Urinary, Plasma, and Serum Biomarkers’ Utility for Predicting Acute Kidney Injury Associated With Cardiac Surgery in Adults: A Meta-analysis

BackgroundEarly accurate detection of acute kidney injury (AKI) occurring after cardiac surgery may improve morbidity and mortality. Although several novel biomarkers have been developed for the early detection of AKI, their clinical utility in the critical intraoperative and immediate postoperative period remains unclear.Study DesignSystematic review and meta-analysis.Setting & PopulationAdult patients having cardiac surgery.Selection Criteria for StudiesEMBASE, CINAHL, Cochrane Library, Scopus, and PubMed from January 1990 until January 2015 were systematically searched for cohort studies reporting the utility of novel biomarkers for the early diagnosis of AKI after adult cardiac surgery. Reviewers extracted data for study design, population, timing of biomarker measurement and AKI occurrence, biomarker performance (area under the receiver operating characteristic curve [AUROC]), and risk of bias.Index TestsNovel urine, plasma, and serum AKI biomarkers, measured intraoperatively and in the early postoperative period (<24 hours).Reference TestsAKI was defined according to the RIFLE, AKIN, or 2012 KDIGO criteria.ResultsWe found 28 studies reporting intraoperative and/or early postoperative measurement of urine (n=23 studies) or plasma or serum (n=12 studies) biomarkers. Only 4 of these studies measured biomarkers intraoperatively. Overall, intraoperative discrimination by the urine biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury marker 1 (KIM-1) demonstrated AUROCs<0.70, whereas N-acetyl-β-d-glucosaminidase (NAG) and cystatin C had AUROCs<0.75. In the immediate 24-hour postoperative period, the urine biomarkers NGAL (16 studies), KIM-1 (6 studies), and liver-type fatty acid binding protein (6 studies) exhibited composite AUROCs of 0.69 to 0.72. The composite AUROCs for postoperative urine cystatin C, NAG, and interleukin 18 were ≤0.70. Similarly, the composite AUROCs for postoperative plasma NGAL (6 studies) and cystatin-C (5 studies) were <0.70.LimitationsHeterogeneous AKI definitions.ConclusionsIn adults, known urinary, plasma, and serum biomarkers of AKI possess modest discrimination at best when measured within 24 hours of cardiac surgery

Study on Development and Storage of Blended Pineapple (Ananas comosus L.) Mango (Mangifera indica L.) Crush

The present research work entitled “STUDY ON DEVELOPMENT AND STORAGE OF BLENDED PINEAPPLE (Ananas comosus L.) MANGO (Mangifera indica L.) CRUSH” was carried out at Post Harvest Lab, Department of Horticulture, Naini Agricultural Institute (NAI) SHUATS, Prayagraj (formerly Allahabad), U.P, INDIA, during 2021-2023. The statistical design adopted for the experiment was Completely randomized design (CRD) with three replications and Eight treatment combinations and the product was analyzed for quality parameters and sensory qualities at the interval of 15 Days till 45 Days of storage period at refrigerated conditions (40C). The present investigation revealed about the quality parameters viz. TSS, Reducing sugars, Non-Reducing Sugars and Total sugars, acidity content during storage of 45 Days&nbsp; .After 45 days of storage, Treatment T5 (Pineapple pulp 50%: Mango pulp 50%) was found superior having TSS (55.850Brix), acidity (0.89%), total sugars (45.42 %), reducing sugar (15.88%) and also give better result in sensory evaluation in colour (7.70), taste (8.02), aroma (8.01), texture (7.98), and overall acceptability (8.02) at refrigerated conditions (40C). Treatment T5 performed well in the economic investment with higher benefit cost ratio i.e., 1.83 which is quite higher than other treatments

Effect of Different Packaging Materials and Chemicals on Shelf Life and Quality of Aonla (Emblica officinalis L.)

To extend the shelf life of Aonla fruits and to regulate marketing for acceptability and profit during distant transportation and storage, Aonla fruits can be coated with chemicals and coating materials which are safe for consumption and packed in packaging materials. So, to find out the effect of different packaging materials and chemicals on shelf life and quality of Aonla (Emblica officinalis L.); a lab experiment was conducted at the Post Harvest Laboratory, Department of Horticulture, Naini Agricultural Institute, SHUATS, Prayagraj (U.P.) during the year 2022-2023. The experiment comprised 13 treatments of different coating materials, viz. untreated fruits, 5% Chitosan Wax, 1% Calcium Nitrate, 400 ppm Cycocel and 0.1% Sodium Benzoate and packaging materials viz. Nylon Net Bags, Poly Ethylene Bags, CFB Box which are replicated three times in a completely randomized design. The objectives of the experiment were to evaluate the effect of different treatments on the shelf life and quality of aonla. From the present investigation treatment T8 (5% Wax + 400 ppm Cycocel packed in Poly Ethylene Bags) was found best with minimum Physiological weight loss %, minimum rotting of fruits and best in terms of Bio-chemical attributes i.e., Total Soluble Solids (TSS 0Brix), Titrable Acidity (%), Ascorbic Acid (mg/100g) and Organoleptic Qualities i.e., maximum retention of Fruit colour and minimum fruit shriveling till the end of storage period

