Search results for: chronic disseminated intravascular coagulation
1664 Sudden Death and Chronic Disseminated Intravascular Coagulation (DIC): Two Case Reports
Authors: Saker Lilia, Youcef Mellouki, Lakhdar Sellami, Yacine Zerairia, Abdelhaid Zetili, Fatma Guahria, Fateh Kaious, Nesrine Belkhodja, Abdelhamid Mira
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Background: Sudden death is regarded as a suspicious demise necessitating autopsy, as stipulated by legal authorities. Chronic disseminated intravascular coagulation (DIC) is an acquired clinical and biological syndrome characterized by a severe and fatal prognosis, stemming from systemic, uncontrolled, diffuse coagulation activation. Irrespective of their origins, DIC is associated with a diverse spectrum of manifestations, encompassing minor biological coagulation alterations to profoundly severe conditions wherein hemorrhagic complications may take precedence. Simultaneously, microthrombi contribute to the development of multi-organ failures. Objective This study seeks to evaluate the role of autopsy in determining the causes of death. Materials and Methods: We present two instances of sudden death involving females who underwent autopsy at the Forensic Medicine Department of the University Hospital of Annaba, Algeria. These autopsies were performed at the request of the prosecutor, aiming to determine the causes of death and illuminate the exact circumstances surrounding it. Methods Utilized: Analysis of the initial information report; Findings from postmortem examinations; Histological assessments and toxicological analyses. Results: The presence of DIC was noted, affecting nearly all veins with distinct etiologies. Conclusion: For the establishment of a meaningful diagnosis: • Thorough understanding of the subject matter is imperative; • Precise alignment with medicolegal data is essential.Keywords: chronic disseminated intravascular coagulation, sudden death, autopsy, causes of death
Procedia PDF Downloads 851663 Prediction of Survival Rate after Gastrointestinal Surgery Based on The New Japanese Association for Acute Medicine (JAAM Score) With Neural Network Classification Method
Authors: Ayu Nabila Kusuma Pradana, Aprinaldi Jasa Mantau, Tomohiko Akahoshi
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The incidence of Disseminated intravascular coagulation (DIC) following gastrointestinal surgery has a poor prognosis. Therefore, it is important to determine the factors that can predict the prognosis of DIC. This study will investigate the factors that may influence the outcome of DIC in patients after gastrointestinal surgery. Eighty-one patients were admitted to the intensive care unit after gastrointestinal surgery in Kyushu University Hospital from 2003 to 2021. Acute DIC scores were estimated using the new Japanese Association for Acute Medicine (JAAM) score from before and after surgery from day 1, day 3, and day 7. Acute DIC scores will be compared with The Sequential Organ Failure Assessment (SOFA) score, platelet count, lactate level, and a variety of biochemical parameters. This study applied machine learning algorithms to predict the prognosis of DIC after gastrointestinal surgery. The results of this study are expected to be used as an indicator for evaluating patient prognosis so that it can increase life expectancy and reduce mortality from cases of DIC patients after gastrointestinal surgery.Keywords: the survival rate, gastrointestinal surgery, JAAM score, neural network, machine learning, disseminated intravascular coagulation (DIC)
Procedia PDF Downloads 2591662 Comparison of Chemical Coagulation and Electrocoagulation for Boron Removal from Synthetic Wastewater Using Aluminium
Authors: Kartikaningsih Danis, Yao-Hui Huang
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Various techniques including conventional and advanced have been employed for the boron treatment from water and wastewater. The electrocoagulation involves an electrolytic reactor for coagulation/flotation with aluminium as anode and cathode. There is aluminium as coagulant to be used for removal which may induce secondary pollution in chemical coagulation. The purpose of this study is to investigate and compare the performance between electrocoagulation and chemical coagulation on boron removal from synthetic wastewater. The effect of different parameters, such as pH reaction, coagulant dosage, and initial boron concentration were examined. The results show that the boron removal using chemical coagulation was lower. At the optimum condition (e.g. pH 8 and 0.8 mol coagulant dosage), boron removal efficiencies for chemical coagulation and electrocoagulation were 61% and 91%, respectively. In addition, the electrocoagulation needs no chemical reagents and makes the boron treatment easy for application.Keywords: boron removal, chemical coagulation, aluminum, electro-coagulation
Procedia PDF Downloads 4041661 The Effectiveness of Pretreatment Methods on COD and Ammonia Removal from Landfill Leachate
Authors: M. Poveda, S. Lozecznik, J. Oleszkiewicz, Q. Yuan
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The goal of this experiment is to evaluate the effectiveness of different leachate pre-treatment options in terms of COD and ammonia removal. This research focused on the evaluation of physical-chemical methods for pre-treatment of leachate that would be effective and rapid in order to satisfy the requirements of the sewer discharge by-laws. The four pre-treatment options evaluated were: air stripping, chemical coagulation, electro-coagulation and advanced oxidation with sodium ferrate. Chemical coagulation reported the best COD removal rate at 43%, compared to 18 % for both air stripping and electro-coagulation, and 20 % for oxidation with sodium ferrate. On the other hand, air stripping was far superior to the other treatment options in terms of ammonia removal with 86 %. Oxidation with sodium ferrate reached only 16 %, while chemical coagulation and electro-coagulation removed less than 10 %. When combined, air stripping and chemical coagulation removed up to 50 % COD and 85 % ammonia.Keywords: leachate pretreatment, air stripping, chemical coagulation, electro-coagulation, oxidation
