Reduction In Hemoglobin Research Articles

Tirzepatide: A Promising Drug for Type 2 Diabetes and Beyond.

Tirzepatide is a promising drug withdual-acting glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) receptor activation that has revolutionized the treatment of type 2 diabetesmellitus (T2DM) as an adjunct to diet and exercise. Inphase 3 clinical trials (SURPASS 1-5), the dose-dependent efficacy and safety of tirzepatide were assessed by once-weekly subcutaneous injection (5mg, 10mg, and 15 mg), as monotherapy or combination therapy, in individuals with T2DM. Tirzepatide has been shown to achieve better glycemic control in terms of glycosylated hemoglobin reduction and improved fasting and postprandial glucose levels as compared to other diabetic medications. Moreover, the studies demonstrate a reduction in body weight (-6.2 to -12.9 kg), and other cardiovascular benefits by altering the lipid profile, reducing blood pressure, and visceral adiposity. Tirzepatide has acceptable side effects and is well tolerated, with a low risk of hypoglycemia. The SURPASS 4 clinical trial has shown positive cardiovascular outcomes in people with T2DM and elevated cardiovascular risk. Additionally, encouraging results from SURMOUNT trials and ongoing SURPASS-CVOT studies will shed more light on cardiovascular safety in the future. In this review, we have summarized the clinical trials and their respective outcomesand highlighted the potential future indications for tirzepatide in the management of obesity, heart failure, and nonalcoholic steatohepatitis.

Prophylactic B-Lynch suture: efficacy in preventing postpartum hemorrhage in high-risk patients

Objective: To evaluate the effectiveness of prophylactic B-Lynch suture in the prevention of postpartum bleeding in patients at high risk for uterine atony, from the Concepción Palaces Maternity Delivery Room Service. Methods: Prospective, comparative and longitudinal study, which included 30 patients with risk factors for uterine atonia, randomly distributed in two groups: with and without B-Lynch compression suture. Echosonographic, clinical and paraclinical follow-up was performed at 12 and 24 hours after the postoperative period. A statistically significant contrast was considered if p < 0.05. Results: Haemoglobin reduction in patients with compressive suture was 0.5 ± 0.4 g/dl and hematocrit was 1.4 ± 1.1%; in the control group it was 1.6 ± 1.6 g/dl and 4 ± 4.7%, respectively (p-0.014/p-0.058). Bleeding at 12 and 24 hours was scarce in 73.3% and 93.3% of patients with compressive and moderate sutures or abundant in 100% and 93.4% of the control group (p-0.000). The reduction in the size of the uterus was greater in the experimental group than in the control group (p-0.000); 33.4% of patients with B-Lynch sutures and 93.4% without sutures had severe or unbearable pain at 12 hours (p-0.007) and at 24 hours there were no cases with severe or unbearable pain in the first group but in the second the frequency was 60%. Conclusions: Prophylactic B-Lynch suture is effective for preventing postpartum uterine atonia hemorrhage

Presence and impact of anemia in patients supported with left ventricular assist devices

Data on anemia and its effects on patients supported with continuous-flow left ventricular assist devices (LVADs) are lacking. This study sought to describe the presence of anemia over time and investigate its association with mortality, quality of life, exercise capacity, and adverse events in LVAD patients. Adults receiving durable LVADs between 2008 and 2017 were identified from the INTERMACS database. The full cohort was stratified according to anemia severity (no anemia, mild, and moderate-severe). The analysis of 19,509 patients (females: 21.2%, age: 56.9±12.9 years) showed that moderate-severe anemia affected 45.2% of patients at baseline, 33.5% of them at 6 months, and 32.3% in the fourth year after implantation. The presence of normal hemoglobin was 24.4% before surgery, 32.5% at 6 months, and 36.6% at 4 years after implantation. Multivariable linear mixed-effect regression revealed that the average hemoglobin over time was significantly lower (β, -0.233, 95% confidence interval (CI): -0.282 to -0.185), and the reduction of hemoglobin over time was bigger (β, -0.032 95% CI: -0.035 to -0.028) for LVAD nonsurvivors compared with LVAD survivors. Adjusted Cox regression showed that the severity of preimplant anemia was associated with higher mortality (HR, mild: 1.19; 95%CI: 1.05-1.35 and moderate-severe: 1.44; 95% CI: 1.28-1.62), with similar results in competing risk regression. Anemia progression during follow-up was associated with decreased Kansas City Cardiomyopathy Questionnaire scores and shorter 6-minute walk distances. In patients supported with LVADs, anemia is a frequent comorbidity, and deterioration over time is associated with poor prognosis.

