Exudative Type Research Articles

Forest types matter for the community and co-occurrence network patterns of soil bacteria, fungi, and nematodes

Tree growth influences the biological, physical, and chemical properties of the soil through the input of different types of litter and various root exudates. However, our understanding of tree-mediated effects on the composition and diversity of soil biota remains limited. This study aimed to determine the effects of physically neighboring forest types (i.e., an artificial Japanese cedar (Cryptomeria japonica) plantation vs. a broadleaf (Quercus serrata) secondary forest) on individual bacterial, fungal, and nematode communities and the associations among these inter-kingdoms. Bacterial, fungal, and nematode aggregates were estimated using MiSeq high-throughput sequencing system. The amplicon sequence variant richness of fungi and nematodes was significantly greater in the cedar plantation than in the broadleaf forest, and the three soil biota community structures were significantly clustered among the forest types. Environmental factors such as soil pH, C, N, and C/N ratio significantly influenced the three soil biota community structures. The bacterial–fungal–nematode co-occurrence network of the broadleaf forest had more nodes and edges than that of the cedar plantation. Moreover, Ascomycota and Basidiomycota fungi mainly co-occurred with fungivorous nematodes in the cedar and broadleaf forests, respectively. Our results suggested that unique soil biota communities and characteristic co-occurrence network patterns were established among the tripartite inter-kingdom relationships between adjacent forest types.

Use of Melaleuca Essential Oil in Healing Pressure Injuries (LP): Case Series

To monitor and describe the healing process of pressure injuries (PI) grades I, II, III, and IV using tea tree essential oil (TTEO). A descriptive-exploratory study, using a multiple case study approach, was developed by monitoring patients with PI at different stages in a teaching hospital in the interior of Rio Grande do Sul, Brazil, from July to October 2021. The Bates-Jensen Wound Assessment Tool (BWAT) was used to assess wound characteristics. The study included 11 male patients hospitalized in the Intensive Care Unit (ICU) and the COVID-19 and clinical-surgical inpatient unit, with eleven PIs predominantly grade III in the sacral region. Regarding the characteristics evaluated by BWAT, a favorable progression in the lesions was observed in the following items when comparing the first and third days of TTEO use: peripheral skin color, exudate type, granulation tissue, wound edges, exudate amount, and epithelialization. However, an increase in scores was noted for necrotic tissue amount, undermining, necrotic tissue type, size, and depth, indicating regression in these aspects. The pharmaceutical formulations used in this study not only highlighted the benefits of TTEO in the healing process but also reinforced its advantages for being natural and more cost-effective compared to existing commercial formulations on the market.

Prevalence, Features, and Outcomes of Type 1 Neovascularization in Eyes with Angioid Streaks

This study aimed to delineate the characteristics, prevalence, and outcomes of neovascularization (NV), particularly aneurysmal Type 1 NV, in patients with angioid streaks (AS) secondary to pseudoxanthoma elasticum (PXE), and to introduce a clinical classification based on multimodal imaging (MMI). Retrospective longitudinal cohort study. 85 patients (168 eyes) with AS secondary to PXE at two tertiary referral centers. Data collection included demographic, medical, and ocular histories. Diagnostic methods comprised fundus photography, autofluorescence, indocyanine green angiography, optical coherence tomography (OCT), and OCT angiography. Prevalence of Type 1 NV, visual acuity (VA), risk of exudation. Type 1 NV was identified in 127 eyes (76%), with 85 of these (67%) showing exclusively Type 1 NV. These lesions often originated around the disc, at sites of Bruch's membrane dehiscences, and followed the path of AS, extending to the posterior pole in 101 eyes (80%). Despite 65% of Type 1 NV remaining non-exudative, 36% evolved into exudative over five years, and 11 eyes experienced mid-peripheral subretinal hemorrhages. Aneurysmal dilations, observed in 57% of cases, substantially increased exudation risk (hazard ratio = 3.86, p=0.02). Despite treatment, VA significantly deteriorated in exudative Type 1 NV (p=0.02). Type 2 NV, detected in 56 eyes (33%), often coexisted with Type 1 NV and was associated with poorer visual outcomes and higher rates of macular atrophy. A classification of AS was developed, ranging from empty AS (stage 0, no NV) to advanced NV (stage 3, both Type 1 and Type 2 NV). Type 1 NV predominates in AS. Although predominantly non-exudative, its progression correlates with substantial visual impairment, similar to the deficits observed with Type 2 NV. Aneurysmal Type 1 NV poses a significant exudation risk, underscoring the need for vigilant monitoring.

