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Open Access February 07, 2023

Prevalence of Anemia and Variations of Hematological Parameters among Anemic Hemodialysis Patients in the Tripoli Region

Abstract Background: Prolonged decline in the ability of the kidney to regulate acid–base balance, eliminate waste products, and manage water homeostasis and entered chronic phase, toxic metabolic accumulates and erythropoietin secretion by the kidney is decreasing and causes hematological changes including decrease of HCT, MCV, RBCs and platelet counts. Hemodialysis became a practical treatment for kidney failure and is the most common method used to treat advanced and permanent kidney failure. Anemia is one of the most common complications in hemodialysis patients. Objectives: The study aimed to evaluate the prevalence of anemia among hemodialysis patients and investigate the variations of hematological parameters among anemic hemodialysis patients in the Tripoli region. Materials and Methods: The present study was conducted on 250 renal failure patients, attending Tripoli Center for dialysis and 100 normal healthy subjects. The study Ethical Committee of the medical centers and the Libyan Academy of graduate studies reviewed and approved the study design and patient consent statements were taken from each patient. Information's about the patients were recorded in a questionnaire. A blood sample of 5 ml was drawn by venous puncture from each normal healthy individual and hemodialysis patient. 2.5 ml of the blood sample was collected in K-EDTA tubes for the hematological examinations and another 2.5 ml of the blood sample was collected in a plain tubes for biochemical tests (serum urea, creatinine, and uric acid concentrations). The hematological parameters (RBCs count, Hb, HCT, MCV, MCH, MCHC, WBCs count, differential count of WBCs, and Platelets count) were determined using an automated hematology analyzer Sysmex (K- 4500) machine. The data were compared using GraphPad Prism version.9. The statistical significance of differences between groups was evaluated with the independent t-test. A P-value of <0.05 was considered significant for all statistical tests. Results: The results showed that the prevalence of anemia among hemodialysis patients was 89.8%. The degrees of anemia were 17% severe, 71.66% moderate, and 11.34% mild anemia. The types of anemia were 13.36% microcytic hypochromic, 82.59% normocytic hypochromic, and 4.05% macrocytic hypochromic anemia. RBCs, WBCs & platelets counts, Hct, MCHC, and Lymphocytes % showed a significant (P<0.01) decrease, and MCV was a significant (P<0.01) increase in the anemic hemodialysis patients compared with the healthy individuals. But, a significant (P<0.05) decrease in MCH was observed in the anemic hemodialysis patients when compared with the healthy individuals. A significant correlation was observed between RBCs and their indices with most of the hematological parameters. A significant (P<0.01) negative correlation was observed between serum urea with Hb, and RBCs count and Hct. While, a significant (P<0.01) positive correlation was recorded between uric acid with platelets count. A significant (P<0.05) positive correlation was observed between gender with platelets count, while, a significant negative correlation was recorded between gender with serum urea (P<0.01), creatinine, and uric acid, and Hb (P<0.05). A significant (P<0.01) negative correlation was observed between blood groups with serum uric acid. A significant (P<0.01) positive correlation was observed between durations of hemodialysis with RBCs count and Hb, while, a significant (P<0.05 [...] Read more.
Background: Prolonged decline in the ability of the kidney to regulate acid–base balance, eliminate waste products, and manage water homeostasis and entered chronic phase, toxic metabolic accumulates and erythropoietin secretion by the kidney is decreasing and causes hematological changes including decrease of HCT, MCV, RBCs and platelet counts. Hemodialysis became a practical treatment for kidney failure and is the most common method used to treat advanced and permanent kidney failure. Anemia is one of the most common complications in hemodialysis patients. Objectives: The study aimed to evaluate the prevalence of anemia among hemodialysis patients and investigate the variations of hematological parameters among anemic hemodialysis patients in the Tripoli region. Materials and Methods: The present study was conducted on 250 renal failure patients, attending Tripoli Center for dialysis and 100 normal healthy subjects. The study Ethical Committee of the medical centers and the Libyan Academy of graduate studies reviewed and approved the study design and patient consent statements were taken from each patient. Information's about the patients were recorded in a questionnaire. A blood sample of 5 ml was drawn by venous puncture from each normal healthy individual and hemodialysis patient. 2.5 ml of the blood sample was collected in K-EDTA tubes for the hematological examinations and another 2.5 ml of the blood sample was collected in a plain tubes for biochemical tests (serum urea, creatinine, and uric acid concentrations). The hematological parameters (RBCs count, Hb, HCT, MCV, MCH, MCHC, WBCs count, differential count of WBCs, and Platelets count) were determined using an automated hematology analyzer Sysmex (K- 4500) machine. The data were compared using GraphPad Prism version.9. The statistical significance of differences between groups was evaluated with the independent t-test. A P-value of <0.05 was considered significant for all statistical tests. Results: The results showed that the prevalence of anemia among hemodialysis patients was 89.8%. The degrees of anemia were 17% severe, 71.66% moderate, and 11.34% mild anemia. The types of anemia were 13.36% microcytic hypochromic, 82.59% normocytic hypochromic, and 4.05% macrocytic hypochromic anemia. RBCs, WBCs & platelets counts, Hct, MCHC, and Lymphocytes % showed a significant (P<0.01) decrease, and MCV was a significant (P<0.01) increase in the anemic hemodialysis patients compared with the healthy individuals. But, a significant (P<0.05) decrease in MCH was observed in the anemic hemodialysis patients when compared with the healthy individuals. A significant correlation was observed between RBCs and their indices with most of the hematological parameters. A significant (P<0.01) negative correlation was observed between serum urea with Hb, and RBCs count and Hct. While, a significant (P<0.01) positive correlation was recorded between uric acid with platelets count. A significant (P<0.05) positive correlation was observed between gender with platelets count, while, a significant negative correlation was recorded between gender with serum urea (P<0.01), creatinine, and uric acid, and Hb (P<0.05). A significant (P<0.01) negative correlation was observed between blood groups with serum uric acid. A significant (P<0.01) positive correlation was observed between durations of hemodialysis with RBCs count and Hb, while, a significant (P<0.05) negative correlation was recorded between durations of hemodialysis with body weight, and MCHC. Conclusion: It can be concluded that a higher prevalence of moderate, normocytic hypochromic anemia among hemodialysis patients. Also, results showed a significant variation in hematological parameters among the anemic hemodialysis patients. So, hemodialysis patients advice to examine the hematological parameters and treated from anemia if detected.
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Open Access August 12, 2024

