Antenatal Bartter Syndrome: A Review

Antenatal Bartter syndrome (ABS) is a rare autosomal recessive renal tubular disorder. The defective chloride transport in the loop of Henle leads to fetal polyuria resulting in severe hydramnios and premature delivery. Early onset, unexplained maternal polyhydramnios often challenges the treating obstetrician. Increasing polyhydramnios without apparent fetal or placental abnormalities should lead to the suspicion of this entity. Biochemical analysis of amniotic fluid is suggested as elevated chloride level is usually diagnostic. Awareness, early recognition, maternal treatment with indomethacin, and amniocentesis allow the pregnancy to continue. Affected neonates are usually born premature, have postnatal polyuria, vomiting, failure to thrive, hypercalciuria, and subsequently nephrocalcinosis. Hypokalemia, metabolic alkalosis, secondary hyperaldosteronism and hyperreninaemia are other characteristic features. Volume depletion due to excessive salt and water loss on long term stimulates renin-angiotensin-aldosterone system resulting in juxtaglomerular hyperplasia. Clinical features and electrolyte abnormalities may also depend on the subtype of the syndrome. Prenatal diagnosis and timely indomethacin administration prevent electrolyte imbalance, restitute normal growth, and improve activity. In this paper, authors present classification, pathophysiology, clinical manifestations, laboratory findings, complications, and prognosis of ABS

Impact of dietary and lifestyle choices on menstrual patterns in medical students

Background: The aim of the study was to evaluate average age of menarche, the pattern and types of menstrual disorders and their relation with BMI, dietary habits, physical exercise and stress.Methods: A cross sectional prospective study was conducted on female medical students during the academic year 2018-2019 at Mallareddy medical college for women, Suraram, Hyderabad, India. The various life style factors including BMI, junk food consumption and physical exercise were factored. Prevalence of each different menstrual abnormality were identified and analyzed by Chi-squire test and p value <0.005 was considered as statistically significant.Results: Study included 255 medical students who had attained menarche without known medical problems. Mean age of menarche was 12.81years. The most frequent menstrual disorders were premenstrual syndrome 192 (75 %), dysmenorrhoea 146 (57 %), and irregular cycle 97(38%). Statistically significant association of Body mass index (BMI) related to premenstrual syndrome (PMS) and dysmenorrhoea was reported (both p<0.05). Similarly, statistically significant association of lack of physical activity had greater risk of premenstrual syndrome and dysmenorrhoea (both p<0.0001). Unhealthy dietary patterns had statistically significant higher risk for dysmenorrhoea (p<0.0001).Conclusions: In conclusion premenstrual symptoms, dysmenorrhoea and menstrual irregularities were more prevalent. Majority of symptoms were stress, pain abdomen, irritability, mood swings. Comprehensive education programs on lifestyle modifications like regular physical activities, promoting healthy eating habits should be emphasised to prevent menstrual abnormalities of young students as early as at school level

Newer drugs for the treatment of hepatitis B viral infection

One of the main disadvantages of hepatitis B virus treatment is the persistence of the virus even after treatment. The main causes of this viral persistence can be an inadequacy of the immune function as well as some viral factors. The currently available drugs for hepatitis B are five oral nucleoside/nucleotide analogs (lamivudine, adefovir dipivoxil, tenofovir, entecavir, telbivudine) and two interferon drugs (interferon alfa-2b, pegylated interferon alfa-2a). However, these therapies do not lead to sustained remission, requiring indefinite treatment as viral load frequently rebounds once suppressive therapy is stopped

An experimental study to evaluate the antidotal activity of Neeli Moola (Indigofera tinctoria) Kalka w.s.r to haematological parameters in Vatsanabha (Aconitum ferox ) induced toxicity

Background: Vatsanabha is a potent cardiac poison comes under the category of Mahavisha with its main active principles aconitine, picraconine and pseudaconine. In the literatures there are descriptions about toxicants and in some traditional Malayalam textbooks antidotes has been explained under the concept “Prathyoushadha”. Neeli Moola has been mentioned as a Prathyoushadha for Vatsanabha poisoning in a renowned textbook ‘Visha Vaidya Jyotsnika’. Hence to evaluate the antidotal activity in Vatsanabha poisoning, Neeli Moola Kalka has been used and the haematological parameters were analyzed to screen the results. Methods: Wistar strain albino rats were used in this study which were divided into 3 groups, normal control, toxic control and the test drug group. The duration of the study was 28 days .The data generated was mentioned as Mean±SEM. Difference among the groups was assessed by employing one way ANOVA followed by Dunnet’s multiple ‘t’ test. Results: Reversible action has been observed after the administration of Neeli Moola Kalka in the hematological parameters which has shown toxicity changes due to administration of Vatsanabha. Conclusion: Neeli Moola Kalka is having mild to moderate antidote effect in Vatsanbha induced toxicity

Antenatal Bartter Syndrome: A Review

Antenatal Bartter syndrome (ABS) is a rare autosomal recessive renal tubular disorder. The defective chloride transport in the loop of Henle leads to fetal polyuria resulting in severe hydramnios and premature delivery. Early onset, unexplained maternal polyhydramnios often challenges the treating obstetrician. Increasing polyhydramnios without apparent fetal or placental abnormalities should lead to the suspicion of this entity. Biochemical analysis of amniotic fluid is suggested as elevated chloride level is usually diagnostic. Awareness, early recognition, maternal treatment with indomethacin, and amniocentesis allow the pregnancy to continue. Affected neonates are usually born premature, have postnatal polyuria, vomiting, failure to thrive, hypercalciuria, and subsequently nephrocalcinosis. Hypokalemia, metabolic alkalosis, secondary hyperaldosteronism and hyperreninaemia are other characteristic features. Volume depletion due to excessive salt and water loss on long term stimulates renin-angiotensin-aldosterone system resulting in juxtaglomerular hyperplasia. Clinical features and electrolyte abnormalities may also depend on the subtype of the syndrome. Prenatal diagnosis and timely indomethacin administration prevent electrolyte imbalance, restitute normal growth, and improve activity. In this paper, authors present classification, pathophysiology, clinical manifestations, laboratory findings, complications, and prognosis of ABS