Outcome, Clinical Profile and Risk Factors for Mortality of Neonates Necessitating Mechanical Ventilation

Background: Assisted ventilation has turn out to be an essential part of the neonatal intensive care unit (NICU). It is one of the main methods of support in the ICU and undoubtedly influences the survival of sick newborns. Aims: 1. To investigate common indications for mechanical ventilation in newborns 2. To investigate factors influencing the outcome. Method: It is a descriptive study of 60 infants admitted to the Department of Pediatric Medicine in the ICU over a one-year period in the department of Paediatrics, Abbasi Shaheed Hospital. The information was gathered and analysed in a pre-designed format. Results: Of a total of 60 infants, 46 survived, 14 died, and one infant was discharged despite medical advice. 36 children were born vaginally, 20 were born via LSCS, and 4 via assisted delivery. Postnatal asphyxia was the most common ventilation indication in full-term newborns, while HMD was present in preterm infants. The best results were obtained in ventilated infants with MAS, with 100% survival, followed by apnoea in premature infants, perinatal asphyxia, and HMD. Pulmonary haemorrhage (48.3%) was the most common complication among deceased infants, followed by sepsis (28.3%) and shock (23.4%) with a significant p <0.05. There were no complications in 76.7% of the surviving infants. Conclusions: Among the many widely available variables studied in this study, maximum and mean peak inspiratory pressure (PIP or (PEEP), maximum respiratory rate, maximum mean airway pressure (MAP) and average ventilation demand was much greater among non-survivals in comparison to the survivors. Bicarbonate, PH and excess base have been found to be important determinants of mortality in ventilated newborns. Keywords: Indications, mechanical ventilation and Results

Quality of Death in Fighting Bulls during Bullfights: Neurobiology and Physiological Responses

During bullfights, bulls undergo physiometabolic responses such as glycolysis, anaerobic reactions, cellular oedema, splenic contraction, and hypovolemic shock. The objective of this review article is to present the current knowledge on the factors that cause stress in fighting bulls during bullfights, including their dying process, by discussing the neurobiology and their physiological responses. The literature shows that biochemical imbalances occur during bullfights, including hypercalcaemia, hypermagnesaemia, hyperphosphataemia, hyperlactataemia, and hyperglycaemia, associated with increased endogenous cortisol and catecholamine levels. Creatine kinase, citrate synthase, and lactate dehydrogenase levels also increase, coupled with decreases in pH, blood bicarbonate levels, excess base, partial oxygen pressure, and oxygen saturation. The intense exercise also causes a marked decrease of glycogen in type I and II muscle fibres that can produce myoglobinuria and muscular necrosis. Other observations suggest the presence of osteochondrosis. The existing information allows us to conclude that during bullfights, bulls face energy and metabolic demands due to the high intensity and duration of the exercise performed, together with muscular injuries, physiological changes, and high enzyme concentrations. In addition, the final stage of the bullfight causes a slow dying process for an animal that is sentient and conscious of its surroundings.

A test of the hypothesis that variable mutation rates create signals that have previously been interpreted as evidence of archaic introgression into humans

It is widely accepted that non-African humans carry 1-2% Neanderthal DNA due to historical inter-breeding. However, inferences about introgression rely on a critical assumption that mutation rate is constant and that back-mutations are too rare to be important. Both these assumptions have been challenged, and recent evidence points towards an alternative model where signals interpreted as introgression are driven mainly by higher mutation rates in Africa. In this model, non-Africans appear closer to archaics not because they harbour introgressed fragments but because Africans have diverged more. Here I test this idea by using the density of rare, human-specific variants (RHSVs) as a proxy for recent mutation rate. I find that sites that contribute most to the signal interpreted as introgression tend to occur in tightly defined regions spanning only a few hundred bases in which mutation rate differs greatly between the two human populations being compared. Mutation rate is invariably higher in the population into which introgression is not inferred. I confirmed that RHSV density reflects mutation rate by conducting a parallel analysis looking at the density of RHSVs around sites with three alleles, an independent class of site that also requires recurrent mutations to form. Near-identical peaks in RHSV density are found, suggesting a common cause. Similarly, coalescent simulations confirm that, with constant mutation rate, introgressed fragments do not occur preferentially in regions with a high density of rare, human-specific variants. Together, these observations are difficult to reconcile with a model where excess base-sharing is driven by archaic legacies but instead provide support for a higher mutation rate inside Africa driving increased divergence from the ancestral human state.

