Increase In Potassium Levels Research Articles

Effect of Different Levels of Potash on Growth, Yield Attributes and Yields of Transplanted Kharif Rice (Oryza sativa L.) in Southern Odisha

The occurrence of drought in the early monsoon period and the role of potassium in resisting water stress motivated me to imitate a field experiment which was conducted during Kharif, 2022-23 at the Post Graduate Research Farm (18.805378800N latitude, 84.1790850E longitude) of the M.S. Swaminathan School of Agriculture, Gajapati, Odisha, on a sandy clay loam soil. The experiment was laid out in Randomized Block Design with three replications and eight treatments. The treatments were: K0 (control) 0 Kg K ha-1, K10 :10 Kg K ha-1, K20: 20 Kg K ha-1, K30 : 30 Kg K ha-1, K40 : 40 Kg K ha-1, K50 : 50 Kg K ha-1, K60: 60 Kg K ha-1, K70 : 70 Kg K ha-1. Rice variety Shatabdi was the test crop. The recommended N and P2O5 (80-40 kg ha-1) were applied to all treatments. The effect of Potassium levels significantly influenced the crop growth parameters like the number of tillers, dry matter accumulation, leaf area index, number of panicles per unit area, panicle length, number of spikelet’s per panicle, number of filled spikelet’s per panicle, percentage of filled spikelet’s and finally grain and straw yields, the treatments K70 recorded best results in terms of dry matter accumulation (775g m-2), leaf area index (3.3), number of tillers m-2 (350.6), number of panicles m-2 (351.6), panicle length (29.6cm), number of spikelet’s panicle-1 (183), number of filled spikelet’s panicle-1 (163), percentage of filled spikelet’s (89.4)and grain and straw yields (5138kgha-1 and 6836 kgha-1, respectively). A continuous increasing trend was recorded with an increase in potassium level from K0 to K70. The harvest index efficiency was maximum under K40. In the present study, all parameters showed a positive response to an increase in potassium levels.

The Effects of Calcium Gluconate Administration on Potassium Levels of Post Packed Red Cell (PRC) Transfusion Patients with More Than Three-Day-Stored Blood at RSUP Haji Adam Malik, Medan

Background: Blood transfusion is an important and routine medical treatment, especially in cases requiring surgeries such as trauma. One of the biochemical changes that occurs in PRC due to erythrocyte storage is an increase in potassium levels. Hyperkalemia is the most common complication of stored blood transfusion. Cardiac arrest has been widely reported in transfusion-associated hyperkalemia. Methods : This study used a pre-experimental study with a pretest-posttest group design to determine the effects of Ca gluconate administration on blood potassium levels in patients receiving packed red cell (PRC) transfusions with blood stored for > 3 days at RSUP Haji Adam Malik Medan. Results : The distribution of sample characteristics in this study showed a mean age of 46 ± 13.63. There were 7 (22.6%) male and 24 (77.4%) female patients, with a mean BMI of 23.28 ± 6.44. Based on the hemodynamic profile, the mean systolic BP was 105.87 ± 20.59, diastolic BP 70.41 ± 11.94, RR 23.06 ± 2.39 and MAP 83.31 ± 14.48. The mean value of potassium levels before an administration of Ca gluconate was 5.84 ± 0.89, while the mean value after the administration was 5.43 ± 0.90. There were no statistically significant changes in the potassium levels after the administration of Ca gluconate in any samples. Conclusions : There are effects of Ca gluconate administration on the potassium levels of post Packed red cell (PRC) transfusion patients with blood stored for > 3 days at RSUP Haji Adam Malik Medan.

The impact of hyperkalemia on ICU admission and mortality: a retrospective study of Chinese emergency department data

