Abdominoscrotal hydrocele with ipsilateral hydroureteronephrosis in an adult: A case report

Abdominoscrotal hydrocele (ASH) is very rare in adults and difficult to suspect on clinical examination. ASH is a very unusual presentation of scrotal hydrocele with extension intra-abdominally through the inguinal canal either communicating to the peritoneal cavity or non-communicating. An ASH is a congenital pathology involving a scrotal hydrocele expanding through the inguinal canal and reaching the abdominal cavity. Here, we present the case of a 25-year-old man admitted with a complaint of pain and lump in the left lower abdomen for 2 months and swelling in the left groin for 2 years. Ultrasound and computed tomography suggest left ASH with left-sided hydroureteronephrosis. A left DJ stent was placed and on exploration, a large cystic mass was seen intraperitoneally extending into the scrotum through the inguinal canal. Excision of the abdominal part and partial excision of the scrotal part were done with eversion of the remaining tunica vaginalis sac. Although ASH is a rare entity, it should always be kept on the list of differential diagnoses during the complaint of large abdominal mass in adults.

Assessment and comparison of distal radial artery diameter in anatomical snuff box with conventional radial artery before coronary catheterization

Background: The distal radial artery (dRA) approach at anatomical snuff box has gained attention of the interventional cardiologist in last few years. The procedural success rate by this novel approach depends on size of the radial artery and therefore the study was planned to study the size of distal radial artery. Methods: Total of 1004 patients of >18 years of age undergoing coronary catheterization were included in the study. The vessel diameter was measured from media to media in the anatomical snuff box a day prior to coronary catheterization. Results: The mean diameter of right radial artery at conventional access site was 2.56 ± 0.35 mm and at distal access site 2.23 ± 0.39 mm (p < 0.001). Females had significantly smaller radial artery diameter as compared to males at right conventional access site (2.42 ± 0.36 mm vs 2.60 ± 0.34 mm; p < 0.001) and distal access site (2.09 ± 0.38 mm vs 2.27 ± 0.39 mm; p < 0.001). The diameter of the right dRA was not significantly correlated with age (r2 linear ¼ 0.002, p ¼ 0.0475) but was positively correlated with height and weight (r2 linear ¼ 0.076, p ¼ <0.001 and r2 linear ¼ 0.005, p ¼ <0.001) and negatively correlated with BMI (r2 linear ¼ 0.076, p ¼ 0.519). Conclusions: This study has shown the size of right dRA 2.27 þ 0.39 mm in males and 2.09 þ 0.38 mm in females. Diabetes, hypertension, height and weight are important predictors of dRA diameter

Association of cognitive function, depression, and quality of sleep with statins among oldest-old individuals

Background: Oldest?old population is rapidly increasing in all countries, with many prescribed statin therapy. Statins are associated with multiple cardiovascular benefits at various ages. The benefits of statins above the age of 75 are being questioned. The objective of this study was to measure statins use among the oldest?old population, aged 80 years and above, and to study the effect of statins on cognitive function, depression, and quality of sleep. Materials and Methods: This cross-sectional study randomly enrolled 200 community-dwelling individuals aged >80 years. Data were collected upon home visits on sociodemographic, cognitive functions, depression, sleep, chronic diseases, functional limitations, and disabilities. Cognitive function (Mini Mental State Examination), depression (Geriatric Depression Scale), and quality of sleep (Pittsburgh Sleep Quality Index) among individuals using statins versus not using statins were compared. Chi?square test and t-test were done; odds ratios (ORs) with 95% confidence interval (95% CI) were reported. Logistic regression was done to calculate adjusted ORwith age, antidepressants, sedatives, antihistaminics, and sleep medicines. P < 0.05 was considered statistically significant. Results: Overall prevalence of statin use in our study population was 12%; 11.3% in women and 13.2% in men. Cognitive functions, depression, and quality of sleep improved among those using statins (P < 0.05): cognitive impairment – OR: 0.38; 95% CI: 0.16–0.91; depression – OR: 0.41; 95% CI: 0.17–1.02, and poor sleep quality – OR: 0.39; 95% CI: 0.16–0.96. On stratification by gender, men showed a significant association of improved cognitive function and quality of sleep with the use of statins, whereas women did not show any significant associations with cognitive function and quality of sleep but showed almost significant association with improvement in depression. Conclusions: The prevalence of the use of statins was low in our population. Statins had positive effects on cognitive functions, quality of sleep, and depression over 80 years of age in our population, although gender difference exists

