Amelioration of galactosamine-induced nephrotoxicity by a protein isolated from the leaves of the herb, <Emphasis Type="Italic">Cajanus indicus</Emphasis> L

Background  

Galactosamine (GalN), an established experimental toxin, mainly causes liver injury via the generation of free radicals and depletion of UTP nucleotides. Renal failure is often associated with end stage liver damage. GalN intoxication also induces renal dysfunction in connection with hepatic disorders. Present study was designed to find out the effect of a protein isolated from the leaves of the herb Cajanus indicus against GalN induced renal damage.     

Retrograde pericatheter urethrography (RPU) technique and its clinical use after urethroplasty: A single center experience

Objective

To describe our technique of retrograde pericatheter urethrography (RPU) and its clinical use after urethroplasty.

Role of Periarticular Liposomal Bupivacaine Infiltration in Patients Undergoing Total Knee Arthroplasty—A Meta-analysis of Comparative Trials

Background

Over last 2 years, many trials have evaluated newly approved liposomal bupivacaine for periarticular infiltration in total knee arthroplasty (TKA) with mixed results. Our meta-analysis attempts to consolidate the results and make evidence-based conclusions.

A panic foretold: Ebola in the United States

This paper reconsiders the Ebola response in the US as a panic that was both predictable and problematic. Public health professionals and policy-makers have historically drawn attention to and prepared for emerging infectious diseases by raising the specter of catastrophe, generating fears that the media and politicians are often willing to amplify. Although this approach can increase awareness of and funding for global health threats, it also sows the seeds of panic, stigmatizing people associated with the disease, and compromising an effective, evidence-based response. We offer lessons for public health leaders as they review the US Ebola response in order to prepare more responsibly for future disease scares such as that posed by the Zika virus.     

Pharmacologic therapy of mycotic keratitis

Mycotic keratitis continues to be an important cause of corneal blindness, especially in tropical and subtropical countries. The prognosis is poor compared with many other forms of keratitis because of the lack of effective antifungal drugs. The currently available antifungal drugs suffer from multiple drawbacks such as poor ocular penetration, unpredictable bioavailability, and adverse effects associated with systemic medications. Over the last decade, several new drugs and drug-delivery systems have been introduced in an attempt to improve the treatment outcomes. Thorough knowledge of the currently available antifungal drugs, their spectrum of action, and associated adverse effects is essential to deal with cases of mycotic keratitis. We discuss the pharmacologic properties and clinical use of the currently available antifungal drugs.     

MRI for Quantification of Liver and Cardiac Iron in Thalassemia Major Patients: Pilot Study in Indian Population

Objective

To evaluate Magnetic resonance imaging (MRI) as a tool to quantify liver and cardiac iron in Indian population with thalassemia major, and correlate liver and cardiac iron values with that of serum ferritin (SF).

Methods

Fifty patients aged between 8 to 18 y, with thalassemia major on regular blood transfusions and oral iron chelation therapy were enroled in the study. Twenty patients within the same age group, having no history of blood transfusions and no liver or cardiac disease were taken as controls. T2* MRI of heart and liver and SF estimation was done for all the cases as well as controls. All MRI scans were done on a 1.5-T Siemens MRI scanner using body coil.

Results

The mean SF among cases was 2150 ng/ml (SD 2179). Significant correlation was found in patients between liver iron concentration (LIC, mean 15) and SF levels (r = 0.522; p < 0.001), and also significant but weaker correlation was found in patients between myocardial iron concentration (MIC, mean 1.3) and SF levels (r = 0.483; p < 0.001). Seventeen (34%) patients had a SF of <1000 ng/ml. Of these, 11 and 3 patients respectively had LIC and MIC more than normal range.

Conclusions

T2* MRI is a valuable non-invasive tool for quantification of liver and cardiac iron deposition in patients with thalassemia major. It can demonstrate high LIC and MIC, even though the targeted SF levels are low in thalassemia, indicating the need for escalation of the chelation therapy. This needs to be confirmed on full-fledged larger prospective studies.

     

Pediatric renal transplant practices in India

Limited access to tertiary‐level health care, limited trained pediatric nephrologists and transplant physicians, lack of facilities for dialysis, lack of an effective deceased donor program, non‐affordability, and non‐adherence to immunosuppressant drugs poses a major challenge to universal availability of pediatric transplantation in developing countries. We present the results of a survey which, to the best of our knowledge, is the first such published attempt at understanding the current state of pediatric renal transplantation in India. A designed questionnaire formulated by a group of pediatric nephrologists with the aim of understanding the current practice of pediatric renal transplantation was circulated to all adult and pediatric nephrologists of the country. Of 26 adult nephrologists who responded, 16 (61.5%) were involved in pediatric transplantation, and 10 of 15 (66.6%) pediatric nephrologists were involved in pediatric transplantation. Most of the centers doing transplants were private/trust institution with only three government institutions undertaking it. Induction therapy was varied among pediatric and adult nephrologists. There were only a few centers (n=5) in the country routinely doing >5 transplants per year. Preemptive transplants and protocol biopsies were a rarity. The results demonstrate lower incidence of undertaking pediatric transplants in children below 6 years, paucity of active cadaveric programs and lack of availability of trained pediatric nephrologists and staff. In contrast to these dissimilarities, the immunosuppressant use seems to be quite similar to Western registry data with majority favoring induction agent and triple immunosuppressant (steroid, mycophenolate mofetil and tacrolimus) for maintenance. The survey also identifies major concerns in availability of this service to all regions of India as well as to all economic segments.