Search results for: bleeding gums

Authors: Muhammad Mansoor Majeed, Imtiaz Ahmed

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For centuries, honey has been used for the management and cure of different diseases for the treatment of wound, ulcers, burns, cough, and sore throat, etc. It has also been proved to decrease inflammation, edema, and exudates in different body tissues. This study is performed to find out the effectiveness of honey in the treatment and prevention of gingivitis, gingival bleeding, and accumulation of plaque. Randomized control trial was performed on two subject groups. Honey provided to one subject group to apply on their gums and tooth and then gargle with water and drink. Frequency of the procedure is thrice a day for a month. Another group was given a placebo. Before and after, readings were taken according to Loe and Silness Plaque and Gingival Index. Initially, the mean plaque index, Gingival index and the percentage of sites which were bleeding in the honey group was 0.910, 0.800 and 58.71% respectively which has reduced to 0.313, 0.296 and 27.6% in 30 ± 3 days whereas the control group did not show signs of improvement. Visible changed has observed in the honey group from 0.910 to 0.313 in mean plaque index, 0.800 to 0.296 in Gingival Index, and the percentage of bleeding sited decreased from 58.71% to 27.6%. No significant changes observed in another group. We can conclude that honey reduces the formation/accumulation of plaque and decreases gingival bleeding as well as it has therapeutic effects.

Keywords: honey, gingivitis, Pakistan, bleeding gums

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Authors: Himanshu Kushwah, Nidhi Sandal, Meenakshi K. Chauhan, Gaurav Mittal

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Excessive bleeding is the primary factor of avoidable death in both civilian trauma centers as well as the military battlefield. Hundreds of Indian troops die every year due to blood loss caused by combat-related injuries. These deaths are avoidable and can be prevented to a large extent by making available a suitable hemostatic dressing in an emergency medical kit. In this study, natural gums were evaluated as potential hemostatic agents in combination with calcium gluconate. The study compares the hemostatic activity of Gum Tragacanth (GT), Guar Gum (GG), Xanthan Gum (XG) and Gum Acacia (GA) by carrying out different in-vitro and in-vivo studies. In-vitro studies were performed using the Lee-White method and Eustrek method, which includes the visual and microscopic analysis of blood clotting. MTT assay was also performed using human lymphocytes to check the cytotoxicity of the gums. The in-vivo studies were performed in Sprague Dawley rats using tail bleeding assay to evaluate the hemostatic efficacy of the gums and compared with a commercially available hemostatic sponge, Surgispon. Erythrocyte agglutination test was also performed to check the interaction between blood cells and the natural gums. Other parameters like blood loss, adherence strength of the developed hemostatic dressing material incorporating these gums, re-bleeding, and survival of the animals were also studied. The data obtained from the MTT assay showed that Guar gum, Gum Tragacanth, and Gum Acacia were not significantly cytotoxic, but substantial cytotoxicity was observed in Xanthan gum samples at high concentrations. Also, Xanthan gum took the least time with its minimum concentration to achieve hemostasis, (approximately 50 seconds at 3mg concentration). Gum Tragacanth also showed efficient hemostasis at a concentration of 35mg at the same time, but the other two gums tested were not able to clot the blood in significantly less time. A sponge dressing made of Tragacanth gum was found to be more efficient in achieving hemostasis and showed better practical applicability among all the gums studied and also when compared to the commercially available product, Surgispon, thus making it a potentially better alternative.

Keywords: cytotoxicity, hemostasis, natural gums, sponge

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Authors: Yogita Weikey, Shobha Lata Sinha, Satish Kumar Dewangan

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In the present investigation, rheology of the three different natural gums has been evaluated experimentally using MCR 102 rheometer. Various samples based on the variation of the concentration of the solid gum powder have been prepared. Their non-Newtonian behavior has been observed by the consistency plots and viscosity variation plots with respect to different solid concentration. The viscosity-shear rate curves of gums are similar and the behavior is shear thinning. Gums are showing pseudoplastic behavior. The value of k and n are calculated by using various models. Results show that the Herschel–Bulkley rheological model is reliable to describe the relationship of shear stress as a function of shear rate. R² values are also calculated to support the choice of gum selection.

Keywords: bentonite, Indian gum, non-Newtonian model, rheology

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Authors: Kyoung Hoon Kim

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This work presents an exergetical performance analysis of regenerative organic Rankine cycle (ORC) using turbine bleeding based on the second law of thermodynamics for recovery of finite thermal energy. Effects of system parameters such as turbine bleeding pressure and turbine bleeding fraction are theoretically investigated on the exergy destructions (anergies) at various components of the system as well as the exergy and the second-law efficiencies. Under the conditions of the critical fraction of turbine bleeding, the simulation results show that the exergy efficiency decreases monotonically with respect to the bleeding pressure, however, the second-law efficiency has a peak with respect to the turbine bleeding pressure.

Keywords: organic Rankine cycle, ORC, regeneration, turbine bleeding, exergy, second-law efficiency

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Authors: Kalyan Koganti

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Background: In India, platelet transfusions are given to large no. of patients suffering from dengue due to the fear of bleeding especially when the platelet counts are low. Though many patients do not bleed when the platelet count falls to less than 20,000, certain patients bleed even if the platelet counts are more than 20,000 without any comorbid condition (like gastrointestinal ulcer) in the past. This fear has led to huge amounts of unnecessary platelet transfusions which cause significant economic burden to low and middle-income countries like India and also sometimes these transfusions end with transfusion-related adverse reactions. Objective: To identify the role of Activated Partial Thromboplastin Time (APTT) in comparison with thrombocytoenia as an indicator to assess the real need of platelet transfusions. Method: A prospective study was conducted at a hospital in South India which included 176 admitted cases of dengue confirmed by immunochromatography. APTT was performed in all these patients along with platelet count. Cut off values of > 60 seconds for APTT and < 20,000 for platelet count were considered to assess the bleeding manifestations. Results: Among the total 176 patients, 56 patients had bleeding manifestations like malena, hematuria, bleeding gums etc. APTT > 60 seconds had a sensitivity and specificity of 93% and 90% respectively in identifying bleeding manifestations where as platelet count of < 20,000 had a sensitivity and specificity of 64% and 73% respectively. Conclusion: Elevated APTT levels can be considered as an indicator to assess the need of platelet transfusion in dengue. As there is a significant variation among patients who bleed with respect to platelet count, APTT can be considered to avoid unnecessary transfusions.

