Reduction In Potassium Research Articles

The study of hormone-like properties of glioxyren

Aim. To study the possible interaction of glioxyrene (a new diuretic substance – a derivative of 2-oxoindoline-3-glyoxyllic acid) with renal receptors of mineralocorticosteroids; to find out the possible role of the dopamine-like effect in the renal effects of glioxyren, as well as study the effectiveness of the simultaneous use of inhibitors of dopamine receptors and glioxyren.Materials and methods. In the experiment in rats the interaction of glioxyren with peripheral renal receptors of dopamine was studied through the effect of the substance on diuresis under blockade of these receptors with domperidone (a blocker of peripheral receptors of dopamine) in the dose of 50 mg/kg. Diuresis, excretion of sodium and potassium were determined for 2 hours. The effect of glioxyren on the receptors of mineralocorticoids on the background of the partial blockade of these receptors by spironolocton in the oral dose of 20 mg/kg was studied. Water diuresis, excretion of sodium and potassium was studied for 2 hours.Results and discussion. It has been found that there is the stimulation of water diuresis with glioxyrene as a result of strengthening of the renal blood flow, activation of sodium excretion due to inhibition of sodium reabsorption as a result of the effect on the epithelium of the nephron tubules, stimulation of natriurea and reduction of potassium due to inhibition of aldosterone secretion in the adrenal glands.Conclusions. Glioxyren has the properties of a dopamine renal receptor agonist as it causes renal dopaminespecific effects associated with the activation of peripheral dopamine receptors. Glioxyren is not an aldosterone renal receptor antagonist.

Polysulfonate Resins in Hyperkalemia: A Systematic Review.

Background:Hyperkalemia is a potentially life-threatening electrolyte abnormality defined as a serum potassium above the lab reference range (usually >5.0-5.5 mEq/L). Polystyrene resins, including sodium polystyrene sulfonate (SPS) and calcium polystyrene sulfonate (CPS), have long been used to treat hyperkalemia. Sodium polystyrene sulfonate/calcium polystyrene sulfonate act by exchanging a cation for potassium within the intestinal lumen. While SPS and CPS have been available since the 1960s, there are rising concerns about the validity of the data supporting its use and about serious adverse gastrointestinal effects.Objective:The objective of this systematic review was to quantify the efficacy and safety of polystyrene sulfonate resins (SPS/CPS) in the treatment of adults with hyperkalemia. This review focuses on the randomized control trial (RCT), interventional non-RCT, and observational data available on SPS/CPS use.Design:Systematic review.Setting:Any country of origin. Both inpatient and outpatient settings.Patients:Adults with hyperkalemia treated with polystyrene sulfonate resins.Measurements:The primary outcome was change in serum potassium. The secondary outcomes included adverse effects of SPS/CPS and prevention of recurrent hyperkalemia.Methods:We conducted a systematic review using Cochrane Library, EMBASE (1947-2019), and Medline (1946-2019) databases. Literature reviews, systematic reviews, case studies, case series, and editorial pieces were excluded. Included studies were assessed for risk of bias.Results:Four RCTs, 21 observational studies, and 5 quasi-experimental trials were included. A total of 212 351 patients were included. Two thousand and fifty-eight patients were studied for the primary outcome and 210 293 patients were studied for the secondary outcomes. Study designs were heterogeneous and not amenable to meta-analysis. Most studies included nonhemodialysis outpatients older than 65 years. Of the included studies, 22/25 (88%) demonstrated a reduction of serum potassium >0.5 mEq/L over the study period. The magnitude of reduction in serum potassium of potassium resin compared with placebo or matched controls in the 3 low-risk studies identified was 0.14 to 1.04 mEq/L. However, each study used different dosing regimens. Ten of 22 studies reported the effects of polystyrene resins on serum potassium within 24 hours. A few high-quality observational studies suggest an increased risk of serious adverse gastrointestinal events with a relative risk of 2.10 and a hazard ratio of 1.25 to 1.94; however, the absolute risk remains low. The incidence of adverse gastrointestinal events is 16 to 23 events per 1000 person-years.Limitations:We acknowledge several limitations in this study. Case studies and case series were excluded from the search results. Large case series may have been excluded despite having comparable sample sizes to studies included due to lack of a comparator and calculated estimates. Due to the heterogeneity of the studies, the data were unable to be meta-analyzed and as such the potassium-lowering effect of polystyrene sulfonate resins remains founded on small studies with potential confounders.Conclusions:This systematic review demonstrates a continued lack of high-quality evidence for the use of SPS/CPS in hyperkalemia. Studies investigated highly variable timelines and the most robust evidence for SPS/CPS use is in chronic hyperkalemia. While the absence of high-quality evidence does not exclude the possibility of benefit, prescribers must understand that the use of SPS/CPS in acute hyperkalemia is not supported by high-quality evidence.Trial registration:The protocol for this systematic review was not registered.

