Pathophysiology of acute kidney injury on a molecular level: A brief review

Acute Kidney Injury (AKI) is a clinical condition with various etiologies. It is also known as acute renal failure, which is a sudden episode of kidney failure or kidney damage that happens within a few hours or a few days in patients. It causes an increase of waste products in blood and makes it hard for the patient kidneys to keep the right balance of fluid in the body. It can also affect other vital organs such as the brain, heart, and lungs. AKI is common in patients who are in the hospital, in intensive care units, and especially in older adults. It results in increased accumulation of a nitrogenous surplus in blood and a reduction in urine volume. The pathophysiology of various types of AKI is different. The earlier we can identify the causes the more effective treatment can be administered. This review attempts to identify changes on a molecular level during different stages of the disease and further discussed understanding the pathophysiology of AKI to find important molecules involved in various metabolic pathways, various phases and types of AKI, and the effect of drugs on kidneys and cellular level changes. This review article would help to design new drugs and the consequences of their metabolites to avoid Acute Kidney Injury.

Posture Related Musculoskeletal Disorders (MSDs) among Computer Users in Higher Education Sectors of Malaysia

@#Introduction: Computer usage has become an indispensable tool in the official set up of all the workplaces in the current era. Predominance of musculoskeletal disorders (MSDs) in relation to habitual posture during work is the utmost problem of modern society. Teaching staff stand out amongst a group of workers exposed to occupational MSDs. The objective of this study was to identify the prevalence and risk factors of musculoskeletal disorders in relation to posture and computer ergonomics at workplace among the college and university staff in Petaling Jaya, Malaysia. Methods: This cross-sectional quantitative study was conducted from August 2019-October 2019, among 419 volunteers by using a self-administered survey questionnaire. Descriptive and bivariate statistics were used for the analyses of multiple variables. The association between demographic characteristics, computer ergonomics and prevalence of musculoskeletal pains were analyzed through Chi-square test. Results: 55.8 % respondents (n=234) reported neck pain (NP), (n=196) 46.8% shoulder pain (SP) and (n=308) 73.5% low back pain (LBP) respectively. A significant relationship between desktop computer usage and musculoskeletal pains in LBP (P=0.036) and SP (P=0.023) was observed. Significant association of head posture was found with NP (P=0.002), SP (P=0.042) and LBP (P=0.001), correspondingly. Discussion: Habitual postures were significantly associated with musculoskeletal pains while using computer. Conclusion: This study proved with precession that higher prevalence rate of musculoskeletal disorders was undoubtedly influenced by prolonged sitting, awkward postures at workstation, and repetitive movements of shoulders and hands. Further synchronous studies are vital to limit the modern era of musculoskeletal disorders

Effect of cypermethrin on reproductive efficacy in zebrafish (Danio rerio): In-vivo and in- silico studies

Aim: The aim of the present study was to evaluate the reproductive efficacy of male and female zebrafish following cypermethrin exposure. Methodology: The adult zebrafish (Danio rerio) of both sexes were exposed to cypermethrin at three selected concentrations 0.1, 1.0 and 10 µgl-1 over a period of 21days. After completion of experimental period, the reproductive endpoints such as fecundity, hatchability, testis and ovarian histology and plasma vitellogenin levels were selected and determined in this study. Results: Cypermethrin exposure did not affect the cumulative fecundity rates in experimental fishes over controls. However, cypermethrin at 10 µgl-1 showed a significant reduction in the sperm number in male fishes over control. On the other hand, the same concentration of cypermethrin did not show significant changes in the plasma vitellogenin levels of both male and female fishes over their respective controls. Analysis of testicular and ovarian architectures of male and female zebrafish exposed to cypermethrin at 10 µgl-1 showed no marked differences over controls. In addition, molecular docking studies revealed that the binding energy between the cypermethrin and zebrafish estrogen receptor (zfER) β1 was almost similar to the binding energies exhibited by reference molecules, estradiol and ethinyl estradiol with zfERβ1. Further, binding energies between the ligands (cypermethrin and its metabolites phenoxybenzaldehyde and 3-phenoxybenzoic acid) with zfERα were low as compared to the binding energies between the reference molecules and zfERα. Interpretation: In-vivo studies indicated that cypermethrin at 10µg l-1 leads to spermatotoxicity in zebrafish and in silico analysis showed that the cypermethrin at least in part interfere with the signalling of zfERα.