ObjectiveThis study assesses the influence of hyperkalemia on both disease severity and the risk of mortality among patients admitted to the emergency room.MethodsThis retrospective observational study utilized data from the Chinese Emergency Triage Assessment and Treatment database (CETAT, version 2.0), which was designed to evaluate and optimize management strategies for emergency room (ER) patients. Patients were systematically categorized based on serum potassium levels. Relationships between serum potassium levels, risk of mortality, and the severity of illness were then analyzed using multifactorial logistic regression and through Receiver Operating Characteristic (ROC) analysis. The effectiveness of various treatments at lowering potassium levels was also investigated.Results12,799 emergency patients were enrolled, of whom 20.1% (n = 2,577) were hypokalemic and 2.98% (n = 381) were hyperkalemic. Among hyperkalemic patients, the leading reasons for visiting the ER were altered consciousness 23.88% (n = 91), cardiovascular symptoms 22.31% (n = 85), and gastrointestinal symptoms 20.47% (n = 78). Comparative analysis with patients exhibiting normal potassium levels revealed hyperkalemia as an independent factor associated with mortality in the ER. Mortality risk appears to positively correlate with increasing potassium levels, reaching peaks when blood potassium levels ranged between 6.5 and 7.0. Hyperkalemia emerged as a strong predictor of death in the ER, with an Area Under the Curve (AUC) of 0.89. The most frequently prescribed treatment for hyperkalemia patients was diuretics (57.32%, n = 188), followed by intravenous sodium bicarbonate (50.91%, n = 167), IV calcium (37.2%, n = 122), insulin combined with high glucose (27.74%, n = 91), and Continuous Renal Replacement Therapy (CRRT) for 19.82% (n = 65). Among these, CRRT appeared to be the most efficacious at reducing potassium levels. Diuretics appeared relatively ineffective, while high-glucose insulin, sodium bicarbonate, and calcium preparations having no significant effect on the rate of potassium decline.ConclusionHyperkalemia is common in emergency situations, especially among patients with altered consciousness. There is a strong positive correlation between the severity of hyperkalemia and mortality risk. CRRT appears to be the most effective potassium reducting strategy, while the use of diuretics should be approached with caution.

The Difference In Potassium Levels In Fresh Blood Bags With Blood Bags Stored At Pku Muhammadiyah Gamping Hospital

Blood transfusion, one of them, is a process of transferring blood components containing glucose, lactate, and potassium. During storage, blood cells undergo metabolic changes such as decreased blood pH, hemolysis, and increased potassium levels. One of the complications of transfusion that must be avoided is hyperkalemia due to the release of potassium. This study aimed to determine differences in stored blood potassium levels and PRC QC results during 11 days of storage. This was an analytic observational study with a cross sectional approach. A T-test was used to analyze the difference. In addition, PRC blood quality control (QC) was also carried out for stored blood according to standards. This study used 40 samples of fresh blood bags obtained from UTD PMI Yogyakarta City. The mean potassium level in fresh blood bags was 4.373 ± 0.417 mmol/L (3.70-5.50) and the average potassium level in blood bags stored for 6 days was 8.290 ± 0.275 mmol/L (7.80-8.90). There was a significant difference in potassium levels between fresh blood bags and blood bags stored for 6 days (p = 0.000). The overall QC PRC result is 50% which indicates the need for improvement in terms of the blood component separation process.

The improvement of antioxidant contents and fruit quality of Sukkary date cultivar using various Potassium levels and Irrigation interval

Sukkary date palms (Phoenix dactylifera L.) were treated with three levels of potassium fertilizer combined with three irrigation intervals regime, five replicates were allocated per treatment, to enhance better date peel color; decrease loose crust, and subsequently, improve high market ability. Potassium sulfate (49% K2O) was applied annually at a rate of 490 g (as common fertilization applied in the farm in which this experiment was carried out, therefore, it was considered as a control treatment), 735 g, or 980 g K2O per palm tree, each level was divided into three equal doses. The first dose was added one month after pollination; the other two doses were added at two month interval, whereas the irrigation treatments were as follows: 24 hrs (as common irrigation application in the farm used for this study, and it was considered as a control treatment), 48 hrs, or 72 hrs. The results showed a great decrease in the loose crust dates at harvesting time. An inverse proportional relationship between irrigation intervals and loose crust of dates was observed. The High potassium fertilizer treatment accompanied with 72 hrs irrigation interval treatment produced a significantly higher date quality regarding with bright yellow color, less darkening, and loose crust. High potassium fertilizer treatments (735, or 980 g K2O per palm) increased total yield, improved date weight, size, and color. Moreover, increasing potassium level affected significantly the date total antioxidant. This study showed that, a potential means to control peel darkening and loose date crust and improve quality of cv. Sukkary dates, which ultimately improves its market ability, through implementing appropriate potassium and irrigation regimes.

Composition Analysis of the Solid Electrolyte Interface of NaK Anodes in Na-Ion Batteries.

