Finger Blood Research Articles

Effect of Aging on Muscle-Pump Baroreflex of Individual Leg Muscles During Standing.

Activation of leg muscles is an important component in the regulation of blood pressure during standing, failure of which could result in syncope and falls. Our previous work demonstrated baroreflex mediated activation of leg muscles (muscle-pump baroreflex) as an important factor in the regulation of blood pressure during standing; however, the effect of aging on the muscle-pump baroreflex of individual leg muscles during standing remains to be understood. Here, the interaction between systolic blood pressure (SBP) and the activation of lateral gastrocnemius (LG), medial gastrocnemius (MG), tibialis anterior (TA), and soleus (SOL) muscles during standing was quantified. Beat-to-beat heart period (RR interval), SBP, electromyography impulse (EMGimp) were derived from continuously acquired electrocardiography, finger blood pressure, and calf-electromyography, respectively. The cardiac baroreflex (SBP→RR) causality (0.88 ± 0.08 vs. 0.94 ± 0.03, p = 0.01), percent time with significant coherence (%SC: 50.95 ± 23.31 vs. 76.75 ± 16.91, p = 0.001), and gain (4.39 ± 4.38 vs. 13.05 ± 8.11, p < 0.001) was lower in older (69 ± 4 years) compared to young (26 ± 2 years) persons. Muscle-pump baroreflex (SBP→EMGimp) causality of LG (0.81 ± 0.08 vs. 0.88 ± 0.05, p = 0.01) and SOL (0.79 ± 0.11 vs. 0.88 ± 0.04, p = 0.01) muscles was lower in older compared to young persons. %SC was lower for all muscles in the older group (LG, p < 0.001; MG, p = 0.01; TA, p = 0.01; and SOL, p < 0.001) compared to young. The study outcomes highlighted impairment in muscle-pump baroreflex with age in addition to cardiac baroreflex. The findings of the study can assist in the development of an effective system for monitoring orthostatic tolerance via cardiac and muscle-pump baroreflexes to mitigate syncope and falls.

Validation of finger blood pressure monitoring in children.

Continuous beat-to-beat blood pressure monitoring permits the rapid detection of blood pressure fluctuations for cardiovascular reflex testing and clinical haemodynamic monitoring. In adults, this can be achieved noninvasively with high accuracy, using finger blood pressure monitoring with volume clamp photoplethysmography. However, data are lacking on the validity of finger blood pressure monitoring in children compared to the gold standard - invasive intra-arterial blood pressure monitoring. We aimed to evaluate the accuracy of novel noninvasive index and middle finger arterial pressure (FinAP) measurements in children. Using prototype paediatric finger cuffs, we compared: mean differences, bias and limits of agreement (Bland-Altman analyses); cumulative percentage differences [clinical grade A-D (based on the percentage of heartbeats in agreement with the standard)]; and waveform morphology (regression analysis and smoothing) between both raw FinAP (Finapres NOVA) and reconstructed finger-brachial arterial pressure (reBAP) compared to intra-arterial blood pressure measurements. Eighteen children were tested (aged 3-13 years; 12 male), with data from 13 included in the analysis. The bias for reBAP for the middle finger was 1.8±6.9, 0.3±6.1 and 0.4±5.3 mmHg for systolic, diastolic and mean arterial pressure, with clinical grades of C, B and A, respectively. reBAP improved numerical accuracy, but reduced waveform morphological agreement. Middle finger arterial measurements with waveform reconstruction provide an acceptable surrogate for invasive intra-arterial recording in children. Finger blood pressure monitoring is a novel comfortable, convenient and accurate alternative approach for noninvasive beat-to-beat blood pressure monitoring in children.

Anti-disturbance Fetal Heart Rate System Based on Combined Maternal-fetal Monitoring

The existing fetal monitor is prone to false detection in the case of high maternal interference in the second stage of labor. With this background, the article designs and implements a combined maternal-fetal fetal heart monitoring system. The system obtains the Doppler signal of the abdominal fetal heart and the blood oxygen signal of the mother's finger, and estimates the maternal interference degree in the fetal heart rate Doppler signal according to the maximum correlation value between the maternal finger blood oxygen signal and the abdominal fetal heart Doppler signal, and switches the fetal heart rate extraction algorithm between the autocorrelation method suitable for lower interference and improved template method suitable for higher interference according to the maternal interference degree. The accuracy of our method is 9.2% which is higher than that of the improved template matching method and 6.1% higher than that of the autocorrelation method.

