Neutrophil Lymphocyte Ratio as a predictor of systemic inflammation - A cross-sectional study in a pre-admission setting. [v1; ref status: indexed, http://f1000r.es/5cy]

Background: Neutrophil:lymphocyte ratio (NLR)  is an emerging biomarker that is used to predict postoperative mortality and morbidity in cardiac and cancer surgeries. The association of this biomarker with systemic illness and its usefulness in risk assessment of preoperative patients has not been fully elucidated. Objectives: To determine the prevalence of elevated NLR in preoperative patients and to examine the relationship between elevated NLR and the presence of systemic illnesses as well as anaesthesia risk indices such as American Society of Anesthesia (ASA) and the revised cardiac risk index (RCRI) scores.  Design: Cross-sectional study Setting: Anaesthesia pre-admission clinic, Toronto Western Hospital, Toronto, Canada Patients: We evaluated 1117 pre-operative patients seen at an anesthesia preadmission clinic. Results: NLR was elevated (>3.3) in 26.6% of target population. In multivariate analysis, congestive cardiac failure, diabetes mellitus and malignancy were independent risk factors predicting raised NLR. After regression analysis, a relationship between NLR and ASA score (Odds Ratio 1.78; 95% CI: 1.42-2.24) and revised cardiac risk index (RCRI, odds ratio 1.33; 95% CI: 1.09-1.64, p-value: 0.0063) was observed. Conclusions:  NLR was elevated (> 3.3) in 26.6% of patients. Congestive cardiac failure and malignancy were two constant predictors of elevated NLR at >3.3 and > 4.5. There was a strong association between NLR and anesthesia risk scoring tools of ASA and RCRI

Comparison of bispectral index and entropy monitoring in patients undergoing internalisation of deep brain stimulators

Introduction: Depth of anaesthesia (DOA) monitors are shown to reduce the intra-operative dose of anaesthetic agents, provide haemodynamic stability and shorten emergence times. Electroencephalography (EEG) based DOA monitors such as bispectral index (BIS) and entropy have been calibrated and validated in healthy subjects. Hence the clinical effectiveness of these monitors may be affected when monitoring patients with neurological disorders (e.g., epilepsy, dystonia, dementia and Parkinson’s disease). The aim of this study was to determine whether BIS and entropy correlate with each other and with clinical indices of DOA in patients with movement disorders under general anaesthesia (GA). Materials and Methods: We conducted a prospective, observational study in patients with movement disorders undergoing internalization of deep brain stimulators. All patients received standard GA with age-adjusted mean alveolar concentration (aaMAC) of an inhalational agent between 0.7 and 1.1. BIS and entropy sensors were applied on the patient’s left forehead. Data collected included clinical parameters and EEG-based DOA indices. Correlation analysis was performed between entropy, BIS and the clinical indices of DOA. Bland Altman analysis was performed to determine the agreement between BIS and entropy. Results: Thirty patients were studied (mean age was 58.4 ± 11 years, male: female 18:12 and weight 79.2 ± 17 kg). Indications for deep brain stimulation were Parkinson’s disease (n = 25), essential tremors (n = 2) and dystonia (n = 3). There was a very strong positive correlation between BIS and response entropy (RE) (r = 0.932) and BIS and state entropy (SE) (r = 0.950) and a strong negative correlation among aaMAC and BIS, RE and SE with r values of −0.686, −0.788 and −0.732, respectively. However, there was no correlation between BIS, RE, SE and haemodynamic values. Conclusion: Our study showed that BIS and entropy perform well in patients with movement disorders. There was a good correlation between the BIS and entropy devices. Haemodynamic parameters were not reliable indicators of DOA in these patients

Effectiveness of Canna indica leaves and stalk biochar in the treatment of textile effluent

Textile effluents often include water polluted with heavy metals, organic and inorganic contaminants, and different colors. It is not practical to remove these pollutants from the water. A variety of methods, including ozone, adsorption, membrane separation, biosorption, biodegradation, electrochemical degradation, and UV radiation, might be used in the water treatment procedure. Biochar made from Canna indica leaves and stems was used to remediate textile industry wastewater, which included color and chemical oxygen demand (COD). By using an absorption technique, the biochar was created by roasting the material at 500 °C, which removed the color and COD from the wastewater. The batches were subjected to many variations in temperature, concentration, and dose of biochar throughout the testing phase. Canna leaves have been shown to be effective in reducing COD at doses between one and 1.5 gm. COD levels were reduced by 83%, and color was reduced by around 94%. On the other hand, while keeping a constant dose, it was shown that canna stalks showed noteworthy effectiveness in lowering COD levels, with a range of 33%–48%. When it comes to eliminating color and COD, the leaves of the canna plant show more specificity than those of other plant species. The Jovanovich isotherm showed a good association with the biochar made from Canna indica leaves, according to the examination of the isotherm computation