Physiological and anatomical responses of Passiflora tripartita var. mollissima (Passifloraceae) in water deficit / Respuestas fisiológicas y anatómicas de Passiflora tripartita var. mollissima (Passifloraceae) al déficit hídrico

Abstract Introduction: Passiflora tripartita var. mollissima (banana passionfruit) is one of the most promising exotic tropical fruits from the diversity of the Passifloraceae family in South America, because of its organoleptic properties and antioxidant activity. Objective: To evaluate the physiological and anatomical responses of banana passionfruit plants under water deficit to better understand the mechanisms that mitigate this stress and affect the production of crops subject to climate change and global warming. Methods: Three-month-old seedlings of banana passionfruit were subjected to a soil water deficit through an irrigation reduction at 70 % for 49 days under greenhouse conditions. Morphology (leaf area, height, and number of leaves) and physiological (stomatal conductance, Fv/Fm, total chlorophyll content) measurements were made through time, and after the irrigation treatments were measured biomass parameters and anatomical foliar traits. Results: The plants experienced a decrease in height, leaf area, number of leaves, leaf area index, and relative water content, that are common responses in plants subjected to reduced irrigation. Additionally, the plants exhibited certain mechanisms that can be attributed to water deficit tolerance such as higher root:shoot ratio, stomatal closing, an increase in stomatal density, a reduction in mesophyll tissue thickness, and a decrease in the number of vessels and its diameter as they enable the banana passionfruit to reduce water loss and decrease the probability of cavitation in xylem vessels. Conclusions: banana passionfruit plants could implement strategies against water scarcity, allowing them to survive and endure challenging environmental conditions.

Resumen Introducción: Passiflora tripartita var. mollissima (banana passionfruit - curuba) es una de las frutas tropicales exóticas de la diversidad de la familia Passifloraceae en Sudamérica, promisoria por sus propiedades organolépticas y actividad antioxidante. Objetivo: Evaluar las respuestas fisiológicas y anatómicas de la curuba bajo déficit hídrico con el fin de comprender mejor los mecanismos que mitigan este estrés y afectan la producción de sus cultivos, que están sujetos al cambio climático y al calentamiento global. Métodos: Plántulas de 3 meses de edad se sometieron a un déficit hídrico mediante una reducción del riego al 70 % durante 49 días en condiciones de invernadero. Se realizaron mediciones morfológicas (área foliar, altura y número de hojas) y fisiológicas (conductancia estomática, Fv/Fm, contenido de clorofilas) a lo largo del tiempo, y transcurridos los tratamientos de irrigación se midieron parámetros de biomasa, además de rasgos anatómicos foliares. Resultados: Las plantas experimentaron una disminución en la altura, área foliar, número de hojas, índice de área foliar y contenido relativo de agua, respuestas comunes en plantas sometidas a una irrigación reducida. Adicionalmente, las plantas exhibieron ciertos mecanismos que pueden atribuirse a la tolerancia al déficit hídrico tales como una mayor relación raíz:vástago, cierre de estomas, un aumento en la densidad estomática, una reducción en el grosor del tejido del mesófilo y una disminución en el número de vasos del xilema y su diámetro; pues le permiten a la curuba disminuir la pérdida de agua y reducir la probabilidad de cavitación en los vasos del xilema. Conclusiones: Las plantas de la curuba tienen la capacidad de implementar estrategias de mitigación frente al déficit hídrico, lo que les permite sobrevivir y soportar condiciones ambientales desafiantes.

Derangement in renal function after stoma creation in a tertiary care centre

Background: We assessed the derangements of renal functions and glomerular filtration rate (GFR) due to dehydration and poor nutrition in stoma patients before the creation of stoma, on discharge and on readmission (closure/complication). Methods: We conducted a retrospective cohort study in 50 patients of both sexes of age group 16-80yr undergoing stoma formation either as an emergency or elective procedure. Changes in levels of urea, creatinine and GFR were checked preoperatively, on discharge and on follow up within 3 months. Diet of the patient, possibility of sepsis and other treatment including nephrotoxic drug treatment history was assessed. Results: Fifty patients including 27 males and 23 females of age group 16-75yr were included in this study. The most common stoma was loop ileostomy in 32 cases followed by double barrel ileostomy in 11 cases. Ileal perforation and ileal stricture are the 2 most common causes of stoma formation and 78% of stoma were made as an emergency procedure. We found that 56% of the cases presented with deranged renal functions and GFR on readmission. Conclusions: Deranged GFR was due to dehydration by high output and poor intake leading to renal injury and deranged renal functions. Proper counselling of the patient regarding nutritious diet, refeeding and adequate hydration is important to prevent renal failure in stoma patient.

Ameliorative Activities of Morus and Jamun against Cr Induced Andro-Hepatic Anomalies

Chromium (Cr) is a vital micronutrient for sugar metabolism while its unauthorized use may agonize health fatalities. This study was conducted about the novelty about exposure of hexavalent chromium (Cr+6) histopatholgical potentials along with Mulberry Fruit Extract and Jamun Fruit Extract to define the ameliorative aptitude. The histological finding in Cr exposure specify; cessation of testicular seminiferous tubules (ST), annihilation of smooth muscles in basement membrane, Leydig抯 cell and spermatids. The ST have halted spermatogenesis, with irregular boundary and dead spermatogonia and Leydig抯 cells are disorganized. The sperm head cross sectional area (CSA), tail length and middle piece diameter (p ? 0.001) significantly reduced while there is significant elevation of hepatocytes nuclei size, central vein CSA and mean width of Sinusoidal Spaces as compared to control. The protuberant marks of steatosis, fibrosis, dehydration and atrophy were nullified by designated fruit extracts and their possible bio-chelating effects was obvious due to the presence of anthocyanin, ?-sitosterol and phytochemicals. The given results specify that hexavalent Cr induce andro-hepatic anomalies when it is freely used without scientific authentication. Cr+6 as food additives in coloring rice and local sweets should be prohibited while bio-products of Morus and Jamun can be recommended and sponsored for traditional medicines.

