Decrease In Hematocrit Levels Research Articles

Effect of UMMB (urea molasses multi-nutrient block) based on coffee skin on erythrocytes, hematocrit and hemoglobin in transport stress of sheep

Transportation stress in livestock can be caused by distance and travel time, crowding in the transport vehicle, malnutrition during transportation, climatic conditions, lack of availability of food and drink and lack of handling during travel. The aim of providing coffee peel-based UMMB is to overcome nutritional deficiencies and stress in livestock during transportation. This research was carried out experimentally with a non-factorial completely randomized design (CRD) with 4 treatments K0 (without UMMB) as control, K1 (UMMB based on 10% fermented coffee peel), K2 (UMMB based on 20% coffee peel), K3 (UMMB based on fermented coffee peel 30%) and 4 repetitions. The research parameters are erythrocytes, hematocrit and hemoglobin. The results showed that administration of UMMB based on fermented coffee peel had a significant effect (P<0.05) on reducing erythrocyte levels (16.58%), decreasing hematocrit levels (18.30%) and decreasing hemoglobin levels (31.72%). The conclusion of this research is that administering coffee peel-based UMMB at a dose of 30% can reduce erythrocyte, hematocrit and hemoglobin levels in sheep transportation stress

Couvelaire Uterus: Point-of-Care Ultrasonography in the Diagnosis of an Uncommon Obstetric Emergency

Point-of-care ultrasonography (POCUS) is a key tool in critical care, including obstetric patients in intensive care units (ICUs). Point-of-care ultrasonography can aid in pregnancy diagnosis, fetal assessment, and detection of complications. This case study is based on a 39-year-old pregnant woman, admitted to critical care for preeclampsia. After cesarean delivery, the patient experienced decreased hematocrit levels, renal dysfunction, and uterine tenderness. The POCUS demonstrated uterine atony (inability of the uterus to contract after childbirth), leading to exploratory surgery that confirmed a Couvelaire uterus (CU). Hysterectomy was performed, and histology showed necrosis and bleeding. Couvelaire uterus is a rare complication of placental abruption, caused by placental vascular damage and uterine bleeding. Conservative management and uterine contraction-stimulating drugs are typically used to treat CU. In this case, POCUS provided real-time data for the diagnosis of this obstetric emergency and perhaps other conditions. This report underscores the significance of surveillance and prompt intervention to prevent adverse outcomes for both mothers and infants.

Clinical parameters for the early detection of complications in patients with blunt hepatic and/or splenic injury undergoing non-operative management.

Complications arising during non-operative management (NOM) of blunt hepatic and/or splenic trauma, particularly in cases of severe injury, are associated with significant morbidity and mortality. Abdominal computed tomography (CT) is the gold standard for the initial detection of complications during NOM. Although many institutions advocate routine in-hospital follow-up scans to improve success rates, others recommend a more selective approach. The use of follow-up CT remains a subject of ongoing debate, with no validated guidelines available regarding the timing, effectiveness, or intervals of follow-up imaging. We aimed to identify the clinical parameters for the early detection of complications in patients with blunt hepatic and/or splenic injury undergoing NOM. This retrospective cohort study included patients with blunt hepatic and/or splenic trauma treated at Songklanagarind Hospital, a level 1 trauma center, from 2013 to 2022. We assessed all patients indicated for non-operative management and examined their clinical parameters and complications. Of 542 patients with blunt hepatic and/or splenic injuries, 315 (58%) were managed non-operatively. High-grade hepatic injuries were significantly associated with complications, as determined through a multivariate logistic regression analysis after adjusting for factors such as contrast blush findings, age, sex, and injury severity score (ISS) (adjusted OR = 7.69, 95% CI 1.59-37.13; p = 0.011). Among the patients with complications (n = 27), 17 (63%) successfully underwent non-operative management. Notably, eight patients presented with clinical symptoms prior to the diagnosis of complications, while only two patients had no clinical symptoms before the diagnosis. Tachycardia, abdominal pain, decreased hematocrit levels, and fever were significant indicators of complications (p < 0.05). Routine CT to detect complications may not be necessary in patients with asymptomatic low-grade blunt hepatic injuries. By contrast, in those with isolated blunt hepatic injuries that are managed non-operatively, high-grade injuries, the presence of a contrast blush on initial imaging, and the patient's age may warrant consideration for routine follow-up CT scans. Clinical symptoms and laboratory observations during NOM, such as tachycardia, abdominal pain, decreased hematocrit levels, and fever, are significantly associated with complications. These symptoms necessitate further management, regardless of the initial injury severity, in patients with blunt hepatic and/or splenic injuries undergoing NOM.