Frailty and Physical Function in Chronic Kidney Disease: The CanFIT Study

Background: Frailty, a manifestation of unsuccessful aging, is highly prevalent in people with chronic kidney disease (CKD) and is associated with comorbid conditions in cross-sectional studies. Longitudinal studies investigating the progression of frailty in those with advanced non-dialysis CKD are lacking. Objectives: Can adian F railty Observation and I nterventions T rial (CanFIT). To determine the natural history, prevalence of perceived and measured frailty and its association with dialysis treatment choices and adverse outcomes in patients with advanced CKD. Design: Longitudinal observational study, designed to collect data from 600 participants over 2 years. Setting: Interprofessional non-dialysis CKD clinics at four tertiary health care centres in central Canada. Patients: People with CKD stage 4 and 5 (eGFR <30 ml/min/1.73 m 2 ) who are not on dialysis at enrollment. Measurements: Multiple Frailty Definitions: Short Physical Performance Battery (SPPB), Fried Frailty Criteria, Frailty Index. Dialysis start: In-Centre Hemodialysis, Home Hemodialysis or Peritoneal Dialysis Outcomes: Death, Opt-out or Lost to follow up. Methods: We will perform physical and cognitive assessments annually. We plan to analyze the relationships between frailty, treatment choices and patient centered outcomes. Results: We have recruited 217 participants in 2 centres; of these, 56 % had reduced physical function at baseline, as defined by the SPPB. Risk of reduced physical function was 8 fold higher in those with diabetes after adjusting for age, gender, eGFR and comorbidities. Limitations: Referred population, use of SPPB as a measure of frailty, inter-operator variability in measurement of hand grip and gait speed, cross-sectional analysis of baseline data in the subset recruited to date. Conclusions: People with advanced CKD have a high burden of reduced physical function, especially those with diabetes. We will continue enrollment into the CanFIT study to further understand the clinical history of CKD and frailty in this population

A Randomized Trial Examining the Impact of Timing of Intradialytic Cycling on Intradialytic Hypotension

Introduction: Intradialytic cycling is often performed during the first half of hemodialysis because of concerns regarding increased frequency of intradialytic hypotension (IDH) late in hemodialysis. This increases exercise program resource needs and limits utility of intradialytic cycling to treat dialysis-related symptoms. Methods: This multicenter, randomized, crossover trial compared IDH rate when cycling during the first half versus the second half of hemodialysis in 98 adults on maintenance hemodialysis. Group A cycled during the first half of hemodialysis for 2 weeks and subsequently during the second half for 2 weeks. In group B, the cycling schedule was reversed. Blood pressure (BP) was measured every 15 minutes throughout hemodialysis. Primary outcome was IDH rate (systolic BP [SBP] decrease of >20 mm Hg or SBP <90 mm Hg). Secondary outcomes included symptomatic IDH rate and time to recover post hemodialysis. Data were analyzed using negative binomial and gamma distribution mixed regression. Results: Mean age 64.7 (SD 12.0) and 64.7 (SD 14.2) years in group A (n = 52) and group B (n = 46), respectively. Proportions of females were 33% in group A and 43% in group B. Median time on hemodialysis was 4.1 (interquartile range [IQR] 2.5, 6.1]) years in group A and 3.9 years (IQR 2.5, 6.7) in group B. IDH rate per 100 hemodialysis hours (95% confidence interval [CI]) was 34.2 (26.4, 42.0) and 36.0 (28.9, 43.1) during early and late intradialytic cycling, respectively (P = 0.53). Timing of intradialytic cycling was not associated with symptomatic IDH (relative risk [RR]: 1.07 [0.75–1.53]) or time to recover post hemodialysis (odds ratio: 0.99 [0.79–1.23]). Conclusion: We found no association between the rate of overall or symptomatic IDH and the timing of intradialytic cycling in patients enrolled in an intradialytic cycling program. Increased use of cycling late in hemodialysis may optimize intradialytic cycling program resource use and should be studied as a possible treatment for symptoms common in late hemodialysis