Construção e avaliação de usabilidade de um protótipo de dispositivo de hidratação subcutânea / Construction and usability evaluation of a prototype of subcutaneous hydration device

Objetivos gerais: construir um protótipo semi-funcional do dispositivo de hidratação subcutânea e avaliar a sua usabilidade. Objetivos específicos: avaliar a eficácia do protótipo do dispositivo de hidratação subcutânea; medir a satisfação do enfermeiro em relação ao protótipo do dispositivo de hidratação subcutânea e verificar a intenção de uso do protótipo do dispositivo de hidratação subcutânea. Método: estudo de natureza descritiva e exploratória, com abordagem qualitativa e quantitativa. O estudo parte de um aprimoramento de uma tecnologia em saúde, um modelo de utilidade nacional que possui o intuito de realizar a administração de soro fisiológico no tecido subcutâneo. Os dados foram coletados em quatro etapas sequenciais. A primeira etapa foi a construção do protótipo do dispositivo de hidratação subcutânea, a partir da utilização de dispositivos disponíveis no mercado; a segunda etapa foi um grupo focal com profissionais da área da saúde; a terceira etapa foi a testagem do protótipo em ambiente simulado com os objetivos de realizar a punção subcutânea e a administração de soro fisiológico no tecido subcutâneo com o uso do protótipo do dispositivo de hidratação subcutânea e entrevista semiestruturada; a quarta etapa foi um grupo focal com enfermeiros que realizaram a testagem em ambiente simulado. O estudo seguiu a análise de conteúdo temática. Resultados: por meio das etapas foi possível realizar a prototipagem do dispositivo de hidratação subcutânea e agregar informações e ideias de forma ampla acerca do protótipo; estabelecer os parâmetros de usabilidade do protótipo: eficácia, satisfação e intenção de uso, e captar recomendações para o seu aprimoramento. Conclusão: o processo de prototipagem foi uma estratégia positiva para o aprimoramento do dispositivo de hidratação subcutânea, e a avaliação de usabilidade foi profícua, estabelecendo que o protótipo é eficaz, que satisfaz os enfermeiros e que possui intenção de uso e incorporação em seu ambiente de trabalho.

General objectives: to build a semi-functional prototype of the subcutaneous hydration device and evaluate its usability. Specific objectives: to evaluate the effectiveness of the hydration device and evaluate its usability prototype; to measure nurse satisfaction with the hydration device and evaluate its usability prototype and to assess the intention to use the hydration device and evaluate its usability prototype. Method: a descriptive and exploratory study, with a qualitative and quantitative approach. The study is based on the improvement of a health technology, a national utility model aimed at administering saline solution subcutaneously. Data were collected in four stages (sequentially). The first stage was the construction of the hydration device and evaluate its usability prototype, which used devices available on the market; the second stage was a focus group with healthcare professionals; the third stage was the testing of the prototype in a simulated environment with the objectives of performing subcutaneous puncture and administering saline solution subcutaneously using the hydration device and evaluate its usability prototype and a semi-structured interview; the fourth stage was a focus group with nurses who performed the testing in a simulated environment. The study followed thematic content analysis. Results: through the stages, it was possible to prototype the hydration device and evaluate its usability and gather comprehensive information and ideas about the prototype; establish usability parameters of the prototype: effectiveness, satisfaction, and intention to use, and gather recommendations for its improvement. Conclusion: the prototyping process was a positive strategy for the improvement of the hydration device and evaluate its usability, and the usability assessment was fruitful, establishing that the prototype is effective, satisfies nurses, and has intention of use and incorporation into their work environment.

Objetivos generales: construir un prototipo semifuncional del dispositivo de hidratación subcutánea y evaluar su usabilidad. Objetivos específicos: evaluar la eficacia del prototipo del dispositivo de hidratación subcutánea; medir la satisfacción del enfermero respecto al prototipo del dispositivo de hidratación subcutánea y verificar la intención de uso del prototipo del dispositivo de hidratación subcutánea. Método: estudio de naturaleza descriptiva y exploratoria, con enfoque cualitativo y cuantitativo. El estudio parte de un perfeccionamiento de una tecnología en salud, un modelo de utilidad nacional que tiene como objetivo administrar suero fisiológico en el tejido subcutáneo. Los datos se recopilaron en cuatro etapas (secuencialmente). La primera etapa fue la construcción del prototipo del dispositivo de hidratación subcutánea, que utilizó dispositivos disponibles en el mercado; la segunda etapa fue un grupo focal con profesionales del área de la salud; la tercera etapa fue la prueba del prototipo en un entorno simulado con el objetivo de realizar la punción subcutánea y la administración de suero fisiológico en el tejido subcutáneo con el uso del prototipo del dispositivo de hidratación subcutánea y una entrevista semiestructurada; la cuarta fue un grupo focal con enfermeros que realizaron la prueba en un entorno simulado. El estudio siguió el análisis de contenido temático. Resultados: a través de las etapas fue posible realizar la prototipación del dispositivo de hidratación subcutánea y agregar información e ideas de manera amplia sobre el prototipo; establecer los parámetros de usabilidad del prototipo: eficacia, satisfacción e intención de uso, y obtener recomendaciones para su perfeccionamiento. Conclusión: el proceso de prototipado fue una estrategia positiva para el perfeccionamiento del dispositivo de hidratación subcutánea, y la evaluación de usabilidad fue fructífera, estableciendo que el prototipo es eficaz, que satisface a los enfermeros y que tiene intención de uso e incorporación en su entorno laboral.