Carbetocin versus Oxytocin with or without Tranexamic Acid for Prophylactic Prevention of Postpartum Hemorrhage after a Vaginal Delivery: A Randomized Clinical Trial

Objective: Our study’s primary objective was to examine the effects of four different prophylactic protocols on the prevention of postpartum hemorrhage following vaginal birth, including carbetocin only, oxytocin only, and a combination of carbetocin or oxytocin with tranexamic acid. Design: A multicentric randomized controlled trial. Participants/Materials, Setting, and Methods: This multicentric center prospective randomized controlled trial was conducted at the Department of Obstetrics and Gynecology of Bezmialem University and Van Health Teaching and Research Hospital from August 2022 to January 2023. The collected data included age, gravidity, parity, gestational age at birth, duration of delivery stages, prepartum hemoglobin and hematocrit concentrations, changes in hemoglobin and hematocrit concentrations, intrapartum blood loss, estimated blood loss after 2 h of vaginal delivery, Apgar scores at 1 and 5 min, birth weight, and neonatal intensive care unit (NICU) admission. Intrapartum blood loss was objectively measured in milliliters using a postpartum drape with a calibrated bag. The amount of bleeding was measured by subtracting the empty weight of the pads placed under the patient in the patient’s bed within 2 h after delivery. Group I: carbetocin 100 μg/mL (n = 75), group II: oxytocin 5 IU/mL (n = 75), group III: carbetocin and tranexamic acid 50 mg/mL (n = 75), group IV: oxytocin and tranexamic acid (n = 75). Results: The hemoglobin concentration decrease significantly differed between groups (1.03 ± 1.04, 1.3 ± 0.85, 1.4 ± 0.85, 1.41 ± 0.87, respectively; p < 0.001). Group 4 has the highest decrease in hemoglobin and hematocrit concentrations. When we investigated the subgroup differences, the decrease in hemoglobin concentration was significantly higher in group 2 than group 1 (1.30 ± 0.85 vs. 1.03 ± 1.04; p = 0.023), in group 2 than group 3 (1.3 ± 0.85 vs. 1.04 ± 0.9; p = 0.013), and in group 4 than group 3 (1.41 ± 0.87 vs. 1.04 ± 0.9; p < 0.001). The decrease in hematocrit level was significantly different between groups (3.07 ± 3.23, 3.55 ± 2.44, 2.13 ± 3.09, 4.25 ± 2.52; p < 0.001, respectively). No significant differences were observed in terms of mean blood loss between the four groups (277.19 ± 208.10, 294.13 ± 198.64, 274.33 ± 199.57, and 283.97 ± 178.11; p = 0.445, respectively). Furthermore, there was no significant difference between the groups in the rate of need for blood transfusion (1.3%, 5.4%, 4%, and 4%, respectively; p = 0.6). Limitations: The most important limitation of the study is a relatively small number of participants. Conclusion: In conclusion, our findings suggest that carbetocin may be more successful than oxytocin and oxytocin plus tranexamic acid regimens in terms of postpartum hemoglobin reduction, and there is no difference in terms of the need for blood transfusion when it is used for postpartum hemorrhage prophylaxis after vaginal delivery.

