International Science Index

13
10007680
Sickle Cell Disease: Review of Managements in Pregnancy and the Outcome in Ampang Hospital, Selangor
Abstract:
The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.
Paper Detail
40
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12
10005345
Identification of Active Phytocomponents in the Ethyl Acetate Extract of Glycosmis pentaphylla Retz. DC by Using GC-MS
Abstract:

Glycosmis pentaphylla is one of the medicinally important plants belonging to the family Rutaceae, commonly known as “Anam or Panal” in Tamil. Traditionally, leaves are useful in fever, hepatopathy, eczema, skin disease, helminthiasis, wounds, and erysipelas. The fruits are sweet and are useful in vitiated conditions of vata, kapha, cough, and bronchitis. The roots are good for facial inflammations, rheumatism, jaundice, and anemia. The preliminary phytochemical investigations indicated the presence of alkaloids, terpenoids, flavonoids, tannins, sugar, glycoside, and phenolic compounds. In the present study, the root part of Glycosmis pentaphylla was used, and the root was collected from Western Ghats of South India. The root was sun/shade dried and pulverized to powder in a mechanical grinder. The powder was successively extracted with various solvents, and the ethyl acetate extract of Glycosmis pentaphylla has been subjected to the GC-MS analysis. Amongst the 46 chemical constituents identified from this plant, three major phytoconstituents were reported for the first time. Marmesin, a furanocumarin compound with the chemical structure 7H-Furo (3,2-G) (1)Benzopyran-7-one,2,3–dihydro–2 - (1-Hydroxy-1methylethyl)-(s) is one of the three compounds identified for the first time at the concentration of 11-60% in ethyl acetate extract of Glycosmis pentaphylla. Others include, Beta.-Fagarine (4.71%) and Paverine (13.08%).

Paper Detail
577
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11
10001819
Effect of Zidovudine on Hematological and Virologic Parameters among Female Sex Workers Receiving Antiretroviral Therapy (ART) in North – Western Nigeria
Abstract:
Hemoglobin (HB) indicates anemia level and by extension may reflect the nutritional level and perhaps the immunity of an individual. Some antiretroviral drugs like Zidovudine are known to cause anemia in people living with HIV/AIDS (PLWHA). A cross sectional study using demographic data and blood specimen from 218 female commercial sex workers attending antiretroviral therapy (ART) clinics was conducted between December, 2009 and July, 2011 to assess the effect of zidovudine on hematologic, and RNA viral load of female sex workers receiving antiretroviral treatment in north western Nigeria. Anemia is a common and serious complication of both HIV infection and its treatment. In the setting of HIV infection, anemia has been associated with decreased quality of life, functional status, and survival. Antiretroviral therapy, particularly the highly active antiretroviral therapy (HAART), has been associated with a decrease in the incidence and severity of anemia in HIV-infected patients who have received a HAART regimen for at least 1 year. In this study, result has shown that of the 218 patients, 26 with hemoglobin count between 5.1 – 10g/dl were observed to have the highest viral load count of 300,000 – 350,000copies/ml. It was also observed that most patients (190) with HB of 10.1 – 15.0g/dl had viral load count of 200,000 – 250,000 copies /ml. An inverse relationship therefore exists i.e. the lower the hemoglobin level, the higher the viral load count even though the test statistics did not show any significance between the two (P = 0.206). This shows that multivariate logistic regression analysis demonstrated that anemia was associated with a CD4 + cell count below 50/μL, female sex workers with a viral load above 100,000 copies/mL, who use zidovudine. Severe anemia was less prevalent in this study population than in historical comparators; however, mild to moderate anemia rates remain high. The study therefore recommends that hematological and virologic parameters be monitored closely in patients receiving first line ART regimen.
Paper Detail
1095
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10
10000888
In vivo Iron Availability and Profile Lipid Composition in Anemic Rats Fed on Diets with Black Rice Bran Extract
Abstract:

Iron is an essential nutrient with limited bioavailability. Nutritional anemia caused mainly by iron deficiency is the most recognized nutritional problem in both countries as well as affluent societies. Rice (Oryza sativa L.) has become the most important cereal crop for the improvement of human health due to the starch, protein, oil, and the majority of micronutrients, particularly in Asian countries. In this study, the iron availability and profile lipid were evaluated for the extracts from Cibeusi varieties (black rices) of ancient rice brans. Results: The quality of K, B, R, E diets groups shows the same effect on the growth of rats. Hematocrit and MCHC levels of rats fed K, B, R and E diets were not significantly (P<0.05). MCV and MCH levels of rats K, B, R were significantly (P<0.05) with E groups but rats K, B, R were not significantly (P<0.05). The iron content in the serum of rats fed with K, B, R and E diets were not significantly (P<0.05). The highest level of iron in the serum was founded in the B group. The iron content in the liver of rats fed with K, B, R and E diets were not significantly (P<0.05). The highest level of iron in the liver was founded in the R group. HDL cholesterol levels were significantly (P<0.05) between rats of fed B, E with K, R, but K and R were not significantly (P<0.05). LDL cholesterol levels of rats fed K and E significantly (P<0.05) with B and R. Conclusions: the bran of pigmented rice varieties has, with some exceptions, greater antioxidant and free-radical scavenging activities. The results also show that pigmented rice extracts acted as prooxidants in the lipid peroxidation assay, possibly by mechanisms described for the pro-oxidant activities of tocopherol and ascorbic. Pigmented rice bran extracts more effectively increases iron stores and reduces the prevalence of iron deficiency.

