Awareness about tuberculosis among nurses working in a tertiary care hospital in Solan, Himachal Pradesh

Background: Tuberculosis has remained a disease of public health importance since ages and is known to inflict large quantum of socioeconomic cost on the society. Since nurses are in direct contact with both hospitalised and ambulatory patients, they are likely to play a vital role in the effective implementation of the RNTCP. The present study attempts to evaluate the awareness of nurses about TB.Methods: This cross sectional study was conducted in a tertiary care institute, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan for period of 1 year. Data was collected from 180 staff nurses and appropriate statistical tests were applied for evaluation of the same.Results: Knowledge regarding the predisposing factors causing the disease, first line drugs under DOTS treatment, full form of DOTS, patient wise boxes and about the side effects of the treatment were comparatively low among the subjects.Conclusions: Nurses are directly handling and managing patients but the knowledge and awareness of tuberculosis was not satisfactory among them. Therefore efforts must be made to organize regular workshops and periodic seminars to upgrade their knowledge.

Comparison of Surgical Outcomes of the Posterior and Combined Approaches for Repair of Cervical Fractures in Ankylosing Spondylitis

STUDY DESIGN: Retrospective cohort study. PURPOSE: To evaluate surgical outcomes and complications of cervical spine fractures in ankylosing spondylitis (CAS) patients who were treated using either the posterior (P) or combined approach (C). OVERVIEW OF LITERATURE: Ankylosing spondylitis typically causes progressive spinal stiffness that makes patients susceptible to spinal fractures. CAS is a highly unstable condition. There is contradictory evidence regarding which treatment option, the posterior or the combined approach, yields superior clinical results. METHODS: A single institution database was reviewed for data in the period 1999 to 2015. All CAS patients who underwent posterior or combined instrumented fusion were enrolled. We analyzed demographic data, radiographic results, perioperative complications, and postoperative results. RESULTS: Thirty-three patients were enrolled (23 in the P group, 10 in the C group). All patients presented with neck pain after a fall. In the P group, mean operative time was 161.1 minutes (100–327 minutes), and mean estimated blood loss (EBL) was 306.4 mL (50–750 mL). In the C group, 90% of patients underwent a staged procedure, typically with posterior surgery first. Mean EBL was 124 mL (25–337 mL). For posterior surgery, mean EBL was 458.3 mL (400–550 mL). EBL of posterior surgery in the C group was higher but this difference was not significant (p=0.16). Postoperative complication rate was higher in the C group but this difference was not significant (50% vs. 17.4%, p=0.09). In the follow-up period, no late reoperations were performed. Patients who underwent C surgery had a higher rate of neurological improvement but this difference was not significant (p=0.57). CONCLUSIONS: Both P and C provided good clinical results. P surgery had lower EBL, lower postoperative complication rate, and shorter length of stay than C surgery; none of these differences were statistically significant.

The Role of Calcium Pyrophosphate Dihydrate Deposition in the Postoperative Outcome of Lumbar Spinal Stenosis Patients

STUDY DESIGN: Retrospective study.PURPOSE: This study aimed to investigate the association of surgical intervention with clinical and quality of life (QoL) outcomes in patients who underwent posterior spinal surgery for lumbar spinal stenosis (LSS) with spinal calcium pyrophosphate dihydrate deposition (SCPPD) versus that in those who underwent the surgery for LSS without SCPPD.OVERVIEW OF LITERATURE: Calcium pyrophosphate (CPP)-associated arthritis is one of the most common types of arthritis. The clinical outcomes are well studied in CPP-associated arthritis of the appendicular joints. However, few studies have investigated SCPPD.METHODS: A single-institution database was reviewed. LSS patients were categorized as those who did and did not have SCPPD, based on histologic identification. Clinical presentations and postoperative results were analyzed. Disability and QoL were assessed using the Oswestry Disability Index (ODI) and the 36-item Short-Form Health Survey.RESULTS: Thirty-four patients were enrolled, with 18 patients being allocated to the SCPPD group and 16 being allocated to the non- SCPPD group. Preoperative and postoperative pain scores were not significantly different between the groups (p=0.33 and p=0.48, respectively). The average preoperative ODI score in the SCPPD group was slightly higher than that in the non-SCPPD group (57 vs. 51, p=0.33); however, the postoperative ODI score was significantly lower (15 vs. 43, p=0.01). The postoperative physical function, vitality, and mental health of the SCPPD patients were also significantly improved (p=0.03, p=0.022, and p=0.022, respectively).CONCLUSIONS: Surgical intervention resulted in good clinical outcomes in SCPPD patients. As per our findings, total removal of CPPinvolved tissue is unnecessary. As such, surgery should be performed as indicated according to clinical presentation without considering the presence of CPPD.

