Introduction: The tunneled hemodialysis catheters(THCs) are preferred for the patients who are expected to
poor survival and the attempts to arteriovenous fistulas (AVF) are failure. In our study,in hemodialysis
patients who are implemented tunneled catheter it is evaluated the mean duration for the catheters , their
complications and the factors which affect the period of the catheters.
Methods: At the Antalya Research and Education Center Hemodialysis Unit it is retrospectively evaluated the
data of 297 hemodialysis patients who are implemented tunneled catheter during 5 years .
Results: The mean duration time of the tunneled catheters has been 224.9+162.9 days. The duration time of
right internal jugular vein(RIJV) is considerably higher than left internal jugular vein(LIJV) and subclavian
veins (235.8+96.6 days). In diabetic hemodialysis patients, the duration time of the catheter is rather lower
than the other end stage renal disease reasons(184.4±72.1 days).
Conclusions: THCs must be considered as an alternative but not a permanent vascular access in hemodialysis
patients. Because of relatively short duration times than AVF, high infection risks and thrombosis , it must be
used only in patients who have problems with the creating permanent vascular access or patients with
expected low survival time. Moreover, it must be taken into consideration the duration time of the catheter is
low in diabetic hemodialysis patients. According to our results, catheter duration time was longer in RIJV than
in other insertion sites and RIJV must be preferred as first place to placement of THCs.
Same Wrist Intervention via the Cubital (Ulnar) Artery in Case of Radial Puncture Failure for Percutaneous Cardiac Catheterization or Intervention: The Multicenter Prospective SWITCH Registry
Same Wrist Intervention via the Cubital (Ulnar) Artery in Case of Radial Puncture Failure for Percutaneous Cardiac Catheterization or Intervention: The Multicenter Prospective SWITCH Registry
Purpose: To assess the effectiveness of a fast track referral system from Vascular Laboratory to Interventional Radiology on
threatened vein bypass grafts in the lower limbs.
Methods: A Fast Track System (FTS) was set up in February 2011 to minimise the delay from duplex scan to intervention for bypass grafts with identifi ed signifi cant stenoses. 111 scans were performed pre - FTS over one year and compared with 190 scans which were performed post-FTS introduction over two years.
Bleeding avoidance strategies, such as a transradial approach (TRA), should be considered especially for patients with high bleeding risk.3) However, PCI operators hesitate to choose conventional TRA for patients on dialysis because of the increased risk of radial artery occlusion (RAO) and general tendency to preserve possible hemodialysis access points for the future.
Safety, risk of complications and the functional feasibility among different kinds of central venous access are still a matter of debate.Not many clinical trials have reported a comparison of complications and patency of CVCs versus Peripherally Inserted Catheters (PICC) as central venous access for indoor patients with advanced gastrointestinal disorder. The aim of the present study was to compare CVCs and PICCs regarding function, complications and convenience in a controlled clinical study on patients aimed for oncology surgery aimed for cure.
Distributions of patients were comparable. Malignant diagnoses were significantly higher among CVC-patients. CVCs and PICCs were used for treatment during equal number of days, without any signifi cant complication rates and with comparable number of days on antibiotics and other potent drugs. The overall cumulative hazard (risk) for treatment interruptions, due to either full-filled clinical indications or due to any complication among the subgroups of patients did not differ.Central Venous Catheter and Peripheral Inserted Central Venous Catheter, for central venous access, did not differ among consecutive unselected patients with serious gastro-intestinal disorders.
Simultaneous estimation of metformin hydrochloride and glibenclamide by rphpl...IJSIT Editor
A high performance reverse phase liquid chromatographic procedure is developed for simultaneous
estimation of Metformin hydrochloride and Glibenclamide in combined tablet dosage form. The method was carried
out on a Agilent Hypersil ODS (25cm x 4.6mm, i.d. 5µ) column with a mobile phase used consisting of acetonitrile:
mono basic sodium phosphate Buffer (50:50) and the pH of buffer was adjusted to 2.5 using 2M Orthophosphoric acid.
The detection of the combined dosage form was carried out at 228 nm and a flow rate employed was 1 ml/min and
column oven temperature at 300C. The retention times of Metformin HCl & Glibenclamide were 2.709& 9.216 minutes
respectively. The developed method was validated in terms of accuracy, precision, linearity, limit of detection, limit of
quantification as per ICH norms. The proposed method can be used for the estimation of these combined drugs.
Purpose: To assess the effectiveness of a fast track referral system from Vascular Laboratory to Interventional Radiology on
threatened vein bypass grafts in the lower limbs.
Methods: A Fast Track System (FTS) was set up in February 2011 to minimise the delay from duplex scan to intervention for bypass grafts with identifi ed signifi cant stenoses. 111 scans were performed pre - FTS over one year and compared with 190 scans which were performed post-FTS introduction over two years.
Bleeding avoidance strategies, such as a transradial approach (TRA), should be considered especially for patients with high bleeding risk.3) However, PCI operators hesitate to choose conventional TRA for patients on dialysis because of the increased risk of radial artery occlusion (RAO) and general tendency to preserve possible hemodialysis access points for the future.
Safety, risk of complications and the functional feasibility among different kinds of central venous access are still a matter of debate.Not many clinical trials have reported a comparison of complications and patency of CVCs versus Peripherally Inserted Catheters (PICC) as central venous access for indoor patients with advanced gastrointestinal disorder. The aim of the present study was to compare CVCs and PICCs regarding function, complications and convenience in a controlled clinical study on patients aimed for oncology surgery aimed for cure.
Distributions of patients were comparable. Malignant diagnoses were significantly higher among CVC-patients. CVCs and PICCs were used for treatment during equal number of days, without any signifi cant complication rates and with comparable number of days on antibiotics and other potent drugs. The overall cumulative hazard (risk) for treatment interruptions, due to either full-filled clinical indications or due to any complication among the subgroups of patients did not differ.Central Venous Catheter and Peripheral Inserted Central Venous Catheter, for central venous access, did not differ among consecutive unselected patients with serious gastro-intestinal disorders.
Simultaneous estimation of metformin hydrochloride and glibenclamide by rphpl...IJSIT Editor
A high performance reverse phase liquid chromatographic procedure is developed for simultaneous
estimation of Metformin hydrochloride and Glibenclamide in combined tablet dosage form. The method was carried
out on a Agilent Hypersil ODS (25cm x 4.6mm, i.d. 5µ) column with a mobile phase used consisting of acetonitrile:
mono basic sodium phosphate Buffer (50:50) and the pH of buffer was adjusted to 2.5 using 2M Orthophosphoric acid.
The detection of the combined dosage form was carried out at 228 nm and a flow rate employed was 1 ml/min and
column oven temperature at 300C. The retention times of Metformin HCl & Glibenclamide were 2.709& 9.216 minutes
respectively. The developed method was validated in terms of accuracy, precision, linearity, limit of detection, limit of
quantification as per ICH norms. The proposed method can be used for the estimation of these combined drugs.
Antibacterial activity of aerial parts of thymus serphyllum linn against clin...IJSIT Editor
In the present research work in vitro antibacterial activity of methanolic extract of aerial parts of
Thymus serphyllum L. growing wild in Kashmir Himalaya was evaluated by agar well diffusion method and
broth dilution assay against nine human pathogenic bacterial strains, known to cause serious infections. The
extract was also screened for the presence of various bioactive phytoconstituents present in the plant. The
extract in the present study possess appreciable potential of inhibiting the growth of all the bacterial strains
at all tested concentrations (30, 60 and 90 mg/ml). The highest sensitivity was exhibited against
Staphylococcus epidermidis MTCC- 435 and Staphylococcus aureus with mean zones of inhibition 20.66 and 20
mm respectively at the concentration of 90 mg/ml. Salmonella typhi showed the least activity with mean zone
of inhibition of 10.00 mm at the concentration of 30 mg/ml. The MIC value ranged between 1.56 to 12.56
mg/ml. The phytochemical analysis of the crude extract revealed the presence of alkaloids, flavonoids,
phenolics, saponins, tannins, cardiac glycosides, terpenes, steroids and carbohydrates. Anthraquinone
glycosides were absent. The present study clearly indicate that the crude methanolic extract of Thymus
serphyllum from high altitude of Kashmir Himalaya (2350 m) shows significant antibacterial activity in
concentration dependent manner.
