Unusual case of immune haemolytic disease causing severe neonatal cholestasis in a newborn

2021 ◽  
Vol 14 (9) ◽  
pp. e243991
Author(s):  
Reema Garegrat ◽  
Prince Pareek ◽  
Snehavardhan Pandey ◽  
Pradeep Suryawanshi
Keyword(s):  
Unusual Case ◽  
Total Bilirubin ◽  
Extreme Values ◽  
Management Strategies ◽  
Direct Bilirubin ◽  
Neonatal Cholestasis ◽  
Haemolytic Disease ◽  
Invasive Therapy ◽  
Factors Associated ◽  
The Common

Neonatal hyperbilirubinaemia is a very common entity witnessed in most of the newborns. Rarely are there events where the bilirubin levels reach extreme values mandating invasive therapy. Unconjugated hyperbilirubinaemia when solely present is easy to manage and diagnose the common aetiological factors associated with it. The issue arises when we come across a mixed picture of conjugated with unconjugated hyperbilirubinaemia and puts us in a dilemma as to what are we treating. Our case highlights a similar picture where we witnessed the highest documented levels of total bilirubin but to our surprise the major component of which was direct bilirubin. This report takes us through the differentials which were ruled out and our management strategies for solving this rare mystery.

scholarly journals Contributions to Management Strategies in the NE Atlantic Regarding the Life History and Population Structure of a Key Deep-Sea Fish (Mora moro)

Biology ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 522
Author(s):  
Régis Santos ◽  
Wendell Medeiros-Leal ◽  
Osman Crespo ◽  
Ana Novoa-Pabon ◽  
Mário Pinho
Keyword(s):  
Population Structure ◽  
Life History ◽  
Deep Sea ◽  
Management Strategies ◽  
Size Composition ◽  
Large Size ◽  
The Common ◽  
Fishing Impacts ◽  
Sea Fish

With the commercial fishery expansion to deeper waters, some vulnerable deep-sea species have been increasingly captured. To reduce the fishing impacts on these species, exploitation and management must be based on detailed and precise information about their biology. The common mora Mora moro has become the main deep-sea species caught by longliners in the Northeast Atlantic at depths between 600 and 1200 m. In the Azores, landings have more than doubled from the early 2000s to recent years. Despite its growing importance, its life history and population structure are poorly understood, and the current stock status has not been assessed. To better determine its distribution, biology, and long-term changes in abundance and size composition, this study analyzed a fishery-dependent and survey time series from the Azores. M. moro was found on mud and rock bottoms at depths below 300 m. A larger–deeper trend was observed, and females were larger and more abundant than males. The reproductive season took place from August to February. Abundance indices and mean sizes in the catch were marked by changes in fishing fleet operational behavior. M. moro is considered vulnerable to overfishing because it exhibits a long life span, a large size, slow growth, and a low natural mortality.

scholarly journals Why Do Immigrant and Swedish Adolescents Engage in Ethnic Victimization? Common and Distinct Underlying Factors

2021 ◽  
Vol 50 (11) ◽  
pp. 2236-2248
Author(s):  
S. Bayram Özdemir ◽  
C. Giles ◽  
M. Özdemir
Keyword(s):  
Ethnic Composition ◽  
Attitudes Toward Immigrants ◽  
Factors Associated ◽  
School Settings ◽  
Immigrant Background ◽  
Positive Attitudes ◽  
The Common ◽  
Native Youth ◽  
Low Levels ◽  
Ethnic Victimization

AbstractYouth of immigrant background are at risk of experiencing victimization due to their ethnic or cultural background. However, limited knowledge is available regarding why youth victimize their immigrant peers, and whether the factors associated with engagement in ethnic victimization vary across adolescents of different background. To address this gap in knowledge, the present study aimed to elucidate the common or differential factors associated with engagement in ethnic victimization among immigrant and native youth. The analytical sample included seventh grade students residing in Sweden from 55 classrooms (N = 963, Mage = 13.11, SD = 0.41; 46% girls; 38% youth of immigrant background). The results showed that being morally disengaged and engaging in general victimization are the common denominators of engagement in ethnic victimization for immigrant and Swedish youth. Low levels of positive attitudes toward immigrants provide a foundation for ethnic victimization among Swedish youth, but not youth of immigrant background. Classroom ethnic composition was not significantly related to engagement in ethnic victimization in either group. Predictors of engagement in ethnic victimization seem to have similarities and differences among immigrant and Swedish youth. The factors involved require further attention in developing strategies to combat bias-based hostile behaviors in diverse school settings.

