Long term outcome of acute kidney injury due to leptospirosis? A longitudinal study in Sri Lanka

BACKGROUND: Leptospirosis is an important zoonotic disease of variable severity and is a common cause of acute kidney injury (AKI) in tropics. However the knowledge on long term renal outcome in leptospirosis is scarce. This study aims to assess the long-term renal outcome of AKI caused by leptospirosis. FINDINGS: Hospital records of patients who had developed AKI following leptospirosis (Serologically confirmed) presented to two Teaching Hospitals in Kandy district over 3 years from 2007 were studied. A total of 44 patients were included and they had been followed up at least for one year in out patient clinics with regular assessment including renal status. Renal histology was studied in two patients. The primary outcome measure was normalization of renal function at one year. Of the 44 patients, 31 were in the risk and injury stage (Group 1), and the rest of them were in the failure stage (Group 2) under RIFLE criteria. Of group 2 patients, 11 had abnormal renal functions on discharge. Their mean serum creatinine and GFR values on discharge were 392 mmol/l and 20 ml/min/1.73 m(2). Other two patients had full renal recovery whilst in the hospital. Nine in the group 2 required renal replacement therapy by means of peritoneal dialysis, intermittent haemodialysis or haemofiltration. Seventeen out of the total had persistently abnormal renal functions on discharge. Of them 13 recovered their renal functions to normal. Four patients (9%) who belonged to group 2, had persistently abnormal renal functions after first year compatible with stage 3 chronic kidney disease (CKD). Renal histology of two patients showed tubulointerstitial lymphocyte infiltrate, tubular atrophy and interstitial fibrosis. CONCLUSION: The long term renal outcome of AKI following leptospirosis is satisfactory as only 9% of patients had abnormal renal functions compatible with early stage of CKD. Even among them, advanced CKD or dialysis dependency had not been observed

Use of lysozyme from chicken egg white as a nitrite replacer in an Italian-type chicken sausage

Background: Sodium or potassium nitrite is widely used as a curing agent in sausages and other cured meat products. Nitrite has strong antimicrobial and antioxidant effects and generates cured meat color. Nitrite, however, can react with secondary or tertiary amines in meat to form carcinogenic, teratogenic and mutagenic N-nitroso compounds. Several findings have been suggested that high consumption of processed meat may increase the risk of cancer, and emphasized that dietary nitrosamines are positively associated with cancer. Lysozyme is one of the major egg proteins that have antimicrobial and antioxidant characteristics. Therefore, lysozyme can be used in meat processing to prevent microbial growth and oxidative degradation in meat products during storage. This study is focused on evaluating the antimicrobial and antioxidant effects of lysozyme extracted from egg white as a replacer of nitrite in a cooked Italian-type chicken sausage. Methods: Four curing treatments including 100% nitrite (control), 100% lysozyme (treatment 1), 25% nitrite + 75% lysozyme (treatment 2) and 50% nitrite + 50% lysozyme (treatment 3) were used to prepare Italian-type chicken sausage samples. Recipe was developed with 64% (w/w) meat, 17% (w/w) binder (bread crumble), 12% (w/w) ice, 4% (w/w) vegetable oil, 2% (w/w) salt, 1% (w/w) spices (chili, black pepper, cardamom). Prepared samples were cooked in an 80 °C smoke house to a core temperature of 65 °C and cooled in cold water to 20-25 °C subsequently packed in polyethylene and stored in a freezer (-18 °C). The antimicrobial effect lysozyme was tested using Escherichia coli and Salmonella. The growth of these pathogens at 0, 3 and 5 days of storage of spore inoculation was determined. The antioxidant activity of lysozyme was determined using the TBARS value during the 25 d storage period. The redness (a*), lightness (L*), and yellowness (b*) of sausages were analyzed using a Minolta color meter (CR 410, Konica Minolta Inc., Japan). The proximate composition (AOAC, 2002) of frozen (-18 °C) sausage samples and sensory properties of cooked samples were determined. Results: 50% nitrite + 50% lysozyme (treatment 3) was as effective as control (100% nitrite) in suppressing the growth of Escherichia coli, Salmonella and limiting lipid oxidation in the Italian-type chicken sausage. Treatment 3 was not significantly different from the control, for lightness (L*), redness (a*) and yellowness (b*) values (P > 0.05) but showed the best sensory characteristics among the treatments (p Conclusion: This study demonstrated that lysozyme can be used as an effective nitrite replacer in the Italian-type chicken sausage. Replacing 50% of nitrate salt with 50% lysozyme did not show any negative effects in controlling microbial growth, preventing lipid oxidation, and color changes but improved the sensory characteristics.This article is published as Abeyrathne, Nalaka Sandun. "Use of lysozyme from chicken egg white as a nitrite replacer in an Italian-type chicken sausage." Functional Foods in Health and Disease 5, no. 9 (2015): 320-330. doi:10.31989/ffhd.v5i9.217.</p