Serum Blood Urea Research Articles

Impact Of Continuous Treatment With Propylthiouracil On Renal And Hepatic Functions In Rabbits

This study was designed to investigate the effect of continuous treatment with the anti-thyroid drug, propylthiouracil (PTU), on renal and hepatic functions in rabbits as an experimental animal model. Animals were randomly divided into four different isolated groups (n = 10); Group I received normal saline. Group II, III, and IV were daily administrated with PTU in oral dosing of 50, 75, and 150 mg/kg, BWT, respectively, for three successive weeks. Serum T3 and T4 levels were measured in all groups. Increased serum creatinine and blood urea nitrogen levels (P<0.05) were also associated. Moreover, liver enzymes levels, aspartate aminotransferase, alanine aminotransferase, and total serum cholesterol levels showed a significant increase in a dose and time decedent manner. Thyroid glands of PTU-treated rabbits showed variable sized-follicles lined by multiple layers of follicular cells, which displayed signs of hyperactivity as the average follicular cell height. The diameter of its width was significantly increased compared with that in the control group. Besides, follicles were filled with a variable quantity of low-dense vacuolated colloids. Kidneys of such animals showed tubulointerstitial nephritis, glomerular atrophy, and multiple focal areas of mononuclear cell reaction. While the observed hepatic lesions were in the form of severe congestion in central vein and hepatic artery, hepatocellular necrosis, and granulocytic lymphoid cellular responses around portal areas associated with peri-portal fibrosis. Such lesions were dependent on doses of PTU. This study referred to that continuous treatment with an antithyroid drug PTU induced a hypothyroid state that was associated with impaired renal and hepatic functions in rabbits.

Protective effect of ginsenoside Rg5 against kidney injury via inhibition of NLRP3 inflammasome activation and the MAPK signaling pathway in high-fat diet/streptozotocin-induced diabetic mice

Diabetic nephropathy (DN) is a common and serious complication of diabetes and causes kidney failure. Ginsenoside Rg5 (Rg5) is an important monomer in the main protopanaxadiol component of black ginseng. Rg5 has exhibited some beneficial biological effects, such as anti-cancer, neuroprotection, and anti-depression, but the effect of Rg5 on DN and its potential mechanism remains unclear. The aim of this study is to investigate the effect of Rg5 on kidney injury of C57BL/6 diabetic mice induced by high-fat diet and streptozotocin. After treatment with different concentration of Rg5 (30 and 60 mg kg−1·d−1) for 6 consecutive weeks, the fasting blood glucose, insulin levels, serum creatinine, serum urea, and serum UA in Rg5-treated DN mice were significantly reduced, while the renal histopathology was remarkably improved, compared with untreated DN mice. Moreover, ROS production, oxidative stress markers (MDA, SOD, and GSH-PX), Nox4 and TXNIP expressions of kidney in DN mice were significantly reduced after Rg5 treatment. Additionally, the expression levels of the NLRP3 inflammasome (NLRP3, ASC, and Caspase-1) and the inflammatory cytokines IL-1β and IL-18 were significantly inhibited, and the expression of NF-kB and the phosphorylation of p38 MAPK were also decreased with Rg5 treatment compared with no treatment in DN mice. Together, our results indicate that Rg5 attenuated renal injury in diabetic mice by inhibiting oxidative stress and NLRP3 inflammasome activation to reduce inflammatory responses, indicating that Rg5 is a potential compound to prevent or control diabetic renal injury.

Effects of Dietary Rosemary Essential Oil on Growth Performance, Carcass Traits and Some Hematological Values of Chukar Partridge

The aim of this study was to determine effects of different dietary rosemary essential oil levels on growth performance, carcass traits and haematological values of breeder chukar partridge. Eighty (60 females and 20 males), 32-week-old breeder chukar partridge were randomly divided in five treatments, with four replicate pens with 4 birds each. Five experimental diets were formulated according to rosemary essential oil inclusion rates 0 mg/kg, 24 mg/kg, 48 mg/kg, 72 mg/kg and 96 mg/kg, respectively. The experiment lasted for 8 weeks. The chukar partridges had free access to ad libitum feed and water. At the end of the trial, 1 male and 1 female partridge were slaughtered for blood analysis. The obtained results showed that there was no significant difference in feed intake, body weight gain between the control and treatment groups. Dietary rosemary essential oil supplementation did not affect blood serum glucose, urea, triglyceride, total cholesterol, HDL-C and LDL-C levels in breeder Chukar partridges. It could be concluded that supplementing rosemary essential oil into Chukar partridges diet show no negative effect on growth performance.