Morphometry of Isan-Thai clavicles as a guide for sex determination / Morfometría de las clavículas en una población Isan-Thai como guía para la determinación del sexo

The dried clavicles have been well documented to determine individual sex and age in many races. Such morphometric investigations in Isan (Northeastern) Thais have never been reported. Therefore, this study aimed to estimate the sex from dried clavicles of Isan-Thais using morphometric analysis. The identified 454 dried clavicles (254 males and 200 females), averaged age (60.69±14.36 years) were measured and analyzed for identification point (IP) and the demarking point (DP) values. The results showed that the identified-bone percentages by IP of the maximum clavicular lengths in males and females were 90.55 % (>139.9 mm) and 89 % (<140.6 mm). In addition, such percentages of the mid shaft circumference measured in male clavicles was 83.46 % (>37.7 mm) and in females was 75 % (<37.0 mm). However, percentages of the DP in all parameters were less than 50%. The highest DP values of maximum length of male clavicles was 43.31% (>152.5). In conclusion, the maximum length and mid shaft circumference investigated from this study can be used as basic data of Isan ­ Thais for applying as a guide in forensic sciences for sex determination from dried clavicle remains.

Las clavículas secas han sido bien documentadas en muchas razas para determinar el sexo y la edad individuales. Tales investigaciones morfométricas en Isan (Noreste de Tailandia) nunca han sido reportadas. Por lo tanto, este estudio tuvo como objetivo estimar el sexo de clavículas secas de Isais-Thais utilizando un análisis morfométrico. Se midieron 454 clavículas secas (254 varones y 200 hembras), con una edad media de 60,69 ± 14,36 años, y fueron analizadas para los puntos de identificación (IP) y de demarcación (DP). Los resultados mostraron que los porcentajes de hueso identificados por IP en relación a la longitud clavicular máxima en hombres y mujeres fueron 90,55 % (> 139,9 mm) y 89 % (<140,6 mm), respectivamente. Además, tales porcentajes de circunferencia media del eje, medido en las clavículas de los hombres, fue 83,46 % (> 37,7 mm) y en las de mujeres fue 75 % (<37,0 mm). Sin embargo, los porcentajes de la DP en todos los parámetros fueron menores al 50 %. Los valores más altos de DP de longitud máxima de las clavículas de los hombres fue 43,31 % (> 152,5). En conclusión, la longitud máxima y la circunferencia media del eje investigados a partir de este estudio se pueden utilizar como datos básicos en Isan - Thais para aplicar como guía en las ciencias forenses para la determinación del sexo a partir de restos de clavícula secas.

In vitro evaluation of cell adhesion and immunomodulatory properties of five Lactobacillus rhamnosus strains isolated from infants