Covid-19 Era in the Coastal Areas: The Cookies Formulation Gonad of Diadema setosum and its Impacts on Malnutrition During Infection

Infection with Salmonella typhi bacteria during the COVID-19 era has the potential to worsen malnutrition in children in low- and middle-income nations, particularly around the coast. Recent studies have demonstrated that one of the best strategies for preventing malnutrition is consuming local food sources from the sea, which are easy to acquire, inexpensive, and high in nutrients. In this study, 15 male mice were used as the test subjects. They were split into two groups: the intervention group and the control group, both before and after intraperitoneal injection of Salmonella typhi. The intervention group was given dosages of cookies containing Diadema setosum gonad (0.40 mg/kg of body weight), whereas the control group received only a natural diet. The blood samples were then analyzed to measure their hemoglobin levels using the Sahli haemometer method, and serum albumin concentrations were determined using the bromocresol green method. The results show that the treatment with Diadema setosum gonad cookies had a significant effect on the levels of albumin and hemoglobin (Hb), as well as the body weights of the intervened mice, with a statistically significant increase (p<0.05). Conversely, BALB/c mice in the control group demonstrated a decrease in their initial food intakes, resulting in a significant reduction in body weight, albumin, and hemoglobin (Hb). This finding implies that the cookie formula with Diadema setosum gonad as the principal ingredient has potential benefits in lowering the incidence of malnutrition for children.

Stone attenuation on computer tomography helps surgeons make decisions between miniaturized percutaneous nephrolithotomy or retrograde intrarenal surgery for lower pole stones: a retrospective study

A retrospective study was performed on 200 patients who underwent miniaturized percutaneous nephrolithotomy (mini-PCNL) or retrograde intrarenal surgery (RIRS) for 10-20mm sized lower pole renal calculi to investigate the relationship between computed tomography (CT) attenuation of calculi and surgical outcomes. CT was used to examine the location, size, and CT attenuation values of the calculi. Additionally, the operation time, hospital stay, hemoglobin (Hb) reduction, stone-free rate (SFR), and complication rate were also meticulously documented and subjected to comparative analysis. Complications were assessed using the Clavien-Dindo grading system. We observed no significant differences in hospitalization data and follow-up outcomes, except for a longer hospital stay and higher Hb drops in patients receiving mini-PCNL. Statistical analysis revealed an association between CT attenuation and operation time. Compared with mini-PCNL, RIRS could reduce bleeding, hospital stay, surgery time, and complications for 10-20mm sized lower pole kidney stones with CT values < 1000 HU. RIRS resulted in longer operation time and lower stone-free rates despite shorter hospital stays and less bleeding than mini-PCNL for stones with CT values > 1000 HU. Therefore, selecting an appropriate surgical method based on CT attenuation might improve outcomes. For patients with stone attenuation values < 1000 HU, RIRS is the recommended option. When stone attenuation values > 1000 HU, the surgical method should be chosen based on the patient's individual situation.

Single Dose of Tranexamic Acid Effectively Reduces Blood Loss in Patients Undergoing Spine Surgery: A Prospective Randomized Controlled Trial

To evaluate the efficacy of oral administration of tranexamic acid (TXA) in spine surgery to achieve blood loss reduction. Sixty patients undergoing major surgery of the spine were randomly assigned into 2 groups. Group 1 was assigned as the control group and the other group comprised patients who received oral administration of TXA 2 hours before surgery. Outcome measures included intraoperative blood loss, postoperative blood loss, hematologic parameters, blood transfusion needed, and surgical complications. Sixty patients linked up with the inclusion criteria. Intraoperative blood loss was significantly lower in the TXA oral group than in the control group; total blood loss in the TXA group was 930.66 ± 614 mL, which was lower than in the control group, with 1075.66 ± 956.11 mL. The mean reduction of hemoglobin was almost the same in both groups. Similarly, the total transfusion package received was lower, and the number of complications and length of stay were akin in both groups. A logistic regression model was performed with patients who had blood loss >1000 mL and surgery time >230 minutes. This result was related to the risk of bleeding, with an odds ratio of 1.31, 95% confidence interval, 1.004-1.023, P= 0.004, independent of the group. Oral TXA is as an effective measure for reducing total blood loss among patients undergoing elective spine surgery.

