Development of a Prognostic Model for Stump Healing in Major Lower Limb Amputation among the Diabetic Population

Background: This study aimed to explore the effect of haematological markers as well as patient characteristics on stump healing in patients who underwent a lower limb amputation procedure. In addition, a practical model regarding factors that affected stump healing was developed. Methods: Patients who underwent a major lower limb amputation (above knee and below knee) at the Royal Infirmary of Edinburgh from the period of 2007 to 2010 were included in this study. A prognostic model utilizing backward stepwise logistical regression was developed to measure the probability of lower limb stump healing. The relationship between the dependent and independent variables was identified using univariate and multivariate logistic regression. Results: Three variables, namely serum sodium, serum creatinine and serum high density lipid cholesterol were identified which influenced stump healing. Patients with normal serum sodium were 75% more likely to have lower limb stump healing compared to that of patients with abnormal serum sodium (odds ratio [OR] 1.756; 95% confidence interval [CI] 1.048–2.942). Patients with normal serum creatinine were 66% more likely to have their stump healed (OR 1.664; 95% CI 0.94 to 2.946). The healing rate of patients with a normal level of serum high density lipid cholesterol was 75%, in contrast to patients with an aberrant level of serum high density lipids cholesterol (OR 1.753; 95% CI 1.061 to 2.895). The effectiveness of the retrospective stump-healing model was demonstrated by the area under the ROC curve (0.612), which was supported by the Hosmer and Lemeshow goodness-of-fit test (p = 0.879). Conclusions: Serum sodium, serum high density lipid cholesterol and serum creatinine have a strong correlation with lower limb stump healing. However, serum sodium and serum high density lipid cholesterol secondary to multiple co-morbidities in this cohort group could be altered secondary to disease pathology itself.

SYNERGISTIC EFFECT OF GINGER, PROPOLIS ADDED TO CONCENTRATED DIET ON SOME PRODUCTION AND PHYSIOLOGICAL CHARACTERISTICS OF THE AWASSI EWES

This study was aimed to find out the synergistic effect of ginger and propolis some productivity and physiological traits of Awassi ewes. The study was conducted in field the Department of Animal Production - College of Agriculture, University of Baghdad Al-Jaderia, during 14/01/2016 - 03/27/2016, using 12 Awassi ewes with ages from 9 -11 months old ,average weight of 31 kg, The results showed a significant increase in the glucose for concentration (P <0. 05) in the ginger group compared with other groups where .significant increase in the concentration of blood sugar(81.0 mg / 100 ml of blood) in the first month and continued to the second month,The level of cholesterol increase (65.90) in the second month of the group of ginger, triglycerides, Low-density lipid had significant increase in the group ginger , significant increase in propolis group with high density lipid (54.00) , total protein , albumin and GPT enzyme shows significant increased effect on the contrary GOT enzyme was increased significant in mixture group in the second month (13.00IU / liter), while the level of hemoglobin and the Packed cells volume and the total count of white blood cells and red blood cells did not show any significant differences(normal value ) , It can be conclude from this study that the addition of 25 g ginger to concentrated diet / head / day is the best treatment.

Initial Hypoalbuminemia and Hyperlipidemia Persist during Chronic Peritoneal Dialysis in Children

Objective To document serum lipid values in pediatric peritoneal dialysis (PD) patients, particularly the very young, and investigate relationships with serum albumin levels. Design Retrospective review of all PD patients seen in the first 11 years of the PD program at our institution. Patients and Methods Any pediatric PD patient was eligible for inclusion if at least four simultaneous measurements of serum lipids and albumin were recorded over a minimum of 90 days of PD. Results Thirty-nine continuous ambulatory peritoneal dialysis (CAPD) patients (9, aged <5 years) and 14 continuous cycling peritoneal dialysis (CCPD) patients (7, aged <5 years) were followed for 90–1200 days. Hypoalbuminemia, present In 43% of initial recordings, did not alter significantly during PD in any group; it was most marked in the CAPD <5 year (mean 30.7 g/L) and CCPD >5 year groups (mean 31.4 g/L). Average serum cholesterol levels were 27% higher, and triglyceride 122% higher, than the maximum accepted 18-year-old level and did not change significantly during PD. Similarly, 33% of high-density lipid recordings were below normal and remained unaltered during PD. Conclusions Our results confirm the high incidence of hypoalbuminemia, hypertriglyceridemia, and hypercholesterolemia and associated low levels of high density lipids, even in young PD patients, and demonstrate that these remain unchanged during PD. Such results have not previously been reported in PD patients as young as ours. Abnormal lipid profiles are a neglected cardiovascular risk factor in children with renal failure; therapeutic interventions should therefore be seriously considered.