Comparison of outcomes of different modalities of renal replacement therapy in patients of acute kidney injury: a single centre prospective observational study.

BACKGROUND: Acute Kidney Injury (AKI) is one of the most important causes of in-hospital mortality. The global burden of AKI continues to rise without a marked reduction in mortality. As such, the use of renal replacement therapy (RRT) forms an integral part of AKI management, especially in critically ill patients. There has been much debate over the preferred modality of RRT between continuous, intermittent and intermediate modes. While there is abundant data from Europe and North America, data from tropical countries especially the Indian subcontinent is sparse. Our study aims to provide an Indian perspective on the dialytic management of tropical AKI in a tertiary care hospital setup. METHODS: 90 patients of AKI, 30 each undergoing Continuous Renal Replacement Therapy (CRRT), Intermittent Hemodialysis (IHD) and SLED (Sustained Low-Efficiency Dialysis) were included in this prospective cohort study. At the end of 28 days of hospital stay, discharge or death, outcome measures were ascertained which included mortality, duration of hospital stay, recovery of renal function and requirement of RRT after discharge. In addition median of the net change of renal parameters was also computed across the three groups. Lastly, Kaplan Meier analysis was performed to assess the probability of survival with the use of each modality of RRT. RESULTS: There was no significant difference in the primary outcome of mortality between the three cohorts (p=0.27). However, CRRT was associated with greater renal recovery (p= 0.015) than IHD or SLED. On the other hand, SLED and IHD were associated with a greater net reduction in blood urea (p=0.004) and serum creatinine (p=0.053). CONCLUSION: CRRT, IHD and SLED are all complementary to each other and are viable options in the treatment of AKI patients.

Prevalence of diabetes distress and cross-cultural reliability of DDS-17 scale in rural Haryana.

Background: Diabetes distress associated with diabetes is an important under-appreciated domain of diabetes management. The aim of the study is to assess the prevalence of diabetes distress among T2DM patients in Jhajjar district of Haryana, using widely accepted DDS-17 scale along with testing the scale's reliability through Cronbach's α. Material and Methods: This observational study with cross-sectional design was carried out among 503 T2DM patients in district, Jhajjar, Haryana. DDS-17 scale was used for diabetes distress assessment. Data entry and analysis were performed using appropriate software. Results: 37.97% subjects had diabetes distress either in moderate (DDS-17 Score ≥2) or severe (DDS-17 Score ≥3) form. English version of DDS-17 scale showed good internal consistency reliability (α = 0.79). Conclusions: This study conclusively showed that diabetes distress is very common among T2DM patients as more than one third of the T2DM patients had diabetes distress and diabetes distress scale (DDS-17) is an easy, well-accepted questionnaire with good reliability.

Rice (Oryza sativa) alleviates photosynthesis and yield loss by limiting specific leaf weight under low light intensity.

The physiological mechanisms of shade tolerance and trait plasticity variations under shade remain poorly understood in rice (Oryza sativa L.). Twenty-five genotypes of rice were evaluated under open and shade conditions. Various parameters to identify variations in the plasticity of these traits in growth irradiance were measured. We found wide variations in specific leaf weight (SLW) and net assimilation rate measured at 400µmolm-2 s-1 photosynthetic photon flux density (PPFD; referred to as A 400 ) among the genotypes. Under shade, tolerant genotypes maintained a high rate of net photosynthesis by limiting specific leaf weight accompanied by increased intercellular CO2 concentration (C i ) compared with open-grown plants. On average, net photosynthesis was enhanced by 20% under shade, with a range of 2-30%. Increased accumulation of biomass under shade was observed, but it showed no correlation with photosynthetic plasticity. Chlorophyll a /b ratio also showed no association with photosynthetic rate and yield. Analysis of variance showed that 11%, 16%, and 37% of the total variance of A 400 , SLW, and C i were explained due to differences in growth irradiance. SLW and A 400 plasticity in growth irradiance was associated with yield loss alleviation with R 2 values of 0.37 and 0.16, respectively. Biomass accumulation was associated with yield loss alleviation under shade, but no correlation was observed between A 400 and leaf-N concentration. Thus, limiting specific leaf weight accompanied by increased C i rather than leaf nitrogen concentration might have allowed rice genotypes to maintain a high net photosynthesis rate per unit leaf area and high yield under shade.

