Pre Group Research Articles

The correlation between stress score. Quality and duration of sleep with lipid profile and glycemic status.

Diabetes (DM) is a disease of global concern. Studies have suggested that sleep disturbance is affiliated with insulin resistance and poor lipid. Impaired glucose tolerance precedes the diabetic state and we are aware that the blood glucose levels are deranged in these patients, but not much research is done to comment on the pattern of lipid abnormalities, sleep quality and stress in these patients. Hence our study is aimed to identify abnormal patterns or similarities in the above parameters in pre diabetic and diabetic groups. This is a cross - sectional study carried out at the tertiary care hospitals.The data of 45 pre diabetic and diabetic (30 to 70 years) were collected from the files history from Medical Records Department (MRD) after taking permission. The following parameters like glucose and lipid parameters were taken for the study and standard questionnaire was given to correlate the sleep and stress levels. Data analysis were done using SPSS (Statistical Package for Social Sciences) version write the verson number). In the pre diabetic participants, sleep duration varied with stress levels (p=0.03) and their HDL was positively correlated to HbA1c (p=0.02) In the diabetic participants, TC (total cholesterol) varied with both stress (p=0.02) and sleep quality (p=0.001), LDL,& TC: HDL ratio varied only with sleep quality (p=0.04 ratio quality (p=0.01). Triglyceride levels were significantly higher in the diabetic group (p=0.04), as it is a major component of the triad of diabetic dyslipidemia. No other correlations or variations were significant. Poor sleep, abnormal lipid profiles, and stress may serve as risk factors predicting the onset of prediabetes and poor glycemic control. Confirming a direct relationship between these parameters through cohort or experimental studies could facilitate early detection of diabetes and encourage the adoption of appropriate healthy lifestyle measures.

Impact of a Pharmacist-Driven Medication Diluent Volume Optimization Protocol on Fluid Balance and Outcomes in Critically Ill Patients.

Background: Volume overload (VO) is common in the intensive care unit (ICU) and associated with negative outcomes. Approaches have been investigated to curtail VO; however, none specifically focused on medication diluent volume optimization. Objective: Investigate the impact of a pharmacist-driven medication diluent volume optimization protocol on fluid balance in critically ill patients. Methods: A prospective, pilot study was conducted in a medical ICU during October 2021 to December 2021 (pre) and February 2022 to April 2022 (post). A pharmacist-driven medication diluent volume optimization protocol focusing on vasopressor and antimicrobial diluent volumes was implemented. Demographics and clinical data were collected during ICU admission up to 7 days. The primary outcome was net fluid balance on day 3. Secondary outcomes were medication volumes administered, net fluid balance, ICU length of stay, and mortality. Results: Supply chain shortages caused the study to stop at the end of February 2022. Overall, 152 patients were included (123 pre group, 29 post group). The most common admission diagnosis was acute respiratory failure (35%). Vasopressors and antimicrobials were utilized in 47% and 66% of patients, respectively. Net fluid balance on day 3 was greater but not significant in the post group (227.1 mL [-1840.3 to 3483.7] vs 2012.3 mL [-2686.0 to 4846.0]; P = .584). Antimicrobial diluent volumes were significantly less in the post group. No differences were seen in other secondary outcomes. Protocol group assignment was not associated with net fluid balance on day 3. Conclusion: Despite decreasing antimicrobial volume contributions, optimizing diluent volumes alone did not significantly impact overall volume status. Future studies should focus on comprehensive approaches to medication diluent optimization and fluid stewardship.

The Effects of Mulligan Technique and Ultrasound on Pain and Functional Ability in Shoulder Impingement Condition at EMC Sentul Hospital

