Variables Impacting Gfr Estimation Method For Drug Dosing In Ckd: Artificial Neural Network Prediction Model

Objective: This study aimed to measure concordance between different renal function estimates in terms of drug doses and determine the potential significant clinical differences. Methods: Around one hundred and eighty patients (≥ 18 y) with chronic kidney disease (CKD) were eligible for inclusion in this study. A paired-proportion cohort design was utilized using an artificial intelligence model. CKD patients refined into those who have drugs adjusted for renal function. For superiority of Cockcroft-Gault (CG) vs. modified diet in renal disease (MDRD) guided with references for concordance or discordance of the two equations and determined the dosing tiers of each drug. Validated artificial neural networks (ANN) was one outcome of interest. Variable impacts and performed reassignments were compared to evaluate the factors that affect the accuracy in estimating the kidney function for a better drug dosing. Results: The best ANN model classified most cases to CG as the best dosing method (79 vs. 72). The probability was 85% and the top performance was slightly above 93%. Creatinine levels and CKD staging were the most important factors in determining the best dosing method of CG versus MDRD. Ideal and actual body weights were second (24%). Whereas drug class or the specific drug was an important third factor (14%). Conclusion: Among many variables that affect the optimal dosing method, the top three are probably CKD staging, weight, and the drug. The contrasting CKD stages from the different methods can be used to recognize patterns, identify and predict the best dosing tactics in CKD patients.

Assessment of urban air pollution and it’s probable health impact.

The present study deals with the quantitative effect of vehicular emission on ambient air quality during May, 2006 in urban area of Lucknow city. In this study, SPM, RSPM, SO2, NOx and 7 trace metals associated with RSPM were estimated at 10 representative locations in urban area and one village area for control. Beside this, air quality index (AQI), health effects of different metals and mortality were assessed. The 24 hr average concentration of SPM, RSPM, SO2 and NOx was found to be 382.3, 171.5, 24.3 and 33.8 μg m-3 respectively in urban area and these concentrations were found to be significantly (p<0.01) higher by 94.8, 134.8, 107.4 and 129.6% than control site respectively. The 24 hr mean of SPM and RSPM at each location of urban area were found to be higher than prescribed limit of National Ambient Air Quality Standard (NAAQS) except SPM for industrial area. The 24 hr mean concentration of metals associated with RSPM was found to be higher than the control site by 52.3, 271.8, 408.9, 75.81, 62.7, 487.54 and 189.5 % for Fe, Cu, Pb, Zn, Ni, Mn and Cr respectively. The inter correlation of metals Pb with Mn, Fe and Cr; Zn with Ni and Cr; Ni with Cr; Mn with Fe and Cu with Cr showed significant positive relation either at p<0.05 or p<0.01 level. Metals Pb, Mn and Cr (p<0.01) and Cu (p<0.05) showed significant positive correlation with RSPM. These results indicate that ambient air quality in the urban area is affected adversely due to emission and accumulation of SPM, RSPM, SO 2 , NO x and trace metals. These pollutants may pose detrimental effect on human health, as exposure of these are associated with cardiovascular and respiratory diseases, neurological impairments, increased risk of preterm birth and even mortality and morbidity.

Actinomycosis - Left Post Chest Wall.

A forty year old female of weak body built presented with recurring small hard lumps in let posterior chest wall for 3 years and discharging ulcers for 3 months duration. Clinically, the provisional diagnosis was malignancy with secondary infection. FNAC showed features suggestive of dysplasia but histopathology confirmed the diagnosis as actinomycosis. The present case is reported due to rare incidence of actinomycosis at post chest wall with muscle involvement.

Profile of noise pollution in Lucknow city and its impact on environment.

Automobiles, construction, festivals, factories, stations, diesel shades, garages and workshops are sources of noise. Vehicles are increasing enormously beyond the carrying capacity of the road. Study was carried out at 12 locations with sound level meter to assess day time and night time noise levels of Lucknow city. In residential areas, noise ranged between 67.7 to 78.9 and 52.9 to 56.4; in commercial cum traffic areas 74.8 to 84.2 and 68.2 to 74.9 and in industrial areas 76.9-77.2 and 72.2-73.1 dB(A) during day and night time respectively. Values were higher than their prescribed standards which may pose a significant impact on quality of life.

A study of effects of acid activated saw dust on the removal of different dissolved tannery dyes (acid dye) from aqueous solutions.

The effectiveness of acid activated sawdust in absorbing D-Brown EGP and Lurazol Brown PM dyes from aqueous solutions was studied as a function of agitation time and initial dye concentration. The experimental data were fitted to Langmuir and Freundlich isotherm and found that adsorption process follows both the isotherms. The values of Langmuir and Freundlich constants indicate favorable and beneficial adsorption. Saw dust is an excellent low cost adsorbent of colored organic anions and may have significant potential as a color removal from tannery wastewater.

Recurrent infantile digital fibromatosis--a rare entity.

We present here a rare case of Infantile Digital Fibromatosis in a six year old female child who presented with recurrent swelling over the phalanx of left middle finger.

Pneumothorax due to electrical burn.

A 25-year-old male developed early as well as delayed (15 days post burn) pneumothorax of right side following high voltage, 1100 KV, electrical burn of the right side of the chest wall. Diagnosis was established by clinical examination and chest x-ray. Intercostal tube drainage with underwater seal relieved the patient of pneumothorax.

Comparison of liver histology in chronic active hepatitis C and chronic active hepatitis B.

OBJECTIVE: To study the histological features of chronic active hepatitis C (CAH-C) and to compare these with those of chronic active hepatitis B (CAH-B). METHODS: Thirty-two liver biopsy specimens from patients with chronic active hepatitis and presence of antibodies to hepatitis C on second generation enzyme immunoassay were studied and compared with those in 34 patients with CAH-B. Seventeen of the 32 CAH-C patients had fully developed or developing cirrhosis of liver whereas the remainder had only chronic active hepatitis. RESULTS: Among 32 patients with CAH-C, fatty change (20), Kupffer cell hyperplasia (30), sinusoidal lymphocytosis (27) lymphoid follicles aggregates in portal tracts (26) and bridging necrosis (16) were regular features. Focal necrosis, bile duct necrosis, cholestasis and ground glass cells were however seen much less often. On the other hand, in patients with CAH-B, fatty change (no patient), sinusoidal lymphocytosis (one patient) and lymphoid follicles/aggregates in portal tracts (one patient) were rare. Also, Kupffer cell hyperplasia (22 patients) was seen less commonly in patients with CAH-B as compared to CAH-C. Focal necrosis (34 patients), bile ductular proliferation (9 patients), cholestasis (17 patients) and ground glass cells (15 patients) were more prominent in CAH-B. CONCLUSION: Presence of certain histological features can help in distinguishing between CAH-C and CAH-B.