Sodium-ion batteries have emerged as a promising alternative to Li-ion batteries due to the abundance of sodium. However, anodes in Na-ion batteries face challenges such as dendrite formation and an unstable solid electrolyte interface layer. To address these challenges, NaK liquid metal alloy anodes have been proposed as an alternative because they do not form dendrites. In our study, we demonstrate that the NaK alloy anode interacts with the commonly used ethylene carbonate and dimethyl carbonate electrolyte, leading to a continuously growing unstable SEI layer, evidenced by cycling failures under 100 cycles and an increasing charge transfer resistance in electrochemical impedance spectroscopy studies. In situ surface-enhanced Raman spectroscopy and X-ray photoelectron spectroscopy reveal that over the course of cycling the surface of the NaK anode becomes increasingly sodium-rich. After 30 cycles, XPS analysis detects only trace amounts of potassium on the NaK anode surface. When the electrolyte is analyzed postcycling using inductively coupled plasma optical emission spectroscopy, there is a noticeable increase in potassium levels, suggesting that potassium metal dissolves into the electrolyte. The introduction of a 10 wt % fluoroethylene carbonate additive can mitigate this problem to some extent, enabling an enhanced cycling performance of up to 800 cycles at 1C. Nevertheless, the dissolution of K metal is still evident in the XPS results, albeit to a lesser degree. These discoveries provide valuable insights for designing a more robust SEI layer for the NaK anode.

Predictors of death in seriously injured patients

The purpose of the study. To analyze the structure of the incoming flow in conditions of conducting large-scale military operations at the stage of emergency specialized surgical care and to determine the predictors of an unfavorable outcome in patients with severe combined wounds. Materials and methods. A retrospective cohort study of medical data was performed in seriously wounded during a special military operation who were admitted to the department of anesthesiology, intensive care and intensive care of a level 3 military medical organization with severe combined wounds and trauma in 45 seriously wounded. Depending on the outcome of treatment, the seriously injured and injured were divided into 2 groups: survivors (n=30, 66.6%) and deceased (n=15, 33.4%) within a 30-day period from the moment of injury. Results. In the structure of seriously injured people in need of resuscitation, gunshot wounds predominate 84.5% (fragmentation — 95.4%, bullet — 4.6%), surgical diseases account for 7.2% of cases, closed trauma occurs in 5.1% of cases, thermal lesions — 3.2%. Combined and multiple wounds were diagnosed in 96.2% of cases. Upon admission, the predictors of death are hypothermia (p-value=0.011), the time elapsed from injury to qualified surgical care (p-value=0.035), the severity of the condition on the APACHE II scale (p-value=0.047). During treatment at the stage of emergency specialized surgical care, the predictors of death are the laboratory assessment of total bilirubin (p-value=0.006), the SOFA scale (p-value=0.015), an increase in creatinine levels (p-value=0.018), the appearance of metabolic acidosis (p=0.022), an increase in the dose of norepinephrine (p-value=0.015).value=0.033), as well as an increase in potassium levels (p-value=0.041). Conclusion. The result of the study showed a high frequency of combined injuries admitted to the OARIT. The predictors of an unfavorable outcome at admission were hypothermia; the time elapsed from the moment of injury to the provision of qualified surgical care; the severity of the condition on the APACHE II scale. And during intensive therapy, the predictors were: an assessment on the SOFA scale, an increase in creatinine levels, total bilirubin, potassium levels and metabolic acidosis.

Effect of P-glycoprotein inhibitor (Carvedilol) on pharmacological and hematological effects of its substrate (methotrexate) on pregnant and lactating rat mothers