Paper Detail
1237
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9
10000202
Comparative Study Using Weka for Red Blood Cells Classification
Abstract:

Red blood cells (RBC) are the most common types of blood cells and are the most intensively studied in cell biology. The lack of RBCs is a condition in which the amount of hemoglobin level is lower than normal and is referred to as “anemia”. Abnormalities in RBCs will affect the exchange of oxygen. This paper presents a comparative study for various techniques for classifying the RBCs as normal or abnormal (anemic) using WEKA. WEKA is an open source consists of different machine learning algorithms for data mining applications. The algorithms tested are Radial Basis Function neural network, Support vector machine, and K-Nearest Neighbors algorithm. Two sets of combined features were utilized for classification of blood cells images. The first set, exclusively consist of geometrical features, was used to identify whether the tested blood cell has a spherical shape or non-spherical cells. While the second set, consist mainly of textural features was used to recognize the types of the spherical cells. We have provided an evaluation based on applying these classification methods to our RBCs image dataset which were obtained from Serdang Hospital - Malaysia, and measuring the accuracy of test results. The best achieved classification rates are 97%, 98%, and 79% for Support vector machines, Radial Basis Function neural network, and K-Nearest Neighbors algorithm respectively.

Paper Detail
1917
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8
9999608
Isolation and Classification of Red Blood Cells in Anemic Microscopic Images
Abstract:

Red blood cells (RBCs) are among the most commonly and intensively studied type of blood cells in cell biology. Anemia is a lack of RBCs is characterized by its level compared to the normal hemoglobin level. In this study, a system based image processing methodology was developed to localize and extract RBCs from microscopic images. Also, the machine learning approach is adopted to classify the localized anemic RBCs images. Several textural and geometrical features are calculated for each extracted RBCs. The training set of features was analyzed using principal component analysis (PCA). With the proposed method, RBCs were isolated in 4.3secondsfrom an image containing 18 to 27 cells. The reasons behind using PCA are its low computation complexity and suitability to find the most discriminating features which can lead to accurate classification decisions. Our classifier algorithm yielded accuracy rates of 100%, 99.99%, and 96.50% for K-nearest neighbor (K-NN) algorithm, support vector machine (SVM), and neural network RBFNN, respectively. Classification was evaluated in highly sensitivity, specificity, and kappa statistical parameters. In conclusion, the classification results were obtained within short time period, and the results became better when PCA was used.

Paper Detail
2170
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7
9998658
Multiple Organ Manifestation in Neonatal Lupus Erythematous (Report of Two Cases)
Abstract:

Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Paper Detail
1324
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6
9997458
Aflatoxins Aggravate the Incidence of Salmonellosis Outbreak in Fattening Calves: A Case Study
Abstract:

Fever, bloody diarrhea and high mortality rate were the main clinical finding in a group of fattening calves. Analysis of corn silage revealed presence of aflatoxins at level of 370 ppb. This level of aflatoxins in the feed of cattle is somewhat low to be the main cause of reported signs. Leukocytopenia, anemia, decreased lymphocytic activity and lowered phagocytic index are the main hematological and immunological alterations in diseased calves. Bacteriological investigation revealed isolation of pathogenic Salmonella typhimurium from the rectal swabs of diseased calves. Our results suggested that, long duration of exposure to aflatoxins even at small concentrations may considered as predisposing factor for the incidence of natural infectious outbreaks as salmonellosis due to its immunosuppressive effect. We can conclude that the veterinarians and owners must be given an attention to the relation between aflatoxicosis and salmonellosis under field condition. We are recommended that the treatment program during similar outbreaks must be including anti-aflatoxins preparations beside the antimicrobial therapy.