The using of a neurally adjusted ventilatory assist in premature infants. Article

Introduction. The problem of choosing an adequate mode and parameters of mechanical ventilation (MV) in premature infants remains extremely important in neonatology. Objectives. To assess the effect of nerve-regulated MV on the gas composition of the blood, the concentration of malondialdehyde (MDA) and glutathione in premature infants. Materials and methods. The study included 46 premature infants who underwent MV from birth. The gestational age of children was 25-32 weeks, birth weight - 520-1100 grams. Two study groups were formed. The first group consisted of newborns with respiratory support in the Synchronized Intermittent Mandatory Ventilation (SIMV), the second group consisted of children who underwent Neurally Adjusted Ventilatory Assist (NAVA).At birth and during the first three days, the parameters of the gas composition of venous blood are measured: pH, pCO2, pO2, BE; lactate level. Concentrations of MDA and glutathione determine the first and seventh days of life. Results. In children of the first group, hypocapnia was observed during the first three days of life, while the minimum level of partial pressure of carbon dioxide (pCO2) was observed on the first day and amounted to 32.0 (24.9; 37.8) mm Hg. In patients of the second group, pCO2 indices were close to the reference ones and amounted to 36.0 (32.5; 42.2) mm Hg (p = 0.01).Indicators of excess base (BE) were reduced in patients in both groups and on the third day amounted to -6.4 (-7.4;-5.2) mmol/l in children of the first group and -4.7 (-6.0;-3.1) mmol/l in children of the second group (p = 0.02). No statistically significant differences in the partial pressure of oxygen (pO2), lactate, and glutathione were observed. Values of MDA were increased in patients of the first and second groups, however, a decrease in its concentration was observed in the dynamics in both groups. On the 7th day, in patients of the first group, the concentration of malondialdehyde decreased from 13.4 nmol/l to 12.0 nmol/l. In patients of the second group, its indices decreased twofold from the initial ones and amounted to 6.3 (5.4; 7.4) nmol/l (p = 0.01). Conclusion.The use of NAVA ventilation in premature infants ensures a constant gas composition of the blood, and also prevents the activation of lipid peroxidation resulting from hypoxia.

Biosorpsi logam Zn oleh biomassa Saccharomyces cerevisiae *) Biosorption of Zn metal by Saccharomyces cerevisiae biomass

