Search results for: neonatal aorta
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 25

Search results for: neonatal aorta

25 The Biomechanical Properties of the Different Modalities of Surgically Corrected Coarctation of the Aorta in Neonates and Infants

Authors: Elina Ligere, Valts Ozolins, Lauris Smits, Normunds Sikora, Ivars Melderis, Laila Feldmane, Aris Lacis, Vladimir Kasyanov

Abstract:

Biomechanical properties of infantile aorta in vitro in cases of different standard anastomoses: end-to-end (ETE), extended anastomosis end-to-end (EETE) and subclavian flap aortoplasty (SFA) used for surgical correction of coarctation were analyzed to detect the influence of the method on the biomechanics of infantile aorta and possible changes in haemodinamics. 10 specimens of native aorta, 3 specimens with ETE, 4 EEET and 3 SFA were investigated. The experiments showed a non-linear relationship between stress and strain in the infantile aorta, the modulus of elasticity of the aortic wall increased with the increase of inner pressure. In the case of anastomosis end-to-end the modulus was almost constant, relevant to the modulus of elasticity of the aorta with the inner pressure 100-120 mmHg. The anastomoses EETE and SFA showed elastic properties closer to native aorta, the stiffness of ETE did not change with the changes in inner pressure.

Keywords: biomechanics, coarctation, mechanical properties, neonatal aorta

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24 Diagnosis of the Abdominal Aorta Aneurysm in Magnetic Resonance Imaging Images

Authors: W. Kultangwattana, K. Somkantha, P. Phuangsuwan

Abstract:

This paper presents a technique for diagnosis of the abdominal aorta aneurysm in magnetic resonance imaging (MRI) images. First, our technique is designed to segment the aorta image in MRI images. This is a required step to determine the volume of aorta image which is the important step for diagnosis of the abdominal aorta aneurysm. Our proposed technique can detect the volume of aorta in MRI images using a new external energy for snakes model. The new external energy for snakes model is calculated from Law-s texture. The new external energy can increase the capture range of snakes model efficiently more than the old external energy of snakes models. Second, our technique is designed to diagnose the abdominal aorta aneurysm by Bayesian classifier which is classification models based on statistical theory. The feature for data classification of abdominal aorta aneurysm was derived from the contour of aorta images which was a result from segmenting of our snakes model, i.e., area, perimeter and compactness. We also compare the proposed technique with the traditional snakes model. In our experiment results, 30 images are trained, 20 images are tested and compared with expert opinion. The experimental results show that our technique is able to provide more accurate results than 95%.

Keywords: Adbominal Aorta Aneurysm, Bayesian Classifier, Snakes Model, Texture Feature.

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23 Segmentation of Ascending and Descending Aorta in CTA Images

Authors: H. Özkan

Abstract:

In this study, a new and fast algorithm for Ascending Aorta (AscA) and Descending Aorta (DesA) segmentation is presented using Computed Tomography Angiography images. This process is quite important especially at the detection of aortic plaques, aneurysms, calcification or stenosis. The applied method has been carried out at four steps. At first step, lung segmentation is achieved. At the second one, Mediastinum Region (MR) is detected to use in the segmentation. At the third one, images have been applied optimal threshold and components which are outside of the MR were removed. Lastly, identifying and segmentation of AscA and DesA have been carried out. The performance of the applied method is found quite well for radiologists and it gives enough results to the surgeries medically.

