Hyperhomocysteinemia in pre-eclampsia: is routine screening rational?

2017 ◽  
Vol 6 (4) ◽  
pp. 1271
Author(s):  
Sonia Miglani ◽  
Ruchira Nautiyal ◽  
Archana Prakash
Keyword(s):  
Prospective Observational Study ◽  
Placental Abruption ◽  
Vascular Diseases ◽  
Maternal Serum ◽  
Control Group ◽  
P Value ◽  
Routine Test ◽  
Mean Values ◽  
Serum Homocysteine ◽  
The Mean

Background: Hypertensive disorders complicate upto 5 to 10% of all pregnancies. Though the exact cause of pre-eclampsia is still undecided, maternal hyperhomocysteinemia has been implicated as a risk factor for pre eclampsia, placental abruption and other vascular diseases. The objectives of present study were to estimate the levels of serum homocysteine in antenatal patients and to study the above parameters in patients of pre-eclampsia.Methods: A prospective observational study was performed with 30 pre eclamptic patients and an equal number taken as control having comparable demographic characteristics. Level of homocysteine was measured by an enzymatic method, using Diazyme homocysteine 2 reagent enzymatic assay kit on Beckman coulter analyzer in all the patients. Obstetrics and neonatal outcomes were observed in all the patients. The statistical analysis was done using unpaired T test for determining level of significance.Results: Mean Serum homocysteine in the study group was 13.99±5.46 µmol/l and was 6.03±2.58 µmol/l in control group. This was statistically significant (p value 0.002). However the mean values of serum homocysteine did not correlate with severity of pre-eclampsia 14.32±6.72 µmol/l in mild pre-eclampsia and 13.60±3.77μmol/l in severe pre-eclampsia respectively (p value - 0.727).Conclusions: It appears that maternal serum homocysteine has a causal role in pathogenesis of pre eclampsia, however to recommend it as a routine test, larger studies are required.

scholarly journals EVALUATION OF PSYCHIATRIC MORBIDITY IN PATIENTS WITH ACNE VULGARIS

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Dr. Mukesh Batra
Keyword(s):  
Acne Vulgaris ◽  
Adult Population ◽  
Psychiatric Morbidity ◽  
Study Participant ◽  
Control Group ◽  
P Value ◽  
Symptom Index ◽  
Cross Sectional ◽  
Mean Values ◽  
The Mean

Background: Acne vulgaris is reported as an inflammatory disease of pilosebaceous glands of the skin which mainly occur on the face and trunk. Acne is among one of the most common skin conditions which commonly seen in adolescent’s population. However, it can also present among the adult population. Material & Methods: The present cross‑sectional prospective study 100 patients who were diagnosed with acne vulgaris and 100 controls who were not having acne and without a known clinical disease were enrolled for present study by simple random sampling. Written informed consent was taken from each study participant. Results:  SCL 90-R Global Symptom Index was higher and statistically significant ( P value ＜0.05) among acne group in compared to control group. The mean values of SCL 90-R somatization was higher and statistically significant ( P value ＜0.05) among acne group in compared to control group. The mean values of Male SCL 90-R depression was higher and statistically significant ( P value ＜0.05) among acne group in compared to control group. The mean values of Female SCL 90-R anxiety was higher and statistically significant ( P value ＜0.05) among acne group in compared to control group. Conclusion:  We concluded from the present study that acne vulgaris is significantly associated with psychiatric disorders. Patients with acne vulgaris and found that higher prevalence of anxiety and depression among them which was significantly associated with poor quality of life. Key words: Acne, Anxiety, Depression.

scholarly journals The effectiveness of mini-CEX assessment tool for clinical competency achievement in clinical practice among anesthesia trainee.

