Silent brain infarcts in chronic kidney disease patients with nonspecific neurological symptoms

Introduction: Silent brain infarcts (SBI) are parenchymal lesions of previous infarcts, classified as type III cerebrovascular disorder. A study was undertaken to find the relation between SBIs and nonspecific neurological complaints, an association of high sensitivity C-reactive protein (hsCRP) with silent brain infarcts. Methodology: It was a cross-sectional study conducted in the department of Nephrology, GSL Medical College, from January to December 2020. Individuals aged > 18 years with nonspecific neurological complaints were included. MRI brain, hsCRP and electrocardiogram were also carried as per the standard protocol. Fischer exact test was used to find the statistical significance; P < 0.05 was considered statistically significant. Results: A total of 51 members have included the male-female ratio was 1.04. SBI was presented in 27.4% (14). Age-wise, among the cortical SBI patients, maximum (75%) were in the> 61 years group. High density lipoprotein levels were > 40 mg/dL in 39.2%, normal triglycerides (TGL) were observed in 71% and raised hsCRP in 62.7% (32). Statistically, there was no significant difference in TGL levels. hsCRP levels were raised in 3 (75%) members with cortical SBI; statistically, there was no significant difference. Conclusion: The traditional risk factors associated with stroke were present in the patients with SBI. hsCRP was raised in chronic kidney disease patients having NSCL and having SBI

A study on dietary recall among the maintenance haemodialysis patients in East Godavari district.

Introduction: Individuals with end-stage renal diseases are usually at an increased risk of nutritional disorders. Protein-energy malnutrition is observed in a significant number of maintenance haemodialysis (MHD) patients. Hence a study was conducted to find whether dietary intake meets recommended dietary allowance (RDA) among MHD individuals. Materials and methods: This was cross-sectional research conducted in the department of Nephrology, GSL Medical College, for 18 months. Individuals are aged 18 years or more, metabolically stable and undergoing MHD were included. Software called Dietsoft was used to know the dietary calculations. Parameters including energy, carbohydrates, proteins, fats, vitamins, minerals and essential amino acids (EAA) were evaluated. Mann Whitney U test was used to find the significant difference, and P < 0.05 was considered statistically significant. Results: Of the 31 patients, 18 were male, and 13 were female. The calorie intake was as recommended, but statistically, there was no significant difference. But the intake of the macronutrients and dietary fibre was higher than the recommended, which was statistically significant. In females, there was a considerable difference. The difference was statistically not significant in minerals intake. Conclusion: There was considerable malnutrition among the patients undergoing MHD. Hence regular dietary assessment is required

Evaluation of the efficacy of tamsulosin with or without deflazacort for stone clearance after extracorporeal shockwave lithotripsy for upper ureteral and renal calculi

Background: Medical expulsive therapy in the form of alpha blockers, corticosteroids, calcium channel blockers is being used with success for medical treatment of lower ureteric calculus. Adjunctive use of these therapeutic agents in post extracorporeal shockwave lithotripsy period is also being tried.With this background, we evaluated the efficacy of tamsulosin with or without deflazacort for various outcome factors after ESWL of upper ureteral and renal calculi.Methods: A Prospecive study during period from February 2014 to April 2015 including a total of 90 patients with solitary upper ureteral or renal calculus who underwent ESWL was conducted. Patients were divided into three groups. Group A(30 patients) were given standard therapy (analgesics and antibiotics for 5 days), Group B (30 patients) were given standard plus tamsulosin (0.4 mg once daily) for 4 weeks and Group C (30 patients) were given standard therapy plus tamsulosin (0.4 mg once daily) and deflazacort (6 mg twice daily) for 4 weeks . Patients were evaluated at 2 and 4 weeks post ESWL with X ray KUB and USG.Results: At the end of 4 weeks, 10, 17, and 26 patients in group A, B and C respectively cleared their stones. Out of these 2, 6 and 19 patients in group A, B and C respectively cleared their stones in first 2 weeks. Clearance in group C was significantly higher as compared to group A and B.Conclusions: Addition of alpha-blocker tamsulosin along with deflazacort post ESWL for renal and upper ureteric calculi increases the stone expulsion rate and reduces the expulsion duration as shown by highly statistically significant results in group C.

