A study of factors determining outcome of acute kidney injury patients requiring hemodialysis

Background: High mortality rate in acute kidney injury (AKI) has interested many authors to conduct studies about factors predicting its outcome. The need for both dialysis and ICU care defines a group of critically ill patients who may have poor prognosis and consume vast amounts of resources. In this study we determine the variables predicting the outcome of patients with severe acute kidney failure requiring haemodialysis and to ascertain the aetiology of acute kidney injury in this group.Methods: We prospectively analysed 114 patients admitted with severe renal failure requiring renal replacement therapy over a period of one year. The influence of various factors such as demographic variables, pre morbidities, details of admission, clinical presentation and extent of organ dysfunction on the clinical outcome such as mortality and progression to end stage kidney disease were statistically analyzed using SPSS version 12 (SPSS Inc., Chicago, Ill).Results: Univariate and multivariate analysis showed that parameters such as chronic liver disease, preexisting heart disease, mechanical ventilation and vasopressor requirement, oliguria, sepsis, hepatorenal syndrome, cardiogenic shock and admission in ICU were associated with high mortality (p<0.05). Of the 114 patients, 49 died (42.98%), 61 (53.5%) were dialysis independent and 4 patients (3.5%) progressed to end stage renal disease (ESRD).Conclusions: AKI patients requiring hemodialysis were associated with high hospital mortality.  Patients who were diagnosed to have acute glomerulonephritis especially rapidly progressing glomerulonephritis as the cause of AKI were more prone to ESRD. Most survivors were dialysis independent at the time of discharge

Biogenic silver nanoparticles mediated by Broussonetia papyrifera: anticancer and antimicrobial activity against pathogenic organisms

Objective: To evaluate the potential aspects of biologically synthesized silver nanoparticles mediated by Broussonetia papyrifera against the human pathogens. The same is acknowledged to have high efficiency in the field of Pharmaceutical industry.Methods: The 1Mm of AgNO3 is prepared and mixed with appropriate volume of plant extract and reaction volume was made up to 100 ml. the physical   characterization of AgNPs was done. The anti-microbial activity was done against dread pathogens. Cytotoxic activity of the AgNPs was investigated against breast and lung cancer cell lines.Results: The FESEM and EDAX of the microscopic level showed the particle surface measurements around 44 nm to 50 nm. The XRD investigations are being an evidence for the crystalline structure of the AgNPs with 30 nm. The bacterial pathogen Rhodococcus rhodochrous showed the maximum zone of inhibition (11.8±0.447). The A549 human lung cancer cell line and MCF-7 human breast cancer cell line were tested against the toxicity of AgNPs. The toxicity of AgNPs was valued and corresponding IC50 for Lung cancer (A549) is 12.95± 0.05 µg/mL and Breast cancer (MCF-7) is 10.75± 0.05 µg/mL respectively.Conclusion: The present research denotes that biomolecules derived AgNPs have larger impact as antimicrobials in the biomedical field. Since the aggressive chemicals are not involved AgNPs production, these bio-substances can of alternative medicine to resistant once. The in-vitro experiments exhibits the therapeutic effect of this AgNPs based on the ambient concentration on the process.Â

A study of clinicopathological features and outcomes of crescentic glomerulonephritis

Background: Crescentic Glomerulonephritis (CrGN) is characterized by rapidly progressive renal failure. Most of the literatures have defined >50% crescents in biopsy as CrGN. Only very few studies have included the presence of 10% crescents on renal biopsy and comparing them splitting our diagnosis into Immune Complex Mediated CrGN (ICCGN) and non-immune complex mediated CrGN (NICCGN) groups.Results: ICCGN was the commonest group. When compared to ICCGN group, NICCGN patients were older, anuric, had more glomerular necrosis and severe IFTA in biopsy at presentation, more became dialysis dependent at index visit discharge. When patients with >50% crescents in both the groups were compared similar results were seen except that infective complications and proliferative lesions were more in ICCGN. When patients with 60%, moderate to severe IFTA are the independent risk factors for dialysis dependency at index visit discharge

Trends and Challenges in the Utilization of Web-Based Information Repositories for the Academicians of University Libraries in Tamil Nadu