Procedia PDF Downloads 8431660 Lamb Wave-Based Blood Coagulation Measurement System Using Citrated Plasma
Authors: Hyunjoo Choi, Jeonghun Nam, Chae Seung Lim
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Acoustomicrofluidics has gained much attention due to the advantages, such as noninvasiveness and easy integration with other miniaturized systems, for clinical and biological applications. However, a limitation of acoustomicrofluidics is the complicated and costly fabrication process of electrodes. In this study, we propose a low-cost and lithography-free device using Lamb wave for blood analysis. Using a Lamb wave, calcium ion-removed blood plasma and coagulation reagents can be rapidly mixed for blood coagulation test. Due to the coagulation process, the viscosity of the sample increases and the viscosity change can be monitored by internal acoustic streaming of microparticles suspended in the sample droplet. When the acoustic streaming of particles stops by the viscosity increase is defined as the coagulation time. With the addition of calcium ion at 0-25 mM, the coagulation time was measured and compared with the conventional index for blood coagulation analysis, prothrombin time, which showed highly correlated with the correlation coefficient as 0.94. Therefore, our simple and cost-effective Lamb wave-based blood analysis device has the powerful potential to be utilized in clinical settings.Keywords: acoustomicrofluidics, blood analysis, coagulation, lamb wave
Procedia PDF Downloads 3401659 Evaluation of Coagulation State in Patients with End Stage Renal Disease (ESRD) by Thromboelastogram (TEG)
Authors: Mohammad Javad Esmaeili
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Background: Coagulopathy is one of the complications with end stage renal disease with high prevalence in the world. Thromboelastogram is adynamic test for evaluation of coagulopathy and we have compared our patient's coagulation profiles with the results of TEG. Material and methods: In this study 50 patients with ESRD who were on regular hemodialysis for at least 6 months was selected with simple sampling and their coagulation profile was done with blood sampling and also TEG was done for every patient. Data were analyzed with SPSS and P<0.05 consider significant. Results: Protein s, Protein c and Antithrombin III deficiency was detected in 32%, 16% and 20% of patients and activated protein c resistance was abnormal in 2% of patients. In TEG, R time in 49% and K in 22/5% of patients was lower than normal and a-angle in 26% and maximum amplitude in 36% of patients was upper than normal (Hypercoagulable state). PS with R and ATIII with K have correlation. Conclusion: R time and K in TEG can be a suitable screening test in patients with suspicious to PS and ATIII deficiency.Keywords: thromboelastography, chronic kidney disease, Coagulating disorder, hemodialysis
Procedia PDF Downloads 761658 Adhesion of Staphylococcus epidermidis and Staphylococcus aureus to Intravascular cannulae
Authors: Ghadah Abusalim, Suliman Alharbi, Hesham Khalil, Milton Wainwright, Mohammad A. Khiyami
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The use of implantable foreign devices in medicine has recently increased dramatically. Intravascular cannulae and catheters are used to administer fluids, medications, parenteral nutrition, and blood products in order to monitor hemodynamic status and also to provide hemodialysis. The early and late failure of inserted or implanted devices is largely the result of bacterial infection and may lead to the disruption of integration between the device and the tissues which surround it. Staphylococcus aureus and Staphylococcus epidermidis are widely considered to be the most common organisms causing device-related infection. Our study showed that S. aureus and S. epidermidis adhered to intravascular cannulae made up of PTFE, SPTFE and vialon. Adhesion of S. epidermidis and S. aureus to intravascular cannulae varied significantly depending upon the type of material used and the presence of coating materials. Both bacteria adhered less to PTFE followed by Vialon and SPTFE and the adhesion capacity of S. aureus and S. epidermidis increased over time. Coating intravascular cannulae with human serum albumin inhibited the adhesion of S. aureus and S. epidermidis to these cannulae, and pretreatment of cannulae with fibronectin inhibited the adhesion of S. epidermidis but increased the adhesion of S. aureus to all types of cannulae. Pretreatment of cannulae surface with potassium chloride or calcium chloride increased the adhesion of S. aureus and S. epidermidis to cannulae, suggesting a role for electrostatic forces in the mechanism of such adhesion. This study will hopefully clarify the mechanism of adhesion and provide possible means of preventing such adhesion either by the use of better material coatings or by interfering with the process of adhesion by targeting bacterial structures responsible for it. Currently we recommend the use of PTFE cannulae as they exhibit a lower bacterial adhesion capacity compared to the other tested cannulae.Keywords: Staphylococcus epidermidis, Staphylococcus aureus, adhesion, cannulae, PTFE, Vialon
Procedia PDF Downloads 3481657 Optimal Temperature and Time for Lactic Coagulation of Milk Containing Antibiotic: Evaluation of Yogurt Fermentation Parameters
Authors: Arezoo Ghadi, Adonis Pishdadian, Ehsan Zahedi, Vahideh Rashedi, Mozhgan Mohammadi
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The presence of antibiotics in milk is one of the problems of dairy production units, especially yogurt and cheese, which leads to a decrease in lactic coagulation. Here, to assess the incubation conditions for the fermentation of milk containing antibiotics, concentrations of 50, 75, 100, and 200 ppb of tetracycline were added to each liter of milk. Inoculation process with starter culture performed at three temperatures of 35°C, 45°C, and 50°C. Afterward, pH, acidity, oxidation-reduction potential, and lactic coagulation of yogurt were evaluated. The results showed the existence of antibiotics in milk affects the quality and physicochemical properties of yogurt. However, antibiotic concentration and change in incubation temperature play a crucial role in the lactic coagulation of yogurt, such that the best lactic coagulation was observed at 50°C and a concentration of 50ppb. Hence, for tetracycline concentrations less than 75ppb, a process temperature of 50°C and incubation time of ~10 h recommend for fermentation of milk containing antibiotics.Keywords: antibiotics residues, yogurt, fermentation parameters, incubation temperature
