Association Between CYP3A4 and CYP3A5 Genotypes and Cyclosporine's Blood Levels and Doses among Jordanian Kidney Transplanted Patients

2019 ◽  
Vol 20 (8) ◽  
pp. 682-694 ◽  
Author(s):  
Sahar El-Shair ◽  
Mohammad Al Shhab ◽  
Khaled Zayed ◽  
Moaath Alsmady ◽  
Malek Zihlif
Keyword(s):  
Kidney Transplantation ◽  
Strong Association ◽  
Mean Difference ◽  
Allele Frequencies ◽  
Assay Method ◽  
Therapeutic Window ◽  
Blood Levels ◽  
Nucleotide Polymorphisms ◽  
Significant Difference ◽  
The Mean

Background: Cyclosporine is used as an immunosuppressive agent in kidney transplantation. It has a narrow therapeutic window. Cyclosporine is predominantly metabolized by CYP3A4 and CYP3A5. The most common Single Nucleotide Polymorphisms (SNPs) affecting cyclosporine metabolism (CYP3A4*1B, CYP3A4*1G, CYP3A4*22 and CYP3A5*3) were investigated among Jordanian kidney transplanted patients to find out the genotypes and allele frequencies of these SNPs. Additionally, this study investigated whether genotypes of CYP3A4 and CYP3A5 affect C2 blood levels, dosing of cyclosporine and the prevalence of acute rejection. Methods: Blood samples of 109 adult patients taking cyclosporine as their primary immunosuppressant for kidney transplantation were collected from the Prince Hamzah Hospital, Amman, Jordan. Patients’ first C2 blood levels and their first two given doses were collected. Patients were genotyped for the four SNPs using Polymerase Chain Reaction- restriction Fragment Length Polymorphism (PCR-RFLP) assay method. Results: Allele frequencies among Jordanian patients for CYP3A4*1B, CYP3A4*1G, CYP3A4*22 and CYP3A5*3 were 0.037, 0.399, 0.037 and 0.271, respectively. There was a significant association between CYP3A4*22 and mean difference in the second and first given doses (P=0.034). There was a big difference between CYP3A4*22 and the mean of the first C2 blood levels (P=0.063). Conclusion: There was a strong association between CYP3A4*22 and the mean difference between the second and first given doses. There was a trend of significant difference between the mean of the first C2 blood levels among heterozygous CYP3A4*22 patients. Pharmacogenomics may hold promise in assisting the prediction of the best cyclosporine dose and C2 blood level among Jordanian kidney transplant patients.

scholarly journals Corneal Biomechanical Parameters and Central Corneal Thickness in Glaucoma Patients, Glaucoma Suspects, and a Healthy Population

2021 ◽  
Vol 10 (12) ◽  
pp. 2637
Author(s):  
Mª. Ángeles del Buey-Sayas ◽  
Elena Lanchares-Sancho ◽  
Pilar Campins-Falcó ◽  
María Dolores Pinazo-Durán ◽  
Cristina Peris-Martínez
Keyword(s):  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Mean Difference ◽  
The Other ◽  
Control Group ◽  
Healthy Population ◽  
Diagnostic Categories ◽  
Significant Difference ◽  
Biomechanical Parameters ◽  
The Mean