Association of Cytological and Biochemical Oarameters with Pleural Effusion in Patients attending a Tertiary Care Hospital of Western U.P.

Background: Pleural effusion is the pathological accumulation of fluid in the pleural space. This study was done to assess the association of cytological, biochemical, radiological and microbiological parameters in the evaluation of pleural effusion.Materials and Methods: Present study was done in Saraswathi Institute of Medical Sciences- OPD/IPD ofRespiratory Medicine department. As per the inclusion /exclusion criteria the study included 70 participants.Ethical clearance was taken before the commencement of study. Data was analyzed using SPSS software version 26.Majority of participants in present study were males. Majority belongs to age group 19-29 years with mean age was found to be 34.93 ± 12.99 years. Majority of patients had exudative type of pleural effusion. Lymphocyteswas found to be higher as compare to neutrophils and other cells in Tubercular cases than Non-TB cases. Similar findings were found in other studies too.Conclusion: The present study suggest that a high fluid ADA is a vital diagnostic tool and suggest its usage as a quick diagnostic method to diagnose Tuberculous Pleural Effusion

The Assessment of Pleural Effusion Using CT Pulmonary Angiography-A Review

Background: Pleural effusion is a common clinical presentation with various etiologies, including pulmonary embolism (PE), which remains underdiagnosed. The association between PE and pleural effusion, particularly the exudative type, necessitates a thorough understanding of the diagnostic role of computed tomography pulmonary angiography (CTPA). Objective: This review aims to elucidate the prevalence and characteristics of pleural effusions in PE patients and to evaluate the effectiveness of CTPA in the diagnosis of unilateral pleural effusions of unknown etiology. Methods: A systematic search across databases such as Google Scholar, PubMed, and NCBI yielded 39 articles, from which 20 met the inclusion criteria focused on the diagnostic utility of CTPA for unilateral pleural effusion. Studies were appraised for relevance to PE and pleural effusion, methodological rigor, and contribution to the field. Results: The review revealed that pleural effusions associated with PE typically present modestly and peak around the third day post-embolism. Persistent or late-onset effusions may suggest recurrent embolism or other pathologies. Contrast-enhanced CT demonstrated variable sensitivity and specificity in detecting malignant pleural effusions, suggesting the need for cautious interpretation and possible further invasive investigation. Conclusion: CTPA plays a critical role in the evaluation of pleural effusion, especially when PE is suspected. An integrated diagnostic approach, including pleural-phase thoracic CT, is recommended for patients with suspected malignant pleural effusions to improve clinical outcomes.

Can ultrasound shear wave elastography differentiate between malignant and benign pleural effusions?

BackgroundMalignant pleural effusion is a common and unfortunately serious condition that is related to life poor quality and mortality. The majority of malignant pleural effusion is metastatic in nature, with the most encountered primary neoplasm in men is the lung cancer while in women is the breast cancer. Ultrasound elastography, with its ability of evaluating tissue stiffness, has been used to differentiate malignant from benign diseases. Shear wave elastography (SWE) has been explored in several organs, like the liver, breast, thyroid, lymph nodes and prostate, with the pleura can now be included among the growing list of SWE applications. Shear wave elastography may help in the differentiation of transudative and exudative types of pleural effusions.ResultsIn this study, a total of 36 patients were included, 50% revealed malignant pleural effusions (10/18 mesothelioma) and (8/18 metastatic), while the 50% revealed benign pleural effusions (9/18 transudates) and (9/18 exudates). By using sensitivity analysis test of the SWE values with V1 represents the minimum value, V2 the maximum value to calculate the cutoff values that will be used in our final diagnosis in order to differentiate benign and malignant cases. V1 shear wave elastography can significantly predict the malignant pleural effusion with p value 0.001 using a cutoff 48 kPa with calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were as follows 94.4%, 88.9%, 89.5% & 94.4% respectively with diagnostic accuracy of 92%. SWE maximum value (V2) can significantly predict the malignant pleural effusion with p value 0.001 using a cutoff 54.2 kPa, with calculated sensitivity, specificity, PPV and NPV were as follows 94.4%, 94.4%, 94.4% and 94.4% respectively with diagnostic accuracy 94.4%. So, through comparing both cutoff values, we concluded that the cutoff value 2 is better with greater specificity, PPV and NPV in relation to the final diagnosis.ConclusionsCombination of both conventional transthoracic ultrasound and SWE quantitative and qualitative abilities in assessment of both pleural and parenchymal lesions can result in high diagnostic accuracy. Shear wave elastography alone is a sensitive, specific, useful, cost-effective, widely available and noninvasive tool for assessment of tissue stiffness and in matters of high sensitivity. 54.2 kPa can be used as the cutoff value to distinguish MPE from benign pleural disease.