SUN-126 Discordantly High Hemoglobin A1c Caused by Hemoglobin Wayne Variant

Background: The Hemoglobin A1c is a commonly test used for the diagnosis of diabetes mellitus. It does not require fasting and can be drawn at any time of day, making it more convenient for providers to use as compared to the fasting plasma glucose and the oral glucose tolerance test. Certain pitfalls exist in the use of its measurement. We present a case of a patient who had a falsely elevated HbA1c as a result of an uncommon hemoglobin variant interfering with the measurement. Clinical Case: A 55-year-old Caucasian male was diagnosed with type 2 diabetes mellitus based on A1c value of 10%. He was started on metformin 500 mg twice daily. He subsequently lost 40 pounds through lifestyle modifications. His blood glucose log showed excellent glycemic control with both fasting and pre-prandial blood glucose values mostly running between 80-120 mg/dL. However, his repeat Hb-A1c was 10.5% and 10% three and eight months later using high performance liquid chromatography (HPLC) method. This did not correlate with his current finger blood glucose level. Therefore, he was referred to our clinic for further management. He did not report any hypoglycemic episodes. There was no history of microvascular or macrovascular complications. Basic metabolic panel showed random blood glucose of 98 and a normal creatinine of 0.9 with GFR of > 60. Liver function tests, fasting lipid and CBC were all within the normal range. Serum folic acid, vitamin B12 level and iron studies were also normal. GAD-65 autoantibody and anti-pancreatic islet cell antibodies were negative. Due to the discrepancy between the A1c and the blood glucose levels, more testing was done including Serum fructosamine level which was 224 (0-285) and Hemoglobin electrophoresis. Hemoglobinopathy panel showed Hb-variant consistent with Hb-Wayne. Pattern and concentrations consistent with heterozygous hemoglobin Wayne. He also had a 7 day Continuous glucose monitoring done which showed a Blood glucose average of 95. Repeat Hb-A1c using baronate affinity method was 5.3%. Conclusion: Hemoglobin A1c is a convenient and reliable test for diagnosis of diabetes mellitus and to monitor the impact of management. However, in patients with hemoglobin Wayne variant, there is an overestimation of A1c because of an amino acid substitution that confers a similar charge to A1c. An increased awareness is needed about different Hemoglobin variants which can affect the A1c result. Alternate methods to assess glycemic control will be needed in these cases.

The influence of microgravity on cerebral blood flow and electrocortical activity.

Changes in gravity conditions have previously been reported to influence brain hemodynamics as well as neuronal activity. This paper attempts to identify a possible link between changes in brain blood flow and neuronal activity during microgravity. Middle cerebral artery flow velocity (MCAv) was measured using Doppler ultrasound. Brain cortical activity (i.e., cortical current density) was measured using electroencephalography. Finger blood pressure was recorded and exported to generate beat-by-beat systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), and cerebrovascular conductance index (CVCi). Seventeen participants were evaluated under normal gravity conditions and microgravity conditions, during 15 bouts of 22-s intervals of weightlessness during a parabolic flight. Although MAP decreased and CO increased, MCAv remained unchanged in the microgravity condition. CVCi as the quotient of MCAv and MAP increased in microgravity. Cortical current density showed a global decrease. Our data support earlier data reporting a decrease in the amplitude of event-related potentials recorded during microgravity. However, the general decrease in neural excitability in microgravity seems not to be dependent on hemodynamic changes.