Keywords: activated partial thromboplastin time, dengue, platelet transfusion, thrombocytopenia

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Authors: Akhad Ibrokhimov

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Update of preventive medicine has exacerbated the problem of cause-and-effect relationship between the presence of herpetic stomatitis (HS) and periodontal disease. Comprehensive survey of children with herpetic stomatitis, according to WHO equirements, on the territory of Tashkent years was conducted. Objective: To analyze the prevalence and intensity of periodontal tissue diseases in children with herpetic stomatitis. Materials and methods. Dental disease in Tashkent was studied in 156 children with herpetic stomatitis, as a control, the incidence of dental studied in 153 children of comparable age and sex never without a history of herpetic stomatitis. Results and discussion. The study revealed that 42,86 ± 13,23% of children with Herpetic stomatitis in the age group 6 years, 1 month - 10 years suffered from periodontal disease, the incidence of periodontal disease in the control group was 14,29 ± 9,35% (R≥0 05) corresponding to the frequency of detection of sextants with bleeding and tartar was equal to 35,71 ± 12,80% vs. 7,14 ± 6,88% (R≥0,05) and 14,29 ± 9,35% against 7 14 ± 6,88% (R≥0,05). Status of periodontal tissues was assessed in age groups 6 years, 1 month - 10 years and 10 years, 1 month - 15 years. The intensity of periodontal lesions observed at the level of 1,79 ± 0,06 vs. 0,66 ± 0,03 (P ≤ 0,05) affected sextant, including sextants with bleeding 1,62 ± 0,07 vs. 0.65 ± 0 , 03 (P ≤ 0,05) and sextants tartar - 0,17 ± 0,008 vs. 0,10 ± 0,008 (P ≤ 0,05). At age 10 years, 1 month - 15 years, a higher prevalence of signs of periodontal lesion was identified in patients with table of contents in 80,00 ± 12,65% of cases versus 30,00 ± 14,49% (P ≤ 0,05), and prevailed bleeding gums 70,00 ± 14,49% against 20,00 ± 11,83% (p ≤ 0.05), tartar was diagnosed respectively in 30,00 ± 14,49% against 10,00 ± 9,48% (R≥0,05) surveyed.

Keywords: vestibular surface, abnormal abrasion, composites, prosthesis

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Authors: Patcharawalai Jaisamut, Kamonthip Wiwattanawongsa, Ruedeekorn Wiwattanapatapee

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Supersaturation of drugs in the gastrointestinal tract is one approach to increase the absorption of poorly water-soluble drugs. The stabilization of a supersaturated state was achieved by adding precipitation inhibitors that may act through a variety of mechanisms.In this study, the effect of the natural gums, acacia, gelatin, pectin and tragacanth on curcumin supersaturation in simulated gastric fluid (SGF) (pH 1.2), fasted state simulated gastric fluid (FaSSGF) (pH 1.6), and simulated intestinal fluid (SIF) (pH 6.8)was investigated. The results indicated that all natural gums significantly increased the curcum insolubility (about 1.2-6-fold)when compared to the absence of gum, and assisted in maintaining the supersaturated drug solution. Among the tested gums, pectin at 3% w/w was the best precipitation inhibitor with a significant increase in the degree of supersaturation about 3-fold in SGF, 2.4-fold in FaSSGF and 2-fold in SIF.

Keywords: curcumin, solubility, supersaturation, precipitation inhibitor

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Authors: Puntarikorn Rungrattanakasin

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Objectives: To develop the trigger tool to warn about the risk of bleeding as an adverse event from warfarin drug usage during admission in Medical Wards of Chumphae Hospital. Methods: A retrospective study was performed by reviewing the medical records for the patients admitted between June 1st,2020- May 31st, 2021. ADEs were evaluated by Naranjo’s algorithm. The international normalized ratio (INR) and events of bleeding during admissions were collected. Statistical analyses, including Chi-square test and Reciever Operating Characteristic (ROC) curve for optimal INR threshold, were used for the study. Results: Among the 139 admissions, the INR range was found to vary between 0.86-14.91, there was a total of 15 bleeding events, out of which 9 were mild, and 6 were severe. The occurrence of bleeding started whenever the INR was greater than 2.5 and reached the statistical significance (p <0.05), which was in concordance with the ROC curve and yielded 100 % sensitivity and 60% specificity in the detection of a bleeding event. In this regard, the INR greater than 2.5 was considered to be an optimal threshold to alert promptly for bleeding tendency. Conclusions: The INR value of greater than 2.5 (>2.5) would be an appropriate trigger tool to warn of the risk of bleeding for patients taking warfarin in Chumphae Hospital.