Paper Detail
1504
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5
1277
The Effect of a Nutrient Fortified Oat Drink on Iron, Zinc, Vitamin A, and Vitamin C Status among Filipino Children
Abstract:

The effectiveness of consuming a nutrient fortified oat drink on iron, zinc, vitamin A and vitamin C status was assessed among a cohort of school-aged Filipino children. Ultimate study implementation permitted only a within-subject comparison of change in nutritional status after four months of consuming a nutrient fortified oat drink. Thirty-eight anemic children (5-8 years) consumed an oat drink fortified with iron as NaFeEDTA, zinc, vitamin A and vitamin C for 120 days. Height, weight, serum nutrient levels, anemia status and dietary intake were assessed pre and post intervention. Thirty-four anemic children completed the intervention. After 4 months of intervention, prevalence of anemia decreased by 68% and significant improvements in iron and vitamin A status were observed. Results demonstrate the effectiveness of the fortified oat drink in alleviating anemia in young children and highlight the value of fortification programs

Paper Detail
1513
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4
12851
Study of Sickle Cell Syndromes in the Population of the Region of Batna
Abstract:
Sickle cell anemia is a recessive genetic disease caused by the presence in the red blood cell, of abnormal hemoglobin called hemoglobin S. It results from the replacement in the beta chain of the acid glutamic acid by valin at position 6. Topics may be homozygous (SS) or heterozygous (AS) most often asymptomatic. Other mutations result in compound heterozygous: - Synthesis of hemoglobin C mutation in the sixth leucin codon (heterozygous SC); - ß-thalassemia (heterozygous S-ß thalassemia). SS homozygous, heterozygous SC and S- ß -thalassemia are grouped under the major sickle cell syndromes. To make a laboratory diagnosis of hemoglobinopathies in a portion of the population in region of Batna, our study was conducted on 115 patients with suspected sickle cell anemia, all cases have benefited from hematological tests as blood count (count RBC, calculated erythrocyte indices, MCV and MCHC, measuring the hemoglobin concentration) and a biochemical test in this case electrophoresis CAPILLARYS HEMOGLOBIN (E). The results showed: 27 cases of sickle cell anemia were found on 115 suspected cases, 73,03% homozygous sickle cell disease and 59,25% sickle cell trait. Finally, the double heterozygous S/C, represent the incidence rate of 3, 70%.
Paper Detail
924
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3
10505
Mathematical Model for the Transmission of Two Plasmodium Malaria
Authors:
Abstract:
Malaria is transmitted to the human by biting of infected Anopheles mosquitoes. This disease is a serious, acute and chronic relapsing infection to humans. Fever, nausea, vomiting, back pain, increased sweating anemia and splenomegaly (enlargement of the spleen) are the symptoms of the patients who infected with this disease. It is caused by the multiplication of protozoa parasite of the genus Plasmodium. Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale are the four types of Plasmodium malaria. A mathematical model for the transmission of Plasmodium Malaria is developed in which the human and vector population are divided into two classes, the susceptible and the infectious classes. In this paper, we formulate the dynamical model of Plasmodium falciparum and Plasmodium vivax malaria. The standard dynamical analysis is used for analyzing the behavior for the transmission of this disease. The Threshold condition is found and numerical results are shown to confirm the analytical results.
Paper Detail
990
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2
11889
Fuzzy Logic Approach to Robust Regression Models of Uncertain Medical Categories
Abstract:

Dichotomization of the outcome by a single cut-off point is an important part of various medical studies. Usually the relationship between the resulted dichotomized dependent variable and explanatory variables is analyzed with linear regression, probit regression or logistic regression. However, in many real-life situations, a certain cut-off point dividing the outcome into two groups is unknown and can be specified only approximately, i.e. surrounded by some (small) uncertainty. It means that in order to have any practical meaning the regression model must be robust to this uncertainty. In this paper, we show that neither the beta in the linear regression model, nor its significance level is robust to the small variations in the dichotomization cut-off point. As an alternative robust approach to the problem of uncertain medical categories, we propose to use the linear regression model with the fuzzy membership function as a dependent variable. This fuzzy membership function denotes to what degree the value of the underlying (continuous) outcome falls below or above the dichotomization cut-off point. In the paper, we demonstrate that the linear regression model of the fuzzy dependent variable can be insensitive against the uncertainty in the cut-off point location. In the paper we present the modeling results from the real study of low hemoglobin levels in infants. We systematically test the robustness of the binomial regression model and the linear regression model with the fuzzy dependent variable by changing the boundary for the category Anemia and show that the behavior of the latter model persists over a quite wide interval.

Paper Detail
900
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1
12971
Plasmodium Vivax Malaria Transmission in a Network of Villages
Abstract:
Malaria is a serious, acute and chronic relapsing infection to humans. It is characterized by periodic attacks of chills, fever, nausea, vomiting, back pain, increased sweating anemia, splenomegaly (enlargement of the spleen) and often-fatal complications.The malaria disease is caused by the multiplication of protozoa parasite of the genus Plasmodium. Malaria in humans is due to 4 types of malaria parasites such that Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale. P.vivax malaria differs from P. falciparum malaria in that a person suffering from P. vivax malaria can experience relapses of the disease. Between the relapses, the malaria parasite will remain dormant in the liver of the patient, leading to the patient being classified as being in the dormant class. A mathematical model for the transmission of P. vivax is developed in which the human population is divided into four classes, the susceptible, the infected, the dormant and the recovered. In this paper, we formulate the dynamical model of P. vivax malaria to see the distribution of this disease at the district level.
Paper Detail
828
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