scholarly journals Prevalence of sickle cell trait and its association to renal dysfunction among blood donors at university of medical sciences teaching hospital, Ondo, Nigeria

2021 ◽  
Vol 21 (3) ◽  
pp. 1237-1242
Author(s):  
Akinwumi Ayodeji Akinbodewa ◽  
Adeyemi Ogunleye ◽  
Oluseyi Ademola Adejumo
Keyword(s):  
Renal Function ◽  
Sickle Cell ◽  
Blood Donors ◽  
Sickle Cell Trait ◽  
P Value ◽  
Healthy Donors ◽  
Significant Difference ◽  
High Prevalence ◽  
The Mean ◽  
Estimated Glomerular Filtration Rates

Introduction: Prospective blood donors are routinely screened for blood borne infections but medical illnesses and haemo- globin genotype are overlooked despite a high prevalence of haemoglobin AS among Nigerian donors. Objective: To determine the prevalence of haemoglobin AS and its association to renal function, if any. Method: Apparently healthy donors were studied between February and December 2018. Their haemoglobin genotype and, estimated glomerular filtration rates were determined. Results: There were 96 males (94.1%) and 6 (5.9%) females with mean age of 26.7±4.5 years (range 19-44 years) and mean eGFR of 103.97±19.00ml/min/1.73m2. Eighty one (79.4%) and 21 (20.6%) subjects had haemoglobin AA and AS geno- types respectively. The mean eGFR for subjects with haemoglobin AA and AS were 105.2±18.6ml/min/1.73m2 and 99.9 ± 21.2ml/min/1.73m2 respectively (p value = 0.270). Eighty one (79.4%), 20 (19.6%) and 1 (1.0%) subjects had renal function at >90ml/min/1.73m2, 60-89ml/min/1.73m2 and 30-59ml/min/m2 respectively. There was no significant difference in the mean eGFR between subjects with haemoglobin AA and AS (mean difference 5.3, p = 0.265, 95%CI = -4.07 to 14.60). Conclusion: The prevalence of sickle cell trait among Nigerian blood donors is high. There is no significant difference in the renal function status of blood donors with SCT and normal haemoglobin genotype. Keywords: Haemoglobin genotype; sickle cell trait; renal function; blood donor; Nigeria.

scholarly journals Frequency of red blood cell alloimmunization in sickle cell patients and healthy donors: the influence of racial and antigenic pattern differences

2017 ◽  
Vol 4 (7) ◽  
pp. 2226
Author(s):  
Majid Vafaei ◽  
Bijan Keikhaei-dehdazi
Keyword(s):  
Blood Cell ◽  
Sickle Cell ◽  
Red Blood Cell ◽  
Blood Donors ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Healthy Donors ◽  
Significant Difference ◽  
The Common ◽  
The Mean

Background: Red blood cell (RBC) transfusions are frequently used in patients with sickle cell disease (SCD) to treat and prevent of their disease complications. However repeated blood transfusions are often complicated by RBC alloimmunization. Race and antigenic pattern differences are the common risk factor to develop alloimmunization. This study was performed to determine the frequency of RBC alloimmunzation in sickle cell patients and healthy blood donors.Methods: This is a cross sectional study that has been done on 140 patients with SCD and 140 healthy blood donors from April 2015 to April 2016. The RBC phenotype of all patients and donors investigated by Tub method and all panel test phases were done at immunohematology laboratory of Iranian Blood Transfusion Organization of Ahwaz.Results: Of all SCD patients 61 (43.6%) were male and 79 (56.4%) were female. 68 (48.5%) were HbSS and 72 (51.4%) were S/B thalassemia. The mean age of patients was 19.69 (range: 2-60) years. Of all patients, 114 (81.25%) had received transfusion. The RBC alloimmunization rate among SCD patients was 7.1% and 50% of the RBC alloimmunization had anti-Kell and 30% had anti-Rh. The comparison of the RBC phenotypes between the group of patients with SCD and the group of blood donors (non-Arab) revealed a statistically significant difference in the frequency of S (54% vs. 67%, p=0.024), M (82.7% vs. 90.7%, p=0.049), and FYb (73.4% vs. 55.7%, p=0.002).Conclusions: Althoguh alloimmunization rate in SCD patients in this study was lower than reported by other studies but cross matchining at least for the Rh and Kell systems from the time of initial transfusion may decrease the incidence of alloimmunization. 