A case of neonatal Netherton syndrome / 中国当代儿科杂志

A male infant, aged 6 days, was admitted to the hospital due to respiratory distress and systemic desquamative rash after birth. The infant presented with erythema and desquamative rash, respiratory failure, recurrent infections, chronic diarrhea, hypernatremic dehydration, and growth retardation. Comprehensive treatment, including anti-infection therapy, intravenous immunoglobulin administration, and skin care, resulted in improvement of the rash, but recurrent infections persisted. Second-generation sequencing revealed a homozygous mutation in the SPINK5 gene, consistent with the pathogenic variation of Netherton syndrome. The family opted for palliative care, and the infant died at the age of 2 months after discharge. This report documents a case of Netherton syndrome caused by the SPINK5 gene mutation in the neonatal period, and highlights multidisciplinary diagnosis and therapy for this condition.

Role of DREB genes in the regulation of salt stress-mediated defense responses in plants

Abiotic stress plays a major role in plant growth and its development, multiple stress elements such as drought, cold, elevated temperature, and heavy metal contamination may influence them. However, salinity is still a universal abiotic stressor that stunts plant development worldwide. During such adverse conditions, certain stress-resistant genes are upregulated, wherein dehydration responsive element binding (DREB) genes are one such class of apetala 2/ethylene responsive element binding protein which binds to dehydration responsive element (DRE)/C-repeat that can be activated by the action of abscisic acid-dependent or independent pathway. DREB genes influence the stress tolerance of various plants, the cis-element DRE present adjacent to the foremost promoter area of stress-receptive genes is where the DREB transcription factors fix osmotic stress in plants, and their subclasses DREB1 and DREB 2 also involved in cold and dehydration stress, respectively. As per Central Soil Salinity Research Institute, salinity affects nearly 67,44,968 ha of land in India. This review focuses on salinity stress, its influence on the activation of the DREB genes, and its effect on eliciting structural and functional changes in plant development and transgenic research.

Mesoamerican nephropathy: a narrative review

Mesoamerican nephropathy (MeN) also known as chronic kidney disease of unknown etiology (CKDu) is prevalent in agriculturally rich areas. The most widely accepted pathophysiological explanation for MeN is chronic dehydration caused by prolonged exposure to the sun. Other theories include oxidative stress, chronic inflammation, infection and tubulointerstitial fibrosis. The clinical presentation is quite vague and is diagnosed similar to CKD from any cause using blood, urine analysis and ultrasound. The study highlights the need for interdisciplinary cooperation among physicians, epidemiologists, toxicologists, and geneticists while identifying significant research gaps and future objectives. Occupational health related to agriculture is not emphasised enough especially in third world countries where a large chunk of population heavily depend on farming. To safeguard the population at risk, the significance of community-based initiatives, occupational health measures, and regulatory changes is emphasised.

Influencia de la altitud y el estado de hidratación en los soldados de la VIII Brigada de Montaña al nivel de alta montaña / Influence of altitude and hydration status on soldiers of the VIII Mountain Brigade at high mountain level

Resumen Introducción: realizar ejercicio en altitudes elevadas merece consideraciones especiales a la hora de determinar las necesidades de líquidos en los deportistas y más aún en las tropas de montaña del ejército. Mantener un estado de euhidratación durante la actividad física es imprescindible para evitar complicaciones en la salud. Esta investigación tiene como objetivo identificar el estado de hidratación en los soldados de la Brigada de Montaña VIII del Ejército Argentino con asiento en Mendoza, Argentina en el año 2021. Materiales y método: estudio descriptivo, observacional, longitudinal. La muestra fue conformada por 87 soldados masculinos. Los datos recopilados incluyeron la cantidad y tipo de ingesta de líquidos, la gravedad específica urinaria mediante un refractómetro manual, el porcentaje de cambio de peso y la percepción subjetiva de sed. El análisis estadístico para variables cualitativas se realizó con la prueba χ2 y con IC 95%, las cuantitativas se compararon mediante la prueba t-Student. Resultados: el 96,5% de los soldados se hidrataron con agua. La ingesta media de líquidos fue 1,34±0,74 litros (L), con una ingesta máxima de 4 L y un mínimo de 0,5 L. El 36% de la muestra presentó una pérdida de peso corporal superior al 2% al finalizar la actividad, la diferencia relativa referida al peso inicial medio fue 1,7±1,4%. Al finalizar, el 43% clasificó como euhidratado y 29% como hipohidratado severo según la gravedad específica urinaria. Según la percepción subjetiva de sed al finalizar solo un 14% de los soldados no tenía sed. Conclusión: el estudio reflejó que el 64% de los soldados mantuvo una estrategia de reposición de líquidos óptima, dado que las pérdidas de peso se limitaron a lo esperable.

Abstract Introduction: exercising at high altitudes deserves special considerations when it comes to determining fluid requirements in athletes, especially in Army mountain troops. Maintaining a state of euhydration during physical activity is essential to avoid health complications. The aim of this research is to identify the hydration status of soldiers of the VIII Mountain Brigade of the Argentine Army based in Mendoza, Argentina in 2021. Materials and method: descriptive, observational, longitudinal study. The sample consisted of 87 male soldiers. The data collected included the amount and type of fluid intake, urinary specific gravity by using a manual refractometer, percentage of weight change and subjective perception of thirst. Statistical analysis for qualitative variables was done with the χ2 test and 95% CI, quantitative variables were compared using the t-Student test. Results: 96.5% of soldiers hydrated themselves with water. The mean fluid intake was 1.34±0.74 liters (L), with a maximum intake of 4 L and a minimum of 0.5 L. 36% percent of the sample presented a body weight loss of more than 2% at the end of the activity, the relative difference referred to the mean initial weight was 1.7±1.4%. At the end, 43% were classified as euhydrated and 29% as severely hypohydrated according to specific urinary gravity. According to the subjective perception of thirst at the end, only 14% of the soldiers were not thirsty. Conclusion: the study showed that 64% of the soldiers maintained an optimal fluid replacement strategy, given that weight losses were limited to what was expected.

