A study of anemia and iron deficiency in chronic systolic heart failure

Background: Iron deficiency (ID) is an emerging problem in patients with chronic systolic heart failure and can be a potential therapeutic target. However, not much is known about the frequency, predictors of iron deficiency and anemia in patients with chronic heart failure. Objectives: The primary objective of this study was to determine the frequency of iron deficiency in chronic systolic heart failure patients who were follow up in Hospital Universiti Sains Malaysia. The secondary objectives included were to determine the frequency of anemia in the same study population, correlation between ejection fraction and blood parameters and determining risk factors for anemia in chronic systolic heart failure. Methods: A total of 81 patients who were followed up in Hospital Universiti Sains Malaysia were recruited into this cross sectional study using purposive sampling method. These patients had history of chronic systolic heart failure for more than 6 months with left ventricular ejection fraction less than 45% as assessed by echocardiography using Simpson’s planimetric method. 10mls of venous blood was drawn from each participant and analyzed. Results: Thirty three patients were anemic (40.7%) as compared to 48 patients (59.3%) who did not. Sixteen patients were iron deficient (19.8%). All iron deficiency patients were anemic patients. There were positive correlation between serum ferritin (r=0.624, p<0.001), transferrin saturation (r= 0.346, p<0.001) and hemoglobin (r=0.528, p<0.001) with ejection fraction, respectively. Anemia in chronic systolic heart failure was independently associated with serum ferritin (OR 0.974, 95% CI 0.959, 0.988), transferrin saturation (OR 0.831, 95% CI 0.726, 0.952), and diabetes mellitus (OR 6.680, 95% CI 1.599, 27.897) based on multiple logistic regression analysis. Conclusion: This study demonstrated high frequency of anemia in chronic systolic heart failure patients. Majority of anemic patients were iron deficient. Besides that, serum hemoglobin and serum ferritin and transferrin saturation were positively correlated with left ventricular ejection fraction. It is recommended in future, an appropriately powered randomized trials with correction of anemia using erythropoietin and intravenous iron be carried out to validate the study findings

COMPARISON OF LABORATORY AND INDUSTRIAL SACCHAROMYCES CEREVISIAE STRAINS FOR THEIR INHIBITOR RESISTANCE AND XYLOSE UTILIZATION

There are various kinds of stresses during the process of ethanol fermentation and more inhibitory factors are produced when lignocelluloses hydrolysate is used as the substrate. The pretreatment of lignocelluloses biomass before fermentation causes the increase in the amount of acids and thus the decrease in pH. Low-molecular weight aliphatic acids, furaldehydes and a broad range of aromatic compounds are produced during the pretreatment process. They are the inhibitors for the ethanol producers, such as Saccharomyces cerevisiae. Furthermore, besides glucose, lignocellulose hydrolysate contains other sugars, such as xylose, arabinose, galactose and mannose etc., among which xylose is taking the major proportion. Stress tolerance and xylose utilization are therefore essential for Saccharomyces cerevisiae strains to get high-efficiency fermentation and high-yield ethanol production. In this study, a few laboratory and industrial Saccharomyces cerevisiae strains were selected for the evaluation of their potentials in pH tolerance, inhibitor resistance and xylose utilization. Industrial strains such as TJU (an industrial strain used in some of the bioethanol plants in China), ATCC 4126, and ATCC 96581, an isolate from spent sulfite liquor were compared with some laboratory strains such as ATCC 44771, ATCC 24860 and CBS 8066. The difference of these strains in their pH tolerance was insignificant despite the fact that almost all the strains had less growth when pH was below 4. Among all the yeast strains tested, the haploid laboratory strain ATCC 44771 showed the lowest tolerance to the decrease of pH. As to the inhibitor resistance studies almost all the industrial strains tested had higher inhibitor resistance than the laboratory strains, with ATCC 44771 being the least resistant to the increase in the inhibitor concentrations. The laboratory strain ATCC 24860 showed almost equivalent inhibitor resistance compared with these industrial strains. Further analysis of these strains on their xylose utilization was carried out. Random mutagenesis followed by xylose adaptation was applied. Almost all the laboratory strains died after mutation and all the industrial strains survived with their xylose unitization capabilities increased. In addition, the presence of inhibitors such as 5-hydroxymethylfurfural (HMF) and furfural had enhanced their xylsoe assimilation. The above analysis indicated that industrial Saccharomyces cerevisiae strains could be trained for biomass hydrolysate fermentation as they have high pH tolerance, high inhibitor resistance and potentials in xylose utilization. As such, the potential xylose-utilizing mutants are being evaluated for their potentials in biomass hydrolysate fermentation

Comparing quality of life and treatment satisfaction between patients on warfarin and direct oral anticoagulants : a cross-sectional study

