Post-Diarrheal Acute Kidney Injury During an Epidemic in Monsoon - A Retrospective Study from a Tertiary Care Hospital.

Background: Acute kidney injury (AKI) is a severe complication of acute diarrheal diseases; however, there is limited data on post-diarrheal AKI (PD-AKI) epidemiology and outcomes. This study aimed to investigate the clinicodemographic profile and outcomes of PD-AKI in our hospital. Materials and Methods: We retrospectively analyzed data from 93 patients admitted with PD-AKI during a diarrheal illness epidemic. Patients were stratified based on the Kidney Disease: Improving Global Outcomes (KDIGO) AKI stage and quick Sequential Organ Failure Assessment (qSOFA) score. Clinicodemographic data and outcomes were recorded and analyzed. Results: The mean age of the patients was 45.7 ± 11.9 years, with a majority being men (n = 55, 59%). All patients presented with watery diarrhea, 85% (n = 79) had vomiting, and 66% (n = 61) presented in shock. At presentation, 59% were oliguric, while 32% were anuric. KDIGO stage 3 AKI was observed in 71% (n = 66) of patients. Dialytic support was required in 29% (n = 27) of cases. The mortality rate was 6.5% (n = 6), mostly due to refractory shock, while the remaining patients recovered. Risk factor analysis demonstrated a higher qSOFA score, and peak serum creatinine levels were associated with an increased likelihood of requiring renal replacement therapy and delayed renal recovery. Conclusion: This study provides valuable insights into the clinicodemographic characteristics and outcomes of PD-AKI. The high prevalence of severe AKI emphasizes the importance of early recognition and appropriate management strategies for these patients.

Impact of online classes on eye health of children and young adults in the setting of COVID-19 pandemic: A hospital-based survey.

BACKGROUND: To analyze the impact of online classes on eye health of children and young adults during the COVID-19 pandemic. MATERIALS AND METHODS: An observational study with a written questionnaire and comprehensive ophthalmic evaluation at a tertiary eye care center in South India, during the COVID-19 pandemic. RESULTS: Of the 496 patients, most were 5-10 years old, attending online classes 1-2 h/day with majority (84.7%) having <4 h of classes. Electronic gadget use after classes was seen in 95.6% participants and 28.6% admitted to using it for more than 2 h/day. Digital eye strain (DES) was seen in 50.8% of patients of which headache or eye ache were the most common symptom (30.8%). Duration of online class was found to be the single most independent factor associated with the development of eye complaints (P = 0.001). Duration of class hours (P = 0.007) and light setting (P = 0.008) was found to be independent determinants of developing DES. CONCLUSIONS: Increased screen time, inadequate light setting, and excessive application of near vision can produce undesirable effects including the development of DES, worsening or development of new refractive errors and squint.

OUTER FOVEAL DEFECTS IN TYPE-2 MACULAR TELANGIECTASIA.

PURPOSE: To report characteristics of outer foveal defects (OFDs) in type-2 macular telangiectasia (MacTel) on spectral domain optical coherence tomography. METHODS: This was a single-center observational study. From a registry of 745 patients with MacTel, patients with OFDs were characterized. All patients underwent multimodal imaging including color fundus photography, confocal blue reflectance, fundus autofluorescence, and spectral domain optical coherence tomography. Staging of eyes was done using the Gass and Blodi classification. Spectral domain optical coherence tomography characteristics in the central 1 mm of the macula in eyes with OFD are reported. RESULTS: Outer foveal defect was observed in 21 eyes of 15/745 (2%) patients with MacTel. These defects were bilateral in 6/15 (40%) patients and seen in stage 2 MacTel eyes. In order of prevalence, foveal parameters seen in OFD included hyper-reflective dots in outer retina in 19/21 (90%), ellipsoid zone loss in 18/21 (86%) eyes, interdigitation zone loss in 17/21 (81%) eyes, outer retinal hyporeflective cavitation in 14 (67%) eyes, hyporeflective cavitation at foveal pit in 8 (38%) eyes, and loss of external limiting membrane in 1 (5%) eye. The mean baseline length of the foveal ellipsoid zone loss was 240.17 ± 117.249 µm. The mean baseline central subfield thickness was 155.43 ± 17.215 µm. A total of 8/11 eyes (73%) showed an increase in size of OFD on follow-up. CONCLUSION: Outer foveal defect in MacTel eyes is characterized predominantly by foveal loss of ellipsoid zone and interdigitation zone with relative preservation of external limiting membrane.

