According to the World Health Organization, the diagnosis of acute myocardial infarction AMI is based on two of the three main criteria changes in the ECG up to 25 of myocardial infarctions are not reflected in the ECG , anginous pain, and increased markers of myocardial necrosis. In 2000, the European Scientific Society and the American College of Cardiology made a correction to the definition of AMI, according to which the determining factor in the diagnosis of AMI is the detection of an increased level of specific markers of myocardial necrosis — cardiac troponins in the blood. Troponin is a protein that is part of myofibrils. Cardiac troponin contains three subunits T, I, and C. Troponin C is non specific for the myocardium, in contrast to the T and I subunits, whose structure in the contractile fibers of cardiomyocytes differs from similar proteins of other muscle cells. The widespread use of the determination of cardiac troponins in the blood significantly increased the detection of AMI by 30 200 . Until recently, it was believed that troponins enter the blood only as a result of the death of cardiomyocytes. However, in recent years, it has been shown that troponins can penetrate into the interstitial space, and then into the blood, when cardiomyocytes are damaged with an increase in the permeability of their cell membranes, which can be caused not only by AMI, but also by conditions accompanied by hyper production of pro inflammatory cytokines tumor necrosis factor a, interleukin 1, etc. . The aim of this study was to analyze the final diagnoses in patients with increased cardiac troponin T levels without a clinical picture and characteristic ECG changes in AMI. Khusainova Munira Alisherovna "Increased Cardiac Troponin-T in Patients without Myocardial Infarction" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Special Issue | Innovative Development of Modern Research , April 2021, URL: https://www.ijtsrd.com/papers/ijtsrd40034.pdf Paper URL : https://www.ijtsrd.com/medicine/other/40034/increased-cardiac-troponint-in-patients-without-myocardial-infarction/khusainova-munira-alisherovna
cardiac bio markers are important diagnostic and prognostic tool in acute coronary syndrome. several new emerging bio markers are coming with more sensitivity and specificity.
Cardiac biomarkers have evolved over last 20 years. From enzymes like CPK,SGOT,LDH, the focus shifted to CPKMB mass & currently to high sensitive Troponins. Similarly the definition of AMI also evolved and included these markers in guidelines. Natriuretic peptides (BNP & Nt-proBNP) are good markers for heart failure. however, ACS in renal failure continues to have diagnostic challenges.
cardiac bio markers are important diagnostic and prognostic tool in acute coronary syndrome. several new emerging bio markers are coming with more sensitivity and specificity.
Cardiac biomarkers have evolved over last 20 years. From enzymes like CPK,SGOT,LDH, the focus shifted to CPKMB mass & currently to high sensitive Troponins. Similarly the definition of AMI also evolved and included these markers in guidelines. Natriuretic peptides (BNP & Nt-proBNP) are good markers for heart failure. however, ACS in renal failure continues to have diagnostic challenges.
Aim: of the study was to conduct a comparative analysis of inflammatory markers in patients with coronary heart disease of stable and unstable flow. Methods: 78 patients aged 36 to 75 years were enrolled in this study (mean age 58.2±12.6 years). Laboratory and instrumental data were obtained and assessed. IL-6, TNF-α in blood plasma was carried out by the method of enzyme immunoassay on a solid-phase analyzer «Humareader Single». Statistical processing of the obtained results was carried out using vibrational statistics methods recommended for biomedical research on the IBM PC AT Pentium IV. Results: In patients with unstable angina (UA), the frequency of elevated levels of CRP, TNF-α, and leukocytes was statistically significantly higher than in the group with stable ischemic heart disease (P<0.05). The mean levels of these markers were statistically significantly higher in patients with UA compared with patients with stable form of coronary heart disease (CHD, P<0.05): CRP (4.3 ± 2.4 and 2.9 ± 2.3 mg / L, p <0.05, respectively), TNF-α (10.5 ± 2.5 and 7.7 ± 3.4 pg / ml, p <0.05) and leukocytes (9.2 ± 2.5 6.9 ± 2.3x109 / l, p <0.05). The level of interleukin-6 in patients with UA was higher in comparison with patients with stable angina (SA, 3.4 ± 1.7 and 2.9 ± 0.5 pg/ml), but the difference was statistically not significant (p> 0.05 ). There were no significant differences in the level of fibrinogen and ESR between patients with UA and SA. Conclusion: It was noted that the signs of inflammation are detected both in patients with unstable forms and in patients with stable form of CHD, but the degree of inflammation in patients with UA (level of TNF-α, CRP and leukocytes) is higher than in patients with stable ischemic heart disease.
Aim: of the study was to conduct a comparative analysis of inflammatory markers in patients with coronary heart disease of stable and unstable flow. Methods: 78 patients aged 36 to 75 years were enrolled in this study (mean age 58.2±12.6 years). Laboratory and instrumental data were obtained and assessed. IL-6, TNF-α in blood plasma was carried out by the method of enzyme immunoassay on a solid-phase analyzer «Humareader Single». Statistical processing of the obtained results was carried out using vibrational statistics methods recommended for biomedical research on the IBM PC AT Pentium IV. Results: In patients with unstable angina (UA), the frequency of elevated levels of CRP, TNF-α, and leukocytes was statistically significantly higher than in the group with stable ischemic heart disease (P<0.05). The mean levels of these markers were statistically significantly higher in patients with UA compared with patients with stable form of coronary heart disease (CHD, P<0.05): CRP (4.3 ± 2.4 and 2.9 ± 2.3 mg / L, p <0.05, respectively), TNF-α (10.5 ± 2.5 and 7.7 ± 3.4 pg / ml, p <0.05) and leukocytes (9.2 ± 2.5 6.9 ± 2.3x109 / l, p <0.05). The level of interleukin-6 in patients with UA was higher in comparison with patients with stable angina (SA, 3.4 ± 1.7 and 2.9 ± 0.5 pg/ml), but the difference was statistically not significant (p> 0.05 ). There were no significant differences in the level of fibrinogen and ESR between patients with UA and SA. Conclusion: It was noted that the signs of inflammation are detected both in patients with unstable forms and in patients with stable form of CHD, but the degree of inflammation in patients with UA (level of TNF-α, CRP and leukocytes) is higher than in patients with stable ischemic heart disease.