Shoulder impingement is a painful shoulder condition caused by injuries to the structures in the subacromial space. The research aims to analyze the effects of the Mulligan Technique and Ultrasound on pain and functional ability in shoulder impingement conditions at EMC Sentul Hospital. The research method used is a quasi-experimental design with pre and post-test control groups. Thirty participants were divided into two groups: an intervention group receiving the Mulligan Technique and Ultrasound (15 participants) and a control group receiving TENS and conventional exercise therapy (15 participants). Each participant underwent six sessions per week, twice a week. Before and after the treatment, each participant's pain level was measured using the Numeric Rating Scale (NRS), and functional ability was assessed using the Shoulder Pain and Disability Index (SPADI). The analysis of the data showed that both treatments in the two groups reduced pain and improved functional ability in shoulder impingement conditions. However, there was a significant difference in the group receiving the Mulligan Technique and Ultrasound, with an average pain reduction from 6.6 NRS to 1.3 NRS and an increase in functional ability from 62.6% to 11.85%. The group receiving TENS and conventional exercise therapy showed an average pain reduction from 3.6 NRS to 6.13 NRS and an increase in functional ability from 61.3% to 40.2%. In conclusion, the study suggests that the application of the Mulligan Technique and Ultrasound is more effective in reducing pain and improving functional abil-ity compared to TENS and conventional exercise therapy in shoulder impingement conditions.

THE EFFECT OF MUSIC THERAPY AND POSITIVE AFFIRMATIONS (TEMATIVE) ON REDUCING DEPRESSION LEVELS IN ELDERLY FAMILIES WITH SRTOKE

Introduction: In Indonesia, the problem of stroke is becoming increasingly important to pay attention to because the incidence of stroke in Indonesia is the highest in the Asian region. Stroke sufferers in Indonesia have increased according to 2018 Basic Health Research (RISKESDAS) data based on age groups. Stroke incidents are more common in the 55–64-year age group. Stroke in the elderly is a complex problem because it has an impact on the family. Apart from physical factors, there are psychological problems and illnesses such as chronic disease, poverty, successive failures, prolonged stress, or conflict with family or children. Living conditions like this can trigger depression. Depression can affect anyone, but people with chronic illnesses such as stroke are at higher risk. One method to reduce depression levels is music therapy. The aim of this research is to determine the effect of music therapy on reducing levels of depression. The methodology used is "Quasi experimental pre-post-test wit control group". With the intervention package providing music therapy to the intervention group. Meanwhile, the control group was not given intervention, only given direction. The population in this study were elderly people in the PKM Cipayung work area. Analysis results the results of statistical tests in the control group obtained a p value = 0.254. which means there is no significant difference in the average pre and post-depression levels in the control group. The results of statistical tests in the intervention group showed a p value = 0.058, meaning that there was a significant difference in the average level of anxiety in the pre and post intervention groups.

Efficacy of Game Based Learning (GBL) Instructional Approach on Students’ Task Persistence in Number Bases

This study investigated the efficacy of Game Based Learning (GBL) instructional approach on Junior Secondary School three students’ task persistence in number bases in public secondary schools in South East Nigeria. To achieve the purpose of the study, two research questions and three null hypotheses guided the study. The design of the study was quasi-experimental design; specifically, pre test-post test non-equivalent control group design. The population of the study comprised all the JSS3 students in the region. The sample of four (4) schools was drawn using multi-stage sampling procedures. Out of the four (4) schools sampled, two (2) were assigned to experimental groups and the other two (2) schools were assigned to control groups. Game Based Task Persistence Rating Scale (GBTPRS) containing of 20 items, was the instrument used for the study. The instrument was validated by three experts in Faculty of Education University of Nigeria, Nsukka. The instrument was trial tested on a sample of 30 JSS 3 students in private school and the reliability index of 0.83 was gotten using Cronbach’s Alpha. Six (6) lesson plans which lasted for three weeks, three (3) for the experimental group and the other three (3) for the control group were used for the study. The data collected were analyzed using mean, and standard deviation to answer the research questions and Analysis of Covariance (ANCOVA) was used to test the null hypotheses at 0.05 level of significance. The results of the study revealed that Game Based Learning instructional approach was efficacious in improving the students’ task persistence in number bases than conventional based learning instructional approach. Based on the findings, it was recommended that Mathematics teachers should use GBL instructional approach while teaching the subject.