Keywords: trigger tool, warfarin, risk of bleeding, medical wards

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Authors: Reenu Yadav, Vidhi Guha, Udit N. Soni, Jay Ram Patel

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Chewing gums are mobile novel drug delivery systems, with a potential for administering drugs either for local action or for systemic absorption via the buccal route. An antimicrobial chewing gum delivery system of the methanolic extracts of Beatea monosperma (barks and twigs), Cordia obliqua (leaves and seeds) and Cuminun cyminum (seeds) against periodontal diseases caused by some oral pathogens, was designed and characterized on various parameters.The results of the study support the traditional application of the plants and suggest, plant extracts possess compounds with antimicrobial properties that can be used as potential antimicrobial agents and gums can be a good carrier of herbal extracts. Developed formulation will cure/protect from various periodontal diseases. Further development and evaluations chewing gums including the isolated compounds on the commercial scale and their clinical and toxicological studies are the future challenges.

Keywords: periodontal diseases, herbal chewing gum, herbal extracts, novel drug delivery systems

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Authors: Dewi Tristantini, Jason Jonathan

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Coronary Artery Disease (CAD) is one of the deathliest diseases which is caused by atherosclerosis. Atherosclerosis is a disease that plaque builds up inside the arteries. Plaque is made up of fat, cholesterol, calcium, platelet, and other substances found in blood. The current treatment of atherosclerosis is to provide antiplatelet therapy treatment, but such treatments often cause gastrointestinal irritation, muscle pain and hormonal imbalance. Mimusops elengi L.’s leaves can be utilized as a natural and cheap antiplatelet’s source because it contains flavonoids such as quertecin. Antiplatelet aggregation effect of Mimusops elengi L.’s leaves’ wet extract was measured by bleeding time on DDY strain mice with the test substances were given orally during the period of 8 days. The bleeding time was measured on first day and 9th day. Empirically, the dose which is used for humans is 8.5 g of leaves in 600 ml of water. This dose is equivalent to 2.1 g of leaves in 350 ml of water for mice. The extract was divided into 3 doses for mice: 0.05 ml/day; 0.1 ml/day; 0.2 ml/day. After getting the percentage of the increase in bleeding time, data were analyzed by analysis of variance test (Anova), followed by individual comparison within the groups by LSD test. The test substances above respectively increased bleeding time 21%, 62%, and 128%. As the conclusion, the 0.02 ml/day dose of Mimusops elengi L.’s leaves’ wet extract could increase bleeding time better than clopidogrel as positive controls with 110% increase in bleeding time.

Keywords: antiplatelets, atheroschlerosis, bleeding time, Mimusops elengi

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Authors: Mekha Mathew, Varun P Gopi

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Wireless Capsule Endoscopy (WCE) has become a great device in Gastrointestinal (GI) tract diagnosis, which can examine the entire GI tract, especially the small intestine without invasiveness and sedation. Bleeding in the digestive tract is a symptom of a disease rather than a disease itself. Hence the detection of bleeding is important in diagnosing many diseases. In this paper we proposes a novel method for distinguishing bleeding regions from normal regions based on Contourlet transform and Local Binary Pattern (LBP). Experiments show that this method provides a high accuracy rate of 96.38% in CIE XYZ colour space for k-Nearest Neighbour (k-NN) classifier.

Keywords: Wireless Capsule Endoscopy, local binary pattern, k-NN classifier, contourlet transform

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Authors: Rashmi Ranade, Neelu Joshi

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Barleria prionitis L. is a well explored Indian medicinal plant valued for its stem and leaf which forms an important ingredient of many Ayurvedic formulations. It is used for the treatment of various disorders like toothache, bleeding gums, strengthening gums, whooping cough, inflammation, arthritis, enlargement of scrotum and sciatica etc. The plant is propagated vegetatively through stem cuttings. Frequent harvesting of this plant has led to the shortage of planting material, and it has acquired the status of vulnerable plant species. Plant tissue culture technology offers a very good alternative for propagation and conservation of such plant species. The present investigation was undertaken to develop in vitro regeneration protocol for B. prionitis L. via callus organogenesis pathway. Stem and leaf explants were used for this purpose. Different media and plant growth regulators were optimized to develop the protocol. The problem of phenol secretion and browning and in vitro cultures at the establishment phase was successfully curbed with the usage of antibrowning agents such as ascorbic acid and activated charcoal. Optimum shoot multiplication was achieved by the use of liquid media and incorporation of silver nitrate and TIBA (triiodobenzoic acid) into the media. High percent rooting (76%) was observed on WPM media supplemented with IBA (2.0 mg/l), IAA (0.5 mg/l), GA3(0.5) and activated charcoal(500 mg/l). The rooted plantlets were subjected to in vitro hardening on sterile potting mix (soil:farmyard manure:compost; 1:2:1) and acclimatized under greenhouse conditions. Around 85% survival of plantlets was recorded upon acclimatization. This lab scale protocol would be tested for in vitro scaling up production of B. prionitis L.

Keywords: explant browning, liquid culture, micropropagation, shoot multiplication, phenolic secretion

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Authors: Muhammad Faisal Khilji, Rana Shoaib Hamid

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Subdural hematoma (SDH) is an extremely rare complication of immune thrombocytopenic purpura (ITP). We present a case of a 34 years old female who presented to the Emergency department of a tertiary care hospital with complaints of headache, on and off gums bleeding and upper respiratory tract symptoms for the last two weeks. Examination was unremarkable except some purpura over limbs. Investigations revealed zero platelets and peripheral film suggestive of ITP. Computerized tomography (CT) brain revealed bilateral SDH in the frontal areas extending into Falx cerebri. Impression of ITP with SDH was made. Patient was treated with intravenous immunoglobulin (IVIg), methyl prednisolone and initial Platelets transfusion. Patient recovered uneventfully with platelets reaching normal levels within a few days and resolution of SDH without surgery.