Portable Hemodialysis Machine for Chronic Hemodialysis in Hospital—Advantages and Future Uses

Introduction: Nx stage one machine results can help to enhance the clinical efficiency and shortage concerning the use of home hemodialysis. Therefore, the study investigates effectiveness of Nx stage machine for intermittent conventional hemodialysis in hospital for inpatients and outpatients to replace conventional hemodialysis in stable chronic hemodialysis patients. Methods: Prospective observatory study was conducted in Nephrology Division, King Fahd General Hospital from April 1 to June 1 2018. Patients with ESRD, who were dependent on dialysis and maintained on regular hemodialysis were recruited. Fifty-two sessions of hemodialysis were performed. The patients were given intermittent dialysis using Nx stage one machine. Pre and Post dialysis investigations and body weight were taken, and patients were observed for any complications during or post-dialysis. Findings: The primary endpoint ultrafiltration with a goal to remove 1 - 4 kg was achieved without any technical difficulty. Secondary endpoint for potassium reduction levels was achieved with mean SD post-dialysis 3.53 ± 0.3, and the tertiary endpoint was achieved in a patient less than 50 kg weight with spKt/V above 1.2. It was difficult to achieve spKt/V in patients with weight more than 60 kg due to limitations in the duration of sessions or dialysate volume. Target spkT/V was achieved for patients with body weight less than 50 kg; however, it was not achieved among the patients with body weight more than 60 kg. Discussion: Nx stage one machine can replace conventional intermittent dialysis in terms of ultrafiltration and Potassium correction; however, further investigation is needed for urea clearance.

Efficacy and safety of sodium zirconium cyclosilicate in patients with baseline serum potassium level \u2265 5.5 mmol/L: pooled analysis from two phase 3 trials

BackgroundReliable, timely-onset, oral treatments with an acceptable safety profile for patients with hyperkalemia are needed. We examined the efficacy and safety of sodium zirconium cyclosilicate (SZC; formerly ZS-9) treatment for ≤ 48 h in patients with baseline serum potassium level ≥ 5.5 mmol/L.MethodsData were pooled from two phase 3 studies (ZS-003 and HARMONIZE) among patients receiving SZC 10 g three times daily. Outcomes included mean and absolute change from baseline, median time to potassium level ≤ 5.5 and ≤ 5.0 mmol/L, and proportion achieving potassium level ≤ 5.5 and ≤ 5.0 mmol/L at 4, 24, and 48 h. Outcomes were stratified by baseline potassium. Safety outcomes were evaluated.ResultsAt baseline, 125 of 170 patients (73.5%) had potassium level 5.5–< 6.0, 39 (22.9%) had potassium level 6.0–6.5, and 6 (3.5%) had potassium level > 6.5 mmol/L. Regardless of baseline potassium, mean potassium decreased at 1 h post-initial dose. By 4 and 48 h, 37.5% and 85.0% of patients achieved potassium level ≤ 5.0 mmol/L, respectively. Median (95% confidence interval) times to potassium level ≤ 5.5 and ≤ 5.0 mmol/L were 2.0 (1.1–2.0) and 21.6 (4.1–22.4) h, respectively. Fifteen patients (8.8%) experienced adverse events; none were serious.ConclusionsSZC 10 g three times daily achieved serum potassium reduction and normokalemia, with a favorable safety profile.Trial registrationClinicalTrials.gov identifiers: ZS-003: NCT01737697 and HARMONIZE: NCT02088073.

IK1 channel agonist zacopride suppresses ventricular arrhythmias in conscious rats with healing myocardial infarction

AimsArrhythmogenesis of chronic myocardial infarction (MI) is associated with the prolongation of action potential, reduction of inward rectifier potassium (IK1, Kir) channels and hyper-activity of Calcium/calmodulin-dependent kinase II (CaMKII) in cardiomyocytes. Zacopride, a selective IK1 agonist, was applied to clarify the cardioprotection of IK1 agonism via a CaMKII signaling on arrhythmias post-MI. MethodsMale SD rats were implanted wireless transmitter in the abdominal cavity and subjected to left main coronary artery ligation or sham operation. The telemetric ECGs were monitored per day throughout 4 weeks. At the endpoint, isoproterenol (1.28 mg/kg, i.v.) was administered for provocation test. The expressions of Kir2.1 (dominant subunit of IK1 in ventricle) and CaMKII were detected by Western-blotting. Key findingsIn the telemetric rats post-MI, zacopride significantly reduced the episodes of atrioventricular conduction block (AVB), premature ventricular contraction (PVC), ventricular tachycardia (VT) and ventricular fibrillation (VF), without significant effect on superventricular premature contraction (SPVC). In provocation test, zacopride suppressed the onset of ventricular arrhythmias in conscious PMI or sham rats. The expression of Kir2.1 was significantly downregulated and p-CaMKII was upregulated post-MI, whereas both were restored by zacopride treatment. SignificanceIK1/Kir2.1 might be an attractive target for pharmacological controlling of lethal arrhythmias post MI.