2020 ◽  
Vol 27 (02) ◽  
pp. 279-283
Author(s):  
Aamir Furqan ◽  
Azeem Gulzar ◽  
Bilal Nazar ◽  
Masood Alam ◽  
Rahat Akhtar ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Assessment Tool ◽  
Clinical Skills ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Clinical Expertise ◽  
The Mean ◽  
Preoperative Examination

Objectives: To determine the efficacy of Mini-CEX in assessing clinical expertise of anesthesia trainee during examination at Anesthesia department of Multan Hospitals. Study Design: Prospective Observational Study. Setting: Department of Anesthesia and Intensive Care Ch. Pervez Ellahi Institute of Cardiology and Nishtar Hospital Multan. Period: From January 2017 to March 2019. Material & Methods: The design of study was prospective observational study having the post-test with control group only. The size of the sample was based upon 70 trainee anesthesia being divided into two further groups: 35 trainee anesthesia were included in the control group whereas 35 trainee were part of the intervention group. The analysis of data was done by Mann Whitney test and it was descriptive type of test. Results: The mean result of Preoperative examination skills among the intervention group was greater than the control group. The mean score of Preoperative examination competence in control group was 72.11±4.56, while the mean score of Preoperative examination competence in intervention group was 81.28±2.86. The mean score of anesthesia trainees towards satisfaction of control and intervention group was 5.37±0.38 and 8.95±0.64, respectively. While the mean score of evaluators towards satisfaction of control and intervention group was 6.24±0.53 and 8.04±0.52, respectively. The difference of clinical abilities was significant among the two groups having the p value 0.000 (p<0.05). Conclusion: Clinical expertise among anesthesia trainee was significantly ameliorated after the use of Mini-CEX program. It is therefore suggested for anesthesia trainers to use the Mini-CEX program in order to determine the clinical skills among students.

scholarly journals Serum Interleukin-17 Alterations in Patients With Chronic Kidney Disease Undergoing Eight Weeks of Aerobic Training

2021 ◽  
Vol 6 (2) ◽  
pp. 69-73
Author(s):  
Arman Jalili ◽  
Ali Asghar Ravasi ◽  
Sirous Choobineh ◽  
Ali Alidadi ◽  
Rahman Suri ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Aerobic Training ◽  
Control Group ◽  
P Value ◽  
Interleukin 17 ◽  
Maximal Heart Rate ◽  
Mean Values ◽  
Before And After ◽  
The Mean

Introduction: Regular physical activities may have effect on the course of chronic kidney disease (CKD). Here, we aimed to ascertain the changes of serum interleukin-17 (IL-17) following eight weeks of aerobic training in CKD patients. Methods: The CKD patients referred to Zahedan Edalat Clinic and Ali-Ibn Abi Talib hospital in Zahedan city (Iran) were enrolled. Sixty patients aged between 30 and 50 years old were chosen by a random method and assigned into the control and intervention groups (each group constituted 30 people). In this study, aerobic exercises were performed at 50%–80% of the maximal heart rate. Peripheral blood was obtained one day before the beginning of exercise and one day after the end of the intervention. Serum IL-17 level was quantified using a commercial specific ELISA kit. Results: The mean values of IL-17 in CKD patients before and after 8 weeks of aerobic exercise were 1.67 ± 0.403 pg/mL and 1.58 ± 0.170 pg/mL in the intervention group (P value= 0.039) whereas the mean values of IL-17 in the control group before and after the intervention were 1.31 ± 0.529 pg/mL and 1.35 ± 0.505 pg/mL (P value= 0.794).Conclusion: Eight weeks of aerobic training can significantly reduce serum IL-17, an inflammatory marker, in CKD patients.

scholarly journals THE ASSESSMENT OF COMORBID PATHOLOGY IN CLEAN-UP WORKERS OF THE ACCIDENT CONSEQUENCES AT THE CHORNOBYL NPP HAVING CARDIOVASCULAR DISEASES

2020 ◽  
Vol 25 ◽  
pp. 402-420
Author(s):  
D. Belyi ◽  
◽  
O. Nastina ◽  
G. Sydorenko ◽  
Z. Gabulavichene ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Quantitative Assessment ◽  
Rating Scale ◽  
Vascular Diseases ◽  
Mean Value ◽  
Main Group ◽  
Control Group ◽  
Mean Values ◽  
Organ Systems ◽  
The Mean