Procedia PDF Downloads 991656 Preparation and Performance Evaluation of Green Chlorine-Free Coagulants
Authors: Huihui Zhang, Zhongzhi Zhang
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Coagulation/flocculation is regarded a simple and effective wastewater treatment technology. Chlorine-containing coagulants may release chloride ions into the wastewater, causing corrosion. A green chlorine-free coagulant of polyaluminum ferric silicate (PSAF) was prepared by the copolymerization method to treat oily refractory wastewaters. Results showed that the highest removal efficiency of turbidity and chemical oxygen demand (COD) achieved 97.4% and 93.0% at a dosage of 700 mg/L, respectively. After PSAF coagulation, the chloride ion concentration was also almost the same as that in the raw wastewater. Thus, the chlorine-free coagulant is highly efficient and does not introduce additional chloride ions into the wastewater, avoiding corrosion.Keywords: coagulation, chloride-free coagulant, oily refractory wastewater, coagulation performance
Procedia PDF Downloads 2181655 Modeling of Coagulation Process for the Removal of Carbofuran in Aqueous Solution
Authors: Roli Saini, Pradeep Kumar
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A coagulation/flocculation process was adopted for the reduction of carbamate insecticide (carbofuran) from aqueous solution. Ferric chloride (FeCl3) was used as a coagulant to treat the carbofuran. To exploit the reduction efficiency of pesticide concentration and COD, the jar-test experiments were carried out and process was optimized through response surface methodology (RSM). The effects of two independent factors; i.e., FeCl3 dosage and pH on the reduction efficiency were estimated by using central composite design (CCD). The initial COD of the 30 mg/L concentrated solution was found to be 510 mg/L. Results exposed that the maximum reduction occurred at an optimal condition of FeCl3 = 80 mg/L, and pH = 5.0, from which the reduction of concentration and COD 75.13% and 65.34%, respectively. The present study also predicted that the obtained regression equations could be helpful as the theoretical basis for the coagulation process of pesticide wastewater.Keywords: carbofuran, coagulation, optimization, response surface methodology
Procedia PDF Downloads 3241654 Revisiting Classic Triad of Japanese Spotted Fever: A Case Series of Forty-Three Patients
Authors: Y. Kunitani, Y. Nakashima, S. Yamauchi, Y. Ishigami, K. Naito, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi
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Background: Japanese Spotted Fever (JSF) is one of the Rickettsial infections, caused by Rickettsia japonica, which is transmitted by ticks. JSF is seen in limited area, such as Japan and South Korea. Its clinical triad is rash, eschar and fever. It often shows leukocytopenia, thrombopenia, elevated transaminase and high C-reactive protein (CRP). Sometimes it can be life-threatening due to disseminated intravascular coagulation or multiple organ failure. Study Aim: The aim of this study is to describe the features of JSF, as this unique infection is rapidly growing in Japan. Methods: This is a case series of JSF from 2009 to 2016, in Mie Prefectural Hospital in Japan. We collected JSF cases, which were diagnosed by polymerase chain reaction (PCR) of the skin or blood serum, or the elevation of the antibody titer of paired blood samples. Results: There were 43 JSF patients (19 male, 24 female) with a median age of 71 years [IQR:65-80]. The median body temperature was 38.1°C[IQR: 37.5-39.0]. 95% had a rash, 67% had eschar and 50% had fever. The median WBC count was 6,700 [IQR: 5,750-8,200] and leukocytopenia was observed in only 7%. The median platelet count was 14x104 [IQR10x104-17x104], thrombopenia was observed in 65%. The median aspartate transaminase (AST) was 53 IU/L [IQR: 41-93]; the median alanine aminotransferase (ALT) was 34 IU/L [IQR: 24-54]; the median CRP was 10.4 mg/dL [IQR:7.2-13.9]; the median lactate dehydrogenase (LDH) was 352IU/L [IQR:282-451]. CRP and LDH were elevated in almost all of the patients. Median length of stay in hospital was 8 days [IQR: 6-11]. All patients were treated with tetracycline and quinolone on the day of the presentation. There was no fatality from JSF. Conclusion: The patients with JSF classically presents with eschar, rash and fever. However, in this study, the half of the patients were afebrile. Although JSF is not a common infectious disease worldwide, if the patient had previously visited Japan or South Korea and presented with rash and eschar with or without fever, we should consider JSF as a potential diagnosis.Keywords: infectious disease, Japanese spotted fever, Rickettsial disease, Rickettsia japonica
Procedia PDF Downloads 2291653 Encapsulated Rennin Enzyme in Nano and Micro Tubular Cellulose/Starch Gel Composite for Milk Coagulation
Authors: Eleftheria Barouni, Theano Petsi, Argyro Bekatorou, Dionysos Kolliopoulos, Dimitrios Vasileiou, Panayiotis Panas, Maria Kanellaki, Athanasios A. Koutinas