Clinical Complications in Adult Patients with Sickle Cell Anemia and β-Thalassemia-Sickle Cell Disease

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4767-4767
Author(s):  
Giovanna Graziadei ◽  
Alessia Marcon ◽  
Martina Soldarini ◽  
Ilaria Gandolfi ◽  
Luisa Ronzoni ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Acute Chest Syndrome ◽  
P Value ◽  
Cell Disease ◽  
Transfusion Therapy ◽  
Clinical Complications ◽  
Significant Difference ◽  
The Mean

Abstract Abstract 4767 Background. Sickle-Cell Disease (SCD) is one of the most common severe monogenic inherited disorders worldwide, due to hemoglobin S (HbS), with reduced affinity for the oxygen. HbS polymerization, leading to erythrocyte rigidity, vaso-occlusion and hemolytic anemia, is central in the pathophysiology and crucial for the clinical outcome. The term SCD refers to Sickle Cell Anemia (SCA) due to homozygosis for βS allele, HbS/β-thalassemia (T-SCD) due to compound of β-thal and βS allele, and HbSC disease, owing to the coinheritance of βS and βcalleles. SCD is a multiorgan disease characterized by recurrent acute events and progressive organ damage, worsening during the life. Aims. This is a retrospective monocentric study aimed to assess and compare the clinical complications among 59 adult SCD patients, followed at the Hereditary Anemia Centre of the Foundation IRCCS “Ca Granda” Ospedale Maggiore Policlinico, in Milan, Italy. Methods. Mutation analysis of the b globin gene was established by direct DNA sequencing on the ABI Prism 310 genetic analyzer. Clinical and hematological features were evaluated by routine tests and physical examination, with special attention to the erythropoiesis stress parameters as LDH values and extramedullary erythropoietic (EE) masses. Results. Fifty-nine adult SCD patients, 16 SCA and 43 T-SCD, were evaluated. In T-SCD patients detected b-mutations were severe (b°) in 69.8%, and moderate or mild (b+-b++) in 30.2%. The mean age of SCA patients was 36±9 and 41±11 years for T-SCD patients. For both groups the mean follow-up was 20±6 years, while the mean age at the presentation in our Centre was 32±8 years in SCA patients and 31±10 years in T-SCD ones. Five out of 16 (31.2%) SCA patients and 16/43 (37.2%) T-SCD patients were male. HbF mean levels were 6.9±5.1% and 10.1±7.2%, respectively in SCA and T-SCD group; surprisingly Hb mean levels were lower in SCA (9.3±1.3 g/dl) than in T-SCD (9.9±1.4 g/dl) patients. Comparing SCA and T-SCD, there was statistically significant difference in splenic features: splenectomy was performed in 2/16 (12.5%) SCA patients vs 21/43 (48.8%) T-SCD patients (p-value < 0.01). Splenomegaly was absent in SCA, while was detected in 11/22 (50%) T-SCD (p-value < 0.0001); all SCA patients had functional asplenia, not observed in T-SCD patients; splenic infarctions were absent in SCA patients and were detected in 7/22 (31.8%) T-SCD patients, of whom 5 had splenomegaly and 2 had normal spleen size (pvalue <0.001). On the other side, there was not statistically significant difference in the prevalence of stroke, acute chest syndrome (ACS), bone pain crisis, sepsis, leg ulcers and priapism. However, we observed some clinical differences, even if not statistically significant. Cholecistectomy was performed in 4/16 (25%) SCA patients vs 17/43 (39.5%) T-SCD patients, and gallstones were detected respectively in 5/12 (41.7%) and in 14/26 (53.8%) of SCA and T-SCD patients. Thrombotic events were absent in SCA patients, compared to 4/43 (9.3%) T-SCD patients. Furthermore, we detected EE in 3/16 (18.6%) SCA and in 3/43 (7%) T-SCD, all carrying b° thal mutations. We underlie that Hb levels and LDH values were higher in SCA than in T-SCD patients (823±295 vs 689±209 U/L). About the treatment, 14/16 (87.5%) SCA and 31/43 (72%) T-SCD underwent to top-up transfusion; 5/43 (11.6%) T-SCD were regularly transfused. Seven out of 16 (43.8%) SCA and 18/43 (41.8%) T-SCD patients were treated with Hydroxycarbamide (HU). Criteria for transfusion therapy were: painful crisis not responsive to HU, major clinical complications, such as stroke or ACS, extramedullary erythropoietic masses associated with high LDH levels and low Hb values. Conclusions. These data suggest that SCA and T-SCD patients have similar clinical course. Splenomegaly is present only in T-SCD patients, probably due to the increased amount of extravascular hemolysis. Surprisingly, SCA patients showed EE and lower Hb levels with higher LDH values compared to T-SCD ones. This could be related to the prevalence of intravascular hemolysis, that can lead to erythropoietic stress in SCA, even if tissues are better oxygenated in these patients because of biochemical characteristic of HbS in terms of decreased oxygen affinity. These observations could be important to evaluate transfusion and HU treatment. Disclosures: Cappellini: Novartis: Research Funding.

