Calcium fortification is usually achieved by employing wheat flour as the most frequently used vehicle. In this study, potential of calcium extraction from chicken eggshell and its utilization as a bread fortificant in straight grade flour (SGF) is investigated. In addition, the fortified and unfortified (control) flour samples were evaluated for nutrient composition and rheological properties. Results showed that addition of fortificant at different concentrations significantly (p<0.05) enhanced calcium content of fortified flour and it was considerably increased from 115.80 mg/kg (T o) to 1135.1 mg/kg (T 3). Nutrient composition data of fortified flour have shown a significant (p<0.05) reduction in moisture content of flour from 12.7% (T o) to 11.76% (T 3) and protein content from 9.89% (T o) to 9.79% (T 3). However, a significant increase in ash content was observed by increasing fortificant level from 0.54% (T o) to 1.04% (T 3). Rheological properties indicated a significant increase in water absorption from 63.60 to 67.527%, dough development time (DDT) from 7.38 to 11.37 min and dough stability from 13.79 to 17.37 min. Textural characteristics of fortified bread revealed a significant reduction for hardness values from 11.40 N (control) to 6.50 N (T 3) in response to fortificant addition. Quality assessment of bread indicated that bread quality was significantly affected with corresponding rises in fortificant addition levels.
BackgroundCOVID-19 pandemic has globally affected healthcare including the transplantation programmes.Materials and methodsWe retrospectively studied the impact of COVID-19 on live liver donor (LLD) programme at liver transplant centre in Gambat, Pakistan. Standard operative procedures (SOPs) including COVID-19 nasopharyngeal swab PCR, CT scans, personal protective equipment use, 6-feet distancing were developed for LLD and transplant team to mitigate COVID-19 exposure. We compared the complications, healthcare utilisation (hospital stay, readmission) and mortality between two LLD cohorts—before and during COVID-19 pandemic from March 2019 to December 2020.ResultsDuring study period 300 LLD surgeries were performed. There was an increase in rate of LLDs from 132 (44%) in pre-COVID to 168 (56%) during COVID-19 era. Average numbers of transplants per month performed during pre-COVID and during COVID-19 era were 10.1 and 14, respectively. No donor has developed COVID-19 infection during hospitalisation. Rate of all LLD complications (32 (21.47%) and 49 (29.16%), p=0.43), uneventful discharges (120/168 (71.4%) and 88/132 (66.6%), p<0.05), mean hospital stay (6±2 days and 5±2 days, p=0.17) and readmission (5 (4%) and 3 (1.8%), p=0.43) were similar during the pre-COVID and COVID-19 era. No donor mortality was observed during study period.ConclusionWith the implementation of mindful SOPs, rate of LLD increased without any case of COVID-19 infection. Our SOPs were helpful in continuation of LLD programme in a developing country during COVID-19 pandemic.