Choroidal remodeling following different anti-VEGF therapies in neovascular AMD

The purpose of this study was to investigate choroidal morphology remodeling in AMD-associated type 1 macular neovascularization using two different anti-VEGF drugs. We registered 73 treatment-naïve eyes with a diagnosis of exudative AMD and type 1 MNV. Patients received 3 monthly intravitreal aflibercept (n = 36, aflibercept group [AG]) or brolucizumab (n = 37, brolucizumab group [BG]). Baseline best-corrected visual acuity (BCVA) and anatomical (structural optical coherence tomography) parameters were collected at “T1 control”, before the loading phase (LP) of intravitreal injection, and at “T2 control”, 1 month after the last injection. The main outcomes measured were choroidal vascularity index (CVI), sub-foveal choroidal thickness (SFCT), and central macular thickness (CMT). Our results displayed significant SFCT reduction in both groups between T1 and T2 (p < 0.05), We did not find choroidal vascularity modifications (p > 0.05) after the loading aflibercept injections. Moreover, only the BG displayed a significant choroidal remodeling (stromal choroidal area [SCA], total choroidal area [TCA] and CVI) at T2 (p < 0.05). In particular, a relevant stromal and total choroidal volume reduction was noted, accompanied by an increase in CVI. To conclude, the latter modifications of the choroidal morphology were found significant between two groups (p < 0.05). Our analysis showed a significant impact of brolucizumab on choroidal morphology in eyes affected by type 1 nAMD. This effect was found relevant when compared with aflibercept.

Effect of Brazilian green propolis in chronic ulcer treatment: a randomized clinical trial.

to assess the effectiveness of 5% Brazilian green propolis (ointment) in individuals with chronic ulcers. a randomized clinical trial, developed with 40 patients randomized equally to control group (treated with essential fatty acid) and experimental group (treated with 5% green propolis) for 30 days. The outcomes of interest were sociodemographic, clinical and laboratory characteristics, lesion characteristics, such as type of tissue in the bed, presence of exudate, edge characteristics, microbial content and pain. regarding sociodemographic, clinical and laboratory characteristics, the two groups did not show statistically significant differences. After assessment in 30 days, an effect was observed for both treated groups, but for the experimental group, greater effectiveness in terms of the type of tissue in the bed, type of exudate, edge characteristics, microbial content and pain. propolis-based ointment showed a healing effect, presenting itself as a potential tool in healing chronic ulcers.

Characterization of Markers in Blood Tests of Patients With Pleural Effusion and Their Correlation to Different Etiologies.

To investigate the etiology of pleural effusion, a variety of examinations are performed, including invasive ones: Thoracentesis is an invasive procedure to remove fluid or air from the pleural cavity for diagnostic or therapeutic purposes. Until now, there are no blood markers that can help us diagnose the type of pleural effusion without the need for pleural puncture or drainage. The aim of this study was to investigate the relationship and the utility of the new inflammatory markers taken from complete blood count (CBC) to differentiate between the various types of pleural effusion before the invasive procedure decision. This is an observational retrospective study. Data was collected from medical records of patients aged 18-90 admitted in Ziv Medical Center, Safed, Israel that were diagnosed with pleural effusion from 2013 to 2019. Of those patients, of whom inflammatory markers from blood counts and thoracentesis results were obtained, the outcomes were compared with the diagnosis type of pleural effusion. This study involved 391 patients, 256 suffered from exudate type effusion, their median age was 72 years, while 135 suffered from transudate effusion, their median age was 80 years. Those with exudate effusion had higher levels of CRP, platelets, neutrophils, and lymphocytes in blood, whereas those with transudate effusion had higher levels of MPV and RDW in blood. Other blood markers such as NLR and PLR were not statistically significant, but were also higher in the blood of patients with exudate effusion. An evaluation of simple and inexpensive measurements of blood count such as platelets, neutrophils, lymphocytes, MPV, RDW may provide insight into the etiology of pleural effusion.