URINARY LEAD CONCENTRATION IN CHRONIC KIDNEY DISEASE PATIENTS AT NEPHROLOGY CLINIC IN SABAH

Presently, scientific knowledge on the association between urinary lead concentration and renal profile is limited, especially on the characteristic of urinary lead that could aggravate existing kidney disease. This study aims to determine the concentration of urinary lead with serum creatinine and blood urea nitrogen in chronic kidney disease patients and to identify the influences of confounding factors and the blood pressure on the chronic kidney disease patients. Graphite Furnace Atomic Absorption Spectrometer was used to determine the urinary lead concentration. The differences and correlation of urinary lead with serum creatinine, blood urea nitrogen and diastolic blood pressure between the chronic kidney disease patients and control groups were assessed using Mann Whitney U and Spearman correlation tests. Our findings indicated a significantly higher urinary lead concentration in the chronic kidney disease group compared to the control group (p-=0.002). Nevertheless, there is a weak relationship between urinary lead with serum creatinine, blood urea nitrogen and diastolic blood pressure in the chronic kidney disease group (r values: -0.123, 0.101, and 0.127). In addition, sociodemographic factors did not influence the concentration of urinary lead (p&gt;0.05). The urinary lead concentration in the chronic kidney disease group is not substantial, thus the evidence of urinary lead accumulation in chronic kidney disease group who have yet to start renal replacement therapy is inconclusive.

Serum osmolarity as a potential predictor for contrast-induced nephropathy following elective coronary angiography.

Contrast-induced nephropathy (CIN) is a relatively common complication following primary coronary angiography (CAG) or percutaneous coronary intervention (PCI), especially in at-risk patients. The goal of this study is to evaluate the role of pre-procedural serum osmolarity as a risk factor for CIN in patients undergoing elective CAG for stable coronary artery disease (CAD). A total of 356 stable CAD patients scheduled to undergo CAG or PCI were included in this two-center study. Serum osmolarity was calculated on admission. CIN was defined according to the KDIGO criteria. There were 45 (12.6%) patients who developed CIN 48-72h after CAG or PCI. CIN patients had a higher prevalence of diabetes (51.1% in those with CIN vs 24.4% in those without CIN, p < 0.001), higher serum glucose (129mg/dL in those with CIN vs 108mg/dL in those without CIN, p < 0.001), blood urea nitrogen (22.4mg/dL in those with CIN vs 19.0mg/dL in those without CIN, p = 0.01) and serum osmolarity (294.2mOsm in those with CIN vs 290.1mOsm in those without CIN, p < 0.001) levels, had received a higher dose of contrast (250mL in those with CIN vs 200mL in those without CIN, p = 0.03) but had lower hemoglobin (12.9g/dL in those with CIN vs 13.6g/dL in those without CIN, p = 0.04) level. In multivariate analysis, serum osmolarity [odds ratio (OR) 1.11; 95% confidence interval (CI) 1.04-1.18 for each mOsm/L increase; p = 0.001], diabetes (OR 2.43, 95% CI 1.26-4.71; p = 0.01), C-reactive protein (OR 1.04, 95% CI 1.01-1.08 for each mg/dL increase; p = 0.02) and contrast volume (OR 34.66, 95% CI 1.25-962.22 for each L increase; p = 0.04) remained as independent predictors of CIN. Serum sodium, glucose and blood urea nitrogen contributed to the excess serum osmolarity of CIN patients. Serum osmolarity is a cheap and widely available marker that can reliably predict CIN after CAG or PCI. Future research should focus on determining a clinically optimal cutoff for serum osmolarity that would warrant preventive interventions. Furthermore, later research may investigate the role of serum osmolarity not only as a risk factor but also as a pathogenetic mechanism underlying CIN.

