Outcome of Lactoferrin Supplementation In Critically Ill Septic Children With Acute Gut Failure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hanan M Ibrahim ◽  
Eriny E Sabery ◽  
Sondos M Magdy
Keyword(s):  
Critically Ill ◽  
Intestinal Failure ◽  
Clinical Syndrome ◽  
Control Group ◽  
P Value ◽  
University Hospitals ◽  
Citrulline Level ◽  
Gut Barrier Function ◽  
Significant Difference ◽  
Group 2

Abstract Background Sepsis is a clinical syndrome caused by many infections. Septic patients may suffer from Gut failure resulting in severe complications. To improve Gut function, the effect of lactofferin supplementation has been studied. Objective To test the effect of lactoferrin supplementation on improving gut barrier function by using plasma citrulline level as a marker of functional enterocytic mass. Patients and Methods This double armed single blinded therapeutic clinical trial study was conducted on 40 children admitted to (PICUs) of Ain Shams University Hospitals. By diagnosis sepsis and gut failure, twenty of them weren't supplemented with LF (group 1) and the other twenty were supplemented (group 2). All critically ill septic patients diagnosed with acute gut failure admitted from October 2018 to 2019 were subjected to citrulline level measurement by (ELISA). Results We found that citrulline concentration was significantly lower in patients (9.52 nmol/L) than control group (122 nmol/L) and lowered in non survivors (5.13 nmol/L) than survivors (30.68 nmol/L) with p value of 0.027 and 0.034 respectively and a cut off value ≤ 7.82 mmol/L. There was no significant difference between the groups 1 and 2 in treatment of sepsis with gut failure. Conclusion (1) Citrulline level can be used as a predictor of intestinal failure severity and mortality. (2) Lactoferrin supplementation was not beneficial in pediatric septic patient with gut failure and did not improve outcome or prognosis of patients.

Estimation of D lactat level as amarker of bacterial translocation in gut failure incritically ill pediatric patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hanan M Ibrahim ◽  
Eman I Elgendy ◽  
Sondos M Magdy
Keyword(s):  
Septic Patient ◽  
Bacterial Translocation ◽  
Lactate Level ◽  
Intestinal Failure ◽  
Control Group ◽  
P Value ◽  
University Hospitals ◽  
Gut Barrier Function ◽  
Egyptian Children ◽  
Significant Difference

Abstract Background Sepsis is defined as life-threatening multi organ failure caused by a dysregulated host response to infection leading to development of gut failure, D-lactate is produced by indigenous bacteria in the gastrointestinal tract lactoferrin is important constitute of human milk and other body fluid act to improve gut function. Aim of the Work To test effect of lactoferrin supplementation for improving gut barrier function, prognosis and the outcome of septic patients using D lactate as a marker of bacterial translocation in sepsis with gut failure. Patients and Methods After ethical committee approval and informed consent from the parents, this double armed single blinded therapeutic clinical trial study was conducted on 40 Egyptian children admitted to PICUs of Ain Shams University Hospitals, by diagnosis sepsis and gut failure, twenty of them weren't supplemented with LF (group 1) and the other twenty were supplemented with it (group 2). D lactate level was measured in plasma using ELISA. Results The study show highly significant difference between Patient and control group in D lactate level, and we found no statistical difference before and after giving lactoferrin in our septic patient who weren’t in treatment of sepsis and gut failure. And we found plasma D lactate higher in non survivors with p value.048. and cut of point< 43.9 mmol\L Conclusion Lactoferrin supplementation was not beneficial in pediatric septic patient with gut failure and did not improve outcome or prognosis of patients, D lactate can be used as a predictor of intestinal failure severity and mortality. D lactate may be predictor of gut failure in sepsis and mortality

Estimation of Intestinal Fatty Acid Binding Protein Level as a Marker of Gut Failure in Critically ILL Pediatric Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hanan M Ibrahim ◽  
Christina E Hermina ◽  
Sondos M Magdy
Keyword(s):  
Critically Ill ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
P Value ◽  
University Hospitals ◽  
Rapid Reduction ◽  
Cross Sectional ◽  
Fatty Acid Binding ◽  
Gut Barrier Function ◽  
Egyptian Children