Skipping breakfast and non–high-density lipoprotein cholesterol level in school children: a preliminary analysis

ObjectiveThe objective of the study is to examine whether the increased levels of non–high-density lipoprotein cholesterol (non-HDL-c) are associated with skipping breakfast among school children. Study designA cross-sectional survey was conducted among 539 school children aged 8–12 years from the Niagara Region of Canada. MethodsNon-fasting finger blood was taken for total cholesterol (total-c) and HDL-c measurements. Non-HDL-c was calculated as the difference between total-c and HDL-c. The information of skipping breakfast in a week was obtained from a questionnaire, which was categorized into three groups, i.e., none, 1–3 times and 4 + times. Demographic information and other related variables were described by the three breakfast-skipping groups. ResultsApproximately 44% of children (n = 182) reported skipping breakfast. There were significant differences between the three groups in the means of total-c, non-HDL-c, body mass index, waist circumference, proportions of overall health excellent, eating dinner with parent and skipping breakfast that affects learning (P < 0.05). The number of days of skipping breakfast was weakly correlated to the level of non-HDL-c (r = 0.145, P < 0.0001). Multiple regression results indicated that every one more time of skipping breakfast would increase approximately 0.05 mmol/L level of non-HDL-c (P < 0.01), on average, after adjusting for those aforementioned potential confounding variables. The adjusted mean levels of non-HDL-c were 2.77, 2.94 and 3.07 mmol/L for none, skipping 1–3 times and skipping 4 + times of breakfast, respectively; the mean differences between none and the other two groups were statistical significant (P < 0.05). ConclusionNon-HDL-c levels is positively associated with the number of skipping breakfast among school children, and further research is needed to confirm this relationship.

Community Behavior towards Filariasis Mass Drug Administration in Tegaldowo Village, Pekalongan Distsrict, Indonesia

Mass drug administration (MDA) is a strategy to reduce lymphatic filariasis (LF) transmission, and finally eliminate it. This study aimed to identify community behavior towards MDA and the role of elimination officer in MDA campaign. This was a descriptive cross-sectional study conducted in Tegaldowo village, Pekalongan District (an endemic area of LF). Study subject consisted of 100 persons. LF was detected by ICT filariasis using finger blood. The result most of the subjects were female, who did not go to school, worked as laborer, and married. Prevalence of filariasis was 7.0%. Most subjects had good knowledge toward MDA and received drugs during MDA. Among subjects who received drugs, only 8.6% refused to take the drugs due to breastfeeding. Adverse reaction was also the case in Tegaldowo, 40, 0% subjects experienced adverse reaction after taking the drugs. Less than half cadres had good performance as elimination officers/drug distributors. Most of the subject gained information about MDA from health officers (34.4%). However, nearly half (43.0%) of subjects admitted they did not receive any information about MDA. This study concluded the prevalence of filariasis in Tegaldowo Village has not met WHO target. Factor that may be associated with the coverage of mass drug administration was lack of MDA campaign.

Assessing Inflammatory Status of Pulp in Irreversible Pulpitis Cases with Pulse oximeter and Dental Hemogram.

Objective: This study evaluated pulse oximetry and dental hemogram in teeth with the clinical diagnosis of irreversible pulpitis (IP) to assess the inflammatory status of the pulp. Study design: The study and control groups (30n each) had teeth with IP and sound teeth respectively. Patients in the study group had night pain with or without pain on mastication (NM, N). Blood oxygen saturation (%SpO2) was recorded with a custom made pulse oximeter (CPO). For dental and peripheral hemogram, smears were made for each patient from the first drop of blood while entering the pulp and finger blood respectively. Results: Control group had mean %SpO2 in finger 91% (86-97); and in teeth 84% (80-91), while the study group had mean %SpO2 in finger 92% (88-98) and in teeth 83% (71-94). Fifty percent of IP cases were vital while no tooth showed necrosis according to CPO which was further confirmed by bleeding status from the pulp. Based on the findings of the clinical diagnosis, %SpO2 and bleeding status of IP and normal cases, the terminology as coronal or total pulpitis seems more appropriate. The statistical difference was significant in fingers while non-significant in teeth of IP and normal pulp cases. Dental hemogram of IP cases showed an overall significant fall of neutrophil, lymphocyte, eosinophil and monocyte counts compared to normal. Conclusion: Pulse oximetry was the most accurate pulp test to diagnose vitality in normal as well as inflamed pulps while hemogram was inconclusive for the same.