Purpose: To evaluate and compare corneal hysteresis (CH), corneal resistance factor (CRF), and central corneal thickness (CCT), measurements were taken between a healthy population (controls), patients diagnosed with glaucoma (DG), and glaucoma suspect patients due to ocular hypertension (OHT), family history of glaucoma (FHG), or glaucoma-like optic discs (GLD). Additionally, Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated IOP (IOPcc) were compared between the different groups of patients. Methods: In this prospective analytical-observational study, a total of 1065 patients (one eye of each) were recruited to undergo Ocular Response Analyzer (ORA) testing, ultrasound pachymetry, and clinical examination. Corneal biomechanical parameters (CH, CRF), CCT, IOPg, and IOPcc were measured in the control group (n = 574) and the other groups: DG (n = 147), FHG (n = 78), GLD (n = 90), and OHT (n = 176). We performed a variance analysis (ANOVA) for all the dependent variables according to the different diagnostic categories with multiple comparisons to identify the differences between the diagnostic categories, deeming p < 0.05 as statistically significant. Results: The mean CH in the DG group (9.69 mmHg) was significantly lower compared to controls (10.75 mmHg; mean difference 1.05, p < 0.001), FHG (10.70 mmHg; mean difference 1.00, p < 0.05), GLD (10.63 mmHg; mean difference 0.93, p < 0.05) and OHT (10.54 mmHg; mean difference 0.84, p < 0.05). No glaucoma suspects (FHG, GLD, OHT groups) presented significant differences between themselves and the control group (p = 1.00). No statistically significant differences were found in the mean CRF between DG (11.18 mmHg) and the control group (10.75 mmHg; mean difference 0.42, p = 0.40). The FHG and OHT groups showed significantly higher mean CRF values (12.32 and 12.41 mmHg, respectively) than the DG group (11.18 mmHg), with mean differences of 1.13 (p < 0.05) and 1.22 (p < 0.001), respectively. No statistically significant differences were found in CCT in the analysis between DG (562 μ) and the other groups (control = 556 μ, FHG = 576 μ, GLD = 569 μ, OHT = 570 μ). The means of IOPg and IOPcc values were higher in the DG patient and suspect groups than in the control group, with statistically significant differences in all groups (p < 0.001). Conclusion: This study presents corneal biomechanical values (CH, CRF), CCT, IOPg, and IOPcc for diagnosed glaucoma patients, three suspected glaucoma groups, and a healthy population, using the ORA. Mean CH values were markedly lower in the DG group (diagnosed with glaucoma damage) compared to the other groups. No significant difference was found in CCT between the DG and control groups. Unexpectedly, CRF showed higher values in all groups than in the control group, but the difference was only statistically significant in the suspect groups (FHG, GLD, and OHT), not in the DG group.

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.

scholarly journals DAILY JOURNAL WRITING TO ENHANCE STUDENT'S WRITING SKILLS

2016 ◽  
Vol 1 (2) ◽  
pp. 27-35
Author(s):  
Ester Eveline Sihite ◽  
Debora Chaterin Simanjuntak
Keyword(s):  
Standard Error ◽  
Test Scores ◽  
Journal Writing ◽  
Writing Skills ◽  
Mean Difference ◽  
Significant Difference ◽  
Post Test ◽  
The Mean ◽  
Experimental Group

This study aims to enhance students’ writing skills through Daily Journal writing. This research was divided into three steps: giving pre-test, giving treatment (writing daily journal), and giving posttest. The result showed significant difference between control and experimental group. Experimental participants was improved through the writing of daily journal, and the score gained by participants showed that there was a significant effect on students’ writing skills. The achievements showed that the mean difference of post-test scores between the two groups was -.45433 and for the standard error mean was .03840 with pValue .050 (see Table 3), means that Ha is accepted and Ho is not accepted. It means, writing daily journal is strong enough to improve the students’ writing skills. Keywords: Journal Writing, Writing Skills, Daily Journal Variations

scholarly journals Difference of Procalcitonin Levels in Gram-Positive and Gram-Negative Bacterial Sepsis Patients of Indonesia Army Central Hospital Gatot Soebroto in 2016

2022 ◽  
Vol 13 (1) ◽  
pp. 38
Author(s):  
Nindy Handayani ◽  
Soroy Lardo ◽  
Nunuk Nugrohowati
Keyword(s):  
Mean Difference ◽  
P Value ◽  
Central Hospital ◽  
Bacterial Sepsis ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Significant Difference ◽  
The Mean

