Next up will be Dr. Shrestha talking about his work in ICH patients, and this work has been awarded the AANS International Traveler Scholarship Award. Congratulations. I'll hold it for you. Thank you, sir. Respected modulators, chairperson on decks, and ladies and gentlemen, it's my great pleasure to present Thymosin Alpha-1 and its effect in post-operative ICH patients. As we know, intracranial hemorrhage is a universal public health problem, having the high morbidity and mortality even in this 21st century. Infection rate of post-operative patients is still 26%. In our history, there was 80 number of post-operative patients, which was done in West China Hospital from March 2014 to May 2015, and then CT was done every patient. And these are the inclusion criteria. We did ICH cases identified by the CT scan as greater than 18 years, received emergency hematoma evacuation or surgery within the 24 hours, having the ICH volume more than 30 ml. In our study, there was two groups, Thymosin group and control group, and the randomization ratio was 2 to 1 in treatment and control group. Thymosin group receives the Thymosin Alpha-1 1.6 milligram subcutaneously two weeks at least and three weeks. And then control group also received the same amount of normal saline for three weeks at least. And then we collected venous sample within 24 hour of ICTAS, and then five day of ICTAS, and then 10 day of admission or later. These are modified risk scale. This is the clinical characteristic of the ICH patient. Here we can see here is a volume was more than 40 in the Thymosin group and control group. And then there are patients who have been around 60. There is around in the Thymosin, there was mortality in 2% in the Thymosin group and 10% in control group. The infection rate in the Thymosin group was 5%. Around here, you can see around 30%. Here in this table, we can see there is some changes in WBC and lymphocyte subgrade. There is significant changes in the Thymosin and control group. WBC, we can see its P value is more significant. And interleukin-2 are also more significant. And then we compare the first day and day five, and then 10 day or later, and then WBC, leukocyte was significant. CD4 was significant, and interleukin-2 are also significant. In this chart, chart line also displaying the trend of the CD4 of Thymosin and control group. Here we can see the blue line is going up. This is the Thymosin group. And then this is control group is progressing. And in the cluster column, displaying trend of interleukin-2R, we can see in this Thymosin group having the gradually increasing, but in the control group, there is interleukin-2R is same level. Nosocomial pneumonia developed in 2% in Thymosin group and 5 cases in the control group. However, immunoboosting effect of Thymosin was manifested by the decrease in infection rate in the treatment group. The mortality was lower in Thymosin group 2% compared to the control group 10%. There is some limitation. Firstly, history was small in size mutation. Secondly, clinical trial is not proved by the experimental study. And thirdly, there was variable in the study design and bias. Finally, there is not much follow-up. In conclusion, Thymosin alpha-1 might have profound implication as immunomodulator during the early stage of pathogen infection in ICS. And Thymosin alpha-1 has been sound-tolerated by ICS and has not any significant side effect. Thymosin alpha-1 appeared to increase level of interleukin-2R and T lymphocyte in the group of patient with ICS and ICS to lower the possibility of postoperative pneumonia. Thank you for attention. This is the place where I am from. There is ambulance. This is the place where school is moving. And this is the place where elephant play football. Yeah. Welcome to Nepal. Thank you. Thank you. Congratulations.

Thymosin Alpha-1

post-operative intracranial hemorrhage

mortality rate

Thymosin group

interleukin-2R levels