SummaryHeavy metal in waste water potentiallycauses environmental pollution. Generally,heavy metal pollutions come from metalplating, textile, latex-rubber goods, and otherindustries. The process of latex-rubber goodindustries uses heavy metal in the form ofZnO as accelerator for rubber vulcanizationprocess, so that Zn 2+ ion exists in wastewatereffluents in concentration as much as 300 ppm,whereas the maximum limit allowed is 2.5 ppm.The chemical way generally used to decreaseZn 2+ concentration in wastewater effluents isby adding bases, NaOH or Ca(OH) 2 until pHreached 11, hence this metal is precipitated asits hydroxide. However, the way is done, isvery high cost and has a risk of the emergencesecondary pollution caused by excess base. Analternative way to absorb Zn 2+ consideredinexpensive is by using biosorbent in the formof Saccharomyces cerevisiae biomass frombioethanol industrial waste. The research wasconducted using artificial wastewater withZn 2+ ion concentration of 300 ppm and the pHwas adjusted to the range between 3-7.Biosorption was conducted by addition of freeS. cerevisiae biomass as well as byimmobilized cells on filter paper. Observationwas carried out for Zn 2+ concentration aftercontact time of two and five hours. The resultsof the research indicated that free andimmobilized S. cerevisiae biomass couldabsorb Zn 2+ metal and decreased itsconcentration from 250-300 ppm to 20-50 ppm.The optimum contact time was reached at onehour, while optimum sorption process occurredat pH 5. At low concentration, less than20 ppm S. cerevisiae biomass absorbed lessZn 2+ The NaOH-treated biomass showed bettersorption capabilities compared to cells treatedby formaldehyde or heat treatments. Thecontinue experiment showed the high capacityof biomass treated with NaOH to absorb Zn 2+ ,until concentration 24,02- 47,95 ppm in thefirst sampling and 1,15-10,99 ppm in thesecond sampling. Combination adsorptionprocess using charcoal and zeolite couldadsorp remain concentration of Zn 2+ , so thatcould reached the limit concentration-allowed.RingkasanLogam berat di dalam air limbahmerupakan penyebab pencemaran lingkunganyang potensial. Pencemaran logam berat padaumumnya berasal dari industri penyepuhanlogam, tekstil, barang jadi lateks, serta industrilain. Pada proses industri barang jadi lateksdigunakan logam berat dalam bentuk ZnOsebagai akselerator proses vulkanisasi karet,sehingga ion Zn 2+ terbawa dalam air limbahindustri barang jadi dengan konsentrasimencapai 300 ppm, sedangkan ambang bataskonsentrasi yang diperbolehkan maksimaladalah 2,5 ppm. Cara kimia yang umum di-gunakan untuk menurunkan kandunganZn 2+ dalam air limbah adalah dengan caramenambahkan basa, umumnya NaOH atauCa(OH) 2 , sampai pH sekitar 11, sehinggalogam berat ini diendapkan sebagai hidroksida-nya. Namun demikian, cara ini sangat mahaldan beresiko munculnya pencemaran sekunderakibat kelebihan basa. Salah satu alternatifyang murah untuk penyerapan Zn 2+ adalahmenggunakan biosorben berupa biomassaSaccharomyces cerevisiae yang berasal darilimbah pabrik bioetanol.Penelitian dilakukan dengan mengguna-kan air limbah artifisial yang mengandung ionZn 2+ dengan konsentrasi 300 ppm. Limbahartifisial diatur pHnya antara 3-7. Biosorpsidilakukan dengan menambahkan biomassaS. cerevisiae bebas maupun yang diamobilisasidengan kertas saring. Pengamatan dilakukanterhadap kandungan Zn 2+ setelah waktu kontakdua dan lima jam. Hasil penelitian menunjuk-kan bahwa biomassa S. cerevisiae bebasmaupun amobil mampu menyerap logam Zn 2+dan menurunkan konsentrasinya dari 250-300 ppm menjadi 20-50 ppm. Waktu kontakoptimum dicapai setelah satu jam, sedangkanproses sorpsi optimum terjadi pada pH 5.Biomassa S. cerevisiae kurang efektifmenyerap logam Zn 2+ pada konsentrasi rendah,di bawah 20 ppm. Perlakuan biomassa meng-gunakan NaOH menunjukkan kemampuanpenyerapan yang lebih baik jika dibandingkandengan yang diperlakukan menggunakanformaldehida dan pemanasan. Percobaan padaaliran kontinyu yang menggunakan biomassayang diperlaukan menggunakan NaOH,menunjukkan bahwa limbah artifisial Zn 2+dapat diturunkan sampai konsentrasi 24,02-47,95 ppm pada sampling pertama, dan 1,15-10,99 ppm pada sampling kedua. Kombinasipenyerapan menggunakan arang aktif danzeolit dapat menyerap sisa Zn 2+ mencapai batasyang diperbolehkan.

Biosorpsi logam Zn oleh biomassa Saccharomyces cerevisiae *) Biosorption of Zn metal by Saccharomyces cerevisiae biomass

