Higher Blood Urea Levels Research Articles

Brazilian Corn Ethanol Coproducts for Pigs: Feeding Value and Blood Parameters.

This study aimed to determine the values of net energy (NE), digestible energy (DE) and metabolizable energy (ME) and digestibility coefficients of corn ethanol coproducts produced in Brazil and their effects on the nitrogen balance and blood parameters of pigs. Ten barrows were housed in metabolic study cages for total collection and fed a reference diet (RD) or 800 g/kg RD + 200 g/kg of a coproduct of corn ethanol. Distiller's dried grains with solubles (DDGS), corn bran with solubles (CBS), distiller's dried grains (DDG) and high-protein distiller's dried grain (HPDDG) were evaluated. The experimental design was randomized blocks with three repetitions per period, totaling six repetitions per diet. Diets containing the HPDDG had greater DE and ME than those containing CBS and DDGS and greater DE than those containing the DDG (p < 0.05). HPDDG, DDG, CBS and DDGS showed 4498, 3419, 3029 and 3335 kcal/kg DE; 4366, 3305, 2934 and 3214 kcal/kg ME; and 2515, 1938, 1649 and 1725 kcal/kg NE, respectively. Pigs fed diets containing HPDDG and CBS showed greater nitrogen retention efficiency than pigs fed DDGS (p < 0.05). Pigs fed diets containing HPDDG had higher blood urea levels than pigs fed CBS and RD, while triglyceride levels in animals that received the CBS diet were greater than those in animals that received all other diets. The HPDDG had the highest energy levels and the best digestibility coefficients. The chemical composition of coproducts influences the nitrogen balance and circulating levels of urea and triglycerides in pigs.

Predicting the onset of metabolic syndrome in a cohort study using a logistic regression model

Introduction: Metabolic syndrome (MetS) is a complex condition manifested as a group of metabolic disorders and is associated with the prevalence of certain diseases. Early prediction of MetS risk in the middle-aged population can be effective in controlling and preventing cardiovascular diseases. This study aimed to use logistic regression to predict metabolic syndrome and identify risk factors related to this condition. Method: This cohort study investigated factors associated with metabolic syndrome in the Mashhad study, which included a total of 11,570 participants. Factors that increase the relative risk of metabolic syndrome were evaluated using logistic regression, and predictive modeling was performed using logistic regression. Results: The results of the analysis using the logistic regression model showed that some factors, such as body mass index, history of high blood lipids, history of high blood pressure, and diabetes, increased the risk of metabolic syndrome. Various indicators, such as inactivity, high blood urea level, red blood cell hemoglobin content, aging, female gender, high levels of liver gamma-glutamyl transferase, and blood uric acid increase the risk of developing metabolic syndrome. Conclusion: It seems that body mass index, history of diabetes, and heart disease are related to the relative risk of developing the MetS syndrome compared to the other indicators, such as history of blood lipids, sedentary blood pressure, blood urea, uric acid, and hemoglobin content of red blood cells. These findings were obtained using the logistic regression model.

Early acute kidney injury in sepsis and septic shock

ABSTRACT Background: Acute kidney injury is one of the severe conditions in hospitalized patients. Acute kidney injury can develop early from admission, usually within the first 24 hours of ICU admission. In Vietnam, there have been limited studies monitoring the progression of acute kidney injury in the early stages. This study aims to investigate the incidence, severity, clinical, laboratory characteristics, and progression of acute kidney injury in patients with sepsis and septic shock within the first 48 hours. Methods: This study is a cross-sectional descriptive analysis of 101 patients who are 15 or older and have been diagnosed with severe infection and septic shock. These patients were treated in the Intensive Care Unit of Hue Central Hospital. The patient had treatment in accordance with a standardized protocol while being closely observed. Samples were collected for diagnostic testing, and the patient’s urine output and blood creatinine levels were diligently checked. Results: The prevalence of acute renal injury (AKI) was 60.40%, with stage 1 accounting for 50.82% of cases, stage 2 accounting for 22.95%, and stage 3 accounting for 26.23%. The cohort of individuals diagnosed with AKI exhibited an advanced age, with a mean age of 60.72 ± 17.41 years, and predominantly consisted of male subjects. Patients diagnosed with acute kidney injury showed a statistically significant decrease in urine output and an increased incidence of shock (p &lt; 0.05). Additionally, these patients demonstrated lower levels of Hct, blood pH, and bicarbonate while exhibiting higher levels of blood urea, blood creatinine, AST, ALT, total bilirubin, PCT, and blood lactate (p &lt; 0.05) compared to individuals without AKI. Patients with AKI had significantly elevated SOFA and APACHE II scores compared to individuals without AKI, as indicated by statistical analysis (p &lt; 0.05). Upon admission, a significant proportion of patients, precisely 81.97%, experienced the development of AKI. Furthermore, a observation was made about the prompt recovery of these patients within the initial 24 and 48 hours following admission. Conclusion: The prevalence of AKI was accounted for 60.40%. Among the cases of AKI, stage 1 accounted for 50.82%, while stage 2 and stage 3 accounted for 22.95% and 26.23%, respectively. There were observed variations in urine output and rates of shock among individuals diagnosed with AKI. Additionally, SOFA and APACHE II scores were elevated. The percentage of AKI was 81.97% of patients upon their initial hospital admission, with a significant proportion seeing early recovery within the first 24 to 48 hours.