Keywords: Ascending aorta (AscA), Descending aorta (DesA), Computed tomography angiography (CTA), Computer aided detection (CAD), Segmentation

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22 Identification of Differentially Expressed Gene(DEG) in Atherosclerotic Lesion by Annealing Control Primer (ACP)-Based Genefishing™ PCR

Authors: M. Maimunah, G. A. Froemming, H. Nawawi, M. I. Nafeeza, O. Effat, M. Y. Rosmadi, M. S. Mohamed Saifulaman

Abstract:

Atherosclerosis was identified as a chronic inflammatory process resulting from interactions between plasma lipoproteins, cellular components (monocyte, macrophages, T lymphocytes, endothelial cells and smooth muscle cells) and the extracellular matrix of the arterial wall. Several types of genes were known to express during formation of atherosclerosis. This study is carried out to identify unknown differentially expressed gene (DEG) in atherogenesis. Rabbit’s aorta tissues were stained by H&E for histomorphology. GeneFishing™ PCR analysis was performed from total RNA extracted from the aorta tissues. The DNA fragment from DEG was cloned, sequenced and validated by Real-time PCR. Histomorphology showed intimal thickening in the aorta. DEG detected from ACP-41 was identified as cathepsin B gene and showed upregulation at week-8 and week-12 of atherogenesis. Therefore, ACP-based GeneFishing™ PCR facilitated identification of cathepsin B gene which was differentially expressed during development of atherosclerosis.

Keywords: Atherosclerosis, GeneFishing™ PCR, cathepsin B gene.

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21 Early Onset Neonatal Sepsis Pathogens in Malaysian Hospitals: Determining Empiric Antibiotic

Authors: Nazedah Ain Ibrahim, Mohamed Mansor Manan

Abstract:

Information regarding early onset neonatal sepsis (EONS) pathogens may vary between regions. Global perspectives showed Group B Streptococcal (GBS) as the most common causative pathogens, but the widespread use of intrapartum antibiotics has changed the pathogens pattern towards gram negative microorganisms, especially E. coli. Objective of this study is to describe the pathogens isolated, to assess current treatment and risk of EONS. Records of 899 neonates born in three General Hospitals between 2009 until 2012 were retrospectively reviewed. Proven was found in 22 (3%) neonates. The majority was isolated with gram positive organisms, 17 (2.3%). All grams positive and most gram negative organisms showed sensitivity to the tested antibiotics. Only two rare gram negative organisms showed total resistant. Male was possible risk of proven EONS. Although proven EONS remains uncommon in Malaysia, nonetheless, the effect of intrapartum antibiotics still required continuous surveillance.

Keywords: Early onset neonatal sepsis, neonates, pathogens, gram positive, gram negative.

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20 Effect of Parenteral Administration of Vitamin A in Late Pregnant Cows on Vitamin A Status of Neonatal Calves

Authors: Samad Lotfollahzadeh

Abstract:

To evaluate the effect of intramuscular administration of vitamin A in pregnant dairy cows during late stages of pregnancy, on vitamin A status of neonatal calves, a total of 30 cows were randomly selected and divided into three groups; two treatment groups and one control group. Single intramuscular injection of 2000000 IU vitamin A; was carried in 10 dairy cows at 7 months of pregnancy (group 1). In second group of treated animals (10 cows) the injection was performed in 8 months of pregnancy (group 2). Ten pregnant dairy cows were received saline injection as placebo and selected as control group. Blood samples were collected from experimental dairy cows at 7 and 8 months of pregnancy as well as their newborn calves’ pre and after colostrum intake. There was no significant difference between vitamin A and β-carotene concentration of dairy cows of three groups in two last months of pregnancy (P> 0.05). Vitamin A concentration of calves of two treatment groups before and after receiving of colostrum were significantly higher than that in control group (P< 0.05). There was no significant difference between serum concentrations of vitamin A in calves of two treated groups (P> 0.05). β-Carotene concentration of serum samples of dairy cows and neonatal calves of three groups were not significantly different as compared with together. From results of the present study it can be concluded that single injection of vitamin A during at 7 or 8 month of pregnancy can significantly increase level of vitamin A in their colostrum and neonatal calves.

Keywords: Dry cow, Beta-carotene, Newborn calves, Vitamin A.