Study of prevalence of anaemia and haematological parameters in children below 12 years in Northern Karnataka

Anaemia may be defined as a reduction in red blood cell (RBC) mass or blood haemoglobin (HGB) concentration. The most common cause of anaemia in newborns include blood loss, Rh or ABO incompatibility in 3 to 6 months suggests hemoglobinopathy, Nutritional iron deficiency causes after six months hence symptoms of blood examination in children play a significant role below 12 years. 92 children below 12 years of age having anaemia were studied. The blood examination was done to rule out PCV, MCV, MCH, MCHC, RPW, Hb%, PS study, reticulocyte count, and serum iron (Fe), Serum B, folic acids. The types of anaemia were 53(57.6%) anaemia, 13(14.1%) Thalassemia, 10(10.8%) Megablastic anaemia, 8(8.6%) Anaemia of acute haemorrhage, 5(5.4%) sickle cell anaemia, 2(2.1%) aplastic anaemia, 1(1.08%) leukaemia. Clinical manifestations had 92(100%) pallor, 78(84.7%) weakness and fatigability, 36(39.1%) fever, 26(28.2%) Icterus, 19(20.6%) shortness of breathing, 16(17.3%) hepatomegaly, 14(15.2%) cough, 13(14.1%) history of pica, 12(13%) splenomegaly, 10(10.8%) petechiae, 9(9.7%) vomiting, 9(9.7%) Koilonychias, 5(5.4%) hyper-pigmentation, 6(6.5%) tremors, 21(22.8%) was mild anaemia, 42(45.6%) moderate, 29(31.5%) severe anaemia on the basis of haemoglobin level. This pragmatic study of anemia had iron deficiency was a major cause followed by thalassemia, megaloblastic, acute hemorrhagic sickle cell, aplastic anemia. This study will be helpful to the pediatrician to treat such children efficiently to avoid morbidity and mortality.

Analysis of stone-free rates and residual fragment sizes following standard percutaneous nephrolithotomy: mistakes in the treatment of non-opaque kidney stones

Our presented study aimed to evaluate the possible effects of stone opacity, on both the success of percutaneous nephrolithotomy and the sizes of residual fragments following the procedure. Medical records of patients undergoing PCNL treatment for kidney stones at our clinic between July 2014 and May 2022 were evaluated in a retrospective manner. A total sample size of 304 patients with the required criteria was included. Patients were divided into two groups based on the radiopacity status of the stones assessed in the kidney-ureter-bladder graphy (KUB) [Group O (n = 211): opaque, Group N (n = 93): non-opaque)]. Demographic data, laboratory results, and surgical follow-up information were comparatively evaluated between groups. The mean age and percentage of female patients were higher in Group N (45.2 vs. 25,1%; p < 0.001). Also, patients in this group were associated with more comorbidities. No significant difference was present regarding stones' laterality, size, surface area, and localization. Cases in the Group N group demonstrated higher median hemoglobin reduction [1.7 (IQR = 1.2-2.5) vs. 2 (IQR = 1.6-2.6); p = 0.047]. The stone-free rates in Group O patients were higher (67.8% vs. 53.8%; p = 0.014). The size of the residual fragments was meaningfully larger in Group N cases [8 (IQR = 7-13) vs. 10 (IQR = 8-16); p = 0.032]. Finally, no significant difference was observed between the groups regarding both minor (as grade 3a and below) and major (grade 3b and above) assessed by the Modified Clavien-Dindo Classification. Our data show that treatment of patients with so-called non-opaque kidney stones by PCNL results in low SFR and larger residual fragments, which is due to a variety of errors that should be avoided by appropriate measures.

