Clinical profile of hepatorenal syndrome: a prospective study.

Background: Hepatorenal syndrome is the development of renal failure in patients with advanced liver cirrhosis, occasionally fulminant hepatitis, who have portal hypertension and ascitis in the absence of some other kidney disease. Objective: To study the clinical profile of hepatorenal syndrome. Methods: All patients of chronic liver disease with renal involvement were studied and patients fulfilling the criteria of hepatorenal syndrome were recruited in the study. The etiology, clinical presentation, morbidity and outcome of patients were recorded. Various variables were studied between survivor group and non survivor group to detect possible predictors of non survival in hepatorenal syndrome. The data was analyzed using SPSS software. Results: 42 patients of hepatorenal syndrome were clinically evaluated. 95% were males and 5% females with mean age of 50.29±8.87 in survivor group and 45.92±10.1 in non survivor group. High level of serum bilirubin, hepatic encephalopathy, decreased level of albumin, hyponatremia and coagulopathy were significant in non survivor group as compared to survivor group. Conclusion: The poor prognostic factors were found to be ascites, severe jaundice, hepatic encephalopathy, alcohol abuse, hypoalbuminemia, progressive renal failure and child pugh score greater than 10. Thus hepatorenal syndrome is decompensated cirrhosis which needs judicious treatment especially using terlipressin and albumin.

Aflatoxin contamination in stored rice variety PAU 201 collected from Punjab, India.

Background & objectives: The present study was carried out on stored rice variety PAU 201 in Punjab that was not permitted for milling and public distribution due to the presence of damaged grains at levels exceeding the regulatory limits of 4.75 per cent. The aim of the study was to determine fungal and aflatoxin contamination in the rice samples to assess hazard from the presence of damaged grains. Presence of iron in discoloured rice grains was also assessed. Methods: Stored samples of paddy of PAU 201 rice variety were collected from six districts of Punjab, milled and analysed for presence of fungal and aflatoxin contamination. Scanning electron microscopy (SEM), energy dispersive X-ray (EDX) analysis and Prussian blue staining was used to determine fungal spores and presence of iron, respectively. Results: Aflatoxin analysis of rice samples indicated that none exceeded the Food Safety and Standards (Contaminants, Toxins and Residues) Regulations, 2011 tolerance limit of 30 μg/kg and majority of the samples had levels <15 μg/kg. The proportion of damaged grains exceeding the limit of 5 per cent was observed in 85.7 per cent of the samples. SEM and Prussian blue staining and EDX analysis of black tipped and pin point damaged rice grains did not show presence of fungal structures and presence of iron. Interpretation & conclusions: The results of the study indicated that the stored rice samples did not pose any health concern with respect to aflatoxin contamination as per the criteria laid down by the Food Safety and Standards Authority of India.

Effects of resistance training on metabolic profi le of adults with type 2 diabetes.

Background & objectives: The number of diabetes in India is increasing at an alarming rate. The effects of physical activity in the form of resistance training or aerobic exercises on type 2 diabetes have not been studied in Indian population. The objective of this study was to analyse the effects of eight weeks of progressive resistance training (PRT) compared with aerobic exercise (AE) on glycaemic control, metabolic profi le, cardiovascular fi tness parameters and general well being in adults with type 2 diabetes. Methods: Thirty adults (14 females and 16 males mean; age 53.8 ± 8.8 yr) with type 2 diabetes were randomly assigned to 8 wk supervised PRT (n=10) or AE (n=10) or control group (n=10). Glycosylated haemoglobin (HbA1c), lipid profi le, blood pressure, heart rate, body mass index (BMI) and general well being were measured before training (i.e. 0 wk) and after 8 wk of training period. Results: Plasma glycosylated haemoglobin levels decreased signifi cantly : signififi (P<0.05) both in the PRT group (7.57 ± 2.4% to 6.23 ± 0.8%) and in AE group (8.11±0.9% to 6.66 ± 0.9%).Total cholesterol levels decreased signifififi cantly (P<0.05) by 13.3 per cent in PRT group and by 6.1 per cent in AE group. Both exercise groups showed signifififi cantly reduction in systolic blood pressure (P<0.05). General well being improvement was much more in PRT (8.6%) as compared to AE group (2.7%). Interpretation & conclusions: Our fi ndings showed that both PRT and AE were effective in improving metabolic profi le of adults with type 2 diabetes but the percentage improvement in triglycerides, total cholesterol levels and general well being with PRT was more compared to AE. Further studies on a larger sample need to be done to confirm these findings.

Sonographic evaluation of renal allograft.

Sonography has become an integral part of the care of renal allograft recipients. It is a simple, inexpensive and readily available non-invasive imaging modality. It is indicated as the initial investigation in patients presenting with decreased urine output, pain, infection and hematuria and for doing a percutaneous allograft biopsy. While sonography confirms the diagnosis of obstructive nephropathy and perinephric fluid collections, Doppler is an effective screening modality for the detection of post-transplant vascular complications.

Smoking--a renal risk factor.

Smoking has adverse effects on health, causing ischemic heart disease, stroke, chronic obstructive lung disease and cancers of the respiratory, gastrointestinal, pancreas, kidney and urinary tract. Smoking causes an acute increase in mean arterial pressure and heart rate. Chronic smoking reduces the renal plasma flow. There is clinical evidence that smoking has adverse effects on renal outcome in essential hypertension, diabetic nephropathy, primary glomerular diseases, systemic diseases involving the kidney and renal allograft recipients.

Immunomodulators in clinical practice.

Immunomodulators have opened new vistas in the management of the immunocompromised patient. They have been shown to enhance the efficacy of vaccines in infections, head and neck malignancy, the immunosuppressed and recently in AIDS. The mechanism of their action is discussed. They hold promise of further advances in immunotherapy.

Effects of cyproterone acetate on the testicular function of bat (Rhinopoma kinneari Wroughton).

1-Cyproterone acetate administration (0.2 mg/day/animal for 25 days) caused widespread testicular necrosis. The lumen of the epididymides were devoid of spermatozoa. The RNA, protein, sialic acid and phosphatase enzyme activity of the testes were reduced. Serum transaminase enzyme activity was slightly changed. Haemoglobin, hematocrit, blood sugar, and blood urea levels were in the normal range. Regressed Leydig cell tissue and decreased production of RNA and sialic acid in the testes could be due to the antiandrogenic action produced by cyproterone acetate.