Specific Features of Pulmonary Tuberculosis Patients Treatment with Interferon-Gamma Depending on the Nature of the Tissue Inflammatory Reaction

The objective: to evaluate effectiveness of treatment of infiltrative pulmonary tuberculosis patients with exudative or productive types of the tissue inflammatory reaction when additional immunotherapy with recombinant IFN-γ is used.Subjects and Methods. 127 infiltrative tuberculosis patients were enrolled in the study, of them 66 had an exudative type of the inflammatory reaction (2 Groups OG-1 and GS-1 were formed), 61 had a proliferative type (2 Groups OG-2 and GS-2 were formed). Patients from OG-1 and OG-2 Groups additionally received different regimens with recombinant interferon-γ.Result: Comprehensive treatment of infiltrative tuberculosis including intramuscular administration (according to a certain regimen) of recombinant IFN-γ contributes to achievement of pronounced positive changes of clinical and radiological symptoms in patients with both exudative and productive types of the tissue inflammatory reaction. In the groups treated with recombinant IFN-γ, restoration of the cellular immune response, cellular cooperation, normalization of the cytokine profile and increased phagocytosis activity were confirmed by the results of laboratory tests.

A STUDY OF CLINCOETIOLOGICAL PROFILE OF PATIENTS WITH PLEURAL EFFUSION: A CROSS-SECTIONAL STUDY

Objectives: The objective of this study was to determine the clinical profile, etiology in patients presenting with plural effusion and correlation between etiology, clinical, and radiological findings. Methods: It was a cross-sectional study carried out at the GRMC JAH Department of Medicine, Gwalior, from to July 2013 to October 2014 after getting the permission from the Institutional Ethical Committee. Inclusion criteria were all 100 patients above 14 years of age with clinical and radiological evidence of plural effusion. Patients with history of trauma chest and thoracocentesis were excluded from the study. The demographic variables were gender, age in years, sex, and address. The research variables were breathlessness, fever, cough, chest pain, generalized edema, abdominal pain, hemoptysis, and cause of pleural effusion. Investigations such as complete blood count, retained blood syndrome, renal function test, serum albumin, chest X-ray, pleural fluid analysis, ultrasonography chest and abdomen, echocardiogram, upper gastrointestinal endoscopy, blood culture, fine-needle aspiration cytology, and computed tomography scan. There were eight age groups between below 21 years and above 81 years. Nominal data were analyzed for frequency and (%) and the numeric data were analyzed by Chi-square test p-value. Results: In the present study, maximum cases (66%) presented with exudative type of pleural effusion. Of these 43 cases (65.15%) had tuberculosis, 5 cases (7.5%) had malignancy and 4 cases (6.06%) had pneumonia. About 34% cases presented with transudative type of pleural effusion. Of these 10 cases (29.41%) had hepatic involvement, and 8 cases (23.52%) had congestive cardiac failure. Acute febrile illness 9 (9%), nephrotic syndrome 4 (16%), renal failure 5 (5%), hypoalbuminemea 5 (5%), pancreatitis (1%), and adult respiratory distress syndrome (1%) were other causes of pleural effusion in this study.

Effects of diabetic retinopathy on longitudinal morphological changes in AMD-associated type 1 macular neovascularization

The purpose of this study was to investigate the effect of diabetic retinopathy (DR) on longitudinal morphological changes in AMD-associated type 1 macular neovascularization using optical coherence tomography angiography (OCTA). We enrolled fifty treatment-naïve eyes with a diagnosis of exudative AMD and type 1 MNV. Twenty of 50 eyes were affected by mild DR. En face OCT angiography were examined for the MNV lesion area (mm2), the MNV flow area (mm2), the central macular thickness (CMT) and the BCVA. The OCTA acquisition was performed at the following visits: (i) before the loading phase (LP) of intravitreal injection of aflibercept (T1), and (ii) 1 month after the last intravitreal injection of loading phase comprising 3 monthly injections (T2). All morpho-functional parameters showed a significantly change at T2 compared to T1 values in both groups. Furthermore, we found a greater MNV area reduction after LP in eyes without DR (P = 0.023). With regard to the remaining parameters, no significant changes were found between two groups (P > 0.05). Our analysis revealed a less MNV area reduction after loading dose of anti-VEGF therapy in eyes affected by diabetic retinopathy.

