Decrease Incidence of Blood Transfusion In Hip Arthroplasty Patients Due To Combined Blood Saving Measures

Background: Hip arthritis is a common and crippling disease causing severe pain, deformity and significant disability. Worldwide arthroplasty is among the commonest orthopaedic surgeries of degenerated hip that can result in considerable blood loss. This results in a postoperative decline in haemoglobin levels of 3.0 to 4.0 gram/decilitre from preoperative haemoglobin levels of 14.0 gram/decilitre on an average. Postoperative anaemia may seriously decrease functional mobility in the early postoperative phase following total hip arthroplasty. In recent years there has been an increasing awareness and positive attitude toward blood-saving measures. Blood-saving techniques can be broadly divided into preoperative, intraoperative and postoperative measures in total hip arthroplasty. Our aim is to assess the Decrease incidence of blood transfusion in hip arthroplasty patients due to combined blood saving measures. Methods: The study was a hospital based prospective observational study conducted during the period of March 2015 to august 2017 in the department of orthopedics, Patna medical college and hospital, Patna. Patients between the age of 50-85 years were included who underwent total hip arthroplasty between March 2015 to august 2017 in the department of orthopedics, Patna medical college and hospital, Patna. Patients were selected as per inclusion and exclusion. Surgery was done. Preoperative, intraoperative and postoperative blood saving modality was used in total hip arthroplasty. Blood loss and Blood transfusion assessment was done. Results: In this study out of 38 patients, Female were 26 (68.4%) and Male were 12 (31.6%). 26.3 % (10/38) patients were between 50-60 years of age, 47.4 % (18/38) between 61-70 years of age, 21.0 % (8/38) between 71-80 years of age and 5.3 % (2/38) patients above 81 years of age. left total hip replacement was done in 14/38 (36.8%), right total hip replacement was done in 24/38(63.2%) patients.Anaesthesia given was: Combined spinal epidural=22/38(57.9%), spinal anaesthesia+ block=12/38 (31.6 %), spinal anaesthesia=2/38 (5.3 %), general anaesthesia+ block=2/38 (5.3 %). Mean diastolic blood pressure was 81.60 millimetre of mercury pre op and intra op 71.11. Mean systolic blood pressure was 135.51 millimetre of mercury pre op and intra op 98.02. In this study only 1 patient out of 38 patients were subjected to blood transfusion accounting to 2.6 % which was statistically significant. Conclusion:Use of combined blood saving measures helps to decrease incidence of blood transfusion in arthroplasty. Due to low incidence of blood transfusion, blood related adverse event is prevented. There was statistically significant reduction in haemoglobin level after operation. There was statistically significant reduction in haematocrit level after operation.

Role Of Bone Mineral Density To Asses Osteoporosis At Tertiary Centre In Men

Background: Osteoporosis is highly prevalent, with an estimated 30 million women diagnosed to have osteoporosis. A bone mineral density (BMD) test measures how much calcium and other types of minerals are present in a section of bone. The absolute amount of bone as measured by bone mineral density (BMD) testing generally correlates with bone strength and its ability to bear weight. Osteoporosis is a progressive bone disease that is characterized by a decrease in bone mass and density and that leads to an increased risk of fractures. Osteoporosis is defined by the World Health Organization (WHO) as a bone mineral density that lies 2.5 standard deviations or more below the a T-score of <-2.5SD.(average of young, healthy adults) as measured by dual-energy X-ray absorptiometry. Quantitative ultrasound (QUS) of bone is a technique for assessing bone microarchitecture in addition to bone mass. QUS has many advantages compared with traditional densitometry, including lack of radiation, cost and potential portability. Methods:Retrospective study was done in 1220 male patients in department of orthopedics, Patna medical college and hospital, Patna presenting with back pain, history of fracture after minor trauma, alcoholics, patient on drugs like steroids and chronic smokers. The study does not include the patients having fractures due to road traffic accidents or pathological fractures associated with primary or secondary bone tumors. The BMD estimation of these patients was done by quantitative ultrsonography of the calcaneal bone and the analysis done on the basis of T –scores.. Results: 1220 patients were included in the study from department of orthopedics, Patna medical college and hospital, Patna. Patients were in the age group of 25-75 yrs. Among these 30% (n=366) were between 25-40yrs, 45% (n=550) between 41-60yrs and 25% (n=304) between 61-75 yrs. Commonest presenting symptom in the study population was Backache which was60% (n=732). 30% (366) presented with generalized bone pain and 10% (122) patients had a history of fracture after trivial trauma. Of the 1220 patients included in the study 45% (n=550) were osteoporotic, 29% (n=354) were osteopenia and severe osteoporosis 10%. Majority of the osteoporotic patients fell in the age group of 41-60 yrs. Conclusion:Our study shows that the osteoporosis and osteopenia is more common in males in the age group of 40-60 yrs. Early detection and prompt treatment is required to prevent pathological fractures. Quantitative ultrsonography is one of the most effective tools for early detection of osteopenia and osteoporosis as this is cost effective, lacks radiation exposure and yields good results, comparable to other diagnostic tools like DEXA scan.