Association of eGFR with stages of diabetic retinopathy and age-related macular degeneration in Indian population.

To investigate the influence of glomerular filtration rate in renal disease decline and its association with diabetic retinopathy (DR) and age-related macular degeneration (ARMD) in patients in South India. A population-based cross-sectional study was conducted including participants with DR and ARMD recruited from urban and rural populations. The data collection included medical history, anthropometric measurements, and ophthalmic work-up. The estimated glomerular filtration rate (eGFR) was calculated using the equation of chronic kidney disease-epidemiology collaboration (CKD-EPI). The grading of AMD was done by a single experienced (more than 5 years) vitreoretinal surgeon as per the International ARM Epidemiological Study Group and it was staged based on grading in the worsened eye. A decline in eGFR was observed as the severity of DR increased ( P < 0.001). Baseline characteristics such as age ( P < 0.001), duration of diabetes ( P < 0.001), gender ( P < 0.001), creatinine ( P < 0.001), albumin to creatinine ratio (ACR; P < 0.001), albuminuria ( P = 0.023), blood urea ( P < 0.001), and high-density lipoprotein (HDL; P = 0.003) were found to be statistically significant. The risk for developing DR with CKD was found to be 5 times higher in male patients compared to female patients. Age and high blood urea level, diastolic blood pressure, mild and moderate DR were the risk factors associated with CKD. A decline in eGFR was observed as the severity of ARMD increased ( P < 0.001). The risk factors associated with CKD were age, gender, smoking, alcohol consumed, presence of hypertension, duration of diabetes, systolic and diastolic blood pressure, history of diabetes, body mass index (BMI), serum triglycerides, and serum HDL cholesterol. Reduced eGFR values were associated with an increase in the severity of DR and ARMD.

Expanding Role for Vitamin D3 in Diabetic Mellitus and Chronic Kidney Disease

In between 30% and 50% of people, lack of vitamin D and insufficiency are reputed to be serious health concerns. Diabetes mellitus (DM) and chronic renal disease are both connected with insufficient amounts of vitamin D (CKD). Diabetes' onset and development have both been connected to vitamin D deficiency. But even if there is a connection the relationship between impaired beta cells, insulin resistance, and synthesis of these hormones in patients with diabetes. In modern study, in female the level of Vit D is decreased compared with male, as well as he values of HbA1c were significantly higher in cases than in controls (p&lt; 0. 01). A lack of vitamin D has been associated with the development of DM. Although there is growing evidence that a vitamin D deficiency the likelihood of getting chronic kidney disease (CKD) and diabetic mellitus (DM) both rises), the relationship between vitamin D, creatinine, and blood urea has been established. As a result, patients with D3 deficiency have higher blood urea levels than controls, which is a significant difference. The level of Creatinine was the highest in the D3 delicacy patients (1.689±0.142) and showed a significant difference when it compared with controls (1.000±0.040) in different significant (P≤0.01). this study observed that serum creatinine increased in individuals who lack vitamin D and have chronic renal dysfunction and it's widely interpreted as a measure only of renal function.