Aims: Five Lactobacillus rhamnosus strains (UBU03, UBU06, UBU09, UBU34 and UBU37) with good in vitro probiotic properties, isolated from breast-fed infants, were evaluated for in vitro adhesion, competitive adhesion and immunomodulatory properties. Knowledge of such properties is important when considering specific circumstances when these strains might be used clinically. Methodology and results: The Caco-2 cell line was used for adhesion assays and for competitive adhesion assays against Escherichia coli O157:H7. Lactobacillus rhamnosus GG was used as the reference strain for adhesion assays. The immunomodulatory activities of the five strains were evaluated by determining the levels of the inflammatory cytokines IL-6, IL-12 and TNF-α, and of the immunoregulatory cytokine IL-10, produced by bacterial-activated THP-1 cells after 6, 12 and 24 h of stimulation. In the cell-adhesion assays, all five strains showed high adhesion properties. For UBU09, UBU34 and UBU37, adhesive capacity was higher than that of the reference strain. All strains except UBU03 showed the ability to inhibit adhesion of E. coli O157:H7 to Caco-2 cells. All strains induced IL-6 production but not IL-12 production. UBU03 and UBU09 could induce only one cytokine IL-6. UBU06 and UBU34 could each induce two (IL-6/IL-10 and IL-6/TNF-α, respectively). UBU37 could induce three cytokines (IL-6/TNF-α /IL-10). Conclusion, significance and impact of study: These five probiotic L. rhamnosus strains with high adhesion properties and with different in vitro cytokine induction profiles should be investigated further in different immunological conditions to identify appropriate circumstances for their clinical use.

Probiotic characterization of lactic acid bacteria isolated from infants feces and its application for the expression of green fluorescent protein

Aims: In this study, lactic acid bacteria (LAB) were isolated from 42 healthy infants and determined for probiotic properties. Twelve LAB isolates with potential probiotic properties were selected and screened for their feasibility of heterologous protein expression by selection of erythromycin sensitive isolates. Methodology and results: One of eleven erythromycin-sensitive LAB isolates identified and designated as Lactobacillus fermentum 47-7 was able to acquire and stable maintain the Escherichia coli-Lactobacillus shuttle vector, pRCEID-LC13.9. Further electrotransformation of L. fermentum 47-7 with the recombinant pLC13.9:LDH-PRO1:GFPuv containing green fluorescent protein (GFP) gene found that recombinant L. fermentum can express GFP. Conclusion, significance and impact of study: The probiotic L. fermentum isolate can be used as host for expression of heterologous proteins and could possibly be further developed as the alternate oral delivery system for various biomolecules for biotechnological application.

Incidence of metopism in adult Thai skulls / Incidencia de metopismo en cráneos tailandeses adultos

The persistent metopic suture on adult skull (also known as metopism) can confuse the clinicians during diagnosis of the frontal bone fractures in emergency conditions. The incidences of metopism have been documented in many populations except in Thais. Therefore, this study was aimed to determine the incidence of metopism in adult Thai skulls. The identified 706 Thai dried skulls (481 males and 225 females) were carried out for metopic suture observations. The results showed that 53 skulls (7.51%) were present of the metopic sutures. The metopism observed could be classified into major two types (complete metopic suture (20 skulls [2.83%]) and incomplete metopic suture (33 skulls [4.67%]). For the incomplete metopic suture could be further classified into two subtypes, bregma-incomplete metopic suture and nasion- incomplete metopic suture. This incidence maybe a basic information for Thai radiologists to concern about metopic suture in emergency diagnosis of frontal bone fractures.

La persistencia de la sutura metópica en el cráneo adulto (también conocido como metopismo) puede provocar confusión en los médicos durante el diagnóstico de las fracturas de los huesos frontales en situaciones de emergencia. La incidencia de metopismo se ha documentado en muchas poblaciones, excepto en individuos tailandeses. Por lo tanto, este estudio tuvo como objetivo determinar la incidencia de metopismo en cráneos tailandeses adultos. Se identificaron 706 cráneos secos (481 hombres y 225 mujeres) y se llevó a cabo la observación de ls sutura metópica. Los resultados mostraron que en 53 cráneos (7,51%) estaba presente la sutura metópica. Según nuestras observaciones, el metopismo podría ser clasificado en dos tipos principales: sutura metópica completa (20 cráneos [2,83%]) y sutura metópica incompleta (33 cráneos 4,67%). A su vez, la sutura metópica incompleta podría ser clasificada en dos subtipos: sutura metópica incompleta "bregma" y sutura metópica incompleta "nasion". Consideramos que la indicedencia de metopismo registrado en este trabajo configura una información de relevancia para los radiólogos tailandeses en relación a la sutura metópica y el correcto diagnóstico en la emergencia de fracturas óseas frontales.