Morpho-toxicology of chlorpyrifos to prolactin cells of a freshwater catfish, Heteropneustes fossilis - doi: 10.4025/actascibiolsci.v34i4.9134

In the present study, an organophosphorus compound Coroban (active ingredient chlorpyrifos E.C. 20%) was used. In short-term exposure the fish were subjected to 0.8 of 96h LC50 value of chlorpyrifos (1.76 mg L-1) for 96h. In long-term exposure the experiment was performed for 28 days by using 0.2 of 96h LC50 value of chlorpyrifos (0.44 mg L-1). Fish were killed on each time intervals from control and experimental (chlorpyrifos) groups after 24, 48, 72, and 96h in short-term exposure and after 7, 14, 21, and 28 days in long-term experiment. Blood samples were collected and sera were analyzed for calcium. Pituitary glands were fixed for histological studies and stained with Herlant tetrachrome and Heidenhains azan techniques. Short-term exposure of chlorpyrifos caused decrease in the serum calcium levels. No change was noticed in the prolactin cells of chlorpyrifos treated fish. Long-term treatment with chlorpyrifos provoked hypocalcemia. The prolactin cells of treated fish exhibited slight degranulation after 21 days whereas the nuclear volume remained unchanged. After 28 days, the prolactin cells exhibited further degranulation and the nuclear volume recorded an increase. Cytolysis and vacuolization were also visible.

Morpho-toxicology of chlorpyrifos to prolactin cells of a freshwater catfish, Heteropneustes fossilis / Morfotoxicologia de clorpirifos para as células de prolactina de bagre de água doce Heteropneustes fossilis

In the present study, an organophosphorus compound Coroban (active ingredient chlorpyrifos ­ E.C. 20%) was used. In short-term exposure the fish were subjected to 0.8 of 96h LC50 value of chlorpyrifos (1.76 mg L-1) for 96h. In long-term exposure the experiment was performed for 28 days by using 0.2 of 96h LC50 value of chlorpyrifos (0.44 mg L-1). Fish were killed on each time intervals from control and experimental (chlorpyrifos) groups after 24, 48, 72, and 96h in short-term exposure and after 7, 14, 21, and 28 days in long-term experiment. Blood samples were collected and sera were analyzed for calcium. Pituitary glands were fixed for histological studies and stained with Herlant tetrachrome and Heidenhain's azan techniques. Short-term exposure of chlorpyrifos caused decrease in the serum calcium levels. No change was noticed in the prolactin cells of chlorpyrifos treated fish. Long-term treatment with chlorpyrifos provoked hypocalcemia. The prolactin cells of treated fish exhibited slight degranulation after 21 days whereas the nuclear volume remained unchanged. After 28 days, the prolactin cells exhibited further degranulation and the nuclear volume recorded an increase. Cytolysis and vacuolization were also visible.

No estudo presente, o composto organofosforo Coroban (ingrediente ativo clorpirifo ­ E.C. 20%) foi usado. Na exposição a curto prazo os peixes foram submetido a 0,8 de valor LC50 de 96h de clorpirifo (1,76 mg L-1) durante 96h. Na exposição a longo prazo o experimento foi executado durante 28 dias usando 0,2 de valor LC50 de 96h de clorpirifos (0,44 mg L-1). Os peixes foram mortos a cada intervalo dos grupos controle e experimental (clorpirifos) após 24, 48, 72, e 96h em exposição a curto prazo e após 7, 14, 21, e 28 dias no experimento a longo prazo. As amostras de sangue foram colhidas e o soro foi analisado para cálcio. As glândulas pituitárias foram fixadas para estudos histológicos e colorido por tetracromo de Herlant e por técnicas de azan do Heidenhain. A exposição a curto prazo do clorpirifo diminuiu os níveis de cálcio no soro. Nenhuma mudança foi observada nas células de prolactina nos peixes tratados com clorpirifo. O tratamento a longo prazo com clorpirifo causou hipocalcemia. As células de prolactina dos peixes tratados mostraram uma leve degranulação após 21 dias ao passo que o volume nuclear permaneceu inalterado. Depois de 28 dias, as células de prolactina mostraram mais degranulação e o volume nuclear registrou um aumento. Citólise e vacuolização também eram visíveis.

Changes in Perceptions of George W. Bush's Personality in the Wake of the September 11 2001 World Trade Center Attacks / Cambios en la percepción de la personalidad de George W. Bush posterior a los ataques al World Trade Center el 11 de Septiembre de 2001

Using data gathered just before and just after the September 11th terrorist attacks, we examine how perceptions of Bush's personality changed in the following two weeks. Fifty participants provided ratings of Bush using the California Q-sort at various times before (including immediately before) and after the attacks. At each time interjudge agreement was strong. There was general consistency between the pre-and post-attack assessments, but the common view of Bush shifted in several important ways. Consistent with his soaring popularity, the changes were toward more positive perceptions, even for characteristics unrelated to the attacks. Findings are discussed in terms of possible mechanisms driving the changes in perception. These findings, which are based on careful assessments conducted shortly before the emergence of any hint of what was to come, provide a unique perspective on changes in Bush's image as they unfolded in the immediate wake of the terrorist attacks.

Utilizando información recolectada justo antes y justo después de los ataques terroristas de septiembre 11 de 2001, se examinó cómo las percepciones de la personalidad de George Bush cambiaron en las dos semanas subsecuentes. Cincuenta participantes proveyeron puntajes sobre Bush utilizando el California Q-Sort en diferentes momentos antes (incluyendo el "inmediatamente antes") y después de los ataques. En cada momento temporal el acuerdo entre-jueces fue alto. Hubo consistencia general entre las evaluaciones antes y después de los ataques, pero la manera de ver a Bush tuvo cambios importantes en algunos puntos específicos. De manera consistente con su altísima popularidad, los cambios fueron hacia percepciones más positivas, aún en características no relacionadas con los ataques. Los hallazgos son discutidos en términos de mecanismos positivos que conducen los cambios en la percepción. Estos hallazgos, que están basados en evaluaciones cuidadosamente realizadas antes de siquiera haber tenido noción de lo que iba a suceder, proveen una perspectiva única de los cambios en la imagen de Bush tal y como se desarrollaron después de los ataques terroristas.