Prevalence of Itching in Dengue and Its Correlation with Thrombocytopenia in Bundelkhand Region- A Tertiary Care Hospital-Based Study in the Region of Central India.

According to NVBDCP1 dengue is one of the vector born disease responsible for high morbidity as well as mortality in India. Previous studies have concluded that itching is common among dengue patients and could be a prognostic indicator. Our aim was to study the prevalence of itching as a symptom and its association with platelet count at presentation and discharge.METHODSThis is a cross sectional study conducted among 73 patients of acute febrile illness in MLB Medical College, Jhansi, who were diagnosed to have dengue as per NVBDCP guidelines. We designed a proforma and collected data which was further analysed in detail.RESULTSOut of 73 patients, 15 patients (20.5%) developed itching; mean platelet count was comparable at admission, but at the time of discharge mean platelet count was better in itching group when compared to non-itching group (p value 0.0085). Only 2 patients (13.33%) among itching group required blood/platelet transfusion whereas 9 patients (15.52%) among non-itching group required blood/platelet transfusion.CONCLUSIONSThe prevalence of itching was significant in dengue patients and was associated with better rate of correction of thrombocytopenia and there was lesser need of platelet/blood transfusion among itching group.

Belatacept in kidney transplantation - past and future perspectives / Belatacept no transplante renal - perspectivas passadas e futuras

Abstract Calcineurin inhibitors (CNIs) are used widely for maintenance immunosuppression in renal transplant recipients. However, their side effect profile has led researchers to attempt to find safer alternatives that can maintain effective long-term immunosuppression with less toxicity. Belatacept is a CTLA4-Ig molecule designed to block the costimulatory B7-CD28 signal needed for activation of effector T cells. While it has shown great promise in clinical trials, it has made halting progress towards replacing CNIs in actual clinical practice. The BENEFIT trial revealed some of the advantages of belatacept in terms of maintaining renal function after transplant and reducing some of the metabolic side effects of CNIs related to hypertension and dyslipidemia. Despite that, some cautionary signals have emerged as well, in that belatacept-treated patients experience higher acute rejection rates and greater risk for PTLD. Furthermore, the requirement for monthly intravenous infusions has presented logistical and cost challenges for widespread adoption.

Resumo Os inibidores da calcineurina (INC) são amplamente utilizados para a imunossupressão de manutenção em pacientes receptores de transplante renal. No entanto, o seu perfil de efeitos colaterais tem levado os pesquisadores a tentar encontrar alternativas mais seguras, que possam manter efetiva imunossupressão de longo prazo com menos toxicidade. O Belatacept é uma molécula de CTLA4-IgG concebida para bloquear o sinal co-estimulador B7-CD28, necessário para a ativação de linfócitos T efetores. Embora tenha demonstrado grande promessa em ensaios clínicos, não tem tido progresso na substituição de INCs na prática clínica. O estudo BENEFIT revelou algumas das vantagens do belatacept em termos da manutenção da função renal após o transplante, e da redução de alguns dos efeitos secundários metabólicos dos INCs, relacionados à hipertensão e dislipidemia. Apesar disso, alguns sinais de precaução também têm surgido, quando doentes tratados com belatacept tem maiores taxas de rejeição aguda e maior risco de DLPT. Além disso, a necessidade de perfusões intravenosas mensais apresenta desafios logísticos e de custo para sua adoção generalizada.

Effects of fly ash, Pseudomonas striata and Rhizobium on the reproduction of nematode Meloidogyne incognita and on the growth and transpiration of pea.

Glasshouse experiments were conducted twice to assess the ash amendments (0, 20, and 40% with soil), a phosphate solubilizing microorganism Pseudomonas striata and a root-nodule bacterium Rhizobium sp on the reproduction of root-knot nematode Meloidogyne incognita and on the growth and transpiration of pea. Amendments of fly ash with soil had no effect on transpiration. However, M. incognita reduced the rate of transpiration from 1st week onward after inoculation while inoculation of Rhizobium sp and P. striata increased transpiration from 1st week onward after their inoculation both in nematode inoculated and uninoculated plants. Increase in transpiration was greater when both organisms were inoculated together. Addition of 20 and 40% fly ash with soil was beneficial for plant growth both in nematode inoculated and uninoculated plants. Inoculation of above organisms also increases plant growth of nematode inoculated and uninoculated plants in different fly ash soil mixture but increase in growth was greater when both organisms were inoculated together. Use of 20% fly ash increased galling and nematode multiplication over plants grown in without fly ash while 40% fly ash had adverse effect on galling and nematode multiplication. Rhizobium sp had greater adverse effect on galling and nematode multiplication than P. striata. Use of both organisms together had greater adverse effect on galling and nematode multiplication than caused by either of them alone. Highest reduction in galling and nematode multiplication was observed when both organisms were used in 40% fly ash amended soil. However, highest transpiration was observed in plants without nematodes and inoculated with both organisms together both in with or without fly ash amended soil.