Objective. Analysis of comorbid pathology based on the use of methods for its quantitative assessment in persons who were exposed to radiation because of the Chornobyl accident. Materials and methods. Comorbid pathology was studied in 608 men, including 420 clean-up workers (CW) of the accident consequences at the Chornobyl NPP (main group) and 188 non-irradiated persons (control group – CG). All patients had cardiovascular diseases as their main pathology and were examined in the cardiology department of the NRCRM hospital during 2011–2019. The groups did not differ by age, either at the beginning of the accident or at the time of their last examination. Patients of both groups before the accident were practically healthy people and were not registered at the dispensary. The Cumulative Illness Rating Scale (CIRS) was used to quantify comorbid pathology. Results. Comorbid pathology was detected in 418 CW (99.5 %) and 183 patients of CG (99.3 %). The total score in CW (10.3 ± 2.9) units significantly (р = 0.000) exceeded the same index in non-irradiated patients (8.8 ± 3.0) units, as well as the mean number of CIRS categories, whose level severity was 1 point (3.3 ± 1.7 vs. 2.6 ± 1.5, р = 0.000), 2 points (1.8 ± 1.0 vs. 1.6 ± 1.0, p = 0.032) and 3–4 points (1.2 ± 0.8 vs. 1.0 ± 0.9, р = 0.062). In contrast, the mean value of the categories with zero score, i.e. without diseases, was more common in CG (7.8 ± 1.8 vs. 8.8 ± 1.7, р = 0.000). The most common pathology in CW and CG were heart (98.3 % vs. 94.7 %, р < 0.05) and vascular diseases (92.9 % vs. 87.8 %, р > 0.05), followed by diseases of nervous system (79.0 % vs. 57.4 %, р <0.001), musculoskeletal system and skin (69.8 % vs. 56.9 %, р < 0.01), endocrine (56.0 % vs. 49,5 %, р > 0.05) and the respiratory system (53.8 % vs. 53.7 %, р > 0.05) and liver (51.2 % vs. 36.2 %, р < 0.001), which were detected more than in half patients of the main group. Diseases of the kidneys (3.3 % vs. 4.8 %, р > 0.05) and lower gastrointestinal tract (3.3 % vs. 0.5 %, р < 0.01) were quite rare. The incidence of the other four CIRS categories was 18.6–34 %. The total score in subgroups with different ages varied in descending order of mean values as follows: CW > 65 years (10.5 ± 2.9) units, CW < 65 years (9.9 ± 2.8) units, CG > 65 years (9.5 ± 2.8) units and CG < 65 years (7.8 ± 2.9) units with significant differences both between age subgroups in each of the groups and between CW and CG older subgroups. Conclusions. Quantitative assessment of comorbidity by CIRS showed that in persons irradiated during their emergency work due to the Chornobyl accident, the incidence of combined pathology of such organ systems as cardiovascular, nervous, endocrine, hematopoietic, urogenital, musculoskeletal, gastrointestinal, liver and kidneys was significantly higher than in non-irradiated patients. In irradiated patients, the course of comorbid pathology was more severe for each system and in general, reflecting higher values of the total CIRS score. Both among CW and non-irradiated controls, higher values of the total comorbidity score were observed in patients 65 years and older, compared with younger individuals. In both age subgroups of CW the total score was higher than in patients of the control group. Key words: clean-up workers of the accident consequences at the Chornobyl NPP, ionizing radiation, comorbid pathology, chronic diseases.

scholarly journals Gamma glutamyl transferase and lactate dehydrogenase as biochemical markers of severity of preeclampsia among Sudanese pregnant women

2018 ◽  
Vol 7 (8) ◽  
pp. 3020
Author(s):  
Salih Ezzaldein Salih Elias ◽  
Abdelgadir Eltom ◽  
Ahmed L. Osman ◽  
Asaad MA. Babker
Keyword(s):  
Lactate Dehydrogenase ◽  
Pregnant Women ◽  
Biochemical Markers ◽  
Control Group ◽  
P Value ◽  
Gamma Glutamyl Transferase ◽  
Mean Values ◽  
Gamma Glutamyl ◽  
The Mean ◽  
Glutamyl Transferase