A Comparison of Retention Between Acetal Resin and Stainless Steel Wrought Wire Retentive Clasp Arms

The objective of this study was to compare the retention of three different groups of acetal resin retentive clasp arm and a group of stainless steel wrought wire retentive clasp arm. The differences in design of acetal resin retentive clasp arms were as follow: group A, 1/3 terminal clasp arm was below a survey line and engaged retentive undercut 0.02˝ ; group B, 1/3 terminal clasp arm was below a survey line and engaged retentive undercut 0.03˝ ; group C, 2/3 terminal clasp arm was below a survey line and engaged retentive undercut 0.03˝ where as group D, stainless steel wrought wire clasp arm engaged retentive undercut 0.02˝ Tensile load of each clasp arm was performed by a Universal testing machine and the retentive force for group A, B, C, and D were 1.21, 1.67, 1.51, and 6.32 N respectively. One way ANOVA and Dunnett T3 multiple comparison reveal no significant difference in retentive force between group B and C but there were significant differences between these two groups and group A and D at p \<0.05.\  Keywords:\ acetal resin retentive clasp arm, stainless steel wrought wire retentive clasp arm

Family Strength in Caring for a Stroke Survivor at Home

This hermeneutic phenomenological study explored the meaning of family strength when caring for a stroke member at home. Family strength is considered to be the competency of a family when faced with a stressful life event that can be viewed through a continuous man-environmental interaction process. Six family units were purposively recruited and screened using the Family Hardiness Index (four with high-level of hardiness, and two with moderate-level of hardiness). Data were collected through in-depth interviews, field observations and field notes, and analyzed using Braun and Clarke’s thematic analysis method. Findings revealed families with high-hardiness continuously strove to overcome caregiving hardships and had hope for the stroke member’s long existence, while families with moderate-hardiness demonstrated less effort to overcome caregiving hardships and held no hope for the stroke member’s long existence. Primary caregivers among families with high-hardiness revealed more self-development incarer role than did those of families with moderate-hardiness. Families with high-hardiness shared caregiving and family task responsibilities, while families with moderate-hardiness lacked collaboration regarding caregiving and family tasks. In addition, family strength emerged from families overcoming caregiving hardships through: hope for the stroke member’s long existence; development, accumulated experiences of “can do” family members; and, establishment of shared caregiving and family task responsibilities. Consideration of views and abilities of the family unit to provide homecare for a stroke member can enhance nurses’ understanding of different developmental experiences of home caregiving families. In addition, such knowledge can facilitate adoption of meaningful nursing interventions to support the families.

Blood Exchange in Severe Leptospirosis at Mahasarakham Hospital

Leptospirosis is a disease being the important problem of Thailand because the patient may die when has complication such as acute renal failure, pulmonary complication and hyperbilirubinemia. The aim of this study was to review the benefit of blood exchange in severe leptospirosis.During an outbeark of leptospirosis in northeastern Thailand, 39 patient with severe leptospirosis diagnosed by WHO criteria were hospitalized at Mahasarakham Hospital. The clinical features were consistent with those described for the classic manifestation of the disease However, of these patients with severe leptospirosis, 35(89%) had acute renal failure; 17 (43%) had hyperbilirubin above 15 mg% and 6(15%) had pulmonary complications, including pulmonary edema,hemorrhage and acute respiratory distress syndrome. Blood exchange was performed in 15 patient with hyperbilirubinemia, acute renal failure and pulmonary complications, Result of the treatment with blood exchange, 13 (86.66%) survived and 2 (13.33%) died.Conclusion: Blood exchange, in addition to conventional treatment was beneficial in severe leptospirosis with complication and hyperbilirubinemia.