Phytochemical analysis of sida ovata seed oil a new source of cyclopropenoid ...IJSIT Editor
The seeds of Sidaovata were collected from the arid zone of Rajasthan and analysed for the
characterization of the fatty acids. This paper accounted the presence of Cyclopropenoid fatty acids(Malvalic
and Sterculic). The occurrence of CPFA was confirmed by HBr-titration, Halphen test, TLC, NMR and IR
spectroscopic methods.
Development of new robust rp hplc method for analysis of levo dopa in formula...IJSIT Editor
HPLC method was developed for the analysis of Levo Dopa in formulations. In this method we focused on
easy and more accuracy. A mixture of Acetonitrile: Methanol: orthophosphoric acid in the ratio of 30:50:20, v/v/v was
prepared and used as mobile phase. The mobile phase is 6.8. The wave length of U.V detector 280 nm. We obtained a
good resolution peak 2.4 min. The linearity of method is 10-25 ppm. The recovery range of method is 98.6-99.85.
Effect of food on pharmacokinetics of meloxicam ijsit 2.3.7IJSIT Editor
The primary objective of the study was to investigate the effect of food on the pharmacokinetics of
MELOXICAM. Cmax, Tmax and AUC of MELOXICAM were defined as the main parameters for the assessment
of bioavailability and bioequivalence of MELOXICAM administered in fasting and fed conditions. The 90% CI
for the fed/fasting MELOXICAM did not contained within the acceptance interval (80, 125) and, therefore, it
can be concluded that the rate of systemic exposure to MELOXICAM does not fit the claim of bioequivalence
between administration in fasting and fed conditions. This study has demonstrated that all the
pharmacokinetic parameters of both the treatments were statistically different from each other. In the fed
condition the values of Cmax and AUC were decreased while Tmax increases than that of fasting which
demonstrated that the extent of systemic exposure to MELOXICAM was affected by the delay in absorption of
MELOXICAM in the presence of food. None of the study volunteers reported any serious adverse effects
throughout the study. The only two AEs reported were mild and not related to the study medication. The AEs
reported were, according to the study medical expert, related to the sampling procedure and were self
limiting and did not require any treatment. There was no change in the vital signs of the volunteers
throughout the study period. The presented data are of major importance in identifying the optimal dosing
regimen for future clinical trials with oral MELOXICAM. In our study, only one type of food (a standardized
continental breakfast) was evaluated; further studies are needed to assess the effects of foods with different
compositions and contents on the bioavailability of MELOXICAM.
Protective effects of commelina benghalensis linn (root) extract on ethanol i...IJSIT Editor
The present study was undertaken to investigate the protective effect and possible mechanism of
alcoholic (AlE) and aqueous extract (AqE) from Commelina benghalensis root (CB) on EtOH-induced hepatic
injury in Wistar rat. Hepatotoxic parameters studied in vivo include serum transaminases (AST, and ALT),
ALP, bilirubin, protein, lipid profile (Cholesterol, triglyceride, VLDL and HDL) and level of antioxidants
together with histopathological examination. Liv 52® was used as a reference hepatoprotective agent
(5ml/kg-1b.w.). AlE and AqE (200 mg/kg-1b.w.) on oral administration decreased the level of AST, ALP, ALT,
bilirubin, cholesterol, triglyceride, VLDL, MDA and increased the level of protein, HDL and antioxidants (SOD,
GSH and CAT) in rats being treated with ethanol (EtOH). Pentobarbitone -induced sleeping time study was
carried out to verify the effect on microsomal enzymes Histopathological observations confirmed the
beneficial roles of MF against EtOH-induced liver injury in rats. Possible mechanism may involve their
antioxidant activity
ANTIFUNGAL ACTIVITY OF SELECTED MEDICINAL PLANT EXTRACS AGAINST PLANT PATHOG...IJSIT Editor
The aim of this work was to find an alternative to chemical fungicides currently used in the control
plant pathogenic fungi Rhizoctoniasolani ,ColletotrichummusaeandFusariumoxysporum,. The antifungal
activity of the methanol extracts of six medicinal plants used in native medicine in Sri Lanka is reported.All
plant extracts were screened for their fungistatic, fungicidal activities and minimum inhibitory dilution (MID)
against above fungi. The media amended with methanol and recommended fungicide for respective fungal
strain were consider as negative and positive control respectively.Results showed that radial growth in all the
three tested organisms was significantly impaired (p<0.05) by the addition of the extracts in the culture
medium used. The test fungi differed in their reaction to the different extracts but on the whole, growth
inhibition increased with the concentration of each extract. The most active extracts, shows a marked effect of
the 20% methanol extracts from sweet flag with inhibition values of 91%, 86% and 84 % for F. oxysporum,R.
solani and C.muceawhereas those from wild basil inhibited the growth of the same pathogens by 89%, 84%
and 74%.The results showed minimal inhibitory concentrations (MIC) were 5 % (v/v) for sweet flag and wild
basil and 20% (v/v) for all other plant crude extracts. Out of six plants extract screened, wild basil and sweet
flag showed more than 80% fungal inhibition after 6 hour immersion and other extracts could not exceed
60% inhibition after any exposure time. The study revealed that methanol crude extract of sweet flag and
wild basil exhibit strong fungistatic and fungicidal activities against tested fungi. These results support the
potential use of these plant extracts in the management of diseases caused by tested plant pathogenic fungi.
Characterization and quantitative indicators of ground water quality in okrik...IJSIT Editor
The study aims at appraising the suitability of the water for domestic purposes. The pH values as
recorded in the area range from 6.2 – 7.7 with a mean of 6.9, indicating that the groundwater is weakly acidic
to alkaline. The low acidity of groundwater in the area probably results from industrial wastewaters. The
electrical conductivity values ranges from 12.25 – 92.7 (µS/cm) with an exception at George-Ama (Location
6) with 486.0µS/cm. Apart from this location all others fall within the WHO stipulated range of 150µS/cm.
Total Dissolved Solids (TDS) ranges between 6.12 – 237.0mg/l against the WHO standard of 250mg/l. BH 1,
BH 3, BH 5, BH 6, BH 8, BH 11, BH 12, BH 14 and BH 16, all exceed 250mg/l. The high concentration is also
reflected in the conductivity of the area with BH 1, BH 3, BH 5, BH 6, and BH 11, all showing increasing
conductivity with increasing TDS. Total suspended solids (TSS) ranges from 0.00mg/l – 58.00mg/l. Chloride
concentration ranges between 18.00mg/l – 300mg/l. Chloride concentration above 40mg/l in groundwater is
an indication of saltwater intrusion BH 1, BH 2, BH 6, BH 8 and BH 13 show values higher than 40mg/l with
BH 2 (Gream-Ama) having 300mg/l. Apart from BH 2, all other areas fall within the WHO standards of
250mg/lIron values ranges from 0.01 to 2.50mg/l. This falls below the standard of 0.3mg/l, except in
Ogoloma (BH 4) and Ogbogbo (BH 5) with 2.50mg/l and 0.3mg/l, respectively. The average total hardness
recorded in the area is 31mg/l, this is indicative of soft groundwater in the area. The area has a low static
water level and minor records of salinity, which does not render the water unsuitable. A comparison of the
results with internationally accepted standards shows that the water is suitable for drinking and other
domestic purposes and for agricultural and industrial purposes. From the Piper’s trilinear diagram of the
concentrations of the major cations and anions in groundwater samples, the hydrochemical facies has been delineated as Sulphate – Chloride - Calcium – Biocarbonate (Cl-Ca-HCO3
-). It is suggested that the aquifers
should be protected against pollution and monitoring of groundwater quality on a regular basis to identify
any future degradation of the water in the area.