The Analysis Distribution of Filariasis Vector in Sanggu Village, Southern Barito District

One of filariasis endemic area is located in South Barito, Central Kalimantan, and Indonesia. Finger blood surveys were first conducted in 2004 in Sanggu with 1.34% f rate. The objective of this study is to analyze the spread of filariasis vector in Sanggu, South Barito. The sample of this study is all of the mosquitoes which caught inside and outside the houses which come from 3 point of research location that includes settlement like forest, swamp and lake. The results showed that there are number of species of mosquitoes. Culex sp were found outside and inside the house and 5 species of mosquitoes were; Mansonia sp, Culex sp, Anopheles sp, Aedes aegypti and Aedes albopictus found near in the swamp, lake and forest. The conclusion of the study showed that the most caught mosquito species were Culex Sp and Mosquito as filariasis vector that is inside the house of 12 heads/person/hour and outside of house is 27, 2 tail/person/hour. These could be influenced by the temperature and humidity in the village ranging from 24 ⁰C-28 ⁰C and 84%-90%. The prevention could be done by socializing the discovery of chronic filariasis sufferer, spraying, collecting data of chronic filariasis patient, keeping the house always clean, cleaning environment; cutting shrub or tree and its branches so that sunlight could shine the entire house.

Dynamic cerebral autoregulation after confinement in an isolated environment for 14\u2009days

BackgroundTo develop human space exploration, it is necessary to study the effects of an isolated and confined environment, as well as a microgravity environment, on cerebral circulation. However, no studies on cerebral circulation in an isolated and confined environment have been reported. Therefore, we investigated the effects of a 14-day period of confinement in an isolated environment on dynamic cerebral autoregulation.MethodsWe participated in an isolation and confinement experiment conducted by the Japan Aerospace Exploration Agency in 2016. Eight healthy males were isolated and confined in a facility for 14 days. Data were collected on the days immediately before and after confinement. Arterial blood pressure waveforms were obtained using a finger blood pressure monitor, and cerebral blood flow velocity waveforms in the middle cerebral artery were obtained using transcranial Doppler ultrasonography for 6 min during quiet rest in a supine position. Dynamic cerebral autoregulation was evaluated by transfer function analysis between spontaneous variability of beat-to-beat mean arterial blood pressure and mean cerebral blood flow velocity.ResultsTransfer function gain in the low- and high-frequency ranges increased significantly (0.54 ± 0.07 to 0.69 ± 0.09 cm/s/mmHg and 0.80 ± 0.05 to 0.92 ± 0.09 cm/s/mmHg, respectively) after the confinement.ConclusionThe increases observed in transfer function gain may be interpreted as indicating less suppressive capability against transmission from arterial blood pressure oscillation to cerebral blood flow velocity fluctuation. These results suggest that confinement in an isolated environment for 14 days may impair dynamic cerebral autoregulation.Trial registrationUMIN000020703, Registered 2016/01/22.

Clinical Testing of Hemechip in Nigeria for Point-of-Care Screening of Sickle Cell Disease