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19 Medical Image Segmentation Using Deformable Model and Local Fitting Binary: Thoracic Aorta

Authors: B. Bagheri Nakhjavanlo, T. S. Ellis, P.Raoofi, Sh.ziari

Abstract:

This paper presents an application of level sets for the segmentation of abdominal and thoracic aortic aneurysms in CTA datasets. An important challenge in reliably detecting aortic is the need to overcome problems associated with intensity inhomogeneities. Level sets are part of an important class of methods that utilize partial differential equations (PDEs) and have been extensively applied in image segmentation. A kernel function in the level set formulation aids the suppression of noise in the extracted regions of interest and then guides the motion of the evolving contour for the detection of weak boundaries. The speed of curve evolution has been significantly improved with a resulting decrease in segmentation time compared with previous implementations of level sets, and are shown to be more effective than other approaches in coping with intensity inhomogeneities. We have applied the Courant Friedrichs Levy (CFL) condition as stability criterion for our algorithm.

Keywords: Image segmentation, Level-sets, Local fitting binary, Thoracic aorta.

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18 Fetal and Infant Mortality in Botucatu City, São Paulo State, Brazil: Evaluation of Maternal - Infant Health Care

Authors: Noda L. M., Salvador I. C, C. M. L. G. Parada, Fonseca C. R. B.

Abstract:

In Brazil, neonatal mortality rate is considered incompatible with the country development conditions, and has been a Public Health concern. Reduction in infant mortality rates has also been part of the Millennium Development Goals, a commitment made by countries, members of the Organization of United Nations (OUN), including Brazil. Fetal mortality rate is considered a highly sensitive indicator of health care quality. Suitable actions, such as good quality and access to health services may contribute positively towards reduction in these fetal and neonatal rates. With appropriate antenatal follow-up and health care during gestation and delivery, some death causes could be reduced or even prevented by means of early diagnosis and intervention, as well as changes in risk factors and interventions. Objectives: To study the quality of maternal and infant health care based on fetal and neonatal mortality, as well as the possible actions to prevent those deaths in Botucatu (Brazil). Methods: Classification of prevention according to the International Classification of Diseases and the modified Wigglesworth´s classification. In order to evaluate adequacy, indicators of quality of antenatal and delivery care were established by the authors. Results: Considering fetal deaths, 56.7% of them occurred before delivery, which reveals possible shortcomings in antenatal care, and 38.2% of them were a result of intra- labor changes, which could be prevented or reduced by adequate obstetric management. These findings were different from those in the group of early neonatal deaths which were also studied. Adequacy of health services showed that antenatal and childbirth care was appropriate for 24% and 33.3% of pregnant women, respectively, which corroborates the results of prevention. These results revealed that shortcomings in obstetric and antenatal care could be the causes of deaths in the study. Early and late neonatal deaths have similar characteristics: 76% could be prevented or reduced mainly by adequate newborn care (52.9%) and adequate health care for gestational women (11.7%). When adequacy of care was evaluated, childbirth and newborn care was adequate in 25.8% and antenatal care was adequate in 16.1%. In conclusion, direct relationship was found between adequacy and quality of care rendered to pregnant women and newborns, and fetal and infant mortality. Moreover, our findings highlight that deaths could be prevented by an adequate obstetric and neonatal management.

Keywords: Fetal Mortality, Infant Mortality, Maternal-Child Health Services, Program Evaluation.

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17 Morphology and Risk Factors for Blunt Aortic Trauma in Car Accidents - An Autopsy Study

Authors: Ticijana Prijon, Branko Ermenc

Abstract:

Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall. An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.

Keywords: Aorta, blunt trauma, car accidents, morphology, risk factors.