BIO CHEMICAL EFFECT OF 1, 5-BIS (3, 5-DIMETHYLPYRAZOL-1-YL)-3- OXAPENTANE-DIA...IJSIT Editor
The present study provides evidence that 1,5-Bis (3,5-Dimethylpyrazol-1-yl)-3-oxapentane-diacetatocopper has an antidiabetic effect, as hypoglycemic agent and as antilipolytic agent, but with many abnormalities. It affected blood and liver biochemistry in rats. Sera of animals treated with 1,5-Bis(3,5-Dimethylpyrazol-1-yl)-3-oxapentane-diacetatocopper in the present study revealed a significant decrease in serum glucose and albumin, while reported a significant increase in ALT and AST. Moreover, significant decrease in body weight.
Comparative study of phytochemical, antimicrobial, cytotoxic and antioxidant ...IJSIT Editor
India is a vast repository of medicinal plants that are used in traditional medical treatments. India gave
‘Ayurveda’ the oldest golden book in herbal medicine system. Medicinal plants play a vital role for the development of
new drugs. Natural products from plant, animal and minerals have been the basis of the treatment of human disease
but plants stood above all. Traditional knowledge can serve as powerful search engine, which will greatly facilitate
intentional, focused and safe natural product drug discovery. These traditions have relatively organized database, and
more exhaustive description of botanical material[1,2]. People of small village are directly in touch with herbs and plant
for treatment purpose, so we have to work together for better result. Although the herbal medicine doesn’t have side
effect but we should follow the strict quality control process. Globalization of herbal medicine system comes with the
better advancement of many oxidative stress related diseases are as a result of accumulation of free radicals in the
body. A lot of researches are going on worldwide directed towards finding natural antioxidants of plants origins. The
aims of this study were to evaluate in vitro phytochemical, antimicrobial, cytotoxic and antioxidant activities and to
screen for phytochemical constituents of Blepharis genus. [Family Acanthaceae] Methonolic crude extract.
Hplc method development for proteins and polypeptides ijsit 2.4.2IJSIT Editor
In the pharmaceutical field, there is considerable interest in the use of peptides and proteins for therapeutic
purposes. High performance liquid chromatography (HPLC) and its methods of complex peptide or protein
mixtures remains a general method of choice because of the resolution it provides. Unlike small organic
molecules whose chromatographic behavior is described by a finite partitioning equilibrium between the
stationary phase and the mobile phase, proteins and peptides typically do not exhibit such an effect. Instead,
they exhibit an adsorption phenomenon in which the polypeptide is adsorbed onto the stationary phase and
elutes only when the solvent strength of the mobile phase is sufficient to compete with the hydrophobic
forces keeping it there. For this reason, elution of peptides or proteins from reversed-phase supports is by
gradients of increasing solvent strength. There are other differences that one needs to be aware of in order to
develop HPLC methods for separations of proteins and peptides as efficiently as possible.
Ethno medicinal claims existing among mising tribes of assam ijsit 2.4.4IJSIT Editor
The present study attempts to explore the ethno medico system of Mising (Miri) tribe of the Majuli
subdivision, Jorhat district of Assam, India. The study mainly deals with the identification of medicinal plant
species with the local names, preparation methods, treatment techniques that used frequently for curing
several diseases. The practices of herbal treatments were more in the char-chapori(riverine) area as
compared to areas nearer to the modern medical facilities. An interesting fact is that the magico-religious
practices were done before any type of treatments in the Mising community. The popularity of modern
medicines though has increased a lot, but they have ardent faith only on qualitative herbal medicine.
HALO AND PSEUDOHALO-DEMETALLATION IN TETRA AND PENTAORGANOMETAL AND METALLOIDSIJSIT Editor
Halo and pseudohalo demetallation reactions of higher valent pentaphenyl –arsenic and antimony and,
tetrapolyfluorophenyl tin have been carried out employing halogens X2 (X = Br, I) interhalogens IX (X = Cl, Br), ICl3,
pseudohalogen (SCN)2, halo-pseudohalogens XSCN (X = Cl, Br) IN3, INCO and, metallic halides TeCl4 and (NH4)2PbCl6.
Reaction of (C6H5)5M (M= As,Sb) with these electrophiles afforded corresponding arsonium and stibonium derivatives
(C6H5)4MX while reactions of tetrafluorophenyl tin (C6F5)4Sn with halogens and interhalogens yielded corresponding
(C6F5)nSnX4-n (X = Cl, Br n = 2,3) derivatives depending upon the molar ratio of reactants and the reaction conditions.
The products have been identified by m.p. elemental analysis and spectroscopic data
Pharmacognostical and phytochemical standerdisation of panchavalkaladi varti....IJSIT Editor
UpaplutaYonivyapadis one of the 20 Yonivyapad, which is described by AcharyaCharaka, both
Vagbhattas and Sarangadhara.In the present study, PanchavalkaladiVartiisselected for the local application.
The present study was aimed at setting up a standard profile ofPanchavalkaladiVartiwhich was prepared
using pharmacognostically authenticate draw drugs followed by subjecting it to detailed pharmacognostical,
physicochemical and phytochemical (including Thin Layer Chromatography) analysis as per standard
protocol. The observations were systematically recorded. Pharmacognostical findings (crystals, fibres, stone
cells etc.) confirm the ingredients present in the finished product. Identified phytochemical components
(Flavonoids, Alkaloids, Tannins compounds etc.) support the intended action of the formulation in vaginal
discharge.
BLOOD TRANSFUSIONS ARE ASSOCIATED WITH MORTALITY IN PEDIATRIC PATIENTS WITH S...Texas Children's Hospital
Restrictive thresholds for red blood cell (RBC) transfusion have not been shown to be inferior to liberal transfusion thresholds after cardiac surgery in pediatric or adult patients.1,2
RBC transfusions are associated with readmission due to heart failure (HF) in adults after aortic valve replacements, and with increased risk of right ventricle-pulmonary artery conduit failure in pediatric patients.3,4
Data are limited about RBC transfusions in pediatric patients with HF.
Study of 89 Cases of Peripheral Vascular Disease by CT AngiographyM A Hasnat
The purpose of this study was to observe the morphological pattern by CT angiography
and risk factors for development of peripheral vascular disease in Bangladeshi patient suffering
from peripheral vascular disease using a multidetector scanner in the evaluation of patients with
peripheral vascular disease.
Outcome After Procedures for Retained Blood Syndrome in Coronary SurgeryPaul Molloy
OBJECTIVES:
Incomplete drainage of blood from around the heart and lungs can lead to retained blood syndrome (RBS) after cardiac sur-
gery. The aim of this study was to assess the incidence of and the outcome after procedures for RBS in patients undergoing isolated coronary artery bypass grafting (CABG)-
Morbidity and Mortality are Not Improved by Preemptive ICU Transfer of Acute ...semualkaira
Acute myeloid leukemia (AML) is associated
with a high rate of life-threatening early complications. Patients
presenting with hyperleukocytosis >50x10⁹/L and/or promyelocytic leukemia at the time of AML diagnosis can be considered at
high risk of early complications (HReC) and thus at high risk of
mortality. At our institution, we propose preemptive ICU admission to HReC patients. In so doing, our goal is to prevent complication occurrence, or, failing that, to provide rapid life-sustaining
treatment (LST). In the present retrospective study, we sought to
determine whether preemptive ICU admission improves survival
for patients newly diagnosed with AML.
Similar to OUTCOME OF TUNNELED CATHETERS IN HEMODIALYSIS PATIENTS: FIVE YEARS SINGLE CENTER EXPERIENCE (20)
CHITINASE AS THE MOST IMPORTANT SECONDARY METABOLITES OF STREPTOMYCES BACTERISIJSIT Editor
Fungal phytopathogens pose serious problems worldwide in the cultivation of economi cally
important plants.
Chemical fungicides are extensively used in current agriculture.However, excessive use of chemical
fungicides in agriculture has led to deteriorating human health , environmental pollution, damaged to
ecosystem and development of pathogen resistance to fungicide.
Because of the worsening problems in fungal disease control , a serious search is needed to identify
alternative methods for plant protection, which are less dependent on chemicals and are more
environmentally friendly. Microbial antagonists are widely used for the biocontrol of fungal plant diseases.