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The aim of the present work was the production and use of a composite filter (TC/starch), containing rennin enzyme, in continuous system and in successive fermentation batches (SFB) for milk coagulation in order to compare the operational stability of both systems and cheese production cost. Tubular cellulose (TC) was produced after removal of lignin from lignocellulosic biomass using several procedures, e.g. alkaline treatment [1] and starch gel was added for the reduction of TC tubes dimensions to micro- and nano- range[2]. Four immobilized biocatalysts were prepared using different ways of the enzyme entrapment. 1) TC/ rennin (rennin entrapped in the tubes of TC), 2) TC/SG-rennin (rennin entrapped in the tubes of the composite), 3) TC-SG/rennin (rennin entrapped into the layer of starch gel) and 4) TC/rennin- SG/rennin (rennin is entrapped both in the tubes of the TC and into the layer of starch gel). Firstly these immobilized biocatalysts were examined in ten SFB regarding the coagulation time and their activity All the above immobilized biocatalysts remained active and the coagulation time was ranged from 90 to 480, 120-480, 330-510, and 270-540 min for (1), (2), (3), and (4) respectively. The quality of the cheese was examined through the determination of volatile compounds by SPME GC/MS analysis. These results encouraged us to study a continuous coagulation system of milk. Even though the (1) immobilized biocatalyst gave lower coagulation time, we used the (2) immobilized biocatalyst in the continuous system. The results were promising.Keywords: tubular cellulose, starch gel, composite biocatalyst, Rennin, milk coagulation
Procedia PDF Downloads 3261652 A Monopole Intravascular Antenna with Three Parasitic Elements Optimized for Higher Tesla MRI Systems
Authors: Mohammad Mohammadzadeh, Alireza Ghasempour
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In this paper, a new design of monopole antenna has been proposed that increases the contrast of intravascular magnetic resonance images through increasing the homogeneity of the intrinsic signal-to-noise ratio (ISNR) distribution around the antenna. The antenna is made of a coaxial cable with three parasitic elements. Lengths and positions of the elements are optimized by the improved genetic algorithm (IGA) for 1.5, 3, 4.7, and 7Tesla MRI systems based on a defined cost function. Simulations were also conducted to verify the performance of the designed antenna. Our simulation results show that each time IGA is executed different values for the parasitic elements are obtained so that the cost functions of those antennas are high. According to the obtained results, IGA can also find the best values for the parasitic elements (regarding cost function) in the next executions. Additionally, two dimensional and one-dimensional maps of ISNR were drawn for the proposed antenna and compared to the previously published monopole antenna with one parasitic element at the frequency of 64MHz inside a saline phantom. Results verified that in spite of ISNR decreasing, there is a considerable improvement in the homogeneity of ISNR distribution of the proposed antenna so that their multiplication increases.Keywords: intravascular MR antenna, monopole antenna, parasitic elements, signal-to-noise ratio (SNR), genetic algorithm
Procedia PDF Downloads 2991651 Treatment of Tannery Effluents by the Process of Coagulation
Authors: Gentiana Shegani
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Coagulation is a process that sanitizes leather effluents. It aims to reduce pollutants such as Chemical Oxygen Demand (COD), chloride, sulphate, chromium, suspended solids, and other dissolved solids. The current study aimed to evaluate coagulation efficiency of tannery wastewater by analysing the change in organic matter, odor, colour, ammonium ions, nutrients, chloride, H2S, sulphate, suspended solids, total dissolved solids, faecal pollution, and chromium hexavalent before and after treatment. Effluent samples were treated with coagulants Ca(OH)2 and FeSO4 .7H2O. The best advantages of this treatment included the removal of: COD (81.60%); ammonia ions (98.34%); nitrate ions (92%); chromium hexavalent (75.00%); phosphate (70.00%); chloride (69.20%); and H₂S (50%). Results also indicated a high level of efficiency in the reduction of fecal pollution indicators. Unfortunately, only a modest reduction of sulphate (19.00%) and TSS (13.00%) and an increase in TDS (15.60%) was observed.Keywords: coagulation, effluent, tannery, treatment
Procedia PDF Downloads 3431650 Effect of Thermal Energy on Inorganic Coagulation for the Treatment of Industrial Wastewater
Authors: Abhishek Singh, Rajlakshmi Barman, Tanmay Shah
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Coagulation is considered to be one of the predominant water treatment processes which improve the cost effectiveness of wastewater. The sole purpose of this experiment on thermal coagulation is to increase the efficiency and the rate of reaction. The process uses renewable sources of energy which comprises of improved and minimized time method in order to eradicate the water scarcity of the regions which are on the brink of depletion. This paper includes the various effects of temperature on the standard coagulation treatment of wastewater and their effect on water quality. In addition, the coagulation is done with the mix of bottom/fly-ash that will act as an adsorbent and removes most of the minor and macro particles by means of adsorption which not only helps to reduce the environmental burden of fly ash but also enhance economic benefit. Also, the method of sand filtration is amalgamated in the process. The sand filter is an environmentally-friendly wastewater treatment method, which is relatively simple and inexpensive. The existing parameters were satisfied with the experimental results obtained in this study and were found satisfactory. The initial turbidity of the wastewater is 162 NTU. The initial temperature of the wastewater is 27 C. The temperature variation of the entire process is 50 C-80 C. The concentration of alum in wastewater is 60mg/L-320mg/L. The turbidity range is 8.31-28.1 NTU after treatment. pH variation is 7.73-8.29. The effective time taken is 10 minutes for thermal mixing and sedimentation. The results indicate that the presence of thermal energy affects the coagulation treatment process. The influence of thermal energy on turbidity is assessed along with renewable energy sources and increase of the rate of reaction of the treatment process.Keywords: adsorbent, sand filter, temperature, thermal coagulation
Procedia PDF Downloads 3211649 The Magnitude and Associated Factors of Coagulation Abnormalities Among Liver Disease Patients at the University of Gondar Comprehensive Specialized Hospital Northwest, Ethiopia
Authors: Melkamu A., Woldu B., Sitotaw C., Seyoum M., Aynalem M.