Common Infectious and Parasitic Diseases in Goats of Tropical Africa and their Impacts on Production Performance: A Review

Available scientific studies on goat diseases in tropical Africa are limited to specific regions or specific diseases. This study aimed to review scientific research findings on goat diseases in tropical Africa, focusing on their prevalence and impacts on production performance. All main diseases, such as parasitic, viral, and bacterial diseases, are included in the present study. Studies conducted in different countries have revealed high prevalence rates of gastrointestinal parasites exceeding 95%. These parasites resulted in growth retardation and reduced carcass weight at slaughter. Management of mites could decrease production and reproductive function. Trypanosomiasis led to decreased hematocrit levels, abortions, low birth weight, and high kid mortality. The prevalence of trypanosomiasis has been different across regions, ranging from 2.95% to 57.1%. Peste des Petits Ruminants has been reported in many African countries, causing significant outbreaks with seroprevalence rates ranging from 30% to 55%. Rift Valley fever was characterized by high mortality in adult goats (20-30%) and numerous abortions 2 weeks after infection, with seroprevalence rates ranging up to 25.8%. Contagious Caprine Pleuropneumonia indicated high morbidity (approximately 100%) and high mortality (80% to 100%), with prevalence ranging from 22% to 39% in abattoirs and from 35% to 52% in farms. Brucellosis did not affect the weight of infected animals but reduced litter size in goats and disrupts vital organs. This review highlights the extent of goat diseases in tropical Africa to determine the most appropriate prevention and control strategies.

Myocardial microstructure assessed by T1 mapping after on-pump and off-pump coronary artery bypass grafting.

The correlation between the release of cardiac biomarkers after revascularization, in the absence of late gadolinium enhancement (LGE) or myocardial edema, and the development of myocardial tissue damage remains unclear. This study sought to identify whether the release of biomarkers is associated with cardiac damage by assessing myocardial microstructure on T1 mapping after on-pump (ONCAB) and off-pump coronary artery bypass grafting (OPCAB). Seventy-six patients with stable multivessel coronary artery disease (CAD) and preserved systolic ventricular function were included. T1 mapping, high-sensitive cardiac troponin I (cTnI), creatine kinase myocardial band (CK-MB) mass, and ventricular dimensions and function were measured before and after procedures. Of the 76 patients, 44 underwent OPCAB, and 32 ONCAB; 52 were men (68.4%), and the mean age was 63±8.5 years. In both OPCAB and ONCAB the native T1 values were similar before and after surgeries. An increase in extracellular volume (ECV) values after the procedures was observed, due to the decrease in hematocrit levels during the second cardiac resonance. However, the lambda partition coefficient showed no significant difference after the surgeries. The median peak release of cTnI and CK-MB were higher after ONCAB than after OPCAB [3.55 (2.12-4.9) vs. 2.19 (0.69-3.4) ng/mL, P=0.009 and 28.7 (18.2-55.4) vs. 14.3 (9.3-29.2) ng/mL, P=0.009, respectively]. Left ventricular ejection fraction (LVEF) was similar in both groups before and after surgery. In the absence of documented myocardial infarction, T1 mapping did not identify structural tissue damage after surgical revascularization with or without cardiopulmonary bypass (CPB), despite the excessive release of cardiac biomarkers.

Intraamniotic digoxin administration versus intracardiac or funic potassium chloride administration to induce foetal demise before termination of pregnancy: a prospective study

Different foeticide techniques and pharmacological agents have been used to achieve foetal asystole. This study aimed to compare the success of intraamniotic digoxin, intracardiac potassium chloride (KCl), and funic KCl in achieving foetal asystole and discuss procedural difficulties for physicians and clinical outcomes. This prospective observational study included 124 patients who received foeticide at 22–31 weeks of gestation. All procedures were performed transabdominally, and 1 mg of intraamniotic digoxin, funic KCl, or intracardiac KCl was administered. Procedure times, procedural difficulty scores, patient pain scores, decrease in haematocrit levels, induction and hospitalisation times, and the presence of chorioamnionitis were recorded. The foeticide success rates were 93.0, 95.1, and 97.5% for intraamniotic digoxin, intracardiac KCl, and funic KCl, respectively. Intraamniotic digoxin was associated with shorter procedure times, lower procedural difficulty scores, and lower patient pain scores (p < 0.001). Decreases in haematocrit, induction times, and chorioamnionitis were similar in all three procedures. Success rates and clinical results were similar for all three procedures. Foeticide with intra-amniotic digoxin has a high success rate, the procedure is easier to perform, and patients experience less procedural pain. IMPACT STATEMENT What is already known on this subject? Different foeticide techniques and pharmacological agents have been used to achieve foetal asystole. Pharmacological agents used in the foeticide procedure can be injected as intracardiac, funic, intrafetal, or intraamniotic, and the most commonly used are potassium chloride (KCl), digoxin, and lidocaine. What do the results of this study add? The success rates and clinical outcomes in achieving foetal asystole are similar for intracardiac KCl, funic KCl, and intra-amniotic digoxin procedures. Foeticide with intra-amniotic digoxin is less difficult to perform, and patients experience less pain associated with the procedure. All three techniques appear to be safe and have similar short-term obstetric outcomes. What are the implications of these findings for clinical practice and/or further research? Physicians may prefer foeticide with intra-amniotic digoxin as the procedure is technically simpler and has similar success rates to intracardiac or funic KCl administration. A prospective randomised study could better compare the advantages and limitations of the foeticide techniques.