Assessing the impact of creating virtual windows on the incidence of delirium in a surgical intensive care unit: a before and after study

Introduction: Delirium is a frequent and important problem in the intensive care unit (ICU), and non-pharmacological means of prevention are limited. The importance of the physical environment in the occurrence of delirium in intensive care has been reported, particularly the presence of windows and daylight. We organized a trial to evaluate if the installation of virtual windows in the form of paintings in rooms without an actual window can limit the occurrence of delirium in ICU patients. Methods: We conducted a retrospective pre and post cohort study in a surgical ICU of a university-affiliated hospital. Patients residing for more than 48 hours in a windowless room before and after the installation of virtual windows were included in the trial. The primary endpoint was the incidence of a positive screening test for delirium during their time in the ICU. The Intensive Care Delirium Screening Checklist (ICDSC) was used as an objective screening tool to assess the occurrence of delirium. Results: A total of 400 patients were included in this trial (pre group: n = 200; post group: n = 200). The groups were well balanced except for the score APACHE II who was significantly higher in the post intervention group. The incidence of a positive screening test for delirium was similar in both groups after correction for confounding factors (29% vs 27%; OR 0,906 [0,584-1,402], p=0,656). Conclusion: The installation of virtual windows did not reduce the incidence of delirium in a surgical intensive care unit. Keywords Critical care, delirium, windows, prevention, circadian cycle.

The effect of cardio and tabata training methods in reducing body fat and increasing maximum aerobic capacity in obese students

This study aimed to determine the effect of cardio and tabata training on reducing body fat and increasing aerobic capacity. This research is an experimental research with a pre and post-control group design. The research sample was split into three groups, each with 9 participants: control group (K1), cardio group (K2), and Tabata group (K3), group division was carried out randomly on research subjects. K1 without any exercise, whereas K2 (cardio) is running and skipping at an intensity of 55% and 70% of one's maximum heart rate. K3 (Tabata) performs burpees and jogging with a 90% – 95% HR maximum intensity. A skinfold calliper was used to quantify body fat, and a 12-minute Cooper test was used to gauge aerobic capacity. The Manova test was employed for data analysis, and a significance threshold 0.05 was used. The result of this study is that K3 had significantly less body fat than K1 and K2, and K2 had significantly less body fat than K1 (p 0.05). Comparing K3 and K2 to K1, aerobic capacity was substantially improved (p 0.05). In conclusion, six weeks of cardio and Tabata training impacted lowering body fat and raising maximum aerobic capacity.

Pulmonary Fibrosis with Increasing of Interleukin-6 in Sprague Dawley Rats with Metabolic Syndrome

Background: Pulmonary fibrosis is the result of chronic inflammation causing decreased lung function. Severe lung damage and worsening respiratory symptoms can caused by metabolic syndrome. In metabolic syndrome, obesity, dyslipidemia, hypertension, and insulin occurs, also chronic inflammation and increased interleukin-6. Research on rats with high-fat high-fructose diet caused metabolic syndrome that triggered chronic inflammatory formed pulmonary fibrosis, which decreased lung function. The study result aim to increase awareness of pulmonary fibrosis due to chronic inflammation in metabolic syndrome. Methods: The study design was true experimental in vivo test, pre and post test control group, with male Sprague-Dawley rats aged 37 weeks. Comparing each of 10 in control and metabolic syndrome groups. Metabolic syndrome expressed by increase of weight, triglycerides, blood sugar, and low HDL. Pulmonary tissue fibrosis assessed with modified Aschroft score. Examination of plasma and tissue Interleukin-6 by ELISA, and the degree of tissue fibrosis by HE staining under a microscope. Different test with independent T-test and Mann-Whitney methods. Results: There were significant differences in plasma and tissue Interleukin-6 and degree of lung tissue fibrosis between control and metabolic syndrome groups with each p<0.05. There is an increase of plasma Interleukin-6, tissue Interleukin-6, and also degree of lung tissue fibrosis on metabolic syndrom group than control group. Conclusion: There is an increase in the degree of pulmonary tissue fibrosis accompanied by an increase in plasma and tissue IL-6 in rats with metabolic syndrome.