Study the Link between Laparoscopic Cholecystectomy and Abdominal Wall Paraumbilical Hernia

A laparoscopic cholecystectomy is a surgery which includes the removal of gallbladder. It is a minimally invasive cholecystectomy wherein inside of the abdomen is visualize with the help of camera introduced through 4 small incisions to remove the gallbladder by using long tools. The aim of the present study is to evaluate the correlation between abdominal wall hernia (paraumbilical hernia) and laparoscopic cholecystectomy in the Iraqi patients (n=100). The age of the patients was 25 to 36 years. Before surgery, the red blood cells, white blood cells and serum urea were found to be 105.67±3.00; 13731±1940.4 and 33.48±0.47, respectively. After surgery, the red blood cells, white blood cells and serum urea were found to be 117.95±4.21; 10307.9±1057.7 and 35.25±0.46, respectively. The laparoscopic cholecystectomy with previous abdominal wall hernia is the easiest operative procedure. However, it required good experience and careful dissection.

Influence of Iron Administration on Kidney Serum Parameters

Some minerals are essential nutrients for organisms being necessary in different quantities, but any homeostasis disturbance (deficiency or excess) can lead to various diseases. Iron in the body plays a critical role being directly involved in the respiration process - more precisely O2 and CO2 transportation, and also in beneficial oxidation-reduction processes. But sometimes the iron can also lead to the formation of substances with toxicogenic potential, more precisely to free radicals formed as a result of oxidative stress. In the liver, there is a specialized protein - hepcidin - which is the key regulator of circulating iron in the organism. In several cases of overdose, this protein blocks the iron transportation, binds it to the export channels of ferroportin and finally sends the excess iron to the kidney for urinal excretion. Our experiment tried to evaluate if in case of iron intraperitoneal administration in excess to rabbits, for a short period of time, it influences the serum creatinine, uric acid, and blood urea nitrogen if the rabbits were fed with a special organic diet. The results of the experiment presented a lower concentration of creatinine (with 24.46%), uric acid (with more than 41.48%), and blood urea nitrogen - BUN (6.45%) for experimental rabbits compared to the control group, proving that a well-documented diet influences the accumulation and excretion of excess iron. Keywords: iron, creatinine, uric acid, blood urea nitrogen

EVALUATION OF THE IMPACTS OF METALS ON SOIL SAMPLES, SERUM CREATININE AND BLOOD UREA NITROGEN OF RESIDENTS IN SELECTED INDUSTRIAL COMMUNITIES IN A DEVELOPING COUNTRY

Information on the major exposure biomarkers of people living around industrial areas in Africa are very limited. This study aims to analyse the level of hazardous metal (cadmium, lead, copper, and zinc) in two seasons’ soil samples of four industrial and one (1) control areas of Ogun State, Nigeria. Similarly, blood samples of the volunteers (n = 200) were analysed for the impacts of the metals on serum creatinine (SCr) and blood urea (BUN). The mean metal concentrations for soils samples exhibited significant differences with strong positive correlations (r = 0.995 and 1). Compared with regulatory limits for normal individual concerning BUN and SCr, the results of volunteers were all higher, with BUN at ~200% and SCr at ~82% more. The results presented in this study revealed that both the soil environment and the body health system of the residents are being affected by the rapid industrialization, hence heavily burdened.

Spontaneous unilateral hyphema from a strand of persistent pupillary membrane.