Abstract Background Sepsis is a life-threatening condition and frequently associated with gut failure manifestations. Gut failure was defined as a rapid reduction of smallbowel enterocytic function. Gut barrier function has been studied using serum IFABP level as a marker of functional enterocytic mass. Objective To estimate the serum IFABP level in septic pediatric cases associated with gut failure. Patients and Methods This cross-sectional study was conducted on 40 Egyptian children admitted to Pediatric Intensive Care Units (PICUs) of Ain Shams University Hospitals. Serum IFABP level was measured in plasma using enzyme-linked immunosorbent assay (ELISA). All critically ill septic patients diagnosed with acute gut failure admitted in the period from 1/4/2018 to 1/5/2019 were subjected to serum IFABP level measurement at the first and the tenth day of diagnosis. Results The serum IFABP median levels on day one and day ten were higher in patients group (5.08 µmol/ml - 9.34 µmol/ml) than control group (0 1.7 µmol/ml – 1.7 µmol/ml) with p value 0.014, 0.020 respectively. Also it was higher in survivors group (17.78 µmol/ml) than non survivors group (3.39µmol/ml) with p value 0.047. SOFA score was lower in survivors (5) than non survivors (8) with p value 0.020. Conclusion IFABP serum level can be a promising marker to detect early intestinal wall and enterocyte damage, taking into consideration time of sampling and inotropes administration.

scholarly journals EFFECT OF TAMSULOSIN ON STENTRELATED SYMPTOMS

2016 ◽  
Vol 23 (01) ◽  
pp. 114-118
Author(s):  
Rana Ata ur Rehman ◽  
Muhammad Muzammil Tahir ◽  
Muhammad Seerwan
Keyword(s):  
Placebo Group ◽  
Ureteral Obstruction ◽  
Controlled Trial ◽  
Ureteral Stent ◽  
Control Group ◽  
P Value ◽  
Routine Practice ◽  
Ureteral Stents ◽  
Significant Difference ◽  
Group 2

Introduction: Cystoscopic intraluminal placement of ureteral stents has become a routine practice in urology. Ureteral stents preserve urine flow from the kidney to the bladder in cases of ureteral obstruction (intrinsic or extrincis). In patients with obvious ureteral obstruction, the placement of a ureteral stent will restart urine transport and protect the kidney from possible risks. Ureteral stents are troublesome in some patients and causes LUTS. Study Design: Prospective randomized controlled trial. Setting: Urology Department, Sheikh Zayed Hospital Lahore. Period: Six month started from August 2015 to December 2015. Material and Methods: 100 patients who were randomly divided into two equal groups. The patients were between 18 to 50 years of age of both gender undergo retrograde double-J ureteral stent placement. Before the double-J stent will be applied, all patients completed an International Prostate Symptom Score (IPSS) questionnaire for evaluation of lower urinary tract symptoms.Patients were divided in two groups on the basis of lottery method tamsolusin group (1) and placebo group (2). Tamsulosin group patients was given tamsulosin post operatively and placebo group was given a placebo postoperatively. Results: There were total 100 patients who were enrolled in this study with a mean age of 42.63±6.24. There were 75(75%) were male while 25(25%) were female. The mean IPSS sore at presentation was 2.47±1.43 and post treatment was 5.20±1.65. There was significant difference in IPSS score in control group with mean 5.28±1.69 versus study as mean 2.22±1.05 group, p-value= 0.010. Conclusion: There is difference in lowering of IPSS score in the patients who are given tamsolusin versus those who were retained on placebo.

scholarly journals Effect of sodium fluoride in chlorhexidine mouthwashes on force decay and permanent deformation of orthodontic elastomeric chain

2021 ◽  
Vol 33 (1) ◽  
pp. 74
Author(s):  
Erliera Sufarnap ◽  
Kholidina Imanda Harahap ◽  
Terry Terry
Keyword(s):  
Sodium Fluoride ◽  
Artificial Saliva ◽  
Permanent Deformation ◽  
Control Group ◽  
P Value ◽  
Control Group Design ◽  
Force Decay ◽  
Significant Difference ◽  
Group 2 ◽  
Elastomeric Chains