Pre-Interventional Cardiac and ECG Changes in Acute Organophosphate Poisoning Cases Admitted to a Tertiary Hospital in India

Background: Cardiac complications are the less common fatal effect of acute organophosphate poisoning. This study was undertaken to analyze the pre-interventional cardiac and Electrocardiographic (ECG) changes in acute organophosphate poisoning cases.Materials and Methods: Clinical records of acute organophosphate poisoning patients of age less than 50 years admitted to KLE’s Dr. Prabhakar Kore Hospital, Belgaum, Karnataka, from 01-01-2010 to 31-12-2010 were analyzed. Cases of organophosphate poisonings referred from other hospitals, poisoning with multiple agents, patients with history of previous cardiac diseases and coexisting medical conditions were excluded from the study. Poisoning Severity Score was calculated as per International Programme on Chemical Safety and patients were grouped into 3 grades.Results: In this study, 50 cases of acute organophosphate poisoning (male - 32; female - 18) were analyzed. Sinus tachycardia was present in 45 patients (90%), hypertension in 13 (26%) and hypotension in 12 (24%). Prolonged corrected QT interval was observed in 14 patients (28%), elevated ST segment in 2 (4%), inverted T wave in 13 (26%) and conduction defects in 1 (2%). Among 14 patients with prolonged corrected QT interval, 12 were in grade III and 2 in grade II severity; and, among 13 patients who had inverted T wave, 2 were in grade I, 4 in grade II and 7 in grade III severity. Acidosis, as assessed by blood pH and HCO3, was observed in 22 patients (44%).Conclusion: Fatal cardiac complications do occur in acute organophosphate poisoning, which are overlooked at times as the most common complications expected are respiratory complications. Higher incidence of ECG changes in Grade III cases suggests that if the cardiac complications develop, the patient should be immediately transferred to an intensive cardiac care unit

Fluorescent Asymmetrically Cobalt-Tipped CdSe@CdS Core@Shell Nanorod Heterostructures Exhibiting Room-Temperature Ferromagnetic Behavior

A colloidal two-step seeded-growth approach has been devised to selectively synthesize three-component magnetic/semiconductor hybrid nanocrystals (HNCs) with a matchstick-like profile and tunable geometric parameters. The newly developed heterostructures individually comprise a single metallic Co head connected to either apexes of one rod-shaped section made of a CdSe core eccentrically embedded in a CdS shell. The specific topological arrangement realized arises from the peculiar anisotropic reactivity of the noncentrosymmetric CdSe@CdS core@shell nanorods that have been used as substrates to seed heterogeneous nucleation of Co in a surfactant-free environment from an organometallic precursor. The HNCs retain appreciable fluorescent emission in spite of photoexcited charge transfer from the semiconductor to the metal domain and exhibit unusual ferromagnetic-like behavior at room temperature

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Nephrogenic ascites: prevalence and effect of daily nocturnal high flux hemodialysis

Background: Nephrogenic ascites (NA) is the end stage renal disease. A study was conducted to find the prevalence of NA in chronic kidney disease (CKD) maintenance hemodialysis (MHD) patients and also to find the effect of daily nocturnal high flux hemodialysis (NHFH) as treatment modality in these study members. Methods: It was a prospective observational study, conducted in the department of nephrology, GSL Medical College. Individuals aged >18years, on CKD V on MHD, diagnosed with NA and treated with daily NHFH for one month were included. Various factors such as variation in body weight, heart rate, blood pressure (BP), abdominal girth, serum parameters such as albumin, calcium, phosphorous, PTH, Hb%, Kt/v, portal vein diameter, ejection fraction, left ventricular mass index (LVMI), AV access failure before and after initiation of nocturnal hemodialysis (NH) were analysed. Student’s t-test was used to find the mean difference. Results: Total 12 (100%) participants were included male female ratio was 3. Statistically there was significant difference in mean systolic and diastolic BP, serum calcium, Phosphrous and PTH before and after NHD. But there was no significant difference in serum albumin levels. Conclusion: Decrease in NA with daily NH using high flux dialyzer. In addition, improvement in clinical parameters such as reduction of BP, HR, body weight, improvement in various serum parameters and decrease in LV mass index, improvement in LVEF. However, studies with large sample size is strongly recommended