Effects of bilirubin configurational photoisomers on the measurement of direct bilirubin by the vanadate oxidation method

2021 ◽  
pp. 000456322199906
Author(s):  
Shohei Kawamoto ◽  
Kosuke Koyano ◽  
Miyo Ozaki ◽  
Takeshi Arai ◽  
Takashi Iwase ◽  
...  
Keyword(s):  
High Performance ◽  
Total Bilirubin ◽  
Critical Factor ◽  
Chemical Oxidation ◽  
Direct Bilirubin ◽  
Serum Samples ◽  
Structural Isomers ◽  
Extreme Caution ◽  
Light Emitting ◽  
Oxidation Method

Background Direct-reacting bilirubin concentrations measured using vanadate chemical oxidation method do not exactly match the conjugated bilirubin concentration. One of the causes is the effect of bilirubin photoisomers. However, the quantitative evaluation of the effects of these photoisomers has not been sufficiently conducted. In particular, the influence of bilirubin configurational isomers on direct bilirubin is the most critical factor. Methods Sixteen residual serum samples were used. For quantitative analysis based on the change in direct bilirubin and bilirubin configurational isomer, samples were irradiated via blue light-emitting diodes to suppress the production of bilirubin structural isomers. Total bilirubin and direct bilirubin concentrations were measured using the vanadate chemical oxidation method. Concentrations of 4Z,15Z-bilirubin IXα and its photoisomers were measured using high-performance liquid chromatography. The sum of 4Z,15E-bilirubin IXα and 4E,15Z-bilirubin IXα was notated as bilirubin configurational isomer, and the differences between the measured values of the irradiated and non-irradiated samples were calculated and notated as ΔDB and ΔBCI. Results In non-irradiated and irradiated samples, total bilirubin and direct bilirubin concentrations were 10.73 mg/dL with significant a decrease to 10.60 mg/dL and 0.69 mg/dL with a significant increase to 0.78 mg/dL, while bilirubin configurational isomer values were 1.00 mg/dL and 1.52 mg/dL, respectively. The linear regression equation revealed a significant positive correlation of Y = 0.187X−0.006 between ΔDB (Y) and ΔBCI (X). Conclusion Applying the vanadate chemical oxidation method affected approximately 19% of the bilirubin configurational isomer concentration for direct bilirubin. Extreme caution is necessary when interpreting the measured values of samples indicative of unconjugated hyperbilirubinaemia.

scholarly journals Development of Resistance to Hymexazol Among Pythium Species in Cucumber Greenhouses in Oman

Plant Disease ◽  
2018 ◽  
Vol 102 (1) ◽  
pp. 202-208 ◽  
Author(s):  
Zainab M. Al-Balushi ◽  
Hesham Agrama ◽  
Issa H. Al-Mahmooli ◽  
Sajeewa S. N. Maharachchikumbura ◽  
Abdullah M. Al-Sadi
Keyword(s):  
Ribosomal Rna ◽  
Management Strategies ◽  
Soil Samples ◽  
Integrated Disease Management ◽  
Pythium Species ◽  
Internal Transcribed Spacer Region ◽  
Development Of Resistance ◽  
The Common ◽  
Cucumber Roots ◽  
Further Development

A study was conducted to characterize the common Pythium spp. in greenhouses in Oman and their level of resistance to hymexazol, a widely used fungicide in the country. Pythium isolates were obtained from soil samples, cocopeat bags, and cucumber roots collected from seven regions in the country. Identification of 80 Pythium isolates to the species level using sequences of the internal transcribed spacer region of the ribosomal RNA showed that they belong to four species: Pythium aphanidermatum (77 isolates), P. spinosum (1 isolate), P. myriotylum (1 isolate), and P. catenulatum (1 isolate). Investigating the aggressiveness of three Pythium spp. on cucumber showed that P. aphanidermatum, P. myriotylum, and P. spinosum are pathogenic. Phylogenetic analysis of P. aphanidermatum isolates showed that most of the isolates obtained from cocopeat clustered separately from isolates obtained from soil and roots. This may indicate a difference in the origin of the cocopeat isolates. Evaluating the resistance of 27 P. aphanidermatum isolates to hymexazol showed that most isolates were sensitive (0.9 to 31.2 mg liter−1) whereas one isolate was resistant (142.9 mg liter−1). This study is the first to report P. myriotylum and P. catenulatum in Oman. It is also the first to report the development of resistance to hymexazol among P. aphanidermatum populations from greenhouses. Growers should use integrated disease management strategies to avoid further development of resistance to hymexazol.