Calcium foliar fertilization and its effect on quality and shelf life in andean blackberry fruits (Rubus glaucus Benth.)

Calcium is the third most crucial nutrient for andean blackberry; however, its absorption is limited in acid soils, and its low mobility in the plant decreases its effects on fruits. Therefore, the effect of foliar fertilizers with calcium on andean blackberry fruits was estimated. In three locations, experiments were established with five calcium sources (Ca chelate, CaB nitrate, Ca oxide, CaB and CaBZn gluconate) and a control without calcium, applied in three phenological stages and recording: weight, diameters, firmness, color, juice, pulp, pH, soluble solids, acidity, dehydration, and damage. Soil and tissue analysis was performed to identify the relationship between the plant's nutritional conditions and its fertilization response. For the statistical analysis were used mixed models, tests of means, and principal components. Foliar fertilization with chelate, nitrate, and calcium oxide in andean blackberry crops with thorns, in production, with pruning management, and in the phenological stages of flower bud, fruit set, and red fruit, is a viable alternative to improve firmness, weight, and diameter of the fruits. In contrast, the chemical and color parameters in andean blackberry fruits depend on the edaphoclimatic conditions of each zone. This fertilization should be considered as a complement in soils without acidity problems and with balanced cationic saturations.

El calcio es el tercer nutriente más importante para la mora; sin embargo, su absorción se ve limitada en suelos ácidos y su baja movilidad en planta disminuye su efecto en frutos. Por tanto, se estimó el efecto de fertilizantes foliares con calcio en frutos de mora. En tres localidades, se establecieron experimentos con cinco recursos de Ca (quelato de Ca, nitrato de CaB, óxido de Ca, KCaB y gluconato de CaBZn) y un control sin calcio, aplicados en tres etapas fenológicas y registrándose: peso, diámetros, firmeza, color, jugo, pulpa, pH, sólidos solubles, acidez, deshidratación y daños. Se realizó análisis de suelo y tejido, para identificar la relación entre las condiciones nutricionales de la planta y su respuesta a la fertilización. Para el análisis estadístico, se utilizaron modelos mixtos, pruebas de medias y componentes principales. La fertilización foliar con quelato, nitrato y óxido de calcio en cultivos de mora andina con espinas, en producción, con manejo de podas y en las etapas fenológicas de botón floral, cuajado y fruto rojo, es una alternativa viable para mejorar la firmeza, peso y diámetro de los frutos. En contraste, los parámetros químicos y de color en frutos de mora andina dependen de las condiciones edafoclimáticas propias de cada zona. Esta fertilización, se debe considerar como complemento en suelos sin problemas de acidez y con saturaciones catiónicas equilibradas.

Role of oral fluid, electrolytes and energy in various pediatric illnesses beyond diarrhea: an Indian expert panel consensus recommendation

Dehydration in non-diarrheal illnesses often goes unnoticed and there are no consensus treatment recommendations for management of dehydration in non-diarrheal illnesses. A multi-disciplinary committee of 10 experts from India gathered on virtual platform in September 2020 to develop consensus recommendation on current treatment strategies for managing oral fluid electrolyte and energy in pediatric patients during non-diarrheal illnesses and to identify unmet needs and gaps. A pre-meeting questionnaire-based voting system was adopted to reach consensus followed by a discussion between panel members. In absence of consensus, the topic was opened for debate to arrive at an aligned recommendation. Key clinical challenges include identifying dehydration in acute illnesses and recommending appropriate quantity and type of oral fluids based on symptom severity. This consensus statement provides guidance on management of dehydration in non-diarrheal illnesses including recommendation on oral fluid, electrolytes, and appropriate energy management in pediatric population. Oral fluid, electrolyte and energy supplementation were recommended based on symptoms in acute non-diarrheal illness increased insensible losses and/or decreased intake. Oral rehydration fluids should be prescribed accurately and at the right-time for countering dehydration, ideally early in the course of illness. Prescribing pattern should be precise and like intravenous fluids. Carbonated drinks and canned juices should not be recommended. Plain water may not be optimal in replacing electrolytes especially for anorexic patients who can only tolerate fluids. These clinical practice statements provide guidance for oral fluid, electrolytes, and energy recommendations for pediatric patients with various acute illnesses beyond diarrhea.

Diagnosis and treatment of hypertonic dehydration in the elderly / 中华老年医学杂志

Hypertonic dehydration is prevalent in the elderly, increases the risk of adverse events, reduces quality of life, and increases hospitalization and mortality.Current methods of diagnosing dehydration, such as physical signs, urine tests, urea nitrogen/creatinine, bioelectrical impedance and saliva, are not suitable for the diagnosis of dehydration in the elderly.There is no gold standard for the diagnosis of hypertonic dehydration in the elderly.The European Society for Clinical Nutrition and Metabolism(ESPEN)recommends the direct measurement of plasma/serum osmotic pressure or using an osmotic pressure formula[osmolarity(mmol/L)=1.86 ×(Na + + K + )+ 1.15×glucose+ urea+ 14](all measured in mmol/L)for the diagnosis of hypertonic dehydration.