Many species of actinomycates, particulary those belonging to the genus sterptomyces, are well known as
antifungal biocontrol agents that inhibit several plant pathogenic fungi.
Another way biological control has been developed as an alternative of chemicals to tock with plant
pathogenic fungi. Considering high presence of chitin in fungal cell wall, chitinase enzyme is camped as an
effective biocontrol agent against phytopathogenic fungi. Streptomyces bacteria are able to produce various chitinase enzymes, chitinases produced by streptomyces belong to the families 18 and 19 glycosyl hydrolases.
The antifungal activity is mostly shown by fomily 19 Chitinases. In comparison with bacterial family 18
chitinases, the specific hydrolyzing activity of chitinase 19 against soluble and in soluble chitinous substrates
has been markedly higher. Considering the importance of family to investigate antifungal potential of
streptomyces bacteria isolated from east Azarbijan region soils based on molecular identification of family 19
chitinase. encoding gene in these bacteria.
To aim the purpose 110 soil samples were collected from East Azarbaijan and 310 strepomyces
isolates were selected using macroscopic and microscopic observations. DNA genomic of all of the isolates
were extracted and PCR reactions was done using chitinase 19 designed primers as marker.
Totally isolates were selected with molecular selection and antagonistic test were done. One of the isolates
exhibit the most strong antifungal activity.
The strain was identified using 16srDNA gene, and the chitinase encoding gene were amplified partially to
prove the PCR selection. Finally the bacterium were introduced as potentially biological fertilizer.
MOLECULAR ANALYSIS OF BACTERIAL GENE CODING CHITINASE ENZYMES, FAMILY 19 STR...IJSIT Editor
Fungal phytopathogens pose serious problems worldwide in the cultivation of economically
important plants.
Chemical fungicides are extensively used in current agriculture.However, excessive use of chemical
fungicides in agriculture has led to deteriorating human health , environmental pollution, damaged to
ecosystem and development of pathogen resistance to fungicide.
Because of the worsening problems in fungal disease control , a serious search is needed to identify
alternative methods for plant protection, which are less dependent on chemicals and are more
environmentally friendly. Microbial antagonists are widely used for the biocontrol of fungal plant diseases.
Many species of actinomycates, particulary those belonging to the genus sterptomyces, are well known as
antifungal biocontrol agents that inhibit several plant pathogenic fungi.
Another way biological control has been developed as an alternative of chemicals to tock with plant
pathogenic fungi. Considering high presence of chitin in fungal cell wall, chitinase enzyme is camped as an
effective biocontrol agent against phytopathogenic fungi. Streptomyces bacteria are able to produce various chitinase enzymes, chitinases produced by streptomyces belong to the families 18 and 19 glycosyl hydrolases.
The antifungal activity is mostly shown by fomily 19 Chitinases. In comparison with bacterial family 18
chitinases, the specific hydrolyzing activity of chitinase 19 against soluble and in soluble chitinous substrates
has been markedly higher. Considering the importance of family to investigate antifungal potential of
streptomyces bacteria isolated from east Azarbijan region soils based on molecular identification of family 19
chitinase. encoding gene in these bacteria.
To aim the purpose 110 soil samples were collected from East Azarbaijan and 310 strepomyces
isolates were selected using macroscopic and microscopic observations. DNA genomic of all of the isolates
were extracted and PCR reactions was done using chitinase 19 designed primers as marker.
Totally isolates were selected with molecular selection and antagonistic test were done. One of the isolates
exhibit the most strong antifungal activity.
The strain was identified using 16srDNA gene, and the chitinase encoding gene were amplified partially to
prove the PCR selection. Finally the bacterium were introduced as potentially biological fertilizer.
THE EFFECTS OF HELPING BACTERIA (PSEUDOMONAS SPP.) IN NITROGEN GREEN BEANS F...IJSIT Editor
Some- bacteria settle in the rhizosphere of legume plants and enhance the performance of ribosome
bacteria to nitrogen fixation and nodulation. In this paper, we used four isolated from two species of
Pseudomonas containing P.putida, P.fluorescens Chao, P.Flouresence Tabriz, P.flouresence B119 and Rhizobium
leguminosarumbv.phaseoli. In a factorial experiment with complete randomized blocks were used 5 levels of
helping bacteria(Pseudomonas spp.) and two rhizobium levels, four replicates were employed. Jamaran418
green bean was utilized as host plant. At the end, nodulation, growth and plant’s nitrogen indexes were
measured. The results showed that all above mentioned helping bacteria enhance the growth and nodulation
performance of green bean. It should be said that P.putida had the highest effect on the green bean
nodulation increase along with rhizobium (130%) followed by P.fluorescens Tabriz, P. fluorescens Chao and
P.fluorescens B119, ( 83, 63 and 17%, respectively). Also, we observed 45, 33, 22 and 8% performance
increase under the effect of P.putida, P. fluorescens Chao, P. fluorescens Tabriz and P. fluorescens B119,
respectively.
ANTIMICROBIAL PROPERTY OF AQUEOUS AND PETROLEUM ETHER LEAF EXTRACTS OF JATRO...IJSIT Editor
The experiment was carried out to investigate the antimicrobial property of aqueous and Petroleum
ether leaf extracts of Jatrophacurcas against some gram positive micro-organisms: Staphylococcus aureus,
Bacillus subtilis and some gram negative micro-organisms: Escherichia coli, Salmonella typhi using
antibiotics; Gentamycin as control. The phytochemical screening of aqueous and petroleum ether extracts
showed the presences of cardiac glycosides, steroids and terpenes, tannins, phlobatannins, anthraguinones
and saponins. The disc diffusion techniques was used to test the sensitivity of the micro-organism to the
extracts of Jatrophacurcas the results obtained show mean zones of inhibition between (19 + 0.6mm) to (30 +
0.3mm) for aqueous extract and (24 + 0.5mm) to (35 + 0.8mm) for petroleum ether extract. Micro-organisms
showed sensitivity in the following order: E.coli;(17 + 0.3mm) and (25 + 0.8mm), S.aureus; (26 + 0.2mm) and
(28 + 0.6mm), B.subtilis; (16 + 0.1mm) and (20 + 0.7mm), and S.typhi (25 + 0.2mm) and (27 + 0.6mm) for
aqueous and petroleum ether extracts respectively. The minimum inhibition concentration (MIC) for both
extracts show that the extracts inhibited the growth of the entire test organism at concentration 0.6mg/ml.
This result thus suggests the potency of Jatrophacurcas as an antimicrobial agent especially at the
concentration employed.
THE EFFECT OF ALSTONEA BOONEI STEM BARK PLUS CISPLATININDUCED RENAL INSUFFIC...IJSIT Editor
The bark of Alstoniaboonei stem was analysed for the medicinal and the effect of extracts on induced
renal insufficiency. The plant material was collected in August-September 2012 and Rats 100-150g body
weights were subjected to the study. Normal saline as control, Cisplatin, and cisplatin plus Alstoneiboonei
stem bark extract were administered and the result summary for serum creatinine in cisplatin treated Rats
(2.69±0.32mg/dl) and in Rats administrates cisplastin plus Alstoniaboonei stem bark extract
(2.5±0.01mg/dl) were elevated compared to saline control (1.89±0.89mg/dl). Serum urea in cisplatin treated
Rats was (38.4 ±2.98mg/dl) compared to Rats administrates with cisplatin plus the extract (38.4±2.98mg/dl)
and saline control (24.94±3.76mg/dl). The study indicates Alstoniaboonei stem bark extract reduced the
renal insufficiency in rats.