Sixty albino rats (40 female rats and 20 males) were allocated into four dosing groups administered orally carvedilol (T1) 0.72mg/kg, methotrexate (T2) 0.36mg/kg, combined doses (T3) carvedilol + methotrexate and control group (Distilled water) for 2 months in male and 2 weeks in female rats before mating and after copulation and approval of pregnancy, dosing continued in female groups during pregnancy and lactation periods. Half of the animal groups were euthanized one day before parturation to determine P-gp concentration in the placenta and liver of pregnant mothers. In contrast, the other half was left for parturition and lactation to study the effects of carvedilol (P-gp inhibitor) on methotrexate (P-gp substrate) when given alone and in combination with some pharmacological, hematological, and biochemical parameters in lactating mothers and pups at the end of lactation. The pharmacological results showed the highest significant antinociceptive responses both in the early and late phase in the T3 (CV+MTX) followed by the T2 (MTX) group. In contrast, the T1 (Cv) animal group showed nearly resembling results as that of the control group in the early and late phases of the formalin test. The written test also recorded the same result as the Formlin test, indicating a significantly higher analgesic effect in T3 followed by T2 in comparison to T1 and control groups. The TNF alpha results supported the anti-inflammatory effect, recording a significant decline mainly in the T3 and T2 groups. The hematological results recorded significantly more reduction in WBC levels in mother and their pups in comparison with T1 and control groups. The serum electrolyte levels (Na+, K+, Ca+2) recorded in all treated groups and pups showed a significant increase in potassium levels in the T1 and T2 mother rat groups. The P-glycoprotein (P-gp) concentration measured in liver and placenta of euthanized pregnant mother before delivery recorded potent inhibition of P-gp in T1 & T3 groups which might altered pharmacokinetic and pharmacodynamic effects of substrate by carvedilol that considered a potent P-gp inhibitor drugs, this might explain our results of increase in pharmacological effect of methotrexate and their side effect on electrolyte concentration and hematology in combined group of CV+ MTX. Keywords: Carvedilol, Methotrexate, p-gp inhibitor, Anti-inflammatory, Hematology, Electrolyte.

Heparin-induced hyperkalemia, can LMWH cause hyperkalemia? A systematic review.

Hyperkalemia, an elevated blood potassium concentration exceeding 5.0mEq/L, is associated with adverse outcomes and is frequently observed in hospitalized patients. Drug-induced hyperkalemia accounts for a significant proportion of cases, with heparin, commonly used for venous thrombosis prevention, suspected to contribute, though less recognized than other heparin-related side effects. Both unfractionated heparin (UFH) and low molecular weight heparin (LMWH) have been implicated in inducing hyperkalemia, primarily through the suppression of aldosterone levels and modulation of angiotensin II receptors. This systematic review examines the relationship between heparin, particularly LMWH, and hyperkalemia. Thirteen studies involving 1407 patients were analyzed. Findings indicated a lack of highquality evidence, with no significant increase in potassium levels associated with LMWH use. LMWH did not exhibit a dose-response relationship with hyperkalemia incidence. Additionally, mechanisms underlying the hypothetical LMWHinduced hyperkalemia remained inconclusive. While this suggests that LMWH is unlikely to be a primary cause of hyperkalemia, caution is warranted, especially in patients with elevated baseline potassium levels.

Potassium level changes in chronic kidney disease patients following balanced crystalloid administration in the emergency department.

One common reason why clinicians are often hesitate to administer balanced crystalloids in the emergency department is the potential occurrence of unexpected hyperkalemia in patients with chronic kidney disease (CKD). In order to investigate the changes in potassium levels resulting from the administration of balanced crystalloids, specially Plasma Solution A (a generic version of Plasma-Lyte), to emergency department patients with CKD, we conducted an evaluation. A retrospective cohort study was conducted at a single academic hospital. Our study included patients with CKD who received intravenous Plasma Solution A and underwent electrolyte follow-up testing within 24 hours of administration. In total, there were 745 patients included in this study, of whom 87 had CKD. Through a 1:1 propensity score matching procedure for factors other than the estimated glomerular filtration rate, we matched 87 patients with normal kidney function to 87 CKD patients. For patients with CKD, the mean standard deviation SD administered volume of Plasma Solution A was 28.7 (21.0) mL/kg, and the mean SD administration duration was 13.2 (4.5) hours. The mean SD potassium level decreased from 4.3 (0.6) mmol/L to 4.1 (0.6) mmol/L (P = .029). Our study findings suggest that there may be no significant harmful increase in potassium levels or worsening of renal function within 24 hours after the intravenous administration of approximately 2 L of Plasma Solution A to patients with CKD.