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16 Structured Phospholipids from Commercial Soybean Lecithin Containing Omega-3 Fatty Acids Reduces Atherosclerosis Risk in Male Sprague dawley Rats which Fed with an Atherogenic Diet

Authors: Jaya Mahar Maligan, Teti Estiasih, Joni Kusnadi

Abstract:

Structured phospholipids from commercial soybean lecithin with oil enriched omega-3 fatty acid form by product of tuna canning is alternative procedure to provides the stability of omega-3 fatty acid structure and increase these bioactive function in metabolism. Best treatment condition was obtain in 18 hours acidolysis reaction with 30% enzyme concentration, which EPADHA incorporation level was 127,47 mg/g and incorporation percentage of EPA-DHA was 51,04% at phospholipids structure. This structured phospolipids could reduce atherosclerosis risk in male Sprague dawley rat. Provision of structured phospholipids has significant effect (α = 0.05) on changes in lipid profile, intima-media thickness of aorta rats (male Sprague dawley) fed atherogenic diet. Structured phospholipids intake can lower total cholesterol 78.36 mg/dL, total triglycerides 94,57 mg/dL, LDL levels 87.08 mg/dL and increased HDL level as much as 12,64 mg/dL in 10 weeks cares. Structured phospholipids intake also can prevent the thickening of the intima-media layer of the aorta.

Keywords: Structured phospholipids, commercial soybean lecithin, omega-3 fatty acid, atherosclerosis risk.

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15 Ultrasonographic Manifestations of Periventricular Leukomalacia in Preterm Neonates at Teaching Hospital Peradeniya, Sri Lanka

Authors: P. P. Chandrasekera, P. B. Hewavithana, S. Rosario, M. H. M. N. Hearth, D. M. R. D. Mirihella

Abstract:

Periventricular Leukomalacia (PVL) is a White Matter Injury (WMI) of preterm neonatal brain. Objectives of the study were to assess the neuro-developmental outcome at one year of age and to determine a good protocol of cranial ultrasonography to detect PVL. Two hundred and sixty four preterm neonates were included in the study. Series of cranial ultrasound scans were done by using a dedicated neonatal head probe 4-10 MHz of Logic e portable ultrasound scanner. Clinical history of seizures, abnormal head growth (hydrocephalus or microcephaly) and developmental milestones were assessed and neurological examinations were done until one year of age. Among live neonates, 57% who had cystic PVL (Grades 2 and 3) manifested as cerebral palsy. In conclusion cystic PVL has permanent neurological disabilities like cerebral palsy. Good protocol of real time cranial ultrasonography to detect PVL is to perform scans at least once a week until one month and at term (40 weeks of gestation).

Keywords: Cerebral palsy, cranial ultrasonography, Periventricular Leukomalacia (PVL), preterm neonates.

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14 Multiple Organ Manifestation in Neonatal Lupus Erythematous (Report of Two Cases)

Authors: Lubis A., Widayanti R., Hikmah Z., Endaryanto A., Harsono A., Harianto A., Etika R., Handayani D. K., Sampurna M.

Abstract:

Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: Neonatus lupus erythematous, maternal autoantibody, clinical characteristic.

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13 Microneedles-Mediated Transdermal Delivery

Authors: M. Petchsangsai, N. Wonglertnirant, T. Rojanarata, P. Opanasopit, T. Ngawhirunpat

Abstract:

The objective of the present study was to evaluate the potential of hollow microneedles for enhancing the transdermal delivery of Bovine Serum Albumin (MW~66,000 Da)-Fluorescein Isothiocyanate (BSA-FITC) conjugate, a hydrophilic large molecular compound. Moreover, the effect of different formulations was evaluated. The series of binary mixtures composed of propylene glycol (PG) and pH 7.4 phosphate buffer solution (PBS) was prepared and used as a medium for BSA-FITC. The results showed that there was no permeation of BSA-FITC solution across the neonatal porcine skin without using hollow microneedles, whereas the cumulative amount of BSA-FITC released at 8 h through the neonatal porcine skin was about 60-70% when using hollow microneedles. Furthermore, the results demonstrated that the higher volume of PG in binary mixtures injected, the lower cumulative amount of BSA-FITC released and release rate of BSA-FITC from skin. These release profiles of BSA-FITC in binary mixtures were expressed by Fick-s law of diffusion. These results suggest the utilization of hollow microneedle to enhance transdermal delivery of protein and provide useful information for designing an effective hollow microneedle system.