Assessment of mothers' knowledge and use of oral rehydration therapy for diarrhoea in children under 5 years in Ife, Nigeria

Diarrhoeadisease is the second leading cause of death in children under 5 years old, and is responsible for killing about 300, 000 children annually in Nigeria. Oral rehydration therapy (ORT) is the preferred treatment for fluid and electrolyte losses due to diarrhoea in children with mild to moderate dehydration. This study aimed to assess the knowledge and use of ORT in the management of diarrhoea in children under 5 years at Seventh Day Adventist Hospital (SDAH, Ife).Method: A structured questionnaire was adopted for this study design and data was collected using a self-structured questionnaire both self-administered and interviewer administered.Results: Of 80 participants, 44 (55%) of the respondents had heard of ORT before this study, while 36 (45%) had not. 48 (60%) responded that they use oral rehydration solution while 32 (40%) of mothers said they had not used ORT. There was significant difference in both outcomes. The result revealed that there was significant difference in morbidity and mortality between mothers who use ORT and those who do not. But there was no significant difference between the knowledge of ORT compared with its use.Conclusion:Appropriate knowledge of the therapy will positively influence its use which will drastically prevent morbidity associated with diarrhoea as well as contain the incidence of mortality

Factores de riesgo asociados a deshidratación hipernatrémica neonatal / Risk factors associated with neonatal hypernatremic dehydration

Introducción: La deshidratación hipernatrémica neonatal es un problema creciente, en la que la alimentación y los conocimientos sobre cuidados del recién nacido juegan un papel primordial. Objetivo: Determinar los factores de riesgo asociados a la deshidratación hipernatrémica en neonatos. Métodos: Estudio observacional descriptivo retrospectivo en una población de 20 neonatos con deshidratación hipernatrémica ingresados en el servicio de cuidados intermedios de un hospital de Lima, Perú entre junio 2017- septiembre 2018. Todos tenían concentraciones de sodio sérico≥150 mmol/L. La recolección de la información se extrajo de las historias clínicas. Resultados: De los 20 neonatos con deshidratación hipernatrémica; los nacidos por cesárea equivalen a 30 por ciento, mientras que por parto vaginal, a 70 por ciento de los casos. Se demostró que hay una relación inversa entre número de gestación y concentraciones de sodio al ingreso, sin embargo, no hubo significación estadística. Se logró una disminución entre sodio de entrada y su primer control, con una media de disminución de 0,57 meq/L/h. Clínicamente los neonatos afectados desarrollaron en mayor porcentaje ictericia y fiebre. No se encontró relación significativa entre el resto de los factores asociados. Conclusiones: Entre los factores de riesgo asociados a la deshidratación hipernatrémica, destaca que el grupo nacidos por cesárea fue menor que los nacidos por parto vaginal, lo que influye en el número de altas precoces al nacimiento. Ictericia y fiebre continúan siendo las características clínicas que debe identificarse tempranamente. Se trata de un cuadro prevenible si se brinda adecuada información a la madre sobre cuidado neonatal(AU)

Introduction: Neonatal hypernatremic dehydration is a growing problem, in which feeding and knowledge about newborn care play a key role. Objective: To determine the risk factors associated with hypernatremic dehydration in neonates. Methods: Retrospective descriptive observational study in a population of 20 neonates with hypernatremic dehydration admitted to the intermediate care service of a hospital in Lima, Peru between June 2017 and September 2018. All of them had serum sodium concentrations≥150 mmol/L. The collection of information was extracted from medical records. Results: Of the 20 neonates with hypernatremic dehydration, those born by cesarean section are equivalent to 30 , while by vaginal delivery, 70% of cases. It was shown that there is an inverse relationship between gestation number and sodium concentrations at admission, however, there was no statistical significance. A decrease was achieved between input sodium and its first control, with a mean decrease of 0.57 meq/L/h. Clinically, the affected neonates developed a higher percentage of jaundice and fever. No significant relationship was found between the rest of the associated factors. Conclusions: Among the risk factors associated with hypernatremic dehydration, it stands out that the group born by cesarean section was lower than those born by vaginal delivery, which influences the number of early discharges at birth. Jaundice and fever continue to be the clinical features that should be identified early. This is a preventable condition if adequate information is provided to the mother about neonatal care(AU)

Receptor Activator of NF-kB Ligand Induced Osteoclastogenesis in Cervical Spondylosis - Role of Balamula Ghritam (A Powerful Antioxidant Drug) as Uttarabhaktika Sneha

The discs which are located in between the vertebras to act as shock absorbers during jolts to prevent spine injuries get either dislocated, bulged out or get thinned on continuous pressure being exerted upon them either by travel or a posture that is unsuitable to their alignment. In cases of discs getting thinned out and the height of these discs get reduced due to various causes produce undue pressure over the cervical spine resulting in oxidative stress and production of free radicals in the body causing deterioration of bone tissue and bone mass leading to regulation of RANKL/OPG ratio levels causing degeneration of bone. It is possible to resurrect the dehydrated discs with rehydration using Balamula (Sida cordifolia root) with the help of its properties and actions that it can positively act upon the area by refilling the gaps of erosions and assure a recovery with the proper administration of it in the form of ghee which has been processed with it and its intake being after food. Material & Methods: Various Ayurvedic classical textbooks and published journal articles were reviewed and analysed. Results: Evidences from various studies show that the phytochemicals obtain from Balamula (Sida cordifolia root) and Go- Ghritam (cow’s ghee) acts as antioxidant, reduces the activity of osteoclast and bone resorption by inhibiting RANKL receptor pathway. It also has anti-inflammatory, anti-arthritic, anti-analgesic effect that found to be effective in reducing the symptoms of cervical spondylosis.