In sub-Saharan Africa, nearly a quarter of a million babies are born with sickle cell disease (SCD) each year. An estimated 50-90% of these babies die before age 5 due to lack of early diagnosis and timely treatment. The World Health Organization estimates that more than 70% of SCD related deaths are preventable with simple, cost-effective interventions, such as early screening followed by affordable and widely available treatment regimens. Here, we present the early clinical testing results of HemeChip, which is the first single-use cartridge-based microchip electrophoresis hemoglobin screening platform. HemeChip was developed by Hemex Health, Inc., based on technology licensed from Case Western Reserve University. HemeChip allows affordable, objective, quantitative screening of hemoglobin variants at the point-of-care. HemeChip works with a drop of finger or heel-prick blood and separates hemoglobin variants on a piece of cellulose acetate paper that is housed in an injection molded plastic cartridge with a precisely controlled electric field.HemeChip works with a portable reader to produce easily understandable, objective, and quantitative descriptions of the hemoglobin types and percentages present in a blood sample. The HemeChip reader guides the user step-by-step through the test procedure with animated on-screen instructions to minimize user errors. Hemoglobin identification and quantification is automatically done with a custom software on the reader. HemeChip reader records and analyzes the hemoglobin electrophoresis real-time, and it can wirelessly transmit the test results to a central electronic database, if needed.HemeChip prototype units have been clinically tested and benchmarked against the clinical standard technique in Kano, Nigeria, where the SCD prevalence is the highest in the world. We tested a total of 248 subjects (228 children aged 6 weeks to 5 years in Kano, Nigeria; and 20 adults in Cleveland, Ohio, United States) under institutional review board approval, using both HemeChip and the clinical standard laboratory method, High Performance Liquid Chromatography (HPLC, VARIANT™ II, Bio-Rad Laboratories, Inc., Hercules, California). HemeChip tests were done on eHealth Africa campus in Kano, Nigeria, by trained local healthcare workers using blood samples collected at the nearby Aminu Kano Teaching Hospital. Clinical standard (HPLC) testing was done independently by the International Foundation Against Infectious Disease in Nigeria (IFAIN, Abuja, Nigeria) for the blood samples obtained in Kano or by the University Hospitals Cleveland Medical Center Clinical Laboratories (Cleveland, Ohio) for the blood samples obtained in Cleveland.Test results included the following: homozygous SCD (HbSS), heterozygous sickle hemoglobin C disease (HbSC), heterozygous sickle trait (HbAS), and normal (HbAA). HemeChip identified the subjects with HbSS with 100% accuracy, HbSC with 100% accuracy, HbAS with 98.2% accuracy, and HbAA with 96.4% accuracy in comparison to HPLC (Table 1). Overall accuracy of HemeChip was 97.2% in comparison to HPLC for the subjects tested. HemeChip sensitivity was 100% for all hemoglobin variants tested (Table 2), and specificity was 96.4% for HbSS vs. HbAA, 98.2% for HbSS vs. HbAS, 100% for HbSC vs. HbAS, and 100% for HbAS vs. HbAA. Bland-Altman analysis indicated strong agreement between the quantitative HPLC and HemeChip results for hemoglobin percentages, with a mean bias of -3.2%.HemeChip enables, for the first time, accurate, cost-effective identification and quantification of hemoglobin variants at the point-of-need. HemeChip has been developed based on a versatile, mass-producible microchip electrophoresis platform technology that may address other unmet needs in biology and medicine that require rapid, decentralized hemoglobin or protein analysis, identification, and/or quantification. [Display omitted] DisclosuresThota:Hemex Health Inc: Employment. Little:PCORI: Research Funding; Hemex: Patents & Royalties: Patent, no honoraria; NHLBI: Research Funding; Doris Duke Charitable Foundations: Research Funding.

Knowledge, attitudes, and practices (KAP) related to blood cholinesterase level among tobacco farmers in Northern Thailand

Tobacco is one of the crops using a lot of pesticides, especially organophosphate and carbamate pesticides. A cross-sectional study was conducted to investigate knowledge, attitudes, and Practices (KAP) related to blood cholinesterase levels related to pesticide use among tobacco farmers. A questionnaire and a reactive-paper finger blood test were completed by 44 tobacco farmers. The results showed that most of the participants were females (75.0%) between 51 and 60 years old (54.5%). Almost 95.5% of respondents acknowledged that they should wear a mask while spraying and most of them read pesticide labels before use (93.2%). Most of the tobacco farmers had moderate level of knowledge and attitudes, 63.6% and 70.5%, respectively and good practice (84.1%). The prevalence of risky levels of blood cholinesterase among tobacco farmers in the study area was high. The study found a strongly significant association between level of knowledge and blood cholinesterase level (P < 0.001). Policy implementation and risk communication will be introduced to the community in order to develop a safety program. Government authorities should be provided with the appropriate recommendations regarding pesticide exposure of tobacco farmers in this area.

High-Intensity Exercise Mitigates Cardiovascular Deconditioning During Long-Duration Bed Rest.