Keywords: Hydrophilic macromolecules, Microneedles, Propylene glycol, Transdermal drug delivery

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12 Atherosclerosis Prevalence within Populations of the Southeastern United States

Authors: Samuel P. Prahlow, Anthony Sciuva, Katherine Bombly, Emily Wilson, Shiv Dhiman, Savita Arya

Abstract:

A prevalence cohort study of atherosclerotic lesions within cadavers was performed to better understand and characterize the prevalence of atherosclerosis among Georgia residents within body donors in the Philadelphia College of Osteopathic Medicine (PCOM) - Georgia body donor program. We procured specimens from cadavers used for medical student, physical therapy student, and biomedical science student cadaveric anatomical dissection at PCOM - South Georgia and PCOM - Georgia. Tissues were prepared using hematoxylin and eosin (H&E) stain as histological slides by Colquitt Regional Medical Center Laboratory Services. One section from each of the following arteries was taken after cadaveric dissection at the site of most calcification palpated grossly (if present): left anterior descending coronary artery, left internal carotid artery, abdominal aorta, splenic artery, and hepatic artery. All specimens were graded and categorized according to the American Heart Association’s Modified and Conventional Standards for Atherosclerotic Lesions using x4, x10, x40 microscopic magnification. Our study cohort included 22 cadavers, with 16 females and 6 males. The average age was 72.54 and median age was 72, with a range of 52 to 90 years old. The cause of death determination listing vascular and/or cardiovascular causes were present on 6 of the 22 death certificates. 19 of 22 (86%) cadavers had at least a single artery grading > 5. Of the cadavers with at least a single artery graded at greater than 5, only 5 of 19 (26%) cadavers had a vascular or cardiovascular cause of death reported. Malignancy was listed as a cause of death on 7 (32%) of death certificates. The average atherosclerosis grading of the common hepatic, splenic and left internal carotid arteries (2.15, 3.05, and 3.36 respectively) were lower than the left anterior descending artery and the abdominal aorta (5.16 and 5.86 respectively). This prevalence study characterizes atherosclerosis found in five medium and large systemic arteries within cadavers from the state of Georgia.

Keywords: Atherosclerosis, cardiovascular, histology, pathology.

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11 Contrast-Enhanced Magnetic Resonance Angiography in Rats with Gadobenate Dimeglumine at 3T

Authors: Jo-Chi Jao, Yen-Ku Chen, Twei-Shiun Jaw, Po-Chou Chen

Abstract:

This study aimed to investigate the magnetic resonance (MR) signal enhancement ratio (ER) of contrast-enhanced MR angiography (CE-MRA) in normal rats with gadobenate dimeglumine (Gd-BOPTA) using a clinical 3T scanner and an extremity coil. The relaxivities of Gd-BOPTA with saline only and with 4.5% human serum albumin (HSA) were also measured. Compared with Gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA), Gd-BOPTA had higher relaxivities. The maximum ER of aorta (ERa), kidney, liver and muscle with Gd-BOPTA were higher than those with Gd-DTPA. The maximum ERa appeared at 1.2 min and decayed to half at 10 min after Gd-BOPTA injection. This information is helpful for the design of CE-MRA study of rats.

Keywords: Contrast-Enhanced Magnetic Resonance Angiography, Gd-BOPTA, Gd-DTPA, Rat.