The severity of acute kidney injury correlates with plasma venom levels in Bothrops atrox envenomings

The Brazilian Amazon has high rates of snakebite envenomings (SBEs), with ∼90% caused by Bothrops atrox. Envenomings by this species can trigger local and systemic effects, such as acute kidney injury (AKI). Our aim was to identify predictors of AKI in Bothrops SBEs in patients from Manaus, Western Brazilian Amazon. A total of 127 patients were enrolled, with a predominance of men between 16 and 45 years old from rural areas. Of the 127 patients, 38.6% developed AKI, with 61.2% presenting stage I, 34.7% presenting stage II and 4.1% presenting stage III severity. The age groups 0–10 years and ≥60 years presented a significantly higher frequency of AKI compared to the 11–40 years group. Moderate/severe edema in the affeccted limb was significantly associated with lower risk of AKI [p = 0.01; OR = 0.11 (95%CI 0.02–0.53)]. Nausea [p = 0.01; OR = 54.44 (95%CI = 3.26–909.27)] and high blood urea levels [p = 0.01; OR = 5.38 (95%CI = 2.12–13.66)] were risk factors for AKI. There was a significant positive correlation between circulating venom levels and the highest creatinine serum values during the hospital stay (p = 0.03) and with the difference between the maximum creatinine levels and the creatinine levels on admission (p = 0.02). A positive correlation between serum venom concentrations and creatinine levels suggests a direct or indirect dose-dependent participation of the venom toxins in the pathogenesis of AKI.

The Challenges in Treating Uremic Stomatitis Patient with Chronic Renal Failure Disease

Background: Uremic stomatitis is a rare oral manifestation of chronic and acute kidney disease. The incidence of uremic stomatitis is low, especially because process disease develops gradually over years and occurs in advanced renal failure. This disease is associated with high levels of blood urea. There are four forms of uremic stomatitis that have been identified, namely ulcerative, erythemopultaceous, hyperkeratotic and hemorrhagic. Usually the lesions were seen on buccal mucosa, dorsal or ventral surface of tongue, gingiva, lips and floor of mouth. Purpose: To discuss the challenges in treating uremic stomatitis patient with poor systemic condition. Case: A 73 year old male patient was referred from cardiology department to oral medicine department because there were painful lesions on lips, tongue, palate and buccal mucosa. He was a chronic kidney disease patient whose laboratory results showed high urea and creatinine values. Case management: The Patient was given oral hygiene instruction to clean his teeth and tongue with a gauze soaked in NaCl at least three times a day, compressing the lips and rinse with chlorine dioxide based mouthwash (Oxyfresh®, USA) three times a day. The improvement of oral lesions were not significant because the blood urea and creatinine value were still high. Conclusion: Management of uremic stomatitis needs multidisciplinary teamwork in order to achieve the kidney function and other comorbidities improvement as well as oral lesions to improve the quality of life.

Associations Between Kidney Dysfunction and Risk Factors in Patients with Transurethral Resection of the Prostate.

PurposeBenign prostate hyperplasia (BPH) with urinary retention can result in kidney dysfunction. Several risk factors might influence deterioration in kidney function. The aims of this study were to assess the association between kidney dysfunction and risk factors in patients with transurethral resection of the prostate (TURP).MethodsWe reviewed medical records of BPH patients managed by TURP and having high levels of blood urea and creatinine. Data collected were age, history of hypertension, diabetes mellitus (DM), urinary tract infection (UTI), urinary retention, and urinary tract stones, duration of obstruction, and blood-urea and -creatinine levels before and after TURP. Chi-suare and paired t- tests were used.ResultsThere were 64 patients in the study. More were aged 60–69 years (42.2%) than other age-groups, 53.1% had a history of hypertension, 12.5% DM, 35.9% UTI, all urinary retention, 14.1% urinary tract stones, and 92.2% obstruction duration <14 days. There were significant differences in blood-urea and -creatinine levels between before and after TURP (p<0.001). There were no significant differences between age-group, hypertension, DM, UTI, urinary retention, urinary stones, or duration of obstruction with kidney dysfunction after TURP (p>0.001).ConclusionAge, hypertension, DM, UTI, urinary retention, urinary tract stones, and duration of obstruction can be risk factors of kidney dysfunction in TURP patients, and TURP might improve blood-urea and -creatinine levels. There was no significant association between kidney recovery and kidney dysfunction with the number of risk factors in TURP and pre-TURP patients.