Introduction: Orthodontic elastomeric chain is polyurethane elastomer that is widely used among orthodontists due to its functions. Chlorhexidine (CHX) and sodium fluoride (NaF) are listed in mouthwash composition which could affect the mechanical properties of the elastomeric chain. This study was aimed to analyze the effect of sodium fluoride in chlorhexidine mouthwashes on force decay and permanent deformation of orthodontic elastomeric chains. Methods: This research is an experimental analytic laboratory with pretest-posttest control group design. 150 samples of orthodontic chains were divided into three groups. Group 1: artificial saliva (control group); Group 2: 0,1% chlorhexidine gluconate solution (CHX); Group 3: 0,1% chlorhexidine digluconate with sodium fluoride solution (CHX-NaF). The orthodontic elastomeric chain was stretched and maintained at a standardized distance equivalent to a force of 300 g. The measurement of force decay and permanent deformation were performed with digital force gauge and digital caliper (0.01mm) at intervals of the first, seventh, fourteenth, twenty-first, and twenty-eighth days, respectively. Results: The force decay and permanent deformation of the elastomeric chain compared between three groups (control, CHX mouthwash and CHX+NaF mouthwash) showed did not have any significantly different (p-value>0,05) at the first, seventh, fourteenth, twenty-first, and twenty-eighth days, respectively. Conclusion: Sodium fluoride in chlorhexidine mouthwash showing no significant difference among saliva, CHX mouthwash and CHX+NaF mouthwash on force decay and permanent deformation of elastomeric chain.

scholarly journals MTA versus CEM root-end fillings effect on fracture resistance of endodontically treated simulated immature teeth restored with cast metal posts: an in-vitro study

2021 ◽  
Author(s):  
Ensieh Grayli ◽  
Abbas Dashtban ◽  
Leyla Shadan ◽  
Naser Behnampour ◽  
Elham Afshari
Keyword(s):  
Fracture Resistance ◽  
Testing Machine ◽  
Control Group ◽  
P Value ◽  
Cast Metal ◽  
Immature Teeth ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background: Endodontically treated immature teeth which are restored with cast metal posts are of the most susceptible teeth to fracture. An apical plug is usually used as root end filling in order to seal the wide apical foramen. The current study was performed to evaluate the effect of different root-end filling materials (MTA and CEM) on fracture resistance of teeth restored with cast metal posts.Methods: A total of 40 extracted intact single-rooted human mandibular premolars (removed for orthodontic reasons) were used in the study. The coronal part of each tooth was removed and root canal preparation was performed. A size 4 Gates Glidden drill was used to enlarge the canal and was passed through the apical foramen in order to simulate an immature apex. Samples were randomly divided into 5 groups according to apical plug (Group 1: No plug, Group 2: 5 mm MTA plug, Group 3: 5 mm CEM plug, Group 4: 2 mm MTA plug, Group 5: 2 mm CEM plug). Post-space preparations were performed and cast metal post-and-cores were fabricated and cemented. Fracture resistance was assessed using a universal testing machine. Fracture thresholds were recorded and data were analyzed using SPSS 16.0 with significance level at P value < 0.05. Results The analysis showed a significant difference of fracture resistance between groups (p-value<0.05). The mean fracture resistance of samples in group 1 was significantly lower than group 2 (p-value=0.003). there was no significant difference between other groups (p-value>0.05).Conclusions: Within the limits of this study, the evidence indicated that placement of a 5 mm MTA apical plug increased the fracture resistance in simulated immature teeth which are restored with cast metal posts, compared to control group (gutta-percha and sealer). While the results were not as promising for a 2 mm MTA apical plug or either 2 or 5 mm CEM apical plug.

Clinical-Reported Outcomes Of Deferoxamine Versus Deferasirox In The Treatment Of Homozygous BetaThalassemia

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Zeina A Munim Al-Thanoon ◽  
Zeina A Munim Al-Thanoon ◽  
Mustafa Basil ◽  
Nasih A Al-Kazzaz
Keyword(s):  
Serum Ferritin ◽  
Iron Chelation ◽  
Iron Chelator ◽  
Beta Thalassemia ◽  
Control Group ◽  
Current Standard ◽  
Cross Sectional ◽  
Significant Difference ◽  
Multiple Blood ◽  
Group 2

Iron chelation therapy with deferoxamine (DFO),the current standard for the treatment of iron overload in patients with betathalassemia,requires regular subcutaneous or intravenous infusions. This can lead to reduced quality of life and poor adherence,resulting in increased morbidity and mortality in iron-overloaded patients with beta-thalassemia. Deferasirox (DFX) is an orally administered iron chelator that has been approved for use in many countries. The requirement of an effective,well tolerated iron chelator with a less demanding mode of administration has led to the development of deferasirox. The present study was aimed to compare the satisfaction and compliance with deferoxamine versus deferasirox (Exjade®),a novel oral iron chelator in patients with transfusion - dependent beta- thalassemia. A cross-sectional,single-center investigation study was carried out in the Thalassemia Center of Ibn-Atheer Teaching Hospital in Nineveh province,Iraq. One hundred and eight thalassemic patients aged between 2- 20 years old having received multiple blood transfusions and a serum ferritin greater than 1500 ng/ml. Patients were randomised into two groups. Group 1 received deferoxamine at a dose of 20-50mg/kg/day and group 2 received deferasirox at the dose of 10-30 mg/kg/day. Another 56 apparently healthy volunteers were used as a control group. The assessment of chelation was done during the period between November 2013 and February 2014 by measurement of serum ferritin. Satisfaction and compliance was assessed by using a special questionnaire prepared by the researcher. Out of the 108 thalassemic patients enrolled there was no discontinuation in treatment with the two drugs under study. The serum ferritin did not change significantly in any of the chelation groups. In comparison with the patients who were treated with DFO,those receiving DFX reported a significantly higher rate of compliance and satisfaction (P < 0.05). However,no significant difference was observed between the two groups regarding their satisfaction (P > 0.05).Compliance with deferasirox (50 %) was more than that with deferoxamine (20 %). Satisfaction with deferoxamine was significantly lower than deferasirox (p= 0.00).