Head-down-tilt bed rest (HDT) mimics the changes in hemodynamics and autonomic cardiovascular control induced by weightlessness. However, the time course and reciprocal interplay of these adaptations, and the effective exercise protocol as a countermeasure need further clarification. The overarching aim of this work (as part of a European Space Agency sponsored long-term bed rest study) was therefore to evaluate the time course of cardiovascular hemodynamics and autonomic control during prolonged HDT and to assess whether high-intensity, short-duration exercise could mitigate these effects. A total of n = 23 healthy, young, male participants were randomly allocated to two groups: training (TRAIN, n = 12) and non-training (CTRL, n = 11) before undergoing a 60-day HDT. The TRAIN group underwent a resistance training protocol using reactive jumps (5–6 times per week), whereas the CTRL group did not perform countermeasures. Finger blood pressure (BP), heart rate (HR), and stroke volume were collected beat-by-beat for 10 min in both sitting and supine positions 7 days before HDT (BDC−7) and 10 days after HDT (R+10), as well as on the 2nd (HDT2), 28th (HDT28), and 56th (HDT56) day of HDT. We investigated (1) the isolated effects of long-term HDT by comparing all the supine positions (including BDC−7 and R+10 at 0 degrees), and (2) the reactivity of the autonomic response before and after long-term HDT using a specific postural stimulus (i.e., supine vs. sitting). Two-factorial linear mixed models were used to assess the time course of HDT and the effect of the countermeasure. Starting from HDT28 onwards, HR increased (p < 0.02) and parasympathetic tone decreased exclusively in the CTRL group (p < 0.0001). Moreover, after 60-day HDT, CTRL participants showed significant impairments in increasing cardiac sympathovagal balance and controlling BP levels during postural shift (supine to sitting), whereas TRAIN participants did not. Results show that a 10-day recovery did not compensate for the cardiovascular and autonomic deconditioning following 60-day HDT. This has to be considered when designing rehabilitation programs—not only for astronauts but also in general public healthcare. High-intensity, short-duration exercise training effectively minimized these impairments and should therefore deserve consideration as a cardiovascular deconditioning countermeasure for spaceflight.

Reliability of the portable coagulometer qLabs to accurately measure the activated thromboplastin time and international normalized ratio: a prospective study in critically ill patients.

: The current prospective study was aimed at investigating whether a portable coagulometer (qLabs) can be used to reliably monitor activated thromboplastin time (aPTT) and international normalized ratio (INR) in critically ill patients, as compared with standard central laboratory measurement. Both precision and accuracy of INR and aPTT measured by qLabs were assessed in this observational study by finger prick group (N = 30 patients) and blood droplet group from central venous catheter drawn (N = 60). For accuracy, clinical agreement percentage was ±0.3 for INR and ±10 s for aPTT. Precision of INR measurement in qLabs showed excellent intraclass correlation coefficient (ICC > 90%). Precision of aPTT measurement in qLabs was less acceptable for both finger prick [ICC: 0.70; Bland-Altman plot: 2.2 s (-19.8, 24.2)] and blood droplet [ICC: 0.50; Bland-Altman plot: 0.4 s (-70.9, 71.8)] groups. Accuracy of qLabs was acceptable for INR assessment (clinical agreement 90 and 81%, for finger prick and blood droplet groups, respectively), but not for aPTT (clinical agreement 55 and 68%, respectively). Accuracy of finger prick and blood droplet measurements in qLabs was better for INR and aPTT values near-to-normal (1.2 and 37 s, respectively). INR values from qLabs were consistent with the 'gold standard'. qLabs measurement is only reliable for aPTT values near-to-normal.

Cardio-respiratory autonomic responses to nociceptive stimuli in patients with disorders of consciousness.