scholarly journals Pregnancy Outcomes in Women with Sickle Cell Trait

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4176-4176
Author(s):  
Sarah S Sewaralthahab ◽  
Jiling Chou ◽  
Stephen Fernandez ◽  
Nawar Shara ◽  
Hedy Smith
Keyword(s):  
Sickle Cell ◽  
Subgroup Analysis ◽  
Sickle Cell Trait ◽  
Private Insurance ◽  
Adverse Outcomes ◽  
Control Group ◽  
P Value ◽  
Benign Condition ◽  
Significant Difference ◽  
Fetal Complications

Abstract Introduction Sickle cell trait (SCT) is a heterozygous condition in which individuals inherit one copy of the hemoglobin S allele (Hb S) which harbors a point mutation in codon 6 of the beta globin gene and one copy of the hemoglobin A allele (Hb A). SCT is a highly prevalent state affecting 300 million people worldwide with 5.5 million births annually. Individuals with SCT are generally asymptomatic with a normal life expectancy unlike their counterparts with sickle cell disease (Hb SS). Historically, they had been considered to have a benign condition with no adverse outcomes on quality or length of life. More recently extensive literature has been published regarding the potential morbidity associated with SCT, especially under extremes of stress or high oxygen demand states. There is a paucity of high-quality data addressing the implications of SCT on pregnancy but pregnant women with SCT appear to have an increased risk of maternal and fetal complications. We looked at the association between SCT and maternal and fetal complications via retrospective analysis. Methods We extracted data from the electronic medical records at our tertiary medical center on all deliveries that occurred between January 2015 and December 2020. A total of 21,198 deliveries occurred in this time frame. One hundred and sixty-two women with sickle cell trait (7.6%) were identified and matched in a 2:1 fashion to women without SCT controlling for age, gravidity, and race. Subgroup analysis by age, hemoglobin (Hb), body mass index (BMI), history of hypertension, and type-2 diabetes were carried out however subgroup analyses by a history of deep vein thrombosis or pulmonary embolism (DVT/PE) and chronic kidney disease (CKD) were not conducted due to the small frequencies in the "Yes" groups. Results The median age was 27.5 years and 92.5% were African American. Of the cohort, 31.7% carried private insurance, 65.4% carried federal insurance (Medicaid) and 2.9% were self-pay (defined as other). Despite the lack of statistical significance between the two cohorts, some variables were noted to have numerically noticeable differences. Vaso-occlusive crisis (VOC) was seen in 1.9% of the SCT group (n=3) and in none of the control group and pyelonephritis/UTI was seen in 11.7% of the SCT group vs 7.1% in the control group (p-value 0.123) [Table 1]. On subgroup analysis by age (≤ 35 years vs &gt;35 years) a statistically significant difference was seen in pregnancy-related hypertensive disorders (PRHD which includes gestational hypertension, preeclampsia, eclampsia, and HELLP syndrome) (60% of women with SCT vs 30% in women without SCT, p-value 0.05). VOC was only noted in women with SCT ≤ 35 years [Table 2]. When the cohorts were analyzed by Hb value ( ≤ 10 g/dL vs &gt;10 g/dL), a statistically significant difference in PRHD was noted in women with Hb &lt;10 g/dL (61% of in women with SCT vs 38.4% in women without SCT, p-value 0.033) [Table 3]. No differences were noted in subgroup analysis by essential hypertension, BMI, or type-2 diabetes. Discussion Despite the relatively small cohort, it is evident that SCT is not a benign condition in pregnancy. The racial and socioeconomic disparities are evident by the higher percentage of African Americans (92.5%) and women lacking private insurance coverage (68.3% of the cohort were covered by Medicaid or uninsured) who suffered adverse outcomes. VOC was noted exclusively in women with SCT (0.6% of the entire cohort) consistent with the notion that stress and/or hypoxia induce sickling. The interesting findings in this cohort were related to PRHD which occurred more frequently in women with SCT older than 35 years and in women with SCT and a Hb ≤10 g/dL. Although advanced maternal age and severe anemia are known risk factors for preeclampsia, the higher incidence of PRHD in women with SCT and advanced age (&gt;35 years) or anemia (Hb ≤10 g/dL) warrants specific examination in future studies. Additionally, studies are needed to interrogate the pathophysiology of the hypertensive disease that occurs in SCT pregnancies. One limitation of the current retrospective study is that we were unable to define the precise subtype of the PRHD. In future studies, we would specifically examine the incidence of pre-eclampsia causing PRHD in individuals with SCT. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