Unusual Foreign Bodies in the Respiratory Tract of Children.

Background: Diagnosis of a foreign body without history of aspiration has always been a challenge to pediatricians.Case Characteristics: Four cases presented with non-relieving acute or chronic history of respiratory symptoms. Observations: All of them had unusual types of foreign bodies – plastic flower toy, button, sticker or stone in their respiratory tract. Outcome: All four patients improved after removal of the foreign body. Message: A differential diagnosis of foreign body should always be made in an acute or chronic presentation of respiratory cases.

Efficacy of commercial and household denture cleansers against Candida albicans adherent to acrylic denture base resin: An in vitro study.

Aim: To evaluate and compare the efficacy of two commercial and two household denture cleansers against Candida albicans adherent to acrylic denture base resin. Materials and Methods: Fifty specimens of acrylic denture base resin (10 × 10 × 2 mm) were fabricated and processed according to the manufacturer's instructions. Sterile acrylic resin specimens were inoculated by immersing in Sabouraud broth containing C albicans for 16 hours at 37°C in an incubator. Then the specimens were washed and immersed in denture cleansers (four groups) - Clinsodent® (powder form), Fittydent® (tablet form), vinegar (4% acetic acid), diluted vinegar (50% diluted with water), and water (control group) for 8 hours at room temperature. After 8 hours the acrylic resin specimens were washed, fixed with methanol, and stained with crystal violet. Candida cells adherent to the acrylic resin specimens were counted under microscope. The number of cells adherent to the test samples were compared with that adherent to the control. Statistical Analysis: The data were analyzed using the independent-samples 't ' tests, analysis of variance (ANOVA), and Tukey's HSD test. Results: All the denture cleansers were highly effective against C albicans. The effectiveness of commercial denture cleansers was significant better than that of household denture cleansers. Fittydent® fared better than Clinsodent® , but the difference between the two was not statistically significant (P=.765). Vinegar was more effective than diluted vinegar (P<.05). Conclusion: Within the limitations of this in vitro study, denture cleansers were found to be effective in reducing C albicans cells adhering to dentures. The commercial denture cleansers (Fittydent® and Clinsodent® ) were more effective than household denture cleansers (vinegar and diluted vinegar).

Role of electron beam treatment in postoperative management of carcinoma of the breast.

The aim of post operative radiotherapy to chest wall and drainage areas in advanced breast cancer is to sterilize the possible microscopic disease. Fifty cases of post surgical breast cancers were evaluated in a prospective study of chest wall radiation therapy by electrons. Fifty women of histologically proved post operative invasive breast cancers underwent simple mastectomy with axillary dissection followed by post-operative radiotherapy (Electron) to chest wall +/- drainage area. The chest wall and IMC was treated by a direct electron beam (9/12 MeV and 12 MeV) at fixed angle. 6 MV X-ray beam was used to treat axillary apex and supraclavicular area. In some cases, supplement RT was given by 6 MV X-rays through small posterior axillary portal. The energy of electron beam was 9 MeV or 12 MeV depending on the thickness of treated area. The supraclavicular and axillary lymphatic regions were treated, by direct custom shaped anterior portal. The dose delivered was 50 Gy over 5 weeks at 2 Gy per fraction. Adjuvant chemotherapy was given to patients who were pre-menopausal with histologically proved axillary node involvement as Cyclophosphamide, Methotrexate and 5-Fluorouracil (CMF) after radiotherapy. Post menopausal patients received adjuvant tamoxifen 10 mg.bid. The overall time varied from 26 to 87 days with a median of 41.5 days (SD 11.7). The followup period varied from 4-32 months with a mean of 22 months (SD 6.4). All the fifty patients developed dense pigmentation towards the end of radiation therapy, along with patchy dry desquamation. Moist desquamation occurred in 6 patients. The median OTT in the patients who developed moist desquamation was 34.5 days. The moist reaction healed over 10-15 days after completion of radiotherapy. Lung Fibrosis (Apical lobe) occurred in four patients. The fibrosis was evident at a median of 12 months of follow up. Lymphoedema of the ipsilateral arm occurred in six patients. None of 50 patients developed late sequalae like Cardiac effects, Rib fracture, Brachial Plexopathy, Shoulder joint impairement and Soft tissue effects. Local control in this study was 96% (48 patients). The two year actuarial overall survival was 80%. In early stages survival was significantly better compared to late stages. The actuarial two year DFS was 72%. In early stages DFS was significantly better compared to late stages.