A Case of Multiple Aneurysms in Northeast Thailand Embalmed Cadaver

Background: Aneurysms left in the cadaver has been difficult to find in our experiences, during 34 years from the establishment of Khon Kaen University Medical School. We witnessed the first case of multiple aneurysms in 2007 in the male cadaver out of 843 of both gender specimens. We always have diagnosed and treated the patients now and then in our teaching hospital, Srinagarind.Purpose: 1) To record the basic data for clinical management of aneurysm. 2) To stimulate the interests of the medical students to make them pay more attention to gross anatomy as it is the basis for tackling the aneurysm problem early in the medical career.Materials \& Methods: We redissected 843 cadavers after the standard procedure. They were 371 females aged between 21-92 years and 472 males between 38-88 years old at the time of death. The work was accomplished in the KKU Dept. Anat. dissecting room and from 1973-2007.Results: We found 3 aneurysms in one male cadaver aged 65 years, They were, 1) right popliteal aneurysm, 2) right internal iliac aneurysm, and 3) left common iliac aneurysmConclusion: The gross lesion of aneurysm seen in the dissecting room is very exciting for the medical students and the anatomists which lead to the stimulation of the students’ interests. This leads further to the thoughts for the application in the patients. This also enhances the teaching and learning process. The other morbid anatomy in the cadaver will surely serve the same objective. The etiology was discussed.Key words: aneurysm, Northeast Thailand, etiology

Effectiveness of Sepsis CPG after Sepsis-Coordinator Nurse System Implementation

The outcomes of sepsis clinical practice guideline (CPG) implement were not complete because of ineffective CPG management. This analytic study was conducted to compare effectiveness of sepsis CPG before and after sepsis-coordinator nurse system implementation by retrospective review of medical records during February to April, 2007 and compared to those of post-period during June to July, 2007. The primary effectiveness was early goal-directed therapy (EGDT). The secondary goals were organ failure, ICU length of stay (LOS) and hospital LOS. Chi-square and Mann-Whitney U test were used with significant level at 0.05. There were 77 patients in both pre- and post-periods. Age and gender of patients in pre-and post-periods were not different (p=0.105, p=0.258 respectively). The most common cause of sepsis in both pre- and post-periods was pneumonia. Septic mortality rate was not different (p=0.519). Acute respiratory distress syndrome (ARDS) was significantly reduced (p

In vitro antimicrobial activity of phramongkutklao hydroxyapatite antibiotic pellet.

OBJECTIVE: Assess the antimicrobial activity of Phramongkutklao antibiotic hydroxyapatite pellets in vitro. MATERIAL AND METHOD: The selected bacteria used in the present study were the standard and drug-resistant strains of Staphylococcus aureus and Pseudomonas aeruginosa, which are the common organisms causing infection in Orthopedics. Phramongkutklao antibiotic hydroxyapatite pellets developed by the Orthopedics Department, Phramongkutklao Hospital contained either Vancomycin, Fosfomycin, or Gentamycin. Each preparation was placed on an agar plate inoculated with each bacterium. The inhibition zones were monitored in 24 hours. Then the pellets were moved onto the new inoculated plate every day for 28 days. RESULTS: Compared with the control group, Phramongkutklao antibiotic hydroxyapatite pellets had good inhibitory effect against S.aureus. Vancomycin hydroxyapatite pellets were able to maintain their activity for 28 days whereas Gentamycin hydroxyapatite pellets was effective for only three days. Fosfomycin hydroxyapatite pellets could inhibit MSSA for 13 days and MRSA for 25 days. On the contrary, all three Phramongkutklao antibiotic hydroxyapatite pellets had very low efficacy against Paeruginosa. CONCLUSION: Phramongkutklao antibiotic hydroxyapatite pellets were able to inhibit the growth of S. aureus both MSSA and MRSA while the activity against P. aeruginosa needs to be developed.