Changes in serum potassium with concomitant administration of renin-angiotensin system agents and potassium-sparing diuretics: U.S. cohort study using electronic health record data

BackgroundPotassium-sparing diuretics (KSDs) and renin-angiotensin system (RAS) agents (including angiotensin-converting enzyme inhibitors [ACEIs] and angiotensin II receptor blockers [ARBs]) are commonly prescribed for the management of hypertension, cardiovascular diseases, and diabetic nephropathy. However, there is a concern of developing hyperkalemia when these drugs are concomitantly used. This study investigates the change in serum potassium during concomitant administration of RAS agents (ACEI or ARB) and KSD. MethodsThis is a retrospective observational study using the Cerner Health Facts database. Electronic health records from unique patient hospitalization encounters were used to compare change in the serum potassium among 5 different cohorts (ACEI, ARB, KSD, ACEI-KSD, and ARB-KSD) and a non-RAS non-KSD exposed one (acetaminophen [APAP] cohort). Descriptive data of the cohorts and the risk of increase in potassium serum were estimated by generalized linear regression. ResultsA total of 5816 patients’ unique encounters were analyzed. After admission, 5.2% (N = 303) had serum potassium greater than 5.5 mmol/L. Results showed a significant increase in serum potassium during concomitant use of KSD and RAS agents and when only using KSD compared with the control APAP group (all P < 0.05). Other significant predictors of increased serum potassium levels included male (P = 0.002), black race (P < 0.001), and individuals with low estimated glomerular filtration rate (P < 0.001). ConclusionsThis study found no evidence of hyperkalemia when combining KSD and other medications that may increase potassium levels, even when controlling for other potential factors that may affect serum potassium levels, for patients within institutional settings. Warnings concerning excessive potassium levels when a KSD is prescribed with a medication that may affect potassium should be limited to patients with pre-existing higher levels of potassium.

The Expression of CD47 and Its Association with Other Biochemical Storage Lesions in Stored Non-Leucoreduced versus Leucoreduced Red Blood Cell Units

Abstract Background The emergent need for blood transfusion required blood storage at low temperature which induced biochemical and biomechanical changes, collectively known as RCSL(red cell storage lesion). CD47 is an integrin associated protein which decreases with PRBCs(packed red blood cells) prolonged storage that possibly leads to less effective blood transfusion. Electrolyte imbalance occurs due to inactivation of Na+/K+ ATPase pump in low temperature which inturn leads to continuous increase of extracellular potassium which is considered life threatening for patients with renal failure or those with massive transfusions. Aim of the Work The aim of our study is to Evaluate the expression of CD47 by flow cytometry with other biochemical storage changes (pH, sodium and potassium ions) in CPD/SAGM packed non-leucoreduced Group(A) versus CPD/SAGM leucoreduced Group(B) red blood cell units at different storage times (on day 7, 14, 28 from date of red blood cells collection). Subjects and Methods 450 ml of whole blood is obtained into Quadruple blood bags and further subdivided into 20 non-leucoreduced units and 20 leucoreduced units. Non-leucoreduced and leucoreduced units are stored at 4 ± 2◦C. Samples are taken from each packed red blood cell unit at days 7,14 and 28 and tested for (Na+&amp;K+) ions, pH and CD47 marker by flow cytometry. Results Both leucoreduced and non-leucoreduced units show a highly significant decrease in sodium, pH and CD47 expression and a highly significant increase in potassium level. However, there was no statistically significant difference found between 2 studied groups regarding sodium &amp; potassium level, pH and CD47 expression on packed red cells except for sodium on 28th day which was slightly higher in leucoredced than non-leucoreduced units. Conclusion Red cell storage lesion is an inevitable process. Our study showed a highly statistically significant decrease in CD47 by flow cytometry in both leucoreduced and non-leucoreduced PRBCs along the storage period from day 7 to day 28. Red cell concentrates show significant decrease in sodium and pH and increase in the level of potassium during storage. Unlike many other studies, leucoreduction didn’t affect the expression of neither CD47 nor biochemical parameters (Na, K and pH) from day 7 to day 28 of PRBc storage.

Evaluation of Agronomic Efficiency with Regional Source of Natural Potassium in the Brazilian Midwest

Brazil plays an important role in global food production, but faces challenges due to its dependence on imported fertilizers. To reduce this vulnerability of the agricultural sector, the use of natural sources such as agrominerals, also known as rock dust, is gaining ground. The objective of this study was to characterize and evaluate a new source of natural potassium, extracted from a deposit located in the Brazilian Midwest, through geological characterization and agronomic evaluation through yield tests, soil and foliar potassium content. The tests were conducted in a greenhouse with seven treatments, two soil types and four replications, with millet, soybeans and beans in succession to evaluate the residual effect of the product. The agromineral was classified as a nepheline syenite saprolite with an average K2O content of 11.6%. The effects of the agromineral were promising, especially in the medium term. In the case of beans, at the standard dose of 60 K2O, yields in clay soils were 3.6 Mg ha-1 higher than in the 60 KCl treatment, which obtained only 2.3 Mg ha-1, probably due to absorption or leaching losses, since the effect evaluated was residual in nature. For all the crops evaluated, the agromineral showed an increase in potassium levels in both the soil and the leaves compared to the control group, indicating that it is a potential alternative to gradually reduce the use of traditional chemical fertilizers. Field trials are recommended to validate these benefits, taking into account more realistic environmental variations.

