37 research outputs found
High Prevalence of Diabetes and Metabolic Syndrome Among Policemen
The prevalence of diabetes is rapidly rising all over
the globe at an alarming rate.1 Over the past 30 years,
the status of diabetes has changed from being considered
a mild disorder of the elderly, to one of the major causes
of morbidity and mortality affecting the youth and middle
aged. It is important to note that the rise in prevalence is
seen in all six inhabited continents of the globe.2 The major
driver of the epidemic is the more common form of diabetes
namely type 2 diabetes, which accounts more than 90% of
all diabetic cases
Immediate access arteriovenous grafts versus tunnelled central venous catheters: study protocol for a randomised controlled trial
Background
Autologous arteriovenous fistulae (AVF) are the optimal form of vascular access for haemodialysis. AVFs typically require 6 to 8 weeks to “mature” from the time of surgery before they can be cannulated. Patients with end-stage renal disease needing urgent vascular access therefore traditionally require insertion of a tunnelled central venous catheter (TCVC). TCVCs are associated with high infection rates and central venous stenosis.
Early cannulation synthetic arteriovenous grafts (ecAVG) provide a novel alternative to TCVCs, permitting rapid access to the bloodstream and immediate needling for haemodialysis. Published rates of infection in small series are low.
The aim of this study is to compare whether TCVC ± AVF or ecAVG ± AVF provide a better strategy for managing patients requiring immediate vascular access for haemodialysis.
Methods/design
This is a prospective randomised controlled trial comparing the strategy of TCVC ± AVF to ecAVG ± AVF. Patients requiring urgent vascular access will receive a study information sheet and written consent will be obtained. Patients will be randomised to receive either: (i) TCVC (and native AVF if this is anatomically possible) or (ii) ecAVG (± AVF).
118 patients will be recruited. The primary outcome is systemic bacteraemia at 6Â months. Secondary outcomes include culture-proven bacteraemia rates at 1Â year and 2Â years; primary and secondary patency rates at 3, 6, 12 and 24Â months; stenoses; re-intervention rates; re-admission rate; mortality and quality of life. Additionally, treatment delays, impact on service provision and cost-effectiveness will be evaluated.
Discussion
This is the first randomised controlled trial comparing TCVC to ecAVG for patients requiring urgent vascular access for haemodialysis. The complications of TCVC are considered an unfortunate necessity in patients requiring urgent haemodialysis who do not have autologous vascular access. If this study demonstrates that ecAVGs provide a safe and practical alternative to TCVC, this could instigate a paradigm shift in nephrology thinking and access planning.</p
Immediate access arteriovenous grafts versus tunnelled central venous catheters: study protocol for a randomised controlled trial
Efficacy of Quasi Agro Binding Fibre on the Hybrid Composite Used in Advance Application
The choice for natural fibre obtained from agricultural products is on the rise
due to its solution to eco-friendly, environmental and improved mechanical
properties concerns. Its abundant availability, low cost, emission reduction and
adaptability to base material for composite make it a prime material for
selection. This review explores diverse perspectives to the future trend of agro
fibre in terms of the thermo-mechanical properties as it applies to advanced
application in building structures. It is important to investigate the
ecofriendliness of the products of composites from fibres in agricultural
wastes so as to achieve a green and sustainable environment. This will come
to fore by the combined efforts of both researchers and feedback from
building stakeholders