Introduction: Procalcitonin is known as a marker of infection and indicator for severity of infections. In sepsis, elevated procalcitonin levels in blood have a significant value that can be used as a sepsis biomarker. The aim of this study was to determine the mean difference of procalcitonin levels in Gram-positive and Gram-negative bacterial sepsis patients.Methods: This study used quantitative method with cross sectional approach. The sample of this study were bacterial sepsis patients of Indonesia Army Central Hospital Gatot Soebroto in 2016 which were divided into two groups: Gram-positive and Gram-negative bacterial sepsis patients with the number of each group was 30 samples. The data were analyzed by using independent t test.Results: This study showed that mean levels of procalcitonin in Gram-positive bacterial sepsis patients was 6.47 ng/ml and Gram-negative was 66.04 ng/ml. There was a significant difference between mean levels of procalcitonin in Gram-positive and Gram-negative bacterial sepsis patients of Indonesia Army Central Hospital Gatot Soebroto in 2016 with p value = 0.000 (p < 0.05).Conclusion: The mean difference of procalcitonin levels in Gram-negative bacterial sepsis patients were higher than Gram-positive bacterial sepsis patients, because Gram-negative bacteria have lipopolysaccharide which is a strong immunostimulator and increases TNF-α production higher than Gram-positive bacteria. 

Evaluation of infrared technology to detect category I and suspected deep tissue injury in hospitalised patients

2019 ◽  
Vol 28 (Sup12) ◽  
pp. S9-S16
Author(s):  
Fazila Abu Bakar Aloweni ◽  
Shin Yuh Ang ◽  
Yee Yee Chang ◽  
Xin Ping Ng ◽  
Kai Yunn Teo ◽  
...  
Keyword(s):  
Skin Temperature ◽  
Infrared Thermography ◽  
Tissue Injury ◽  
Mean Difference ◽  
Deep Tissue ◽  
Thermal Images ◽  
Deep Tissue Injury ◽  
Hospitalised Patients ◽  
Significant Difference ◽  
The Mean

Objective: To evaluate the use of an infrared thermography device in assessing skin temperature among category I pressure ulcer (PU) and/or suspected deep tissue injuries (SDTI) with intact skin. Methods: An observational cross-sectional study design was used. Adult inpatients (cases) who had a category I PU or suspected deep tissue injury (skin intact) on the sacral or heel during the study period (March to April 2018) were recruited. Patients without a PU were also recruited to act as control. Thermal images of the patient's PU site and non-PU site were taken within 24 hours of PU occurrence. Thermal images of the control patients (no PU) were also taken. Each PU case was matched to three control patients in terms of age, gender, race and anatomical sites. All thermal images were taken using a portable CAT S60 Thermal Imaging Rugged Smartphone (Caterpillar Inc., US) that provided readings of the skin temperature in degrees Celsius. Results: A total of 17 cases and 51 controls were recruited. Among the cases, the mean difference in skin temperature between the PU site (mean: 31.14°C; standard deviation [SD]: 1.54) and control site within the cases (mean: 28.93°C; SD: 3.47) was significant (difference: 2.21±3.66°C; p=0·024). When comparing between all cases and controls, the mean temperature difference was non-significant. When comparing between the category I PU and suspected deep pressure injury cases, the mean difference was also non-significant. Conclusion: Using infrared thermography technology at the bedside to measure skin temperature will support the clinical diagnosis of patients with skin types I to III. However, there is a need for a more accurate and objective measurement to identify and diagnose early category I PU or suspected deep tissue injury in adult patients with darker skin types 4 and above, enabling early initiation of preventive measures in the hospital acute care setting.

scholarly journals The Role of Mean Platelet Volume as a Predictor of Mortality in Critically Ill Patients: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Pattraporn Tajarernmuang ◽  
Arintaya Phrommintikul ◽  
Atikun Limsukon ◽  
Chaicharn Pothirat ◽  
Kaweesak Chittawatanarat
Keyword(s):  
Systematic Review ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Mean Platelet Volume ◽  
Meta Analysis ◽  
Small Sample ◽  
Mean Difference ◽  
Platelet Volume ◽  
Significant Difference ◽  
The Mean