Prognostic Factors and Predictors of In-Hospital Mortality Among COVID-19 Patients Admitted to the Intensive Care Unit: An Aid for Triage, Counseling, and Resource Allocation.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains today a global health pandemic. Those with severe infection are at risk of rapid clinical deterioration; as a result, intensive care unit (ICU) admission is not uncommon in such patients. A number of determinants have been identified as predictors of poor prognosis and in-hospital mortality, ranging from demographic characteristics, laboratory and/or radiological findings.Aim: To identify determinants of in-hospital mortality and examine the accuracy of seven early warning scores in predicting in-hospital mortality.Methods: This is a retrospective study conducted in Kuwait from July 2020 to March 2021, and participants were adult patients with a positive test on the real-time polymerase chain reaction (RT-PCR) for SARS-CoV-2 and who met the criteria for ICU admission. Data collected included: demographics, clinical status on hospital arrival, laboratory test results, and ICU course. Furthermore, we calculated seven early warning scores for each of our patients.Results: A total of 133 patients were admitted to our COVID-19 ICU with a median age of 59 years. Arrival to ICU on mechanical ventilation (MV), developing in-hospital complications, having chronic kidney disease (CKD), having a high white blood count (WBC), lactate dehydrogenase (LDH), lactate, or urea levels were found to be significant predictors of in-hospital mortality. Furthermore, the 4C mortality score for COVID-19, VACO index for COVID-19 mortality, and the PRIEST COVID-19 clinical severity score proved to be the most superior in predicting in-hospital mortality.Conclusion: Identifying high-risk patients and those with a poor prognosis allows for efficient triaging and the delivery of high-standard care while minimizing the strain on the healthcare system.

Epidemiological, Clinical, and Laboratory Predictors of In-Hospital Mortality Among COVID-19 Patients Admitted in a Tertiary COVID Dedicated Hospital, Northern India: A Retrospective Observational Study.

IntroductionCOVID-19 pandemic still poses a serious challenge to health system worldwide. This study was planned to determine exposure characteristics, in-hospital mortality, and predictors of in hospital mortality among COVID-19 patients.Material and methodsWe retrospectively investigated epidemiological, clinical, and laboratory profile of confirmed COVID-19 patients admitted from 25th March to 31st August 2020. COVID-19 patient profiles were collected from Medical Record Section of the hospital.ResultsIn hospital mortality occurred in 159 (11%) cases. Increasing respiratory rate, higher temperature, higher total leukocyte count, and high blood urea levels were found to be independent risk factors for in hospital mortality whereas higher hemoglobin and higher oxygen saturation at the time of hospital admission were found to be protective against in hospital mortality.ConclusionIn hospital mortality among COVID-19 patients is almost 1 in 10 in tertiary care hospital. Patients with advancing age (AOR: 1.048; 95% CI: 1.021-1.076), higher respiratory rate (AOR: 1.248; 95% CI: 1.047-1.489), higher temperature (AOR: 1.758; 95% CI: 1.025-3.016), higher leukocyte count (AOR: 1.147; 95% CI: 1.035-1.270), and higher urea levels (AOR: 1.034; 95% CI: 1.005-1.064) at the time of admission are important predictors of COVID-19 in-hospital mortality.

Gender Difference in Perceived Symptoms and Laboratory Investigations in Suspected and Confirmed COVID-19 Cases: A Retrospective Study.

Background:Evaluating gender-specific effects of COVID-19 is important to develop effective therapeutic strategies. The aim of this study was to explore gender difference in perceived symptoms and laboratory investigations in suspected and confirmed cases.Methods:This is a retrospective study that included data from suspected COVID-19 patients during the first wave of the pandemic. Participants using the phone triaging system at Kasralainy outpatient clinics were included. The analyzed data included patient history and results of nasopharyngeal swab and laboratory data.Results:Out of 440 COVID-19 suspected cases, 56.36% were females. The perceived COVID-19 symptoms showed no significant gender difference in suspected cases while in confirmed cases females were 4 times more likely to complain of cough [OR (95% CI) 3.92 (1.316–11.68), P-value .014] and 5 times more likely to experience loss of smell or taste [OR (95% CI) 4.84 (1.62–14.43), P-value .005]. Laboratory markers revealed high levels of aspartate aminotransferase, alanine aminotransferase, blood urea, serum creatinine, creatine kinase, and serum ferritin in males and this was statistically significant (P-value <.001) in suspected and confirmed cases. Females confirmed with COVID-19 were 80%, 97%, and 97% less likely to have high levels of ALT, creatin kinase, and serum ferritin [OR (95% CI) 0.20 (0.07–0.54), 0.07 (0.01–0.38), and 0.07 (0.01–0.90), P-value .002, .002, and .041, respectively].Conclusion:Gender differences were found in laboratory markers in COVID-19 suspected and confirmed cases and in perceived symptoms in confirmed cases.