The Effectiveness of Using a Mobile Messenger as an Educational Supporting Tool among Nursing Students

2020 ◽  
Vol 4 (1) ◽  
pp. 67-77
Author(s):  
Rohimah Ismail ◽  
Chong Mei Chan ◽  
Wan Muhammad Azly W. Zulkafli ◽  
Hasnah Zani ◽  
Zainab Mohd Shafie
Keyword(s):  
Nursing Education ◽  
Nursing Students ◽  
Clinical Decision Making ◽  
Intervention Group ◽  
Great Influence ◽  
Control Group ◽  
P Value ◽  
Significant Difference ◽  
Supporting Tool ◽  
Nursing College

                The evolution of information technology has exerted great influence on nursing education via new pedagogy of knowledge delivery without time and place restriction. Mobile technology revolutionises nursing education and clinical practice via empowering skills of critical thinking and clinical decision-making through learning. The aim of this study is to evaluate the effectiveness of using mobile messenger (Whatsapp) as an educational supporting tool among nursing students. The study design used is a Cluster Randomized Control Trail. Two nursing colleges were selected. Sample size was 93 participants, 48 from the Kuala Terengganu Nursing College Kuala Terengganu as the intervention group while the control group were recruited among 45 participants from UniSZA Nursing College. There is a significant difference in the level of knowledge between pre and posttest among intervention group (mean difference was -8.70 with a standard deviation 8.42, p-value< 0.001) and 93.8 percent of the respondents perceived the usefulness of using WhatsApp mobile messenger to enhance learning. This demonstrates that learning through mobile messenger (WhatsApp) enhances learning and is well received as a new method of learning by almost all students.   Keywords: Mobile learning, WhatsApp messenger, Social Interaction

scholarly journals Can the cytokine adsorber CytoSorb® help to mitigate cytokine storm and reduce mortality in critically ill patients? A propensity score matching analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Christina Scharf ◽  
Ines Schroeder ◽  
Michael Paal ◽  
Martin Winkels ◽  
Michael Irlbeck ◽  
...  
Keyword(s):  
Propensity Score ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Wilcoxon Test ◽  
Relative Reduction ◽  
Cytokine Storm ◽  
Saps Ii ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background A cytokine storm is life threatening for critically ill patients and is mainly caused by sepsis or severe trauma. In combination with supportive therapy, the cytokine adsorber Cytosorb® (CS) is increasingly used for the treatment of cytokine storm. However, it is questionable whether its use is actually beneficial in these patients. Methods Patients with an interleukin-6 (IL-6) > 10,000 pg/ml were retrospectively included between October 2014 and May 2020 and were divided into two groups (group 1: CS therapy; group 2: no CS therapy). Inclusion criteria were a regularly measured IL-6 and, for patients allocated to group 1, CS therapy for at least 90 min. A propensity score (PS) matching analysis with significant baseline differences as predictors (Simplified Acute Physiology Score (SAPS) II, extracorporeal membrane oxygenation, renal replacement therapy, IL-6, lactate and norepinephrine demand) was performed to compare both groups (adjustment tolerance: < 0.05; standardization tolerance: < 10%). U-test and Fisher’s-test were used for independent variables and the Wilcoxon test was used for dependent variables. Results In total, 143 patients were included in the initial evaluation (group 1: 38; group 2: 105). Nineteen comparable pairings could be formed (mean initial IL-6: 58,385 vs. 59,812 pg/ml; mean SAPS II: 77 vs. 75). There was a significant reduction in IL-6 in patients with (p < 0.001) and without CS treatment (p = 0.005). However, there was no significant difference (p = 0.708) in the median relative reduction in both groups (89% vs. 80%). Furthermore, there was no significant difference in the relative change in C-reactive protein, lactate, or norepinephrine demand in either group and the in-hospital mortality was similar between groups (73.7%). Conclusion Our study showed no difference in IL-6 reduction, hemodynamic stabilization, or mortality in patients with Cytosorb® treatment compared to a matched patient population.