Environmental impact and risk management strategies of Bt cotton commercialization in China

2007 ◽  
Vol 4 (2) ◽  
pp. 93-97 ◽  
Author(s):  
Wu Kong-Ming
Keyword(s):  
Risk Management ◽  
Environmental Impact ◽  
Management Strategies ◽  
Cotton Bollworm ◽  
Bt Cotton ◽  
Resistance Risk ◽  
Factors Associated ◽  
Major Threat ◽  
Risk Management Strategies ◽  
Evolution Of Resistance

AbstractTransgenic cotton expressing the Cry1Ac toxin from Bacillus thuringiensis has been planted widely in China since 1997, and reached 70% of the total cotton area in 2006. The results of monitoring the environmental impact of Bt cotton commercialization indicated that the target pests, cotton bollworm (Helicoverpa armigera) and pink bollworm (Pectinophora gossypiella), were effectively controlled while the mirids (Hemiptera: Miridae) evolved to be key pests in the cotton system. There were no significant changes in resistance gene frequency of field populations of cotton bollworm, but a shift toward increased tolerance was apparent in the area of intensive planting of Bt cotton, indicating that the potential risk of resistance of the target pest has become a major threat for sustainable planting of Bt cotton. Considering the factors associated with the evolution of resistance, risk management strategies are discussed in this paper.

scholarly journals “Fiat Lux.” Navigating chaos through Sensing Leadership

2018 ◽  
Vol 4 (2) ◽  
Author(s):  
Johan Van der Merwe
Keyword(s):  
Change Management ◽  
Interpersonal Relationships ◽  
Leadership Style ◽  
Management Strategies ◽  
Sense Making ◽  
Leadership Attributes ◽  
Complex Interactions ◽  
Biblical Narratives ◽  
The Common ◽  
Response To Change

This article provides an overview of change management strategies described in business science. From the distinctions made, it becomes clear that change is all-pervasive and the result of complex interactions within and between the internal and external environments of organizations and communities. Complexity theory is subsequently considered as a better vantage point from where a response to change may be informed. The leadership style to correspond to this new reading of change needs to be that of “transcending leadership” where sensing and sense-making skills are honed to sense emerging meaning in organizations, in interpersonal relationships and through intrapersonal reflection. Instead of “making” change happen, the new leadership “lets” things happen, sensing the connections between emerging events in the context and creating a level of readiness to find the potential meaning in what may usually have been perceived as mere chaos. The creation narrative and a new reading of chaos as possibility provide Judeo-Christian sources of spirituality in this regard. Other Biblical narratives are cited to show in which way different change management frameworks can be applied to the respective narratives, but also how sensing and sense-making remain the common leadership attributes in successfully navigated change.

scholarly journals A mini review on the Lactic Acidosis in goats and its remedial approaches

2020 ◽  
Vol 5 (2) ◽  
pp. 98-103
Author(s):  
Asad Ali Khaskheli ◽  
Muhammad Ibrahim Khaskheli ◽  
Allah Jurio Khaskheli ◽  
Arshad Ali Khaskheli
Keyword(s):  
Alkaline Phosphatase ◽  
Lactic Acidosis ◽  
Sodium Bicarbonate ◽  
Glucose Level ◽  
Magnesium Hydroxide ◽  
Total Bilirubin ◽  
Direct Bilirubin ◽  
Cassia Fistula ◽  
Indirect Bilirubin ◽  
Rumen Ph