Neuroendocrine tumors of the urinary bladder - Report of two cases

Primary paraganglioma and small cell neuroendocrine carcinoma of the urinary bladder are rare tumors, comprising 0.05% of all bladder tumors and <1% of all malignant bladder tumors, respectively. These tumors can be the cause of a diagnostic dilemma or misdiagnosis on morphology. Paraganglioma is often mistaken for urothelial carcinoma and small cell carcinoma for poorly differentiated carcinoma or lymphoma. Herein, we report a case of primary paraganglioma and another of a small cell carcinoma of the urinary bladder and discuss their closest differential diagnoses. The diagnostic pitfalls should be kept in mind so that correct, timely diagnosis of these entities can be made due to implications in the management and prognosis.

Systemic Scleroderma with Complete Heart Block

For patients with Systemic Sclerosis (SSc), cardiac involvement (CI) is directly caused by myocardial fibrosisor ischemia or is secondary to pulmonary arterial hypertension1 Here we present a similar case of a femalepatient aged 45 yr old female who presented with complaint of recurrent syncopal attacks, and difficulty inswallowing food and liquids. She had typical CREST Syndrome manifestations with complete heart block(CHB). For which pacemaker implantation was done.

Emerging Threat of Salmonella typhimurium in Extraintestinal Infections: Cases from a Tertiary Care Hospital in North India

Purpose:Infections due to invasive non-typhoid salmonella can be dangerous and fatal. The mode of infection and the severity varies from the typhoidal fevers. It is important to find the association between clinical features and the infecting serovar to understand the pathophysiology and course of treatment Methods:In the present study, extra-intestinal specimens (blood, cerebrospinal fluid and pus) from three patients suffering from septicaemia, meningitis and osteomyelitis were received. Micro-biological and biochemical test for species identification and antibiotic susceptibility was done as per standard protocol.Further, PCR based amplification and sequencing of a portion of the flagellin gene (FliC) was done to confirm the serovar.Results: Salmonellaentericawas identified from all the threeby microbiological and biochemical examination.The sequence of the Flic gene confirmed the serovar to be S.typhimurium. All the patients were treated successfully for the infectionby appropriate antibiotic therapy. Conclusion:The study highlights that serovarTyphimurium is common in invasive non-typhoidal salmonellosis and its pathophysiology and virulence factors expression should be understood in various organ types for better treatment options and outcomes

Single cell oil production by a novel yeast Trichosporon mycotoxinivorans for complete and ecofriendly valorization of paddy straw

Background: Oleaginous yeasts can be grown on different carbon sources, including lignocellulosic hydrolysate containing a mixture of glucose and xylose. However, not all yeast strains can utilize both the sugars for lipogenesis. Therefore, in this study, efforts were made to isolate dual sugar-utilizing oleaginous yeasts from different sources. Results: A total of eleven isolates were obtained, which were screened for their ability to utilize various carbohydrates for lipogenesis. One promising yeast isolate Trichosporon mycotoxinivorans S2 was selected based on its capability to use a mixture of glucose and xylose and produce 44.86 ± 4.03% lipids, as well as its tolerance to fermentation inhibitors. In order to identify an inexpensive source of sugars, nondetoxified paddy straw hydrolysate (saccharified with cellulase), supplemented with 0.05% yeast extract, 0.18% peptone, and 0.04% MgSO4 was used for growth of the yeast, resulting in a yield of 5.17 g L−1 lipids with conversion productivity of 0.06 g L−1 h−1 . Optimization of the levels of yeast extract, peptone, and MgSO4 for maximizing lipid production using Box­Behnken design led to an increase in lipid yield by 41.59%. FAME analysis of single cell oil revealed oleic acid (30.84%), palmitic acid (18.28%), and stearic acid (17.64%) as the major fatty acids. Conclusion: The fatty acid profile illustrates the potential of T. mycotoxinivorans S2 to produce single cell oil as a feedstock for biodiesel. Therefore, the present study also indicated the potential of selected yeast to develop a zero-waste process for the complete valorization of paddy straw hydrolysate without detoxification

