A Review on Salyajanya Nadi Vrana (pilonidal sinus) with clinical approach

A Pilonidal Sinus is a common disease of the natal cleft. Pilonidal Sinus is a track which contains hairs. The incidence of the disease is calculated to be 26 per 100,000 people. Pilonidal disease has a male predominance with a ratio of 3:1. There are several methods to treat pilonidal sinus, but the recurrence rate is more in modern surgical interventions. According to Ayurveda it can be correlated to Salyajanya Nadi Vrana (pilonidal sinus), a type of Nadi Vrana (sinus). Whose etiopathology is described in Nidanasthana and treatment aspect in Chikitsasthana of Susrutha Samhita. Susrutha mentioned the application of Kshara (caustic alkali) and Ksharasutra (Seton) in the management of Nadivrana. Studies shows that by Ayurvedic treatment, it helps to reduce recurrence rate, even though Nadivrana is said to be Kricchrasadhya (difficult to cure). Hence sucessful management of this disease depends on the knowledge of pathogenesis, patients presentation and knowledge on treatment aspects

Variations in lung fissures and lobes morphology in population of Andhra Pradesh of South India (a cadaveric study)

Knowledge of the position of lung fissures is necessary for the appreciation of lobar anatomy and thus locating the bronchopulmonary segments. The study aimed to investigate the patterns of fissures and lobes of the lungs and their variations in Andhra Pradesh, India and to find their clinical implications and compare them with the previous studies. Methods: The patterns of lobes, fissures, and hilar anatomy of lungs and its variations of 47 lungs by dissection method of embalmed cadavers was performed in the Department of Anatomy, Narayana Medical College (Nellore, India). The specimens were macroscopically observed for gross morphology of fissures and lobes. Results. The study showed oblique fissure in 33 % (grade 1), 26 % (grade 2), 24 % (grade 3) and 14 % (grade 4) of right lungs and 27 % (grade 1), 31 % (grade 2), 12 % (grade 3) and 12 % (grade 4) of left lungs. The incomplete horizontal fissure was seen in 38 % of right-sided lungs (grade 1). 19 % of right lungs and 10 % of left lungs had accessory lung fissures. Conclusions. Awareness of the variations in the lobes and fissures of the lungs is important for radiologists while interpreting magnetic resonance imaging and computed tomography scans. Also, we believe that the data from the present study certainly adds an important reference in the medical literature to thoracic surgeons in performing pneumonectomy and segmental resection

Anatomical deviations in the position of vermiform appendix: the cadaveric study

Vermiform appendix is the only organ in the body that has no constant anatomical position. It is so named because of its worm like appearance. Most common surgical cause of abdominal pain is appendicitis; its diagnosis is affected by anatomical variations of the vermiform appendix, because this is the most variable abdominal organ in terms of position and organ relations. Aim of the study was to examine anatomical features and different positions of the vermiform appendix in human cadavers. Material and methods. This study was carried on 45 human cadavers irrespective of sex and age from the Department of Anatomy at Andhra Pradesh over a period of 12 months. Results. Mean length of appendix was found to be 3.98 ± 1.27 cm. Mean outer girth was 2.17 ± 0.26 cm. Mean distance of vermiform appendix from ileocaecal junction was found to be 2.11 ± 0.43 cm. Commonest position was retrocaecal (44 %), followed by pelvic (21 %), postileal (9 %), subcaecal (13 %) and midinguinal (10 %). Conclusions. Variations in position of vermiform appendix will help the surgeons to make a diagnosis of appendicitis and aware about appendiceal rupture

IN SILICO DESIGN, SYNTHESIS, CHARACTERIZATION, IN VITRO ANTI-INFLAMMATORY, AND ANTIOXIDANT STUDIES OF 4-ARYL-4H-CHROMENE DERIVATIVES

Objective: The objective of the study was to explore in silico design, preparation, characterization, and evaluation in vitro of some novel 4H-chromene derivatives as anti-inflammatory and antioxidant agents.Methods: 4-phenyl-4H chromene derivatives were imperiled to in silico modeling studies at the molecular level. The ligands were docked against cyclooxygenase-2 (COX-2) receptor targets using Argus Lab. Based on the result, the derivatives were selected for wet lab synthesis. A highly efficient multicomponent reaction of 4H chromene was carried out by one-step condensation of aldehyde with malononitrile and resorcinol without catalyst in water under ultrasound irradiation. The prepared compounds were characterized by noting their melting point, ultraviolet (UV) spectroscopy, infrared (IR) spectroscopy, and thin layer chromatography (TLC) and were scrutinized for its in vitro anti-inflammatory and antioxidant activitives by in vitro cell culture studies. IR spectra of the two compounds were analyzed and studied. Thus, using melting point, TLC and UV spectroscopy the synthesized compounds were found to be pure and identified chemically. The synthesized compounds were then screened for in vitro antioxidant (by 2,2-diphenyl-1-picrylhydrazyl (DPPH) and hydrogen peroxide free radical scavenging) activity and anti-inflammatory activity by Raw 264.7 cell lines.Result: From the study, it was noticed that chemical structure-2 showed better antioxidant and anti-inflammatory activitives than chemical structure. In the 4-phenyl-4H chromene derivatives, hydroxyl substitution at 7th position and electronegative halogen at 4th position showed better antioxidant and anti-inflammatory activities.Conclusion: The results disclosed that these synthesized derivatives be likely to have moderate action against COX-2 mediated diseases, thereby it may lessen inflammation and agony because of its antioxidant and anti-inflammatory activitives