A 48-year-old female presented to us with sudden onset dimness of vision in her right eye (RE). There was no history of trauma. Her best corrected visual acuity (BCVA) was 6/9 (partial) (Snellen's) in her RE and 6/6 in her left eye (LE). Her RE showed strands of PPM crossing the pupil. There was active bleeding seen from a point source on one of the strands of the PPM resulting in hyphema formation, 3 mm in height [Fig. 1]. The patient was seen and pupillary dilatation had been done at a local clinic and thus her RE was pharmacologically dilated at presentation. Both eyes had nuclear sclerosis grade II cataract and the intraocular pressures (IOPs) were 16 mmHg and 14 mmHg in the RE and LE, respectively. Gonioscopy showed wide open angles without any new vessels at the angle in both eyes. Fundus examination of both eyes was normal.Figure 1: This is a photograph of the right eye of the patient showing clear cornea, dilated pupil with strands of PPM crossing the pupillary axis. Active bleeding can be seen from a point source on one of the strands of the PPM (white arrow). The resultant hyphema, 3 mm, due to the bleeding from the strand of PPM can be seen in the inferior aspect of the anterior chamber (white arrow with black outline). Plasmoid aqueous can also be noted in the anterior chamberHer systemic examination was normal with normal blood pressure and random blood sugar levels. Gentle compression of the right eye with a pinkie-ball for 3 min was done and the bleeding stopped completely. She was prescribed topical steroids (Loteprednol etabonate 0.5% w/v) four times daily and a mydriatic/cycloplegic eye drop twice daily in the RE for 7 days. She was advised routine blood tests: complete hemogram, fasting and post-prandial blood sugar, serum urea and creatinine, lipid profile and coagulation profile and advised follow-up after 1 week with the reports. At her follow-up after 1 week her BCVA was 6/6 in both eyes and there were no signs of hyphema or active bleeding. PPM in RE was noted as fine strands crossing the pupillary axis [Fig. 2]. Her blood work-up was normal. She refused to undergo an iris angiography since it was an invasive procedure. At her next follow-up visit after 1 month she was asymptomatic with no recurrence of bleeding from the PPM.Figure 2: These photographs show both the eyes of the patient at one week follow-up. In the right eye, strands of PPM can be seen crossing the pupillary axis (white arrows). There is no active bleeding noted from the PPM strands and the hyphema has completely resolved (a). The left eye is normal with no evidence of any PPM (b)The pupillary membrane is a transitory vascular connective tissue covering the anterior surface of the lens during embryonic development. By eight and a half months, the central arcades gets fragmented and disappear. Clinically the remnants of the pupillary membrane are often seen as white strands, in 17.6–31.9% of the cases, but persistent functional vessels are found in only 0.3% which may very rarely bleed.[1234] Our case presented with active bleeding from such a PPM strand. Spontaneous hyphema in the anterior chamber is rare and can occur due to certain reasons like intraocular neoplasms, blood disorders (leukemia, hemophilia), uveitis, rubeosis iridis, fibrovascular membranes in retrolental or zonular area (retrolental fibroplasia, persistent primary vitreous, retinoschisis), juvenile xanthogranuloma, occult trauma or trauma with late effect, hydrophthalmos, vascular anomalies of the iris, histiocytosis X, post-glaucoma surgery and very rarely from PPM.[1234] Literature search revealed that there are very few cases of bleeding from a strand of PPM in adults and it is extremely rare.[12345] Some case reports have documented an iris angiography which showed the anomalous vasculature or aneurysmal dilatation within the PPM strand.[2345] In most of the previously reported cases a predisposing factor, either strenuous effort immediately preceding the bleeding[12] or systemic hypertension[34] contributed in the causation of hyphema; however, Kotamarthi et al. reported the only case of truly spontaneous hyphema similar to our case.[5] This case illustrates that spontaneous bleeding may occur from a strand of PPM. To our knowledge, this is the first case of truly spontaneous bleeding from a strand of PPM being reported from India. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Urinary Enzymes as Early Diagnostic Marker for Diabetic Nephropathy: A Comparison with Cystatin C

Background: Renal damage is a serious major microvascular diabetic complication leading to the death of diabetic patients. Thus, diagnosis of diabetic nephropathy in an earlier stage would be critical. Urinary enzymes which are markers of tubular damage viz. urinary GGT/ALP/LDH and their creatinine standardized ratio can serve as cost effective, feasible, widely available early diagnostic markers for diabetic nephropathy Materials and Methods: Study enrolled 60 subjects for each group. Measurement of fasting blood sugar, random blood sugar, serum urea, serum creatinine, and serum cystatin c were done in serum. Measurement of ALP, LDH, GGT was done in urine. Results: The urinary enzyme levels were significantly high in patients of diabetic nephropathy in comparison to other study subjects. Correlation analysis of Urine Albumin Creatinine Ratio and Urine ALP (r value- -0.1, p value-<0.0001), and Urine GGT (r value- -0.2, p value- <0.0001) Urine LDH (r value- -0.3, p value- <0.0001) of patients suffering from Diabetic Nephropathy was performed using Pearson’s correlation analysis. Correlation analysis of Serum Cystatin C and Urine ALP (r value- 0.2, p value-<0.0001), Urine LDH (r value- 0.01, p value- <0.0001), and Urine GGT (r value- 0.14, p value-<0.0001) of patients suffering from Diabetic Nephropathy was performed using Pearson’s correlation analysis. Conclusion: Correlation studies of urinary enzyme levels with albumin-creatinine ratio (urine) and cystatin C (serum) levels didn’t show any strong correlation (positive or negative) among the enzyme’s levels with established markers of diabetic nephropathy. Given the fact that urinary enzyme levels are increased in case of tubular dysfunction of the nephrons, the result of our study show that, diabetic nephropathy primarily affects the glomerular function.