Effects of Solar Drying on the Structural and Thermodynamic Characteristics of Bee Pollen / Efectos del secado solar sobre las características estructurales y termodinámicas del polen apícola

Background: Bee pollen is a natural product collected and transformed by bees, intended for human consumption, given its nutritional and bioactive richness. The fundamental operation of adequacy is drying, which allows its preservation, avoiding chemical or microbiological degradation, typically using tray dryers with hot air that use electricity or fuel for heat generation. Solar drying is an alternative that uses radiation as an energy source. However, it should be ensured that this type of process guarantees the quality of the product while not degrading its properties and, therefore, maintaining its morphological integrity. Objective: to establish the effect of solar drying on bee pollen structure compared to the conventional cabin dehydration process. Methods: Bee pollen was dehydrated using two types of dryers: a solar dryer and a forced convection oven. The solar dryer operating conditions were an average temperature of 19-35 °C with a maximum of 38 °C and average relative humidity (RH) of 55 %. Cabin dryer operating conditions were a set point temperature of 55 ± 2 °C and 10 % RH average humidity. The morphologic and thermodynamic properties of dried bee pollen, such as phase transition enthalpy through Differential Scanning Calorimetry (DSC), porosity and surface area through surface area analysis, and microscopic surface appearance by Scanning Electron Microscopy (SEM), were measured. Results: The results showed dry bee pollen, both in the cabin dryer and solar dryer, did not suffer morphological changes seen through SEM compared to fresh bee pollen. Moreover, surface area analysis indicated the absence of porosity in the microscopic or macroscopic structure, demonstrating that solar or cabin drying processes did not affect the specific surface area concerning fresh bee pollen. Additionally, Differential Scanning Calorimetry (DSC) and Thermo Gravimetric Analysis (TGA) showed that endothermic phase transitions for dried bee pollen by cabin or solar dryer were at 145 °C and 160 °C, respectively. This can be mostly associated with free water loss due to the morphological structure preservation of the material compared to fresh bee pollen. Conclusion: These results demonstrate that solar drying is a reliable alternative to bee pollen dehydration as there were no effects that compromised its structural integrity

Antecedentes: El polen apícola es un producto natural recolectado y transformado por las abejas. La operación fundamental de adecuación del polen es el secado, lo que permite su conservación, evitando su degradación química o microbiológica, típicamente se utilizan secadores de bandejas con aire caliente que emplean electricidad o combustibles para la generación de calor. El secado solar es una alternativa que utiliza la radiación solar como fuente de energía. Sin embargo, se debe garantizar que este tipo de proceso asegure la calidad del producto a la vez que no degrade sus propiedades, manteniendo su integridad morfológica. Objetivo: Establecer el efecto del secado solar sobre la estructura del polen apícola en comparación al proceso convencional de deshidratación en cabina. Métodos: El polen de abeja se deshidrató utilizando dos tipos de secadores: secador solar y horno de convención forzada. Las condiciones de operación del secador solar fueron una temperatura promedio de 19-45 °C con un máximo de 38 °C y una humedad relativa (HR) promedio de 55 %. Las condiciones de operación del secador de cabina fueron una temperatura de referencia de 55 ± 2 °C y una humedad promedio de 10 % HR. Se midieron las propiedades morfológicas y termodinámicas del polen de abeja desecado, como la entalpía de transición de fase mediante calorimetría diferencial de barrido (DSC), la porosidad y el área superficial mediante análisis de área superficial y el aspecto microscópico de la superficie mediante microscopía electrónica de barrido (SEM). Resultados: Los resultados mostraron que el polen seco tanto en el secador de cabina como en el secador solar muestra que no sufrió cambios morfológicos vistos a través de Microscopía Electrónica de Barrido y en comparación con el polen fresco de abeja, además un análisis de sortometría indicó la ausencia de porosidad en la estructura microscópica y macroscópica, lo que indica que los procesos de secado solar o en cabina no tuvieron efectos sobre el área superficial específica con respecto al polen fresco de las abejas. En adición, los resultados de calorimetría diferencial de barrido (DSC) y análisis termogravimétrico (TGA) muestran que las transiciones de fase endotérmicas para el polen seco tanto en secado de cabina como solar fueron a 145 °C y 160 °C, que puede asociarse mayormente a la pérdida de agua libre, debido a la conservación de la estructura morfológica del material y en comparación al polen fresco. Conclusión: Estos resultados demuestran que el secado solar es una alternativa viable para la deshidratación del polen al no existir efectos que comprometan su integridad estructural

Comparison Between Oral Rehydration and Intravenous Fluid Therapy Among Children under 5 Years with Acute Diarrhea with some Dehydration in the Emergency Department of the Children’s Hospital, Vientiane, Lao PDR / Lao Medical Journal

Background@#Worldwide, diarrhea is a common disease in children and is a problem that causes many children to become sick and die. Diarrhea is found to be the leading cause of death of children under 5 years of age, with 700,000 cases per year worldwide. The incidence of diarrhea is increasing in Laos.@*Objective@#To study oral rehydration and intravenous fluid therapy in children under 5 years of age with acute diarrhea with some dehydration in the Emergency Department of the Children’s Hospital, Vientiane, Lao PDR.@*Methodology@#This was cross-sectional descriptive study; data were collected by using questionnaire interview by doctors. The data entered by Epi-data with analysis by SPSS.@*Results@#Among 90 participants it was found that anxiety or irritability, sunken eyes, nausea, vomiting and flatulence were statistically significantly associated with outcome of treatment (p-value <0.05). More than half of the patients are male (52.2%), aged between 1-2 years and most (83.3%) had normal BMI values. In addition, 44.4% had a history of diarrhea for 2 days with 4 to 5 times a day in 34.4% and stools were watery in 57.8%. A number of participants (47.8%) had a history of previous diarrhea before the current illness and most of them had had it 3 times a year (41.9%). When comparing between oral rehydration and intravenous fluid therapy it was found that the children had no symptoms of anxiety or irritable (in 97.8% vs 77.8%), children with sunken eyes (in 91.1% vs 71.1%), children with vomiting (in 100% vs 64.4%) and children with flatulence (in 97.8% vs 80.0%). Excessive thirst and decreased skin turgor were not statistically different between before and after rehydration therapy (p-value >0.05).@*Conclusion@#The outcome of treatment with intravenous fluids was better than oral rehydration since former decreased vomiting, shortened hospital stays, lowered the costs and increase more parents ‘satisfaction. The oral dehydration therapy often increased the symptoms of flatulence.