Sodium glucose co-transporter 2 inhibition increases epidermal growth factor expression and improves outcomes in patients with type 2 diabetes

Underlying molecular mechanisms of the kidney protective effects of sodium glucose co-transporter 2 (SGLT2) inhibitors are not fully elucidated. Therefore, we studied the association between urinary epidermal growth factor (uEGF), a mitogenic factor involved in kidney repair, and kidney outcomes in patients with type 2 diabetes (T2D). The underlying molecular mechanisms of the SGLT2 inhibitor canagliflozin on EGF using single-cell RNA sequencing from kidney tissue were examined. Urinary EGF-to-creatinine ratio (uEGF/Cr) was measured in 3521 CANagliflozin cardioVascular Assessment Study (CANVAS) participants at baseline and week 52. Associations of uEGF/Cr with kidney outcome were assessed using multivariable-adjusted Cox regression models. Single-cell RNA sequencing was performed using protocol kidney biopsy tissue from ten young patients with T2D on SGLT2i, six patients with T2D on standard care only, and six healthy controls (HCs). In CANVAS, each doubling in baseline uEGF/Cr was associated with a 12% (95% confidence interval 1-22) decreased risk of kidney outcome. uEGF/Cr decreased after 52 weeks with placebo and remained stable with canagliflozin (between-group difference +7.3% (2.0-12.8). In young persons with T2D, EGF mRNA was primarily expressed in the thick ascending loop of Henle. Expression in biopsies from T2D without SGLT2i was significantly lower compared to HCs, whereas treatment with SGLT2i increased EGF levels closer to the healthy state. In young persons with T2D without SGLT2i, endothelin-1 emerged as a key regulator of the EGF co-expression network. SGLT2i treatment was associated with a shift towards normal EGF expression. Thus, decreased uEGF represents increased risk of kidney disease progression in patients with T2D. Canagliflozin increased kidney tissue expression of EGF and was associated with a downstream signaling cascade linked to tubular repair and reversal of tubular injury.</p

Assessment of the sensitivity of model responses to urban emission changes in support of emission reduction strategies

© 2023 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/The sensitivity of air quality model responses to modifications in input data (e.g. emissions, meteorology and boundary conditions) or model configurations is recognized as an important issue for air quality modelling applications in support of air quality plans. In the framework of FAIRMODE (Forum of Air Quality Modelling in Europe, https://fairmode.jrc.ec.europa.eu/) a dedicated air quality modelling exercise has been designed to address this issue. The main goal was to evaluate the magnitude and variability of air quality model responses when studying emission scenarios/projections by assessing the changes of model output in response to emission changes. This work is based on several air quality models that are used to support model users and developers, and, consequently, policy makers. We present the FAIRMODE exercise and the participating models, and provide an analysis of the variability of O3 and PM concentrations due to emission reduction scenarios. The key novel feature, in comparison with other exercises, is that emission reduction strategies in the present work are applied and evaluated at urban scale over a large number of cities using new indicators such as the absolute potential, the relative potential and the absolute potency. The results show that there is a larger variability of concentration changes between models, when the emission reduction scenarios are applied, than for their respective baseline absolute concentrations. For ozone, the variability between models of absolute baseline concentrations is below 10%, while the variability of concentration changes (when emissions are similarly perturbed) exceeds, in some instances 100% or higher during episodes. Combined emission reductions are usually more efficient than the sum of single precursor emission reductions both for O3 and PM. In particular for ozone, model responses, in terms of linearity and additivity, show a clear impact of non-linear chemistry processes. This analysis gives an insight into the impact of model’ sensitivity to emission reductions that may be considered when designing air quality plans and paves the way of more in-depth analysis to disentangle the role of emissions from model formulation for present and future air quality assessments.Peer reviewe

Endogenous adenine mediates kidney injury in diabetic models and predicts diabetic kidney disease in patients