Targeting Transferrin Receptor 2: A Novel “Erythropoiesis-Stimulating Approach” in a Model of Anemia of Chronic Kidney Disease

Introduction Anemia is a common and invalidating complication of chronic kidney disease (CKD) mainly due to the impaired erythropoietin (EPO) production that parallels the progression of kidney failure. The current treatment, based on erythropoiesis-stimulating agents (ESA), is far from optimal, because of potential off-target side effects. The same holds true for HIF-stabilizers tested in phase 3 clinical trials. For this reason, the identification of agents that selectively boost erythropoiesis would be of great benefit. Transferrin Receptor 2 (TFR2) is a protein expressed in hepatocytes, where it modulates iron homeostasis activating hepcidin production, and in erythroid cells, where it acts as a partner of erythropoietin (EPO) receptor decreasing EPO signaling. Tfr2 deletion in the liver causes iron overload due to low hepcidin levels, while its deletion in erythroid compartment enhances erythropoiesis through increased EPO sensitivity. Aim The study aims at exploring whether erythroid TFR2 is a potential therapeutic target in anemia of CKD, characterized by reduced EPO production and function. Methods CKD was induced by feeding animals an adenine-rich diet for 8 weeks. The protocol was applied to both wild-type animals, to set-up the system, and to mice with genetic bone marrow Tfr2 deletion (Tfr2BMKO). Complete blood count (CBC) and serum urea were evaluated every 2 weeks during the entire protocol. At the end of the 8 weeks animals were sacrificed and a complete phenotypic analysis of hematological parameters, renal damage and iron homeostasis was performed. Results Wild-type mice fed the adenine diet showed renal damage and inflammation, anemia and iron restriction, recapitulating the main features of human CKD. Renal damage and iron restriction were similar between Tfr2BMKO and control mice, excluding a differential effect of the diet on the two genotypes. Tfr2BMKO mice maintained higher red blood cell count relative to controls for the entire timespan. Hemoglobin levels were higher in Tfr2BMKO mice for 6 weeks, while reached levels of controls at 8 weeks. Based on these findings we conclude that BM Tfr2deletion, increasing EPO sensitivity of erythroid cells, improves erythropoiesis and anemia until iron levels remains adequate. Conclusions We confirm that the adenine-induced murine model of CKD can be a suitable tool for the study of the pathophysiology of renal anemia and for the identification and validation of novel potential therapeutic approaches. More importantly, our results suggest that targeting Tfr2 could become a novel approach to ameliorate anemia of CKD. Given the TFR2 restricted expression, its inactivation would enhance EPO responsiveness selectively in erythroid cells, minimizing the risk of side effects. Targeting erythroid Tfr2 might be considered a novel "erythropoiesis-stimulating approach", likely applicable to other forms of anemia due to insufficient EPO stimulation and response. Disclosures Camaschella: Celgene: Consultancy; Vifor Iron Core: Consultancy; Novartis: Consultancy.

Association of the ACE (rs1800764) Polymorphism with Risk of Diabetic Kidney Disease in Saudi Arabian Population: A Pilot Study using the PCR-RFLP Method

Diabetic kidney disease (DKD) also known as diabetic nephropathy is the leading cause of end-stage renal disease, with multiple genetic and environmental factors involving in its etiology. Angiotensin-converting enzyme (ACE) gene is considered to have an important role in the development and progression of DKD. In this case-control study, we investigated the role of ACE T3892C (rs1800764) polymorphism in the development of DKD in Saudi Arabian population. We recruited 150 type 2 diabetic cases with DKD and 150 type 2 diabetic controls without DKD. The differences in age, sex, systolic blood pressure (SBP), diastolic blood pressure (DBP), duration of diabetes, fasting blood glucose, urinary albumin, albumin/creatinine ratio, serum urea and serum-creatinine between the two groups were analyzed. The genotyping of ACE T3892C polymorphism was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Genotype and allele frequencies were calculated by direct counting. Deviations from Hardy–Weinberg equilibrium (HWE) were tested using the Chi-square (χ2) test in both of studied groups. Odds ratio (OR) with 95% CI were used to evaluate the relationship of ACE T3892C polymorphism with DKD susceptibility. Statistical analysis was performed using SPSS (version 21.0) software and Medcalc software (version 16.4.3). The frequency distribution of ACE T3892C polymorphism was found to be different between case and control groups significantly indicating ACE gene could play an important role in the pathogenesis of DKD in Saudi Arabian population.