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10 Remote Vital Signs Monitoring in Neonatal Intensive Care Unit Using a Digital Camera

Authors: Fatema-Tuz-Zohra Khanam, Ali Al-Naji, Asanka G. Perera, Kim Gibson, Javaan Chahl

Abstract:

Conventional contact-based vital signs monitoring sensors such as pulse oximeters or electrocardiogram (ECG) may cause discomfort, skin damage, and infections, particularly in neonates with fragile, sensitive skin. Therefore, remote monitoring of the vital sign is desired in both clinical and non-clinical settings to overcome these issues. Camera-based vital signs monitoring is a recent technology for these applications with many positive attributes. However, there are still limited camera-based studies on neonates in a clinical setting. In this study, the heart rate (HR) and respiratory rate (RR) of eight infants at the Neonatal Intensive Care Unit (NICU) in Flinders Medical Centre were remotely monitored using a digital camera applying color and motion-based computational methods. The region-of-interest (ROI) was efficiently selected by incorporating an image decomposition method. Furthermore, spatial averaging, spectral analysis, band-pass filtering, and peak detection were also used to extract both HR and RR. The experimental results were validated with the ground truth data obtained from an ECG monitor and showed a strong correlation using the Pearson correlation coefficient (PCC) 0.9794 and 0.9412 for HR and RR, respectively. The root mean square errors (RMSE) between camera-based data and ECG data for HR and RR were 2.84 beats/min and 2.91 breaths/min, respectively. A Bland Altman analysis of the data also showed a close correlation between both data sets with a mean bias of 0.60 beats/min and 1 breath/min, and the lower and upper limit of agreement -4.9 to + 6.1 beats/min and -4.4 to +6.4 breaths/min for both HR and RR, respectively. Therefore, video camera imaging may replace conventional contact-based monitoring in NICU and has potential applications in other contexts such as home health monitoring.

Keywords: Neonates, NICU, digital camera, heart rate, respiratory rate, image decomposition.

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9 Mathematical Model of the Respiratory System – Comparison of the Total Lung Impedance in the Adult and Neonatal Lung

Authors: M. Rozanek, K. Roubik

Abstract:

A mathematical model of the respiratory system is introduced in this study. Geometrical dimensions of the respiratory system were used to compute the acoustic properties of the respiratory system using the electro-acoustic analogy. The effect of the geometrical proportions of the respiratory system is observed in the paper.

Keywords: Electro-acoustic analogy, total lung impedance, mechanical parameters, respiratory system.

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8 Calculation of Reorder Point Level under Stochastic Parameters: A Case Study in Healthcare Area

Authors: Serap Akcan, Ali Kokangul

Abstract:

We consider a single-echelon, single-item inventory system where both demand and lead-time are stochastic. Continuous review policy is used to control the inventory system. The objective is to calculate the reorder point level under stochastic parameters. A case study is presented in Neonatal Intensive Care Unit.

Keywords: Inventory control system, reorder point level, stochastic demand, stochastic lead time

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7 Perinatal Outcome in Cases with Bleeding during First and Early Second Trimester

Authors: S. Chhabra, C. Tickoo, P. Kalra

Abstract:

Background: Bleeding during first half of pregnancy mostly originates from placenta, some abort, others are at risk of complications. Objective: Study was done to know perinatal outcome with bleeding up to 20 weeks in singleton pregnancy. Material Methods: Subjects were 1020, equal controls managed over 2 years, 435 had viable pregnancy at admission, 135 excluded, 300 followed for perinatal outcome, 99 (19.52% up to 10 weeks), 201 (39.18% of 11-20 weeks). Results: Hypertensive disorders occurred in 24% cases of bleeding within 10 weeks, 22% 11-20 weeks 14.79% controls, placenta previa 4% in 10 weeks, 0.9% 11-20 weeks, 0.97% controls, prelabor rupture of membranes in 16%, 7.45% controls. 20% up to 10 weeks, 35% 11-20 weeks, 18% controls had fetal growth restriction, 34.34% up to 10 weeks 30.35% of 11-20 weeks 17.17% controls had preterm births, perinatal mortality rate in study was 118.62, in controls 68.16 (Uneventful pregnancy in 13.52% study, 46.11% controls). Conclusion: Once bleeding occurs, one third continue pregnancy, maternal neonatal outcome gets affected with variations in cases of bleeding within first 10 weeks & 11-20 weeks.