Curcumin: Compound in Turmeric that Has the Potential to Increase Serum Interleukin-10 (IL-10) Levels After High-Intensity Exercise

This study aims to analyze the effect of curcumin on serum IL-10 levels after high-intensity exercise. This experimental research uses pre and post-control group design. Research subjects were selected using purposive sampling technique. Next, the subjects were divided into 2 groups, namely group (K1) given placebo and group (K2) given curcumin. A total of 20 healthy men participated in this study who were selected based on inclusion and exclusion criteria. On the first day, all subjects collected data on the characteristics of the research subjects, then warmed up, then the subjects did exercises in the form of squad exercises and leg presses with an intensity of 80-90% of their maximum ability. Exercises are done in 4 sets, 10 repetitions for each form of exercise and rest between sets for approximately 60 seconds. On the second day, after 24 hours, all subjects had pre-test blood samples taken to measure serum IL-10 levels and were given intervention according to group. On the third day, after 24 hours, all subjects had post-test blood samples taken to measure serum IL-10 levels. Blood samples were analyzed in the laboratory using the ELISA method with the Human IL-10 ELISA kit catalog number MDBEH6154. The results of this study reported that the group given curcumin at a dose of 400 mg had significantly increased serum IL-10 levels (p<0.05). Increasing serum IL-10 levels, which is an anti-inflammatory cytokine, has the potential to control uncontrolled inflammation after exercise. So in this case, the anti-inflammatory properties of curcumin also have the potential to reduce post-exercise muscle pain. Reducing the intensity of pain after high intensity exercise is necessary to support body function. Keywords: Curcumin, Inflammation, Cytokines, Pain Intensity, Exercise

The Effect of Warm Compress Hydrotherapy Technique Towards The Intensity of The First Active Stage In Labor Pain For Inpartu Mothers at Herlang Public Health Centre of Bulukumba Regency in 2023

Almost all inpartum mothers experience labor pain, but each mother has a different intensity. Psychology of mothers during childbirth and support from people around during the labor process can affect the intensity of labor pain. When labor pain can not be handled properly, it can make the mother stressed and can hinder the birth process itself.
 This research aimed to know the effect of warm compress hydrotherapy technique towards the intensity of the first active stage in labor pain for inpartum mothers at Herlang Public Health Centre of Bulukumba Regency in 2023.
 This research was a quasi-experimental, namely non-equivalent control group. The sample of this research was inpartu mothers using purposive sampling technique consisting of 30 respondents. Data were analyzed by using univariately in a frequency distribution and bivariate to test the relationship between variables by testing Wilcoxon in the pre - post group and the Mann-Whilney test in the control intervention group.
 The results showed that in the control intervention group using the Mann-Whitney U test was obtained was (0.000 <0.05) and the pre post intervention control group using the Wilcoxon test was obtained value (0.000 0.05).
 The conclusion in this research there is an effect effect of warm compress hydrotherapy technique Towards the intensity of the first active stage in labor pain for inpartum mothers. It is expected to health workers can apply warm compress hydrotherapy techniques to reduce the intensity of labor pain.

Service evaluation of the implementation of SGLT-2 Inhibitor checklist on information communicated and documented to patients and transfer of care-records

Abstract Introduction Sodium Glucose Co-Transporter 2 (SGLT-2) Inhibitors’ therapeutic role has evolved1 as recent clinical trials showed they have beneficial effects across all stages of the cardio-renal metabolic spectrum2. There are different indications and specialities responsible for the initiation of these medications, so communication from health professionals to patients and documentation of this on transfer of care records is paramount3. It is important all health-care professionals ensure their clinical knowledge is current and updated to be able to communicate accurate and correct information to patients on their medications. A SGLT-2 Inhibitor counselling checklist was developed and approved for implementation in The Trust to promote awareness of new clinical guidelines and support the counselling provided to patients. The checklist included recommendations of the information to communicate and document on patient care records. Aim The aim was to assess the impact of the SGLT-2 Inhibitor counselling checklist on the information provided to patients and to identify if the indication and speciality responsible were recorded on transfer of patient care records for patients newly prescribed SGLT-2 inhibitors. Methods Ethical approval was not required for this quantitative research service evaluation. A data collection tool designed in Excel Microsoft 365 was used to collect data. Data was collected manually by the lead author retrospectively (pre-implementation of the checklist) from 1st January – 30th March 2022, and prospectively (post-implementation) from 1st July – 30th September 2022 from discharge prescriptions detailing newly prescribed SGLT-2 Inhibitors related to patients from four selected wards (A- D). Descriptive statistical analysis was carried out to compare the pre and post implementation data. Results Over the 6 month study period, a total of 110 patients were newly prescribed a SGLT-2 Inhibitor (63 pre- implementation and 47 post implementation). There was increased information communicated to patients in the post implementation group when compared to the pre implementation group. The percentage of patients provided with medicine information books and ‘protect my kidney’ cards increased from 25% to 70% and the proportion that received counselling increased from 27% to 70%. The indication and speciality involved with initiation and prescribing of SGLT-2 Inhibitors was well communicated and documented from 3% unknown in the pre group compared to 0% in the post implementation group. Discussion/Conclusion Despite this study being limited to a short collection period and a small sample size, the data collected demonstrates that the SGLT-2 inhibitor counselling checklist can increase the information communicated to patients and improve information included on transfer of care records, which is paramount between healthcare professionals to ensure a seamless transfer of care3. A key implication is the need to ensure use of counselling checklists as part of the discharge process.