Background. An increase in the mean platelet volume (MPV) has been proposed as a novel prognostic indicator in critically ill patients.Objective. We conducted a systematic review and meta-analysis to determine whether there is an association between MPV and mortality in critically ill patients.Methods. We did electronic search in Medline, Scopus, and Embase up to November 2015.Results. Eleven observational studies, involving 3724 patients, were included. The values of initial MPV in nonsurvivors and survivors were not different, with the mean difference with 95% confident interval (95% CI) being 0.17 (95% CI: −0.04, 0.38;p=0.112). However, after small sample studies were excluded in sensitivity analysis, the pooling mean difference of MPV was 0.32 (95% CI: 0.04, 0.60;p=0.03). In addition, the MPV was observed to be significantly higher in nonsurvivor groups after the third day of admission. On the subgroup analysis, although patient types (sepsis or mixed ICU) and study type (prospective or retrospective study) did not show any significant difference between groups, the difference of MPV was significantly difference on the unit which had mortality up to 30%.Conclusions. Initial values of MPV might not be used as a prognostic marker of mortality in critically ill patients. Subsequent values of MPV after the 3rd day and the lower mortality rate unit might be useful. However, the heterogeneity between studies is high.

scholarly journals Can the blood gas analyser results be believed? A prospective multicentre study comparing haemoglobin, sodium and potassium measurements by blood gas analysers and laboratory auto-analysers

2019 ◽  
Vol 47 (2) ◽  
pp. 120-127 ◽  
Author(s):  
Katherine E Triplett ◽  
Bradley A Wibrow ◽  
Richard Norman ◽  
Dana A Hince ◽  
Liesel E Hardy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Point Of Care ◽  
Mean Difference ◽  
Full Blood Count ◽  
Blood Gas ◽  
Prospective Multicentre Study ◽  
Significant Difference ◽  
The Mean ◽  
Sodium And Potassium

Blood gas analysers are point-of-care testing devices used in the management of critically ill patients. Controversy remains over the agreement between the results obtained from blood gas analysers and laboratory auto-analysers for haematological and biochemistry parameters. We conducted a prospective analytical observational study in five intensive care units in Western Australia, in patients who had a full blood count (FBC), urea, electrolytes and creatinine (UEC), and a blood gas performed within 1 h of each other during the first 24 h of their intensive care unit admission. The main outcome measure was to determine the agreement in haemoglobin, sodium, and potassium results between laboratory haematology and biochemistry auto-analysers and blood gas analysers. A total of 219 paired tests were available for haemoglobin and sodium, and 215 for potassium. There was no statistically significant difference between the results of the blood gas and laboratory auto-analysers for haemoglobin (mean difference –0.35 g/L, 95% confidence interval (CI) –1.20 to 0.51, P = 0.425). Although the mean differences between the two methods were statistically significant for sodium (mean difference 1.49 mmol/L, 95% CI 1.23–1.76, P < 0.0001) and potassium (mean difference 0.19 mmol/L, 95% CI 0.15–0.24, P < 0.0001), the mean biases on the Bland–Altman plots were small and independent of the magnitude of the measurements. The two methods of measurement for haemoglobin, sodium and potassium agreed with each other under most clinical situations when their values were within or close to normal range suggesting that routine concurrent blood gas and formal laboratory testing for haemoglobin, sodium and potassium concentrations in the intensive care unit is unwarranted.

scholarly journals Effect of Using Scientific Stations Strategy in Developing Deductive Thinking of Intermediate School Students in General Sciences

2020 ◽  
Vol 12 (2) ◽  
pp. 35-48
Author(s):  
Heba Mohammed Saleh Al-Hafidh
Keyword(s):  
Statistical Processing ◽  
Mean Difference ◽  
Control Group ◽  
Intermediate School ◽  
School Students ◽  
Statistical Significant Difference ◽  
Significant Difference ◽  
The Mean ◽  
Level Of Significance ◽  
Experimental Group