Marine toxin C17-SAMT causes major structural damage to vital organs in mice following subchronic toxicity trials

C17-sphinganine analog mycotoxin (C17-SAMT) has been characterized as the contaminant responsible for the atypical toxicity reported in mussels from the Bizerte lagoon (northern Tunisia) over the past decade. C17-SAMT exhibited common symptoms of toxicity in mice, including flaccid paralysis and severe respiratory distress, followed by rapid death. To determine the potential health risks of this neurotoxin, we assessed its subchronic toxicity according to the recommendations of OCDE n° 407. The body weight and the structural changes of vital organs were recorded. Biochemical and hematological parameters were also quantified. Macroscopic observations showed that mice treated with 0.9, 9, and 90 µg/kg C17-SAMT had significantly reduced stomach weights, swollen and fragile intestines, and signs of nephritis with renal abscesses. Transaminase assays pointed out that exposure to C17-SAMT can lead to transaminitis. Above-average lactate dehydrogenase values were recorded in both the treated and satellite groups. Hematology data showed a significant reduction in red blood cell counts in high-dose-treated group. Reductions in hemoglobin and hematocrit were also recorded. Mean leukocyte counts were significantly elevated in the high-, mid-dose treated and satellite groups. At the microscopic level, we noted myocardial atrophy and hyperemia. In the lungs, we noted necrosis associated with macrophages perivascular infiltration and congestion. The kidneys showed mild inflammation and glomerular atrophy. The stomach exhibited mucosal atrophy, while a thin colon and distended small intestine were observed in high-dose-treated group. The liver was affected by vascular congestion, inflammatory infiltration, and lobular necrosis that evolved into acute hepatitis. Lesions, such as inflammatory infiltration and mild necrosis of the liver, cortical abscess with central necrosis in the kidney, and mild congestion of cardiac tissue were recorded in the satellite group.

Lafutidine Ameliorates Indomethacin-Induced Small Intestinal Damage in Rats by Modifying the Intestinal Mucosal Barrier, Inflammation, and Microbiota

Introduction: Nonsteroidal anti-inflammatory drug (NSAID)-induced small intestinal damage is a serious and escalating clinical problem without effective treatment. Lafutidine (LAF) is a novel histamine H2 receptor antagonist with a mucosal protective action. This study aimed to investigate the protective effect of LAF on indomethacin (IND)-induced enteropathy in rats. Methods: Rats were treated with LAF for 10 days with concomitant IND treatment on the final 5 days. Changes in metabolism and hematological and biochemical parameters were measured, and intestinal damage was blindly scored. Intestinal mucosal tissue and luminal contents were collected for transcriptome and microbiota sequencing. Intestinal inflammation and barrier function were also evaluated. Results: LAF treatment prevented anorexia and weight loss in rats and ameliorated reductions in hemoglobin, hematocrit, total protein, and albumin levels. LAF reduced the severity of IND-induced intestinal damage including macroscopic and histopathological damage score. Transcriptome sequencing results indicated that LAF might have positive effects on intestinal inflammation and the intestinal mucosal barrier. Further research revealed that LAF decreased neutrophil infiltration, and IL-1β and TNF-α expression in intestinal tissue. Besides, the treatment increased mucus secretion, MUC2, Occludin, and ZO-1 expression, and decreased serum D-lactate levels. LAF treatment also ameliorates microbial dysbiosis in small intestine induced by IND and increased the abundance of Lactobacillus acidophilus. Conclusion: LAF may protect against NSAID enteropathy via enhancing the intestinal mucosal barrier, inhibiting inflammation, and regulating microbiota.

Early Postoperative Outcomes of Retroperitoneal Partial Nephrectomy of Anterior and Posterior Renal Tumors: A 5-Year Experience in A Single Center.