A Comparison of Automated Red Blood Cell Depletion/Exchange to Automated Red Cell Blood Exchange in Sickle Cell Patients.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2281-2281 ◽  
Author(s):  
Kevin H.M. Kuo ◽  
David Barth
Keyword(s):  
Clinical Outcome ◽  
Blood Cell ◽  
Sickle Cell ◽  
Red Blood Cell ◽  
Conflicts Of Interest ◽  
P Value ◽  
Entire Study ◽  
Blood Exchange ◽  
Significant Difference ◽  
The Mean

Abstract Abstract 2281 Introduction: Chronic red blood cell (RBC) exchange transfusion (RBCX) is employed in the prevention and treatment of complications from sickle cell disease (SCD). Although regular automated RBCX by an apheresis device can consistently maintain a low sickle hemoglobin (HbS) percentage at a relatively constant hematocrit level (Hct) with no iron loading, it exposes the patient to significantly more donor erythrocyte units than simple (top-up) transfusion. Since October 2010 the University Health Network, a sickle cell comprehensive care centre in Canada, has started performing automated depletion RBCX with the Caridian Optia Apheresis System. In depletion/exchange, a portion of the patient's RBC is first cytapheresed by the apheresis device prior to the exchange phase of the procedure, with albumin as colloid replacement to maintain intravascular volume and pressure. The clinical effectiveness of depletion/exchange has not been demonstrated in a systematic manner. A retrospective observational cohort study was conducted to investigate the hypothesis that depletion/exchange RBCX, when compared to traditional automated RBCX, will reduce a patient's donor RBC exposure while providing similar hematological and clinical benefit. The laboratory and clinical outcome 1 year before (October 1, 2009) and 1 year after (October 30, 2011) the introduction of depletion/exchange RBCX were compared on a patient-by-patient, rather than on an aggregate, basis. Results: Seven patients, 2 females, 5 males, median age 29 years (range 26 – 38 years), totaling 135 RBCX sessions were examined. Five patients were homozygous for the sickle mutation and 2 were SC compound heterozygotes (HbSC). Stroke was the most prevalent indication (n = 3). Median interval between exchange sessions was 5 weeks (range 4 – 8 weeks). The fraction cell remaining (FCR) was fixed at 20 and did not change when patients were transitioned from non-depleted to depleted exchange. The minimum Hct was reduced to 0.24 in all patients. The inlet speed of the apheresis device and anticoagulant ratio employed were similar across all patients. There was no significant difference in pre-RBCX HbS (or HbS+C in HbSC patients) in 6 patients (P value ranged from 0.0589 to 0.6870). The pre-RBCX HbS was higher with depletion/exchange in 1 patient (P = 0.0071). There was no significant difference in post-RBCX Hct in 5 patients (P value ranged from 0.1056 to 0.8995), and in 2 patients, the mean post-RBCX Hct was lower with depletion/exchange (P = 0.0004 and 0.0148). The mean RBC volume used was reduced by 25 mL/kg/year with depletion/exchange. The mean volume of albumin used was 6.0 ± 2.5 mL/kg per session. Ferritin remained stable throughout the study period (P = 0.2289). None of the patients were on iron chelators. There was no significant difference in mean duration of RBCX session between depletion/exchange and non-depletion exchange in all patients except one. The median duration of one session was 148 ± 51 min. and 147 ± 43 min. in depletion/exchange and non-depletion exchange respectively. A total of 11 adverse events occurred in 135 sessions, with citrate reaction being the commonest (n = 4). There was no significant difference in the rate of adverse event between depletion and non-depletion RBCX (8/74 and 4/61 respectively, P = 0.3874). There was also no incidence of treatment failure, defined as the occurrence of an SCD-related complication in which the RBCX was intended to prevent, in any of the patients during the entire study period, regardless of RBCX method. Conclusion: In this first clinical study of depletion/exchange, this strategy significantly reduced RBC usage in majority of the patients without any negative impact on laboratory and clinical outcome. The use of depletion/exchange reduced RBC usage by 25 mL/kg/year, equivalent to 5 units of packed RBC in a 60 kg person. Further optimization of the technique by modification of the FCR and minimum Hct may yield higher reduction in RBC usage, thereby reducing the risk of exposure to blood products. Disclosures: No relevant conflicts of interest to declare.