Keywords: First, Second trimester, bleeding, Disorders, Perinatal Outcome.

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6 The Comparation of Activation Nuclear Factor Kappa Beta (NFKB) at Rattus Novergicus Strain Wistar Induced by Various Duration High Fat Diet (HFD)

Authors: Titin Andri Wihastuti, Djanggan Sargowo

Abstract:

NFκB is a transcription factor regulating many function of the vessel wall. In the normal condition , NFκB is revealed diffuse cytoplasmic expressionsuggesting that the system is inactive. The presence of activation NFκB provide a potential pathway for the rapid transcriptional of a variety of genes encoding cytokines, growth factors, adhesion molecules and procoagulatory factors. It is likely to play an important role in chronic inflamatory disease involved atherosclerosis. There are many stimuli with the potential to active NFκB, including hyperlipidemia. We used 24 mice which was divided in 6 groups. The HFD given by et libitum procedure during 2, 4, and 6 months. The parameters in this study were the amount of NFKB activation ,H2O2 as ROS and VCAM-1 as a product of NFKB activation. H2O2 colorimetryc assay performed directly using Anti Rat H2O2 ELISA Kit. The NFKB and VCAM-1 detection obtained from aorta mice, measured by ELISA kit and imunohistochemistry. There was a significant difference activation of H2O2, NFKB and VCAM-1 level at induce HFD after 2, 4 and 6 months. It suggest that HFD induce ROS formation and increase the activation of NFKB as one of atherosclerosis marker that caused by hyperlipidemia as classical atheroschlerosis risk factor.

Keywords: High Fat Diet, NFKB, H2O2, atherosclerosis

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5 Outcomes of Teenage Mothers at Dankhunthot Hospital, Nakhon Ratchasima

Authors: Nareelux Suwannobol, Supap Chobkhayan

Abstract:

The aim of this study was to investigate the pregnancy outcomes of teenage mothers at DanKhunThot hospital, Nakhon Ratchasima, Thailand. A retrospective descriptive study was conducted in 573 of teenage pregnant from charts reviewed from 1st October 2010-31st March, 2012. Data were analyzed by frequency distribution, mean and Standard Deviation. The results shown several problems and negatives outcomes of pregnancy in teenager such as not attended prenatal care, Low birth weight infants, death fetus in utero and other complications. The results of this study can be utilized in the development of prenatal, perinatal and post natal care services, especially in DanKhunthot Hospital contexts. Moreover, the results were present to the District Health Care committees in order to enhance health care service system for teenage pregnancy of DanKhunthot District in further.

Keywords: Teenage mothers, Pregnancy outcome, Neonatal outcomes, Maternal outcomes.

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4 Dexamethasone: Impact on Testicular Activity

Authors: H. Sadi-Guettaf, F. Hadj Bekkouche

Abstract:

Dexamethasone (Dex) is a synthetic glucocorticoid that is used in therapy. However prolonged treatments with high doses are often required. This causes side effects that interfere with the activity of several endocrine systems, including the gonadotropic axis. The aim of our study is to determine the effect of Dex on testicular function in prepubertal Wistar rats. Newborn Wistar rats are submitted to intraperitoneal injection of Dex (1μg of Dex dissolved in NaCl 0.9% / 5g bw) for 20 days and then sacrificed at the age of 40days. A control group received NaCl 0.9%. The rat is weighed daily. The plasmatic levels of testosterone, LH and FSH were measured by radioimmunoassay. A histomorphometric study was performed on sections of testis. Treated groups showed a significant decrease in body weight (p < 0.05), testis weight (p < 0.05) and plasma levels of testosterone (p < 0.05), of LH (P < .05) and FSH (p> 0.05). There is a reduction of seminiferous tubules average diameter and also of the seminiferous epithelium thickness with an increasing of lumen tubular. The diameter of the Leydig cells and Sertoli cell nucleus is also significantly reduced. Spermatogenesis is blocked at the stage round spermatid unlike witnesses or elongated spermatid stage is found. These results suggest that Dex administered during neonatal life influences testicular activity in the long term.