Keywords: headache, immune thrombocytopenia, purpura, subdural hematoma

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Authors: Seyed Abbas Tabatabaei, Fereydoon Moghadas Nejad, Mohammad Saed

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The bleeding prediction of the asphalt is one of the most complex subjects in the pavement engineering. In this paper, an Adaptive Neuro Fuzzy Inference System (ANFIS) is used for modeling the effect of important parameters on bleeding is trained and tested with the experimental results. bleeding index based on the asphalt film thickness differential as target parameter,asphalt content, temperature depth of two centemeter, heavy traffic, dust to effective binder, Marshall strength, passing 3/4 sieves, passing 3/8 sieves,passing 3/16 sieves, passing NO8, passing NO50, passing NO100, passing NO200 as input parameters. Then, we randomly divided empirical data into train and test sections in order to accomplish modeling. We instructed ANFIS network by 72 percent of empirical data. 28 percent of primary data which had been considered for testing the approprativity of the modeling were entered into ANFIS model. Results were compared by two statistical criterions (R2, RMSE) with empirical ones. Considering the results, it is obvious that our proposed modeling by ANFIS is efficient and valid and it can also be promoted to more general states.

Keywords: bleeding, asphalt film thickness differential, Anfis Modeling

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Authors: Marie Madeleine Nanga Ndjang, Julie Mathilde Klang, Edwin M. Mmutlane, Derek Tantoh Ndinteh, Eugenie Kayitesi, Francois Ngoufack Zambou

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Gluten intolerance and the unavailability of wheat flour in some parts of the world have led to the development of gluten-free bread. However, gluten-free bread generally results in a low specific volume, and to remedy this, the use of hydrocolloids and bases has proved to be very successful. Thus, the present study aims to determine the optimal proportions of gum extract of Triumffetapentendraand sodium bicarbonate in breadmaking of a composite flour based on sour cassava starch, peanut, and cowpea flour. To achieve this, a BoxBenkhendesign was used, the variable being the amount of extract gums, the amount of bicarbonate, and the amount of water. The responses evaluated were the specific volume and texture properties (Hardness, Cohesiveness, Consistency, Elasticity, and Masticability). The specific volume was done according to standard methods of AACC and the textural properties by a texture analyzer. It appears from this analysis that the specific volume is positively influenced by the incorporation of extract gums, bicarbonate, and water. The hardness, consistency, and plasticity increased with the incorporation rate of extract gums but reduced with the incorporation rate of bicarbonate and water. On the other hand, Cohesion and elasticity increased with the incorporation rate of bicarbonate and water but reduced with the incorporation of extract gum. The optimate proportions of extract gum, bicarbonate, and water are 0.28;1.99, and 112.5, respectively. This results in a specific volume of 1.51; a hardness of 38.51; a cohesiveness of 0.88; a consistency of 32.86; an elasticity of 5.57, and amasticability of 162.35. Thus, this analysis suggests that gum extracts and sodium bicarbonate can be used to improve the quality of gluten-free bread.

Keywords: box benkhen design, bread-making, gums, textures properties, specific volume

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Authors: Fedili Benamar, Belloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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Introduction: Perioperative blood loss is a frequent cause of complications in total hip replacement (THR). The present prospective study assessed the efficacy of tranexamic acid (Exacyl(®)) in reducing blood loss in primary THR. Hypothesis: Tranexamic acid reduces blood loss in THR. Material and method: -This is a prospective randomized study on the effectiveness of Exacyl (tranexamic acid) in total hip replacement surgery performed on a standardized technique between 2019 and September 2022. -It involved 154 patients, of which 84 received a single injection of Exacyl (group 1) at a dosage of 10 mg/kg over 20 minutes during the perioperative period. -All patients received postoperative thromboprophylaxis with enoxaparin 0.4 ml subcutaneously. -All patients were admitted to the post-interventional intensive care unit for a duration of 24 hours for monitoring and pain management as per the service protocol. Results: 154 patients, of which 84 received a single injection of Exacyl (group 1) and 70 patients patients who did not receive Exacyl perioperatively : (Group 2 ) The average age is 57 +/- 15 years The distribution by gender was nearly equal with 56% male and 44% female; "The distribution according to the ASA score was as follows: 20.2% ASA1, 82.3% ASA2, and 17.5% ASA3. "There was a significant difference in the average volume of intraoperative and postoperative bleeding during the 48 hours." The average bleeding volume for group 1 (received Exacyl) was 614 ml +/- 228, while the average bleeding volume for group 2 was 729 +/- 300, with a chi-square test of 6.35 and a p-value < 0.01, which is highly significant. The ANOVA test showed an F-statistic of 7.11 and a p-value of 0.008. A Bartlett test revealed a chi-square of 6.35 and a p-value < 0.01." "In Group 1 (patients who received Exacyl), 73% had bleeding less than 750 ml (Group A), and 26% had bleeding exceeding 750 ml (Group B). In Group 2 (patients who did not receive Exacyl perioperatively), 52% had bleeding less than 750 ml (Group A), and 47% had bleeding exceeding 750 ml (Group B). "Thus, the use of Exacyl reduced perioperative bleeding and specifically decreased the risk of severe bleeding exceeding 750 ml by 43% with a relative risk (RR) of 1.37 and a p-value < 0.01. The transfusion rate was 1.19% in the population of Group 1 (Exacyl), whereas it was 10% in the population of Group 2 (no Exacyl). It can be stated that the use of Exacyl resulted in a reduction in perioperative blood transfusion with an RR of 0.1 and a p-value of 0.02. Conclusions: The use of Exacyl significantly reduced perioperative bleeding in this type of surgery.