Anti-Hyperglycemic Effect of Combination Etanolic Extract of Sambiloto (Andrographis paniculata) and Bitter Melon Fruit (Momordica charantia L) on Alloxan-Induced Wistar White Rats

Diabetes Mellitus is a metabolic disorder characterized by hyperglycemia caused by a decrease in insulin secretion. Sambiloto leaves (Andrographis paniculata (Burm.f.) Wall. Ex Ness) and bitter melon (Momordica charantia L) are types of plants that are used as regulators of blood sugar levels. The study aimed to determine the effectiveness and effective comparative doses in the combination of sambiloto leaf extract (Andrographis paniculata (Burm.f.) Wall. Ex Ness) and bitter melon (Momordica charantia L) on alloxan-induced Wistar white rats. This study is experimental research with a pre and post-control group design, using a sample of 24 subjects. The data analysis in this study employed normality and homogeneity tests, obtaining a significance result of p>0.05. The development of the ANOVA test revealed a significant value of p

Soursop Leaf Nanoparticles On Blood Glucose Levels And Ankle Brachial Pressure Index (ABPI) Values In Type-2 Diabetes Mellitus Patients

Chronic hyperglycemia will cause legs and blood circulation disorders. Treatment with insulin is still quite expensive and with some side effects of oral hypoglycemic drugs. This experience made the management of DM switch to herbal treatment, namely soursop leaves (Annona muricata). The study used a pre and post test control group design with random allocation. Quasy experimental study with a two group pre tpost-testest – post tepost-testst design at 36type-2 DM patients in the Pekalongan City area. Blood glucose levels in the treatment group were measured before and after administration of soursop leaf nanoparticles500 ml/20 gBB 3 times a day for 6 days and 500 mg metformin. Giving soursop leaf nanoparticles at a dose of 500 ml/20 grBW 3 times a day for 6 days is effective on fasting blood glucose levels clinically with a change in value of 65 mg/dL, and has a statistically significant effect on reducing fasting glucose levels (p=0.035).

The Effect of Moringa Leaf Extract (Moringa Oliefera) On Triglyceride Levels in Streptozotocin Induced Type 2 Diabetes White Wistar Rats

High blood sugar levels can hasten the liver's production of triglycerides. Normally, the body uses glucose as one of its energy sources. This study aimed to determine changes in the weight of mice and decrease triglyceride levels in mice by administering Moringa leaf extract. This type of research is a pure experiment with a "pre and post-randomized controlled group" design. This was carried out using a repeated ANOVA test, a sample of 25 mice. The research used male white rats of the Wistar strain, which were induced with STZ (Streptozotocin) at a dose of 65 mg/kg BW and NA 230 mg/kg BW, where the experimental animals were divided into 5 groups, namely negative control group, positive control and 3 treatment groups given the extract. from Moringa leaves at a dose of 200, 300, 400 mg/kg BW of rats. The optimal dose of Moringa leaves for losing weight and reducing triglyceride levels in mice is a dose of 400 mg/kg of mouse body weight. Glibenclamide (0.09 mg/kg rat body weight) and Moringa leaf extract (300 mg/kg rat body weight) are each the optimal dose to reduce glucose levels in rats. With a p value for each variable of 0.001, administration of Moringa leaf extract affected body weight, glucose and triglyceride levels in white Wistar rats with type 2 diabetes induced by streptozotocin. These findings suggest that Moringa leaf extract may have potential therapeutic effects in treating diabetes-related complications.