The study was carried out to investigate the effect of the aqueous extracts of
Myristicafragrans(Nutmeg), Murrayakoenigi(curry leaf) and Aframomummelegueta(Guinea pepper) on Some
Biochemical and haematologicalParameters. Sixteen (16) wister strain rats weighing between 130 – 180g
were divided into four (4) groups of four (4) rats each and for 21 days fed the following diets: Group A –
normal diet + myristicafragrans (Nutmeg) aqueous extract, Group B – normal diet + murrayakoenigi (curry
leaf) aqueous extract, Group C – normal diet + aframomummelegueta (Guinea pepper) aqueous extract, Group
D – normal diet (control). After a period of 21 days the rats were sacrificed and the serum was taken for the
following estimations: total protein, albumin, total bilirubin, direct bilirubin, aspartate transaminase, alanine
transaminase, alkaline phosphatase, total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol and
glucose. The whole blood was taken for packed cell volume and white blood cell count. The results indicated
that oral administration of myristicafragrans, murrayakoenigi and aframomummelegueta to rat’s exhibit
remarkable hypolipidaemic activity and lowering glucose concentration. The oral administration of these
three spices exhibit protein increasing activities compared with the control rats. The packed cell volume and
white cell values of all the rats decreased after feeding with experimental diet (aqueous extract) compare
with the control rats. It is clear from this study thatMyristicafragrans(Nutmeg), Murrayakoenigi(curry leaf)
andAframomummelegueta (Guinea pepper) contain significant amounts of phytochemicals and exhibit
hypolipidaemic activity when consumed.
THE INFLUENCE OF SILICONE ANTIFOAM FROM LEATHER AND DYING WASTE WATER EFFLUE...IJSIT Editor
This study investigates the influence of silicone antifoam agent on waste water from Gashash leather
and Nigerian Spinning and Dying industries (NSD). Waste water from the outlet of the industries were
collected and analyzed for physicochemical parameters. Silicone antifoam was added to the wastewater to
determine the impact of the silicone antifoam on turbidity and chemical oxygen demand (COD)
concentrations. The result shows that both turbidity and COD values significantly increased even when small
concentration of the silicone antifoam was added. Further, independent t-test was used to identify the
variance between the mean value of the wastewater from leather, spinning and dying industries, the results
indicated that there are no significant differences (observed t 0.544, critical t 2.015, and p value 0.589)
between the waste water in leather and dying industries.
WATER INTAKE CHARACTERISTICS OF DIFFERENT SOIL TYPES IN SOUTHERN BORNO NIGERIA IJSIT Editor
The water intake characteristics of soils under arable crop practice were studied with a view to
obtaining useful information for the design of irrigation and drainage system and for effective soil
management techniques. Parameters determined; infiltration, hydraulic conductivity, permeability, bulk
density, particle density, porosity and moisture content. The textural class of the soils from the three sites
was found to be clay. The result obtained indicates that infiltration was high initially but decreases later. This
may be due to the soil reaching a saturation point. On the average the infiltration rate was observed to
decrease with time. The coefficient of permeability was found to be 9.26 x 10 , 7.66 x 10 and 2.15 x 10 cm/s
for site A, B and C respectively. Information on infiltration and permeability are useful tools in irrigation and
other engineering design.
DETERMINATION OF ENGINEERING PROPERTIES OF POMEGRANATE FRUIT TO CALCULATION ...IJSIT Editor
In avoiding damage to fruit species the permissible falling height and permissible static pressure are
of great importance. The former is important in planning harvesting and handling operations, the latter in
selecting the height of transport containers. Fruits are generally transported in containers. The static and
dynamic forces which then act on the fruit will cause damage if they exceed given value. The static force may
be calculated from the weight of the fruit column being transported while the dynamic load is a consequence
of vibration caused by transport. The permitted static load for a given fruit may be determined
experimentally. In this study, physical properties of interest were determined for fresh pomegranate fruit
then calculations for the design of a suitable height were conducted based on the measured properties using
Ross and Isaacs’s theory. Maximum height for packing and storing of fresh pomegranate fruit in the box was
determined to be less than 123 cm based on a rupture force of 40.7 N.
COMPARSION OF ANTIOXIDANT POTENTIAL OF DIMOCARPUS LONGAN LOUR. EXTRACTS AND ...IJSIT Editor
The present study was carried out to evaluate antioxidant activity of Dimocarpus longan stems
extracts and also to investigate the main phytoconstituents in the bio-active extract. N-hexane,
dichloromethane, ethyl acetate and methanol 80% extract were tested for free radical scavenging activity on
model reaction with stable 2,2-diphenyl-1-picrylhydrazyl radical (DPPH). The results showed that ethyl
acetate was the most active one as antioxidant agent and phytochemical analysis of that extract revealed the
presence of triterpenes, flavonoids, tannins and carbohydrates. The results may help to discover new
chemical classes of natural antioxidant substances that could serve as selective agents for infectious diseases.
DIRECT EXPANSION GROUND SOURCE HEAT PUMPS FOR HEATING AND COOLINGIJSIT Editor
This article is an introduction to the energy problem and the possible saving that can be achieved
through improving building performance and the use of ground energy sources. The relevance and
importance of the study is discussed in the paper, which, also, highlights the objectives of the study, and the
scope of the theme. This study discusses some of the current activity in the GSHPs field. The basic system and
several variations for buildings are presented along with examples of systems in operation. Finally, the GCHP
is presented as an alternative that is able to counter much of the criticism leveled by the natural gas industry
toward conventional heat pumps. Several advantages and disadvantages are listed. Operating and installation
costs are briefly discussed.
BIOMINERALISED SILICA-NANOPARTICLES DETECTION FROM MARINE DIATOM CULTURE MEDIAIJSIT Editor
Diatoms are unicellular algae the most spectacular among the microorganisms assemble into a
micro-shell with a distinct 3-D shape and pattern of fine nanoscale features. In this investigation, we present
results; Field Emission Scanning Electron Microscopy images show the presence of ordered arrays of silica
nanoparticles. A number of diatoms with partially opened valves were observed on the surface of the diatom,
which indicates that cell contents inside of diatoms could release the nanoparticles into the culture solution.
We believe that the film forming silica nanoparticles are either released by the diatoms during reproduction
or after cell death due to bacterial action. Further research will investigate whether the silica nanoparticles
are produced intracellular and then released or whether synthesis occurs in cell culture medium. This
approach provides an environmentally friendly means for fabricating silica nanoparticles for drug delivery,
disease diagnostics, artificial opal films, decorative coatings and novel optical materials.
COMPARATIVE STUDIES ON NUTRITIONAL VALUE OF NORMAL AND TUMOR TISSUE, SARDINE...IJSIT Editor
Fish are at present in high demand in food markets, they are widely consumed in many parts of the
world because they posses high protein content, saturated fat and also contain omega fatty acids known to
support good health. The present study deals with biochemical composition of common fish,Sardinella
longiceps. The proximate composition of protein, carbohydrate, lipid, amino acids and fatty acids were
studied. The results of proximate composition in S. longiceps showed the percentage of protein was high in
the normal and tumor infected fish tissue (29.15 &18.93%), followed by the carbohydrate (5.81 & 2.42 %)
and lipid (15.61 & 9.28 %). The percentage compositions of essential and non-essential amino acids are
presented in normal tissue and tumor infected tissue were found to be as 46.09 % & 41.47 % and 37.23% &
40.63%. In the analysis, the fatty acid profile by gas chromatography revealed the presence of higher amount
of PUFA (Linolenic acid 32.74 %) in normal tissue. The details of the vitamins detected in S. longicepstissue.
Among them, vitamin A was found in higher levels (91.16 mg/gm) at normal tissue. In the present study,
totally 5 macro minerals and 2 trace minerals were reported. The S. longiceps normal and infected tissue
contributed maximum sodium (289.6 mg/gm) and Potassium (166.5 mg/gm) of minerals. The result shows
that marine fish (S. longiceps) tissue is a valuable food recipe for human consumption, due to its high quality
protein and well-balanced amino acids fatty acids and vitamins and minerals.
ANTIBACTERIAL ACTIVITY OF Citrus limonON Acnevulgaris (PIMPLES) IJSIT Editor
Research was carried out on antibacterial activity of Citrus limon on Acnevulgaris (Pimples). Samples
were obtained from individuals having Pimples, by swabbing their faces, backs and chests. Samples were
collected from Amanawa hospital in sokoto, Nigeria using Swab sticks. The sticks were transported to the
Microbiology Laboratory of the Usmanu Danfodiyo University Sokoto. Citrus limon juice was used at different
concentrations of (20%, 40%, 60%, 80% and 100%) on Propionibacteriumacnes, the bacteria that cause
Acnevulgaris (Pimples). The Citrus limon juice was found to be effective at all Concentrations used.