A Web-Based Information repository is a technology used to collect and organize multimedia information such as images, text, audio, video, software, and scientific data. It improves knowledge management and provides high-speed access to the database. The researcher made an initiative to analyze the trends in information services accessed from the university library website and to analyze the satisfaction of the respondents with Web-Based Information Repositories available in the sample unit. The target population of this study is research scholars in various departments of Madurai Kamaraj University, Madurai. The questionnaire method has been used for the collection of data required. A well-designed questionnaire was personally distributed to selected academicians covering different university departments. On the whole, 150 questionnaires were distributed to the respondents. Only 125 teaching faculties have responded to the request, with a response rate of 83.33%. The data was then tabulated and analysed for results and discussions

A cultural interpretation of value changes in popular Indian - Tamil films (1950-1990).

This thesis examined and interpreted the shared values in Tamil-Indian society using James Carey\u27s theory, a cultural approach to communication. According to him, communication is a ritual that brings people together as a community, to share the commonality of meanings and partake in common activities. The changes in values in Indian society through the years 1950-1990 were observed from an examination of eight popular Tamil films. Two out of the five most popular films from each decade were used as representative texts for interpretation. For each film, five value-related categories--caste issues, family: respect for elders, marriage, religion and education were interpreted and examined. These categories were analyzed from the narrative patterns, and from the behavior of the characters in the films. Some of the value-expressive categories like family structure and caste issues have changed drastically in the last forty years while others like religion, marriage, respect for elders, and education have changed slowly. (Abstract shortened by UMI.)Dept. of Communication Studies. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis1992 .L685. Source: Masters Abstracts International, Volume: 31-04, page: 1413. Thesis (M.A.)--University of Windsor (Canada), 1992

A Study of Aspartate Platelet Ratio Index (APRI) as a Noninvasive and Cost Effective Predictor for the Diagnosis of Liver Fibrosis and Esophageal Varices in Chronic Liver Disease Patients

INTRODUCTION: Chronic liver disease, the leading cause of global mortality and morbididty. The major causes are chronic infection with hepatitis B and C viruses, and alcoholic and non-alcoholic fatty liver disease and autoimmune hepatitis. OBJECTIVES: To Use Aspartate Platelet Ratio Index (APRI) as a non invasive and cost –effective biomarker for the diagnosis of liver fibrosis and esophageal varices in chronic liver disease patients JUSTIFICATION FOR STUDY : In chronic liver disease, liver biopsy has always been the gold standard test for assessing the fibrosis and for staging it. The procedure has its own short comings like invasiveness, highly expensive, inter and intra-observer variations. To overcome such limitations, in recent times, many blood markers and instrumental methods have been proposed for the non invasive assessment of liver fibrosis. These noninvasive modalities can be performed easily on an out patient basis with good patient compliance economically. METHODOLOGY: A cross sectional study done among 100 chronic liver diseased patients, admitted in medical gastroenterology ward at PSG IMS&R, Coimbatore. Study participants were selected as per inclusion, exclusion criteria. DISCUSSION: In clinical practice nowadays staging of liver fibrosis and esophageal varices identification were absolutely essential for planning the management of chronic liver disease patients and hence there is an emerging need for non-invasive investigative modalities. One such investigation is APRI (Aspartate transaminase and Platelet Ratio Index). In this study, we have analysed the effectiveness of APRI in detecting fibrosis & varices in CLD patients by performing Acoustic Radiation Force Impulse (ARFI) Elastography and upper GI scopy. Here-in,100 CLD patients of various etiologies were analysed for their liver fibrosis and presence of varices. Of the total study population, 31% belong to the age group of 41-50,the median age being 48.There is a strong association between APRI and liver disease patients developing varices with a significant p value of 0.00.It has a specificity of 96% and positive predictive value of 88.8%.Also,there is a strong association between APRI and patients with F2 level of fibrosis with the significant p value of 0.001.For detecting fibrosis in Hepatitis C patients, we obtained an AUC of 0.469 and it has a specificity of 78.8%,sensitivity of 20% which corresponds to a APRI score of 0.3.It has got a negative predictive value of 89.8%. For detecting fibrosis in Hepatitis B patients, we obtained an AUC of 0.372 and it has a specificity of 81.1%,sensitivity of 50% which corresponds to a APRI score of 0.3.It has got a negative predictive value of 93.5%. For detecting fibrosis in autoimmune hepatitis patients, we obtained an AUC of 0.618 and it has a specificity of 95.5% which corresponds to a APRI score of 0.3.It has got a negative predictive value of 89.5%. For detecting fibrosis in Alcoholic liver disease patients, we obtained an AUC of 0.618 and it has a specificity of 77.7%, sensitivity of 10% which corresponds to a APRI score of 0.3. It has got a negative predictive value of 88.6%. For detecting fibrosis in NAFLD patients, we obtained an AUC of 0.538 and it has a specificity of 66.6%,sensitivity of 20% which corresponds to a APRI score of 0.5.It has got a negative predictive value of 88.2%. In this study, we have also analysed the effectiveness of ARFI elastography in detecting fibrosis in CLD patients. ARFI has got a specificity of 78.9%, positive predictive value of 80.9% in detecting fibrosis in hepatitis 4C patients. ARFI has got a specificity of 89.4%, positive predictive value of 90.9% in detecting fibrosis in hepatitis B patients. ARFI has got a specificity of 94.7%,positive predictive value of 75% in detecting fibrosis in autoimmune liver disease. ARFI has got a specificity of 73.6%,positive predictive value of 76.1% in detecting fibrosis in alcoholic liver disease. ARFI has got a specificity of 63.1%, positive predictive value of 78.1% in detecting fibrosis in NAFLD patients. CONCLUSION: In our study, APRI has got a strong association with a significant p value in detecting varices for a threshold level of >0.3. APRI also got a association with significant fibrosis which is statistically insignificant owing to small sample size. From the study a threshold APRI value of 0.3 rules in significant fibrosis in HEPATITIS B, HEPATITIS C, alcoholic liver disease and autoimmune hepatitis, while a threshold value of 0.5 rules in significant fibrosis in non alcoholic fatty liver disease patients. ARFI elastography has got a strong association in assessing significant fibrosis. APRI has got a good specificity and negative predictive value in predicting significant fibrosis and a good positive predictive value in predicting varices. To conclude APRI can be used as a useful non invasive alternative for the assesment of liver fibrosis and esophageal varices in CLD patients