Handling Practices of Folded Vermicelli by Small-scale Processors in Tanga City, Tanzania

Abstract This study assessed the handling and processing practices of 30 small-scale folded vermicelli processors in Tanga, specifically in urban areas of Tanga City, Tanzania. However, the micro- and small-scale processors were producing in unhygienic way because they are lacking facilities and equipment to process and handle the product hygienically. Multistage sampling design was adopted for this study [...] Read more.
This study assessed the handling and processing practices of 30 small-scale folded vermicelli processors in Tanga, specifically in urban areas of Tanga City, Tanzania. However, the micro- and small-scale processors were producing in unhygienic way because they are lacking facilities and equipment to process and handle the product hygienically. Multistage sampling design was adopted for this study and face-to-face interviews were conducted to collect data from all processing units through nine streets using semi-structured questionnaires and observation checklists. Data were analyzed using Statistical Package for Social Sciences, where the statistics aspect was determined from the results obtained. The processors found across various streets (ranging from 3.3% in Kwaminchi Street to 23.3% in Mabawa Street), exhibited diverse demographics, with 53.3% being owner-operators and 40% and 6.7% in labourer and supervisor roles, respectively. A significant portion (53.3%) had 1-3 years of experience, and a small portion (10%) attended formal training in pasta processing. Despite 73.3% possessing food manufacturing licenses, many were unfamiliar with legal requirements, lacking documentation and standardized processes, raising concerns about food safety. Raw materials were sourced locally, but 56.7% lacked storage facilities. Hygienic practices varied, with 43.3% undergoing periodic medical check-ups, 70% using protective gear, and 60% had hand washing facilities. Sun drying was the sole method employed, with 86.7% placed drying trays on rooftops. Packaging practices raised concerns, as 93.3% reused woven polypropylene bags, potentially impacting product quality. Awareness of aflatoxin and its health implications was lacking in 90% of the processors. Overall, the study highlighted gaps in awareness, training, and adherence to standards among processors, posing potential risks to food safety and quality. Encourage them to adhere with Tanzania Bureau of Standards requirements and formalize their quality control practices.
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Open Access June 27, 2023

Teachers’ Knowledge Base in Community Resources Used in Assessing Social Studies Concepts