Diabetic kidney disease (DKD) can lead to end-stage kidney disease (ESKD) and mortality; however, few mechanistic biomarkers are available for high-risk patients, especially those without macroalbuminuria. Urine from participants with diabetes from the Chronic Renal Insufficiency Cohort (CRIC) study, the Singapore Study of Macro-angiopathy and Micro-vascular Reactivity in Type 2 Diabetes (SMART2D), and the American Indian Study determined whether urine adenine/creatinine ratio (UAdCR) could be a mechanistic biomarker for ESKD. ESKD and mortality were associated with the highest UAdCR tertile in the CRIC study and SMART2D. ESKD was associated with the highest UAdCR tertile in patients without macroalbuminuria in the CRIC study, SMART2D, and the American Indian study. Empagliflozin lowered UAdCR in nonmacroalbuminuric participants. Spatial metabolomics localized adenine to kidney pathology, and single-cell transcriptomics identified ribonucleoprotein biogenesis as a top pathway in proximal tubules of patients without macroalbuminuria, implicating mTOR. Adenine stimulated matrix in tubular cells via mTOR and stimulated mTOR in mouse kidneys. A specific inhibitor of adenine production was found to reduce kidney hypertrophy and kidney injury in diabetic mice. We propose that endogenous adenine may be a causative factor in DKD.</p

Endogenous adenine mediates kidney injury in diabetic models and predicts diabetic kidney disease in patients

Diabetic kidney disease (DKD) can lead to end-stage kidney disease (ESKD) and mortality; however, few mechanistic biomarkers are available for high-risk patients, especially those without macroalbuminuria. Urine from participants with diabetes from the Chronic Renal Insufficiency Cohort (CRIC) study, the Singapore Study of Macro-angiopathy and Micro-vascular Reactivity in Type 2 Diabetes (SMART2D), and the American Indian Study determined whether urine adenine/creatinine ratio (UAdCR) could be a mechanistic biomarker for ESKD. ESKD and mortality were associated with the highest UAdCR tertile in the CRIC study and SMART2D. ESKD was associated with the highest UAdCR tertile in patients without macroalbuminuria in the CRIC study, SMART2D, and the American Indian study. Empagliflozin lowered UAdCR in nonmacroalbuminuric participants. Spatial metabolomics localized adenine to kidney pathology, and single-cell transcriptomics identified ribonucleoprotein biogenesis as a top pathway in proximal tubules of patients without macroalbuminuria, implicating mTOR. Adenine stimulated matrix in tubular cells via mTOR and stimulated mTOR in mouse kidneys. A specific inhibitor of adenine production was found to reduce kidney hypertrophy and kidney injury in diabetic mice. We propose that endogenous adenine may be a causative factor in DKD.</p

Clinical Characteristics and Treatment Patterns of Children and Adults With IgA Nephropathy or IgA Vasculitis: Findings From the CureGN Study

Introduction: The Cure Glomerulonephropathy Network (CureGN) is a 66-center longitudinal observational study of patients with biopsy-confirmed minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, or IgA nephropathy (IgAN), including IgA vasculitis (IgAV). This study describes the clinical characteristics and treatment patterns in the IgA cohort, including comparisons between IgAN versus IgAV and adult versus pediatric patients. Methods: Patients with a diagnostic kidney biopsy within 5 years of screening were eligible to join CureGN. This is a descriptive analysis of clinical and treatment data collected at the time of enrollment. Results: A total of 667 patients (506 IgAN, 161 IgAV) constitute the IgAN/IgAV cohort (382 adults, 285 children). At biopsy, those with IgAV were younger (13.0 years vs. 29.6 years, P < 0.001), more frequently white (89.7% vs. 78.9%, P = 0.003), had a higher estimated glomerular filtration rate (103.5 vs. 70.6 ml/min per 1.73 m2, P < 0.001), and lower serum albumin (3.4 vs. 3.8 g/dl, P < 0.001) than those with IgAN. Adult and pediatric individuals with IgAV were more likely than those with IgAN to have been treated with immunosuppressive therapy at or prior to enrollment (79.5% vs. 54.0%, P < 0.001). Conclusion: This report highlights clinical differences between IgAV and IgAN and between children and adults with these diagnoses. We identified differences in treatment with immunosuppressive therapies by disease type. This description of baseline characteristics will serve as a foundation for future CureGN studies

Effect of garlic on cardiovascular disorders: a review

Garlic and its preparations have been widely recognized as agents for prevention and treatment of cardiovascular and other metabolic diseases, atherosclerosis, hyperlipidemia, thrombosis, hypertension and diabetes. Effectiveness of garlic in cardiovascular diseases was more encouraging in experimental studies, which prompted several clinical trials. Though many clinical trials showed a positive effect of garlic on almost all cardiovascular conditions mentioned above, however a number of negative studies have recently cast doubt on the efficary of garlic specially its cholesterol lowering effect of garlic. It is a great challenge for scientists all over the world to make a proper use of garlic and enjoy its maximum beneficial effect as it is the cheapest way to prevent cardiovascular disease. This review has attempted to make a bridge the gap between experimental and clinical study and to discuss the possible mechanisms of such therapeutic actions of garlic