Clinical Outcome after Application of CPG for Sepsis

OBJECTIVE: To compare clinical outcome before and after application of clinical practice guideline (CPG) for sepsis. METHOD: The study was an observational study with historical control. The data of pre-guideline period collected by retrospective review of medical records during August 1st to October 30th 2005 were compared to those of post-guideline period collected during February 1st to April 30th 2006. The primary outcome was in-hospital mortality and the secondary outcome were organ failure, ICU length of stay and hospital length of stay. Data analysis used the computer’s package for chi-square, and Fisher’s exact test with significant level at 0.05. RESULTS: One hundred and seventy three patients with sepsis or septic shock were included; 90 patients in pre-CPG period and 83 patients in post-CPG period. Baseline characteristics of patients in pre-CPG and post-CPG periods were comparable. The common causes of sepsis were pneumonia, urinary tract infection, gastrointestinal and intra-abdominal infection, consecutively. Hospital mortality rate was significantly reduced from 73.3% in pre-CPG period to 54.2% in post-CPG period (p=0.01). With regard to organ failure, acute respiratory distress syndrome was significantly increased from 26.7% to 44.9% (p=0.02) during the same period. Meanwhile, proportion of acute tubular necrosis and disseminated intravascular coagulopathy were found to be greater after introduction of the guideline. Furthermore, the length of ICU stay and total hospital stay trended longer in post-CPG period. CONCLUSIONS: The CPG for sepsis is effective in reducing in-hospital mortality. The reciprocal increase in morbidity, acute respiratory distress syndrome indicates that the CPG implementation might imperfect and requires further improvement.

Diffuse Neonatal Hemangiomatosis: report of 5 cases.

Diffuse Neonatal Hemangiomatosis (DNH) is a rare, life-threatening condition associated with a few to hundreds of small, cutaneous and visceral hemangiomas. The authors reported 5 cases of DNH in which hepatic hemangioma were the most common visceral involvement. Response to prednisolone in these cases was not good, one died and four required second line therapy. Of these four cases, one case with embolisation; one with interferon and two with vinblastine. Response to vinblastine was good, but long-term follow-up of the side effects are needed.

Restrictive lung disease and serum TGF-beta1 in thalassemia major children.

A cross sectional study was performed in 21 thalassemia major (TM) children at King Chulalongkorn Memorial Hospital during March to August, 2003 to determine whether restrictive lung disease (RLD) was related to serum transforming growth factor-beta 1 (TGF-beta1). All studied patients (57% female, age 11.2 +/- 2.6 yrs, duration of transfusion 7.7 +/- 4.1 yrs) never had desferoxamine treatment and their pulmonary function, serum ferritin and serum TGF-beta1 were evaluated. Five (24%) had RLD. RLD patients had significantly longer durations of transfusion and higher serum ferritin levels than non-RLD patients (9.1 +/- 1.9 vs 5.5 +/- 3.2 yrs; p = 0.03 and 3,816.6 +/- 1,715.9 vs 2,084.5 +/- 1,504.8 ng/ml; p = 0.04, respectively). TM children had lower serum TGF-beta1 levels than normal children (7.9 vs 78.8 pg/ml; p < 0.001). The serum TGF-beta1 level was not different between RLD and non-RLD patients (13.3 vs 4.2 pg/ml; ns), concluding that RLD was related to longer duration of transfusion and higher serum ferritin but not related to serum TGF-beta1 levels.

Health promotion program for the safe use of pesticides in Thai farmers.

The purpose of this study was to determine the knowledge, attitudes and practices (KAP) concerning the safe use of pesticides of Thai farmers in Don Kha subdistrict, Bang Phae district, Ratchaburi Province. Thirty-three voluntary Thai farmers of thirty-three farming families, recruited by convenience sampling, participated in a training program for six months. Data were collected by questionnaire interviews, and KAP on the safe use of pesticides were compared by paired t-test. Research findings showed that the mean scores of KAP in the posttest were significantly higher than the pretest. The results of this study provided health professionals with information to develop more effective prevention and intervention programs. To prevent illness, the most important role of health officers should to be focus on education and information for individuals, families, and communities.

Outcome of pediatric hematopoietic stem cell transplantations from Thai unrelated donors matched with high-resolution HLA typing.