A Single Arm Trial in Treatment of CKD Patients with Sodium Copper Chlorophyllin Formulation

In a prospective, single arm study of 34 Chronic Kidney Disease (CKD) patients in a trial of 90 days wherein patients got standard-of-care treatment and liquid composition containing Sodium Copper Chlorophyllin, the Investigational Product (IP), as add-on treatment for first 60 days and patients were ‘off’ the IP for last 30 days. Significant reduction in serum creatinine, Blood Urea and Uric acid level and significant improvement in estimated Glomerular Filtration Rate (eGFR), and Health related criteria for quality of life were observed in 60 days’ period of administration. eGFR remained significantly higher on 90th day than 0 day despite withdrawal of IP after 60 days. These observations suggest partial/limited reversal of lost kidney function as a lingering effect of the IP. Both these are first observations opening up new avenues for improving life of CKD patients. This is first clinical trial report of an orally consumed product that decreases serum creatinine and also actually improved health related quality of life within 60 days and a surprising evidence that suggests significant degree of restoration of kidney function in the progressively degenerative disease CKD. This clinical trial opens opportunities for managing CKD that were never available so far.

Tranexemic acid induced bilateral acute renal cortical necrosis

Acute renal cortical necrosis (RCN) most commonly occurs from obstetric complications. However other rare cause includes medications like antifibrinolytics like tranexamic acid, which is used for acute bleeding. We report a case of 17 years female, operated for left cheek arteriovenous malformation and managed post-operatively by intravenous fluids, diuretics, antibiotics and antifibrinolytics (tranexemic acid). Postoperatively she started complaining of severe abdominal pain, breathlessness, weakness and loss of orientation with increasing levels of serum creatinine and blood urea nitrogen (BUN). Patient succumbed to death on day 6 post operative and complete autopsy was performed. All organs were unremarkable except bilateral lungs showed pulmonary edema and bilateral kidneys showed features of diffuse pattern of cortical necrosis both on gross and histopathological examination. As patient had no obstetric or other related history the cause of RCN was attributed to tranexemic acid. Thus patients on antifibrinolytics must be screened for RCN to avoid its fatal complication.

Beneficial Effects of Qingzixiaoban Granule on Henoch-Schönlein Purpura Nephritis Mice through Inhibiting Immune Complex Deposition and Th2 Immunodeviation.

Background Henoch–Schönlein purpura nephritis (HSPN) is the principal cause of morbidity and mortality in Henoch–Schönlein purpura (HSP). However, there is no absolute consensus for the best management of severe HSPN till now. Qingzixiaoban Granule (QZXB GR), a traditional Chinese medicine formula, has been applied to treat HSP in clinical in China. However, the therapeutic effects and potential mechanism of QZXB GR on HSPN is still unknown. Methods A Gliadin plus Indian Ink-induced HSPN mice model was established. Renal histopathologic changes and the subcutaneous hemorrhage on left legs were assessed. Hematuria and proteinuria were determined using hemocytometer and bicinchoninic acid assay, respectively. The serum circular immune complex and interleukin-6 were quantified by ELISA. Using blood biochemical analyzer, the renal biochemical parameters, including serum total protein, albumin, creatinine, and blood urea nitrogen, were measured. The deposition of immune complex in renal tissues and the lymphocyte subsets in peripheral blood and spleen was investigated by immunohistochemistry and flow cytometry. Results QZXB GR treatment significantly ameliorated renal injury in HSPN mice, by attenuating renal histopathological changes, reducing subcutaneous hemorrhage, decreasing proteinuria/hematuria, regulating renal biochemical parameters, and inhibiting the release of serum interleukin-6. Furthermore, QZXB GR treatment significantly decreased the level of serum circular immune complex, decreased immune complex IgA and IgG deposition in renal tissue, and suppressed Th2 immunodeviation. Conclusion QZXB GR could prevent renal injury in HSPN mice, and its renoprotective mechanism might be exerted partly through suppressing immune complexes deposition and Th2 immune deviation.