Primary central nervous system lymphoma a report of nine cases.

Primary Central Nervous System Lymphoma (PCNSL) is a rare neoplasm of B cell origin and constitute less than 1% of Non-Hodgkin's lymphoma (NHL). Histology is mainly of high grade and intermediate type. Although NHL is known to be highly sensitive to both irradiation and cytotoxic drugs, being a curable malignancy, the therapeutic results remain disappointing. Clinical observations on nine cases of PCNSL seen in one of the major cancer centres in India is presented in this paper. Radiotherapy combined with Chemotherapy although yielded encouraging initial response in these patients, the long term response was unsatisfactory with median survival for these patients being only 19 months. This warrants an alternative therapeutic approach to improve the dismal prognosis of PCNSL.

Intraluminal brachytherapy in carcinoma of the oesophagus: comparison of afterloading techniques.

For improved local control or palliation of oesophageal cancers, Intra-luminal brachytherapy (ILB) has emerged as an increasingly popular treatment modality of therapy in recent years. In combination with external radiotherapy, afterloaded ILB can increase local control rates and may prolong survival of these patients. In this paper two techniques of ILB viz., manual and low dose-rate remote after loading methods, using Caesium-137 tubes and pellets respectively, are described in detail. On comparison of these two techniques it was found that both of them were similar with respect to their physical characteristics (dose rate, dose fall-off, maximum spinal cord dose, total reference air kerma, etc.). Clinically, the manual afterloaded ILB technique was found to be easier to use when compared with the low-dose rate remote afterloader. In addition, the number of patients with uterine cancers being high in a developing country, it was found that it was inappropriate to use the low dose remote afterloaders, designed for use in gynaecological cancers, for ILB of oesophageal cancers. Therefore, in the absence of high dose rate afterloaders, which can be utilized for intracavitary treatments of both uterine and oesophageal malignancies effectively, the manual after-loading ILB system as described in this paper could be a practical alternative. Cancer Oesophagus, Intraluminal radiotherapy technique.

The dose time relationship in the radiotherapy of carcinoma of the cervix--application of CRE formalism.

A retrospective analysis of 291 patients with cancer of the uterine cervix treated with a combination of external and intracavitary radiotherapy was carried out. Patients were either treated with 45 Gy in 20 fractions by five fractions per week or with 42 Gy in 14 fractions by three fractions per week or with 42 Gy in 14 fractions by three fraction per week schedule by external radiotherapy. For brachytherapy the total dose was 24 to 32 Gy at a dose rate of 1.4 to 2.2 Gy per hour. Complication were correlated with total CRE values for point A (CRE TA) and for rectum CRE TR. Correlations of CRE TA with overall complication rate (p value < 0.05) and rectal complication rate (p value < 0.01) were excellent. Lack of correlation was observed between CRETR and overall complication rate (p value > 0.1) as well as rectal complication rate (p value > 0.1). In order to limit Grade II and III rectal and bladder complications to acceptable level, in combined external and intracavitary treatments, CRETA value of less than 2500 reu is suggested.

Alterations in some dehydrogenase profiles of sciatectomized toad gastrocnemius muscle-metabolic modifications by malate.

Sciatectomized toad gastrocnemius has shown a progressive loss in lactate (LDH), succinate (SDH) and malate (MDH) dehydrogenase activities and elevation of glutamate dehydrogenase (GDH) activity during post-neurectemic days. The possible role of malate in the restoration of metabolic homeostasis in denervated muscle is discussed.