Abnormalities of Kidney Function in Acute Malarial and non-Malarial Infections

INTRODUCTION

The tropical environment is endemic with malaria and non-malarial infections which are responsible for the high morbidity and mortality in these low- and middle-income countries. In particular, acute malarial infection can cause significant multi-organ dysfunction, including kidney involvement. Early detection of kidney dysfunction will help to improve the quality of care and reduce associated morbidity and mortality. This study aimed at identifying the spectrum of kidney dysfunction in patients with acute malaria and non-malarial infections.

METHODS

This was a prospective observational study in which participants with acute malarial infection, acute non-malarial infection, and apparently healthy individuals were enrolled. For acute malarial infection, participants with thick blood smear parasite density of ≥1000 parasite/µl and falciparum species on thin smear were enrolled. Demographic, clinical, and laboratory parameters were measured. The renal abnormalities examined were urea, creatinine and eGFR, albuminuria, electrolytes, and presence of acute kidney injury (AKI).

RESULTS

The following electrolyte abnormalities were observed in participants with acute falciparum infection: hyponatraemia (10.7%), hypernatraemia (4.0%), hypokalaemia (8.0%), and hyperkalaemia (13.3%). The mean serum urea in participants with acute malaria was 33.8±8.8mmol/l while participants with non-malarial febrile illnesses and healthy controls had 34.7±9.0mmol/l and 26.8±7.6mmol/l, respectively. The mean serum creatinine among participants with acute falciparum infection was 1.0±0.3mg/dl compared to those of participants with non-malarial infections and healthy controls which were 1.1±0.4mg/dl and 0.8±0.3mg/dl, respectively. The difference in the observed mean serum creatinine among the 3 groups was statistically significant (p=0.023). The mean urinary sodium among participants with non-malarial infection was highest at 23.03mmol/l. There was transient albuminuria in 6.7% of participants with acute malarial infection which resolved after recovery from the infection.

CONCLUSION

A relatively high frequency of serum electrolyte abnormalities, albuminuria and urine microscopic abnormalities were observed among subjects with acute malaria compared to those without malaria infection.

Alteration of media enables efficient in vitro cloning of mature Elaeocarpus serratus L. (Ceylon olive): a commercially important fruit tree

Elaeocarpus serratus is a fruit tree able to propagate through conventional vegetative means to a limited extent restricts its wide cultivation by the farmers. In the present report, we have developed an efficient in vitro propagation protocol using mature nodal explants from a 17-year-old tree for the first time with 6.6 shoots/culture. Explants cultured on agar (0.8%) gelled standard Murashige and Skoog (MS) medium, ½ MS, ¾ MS, White's, Gamborg's B₅ or woody plant medium (WPM) supplemented with 2.5 µM benzyl adenine (BA) and 0.1 µM α-naphthalene acetic acid (NAA) showed the superiority of ½ MS medium in terms of explant response and number shoots (6.6). Further optimization of ½ MS medium by altering nutrient elements (macros, micros, vitamins and Fe EDTA) were undertaken, and MS medium composed of half-strength major salts, original strength of minor salts and vitamins were supplemented with BA (2.5 µM) and NAA (0.1 µM), produced enhanced axillary bud proliferation (8.88/explant) and shoot elongation (3.83 cm). Reculturing of original explant on this medium after IV passages produced more than 16 healthy shoots per culture which attained a length of 4.13 cm. Microshoots raised through this way were rooted (86.11%) ex vitro by pulse treatment with 2 mM indole-3-butyric acid (IBA) for 5 min followed by planting in nursery pots containing a 1:1:1 (v/v/v) mix of sand, soil, and farmyard manure. The hardened plants were successfully planted in the fruit tree garden of the Department. Genetic fidelity of micropropagated and mother plants were tested using random amplified polymorphic DNA (RAPD) and inter simple sequence repeat (ISSR) markers which showed a high degree of monomorphism thus supported morphological uniformity of micropropagated plants.

Plasmonic photocatalytic activity of ZnO:Au nanostructures: Tailoring the plasmon absorption and interfacial charge transfer mechanism

ZnO:Au nanostructures with tunable surface Plasmon band were synthesizedvia co-precipitation method. X-ray diffraction analysis, high resolution transmission electron microscopy and Raman spectra confirmed the hexagonal wurtzite phase for these ZnO:Au nanostructures with preferential growth along the (101) plane. The selective enhancement in the intensity of Raman band due to the excited free electrons of Au nanoparticles confirmed the incorporation of Au in ZnO matrix. Scanning electron microscopic images showed the transformation of morphology of these nanostructures from rod geometry to rose flower and then to marigold flower-like structures with increase in the Au content. Detailed investigations were carried out to understand the role of plasmons present in the ZnO:Au nanostructures on the photocatalytic degradation of sulforhodamine B under sunlight. It is found that ZnO:Au nanostructures with plasmon band in the close approximation of solar maximum ˜550 nm as catalysts exhibit ultra-fast degradation of the dye. This highly efficient photocatalytic activity of these nanostructures is attributed to the electron scavenging action of Au due to its high electronegativity, enhanced absorption of sunlight due to plasmons, the enhanced surface area of ZnO:Au nanostructures and the formation of Schottky barrier between the Au and ZnO interface. The reusability and photostability of these catalysts were tested through repetitive cycles and demonstrated that these nanostructures can form excellent reusable photocatalysts for the degradation of toxic organic waste in water.

Simultaneous carotid and coronary artery surgery: indications and perioperative outcome

BACKGROUND

A significant number of patients with coronary artery disease is diagnosed with additional carotid artery disease. This subset of patients has been identified as a high-risk group for cardiac and cerebral complications following surgical intervention.

METHODS

In a retrospective analysis we investigated the perioperative outcome of combined single-stage carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) in 63 patients operated between January 1989 and August 1998. In all of these patients, CEA was performed prior to CABG and before initiation of cardiopulmonary bypass.

RESULTS

Perioperative mortality rate was 7.9% (5/63) for simultaneous CEA and CABG and was due to cardiac complications in all patients. Postoperative unilateral neurological symptoms were diagnosed in 1 patient (1.7%) and were completely reversible. No neurologic events suggestive for permanent cerebral damage were observed during the 30 d postoperative period.

CONCLUSIONS

In our study combined single-stage CEA and CABG was associated with low cerebral morbidity and patient outcome was mainly determined by cardiac complications. In this subset of patients, simultaneous CEA and CABG appears to be a safe method.