A highly potential acyclic Schiff base fluorescent turn on sensor for Zn2+ ions and colorimetric chemosensor for Zn2+, Cu2+ and Co2+ ions and its applicability in live cell imaging.

Herein, we report two acyclic Schiff base receptors CS-1 and CS-2 capable of being selective fluorescent turn on for Zn2+ions and colorimetric chemosensor for Zn2+, Cu2+, and Co2+ ions by showing a colour change from colourless to yellow in 1:1 ratio of acetonitrile and HEPES buffer (1:1, v/v, pH 7.4) without the interference from other metal ions screened (Cd2+, Hg2+, Sn2+, Ni2+, Cr3+, Mn2+, Pb2+, Ba2+, Al3+, Ca2+, Mg2+, K+ and Na+). The fluorescence turn on enhancement towards Zn2+ ions is ascribed to PET blocking, suppression of -C=N- isomerisation, and the ESIPT process. The selectivity, competitivity and reversibility of the synthesised probes (CS-1 and CS-2) made them promising chemosensors for the detection of Zn2+, Cu2+, and Co2+ ions. The density functional theory (DFT) calculations have theoretically endorsed the colorimetric changes in the examined absorption spectra and binding mode of both CS-1/CS-2 with metals ions. In addition, 1H NMR titrations were also consistent with the recognition mechanism of Zn2+ ions with the CS-1/CS-2. Further, the Jobs plot analysis infers a 1:1 stoichiometric ratio for both evaluating receptors CS-1 and CS-2 with Zn2+, Cu2+ and Co2+ ions and was supported by DFT, NMR (only for Zn2+ ions), UV-Visible, and fluorescence spectroscopic studies. Moreover, the detection limits of CS-1 and CS-2 for Zn2+ ions were determined to be 7.69 and 5.35 nM, respectively, which is less compared to the detection limit of Cu2+, Co2+ ions as well as the limit approved by the United State Environmental Protection Agency (US EPA). The probes CS-1 and CS-2 found to show high fluorescence quantum yields at pH = 7 during the titration with Zn2+ as compared with other pHs (5-6 and 8-11). Gratifyingly, fluorescence microscopy imaging in HeLa cells revealed that the pair of receptors can be employed as an excellent fluorescent probe for the detection of Zn2+ions in living cells, indicating that this facile chemosensor has a huge potential in cellular imaging.

Biochemical predictors for Sars-Cov-2 severity.

It is of interest to assess the inflammatory marker profile in SARS-CoV-2 patients and to correlate the levels of systemic inflammatory biomarkers such as neutrophil-to-lymphocyte ratio (NLR), C-Reactive Protein CRP, Ferritin, Creatine kinase (CK), Lactate dehydrogenase (LDH) and liver function analytes total serum proteins, albumin, total bilirubin, direct bilirubin, alkaline phosphatase, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) with the severity of SARS-CoV-2 infections. A total of 1000 COVID-19 positive patient's data were collected. Laboratory assessments consisted of NLR (neutrophil-lymphocyte ratio) by cell counter, C Reactive Protein (CRP) by immunoturbidimetry, Ferritin by electrochemiluminescence (ECLIA) and Creatine Kinase (CK), Lactate Dehydrogenase (LDH), Alkaline phosphatase (ALP), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Total Bilirubin, Direct Bilirubin, Total Protein and Albumin by spectrophotometry. The mean plasma CRP levels, NLR, ferritin, CK and LDH levels were higher in severe cases than in non-severe cases, and the difference was statistically significant (p<0.05). All liver function tests such as the total and direct bilirubin, AST, ALT, ALP, total protein and albumin were higher in severe patients than non-severe patients and the difference was statistically significant (p<0.05). Data indicate that NLR, CRP, Ferritin, CK, LDH and liver function analytes have a crucial role as prognostic markers for SARS-CoV-2 infections and hence should be routinely recommended for risk assessment and stratification of the patients to reduce the associated morbidity and mortality.