Ayurvedic management of pituitary macroadenoma-a case report

Pituitary macroadenoma is an infrequently encountered clinical condition, characterized by a non-metastasizing neoplasm situated within the pituitary gland. This case report endeavours to elucidate the efficacy of ayurvedic interventions in achieving symptomatic resolution. A 44-year-old female patient, residing in Thrissur, diagnosed with features suggestive of pituitary macroadenoma, sought admission to Vaidyaratnam ayurveda college hospital for complaints of generalized pain, heaviness of head, impaired peripheral vision in the left eye, and amenorrhea persisting for approximately 7 months. The case was conclusively diagnosed as Pituitary Macroadenoma and meticulously addressed through therapeutic modalities including takradhara, nasyam, and thalapothichil.  patient was already prescribed with Caberlin tablets at a dosage of 0.25 mg twice weekly, administered nocturnally. Following 21 days of treatment, notable improvement in the LBNQ-Pituitary score was observed from 60 to 21 accompanied by significant symptomatic alleviation. A specific treatment protocol for the management of pituitary macroadenoma is currently unavailable

TOXICITY OF ATRAZINE AND RELATED TO TESTICULAR, TISSUE DAMAGING ENZYME LEVELS IN POECILIA SPHENOPS

Objective: This study was designed to evaluate the toxic effects of Atrazine (ATZ) on the enzyme levels in Poecilia sphenops.Methods: The cytosolic testicular enzyme and tissue-damaging enzyme activity were measured in Poecilia sphenops was exposed to 3 sub-lethal concentrations (1.25, 2.5 and 5 mg/l) of atrazine for 100days and control was also maintained. The toxic effects of ATZ to Poecilia sphenops were assessed through testicular marker enzyme, tissue-damaging enzyme level.Results: The activities of testicular functional enzyme ALP, ACP, SDH, LDH, G6PDH and tissue-damaging the activities of glutamate oxaloacetic transaminase (GOT) and glutamate pyruvic transaminase (GPT) activity levels were altered in treated groups compared with that of the control.Conclusion: This study demonstrates that atrazine induces tissue damage in terms of enhanced enzyme activity and testicular enzyme activity in Poecilia sphenops. Atrazine has toxicity to the reproductive system in Poecilia sphenops