ABSTRACT
INTRODUCTION: Therapeutic plasma exchange (TPE) is used to manage various life-threatening illnesses. It is widely performed by nephrologists, intensivists, pathologists, or experts in transfusion medicine worldwide. However, the costs of TPE sessions are exceedingly high, and they have a huge impact on patients' financial burden. Herein, we investigated the outcomes of the reuse of plasma filters in TPE on several occasions. METHODS: This is a retrospective analysis of patients receiving TPE from January 1, 2020, to April 30, 2023, in the Department of Nephrology. A formulation of 4.5% peracetic acid and 24% hydrogen peroxide acid with RO water dilution was used for reprocessing. Clinical outcomes, risks, and cost-benefit were evaluated and compared between the plasma filter reuse group (GP-1) and the no-reuse group (GP-2). RESULTS: A total of 70 patients were included in this study. 200 and 112 TPE sessions were performed in GP-1 and GP-2, respectively. The most common indication for TPE in both groups was neurological. The clinical efficacy of TPE was similar in both groups. There was no difference in the clotting of the plasma filter, any allergic reaction, infection, or bleeding in the group. However, there was a significant difference in levels of fibrinogen (p=0.03) pre and post-procedure in both groups. The incidence of hypotension was found to be higher in GP-1 (26%) compared to GP-2 (15.6%), p = 0.05. The cost of overall treatment was 38% less in GP-1. CONCLUSION: The reuse of plasma filters is a safe and effective method for cost minimization in patients requiring TPE. This method can be effectively utilized in resource-poor settings without any increased risk of adverse effects.
ABSTRACT
INTRODUCTION: COVID-19 is a pandemic affecting mainly respiratory and gastrointestinal system. Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) binds angiotensin converting enzyme 2 (ACE-2) of renin-angiotensin system (RAS) resulting in hypokalaemia. We hereby report the a of hypokalaemic paralysis induced by COVID-19. CASE: A 56 years old male with no co-morbidities presented with fever (2days), weakness in bilateral lower limbs (1 day). His had severe hypokalaemia with serum potassium of 2.05 mEq/L. RT-PCR of nasopharyngeal swab for SARS-CoV- 19 was positive. He was diagnosed as a case of hypokalaemic paralysis induced by COVID-19 infection. CONCLUSION: We suggest that during this pandemic era if a COVID-19 patient presents with paralysis, hypokalaemia induced paralysis should be kept in the differential diagnosis. WHAT IS KNOWN: COVID-19 infection leads to hypokalemia. WHAT IS NEW: Hypokalaemic paralysis as a manifestation of COVID-19.
Subject(s)
COVID-19 , Hypokalemia , Humans , Hypokalemia/etiology , Male , Middle Aged , Pandemics , Paralysis/etiology , SARS-CoV-2ABSTRACT
AIMS/OBJECTIVES: To evaluate the effect of glass and polyethylene fiber inserts and flowable composite as a liner on the microleakage of Class II composite restorations with gingival margins on root surfaces. MATERIALS AND METHODS: Class II slots were prepared on both the proximal sides of thirty freshly extracted mandibular molars and were divided into six groups, according to the type of fiber insert and use of flowable composite (Filtek Z350) as a liner. Filtek P-60 (3M/ESPE) posterior composite was used to restore all cavities. The specimens were thermocycled and stained with 2% Basic Fuchsin dye, and sectioned to evaluate the dye penetration under Stereomicroscope. Statistical analysis was done using Kruskalwallis test and Mann whitney U test. RESULTS AND CONCLUSION: This study showed that, fiber insert groups, with or without flowable liner, had reduced microleakage scores as compared to the control groups. However, statistically no significant difference was found between the groups with fiber inserts. Less microleakage was seen in Group IV (With flowable liner and without Fiber inserts) as compared to Group I (Without flowable liner and Fiber inserts).