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Background: Liver disease is any condition that affects the liver cells and their function. It is directly linked to coagulation disorders since most coagulation factors are produced by the liver. Therefore, this study aimed to assess the magnitude and associated factors of coagulation abnormalities among liver disease patients. Methods: A cross-sectional study was conducted from August to October 2022 among 307 consecutively selected study participants at the University of Gondar Comprehensive Specialized Hospital. Sociodemographic and clinical data were collected using a structured questionnaire and data extraction sheet, respectively. About 2.7 mL of venous blood was collected and analyzed by the Genrui CA51 coagulation analyzer. Data was entered into Epi-data and exported to STATA version 14 software for analysis. The finding was described in terms of frequencies and proportions. Factors associated with coagulation abnormalities were analyzed by bivariable and multivariable logistic regression. Result: In this study, a total of 307 study participants were included. Of them, the magnitude of prolonged Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) were 68.08% and 63.51%, respectively. The presence of anemia (AOR = 2.97, 95% CI: 1.26, 7.03), a lack of a vegetable feeding habit (AOR = 2.98, 95% CI: 1.42, 6.24), no history of blood transfusion (AOR = 3.72, 95% CI: 1.78, 7.78), and lack of physical exercise (AOR = 3.23, 95% CI: 1.60, 6.52) were significantly associated with prolonged PT. While the presence of anaemia (AOR = 3.02; 95% CI: 1.34, 6.76), lack of vegetable feeding habit (AOR = 2.64; 95% CI: 1.34, 5.20), no history of blood transfusion (AOR = 2.28; 95% CI: 1.09, 4.79), and a lack of physical exercise (AOR = 2.35; 95% CI: 1.16, 4.78) were significantly associated with abnormal APTT. Conclusion: Patients with liver disease had substantial coagulation problems. Being anemic, having a transfusion history, lack of physical activity, and lack of vegetables showed significant association with coagulopathy. Therefore, early detection and management of coagulation abnormalities in liver disease patients are critical.Keywords: coagulation, liver disease, PT, Aptt
Procedia PDF Downloads 601648 A 30 Year Audit of the Vascular Complications of Ports: Permanent Intravascular Access Devices
Authors: S. Kershaw, P. J. Barry, K. Webb
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Background: Cystic Fibrosis (CF) is a chronic lung disease where patients have chronic lung infection punctuated by acute exacerbations that require intermittent intravenous (IV) antibiotics during their lives. With time, peripheral venous access can become difficult and limited. Accessing these veins can become arduous, traumatic, painful and unworkable. A permanent intravascular access device or Port is a small device that is inserted into the central venous system that allows the delivery of medicine eliminating the need for peripheral venous access. Ports represent a convenient and efficient method when venous access is required on a permanent basis however they are also associated with significant vascular complications. Superior Vena Cava Obstruction (SVCO) is a rare but significant vascular complication of ports in this setting. Objective: We aimed to look at a single CF centre’s experience of port-related SVCO over a thirty year period. Methods: Retrospective data was extracted using patient’s notes, electronic radiological reports and local databases over a period in excess of 30 years from 1982 to 2014. Results: 13 patients were identified with SVCO as a result of their port. 11 patients had CF (9 female, 2 male), one male patient had Primary Ciliary Dyskinesia and one female patient had severe Asthma. The mean port function was 1532 days (range 110 – 4049) and the mean age at SVCO was 24 years (range 11.1 to 36.5 years). The most common symptoms were facial oedema (n=8, 61.5%) and dilated veins (n=6, 46.2%). 7 patients had their Ports removed after SVCO. 6 patients underwent attempted stenting (46.2%) and 6 did not. 4 out of the 6 who underwent stenting required/had re-intervention. 3 of the 6 patients who underwent stenting had symptom resolution, however, 4 of the 6 patients who were not stented had symptom resolution also. Symptom resolution was not guaranteed with stenting and required re-intervention in two-thirds. Conclusion: This case series represents the experience of one of the longest established CF units in the UK and represents the largest cohort ever reported in the literature.Keywords: ports, Superior Vena Cava Obstruction, cystic fibrosis, access devices
Procedia PDF Downloads 3221647 Treatment of Rice Industry Waste Water by Flotation-Flocculation Method
Authors: J. K. Kapoor, Shagufta Jabin, H. S. Bhatia
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Polyamine flocculants were synthesized by poly-condensation of diphenylamine and epichlorohydrin using 1, 2-diaminoethane as modifying agent. The polyelectrolytes were prepared by taking epichlohydrin-diphenylamine in a molar ratio of 1:1, 1.5:1, 2:1, and 2.5:1. The flocculation performance of these polyelectrolytes was evaluated with rice industry waste water. The polyelectrolytes have been used in conjunction with alum for coagulation- flocculation process. Prior to the coagulation- flocculation process, air flotation technique was used with the aim to remove oil and grease content from waste water. Significant improvement was observed in the removal of oil and grease content after the air flotation technique. It has been able to remove 91.7% oil and grease from rice industry waste water. After coagulation-flocculation method, it has been observed that polyelectrolyte with epichlohydrin-diphenylamine molar ratio of 1.5:1 showed best results for the removal of pollutants from rice industry waste water. The highest efficiency of turbidity and TSS removal with polyelectrolyte has been found to be 97.5% and 98.2%, respectively. Results of these evaluations also reveal 86.8% removal of COD and 87.5% removal of BOD from rice industry waste water. Thus, we demonstrate optimization of coagulation–flocculation technique which is appropriate for waste water treatment.Keywords: coagulation, flocculation, air flotation technique, polyelectrolyte, turbidity
Procedia PDF Downloads 4801646 Disseminated Tuberculosis: Experience from Tuberculosis Directly Observed Treatment Short Course Center at a Tertiary Care Teaching Hospital in the Philippines
Authors: Jamie R. Chua, Christina Irene D. Mejia, Regina P. Berba