scholarly journals The Effectiveness of Homemade Soymilk in Increasing Haemoglobin (Hb) Levels in Pregnant Women

2019 ◽  
Vol 6 (2) ◽  
pp. 41
Author(s):  
Teungku Nih Farisni ◽  
Fitriani Fitriani ◽  
Yarmaliza Yarmaliza
Keyword(s):  
Fatty Acids ◽  
Pregnant Women ◽  
Essential Fatty Acids ◽  
P Value ◽  
Soy Milk ◽  
Second Trimester ◽  
Average Increase ◽  
Significant Difference ◽  
High Prevalence ◽  
The Mean

The high prevalence of anaemia in pregnant women in West Aceh Regency (40.5%), which is indicated by the haemoglobin (Hb) levels of below 11 g%, should receive special attention because anaemia will have an impact on maternal and infant mortality. Soy milk is one processed beverage that contains iron, high protein, essential fatty acids, fibre, vitamins and minerals. Nutrients contained in soy can produce energy, maintain optimal body functions, and meet the needs of iron in pregnant women. Soybean is a type of food which is ranked third to have the richest iron (8.8 mg%) after meat and cereals. The purpose of this study was to examine the effectiveness of homemade soy milk in increasing Hb levels in pregnant women. The study design was an experiment on pregnant women. The object of this study was pregnant women in their first and second trimester of pregnancy. The intervention was giving homemade soy milk by adding 10 ml of honey, as a substitute for sugar, to 1 cup of homemade soy milk (250 ml), from a basic intake of 4 mg of iron per day for pregnant women. This intervention resulted in a significant increase in Hb levels in pregnant women (P < 0.005). The provision of homemade soy milk can significantly increase the mean of Hb levels in pregnant women with an average increase of 2.99 mg% ± 1.422. Furthermore, the p-value obtained was = 0.000, indicating that there was a significant difference in Hb levels between measurement I (before being given homemade soy milk) and after being given homemade soy milk for 3 months. Homemade soy milk is an effective drink in increasing Hb levels in pregnant women.