Delayed Spontaneous Thrombosis of Neglected Direct Carotid-Cavernous Fistula: A Case Report / 신경중재치료의학

Direct carotid-cavernous fistula (CCF) refers to direct communication between the cavernous portion of the internal carotid artery (ICA) and the cavernous sinus due to rent in the ICA, most commonly secondary to trauma. These are generally high-flow fistula and rarely resolve spontaneously. We report a case of a young male who developed features of direct CCF after trauma, was denied any treatment for 4 years, and then presented with spontaneous thrombosis of the fistula and a residual large pseudoaneurysm of the cavernous segment of the right ICA, which was subsequently managed with parent vessel occlusion.

Dosimetric comparison of 60Co and 192Ir high dose rate source used in brachytherapy treatment of cervical cancer

Purpose: The study purpose included dosimetric comparison of cobalt 60 (60Co) and iridium 192 (192Ir) high dose rate (HDR) source used in brachytherapy treatment of cervical cancer. Materials and Methods: Computed tomography (CT) scans for 15 patients of carcinoma of uterine cervix using 3-mm slice thickness were considered for the study The contouring of high-risk clinical target volume (HRCTV), bladder, and rectum on CT images was done as per the GEC ESTRO guidelines with the help of magnetic resonance imaging images in the treatment planning system. All parameters were kept the same for 60Co (3.5 mm active length, 0.5 mm active dia, Bebig) and 192Ir (3.5 mm active length, 0.6 mm active dia, Bebig) HDR source with 2.5-mm step size and dose prescription to Point A. As per the International Commission on Radiation Unit (ICRU)-89 guidelines, the dose–volume parameters such as D50(Gy), D90(Gy), and D98(Gy) for HRCTV and D0.1cc (Gy), D1cc (Gy), D2cc (Gy), and D5cc (Gy) to the bladder and rectum were calculated for both the HDR sources. Results: The difference in dose–volume histogram parameters such as D50,D90,and D98 of HRCTV was 3.19%, 1.13%, and 0.50%, respectively, for the two radioisotopes. The difference in dose values of D0.1cc, D1cc, D2cc, D5cc, and ICRU reference points of bladder was –0.58%, –0.67%, –0.99%, –0.94%, and –1.75%, respectively. On the other hand, dose difference for D0.1cc, D1cc, D2cc, D5cc, and ICRU reference points of rectum was 0.67%, 0.26%, 0.56%, 0.63%, and –0.33%, respectively. Conclusions: The present study results show that all the dose parameters of HRCTV, bladder, and rectum with 60Co were comparable with those of 192Ir HDR source. The isodose distribution is more bulge out for 60Co in cranial-caudal direction compared to that of 192Ir. However, these differences can be reduced by treatment planning optimization techniques. The clinical plan evaluation in each slice and plane is necessary to explore the logistic and financial benefits of miniaturized 60Co source over 192Ir HDR source

Assessment of various genetic components through NCD-I and NCD-III designs of biparental mating in opium poppy