Evolution of connective glands reveals a new synapomorphy for Malpighiaceae and the hidden potential of staminal glands for Malpighiales systematics.

Connective glands are important morphological characters for the taxonomy of some genera of Malpighiaceae, with few recent studies having just elucidated these glands' anatomical and ecological functions. In order to test the systematic relevance of connective glands to the currently accepted phylogenetic informal clades of Malpighiaceae, we characterised the anatomy and/or histochemistry of two-thirds of Malpighiaceae genera and ten species from nine families of Malpighiales to test: 1. Do connective glands occur in the flowers of all informal clades of Malpighiaceae?; and 2. Are they taxonomically relevant to characterise those clades? We sampled 25 genera and 26 species of Malpighiaceae, processing their anthers using traditional anatomical methods and characterising their glands using light microscopy and SEM imaging. Selected species were subjected to histochemical tests, and an additional 21 genera and 33 species of Malpighiaceae and nine families (ten species) of Malpighiales were included in our sampling from the literature. Three anatomical characters were scored, coded and mapped using Maximum Likelihood methods onto the molecular phylogeny of Malpighiaceae. All sampled species of Malpighiaceae showed connective glands characterised as epidermal or trichomal elaiophores. Our character-mapping analyses recovered connective elaiophores as a new synapomorphy for Malpighiaceae. Different types of epidermal or trichomal elaiophores were recovered as homoplasies for the Christianella and Banisteriopsis clades and the genera Byrsonima, Camarea and Cottsia. Our analyses also recovered the glands' place of insertion in the stamen and the exudate type as potential new synapomorphies or homoplasies for the families of Malpighiales sampled. Our results propose the connective elaiophores as a new synapomorphy for Malpighiaceae and hypothesise the role that different staminal glands might play in the systematics of Malpighiales. Further comprehensive anatomical studies are still needed for the staminal glands of most families of this order to shed new light on the patterns recovered in our study.

Plant Hormone and Fatty Acid Screening of Nicotiana tabacum and Lilium longiflorum Stigma Exudates.

Pollen germination in vivo on wet stigmas is assisted by the receptive fluid-stigma exudate. Its exact composition is still unknown because only some components have been studied. For the first time, hormonal screening was carried out, and the fatty acid (FA) composition of lipid-rich (Nicotiana tabacum) and sugar-rich (Lilium longiflorum) exudates was studied. Screening of exudate for the presence of plant hormones using HPLC-MS revealed abscisic acid (ABA) in tobacco stigma exudate at the two stages of development, at pre-maturity and in mature stigmas awaiting pollination, increasing at the fertile stage. To assess physiological significance of ABA on stigma, we tested the effect of this hormone in vitro. ABA concentration found in the exudate strongly stimulated the germination of tobacco pollen, a lower concentration had a weaker effect, increasing the concentration did not increase the effect. GC-MS analysis showed that both types of exudate are characterized by a predominance of saturated FAs. The lipids of tobacco stigma exudate contain significantly more myristic, oleic, and linoleic acids, resulting in a higher unsaturation index relative to lily stigma exudate lipids. The latter, in turn, contain more 14-hexadecenoic and arachidic acids. Both exudates were found to contain significant amounts of squalene. The possible involvement of saturated FAs, ABA, and squalene in various exudate functions, as well as their potential relationship on the stigma, is discussed.