Seasonal variations of airborne microbial diversity in waste transfer stations and preventive effect on Streptococcus pneumoniae induced pulmonary inflammation

Environment, location, and season are important factors that influence the microbiological community, yet, little research on airborne microorganisms in waste transfer stations (WTSs). Here, the airborne bacterial and fungal communities at four WTSs during different seasons were analyzed by high-throughput sequencing. The bacteria were isolated by cultural method and screened bacterium alleviate inflammation induced by Streptococcus pneumoniae (Spn) by regulating gut microbiome. The results revealed that collected bioaerosols from the WTSs varied significantly by location and season. Proteobacteria and Pseudomonadota are prevalent in summer and winter, respectively. Ascomycota was predominant in two seasons. Hazard quotients for adults from four WTSs were below one. Three selected potential probiotics were formulated into a microbial preparation with a carrier that effectively prevented inflammation in bacterial and animal experiments. The expression levels of interleukin-1β, interleukin-6, and tumor necrosis factor-α in Pre group (0.11, 0.17, and 0.48-fold) were significantly lower than Spn group (2.75, 1.71, and 5.01-fold). These mechanisms are associated with changes in gut microbiota composition and short-chain fatty acids (SCFAs) levels, such as affecting Lachnospiraceae lachnospira abundance and acetic acid content. This study provides insights into the potential application of probiotics derived from WTSs as an alternative approach to preventing respiratory infections.

1272. Teaching the ABCs of ASB in a 60-minute educational intervention. A quality improvement project.

Abstract Background Asymptomatic bacteriuria (ASB) refers to the presence of bacteria in the urine of individuals that do not present with symptoms of urinary tract infection (UTI). Treatment for ASB is not recommended in most cases. [1] Previous studies have shown that provider education on proper antibiotic use has been effective in mitigating the ongoing wave of antimicrobial-resistant organisms across hospitals in the United States.[2] We aimed to decrease the proportion of cases classified as having asymptomatic bacteria by 20% in four months after the intervention using a small group discussion and a presentation. Methods We evaluated the rates of inappropriate antimicrobial prescribing for asymptomatic bacteriuria (ASB) for 4 months before educational intervention and 4 months after. Data was extracted from the electronic medical record (Cerner®), imported into REDCap®, and with standardized manual chart review. Data analysis was completed using STATA® 17 & 18. Results The mean duration of antibiotic therapy was 7.9 days in the pre-intervention group and 6.1 days in the post-intervention group. See Table 1 for more details on demographics. Following the intervention, the rate of inappropriate use of antimicrobial therapy in ASB was reduced by 29.8% (p-value 0.035). The mean duration of antibiotic therapy decreased by almost 2 days in the post-intervention group. Conclusion This quality improvement project suggests that focused interventions of short interactive educational sessions in small groups may reduce the inappropriate use of antibiotics in ASB by almost 30%. The mean duration in days of antibiotic treatment decreased from 7.9 days to 6.1 days in the pre and post-intervention groups (p-value 0.060). Of note the total number of cases with providers selecting UTI as an indication was also lower in the post-intervention group and although we can’t determine causality, it provided evidence of a lower number of cases, providers initially classified as UTI between the pre and post-intervention period from 33 to 19. Further research may include incorporating small groups and interprofessional educational interventions to help implement good antimicrobial stewardship in inpatient care facilities. [4,5,6] Disclosures All Authors: No reported disclosures

Investigation of the Possible Association Between Galectin and Apoptosis in Gastric Cancer Patients