TraumaLink: A Community-Based First-Responder System for Traffic Injury Victims in Bangladesh.

INTRODUCTION: Road traffic injuries are a rapidly growing epidemic in low- and middle-income countries (LMICs). However, many countries lack formal prehospital emergency medical services, often leaving victims without access to first aid when it can be most effective in preventing death or disability. METHODS: To address the lack of a dedicated prehospital emergency medical system in Bangladesh, we developed TraumaLink, a community-based network of volunteer first responders for traffic injury victims. The service uses an emergency hotline number and 24-hour call center with local first responders who are trained in basic trauma first aid, given essential medical supplies, and dispatched to crash scenes through mobile phone text message notifications. We designed the training curriculum to teach simple lifesaving skills that people with any level of education and no prior medical background could learn and perform. We retrospectively analyzed data originally collected for quality monitoring and evaluation to provide a descriptive analysis of the program's impact. RESULTS: During the first 6 years, operations were expanded from a 14-km section of 1 highway to 135 km on 3 national highways, and free care was provided to 3,119 patients involved in 1,544 crashes. All calls to the service received a response, and in 88% of cases, first responders were at the scene in 5 minutes or less. Most patients were young adult men, and 76% of victims transported to the hospital arrived there within 30 minutes of the crash. Assessments of injury severity at the accident scene aligned closely with patient dispositions, reflecting the accuracy of these triage decisions. CONCLUSION: The strong community support and rapid, reliable volunteer responses suggest that this flexible and scalable model could be expanded throughout Bangladesh and adapted for other LMICs that face similar challenges with traffic injury victims.

Experience of Bangladeshi Dental Students towards Online Learning during the COVID-19 Pandemic: A Web-Based Cross-Sectional Study.

BACKGROUND: During the COVID-19 pandemic, dental education institutions throughout the world experienced significant challenges, including a quick shift to an online learning paradigm. Since the pandemic has had a considerable impact on dental education, this research evaluated the perspectives and attitudes towards online learning among undergraduate dental students in Bangladesh. METHODS: The research was conducted through a cross-sectional method using self-administered online questionnaires. The questionnaire included information on the students' sociodemographic status, their views, and their attitudes about the changes in the educational system, specifically regarding online learning. The study gathered data from 952 undergraduate students from 14 dental institutions in Bangladesh. RESULTS: The results suggested that 87.5% of all the students were unsatisfied with their online programs. Most of the respondents who expressed dissatisfaction with their online classes were female, did not receive assistance in overcoming barriers to accessing the classes or materials (64.23%), did not have access to the institutional online-learning management system (OLMS) (67.35%), and did not have access to the online course materials (71.43%). The students considered that the shift to online learning failed to provide quality clinical teaching. CONCLUSIONS: The lack of an OLMS was found to be linked with dissatisfaction with online learning among Bangladeshi dental students during the COVID-19 outbreak. Additionally, insufficient time allocation and a lack of support through online training were found to be strongly correlated with the students' discontent. The overall findings highlight the need to develop and implement effective online dentistry educational interventions to promote academic advancement and key practical skills.

An economical strategy towards the managing of selenium pollution from contaminated water: A current state-of-the-art review.