Background: Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks' gestation and can present as late as 4-6 weeks post-partum. Pre-eclampsia is a syndrome with multiple aetiologies which has made it difficult to develop adequate screening tests and treatments. Objective of this study to assess the level of gamma glutamyl transferase and lactate dehydrogenase as biochemical markers of severity of preeclampsia in Sudanese pregnant women.Methods: This is a case control hospitalize base study. The study was conducted in preeclamptic pregnant women in Omdurman maternity hospital and medical military hospital in Khartoum state. In this study glutamyl transferase and lactate de-hydrogenase was estimation in 100 Sudanese pregnant women by spectrophotometer method, 50 of them were diagnosed with preeclampsia 27 from this is severe preeclampsia and 23 is mild preeclampsia was matched in aged. Serum samples of all the cases were assayed for GGT and LDH. The data was recorded and analyzed using statistical package for social sciences (SPS –version 16) on programmed computer. The mean standard deviations of variable were calculated for both the test group and the control group and P value for comparison was obtained.Results: The mean values of plasma gamma glutamyl transferase in mild and severe preeclamptic pregnant women were insignificant difference when compared to control P value (0.346 - 0.089) respectively. The mean values of plasma lactate dehydrogenase in mild and severe preeclamptic pregnant women were significant increase when compared to control P value (0.008 - 0.001) respectively.Conclusions: The levels of LDH is raised in Sudanese pregnant women with hypertensive also can be useful biochemical marker that reflects the severity of and the occurrence of complications of pre-eclampsia. GGT levels were normal in Sudanese pregnant women with hypertensive preeclampsia.

scholarly journals Analgesic Efficacy of Perioperative Esmolol as an Adjunct to Morphine in Mastectomy- A Prospective Observational Study

2021 ◽  
Author(s):  
Jose Tania ◽  
Vadakkoot Raghavan Hema ◽  
Prabhakaran Vineetha
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Control Group ◽  
P Value ◽  
Numerical Rating ◽  
The Mean

Introduction: Multimodal analgesia with opioids as the prime component is the mainstay of postoperative analgesia for mastectomy, which can lead to many opioid related unwanted side-effects. Esmolol infusion has been found as a useful adjunct in reducing opioid requirements. Aim: To find the effect of perioperative esmolol infusion on postoperative pain and opioid requirements. Materials and Methods: This prospective observational study was done in 140 American Society of Anaesthesiologists (ASA) physical status l and ll patients, between 20-65 years of age posted for mastectomy under general anaesthesia. Esmolol group (group E) received 0.25 mg/kg of esmolol bolus ten minutes before induction followed by continuous infusion 5 μg/kg/min till end of surgery while control group (group C) received equivalent volumes of saline. Primary outcome measures were Numerical Rating Scale (NRS) for pain, total postoperative opioid consumption and time to first rescue analgesic dosage till 24 hours. Intraoperative haemodynamics and other side-effects were secondary outcomes. Descriptive statistics of numerical rating scores and analgesic requirements were analysed in terms of mean and standard deviation. Independent t-test was used to compare numerical rating scores and analgesic requirement of the two groups. A p-value of <0.05 was considered statistically significant. Results: The mean numerical pain scores were significantly lower in the esmolol group for the first 24 hour. The mean time to first rescue analgesic was 17.59±5.012 hour in the esmolol group and 8.21±2.22 hour in the control group which was statistically significant (p<0.001). The total tramadol consumption was also significantly lesser in the esmolol group (42.14±29.03 mg), compared to control group (102.86±22.3 mg), (p=0.0001). Mean heart rate was statistically lower in the esmolol group, but there was no incidence of bradycardia requiring treatment. Mean Arterial Pressures (MAP) were comparable. Conclusion: Perioperative esmolol infusion when used as an adjunct to morphine decreased postoperative pain and analgesic requirements for the first 24 hours without any haemodynamic disturbances.