The Use of the Transfemoral Transcaval Liver Biopsy Technique for Biopsies of Hepatic Masses

The purpose of this study was to investigate the safety and effectiveness of the transfemoral transcaval (TFTC) liver biopsy technique in patients with hepatic masses with relative contraindications to percutaneous biopsy and/or mass location abutting the inferior vena cava. The medical records of 16 patients (56% men; age range, 21–88 years) who underwent TFTC biopsy of hepatic masses (ranging in diameter from 2.1 to 13.2 cm) from September 2015 to August 2021 were reviewed. Histopathologic diagnoses were made in 15 of 17 (88%) procedures. Two adverse events were noted: worsened preexisting hemobilia requiring embolization in 1 patient, and a decrease in hematocrit level in another patient, requiring only observation. In conclusion, this report showed that the TFTC technique is a relatively safe and effective method for sampling hepatic masses in select cases.

Evaluation of the safety of ethanolic extract from Piper amalago L. (Piperaceae) leaves in vivo: Subacute toxicity and genotoxicity studies

Piper amalago L. (Piperaceae) is traditionally used due to its anti-inflammatory, analgesic, diuretic, and antiparasitic properties. However, few studies have focused on its adverse effects, compromising its safe use. This study evaluated the toxicological safety of ethanolic extract from Piper amalago leaves (EEPA), through subacute toxicity and genotoxicity assays in rodents. In subacute toxicity, 100, 200 or 300 mg/kg of EEPA were tested in female Wistar rats, by gavage, for 28 days. For genotoxicity test, female Swiss mice were orally treated with 17.5, 175 or 1750 mg/kg of EEPA and the comet, micronucleus, and splenic phagocytic assays were evaluated. In subacute toxicity, the extract induced an increase in the food and water intakes, as well as in the liver absolute weight, and in the heart and kidney relative weights. EEPA also provoked alterations in histopathological analysis of liver and in hemato-biochemical parameters, evidenced by a decrease in hematocrit levels and albumin levels, and an increase in the number of platelets and in alkaline phosphatase and cholesterol levels. However, EEPA did not presented genotoxic nor mutagenic properties. EEPA showed hemato-biochemical toxicity profile in rats and should be used with caution, especially when for prolonged period.

Hematocrit Value in Diarrhea Patients

Diarrhea is the discharge of stool that is not normal or the form of watery stools with more frequency than usual. Diarrhea can be caused by various things, namely infectious and non-infectious. In acute diarrhea, complications can occur, including dehydration. On hematological.examination. of. diarrhea. patients,.there can be an increase in several blood tests such as an increase in hematocrit and hemoglobin in a state of severe dehydration. The. purpose. of. this. study. was. to. determine. the. hematocrit value in inpatient diarrhea patients at the Tonjong Public Health Center, Brebes Regency. This is a descriptive study using a non-probability sampling technique that relies on medical record data for 30 respondents at the Tonjong Public Health Center, Brebes Regency. The results showed that there were 3 men who had decreased hematocrit levels and 8 people who had normal hematocrit levels. Whereas in women, the hematocrit levels decreased as many as 17 people and those who had normal hematocrit levels were 2 people. Based on the age category, the most are the late elderly as many as 8 people and the final adults as much as 2 people. Meanwhile, based on the status of dehydration, all diarrhea patients who came for treatment at the Tonjong Health Center, Brebes Regency, 100% did not experience diarrhea with dehydration. The hematocrit levels in diarrhea patients at the Tonjong Public Health Center, Brebes Regency were 30 samples, on average they had low hematocrit levels.