Pemanfaatan Gel Ekstrak Kulit Buah Mangga Arumanis (Mangifera indica L.) Sebagai Antiinflamasi Dengan Metode Kantong Granuloma Secara In-Vivo

In previous research, mango rind extract has been studied as an antioxidant, antihypertensive, and antidiabetic, because it contains flavonoids and 17% mangiferin compounds. In this research, the effect of arumanis mango rind extract gel (Mangifera indica L.) as an anti-inflammatory was tested in male white mice induced by carrageenan using the granuloma pouch method. This experimental study used experimental white male mice which were grouped into 5 groups: the control group, the group with 2% mango rinf extract, the group with 4% mango rind extract, the group with 8% mango rind extract, and the comparison group. The parameters that were analyzed were exudate volume, total leukocytes, and type of leukocytes on days 3, 5, 7. The results showed that mango arumanis (Mangifera indica L.) rind extract had anti-inflammatory effectiveness topically as indicated by a decrease in the average exudate volume, total leukocytes, and leukocyte cell types (segmented neutrophil cells and lymphocyte cells) in each concentration group of mango rind extract, based on two-way ANOVA test and Duncan's test showed significant differences with respect to concentration and time (p&lt;0.05). It can be concluded that all gel concentrations of arumanis mango rind extract (Mangifera indica L.) 2%, 4%, and 8% have anti-inflammatory effects.

Pendekatan Berbasis U-Net untuk Segmentasi Hard Exudate dalam Citra Fundus Retina

World Health Organization estimates that globally, 422 million adults over the age of 18 lived with diabetes in 2014. It is also supported by the World Diabetes Foundation estimates that more than 439 million people will be threatened with diabetes by 2030. One of the diseases caused by diabetes is diabetic retinopathy which can cause impaired vision to blindness. Damage to blood vessels and damage to the nerve fibers of the eye are called exudates, which are blood spots containing yellowish-colored fats that have an erratic shape. The types of exudates are divided into two, namely hard exudate and soft exudate. Soft exudate is also known as cotton wool spots and appears with a whitish color with less pronounced edges. While hard exudate occurs due to leakage of proteins and lipid vessels of the retina. The shape appears sharp and bright. To find out where the hard exudate is located in the retinal fundus image, experts or doctors are still looking manually, so it takes a long time to find out location of the hard exudate. Therefore, this research work, contributes to segmenting hard exudate using deep learning, which the method is U-Net. The final result of hard exudates segmentation using U-Net methods is validated with ground truth images by measuring accuracy, sensitivity, and specificity metric score. The results of hard exudate segmentation show for the U-Net metric score is 0.993, 0.454, and 0.997 respectively.

Effect of oxpecker’s interaction on wounds healing process in calves at Federal Uuniversity of Agriculture cattle production farm, Abeokuta Southwest Nigeria

This study investigated the role of oxpeckers in wound creation and healing in calves at the Cattle Production Venture of the Federal University of Agriculture, Abeokuta. Eleven calves with wounds out of twenty in the herd of 234 animals were randomly recruited for this study. Bates-Jensen wound assessment tool (BWAT) was used to assess the size, depth and edges of the wound, necrotic tissue type and tissue, exudate type and amount, skin colour surrounding wound, peripheral tissue edema and induration, granulation tissue and epithelialization to determine the severity. Descriptive statistics and ANOVA were used to analyse data obtained. Nine (81%) out of the 11 calves had more than one wounds. The score for all wounds decreased on day 15. The highest average score was 38.2 while the lowest was 17.8. The average score for each wound fell under wound status continuum. The highest percentage of reduction was 16.2% while the lowest was 0.9%. All wounds granulated at one stage or the other, except in one calf that did not throughout the study. Three calves had epithelialization above 75% on BWAT score of 2. At the termination of the study, 5 calves showed epithelialization of their wounds, 3 above 75% and 2 less than 50% while one wound did not epithelialize. In conclusion, wounds induced or exacerbated on calves by oxpeckers were under the status of continuum, and none neither regenerated nor degenerated. The activities of oxpeckers contributed to the delay in the wound healing process in the calves.

CLINICAL PROFILE OF ASCTES BASED ON PRESENTATION AND LABORATORY FINDINGS:AN INSTITUTIONAL EXPERIENCE FROM MAHARASHTRA,INDIA