Abstract The purpose of this study was to examine teachers’ knowledge base in community resources used in assessing Social Studies concepts in the University of Education Practice Junior High School (JHS), Winneba. The case study design was employed as the study's qualitative methodology. The population comprised two Social Studies teachers in the University Practice JHS, Winneba. Purposive and convenient [...] Read more.
The purpose of this study was to examine teachers’ knowledge base in community resources used in assessing Social Studies concepts in the University of Education Practice Junior High School (JHS), Winneba. The case study design was employed as the study's qualitative methodology. The population comprised two Social Studies teachers in the University Practice JHS, Winneba. Purposive and convenient sampling techniques were used to select the teachers and school for the study. The main instrument for data collection was the interview guide. The two teachers were interviewed because they were in a position to give all the relevant information required for the research. They were also readily available at the time of the research. The study revealed that even though the Social Studies teachers were aware of community resources, they did not involve them often in their lesson delivery. However, in the only case where a teacher took the learners round the school compound to look at the various types of rocks, the learners were excited and willing to learn. The assessment results also showed that almost all learners, both low and high achievers had high scores. Evidence from the inquiry also shows that teachers used only traditional forms of assessment in Social Studies. Teachers give multiple choice and essay type of assessment items to learners. Teachers did not involve community resources in the assessment of Social Studies concepts because of challenges like inadequate time allocated for the teaching of the subject, financial constraints, bureaucratic processes involved in obtaining permission and the need to meet the requirements of external examinations. It is recommended that the Ghana Education Service (GES) should design appropriate policies to ensure that provision is made in the school academic calendar for field trips and community resource engagement for Social Studies education. Social Studies teachers should also be trained on the full range of assessment techniques suggested in the 2012 syllabus. Emphasis should be laid on authentic/alternate assessment practices. At the school level, heads of Social Studies department should organise periodic in-service training for the teachers to ensure that the curriculum, instruction and assessment practices are aligned to ensure that the subject attains its intended goals and outcomes.
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Open Access October 15, 2022

Cyclophosphamide Induces Hepatorenal Toxicity and Attenuation by 5-fluorouracil in Male Albino Rats

Abstract Background: Cyclophosphamide (CPA) induces acute inflammation of the urinary bladder, renal damage, and liver damage, thereby limiting its therapeutic use. Objectives: The present study aimed to evaluate the hepatorenal toxicity induced by cyclophosphamide and amelioration by 5-fluorouracil in male albino rats. Materials and Methods: Twenty-eight male adult rats were [...] Read more.
Background: Cyclophosphamide (CPA) induces acute inflammation of the urinary bladder, renal damage, and liver damage, thereby limiting its therapeutic use. Objectives: The present study aimed to evaluate the hepatorenal toxicity induced by cyclophosphamide and amelioration by 5-fluorouracil in male albino rats. Materials and Methods: Twenty-eight male adult rats were grouped randomly into four groups (n=5 for each group). Group I (control): Rats were injected with saline intraperitoneally and at a dose of 1.0 ml/kg b.w. for 14 days. Group II cyclophosphamide (CPA): Cyclophosphamide at a dose of 10 mg/kg day by day through i.p. to rats for 14 days. Group III Fluorouracil (5-FU): 5-Fluorouracil at a dose of 10 mg/kg day by day in saline was given through i.p. to rats for 14 days. Group IV (CPA+5-FU): Rats were given CPA followed by 5-FU at a dose of 10 mg/kg per day (day by day) through i.p. to rats for 14 days. At the end of the experimental period, rats were anesthetized using light ether. Blood samples were taken and prepared for biochemical measurements. Results: Serum total protein, albumin, and globulin concentration significantly reduced in animal groups that received cyclophosphamide. 5-FU and CPA combination reduced the changes in total protein, albumin, and globulin compared to CPA treated group. A significant increase in LDH serum concentration was found in CPA, 5-FU, and their combination-treated animals. The mean values of the combination of chemotherapy were above that in CPA followed by 5-FU treatment. Administration of CPA, 5-FU resulted in a significant increase in serum AST, ALT, ALP, and bilirubin compared to the control. Co-treatment 5-FU with CPA significantly attenuated the increase in serum AST, ALT, ALP, and bilirubin when compared to CPA – treated rats. Compared to controls, urea and creatinine levels were increased in CPA-treated rats, while uric acid was reduced in CPA, 5-FU, and their combination. The changes in urea and creatinine produced by the chemotherapy were restored when rats received CPA in combination with 5-FU. Conclusion: It could be concluded that the treatment of mammals with chemotherapy is associated with the production of free radicals that lead to hazardous alterations in biochemical parameters. However, 5-FU and CPA combination could produce a significant amelioration in most cases for these changes, and it may be considered as a potentially useful candidate in the combination chemotherapy with CPA to combat oxidative stress-mediated non-target organ injury even if it was not complete protection. Future work should consider combined chemotherapy regimens, as two or more mechanisms of action of chemotherapeutic drugs could be more powerful than one mechanism. Toxicological studies must be performed before using drugs as a combination before application. Further research is required on the toxicological impacts of drugs and pollutants mixtures.
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