Introduction and aim: Patient quality of life (QOL) while on long-term oral anticoagulant therapy has been receiving greater attention in recent years due to the increase in life expectancy brought about by advances in medical care. This study aimed to compare the QOL, treatment satisfaction, hospitalization and bleeding rate in patients on long-term warfarin versus direct oral anticoagulants (DOAC). Methods: This was a cross-sectional study of patients with non-valvular atrial fibrillation (NVAF) or venous thromboembolism (VTE) on long-term anticoagulant therapy attending the cardiology clinic and anticoagulation clinic of the University Malaya Medical Centre from July 1, 2016, to June 30, 2018. Patient QOL was assessed by using the Short Form 12 Health Survey (SF12), while treatment satisfaction was assessed by using the Perception of Anticoagulation Treatment Questionnaire 2 (PACT-Q2). Results: A total of 208 patients were recruited; 52.4% received warfarin and 47.6% received DOAC. There was no significant difference in QOL between warfarin and DOAC based on SF12 (physical QOL, P=0.083; mental QOL, P=0.665). Nevertheless, patients in the DOAC group were significantly more satisfied with their treatment compared to the warfarin group based on PACT-Q2 (P=0.004). The hospitalisation rate was significantly higher in the warfarin group than the DOAC group (15.6% versus 3.0%, P=0.002). Clinically relevant minor bleeds and severe bleeding events were non-significantly higher in the warfarin group than the DOAC group (66.7% versus 40.0%, P=0.069). Conclusion: Compared to warfarin, treatment of NVAF and VTE with DOAC showed comparable QOL, higher treatment satisfaction, lesser hospitalization, and a non-significant trend toward fewer bleeding episodes

Streptomyces antioxidans sp. nov., a Novel Mangrove Soil Actinobacterium with Antioxidative and Neuroprotective Potentials

A novel strain, Streptomyces antioxidans MUSC 164(T) was recovered from mangrove forest soil located at Tanjung Lumpur, Malaysia. The Gram-positive bacterium forms yellowish-white aerial and brilliant greenish yellow substrate mycelium on ISP 2 agar. A polyphasic approach was used to determine the taxonomy status of strain MUSC 164(T). The strain showed a spectrum of phylogenetic and chemotaxonomic properties consistent with those of the members of the genus Streptomyces. The cell wall peptidoglycan was determined to contain LL-diaminopimelic acid. The predominant menaquinones were identified as MK-9(H(6)) and MK-9(H(8)), while the identified polar lipids consisted of aminolipid, diphosphatidylglycerol, glycolipid, hydroxyphosphatidylethanolamine, phospholipid, phosphatidylinositol, phosphatidylethanolamine, phosphatidylglycerol and lipid. The cell wall sugars consist of galactose, glucose and ribose. The predominant cellular fatty acids (>10.0%) were identified as iso-C(15:)(0) (34.8%) and anteiso-C(15:)(0)(14.0%). Phylogenetic analysis identified that closely related strains for MUSC 164(T) as Streptomyces javensis NBRC 100777(T) (99.6% sequence similarity), Streptomyces yogyakartensis NBRC 100779(T) (99.6%) and Streptomyces violaceusniger NBRC 13459(T) (99.6%). The DNA–DNA relatedness values between MUSC 164(T) and closely related type strains ranged from 23.8 ± 0.3% to 53.1 ± 4.3%. BOX-PCR fingerprints comparison showed that MUSC 164(T) exhibits a unique DNA profile, with DNA G + C content determined to be 71.6 mol%. Based on the polyphasic study of MUSC 164(T), it is concluded that this strain represents a novel species, for which the name Streptomyces antioxidans sp. nov. is proposed. The type strain is MUSC 164(T) (=DSM 101523(T) = MCCC 1K01590(T)). The extract of MUSC 164(T) showed potent antioxidative and neuroprotective activities against hydrogen peroxide. The chemical analysis of the extract revealed that the strain produces pyrazines and phenolic-related compounds that could explain for the observed bioactivities

Riverine sustainment 2012

Student Integrated ProjectIncludes supplementary materialThis technical report analyzed the Navy's proposed Riverine Force (RF) structure and capabilities for 2012. The Riverine Sustainment 2012 Team (RST) examined the cost and performance of systems of systems which increased RF sustainment in logistically barren environments. RF sustainment was decomposed into its functional areas of supply, repair, and force protection. The functional and physical architectures were developed in parallel and were used to construct an operational architecture for the RF. The RST used mathematical, agent-based and queuing models to analyze various supply, repair and force protection system alternatives. Extraction of modeling data revealed several key insights. Waterborne heavy lift connectors such as the LCU-2000 are vital in the re-supply of the RF when it is operating up river in a non-permissive environment. Airborne heavy lift connectors such as the MV-22 were ineffective and dominated by the waterborne variants in the same environment. Increase in manpower and facilities did appreciable add to the operational availability of the RF. Mean supply response time was the biggest factor effecting operational availability and should be kept below 24 hours to maintain operational availability rates above 80%. Current mortar defenses proposed by the RF are insufficient.N

An Examination Of Analysts' Recommendations In Malaysian Stock Market

The research empirically examined the impact of stock recommendations produced by brokerage analysts in Malaysia on the equity market. The objective of this research is to examine the impact whether the analysts' recommendations generate the abnormal return for the investor