Creation of genetic variability and development of varieties having higher yield potential depends on information about nature of gene action. The present investigation was undertaken to decipher the nature of gene action and allied genetic parameters involved in the inheritance of yield and yield-related component traits in opium poppy (Papaver somniferum L.). The biparental inbreeding progenies derived from four segregating base populations of crosses NB-1Kr40-3/3×NB-1Kr30+0.2-2/1, NB-5Kr40-7/2×58/1, NB-1Kr30+0.2-2/1×58/1 and NB-Kr40-3/3×NB-5Kr40-7/2 of opium poppy were analysed to study the gene actions involved in the inheritance of yield and component traits. Additive component of variance played a predominant role in North Carolina design (NCD)-I, while both additive and dominance genetic components were found important in NCD-III design. The presence of additive as well as nonadditive components of variance suggested that one or two generations of intermating in further generations followed by selection may lead to development of novel genotypes.

Clinicopathological Study on Uterine Fibroid in a Medical College Hospital

Uterine fibroid are the most common benign pelvic tumor in females. Its occurrence in reproductive age group makes it important. Methods: The present hospital based cross-sectional study was done to find the clinicopathological features of fibroid of uterus at a tertiary care center. Histopathological examination was done to observe the type and morphology of these lesions. Results: Uterine fibroids are commonly seen in females of <40 years age and present with menorrhagia (55.2%) and abdominal pain (27.1%). The most common location was intramural (63.5%) and the most common degeneration was hyaline change (12.5%). Conclusion: Routine histopathological examination of hysterectomy specimen is needed to rule out tumor or infective pathology.

Study on Clinico-Aetiological Profile of Bicytopenia / Pancytopenia among Pediatric Patients

The common causes of bicytopenia or pancytopenia include either marrow suppression or marrow infiltration. It may be due to aplastic anemia, megaloblastic anemia or hematological malignancies. The present study was done to find the clinico-aetiological profile of bicytopenia & pancytopenia among pediatric patients. Methods: The present hospital based cross-sectional study was done on children suffering from bicytopenia or pancytopenia. Detailed clinical history, thorough physical examination and hematological tests were done. Appropriate statistical calculations for summarization of data were done. Results: Bicytopenia was seen in 58.2% and pancytopenia in 41.8% patients. Megaloblastic anemia (43.6%), infection (23.6%), aplastic anemia (14.5%) and leukemia (10.9%) were the aetiological factors. Patients presented with pallor (85.5%), fever (76.4%), petechial haemorrhage (43.6%), hepatomegaly (38.2%), splenomegaly (23.6%), anorexia (21.8%) and lymphadenopathy (18.2%). Conclusion: Non-malignant causes were responsible in majority of cases (89.9%) and can be treated.

Neuropharmacological evaluation on four traditional herbs used as nervine tonic and commonly available as Shankhpushpi in India

Background: Shankhpushpi is an Ayurvedic drug, widely used for its actions on the central nervoussystem, especially to improve intellect and boost memory. Four botanicals viz. Canscora decussata Schult.(CD), Clitorea ternatea Linn. (CT), Convolvulus pluricaulis Choisy. (CP) and Evolvulus alsinoides Linn. (EA)are considered as sources of Shankhpushpi by Indian practitioners on the basis of their morphologicaldescriptions given in ancient texts.Objective: The present study was undertaken to evaluate the neuropharmacological effect of four herbscommonly identified as source of Shankhpushpi.Materials and methods: Methanol extracts of all four varieties were tested and evaluated in vitro and invivo for their neuropharmacological effects. Experiments such as protection against b-amyloid inducedneurotoxicity on brain cell line (Neuro 2A), antioxidant potential, AchE (acetylcholinesterase enzyme)inhibition, and 5-LOX (lipoxygenase) enzyme inhibition were conducted for in vitro evaluation. For in vivoevaluation, scopolamine (0.3 mg/kg i.p.) induced memory retrieval using pole climbing apparatus andMorris water maze were performed in rat models.Results: It was found that protective effects of EA and CD against b-amyloid induced neurotoxicity inNeuro 2A cells were significantly higher than CT and CP. EA proved to be superior than other varieties onthe basis of antioxidant activity, AchE inhibitory and LOX inhibitory activities. The preventive activity ofEA on scopolamine induced memory retrieval in pole climbing and Morris water maze task in rats wasfound to be higher than that of CD, CT and CP.Conclusion: EA has remarkable neuropharmacological effect as compared to other three varietiesof Shankhpushpi. This effect may be attributed due to the presence of steroids (stigmasterol and betulinicacid), coumarins (scopoletin) and flavonoids (b-carotene and chlorogenic acid). Hence it can be used as apromising lead in development and management of neuronal disorders including Alzheimer's disease.© 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Depression and its correlates among geriatric people: A community based study from Southern Haryana, India