SummaryHeavy metal in waste water potentiallycauses environmental pollution. Generally,heavy metal pollutions come from metalplating, textile, latex-rubber goods, and otherindustries. The process of latex-rubber goodindustries uses heavy metal in the form ofZnO as accelerator for rubber vulcanizationprocess, so that Zn 2+ ion exists in wastewatereffluents in concentration as much as 300 ppm,whereas the maximum limit allowed is 2.5 ppm.The chemical way generally used to decreaseZn 2+ concentration in wastewater effluents isby adding bases, NaOH or Ca(OH) 2 until pHreached 11, hence this metal is precipitated asits hydroxide. However, the way is done, isvery high cost and has a risk of the emergencesecondary pollution caused by excess base. Analternative way to absorb Zn 2+ consideredinexpensive is by using biosorbent in the formof Saccharomyces cerevisiae biomass frombioethanol industrial waste. The research wasconducted using artificial wastewater withZn 2+ ion concentration of 300 ppm and the pHwas adjusted to the range between 3-7.Biosorption was conducted by addition of freeS. cerevisiae biomass as well as byimmobilized cells on filter paper. Observationwas carried out for Zn 2+ concentration aftercontact time of two and five hours. The resultsof the research indicated that free andimmobilized S. cerevisiae biomass couldabsorb Zn 2+ metal and decreased itsconcentration from 250-300 ppm to 20-50 ppm.The optimum contact time was reached at onehour, while optimum sorption process occurredat pH 5. At low concentration, less than20 ppm S. cerevisiae biomass absorbed lessZn 2+ The NaOH-treated biomass showed bettersorption capabilities compared to cells treatedby formaldehyde or heat treatments. Thecontinue experiment showed the high capacityof biomass treated with NaOH to absorb Zn 2+ ,until concentration 24,02- 47,95 ppm in thefirst sampling and 1,15-10,99 ppm in thesecond sampling. Combination adsorptionprocess using charcoal and zeolite couldadsorp remain concentration of Zn 2+ , so thatcould reached the limit concentration-allowed.RingkasanLogam berat di dalam air limbahmerupakan penyebab pencemaran lingkunganyang potensial. Pencemaran logam berat padaumumnya berasal dari industri penyepuhanlogam, tekstil, barang jadi lateks, serta industrilain. Pada proses industri barang jadi lateksdigunakan logam berat dalam bentuk ZnOsebagai akselerator proses vulkanisasi karet,sehingga ion Zn 2+ terbawa dalam air limbahindustri barang jadi dengan konsentrasimencapai 300 ppm, sedangkan ambang bataskonsentrasi yang diperbolehkan maksimaladalah 2,5 ppm. Cara kimia yang umum di-gunakan untuk menurunkan kandunganZn 2+ dalam air limbah adalah dengan caramenambahkan basa, umumnya NaOH atauCa(OH) 2 , sampai pH sekitar 11, sehinggalogam berat ini diendapkan sebagai hidroksida-nya. Namun demikian, cara ini sangat mahaldan beresiko munculnya pencemaran sekunderakibat kelebihan basa. Salah satu alternatifyang murah untuk penyerapan Zn 2+ adalahmenggunakan biosorben berupa biomassaSaccharomyces cerevisiae yang berasal darilimbah pabrik bioetanol.Penelitian dilakukan dengan mengguna-kan air limbah artifisial yang mengandung ionZn 2+ dengan konsentrasi 300 ppm. Limbahartifisial diatur pHnya antara 3-7. Biosorpsidilakukan dengan menambahkan biomassaS. cerevisiae bebas maupun yang diamobilisasidengan kertas saring. Pengamatan dilakukanterhadap kandungan Zn 2+ setelah waktu kontakdua dan lima jam. Hasil penelitian menunjuk-kan bahwa biomassa S. cerevisiae bebasmaupun amobil mampu menyerap logam Zn 2+dan menurunkan konsentrasinya dari 250-300 ppm menjadi 20-50 ppm. Waktu kontakoptimum dicapai setelah satu jam, sedangkanproses sorpsi optimum terjadi pada pH 5.Biomassa S. cerevisiae kurang efektifmenyerap logam Zn 2+ pada konsentrasi rendah,di bawah 20 ppm. Perlakuan biomassa meng-gunakan NaOH menunjukkan kemampuanpenyerapan yang lebih baik jika dibandingkandengan yang diperlakukan menggunakanformaldehida dan pemanasan. Percobaan padaaliran kontinyu yang menggunakan biomassayang diperlaukan menggunakan NaOH,menunjukkan bahwa limbah artifisial Zn 2+dapat diturunkan sampai konsentrasi 24,02-47,95 ppm pada sampling pertama, dan 1,15-10,99 ppm pada sampling kedua. Kombinasipenyerapan menggunakan arang aktif danzeolit dapat menyerap sisa Zn 2+ mencapai batasyang diperbolehkan.