Predictors of Ischaemia and Outcomes in Egyptian Patients with Diabetes Mellitus Referred for Perfusion Imaging. Samir Rafla*, Ahmed Abdel-Aaty, Mohamed Ahmed Sadaka, Aly Ahmed Abo Elhoda and Ahmed Mohamed Shams
Copeptin as a Novel Biomarker in the Diagnosis of Acute Myocardial Infarction...Premier Publishers
To evaluate the diagnostic value of Copeptin as a novel biomarker in early diagnosis of Acute Myocardial Infarction. 56 patients with acute Myocardial Infarction (STEMI) and 25 healthy controls who were admitted to the Cardiology and Clinical Pathology Departments, national heart institute (NHI) from October 2015 to April 2016. The kit used a double-antibody sandwich enzyme-linked immune-sorbent assay (ELISA) to assay the level of Human Copeptin in samples. As regard copeptin, the median range of copeptin level was 242.5pg/ml in patient group and 75pg/ml in control group. The comparative study between the two groups shows a significant difference (p < 0.05) Conclusion: Copeptin is a reliable diagnostic tool in patients with AMI (STEMI) with sensitivity 85.7%, specificity 86.7%, PPV 96% and NPV 61.9%.
Background: Myocarditis is a relatively common inflammatory disease that affects the myocardium. Infectious disease accounts for most of the cases either because of a direct viral infection or post-viral immune-mediated reaction. Cardiovascular magnetic resonance (CMR) has become an established non-invasive diagnosis tool for acute myocarditis. A recent large single centre study with patients with biopsy-proven viral myocarditis undergoing CMR scans found a high rate of mortality. The aim of this study was to assess the rate of clinical events in our population of patients with diagnosed myocarditis by CMR scan.
Methods: Patients who consulted to the emergency department with diagnosis of myocarditis by CMR were retrospectively included in the study from January 2008 to May 2012. A CMR protocol was used in all patients, and were followed up to assess the rate of the composite endpoint of all-cause death, congestive heart failure, sudden cardiac death, hospitalization for cardiac cause, recurrent myocarditis or need of radiofrequency ablation or implantable cardiac defibrillator (ICD). A descriptive statistical analysis was performed.
Results: Thirty-two patients with myocarditis were included in the study. The mean age was 42.6±21.2 years and 81.2% were male. In a mean follow up of 30.4±17.8 months, the rate of the composite endpoint of all-cause death, congestive heart failure, sudden cardiac death, hospitalization for cardiac cause, recurrent myocarditis or need of radiofrequency ablation or ICD was 15.6% (n=5). Two patients had heart failure (one of them underwent heart transplant), one patient needed ICD because of ventricular tachycardia and two other patients were re-hospitalized, for recurrent chest pain and for recurrent myocarditis respectively.
Conclusions: In our series of acute myocarditis diagnosed by CMR we found a low rate of cardiovascular events without mortality. These findings might oppose data from recently published myocarditis trials.
Clinical Profile of Acute Coronary Syndrome among Young AdultsPremier Publishers
Acute Coronary Syndrome accounts for 30% of hospital admissions with cardiovascular diseases. The risk of this syndrome is increasing among the younger adults, and a deep insight into the clinical profile among these patients will help in devising a preventive strategy, in order to alleviate the morbidity and mortality due to the syndrome. A cross sectional study was done among 125 subjects admitted to our tertiary care hospital with Acute Coronary Syndrome. Their risk factors were assessed and a 12 Lead electrocardiogram and 2D Echocardiogram were taken. Cardio III panel which consists of Troponin I, CK MB, BNP by COBAS meter machine was also measured. STEMI was present in 73.6% of the patients, while unstable angina was present in 16%. About 90% of STEMI patients were males and 62% of them were hypertensives. LV Ejection Fraction <30% was found in 9% of STEMI patients. This study elucidates the need for a preventive strategy for primordial prevention of cardiovascular events among young adults. The study envisaged the male, urban preponderance towards these events.
Cosmetics are defined as “items with mild action on the human body for the purpose of cleaning, beautifying, adding to the attractiveness, altering the appearance, or keeping or promoting the skin or hair in good condition- while functional cosmetics, even if falling under the cosmetic definition, are designated as “items fulfilling specific actions like skin whitening, minimizing the appearance of lines in the face and body, protecting from the sun and sun tanning-. Ahiya Noor | Dr. Gaurav Kumar Sharma | Dr. Kaushal Kishore Chandrul "Cosmetic Science: An Overview" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45135.pdf Paper URL: https://www.ijtsrd.com/pharmacy/other/45135/cosmetic-science-an-overview/ahiya-noor
Standardization and Formulations of Calotropis ProceraYogeshIJTSRD
Plants growing in arid regions have elicited increased attention, because the hostile environment, in which these plants survive, forces them to develop chemical protective systems through adaptation which is rarely found in vegetation of other ecosystems. Furthermore, many of the plants grow in areas, where the dependence on traditional, plant based medicines over industrially produced pharmaceuticals persists to this day. The two plants, Calotopris Procera giant milkweed, also named C. Persica and Calotropis gigantea crown ower , have been used widely in traditional medicine in North Africa, the Middle East, and South and South East Asia. This has led to extensive research on the chemical constituents of the plants. Both plants are known to be sources of cardenolides, and newer research has yielded a number of interesting cancer active constituents. In addition, extracts of both plants have remarkable nematocidal, molluscidal and insecticidal activities. In many regions, the wood of Calotropis plants has been used as a building material and as a source of fuel. In addition, certain parts of the plants have been used as feed for livestock. In other regions, Calotropis plants are seen as invasive species that threaten local plant life and that due to their toxicity also pose a threat to grazing eld animals. Jaffar Khan | Pankaj Chasta | Dr. Gaurav Kumar Sharma | Dr. Kaushal Kishore Chandrul "Standardization and Formulations of Calotropis Procera" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45145.pdf Paper URL: https://www.ijtsrd.com/pharmacy/other/45145/standardization-and-formulations-of-calotropis-procera/jaffar-khan
Review of the Diagnosis and Treatment of ParalysisYogeshIJTSRD
Paralysis is a complete loss of motor power in any muscle group. When paralysis affects all four extremities, it is called quadriplegia when it affects only the lower extremities, paraplegia and when it affects the extremities on one side of the body, hemiplegic. For this reason, the term paralysis is generally reserved for more focal, less stereotyped weakness, for instance, affecting all the muscles innervated by a peripheral nerve. Many different anatomical lesions and etiologies can cause paralysis and determine its treatment. Bikash Debsingha | Dr. Gourav Kr. Sharma | Dr. Kausal Kishore Chandrul "Review of the Diagnosis and Treatment of Paralysis" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45108.pdf Paper URL: https://www.ijtsrd.com/pharmacy/pharmacology-/45108/review-of-the-diagnosis-and-treatment-of-paralysis/bikash-debsingha