Objective: Partial nephrectomy (PN) is one of the surgical treatment options for renal tumors. Therefore, the aim of this study was to compare the surgical outcomes of retroperitoneal PN for anterior and posterior tumors. Materials and Methods: This study enrolled 177 patients who had renal tumors that were detected on abdominal computed tomography and underwent PN between January 2017 and April 2021. Tumor position was defined by the anatomic avascular Brodel's line. Surgical outcomes were compared between approaches using the chi-squared Student's t-tests, logistic regression analysis, and stratification analysis. Results: Of the 177 patients, 97 (54.8%) patients had anterior renal tumors and 80 (45.2%) had posterior renal tumors. On comparing the surgical results between the two groups, the anterior group had higher levels of hemoglobin (Hb) reduction (-1.92 vs -1.54 g/dL, p = 0.0444), but the estimated blood loss showed no significant difference between the two groups (497.6 vs 433.2 mL, p = 0.4149). In addition, the alteration in estimated glomerular filtration rate at postoperative 1st day (p = 0.5616), 6th month (p = 0.5046), and at postoperative 1st year (p = 0.7085) was not significantly different between the two groups. Other surgical outcomes, such as blood transfusion rate, complications, and lengths of stay, also had no significant difference. Stratified analysis revealed the anterior renal tumors had a 3.76 times risk (p = 0.0186) than the posterior tumors for decreasing Hb >10% under laparoscopic PN. No postoperative gastrointestinal-related complications were reported. Conclusions: This study demonstrated retroperitoneal surgical access to renal tumors and revealed equivalent surgical outcomes for both anterior and posterior renal tumors. Moreover, anterior renal tumors had benefits under robotic PN for bleeding control. Retroperitoneal PN can be considered as a good approach for both anterior and posterior renal tumors with few intra-abdominal complications.

Abstract 6334: VBI-002, a CD47xICAM-1 bispecific antibody for the treatment of hepatocellular carcinoma, melanoma and non-small cell lung cancers

Abstract Intercellular Cell Adhesion Molecule 1 (ICAM-1, CD54) is a type I transmembrane protein and a member of the immunoglobulin superfamily. ICAM-1 is involved in many key processes such as cell-cell interactions, signal transduction and leukocytes trans-endothelial migration. ICAM-1 is constitutively present at low levels on healthy tissues but highly expressed in some hematological cancers and solid tumors, making it an attractive tumor target. VBI-002 is a novel human IgG1 based CD47xICAM-1 bispecific antibody with excellent safety profile and potent single agent activities in xenograft models of lymphoma, multiple myeloma and some solid tumors (Cancer Res 2022;82(12_Suppl):Abstract nr 3430). The bispecific design allows VBI-002 to selectively block CD47/SIRPα binding in tumor cells with high ICAM-1 expression. In contrast to the benchmark CD47 monoclonal antibody, VBI-002 exhibits minimal red blood cell binding and does not cause hemagglutination. In non-human primate (NHP) safety study, four weekly doses of 60 mg/kg VBI-002 were well-tolerated with only mild and reversible reduction in hemoglobin and platelets. Here we further investigate the anti-tumor activities of VBI-002 in solid tumors. Gene expression analysis suggested that ICAM-1 is highly expressed in non-small cell lung cancers (NSCLC), melanoma and a subset of hepatocellular carcinoma. Flow cytometry studies confirmed the frequent co-expression of ICAM-1 and CD47 in these tumors. VBI-002 has potent ICAM-1 dependent SIRPα blocking, antibody-dependent cellular phagocytosis and antibody-dependent cellular cytotoxicity activities against cell lines of NSCLC, hepatocellular carcinoma, and melanoma. Furthermore, in vivo efficacy studies demonstrated that VBI-002 has potent single agent activities in cell line derived xenograft (CDX) models of NSCLC, hepatocellular carcinoma, and melanoma. Weekly dose of 20 mg/kg VBI-002 is sufficient to stop tumor growth or drive tumor regression in most models. Notably, VBI-002 is highly effective against NSCLC CDX models carrying Kras mutation and it synergizes with paclitaxel to provide additional anti-tumor activity. In conclusion, VBI-002 is a versatile novel CD47xICAM-1 bispecific antibody with potent single agent activity in various solid tumors and combined well with standard of care chemotherapies for added activity. Thus, VBI-002 warrants clinical evaluations as a single agent and in combination with standard of care chemotherapies. Citation Format: Oi Kwan Wong, Xinhua Wang, Leonard Post, Xiaocheng Chen. VBI-002, a CD47xICAM-1 bispecific antibody for the treatment of hepatocellular carcinoma, melanoma and non-small cell lung cancers. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6334.

