Modulation of Renal Parenchyma in Response to Allogeneic Adipose-Derived Mesenchymal Stem Cells Transplantation in Acute Kidney Injury

BACKGROUND AND OBJECTIVES: In regenerative medicine, mesenchymal stem cells derived from adipose tissues (Ad-MSCs) are a very attractive target to treat many diseases. In relation to nephrology, the aim of the current study is to investigate the effects of Ad-MSCs for the amelioration of acute kidney injury and to explore the mechanism of renal parenchymal changes in response to allogeneic transplantation of Ad-MSCs. METHODS AND RESULTS: The nephrotoxicity was induced by cisplatin (CP) in balb/c mice according to RIFLE Class and AKIN Stage 3. PCR, qRT-PCR and fluorescent labeled cells infusion, histopathology, immunohistochemistry, functional analyses were used for genes and proteins expressions data acquisition respectively. We demonstrated that single intravenous infusion of 2.5×107/kg mAd-MSCs in mice pre-injected with CP recruited to the kidney, restored the renal structure, and function, which resulted in progressive survival of mice. The renal tissue morphology was recovered in terms of diminished necrosis or epithelial cells damage, protein casts formation, infiltration of inflammatory cells, tubular dilatation, and restoration of brush border protein; Megalin and decreased Kim-1 expressions in mAd-MSCs transplanted mice. Significant reduction in serum creatinine with slashed urea and urinary protein levels were observed. Anti-BrdU staining displayed enhanced tubular cells proliferation. Predominantly, downgrade expressions of TNF-α and TGF-β1 were observed post seven days in mAd-MSCs transplanted mice. CONCLUSIONS: Ad-MSCs exerts pro-proliferative, anti-inflammatory, and anti-fibrotic effects. Ad-MSCs transplantation without any chemical or genetic manipulation can provide the evidence of therapeutic strategy for the origin of regeneration and overall an improved survival of the system in functionally deprived failed kidneys.

management of glycemic control in associated disorders

Glycemic control is a very useful parameter for the prevention of the chronic metabolic diseases complications such as diabetes, metabolic syndrome, cardiovascular and kidney disease. Glycemic control management among chronic metabolic diseases has been an area of active research from the past decades. The glycemic index specifies that how fasting blood glucose level is elevated after consuming a high carbohydrate-containing diet. The metabolic studies among the human populations showed that glycemic index is directly related with different chronic metabolic diseases. The sturdiest associations are suggested that the low caloric diet consumption can prevents metabolic complications. Primary and tight glycemic control is compulsory to prevent and reduce the development of vascular complications in individuals with chronic disorders. The aim of this review was to provide a practical guideline on the bases of the survey of the related key studies which had reflected the clinical guidelines and current perspectives related to glycemic management. The objective of this review is also to investigate the interventions, related to glycemic control in patients with diabetes, metabolic syndrome and cardiovascular diseases. In conclusion, we can say that multidisciplinary management of glycemic control are powerful measure for the prevention of metabolic diseases complications, providing necessary support for reducing in economic burden of chronic metabolic diseases

Fetomaternal outcome of pregnancy with Mitral stenosis

Objective: To evaluate the frequency of fetomaternal outcome of pregnancy with Mitral stenosis admitted in Civil Hospital Karachi. Methods: It was a two years descriptive study done in the Department of Obstetrics and Gynaecology Civil Hospital Karachi. All pregnant women with a known or newly diagnosed Mitral stenosis on echocardiography were included in the study. History was taken regarding age, parity, gestational age [calculated by ultrasound] and complaints. Mode of delivery and Maternal mortality noted. Foetal outcome was analyzed by birth weight and Apgar score. Results: A total of 101 patients meeting the inclusion criteria were enrolled in the study. The ages of the women ranged between 20-29 years [69%] and 81% were multigravidas. Vaginal delivery occurred in 67 [66.3%] women and 78.3% were term pregnancies. Preterm deliveries were 21.8% and 27.7% newborns were low birth weight. APGAR score <7 was found in 14.9% of neonates and 9 babies had intrauterine death. Low ejection fraction<55% was diagnosed in 20[13.9%] women and Maternal mortality was found in two cases. Conclusion: Heart disease in pregnancy is associated with significant morbidity, it should be carefully managed in a tertiary care hospital to obtain optimum maternal and foetal outcome

Prevalence of metabolic syndrome among obese diabetic subjects

Background: Metabolic syndrome [MS] is a cluster of metabolic risk factors including obesity, glucose intolerance, insulin resistance, dyslipidemia and hypertension. MS in obese and type 2 diabetic [T2DM] subjects increases the risk of cardiovascular diseases [CVD]. The objective of the present study is to estimate the prevalence of MS in obese T2DM subjects by using International Diabetes Federation [IDF] and National Cholesterol Education Program-Adult Treatment Panel III [NCEP-ATP III] definitions

Methods: Obese T2DM [n=70] and normal healthy subjects [n=30] of both genders were selected from hospitals and diabetic centers of various localities of Karachi, Pakistan. The frequency of MS was estimated by utilizing criteria of the proposed definitions of IDF and NCEP-ATP III

Results: The prevalence of MS using IDF definition in obeseT2DM subjects was 85.7%. It is significantly higher [p

Conclusion It is concluded that, the overall prevalence of MS is increasing significantly in obese T2DM subjects by using IDF and NCEP - ATP III definitions. However, IDF is more stringent for defining MS. Therefore, it is needed to initiate the preventive measures of a healthy lifestyle and emphasis should be given to reduce weight, increase physical activity, and increase intake of healthy low-glycemic-index foods

psyche of caesarean

The present study was conducted to assess psychological, social and physical impact of caesarean on a woman. It is a Cross sectional and comparative study and was conducted at department of Obstetrics and Gynaecology, Jinnah Hospital, Lahore. The study included random selection of two hundred and twelve women with recent caesarean section [within 6 weeks] admitted in the ward or presenting in out patient department of Jinnah Hospital, Lahore From January 2004 to April 2004. They were divided in two groups. Group I with one caesarean section included 124 patients and Group II with repeat caesarean sections included 88 patients. The women were interviewed according to a preset proforma. Out of the two hundred and twelve women interviewed, the age, social and educational status were comparable between the two groups. 40.3% of the patients in group I and 56.8% in group II [P value < 0.05] were apprehensive because of pain. 40.3% of group I and 50% of group II [P value > 0.05] patients were scared of immobility. 40.3% in group I and 36.4% in group II [P value > 0.05] said that they had to stay longer in the hospital. 56.5% in group I and 56.8% in group II [P value > 0.05] were afraid of anaesthesia. 27.4% in group I and 15.9% in group II [P value < 0.05] had reservations because of excessive blood loss. 9.7% in group I and 18.2% in group II didn't like caesarean section because of risk of infection [P value > 0.05]. 38.7% in group I and 40.9% in group II felt bad of scar in the abdomen [P value > 0.05]. 37.1% in group I and 31.8% in group II [P value > 0.05] had social pressures. 58.1% in group I and 56.8% [P value > 0.05] in group II had problems with care of the neonate [Feeding]. 4.0% of group I and 6.8% [P value > 0.05] of group II patients had mild psychological problems like anxiety and postpartum blues, which settled with psychological support and anxiolytics. 35.5% of group I and 28.4% of group II [P value > 0.05] had fears about future fertility. 25.8% in group I and 40.9% [P value < 0.05] in group II did not mind having caesarean in next pregnancy. Although there are some fears in the minds of women about caesarean section, the common problem are benign and manageable, they can be alleviated through counseling and better care. Larger studies are required to assess each variable independently