scholarly journals Effect of Cooling Irrigating Saline in Tongue Base Ablation in Obstructive Sleep Apnea

OTO Open ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 2473974X2198959
Author(s):  
Ahmed Yassin Bahgat
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Controlled Trial ◽  
Tongue Base ◽  
Control Group ◽  
University Hospitals ◽  
Energy Field ◽  
Obstructive Sleep ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference

Objective Plasma is formed by creating a high-density energy field within an electrically conductive fluid such as saline. Sometimes ablated bits of tissue get stuck between the electrodes of the wand, obstructing the suction channel. The purpose of this study is to investigate the effect of cooling the irrigating saline during ablation of the hypertrophied tongue base in patients with obstructive sleep apnea. Study Design Prospective randomized controlled trial. Setting An otorhinolaryngology department in Main University hospitals. Methods Sixty adult patients with obstructive sleep apnea and tongue base hypertrophy underwent tongue base ablation surgery. Patients were randomly divided into 2 groups of 30 patients each: cooled saline and room temperature saline. The Coblation wand used was the EVac 70 Xtra HP (Smith & Nephew). Results In this study, a significant difference in operative time (mean ± SD) was seen between groups: 21.2 ± 5.5 minutes in the cold group and 47 ± 9.5 minutes in the control group ( P = .001). The wands in the cold group did not obstruct, while all the wands in the control group were obstructed by tissue clogs with variable degrees, hence wasting more time to clean the wands’ tips. Conclusion Cooling the irrigating saline overcame the problem of wand clogs, and the wand tip did not occlude at all during the procedures, thus saving time lost in wand cleaning and demonstrating a faster and safer surgical procedure. Further studies are needed to identify the hemostatic effect of the cooled saline over the regular one.

scholarly journals Association of interleukin-17A rs2275913 polymorphism with rheumatoid arthritis susceptibility in Sudanese population

2021 ◽  
Vol 9 ◽  
pp. 205031212110202
Author(s):  
Rgda Mohamed Osman ◽  
Mounkaila Noma ◽  
Abdallah Elssir Ahmed ◽  
Hanadi Abdelbagi ◽  
Rihab Ali Omer ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Confidence Interval ◽  
Statistical Tests ◽  
Demographic Data ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Molecular Technique ◽  
Interleukin 17A ◽  
Significant Difference

Objectives: Rheumatoid arthritis is a chronic inflammatory autoimmune disease. This study aimed to determine the association of interleukin-17A-197G/A polymorphism with rheumatoid arthritis in Sudanese patients. Methods: A case–control study was conducted between March and December 2018. Clinical and demographic data of the study participants were collected and analyzed. Polymerase chain reaction restriction fragment length polymorphism molecular technique was done to investigate interleukin-17A-197G/A polymorphisms. All statistical tests were considered statistically significant when p < 0.05. Results: The study population included 266 participants aged between 1 and 85 years, with an average of 40 years, classified into 85 (31.2%) cases (mean age 48.5 ± 11.3 years), and 181 (68.8%) controls (mean age 35.3 ± 15.9 years). The interleukin-17A homozygote AA genotype was more frequent among the control group compared to the case group; 95 (52.5%) and 7 (8.2%), respectively. The homozygote GG and the heterozygote AG genotypes were proportionally not different among the cases and control groups; 13 (54.2%) and 11 (45.8%), and 65 (46.4%) and 75 (53.6%), respectively. According to the distribution of interleukin-17A genotypes, a statistically significant difference was observed among cases with the interleukin-17A AA and AG genotypes, p values 0.001 and 0.004, respectively. For the association interleukin-17A genotypes and family history a negatively significant association was reported (95% confidence interval, –0.219, p value = 0.001). There was also a negatively significant association of interleukin-17A genotypes and anti-cyclic citrullinated peptide (95% confidence interval, −0.141, p value = 0.002). Conclusion: This study is the first study in Sudan established the association between interleukin-17A-197G/A (rs2275913) polymorphisms and susceptibly to rheumatoid arthritis. These findings appeal for further research in Sudan to investigate the exact role of IL-17A in immunopathology and disease severity among Sudanese rheumatoid arthritis

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