Keywords: acid tranexamic, blood loss, anesthesia, total hip replacement, surgery

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Authors: Tadesse Melaku Abegaz, Akshaya Srikanth Bahagavathula, Abdulla Shehab Sheab, Asim Hassen

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Objectives: Non-adherence and discontinuation of anticoagulant therapy lead to increased ischemic stroke risk and contributes to suboptimal outcomes of the anticoagulant treatment. This systematic review and meta-analysis were aimed to investigate the adherence to NOACs and adverse events in patients with AF. Methods: Original research articles conducted on patients with AF and using any NOACs (dabigatran, rivoraxaban and apixaban) reporting adherence for at least 35 days were included. Scientific databases including PubMed, Web of Science, and Google Scholar were searched using MeSH keywords to obtaining literature researched between 2008 to till June, 2016. Study characteristics, patient’s sociodemographic and clinical characteristics, medication adherence levels and bleeding events reported were recorded. Results: The overall sample size of the six studies is 1,640,157, with CHADS2 scores < 2 in 551 patients, CHADS2-VASc ≥ 2 in 62,232 AF patients. Three-forth [75.6% (95%CI= 66.5-84.8), p < 0.001] are adherent to NOACs. However, a higher rate [72.7% (62.5-82.9), p < 0.001] of adherence was observed with Dabigatran than Apixaban [59.9% (3.2-123.1), p=0.063] and Rivaroxaban [59.3% (38.7-80.0), p<0.001]. Sub-group analysis revealed that nearly 57% of the AF patients on NOACs have CHADS2 scores < 2 and 20% of these patients were non-adherent to NOACs. Overall bleeding events rate associated with NOACs non-adherent AF patients was found to be 7.5% (0.2-14.8), p=0.045. However, nearly 11.2% of AF patients experienced bleeding events were non-adherent to NOAC medications. A higher proportion of bleeding events were noticed with Dabigatran (14.7%). Conclusions: Adherence rates, while uniformly suboptimal, nevertheless varied considerably, lowest at 59.3% for rivaroxaban and 59.9% for apixaban, followed by dabigatran (75.6%). Overall bleeding events associated with NOACs rates were 7.5%. However, lower adherence to NOACs was associated with worse outcomes among patients with greater stroke risk.

Keywords: atrial fibrillation, bleeding events, meta-analysis, novel oral anticoagulants

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Authors: Samindi Samarakoon, Ørjan Sletbakk Vie, Remi Kleiven Fjelldal

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White concrete facade elements are widely used in construction industry. It is challenging to achieve the desired workability in casting of white concrete elements. Particle Matrix model was used for proportioning the self-compacting white concrete (SCWC) to control segregation and bleeding and to improve workability. The paper presents how to reach the target slump flow while controlling bleeding and segregation in SCWC. The amount of aggregates, binders and mixing water, as well as type and dosage of superplasticizer (SP) to be used are the major factors influencing the properties of SCWC. Slump flow and compressive strength tests were carried out to examine the performance of SCWC, and the results indicate that the particle matrix model could produce successfully SCWC controlling segregation and bleeding.

Keywords: white concrete, particle matrix model, mix design, construction industry

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Authors: Asamaporn Puetpaiboon, Sunisa Chatmongkolchart, Nalinee Kovitwanawong, Osaree Akaraborworn

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Traumatic patients with massive bleeding require intensive resuscitation. The actual cost of anesthesia per case has never been clarified, so our study aimed to quantify the direct cost, and cost-to-charge ratio of anesthetic care in traumatic patients with intraoperative massive bleeding. This study was a prospective, observational, cost analysis study, conducted in Prince of Songkla University hospital, Thailand, with traumatic patients, of any mechanisms being recruited. Massive bleeding was defined as estimated blood loss of at least one blood volume in 24 hours, or a half of blood volume in 3 hours. The cost components were identified by the micro-costing method, and valued by the bottom-up approach. The direct cost was divided into 4 categories: the labor cost, the capital cost, the material cost and the cost of drugs. From September 2017 to August 2018, 10 patients with multiple injuries were included. Seven patients had motorcycle accidents, two patients fell from a height and another one was in a minibus accident. Two patients died on the operating table, and another two died within 48 hours. The median Sequential Organ Failure Assessment (SOFA) score was 8. The median intraoperative blood loss was 3,500 ml. The median direct cost, per case, was 250 United States Dollars (2017 exchange rate), and the cost-to-charge ratio was 0.53. In summary, the direct cost was nearly half of the hospital charge, for these traumatic patients with massive bleeding. However, our study did not analyze the indirect cost.

Keywords: cost, cost-to-charge ratio, micro-costing, trauma

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Authors: Kübra Aktaş, Nermin Bilgiçli, Tayyibe Erten, Perihan Kübra Çiçek

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In this research, different wheat-legume flour blends were used in Turkish noodle preparation with the aid of some gums (xanthan and guar). Chickpea, common bean and soy flours were used in noodle formulation at 20% level with and without gum (1%) addition. Some physical, chemical and sensory properties of noodles were determined. Water uptake, volume increase and cooking loss values of the noodles changed between 92.03-116.37%, 125.0-187.23% and 4.88-8.10%, respectively. Xanthan or guar gam addition decreased cooking loss values of legume fortified noodles. Both legume flour and gum addition significantly (p<0.05) affected the color values of the noodles. The lowest lightness (L*), redness (a*) and the highest yellowness (b*) values were obtained with soy flour usage in noodle formulation. Protein and ash values of noodles ranged between 15.14 and 21.82%; 1.62 and 2.50%, respectively, and the highest values were obtained with soy flour usage in noodle formulation. As a result of sensory evaluation, noodles containing chickpea flour and guar gum were rated with higher taste, odor, appearance and texture scores compared to other noodle samples.

