Prevalence of early stages of chronic kidney disease in healthy army personnel

Introduction: Chronic kidney disease (CKD) is associated with significant morbidity and mortality. Screening and detection of early stages of CKD can help institute interventions that may delay the progression of the disease. One aim was to study the prevalence of early stages of CKD in the Army.Methods: A cross-sectional study ofArmy Personnel in an Army cantt in Central India was carried out. All participants filled a structured questionnaire and anthropometric data was collected. Investigative profile included routine urine exam, semi-quantitative microalbuminuria (MAU), serum creatinine, lipid profile and fasting blood glucose. Glomerular Filteration rate (eGFR) was calculated using the Modification of Diet in Renal Diseases (MDRD) study equation.Result: A total of 1920 subjects were examined with 731 (38.07%) from Arms and 1189 (6I.93%) from Services. 348 were excluded and of the remaining 1572 subjects, 141 (8.97%) had MAU and 157 (9.99%) had deranged Albumin Creatinine Ratio (ACR). Mean eGFR by MDRD equation was 102 ± 25.84 ml/min/1.73m². Early CKD was seen in 150 (9.54%) with 84 (5.34%) in stage I CKD, 55 (3.5%) in stage II and 11 (0.7%) in stage III. Multiple logistic regression showed BMI > 23, the presence of DM and HTN were independent risk factors for CKD.Conclusion: 9.54 % of healthy army personnel were found to have early stages of CKD. Institution of screening programs can result in early detection of CKD.     

Interferon-γ modulates the functional profile of in-vitro-cultured porcine microglia

Microglia are the most important immune cells within the highly specialized environment of the central nervous system. Upon activation, they transform from a resting 'ramified' into a fully functional 'amoeboid' phenotype with the ability to perform phagocytosis and generate free radicals. A combined flow cytometric assay for the simultaneous measurement of these two functions in porcine microglia in vitro is presented: reactive oxygen species are detected using hydroethidine; phagocytosis is assessed using fluorescein isothiocyanate-labeled latex beads. The combination of these two probes allowed us to distinguish four subpopulations within cultured porcine microglia on the basis of their functional activity. The effect of several exogenous stimuli [phorbol myristate acetate, conditioned medium, interferon γ (IFN-γ)] on the in-vitro functional properties of porcine microglia is investigated using this test. In particular for IFN-γ, a significant modulatory effect on the intracellular reactive oxygen species production and phagocytic activity was observed. This result suggests an alternative role of IFN-γ acting on cultured porcine microglia.     

EXPERIENCE WITH VIPERINE ENVENOMATION

Two hundred and twenty one cases of viperine envenomation, who presented to hospital without specific treatment, seen over an twenty five years period, have been presented. Mild, moderate and severe envenomation was encountered in 33 per cent, 47 per cent and 20 per cent respectively. Bites on feet and ankles were seen in 85.5 per cent of cases. The average time interval between bite and hospitalisation was 4.8 hours, range being 15 minutes to 7 days. Local swelling was observed in 97.7 per cent, hematuria in 62 per cent, mucosal haemorrhages in 24.8 per cent and haematemesis in 19 per cent of patients. Average Antisnake Venom (ASV) required in mild, moderate and severe envenomation was 50 ml, 147.5 ml and 324 ml respectively. Major complications observed were renal failure in 10, intracompartmental syndrome in 3, intracerebral bleed and septicaemia in 2 each. One patient each developed finger gangrene, osteomyelitis, perirenal haematoma, sinus bradycardia and uncontrolled bleeding. Blood transfusion was required in 32 patients. Reactions to ASV were seen in 12 patients and overall there were 5 deaths.KEY WORDS: Antisnake venom, Viperine envenomation     

Management of anterior cruciate ligament lesions: surgical fashion, personal whim or scientific evidence? Study of medium- and long-term results.

The medium- and long-term results of conservative and surgical treatment of ACL lesions were evaluated by analysis of the current literature. Only reports with a minimum follow-up of 4 years were taken into account. Concerning conservative treatment, the literature search revealed only 7 papers with a total of 636 cases. Reports on the results of surgical treatment were separated into four categories: primary repair, with 13 papers (1205 cases), extraarticular tenodesis, with 4 papers (232 cases), ACL reconstruction, with 26 papers (2693 cases) and ACL prosthetic replacement (reconstruction using synthetics) with 5 papers (370 cases). The mean functional scores show about 70% good and excellent results for all treatment regimens. Clinical laxity persists in almost all conservatively treated cases, in almost half of the cases with primary repair, extra-articular tenodesis, and synthetic substitution, and in almost one-third of the cases with ACL reconstruction. The incidence of secondary ACL surgery was lowest in the conservative group (4.6%), whereas secondary meniscus surgery was lowest in the ACL reconstruction group (3.5%). Compared with the conservative group (12%), surgical treatment evolved to a higher osteoarthritic morbidity. Sports participation was higher in the ACL reconstruction group. This analysis may provide a more realistic view on the outcome of treatment of ACL lesions, and on the relationship between treatment, activity level and osteoarthritis.     

Replacing Vascular Corrosion Casting by <Emphasis Type="Italic">In Vivo</Emphasis> Micro-CT Imaging for Building 3D Cardiovascular Models in Mice

Purpose  

The purpose of this study was to investigate if in vivo micro-computed tomography (CT) is a reliable alternative to micro-CT scanning of a vascular corrosion cast. This would allow one to study the early development of cardiovascular diseases.