Characteristics of micro-propagated banana (Musa spp.) cultures stressed with NaCl and polyethylene glycol

The effect of NaCl and PEG was assessed on plant micro-propagation rate in banana (Musa spp.) cv., Basrai. Well micro-propagated plantlets were cultured on four different stresses of NaCl and PEG-4000 including control level: MS2b (MS0 + 3.0 mg l-1 BAP), MS2c (MS0 + 100 mol m-3 NaCl), MS2d (MS0 + 5% PEG) and MS2e (MS0 + 100 mol m-3 NaCl + 5 % PEG) for 6-weeks. Efficiency of plant micro-propagation was reduced significantly among the stressed cultures. Similarly, photosynthetic pigments like chl a was decreased non-significantly but chl b, chl ab were decreased significantly. Total carotenoids were increased in the saline as well as PEG stressed cultures. Cell size of epidermis and aerenchyma was increased (p < 0.05), while parenchyma decreased. Proline and glycinebetain contents were increased (p < 0.05) in each stressed culture but were high in MS2 than in MS3 and MS4 cultures. Meanwhile, proteins, sugars, phenolics and nitrates were observed to be in the reversed (p < 0.05) phenomena. In conclusion, NaCl treatment was observed to be most toxic than the PEG or PEG with NaCl on the banana micro-propagation.Key words: Musa spp., micro-propagation, NaCl (sodium chloride), PEG (polyethylene glycol), chlorophyll contents, proline, reducing sugars

Microvascular and macrovascular complications in diabetic nephropathy patients referred to nephrology clinic

To evaluate the diabetic complications and fate of diabetic nephropathy in Saudi population, we studied 184 diabetic nephropathy (DN) patients who were referred to nephrology clinic of King Khalid University Hospital, Riyadh, Saudi Arabia from January 2003-June 2006. The patients had mean age of 61.9 ± 13.1 years, included 128 (69.6%) males, and were followed up for a mean period of 10.2 ± 1.5 years. The mean duration of diabetes mellitus (DM) was 19.5 ± 5.8 years, and duration of nephropathy was 7.7 ± 3.3 years. Family history of DN was documented in 52 (28.2%) patients. At initial visit, the mean systolic blood pressure was 164 ± 14.5 mmHg, the mean diastolic blood pressure was 97.9 ± 10.4 mmHg. Thirty-seven (20%) patients had normal BMI, 88 (48%) were overweight, while 55 (30%) were obese. Mean creatinine clearance was 51.7 ± 26.3 mL/min, 24 hrs urinary proteins 1.99 ± 2.48 gm/day, HbA1C 9.2 ± 1.8 %, triglyceride 2.1 ± 1.3 mmol/L, and cholesterol 5.17 ± 1.54 mmol/L. Diabetic complications included angiography proven coronary artery disease in 106 (57.6 %) patients, stroke in 21 (11.4%), myocardial infarction (MI) in 27(14.6%), angina in 87 (47.2 %), retinopathy in 82 (44.5%), Blindness in 3 (1.6%), peripheral vascular disease in 121 (65.7%), Neuropathy in 123 (66.8%), hypertension in178 (96.7%), diabetic foot in 25 (13.5%), Amputation in 10 (5.4%), and end-stage renal disease in 70 (38%). Total of 13 (7.05%) patients died in the hospital. Thirty-seven percent of patients developed > 6 concomitant complications. 28% developed 5, 17% developed 4, and the rest developed < 3. DN was relatively refractory to therapy and progressive; 123 (66.8%) patients doubled their serum creatinine in 3.59 ± 2.88 years, 32 (17.3%) maintained stable renal function, 136 (73.6 %) deteriorated, and 12 (6.52%) improved. we conclude that the prevalence of diabetic complications is high among Saudi patients, and many had multiple complications. Baseline creatinine clearance and proteinuria, high systolic blood pressure, advanced age, and longer duration of diabetes were the most significant risk factors for developing complications

Outcome and complications in peritoneal dialysis patients: A five-year single center experience

Peritoneal dialysis (PD) is one of the modes of renal replacement therapy being utilized for the management of end-stage renal failure in King Khalid University Hospital, King Saud Uni-versity, Riyadh, for more than two decades. The aim of this study was to evaluate the complications related to PD as well as its outcome in patients on this mode of therapy during the period between January 2004 and December 2008. There were 72 patients included in the study, of whom 43 were females. The average age was 50.7 ± 30.1 years (14-88 years). Diabetes was the leading cause of end-stage renal disease (ESRD) seen in 40.2% of the study patients. Twenty-eight patients (38.9%) were on continuous ambulatory peritoneal dialysis (CAPD) and 44 (61.1%) were on automated PD (nocturnal intermittent peritoneal dialysis, NIPD or continuous cycler peritoneal dialysis, CCPD). The mean du-ration on PD of the study patients was 25.5 ± 16.58 months (1-60 months). The peritonitis rate was one episode per 24.51 patient-months or one episode per 2.04 patient-years. The incidence of peritonitis per person-year was calculated as 0.42. The leading causative agent for peritonitis was Staphylococcus (32%). Exit-site infection (ESI) rate was one episode per 56.21 patient-months. The incidence of ESI was 0.214 per person-years. The most common infective organism for ESI was Pseudomonas aeru-ginosa (58.8%). At the end of 5 years, 35 patients were continuing on PD, 13 patients were shifted to hemodialysis (HD), nine patients underwent renal transplantation, and six patients were transferred to other centers. Among the 13 patients who were shifted to HD, four patients had refractory peritonitis, four others had catheter malfunction, three patients had inadequate clearance on PD and two patients had lack of compliance. A total of 11 patients died during the study period, giving an overall mortality rate of 15.27% for the five-year period. Our study suggests that there has been considerable improvement in overall outcome and mortality in patients on PD. Additionally, a marked reduction in the infectious and non-infectious complications was noted with the peritonitis and ESI rates in our center being comparable to other studies and international guidelines