Síndrome de enterocolite induzida por proteína alimentar como diagnóstico diferencial das alergias alimentares: relato de caso / Food protein-induced enterocolitis syndrome as a differential diagnosis for food allergies: a case report

A síndrome da enteropatia induzida por proteína alimentar, aguda ou crônica, é um tipo de alergia alimentar não mediada por IgE, que surge entre os 5 e 9 meses de idade, e é caracterizada por episódios de vômitos que começam aproximadamente 1 a 4 horas após a ingestão do alérgeno, algumas vezes acompanhados de letargia, palidez cutânea e diarreia com sangue, resultando em instabilidade hemodinâmica e choque em 15% dos casos. Sua epidemiologia em larga escala é desconhecida, assim como o mecanismo imunopatológico, no entanto, sugere-se um papel importante das células T no processo inflamatório. As manifestações e a gravidade dependem da frequência e da dose do alimento desencadeante, bem como do fenótipo e da idade de cada paciente. A suspeita se dá com base principalmente na história clínica e nos sintomas característicos da doença, que tendem a melhorar após a retirada do alimento suspeito. O teste de provocação oral é o padrão ouro para o diagnóstico, mas deve ser reservado para os casos em que a história é confusa e a hipótese incerta. A abordagem de primeira linha no tratamento visa corrigir a desidratação ou estabilizar o choque quando presente, e interromper imediatamente a oferta de alimentos com potencial indutor de reação alérgica. Relatamos o caso de uma lactente de 2 meses de idade com diagnóstico da síndrome, cujo objetivo é atentar o leitor quanto as suas particularidades, auxiliando-o no diagnóstico precoce e adequado a fim de evitar a depleção progressiva e a evolução para sua forma potencialmente grave.

Acute or chronic food protein-induced enteropathy syndrome is a type of non-IgE-mediated food allergy occurring between 5 and 9 months of age. It is characterized by episodes of vomiting that begin approximately 1 to 4 hours after allergen intake, sometimes accompanied by lethargy, skin pallor, and bloody diarrhea, leading to hemodynamic instability and shock in 15% of cases. Its epidemiology is largely unknown, as well as its immunopathological mechanism; however, an important role of T cells in the inflammatory process is observed. Manifestations and severity depend on the frequency and dose of the triggering food, as well as the phenotype and age of each patient. Suspicion is based mainly on clinical history and characteristic symptoms of the disease, which tend to improve after the removal of the suspect food. Oral provocation testing is the gold standard for diagnosis, but it should be reserved for cases whose history is confusing and hypothesis is uncertain. The first-line treatment approach seeks to correct dehydration or to stabilize shock, if present, and to immediately stop the supply of food that potentially induce an allergic reaction. We report the case of a 2-month-old infant diagnosed with the syndrome, with the aim of drawing the readers' attention to its particularities, thus assisting in early and adequate diagnosis in order to avoid progressive depletion and deterioration to its potentially severe form.

Risk Factors for Dyselectrolytemia in Children with Acute Diarrhoea in the Inpatient Setting in North India

Background: Dyselectrolytemia is a common accompaniment of acute diarrheal illnesses and contributes to increased morbidity and mortality. Aim: To study the incidence and identify the risk factors for developing dyselectrolytemia in children getting admitted with acute diarrhoea. Study design: Prospective observational study. Methods: Detailed history, examination, and investigations were recorded in specially designed proforma. Serum electrolyte levels were measured at admission in all the study subjects and correlated with clinical presentation and demographic profile. Results: Out of 107 children, 64.5% had no dehydration, 31.8% had some dehydration, and only 3.4% were severely dehydrated at the time of admission. Most common electrolyte abnormality were hyponatremia(25.2%) and hypochloraemia (25.2%), followed by hypokalaemia (11.2%), hyperchloremia (9.3%) and hypernatremia (6.5%). The degree of dehydration was found to significantly affect serum electrolyte profile (p value<0.05). Hyponatremia (41%), hypokalaemia(26.5%), and hypochloraemia(35%) were seen more commonly in patients with some dehydration, while a higher proportion of patients with severe dehydration had hypernatremia (50%) and hyperkalaemia (25%). Consumption of diluted ORS was significantly associated with the development of hyponatremia (73.9%), hypokalaemia(34.8%), and hypochloraemia(56.5%) p value<0.05. Conclusion: Dyselectrolytemia is a common accompaniment of diarrheal dehydration, the most common being hyponatremia. The severity of dehydration and dilute ORS administration are important risk factors for dyselectrolytemia.

Consumption of osmo-dehydrated Andean Berry (Vaccinium meridionale Swartz) decreases levels of pro-inflammatory biomarkers of overweight and obese adults / Consumo de agraz osmodeshidratado (Vaccinium meridionale Swartz) disminuye los niveles de biomarcadores proinflamatorios de adultos con sobrepeso y obesidad

Background: A Body Mass Index (BMI) greater than 24.9 Kg/m2 promotes chronic inflammation due to increased secretion of pro-inflammatory adipokines. Consuming fruits rich in bioactive compounds such as berries is a promising strategy to counteract this effect. Objectives: Determine the effect of osmo-dehydrated Andean Berry consumption on inflammatory biomarkers (TNF-α, IL- 6, IL-1ß, and adiponectin) and plasma antioxidant capacity in overweight and obese adults after 21 days. Methods: Andean Berry was osmo-dehydrated in 70% sucrose syrup. Antioxidant activity, proximal composition, phenolic content, microbiological analysis, and sensory analysis of the product were determined. Twenty-five obese and overweight subjects consumed 35g of osmo-dehydrated berry for 21 days. Inflammatory biomarkers and antioxidant capacity in plasma were evaluated at the beginning and end of the study. Results: Osmo-dehydrated Andean Berry presented a total phenolic content of 692.7 ± 47.4 mg Gallic Acid Equivalents/100 g. All biomarkers evaluated in the subjects showed statistically significant differences (p> 0.05), except for CRP, before and after the study. IL-6 presented the more significant reduction among all pro-inflammatory adipokines with an effect size of 18.4 Conclusions: Regular consumption of osmo-dehydrated Andean Berry contributes to decreasing pro-inflammatory biomarkers and improves the plasma antioxidant capacity of overweight and obese adults