Serum-deprived differentiated neuroblastoma F-11 cells express functional dorsal root ganglion neuron properties.

The isolation and culture of dorsal root ganglion (DRG) neurons cause adaptive changes in the expression and regulation of ion channels, with consequences on neuronal excitability. Considering that not all neurons survive the isolation and that DRG neurons are heterogeneous, it is difficult to find the cellular subtype of interest. For this reason, researchers opt for DRG-derived immortal cell lines to investigate endogenous properties. The F-11 cell line is a hybridoma of embryonic rat DRG neurons fused with the mouse neuroblastoma line N18TG2. In the proliferative condition, F-11 cells do not display a gene expression profile correspondent with specific subclasses of sensory neurons, but the most significant differences when compared with DRGs are the reduction of voltage-gated sodium, potassium and calcium channels, and the small amounts of TRPV1 transcripts. To investigate if functional properties of mature F-11 cells showed more similarities with those of isolated DRG neurons, we differentiated them by serum deprivation. Potassium and sodium currents significantly increased with differentiation, and biophysical properties of tetrodotoxin (TTX)-sensitive currents were similar to those characterized in small DRG neurons. The analysis of the voltage-dependence of calcium currents demonstrated the lack of low threshold activated components. The exclusive expression of high threshold activated Ca2+ currents and of TTX-sensitive Na+ currents correlated with the generation of a regular tonic electrical activity, which was recorded in the majority of the cells (80%) and was closely related to the activity of afferent TTX-sensitive A fibers of the proximal urethra and the bladder. Responses to capsaicin and substance P were also recorded in ~20% and ~80% of cells, respectively. The percentage of cells responsive to acetylcholine was consistent with the percentage referred for rat DRG primary neurons and cell electrical activity was modified by activation of non-NMDA receptors as for embryonic DRG neurons. These properties and the algesic profile (responses to pH5 and sensitivity to both ATP and capsaicin), proposed in literature to define a sub-classification of acutely dissociated rat DRG neurons, suggest that differentiated F-11 cells express receptors and ion channels that are also present in sensory neurons.

Biochemical, Histopathological and Mutagenic Changes Following the Co-administration of Antihelminthic and Antimalarial Drugs in Wistar Rats

Aim: To determine the effects of antimalaria and antheminthic drugs combination in the incidence of histopathological alteration and biochemical modulations in liver and kidney of albino rats.&#x0D; Place and Duration of Study: The study was undertaken at the Zoology Department University of Lagos Akoka Lagos Nigeria.&#x0D; Methodology: A total of twenty (25) Male adult albino rats of 13-15 weeks old were divided into 5 groups of 5 rats each and daily oral administration of human therapeutic doses of praziquantel (PZQ 50 mg/kg body weight) separate and in combination with ivermectin (IVM 0.4 mg/kg body weight), albendazole (ALB 15 mg/kg body weight) and Artemether-lumefanthrine (ACT 140 mg/kg body weight) was administered with the group which serve as the control receiving 1ml distilled water. Toxic effects due to these treatments were investigated using histopathological, biochemical and mutagenic indices at day 8th and 15th of the study.&#x0D; Results: Biochemical assessment revealed significant reduction in AST, ALT, ALP and potassium in the treatment group compared to the control. Increase in the level calcium, Albumin and bicarbonate were also observed in treatment groups. Histopathological assessment of the liver showed a general incidence of focal inflammation along the portal tract area, but did not show any differential severity across treatment groups except for single PZQ treatment group which were characterized by fatty infiltration. A general occurrence of mesangial damage and glomerula injury was observed in kidney tissues. Renal lesions were more severe in single PZQ + IVM treatment groups while mild lesions characterized renal tissue from PZQ+ACT treatment groups. Mutagenic effects as indicated by the high incidence of sperm head abnormalities was recorded across combination treatments especially in PZQ+ IVR and PZQ+ ACT groups.&#x0D; Conclusion: Findings suggest that combination therapies are synergistic and could result in nephrotoxicity, antidiuretic effects, dehydration and mutagenicity at human therapeutic doses.