Comparative Analysis of Forced Draft Cooling Tower Using Two Design Methods A...YogeshIJTSRD
Cooling towers make use of evaporation whereby some of the water is evaporated into a moving air stream and subsequently discharged into the atmosphere which results in cooling of the remainder water. The current research reviews various studies conducted on cooling tower using experimental and numerical techniques. Different design configuration and operating conditions on cooling towers are evaluated by various researchers. Significant findings from researches have shown new and improved design of cooling tower with much better performance as compared to conventional design. Neetish Kumar Sao | Dr. Surendra K. Dwivedi "Comparative Analysis of Forced Draft Cooling Tower Using Two Design Methods: A Review" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45100.pdf Paper URL: https://www.ijtsrd.com/engineering/mechanical-engineering/45100/comparative-analysis-of-forced-draft-cooling-tower-using-two-design-methods-a-review/neetish-kumar-sao
Criminology Educators Triumphs and StrugglesYogeshIJTSRD
This research study is geared on determining the triumphs and struggles of criminology educators. Included on the aim is to know their experiences and story being considered as teacher by accident. A qualitative research design was applied in this study. Researchers conducted a personal interview with the respondents with the aid of a guide questions which all points to main issue of this study. The findings of the study revealed that out of seven respondents, four are on the age bracket of 21 to 25 years old, two respondents are on the age bracket of 26 to 30 years old and a single respondent is on the age bracket of 36 to 40 years. Most of the respondents find enthusiasm in teaching and are aware that there is a need for them to proceed in post graduate studies for them to have a considerable salary. As to financial stability, only 1out of 7 considers herself as financially stable. The rest are saying that as of the moment, they are not yet financially stable basing on the rate of their salary. Qualification matters a lot in the field of academe because this was being shared by one of the respondents who considers herself as financially stable. Also, all of the respondents do not consider teaching as their first career of choice but most of them does not have any plan of shifting to another career. Girlie N. Cañete | Harry Santiago P. Achas | Pamela N. Cañete "Criminology Educators: Triumphs and Struggles" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45082.pdf Paper URL: https://www.ijtsrd.com/humanities-and-the-arts/education/45082/criminology-educators-triumphs-and-struggles/girlie-n-cañete
A Review Herbal Drugs Used in Skin DisorderYogeshIJTSRD
The human bodys skin is an organ that allows it to interact with the environment while also shielding it from harmful external influences. People of all ages suffer from skin diseases all over the world. Its vital to keep your skin in good form for a healthy physique. Plants have been employed in some form or another since the beginning of time. This research has highlighted some prevalent skin disease issues, as well as the herbals utilized in disease therapy and the various formulations accessible in the pharmaceutical industry. Some medicinal plants have been shown to be quite effective in removing or reducing skin infection disorders. Chandramita Borah | Dr. Gaurav Kumar Sharma | Dr. Kaushal Kishore Chandrul "A Review: Herbal Drugs Used in Skin Disorder" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45118.pdf Paper URL: https://www.ijtsrd.com/pharmacy/other/45118/a-review-herbal-drugs-used-in-skin-disorder/chandramita-borah
Automatic Query Expansion Using Word Embedding Based on Fuzzy Graph Connectiv...YogeshIJTSRD
The aim of information retrieval systems is to retrieve relevant information according to the query provided. The queries are often vague and uncertain. Thus, to improve the system, we propose an Automatic Query Expansion technique, to expand the query by adding new terms to the user s initial query so as to minimize query mismatch and thereby improving retrieval performance. Most of the existing techniques for expanding queries do not take into account the degree of semantic relationship among words. In this paper, the query is expanded by exploring terms which are semantically similar to the initial query terms as well as considering the degree of relationship, that is, “fuzzy membership- between them. The terms which seemed most relevant are used in expanded query and improve the information retrieval process. The experiments conducted on the queries set show that the proposed Automatic query expansion approach gave a higher precision, recall, and F measure then non fuzzy edge weights. Tarun Goyal | Ms. Shalini Bhadola | Ms. Kirti Bhatia "Automatic Query Expansion Using Word Embedding Based on Fuzzy Graph Connectivity Measures" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45074.pdf Paper URL: https://www.ijtsrd.com/computer-science/artificial-intelligence/45074/automatic-query-expansion-using-word-embedding-based-on-fuzzy-graph-connectivity-measures/tarun-goyal
A New Proposal for Smartphone Based Drowsiness Detection and Warning System f...YogeshIJTSRD
This paper proposes a Smartphone based system for the detection of drowsiness in automotive drivers. The proposed system uses three stage drowsiness detection technique. The first stage uses the percentage of eyelid closure PERCLOS which is obtained by capturing images with the front camera of the Smartphone with a modified eye state classification method. The system uses near infrared lighting for illuminating the face of the driver during night driving. The second step uses the voiced to the unvoiced ratio VUR obtained from the speech data from the microphone, in the event PERCLOS crosses the threshold. The VUR is also compared with a threshold and if it is a value greater than that of the threshold, it moves on to the next verification stage. In the final verification stage, touch response is required within the stipulated time to declare whether the driver is drowsy or not and subsequently sound an alarm. To awake the driver, a vibrating mechanism is done and also the live GPS location is also sent to an emergency contact. We have studied eight other reference papers for the literature review. The system has three advantages over existing drowsiness detection systems. First, the three stage verification process makes the system more reliable. The second advantage is its implementation on an Android smart phone, which is readily available to most drivers or cab owners as compared to other general purpose embedded platforms. The third advantage is the use of SMS service to inform the control room as well as the passenger regarding the loss of attention of the driver. Abishek K Biju | Godwin Jolly | Asif Mohammed C A | Dr. Paul P Mathai | Derek Joseph "A New Proposal for Smartphone-Based Drowsiness Detection and Warning System for Automotive Drivers" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45083.pdf Paper URL: https://www.ijtsrd.com/engineering/computer-engineering/45083/a-new-proposal-for-smartphonebased-drowsiness-detection-and-warning-system-for-automotive-drivers/abishek-k-biju
Data Security by AES Advanced Encryption StandardYogeshIJTSRD