On account of improved life expectancy, better education and health facilities in India, the proportion of the geriatric population has gone up. In India, prevalence of depression estimated to be 4.5% in the year 2015, which affects about 57 million people. Objective: To determine the prevalence of depression and its epidemiological correlates among geriatric people residing in southern Haryana, India. Material and Methods: This community based study with cross-sectional design was conducted in rural and urban field practice areas of department of Community Medicine. Geriatric people were contacted by investigators through house to house visit. Study subjects were screened for depression by using standard shorter version Geriatric Depression Scale (GDS-15). Pearson’s Chi-square test was used for categorical variables. Stepwise multiple logistic regression was used to find out an independent factors associated with depression. Result: A total of 308 elderly persons belonging to rural and urban areas participated in our study. Prevalence of depression (GDS score >5) among the elderly population in the present study was found to be 22.72% (95% CI: 18.2-27.8). Conclusion: Present study depicted that every fourth elderly person was suffering with depression. Nuclear family, sleep problems, not consulting elderly in decisions, chronic morbidity, lack of physical activities, and death of close relatives were identified as risk factors of depression.

Incidence and clinico-immunological assessment of patients of rheumatoid arthritis in Gorakhpur district, Uttar Pradesh, India

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease manifesting itself in various extra-articular signs and progressive articular damage. The present study was designed to find out the incidence and clinico-immunological characteristics of patients with RA.Methods: This one-year observational study involved 150 adult patients attending orthopaedics department at Nehru Hospital, B.R.D. Medical College, 2010. Each patient was subjected to clinical, functional, radiological and laboratorial examination after taking informed consent. SPSS software was used for data analysis.Results: Nearly 36% patients had some radiological changes in the form of surrounding osteopenia articular erosion, joint space narrowing and degenerative changes. All NSAIDs when used alone showed poor fall in values of acute phase reactant i.e. ESR and CRP. Maximum fall in acute phase reactant was obtained by treatment with combination therapy of NSAID + hydroxychloroquine + methotrexate + sulfasalazine. NSAIDs did not prevent radiological progression of disease and in more than 50% radiological progression continued however when NSAIDs used with any DMARDs show radiological regression. Maximum radiological regression was caused by combination therapy of NSAID + hydroxychloroquine + sulfasalazine + methotrexate.Conclusions: All NSAIDs produced poor fall in values of acute phase reactants and radiological progression continued in majority of patients, when a DMARD or combination of DMARDs were used with NSAIDs response was much better and relief was obtained earlier, and remission was sustained for longer duration.

Role of Magnetic Resonance Imaging in Diagnosing Patients Presenting with Non-Traumatic Hip Pain at a Tertiary Care Hospital in Sub-Himalayan Region

