable. The resultant effects of all these are abysmal failure in the management of cities on the part of the governing authorities and other relevant stakeholders as well as unconducive and unwholesome condition of living of the people. This paper attempts to examine holistically the issue of environmental planning management (EPM) process development and management concept with a view for dynamic and interactive approach for various stakeholders as partners in achieving sustainable cities of our dream. The areas of discussion including conceptual and contextual issues, sustainable cities concept, good urban governance including literature review. The paper goes further to examine opportunities and challenges of built environment generally, the nature and context of environmental problems in particular, the role and duties of environmental planning and management (EPM) process in sustainable urban development. The paper further reviewed briefly the various levels of institutionalisation of EPM process with a typical case study of sustainable Ibadan project (SIP). The paper concludes with a list of recommendations to ensure effective and lasting solutions to cities problems through initiation of EPM process achievable in a sustainable manner.

Keywords: built environment, environmental planning, sustainable cities, sustainable development, urbanization

Procedia PDF Downloads 266

Authors: Shyaka Eugene

Abstract:

The efficient and safe demolition of structures is a critical challenge in civil engineering and construction. This study focuses on the development of optimal demolition strategies by investigating the crack propagation behavior in beams induced by soundless cracking agents. It is commonly used in controlled demolition and has gained prominence due to its non-explosive and environmentally friendly nature. This research employs a comprehensive experimental and computational approach to analyze the crack initiation, propagation, and eventual failure in beams subjected to soundless cracking agents. Experimental testing involves the application of various cracking agents under controlled conditions to understand their effects on the structural integrity of beams. High-resolution imaging and strain measurements are used to capture the crack propagation process. In parallel, numerical simulations are conducted using advanced finite element analysis (FEA) techniques to model crack propagation in beams, considering various parameters such as cracking agent composition, loading conditions, and beam properties. The FEA models are validated against experimental results, ensuring their accuracy in predicting crack propagation patterns. The findings of this study provide valuable insights into optimizing demolition strategies, allowing engineers and demolition experts to make informed decisions regarding the selection of cracking agents, their application techniques, and structural reinforcement methods. Ultimately, this research contributes to enhancing the safety, efficiency, and sustainability of demolition practices in the construction industry, reducing environmental impact and ensuring the protection of adjacent structures and the surrounding environment.

Keywords: expansion pressure, energy release rate, soundless chemical demolition agent, crack propagation

Procedia PDF Downloads 63

Authors: Folajinmi Oluwasina, Greg Abiaziem, Moses Luke, Mobolaji Kolawole, Nancy Yibowei, Anne Taiwo

Abstract:

Background: Occurrence of HIV infection has an adverse effect on the natural causes of Hepatitis B Viral (HBV) infection, faster progression of hepatic fibrosis demonstrated in patients with co-infection. This study was carried out to determine the incidence of HBV infection among HIV-positive patients, and to retrospectively evaluate laboratory characteristics of patients with HIV/HBV co-infection. Methods: A retrospective analysis of patient files for all HIV-infected cases followed-up and treated at 52 health facilities. Among HIV-infected cases, those with HBsAg positivity and HIV/Hepatitis B co-infection were determined. Socio demographic, alcohol or substance use, ART, CD4, Viral Load levels and treatment durations were retrospectively evaluated. Results: Of the 125 HIV-infected patients evaluated retrospectively, 17 (13.6%) had HBsAg positivity. Of these 17 cases were 11(64.7%) male and 6 (35.3%) female, with a mean age of 48.7 years. No patients had a history of alcohol or substance use. The mean duration of follow up was 28 months. 9 (52.9%) patients had negative HBV DNA at presentation while 8(47%) had positive HBV DNA, with normal ALT levels in all subjects. Among the 9 cases with negative HBV DNA who had no indication for the treatment of chronic hepatitis B. In five cases, treatment was commenced since HBV DNA was elevated in conjunction with low CD4. One patient in whom treatment was not indicated based on HBV DNA and CD4 levels in conjunction with the absence of AIDS defining clinical picture was currently being followed-up without treatment. Of the patients receiving HAART therapy, the average CD4 count at presentation was 278 cells/mm3 vs. 466 cells/mm3 at the end of 12 months. In three subjects with positive HBV DNA, a decrease in HBV DNA was noted after initiation of treatment. In four patients with negative DNA who received treatment, the HBV DNA negative status was found to remain, while one patient who did not receive treatment had elevated HBV DNA and decreased CD4 levels. Conclusion: It was shown that this group of patients with HIV/HBV co-infection, HAART was found to be associated with a decrease in HBV DNA in HBV DNA positive cases, absence of transition to positivity among those with negative HBV DNA, and with increased CD4 in all subjects.

Keywords: Hepatitis B, DNA, anti retroviral therapy, co-infection

Procedia PDF Downloads 270

Authors: Jan Gayl Barcelon, N. Gorgonio

Abstract:

Renal tubular acidosis, a medical condition that involves the accumulation of acid in the body due to failure of the kidneys to maintain normal urine and blood pH, is rarely encountered in pregnancy. The effect of renal tubular acidosis in pregnancy is not fully established. It may worsen during pregnancy and cause maternal and fetal morbidity. A 30-year-old primigravida was diagnosed with renal tubular acidosis at age 7, but due to uncontrolled disease progression, she developed rickets at age 10. She was first seen in our institution at eight weeks gestation and maintained on bicarbonate and potassium supplementation. At 26 weeks gestation, she was diagnosed with polyhydramnios, causing on and off irregular uterine contractions. At 30 weeks gestation, despite oral Nifedipine, premature labor was uncontrolled; hence she was admitted for tocolysis. With elevated creatinine (123 umol/L) and a normal blood urea nitrogen level (6.70 mmol/L), she was referred to Nephrology Service, which cleared the patient prior to MgSO₄ drip. Dosing of 4g MgSO₄ over 20 minutes followed by a maintenance of 2g/hour x 24 hours for neuroprotection and tocolysis was ordered. Two hours after MgSO₄ drip initiation, hematuria developed with adequate urine output. The infusion was immediately stopped. The serum magnesium level was high normal at 6.7 mEq/L. After 4 hours of renal clearance, the repeat serum magnesium level was normal (2.7 mEq/L) and with clear urine output. The patient was then given Nifedipine 30mg/tab, 3x a day which controlled the uterine contractions. At 37 weeks gestation, the patient delivered via primary low transverse Cesarean Section to a live female with a birthweight of 2470gm, appropriate for gestational age. The use of MgSO₄ for the control of premature labor in patients with chronic renal disease secondary to renal tubular can cause hematuria.

Keywords: hematuria, magnesium sulfate, premature labor, renal tubular acidosis

Procedia PDF Downloads 129