Evaluation of maternal renal cortical elasticity in pregnancies with early- and late-onset preeclampsia

Objective: The current study aimed to investigate renal cortical elasticity (RCE) in early- and late-onset preeclampsia patients and compare the results with healthy controls.Materials and methods: The study consisted of 136 pregnant women. Three groups were identified as; the late-onset preeclampsia (LOP) group (n = 40), the early-onset preeclampsia (EOP) group (n = 32) and the control group (n = 64). RCE values were measured by point shear wave elastography (pSWE). Nine measurements were taken for each kidney and the mean of nine measurements was accepted as the mean RCE value for each kidney. The arithmetic mean of left and right RCE values was accepted as the overall RCE value of a subject. Groups were compared in terms of clinical and biochemical parameters, ultrasonography findings and pSWE values.Results: There was a statistically significant difference between groups in terms of overall RCE values (F[2,133] = 17.96, p < .001). Post hoc comparisons indicated that both preeclampsia groups exhibited significantly higher RCE values than the control group. However, overall RCE values were not significantly different between the EOP and LOP groups. Overall RCE values were significantly and positively correlated with systolic blood pressure (r = 0.363, p < .001), diastolic blood pressure (r = 0.347, p < .001), proteinuria (r = 0.343, p < .001), serum creatinine level (r = 0.181, p = .035), serum uric acid level (r = 0.243, p = .004) and blood urea nitrogen (r = 0.27, p = .001).Conclusion: Our study demonstrated that maternal renal cortical stiffness increased in women with preeclampsia. The increased RCE values may be indicative for the severity of preeclampsia due to positive correlations between renal cortical stiffness and systolic – diastolic blood pressure and serum creatinine level.

P787Long-term prognostic value of the combination of fibrosis-4 index and acute kidney injury in patients with admitted for acute decompensated heart failure

Abstract Background Liver dysfunction in patients with heart failure (HF) is caused by liver congestion, which is related to liver stiffness. It was reported that liver stiffness assessed by non-invasive fibrosis marker such as Fibrosis-4 (FIB4) index (based on age, aspartate aminotransferase [AST] and alanine aminotransferase [ALT] levels, and platelet counts) predicts mortality in HF pts. Acute kidney injury (AKI) during HF treatment is associated with poor outcome in pts admitted for acute decompensated heart failure (ADHF). However, there is no information available on the long-term prognostic significance of the combination of FIB4 index and AKI in ADHF pts. Methods and results We studied 299 ADHF pts with survival discharge. FIB4 index was calculated by the formula: age (yrs) × AST[U/L]/(platelets [103/μL] × (ALT[U/L])1/2). AKI during ADHF treatment was defined according to AKI Network criteria (stage 1: mild, stage 2: moderate, stage 3: severe). During a follow-up period of 4.3±3.3 yrs, 94 pts died. At multivariate Cox analysis, FIB4 index and stage2/3 AKI, but not stage1 AKI, significantly associated with total mortality, independently of prior HF hospitalization and serum sodium and blood urea nitrogen levels after adjustment with BMI, systolic blood pressure, hemoglobin, serum creatinine and albumin levels, left ventricular end-diastolic and left atrial dimension indexes. Pts with both greater FIB4 index (&amp;gt;2.674: median) and stage 2/3 AKI had a significantly higher risk of total mortality than those with none of them. Adjusted hazard ratio in pts with both greater FIB4 index and stage 2/3 AKI was 3.5 (95% CI 1.6–7.7), which was two-fold of that in pts with either of them (1.7 [95% CI 1.1–2.7]). Conclusion The combination of FIB4 index and moderate to severe AKI might identify higher risk subset for total mortality in ADHF pts.

Exposure to ethion alters rhythmic dynamicity of milieu interior of poultry following exposure at cage system of rearing in Ruhelkhand climatic zone

ABSTRACT The study was conducted to evaluate the effect of ethion in biological rhythmicity in cage system rearing. Twenty-four poultry birds were divided into four groups (n = 6) and were administered with ethion i.e. group I (control), group II (2.5 mg/kg body weight), group III (5.0 mg/kg body weight) and group IV (7.5 mg/kg body weight) via per os route, respectively, for 30 days. After two lunar cycles, findings revealed a significant reduction in bodyweight and absolute organ weight of liver and spleen and haemoglobin in intoxicated groups as compared to control. Haematological attributes showed no significant change. Serum glucose showed a significant reduction in intoxicated groups whereas cholesterol, serum creatinine and blood urea nitrogen showed a significant increase in ethion treated groups as compared to control. Cholinesterase showed significant inhibition in ethion-treated groups. Histopathological studies revealed serous inflammation in group II and moderate to severe degeneration and cellular infiltration in group III and IV, respectively. SEM revealed changes in surface topography in ethion treated groups as compared to control. It is concluded from the above study that ethion produces altered nephric and sanguineous rhythmicity following exposure for two fortnights in dose and time-dependent manner as evident through increment in nephric impairment markers as serum creatinine and blood urea nitrogen alongside pathological alterations in histopathological and electron microscopical findings.

