Categories
Probiio

Postbiotic/Probiotics based Solution to Women Healthcare

History of Probiotics Discovery and Implementation

Probiotics 1.0 – gut health effect by microbiota

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Probiotics 2.0  – gut-brain axis

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Probiotics 3.0  – paraprobiotics

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: a cutting-edge microbiology to help promote the children’s health from the day of pregnancy of his/ her mother

Categories
Luko

100% OA System with Energy Recovery

“When it comes to an indoor air quality control system design for a medical facility, we do have to keep in mind that this is probably the most complex problem in aspect of diversed demand and standard levels regarding to temperature, humidity, air filtration level, and pressure gradient. But regardless of everything, let the clear and dried air flow around to take of those moisure”

… Medica Solution (Thailand) Ltd.

Fact:

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Current Challenges:

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Dedicated Outdoor Air system (DOAS) – solves a complex indoor air quality in medical facilities based on ASHRAE-62.1 and ASHRAE-90.2 guidelines

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Categories
Trotec

Indoor Air Quality and Humidity Control

“In pharmaceutical industries, one of the most difficult problems faced everyday by many manufacturers is how to manage the indoor air quality in term of humidity, temperature, and pollution to be in the originally designed range from day one, given that the internal environment parameters change according to the external weather conditiones all year long; especially in hot-and-humid climate like the one in Thailand”

… Medica Solution (Thailand) Ltd.

Fact:

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

Current Challenges:

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Dehumification and Air Purification System – an integrated solution to solve complex indoor air quality problem in the pharmaceutical and cosmatics industries

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Categories
Respower

Respiratory Neuromuscular Electrical Stimulator

ICU-AW (ICUAcquired Weakness) in prolonged on-ventilator patients is mainly caused by respiratory muscle weakness and neuromuscular disorder

Muscle weakness is a frequent problem in the intensive care unit (ICU). The weakness can be due to primary neuromuscualr disorders that trigger the need for intensive care. More often, however, muscle weakness develops as a secondary disorder while patients are being treated for the other-life-threatening conditions. This is called “ICU-Acquired Weakness” or ICU-AW. Clinically speaking, ICU-AW mainly affects limb and respiratory muscles strenght which in turn causes mucus removal efficency reduction due to a weak cough process. Also ICU-AW is one of the major cause of nosocomial infection for ventilated patient including Ventiator-Acquired Pnemonia (VAP). This, in effect, prolongs the ICU stay and difficult weaning from the ventilator itself.

Diaphragm (a main respiratory muscle) weakness is highly prevalent in critically ill patients. It may exist prior to ICU admission and may precipitate the need for mechanical ventilator, but it also frequently develops during the ICU stays. Severyal risk factors for diaphragm weakness have been identified, among them sepsis and mechanical ventilator play central roles. Critically illness-associated diaphragm weakness is consistently associated with poor outcomes including increase ICU mortality, difficult weaning, and prolonged duration on mechanical ventialtion as previously mentioned.

Early Rehabilitation Therapy (ERT) in ICU for ventilated patient can improve recovery and reduce weaning-off period; consequently, mitiagte VAP and ICU-AW problem

Regardless of the underlying pathology, prolonged ICU stay frequently involves sedation and immobilization. This is associated with musculoskeletal, pulmonary, cardiovascualr, immunological, endocrine, and metabolic complications. Musculoskeletal consequences are especially relevant and include muscle atrophy, decreased strength, reduced pretein synthesis, joint contractures, and bone density decrease. More often, ICU patients show critical illness-associated neuromuscular abnormalities. The complexity of ICU patient management is compounded if the underlying disease effects the Central Nervous System (CNS) and/ or Peripheral Nervous System (PNS).

In this respect, early rehabilitative inteventions are fundamental in reducing possible added neurological burden to a disease that already greatly affects pulmonary function. In addition, managing neuromuscular weakness would improve the efficiency of respiratory function, as respiratory muscle atrophy worsens lung function as seen in recent cases of COVID-19.

Respiratory Neuromuscular Electrical Stimulator (Respower) – an emerging approach to deeply stimulate the respiratory nerve (Phrenic) and muscle (Abs) in early rehabilitation therapy

For years, the method known as Neuro-Muscular Electrical Stimulator (NMES) has gain widely acceptance in ICU early therapy. Its major function is to stimultate the contraction and movement of weak respiratory muscles (diaphragm and abdominal) in an early stage of the ICU operation in order to improve respiratory function, strengthen a cough process to remove secretion in the lower respiratory tract, and shorten the weaning period; hence the reduction in morbidity and mortality rate during the ICU stay.