Is It Possible to Include Potato in the Diet of Chronic Kidney Disease Patients? New Culinary Alternatives for Limiting Potassium Content

Despite the nutritional benefits of potato tuber, patients with chronic kidney disease (CKD) should limit the consumption because of its high potassium content. Some culinary treatments have previously been suggested to reduce the final content of this mineral; however, these are either not effective enough or involve very long procedures that affect the final flavor of the food. The aim of this work was to analyze the effect of culinary treatments on the reduction in potassium content in potatoes, offering new alternatives for minimizing the final content of this mineral to allow the increase of potato intake by patients with CKD. Fresh potatoes, canned potatoes, and frozen french fried potatoes were submitted to three different culinary treatments: soaking, normal cooking, and frying. Two types of cut were studied: strips and dice. Initial and final potassium content and % humidity in each cooking treatment applied on the three types of potatoes were analyzed. Potassium content was analyzed using flame photometry. Results show that potato soaking was ineffective for fresh raw potato, while normal cooking achieved insufficient reduction of potassium. However, when a soaking procedure was applied after normal cooking, it was found to be possible to leach up to 70% of the potassium, to final values of under 130mg/100g edible portion in both cut types studied. Subsequent frying did not leach potassium but rather increased potassium content; however, without reaching the 150 mg/100 g edible portion threshold. Similar results were observed for canned potatoes and frozen french fries. With this new proposed culinary method, the potassium content of potatoes is reduced to an acceptable limit. Additionally, the technique maintains a low-potassium content even after frying potatoes, thus allowing potatoes to be incorporated into the CKD dietary pattern.

Exploration of green integrated approach for effluent treatment through mass culture and biofuel production from unicellular alga, Acutodesmus obliquus RDS01

This study deals with the open pond (OP) pilot scale treatment of cassava effluent and enhancement of Ribulose-1,5-bisphosphate carboxylase/oxygenase (RuBisCO) enzyme through CO2 utilization by the microalga, Acutodesmus obliquus RDS01. The cassava effluent treatment (ET) revealed maximum reduction of ammonia (96.8%), calcium (94.6%), chloride (95.2%), chlorine (98.5%), inorganic phosphate (94.6%), magnesium (96.8%), nitrate (96.89%), organic carbon (95.9%), organic phosphorus (96.3%), potassium (97.9%), sodium (97.1%), and sulfate (95.4%) on 15th day using A. obliquus. The microalga produced highest RuBisCO enzyme activity (90%), CO2 utilization efficiency (95%), biomass (8.9 gL−1), lipid (176.65 mg mL−1), carbohydrate (96.78 mg mL−1), biodiesel (4.1 mL g−1), and bioethanol (3.7 mL g−1) during OP treatment. The isolated RuBisCO gene (rbcL) was used to construct the protein model by homology modeling. The microalgal-lipid content was analyzed through thin layer chromatography, the biodiesel produced was analyzed using Fourier-transform infrared spectroscopy and gas chromatography mass spectrometry (GCMS). The bioethanol production was confirmed by high performance liquid chromatography and GCMS analyses. A. obliquus produced of 98.75% biodiesel and 96.83% bioethanol in the OP pilot scale treatment A. obliquus. Overall, the microalga A. obliquus could act as an effective CO2 capturing and bioremediation agent in the cassava ET, and also for the biodiesel and bioethanol can be produced.

Modifying the Parboiling of Rice to Remove Inorganic Arsenic, While Fortifying with Calcium.

Using village-based rice processing plants in rural Bangladesh, this study considered how parboiling rice could be altered to reduce the content of the carcinogen inorganic arsenic. Parboiling is normally conducted with rough rice (i.e., where the husk is intact) that is soaked overnight at ambient temperatures, and then either steamed or boiled for ∼10 min, followed by drying. Across 13 geographically dispersed facilities it was found that a simple alteration parboiling wholegrain, instead of rough rice, decreased the inorganic arsenic content by 25% ( P = 0.002) in the final polished grain. Also, parboiling wholegrain had little impact on milling quality of the final polished rice. The wholegrain parboiling approach caused statistically significant median enrichment of calcium, by 213%; and a reduction in potassium, by 40%; with all other nutrient elements tested being unaffected. Milled parboiled rough rice had an enriched inorganic arsenic compared to nonparboiled milled rice, but parboiling of wholegrain rice did not enrich inorganic arsenic in the final milled product. Polished rice produced from the parboiling of both rough and wholegrain rice significantly reduced cadmium compared to nonparboiled polished rice, by 25%. This study also identified that trimethylarsine oxide and tretramethylarsonium are widely elevated in the husk and bran of rice and, therefore, gives new insights into the biogeochemical cycling of arsenic in paddy ecosystems.