The efficiency and safety of intravenous tranexamic acid administration in open reduction and internal fixation of pelvic and acetabular fractures.

This study aimed to investigate the efficiency and safety of tranexamic acid use in open reduction and internal fixation of pelvis and acetabulum fractures. 73 consecutive patients were included. 1000mg TXA was administered intravenously to all patients before surgery. The patients were evaluated on the basis of preoperative, postoperative first and third day hemoglobin-hematocrit values, amount of drainage collected, total blood loss, transfusion rates and complications. Mean operative time was 120.1min. Average decrease in hematocrit levels between preoperative and postoperative first day was 2.1g/dL. Average collected blood from the drain was 177mL. Mean total blood loss was 1137mL. Transfusion rate of the patients was 21%. Mean transfused units was 0.9 units. Three patients died within 3 weeks after the operation due to myocardial infarction, acute kidney failure and pneumonia. There were no cases of symptomatic venous or pulmonary thromboembolism during the 90days of follow-up. Use of TXA in pelvic and acetabular fractures was found to be effective in reducing total blood loss, hemoglobin drop and transfusion rates without increasing venous and pulmonary thromboembolism in our series.

Analysis of the Nutritional Status in Homeless People in Poland Based on the Selected Biochemical Parameters.

The aim of the study was to assess the nutritional status of adult homeless people using both anthropometric and biochemical measurements. The analysis comprised anthropometric indicators, i.e., body mass index and waist circumference, and the following biomarkers: red blood cells, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, white blood cells, complete lymphocyte count, neutrophils-to-lymphocytes ratio, platelets-to-lymphocytes ratio, platelets-to-leukocytes ratio, C reactive protein level, serum iron concentration, serum albumin concentration, total serum protein, fasting lipids and blood glucose level. There were representative Polish homeless people enrolled (n = 580). The analysis of the conducted studies proved that there is a greater frequency of overweight and obesity than underweight in the target population. The major problem was abdominal obesity that was present statistically more frequently in women than men (p < 0.001). In the majority of cases, homeless people were found to have normal complete blood count parameters. In obese people, there were statistically significant both elevated and decreased hematocrit levels, a significant decrease in red blood cells, elevated serum glucose, triglycerides and total protein level (p < 0.05). The presence of abdominal obesity, elevated glucose concentration, low-density lipoprotein cholesterol, and triglycerides, and decreased high-density lipoprotein cholesterol in serum together with smoking increase the risk of cardiovascular disease.

Peroxiredoxin II is essential for sustaining life span of erythrocytes in mice

AbstractPeroxiredoxins (Prxs) are a family of antioxidant proteins that reduce peroxide levels by using reducing agents such as thioredoxin. These proteins were characterized to have a number of cellular functions, including cell proliferation and differentiation and protection of specific proteins from oxidative damage. However, the physiological roles of the peroxiredoxins have not been determined. To clarify the physiological relevance of this protein type, we generated a mouse model deficient in Prx II, which is abundantly expressed in all types of cells. The Prx II–/– mice were healthy in appearance and fertile. However, they had splenomegaly caused by the congestion of red pulp with hemosiderin accumulation. Heinz bodies were detected in their peripheral blood, and morphologically abnormal cells were elevated in the dense red blood cell (RBC) fractions, which contained markedly higher levels of reactive oxygen species (ROS). The Prx II–/– mice had significantly decreased hematocrit levels, but increased reticulocyte counts and erythropoietin levels, indicative of a compensatory action to maintain hematologic homeostasis in the mice. In addition, a labeling experiment with the thiol-modifying reagent biotinylated iodoacetamide (BIAM) in Prx II–/– mice revealed that a variety of RBC proteins were highly oxidized. Our results suggest that Prx II–/– mice have hemolytic anemia and that Prx II plays a major role in protecting RBCs from oxidative stress in mice.