Objective The study quantified the occurrence and intensity of hyponatremia in decompensated chronic liver disease patients Study design: Descriptive Cross sectional study Place and Duration: Department of Gastroenterology, Centre for Liver Diseases, Holy Family Hospital (CLD, HFH) for a total 6 months duration Methodology: Patients aged 13-75 years, both male and female presenting with Clinical, biochemical, and Ultrasonographic findings of cirrhosis were included in this study. Patients' ages, genders, levels of serum hyponatremia, rates of complications, Child-Pugh scores, and other contextual data were recorded in a standardized proforma. The tests were conducted in the hospital's lab, and a pathologist looked over the results. Results: Among 120 study cases, 72 (60 %) patients were male and 48 (40 %) were female patients. The mean age was 50.83 ± 10.50 years; ranging from 30 years to 70 years. Of these 120 study cases, 32 (26.7 %) were from rural areas while 88 (73.3 %) were from urban areas, 35 (29.2%) were poor, 69 (57.5%) were middle income and 16 (13.3%) were having rich socioeconomic status. Child-Pugh class B was noted in 77 (64.2 %) and Child-Pugh class C was noted in 43 (35.8%) of our study cases. The mean serum sodium level was 131.25 ± 4.34 mmol/L ranging from 118 mmol/L to 141 mmol/L and hyponatremia was noted in 64 (53.3%) of our study cases. Mild hyponatremia was noted in 12 (10%), moderate hyponatremia in 28 (23.3%) and severe hyponatremia in 24 (20%) of our study cases. Hepatic encephalopathy was noted in 16 (13.3%), spontaneous bacterial peritonitis in 36 (30%), variceal bleeding in 44 (36.7%) and Hepatorenal syndrome in 24 (20%). Conclusion: Our study found that people with liver cirrhosis were more likely to be hyponatremic than those without the condition. Hyponatremia was associated with being older age, having problems, and being labelled as a Child-Pugh class C. It was also revealed that the number of problems was strongly correlated with the degree to which the hyponatremia had progressed. Nurses, doctors, and anybody else providing care for cirrhotic patients should all keep a close check on their patients' sodium levels. Keywords: Hyponatremia, liver cirrhosis, Serum Sodium, Child-Pugh
Background The literature lacks data on World Health Organization (WHO) class II and III deficient liver donors who underwent right hepatectomy during living donor liver transplantation (LDLT). Methods In this prospective cohort study, we compared the perioperative outcomes of 15 glucose‐6 phosphate dehydrogenase (G6PD) deficient living liver donors with a matched cohort of 39 nondeficient living liver donors undergoing right lobe donation. Results Out of 15 G6PD deficient donors, four (26.67%) donors had class II, and 11 (73.34%) had class III G6PD deficiency. The mean postoperative trough hemoglobin level was significantly lower in the deficient group than the nondeficient group (9.38 ± 1.59 g/dL vs. 10.27 ± .91 g/dL, p = .046). The mean peak indirect bilirubin level was significantly higher in the deficient group than the nondeficient group (2.22 ± 1.38 mg/dL vs. 1.40 ± .89 mg/dL, p = .047), and a similar trend was observed in total serum bilirubin (3.99 ± 2.57 mg/dL vs. 2.99 ± 1.46 mg/dL, p = .038). Biochemical evidence of hemolysis was found only in three (20%) deficient donors, but none of them needed a blood transfusion. No mortality was observed in either group. All other parameters, including demographics, operative parameters, graft characteristics, and hospital stay were comparable between both groups (p > .05). Conclusion G6PD deficiency with WHO class II and above should not be considered a contraindication for right lobe donation.
Objective: The purpose of this research was to compare gastrointestinal (GI) symptoms in ESRD patients receiving PD and HD to see whether there were any significant changes. Methods: After the ethical approval from the institute review board, this crossectional study was conducted at shahida Islam medical complex ,lodhran. From 01/01/22 to 30/06/22. A modified 15-item gastrointestinal symptom rating scale (GSRS) questionnaire was used to assess GI symptoms; this questionnaire included questions on eating dysfunction. Age, a etiology of ESRD, and most recent adequacy evaluation of dialysis were collected through the follow-up database, patient interviews, and chart reviews. Results: Total seventy patients were included in the present study, N=35 was on hemodialysis and N=35 on peritoneal dialysis. HD and PD patients were similar with respect to age, sex, the occurrence of diabetes mellitus, and average dialysis duration. In ESRD patients’ overall prevalence of GI symptoms (GSRS >1) was 68.5% (48/70 patients). Patients with a GSRS > 1 were more common among those with HD group (28/35; 80%) than those with PD (57%; 20/35) (P 0.058*). In the HD group, more patients suffered from abdominal pain, constipation, and diarrhea (74%, 60% and 68.5%, respectively), compared with those in the PD group (34%, 28.5% and 32%, respectively; P value is 0.003, 0.001, and 0.008 respectively) Conclusion: Gastrointestinal (GI) symptoms vary in frequency, intensity, and variety across HD and PD individuals. Keywords: Gastrointestinal symptom, Hemodialysis, Peritoneal dialysis, End-stage renal disease
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