The autonomic response to pain might discriminate among consciousness disorders. Therefore, aim of this study was to describe differences between minimally conscious state (MCS) and unresponsive wakefulness syndrome (UWS) patients in their autonomic response to a nociceptive stimulus. ECG, respiration, finger blood pressure (BP) and total peripheral resistances (TPR) were continuously recorded before, during and after a standardized noxious stimulus in 20 adult brain-injured patients, 14 in UWS and 6 in MCS. Occurrence of fast autonomic responses synchronous with the stimulus was detected by visual inspection of the tracings; short-term (<20 s) and long-term (between 20s and 50 s from the stimulus) responses were evaluated by beat-by-beat quantitative analysis. The noxious stimulus elicited fast responses in both groups, but only MCS patients showed a significant short-term response in TPR and long-term response in HR. Thus, short- and long-term cardiovascular responses to pain might integrate neuro-behavioural assessments to discriminate between MCS and UWS.

‘Could my son have diabetes too?’

A 32-year-old man with type 1 diabetes brought his 23-month-old son in for evaluation. The father said that he had noticed his son had had increased numbers of wet diapers and increased thirst in the past week. He said that he could have tested the finger blood stick on his son using his own glucometer but he did not want to ‘make the diagnosis’. The system review of the toddler and his physical examination were both unremarkable. The family history was significant for the diagnosis of type 1 diabetes (T1DM) in the father at the age of six years. In the clinic, the non-fasting glucose level of the toddler was 29.082mmol/L (524mg/dL) and his HbA1c level was 53mmol/mol, confirming the diagnosis of diabetes. The father cried in the clinic feeling guilty that he had caused diabetes in his son. We provided positive reinforcement to the father, reassuring him that his good vigilance led to the early diagnosis. Further laboratory evaluation showed positive islet cell antibodies and positive anti-glutamic acid decarboxylase. A diabetes education session was held in the clinic; the father was able to check the glucose and give insulin to his son successfully. The incidence of T1DM varies according to age, ethnic background and geographical area. It is estimated that 24.5 per 100 000 children up to the age of 14 years in the UK are diagnosed with the condition every year.1 The children of patients with T1DM are at increased risk of developing the disease.2 The increased risk is around 6% if the father is affected while it is around 3% if the mother is affected.3, 4 Table 1 shows the increased risk if a parent or sibling has the disease. It is estimated that at diagnosis of T1DM 4–7% of children have a father with T1DM whereas only 1.5–3% have an affected mother.5 A study from Finland showed that the greatest increase of T1DM occurred in the youngest offspring, aged 0–4 years, when the father had T1DM.4 Since there is no typical Mendelian inheritance of T1DM, it is very important that physicians discuss with their T1DM patients this increased risk once it is known they are planning to have children. Understanding the risk of diabetes in offspring of affected parents is important not only in T1DM but also in type 2 diabetes due to the increased rate of childhood obesity related type 2 diabetes,6 as well as in rare forms of maturity-onset diabetes of the young.7 Parents with diabetes may be more vigilant in detecting early symptoms of diabetes, compared to those without diabetes. Early detection of T1DM can prevent life-threatening diabetic ketoacidosis (DKA), especially in very young children.8 Thus, identifying children at risk for diabetes even before the clinical onset can help both physicians and parents in preventing the dramatic course of DKA. The early detection and management of T1DM in children with parents who have diabetes may provide an easier course, faster education process, and better overall management of diabetes at home; nevertheless, parents may have a tremendous feeling of guilt about transmitting diabetes to their children. This emotional factor should be recognised and addressed appropriately by the health care team, stressing the positive benefits about parents’ diabetes knowledge.

Keberhasilan Pengobatan Massal Filariasis di Kecamatan Kusan Hulu Kabupaten Tanah Bumbu Provinsi Kalimantan Selatan

Kusan Hulu Sub-district is one of filariasis endemic areas in Tanah Bumbu District of South Kalimantan Province which has implemented partial Mass Drug Administration (MDA) filariasis program starting in 2012 and simultaneously in all area of Tanah Bumbu District starting in 2015. This study aims to determine endemicity filariasis after the first MDA in 2015 in Kusan Hulu Sub-district by conducting a finger blood survey to determine microfilaria rate and know the type of microfilariae. The design of this study was cross sectional. The study was conducted in Kusan Hulu sub-district from March to November 2015. The results of the finger blood survey showed a mf rate of 0.4% of the 500 population. The type of microfilariae found was Brugia malayi. Both positive patients were of male sex with age&gt; 45 years. There was a decrease in mf rate in Kusan Hulu Sub-district from before MDA compared to after the first MDA was conducted from 12.37% in 2008, and 0.91% in 2011 to 0.4% in 2015, so the area became nonendemic (mf rate &lt;1%).