Haematological Trends and Transfusion during Adult Extracorporeal Membrane Oxygenation: A Single Centre Study.

Patient demographics, haematological and coagulation parameters, plasma haemoglobin and fibrinogen concentrations, platelet count, the international normalised ratio (INR), the activated partial thromboplastin time (APTT), and blood product transfusion data from 138 patients who received ECMO in a single high-volume centre were analysed. Ninety-two patients received venoarterial (VA) ECMO and 46 patients received venovenous (VV) ECMO. The median (IQR) duration of VA, and VV ECMO was 8 (5-13) days and 13 (8-23) days, respectively. There were significant reductions in haemoglobin, the platelet count, and the fibrinogen concentration upon initiation of ECMO. On average, over time, patients on VV ECMO had platelet counts 44 × 109/L higher than those on VA ECMO (p ≤ 0.001). Fibrinogen and APTT did not vary significantly based on the mode of ECMO (p = 0.55 and p = 0.072, respectively). A platelet count < 50 × 109/L or a fibrinogen level < 1.8 g/L was associated with 50% chance of PRBC transfusion, regardless of the ECMO type, and packed red blood cell (PRBC) transfusion was more common with VA ECMO. APTT was predictive of the transfusion requirement, and the decrement in APTT was discriminatory between VVECMO survivors and nonsurvivors. ECMO support is associated with reductions in haemoglobin, platelet count, and fibrinogen. Patients supported with VA ECMO are more likely to receive a PRBC transfusion compared to those on VV ECMO. Thrombocytopaenia, hypofibrinogenaemia, and anticoagulation effect the likelihood of requiring PRBC transfusion. Further research is needed to define optimal blood management during ECMO, including appropriate transfusion triggers and the anticoagulation intensity.

Comparison of the Conventional PNL with Ecirs in the Treatment of Complete Staghorn Kidney Stones.

To analyse the results of conventional percutaneous nephrolithotomy (PNL) and endoscopic combined intrarenal surgery (ECIRS) in treating complete staghorn kidney calculi. A comparative study. Place and Duration of the Study:Department of Urology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey, between January 2007 and January 2022. Clinical data and surgical outcomes of the adult patients who underwent conventional PNL or ECIRS were retrospectively reviewed. Two patient groups were compared regarding the fluoroscopy time, the number of access, surgical time, duration of hospitalisation, haemoglobin (Hb) reduction, complication, and stone-free rates. Results:There were 132 renal units in the conventional PNL (Group 1) and 45 renal units in the ECIRS group (Group 2). The comparative analysis revealed that fluoroscopy time, surgical time, duration of hospital stay, number of access, and the Hb drop were significantly lower in the ECIRS group compared to the conventional PNL group. Although stone-free rates were 48.5% in Group 1 and 64.4% in Group 2, p=0.064 and p>0.05 respectively). The median value of the complication grade was 1 (1-7) in Group 1 and 1 (1-5) in Group 2, (U=2446.5, p=0.026). Conclusion:The ECIRS is a successful and more secure surgical method for treating complete staghorn stones than PNL. PNL, ECIRS, Staghorn, Kidney, Stone.

Some haematological and biochemical parameters assessments in sheep infection by Haemonchus contortus

The study was conducted on (100) sheep naturally infested with Haemonchus contortus, (1-3 years old), in Tikrit city, from ist January 2014 to 31th May 2014. Affected sheep exhibited clinical signs included, emaciation, weakness, pale mucous membranes, rough, easily detached and lusterless coat. Ten ml of blood samples were collected from the jugular vein of all the sheep's using disposable syringes, then take 2.5 ml from blood sample was used to determine CBC the Red blood cells (RBC), white blood cells (WBC) , Haemoglobin estimation (Hb), Packed cells Volume (PCV). The study showed reduction in RBC, hemoglobin, hematocrit and neutrophils (4.7±0.68), (6±0.74), (18±0.19), and (20±0.73) respectively. And reveled leukocytosis; Lymphocyte, eosinophil's and monocyte (11.6± 0.41), (65± 0.51), (10± 0.64) and (5± 0.29) respectively in infected sheep. and the remind samples were centrifuged at 3000 rpm for 10 minute and serum was separated and stored at -20 °c until used for measure the biochemical change by use spectrophotometer. The results showed a significant decrease (P &lt; 0.05) in the rates of total protein concentration, albumin , iron, and zinc (5.02± 0.59 g/dl), (1.7 ± 0.45g/dl), (89.3 ± 12.41 µg/dl), (42.37± 16.22 µg/dl) respectively in the serum of infected sheep according the compared with normal sheep.