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Disseminated tuberculosis is an infectious disease caused by Mycobacterium tuberculosis involving two or more non-contiguous sites identified through bacteriologic confirmation or clinical diagnosis. Over the five year period included in the study, the UP-PGH TB DOTS clinic had total of 3,967 referrals, and the prevalence of disseminated tuberculosis is 1% (68/3967). The mean age was 33.9 years (range 19-64 years) with a male: female ratio of 1:1. 67% (52 patients) had no predisposing comorbid illness or immune disorder. The most common presenting symptoms were abdominal pain (19%), back pain (13%), abdominal enlargement (11%) and mass (10.2%). Anemia, leukocytosis, hypoalbuminemia, and high-normal serum calcium were common biochemical and hematologic findings. Around 36% (25) of patients were diagnosed clinically with disseminated tuberculosis despite lacking bacteriologic evidence of multi-organ involvement. The lungs (86%) is still the most commonly involved site, followed by intestinal (22%), vertebral/Pott’s (27%), and pelvic/genital (19%). The mean time from presentation to initiation of therapy was 22 days (SD 32.7). Only 18 patients (29.3%) were properly recorded to have been referred to local TB DOTs facilities. Of the 68 patients, only 16% (11 patients) continued follow-up at PGH, and all had documented treatment completion. Treatment outcomes of the remaining were unknown. Due to the variety of involved sites, a high index of suspicion is required. Knowledge on clinical features, common radiographic findings, and histopathologic characteristics of disseminated TB is important as bacteriologic evidence of infection is not always apparent.Keywords: disseminated tuberculosis, Mycobacterium tuberculosis, miliary tuberculosis, tuberculosis
Procedia PDF Downloads 2401645 Fast and Accurate Finite-Difference Method Solving Multicomponent Smoluchowski Coagulation Equation
Authors: Alexander P. Smirnov, Sergey A. Matveev, Dmitry A. Zheltkov, Eugene E. Tyrtyshnikov
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We propose a new computational technique for multidimensional (multicomponent) Smoluchowski coagulation equation. Using low-rank approximations in Tensor Train format of both the solution and the coagulation kernel, we accelerate the classical finite-difference Runge-Kutta scheme keeping its level of accuracy. The complexity of the taken finite-difference scheme is reduced from O(N^2d) to O(d^2 N log N ), where N is the number of grid nodes and d is a dimensionality of the problem. The efficiency and the accuracy of the new method are demonstrated on concrete problem with known analytical solution.Keywords: tensor train decomposition, multicomponent Smoluchowski equation, runge-kutta scheme, convolution
Procedia PDF Downloads 4321644 Saline Aspiration Negative Intravascular Test: Mitigating Risk with Injectable Fillers
Authors: Marcelo Lopes Dias Kolling, Felipe Ferreira Laranjeira, Guilherme Augusto Hettwer, Pedro Salomão Piccinini, Marwan Masri, Carlos Oscar Uebel
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Introduction: Injectable fillers are among the most common nonsurgical cosmetic procedures, with significant growth yearly. Knowledge of rheological and mechanical characteristics of fillers, facial anatomy, and injection technique is essential for safety. Concepts such as the use of cannula versus needle, aspiration before injection, and facial danger zones have been well discussed. In case of an accidental intravascular puncture, the pressure inside the vessel may not be sufficient to push blood into the syringe due to the characteristics of the filler product; this is especially true for calcium hydroxyapatite (CaHA) or hyaluronic acid (HA) fillers with high G’. Since viscoelastic properties of normal saline are much lower than those of fillers, aspiration with saline prior to filler injection may decrease the risk of a false negative aspiration and subsequent catastrophic effects. We discuss a technique to add an additional safety step to the procedure with saline aspiration prior to injection, a ‘’reverse Seldinger’’ technique for intravascular access, which we term SANIT: Saline Aspiration Negative Intravascular Test. Objectives: To demonstrate the author’s (PSP) technique which adds an additional safety step to the process of filler injection, with both CaHA and HA, in order to decrease the risk of intravascular injection. Materials and Methods: Normal skin cleansing and topical anesthesia with prilocaine/lidocaine cream are performed; the facial subunits to be treated are marked. A 3mL Luer lock syringe is filled with 2mL of 0.9% normal saline and a 27G needle, which is turned one half rotation. When a cannula is to be used, the Luer lock syringe is attached to a 27G 4cm single hole disposable cannula. After skin puncture, the 3mL syringe is advanced with the plunger pulled back (negative pressure). Progress is made to the desired depth, all the while aspirating. Once the desired location of filler injection is reached, the syringe is exchanged for the syringe containing a filler, securely grabbing the hub of the needle and taking care to not dislodge the needle tip. Prior to this, we remove 0.1mL of filler to allow for space inside the syringe for aspiration. We again aspirate and inject retrograde. SANIT is especially useful for CaHA, since the G’ is much higher than HA, and thus reflux of blood into the syringe is less likely to occur. Results: The technique has been used safely for the past two years with no adverse events; the increase in cost is negligible (only the cost of 2mL of normal saline). Over 100 patients (over 300 syringes) have been treated with this technique. The risk of accidental intravascular puncture has been calculated to be between 1:6410 to 1:40882 syringes among expert injectors; however, the consequences of intravascular injection can be catastrophic even with board-certified physicians. Conclusions: While the risk of intravascular filler injection is low, the consequences can be disastrous. We believe that adding the SANIT technique can help further mitigate risk with no significant untoward effects and could be considered by all performing injectable fillers. Further follow-up is ongoing.Keywords: injectable fillers, safety, saline aspiration, injectable filler complications, hyaluronic acid, calcium hydroxyapatite
Procedia PDF Downloads 1501643 Consumption Insurance against the Chronic Illness: Evidence from Thailand
Authors: Yuthapoom Thanakijborisut