Gambaran Angka Prevalensi Mikrofilaria di Kabupaten Banyuasin Pasca Pengobatan Massal Tahap III

Filariasis is a chronic infectious disease that can cause permanent disability. One effort to interrupt transmission of filariasis is the Mass Drug Administration filariasis (MDA filariasis) in endemic areas of filariasis for 5 years. In 2012, MDA filariasis was carried out in all regions of Banyuasin. After treatment the 3rd year, it is necessary to evaluate the prevalence of microfilaria and microfilaria density. This activity was conducted by finger blood survey to people who’s living in sentinel and spot villages. This study selected 930 people for SDJ activities The test results obtained 4 positive of microfilaria Brugia malayi. The prevalence or microfilaria rate (Mf rate) in the village of sentinel was 0,96 with microfilaria density were 938/mL of blood, Mf rate in spot village was 0.31 with a microfilaria density were 217.75/mL of blood, while the Mf rate district was 0.43 with a microfilaria density were 716.06/mL of blood. People who suffer filiariasis mostly are farmers/fishermen. The prevalence of microfilariae in Banyuasin decreased, but the risk of transmission can still occur because of the density of microfilariae found&gt; 50/mL of blood.

Low-field nuclear magnetic resonance spectrometer for non-invasive monitoring of fluctuations in blood glucose in the human finger

A low-field nuclear magnetic resonance spectrometer for non-invasive monitoring of human finger blood glucose fluctuations was developed. Saline solution and blood serum samples with different glucose concentrations were first detected by the spectrometer and it has been found that there was a high-linear correlation between the glucose concentration and the transverse relaxation time. Then, the spectrometer was employed to noninvasively measure a finger from each of the several volunteers. The experiment results showed that the transverse relaxation time of the human finger increases with human blood glucose concentration. In conclusion, the human finger nuclear magnetic resonance spectrometer could be a potential tool to noninvasive monitoring of human body’s blood glucose fluctuations in the future.

Potential Transmission of Filariasis for Pregnant Women in Subdistrict Muara Pawan, Ketapang District, Province of West Kalimantan

Filariasis (elephantiasis) is a contagious disease caused by filarial worms that lives in the channel and lymph nodes (lymph) in the human body. The disease in transmitted through mosquito bites. Sub District Muara Pawan in Ketapang district is endemic region of filariasis so than Bulk Drug Prevention (Diethyl Citrate Carbamazine) against the whole of society in needed except in pregnant women because of the side effects of these drugs for pregnant women and fetus. Based on the preliminary survey and information from Ketapang District Office there were a few factors that play a role in the transmission, that were environmental factor and social behavior. This research was a descriptive cross sectional design conducted at Sub District Muara Pawan Ketapang District. Data were collected through observation and interviews. The research objective was a determine the potential transmission of filariasis in pregnant at Sub District Muara Pawan Ketapang District in West Kalimantan. Result showed that finger blood test results conducted on 53 samples of pregnant women did not find microfilaria in the blood. The results of the identification of mosquitoes are found is the dominant mosquito species Anopheles letifer. Results of laboratory tests were conducted by B2P2VRP Salatiga to 399 mosquitoes are not found filarial worms in the body of the mosquito. There are five variables that have the potential for transmission of filariasis in pregnant women in Puskesmas Tanjung Pura Sub Muara Pawan namely the level of knowledge is less (66.0%), there is mosquito habitat (75.5%), there is a place resting mosquitoes (71.7%), the habit of not using anti-mosquito drugs (66.0%), the habit of not using a closed clothes at home (73.6%). The conclusion of this study is the environmental factors and poor public behavior turned out to be very influential on the potential transmission of filariasis incidence in pregnant women.