Now a days with the rapid development of multimedia technologies, research on safety and security are becoming more important. Multimedia data are generated and transmitted through the communication channels and the wireless media. The efficiencies of encryption based on different existing algorithms are not up to the satisfactory limit. Hence researchers are trying to modify the existing algorithm or even develop new algorithms that help to increase security with a little encryption time. Here in this paper, we have furnished a new technology to modify the AES algorithm which gives more security with a little encryption time and which can be used to encrypt using 128 bit key. Theoretical analysis on the proposed algorithm with the existing reveals the novelty of our work. Here we have proposed a technique to randomize the key and hidden the key data into an encrypted digital image using the basics concept of cryptography and also using the concept of digital watermarking, the concept of key hide has also been encrypted. We have also proposed a new technique to reposition the pixels to break the correlation between them. So, the proposed scheme offers a more secure and cost effective mechanism for encryption. Next on the AES criteria list good performance. Widespread market adoption will require reasonably good performance on a variety of platforms, ranging from easy tocrack smart cards to the largest servers. Good algorithm performance includes speed for the encryption and decryption process as well as the key schedule. Prateek Goyal | Ms. Shalini Bhadola | Ms. Kirti Bhatia "Data Security by AES (Advanced Encryption Standard)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45073.pdf Paper URL: https://www.ijtsrd.com/computer-science/computer-security/45073/data-security-by-aes-advanced-encryption-standard/prateek-goyal
Antimicrobial and Phytochemical Screening of Phyllantus NiruriYogeshIJTSRD
Theorigin of Phyllanthus niruri is tropical America from there it spread as a weed to other tropic and sub tropics. It is a tropical annual herb shrub which grows as weed in moist humid waste land. Phyllanthus niruri is among more than 500 Phyllanthus species that are widely spread in temperate and tropical climates region Lizuka et al., 2007. It grows 30 40 cm in height, has small leaves and yellow flowers the stem has green capsule, and blooms with flowers with 5 white sepals and apical acute anther.38g of Mueller Hinton Agar was dissolved in 1000ml distilled water in a conical flask, the mouth of the conical flask was plugged with cotton woo wrapped in aluminium foil. This was sterilized in an autoclave at 121oC for 15mns. The media was removed and allowed to cool to 45oC, later poured into a sterilized plastic petri plates which were appropriately labeled. The present study revealed the antimicrobial activity and phytochemical screening of phyllanthus niruri. The antimicrobial activity of phyllanthus niruri shows great significant against pathogens which are responsible for common infections of skin, respiratory, urinary and gastrointestinal tracts. The phytochemical screening of oxalate, terpenoids, tannins, phenols, quinones, flavonoids, alkaloids, saponins and steroids were all found to be active within the plant. This bioactive phytochemicals present in P. niruri can be useful for further researches on the plant P. nururi since the phytochemicals have shown preclinical efficacies for treating human diseases’ which include hepatitis and HIV AIDS. This work has compiled the chemical constituents present and can be useful for further researches Dr. Mohammed Musa Lawan | Yusuf Sale Baba "Antimicrobial and Phytochemical Screening of Phyllantus Niruri" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd44948.pdf Paper URL: https://www.ijtsrd.com/chemistry/other/44948/antimicrobial-and-phytochemical-screening-of-phyllantus-niruri/dr-mohammed-musa-lawan
There is a need for temperature drop in a buried pipeline based on the media and process. Need of some methodology and design requirement for a set of conditions by reducing pipeline surface temperature and the temperature drops to atmospheric temperature at a particular distance of pipeline. Based on the conduction principle, desire reduction up to atmospheric temperature can be possible. Let us understand by below methods and design of Heat sink for buried pipe line. Natvarbhai Prabhudas Gajjar "Heat Sink for Underground Pipe Line" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45117.pdf Paper URL: https://www.ijtsrd.com/engineering/other/45117/heat-sink-for-underground-pipe-line/natvarbhai-prabhudas-gajjar
Newly Proposed Multi Channel Fiber Optic Cable CoreYogeshIJTSRD
Fiber optic cables have single core and multiple core options, but single and multiple core fiber cable -˜s core design need to be updated. Newly proposed design gives facilities to multiple usage than traditional design of cable core. Cable core design needs improvement by using present technology for decreasing material and cost and by improving efficiency of cable. Research need to be carried out in this direction. What do you think Natvarbhai Prabhudas Gajjar "Newly Proposed Multi Channel Fiber-Optic Cable Core" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45116.pdf Paper URL: https://www.ijtsrd.com/engineering/other/45116/newly-proposed-multi-channel-fiberoptic-cable-core/natvarbhai-prabhudas-gajjar
Security Sector Reform toward Professionalism of Military and PoliceYogeshIJTSRD
The need to understand and at the same time give prescriptions for the direction of security reform in Third world countries after the end of World War II has prompted the emergence of a big project called the study of security reform SSR . Within this framework emerge various theories and strategies for security reform, with various variations, including ideological variations that underlie these theories. The reform of the structural aspect is a reform of the institutional and structure of an institution, the instrumental reform includes the reform of the system, laws and regulations, while the reform of the cultural aspect is a reform of the habits or organizational culture in institutions in general and in particular the Timor Leste’s security institutions, both military and police. Arquimino Ramos "Security Sector Reform toward Professionalism of Military and Police" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45061.pdf Paper URL: https://www.ijtsrd.com/humanities-and-the-arts/political-science/45061/security-sector-reform-toward-professionalism-of-military-and-police/arquimino-ramos
Stress An Undetachable Condition of LifeYogeshIJTSRD
Stressful life events affects human body, which may lead to cardiovascular diseases and effect metabolism and immune system. Recent studies showed increase in stress levels in developing countries. This study aimed to determine the stress levels in MBBS students. The objectives of the study are a To determine the current stress level, b To assess relation between stress level and lifestyle of college students. The present study was carried out in Ahmedabad City of Gujarat State. A total of 400 medical students were included in the study, which were selected using multi stage sampling aged between 18 years to 25 years. Students were questioned regarding their socioeconomic and life style parameters. The results showed that physical activity such as walking, exercise, yoga, meditation etc. were associated to stress levels. College students showed high stress levels with more satisfaction were mostly smokers. Their major reason for eating junk food and smoking was, increase in stress. Conclusion Majority of students suffered from moderate stress levels. Despite of having stress they were happy and satisfied with life with less no internet addiction. Spirituality and stress scales had a positive correlation as most of the students were averagely highly spiritual. Discriminant function can be used to determine the stress level of a person using age, BMI, internet addiction, spirituality, happiness scale and life satisfaction scale of that person. Jayshree N. Tolani | Dr. Nitinkumar D. Shah "Stress: An Undetachable Condition of Life" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45054.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45054/stress-an-undetachable-condition-of-life/jayshree-n-tolani