The study aimed to know the effect of using the Scientific stations strategy in developing Deductive thinking of intermediate school students in the science subject. To achieve the aim of the research, the researcher used experimental design with two equal groups, the research sample consisted of (65) intermediate-grade students in Al Nidhal school for boys represented by (30) students of the experimental group and (35) students for the control group, the researcher equivalence of the two research groups with a set of variables including (Intelligence, parents ’educational level, previous achievement, age calculated by months and pre-test for Deductive thinking), to verify the research aim the researcher put the two hypotheses as following : 1- There is no statistical significant difference at the level of significance (0.05) between the scores mean of the members of the experimental group and the members of the control group in the post test of Deductive thinking. 2- There is no statistical significant difference at the level of significance (0.05) between the mean difference between the (pre and post) tests of both experimental and control groups in the Deductive thinking test. To verify the research hypotheses, the researcher prepared a test for Deductive thinking consisting of (20) items the researcher applied the test of Deductive thinking, collected the data, and tabulated it in tables for statistical processing and the results indicated: 1- There is a statistical significant difference between the scores mean of students in both groups in the Deductive thinking test and in favor of the experimental group. 2- There is a statistical significant difference between the mean difference between the two tests (pre - post) and in favor of the experimental group.

scholarly journals Ego Strength and Anxiety among Working and Non-working Women

2015 ◽  
Vol 2 (4) ◽  
Author(s):  
Balvant M. Chhansiya ◽  
Yogesh A. Jogsan
Keyword(s):  
Working Women ◽  
Correlation Method ◽  
T Test ◽  
Mean Difference ◽  
Research Tool ◽  
Ego Strength ◽  
Positive Correlation ◽  
Significant Difference ◽  
The Mean

The main purpose of this research was to find out the mean difference between working and non working women. The total 80 women as a variation belonging to working and non working women were taken. The research tool for Ego Strength was measured by Hasan’s Ego strength Scale and tool for anxiety were used which made by Sinha. Here t-test was applied to check the significant of in Ego strength and Anxiety between working and non working women. To check the relation between Ego strength and anxiety correlation method is used. The study revealed that there was significant difference between working and non working women in Ego strength. There was significant difference between working and non working women in anxiety. While the correlation between Ego strength and anxiety reveals 0.54 positive correlation.

scholarly journals Evaluating the Effect of Retinal Defocus (Blur) on Lateral Heterophoria

2021 ◽  
Vol 23 (1) ◽  
pp. 11-17
Author(s):  
George Nnamdi Atuanya ◽  
Osayimwen Osas Ero ◽  
Raphael Uchenna Enyinnaya Akpalaba
Keyword(s):  
Experimental Study ◽  
Confidence Level ◽  
Mean Difference ◽  
Inclusion Criteria ◽  
Standard Testing ◽  
Defocus Blur ◽  
Significant Difference ◽  
Quasi Experimental ◽  
The Mean ◽  
Ocular Health

Purpose: This study was conducted to ascertain the effect of retinal defocusing or retinal blur on lateral heterophoria at far and near.Methods: This was a quasi-experimental study involving 57 participants aged 5 to 35 years, who were selected based on the inclusion criteria of being myopes and emmetropes who had a normal general and ocular health. The Von Graefe technique was used for measuring phoria under standard testing conditions.Results: The mean baseline lateral phoria for emmetropes were 0.53 ± 1.14∆ exophoria and 2.47 ± 2.08∆ exophoria at far and near respectively, while after defocusing, it was 2.80 ± 0.88∆ exophoria and 4.34 ± 1.70∆ exophoria at far and near respectively. For myopes, the baseline lateral phoria was 1.52 ± 1.09∆ exophoria and 4.76 ± 1.13∆ exophoria at far and near respectively while after defocussing, it was 3.39 ± 0.92∆ exophoria at far and 7.60 ± 1.00∆ exophoria at near. The mean difference in lateral phoria was found to be significant at the 95% confidence level (P = 0.000). There was no statistically significant difference in lateral phoria change at far (P = 0.072), while the near phoria difference was significant (P = 0.002).Conclusion: Gas Retinal defocusing with +2.50D resulted in a shift towards exophoria at both far and near, with myopes experiencing more exophoric shift. This is because they are less sensitive to the presence of blur. This will enable practitioners to be cautious of the inhibition of accommodation due to higher exophoria at near when prescribing lenses. Keywords: Retinal Defocus, Myopia, Emmetropia, Near lateral phoria, Distance lateral phoria.

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