Pattern of acute kidney injury and its outcome in a tertiary care centre

Background: Acute kidney injury is a multiplex disease with severe morbidity and mortality. The trends of acute kidney injury vary according to the regions and the population under study. The aim of this study is to evaluate the trends of acute kidney injury and its outcome in a tertiary care hospital.Methods: The study was a prospective observational study conducted at a tertiary care hospital in a metropolitan city. A total of 102 patients of acute kidney injury were selected based on the Kidney Disease Improving Global Outcomes guidelines of acute kidney injury. The main trends of acute kidney injury presentation and its outcome were assessed.Results: Of 102 patients admitted, 42 had a sepsis related diagnosis (42.41%), 17 patients (17.16%) had cardiovascular disease related acute kidney injury and 12 patients (12.12%) had developed acute kidney injury due to drugs and poisons. According to RIFLE (risk of renal failure, injury to kidney, failure and loss of function and end-stage kidney disease) category, 43.96% of patients belonged to the risk category and 30.77% to the injury category. Of 34 patients in failure category, 23 recovered and 11 did not recover. Authors compared the trends of acute kidney injury in patients who recovered and who deteriorated. The mean serum creatinine values were 3.42 mg/dl in patients who didn’t recover from acute kidney injury and 2.05 mg/dl in patients who recovered. In patients of the recovered group, the mean urine output value is 783 ml/day; in deterioration group, 445 ml/day.Conclusions: Most common etiologies of acute kidney injury in this study include sepsis, drugs and poisons, cardiovascular diseases and diarrheal diseases in order of occurrence. High serum creatinine at admission and oliguria were the most common factors that contributed to deterioration in acute kidney injury.

Correlation between salivary glucose and blood glucose levels in diabetic and non-diabetic individuals

Background: The aim of this study was to determine as well as to compare the salivary glucose levels in the diabetic and non-diabetic population and correlate the values with their fasting blood glucose and HbA1c (glycated Haemoglobin) levels. Many researchers have proposed the possibility of using salivary glucose estimation for screening and monitoring of effect in general population and in resource poor settings. But studies on this subject in Indian population are limited.Methods: The current study was an analytical cross sectional study of a group of 100 diabetic patients and 100 healthy controls, conducted in the Department of General Medicine, SRM medical college hospital. The mean difference in the salivary glucose between diabetic and non-diabetic population was compared using unpaired t-test.Results: There was a strong positive association between FBS (fasting blood sugar) and salivary glucose in the overall population. There was a strong positive correlation between FBS and Salivary glucose in FBS <200. There was a moderate positive association between FBS and salivary glucose in people with FBS value between 200 to 300 mg/dl. There was a weak positive association between FBS and salivary glucose in people with FBS value >300 mg/dl, which was statistically not significant. There was a strong positive correlation between HbA1c and salivary glucose in the overall population.Conclusions: There appears to be a strong positive association between fasting blood sugar and salivary glucose value in both study groups. But the correlation seems to be relatively weak in fasting blood sugar range above 300 mg/dl. Considering this positive association, further studies are needed to explore the possibility of utilizing salivary glucose for monitoring glycemic control.

A rare case of Guillain-Barre syndrome with pregnancy.

Guillain-Barre syndrome is a rare neuorological disorder affecting 6-24/ 1,00,000 population during pregnancy. The case involved a 29-year-old woman conceived after 14 years of marriage presenting with 16 weeks pregnancy and clinical symptoms of Guillain-Barre syndrome. It was confirmed by nerve conduction test and patient was started on intravenous immunoglobulin. She had a rapid recovery following therapy and subsequent follow-up 3 months later showed complete recovery and healthy ongoing pregnancy. Various diagnostic and treatment options are discussed.

Effect of Santhi Kriya on certain psychophysiological parameters: a preliminary study.