Whole blood platelet aggregation kinetics under cardiopulmonary bypass: A pilot study.

Assessing the platelets' functional status during surgery on cardiopulmonary bypass is challenging. This study used multiple electrode impedance aggregometry (Multiplate®) to create a timeline of platelet aggregation changes as induced by cardiopulmonary bypass in antiplatelet-naive patients undergoing elective surgery for mitral valve regurgitation. We performed six consecutive measurements (T1: pre-operatively, T2: after heparinization, T3: 3 min after establishment of cardiopulmonary bypass, T4: immediately after administration of cardioplegia, T5: 5 min after administration of cardioplegia, and T6: 45 min after administration of cardioplegia). Platelet aggregation was determined after stimulation with 3.2-μg/mL collagen, 6.4-μM adenosine diphosphate, and 32-μM thrombin receptor activating peptide. Five patients were included (age: 64 ± 10 years, one female). We observed a decrease in hematocrit levels by -17.1% ± 3.7% (T1 vs T6) with a drop after establishment of cardiopulmonary bypass (T2 vs T3) and slightly decreasing platelet counts by -6.2% ± 7.7% (T1 vs T6). Immediately after establishment of cardiopulmonary bypass (T2 vs T3), we observed reduced platelet aggregation responses for stimulation with adenosine diphosphate (-19.7% ± 12.8%) and thrombin receptor activating peptide (-19.3% ± 6.3%). Interestingly, we found augmented platelet aggregation for all stimuli 45 min after administration of cardioplegia (T5 vs T6) with the strongest increase for collagen (+83.4% ± 42.8%; adenosine diphosphate: +39.0% ± 37.2%; thrombin receptor activating peptide: +34.5% ± 18.5%). Thus, after an initial drop due to hemodilution upon establishment of cardiopulmonary bypass, platelet reactivity increased over time which was not outweighed by decreasing platelet counts due to mechanical platelet destruction and absorption. These findings have implications for rational transfusion, peri-operative antiplatelet therapy, and for the management of patients on other extracorporeal support, such as extracorporeal life support or extracorporeal membrane oxygenation.

The effect of anemia severity on postoperative morbidity among patients undergoing laparoscopic hysterectomy for benign indications.

One-third of non-pregnant women worldwide are anemic.1 Anemia is a known independent risk factor for postoperative morbidity.2 Given that the vast majority of hysterectomies are not performed in the emergency setting, we designed this study to evaluate the effect of preoperative anemia on postoperative morbidity following laparoscopic hysterectomy performed for benign indications. Our main goal is to encourage surgeons to use anemia-corrective measures before surgery when feasible. Retrospective cohort study of 98813 patients who underwent a laparoscopic hysterectomy between 2005 and 2016 for benign indications identified through the American College of Surgeons National Surgical Quality Improvement Program. Anemia was examined as a function of hematocrit and was analyzed as an ordinal variable stratified by anemia severity as mild, moderate or severe. Associations between preoperative anemia and patient demographics, preoperative comorbidities and postoperative outcomes were evaluated using univariate analyses. Multivariable logistic regression models were used to identify independent associations between hematocrit level and postoperative outcomes after adjusting for confounding covariates. At the multivariable logistic regression level, anemia severity was analyzed using hematocrit as a continuous variable to assess the independent association between each 5% decrease in hematocrit level and several postoperative morbidities. Of the 98813 patients who met our inclusion and exclusion criteria, 19.5% were anemic. A lower preoperative hematocrit was associated with higher body mass index, younger age, Black or African American race, longer operative times, and multiple other medical comorbidities. After appropriate regression modeling, anemia was identified as an independent risk factor for extended length of stay, readmission and composite morbidity after surgery. Preoperative anemia is common among patients undergoing laparoscopic hysterectomy. Preoperative anemia increases patients' risk for multiple postoperative comorbidities. Given that most hysterectomies are performed in the elective setting, gynecologic surgeons should consider the use of anemia-corrective measures to minimize postoperative morbidity.