Keywords: noodle, legume, soy, chickpea, common bean, gum

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Authors: Angelis P. Barlampas

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The aim of this work is to denote that during an emergency state, an examination study may not be accomplished by state-of-the-art of imaging and, therefore, cannot obviously reveal all the existing findings. But, such a situation may have disastrous consequences for the patient. When interpreting radiological images, one must try to be as meticulous as possible, especially if the patient has alerting clinical symptoms. A case may be missed because its findings are not so obvious in rapid uncompleted radiological imaging. A thirty-seven years old female patient visited the emergency department because of a headache and hemiparesis of her left leg. Firstly, a CT examination without contrast was done, and mild serpentinous hyperintensities were depicted at the right parietal lobe. In addition to that, there was a linear, mildly hyperattenuating structure resembling a vessel in the nearby middle line. At first, an AVM was suspected, so an MRI examination with i.v. Gd was prescribed. The patient returned a few days later, not having done the MRI and complaining of persisting symptomatology. A new CT examination without and with i.v.c administration was done that showed no hyperintensities but a type-enhancing vessel in the posterior interhemispheric fissure. The latest findings are consistent with a venous malformation with previous bleeding.

Keywords: bleeding, brain, CNS, hemorrhage, CT, venous malformation

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Authors: Mai Ashraf Talaat

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Background: Vitamin C (ascorbic acid) is an essential nutrient for the development and repair of all body tissues. It can be obtained from a healthy diet or through supplementation. Due to its importance, vitamin C has become a mainstay in the treatment and prevention of many diseases and in maintaining immune, skin, bone and overall health. This review article aims to discuss the studies and case reports conducted to evaluate the effect of Vitamin C on oral health and the recent advances in oral medicine that involve the use of vitamin C. Data/Sources: The review was conducted for clinical studies, case reports and published literature in the English language that addresses this topic. An extensive search in the electronic databases of PubMed, PubMed Central, Web of Science, National Library of Medicine and ResearchGate was performed. Conclusion: Vitamin C is thought to treat periodontal diseases and gingival enlargement. It also affects biofilm formation and therefore, it helps in reducing caries incidence. Recently, vitamin C mesotherapy has been used to treat inflamed gingiva, bleeding gums and gingival hyperpigmentation. More research and randomized controlled trials are needed on this specific topic for more accurate judgment. Clinical significance: A minimally invasive approach - the usage of vitamin C in dental care could drastically reduce the need for surgical intervention.

Keywords: oral health, periodontology, vitamin C, Gingivitis

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Authors: Pármenas Costa Macedo do Nascimento

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Periodontal disease is the most common disease in the oral cavity of felines. It starts with the accumulation of bacteria on the tooth surface supporting the tissues of the periodontal tissue, namely gums, alveolar bone, cementum, and periodontal ligament. The main clinical symptom observed by the owner is bad breath, which may lead to local and systemic consequences depending on the stage of periodontal disease, such as bleeding and bone loss. Therefore, the study is important to educate tutors to take better care of the felines oral health in order to try to prevent the disease. For this epidemiological study, the target population has been felines, located on the outskirts of Manaus, in the state of Amazonas, with a geographic area of 155.68 km², with no defined breed, from October 1st to 10th, 2021, whose samples has been randomly selected, with a detailed profile. The variables of interest for this study have been: absence or presence of periodontal disease, gender, age (delimited by age group), and condition (domiciled or homeless). Using a sample of 40 felines from 4 districts of the east side of Manaus chosen at random, an oral exam has been made to identify the studied disease. The animal's apparent age, condition, sex, and presence or absence of periodontal disease has been noted. It has been observed that 70% (28/40) of them had periodontal disease, mostly females, aged between 0 and 5 years and domiciled, totaling 30% (12/40).

Keywords: felines, oral cavity, oral exam, periodontal disease

Procedia PDF Downloads 171

Authors: Muhammad Yasir Tarar

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Background: Intraarticular steroid injections are an effective option in alleviating the symptoms of conditions like osteoarthritis, rheumatoid arthritis, crystal arthropathy, and rotator cuff tendinopathy. Most of these injections are conducted in the elderly who are on polypharmacy, including anticoagulants at times. Up to 6% of patients aged 80-84 years have been reported to be taking Warfarin. The literature availability on safety quotient for patients undergoing intraarticular injections on Warfarin is scarce. It has remained debatable over the years which approach is safe for these patients. Continuing warfarin has a theoretical bleeding risk, and stopping it can lead to even severe life-threatening thromboembolic events in high-risk patients. Objectives: To evaluate the risk of bleeding complications in patients on warfarin undergoing intraarticular injections or arthrocentesis. Study Design & Methods: A literature search of MEDLINE (1946 to present), EMBASE (1974 to present), and Cochrane CENTRAL (1988 to present) databases were conducted using any combination of the keywords, Injection, Knee, Shoulder, Joint, Intraarticular, arthrocentesis, Warfarin, and Anticoagulation in November 2020 for articles published in any language with no publication year limit. The study inclusion criteria included reporting on the rate of bleeding complications following injection of the knee or shoulder in patients on warfarin treatment. Randomized control trials and prospective and retrospective study designs were included. An electronic standardized Performa for data extraction was made. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) the methodology was used. The articles were appraised using the methodological index for nonrandomized studies. The Cochrane Risk of Bias Tool used to assess the risk of bias in included RCTs and the MINORS tool for assessment of bias in observational studies. Results: The search of databases resulted in a total of 852 articles. Relevant articles as per the inclusion criteria were shortlisted, 7 articles deemed suitable to be include. A total of 1033 joints sample size was undertaken with specified knee and shoulder joints of a total of 820. Only 6 joints had bleeding complications, 5 early bleeding at the time of injection or aspiration, and one late bleeding complication with INR of 5, additionally, 2 patients complained of bruising, 3 of pain, and 1 managed for infection. Conclusions: The results of the metanalysis show that it is relatively safe to perform intraarticular injections in patients on Warfarin regardless of the INR range.