Employing Personal Reading Logs through Short Stories to Enhance Students’ L2 Reading Comprehension Achievement

2019 ◽  
Vol 3 (2) ◽  
pp. 1
Author(s):  
Eliyas Sulaiman Mohandas ◽  
Nik Mastura Nik Ismail Azlan ◽  
Salwa Othman ◽  
Muhammad Aizat Azhari
Keyword(s):  
Short Stories ◽  
Reading Comprehension ◽  
P Value ◽  
L2 Reading ◽  
Reading Score ◽  
Paired Samples ◽  
Significant Difference ◽  
Post Test ◽  
The Mean ◽  
L2 Reading Comprehension

This study aims to investigate whether the use of six selected short stories throughout the duration of a 14-week course could enhance students’ reading comprehension achievement at the end of the semester. Out of the six short stories read, three were chosen as in-class assignments known as ‘Personal Reading Logs’ (hereafter, PRLs). One group of semester two Diploma students taking a reading skills course was selected through a convenience sampling method. A pre-test was conducted by having the students answer a past semester reading quiz of which the results would then be compared to their post-test (final reading exam) results. A paired samples t-test revealed no significant difference in the reading scores of the pre-test and the post-test, t (17) = -.265, p > .05. Since the p-value was bigger than 0.05, this indicated that the mean reading score of the post-test (M = 50.556) was not significantly higher than the mean reading score of the pre-test (M = 49.722). Therefore, the null hypothesis which stated that there was no difference in the mean score of the pre-test and post-test was retained. Overall, the result refuted the findings of other studies promoting the effectiveness of using short stories to enhance L2 reading comprehension achievement.

scholarly journals Pattern of symptom improvement following endoscopic sinus surgery for chronic rhinosinusitis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Salma S. Al Sharhan ◽  
Mohammed H. Al Bar ◽  
Shahad Y. Assiri ◽  
Assayl R. AlOtiabi ◽  
Deemah M. Bin-Nooh ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Endoscopic Sinus Surgery ◽  
T Test ◽  
Sinus Surgery ◽  
Symptom Improvement ◽  
P Value ◽  
Psychological Dysfunction ◽  
Significant Difference ◽  
The Mean ◽  
Snot 22

Abstract Background Chronic rhinosinusitis (CRS) is a common inflammation of the nose and the paranasal sinuses. Intractable CRS cases are generally treated with endoscopic sinus surgery (ESS). Although the effect of ESS on CRS symptoms has been studied, the pattern of symptom improvement after ESS for CRS is yet to be investigated. The aim of this study was to determine the magnitude and sequence of symptom improvement after ESS for CRS, and to assess the possible preoperative factors that predict surgical outcomes in CRS patients. Methods This was a longitudinal prospective study of 68 patients who had CRS (with or without nasal polyps). The patients underwent ESS at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. The Sino-nasal Outcome Test-22 (SNOT-22) questionnaire was used for assessment at four time points during the study: pre-ESS, 1-week post-ESS, 4 weeks post-ESS, and 6 months post-ESS. Results The difference between the mean scores recorded for the five SNOT-22 domains pre-ESS and 6 months post-ESS were as follows: rhinologic symptoms (t-test = 7.22, p-value =  < 0.001); extra-nasal rhinologic symptoms (t-test = 4.87, p-value =  < 0.001); ear/facial symptoms (t-test = 6.34, p-value =  < 0.001); psychological dysfunction (t-test = 1.99, p-value = 0.049); and sleep dysfunction (t-test = 5.58, p-value =  < 0.001). There was a significant difference between the mean scores recorded for the five domains pre-ESS and 6 months post-ESS. Rhinologic symptoms had the largest effect size (d = 1.12), whereas psychological dysfunction had the least effect size (d = 0.24). The only statistically significant difference in the SNOT-22 mean scores recorded 4 weeks post-ESS was observed between allergic and non-allergic patients (t = − 2.16, df = 66, p = 0.035). Conclusion Understanding the pattern of symptom improvement following ESS for CRS will facilitate patient counselling and aid the optimization of the current treatment protocols to maximize surgical outcomes and quality of life. Level of evidence Prospective observational.

scholarly journals Assessment of the Tissue Response to Modification of the Surface of Dental Implants with Carboxyethylphosphonic Acid and Basic Fibroblastic Growth Factor Immobilization (Fgf-2): An Experimental Study on Minipigs

Biology ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 358
Author(s):  
Javier Aragoneses ◽  
Ana Suárez ◽  
Nansi López-Valverde ◽  
Francisco Martínez-Martínez ◽  
Juan Manuel Aragoneses
Keyword(s):  
Surface Treatment ◽  
Test Group ◽  
Mean Value ◽  
Control Group ◽  
P Value ◽  
Implant Surface ◽  
Bone Contact ◽  
Bone Implant ◽  
Significant Difference ◽  
The Mean