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This paper studies consumption insurance against the chronic illness in Thailand. The study estimates the impact of household consumption in the chronic illness on consumption growth. Chronic illness is the health care costs of a person or a household’s decision in treatment for the long term; the causes and effects of the household’s ability for smooth consumption. The chronic illnesses are measured in health status when at least one member within the household faces the chronic illness. The data used is from the Household Social Economic Panel Survey conducted during 2007 and 2012. The survey collected data from approximately 6,000 households from every province, both inside and outside municipal areas in Thailand. The study estimates the change in household consumption by using an ordinary least squares (OLS) regression model. The result shows that the members within the household facing the chronic illness would reduce the consumption by around 4%. This case indicates that consumption insurance in Thailand is quite sufficient against chronic illness.Keywords: consumption insurance, chronic illness, health care, Thailand
Procedia PDF Downloads 2381642 Establishing Reference Intervals for Routine Coagulation Tests
Authors: Santina Sahibon, Sivasooriar Sivaneson, Martin Giddy, Nelson Nheu, Siti Sazeelah, Choo Kok Ming, Thuhairah Abdul Rahman, Fatmawati Binti Kamal
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Introduction: Establishing population-based reference intervals (RI) are essential when evaluating laboratory test results and for method verification. Our laboratory initiated an exercise to establish RI for routine coagulation profile as part of the method verification procedure and to determine any differences in RI between three analyzers planned to be used in the laboratory. Methodology: 145 blood samples were collected and analysed for activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR), and fibrinogen] using three coagulation analysers which were CA104, CA660, and CS-2500 (Sysmex, USA). RI was established at 2.5th and 97.5th percentiles. Results: The RI for aPTT between C104, C660 and CS-2500 are (RI: 20.5-30.2 sec), (RI: 21.5-29.2 sec) and (RI: 22.7-30.3 sec) respectively. The RI for PT were (RI: 7.5-10.3 sec), (RI: 9.2- 11.1 sec) and (RI: 9.8-11.9 sec) for C104, CA660 and CS-2500 respectively. INR had an RI of (RI: 0.87- 1.16), (RI: 0.89-1.10) and (0.90-1.11) respectively on CA104, C660 and CS-2500. Fibrinogen RI was (RI: 2.04-4.62 g/L) and (2.05-4.76 g/L) on the CA660 and CS-2500, respectively. Conclusion: The RI was similar across the analytical platforms for aPTT, INR, and fibrinogen. However, CA104 showed lower RI compared to the other two analysers for PT. This highlights the potential variability in results between instruments that need to be addressed when verifying RI.Keywords: coagulation, reference interval, APTT, PT, INR, fibrinogen
Procedia PDF Downloads 1871641 Coagulation-Flocculation of Palm Oil Mill Effluent from Pertubuhan Peladang Negeri Johor, Malaysia
Authors: A. H. Jagaba, Musa Babayo, Ab Aziz Abdul Latiff, Sule Abubakar, I. M. Lawal, Isa Zubairu, M. A. Nasara
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Wastewater containing heavy metals is of extreme importance globally because of its potential threat to both the aquatic ecosystem and the soil environment. Heavy metal is hazardous even at low concentration and thereby causing various forms of diseases. One method which has been tested and found to be effective for heavy metals removal is coagulation-flocculation. For the coagulation process of POME obtained from Pertubuhan Peladang Negeri Johor (PPNJ), Oil Palm Mill Company located in Kahang area of Kluang, Johor Darul Takzim, Malaysia, diffèrent coagulants would be used to absorb and then separate the metals from wastewater. The determination of heavy metals concentration in POME was carried out using an inductively coupled plasma (ICP) and an Atomic Absorption Spectrometer (AAS). Results of the study showed that alum coagulant was successful in effectively reducing Cu, Cd, and Mn from 0.840 mg/l, 0.00509 mg/l and 8.191 mg/l to as low as 0.107 mg/l, 0.000270 mg/l and 0.612 mg/l respectively. All were obtained at a dose of 1000 mg/l. 1000 mg/l dose of ferric chloride reduced Pb concentration from 0.0248 mg/l to 0.00151 mg/l. Chitosan was best at reducing Fe and Zn from 62.91 mg/l and 3.616 mg/l to 6.003 mg/l and 0.595 mg/l all at a dose of 400 mg/l.Keywords: palm oil mill effluent, coagulation, heavy metals, Pertubuhan Peladang Negeri Johor, Malaysia
Procedia PDF Downloads 2261640 An Atlantic Canadian Case of Disseminated Streptococcus equi Subspecies zooepidemicus Infection
Authors: Albert Chang, Duncan Webster
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Streptococcus equi subspecies zooepidemicus infections in humans can be contracted through contact with domestic animals or unpasteurized dairy products. Although infection in humans is rare, the course can be fulminant. We describe the case of a 75-year-old, immunocompetent male, who developed disseminated disease with bacteremia, native aortic valve endocarditis, suppurative pericarditis with cardiac tamponade, meningitis and bilateral endopthalmitis. Despite treatment with pericardial drain placement, intravenous ceftriaxone and rifampin the patient, unfortunately, did not survive. To date, reported cases of disseminated infection by S. zooepidemicus are few. Furthermore, with the review of the literature, this case demonstrates the broadest organ system involvement reported. Of interest, previous studies have suggested an affinity of this organism for certain organ systems and this case corroborates an emerging association of S. zooepidemicus with endopthalmitis. In addition, this is the second Canadian case of documented human infection with both cases being similar in clinical features, presentation, and geographical location. A discussion regarding previous S. zooepidemicus outbreaks and the potential for zoonotic outbreaks to occur is included. In short, this case report should serve to warn clinicians regarding complications and sites of haematogenous seeding in the setting of disseminated S. zooepidemicus infections.Keywords: endopthalmitis, endocarditis, meningitis, Streptococcus equi subspecies zooepidemicus
Procedia PDF Downloads 1941639 Intrathecal Fentanyl with 0.5% Bupivacaine Heavy in Chronic Opium Abusers
Authors: Suneet Kathuria, Shikha Gupta, Kapil Dev, Sunil Katyal