CRT-100.1 Prognostic Implication of Hemoglobin Reduction and Bleeding Status After Percutaneous Coronary Intervention in Patients Hospitalized With Acute Coronary Syndromes

CRT-100.1 Prognostic Implication of Hemoglobin Reduction and Bleeding Status After Percutaneous Coronary Intervention in Patients Hospitalized With Acute Coronary Syndromes

Blood Loss Following Open Posterior Spinal Fusion in Fractures: Cannulated vs. Solid Pedicle Screws.

We aim to delineate whether there is increased blood loss with the use of cannulated pedicle screws compared to solid pedicle screws in patients undergoing posterior spinal fusion. A single-centre retrospective case-control study was undertaken on patients undergoing PSF for spinal fractures. Cannulated screw fixation was compared with solid screw fixation. Intraoperative blood loss was estimated using pre and postoperative haemoglobin levels, recorded estimated blood loss and cell saver reports. Anticoagulation, blood product administration, operative time and number of levels fused were assessed. A total of 64 cases, 32 in each cohort, were included in the analysis. Overall mean haemoglobin reduction from pre- to post-operative was 2.82 ± 1.85 g/L per screw inserted in the cannulated group, compared to a haemoglobin decrease of 2.81 ± 1.521 g/L per screw inserted in the solid screw group (p = 0.971). Total estimated intraoperative blood loss was 616.3 + 355.4 mL in the cannulated group, compared to 713.6 + 473.5 mL in the solid screw group (p = 0.456). Patients with preoperative thrombocytopenia had a transfusion rate of 0.5 ± 0.71 units/patient compared to 0.04 ± 0.19 units/patient in patients with normal platelet levels (p < 0.005). The differences in blood loss observed between cannulated and solid pedicle screws are non-significant overall. The largest predictor for need of transfusion was pre-operative thrombocytopenia, regardless of the type of screw used.

Studies on haematological changes in GI nematodes in cattle and buffalo in Udaipur, district (Rajasthan)

A study on prevalence of for gastrointestinal nematode in the infected and non-infected cattle and buffalo of Udaipur district (Rajasthan) from Sept. 2020 to January 2021 by haematological parameters such as haemoglobin (Hb), packed cell volume (PCV), erythrocyte sedimentation rate (ESR), total leucocyte Count (TLC) and differential leucocyte count (DLC). The highly significant decrease in haemoglobin concentration innematode infected and non-infected buffalo (8.65±0.2335 and 10.12±0.1077) and (8.63±0.2886 and 09.84±0.1411) in infected and in non-infected cattle, respectively. The packed cell volume showed highly significant decrease in nematode infected and non-infected buffalo (28.98±0.2101 and 32.94±0.2477) and (27.64±0.5337 and 30.65±0.3956) in infected and non-infected cattle, respectively. The highly significant decrease in erythrocyte sedimentation rate in nematode infected and non-infected buffalo (0.80±0.0245 and 1.00±0.0167) and in cattle was found to be in infected (0.63±0.0287) and in non-infected (0.97±0.0240), respectively.Total leukocyte count (TLC) value significant increase for infected and noninfected buffalo and cattle buffalo (8.53±0.2784 and 10.45±0.2538) and (8.36±0.2582 and 10.49±0.1689), respectively. In the infected buffalo neutrophils (32.96±0.3084), eosinophils (5.50±0.2049).Basophils (0), lymphocytes (62.36±0.2948) and monocytes (5.48±0.1831). However, in non-infected buffalo neutrophils (37.21±0.3701), eosinophils (4.60±0.2196), basophils (0), lymphocytes (57.21±0.2802) and monocytes (4.99±0.2094). Whereas, in infected cattle neutrophils (28.02±0.2914), eosinophils (5.74±0.1942) basophils (0), lymphocytes (67.48±0.2979) and monocytes (5.57±0.1547). However, in non-infected cattle neutrophils (32.15±0.3088), eosinophils (3.88±0.1836) basophils (0), lymphocytes (61.59±0.3475) and monocytes (5.23±0.1832).There is reduction in haemoglobin, packed cell volume and ESR in the GI nematode infected cattle and buffalo. In total leukocyte count in buffalo and cattle lymphocytes, eosinophils and monocyte showed increased in infected group.