Keywords: Dexamethasone, FSH, LH, rat, testis, testosterone.

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3 Clinical Signs of Neonatal Calves in Experimental Colisepticemia

Authors: Samad Lotfollahzadeh

Abstract:

Escherichia coli (E. coli) is the most isolated bacteria from blood circulation of septicemic calves. Given the prevalence of septicemia in animals and its economic importance in veterinary practice, better understanding of changes in clinical signs following disease, may contribute to early detection of disorder. The present study has been carried out to detect changes of clinical signs in induced sepsis in calves with E. coli. Colisepticemia has been induced in 10 twenty-day old healthy Holstein- Frisian calves with intravenous injection of 1.5 X 109 colony forming units (cfu) of O111:H8 strain of E. coli. Clinical signs including rectal temperature, heart rate, respiratory rate, shock, appetite, sucking reflex, feces consistency, general behavior, dehydration and standing ability were recorded in experimental calves during 24 hours after induction of colisepticemia. Blood culture was also carried out from calves four times during experiment. ANOVA with repeated measure is used to see changes of calves’ clinical signs to experimental colisepticemia, and values of P≤ 0.05 was considered statistically significant. Mean values of rectal temperature and heart rate as well as median values of respiratory rate, appetite, suckling reflex, standing ability and feces consistency of experimental calves increased significantly during study (P<0.05). In the present study median value of shock score was not significantly increased in experimental calves (P> 0.05). The results of present study showed that total score of clinical signs in calves with experimental colisepticemia increased significantly, although score of some clinical signs such as shock did not change significantly.

Keywords: Calves, Clinical signs scoring, E. coli O111:H8, Experimental colisepticemia,

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2 A Study on the Differential Diagnostic Model for Newborn Hearing Loss Screening

Authors: Chun-Lang Chang

Abstract:

According to the statistics, the prevalence of congenital hearing loss in Taiwan is approximately six thousandths; furthermore, one thousandths of infants have severe hearing impairment. Hearing ability during infancy has significant impact in the development of children-s oral expressions, language maturity, cognitive performance, education ability and social behaviors in the future. Although most children born with hearing impairment have sensorineural hearing loss, almost every child more or less still retains some residual hearing. If provided with a hearing aid or cochlear implant (a bionic ear) timely in addition to hearing speech training, even severely hearing-impaired children can still learn to talk. On the other hand, those who failed to be diagnosed and thus unable to begin hearing and speech rehabilitations on a timely manner might lose an important opportunity to live a complete and healthy life. Eventually, the lack of hearing and speaking ability will affect the development of both mental and physical functions, intelligence, and social adaptability. Not only will this problem result in an irreparable regret to the hearing-impaired child for the life time, but also create a heavy burden for the family and society. Therefore, it is necessary to establish a set of computer-assisted predictive model that can accurately detect and help diagnose newborn hearing loss so that early interventions can be provided timely to eliminate waste of medical resources. This study uses information from the neonatal database of the case hospital as the subjects, adopting two different analysis methods of using support vector machine (SVM) for model predictions and using logistic regression to conduct factor screening prior to model predictions in SVM to examine the results. The results indicate that prediction accuracy is as high as 96.43% when the factors are screened and selected through logistic regression. Hence, the model constructed in this study will have real help in clinical diagnosis for the physicians and actually beneficial to the early interventions of newborn hearing impairment.

Keywords: Data mining, Hearing impairment, Logistic regression analysis, Support vector machines

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1 Sickle Cell Disease: Review of Managements in Pregnancy and the Outcome in Ampang Hospital, Selangor

Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

Abstract:

The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: Anemia, haemoglobinopathies, pregnancy, sickle cell disease.

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