Protective Effect of Moringa Oleifera Leaves Against TramadolInduced Nephrotoxicity in Mice

2017 ◽  
Vol 9 (02) ◽  
Author(s):  
Ashraf Albrakati
Keyword(s):  
Oral Dose ◽  
Moringa Oleifera ◽  
Treated Group ◽  
Control Group ◽  
Serum Urea ◽  
Kidney Function Tests ◽  
Mean Values ◽  
Intraperitoneal Dose ◽  
Moringa Oleifera Leaves ◽  
The Mean

Tramadol, a broadly in recent years, is an effective analgesic agent for the treatment of moderate to acute pain. Its metabolites are excreted by the kidney which may cause nephrotoxicity. Moringa oleifera leaves are commonly used to provide herbal and plant-derived medicinal products especially in developing nations. The present study was carried out to determine the biochemical and histopathological changes in the kidney of tramadol-treated albino mice and to evaluate the possible protective role of Moringa oleifera leaves against tramadol-induced nephrotoxicity. Twenty adult albino mice were divided into four groups. Control group (group i) received daily intraperitoneal injection of normal saline only, group ii received oral dose of Moringa oleifera leaves extract (20 mg/kg/bw) for three weeks, group iii received daily intraperitoneal dose of tramadol (0.3 mg/kg/bw) for the same period, group iv, received daily oral dose of Moringa oleifera leaves extract, (20 mg/kg/bw) three hours before injecting intraperitoneal dose of tramadol (0.3 mg/kg/bw), for the same period. Blood samples were withdrawn at the end of the experiment for kidney function tests and specimens from the kidney were processed for histological study. No significant differences in the mean values of the kidney function tests were noticed between Moringa oleifera group and control group. However, there was highly significant increase in the mean values of serum, urea and creatinine in tramadol-treated group as compared to the control group. Although tramadol + Moringa oleifera group revealed significant difference in the mean values of urea and creatinine when compared with tramadol-treated group. So, Moringa oleifera leaves extract have been shown to attenuate the renal dysfunction, improve the renal architecture, with nearly normalization of serum urea and creatinine levels which indicate improvement of renal function. In conclusion, in the light of biochemical results and histological findings, co-administration of Moringa oleifera leaves lessened the negative effects of tramadol-induced nephrotoxicity; possibly by its antioxidant action. Further investigation of these promising protective effects of Moringa oleifera leaves against tramadol-induced renal injury may have considerable impact on developing an adjunct therapy aiming to improve the therapeutic index of some nephrotoxic drugs.

Association of Serum Homocysteine Level and Interstitial Lung Disease in Systemic Sclerosis: A Case-control Study

2018 ◽  
Vol 15 (1) ◽  
pp. 74-78
Author(s):  
Mohammadali Nazarinia ◽  
Asghar Zare ◽  
Mohammad javad Fallahi ◽  
Mesbah Shams
Keyword(s):  
Systemic Sclerosis ◽  
Healthy Subjects ◽  
Case Control Study ◽  
Homocysteine Level ◽  
Case Control ◽  
Control Group ◽  
Lung Involvement ◽  
Serum Homocysteine ◽  
The Mean ◽  
Control Study

Background:Systemic sclerosis is a disorder of connective tissue with unknown cause, affecting the skin and internal organs, characterized by fibrotic changes.Objective:To determine the correlation between serum homocysteine level and interstitial lung involvement in systemic sclerosis. </P><P> Materials and Methods: In this case – control study, 59 patients who fulfilled the ACR/EULAR classification criteria for systemic sclerosis and were referred to Hafez Hospital of Shiraz, Iran, were included as the case group. Fifty nine healthy subjects were involved as the control group. Patients were divided into two groups based on interstitial lung involvement and two subtypes, diffuse and limited type. Serum homocysteine, vitamin B12, and folate levels compared between the controls, and cases groups.Results:Of 59 case and control group, 53 (%89.8) were female and the mean age did not differ in both groups (P=0.929). Thirty five (%59.3) patients had interstitial lung involvement and 38(%64.4) had diffuse cutaneous systemic sclerosis. The mean serum homocysteine level was 13.9±6.3 µmol/L in the case and 13.7±9.2 µmol/L in the control group (P=0.86). The mean serum homocysteine level did not differ between the patients with and without interstitial lung involvement (P=0.52). The patients with lung involvement was older than those without lung involvement (P=0.004). Lung disease was more common in diffuse type (P=0.014).Conclusion:In our study, serum homocysteine level did not differ between the patients and healthy subjects. Also, there was no correlation between serum homocysteine level and lung involvement, but lung involvement was more common in older patients and also diffuse subtype.

