Natriuresis as a Way to Assess the Effectiveness of Diuretic Therapy for Acute Decompensated Heart Failure: Data from a Pilot Study

Aim. To analyze the clinical significance of the sodium level in a single urine test obtained 2 hours after the first dose of a loop diuretic was administered in patients with acute decompensation of chronic heart failure (ADHF).Material and methods. An observational study was conducted on the basis of a rapid-care hospital. The concentration of sodium in urine analysis obtained 2 hours after intravenous administration of the first dose of loop diuretic and natriuresis for the first day of hospitalization were evaluated. The development of resistance to diuretics was taken as the primary endpoint (the need to increase the daily dose of furosemide by more than 2 times compared to the initial one or the addition of another class of diuretic drugs).Results. 25 patients with ADHF were included. The average age of patients was 69.0±14.8 years, 16 (64%) of them were men. The average left ventricular ejection fraction was 49.0±13.5%. The level of the N‐terminal fragment of the brain natriuretic peptide (NT-proBNP) was 3416 (2128; 5781) pg/ml. The average sodium concentration in the urine analysis obtained 2 hours after the start of treatment was 100.6±41.0 mmol / l. The concentration of sodium in urine for the first day was 102.2±39.0 mmol/l. 2 hours after the start of treatment, the sodium concentration in a single urine test was less than 50 mmol/l in 5 (20%) patients. Upon further observation, oligoanuria (defined as diuresis of less than 400 ml within 24 hours) developed in 2 of them. Oligoanuria was not detected among patients whose sodium concentration was more than 50 mmol/l. The need for escalation (any increase in the dose of a loop diuretic and/or the addition of another class of diuretic drugs) arose in 7 (28%) patients; at the same time, we diagnosed the development of resistance to diuretics in 5 (20%) of them. Resistance to diuretics was more common among patients with a sodium concentration in a single urine test obtained 2 hours after the start of furosemide administration, less than 50 mmol/l (p=0.037); when dividing the recruited patient population into subgroups with a sodium concentration in a single urine test ≥50 mmol/l and <50 mmol/l there was no significant difference in the need for any escalation of diuretic therapy [3 (60%) vs 4 (20%), p=0.07].Conclusion. Resistance to diuretics is more common among patients with a sodium concentration in a single urine test obtained 2 hours after the first dose of furosemide, less than 50 mmol / l. Evaluation of natriuresis allows to identify insufficient effectiveness of diuretic therapy already at the beginning of treatment

Issues and Challenges with Changing Perspective of TIME in Cyber Tort

Private details such as usernames, Cybercriminals often collect the victim's identification numbers, credit card information, and social security number in order to conduct fraud in the name of the other person.  These confidential details may be used for a number of illegal purposes, including requesting loans, making online purchases, and getting entry to the victim's financial and health details. The use of an individual's identity for wrongful purposes like fraud and other getting their information illegally is known as identity theft. It can range from using their surname, social security number, or credit card details, against their authorization. The term "identity theft" was created in 1964. Both in the United Kingdom and the United States, identity fraud is now legally characterized by loss of personally identifiable information. Identity fraud is the fraudulent use of some other particular personality to get financial or other rewards

Comparative evaluation of polymerase chain reaction assay with microscopy for detection of asymptomatic carrier state of theileriosis in a herd of crossbred cattle

Aim: This study aims to develop and to standardize a polymerase chain reaction (PCR) assay that will diagnose clinical as well as carrier state of the disease and to compare the results with conventional microscopy technique. Materials and Methods: A herd of crossbred cattle with the previous history of theileriosis in village Lahli, district Rohtak, Haryana, was selected for this study. A total of 29 blood samples were collected randomly from cows including five clinically ill cattle. Blood smears from all animals and lymph node biopsy smears from animal with swollen lymph nodes were examined microscopically after conventional Giemsa staining. Phenol chloroform isoamyl alcohol method was used for extracting DNA from blood. Previously published primers targeting cytochrome b gene sequence of Theileria annulata were used in the PCR assay that was standardized to use in the laboratory. Results: Out of 29 samples tested,18 (62.06%) were found positive for theileriosis by PCR assay, whereas only 10 (34.48%) samples were detected positive by conventional microscopic technique using Giemsa staining method. Conclusions: On the basis results of comparative studies, it can be concluded that PCR assay is a more sensitive than microscopic examination for detection of theileriosis. This can be attributed to the ability of PCR assay to detect small amounts of genomic DNA of T. annulata or low parasitemia in cows. Therefore, PCR assay can serve as a more sensitive tool to detect Theileria for detection of theileriosis even in asymptomatic carrier cattle which is important for the implementation of successful control programs

Isolation, biochemical and molecular identification, and in-vitro antimicrobial resistance patterns of bacteria isolated from bubaline subclinical mastitis in South India

Buffaloes are the second largest source of milk. Mastitis is a major impediment for milk production, but not much information is available about bubaline mastitis, especially subclinical mastitis. The aim of this study was to (a) investigate the application of various tests for the diagnosis of bubaline subclinical mastitis, (b) identify the major bacteria associated with it, and (c) evaluate the antibiotic resistance pattern of the bacteria. To this end, 190 quarter milk samples were collected from 57 domesticated dairy buffaloes from organized (64 samples) and unorganized (126 samples) sectors. Of these, 48.4%, 40.0%, 45.8%, 61.1%, and 61.6% were positive for subclinical mastitis by somatic cell count, electrical conductivity, California mastitis test, bromothymol blue test, and N-acetyl glucosaminidase test, respectively. As compared to the gold standard of somatic cell count, California mastitis test performed the best. However, a combination of the two methods was found to be the best option. Microbiological evaluation, both by biochemical methods as well as by monoplex and multiplex polymerase chain reaction, revealed that coagulase-negative staphylococci were the most predominant (64.8%) bacteria, followed by streptococci (18.1%), Escherichia coli (9.8%) and Staphylococcus aureus (7.3%). Most of the pathogens were resistant to multiple antibiotics, especially to β-lactam antibiotics. We propose that California mastitis test be combined with somatic cell count for diagnosis of subclinical mastitis in domestic dairy buffaloes. Further, our results reveal high resistance of the associated bacteria to the β-lactam class of antibiotics, and a possible major role of coagulase-negative staphylococci in causing the disease in India