Background: Hip pain with a nonspecific history and clinical findings can present a diagnostic dilemma for a clinician. This study aimed to characterize the Magnetic Resonance Imaging (MRI) findings of various conditions which caused non-traumatic hip pain. Methods: An observational study was conducted on all patients who were referred to the Department of Radiodiagnosis at Dr Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh for MRI evaluation of non-traumatic hip pain. After being evaluated physically, MRI of the hip was done on a 1.5 Tesla MRI machine (Signa Excite, GE Healthcare). Images were obtained in the axial, coronal and sagittal planes. Data was analysed descriptively and tabulated. Results: During the study period, 61 consecutive [36 (59%) males and 25 (41%) females] patients with a history of non-traumatic hip pain were included, of which 54 patients were found to have a pathology. The most common intra-articular pathologies detected were infective arthritis in 22 (36%) cases, avascular necrosis (AVN) in 14 (23%), Perthes disease in 5 (8.2%), bone tumors in 2 (3.3%), inflammatory arthritis in 1 (1.6%), posterior labral calcification in 1 (1.6%), femoroacetabular impingement in 1 (1.6%) and stress fracture of femoral neck in 1(1.6%) patient. The extra-articular pathologies detected were bone tumors in 2 (3.3%) patients, stress fracture of pubic rami in 2 (3.3%), sacroilitis in 1 (1.6%), potts spine with bilateral psoas abscess in 1 (1.6%) and tendinits in 1 (1.6%) patient. Conclusions: This study presented our MRI observations of a wide spectrum of clinical cases which were referred to our department with non-traumatic hip pain. MRI assessments are sensitive and specific and enabled us to diagnose conditions in their early stages.

Questionnaire based survey on practicing OTC antimicrobials among 1st and 2nd year medical student of RIMS in Ranchi, India

Background: OTC (over the counter) drugs are defined as “Drugs available freely on the counter without prescription of a registered medical practitioner The WHO has also pointed out that responsible self-medication can help prevent and treat ailments that do not require medical consultation and provides a cheaper alternative for treating common illnesses. Studies have also found that educated people have a greater tendency to practice self-medication than illiterates. several studies have been carried out in different populations to evaluate the practice of self-medication there is a paucity of studies on self medication of antimicrobials among medical students.Methods: This was a questionnaire based study of one months duration. A prevalidated questionnaire was distributed to 258 students, to assess practice of otc anti-microbials in 1st (2nd semester) and 2nd (5th semester) year medical undergraduate students of Rajendra Institute of Medical science, Ranchi.Results: The results of this study showed that out of 258 students 208 (80.6%) students used antimicrobials as OTC. Out of 258 from both the year, 225 students had knowledge about OTC anti-microbials drug. Most common reason for practicing OTC anti-microbials was the minor ailment 86 (41.3%). Again most common indication was diarrhea 69 (33.3%). In this study we observed that the most common source of information regarding OTC anti-microbials were senior students 63 (30.4%) and most commonly used anti-microbials as self-medication were ciprofloxacin 92 (44.3%).Conclusions: This study highlights the very high prevalence of OTC anti-microbials use among medical students, inappropriate use due to the lack of knowledge. At the higher i.e. policy-making level, there is an urgent need to legislate and enforce laws which can restrict access to the supply of medicines without prescription by pharmacies and strict rules regarding pharmaceutical advertising. Again, there is a need for an impactful public enlightenment campaign to educate the people about the disadvantages and life-threatening complication of Otc anti-microbials. And at last emphasis should be given on rationalized use of anti-microbials.

Anthropometric Measurement Of Corneal Curvature By Keratometry In Adult Central Indian Population

Background: Global advances in ophthalmology have created a greater need for ocular parameters in differentclinical and diagnostic fields. One important ophthalmic parameter is the curvature of cornea which is commonlyneeded for intraocular lens power calculation before cataract and refractive surgery and helps ophthalmologistsin contact lens fitting, diagnosis of several eye conditions such as keratoconus, keratoglobus and Marfan’ssyndrome.Subjects and Methods: The data for the study were retrospectively collected from the case files of patients whohad undergone cataract surgery from January 2017 to July 2017 in a private eye hospital Raipur, Chhattisgarh.The data collected were horizontal & Vertical curvature of cornea which was done by manual keratometer forcalculating intraocular lens power (after applying various formulas) to be implanted during cataract surgery.Then by using various statistical methods the results were interpreted.Results: The total number of patients taken for the study were 600 and the total number of eyes were 600, out ofwhich 300 (50%) were males and 300 (50%) females, with the age ranging from 45 to 80 years. The mean cornealrefractive power for the total sample were K1 (vertically) 44.18±1.89D, K2 (horizontally) 44.74± 1.88D, rangesfrom 39 D to 51 D. Although corneal refractive power was slightly higher in female as compared to male but thedifference was not significant. The values were almost similar in right and left eyes.Conclusion: The analysis might provide normative data for curvature of cornea required for IOL calculation incataract patients of Chhattisgarh region. Data of the range will be useful as reference values in case the surgeryis to be done at high volumes in surgical camps in rural areas where biometry equipment may not be available.There were no significant differences noted between male and female, right and left eyes in central Indianpopulation.