Conjunction of Conducting Polymer Nanostructures with Macroporous Structured Graphene Thin Films for High-Performance Flexible Supercapacitors

Fabrication of hybridized structures is an effective strategy to promote the performances of graphene-based composites for energy storage/conversion applications. In this work, macroporous structured graphene thin films (MGTFs) are fabricated on various substrates including flexible graphene papers (GPs) through an ice-crystal-induced phase separation process. The MGTFs prepared on GPs (MGTF@GPs) are recognized with remarkable features such as interconnected macroporous configuration, sufficient exfoliation of the conductive RGO sheets, and good mechanical flexibility. As such, the flexible MGTF@GPs are demonstrated as a versatile conductive platform for depositing conducting polymers (CPs), e.g., polyaniline (PAn), polypyrrole, and polythiophene, through <i>in situ</i> electropolymerization. The contents of the CPs in the composite films are readily controlled by varying the electropolymerization time. Notably, electrodeposition of PAn leads to the formation of nanostructures of PAn nanofibers on the walls of the macroporous structured RGO framework (PAn@MGTF@GPs): thereafter, the PAn@MGTF@GPs display a unique structural feature that combine the nanostructures of PAn nanofibers and the macroporous structures of RGO sheets. Being used as binder-free electrodes for flexible supercapacitors, the PAn@MGTF@GPs exhibit excellent electrochemical performance, in particular a high areal specific capacity (538 mF cm^–2), high cycling stability, and remarkable capacitive stability to deformation, due to the unique electrode structures

Comparison of high and low dose of cyclophosphamide in lupus nephritis patients: A long-term randomized controlled trial

To evaluate the outcome of low doses of cyclophosphamide (Cyclo) therapy in lupus nephritis (LN) patients, we studied 117 biopsy-proven, de novo LN WHO class IV patients double-blinded and randomized in December 1997 to receive Cyclo in different doses; Group I (n=73) received Cyclo 10 mg/kg monthly for six months then every two months for 12 months. Group II (n=44) received Cyclo 5 mg/kg monthly for six months then every two months for 36 months. The patients were followed-up till January 2007. Six months post-induction values for creatinine clearance were significantly higher in Group I (67.7 ± 28.6 mL/min) compared with Group II (55.1 ± 30.1 mL/min), P = 0.026. Serum C4 and ANA were not significantly different between the groups (P > 0.05). At the mean follow-up of 6.77 ± 3.3 years, the mean creatinine clearance was 44.74 ± 31.7 mL/min in Group I vs. 49.3 ± 38.8 in Group II. Urinary protein was 1.65 ± 1.8 g/dL in Group I vs. 1.02 ± 1.01 in Group II (P = 0.03). The survival curve showed that kidney survival overtime was comparable in both groups (P = 0.2). Complete remission was observed in 25 (34.2%) patients in Group I vs. 11 (25%) in Group II (P = 0.288), while partial remission was similar in both groups; 43 (58.9%) patients in Group I vs. 26 (59%) patients in Group II. End-stage renal disease was observed in 10 (13.7%) patients in Group I vs. 9 (20.4%) patients in Group II (P = 0.359). Side-effects were more frequent in Group I patients than in Group II patients; gonadal toxicity and malignancy were lower in Group II patients (P = 0.0000). Moreover, different infections occurred in 23 (31.3%) patients vs. six (13.6%), digital infarcts occurred in 1.35% vs. 0%, diabetes in 4.1% vs. 2.27%, and vasculitis in 4.1% vs. 2.27% in Group I vs. Group II, respectively. Sustained amenorrhea without pregnancy was observed in both groups; however, significantly more in Group I patients, P ≤ 0.05. We conclude that low-dose Cyclo therapy is sufficiently effective for WHO class IV LN patients with lower side-effects compared with standard dose

A prospective, observational, multicentre study to evaluate the efficacy of brivaracetam as adjuvant therapy for epilepsy: The Bravo study

Background: Epilepsy is a persistent tendency to experience epileptic seizures and can lead to various neurobiological disorders, with an elevated risk of premature mortality. This study evaluates the efficacy of brivaracetam adjuvant therapy in patients with epilepsy. Methods: A prospective observational multicentre study that was conducted in Pakistan from March to September 2022, by using a non-probability convenience sampling technique. The population consisted of 543 individuals with a diagnosis of epilepsy for whom adjunctive brivaracetam (Brivera; manufactured by Helix Pharma Pvt Ltd., Sindh, Pakistan) was recommended by the treating physician. The research sample was drawn from various private neurology clinics of Karachi, Lahore, Rawalpindi, Islamabad and Peshawar. Data originating from routine patient visits, and assessments at three study time points, were recorded in the study case report form. Results: Across four clinical sites, 543 individuals participated, with a mean age of 32.9 years. The most prescribed dosages were 50 mg BD, followed by 100 mg BD. Notably, brivaracetam combined with divalproex sodium was the most prevalent treatment, followed by brivaracetam with levetiracetam. At both the 14th and 90th day assessments, a significant reduction in seizure frequency was observed, with 63.1% of individuals showing a favourable response by day 90. Treatment-naive individuals exhibited higher rates of seizure freedom and response compared with treatment-resistant individuals. Conclusions: The study demonstrates the effectiveness of brivaracetam combination therapy in epilepsy management, with notable reductions in seizure frequency and favourable clinical responses observed, particularly in treatment-naive individuals