Should colloid boluses be prioritized over crystalloid boluses for the management of dengue shock syndrome in the presence of ascites and pleural effusions?

<p>Abstract</p> <p>Background</p> <p>Although the WHO guideline for the management of dengue fever considers the presence of ascites or pleural effusions in the diagnosis of DSS, it does not emphasize the importance of their presence when selecting fluids for resuscitation.</p> <p>Case presentation</p> <p>We highlight three patients with DSS who received boluses of crystalloids on priority basis as recommended by WHO guidelines during resuscitation. All three patients had varying degrees of third space fluid loss (ascites and pleural effusions) at the time of development of DSS. Ascites and pleural effusions were detected in all 3 patients at the time of shock irrespective of whether iv fluids were given or not. All three patients had documented liver involvement at the time of shock evidenced by elevation of AST (4800 iu/L, 5000 iu/L and 1960 iu/L). One patient who had profound shock died 6 hours after admission with evidence of acute pulmonary oedema in the convalescence phase. All of them needed CPAP ventilator support and potent diuretics.</p> <p>Conclusions</p> <p>We therefore feel that resuscitation of patients with DSS who already have third space fluid accumulation with crystalloid boluses on priority basis may contribute to recovery phase pulmonary oedema.</p

Profiling of amino acids in traditional and improved rice (Oryza sativa L.) varieties of Sri Lanka and their health promoting aspects

Investigation made on the variation in amino acid compositions among selected traditional and newly improved rice varieties cultivated in Sri Lanka is presented. The free amino acid (FAA) composition including gamma-amino butyric acid (GABA) and protein bound total amino acids (TAAs) of eleven traditional and seven improved rice cultivars grown at Batalagoda across the two major cultivating seasons in the country were evaluated. Significant variations (p < 0.05) in GABA levels, individual and total amino acids in free and protein bound form were observed among the studied varieties. Both traditional and improved varieties reported comparable mean total FAAs and TAA levels. However, significantly higher levels of GABA, which has health promoting functional properties, were found in newly improved rice varieties in comparison to the traditional varieties. Significant impact of seasonal variation on total amino acid levels was observed in majority of the varieties with most of the varieties reporting higher amino acid levels when cultivated during the “Maha”, which is the major cultivation season in the country. The Behethheenati rice out of the traditional, while Bg 300 rice out of the newly improved, was found the most beneficial among the investigated varieties. The potential significant contribution obtainable with several local traditional and improved varieties in fulfilling the majority of the recommended essential amino acid nutrient requirement in the daily diet by the world health organization is highlighted

Problems in seawater industrial desalination processes and potential sustainable solutions: a review

Seawater desalination has significantly developed towards membrane technology than phase change process during last decade. Seawater reverse osmosis (SWRO) in general is the most familiar process due to higher water recovery and lower energy consumption compared to other available desalination processes. Despite major advancements in SWRO technology, desalination industry is still facing significant amount of practical issues. Therefore, the potentials and problems faced by current SWRO industries and essential study areas are discussed in this review for the benefit of desalination industry. It is important to consider all the following five components in SWRO process i.e. (1) intake (2) pre-treatment (3) high pressure pumping (4) membrane separation (performance of membranes and brine disposal) and (5) product quality. Development of higher corrosion resistant piping materials or coating materials, valves, and pumps is believed to be in higher research demand. Furthermore, brine management, that includes brine disposal and resource recovery need further attention. Pre-treatment sludge management and reduced cleaning in place flush volume will reduce the capital costs associated with evaporation ponds and the maintenance costs associated with disposal and transportation reducing the unit cost of water