Antecedentes: un índice de masa corporal (IMC) superior a 24.9 kg/m2 promueve la inflamación crónica debido al aumento en la secreción de adipocinas proinflamatorias. El consumo de frutas ricas en compuestos bioactivos como las bayas es una estrategia prometedora para contrarrestar este efecto. Objetivo: Determinar el efecto del consumo de agraz osmodeshidratado en biomarcadores inflamatorios (TNF-α, IL- 6, IL-1ß y adiponectina) y capacidad antioxidante plasmática de adultos con sobrepeso y obesidad después de 21 días. Métodos: El agraz fue osmo-deshidratado en jarabe de sacarosa al 70%. Se determinó la actividad antioxidante, composición proximal, contenido fenólico, análisis microbiológico y análisis sensorial del producto. Veinticinco sujetos obesos y con sobrepeso consumieron 35 g de agraz osmodeshidratado durante 21 días. Se evaluaron biomarcadores inflamatorios y capacidad antioxidante en plasma al inicio y al final del estudio. Resultados: El agraz osmodeshidratado presentó un contenido fenólico total de 692.7 ± 47.4 mg GAE / 100 g. Todos los biomarcadores evaluados en los sujetos mostraron diferencias estadísticamente significativas (p> 0.05), a excepción de la PCR, antes y después del estudio. La IL-6 presentó la mayor reducción entre todas las adipocinas proinflamatorias con un tamaño del efecto de 18.4 Conclusiones: El consumo regular de agraz osmodeshidratado contribuye a disminuir los biomarcadores proinflamatorios y mejora la capacidad antioxidante plasmática de adultos con sobrepeso y obesidad

VIPoma: a rare cause of diarrhea. A case report / VIPoma: una causa poco frecuente de diarrea. Case report

Abstract Introduction: Vasoactive intestinal peptide-secreting tumor (VIPoma) is a rare functional pancreatic neuroendocrine tumor (F-PNET) characterized by secretory diarrhea, hypokalemia, and hypochlorhydria. Its low incidence and high risk of malignancy pose a clinical challenge that requires a high degree of clinical suspicion. Case presentation: A 61-year-old woman visited the emergency department of a tertiary care hospital in Medellín, Colombia, due to chronic diarrhea (7 months) that led to dehydration, renal failure, metabolic acidosis, and hypokalemia. As a result, a treatment based on loperamide, intravenous fluids and broad-spectrum antibiotics was started. In addition, chromogranin A levels of 477 ug/L (<100) were reported, while an abdominal MRI showed a 33x30mm mass in the head and uncinate process of the pancreas, so outpatient surgical management was decided. However, three days after discharge, and due to the persistence of clinical signs, the patient was admitted to another hospital (also a tertiary care hospital), where, given the high suspicion of VIPoma, and once the diarrhea was solved, the mass was removed (Whipple procedure) without any complication. Finally, the diagnosis was confirmed based on serum vasoactive intestinal peptide levels (930 pg/mL (RV<75)) and the pathology report (PNET tumor grade 2). Two years after the surgery, the patient was asymptomatic, and no residual lesions or metastases were evident in a control MRI. Conclusion: Late diagnosis of VIPoma is associated with worsened quality of life, severe complications, and high prevalence of metastasis. Therefore, it should be suspected in patients with chronic secretory diarrhea that is not caused by an infection, since early diagnosis and timely treatment can contribute to achieving better survival rates in these patients.

Resumen Introducción. El tumor secretor de péptido intestinal vasoactivo o VIPoma es un tumor funcional neuroendocrino pancreático (F-PNET) raro caracterizado por diarrea secretora, hipokalemia e hipoclorhidria. Su baja incidencia y alto riesgo de malignidad representan un reto clínico que requiere un alto grado de sospecha clínica. Presentación del caso. Mujer de 61 años quien consultó al servicio de urgencias de un hospital de tercer nivel en Medellín, Colombia, por diarrea crónica (7 meses) que llevó a des-hidratación, falla renal, acidosis metabólica e hipokalemia, por lo que se inició manejo con loperamida, líquidos endovenosos y antibióticos de amplio espectro. Además, se reportaron niveles de cromogranina A de 477 ug/L (<100) y, mediante resonancia magnética (RM) abdominal, se identificó masa de 33x30mm en cabeza y proceso uncinado de páncreas, por lo que se decidió manejo quirúrgico ambulatorio. Sin embargo, tres días después del alta, la paciente ingresó, por persistencia de los signos, a un segundo hospital (también de tercer nivel), donde ante la alta sospecha de VIPoma, y una vez superada la diarrea, se extirpó la masa (procedimiento de Whipple). Finalmente, con base en los niveles séricos de péptido intestinal vasoactivo (930 pg/ml (VR<75)) y el informe de patología (tumor PNET grado 2), se confirmó el diagnóstico. Dos años después del procedimiento, la paciente se encontraba asintomática y sin evidencia de lesiones residuales ni metástasis en RM de control. Conclusión. El diagnóstico tardío de VIPoma se asocia con detrimento de la calidad de vida, complicaciones graves y alta prevalencia de metástasis, por lo que debe sospecharse en pacientes con diarrea crónica secretora no causada por infecciones, pues de diagnosticarse a tiempo e iniciarse el tratamiento oportuno se pueden lograr mejores tasas de supervivencia en estos pacientes.