Clinical and Etiological Spectrum of Hypokalemic Periodic Paralysis in a Tertiary Care Hospital in Pakistan.

IntroductionHypokalemic periodic paralysis (HPP) is characterized by muscle weakness secondary to low serum potassium levels. It may be primary in origin or there may be secondary causes like thyrotoxic periodic paralysis, renal or suprarenal causes, or non-renal causes like gastroenteritis.AimTo study the etiology, clinical manifestations, and outcome after therapy of patients with hypokalemic paralysis.MethodologyThe study was conducted from January 2016 to December 2016. Patients fulfilling the diagnostic criteria for hypokalemic paralysis, i.e., flaccid muscle weakness involving two or more limb muscles due to serum potassium < 3.5 mmol/L and with no objective sensory signs were included in the study. Relevant investigations were done. Those with other causes of flaccid weakness or on diuretic therapy were excluded from the study. Data was analyzed using SPSS Version 20.0 (IBM Corp., Armonk, NY).ResultsIn our study, 14 patients out of a total of 18 (14/18, i.e., 77.78%) were male and 4/18 (22.22%) were female [Male: Female ratio: 3.5:1]. The mean age of onset of HPP in males (29.5±10.14 yrs.) was lesser than that of females (41±10.8 yrs.), but this difference was statistically not significant (p<0.066). In the entire sample there were 15/18 cases (83.33%) of primary and 3/18 (16.67%) cases of secondary HPP [2/3 had thyrotoxic periodic paralysis and 1/3 had gastroenteritis]. Furthermore, 12/18 patients (66.66%) had symmetrical weakness (five cases of paraparesis and all were male; seven cases of quadriparesis: six males and one female) and 6/18 (33.33%) had asymmetrical weakness (two paraparesis: one male, one female; four quadriparesis: two males, two females). Statistically, no significant difference (p<0.709) was seen in those with symmetrical versus those with asymmetrical weakness. In this study 7/18 (38.89%) cases had absent, 1/18 (5.55%) had diminished, and 10/18 (55.55%) cases had intact deep tendon reflexes. None of the cases had cranial, bulbar, or respiratory involvement. The mean serum potassium of sample was 3.18±0.5 standard deviation (SD). The reduction in serum potassium was moderate (2.5-3.5 mmol/L) in primary and severe (<2.5 mmol/L) in secondary HPP. Those with quadriparesis had severe hypokalemia with a mean serum potassium of 2.1 mmol/L. Only 3/18 patients had concomitant magnesium deficiency. Patients given intravenous potassium replacement (except one with moderate hypokalemia and given oral replacement) recovered dramatically. The mean recovery time was 38.6±20.3 hours. The recovery time in quadriparesis was about 24 hours and in paraparesis was 12 hours. Only one patient with thyrotoxic periodic paralysis (TPP) and with severe serum potassium deficiency (0.9 meq/L) died due to cardiac arrhythmia. No atypical presentation was seen.ConclusionHPP has male preponderance. The age of onset of HPP is earlier in males than in females. Moreover, males are more prone to have symmetrical weakness. Asymmetrical weakness has almost an equal gender distribution. Primary hypokalemic paralysis is more frequent than secondary. Thyrotoxic periodic paralysis is the commonest cause of secondary periodic paralysis. The recovery time in quadriparesis is almost double the recovery time in paraparesis. Respiratory involvement is rare. HPP is an important differential in the diagnosis of acute flaccid muscle weakness. It should be promptly addressed to prevent recurrence of paralysis.

Induced Acute Renal Failure (Injury) by Administration of Ethylene Glycol (Antifreeze) in Cats

Etheylene glycol (EG) poisoning is highly dangerous in cats and a small dose of it could cause signs which are initially non-specific and may be easily missed. So,our study was preformed to determine the various effects of EG administration on cats. 10 cats of both sexes aging 1-3 years old were included in this experimental study. Cats were examined before starting the experiment clinically , physically and ultrasonographically to ensure their soundness, then EG was administrated at a dose of 1.4 ml/kg b.wt. orally by using of sterile syringe.clinical signs started with in 12 hours after adminstraion and 4 cases were died in the 2nd day after ingestion and the remaining 6 cats were followed up to 5th day of EG administration. Clinical, physical, , urine, ultrasonographic and post-mortem examinations were preformed on each cat before EG ingestion and on the 2nd and 5th day after EG ingestion . In addition, Blood samples wre collected from each cat for hematological and serum biochemical analysis. Our results revealed that, clinically the cats were depressed ,anorexic, unwilling to move with decreased rectal temperature and pulse rate while the respiratory rate was sigificantly increased at the 5th day of EG ingestion. Hematological analysis showed a significant increase of erythrocytic count while hemoglobin and PCV levels were significantly decreased at the 5th day of the experiment.The total leucocytic count was significanlty increased with significant neutrophilia and lymphocytopenia at the end of the experiment. Serum analysis of these cats showed azotemia, reduction in calcium, potassium and chloride with elevated phosphorus, sodium and magnesium levels. Urinalysis showed calcium oxalate crystalluria which could be noticed shortly after EG ingestion. It could be conculded that ethylene glycol ingestion could cause a sever renal damage in cats which may be fatal and methods of prevention of its ingestion by cats should be applied to avoid its serious effects.