Comparative Studies of Diabetes in Adult Nigerians Lipid Profile and Antioxid...YogeshIJTSRD
The study sought to determine the extent to which the usage of social media in the marketing of agricultural products in South West Nigeria can enhance farmers turnover. It employed the survey research design to collect data with the help of a structured questionnaire to elicit information from respondents selected from six 6 south western states. Research data were analysed using structural equation modelling. The results showed that the use of social media WhatsApp and Facebook in marketing of agricultural products significantly enhances farmers turnover. The managerial implication is that use of Whatsapp and Facebook in the marketing of agricultural products for the enhancement of farmers’ turnover was found to have significant influence on the enhancement in farmers’ turnover from agricultural products. Policy makers in government should provide the enabling environment for the telecommunication companies to enhance their reach by installing their facilities across the length and breadth of the country so that the network coverage will be strong at all times so that the benefits of social media usage will not be constrained. Egejuru, Leonard O | Akubugwo, Emmanuel I | Ugorji, Beatrice N "Comparative Studies of Diabetes in Adult Nigerians: Lipid Profile and Antioxidants Vitamins (A and C)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45021.pdf Paper URL: https://www.ijtsrd.com/biological-science/biochemistry/45021/comparative-studies-of-diabetes-in-adult-nigerians-lipid-profile-and-antioxidants-vitamins-a-and-c/egejuru-leonard-o
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
Novel Drug Delivery System An OverviewYogeshIJTSRD
In present scenario evolution of an existing drug molecule from a old form to a novel delivery system can significantly improve its performance in terms of patient compliance, safety and efficacy. In the form of a control drug delivery system an existing drug molecule can get a new life. An appropriately designed Novel Drug Delivery System can be a major advance for solving the problems related towards the release of the drug at specific site with specific rate. The porpuse for delivering drugs to patients efficiently and with fewer side effects has prompted pharmaceutical companies to engage in the development of new drug delivery system. This article covers the basic information regarding Novel Drug Delivery Systems and also advantages, factor etc. Chiranjit Barman | Dr. Gaurav Kumar Sharma | Dr. Kausal Kishore Chandrul "Novel Drug Delivery System: An Overview" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45068.pdf Paper URL: https://www.ijtsrd.com/pharmacy/novel-drug-delivery-sys/45068/novel-drug-delivery-system-an-overview/chiranjit-barman
With the growth of technology their grows threat to our data which is just secured by passwords so to make it more secure biometrics came into existence. As biometric systems are adopted and accepted for security purpose for various information and security systems. Hence it is immune to attacks. This paper deals with the security of biometric details of individuals. In this paper we will be discussing about biometrics and its types and the threats and security issues which is not talked about usually. The different technologies evolved and had contributed to biometrics in long run and their effects. Sushmita Raulo | Saurabh Gawade "Security Issues Related to Biometrics" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd44951.pdf Paper URL: https://www.ijtsrd.com/computer-science/computer-security/44951/security-issues-related-to-biometrics/sushmita-raulo
Comparative Analysis of Different Numerical Methods for the Solution of Initi...YogeshIJTSRD
A mathematical equation which involves a function and its derivatives is called a differential equation. We consider a real life situation, from this form a mathematical model, solve that model using some mathematical concepts and take interpretation of solution. It is a well known and popular concept in mathematics because of its massive application in real world problems. Differential equations are one of the most important mathematical tools used in modeling problems in Physics, Biology, Economics, Chemistry, Engineering and medical Sciences. Differential equation can describe many situations viz exponential growth and de cay, the population growth of species, the change in investment return over time. We can solve differential equations using classical as well as numerical methods, In this paper we compare numerical methods of solving initial valued first order ordinary differential equations namely Euler method, Improved Euler method, Runge Kutta method and their accuracy level. We use here Scilab Software to obtain direct solution for these methods. Vibahvari Tukaram Dhokrat "Comparative Analysis of Different Numerical Methods for the Solution of Initial Value Problems in First Order Ordinary Differential Equations" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45066.pdf Paper URL: https://www.ijtsrd.com/mathemetics/applied-mathematics/45066/comparative-analysis-of-different-numerical-methods-for-the-solution-of-initial-value-problems-in-first-order-ordinary-differential-equations/vibahvari-tukaram-dhokrat
Evaluation of Different Paving Mixes Using Optimum Stabilizing ContentYogeshIJTSRD
Bituminous mixes are most commonly used all over the world in flexible pavement construction. It consists of asphalt or bitumen used as a binder and mineral aggregate which are mixed together, laid down in layers and then compacted. Under normal circumstances, conventional bituminous pavements if designed and executed properly perform quite satisfactorily but the performance of bituminous mixes is very poor under various situations. Today’s asphaltic concrete pavements are expected to perform better as they are experiencing increased volume of traffic, increased loads and increased variations in daily or seasonal temperature over what has been experienced in the past. In addition, the performance of bituminous pavements is found to be very poor in moisture induced situations. Considering this a lot of work has been done on use of additives in bituminous mixtures and as well as on modification of bitumen. Research has indicated that the addition of polymers to asphalt binders helps to increase the interfacial cohesiveness of the bond between the aggregate and the binder which can enhance many properties of the asphalt pavements to help meet these increased demands. However, the additive that is to be used for modification of mix or binder should satisfy both the strength requirements as well as economical aspects. Naveen Kumar | Ms. Shivani "Evaluation of Different Paving Mixes Using Optimum Stabilizing Content" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45089.pdf Paper URL: https://www.ijtsrd.com/engineering/civil-engineering/45089/evaluation-of-different-paving-mixes-using-optimum-stabilizing-content/naveen-kumar