Conventional Cleanser was used as positive control, and it was only found to be effective at higher
concentrations of (60%, 80% and 100%) and was not effective at Lower Concentrations (20% and 40%). The
Minimum Inhibitory Concentration (MIC) of Citrulimon on Propionibacterium acnes was taken and presence
of growth was observed at concentrations of 20%, 40% and 60%, and absence of growth was observed at
80% and 100%. The minimum inhibitory concentration of conventional cleanser indicated the presence of
growth at 20% and 40% and absence of Growth at 60%, 80% and 100%. The Minimum bactericidal
Concentration (MBC) taken on Propionibacteriumacnes using both Citrus limon juice and cleanser all showed
absence of growth at all the concentrations used (20%, 40%, 60%, 80% and 100%). From the research
conducted it was observed that lemon juice have strong anti Acne vulgaris effect morethan the convensional
cleansers used for the treatment of Acne vulgaris.
COMPARATIVE STUDY ON HEAVY METAL CHARACTERISTICS OF LEACHATE FROM MUNICIPAL ...IJSIT Editor
Rapid urbanization and population growth are largely responsible for very high increasing rate of
solid waste in the urban areas, its proper management and recycling is major problems of Municipal
Corporation. The analytical analysis revealed that the leachate show high concentration of heavy metals viz.,
Pb, Zn, Fe, Mn and Cu. However, their high concentration in municipal solid waste leachate may cause
contaminants for environmental pollution. Therefore, present investigation deals with analyze the heavy
metals concentration in municipal solid waste leachate.
PHARMACOGNOSTICAL AND PHYTO–CHEMICAL EVALUATION OF RAKTADUSHTIHAR YOGAIJSIT Editor
The Rakta has vital role in the maintenance of health. If Rakta is in proper quantity and having desirable
qualities too, it promotes health, improves complexion, strength and vigor. Raktadushtihara Yoga was
formulated to assess its role in the management of Raktadushti. The present study deals with the
standardization of Raktadushtihara Yoga through the Pharmacognostical and pharmaceutical standards.
Organoleptic features of coarse powder were within normal range. The pH value was 6.5, water soluble
extract 46.9% w/w, methanol soluble extract 25.9%, ash value 8.73%, loss on drying 9.63% and average
weight was 512 mg. HPTLC was carried out after organizing appropriate solvent system in which maximum 2
spots were distinguished at 254 nm.
ESTIMATION OF THE REPRODUCTION NUMBER OF THE NOVEL INFLUENZA A, H1N1 IN MALA...IJSIT Editor
In June 2009, the World Health Organization (WHO) confirmed that the novel influenza A, H1N1 as a
pandemic. After six months, as of December 29, 2009, it was reported by WHO that more than 208 countries
and territories were affected by the pandemic accounting for about 150,000 infected cases and at least 11,516
death. In Malaysia, during the first wave, there are about 14,912 cases were reported from May, 15, 2009
until June, 4, 2010 and a total number of 88 deaths were recorded across the country in 2010. The aim of this
study is to assess the transmissibility of this pandemic in Malaysia by estimating the basic reproduction
number, Ro, which is the average number of secondary cases generated by a single primary case. The value of
Ro is a summary measure of the transmission potential in a given epidemic setting and has been estimated to
range from 1.4 – 1.6 in Mexico, from 2.0 – 2.6 in Japan, 1.96 in New Zealand and 1.68 in China for this current
pandemic.
PHYTOCHEMICAL SCREENING AND ANTIMICROBIAL ACTIVITY OF VARIOUS SOLVENT EXTRAC...IJSIT Editor
The leaves of the plant Annonareticulata were collected and extracted using different ranges of polar
organic solvents like low (Ethyl acetate), medium (Butanol) and high (Methanol). Qualitative analysis and
antimicrobial activity was investigated. The phytochemical screening of the leaf extract revealed that the
presence of alkaloids, tannins, steroids, terpenoids and coumarins. The Ethyl acetate and Methanol extracts
showed better antibacterial activity, the significant inhibitory effect against Escherichia coli, Pseudomonas
putida and Lactobacillus acidophilus, and thus displayed highest inhibitory zone of 19.5mm, 19mm and 19mm
when compared to Butanol. FT-IR spectroscopic analysis of the Ethyl acetate, Butanol and Methanol extract of
A.reticulata revealed the presence of -CH, -OH, CH-OH and –NH2 bond stretching. The clinical isolates were
collected from patients suffered from different microbial infections. The antibacterial and antifungal activity
was determined by using leaf extracts.
A REVIEW ON GREEN ENERGY -A SUSTAINABLE APPROACHIJSIT Editor
The current systems of energy supply and use are clearly not sustainable in terms of economic
environment and society .So there is an urgent need for us to increase energy efficiency, reduce energy
consumption, reduce harmful effects by using fossil fuels, mitigating greenhouse emissions. So it is better to
adopt green energy technology/sustainable energy/clean energy to attain sustainable development. .
Present paper focuses on the green energy/renewable energy technology that can be adopted in
order to achieveSustainable development. Some innovative are also mentioned in this paper
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
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
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?
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
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.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
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Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
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.
OUTCOME OF TUNNELED CATHETERS IN HEMODIALYSIS PATIENTS: FIVE YEARS SINGLE CENTER EXPERIENCE
1. A.Metin Sarikaya -et al., IJSIT, 2013, 2(5),410-420
OUTCOME OF TUNNELED CATHETERS IN HEMODIALYSIS PATIENTS: FIVE
YEARS SINGLE CENTER EXPERIENCE
A.Metin Sarikaya*, Funda Sari, RamazanCetinkaya
*M.D,
Nephrology Department, Education and Research Hospital, Antalya,Turkey
M.D, Nephrology Department, Education and Research Hospital, Antalya, Turkey
ABSTRACT
Introduction: The tunneled hemodialysis catheters(THCs) are preferred for the patients who are expected to
poor survival and the attempts to arteriovenous fistulas (AVF) are failure. In our study,in hemodialysis
patients who are implemented tunneled catheter it is evaluated the mean duration for the catheters , their
complications and the factors which affect the period of the catheters.
Methods: At the Antalya Research and Education Center Hemodialysis Unit it is retrospectively evaluated the
data of 297 hemodialysis patients who are implemented tunneled catheter during 5 years .
Results: The mean duration time of the tunneled catheters has been 224.9+162.9 days. The duration time of
right internal jugular vein(RIJV) is considerably higher than left internal jugular vein(LIJV) and subclavian
veins (235.8+96.6 days). In diabetic hemodialysis patients, the duration time of the catheter is rather lower
than the other end stage renal disease reasons(184.4±72.1 days).
Conclusions: THCs must be considered as an alternative but not a permanent vascular access in hemodialysis
patients. Because of relatively short duration times than AVF, high infection risks and thrombosis , it must be
used only in patients who have problems with the creating permanent vascular access or patients with
expected low survival time. Moreover, it must be taken into consideration the duration time of the catheter is
low in diabetic hemodialysis patients. According to our results, catheter duration time was longer in RIJV than
in other insertion sites and RIJV must be preferred as first place to placement of THCs.
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2. A.Metin Sarikaya -et al., IJSIT, 2013, 2(5),410-420
INTRODUCTION
Adequate care of hemodialysis patients requires vascular access (VA) that delivers a sufficient blood
flow rate, good long term patency, and a low complication rate. Currently, arteriovenous fistula (AVF) is the
best approach for a long term care of these patients (1). Due to the increase in the number of elderly patients
with end stage renal disease (ESRD), especially diabetics referred for hemodialysis therapy and increased
survival on dialysis, VA associated morbidity and mortality problems have become an important issue. (2).