During the last few decades, contamination of selenium (Se) in groundwater has turned out to be a major environmental concern to provide safe drinking water. The content of selenium in such contaminated water might range from 400 to 700 µg/L, where bringing it down to a safe level of 40 µg/L for municipal water supply employing appropriate methodologies is a major challenge for the global researcher communities. The current review focuses mostly on the governing selenium remediation technologies such as coagulation-flocculation, electrocoagulation, bioremediation, membrane-based approaches, adsorption, electro-kinetics, chemical precipitation, and reduction methods. This study emphasizes on the development of a variety of low-cost adsorbents and metal oxides for the selenium decontamination from groundwater as a cutting-edge technology development along with their applicability, and environmental concerns. Moreover, after the removal, the recovery methodologies using appropriate materials are analyzed which is the need of the hour for the reutilization of selenium in different processing industries for the generation of high valued products. From the literature survey, it has been found that hematite modified magnetic nanoparticles (MNP) efficiently adsorb Se (IV) (25.0 mg/g) from contaminated groundwater. MNP@hematite reduced Se (IV) concentration from 100 g/L to 10 g/L in 10 min at pH 4-9 using a dosage of 1 g/L. In 15 min, the magnetic adsorbent can be recycled and regenerated using a 10 mM NaOH solution. The adsorption and desorption efficiencies were over 97% and 82% for five consecutive cycles, respectively. To encourage the notion towards scale-up, a techno-economic evaluation with possible environmentally sensitive policy analysis has been introduced in this article to introspect the aspects of sustainability. This type of assessment is anticipated to be extremely encouraging to convey crucial recommendations to the scientific communities in order to produce high efficiency selenium elimination and further recovery from contaminated groundwater.

Depression among the Non-Native International Undergraduate Students Studying Dentistry in Bangladesh.

BACKGROUND: Bangladesh has been attracting international students with interests in various subjects recently. Every year students from different parts of the world come to study undergraduate and postgraduate courses, mostly at private universities in Bangladesh. This study evaluates the depression status among international students who are studying dentistry in Bangladesh. METHODS: This cross-sectional survey was conducted among International undergraduate dental students who enrolled in the Bachelor of Dental Surgery program in nine public and private dental colleges in Bangladesh. Participants were selected using a convenience sampling method. A total of 206 students completed the survey where 78.5% of them were female students and 21.5% students were male, and a CES-D 10-item Likert scale questionnaire was used for data collection. The Cronbach alpha for the 10-item CES-D scale for this population is 0.812. RESULTS: The majority of the students (79.5%) are below 24 years of age with a mean age of 23.22 years and standard deviation of 2.3, and are students who cannot communicate well in Bengali (Bangla), about 60% of them have experienced depression. About 77.3% (p < 0.00) of the international students having financial difficulties exhibited depression. The international students who went through financial problems were two times more likely to suffer from depression (OR = 2.38; p-value < 0.01). CONCLUSION: This study tried to highlight the struggles faced by international students in Bangladesh studying dentistry. It is evident from the findings that several factors influence students' mental well-being during demanding dental education years.

A perfect PCR based co-dominant marker for low grain-arsenic accumulation genotyping in rice.

The development of low arsenic-accumulating varieties for the contaminated areas is one of the best options for reducing the dietary exposure of arsenic to human population through rice. In this study, grain-arsenic content in one hundred genotypes revealed a large variation ranging from 0.05 mg/kg to 0.49 mg/kg. Compared to high accumulating variety, Shatabdi, 6-8 times the transcript upregulation of Arsenic sequestering ATP binding cassette C1 type gene (ABCC1), was observed in first internode of low accumulating variety Gobindabhog when 5 mg/kg of arsenite was present in soil. A comparison of the genomic sequence of OsABCC1 identified 8 SNPs between the two genotypes; 5 in introns and 3 silent mutations in exons. We identified a PCR based co-dominant marker targeting an SNP (T/G) between the two genotypes, which clearly distinguished 100 genotypes into low (mean 0.14 mg/kg) and high (mean 0.35 mg/kg) accumulating groups. All aromatic genotypes, either long or small grain, carry the Gobindabhog-type ABCC1 allele and are low accumulators of arsenic. Gobindabhog allele carrying 62 RILs and NILs showed almost 40-50% less As-accumulation in grains relative to 84 RILs and NILs carrying Shatabdi type ABCC1-allele. The marker will be useful in introgression of low accumulating allele of OsABCC1 into high yielding photoperiod insensitive varietal backgrounds more easily and accurately.

Identification and analysis of low light tolerant rice genotypes in field conditions and their SSR-based diversity in various abiotic stress tolerant lines.