Cancer is a type of disease that occurs as a result of the uncontrolled growth of cells, which has been very common in recent years, and some species have a poor prognosis. Galectin-3 is a multifunctional protein and is associated with the developmental process of tumors, including cell growth, adhesion, proliferation and metastasis. Galectin-3 has a broad effect on tumor development, including cell proliferation, apoptosis, cell adhesion, invasion, angiogenesis, and metastasis. Members of the BCLF-2 family are anti-apoptotic molecules required for the proteolytic degradation of the cell by caspases, which is the ultimate drive of programmed cell death, which plays a very important role in the regulation of the apoptotic pathway, ensures the integrity of the mitochondrial membrane and prevents the release of cytochrome C from the mitochondria. NF-kB, which is one of the important factors in cancer formation, is found in the cytoplasm, and there is a correlation between the protein levels of proinflammatory cytokines such as interlukin (IL)-1b, and IL-8, and the high incidence of cancer. There are two types of apoptotic caspases: initiator (apical) caspases and effector (executioner) caspases. Initiator caspases (e.g., caspase-2, -8, -9 and -10) cleave inactive pro-forms of effector caspases, thereby activating them. Effector caspases (e.g., caspase-3, -6, -7) in turn cleave other protein substrates within the cell resulting in the apoptotic process. At least fourteen caspases have so far been implicated in human apoptotic pathway cascade. Among these, caspase-3 is considered to be a major executioner protease in apoptosis. To examine this mechanism in more detail, we aimed to examine the difference between Galectin, BCLF-2, Kaspase3, Kaspas 8, Nfkb levels before and after treatment in operable gastric cancer patients with the Elisa test. In this study, We observed a statistical increase in Galectin, BCLF-2, Kaspase3, Kaspas 8, Nfkb levels when the control group was compared with the preoperative group. There was a statistically significant increase in Galectin, BCLF-2, Nfkb, Caspase3, Caspase 8 levels in the preoperative group compared to the control. There is a statistical increased in Galectin, BCLF-2, Kaspase3, Kaspas 8, Nfkb levels in the postoperative group compared to the control. Although there was no statistical difference in Galectin, BCLF-2, Caspase-3, Caspase-8, Nfkb levels between pre and postoperative groups, a significant decrease was observed in Galectin, BCLF-2, Nfkb levels. A very slight increase was observed in Caspase-3 and Caspase-8 levels. In conclusion, we think that Galectin-3 Bcl-2 and NF-kB may be markers for gastric cancer patients. We think that it is appropriate to conduct this study with more patient groups and a longer period.

Incidental Dysplasia During Total Proctocolectomy With Ileoanal Pouch: Is It Associated With Worse Outcomes?

Patients with inflammatory bowel disease (IBD) are at increased risk of colorectal cancer. In cases of invisible or nonendoscopically resectable dysplasia found at colonoscopy, total proctocolectomy with ileal pouch anal anastomosis can be offered with good long-term outcomes; however, little is known regarding cancer-related outcomes when dysplasia is found incidentally after surgery on final pathology. Using our prospectively collected pouch registry, we identified patients who had preoperative colonic dysplasia or dysplasia found only after colectomy. Patients with cancer preoperatively or after colectomy were excluded. Included patients were divided into 3 groups: PRE (+preoperative biopsy, negative final pathology), BOTH (+preoperative biopsy and final pathology), and POST (negative preoperative biopsy, +final pathology). Long-term outcomes in the 3 groups were assessed. In total, 517 patients were included: PRE = 125, BOTH = 254, POST = 137. After a median follow-up of 12 years (IQR 3-21), there were no differences in overall, disease-free, or pouch survival between groups. Cancer/dysplasia developed in 11 patients: 3 (2%) in the PRE, 5 (2%) in the BOTH, and 3 (2%) in the POST group. Only 1 cancer-related death occurred in the entire cohort (PRE group). Disease-free survival at 10 years was 98% for all groups (P = .97). Pouch survival at 10 years was 96% for PRE, 99% for BOTH, and 97% for POST (P = .24). The incidental finding of dysplasia on final pathology after proctocolectomy was not associated with worsened outcomes compared with preoperatively diagnosed dysplasia.

