Incidence and risk factors for any retinopathy of prematurity (ROP) and type 1 ROP in a neonatal care unit (NICU) in North Karnataka

Purpose: To report the incidence and risk factors for any ROP and type 1 ROP and treatment outcomes of type 1 ROP. Methods and Material: Infants born in our hospital with gestational age (GA) of < 34weeks or birth weight (BW) < 2000g were screened for ROP and treated if type 1 ROP developed. Incidence of any ROP and type 1 ROP were calculated. Several variables were evaluated by univariate and multivariate analyses to find their significance for any ROP and type 1 ROP. Results of treatment for type 1 ROP are reported. Results: Out of 263 infants screened, 64 (24.3%) developed any ROP and 15(5.7%) type 1 ROP. All the eyes with type 1 ROP showed complete regression after treatment. Multivariate analysis showed that; infants with GA of 31-34 weeks had significantly less any ROP (P=0.002) and type 1 ROP (p= 0.020) versus infants of GA ≤30w. Infants with BW≥1501g had less any ROP (P=0.025) and less type 1 ROP (P=0.018) versus infants with BW ≤1250g. Infants with BW 1251g to 1500g had less type 1 ROP versus infants with BW≤1250g. (P=0.042) and females had significantly less type 1 ROP (P= 0.012) versus male infants. Conclusions: The incidence of any ROP and type 1 ROP were relatively low in our study. Type 1 ROP regressed completely in all eyes after treatment. GA, BW and gender were significant factors for any ROP and type 1 ROP

Expert consensus document on the management of hyperkalaemia in patients with cardiovascular disease treated with RAAS-inhibitors - Coordinated by the Working Group on Cardiovascular Pharmacotherapy of the European Society of Cardiology.

Renin angiotensin aldosterone system inhibitors/antagonists/blockers (RAASi) are a cornerstone in treatment of patients with cardiovascular diseases especially in those with heart failure (HF) due to their proven effect on surrogate and hard end-points. RAASi are also the basis in treatment of arterial hypertension and they are furthermore indicated to reduce events and target organ damage in patients with diabetes and chronic kidney disease, where they have specific indication because of the evidence of benefit. RAASi therapy, however, is associated with an increased risk of hyperkalaemia. Patients with chronic kidney disease and HF are at increased risk of hyperkalaemia and ∼50% of these patients experience two or more yearly recurrences. A substantial proportion of patients receiving RAASi therapy have their therapy down-titrated or more often discontinued even after a single episode of elevated potassium (K+) level

Incidence of inflammatory reactions after intravitreal injection of a biosimilar of ranibizumab for the treatment of various retinal vascular conditions

BACKGROUND: Razumab is a biosimilar of ranibizumab and its intravitreal injection in various retinal diseases has been reported with good results. However, the incidence of inflammation in the anterior chamber and vitreous after the intravitreal injection of Razumab has not been studied so far. AIMS OF THE STUDY: The aim of this study was to study the incidence of inflammatory reaction in the anterior chamber and vitreous after intravitreal Razumab. MATERIALS AND METHODS: It was a single-center, nonrandomized observational study of eyes that received intravitreal Razumab injection for various retinal indications. The eyes were examined for anterior chamber and vitreous reaction at regular intervals. Preinjection and postinjection visual acuity and intraocular pressure (IOP) were noted. STATISTICAL ANALYSIS: The proportion of eyes developing anterior chamber and vitreous reaction were calculated with confidence intervals. The pre- and postinjection visual acuity and IOP were compared by Student's t-test for significant changes. RESULTS: Eighty-two injections were performed in 40 eyes of 33 patients. Four eyes (4.8%) showed anterior chamber reaction among which one eye had vitreous reaction also. All four eyes had no adverse effect on visual acuity and recovered completely. Mean preinjection logMAR visual acuity of 0.69 ± 0.41 improved to 0.58 ± 0.38 postinjection (P < 0.0001). The mean preinjection IOP changed from 16.2 ± 3.9 mmHg to 14.7 ± 3.4 mmHg postinjection (P = 0.009). CONCLUSIONS: The incidence of inflammatory reaction was found to be higher with Razumab compared to the incidence reported in the literature for ranibizumab. However, visual acuity was not affected by this inflammatory reaction

Hyperkalemia among hospitalized patients and association between duration of hyperkalemia and outcomes.

INTRODUCTION: The aim of the study was to investigate predictors of mortality in patients hospitalized with hyperkalemia. MATERIAL AND METHODS: Data among hospitalized patients with hyperkalemia (serum potassium ≥ 5.1 mEq/l) were collected. Patients with end-stage renal disease on dialysis were excluded. RESULTS: Of 15,608 hospitalizations, 451 (2.9%) episodes of hyperkalemia occurred in 408 patients. In patients with hyperkalemia, chronic kidney disease, hypertension, diabetes, coronary artery disease and heart failure were common comorbidities. Acute kidney injury (AKI) and metabolic acidosis were common metabolic abnormalities, and 359 patients (88%) were on at least one drug associated with hyperkalemia. Mean duration to resolution of hyperkalemia was 12 ±9.9 h. Nonsteroidal anti-inflammatory drugs (HR = 1.59), highest potassium level (HR = 0.61), tissue necrosis (HR = 0.61), metabolic acidosis (HR = 0.77), and AKI (HR = 0.77) were significant independent determinants of duration prior to hyperkalemia resolution. Tissue necrosis (OR = 4.55), potassium supplementation (OR = 5.46), metabolic acidosis (OR = 4.84), use of calcium gluconate for treatment of hyperkalemia (OR = 4.62), AKI (OR = 3.89), and prolonged duration of hyperkalemia (OR = 1.06) were significant independent predictors of in-hospital mortality. CONCLUSIONS: Tissue necrosis, potassium supplementation, metabolic acidosis, calcium gluconate for treatment of hyperkalemia, AKI and prolonged duration of hyperkalemia are independent predictors of in-hospital mortality

Hyperkalemia among hospitalized patients and association between duration of hyperkalemia and outcomes

INTRODUCTION: The aim of the study was to investigate predictors of mortality in patients hospitalized with hyperkalemia. MATERIAL AND METHODS: Data among hospitalized patients with hyperkalemia (serum potassium ≥ 5.1 mEq/l) were collected. Patients with end-stage renal disease on dialysis were excluded. RESULTS: Of 15,608 hospitalizations, 451 (2.9%) episodes of hyperkalemia occurred in 408 patients. In patients with hyperkalemia, chronic kidney disease, hypertension, diabetes, coronary artery disease and heart failure were common comorbidities. Acute kidney injury (AKI) and metabolic acidosis were common metabolic abnormalities, and 359 patients (88%) were on at least one drug associated with hyperkalemia. Mean duration to resolution of hyperkalemia was 12 ±9.9 h. Nonsteroidal anti-inflammatory drugs (HR = 1.59), highest potassium level (HR = 0.61), tissue necrosis (HR = 0.61), metabolic acidosis (HR = 0.77), and AKI (HR = 0.77) were significant independent determinants of duration prior to hyperkalemia resolution. Tissue necrosis (OR = 4.55), potassium supplementation (OR = 5.46), metabolic acidosis (OR = 4.84), use of calcium gluconate for treatment of hyperkalemia (OR = 4.62), AKI (OR = 3.89), and prolonged duration of hyperkalemia (OR = 1.06) were significant independent predictors of in-hospital mortality. CONCLUSIONS: Tissue necrosis, potassium supplementation, metabolic acidosis, calcium gluconate for treatment of hyperkalemia, AKI and prolonged duration of hyperkalemia are independent predictors of in-hospital mortality