Biochemical profile and prognosis of patients with heart failure and diabetes

Aim. To study clinical and hemodynamic and laboratory parameters for the 2-year prognosis of patients with chronic heart failure (CHF) and type 2 diabetes mellitus (DM). Material and methods. The study included 90 patients (61,4±8,6 years old) with NYHA class II-IV CHF related to coronary artery disease and hypertension. All patients underwent clinical examination, resting 12-lead electrocardiography, transthoracic echocardiography, and blood chemistry testing. Two-year follow-up was conducted to determine the prognosis of patients with CHF and DM. Results. CHF duration in patients with DM was 17% more, despite a comparable average age of patients. Echocardiography showed significant left ventricular dilatation and, as a result, systolic dysfunction in patients of the I group (with DM). Hypoalbuminemia was detected in both groups, but it was more pronounced in patients with CHF and DM. With comparable average creatinine concentrations, patients with CHF and DM had higher blood urea levels (13,2±2,1 µmol/L and 9,4±2,6 µmol/L, respectively). Patients of group I had significantly lower glomerular filtration rate (GFR) compared to the comparison group (by 13%). In group I, there were 42 rehospitalizations during the follow-up period, while in the comparison group — 29. Acute cerebrovascular accident was recorded in 7% and 4% of cases, respectively. Myocardial infarction (MI), including recurrent MI, was registered 50% more often in patients with DM. The mortality rate in patients of the group I was 3,5 times higher than in the comparison group. Conclusion. Features of the course of CHF depending on the presence of concomitant type 2 DM were revealed. These include the relatively early manifestation of CHF symptoms, the prevalence of patients with moderate to severe CHF and severe left ventricular systolic dysfunction. The results of a biochemical study of the blood of group I patients were characterized by hypoalbuminemia, hypertriglyceridemia, and a significant decrease in GFR. It is noted that the presence of concomitant DM aggravates the course of CHF of ischemic and nonischemic genesis, which is manifested by an increase in the frequency of repeated hospitalizations and deaths during 2-year follow-up. 87

The role of phenotypic and genetic basis of livestock selection for climate change adaptation and mitigation: A review

Livestock are not only suffering from climate change, but also contribute to climate change through the direct and indirect release of greenhouse gases (CH4, N2O and CO2). Characterization, identification and conservation of heat tolerant livestock breeds are basics for future challenging climate. Properties of the skin, hair, coat color, coat type, sweating, respiration capacity, tissue insulation, surface area relative to body weight, endocrinological profiles and metabolic heat production are important factors involved for heat tolerance. Selection based on these phenotypic characteristics is play indispensible for climate change adaptation and mitigation. Molecular information is used to know the candidate gene for heat tolerance, their action, specific function and location on chromosomes thereby important for modification of gene and selection of heat tolerant breed and feed efficient animals. Genomic information also used to identify genes that regulated during a stressful event can lead to the identification of animals that are genetically superior for coping with stress. Marker assisted selection and proteomics may also be valuable in selection for secondary traits linked to adaptation, such as the genes for high levels of blood urea and ruminal ammonia in certain genotypes, associated with adaptation to low-quality C4 grasses. Scientific research results demonstrated that heat tolerance is heritable trait and variable between/within livestock breeds, thereby variation and heritability of the trait opens the window for selection of heat tolerant animals. Therefore, the combined genomic selection using genome wide DNA markers that predict tolerance to heat stress and phenotypic selection could be accelerated breeding of highly productive and heat tolerant livestock breeds. Further research should be conducted on characterization, identification of indigenous breeds at molecular level and on identification of responsible genes/genomic regions associated with thermoregulation, feed and production efficiency in order to develop suitable adaptive and mitigation strategies to counter environmental stresses.

Could ornithine supplementation be beneficial to prevent the formation of pro-atherogenic carbamylated low-density lipoprotein (c-LDL) particles?