Factors affecting Mortality in Neurosurgical ICU of Manipal Teaching Hospital, Pokhara, Nepal

Introduction: Mortality is an important self-assessment tool in medical practice. This study assesses various factors associated with mortality in Neurosurgery ICU (NS-ICU).&#x0D; Methods: A prospective, cross-sectional study was carried out from January 2017 to December 2017 in 416 patients admitted to NS-ICU. The age, sex, diagnosis, GCS, pupil’s abnormality, vital parameters, laboratory parameters, comorbidities were compared in between mortality and survival group. The individual component of GCS was further evaluated.&#x0D; Results: Out of 416 patients, 374 (89.90%) patients were in survival group and 42 (10.10%) patients in mortality group. Trauma 188(45.20%) and Cerebrovascular accident 133(31.97%) were commonest diagnosis on admission. The GCS, eye-opening and motor component of GCS, abnormal pupils, hypertension (HTN), diabetes mellitus (DM), diastolic blood pressure (DBP), heart rate (HR), operated cases and serum urea levels were found to have significant difference between mortality and survival group. These parameters were further subjected to binary logistic regression which showed DBP (B-0.01, p=0.00), HR (B0.02, p=0.00), motor score of GCS (B-0.50, p=0.04), operated cases (B 1.13,p=0.00), abnormal pupils (B1.85,p=0.00), DM (B1.56, p=0.00) to have significant association with mortality.&#x0D; Conclusions: High heart rate, low diastolic BP, low motor score of Glasgow Coma Scale, abnormal pupils, diabetes mellitus and operated cases were found to be significantly associated with mortality.

Morphological and biochemical parameters of blood of rats for the long-term effect of the drug “Vitosept”

The basis of the drug “Vitosept” is a solution of high-purity sodium hypochlorite (SH), which is obtained in a specially developed dyadiafragm flow electrolyzer, in the process of direct electrochemical reaction, bypassing the formation of molecular chlorine. As an initial electrolyte, an isotonic solution of sodium chloride (0.9% NaCl) was prepared on water purified by a special technology. Such solutions do not contain impurities of organic substances and transition metal ions. The resulting solution of SH is the optimal carrier of active oxygen. The purpose of the study was to find out the effects of various dosage of the drug “Vitosept” for its intravenous introduction, in a long-term experiment. As a result of the conducted experiments, it was found that during the entire observation period of the investigated drug “Vitosept” signs of inadequate reaction, intoxication or death of animals were not observed. At the same time, there were no reservations regarding behavioral reactions, reflex excitability, clinical manifestations of respiratory distress, urinary excision and defecation. Only animals of the 4th group, after administration of the highest dosage of the drug (500 mg/l), were slightly suppressed, were slightly responsive to acoustic and light stimuli, had somewhat disturbed reflex excitability. However, an hour after the cessation of giving the drug, the evidence of all the animals in this group disappeared. It was found out that for long-term intradermal introduction to the laboratory animals of the drug “Vitosept” at dosages of 50 and 100 mg/l, the abnormalities in the studied morphological and biochemical parameters of blood, compared to the same in the control group were not found. Concerning the rats of the IV group that received the highest study dosage of the drug (500 mg/l) through the probe, certain possible changes in the hematological, biochemical parameters of blood (leukocyte count increase in blood, activity of AsAT, LF, decrease in serum urea blood concentration, creatinine) were observed, in our opinion, compensatory and disappeared within a few days after discontinuation of the drug. Consequently, taking into account our previous studies on the establishment of the parameters of acute toxicity of the drug “Vitosept” and the results obtained regarding its effects on hemopoiesis and the functional state of the liver and kidneys, it can be argued that the drug “Vitocet” belongs to the IV class of compounds – low toxicity.