Vascular access problems, especially primary AVF failure, insufficient blood flow rates, and fistula thrombosis
in elderly and diabetic patients now account for a large proportion of renal unit admissions and increasing
cost (3-4). Patients with vessels who are unsuitable for AVF or arteriovenous grafts (AVG) need another
vascular access route. Currently, cuffed and tunneled central venous catheters (THCs) are increasingly being
used for patients with VA problems. THCs have some advantages for VA such as the ability to insert at
multiple sites, venipuncture and maturation time not required, and a long term use is possible(5). But THCs
also have many disadvantages like higher incidence of infection, thrombosis, and insufficient blood flow rate
than AVF (6). In addition, risk of central vein occlusion and stenosis are important complications of THCs(7).
During fıve years followed up, we performed 424 THCs in patients whom AVF or AVG have not been created
due to various factors. The outcomes and complications of the THCs have been recorded before in all patients.
We retrospectively analysed these hospital records to assess mean duration period, factors that implicate
patency rates and complications of THCs in our hemodialysis patients .
PATIENTS AND METHODS
Patients:
During five year followed up period (from January 2004 to January 2009), 424 THCs placed in 297
patients were retrospectively analyzed at the Antalya Research and Education Center Hemodialysis Unit. Data
were obtained from the hospital hemodialysis records. End stage renal disease etiologies, reasons of THCs for
vascular access preference, insertion sites, duration time, early and late complications, and the factors which
influence these paramethers were analyzed. THCs placed in patients whom other VA modalities were
unavailable or failed, and patients with poor survival (advanced congestive heart failure or malignancies).
Causes of ESRD in patients were shown in Table 1. Catheter insertion localizations were right internal jugular
vein(RIJV), left internal jugular vein(LIJV), right subclavian vein(RSV), and left subclavian vein(LSV). Femoral
vein was not preferred site for THC insertion in our clinic. Hemorrhagie, insufficient flow rate, hemothorax,
pneumothorax, and hematoma were recorded as early complications; THC occlusion, insufficient blood flow
rate(<200 ml/min), and infections were recorded as late complications. Causes of catheter removal were
recorded as occlusion or low blood flow rate, creating new AVF or AVG, patient transfer to other treatment
modalities (such as peritoneal dialysis and transplantation), infections , and patient death.
IJSIT (www.ijsit.com), Volume 2, Issue 5, September-October 2013
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3. A.Metin Sarikaya -et al., IJSIT, 2013, 2(5),410-420
Cause
N
%
Diabetes mellitus
166
39.0
Hypertension
105
24.8
Unknown
39
9.2
Chronic Glomerulonepritis
40
9.4
Chronic Pyelonephritis
13
3.1
Obstructive Nephropathy
21
5.0
Secondary Amyloidosis
9
2.1
Multiple myeloma
5
1.2
Polycystic Kidney
22
5.0
Others
4
0.9
Table 1: Causes of ESRD
The catheter:
The same catheter (Medcomp 12.5 Fx28cm hemocath silicone double lumen catheters set with
Dacron cuffs ) were used in all patients. All catheters were placed by the same two nephrologists with local
anesthesia without performing an ultrasound in the hemodialysis unit. Chest X-Ray was performed on all
patients after catheter placement. Catheters were followed up by the trained nurses. After each hemodialysis
session, THC lumens were flushed with 10 ml sterile saline solution and then were locked using pure heparin
1.3 ml for arterial lumen and 1.4 ml for venous lumen. RIJV was chosen as the first preference for catheter
insertion. LIJV, LSV, RSV were respectively preferred when the RIJV was unsuitable for catheter insertion.
Anticoagulant or anti-thrombotic agents were not used in patients with THCs for any reason.
Statistical analysis:
All statistical analysis was performed by SPSS for Windows software (SPSS, Chicago, IL). Continuous
variables were compared by ANOVA, Wilcoxon rank-sum and the categorical variables were compared by chisquare analysis. Results were expressed as mean ± standard deviation (SD). P values < 0.05 were regarded as
statistically significant.
RESULTS
Altogether, 297 patients with end stage renal disease receiving regular hemodialysis therapy with
tunneled catheter, included in this retrospective study ( 161 men, 136 women; mean age 61.6+14.3 years ;
range , 15 and 90 years). The causes of ESRD were diabetic nephropathy (39.2%), hypertension (24.8%),
chronic glomerulonephritis (9.4%), and other diseases (9.2%) (Table 1). Total 424 THCs were performed
because of unsuitable vessels for AVF in 196 (46.2%) , failed AVF or AVG in 118 (27.8%) , and maintaining
initial vascular access in 110 (25.9%) catheter insertion. In 297 (70%) of patients catheterization was
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4. A.Metin Sarikaya -et al., IJSIT, 2013, 2(5),410-420
performed once, in 75 (17.5%) patients it was performed twice, in 34 patients three times, and in 19 patients
four or more times. The site of THC placement was RIJV in 268 (63.2%) , LIJV 99 (23.3%) , RSV in 38 (9%) ,
and LSV in 19 (4.5%) patients (Table 3).
When complications were assessed, the most frequent both early and late complication was
insufficient flow rate (blood flow < 200 ml/min); 2.1% and 13% respectively (Table 2). No patient deaths
were observed during the catheter insertion.
Early Complications
Frequency
Hemorrhage
6(1.4%)
Insufficient flow rate
9(2.1%)
Hemotorax
2(0.5%)
Pneumothorax
2(0.5%)
Hematoma
1(0.2%)
Late Complications
Occlusion
25(5.9%)
Insufficient flow rate
55(13%)
Infection
38 (9%)
Table 2: Early and Late Complications
Localization
N(%)
Early Complications
Late Complications
RIJV
268 (63.2%)
8 (2.98%)
56 (20.8%)
LIJV
99 (23.3%)
5 (5.5%)
33 (33.3%)
RSV
38 (9%)
6 (15%)
17 (44.7%)
LSV
19 (4.5%)
1 (5.2%)
12 (63.1%)
Total
424 (100%)
20 (100%)
118 (100%)
Table 3: Complications according to catheter localizations
RIJV; Right internal Jugular vein, LIJV; Left internal jugular vein, RSV; Right subclavian vein, LSV; Left
subclavian vein.
Early complications were observed in 20 catheters and complication rates were not
statistically
significant (p>0.05) at different catheter placement sites(Table 3). Late complications were observed in 118
catheters and late complications were more frequent in subclavian vein placements than in jugular vein
placements (p<0.05), (Table 3).
The mean catheter duration time was 229.9±162.9 days (range 10-1230 days). The shortest catheter
duration time was found in diabetic ESRD patients (184.4±72.1 days) compared with the other causes of
ESRD (p<0.05). THCs duration times were 235.80±90.6 days in hypertensive ESRD patients, 256.76±86.6
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5. A.Metin Sarikaya -et al., IJSIT, 2013, 2(5),410-420
days in chronic glomerulonephritis and 240.40±66.6 days in other ESRD causes.
The estimated THCs survival rates were at 6 months 82.2%, at 1 year 76.3%, at 2 years 50% , at 3
years %32, at 4 years 12% (Figure 1). At the end of the study, 71 catheters (16.8%) were still functioning.
The mean catheter duration time was 235.80±96.6 days in RIJV, 226.8±128.8 days in the LIJV,
179.1±30 days in the RSV , and 150±24.15 days in the LSV placement. When catheter duration times were
compared according to placement sites, the difference was significant (p<0.05). The longest duration period
was found to be in the RIJV placement and the shortest survival was in the LSV localization.
Early complication rates were similar in terms of the causes of end-stage renal disease, whereas all
late complications were significantly more frequent in diabetic patients (p<0.05). Late complications such as
occlusion, insufficient flow rate, and infections were observed in 8, 41, and 25 diabetic patients respectively
(Table 4).
Cause
N (%)
IFR
Occ.