The current study was performed in order to investigate the threat of lactic acidosis in goats worldwide and explore the curative strategies. In this regards a detailed review was performed, however obtained facts were found to be much interesting and valuable. It was indicated by researchers that lactic acidosis is the most common problem in goats throughout the worlds. It represents significant economic loss due to direct and indirect effects. It was further stated that goats with lactic acidosis show decreased body temperature up to 98.1±0.89 °F, rumen and intestinal movement 0.23±0.48/m, rumen pH 4.8±0.07, blood pH 7.1±0.08, increased respiration rate 56.14±7.15/m and heart rate, 136.28±4.71/m. Affected goats also show signs of dyspnea, anorexia, inactivity, incoordination and recumbancy. The glucose level remains 190.14±36.49 mg/dl, total bilirubin 0.75±0.04 mg/dl, direct bilirubin 0.27±0.03mg/dl, indirect bilirubin 0.40±0.03 mg/dl, alanine aminotransferase ALT 36.42±3.04 U/l and alkaline phosphatase 420±3.65 U/l. Furthermore, Glucose level, total bilirubin, direct bilirubin, indirect bilirubin, ALT (SGPT) and alkaline phosphatase increase with treatment of Cassia Fistula, serum biochemical changes rapidly return to normal compared to treatment with Sodium bicarbonate or Magnesium hydroxide. The ruminal juices changes are also significantly improved with the treatment. The changes in the ingesta color, odor and consistency and rumen pH return to normal with the use of Cassia Fistula, Sodium bicarbonate and Magnesium hydroxide. In conclusion, Cassia fistula, Sodium bicarbonate and Magnesium hydroxide could be used as valuable strategies against lactic acidosis in goats. These therapies have been proved to be effective for treating the acidosis in goats. 

scholarly journals DOSE-DIFFERENTIATED CORRELATION INTERACTIONS BETWEEN INDICES OF HEMOGLOBIN EXCHANGE IN TURKEYS UNDER THE INFLUENCE OF THE PROBIOTIC FORMULATION VETOM 1.2

2020 ◽  
pp. 82-91 ◽  
Author(s):  
M. S. Yakovleva ◽  
N. S. Yakovleva ◽  
N. A. Gotovchikov ◽  
S. N. Tishkov ◽  
L. P. Ermakova
Keyword(s):  
Serum Albumin ◽  
Red Blood Cells ◽  
Total Protein ◽  
Blood Cells ◽  
Bacillus Amyloliquefaciens ◽  
Total Bilirubin ◽  
Inverse Correlation ◽  
Direct Bilirubin ◽  
Subsequent Decrease ◽  
Probiotic Preparation

The effect of the probiotic preparation Vetom 1.2 on the basis of Bacillus subtilis VKPM B-10641, Bacillus amyloliquefaciens VKPM B-10642 and Bacillus amyloliquefaciens VKPM B-10643 in different doses on the correlation interactions between the parameters of turkey hemoglobin exchange, blood erythrocytes and blood red blood cells direct and total bilirubin, total protein and serum albumin was studies. Correlations were calculated using Spearman formula, the reliability of correlations was checked by Student. The formulation was used for turkeys once a day for 30 days in doses of 12.5; 25; fifty; 75 and 100 mg / kg body weight. It was found that Vetom 1.2 in minimal doses leads to an inverse correlation between iron and total bilirubin, direct bilirubin, total protein and albumin, an increase in the concentration of the formulation leads to the disappearance of this effect with a gradual subsequent decrease in this indicator. Vetom 1.2 in doses up to 50 mg / kg leads to an inverse correlation between the concentrations of hemoglobin and direct bilirubin, total protein and serum albumin, at a dose of 75 mg / kg there is a direct correlation between these indicators, and at a dose of 100 mg / kg returns a negative correlation. The probiotic preparation Vetom 1.2 leads to a direct dependence of the concentration of bilirubins (total and direct) in serum on the concentrations of hemoglobin and red blood cells when used in most doses, except 75 mg / kg, which reduces the correlation.