Efficacy and Safety of Eplerenone for Treating Chronic Kidney Disease: A Meta-Analysis.

In recent years, a large amount of clinical evidence and animal experiments have demonstrated the unique advantages of mineralocorticoid receptor antagonists (MRA) for treating chronic kidney disease (CKD). Accordingly, the present study aimed to systematically assess the second-generation selective MRAs eplerenone's safety and effectiveness for treating CKD. Four databases (PubMed, The Cochrane Library, Embase, and Web of Science) were searched for randomized controlled trials (RCT) correlated with eplerenone for treating CKD up to September 21, 2022. By complying with the inclusion and exclusion criteria, literature screening, and data extraction were conducted. A total of 19 randomized controlled articles involving 4501 cases were covered. As suggested from the meta-analysis, significant differences were reported with the 24-h urine protein (MD = -42.23, 95% confidence interval [CI] = -76.72 to -7.73, P = 0.02), urinary albumin-creatinine ratio (UACR) (MD = -23.57, 95% CI = -29.28 to -17.86, P < 0.00001), the systolic blood pressure (SBP) (MD = -2.73, 95% CI = -4.86 to -0.59, P = 0.01), and eGFR (MD = -1.56, 95% CI = -2.78 to -0.34, P = 0.01) in the subgroup of eplerenone vs placebo. The subgroups of eplerenone vs placebo (MD = 0.13, 95% CI = 0.07 to 0.18, P < 0.00001) and eplerenone vs thiazide diuretic (MD = 0.18, 95% CI = 0.13 to 0.23, P < 0.00001) showed the significantly increased potassium levels. However, no statistical significance was reported between the eplerenone treatment groups and the control in the effect exerted by serum creatinine (MD=0.03, 95% CI = -0.01 to 0.07, P = 0.12) and diastolic blood pressure (DBP) (MD = 0.11, 95% CI = -0.41 to 0.63, P = 0.68). Furthermore, significant risks of hyperkalemia were reported in the eplerenone group (K+ ≥ 5.5 mmol/l, RR = 1.70, 95%CI = 1.35 to 2.13, P=<0.00001; K+≥6.0 mmol/l, RR = 1.61, 95% CIs = 1.06 to 2.44, P = 0.02), respectively. Eplerenone has beneficial effects on CKD by reducing urinary protein and the systolic blood pressure, but it also elevates the risk of hyperkalemia.

Formulation and Evaluation of Microspheres of Ramipril

Background: Ramipril an antihypertensive medicine has a 28 percent oral bioavailability and is promptly eliminated from the body through the kidneys. When Ramipril is administered as an immediate dosage form, it has also been linked to a wide range of side effects, including hypotension, an increase in potassium level, and angioedema. The present study was therefore conducted in an effort to reduce the drug's negative effects and boost its bioavailability.&#x0D; Objectives: In the current work, ramipril microspheres are created and evaluated utilizing the solvent evaporation method and natural or synthetic polymers. Use natural polymers like ramipril, sodium hydroxide, potassium dihydrogen orthophosphate, dichloromethane (DCM), and synthetic polymers like ethyl cellulose, eudragit RL100, etc.&#x0D; Methods: A solvent evaporation technique was used to create the microsphere, and polymers like EudragitRL100 and ethyl cellulose were used. Particle size analysis, percent entrapment efficiency, Differential scanning calorimetry (DSC), Drug encapsulation efficiency (DEE), FTIR spectroscopy, in vitro release research, and stability study were all performed on the produced formulations.&#x0D; Results: The results were observed to be within the normative ranges. The FT-IR analysis of the formulations indicated there was no interaction between Ramipril and other excipients. The range of entrapment efficiency was found to be between 68.7 and 94.08%. The drug release investigation was conducted in gastrointestinal fluid (SGF) for 12 hours and demonstrated the largest quantity of drug release in a regulated and sustained manner over a prolonged length of time. The size of the microsphere was in the range of 25.7 to 49.2 m. According to the DSC study, molecules of drugs are uniformly dispersed in an amorphous state.&#x0D; Conclusion: The designed formulation was discovered to be stable and it provides a potential system for the controlled and sustained distribution of ramipril.&#x0D; Keywords: Ramipril, EudragitRL100, Ethylcellulose, Potassium dihydrogen orthophosphate, Solvent evaporation method.