Is ProBNP a New Marker for Predicting Intrauterine Growth Restriction?

2021 ◽  
Vol 225 (02) ◽  
pp. 125-128
Author(s):  
Hasan Eroğlu ◽  
Nazan Vanlı Tonyalı ◽  
Gokcen Orgul ◽  
Derya Biriken ◽  
Aykan Yucel ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Final Analysis ◽  
First Trimester ◽  
Maternal Serum ◽  
Growth Restriction ◽  
Control Group ◽  
Aneuploidy Screening ◽  
Intrauterine Growth ◽  
Potential Marker ◽  
The Mean

Abstract Purpose To evaluate the usability of first-trimester maternal serum ProBNP levels in the prediction of intrauterine growth restriction (IUGR). Methods In this prospective study, blood samples taken from 500 women who applied to our polyclinic for routine serum aneuploidy screening between the 11–14th gestational weeks were centrifuged. The obtained plasma samples were placed in Eppendorf tubes and stored at −80+°C. For the final analysis, first-trimester maternal serum ProBNP levels of 32 women diagnosed with postpartum IUGR and 32 healthy women randomly selected as the control group were compared. FGR was defined as estimated fetal weight below the 10th percentile for the gestational age. Results The mean ProBNP levels were statistically and significantly higher in the women with intrauterine growth restriction (113.73±94.69 vs. 58.33±47.70 pg/mL, p<0.01). At a cut-off level of 50.93, ProBNP accurately predicted occurrence of IUGR (AUC+= 0.794 (95% confidence interval 0.679–0.910), p+= 0.001) with sensitivity and specificity rates of 78.1 and 69.0%, respectively. Conclusion First-trimester serum ProBNP level was significantly higher in women who developed IUGR compared to healthy controls. First-trimester ProBNP level can be used as a potential marker to predict the development of IUGR in pregnant women.

Effect of Medialization of the Trochlear Groove and Lateralization of the Tibial Tubercle on TT-TG Distance: A Cross-sectional Study of Dysplastic and Nondysplastic Knees

2021 ◽  
pp. 036354652098781
Author(s):  
Mathias Paiva ◽  
Lars Blønd ◽  
Per Hölmich ◽  
Kristoffer Weisskirchner Barfod
Keyword(s):  
Trochlear Dysplasia ◽  
Cross Sectional Study ◽  
Magnetic Resonance Images ◽  
Tibial Tubercle ◽  
Control Group ◽  
Trochlear Groove ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mean Values ◽  
The Mean

Background: Tibial tubercle–trochlear groove (TT-TG) distance is often used as a measure of lateralization of the TT and is important for surgical planning. Purpose: To investigate if increased TT-TG distance measured on axial magnetic resonance images is due to lateralization of the TT or medialization of the TG. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 84 knees (28 normal [NK], 28 with trochlear dysplasia [TD], and 28 with patellar dislocation without TD [PD]) were examined. The medial border of the posterior cruciate ligament (PCL) was chosen as the central anatomic landmark. The distance from the TT to PCL (TT-PCL) was measured to examine the lateralization of the TT. The distance from the TG to the PCL (TG-PCL) was measured to examine the medialization of the TG. Between-group differences were investigated by use of 1-way analysis of variance. Results: The mean values for TT-TG distance were 8.7 ± 3.6 mm for NK, 12.1 ± 6.0 mm for PD, and 16.7 ± 4.3 mm in the TD group ( P < .01). The mean values for TT-PCL distance were 18.5 ± 3.6 mm for NK, 18.5 ± 4.5 mm for PD, and 21.2 ± 4.2 mm in the TD group ( P = .03). The mean values for TG-PCL distance were 9.6 ± 3.0 mm for NK, 7.1 ± 3.4 mm for PD, and 5.1 ± 3.3 mm in the dysplastic group ( P < .01). Conclusion: The present results indicate that increased TT-TG distance is due to medialization of the TG and not lateralization of the TT. Knees with TD had increased TT-TG distance compared with the knees of the control group and the knees with PD. The TT-PCL distance did not differ significantly between groups, whereas the TG-PCL distance declined with increased TT-TG.

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