Keywords: arthrocentesis, warfarin, bleeding, injection

Procedia PDF Downloads 49

Authors: A. V. Belousov, Yakushenko

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One of the main problems of modern dentistry is development a reliable method to detect inflammation in the gums on the stages of diagnosis and assessment of treatment efficacy. We have proposed a method of gingival fluid intake, which successfully combines accessibility, excluding the impact of the annoying and damaging the gingival sulcus factors and provides reliable results (patent of RF№ 2342956 Method of gingival fluid intake). The objects of the study were students - volunteers of Dentistry Faculty numbering 75 people aged 20-21 years. Cellular composition of gingival fluid was studied using microscope "Olympus CX 31" (Japan) with the calculation of epithelial leukocyte index (ELI). Assessment of gingival micro circulation was performed using the apparatus «LAKK–01» (Lazma, Moscow). Cytological investigation noted the highly informative of epithelial leukocyte index (ELI), which demonstrated changes in the mechanisms of protection gums. The increase of ELI occurs during inhibition mechanisms of phagocytosis and activation of epithelial desquamation. The cytological data correlate with micro circulation indicators obtained by laser Doppler flowmetry. We have identified and confirmed the correlations between parameters laser Doppler flowmetry and data cytology gingival fluid in patients with gingivitis.

Keywords: gingivitis, laser doppler flowmetry, gingival fluid cytology, epithelial leukocyte index (ELI)

Procedia PDF Downloads 296

Authors: Hasan Ziari, Hassan Fazaeli, Seyed Javad Vaziri Kang Olyaei, Asma Sadat Dabiri

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The presence of cracks in concrete pavements is a place for the ingression of corrosive substances, acids, oils, and water into the pavement and reduces its long-term durability and level of service. One of the causes of early cracks in concrete pavements is the plastic shrinkage. This shrinkage occurs due to the formation of negative capillary pressures after the equilibrium of the bleeding and evaporation rates at the pavement surface. These cracks form if the tensile stresses caused by the restrained shrinkage exceed the tensile strength of the concrete. Different climate conditions change the rate of evaporation and thus change the balance time of the bleeding and evaporation, which changes the severity of cracking in concrete. The present study examined the relationship between the balance time of bleeding and evaporation and the area of cracking in the concrete slabs using the standard method ASTM C1579 in 27 different environmental conditions by using continuous video recording and digital image analyzing. The results showed that as the evaporation rate increased and the balance time decreased, the crack severity significantly increased so that by reducing the balance time from the maximum value to its minimum value, the cracking area increased more than four times. It was also observed that the cracking area- balance time curve could be interpreted in three sections. An examination of these three parts showed that the combination of climate conditions has a significant effect on increasing or decreasing these two variables. The criticality of a single factor cannot cause the critical conditions of plastic cracking. By combining two mild environmental factors with a severe climate factor (in terms of surface evaporation rate), a considerable reduction in balance time and a sharp increase in cracking severity can be prevented. The results of this study showed that balance time could be an essential factor in controlling and predicting plastic shrinkage cracking in concrete pavements. It is necessary to control this factor in the case of constructing concrete pavements in different climate conditions.

Keywords: bleeding and cracking severity, concrete pavements, climate conditions, plastic shrinkage

Procedia PDF Downloads 117

Authors: Pramote Thangkratok

Abstract:

The aims of this experimental study were to investigate the effect of Reverse Trendelenburg Position on the Back Pain after Cardiovascular Angiography and Interventions. In addition, to compare bleeding and hematoma occurrences at the Access site between experimental and control groups. The randomized controlled trial (RCT) was conducted in 70 patients who underwent Cardiovascular Angiography and Interventions via the femoral artery and received post procedural care at the intermediate cardiac care unit, Bangkok Heart Hospital. From December 2015 to February 2016. The control group (35 patients) was to get standard care after the intervention, whereas the experimental group (35 patients) was Reverse Trendelenburg Position 30-45 degrees. The groups were not significantly different in terms of demographic characteristics, Age, Gender, BMI, blood pressure, heart rate. While not significantly different from each other, the intensity of back pain control group had a significantly higher pain score than experimental group. Vascular complications in terms of bleeding and hematoma were not significantly different between the control and experimental groups. The findings show that Reverse Trendelenburg Position after Cardiovascular Angiography and Interventions would reduce or prevent the back pain without increasing the chance of bleeding and hematoma.

Keywords: reverse trendelenburg position, back pain, cardiovascular angiography, cardiovascular interventions