Renin and electrolytes indicate the mineralocorticoid activity of fludrocortisone: a 6 year study in primary adrenal insufficiency

ContextFludrocortisone (FC) is the mineralocorticoid (MC) replacement treatment for patients with primary adrenal insufficiency (PAI).ObjectiveTo explore the dose of FC treatment and its relationship with glucocorticoid therapy, sodium, potassium, renin and clinical parameters.SettingMonocentric cohort.PatientsData of 193 patients with PAI (130 autoimmune) were collected during baseline (T0), intermediate (T1) and last follow-up visit (T2, respectively, after a mean of 38 and 72 months).Main outcome measureUtility of endocrine and clinical parameters to titrate FC dose.ResultsFC dose (50–75 μg/daily) was stable in the follow-up in half patients. The MC activity of FC was dose-dependent: we observed a reduced but significant positive linear correlation between FC dose and sodium (r = 0.132) and negative linear correlation between FC and potassium (r = − 0.162) or renin (r = − 0.131, all p < 0.01). An overall reduction in the FC dose was observed at T2 in the group with longer follow-up (> 60 months, p < 0.05). Higher doses of FC were observed in patients with low-normal renin, especially in autoimmune PAI (86 vs 65 μg/daily, p < 0.05). On the contrary, reduced sodium and increased potassium levels were observed in patients with high renin at T2. The number of cardiovascular events (15 in the whole cohort) was similar in patients sorted by renin levels or FC dose.ConclusionsRenin and electrolytes can indicate the MC activity of FC treatment: they should be routinely evaluated and used to titrate its dose that can be reduced in the long-term follow-up.

Forage productivity and morphogenesis of Mesosetum chaseae under potassium fertilization

The effect of potassium levels (0, 50, 100 and 200 kg of K2O ha-1) on green dry matter (GDM) yield and morphogenetic and structural characteristics of Mesosetum chaseae (Luces) was evaluated under natural field conditions. Potassium fertilization increased significantly (P&lt;0.05) GDM yields, absolute growth rate (AGR), number of tillers/plant, number of leaves plant-1, medium blade length, leaf area, leaf senescence rate, leaf appearance and elongation rates. Maximum GDM yields, AGR, number of tillers/plant, number of leaves/tiller, leaf area and medium blade length were obtained with the application of 167.8; 156.2; 82.7; 101.6; 101.2 and 77.5 kg of K2O ha-1, respectively. The potassium efficiency utilization was inversely proportional to the increased potassium levels.

The Association Between Tacrolimus Levels and Hyperkalemia in Allograft Recipients Who Underwent Heart or Lung Transplantation in New Orleans, USA Between 2013 and 2019: A Single-Center Retrospective Study.

BackgroundTacrolimus, a calcineurin inhibitor, is the cornerstone of immunosuppressive strategies in transplantation. Other studies have concluded that hyperkalemia correlates with tacrolimus therapy, though the impact is poorly understood. In 2 separate analyses, the aim of this study was to investigate if the presence and/or magnitude of exposure to tacrolimus increased potassium levels in heart or lung transplant recipients.Material/MethodsThis retrospective study identified allograft recipients who underwent heart or lung transplantation from January 2013 to December 2019 at Ochsner Health in New Orleans, USA. The first analysis (A-1) comprised 103 lung transplant patients’ assessed potassium levels and prevalence of hyperkalemia in the absence of tacrolimus before transplant versus 30 days after transplant on tacrolimus. The second analysis (A-2) included 187 heart or lung transplant recipients and compared potassium levels and prevalence of hyperkalemia at day 30 after transplant during higher tacrolimus exposure (High-TAC) vs day 300 during lower tacrolimus exposure (Low-TAC).ResultsIn A-1, patients on tacrolimus had higher median potassium (4.7 mmol/L vs 4.1 mmol/L, P<0.0001) and prevalence of hyperkalemia (32.04% vs 5.83%, P<0.0001). In A-2, patients in the High-TAC group had higher median potassium (4.6 mmol/L vs 4.4 mmol/L, P=0.0005) and prevalence of hyperkalemia (22.46% vs 12.30%, P=0.0056).ConclusionsOur findings support those from previous studies. Presence of and higher levels of tacrolimus were associated with hyperkalemia following heart and lung transplantation. These findings highlight the importance of long-term monitoring of potassium levels in patients treated with tacrolimus.