Hematocrit Changes as Parameters for Giving Mannitol in Severe Head Injury

ABSTRACT&#x0D; Introduction. Incidence of head injuries is also quite high in Indonesia, around 1.4 million cases per year with a mortality rate of 15-20% in the population aged 5 to 35 years. Head injuries are commonly divided into two separate time periods namely primary and secondary brain injuries. Primary brain injury is physical damage to the parenchyma (tissue and blood vessels) that occurs during a traumatic event, thus causing compression of the surrounding brain tissue. Secondary brain injury is a continuation of the results of primary brain injury with the main complications of brain injury in the following hours and days. This study was aimed to asses the benefits of administration of mannitol in cases of severe head injury in South Sumatra, Indonesia.&#x0D; Methods. This research was a clinical trial without comparison by looking at hematocrit levels in patients with severe head injuries with intracranial hypertension before and after given mannitol therapy. Data analysis was performed with IBM SPSS Version 23. Data was presented in the form of narrative tables. Then the paired T test was performed. P value &lt;0.05.&#x0D; Results. From 39 research subjects, the age of the subjects ranged between 6-88 years with an average of 33 years. Based on sex there were 28 male sufferers (71.8%) and there were 11 female sufferers 28.2%. GCS varies from 3 to GCS 8 intra-cranial abnormalities. From 39 research subjects with severe head injury without surgery, a hematocrit examination was performed before, after 10 minutes and 6 hours of injection of mannitol bolus 1 g / kg body weight. It was obtained that averaged hematocrit before mannitol administration was 34, after 10 minutes was 33 and after 6 hours was 35.&#x0D; Conclusion. There is a decrease in hematocrit levels after administration of bolus mannitol 1 g / kg BW at the beginning of mannitol administration and hematocrit will increase again after 6 hours of mannitol administration

Bringing Packed Red Blood Cells to the Point of Combat Injury: Are We There Yet?

ObjectiveHemorrhage is the leading cause of injury-related prehospital mortality. We investigated worst-case scenarios and possible requirements of the Turkish military. As we plan to use blood resources during casualty transport, the impact of transport-related mechanical stress on packed red blood cells (PRBCs) was analyzed.Materials and MethodsThe in vitro experiment was performed in the environmental test laboratories of ASELSAN®. Operational vibrations of potential casualty transport mediums such as Sikorsky helicopters, Kirpi® armored vehicles, and the NATO vibration standard MIL-STD-810G software program were recorded. The most powerful mechanical stress, which was created by the NATO standard, was applied to 15 units of fresh (≤7 days) and 10 units of old (>7 days) PRBCs in a blood cooler box. The vibrations were simulated with a TDS v895 Medium-Force Shaker Device. On-site blood samples were analyzed at 0, 6, and 24 h for biochemical and biomechanical analyses.ResultsThe mean (±standard deviation) age of fresh and old PRBCs was 4.9±2.2 and 32.8±11.8 days, respectively. Six-hour mechanical damage of fresh PRBCs was demonstrated by increased erythrocyte fragmentation rates (p=0.015), hemolysis rates (p=0.003), and supernatant potassium levels (p=0.003) and decreased hematocrit levels (p=0.015). Old PRBC hemolysis rates (p=0.015), supernatant potassium levels (p=0.015), and supernatant hemoglobin (p=0.015) were increased and hematocrit levels were decreased (p=0.015) within 6 h. Two (13%) units of fresh PRBCs and none of the old PRBCs were eligible for transfusion after 6 h of mechanical stress.ConclusionWhen an austere combat environment was simulated for 24 h, fresh and old PRBC hemolysis rates were above the quality criteria. Currently, the technology to overcome this mechanical damage does not seem to exist. In light of the above data, a new national project is being performed.