Procedia PDF Downloads 239

Authors: Jeong-Moh John Yahng, Angelika Na

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Introduction: Increasing numbers of general surgical patients are being prescribed antiplatelet and anticoagulant medications (APAC) for various cardiovascular and cerebrovascular conditions. Surgical patients who are on APAC present a management challenge as bleeding risk needs to be balanced with thromboembolic risk. Although guidelines exist in regards to APAC management in elective surgery, there is a lack of guidelines in the emergency surgery setting. In this study we aim to characterise APAC usage in emergency general surgical patients admitted to a rural hospital. We also assess the impact of APAC usage on clinical management of these patients. Methods: Prospective study of emergency general surgical admissions at Northeast Health Wangaratta (Victoria) from 2 July to 25 Oct 2014. Questionnaire collected demographics data, admission diagnosis, APAC usage, anaesthesia techniques, operation types, transfusion requirement and morbidity / mortality data. Results: During the 4 month study, 118 patients were classified into two groups: non-APAC (n=96, 81%) and APAC (n=22, 19%). Patients in the APAC group were older compared to the non-APAC patients (mean age 72 vs 42 years old). Amongst patients younger than 60 years old, only 1% of them were on APAC. In contrast, 49% of patients older than 60 years old were on APAC (p<0.001). Patients who were admitted with a bleeding problem were more likely to be on APAC (p<0.05). 19% of emergency general surgery patients were on APAC. The majority (91%) of them were on antiplatelet medication, with two patients being on dual antiplatelet agents (aspirin + clopidogrel or ticagrelor). 15% of emergency general surgical patients requiring operations were on APAC. 11% of all laparotomies and 33% of gastroscopy for haematemesis/melaena patients were on APAC. Both of the patients operated for bleeding following surgery at another hospital were in the APAC group. In regards to impact on clinical management, 59% of APAC patients had their medications interrupted or ceased, on average by 3.5 days (range 1-13 days). 2 out of 75 operations were delayed due to APAC usage. There was no difference in the use of central venous or arterial line for increased monitoring (p=0.14) or in the use of warming blanket (Bair Hugger™) (p=0.94). Overall, transfusion rate was higher amongst APAC patients (14% vs 3%) (p 0.04). The recorded morbidity (n=2) and mortality (n=1) in this study were all in the APAC group. Discussion: Nineteen percent of emergency general surgical admissions and fifteen percent of operated patients were on APAC. The prevalence of APAC usage was higher in those aged sixty and above. General surgical patients who were admitted with a bleeding problem were more likely to be on APAC. Two patients who were operated for bleeding following surgery at another hospital were in the APAC group. Note that there was no patient in the non-APAC group who was admitted for post-operative bleeding. We observed two cases in which operation was delayed due to APAC usage. Transfusion, morbidity and mortality rate were higher in the APAC group. Conclusion: In this study, nineteen percent of emergency general surgical admissions were on APAC. The use of APAC is more prevalent in the older age group, particularly those aged sixty and above. Higher proportion of APAC compared to non-APAC patients were admitted and operated for bleeding problems. There is an urgent need for clinical guidelines regarding APAC management in emergency general surgical patients.

Keywords: antiplatelet, anticoagulants, emergency general surgery, rural general surgery, morbidity, mortality

Procedia PDF Downloads 110

Authors: Mimoza Canga, Alketa Qafmolla, Vergjini Mulo, Irene Malagnino

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Aim: Assessment of oral health in young people aged 18-29 years after the Covid-19 pandemic in Albania. Materials and methods: The present study was conducted at the University of Medicine in Tirana, Albania, from March 2023 to September 2023. This is s cross-sectional study. In our research, 104 students participated, of which 64 were females (61.5%) and 40 were males (38.5%). In the present survey, the participants were divided into four age groups: 18-20, 21-23, 24-26, and 27-29 years old. Majority of the sample (69%) were 18-20 years. Participants were instructed to complete the questionnaire. The study had no dropouts. The current study was conducted in accordance to Helsinki declaration. Statistical analysis was performed using IBM SPSS Statistics Version 23.0, Microsoft Windows Linux, Chicago, IL, USA. Data were analyzed using analysis of variance (ANOVA). P ≤ 0.05 was considered statistically significant. Results: This study reported that 80 (76.9%) of the participants had passed Covid-19, while 24 (23.1%) of them had not passed Covid-19. Based on our data analysis, 70 (67.3%) of the participants had symptoms such as of fever 38°C- 40.5°C and headache. They stated that were treated with Azithromycin 500 mg tablets, Augmentin 625 mg tablets, Vitamin C 1000 mg, Magnesium, and Vitamin D. 40(38.4%) of the participants noticed hypersensitivity in gums (p = 0.004) and sensitive teeth (p = 0.001) after having passed Covid-19 compared to pre-pandemic. Nearly 40 (38.4%) of the participants who passed Covid-19 were treated with painful relievers for the gums and teeth, such as ibuprofen (Advil), used Sensodyne Toothpaste for sensitive teeth and Clove oil. Conclusion: Within the limitations of this study conducted in Albania, can concluded that Covid-19 has a direct impact on oral health.

Keywords: albania, Covid19, cross-sectional study, oral health

Procedia PDF Downloads 46

Authors: Man Chul Jeong, Hyoung Jin Lee, Sang Yoon Lee, Ji Hyun Park, Min Wook Chang, In-Seuck Jeung

Abstract:

This study focus on the drag reduction effect of the base bleed at supersonic flow. Base bleed is the method which bleeds the gas on the tail of the flight vehicle and reduces the base drag, which occupies over 50% of the total drag in any flight speed. Thus base bleed can reduce the total drag significantly, and enhance the total flight range. Drag reduction ratio of the base bleed is strongly related to the mass flow rate of the bleeding gas. Thus selecting appropriate mass flow rate is important. However, since the flight vehicle has various flight speed, same mass flow rate of the base bleed can have different drag reduction effect during the flight. Thus, this study investigates the effect of the drag reduction depending on the flight speed by numerical analysis using STAR-CCM+. The analysis model is 155mm diameter projectile with boat-tailed shape base. Angle of the boat-tail is chosen previously for minimum drag coefficient. Numerical analysis is conducted for Mach 2 and Mach 3, with various mass flow rate, or the injection parameter I, of the bleeding gas and the temperature of the bleeding gas, is fixed to 300K. The results showed that I=0.025 has the minimum drag at Mach 2, and I=0.014 has the minimum drag at Mach 3. Thus as the Mach number is higher, the lower mass flow rate of the base bleed has more effect on drag reduction.

Keywords: base bleed, supersonic, drag reduction, recirculation

Procedia PDF Downloads 386