Assessment of Potassium Element on Lentil (&amp;lt;i&amp;gt;Lens culinaris&amp;lt;/i&amp;gt; Medic) Agronomy and Nutrient Use Efficiency in Calcareous Soils

Potassium (K) is considered as key element for plant growth and physiology and improvement of productivity and quality of crops. The potassium (K) reduction from agricultural soils of Indo-Gangetic plain had been observed due to rapidly increasing intensive cropping systems, in combination with imbalanced fertilization. Now, burning issue is needed to better understand the role and dynamic of K in plants and K-use efficiency of crops. Hence, this study was undertaken during two consecutive years of 2015-16 and 2016-17 to know the effects of different levels of potassium on lentil productivity, nodulation, nutrient uptake and K use efficiency. The experiment was laid out in randomized complete block design considering five treatments with thrice replicates. The treatments were T1 (K Control), T2 (15 kg K ha-1), T3 (30 kg K ha-1), T4 (45 kg K ha-1) and T5 (60 kg K ha-1) along with the blanket dose of N18P20S10Zn2B1.5 kg ha-1 and cowdung 3 t ha-1. Yield and yield attributes of lentil responded significantly to K fertilizer. The highest mean seed yield (1684 kg ha-1) and maximum seed yield increase over control (31.9%) got from T5 treatment followed by T4 treatment. The highest total nutrient (N, P, K, S, Zn and B) uptake, maximum nodulation and the highest protein content (29.4%) in seed was, however, recorded from the plot receiving of 60 kg K ha-1. Apparent K recovery efficiency was recorded higher (17.8%) from T4 treatment. Apparent K recovery efficiency followed the order: T4>T5>T3>T2. From the economic point of view, T5 followed by T4 treatment is viable and sound. The results of the experiment suggest that 60 kg K ha-1 might be applied along with N18P20S10Zn2B1.5 kg ha-1 for lentil cultivation in calcareous soils of Bangladesh. The K rates for fertilizer recommendation in lentil need to be revised to take account for highest yield by higher increasing rate of K in soil.

Clinical Impact of Saline Volume Infused Through Irrigated-Tip Ablation Catheter in Low Acuity Paroxysmal Atrial Fibrillation Ablation Patients.

Radio-Frequency ablation (RFA) to achieve pulmonary vein isolation (PVI) remains mainstay therapy for symptomatic paroxysmal atrial fibrillation (PAF). The clinical consequences of large saline infusions during AF ablation have not been systematically studied. We utilized the differential flow-rates of the two commercially available ablation catheters (AC): 'ThermoCool' (TCAC) and 'Surround Flow' (SFAC) from Biosense-Webster to evaluate the clinical impact of the saline infused in the immediate post-ablation period. Consecutive charts of PAF patients between 18 and 81 years who underwent RFA procedure at a tertiary care hospital were reviewed. Forty-seven patients were included in the study (33Males, 65±11years, LVEF 58±7% and left atrial diameter 44±7.5mm, 23TCAC-use). The saline volume infused through the AC was significantly higher with TCAC vs SFAC use (1277±316vs697±299 ml; p<0.001), with no difference in volume infused from other sources, total procedure or RFA times (p>0.05). This led to significant increase in post-ablation weight gain (96±23 vs 97.5±24kg; p=0.002), furosemide usage (39% vs 0%; p=0.0006), urine production (120±79 vs 63±31ml/hr; p=0.003) and post-RFA potassium reduction (4.4±0.42 vs 4±0.32mmol/l; p<0.001) with TCAC use. Significant post-RFA reduction in magnesium, calcium and creatinine, associated hyperchloremic metabolic acidosis and a modest QTc prolongation were also observed with use of both ACs albeit only moderate to weakly correlated with saline volume infused through the AC. No clinical adverse outcomes were encountered. Higher saline-volume infusing AC use in PAF ablation causes significant post-ablation weight gain despite higher furosemide use, larger urine production and associated post-RFA potassium reduction without increasing morbidity in lower acuity patients. Furthermore, an array of post-ablation electrolyte disturbances causes a modest and clinically insignificant QTc prolongation.