QTc prolongation in adolescents with acute alcohol intoxication

In adults, alcohol intoxication is associated with prolongation of the QT interval corrected for heart rate (QTc). The QTc is influenced by age and sex. Although alcohol intoxication is increasingly common in adolescents, there are no data on the prevalence of QTc prolongation in adolescents with alcohol intoxication. This study aimed to determine the prevalence of QTc prolongation in adolescents with alcohol intoxication and identify at-risk adolescents. In this observational study including adolescents aged 10–18 years, heart rate and QT interval were automatically assessed from an electrocardiogram (ECG) at alcohol intoxication using a validated algorithm. The QTc was calculated using both the Bazett formula (QTcB) and Fridericia formula (QTcF). If present, an ECG recorded within 1 year of the date of admission to the emergency department was obtained as a reference ECG. A total of 317 adolescents were included; 13.3% had a QTcB and 7.9% a QTcF longer than the sex- and age-specific 95th-percentile. None of the adolescents had a QTcB or QTcF > 500 ms, but 11.8% of the adolescents with a reference ECG had a QTcB prolongation of > 60 ms, while no adolescents had a QTcF prolongation of > 60 ms. QTc prolongation was mainly attributable to an increase in heart rate rather than QT prolongation, which underlies the differences between QTcB and QTcF. Male sex and hypokalaemia increased the likelihood of QTc prolongation.Conclusion: QTc prolongation was seen in approximately 10% of the adolescents presenting with alcohol intoxication, and although no ventricular arrhythmias were observed in this cohort, QTc prolongation increases the potential for malignant QT-related arrhythmias. Clinicians must be aware of the possibility of QTc prolongation during alcohol intoxication and make an effort to obtain an ECG at presentation, measure the QT interval, and give an adequate assessment of the findings. We advocate admitting adolescents with alcohol intoxication and QTc prolongation. During hospital admission, we recommend limiting exposure to QTc-prolonging medication, increasing potassium levels to a high-normal range (4.5–5.0 mmol/L) and obtaining a reference ECG at discharge.What is Known:• One out of five deaths in adolescents is alcohol-related. Alcohol intoxication has been related to cardiac arrhythmias and sudden cardiac death.•In adults, alcohol intoxication is associated with QTc prolongation.What is New:•Approximately 10% of the adolescents with alcohol intoxication had a QTc longer than the age- and sexspecific cut-off. In contrast to adults, in adolescents with alcohol intoxication, QTc prolongation is attributable to an increase in heart rate, rather than a prolongation of the QT interval.•Especially males and adolescents with hypokalaemia are at risk of QTc prolongation.

Effect of Potassium Supply and Water Stress on Potato Drought Tolerance and Water Productivity

ABSTRACT Potato (Solanum tuberosum L.) is one of major food crops grown worldwide and in Lebanon. The response of field grown potato to 0, 200, 300 kg of potassium (K) ha−1 was examined under deficit irrigation (imposed water stress). Trials were conducted under Near East-North Africa (NENA) pedo-climatic conditions found in the semiarid central Bekaa of Lebanon. Irrigation water was provided by a drip irrigation system. A mild deficit irrigation, corresponding to 68% of calculated ET0 in 2015 and 85% of it in 2016, was started at the flowering stage and lasted till foliar senescence. Canopy temperature, at maximum development, showed a slight decrease with the increase of potassium levels. During physiological maturity, the midday leaf temperature was significantly lower at the higher K dose, indicating improved leaf water potential. The highest K dose showed a non-significant, higher, chlorophyll content in the leaves, notably in the first year. A significant increase in the weight of one commercial tuber was found in K300 (247.6 g). The commercial yield ranged between 33.05 and 34.78 Mg ha−1 (K300) and 23.31 and 25.53 Mg ha−1 (K0) in 2015 and 2016 respectively. During the 2016 trial, 8 plots out of 16 had an agronomic water yield between 9 and 13 kg.m−3 against 12 out of 16 plots in 2015, competing with the reported values for potato in the region. Optimizing nutrient and water input in the NENA region can contribute to food security with minimal environmental impact.