Abstract 1122‐000029: Pharmacological and Clinical Factors Associated with Gender Difference in Alzheimer Dementia Patients

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Samuel I Imeh‐Nathaniel ◽  
Oreoluwa O Coker‐Ayo ◽  
Liddy Agbomi ◽  
Nneoma Madubike ◽  
Chika Pamela ◽  
...  
Keyword(s):  
Gender Difference ◽  
Multivariate Analyses ◽  
Management Strategies ◽  
Clinical Factors ◽  
Men And Women ◽  
Alzheimer Dementia ◽  
Factors Associated ◽  
Dementia Patients ◽  
Black Patients ◽  
Analyze Data

Introduction : Alzheimer dementia (AD) has been reported in both men and women. However, factors contributing to gender differences are not fully understood. We tested the hypothesis that specific pharmacological, demographic, and risk factors contribute to gender difference in AD. Methods : A retrospective analytical approach was used to analyze data from 12,632 AD patients, comprising 4,584 men and 8,048 women. Univariate and multivariate analyses determined the factors contributing to the gender difference in AD patients. Results : About 36% of AD patients were men, and 64% were women. Citalopram (OR = 1.187, 95% CI, 1.044 – 1.350, P = 0.009) was associated with men, while escitalopram (OR = 1.213, 95% CI, 1.119 – 1.315, P<0.001) was associated with women. In both men and women, increasing age (OR = 1.075, 95% CI, 1.071 – 1.079, P<0.001/OR = 1.096, 95% CI, 1.093 – 1.100, P<0.001), tobacco use (OR = 1.150, 95% CI, 1.054 – 1.254, P = 0.002/OR = 1.150, 95% CI, 1.073 – 1.233, P<0.001), and black patients (OR = 2.380, 95% CI, 2.120 – 2.674, P<0.001/OR = 1.395, 95% CI, 1.268 – 1.535, P<0.001) were associated with AD. Conclusions : Our findings reveal similarities and differences in factors associated with both men and women AD patients, suggesting the development of management strategies for the care of AD.

Abstract 13030: Causes of Cardiovascular and Non-cardiovascular Mortality in the Ischemia Trial

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mandeep S Sidhu ◽  
Karen P Alexander ◽  
Zhen Huang ◽  
Sean M O’Brien ◽  
Bernard R Chaitman ◽  
...  
Keyword(s):  
Management Strategies ◽  
Multivariable Analysis ◽  
International Study ◽  
Factors Associated ◽  
Clinical Events ◽  
All Cause Mortality ◽  
History Of ◽  
Multivariable Analyses ◽  
Clinical Events Committee

Background: In the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial, all-cause mortality was similar in patients with stable ischemic heart disease (SIHD) randomized to invasive (INV) and conservative (CON) management strategies. This analysis details specific causes of cardiovascular (CV) and non-CV mortality by treatment group. Methods: In ISCHEMIA, 289 deaths occurred after a median follow-up of 3.2 years; 145 (5.6%) in INV and 144 (5.6%) in CON (HR 1.05, CI 0.83-1.32). Deaths were adjudicated by an independent Clinical Events Committee as CV, non-CV with or without a CV contributor or undetermined. The protocol defined CV death as deaths from CV causes, non-CV causes with CV contributor, and cause undetermined; non-CV death was defined as death from non-CV causes without a CV contributor. Multivariable analyses were used to identify factors associated with cause-specific death. Results: CV death was similar between groups [INV 92 (3.6%), CON 111 (4.3%); HR 0.87 (CI 0.66, 1.15)], but INV had more non-CV death [INV 53 (2.0%), CON 33 (1.3%); HR 1.63 (CI 1.06, 2.52)]; fewer undetermined deaths [INV 12 (0.5%) and CON 26 (1.0%); HR 0.48 (0.24, 0.95)] and more malignancy deaths [INV 41 (1.6%), CON 20 (0.8%); HR 2.11 (1.24, 3.61)]. In multivariable analysis, risk factors associated with CV death were age [HR 1.42 (CI 1.19-1.70) per 10-year increase], diabetes [HR 1.39 (CI 1.03-1.87)], history of heart failure [HR 1.96 (CI 1.33-2.91)], and eGFR [HR 1.18 (CI 1.11-1.26) per 5-ml/min decrease below 80ml/min]. Factors associated with non-CV death were age [HR 2.31 (CI 1.75-3.03) per 10-year increase] and randomization to INV [HR 1.76 (CI 1.13-2.75)]. Conclusions: In ISCHEMIA, all-cause mortality was similar for the INV and CON strategies. Excess non-CV deaths in INV with a higher number of deaths from malignancy but a higher number of undetermined deaths in CON requires further evaluation.

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