Cystatin C- an early marker indicative of renal dysfunction in critically ill children: a prospective cohort study

Background: Acute kidney injury (AKI) is a sudden onset of kidney failure or kidney damage that happens within a few hours or a few days and can also affect other organs such as brain, heart and the lungs. Hence early diagnosis and intervention is needed to improve the outcome of the children. In these studies this objective was to determine if cystatin C is an early marker indicative of renal dysfunction in critically ill children and to determine if Cystatin C can detect Acute kidney injury earlier than serum creatinine.Methods: This prospective cohort study was undertaken in PICU at Jubilee Mission Medical College from December 2016- May 2018. Blood samples were collected from 34 critically ill children for serum creatinine estimation at 0,24 and 48 hours of admission and serum and urine were collected for cystatin C estimation at admission. Children were categorized into AKI and NON-AKI based on pRIFLE criteria. Comparison of cystatin C values with serum creatinine was performed and Statistical analysis was done using IBM SPSS version 20.Results: A total of 34 critically ill children were enrolled in this study, out of which 12 children progressed to AKI during the course of illness according to modified Pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease (pRIFLE) criteria. We found a strong positive correlation between cystatin C at 0 hours and serum creatinine at 48 hours among AKI groups.Conclusions: Serum and Urine cystatin C are early markers to diagnose AKI in critically ill children. Serum cystatin C is more sensitive than urine cystatin C for the diagnosis of AKI.

Imaging spectrum and prevalence of variant branching pattern of aortic arch

Background: Variant branching patterns of the aortic arch are not infrequent but are commonly under reported. This study was conducted to determine the spectrum of Variant branching pattern of aortic arch and their prevalence using contrast enhanced computed tomography (CECT) images of the cases from a tertiary care centre.Methods:  Contrast enhanced computed tomography (CECT) images of aortic arch region from 1116(629 male and 487 female) cases from 18 to 85 years of age were examined retrospectively. The images were reviewed for normal and variant anatomy of aortic arch and the results were analyzed statistically.Results: Of 1116 patients, 878 (78.6%) cases showed normal and 238 (21.3%) cases had variant branching pattern of the aortic arch. The most common variation was the common origin of brachiocephalic trunk (BCT) and the left common carotid artery (LCCA) which was observed in 160 (14.3%) cases. In 8 (0.7%) cases, BCT and LCCA took origin from a single common trunk arising from the aortic arch. In 60(5.4%) cases, the left vertebral artery (LVA) originated directly from the aortic arch between the origin of the LCCA and left subclavian artery (SCA). 8 (0.7%) cases had aberrant right subclavian artery. Two (0.2%) cases showed right aortic arch.Conclusions: Interventional radiologists and surgeons should be well aware of variant anatomy of aortic arch. Contrast CT is a highly reliable imaging method for demonstrating anatomical features and variations of the arch.

Antioxidant Status in Blood of Patients with Elevated C - reactive protein in Acute Myocardial Infarction

Background: C-reactive protein (CRP) is well known as a marker of inflammation associated with cardiovascular diseases (CVD). Methods: The study group included was patients whose CRP level was above 7 mg/L diagnosed with acute myocardial infarction as case and normal healthy donors were taken as control. Results: In our study we have found that antioxidant such as glutathione (GSH) and Glutathione peroxidise (GPx) activity was decreased in blood of patients with acute Myocardial infarction (AMI) with elevated CRP compared to healthy control. We have also found that proxidant molecule such as malondialdehyde (MDA) was increased in AMI in comparison with control. Conclusion: The study concluded that in acute MI associated with inflammation there is imbalance in redox balance

A rare case of bilateral nasolabial cysts in a postpartum lady.

Nasolabial cyst, also known as Klestadt's cyst is an uncommon nonodontogenic cyst. Bilateral nasolabial cysts are rarer and less than 10 cases have been reported in the literature. Diagnosis is usually clinical and they present as slow-growing swellings in the nasolabial region causing cosmetic deformity and nasal obstruction. A postpartum lady presented with bilateral swelling of the cheeks. Excision was done via a sublabial approach. She is asymptomatic one year after surgery. Nasolabial cysts are developmental but usually noticed after a trauma. There is no data relating the cysts to pregnancy.

Nature, prevalence and risk factors of alcohol use in an urban slum of southern India.

Background. There is a paucity of data on the use of alcohol in urban slums of southern India. Methods. We screened 2811 men for alcohol use via a household-level census in an urban slum in Vellore, Tamil Nadu, and interviewed 220 age- and area-matched pairs of men drinkers and non-drinkers to examine factors associated with alcohol use. Alcohol Use Disorder Identification Test (AUDIT), a standard instrument, was used to assess risk levels of drinking of 354 drinkers. Prevalence rates were calculated using ageadjusted direct standardization. Odds ratios (ORs) of drinking status and higher-risk drinking were calculated using conditional logistic regression and ordinal logistic regression, respectively. Results. Among all men, we estimated that 46.1% consumed alcohol and 31.4% were hazardous drinkers (19% increased-risk, 7.7% high-risk and 4.7% dependent drinkers). Factors associated with alcohol use were: manual labour occupations (OR 2.08); presence of a common mental disorder (OR 1.50) and smoking (OR 2.08); while Muslim religion was protective (OR 0.43). Factors associated with higher-risk alcohol use were: being reported as a non-drinker during the census (OR 3.96); presence of a common mental disorder (OR 3.83); smoking (OR 1.78); drinking before legal age of 21 years (OR 2.71); spending more than `100 per day on alcohol (OR 6.17); and mainly drinking Indian-made foreign liquor (OR 5.45). Conclusion. High prevalence of hazardous drinking and the factors associated with it suggest the need for populationwide interventions and further investigations to effectively reduce hazardous alcohol use and its harmful effects.

Detection of odoriferous subgingival and tongue microbiota in diabetic and nondiabetic patients with oral malodor using polymerase chain reaction.

Background: Halitosis has been correlated with the concentration of volatile sulfur compounds (VSCs) produced in the oral cavity by metabolic activity of bacteria colonizing the periodontal pockets and the dorsum of the tongue. It has been assumed that there is a relationship between periodontal disease and diabetes mellitus. Objectives: The aim of the study was to assess the malodor using the organoleptic method and tanita device; to quantify odoriferous microorganisms of subgingival plaque and tongue coating, such as P. gingivalis (Pg), T. forsythia (Tf), and F. nucleatum (Fn) using polymerase chain reaction (PCR) in nondiabetic and diabetic chronic periodontitis patients. Patients and Methods: Thirty chronic periodontitis patients (with and without diabetes) with 5-7 mm pocket depth, radiographic evidence of bone loss, and presence of oral malodor participated in this study. Subjective assessment of mouth air was done organoleptically and by using a portable sulfide monitor. Tongue coating was also assessed. Results: The scores of plaque index, gingival index, gingival bleeding index, VSC levels, and tongue coating between the nondiabetic and diabetic patients were not significant (P>0.5). In nondiabetic patients, Fn was found to be significantly (P<0.5) more in tongue samples, whereas Pg and Tf have not shown significant values (P>0.5). In diabetic patients, Fn and Tf have shown significant (P<0.5) an increase in subgingival and tongue samples, respectively, whereas Pg has not shown significant difference between subgingival and tongue samples. Interpretation and Conclusion: The results confirm that there is no difference in clinical parameters between nondiabetic and diabetic periodontitis patients, but the odoriferous microbial profiles in tongue samples of diabetic patients were found to be high. However, there is a weak positive correlation between VSC levels, clinical parameters, and odoriferous microbial profiles.