Carbamylation (or carbamoylation) is a non-enzymatic post-translational modification process of lysine residues and protein N-termini, which occurs throughout the lifespan of both various plasma proteins and low-density lipoprotein (LDL) particles. Carbamylation results from the binding of isocyanates spontaneously derived from high levels of blood urea, environmental pollutants, nutritional sources and leads to the formation of potentially atherogenic carbamylated-LDL (c-LDL) particles. The carbamylation of LDL apolipoproteins is associated unfavorable downstream effects.Ornithine is a non-proteinogenic amino acid, which plays a central role at the urea cycle function. The primary use of ornithine in supplements is to support athletic performance, liver function and wound recovery. Ornithine is structurally highly similar to lysine, and is only one carbon atom shorter in its side-chain. Therefore, we hypothesize that supplemented ornithine could compete with ε-amino groups of lysine residues found in apolipoproteins of native LDL particles in their binding to isocyanates and decrease c-LDL formation. This issue still remains unresolved in current literature and needs to be elucidated in experimental studies.

Nonresponsiveness, Resistance to the Treatment, Drug Switch and Combined Treatments in Macular Edema Secondary to Central Retinal Vein Occlusion

Retinal vein occlusion (RVO) is the second most common retinal vascular disease following diabetic retinopathy. Visual loss in central retinal vein occlusion (CRVO) may occur due to retinal ischemia, macular ischemia, macular edema, or neovascular complications. In CRVO, macular edema can develop due to increased vascular permeability due to inflammation and elevated VEGF levels, and breakdown of the blood-retina barrier. In cases with CRVO, resistance, and/or nonresponsiveness to the treatment develops in about one of three of the cases. The presence of the relative afferent pupillary defect, vitreoretinal traction, poor macular and peripheral retinal perfusion, high blood urea and creatinine levels, ineffectiveness to other cytokines and factors, delay in the initiation of the treatment, VEGF receptor up-regulation, advanced age are risk factors for non-responsiveness. Positive results on visual acuity, central macular thickness, and the number of injections can be obtained by replacing one Anti-VEGF agent with another and/or by combined treatments with steroids in the treatment of the resistant/non-responsive cases.

Bowman's capsule provides a protective niche for podocytes from cytotoxic CD8+ T cells.

T cells play a key role in immune-mediated glomerulonephritis, but how cytotoxic T cells interact with podocytes remains unclear. To address this, we injected EGFP-specific CD8+ T cells from just EGFP death inducing (Jedi) mice into transgenic mice with podocyte-specific expression of EGFP. In healthy mice, Jedi T cells could not access EGFP+ podocytes. Conversely, when we induced nephrotoxic serum nephritis (NTSN) and injected Jedi T cells, EGFP+ podocyte transgenic mice showed enhanced proteinuria and higher blood urea levels. Morphometric analysis showed greater loss of EGFP+ podocytes, which was associated with severe crescentic and necrotizing glomerulonephritis. Notably, only glomeruli with disrupted Bowman's capsule displayed massive CD8+ T cell infiltrates that were in direct contact with EGFP+ podocytes, causing their apoptosis. Thus, under control conditions with intact Bowman's capsule, podocytes are not accessible to CD8+ T cells. However, breaches in Bowman's capsule, as also noted in human crescentic glomerulonephritis, allow access of CD8+ T cells to the glomerular tuft and podocytes, resulting in their destruction. Through these mechanisms, a potentially reversible glomerulonephritis undergoes an augmentation process to a rapidly progressive glomerulonephritis, leading to end-stage kidney disease. Translating these mechanistic insights to human crescentic nephritis should direct future therapeutic interventions at blocking CD8+ T cells, especially in progressive stages of rapidly progressive glomerulonephritis.

Pomegranate juice protects kidneys from Cisplatin-induced nephrotoxicity

Background: Cisplatin is a potent anti-cancer agent used successfully in treatment of cancers of solid organs, but it has a high rate of nephrotoxicity.Objective: The present study was designed to study Cisplatin-induced nephrotoxicity and the nephroprotective property of pomegranate juice.Materials and Methods: The experiment was performed on 36 Iraqi white male domestic rabbits. Rabbits were divided into three groups; control group (received neither pomegranate juice, no Cisplatin), Cisplatin group (received Cisplatin only), and pomegranate group (received pomegranate juice and Cisplatin).Results: Cisplatin group showed marked reduction of renal function manifested by high levels of blood urea, serum creatinine, and low level of serum albumin.Raised levels of oxidative stress markers and severe renal parenchymal damage by histopathology.While, pomegranate group showed almost normal renal function tests and normal levels of oxidative stress markers, and normal renal parenchymal histopathology.Conclusion: Cisplatin in a highly nephrotoxic drug, and Pomegranate juice has a nephroprotective activity against Cisplatin-induced nephrotoxicity.&#x0D;

Diabetic macular edema and its association to systemic risk factors in an urban north Indian population.