The yield potentiality of kharif rice is not completely used even under well-irrigated agro-ecosystem, mainly due to low irradiance by overcast cloud throughout the growing season in eastern India. We observed more than 50% yield reduction compared to the performance of 100 high-yield genotypes for consecutive three years both under open and 30-35% reduced light intensity, mainly by 34%, 25% and 12% reduction of panicle number, grains per panicle and test weight. As per the analysis of variance, genotypic variance explained 39% of the total yield-variation under shade with 58% heritability. Overall, the maintenance of equal panicle per plant in both open and shade has the highest association with shade tolerance. Purnendu, Sashi and Pantdhan19 showed less than 28% yield-reduction by maintenance or even by increasing grain numbers under shade and test weight. On the other hand, maintenance of an equal number of panicle under both situations was the key to the tolerance of Bhasamanik, Sasarang, Rudra and Swarnaprabha. As compared to open, we noticed the improvement of chlorophyll a and b under shade but saw a poor correlation with the shade tolerance index. Comparing the net photosynthesis rate (Pn) in eight genotypes, we found the best tolerant line ranked last with least Pn at low light intensity (400 µmol m-2 s-1). We also identified diverse parental combinations between newly identified shade tolerant and abiotic stress tolerant high-yielding rice lines following diversity analysis using 54 simple-sequence repeats. Thus, the selected tolerant lines from a large set of genotypes with different adjustment ability to keep up high yield under low light intensity can be used for physiological, molecular analysis as well as pyramiding of traits.

Role of Acetyl Salicylic Acid in Controlling the DOCA-Salt Induced Hypertension in Rats by Stimulating the Synthesis of r-Cortexin in the Kidney.

INTRODUCTION: Hypertension is a metabolic disease which is caused by vasoconstriction and that results into elevated blood pressure. A chronic hypertensive condition affects and even damages to various systems in the body. Presence of renal cortexin (r-cortexin), an antihypertensive protein, which is released from the kidney cortex controls the blood pressure. The effect of r-cortexin was mediated through nitric oxide (NO), a universal vasodilating agent. AIM: In our study, acetyl salicylic acid (aspirin), a well-known activator of the endothelial nitric oxide synthase (eNOS) induced r-cortexin synthesis. METHODS: The hypertensive rat model was prepared by injecting deoxy corticosterone acetate (DOCA). Synthesis of r-cortexin was measured by the anti-r-cortexin antibody which was raised in adult white Wister albino rat model. NO level was determined by using methemoglobin method and later confirmed by chemiluminescence method. Change in blood pressure was determined indirectly by using NIBP monitoring system. RESULTS: Aspirin increased the r-cortexin expression from 64.36 ± 12.6 nM to 216.7 ± 21.31 nM in DOCA induced hypertensive rats. The mechanism was proved with the findings of increased level of NO from 0.4 to 1.9 µM. The DOCA induced blood pressure was also decreased from 139.39 ± 7.36 mm of Hg to 116.57 ± 6.89 mm of Hg in case of systolic blood pressure and in case of diastolic pressure from 110.41 ± 7 mm of Hg to 86.4 ± 2.76 mm of Hg that are quite approximate. CONCLUSION: So, from this study it has been found that aspirin induces the r-cortexin synthesis in kidney cortex through the activation of eNOS in DOCA induced hypertensive rats.

Randomized double-blinded trial investigating the impact of a curriculum focused on error recognition on laparoscopic suturing training.

BACKGROUND: Error recognition predicts technical skill. A curriculum including error recognition may improve laparoscopic suturing performance. METHODS: Thirty novices were randomized into 2 groups. Each viewed an instruction videotape and underwent timed objective structured assessments of technical skills. Group A practiced the task, group B viewed an error-instruction video, practiced, followed by re-assessment. Participants counted errors on a videotape. Data were analyzed with the Fisher exact text, the Wilcoxon test, and the Kendall tau test. RESULTS: The improvement in task time was greater in group A than in group B (P < .001). The objective structured assessments of technical skills scores improved for both groups, but did not reveal differences between the groups. Group B recognized significantly more errors than group A (P < 0.001). CONCLUSIONS: The additional error instruction showed a negative impact on performance speed, but improved cognitive error recognition. Whether visual memory overload influenced the outcome requires further examination.