HEMATOLOGICAL PARAMETERS AND BODY COMPOSITION OF SOCCER PLAYERS

ABSTRACT Introduction: Soccer players may experience hematological changes that could be detrimental to their health status. In addition, inadequate body composition may impair performance. Objective: To assess body composition and hematological changes over a year in soccer players. Methods: A retrospective observational study was conducted. Age, weight, height, body composition, blood count, serum iron, serum ferritin, serum transferrin and total iron binding capacity data were collected from the athletes’ medical records in the months of January, May and August of 2015 and January of 2016. Body mass index was also calculated. For the statistical analyses, the Anova and post-hoc Tukey’s post-hoc tests were used for the quantitative variables and the Chi-square test for the qualitative variables. The significance level adopted was p&lt;0.05. Results: Data were evaluated for 51 athletes with a mean age of 23.53 ± 3.11 years, 77.10 ± 6.56 kg, 1.80 ± 0.07 and 15.6 ± 2.89% body fat (BF). We observed significant (p&lt;0.05) changes in mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, cell size and eosinophils during the period evaluated. Among the athletes, 21.6% had decreased hematocrit levels and 3.9% had hemoglobin levels below the reference range. A BF% greater than 16% was significantly related to serum iron depletion (p = 0.01). Conclusion: Small significant hematological changes during the competitive year were observed, but without significant changes in body composition. Level of Evidence III; Study of nonconsecutive patients; without consistently applied reference ‘‘gold’’ standard.

Protective effect of Solanum tuberosum against the breakdown of red blood cells: an experimental study in burn injury model

Introduction: Anemia is known to be an important problem in burn injury. We aimed to investigate the protective effect of Solanum tuberosum (potatoes), against abnormal breakdown of erythrocytes in burn injury.Methods: Ninety-six male (9 to 10 weeks old) Swiss Albino mice (34–40 g) were included into the study, which consisted of two phases: dose optimization phase (n = 48) and study phase (n = 48). Half of the mice were given S. tuberosum juice (study group) and the other half drinking water (control group). The optimal dosage causing minimum decline in hematocrit was as follows: 1.6 mL/kg at 0 h, 0.8 mL/kg at 24 hours, and 0.8 mL/kg at 36 hours of burn injury. The burn injury was induced with a solid 10-mm aluminum bar heated in boiling water.Results: The decrease in hematocrit level was significantly lower in the study group than the control group at 24 and 48 hours (P = 0.05 and P = 0.023, respectively). The increase in anisocytosis, a hemolytic anemia sign, was also significantly lower in the study group than the control group at 48 hours (P = 0.021). There was no significant difference between groups in terms of clotting time or the bleeding time.Conclusion: In burn injury, S. tuberosum may be beneficial against anemia and it may reduce the need for red blood cell transfusion.

Peran Penambahan Misoprostol pada Penatalaksanaan Aktif Kala Tiga dalam Menurunkan Perdarahan Pasca Persalinan

Background: Postpartum haemorrhage is the leading cause of maternal mortality in both developed and developing countries, which is almost 80 % due to the failure of the uterus to contract. Misoprostol is a powerful uterotonic agent used as an alternative in preventing postpartum haemorrhage. Objective: The purpose of this study was to determine whether administration of misoprostol adjunctive therapy in active management of the third stage of labor influenced postpartum blood loss. Method: This study was a non-blinding randomized controlled trial that divided subjects into two groups. The treatment group was the group who received misoprostol 600 mcg orally for adjunctive treatment in active management of the third stage of labor and the control group did not receive misoprostol, each group also got routine oxytocin 10 IU intramuscularly. Both group were assessed of the number of blood loss in the fourth stage of labor, decreased levels of hemoglobin and hematocrit within 24 hours after delivery. Chi square test was conducted to determine the strength of the relationship between the two groups. Result and Discussion: The study recruited 104 subjects, there were significant difference for the mean number of blood loss in the fourth stage of labor and the decrease in hemoglobin levels within 24 hours of postpartum between treatment and control group (OR 2.45; 95% CI 1.05-5.71, p=0.04), (OR 2.99; 95% CI 1.26-7.11, p=0.01). The mean of the decreasing hematocrit levels was statistically not significant between the two groups (OR 0.87; 95% CI 0.38-1.99, p=0.75). Conclusion: The addition of misoprostol to the routine active management of the third stage of labor was statistically significant to decrease amount of postpartum blood loss. Keywords: misoprostol, active management of the third stage of labor, postpartum blood loss, postpartum hemorrhage.