Ethnomedicinal, phytochemical and pharmacological updates on Hygrophila auriculata (Schum.) Hiene: an overview / 中西医结合学报

This article explores the most recent evidence-based information on ethnomedicinal, phytochemical and pharmacological understanding of Hygrophila auriculata for the treatment of various diseases and health conditions. Various ethnomedicinal writings suggest the use of the plant or its parts for the treatment of jaundice, oedema, gastrointestinal ailments, diarrhoea, dysentery, urinogenital disorder, gall stones, urinary calculi, kidney stone, leucorrhoea, rheumatism, tuberculosis, anaemia, body pain, constipation, skin disease, and as an aphrodisiac. The plant has been reported to contain flavonoids (apigenin, luteolin, ellagic acid, gallic acid and quercetin), alkaloids (asteracanthine and asteracanthicine), triterpenes (lupeol, lupenone, hentricontane and betulin), sterols (stigmasterol and asterol), minerals, amino acids, fatty acids, aliphatic esters and essential oils. Extracts and bioactive compounds from the plant have been found to possess antimicrobial, anthelmintic, antitermite, nephroprotective, hepatoprotective, central nervous system protective, antitumour, antidiabetic, anticataract, antioxidant, haematopoietic, diuretic, antinociceptive, anti-inflammatory, antipyretic, antimotility, aphrodisiac, neuroprotection, anti-endotoxin and anti-urolithiatic activities. For this paper, we reviewed patents, clinical studies, analytical studies and marketed formulations from the earliest found examples from 1887 to the end of 2017.

A study of pulmonary function in end-stage renal disease patients on hemodialysis: a cross-sectional study

ABSTRACT BACKGROUND: The aim here was to study acute effects of hemodialysis among end-stage renal disease (ESRD) patients. DESIGN AND SETTING: Prospective study in tertiary-level care center. METHODS: Fifty ESRD patients undergoing hemodialysis were studied. Spirometric pulmonary function tests were performed before and after four-hour hemodialysis sessions. RESULTS: The patients' average age was 45.8 ± 10.0 years; 64% were males and 64% had normal body mass index. Anemia (94%) and hypoalbuminemia (72%) were common. Diabetes mellitus (68%), hypertension (34%) and coronary artery disease (18%) were major comorbidities. Forty-five patients (90%) had been on hemodialysis for six months to three years. The patients' pre-dialysis mean forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were below normal: 45.8 ± 24.9% and 43.5 ± 25.9% of predicted, respectively. After hemodialysis, these increased significantly, to 51.1 ± 23.4% and 49.3 ± 25.5% of predicted, respectively (P < 0.01). The increase in mean FEV1/FVC, from 97.8 ± 20.8% to 99.3 ± 20.1% of predicted, was not significant (P > 0.05). The pre-dialysis mean forced expiratory flow 25-75% was 50.1 ± 31% and increased significantly, to 56.3 ± 31.6% of predicted (P < 0.05). The mean peak expiratory flow was below normal (43.8 ± 30.7%) and increased significantly, to 49.1 ± 29.9% of predicted (P < 0.05). Males and females showed similar directions of change after hemodialysis. CONCLUSIONS: Pulmonary function abnormalities are common among ESRD patients. Comparison of pre and post-hemodialysis parameters showed significant improvements, but normal predicted values were still not achieved.