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Chronic use of opioids in opium abusers can cause poor pain control and increased analgaesic requirement. We compared the duration of spinal anaesthesia in chronic opium abusers and non-abusers. This prospective randomised study included 60 American Society of Anesthesiologists (ASA) Grade I or II adults undergoing surgery under spinal anaesthesia with 10 mg bupivacaine, and 25 μg fentanyl in non-opium abusers (Group A); and chronic opium abusers (Group B), and 40 μg fentanyl in chronic opium abusers (Group C). Patients were assessed for onset and duration of sensory and motor blockade and duration of effective analgesia. Mean time to onset of adequate analgesia in opium abusers was significantly longer in chronic opium abusers than in opium-naive patients. The duration of sensory block and motor block was significantly less in chronic opium abusers than in non-opium abusers. Duration of effective analgesia in groups A, B and C was 255.55 ± 26.84, 217.85 ± 15.15, and 268.20 ± 18.25 minutes, respectively; this difference was statistically significant. In chronic opium abusers, the duration of spinal anaesthesia is significantly shorter than that in opium nonabusers. The duration of spinal anaesthesia with bupivacaine and fentanyl in chronic opium abusers can be improved by increasing the intrathecal fentanyl dose from 25 μg to 40 μg.Keywords: bupivacaine, chronic opium abusers, fentanyl, intrathecal
Procedia PDF Downloads 2971638 On the Mathematical Modelling of Aggregative Stability of Disperse Systems
Authors: Arnold M. Brener, Lesbek Tashimov, Ablakim S. Muratov
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The paper deals with the special model for coagulation kernels which represents new control parameters in the Smoluchowski equation for binary aggregation. On the base of the model the new approach to evaluating aggregative stability of disperse systems has been submitted. With the help of this approach the simple estimates for aggregative stability of various types of hydrophilic nano-suspensions have been obtained.Keywords: aggregative stability, coagulation kernels, disperse systems, mathematical model
Procedia PDF Downloads 3091637 Possibility of Prediction of Death in SARS-Cov-2 Patients Using Coagulogram Analysis
Authors: Omonov Jahongir Mahmatkulovic
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Purpose: To study the significance of D-dimer (DD), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen coagulation parameters (Fg) in predicting the course, severity and prognosis of COVID-19. Source and method of research: From September 15, 2021, to November 5, 2021, 93 patients aged 25 to 60 with suspected COVID-19, who are under inpatient treatment at the multidisciplinary clinic of the Tashkent Medical Academy, were retrospectively examined. DD, PT, APTT, and Fg were studied in dynamics and studied changes. Results: Coagulation disorders occurred in the early stages of COVID-19 infection with an increase in DD in 54 (58%) patients and an increase in Fg in 93 (100%) patients. DD and Fg levels are associated with the clinical classification. Of the 33 patients who died, 21 had an increase in DD in the first laboratory study, 27 had an increase in DD in the second and third laboratory studies, and 15 had an increase in PT in the third test. The results of the ROC analysis of mortality showed that the AUC DD was three times 0.721, 0.801, and 0.844, respectively; PT was 0.703, 0.845, and 0.972. (P<0:01). Conclusion”: Coagulation dysfunction is more common in patients with severe and critical conditions. DD and PT can be used as important predictors of mortality from COVID-19.Keywords: Covid19, DD, PT, Coagulogram analysis, APTT
Procedia PDF Downloads 1071636 Cheese Production at Low Temperatures Using Probiotic L. casei ATCC 393 and Rennin Enzyme Entrapped in Tubular Cellulose
Authors: Eleftheria Barouni, Antonia Terpou, Maria Kanellaki, Argyro Bekatorou, Athanasios A.Koutinas
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The aim of the present work was to evaluate the production of cheese using a composite filter of tubular cellulose (TC) with [a] entrapped rennin enzyme and [b] immobilized L.casei and entrapped enzyme. Tubular cellulose from sawdust was prepared after lignin removal with 1% NaOH. The biocatalysts were thermally dried at 38oC and used for milk coagulation. The effect of temperature (5,20,37 oC) of the first dried biocatalyst on the pH kinetics of milk coagulation was examined. The optimum temperature (37oC) of the first biocatalyst was used for milk coagulation with the second biocatalyst prepared by entrapment of both rennin enzyme and probiotic lactic acid bacteria in order to introduce a sour taste in cheeses. This co-biocatalyst was used for milk coagulation. Samples were studied as regards its effect on lactic acid formation and its correlation with taste test results in cheeses. For both biocatalysts samples were analyzed for total acidity and lactic acid formation by HPLC. The quality of the produced cheeses was examined through the determination of volatile compounds by SPME GC/MS analysis. Preliminary taste tests and microbiological analysis were performed and encourage us for further research regarding scale up.Keywords: tubular cellulose, Lactobacillus casei, rennin enzyme, cheese production
Procedia PDF Downloads 3581635 The Great Mimicker: A Case of Disseminated Tuberculosis
Authors: W. Ling, Mohamed Saufi Bin Awang
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Introduction: Mycobacterium tuberculosis post a major health problem worldwide. Central nervous system (CNS) infection by mycobacterium tuberculosis is one of the most devastating complications of tuberculosis. Although with advancement in medical fields, we are yet to understand the pathophysiology of how mycobacterium tuberculosis was able to cross the blood-brain barrier (BBB) and infect the CNS. CNS TB may present with nonspecific clinical symptoms which can mimic other diseases/conditions; this is what makes the diagnosis relatively difficult and challenging. Public health has to be informed and educated about the spread of TB, and early identification of TB is important as it is a curable disease. Case Report: A young 21-year-old Malay gentleman was initially presented to us with symptoms of ear discharge, tinnitus, and right-sided headache for the past one year. Further history reveals that the symptoms have been mismanaged and neglected over the period of 1 year. Initial investigation reveals features of inflammation of the ear. Further imaging showed the feature of chronic inflammation of the otitis media and atypical right cerebral abscess, which has the same characteristic features and consistency. He further underwent a biopsy, and results reveal positive Mycobacterium tuberculosis of the otitis media. With the results and the available imaging, we were certain that this is likely a case of disseminated tuberculosis causing CNS TB. Conclusion: We aim to highlight the challenge and difficult face in our health care system and public health in early identification and treatment.Keywords: central nervous system tuberculosis, intracranial tuberculosis, tuberculous encephalopathy, tuberculous meningitis
Procedia PDF Downloads 189