Introduction: Ascites is the fluid collection in the potential space of the peritoneal cavity. Alcoholic liver disease and intra-abdominal malignancy are two major etiologies behind it. Also, diagnosis of tuberculous ascites should be thought of due to endemicity. Cirrhotic patients at any time during the course of disease, invariably present with ascites which is one of the marker of decompensation. In our context, etiology behind ascites and its correlation with symptoms and clinical findings not yet studied, so present study is conceptualised. Aim: To study clinical profile of ascites based on presentation and laboratory findings Methods: This is a cross-sectional retrospective descriptive hospital based record review of patients presented with ascites in a tertiary center of Maharashtra . One hundred fourteen patients with ascites under regular follow up of SMBT Hospital were reviewed. Data regarding presenting complaints, examination findings, relevant investigations during first visit and final diagnosis were retrieved from our own record keeping and recorded information were then evaluated. Results: Patients having ascites have myriad of symptoms and signs, commonest clinical feature being icterus (74, 64.9%). Most of them were anemic at presentation. Forty-two (36.8%) had high blood urea and 36 (31.5%) with high creatinine suggesting approximately 30-40% cases presented with deranged renal function test. Ninety-three (81.5%) had raised total serum bilirubin. Similarly, PT/INR derangements were in 74 (64.9%) and 57 (50%) suggesting deranged liver function. Serum albumin was less than 3.5 gram/decilitre in 83(72.8%) cases. Among the patients studied, 80 (70.1%) had high Serum-Ascites Albumin Gradient (SAAG) suggesting transudative type of ascites and rest 34 had low SAAG suggesting exudative type of ascites. Overall assessment revealed, majority of patients (71.05%) had Chronic liver disease (CLD) as the cause of ascites. Conclusions: Ascites due to chronic liver disease was the main finding with etiology supported by laboratory findings. Significant numbers of the patients had deranged renal function on top of liver function derangement, so these parameters need to be properly taken care of.

INFLAMMATION AS A FUNDAMENTAL PATHOLOGICAL PROCESS: LECTURE 1 (ALTERATION, VASCULAR REACTIONS)

Inflammation is the most widespread pathological process in medical practice. Inflammation is the basis of the vast majority of diseases. In this connection, the topic is actual for any medical student, as well as a doctor of any specialty. Local signs of inflammation (redness, swelling, heat, pain, dysfunction) were described more than two thousand years ago. Like any typical pathological process, inflammation includes protective and damaging reactions. Their knowledge is very important for understanding the pathogenesis of inflammatory diseases. The first part of the lecture describes the causes and mechanisms leading to the development of inflammation, as well as the consequences of tissue damage (acidosis, hyperonkia, hyperosmia, synthesis and release of inflammatory mediators). Inflammatory mediators are biologically active substances those regulate all reactions in the focus of inflammation. Various cells (neutrophils, macrophages, lymphocytes, endothelial cells, hepatocytes, etc.) can be sources of mediators. By origin, mediators are divided into cell-derived (biogenic amines, derivatives of arachidonic acid, lysosomal enzymes and reactive oxygen species, cytokines) and plasma-derived (components of the complement system, kinins and the hemostasis system). There are pro-inflammatory mediators (they increase inflammatory response) and anti-inflammatory ones. Under the influence of inflammatory mediators, changes in microcirculatory blood flow begin (vasospasm, arterial hyperemia, venous congestion, stasis) and exudation develops. Exudation is caused by an increase in the permeability of microvessels, its mechanisms are different. The composition of the exudate is determined by the cause of the inflammation and degree of tissue damage, the spectrum and amount of chemoattractants influence the type of exudate as well. The main types of exudates are serous, purulent, fibrinous, hemorrhagic, ichorous, catarrhal.

Pengaruh perawatan luka teknik modern dressing terhadap penyembuhan luka post operasi section caesarea

Inappropriate postoperative wound care measures often inhibit the wound healing process including the use of NaCl gauze compresses as an effort to maintain moisture can not be maintained longer so that the wound must be replaced more often, this phenomenon will have an impact on the re-injury of the wound bed which will stimulate re-inflammation of the wound bed. The use of antiseptics, such as 1% iodine and H2O2 in conventional treatments can trigger damage to blood capillaries, this will affect the stress conditions of tissues that are regenerating. The purpose of this study was to assess the condition of postoperative sectio caesarea wounds before modern wound dressing techniques were applied. The experimental design in this study used pre-experimental using one group pretest-posttest design. From the results of modern wound dressing treatment, the majority of the basic color of the wound was pink as many as 12 people (80%), the type of exudate did not exist as many as 15 people (100%), the amount of exudate was minimal as many as 15 people (100%), and the surrounding skin was healthy as many as 15 people (100%). After being analyzed, the resulting p value is 0.000 so it can be concluded that there is an effect of modern dressing technique wound care on postoperative sectio caesarea wound healing.