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
2024.06.01 Introducing a competency framework for languag learning materials ...
Increased Cardiac Troponin T in Patients without Myocardial Infarction
1. International Journal of Trend in Scientific Research and Development (IJTSRD)
Special Issue on Innovative Development of Modern Research
Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470
ID: IJTSRD40034 | Special Issue on Innovative Development of Modern Research Page 87
Increased Cardiac Troponin-T in
Patients without Myocardial Infarction
Khusainova Munira Alisherovna
Samarkand State Medical Institute, Samarkand, Uzbekistan
ABSTRACT
According to the World Health Organization, the diagnosis
of acute myocardial infarction (AMI) is based on two of the
three main criteria: changes in the ECG (up to 25% of
myocardial infarctions are not reflected in the ECG),
anginous pain, and increased markers of myocardial
necrosis. In 2000, the European Scientific Society and the
American College of Cardiology made a correction to the
definition of AMI, accordingtowhichthedeterminingfactor
in the diagnosis of AMI is the detection of an increasedlevel
of specific markers of myocardial necrosis — cardiac
troponins in the blood. Troponin is a protein that is part of
myofibrils. Cardiac troponin contains three subunits: T, I,
and C. Troponin C is non-specific for the myocardium, in
contrast to the T and I subunits, whose structure in the
contractile fibers of cardiomyocytes differs from similar
proteins of other muscle cells. The widespread use of the
determination of cardiac troponins in the blood
significantly increased the detection of AMI (by 30-200%).
Until recently, it was believed that troponins enter the
blood only as a result of the death of cardiomyocytes.
However, in recent years, it has been shown that troponins
can penetrate into the interstitial space, and then into the
blood, when cardiomyocytes are damaged with anincrease
in the permeability of their cell membranes, which can be
caused not only by AMI, butalsobyconditionsaccompanied
by hyper production of pro-inflammatorycytokines(tumor
necrosis factor-α, interleukin-1, etc.).
The aim of this study was to analyze the final diagnoses in
patients with increased cardiac troponin-T levelswithout a
clinical picture and characteristic ECG changes in AMI.
KEYWORDS: acute myocardial infarction, cardiomyocytes,
cardiac troponin-T, anginous pain
Materials and methods
The study included 54 patients (36 men, 18 women, aged 54
to 87 years, on average-69.8±11.2). The inclusion criterion
was an increase in the level of cardiac troponin-T above the
diagnostically significant level (more than 0.3 ng / ml). The
exclusion criteria were:
clinical picture of acute coronary syndrome (typical
angina attacks);
ECG changes characteristic of AMI on the first day of
inpatient treatment (elevation or severe depression of
the ST segment, the appearance of new Q waves).
All patients underwent a general clinical examination. The
level of cardiac troponin-T in the blood (using the device
Cardiac Reader Roche, Germany) was determined at
admission, or 14-16 hours after the deterioration of the
condition. ECG registration was performed on admission to
the hospital and daily. Echocardiography was performed on
the device GE Vivid 7 (USA) according to the generally
accepted method. In addition, the level of transaminases,
urea, creatinine, bilirubin, total protein, MB-CK in the blood
was analyzed, gases, blood electrolyte, acid-base balance
were examined. Chest radiography was performed at
admission, in some cases — repeatedly. If necessary, the
patients underwent ultrasound examination of the
abdominal cavity and kidneys, blood culture, and brain CT.
The severity of the patient was determined based on the
calculation of the SAPS II index, which assumes an
assessment of the urgency of the patient's admission to the
hospital, the presence of chronic diseases, age, temperature,
daily diuresis, blood pressure, heart rate, blood oxygenation
index (FiO2/PaO2), white blood cells, sodium, potassium,
urea, bicarbonate and bilirubin, as well as an assessment of
the level of consciousness on the Glasgow scale.
The final diagnosis was established on the basis of the
analysis of the clinical picture, the study of the dynamics of
the main symptoms, the data of a comprehensive
examination, in some cases — on autopsy.
Table 1 Mortality of patients included in the study and the level of cardiac troponin-T
Nosological form
Total
number of
patients
Number of
deceased
patients
Troponin-T level in
discharged patients
(ng/ml)
Troponin-T level in the
deceased (ng/ml)
AMI 22 11 0.79±0.19 1.62±0.21*
Septic condition 16 9 0.63±0.14 1.66±0.27*
Oncopathology 8 6 0.74±0.49 1.49±0.34
Diabetic nephropathy with CRF 4 2 0.58±0.34 1.59±0.58
Brain infarction 3 1 0.61±0.45 1.31±0.61
B12-deficiency anemia 1 1 0.49 1.69
Note. Here and in Table. 2: * - statistical significance of differences between the level of troponin T in deceased and
discharged patients (p<0.05).
2. International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
ID: IJTSRD40034 | Special Issue on Innovative Development of Modern Research Page 88
Statistical processing of the results of the study was carried out using the program "STATISTICA 6.0". We used: the
Kolmogorov–Smirnov test to assess the statistical significance of the difference when comparing the indicator of two
independent groups; the Spearman testtoconducta correlationanalysis.Inall measurements,thearithmeticmean wasusedas
an indicator of the average value, and the standard deviation was used for the spread indicator.
Results and discussion
All 54 patients included in the study had manifestations of multiple organ failure: the SAPS II index ranged from 50 to 86 (an
average of 74.4±11.2). 30 patients died. The level of cardiac troponin-T was in the range of 0.06-2.0 ng/ml (on average,
1.21±0.12).