The aim of this study was to evaluate the effect of implant surface treatment with carboxyethylphosphonic acid and fibroblast growth factor 2 on the bone–implant interface during the osseointegration period in vivo using an animal model. The present research was carried out in six minipigs, in whose left tibia implants were inserted as follows: eight implants with a standard surface treatment, for the control group, and eight implants with a surface treatment of carboxyethylphosphonic acid and immobilization of FGF-2, for the test group. At 4 weeks after the insertion of the implants, the animals were sacrificed for the histomorphometric analysis of the samples. The means of the results for the implant–bone contact variable (BIC) were 46.39 ± 17.49% for the test group and 34.00 ± 9.92% for the control group; the difference was not statistically significant. For the corrected implant–bone contact variable (BICc), the mean value of the test group was 60.48 ± 18.11%, and that for the control group, 43.08 ± 10.77%; the difference was statistically significant (p-value = 0.035). The new bone formation (BV/TV) showed average results of 27.28 ± 3.88% for the test group and 26.63 ± 7.90% for the control group, meaning that the differences were not statistically significant (p-value = 0.839). Regarding the bone density at the interthread level (BAI/TA), the mean value of the test group was 32.27 ± 6.70%, and that of the control group was 32.91 ± 7.76%, with a p-value of 0.863, while for the peri-implant density (BAP/TA), the mean value of the test group was 44.96 ± 7.55%, and that for the control group was 44.80 ± 8.68%, without a significant difference between the groups. The current research only found a significant difference for the bone–implant contact at the cortical level; therefore, it could be considered that FGF-2 acts on the mineralization of bone tissue. The application of carboxyethylphosphonic acid on the surface of implants can be considered a promising alternative as a biomimetic coating for the immobilization of FGF-2. Despite no differences in the new bone formation around the implants or in the interthread or peri-implant bone density being detected, the biofunctionalization of the implant surface with FGF-2 accelerates the mineralization of the bone–implant interface at the cortical level, thereby reducing the osseointegration period.

scholarly journals P0949EFFECT OF DIETARY PHOSPHORUS RESTRICTION ON FIBROBLAST GROWTH FACTOR,KLOTHO AND BODY COMPOSITION IN CHRONIC KIDNEY DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Trisha Sachan ◽  
Anita Saxena ◽  
Amit Gupta
Keyword(s):  
Chronic Kidney Disease ◽  
Body Composition ◽  
Renal Function ◽  
Kidney Disease ◽  
Urinary Protein ◽  
Dietary Phosphorus ◽  
Ckd Stage ◽  
Significant Difference ◽  
The Mean ◽  
Fgf 23