Aim: To study the association of systemic risk factors with diabetic macular edema in an urban North Indian population. Materials and Methods: 600 eyes of 300 patients in the age group of 30-70 years with pre-diagnosed diabetes mellitus type II were screened for diabetic retinopathy and diabetic macular edema. All systemic parameters were studied. Results: Diabetic retinopathy was found in 52% males with the male to female ratio being 1.08:1. Cystoid macular edema and serous retinal detachment were associated with increased fasting and post prandial blood sugar levels respectively. Hypertriglyceridemia was significantly associated with cystoid macular edema (p-value=0.001). 73.7% of smokers had cystoid macular edema. Increased serum creatinine is more commonly found in cystoid macular edema. Higher levels of Blood urea is significantly associated with diffuse retinal thickening (p-value=0.006) Conclusion: Of the systemic risk factors found in the diabetic patients, macular edema was found more in females, smokers, those with uncontrolled diabetes mellitus, deranged lipid profile and nephropathy.

Descriptive Analysis of Mortality Predictors in H1n1 Influenza in South Indian Patients.

H1N1 (hemagglutinin-H-neuroaminidase-N) influenza infection is associated with high morbidity and mortality because of associated complications and related factors. Predictors of mortality in H1N1 patients are studied with very few without seasonal/pandemic declaration. This study was carried out to describe the clinical features, complications and different risk factors that affect the outcome in the patients with confirmed H1N1influenza infection. A retrospective study was done in Kasturba Medical College Hospital, Manipal, India by analyzing the medical records of 141 patients admitted from January, 2011 to June, 2015. Of the 141 patients in the study, 51.1% of the patients were female with a mean age of 32±16.2 years. Fever with headache was observed in 92.9% patients while cough in 78.7% patients and breathlessness in 54.6% patients. On the basis of disease severity, 53.2% of the patients were put on mechanical ventilation. For all the patients, treatment for influenza management began with oseltemivir. Diuretics, antianxiety and corticosteroids were given as supportive and symptomatic care which contributed to high mortality in hospitalized patients. Mean hospitalization period was 8.5 days. During the hospitalization, patients developed different complications i.e. 31.20% patients developed respiratory tract infections, while 17.7% patients developed ARDS and 14.4% patients developed sepsis. The mortality rate of this study population was found to be 29.1 %. It was observed that low oxygen saturation during admission, high blood urea level, use of diuretics, corticosteroids, anti-anxiety drugs and complications like ARDS, sepsis influence the mortality rate of patients with H1N1 infection.

Factors affecting treatment success in community-acquired pneumonia.

Treatment failure in hospitalized patients with community-acquired pneumonia is a major cause of mortality. The aim of this study was to evaluate the factors affecting treatment success in community-acquired pneumonia. A total of 537 patients (mean age: 66.1 ± 15.8 years, 365 males) registered to the Turkish Thoracic Society Pneumonia Database were analyzed. Of these, clinical improvement or cure, defined as treatment success, was achieved in 477, whereas 60 patients had treatment failure and/or died. Lower numbers of neutrophils (5989.9 ± 6237.3 vs. 8495.6 ± 7279.5/mm3), higher blood urea levels (66.1 ± 42.1 vs. 51.2 ± 38.2 mg/dL), higher Pneumonia Severity Index (PSI) scores (123.3 ± 42.6 vs. 96.3 ± 32.9), higher CURB-65 scores (2.7 ± 1.2 vs. 2.2 ± 0.9), lower PaO2/FiO2 ratios (216.3 ± 86.8 vs. 269.9 ± 65.6), and the presence of multilobar (33.3% vs. 16.4%) and bilateral (41.7% vs. 18.9%) radiologic infiltrates were related to treatment failure. The PSI score and PaO2/FiO2 ratio were independent parameters affecting treatment results in multivariate linear regression analysis (P < 0.001). The risk of treatment failure is high in patients with severe pneumonia and with respiratory failure. Effective treatment and close monitoring are required for these cases.