In 22 patients out of 54 (40.7%), the final diagnosis was MINE. The diagnosis of AMI was made on the basis of the appearance
of the characteristic dynamics of the ECG, the progression of congestive left ventricular failure. In 7 patients, AMI occurred on
the background of decompensated diabetes mellitus,in9 patients,AMIwasrepeated, andin7patients,therewasrepeatedAMI
on the background of decompensated diabetes mellitus. Of the 22 patients with AMI, 11patientsdied,andthediagnosisofAMI
was confirmed by autopsy.
In the remaining 32 patients, the diagnosis of AMI was not confirmed. Figure 1 and Table 1 show the distribution of patients
included in the study by nosological forms.
Fig.1 Distribution of patients by nosological forms
3 1
22
16
8
4 AMI
Septic condition
Oncopathology
Diabetic nephropathy CRF
Brain infarction
B12-deficiency anemia
In 16 patients were diagnosed with septic condition: 8 and generalized peritonitis (5-and — thrombosis inmesentericvessels
with gangrene of the bowel, 1 destructive cholecystitis, the 1st — perforation of the colon tumor, the 1st — pancreatic
necrosis), 5-and — epistemology jade 2-x —destructivepneumonia,the1stoneisa commoninflammationofthesubcutaneous
and intermuscular adipose tissue of the thigh. In 8 patients,variousoncopathologieswithcancerintoxicationwere detected(in
3-stomach cancer, in 2-lung cancer, in 1-prostate cancer, in 1 — cervical cancer). After computedtomography,3patientswere
diagnosed with a massive cerebral infarction (2-by ischemic type, 1-byhemorrhagictypewitha breakthroughintheventricles
of the brain). In 4 patients, chronic renal failure was detected against the background of long-term diabetes mellitus with
diabetic nephropathy (creatinine level was from 730 to 1131 mmol/l). 1 patient had severe B12 deficiency anemia
(hemoglobin 59 and 64 g/l).
It turned out that the level of troponin-T in the deceased was on average 1.61±0.28 ng/ml, which is significantlyhigherthanin
the discharged patients (0.64±0.19 ng/ml). This indicates an unfavorable prognosis of a pronounced increase in troponin-T.
The level of troponin-T in patients with AMI was practically the same as in patients with other diseases (1.24±0.21 and
1.20±0.19 ng / ml, respectively).
Considering that the level of troponin-T was significantly higher in the subgroup of severe patients, a correlation analysiswas
performed between the level of troponin-T and the integral indicator of the patient's severity-the SAPS II index. A significant
positive correlation was found.
In the majority of patients included in the study, the overall left ventricularcontractilitywasreduced:the ejectionfraction(EF)
was in the range of 17-52% (on average, 37.7±11.2%). The EF in patients with AMI was significantly lower than in other
patients (Table 2). At the same time, the EF in those who died (from AMI and other diseases) was significantly lower than in
those who were discharged.
In patients with AMI, there was no correlation between EF and the level of troponin-T, whereasinpatientswithotherdiseases,
EF was inversely correlated with the level of troponin T (correlation coefficient -0.45;p=0.003). These data may indicate that
the level of troponin may reflect the degree of cardiodepression in patients without AMI, whereas in AMI, the reduction in
contractility is affected not only by the amount of necrotic myocardium,butalsobyotherfactors(hibernatingmyocardium,the
presence of foci of fibrosis after AMI, etc.).
3. International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
ID: IJTSRD40034 | Special Issue on Innovative Development of Modern Research Page 89
The present study showed that AMI is diagnosed only in 40% of patients with elevated troponin-T without a typical clinical
picture of AMI. The remaining patients had another underlying disease with manifestations of multipleorganfailure.Itshould
be emphasized that all the patients included in the study were in critical condition when they were admitted. Increased levels
of troponin-T correlated with the severity of the condition; in deceased patients, the level of troponin was significantly higher
than in discharged patients. It should be noted that the level of troponin-T in patients with AMI and other diseases practically
did not differ. There are reports in the literature that some severe diseases lead toanincreaseinthelevel ofcardiactroponin-T
in the blood. In the present study, an increase in cardiac troponin-Twasdetectedmainlyinpatientswith multipleorganfailure.
According to the literature data, it is multi-organ failurethatleadstoa "non-coronarogenic"increaseincardiactroponinsinthe
blood: for example, Ammann P., Maggiorini M., 2003, studied the level of troponin-T in patients with sepsis without AMI. As a
result of this study, it was shown that an increase in troponin-T was significantly more often detected in patients with septic
shock, which is the cause of multiple organ failure, while the level of troponin-T directly correlated with the level of tumor
necrosis factor-α (TNF-α) and interleukin-6 (IL-6). The authors suggest using troponin-T as an additional factor in the
unfavorable course of the disease in patients with a septic condition.
Table 2 Ejection fraction depending on nosology and outcome (%)
The outcome of the disease
Values of the ejection fraction depending on the nosology
AMI (n=22) other diseases (n=32) p
Favorable outcome (n=24) 43.1±9.1 52.1±10.4 0.039
Fatal outcome (n=30) 23.6±8.4 39.1±8.9 0.028
p 0.013 0.021
The increase in troponin-T levels in patients without AIM
identified in this study appears to be associated with
myocardial damage due to a systemic inflammatory
response. A systemic inflammatory reaction occurs as a
result of massive cell damage due to severe hypoxemia,
acidosis, endo and exogenous intoxication, as well as
exposure to microbial toxins. Damaged tissues secrete a
large amount of pro-inflammatory cytokines, which
contribute to the infiltration of tissues by neutrophils and
macrophages, activation of lipid peroxidation, and
hyperproduction of nitric oxide. All these processes
aggravate the existing tissue damage, leading to the
formation of a vicious circle and multiple organ failure. Ut a
praecessi of hyperproduction de proinflammatorycytokines
ut a praecessi of a systemica inflammatione reactionem,
damnum cardiomyocytes cum progressum myocardial
praesent est possibile. In particulari, pro-inflammatione
substantiae, agere in cellam membrana,augerepermeability.
