IMPROVING HEMODIALYSIS TREATMENT: MODELING, EXPERIMENTAL DESIGN, AND CLINICAL STUDIES

Ph.DDOCTOR OF PHILOSOPH

Effect of cool vs. warm dialysate on toxin removal: rationale and study design

10.1186/s12882-015-0017-5BMC Nephrology16

A newly developed assessment tool on collaborative role of doctor–pharmacist in patient medication management

Background Poor communication is one of the most important common factor contributing to medication errors. Despite their common history, there are many intellectual and practical differences between the professions of medicine and pharmacy that eventually affects patient care and health outcomes. Objectives. The main objective of the study is to evaluate the coordination and teamwork between pharmacist and doctor to provide betterment in the care of the patient health. Material and methods . A questionnaire of 10 questions was developed each for the patient, pharmacist and doctor posted on District Hospital, Moradabad (U.P.), India and data collected from the patient and medical professionals through questionnaire were analyzed for collaborative role of doctor-pharmacist with respect to patient care. The results were analyzed using Graph Pad Prism 5. Results. The data obtained from the questionnaire highlights a significant effort between pharmacist and doctors. However, some patients often doubt in the skills of pharmacist for treatment outcome, but the majority of people responds positive to doctor-pharmacist role as they prove to be fruitful in removing medication errors. Conclusions . To facilitate the patient care, doctor-pharmacist alliance is necessary, desired and should be motivated as professed by the respondents. Collaboration is an important element of effective patient-focused health care delivery

Nuclear localization and target genes analysis of an ABA and drought-responsive transcription factor (RDA1) in rice

364-374Apetala2/Ethylene Responsive Fector (AP2/ERF) family transcription factors (TFs) play an important role in controlling cellular processes and regulating important functions of plant growth and development as well as responses to environmental stimuli. AP2/ERF transcription factor responsive to drought and ABA (RDA1) from rice genotype N22 was chosen for this study. Transient expression revealed that RDA1 was localized in the nucleus. Quantitative expression studies of RDA1 under three different treatments namely drought, ABA and drought + ABA at three different stress levels showed maximum expression (3.92 fold) under drought +ABA treatment. Further, higher expression was found in N22 (drought tolerant) compared to IR 64 (susceptible) at different stress levels. Temporal expression revealed higher relative expression in leaf tissue compared to root tissue in both cultivars. RDA1 acts as a cytokinin primary response gene as per in silico characterization and many of its target genes are involved in transcriptional, post-transcriptional and translational regulation of protein biosynthesis. Relative co-expression studies for target genes revealed positive co-expression of GAMYB-binding protein, leucyl tRNA synthetase and negative co-expression of ribosomal protein L7, crooked neck (CRN) protein and XPAbinding protein with RDA1. Differential co-expression of WD40 and DUF382 domain protein was observed in root and leaf tissue with RDA1

Impact of fluid status and inflammation and their interaction on survival: a study in an international hemodialysis patient cohort

In hemodialysis patients extracellular fluid overload is a predictor of all-cause and cardiovascular mortality, and a relation with inflammation has been reported in previous studies. The magnitude and nature of this interaction and the effects of moderate fluid overload and extracellular fluid depletion on survival are still unclear. We present the results of an international cohort study in 8883 hemodialysis patients from the European MONDO initiative database where, during a three-month baseline period, fluid status was assessed using bioimpedance and inflammation by C-reactive protein. All-cause mortality was recorded during 12 months of follow up. In a second analysis a three-month baseline period was added to the first baseline period, and changes in fluid and inflammation status were related to all-cause mortality during six-month follow up. Both pre-dialysis estimated fluid overload and fluid depletion were associated with an increased mortality, already apparent at moderate levels of estimated pre dialysis fluid overload (1.1-2.5L); hazard ratio 1.64 (95% confidence interval 1.35-1.98). In contrast, post-dialysis estimated fluid depletion was associated with a survival benefit (0.74 [0.62-0.90]). The concurrent presence of fluid overload and inflammation was associated with the highest risk of death. Thus, while pre-dialysis fluid overload was associated with inflammation, even in the absence of inflammation, fluid overload remained a significant risk factor for short-term mortality, even following improvement of fluid status.</p