Phytocomponents and effect of aqueous extract of the leaves of Alstonia boonei (de wild) on serum electrolyte levels in wistar rats

Alstonia boonei, common name cheese wood contains major phytochemical compounds used for healing. This study evaluated the effects of the aqueous leaves extract of A.boonei on renal function of male and female wistar rats. Twenty-four (24) male and female wistar rats weighing between 120-230 g were randomly assigned into eight (8) groups (A - H) of three (3) rats per group. Groups (A and E) were used as male and female controls respectively while male groups (B – D) and female groups (F – H) served as the test groups and received 500, 1000 and 2500 mg/kg of the extract respectively. After twenty-eight days of extract administration all the animals were fasted for twenty-four hours and sacrificed. Blood was collected by cardiac puncture for analysis of serum electrolytes. The results revealed insignificant difference (P > 0.05) in the serum levels for males and females at the doses tested except level of urea in female rats, it also revealed significant (P < 0.05) reduction in serum sodium and potassium in male animals at doses tested. GC-MS analysis revealed the presence of medicinally important phytochemicals such as hydroquinone for lightening the dark patches of skin caused by pregnancy birth control pills and Oleic acid used as a pharmaceutical solvent for the production of soaps, cosmetics, ointments, lubricants and serves as an emulsifier and assist in the absorption of some drugs by the skin. Alstonia boonei leaf must carefully be exploited medicinally because of the increase in urea levels for female rats and decrease in potassium and sodium in male rats at doses used.

LIME AND GYPSUM APPLICATIONS ON SOIL CHEMICAL ATTRIBUTES AND INITIAL GROWTH OF EUCALYPTUS

Eucalyptus crops in Southern Brazil are generally conducted in acidic soils, thus their yield can be increased by lime and gypsum applications. The objective of this study was to evaluate the effect of lime and gypsum applications on soil chemical attributes and initial growth of Eucalyptus benthamii and Eucalyptus dunnii in a Humic Cambisol (Inceptisol). The experiment was conducted in a greenhouse, with seedlings of both species of eucalyptus grown in soil treated with different rates of lime (0, 3, 6, and 12 Mg ha-1), and gypsum (0, 6, 3, 12.6, and 25.2 Mg ha-1). At 90 days after application of the treatments, the soil chemical attributes and growth components of eucalyptus seedlings. The lime increased the production shoot dry weight, however, the response to gypsum was negative. The lime increased the soil pH, exchangeable calcium (Ca), base saturation (V %), and slightly the soil electrical conductivity, decreased the soil aluminium saturation (m %), and promoted little reduction in the exchangeable potassium (K) and magnesium (Mg) contents. The gypsum didn't alter the soil pH, but decreased the m%, increased soil phosphorus (P) contents, and expressively increased the electrical conductivity, which may have had a negative effect on the eucalyptus growth. In conclusion, the addition of limestone decreases the soil acidity and benefits the growth of eucalyptus seedlings. However, the addition of gypsum has no expressive effects upon those variables, but it can decrease the growth of seedlings when the rates are excessive.

Probiotic Prato cheese consumption attenuates development of renal calculi in animal model of urolithiasis

The effect of probiotic Prato cheese containing Lactobacillus casei 01 (7–8 log CFU/g) on urolithiasis was evaluated. Twenty-four male Rattus novergicus, Wistar line (8 weeks old), with surgical implant of calcium oxalate tablets (CaOx) were used. The animals were organized into four groups (n = 6) randomly divided into: Naive Control (NC); Control of calcium oxalate (CaOx-C); Calcium oxalate with conventional cheese (CC), Calcium oxalate with probiotic cheese (PC). Urinalysis was performed to evaluate volume, density, pH, urea, creatinine, together with serum urea, creatinine, sodium, potassium and magnesium, and latero-lateral radiographs of the abdominal cavity. Only the PC group presented a significant reduction in the size of the pellets (CaOx-C Δ = 1.24 mg, CC Δ = 5.78 mg and e PC Δ = −0.933 mg). Changes in urinary mineral excretion were observed, with a reduction in potassium (NC = 183.7, Caox-C = 313.8, CC = 108, and e PC = 76.4 mmol/L), calcium (NC = 11.0, Caox-C = 3.8, CC = 4.7 and e PC = 3.4 mg/dL. p = 0.002) and magnesium (NC = 11.4, Caox-C = 12.9, CC = 5.7 e PC = 2.4 mg/dL, p = 0.01) excretion. Radiological examination confirmed the role of PC in preventing kidney stone development, which support the PC a superior to the current therapeutics, together with a functional ingredient in nutraceutical applications.