Abstract Background and Aims Changes in dietary phosphorus regulate serum FGF-23, parathyroid hormone, 1,25(OH)(2)D and Klotho concentrations . Cardiovascular disease (CVD) is the principal killer of patients with chronic kidney disease and hyperphosphetemia is a potent risk factor it. Of many causative factors for CVD in CKD, dietary interventions involving restriction of dietary phosphorous intake can help reduce onset of CVD at early stages of CKD with other corrective measures. Muscle wasting is a consequence of uremic syndrome which alters body composition. The aim of the study was to study effect of dietary phosphorous restriction on FGF-23, iPTH, Klotho, 1,25(OH)(2)D and body composition in chronic kidney disease patients. Method This is a longitudinal study with 12 months intervention, approved by Ethics Committee of the institute. A total 132 subjects were recruited (66 healthy controls, 66 CKD patient. of 66 patients 33 were in CKD stage 1 and 33 in stage 2. GFR was calculated with the help of MDRD formula. Biochemical parameters of subjects were evaluated at baseline, 6 and 12 months along with the anthropometric measurements (body weight, height, mid upper arm circumference (MUAC), and skin folds). Three days dietary recall was taken to evaluate energy, protein and phosphorous intake. CKD patients whose dietary phosphorous intake was more than 1000 mg/day, were given intense dietary counseling and prescribed dietary modifications by restricting dietary phosphorous between 800-1000 mg/day. Results The mean age of controls and patients was 37.01±9.62 and 38.27±12.06 and eGFR of 136.94±11.77 and 83.69±17.37 respectively. One way ANOVA showed significant difference among controls and the study groups in hemoglobin (p&lt;0.001), s albumin (p&lt;0.001), FGF-23 (p&lt;0.001), klotho (p&lt;0.001), urinary protein (p&lt;0.001) and Nephron Index (p&lt;0.001).The mean energy intake (p = 0.001) and dietary phosphorous intake (p&lt;0.001) of the CKD patients decreased significantly with the decline in the renal function along with the anthropometric measures i.e. BMI (p = 0.041),WHR (p = 0.015) and all four skin folds (p&lt;0.001). On applying Pearson’s correlation, eGFR correlated negatively with urinary protein (-0.739, 0.000), FGF-23 (-0.679, 0.000) and serum phosphorous (-0.697, 0.000) and positively with klotho (0.872, 0.000). FGF-23 correlated negatively with klotho (-0.742, 0.000). Dietary phosphorous was found to be positively correlated with urinary protein (0.496, 0.000), serum phosphorous (0.680, 0.000) and FGF-23 (0.573, 0.000) and negatively with Klotho (-0.602, 0.000). Nephron index revealed a positive correlation with eGFR (0.529, 0.000). Urinary protein correlated negatively with klotho (-0.810, 0.000). A multiple linear regression was run to predict eGFR from anthropometric variables such as BMI, WHR, MUAC, skin folds thickness and handgrip strength. All anthropometric variables predicted decline in eGFR (p&lt;0.05, R2 =0.223). At 6 and 12 months; repeated ANOVAs analysis showed a statistically significant difference in serum creatinine (p=0.000), serum phosphorous (p=0.000), FGF-23(p=0.000) and klotho (p=0.000). Conclusion Elevated levels of FGF-23 and decreased Klotho levels, with the moderate decline in renal function improved with the restricted phosphorous diet at 6 and 12 months emphasizing the importance of phosphorus restriction at an early stage.

TO COMPARE THE EFFECTIVENESS OF NEBULISATION WITH ADRENALINE, 3% HYPERTONIC SALINE AND NORMAL SALINE IN BRONCHIOLITIS IN CHILDREN OF 2 TO 24 MONTHS OF AGE BASED ON CLINICAL SEVERITY SCORE AND NEBULISATION FREQUENCY.

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Priyanka Jain ◽  
Rakesh Jain
Keyword(s):  
Hypertonic Saline ◽  
Normal Saline ◽  
Mean Difference ◽  
Clinical Severity ◽  
Research Centre ◽  
P Value ◽  
College Hospital ◽  
Mean Values ◽  
Significant Difference ◽  
The Mean

Background & Method: We conducted a double blinded study at Index Medical College Hospital & Research Centre, Indore. The sample size was determined to be minimum of 120 cases as based upon previous years admission due to acute bronchiolitis. Initially, 146 cases were included in the study out of which 23 cases dropped out of the study after giving consent by guardian for participation in the study as they left against medical advice from the hospital. Result: The mean difference of CSS between 0 minutes to 60 minutes of nebulisation between groups in all cases was 0.4 ± 0.6, between 60 minutes and 4 hours was 0.8 ± 0.6, between 4 to 8 hours was 0.7 ± 0.6, between 8-12 hours was 0.6 ± 0.4, between 12-24 hours was 1.6 ± 0.9 and between 24-48 hours was 1.9 ± 0.9.The mean values and resultant p-value of ANOVA of various nebulising agents used for improvement in CSS shows significant association between various nebulising agents used along with improvement in CSS at the end of assessment at 48 hours of treatment. Conclusion: This study was conducted to establish the efficacy of each nebulisation agent (i.e.  adrenaline, 3% hypertonic saline and normal saline) currently used and compare the outcomes as there is not enough evidence amongst Indian population on level of efficacy of each drug in causing improvement in symptoms and signs in various severities of bronchiolitis in early childhood. Comparison of significant improvement in mean difference in CSS at various intervals in all cases compared between groups by post hoc test revealed non-significant difference (p-value 0.700) between 3% hypertonic saline and normal saline. Keywords: nebulisation, adrenaline, bronchiolitis & clinical.

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