Respower is, the first of its kind, the only automated NMES device available for a therapist to perform respiratory neuromuscular training at the earliest stage as possible, given that the patient is in an unconcious stage with the ventilator. It can increase contractility and contraction speed of the diaphragm and abdominal, enhance fatique resistance, and increase respiratory muscle strength which in turn help weaning from the ventilator sooner than usual. It can also reduce lung hyperinflation of patients with COPD, increase expiratory flow rate, tidal volume, ventilation per minute; while reducing the respiratory rate.

Respower can be applied for an early rehabilitation in multiple clinical treatments including Chronic Obstructive Pulmonary Disease (COPD), Restrictive Pulmonary Disease, Pulmonary Arterial Hypertension, Lung Cancer, ICU-AW, Spinal Cord Surgery, Neuromuscular Disorder (NMD) which weakens the respiratory muscles,

Categories
CoughSync

Automated Secretion Clearance in Lower Respiratory Tract

VAP (Ventilator Acquired Pneumonia) is one of the major causes in ICU prologned stay or even dealth

For an ICU patient with the respiratory failure, the best possible treatment is to intubate the patient with a mechnical ventilator. Inspite of many of its clinical benefits, the invasive mechanical ventilator yet causes the patient to suffer with retained secretions due to several risk factors including mucus accumulation due to globlet cell excitation by ETT (Endotracheal Tube), subglottic infection due to bacteria located at the site above the ETT’s cuff, Atelectasis condition due to prolonged immobility and large mucus volume, impairment of cough, and secretion retention. What even worse when the muscus is aspirated into a lower respiratory tract which consequently causes Ventilator-Acquired Pneumonia or VAP.

VAP contributes to approximately half of all cases of hospital-acquired pneumonia. It is estimated to occur in 9–27 % of all mechanically ventilated patients, with the highest risk being early in the course of hospitalization. It is widely accepted that VAP is the second most common nosocomial infection in the ICU and the most common in mechanically ventilated patients.

Airway Clearance Therapy (ACT) is proved to be the best possible method to reduce VAP in mechanically-ventilated patient cases. But the current option bring many issues.

ACT has the potential to improve mucociliary clearance by reducing mucus plugging and enhancing the removal of secretions. It may result in improved ventilation, a reduction of airway obstruction and atelectasis, an improved ventilation-perfusion mismatch, and a decrease in proteolytic activity in the airway.

Up until today, routine suctioning via ETT is the most common method for ACT in ICU. It facilitates the removal of airway secretions, maintains airway patency and prevents pulmonary infection. However, tracheal suctioning has associated with the mucosa injury and other adverse sid-effects including decreased arterial oxygen tension. The suctioning must be done manually only by well-trained medical personnels. Also there is the need to temporarily stop the machanical ventilator operation which sometimes causes the loss of PEEP (Postive End-Expiratory Pressure) and potential lung derecruitement. This can be potentially serious in a pathient with high PEEP level and severe hypoxaemia.

Automatic Secretion Removal for Lower Respiratory Tract (CoughSync) – an innovative technology to protect VAP while reducing workload of the medical personels and infection in ICU room

The technique of artificially simulating a cough process – Mechanical In-Exsufflation (MI-E) – dates back to the era of the Polio epidemics 50 years ago. At that time, before the advent of ETT and catheter suction, cought simulation was extensively used for secretion removal in patients being ventilated non-ivasively with an iron lung. However, as intubation and catheter suction gained popularity in the 1960’s, MI-E disappeared from the ICU. In 1993, MI-E was brought back in therapy due to its many clinical benefits compaered to the suction cather; especially the secretion removal in the lower respiratory tract. MI-E was shown to be effective in those patients for routine secreton removal long-term, as well as during episodes of acute pneumonia.

Despite its unique advantages over the current suction cather method, MI-E still possesses some drawbacks. It not compatible with current mechnical ventilator. In fact, it is a stand-alone device and cannot be used with a mechanical ventilator; requiring aa patient to be completely disconnected from the ventilator; hence not suitable for a critically-illed patient.

In-Line Cough Simulation:

CoughSync is a so-called “Inine MI-E” version of an original MI-E. Only is it different in working principle. By these means, CoughSync, instead of being a stand-alone device, works in-line with the ventilator synchronously without interupting the patient’s ventilation at all. As a resut, cough simulation can be performed without having to disconnect the patient from the ventilator, and without interrupting delivery of enriched oxygen or PEEP. CoughSync is truely desinged for an ICU operation.