En bloc enucleation of the prostate with early apical release using a high-power (200 W) thulium device: studying a learning curve.

The aim of this study was to reveal the learning curve of early apical release en bloc laser prostatectomy using a high-power thulium (200 W) laser device. We obtained data on the initial 60 patients who had thulium laser enucleation of the prostate by a single surgeon between October 2021 and August 2022 to treat the signs and symptoms of benign prostatic hyperplasia at our clinic. The cases were split into three groups, each consisting of 20 patients. Prostate volumes, prostate-specific antigen and hemoglobin levels, the International Prostate Symptom Score, Quality of Life scores, the International Index of Erectile Function-5 scores, and uroflowmetry parameters were documented preoperatively. The enucleation weight, the enucleation and morcellation times, as well as the efficiency, hospitalization, and catheterization durations were calculated. The patients were re-evaluated at 6 months postoperatively, examined for functional results, and compared to baseline conditions. Enucleation times, morcellation times, enucleation weight, and enucleation efficiency were significantly different among the groups. However, there was no statistically significant difference in total operative time and morcellation efficiency. In terms of postoperative statistics, the reduction in hemoglobin was significantly greater in Group 1 compared to Group 2. Six months after surgery, all groups had comparable validated ratings (International Prostate Symptom Score, Quality of Life, and the International Index of Erectile Function-5) on postoperative examinations. There were no long-term complications in either group throughout the perioperative period. Completing 40 first cases would be sufficient for managing the learning curve for early apical release en bloc thulium laser enucleation of the prostate.

Oblique supine position versus prone position for percutaneous nephrolithotomy: a systematic review and meta-analysis.

To compare the efficacy and safety of percutaneous nephrolithotomy (PCNL) in the oblique supine position (OSP) and the prone position (PP). To perform a systematic review and meta-analysis to evaluate the efficacy and safety of OSP versus PP for PCNL. A systematic literature search of PubMed, Ovid, SCOPUS, and citation lists was conducted to identify eligible comparative studies up to November 2022. All studies comparing OSP versus PP for PCNL were included. Statistical analysis was performed with the Collaboration's Review Manager (RevMan) 5.4 software. Overall, eight studies were included involving 1185 patients (OSP = 634; PP = 551). There were no statistically significant differences between OSP and PP in age (WMD = -0.95 years; 95% CI: -2.12 to 0.21; p = 0.83) or proportion of male patients (OR = 0.02; 95% CI: -0.03 to 0.08; p = 0.43). We found that OSP was performed more frequently for smaller stone size and patients with higher BMI (WMD = -0.1 cm, 95% CI: -0.18 to -0.02; p = 0.01) and patients with higher BMI (WMD = 0.66 kg/m2; 95% CI: 0.29 to 1.03; p = 0.0005). The operation time was shorter in OSP than PP (WMD = -14 min; 95% CI: -27.00 to -1.00; p = 0.03). The reduction of hemoglobin was lower in OSP than PP (WMD = -0.39 g/dl; 95% CI: -0.60 to -0.13; p = 0.03). There was no significant difference in stone-free rate and hospitalization between the two groups (OR = 1.32; 95% CI: 0.98 to 1.78; p = 0.07; WMD = -5.99 h; 95% CI: -17.15 to 5.16; p = 0.29). The overall complications were fewer in OSP than in PP (OR = 0.59; 95% CI: 0.43 to 0.81; p = 0.001), but no difference was observed between the positions with regard to the major complications (Clavien-Dindo score ≥ 3) (OR = 0.76; 95% CI: 0.43 to 1.34; p = 0.35). OSP showed non-inferior stone-free rate, blood loss, and hospitalization compared with PP. OSP may be superior in terms of operative time and complications than PP.