Infection
Total
Diabetes mellitus
166(39)
8
41
25
74(44.5%)
Hypertension
105 (24.8)
11
11
5
27(25.7%)
Unknown
39 (9.2)
0
1
3
4(12%)
Chronic
40 (9.4)
1
0
1
2(5%)
Glomerulonephritis
13 (3.1)
0
0
0
0
Chronic Pyelonephritis
21 (5)
1
1
1
3(14%)
Obstructive
9 (2.1)
2
1
0
3(33%)
Secondary Amyloidosis
5 (1.2)
0
0
3
3(60%)
Multiple myeloma
22 (5)
2
0
0
2(9.09%)
Polycystic Kidney
4 (0.9)
0
0
0
0
424
25
55
38
118
Others
Total
Table 4: Late complications associated with causes of ESRD
IFR: Insufficient flow rate, O; Occlusion
Total 38 catheter related to infections were observed ; because of retrospective evaluation of the
datas, we only recorded infections that needed catheters removal. 2 exit site infections, 8 tunnel infections,
12 catheter related to bacteriemia and 4 patients died because of septicemia. Staphylococcus epidermitis (22
cases) and Staphylococcus aureus (12 cases) were the bacteria most frequently isolated .
The most frequent indications for THCs removal were patient death in 87 (24.6%), creating new AVF
or AVG in 83 (23.5%), occlusion and insufficient flow rate due to thrombosis fibrin sheath formation in 80
(22.6%) patients (Table 5).
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6. A.Metin Sarikaya -et al., IJSIT, 2013, 2(5),410-420
Cause
N (%)
Occlusion and insufficient flow rate
80 (22.6%)
Conversion to AVF or AVG
83 (23.5%)
Patient death
87 (24.6%)
Peritoneal dialysis
36 (10.1%)
Transplantation
33 (9.3%)
Infection
38 (9.0%)
Dialysis withdrawal
4 (1.1%)
Total
353 (83.2%)
Table 5: Causes of catheter removal
* At the end of the study 71 catheter (16.8%) were still functioning
90
80
70
60
50
40
30
20
10
0
6
12
24
36
48
Figure 1: Catheter survival rates(%) in months
DISCUSSION
Although the guidelines strongly recommends the AVF as an access of first choice, it was confirmed
that there is an rising trend toward hemodialysis catheter use in patients with ESRD (1, 8, 9). Recent data
have indicated that over 70% of the patients with end-stage renal disease initiate dialysis with a catheter.
Additionally, up to 27% of the end-stage renal disease patients in the United States are using THCs as their
permanent access, with placement rates having doubled since 1996 (21). The type of vascular access at the
first dialysis treatment is used as a marker of predialysis care (10). Late referrals of patients to nephrologists
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7. A.Metin Sarikaya -et al., IJSIT, 2013, 2(5),410-420
have 3.6-fold increased risk of starting dialysis therapy with catheters , and are probably the most important
reason of catheter usage(11). Hemodialysis catheters are preferred in late referrals because of its advantages
of being technically simple to insert and permitting immediate access to the vascular system. THCs are
superior than non-tunneled catheters comparing them in view of low infection risk and long duration
time(12).
In recent studies, THCs duration times were found 345 days(18), 86 days (19), 310 days(20) and
289 days(14). In our study mean duration time was 229 days comparable with other studies. We have found
the estimated catheter survival rates were at 6 months 82.2%, at 1 year 76.3%, at 2 years 50% , at 3 years
%32, at 4 years 12% (Figure 1). Ervo S et al. also have found similar results for catheter survival rates at 1
year was 82%, at 2 years 56%, at 3 years 42% and at 4 years 20%. (18) . The catheter duration time was
found shorter in diabetic ESRD patients (184.4±72.1 days) than other ESRD causes. The presence of diabetes
mellitus was significantly related with occlusion and insufficient flow rate as reported previously (7,13).
Using THCs in diabetic patients may be limited because short duration times, so that other forms of
permanent VA should be sought.
The localization of the catheter into RIJV results in significantly better survival as compared with
other insertion sites. The mean catheter duration time was highest in RIJV (235.80±96.6 days) and lowest in
the LSV placement(150±24.15 days). When catheter duration times were compared according to placement
sites, the difference was significant (p<0.05). Similarly Develter W. et al. have showed that RIJV placement
has better catheter duration times (mean survival of 650 days in RIJV compared to a mean survival of 519
days in other sites) (20). Maya ID. also have showed that the primary catheter patency (time from placement
to exchange) was substantially shorter for femoral catheters than for internal jugular dialysis catheters (22).
The possible advantage of placing RIJV catheters over other sites is that doing so may function to preserve
better the left-sided vasculature in general, and in particular, when future left-sided access is planned(23).
When complications were assessed, we have found that the most frequent both early and late
complications were insufficient flow rate (blood flow < 200 ml/min); 2.1% and 13% respectively (Table 2).
Early complications were observed in 20 (4.7%) and late complications
were observed in 118 (27.8%)
catheters in our study( Table 3). Former studies have shown that early complication rates ( hemorrhagia,
hematoma, pneumothorax, hemothorax and primary non-function due to wrong catheter tip placement)
were between 2% to 11.9% (24-29). An important late complication that affects catheter duration times is
occlusion due to thrombosis and fıbrin sheath formation. In previous studies, thrombosis and fibrin sheath
formation rates were between 7%-12% of THCs(24-29). Our late complication rates seem to be high (%27.8)
when compared previous studies. In these studies anti-thrombotic agents were used when catheter occlusion
and low blood flow began. We could not use these agents because of insurance payment problems for these
indications.
THCs related infection is another important complication that affects catheter duration time and
patient’s mortality. Previous studies have shown that the total incidence of THC related infections was 0.18-
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8. A.Metin Sarikaya -et al., IJSIT, 2013, 2(5),410-420
0.82 episodes per 100 catheters-days and total infection rates were 10.2% to 25% (14, 19, 26,28,30,31,32).
In our study these findings were; 0.38 episodes per 100 catheter-days and total infection rate 9.0% . In
diabetic hemodialysis patients catheter related infection rates were found significantly high(15%). Since the
hospital records were analysed retrospectively, the datas were not sufficient to determine the overall
catheter related infections. Only the ones, that caused catheter removal, could be obtained. The strict
preventive protocol, we used to follow up the patients with THCs, also may explain the comparable lower
rate with the studies reported previously.
The most frequent reason of THCs removal was patient death (24.6%) in our study. Cetinkaya et al.
also reported the most frequent reason of THCs removal as patient death (69.4%) (14). Compared to their
study, the difference is probably due to the patient population chosen for the THCs placement. In that study,
THCs were inserted in patients where other VA modalities were unavailable or had failed on multiple
attempts to creating permanent VA and ones with advanced congestive heart failure or malignancies. In
addition to these reasons, we placed THCs in patients awaiting living-related kidney donor transplantation or
maturation of an AVF . The second reason of THCs removal in our study was conversion from catheter to
either fistula or graft (23.5%). In recent studies, it was reported that the conversion of catheters to
arteriovenous accesses, preferably fistulas, is associated with improved survival (15-17). In hemodialysis,
vascular access type is significantly associated with patient survival. The use of a central venous
catheter(CVC) is associated with a substantially greater risk of sepsis, hospitalization, and mortality when
compared with the use of an AVF or an AVG (33-35). In other recent study , Pearl J et al. have identified
40,526 incident adult dialysis patients from the Canadian Organ Replacement Register ( from 2001 to 2008).
Compared with the 7412 peritoneal dialysis patients, 1-year mortality was similar for the 6663 hemodialysis
AVF/AVG patients but was 80% higher for the 24,437 hemodialysis CVC patients. During the entire period of
follow-up, hemodialysis AVF/AVG patients had a lower risk for death, and hemodialysis CVC patients had a
higher risk for death compared with patients on peritoneal dialysis(36).
CONCLUSION
THCs must be considered as an alternative but not a permanent vascular access in hemodialysis patients.
Because of relatively short duration times than AVF, high infection risks and thrombosis , it must be used
only in patients
who have problems with the creating permanent vascular access, patient that needs
maturation time for AVF or patients with expected low survival time. Moreover, it must be taken into
consideration the duration time of the catheter is low in diabetic hemodialysis patients. According to our
results, catheter duration time was longer in RIJV than in other insertion sites and RIJV must be preferred as
first place to placement of THCs.
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