Hoc posito, factum est, et probatum in 1984 per Piper et al.,
tunc sustinetur Wu A. H., Ford L., 1999, et confirmatum per
sequens opus per Ammann P. et al., 2003. Ut a praecessi,
cordis troponins soluta in intercellular spatium. Auctores
explicare posse diffusio cordis troponins-T et ego per
integrum membrana tam parva magnitudine moleculis his
servo se (33.5 et 25.5 kDa, respective), et per eorum alia
ruptio in responsione ad cellularum hypoxia. In connection
with the above, it can be assumed that theincreaseincardiac
troponins in the blood in patients with multipleorganfailure
is not a false positive, but indicates the severity of the
process involving the myocardium in the pathological
process. This assumption is confirmed by the decreaseinleft
ventricular EF in the majority of patients identified in this
study and the inverse correlationbetweenEF andthelevel of
troponin-T and EF in patients without AMI. The inverse
correlation between EF and the level of cardiac troponins
was revealed by verElst K. M. et al., 2000. The absence of a
correlation between EF and the level of troponin-T in AMI
patients is probably due to the fact that some patients
suffered repeated AMI, that is, they already hada decreasein
myocardial contractile function.
In conclusion, we can say that, despite the cardiospecific
nature of troponin-T, its detection in the blood of patients in
extremely serious condition, in the absence of other
manifestations of AMI, is not a specific symptom of AMI, but
indicates the involvement of the myocardium in the
pathological process, which may be a manifestation of
multiple organ failure with a systemic inflammatory
reaction. For this reason, the detection of elevated levels of
cardiac troponins in the blood of this contingent is
prognostically unfavorable.
Literature:
[1] Myocardial infarction redefined — a consensus
document of the Joint european society of
cardiology/american college of cardiologycommittee
for the redefinition of myocardial infarction. J. Am.
Coll. Cardiol.2000; 36: 959—969.
[2] Braunwald E., Antman E. M., Beasley J. W. et
al.ACC/AHA guidelines for the management of
patients with unstable angina and non ST segment
elevation myocardial infarction: a report of the
American college of cardiology/american heart
association task force on practice guidelines. J. Am.
Coll. Cardiol. 2000; 36: 970—1062.
[3] Alpert J. S., Thygesen K., Antman E. et al.Myocardial
infarction rede fined: a consensus document of the
joint european society ofcardiology/americancollege
of cardiology committee for the redefinition of
myocardial infarction. J. Am. Coll. Cardiol. 2000; 36:
959—969.
[4] Collins P. O., Gaze D. C. Biomarkers of cardiovascular
damage. Med. Princ. Pract. 2007; 16: 247—261.
[5] Coudrey L. The troponins. Arch. Int. Med. 1998; 158:
1173—1180.
[6] Ammann P., Pfisterer M., Fehr T. et al.Raised cardiac
troponins. B.M.J. 2004; 328: 1028—1029.
[7] Kontos M. C., Fritz L. M., Anderson F. P. et al. Impact of
the troponin standard on the prevalence of acute
myocardial infarction. Am. Heart J. 2003; 146: 446—
452.
[8] Ferguson J. L., Beckett G. J., Stoddart M. et al.
Myocardial infarction redefined: the new ACC/ESC
definition, based on cardiac troponin, increases the
apparent incidence of infarction. Heart 2002; 88:
343—347.
4. International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
ID: IJTSRD40034 | Special Issue on Innovative Development of Modern Research Page 90
[9] Guest T. M., Ramanathan A. V., Tuteur P. G. et al.
Myocardial injury in critically ill patients:a frequently
unrecognized complication. J.A.M.A. 1995; 273:
1945—1949.
[10] Turner A., Tsamitros M., Bellomo R.Myocardial cell
injury in septic shock. Crit. Care Med. 1999; 27:
1775—1780.
[11] Ammann P., Fehr T., Minder E. I. et al.Elevation of
troponin I in sepsis and septic shock. Intens. Care
Med. 2001; 27: 965—969.
[12] Le Gall J.R., Lemeshow S., Saulnier F. A new simplified
acute physiology score (SAPS II) based on a
European/North American multicenter study. J. A. M.
A. 1993; 270: 2957-2963.
[13] Wu A. H. Increased troponin in patients with sepsis
and septic shock: myocardial necrosis or reversible
myocardial depression? Intens. CareMed. 2001; 27:
959-961.
[14] Wong P., Mussay S., Ramsewak A. et al.Increased
cardiac troponin T levels in patients without acute
coronary syndrome. Postgrad. Med. 2007; 83: 200-
205.
[15] Ammann P., Maggiorini M. Troponin as a risk factor
for mortality in critically ill patients without acute
coronary syndromes. Am. Coll. Cardiol. 2003; 41:
2004—2009.
[16] Afessa B., Green B., Delke I., Koch K. Systemic
inflammatory response syndrome, organ failure and
outcome in critically ill obstetric patients treated in
the intensive care unit. Chest 2001; 120: 1271-1277.
[17] Matsuda N., Hattori Yu. Systemic inflammatory
response syndrome (SIRS): Molecular
pathophysiology and gene therapy. J. Pharmacol. Sci.
2006; 101: 189-198.
[18] Kaye A.D., Hoover J. M., Belukh A. R. Modern review of
multiple organ failure. Middle East J. 2005; 18: 273-
292.
[19] Rudiger A., Singer M. Mechanisms of sepsis-induced
cardiac dysfunction of thion. Crete. Care Med. 2007;
35: 1599-1608.
[20] Piper H. M., Schwartz P., Spar R., et al.Early release of
enzymes from myocardial cells is not associated with
irreversible cell damage. Cell. Cardiol. 1984; 16: 385-
388.
[21] Wu A. H., Ford L. Release of cardiac troponin in acute
coronary syndromes: ischemia or necrosis? Klin.
Chim. Acta 1999; 284: 161-174.
[22] Babuin L., Jaffe A. S. Troponin: a biomarker of choice
for detecting heart damage C. M. A.J.2005;173:1191-
1202.
[23] Wu A. H. Increased troponin levels in patients with
sepsis and septic shock: myocardial necrosis or
reversible myocardial depression? Intensive Care
Med. 2001; 27: 959-961.
[24] Ver Elst K. M., Spapen H. D., Nguyen D. N. et al. Cardiac
troponins I and Ii T-biological markers of left
ventricular dysfunction in septic shock. The wedge.
Chem., 2000; 46: 650-657.