Santhi Kriya is a mixture of combined yogic practices of breathing and relaxation. Preliminary attempts were made to determine the effect of Santhi Kriya on certain psychophysiological parameters. Eight healthy male volunteers of the age group 25.9 +/- 3 (SD) years were subjected to Santhi Kriya practice daily for 50 minutes for 30 days. The volunteer's body weight, blood pressure, oral temperature, pulse rate, respiration, ECG and EEG were recorded before and after the practice on the 1st day and subsequently on 10th, 20th and 30th day of their practice. They were also given a perceptual acuity test to know their cognitive level on the 1st day and also at the end of the study i.e., on the 30th day. Results indicate a gradual and significant decrease in the body weight from 1st to 30th day (P less than 0.001) and an increase in alpha activity of the brain (P less than 0.001) during the course of 30 days of Santhi Kriya practice. Increase of alpha activity both in occipital and pre-frontal areas of both the hemispheres of the brain denotes an increase of calmness. This study also revealed that Santhi Kriya practice increases oral temperature by 3 degrees F and decreases respiratory rate significantly (P less than 0.05) on all practice days. Other parameters were not found to be altered significantly. It is concluded that the Santhi Kriya practice for 30 days reduces body weight and increases calmness.

Biogenic amines in human gingiva in healthy and inflamed states.

As inflammatory disturbance are of significance in every aspect of periodontal disease, it was deemed pertinent to conceive on experimental study exploring the existence and relationship of biogenic amines, at least in the inflammatory gingiva. Gingival samples from 50 human individuals representing varying grades of inflammatory involvement have been utilised in the present work. From the results of this study, it could be elucidated that biogenic amines (noradrenaline, dopamine and 5-hydroxytryptamine) should show elevated concentration in inflammatory states of the gingiva. Further, these amines turnover was confirmed by studying monoamine oxidase which is a catalyzing enzyme of noradrenaline and 5-hydroxytryptamine; and 5-hydroxy indole aceticacid is a metabolic end product of 5-hydroxytryptamine. This was of a transitory nature indicating increased levels at the early stages of inflammation followed by a decrease at the peak of the gingival inflammation. It is assumed that biogenic amines helps in regeneration of connective tissue of the oral mucosa during the initial development of inflammation rather than final stages of the process, thereby emphasizing its transitory role in the inflammatory process.

Cholinergic components in human gingiva in healthy and inflamed states.

Acetylcholine (ACh) and acetylcholinesterase (AChE) are main components in cholinergic nervous system. ACh is a natural constituent of many parts of the nervous system and its chief role is neurotransmission. It is not entirely unique in function to the cholinergic tissues of the human body. Gingiva is the part of the oral mucosa which contains numerous mast cells. They contain a variety of biologically active substances including neurotransmitters such as 5-hydroxytryptamine, histamine etc. In the dental literature accessible to authors no data were found on ACh and AChE in the different oral structures in health and inflamed conditions. Therefore gingiva samples from 50 human individuals representing varying grades of inflammatory involvement have been utilised in the present study. ACh and AChE were estimated in the gingiva tissues by flurometric and spectrophotometric methods. This study established hithero unknown "norms" for the ACh and AChE contents of the clinically normal gingiva, which are found to be 0.85 +/- 0.06(SE) ug/g and 210 +/- 18(SE) micromoles ACh hydrolysed/hr/gm/wet tissues. Results also revealed that the range of variations of ACh is high and AChE is low in all the inflamed states of gingival tissues.

Alcoholism: newer methods of management.

Chronic alcoholics were selected from hospitals and A.A. Centres and subjected to different methods of treatment namely, psycho therapy, stereotaxic surgery, nonvolitional biofeedback, Yoga and meditation and extremely low frequency Pulsed Magnetic Field. Each group comprised a minimum of 20 subjects. All were males between the ages of 20 and 45 years. Investigations done were clinical, psychological, biochemical, neurochemical and electrophysiological. Improvement was noticed in all the patients, the degree varying with the different methods of treatment. The patients were followed up at least for a period of one year.