Abstract 16523: Trends and Outcomes of Preeclampsia Hospitalizations According to the Nationwide Inpatient Sample 2016-2020; An Updated Retrospective Population-Based Study

Introduction: Preeclampsia occurs in about 5-8% of pregnancies and is a leading cause of maternal morbidity and mortality. We aimed to study the inpatient population with preeclampsia. Hypothesis: The disparity gap remains apparent in maternal health, and minority populations would have poorer outcomes Methods: We conducted a retrospective analysis using the 2016 to 2020 Nationwide Inpatient Sample (NIS) database. Using ICD-10 codes, we identified all hospitalizations with a primary diagnosis of preeclampsia. We adjusted for confounders and used a multivariate logistic regression model to estimate the odds ratio (adjusted odds ratios (aOR)) of our outcomes of interest. Results: There were 126,255 primary preeclampsia hospitalizations (PRE) during the study period, of which 2.2% (2,736) had eclampsia (ECL). There was an increase in the number of PRE hospitalizations from 24459 (24.5 per 1000 deliveries) in 2016 to 28448 (28.4 per 1000 pregnancies) in 2020 (p <0.0001). Contrary to PRE admissions, there was a considerable decrease in hospitalizations or diagnoses for ECL from 958 (1 per 1000 deliveries) in 2016 to 417 (0.4 per 1000 deliveries) in 2020 (p<0.0001). The mean age was 29 years (SD=6.3), and the mean length of hospitalization was 4 days (SD=3.6). Compared to their Caucasian counterparts, the risk of eclampsia was higher in the minority populations, with aOR of 2.4 (CI 2.1-2.6, p<0.0001) in the Black, 1.3 (CI 1.1-1.4, p<0.0001) in the Hispanic, 1.01 (CI 0.8-1.3, p=0.7) in the Asian, and 1.7 (CI 1.1-2.4, p<0.0001) in the Native-American populations. Furthermore, the PRE group had a higher likelihood of postpartum acute kidney injury, 9.6 (CI 7.8-11.6, p<0.0001), and postpartum cardiomyopathy 3.3 (2.9-3.9, p<0.0001). Conclusions: Our five-year inpatient analysis revealed that while preeclampsia hospitalizations increased, eclampsia decreased. It also highlighted a higher likelihood of eclampsia in Black, Hispanic, and Native-American women and a subsequent increased risk for postpartum cardiomyopathy and acute kidney injury. Tailoring individualized maternal cardiovascular care based on risk stratification is crucial in these populations.

Abstract 376: Comparison of Pre and Post Conditioning With Poloxamer 188 in Rat Model of Severe Hemorrhagic Shock

Background: Hemorrhagic shock remains a leading cause of morbidity and mortality after trauma. Poloxamer (P) 188, an FDA-approved copolymer-based cell membrane stabilizer, is a nonionic triblock copolymer believed to prevent cellular injury after ischemia and reperfusion. While post conditioning may be used in a broad range of scenarios, pre-conditioning may add improved efficacy in scenarios where hemorrhage can be expected, the peri-operative period. We have previously demonstrated prolonged survival with P188 post-conditioning however without complete rescue, here we hypothesize pre-conditioning would further improve survival. Methods: 35 male Sprague Dawley rats (564+/-73 g) were anesthetized, ventilated and instrumented. All rats underwent rapid controlled blood loss of 40% estimated blood volume over 30 min, followed by prolonged permissive hypotension for 60 min before re-transfusion of the lost blood to euvolemia and up to 6 hrs of monitoring under general anesthesia. Rats were then randomized to 3 groups: 10 rats received a 0.8 cc iv bolus of 250mg/kg P188 15min before hemorrhage (pre), 12 rats received the same dose of P188 after hemorrhage (post), and 13 control rats only received 0.8 cc vehicle. Primary endpoint was survival time from the start of hemorrhage. Data are median and IQ range; statistics: Kruskal-Wallis and Chi-Square tests, *p<0.05. Results: P188 administration immediately after hemorrhage significantly improved median survival time compared to both the pre and control groups [post *245 (49, 314) min vs. control group; 53 (32-60), vs pre; 59 (24-70) min, p = 0.0174, 0.00045, respectively]. However, there was no significant differences in survival time between pre and control grouyps and there were no differences in survival rate at 6 hours (pre; 0% vs post; 8% vs control; 7%). Conclusion: A bolus of P188 given immediately after a severe hemorrhagic insult prolonged survival time significantly. However, administration of P188 15 min before hemorrhage did not produce a significant prolongation of survival time.P188 is a highly promising compound whose dose, application timing and application duration in severe hemorrhagic shock require more research.