The authors evaluated the outcome of ten children given hematopoietic stem cell transplantations from Thai unrelated donors (URD-HSCT) selected using DNA high-resolution typing of both HLA class I and II loci. Six patient/donor pairs (60%) were fully matched; four (40%) were 5/6 matched. Patients had either non-malignant (n=9) or malignant (n=1) diseases. In most cases, graft-versus-host disease (GVHD) prophylaxis composed of cyclosporine and short-term methotrexate. The probability of hematopoietic recovery at day 30 was 90%. The cumulative probability of acute GVHD and of chronic GVHD equaled 44.4 and 0%, respectively. Three patients died of transplant-related complications. The probability of transplant-related mortality (TRM) at 30, 100, and 180 days were 10, 30, and 30%, respectively. The overall and disease-free survival rates were 70 and 70%, respectively. URD-HSCT with donor selection based on high-resolution HLA typing is associated with a low incidence of both severe acute GVHD and graft failure. The observed outcome is comparable to that of children transplanted from HLA-identical siblings.

The difference among stress and rest normal reference databases using non-corrected, scatter corrected, and scatter with attenuation corrected Bull's eye myocardial perfusion scintigraphy in both genders.

OBJECTIVES: To compare 3 types of Bull's eye normal reference maps; non-corrected, scatter corrected, and scatter with attenuation corrected Bull's eye in both genders. MATERIAL AND METHOD: Sixty-seven normal healthy males and females volunteered for the present study. After screening tests to identify low post-test (exercise EKG) likelihood of coronary artery disease, 41 subjects (20 males and 21 females) had stress and rest myocardial perfusion scintigraphy (99mTc-sestamibi). The data were reconstructed by filtered back projection reconstruction in three ways as follows; (1) non-correction (NoC), (2) scatter elimination only (SC), (3) scatter elimination and attenuation correction (SC+AC). Three sets of reconstructed data of both stress and resting studies were added into 6 sets of Bull's eye. The data of each Bull's eve were normalized to 100% of the maximum count. Percentage of uptake in each area was compared by t-test statistics. RESULTS: Stress and rest count distribution of NoC and SC sets were lowest at the inferior wall, followed by the septal wall, anterior wall, and lateral wall in both genders. In the SC+AC sets; septum and lateral walls showed more uptake than anterior and inferior walls. A significant difference of percentage uptake between stress and rest images at septum in NoC and SC images in male and in SC image in female was observed. No difference was seen in the SC+AC groups. CONCLUSION: There was similarity of count distribution between NoC and SC images. SC+AC caused more uniform image. However; some non-uniformity was observed. The use of sex-independent SC+AC bull's eye is possible. Stress study can be omitted for bull's eye collection of normal files.

The benefits of vitamin C and vitamin E in children with beta-thalassemia with high oxidative stress.

The present study aimed to determine the benefits of vitamin C and vitamin E as antioxidant supplements in beta-Thalassemia children who are at risk of iron overload due to multiple blood transfusion and high oxidative stress. Antioxidant status, oxidative products, plasma free hemoglobin, total hemoglobin and bilirubin were discussed. Twenty children who had laboratory confirmation of major beta-Thalassemia at least 6 months with history of packed red cell transfusion without iron chelation were recruited. The informed consent for blood sample collection and antioxidant medication was performed. Most patients (85%) had hyperferritinemia and all of them had high oxidative stress. All of them had low vitamin C and vitamin E level at recruitment. Three months after vitamin C and vitamin E supplementation, plasma vitamin C, vitamin E and glutathione were significantly increased, while total bilirubin was slightly decreased without significance. Other parameters included total antioxidant status (TAS), plasma and erythrocyte malondialdehyde (MDA), hemoglobin and plasma free hemoglobin had no differences during the study period. CONCLUSION: B-Thalassemia major children who had multiple blood transfusion are at risk in iron overload and high oxidative stress. From the present study, no significant improvement in raising hemoglobin and concerning low dose vitamin C is not contraindication in beta-Thalassemia patients. Therefore, vitamin C plus vitamin E supplementation have benefits more than vitamin E alone in promoting antioxidant status and may enhance liver function as total bilirubin tends to decrease.