Reduced Versus Conventional Dose Insulin for Hyperkalemia Treatment

Background: Using a reduced dose of 5 units of regular insulin has been proposed as a strategy to mitigate the risk of hypoglycemia when treating hyperkalemia. The comparative efficacy and safety of this strategy to conventional 10 units is not well established. Objective: To compare the effectiveness of reduced and conventional dosed insulin for hyperkalemia treatment. Methods: Electronic medication administration reports of conventional or reduced doses of insulin given for hyperkalemia treatment were reviewed from July 2013 to September 2015. The primary outcome was reduction in serum potassium. Results: Ninety-two administrations of reduced dose insulin and 309 administrations of conventional dose insulin were included. No significant difference was found in potassium reduction between the groups (−0.096 mmol/L, P value = .2210). Post hoc subgroup analysis of patients with serum potassium > 6 mmol/L revealed a lower reduction in potassium in the reduced dose group compared to the conventional dose group (difference: −0.238 mmol/L, P value = .018). Conclusions Conventional dose insulin may be more effective than reduced dose regular insulin at baseline serum potassium levels >6 mmol/L in the treatment of hyperkalemia. Frequent monitoring of serum potassium and glucose after administration of insulin is necessary to confirm adequate response and avoidance of hypoglycemia.

Improved manure and fertilizer practices changes nutrient dynamics in silage meadows on a dairy farm in eastern Hokkaido, Japan

AbstractImproved fertilizer practices were gradually introduced over 8 years to the silage meadows of Konsen Agricultural Experiment Station, a working dairy farm in eastern Hokkaido (approximately 100 ha, a size common in the area). The entire amount of farmyard manure and slurry that was applied to the fields and the entire amount of harvested herbage was measured directly by weighbridge. The nutrient content of the manure was measured every year from 2004, the nutrient content of the harvested herbage and silage was measured every year from 2006, and the amounts of soil‐available nutrients were measured every year from 2008. The two improved fertilizer practices—“more effective use of livestock manure,” which was introduced in 2005, and “nutrient application depending on soil fertility,” which was introduced in 2008—clearly decreased the input of potassium to the silage meadows. By means of improved weed control at grassland renovation from 2008 onwards and implementation of the improved fertilizer practices, herbage yields were maintained at around the target yield for this area, and botanical compositions (percentages of timothy and legumes) were improved. The potassium content of herbage and silage decreased significantly. Furthermore, the potassium content of the slurry also decreased from the year following that when the potassium content of the silage decreased. Reduction of potassium in the farmyard manure tended to be observed the year following the decrease observed in the slurry. Exchangeable potassium in the top 0–5 cm of soil decreased and neared the recommended level. The cost of chemical fertilizer was also reduced. These improved effects measured directly on a commercial‐scale dairy farm at the Konsen Agricultural Experiment Station provide important quantitative evidence for promoting improved fertilizer practices.

Extracorporeal Filtration of Potassium in a Swine Model of Bilateral Hindlimb Ischemia–Reperfusion Injury With Severe Acute Hyperkalemia

Options for the treatment of hyperkalemia in the pre-hospital setting are limited, particularly in the context of natural disaster or during combat operations. Contemporary interventions require extensive resources and technical expertise. Here we examined the potential for a simple, field deployable bridge-dialysis as a countermeasure for acute hyperkalemia induced by prolonged ischemia-reperfusion. Twenty female swine were randomized into two experimental groups undergoing a 2-hour bilateral hindlimb ischemia-reperfusion injury. Subsequent to injury, hemoperfusion was performed in the presence (Column) and absence (Sham Control) of a high-affinity potassium-binding column (CytoSorbents, Monmouth Junction, NJ, USA). Serial blood gas and chemistries were sampled. Primary endpoint was changed in serum potassium concentrations post-injury and filtration. Serum potassium was significantly elevated following ischemia-reperfusion injury in both groups (149% (12) and 150% (22), p < 0.05 vs respective baseline values). There were no differences observed between groups in respect to physiologic parameters; mean arterial pressure, heart rate, systemic vascular resistance, cardiac output, or central venous oxygenation. Filtration resulted in a significant relative decrease in potassium compared with controls after the first hour as determined by repeated measures two-way ANOVA (p < 0.0001) which continued through end of the study. Significant thrombocytopenia was observed in animals undergoing filtration with a mean reduction in platelets measured at T = 480 minutes (168 × 103μL, p < 0.0001 vs baseline). We demonstrate that serum potassium can be filtered via hemoperfusion utilizing a simple extracorporeal potassium-binding platform, though evolution of this technology will be required to achieve meaningful reduction of potassium in clinically significant hyperkalemia after trauma.