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1.
Environ Sci Pollut Res Int ; 31(9): 12597-12616, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38236573

RESUMO

Zero liquid discharge (ZLD) technology emerges as a transformative solution for sustainable wastewater management in the textile industry, emphasizing water recycling and discharge minimization. This review comprehensively explores ZLD's pivotal role in reshaping wastewater management practices within the textile sector. With a primary focus on water recycling and minimized discharge, the review thoroughly examines the economic and environmental dimensions of ZLD. Additionally, it includes a comparative cost analysis against conventional wastewater treatment methods and offers a comprehensive outlook on the global ZLD market. Presently valued at US $0.71 billion, the market is anticipated to reach US $1.76 billion by 2026, reflecting a robust annual growth rate of 12.6%. Despite ZLD's efficiency in wastewater recovery, environmental challenges, such as heightened greenhouse gas emissions, increased carbon footprint, elevated energy consumption, and chemical usage, are discussed. Methodologies employed in this review involve an extensive analysis of existing literature, empirical data, and case studies on ZLD implementation in the textile industry worldwide. While acknowledging existing adoption barriers, the review underscores ZLD's potential to guide the textile industry toward a more sustainable and environmentally responsible future.


Assuntos
Águas Residuárias , Purificação da Água , Tecnologia , Reciclagem , Purificação da Água/métodos , Água/análise , Indústria Têxtil
2.
Int J Biol Macromol ; 261(Pt 2): 129456, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38237828

RESUMO

Cotton stalk (CS) is a global agricultural residue, with an annual production of approximately 50 million tons, albeit with limited economic significance. The utilization of cellulose derived from CS has gained significant attention in green nanomaterial technologies. This interest stems from its unique properties, including biocompatibility, low density, minimal thermal expansion, eco-friendliness, renewability, and its potential as an alternative source for chemicals, petroleum, and biofuels. In this review, we delve into various extraction and characterization methods, the physicochemical attributes, recent advancements, and the applications of cellulose extracted from CS. Notably, the steam explosion method has proven to yield the highest cellulose content (82 %) from CS. Moreover, diverse physicochemical properties of cellulose can be obtained through different extraction techniques. Sulfuric acid hydrolysis, for instance, yields nanocrystalline cellulose fibers measuring 10-100 nm in width and 100-850 nm in length. Conversely, the steam explosion method yields cellulose fibers with dimensions of 10.7 µm in width and 1.2 mm in length. CS-derived products, including biochar, aerogel, dye adsorbents, and reinforcement fillers, find applications in various industries, such as environmental remediation and biodegradable packaging. This is primarily due to their ready availability, cost-effectiveness, and sustainable nature.


Assuntos
Celulose , Vapor , Celulose/química , Têxteis , Biotecnologia/métodos , Hidrólise
3.
Chem Biodivers ; 20(11): e202301086, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37851484

RESUMO

BACKGROUND: In Vedic context, Nirgundi (V. negundo) has been utilized for its anti-inflammatory, analgesic, and wound-healing properties. It has been employed to alleviate pain, treat skin conditions, and address various ailments. The plant's leaves, roots, and seeds have all found applications in traditional remedies. The knowledge of Nirgundi's medicinal benefits has been passed down through generations, and it continues to be a part of Ayurvedic and traditional medicine practices in India.


Assuntos
Fitoterapia , Vitex , Vitex/química , Medicina Tradicional , Índia , Folhas de Planta/química , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Extratos Vegetais/análise
4.
J Biophotonics ; 16(12): e202300237, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37669917

RESUMO

Tapered profiles are introduced in Bessel and Blackman apodized fiber Bragg grating, and their sensing performance is theoretically estimated. Reflectivity equation of proposed apodized tapered profiles is obtained using transfer matrix method and coupled mode theory. Since the effective refractive index (RI) of proposed waveguides varies with core radius therefore amplitude distribution and penetration depth of light in surroundings are modified. It is found that the exponential tapered profile with Bessel apodization shows a higher sensitivity of 682.5 nm/RIU, detection accuracy of 3858.45, and quality parameter 1718.02/RIU with minimum full width at half maxima (FWHM) 0.3972 nm of the reflection spectra. The spectral response of the tapered fiber Bragg grating is also analyzed through a group delay study. Again, exponential profile was found to be particularly effective, producing less group delay ripples 2.98 ps and is maximum slope of 42.43°. Hence, exponential tapered profile is demonstrated for detection of cancer cells lies between the refractive index of 1.3333-1.4412.


Assuntos
Fibras Ópticas , Refratometria
5.
Funct Integr Genomics ; 23(2): 183, 2023 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-37233833

RESUMO

Cotton is an important fiber crop cultivated around the world under diverse climate conditions and generates billions of dollars in annual revenue globally. Biotic and abiotic stresses have caused reduction in yield and productivity of cotton crops. In this review, we comprehensively analyzed and summarized the effect of biotic and abiotic stress on secondary metabolite production in cotton. The development of cotton varieties with improved tolerance against abiotic and biotic stress can play an important role in sustainable cotton production. Under stress conditions, plants develop a variety of defense mechanisms such as initiating signaling functions to upregulate defense responsive genes and accumulation of secondary metabolites. Understanding the impact of stress on secondary metabolite production in cotton is crucial for developing strategies to alleviate the negative effects of stress on crop yield and quality. Further, the potential industrial applications of these secondary metabolites in cotton, such as gossypol, could provide new opportunities for sustainable cotton production and the development of value-added products. Additionally, transgenic and genome-edited cotton cultivars can be developed to provide tolerance to both abiotic and biotic stress in cotton production.


Assuntos
Gossypium , Metabolômica , Gossypium/genética , Estresse Fisiológico/genética
6.
Cells ; 11(18)2022 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-36139367

RESUMO

Stem cells are a well-known autologous pluripotent cell source, having excellent potential to develop into specialized cells, such as brain, skin, and bone marrow cells. The oral cavity is reported to be a rich source of multiple types of oral stem cells, including the dental pulp, mucosal soft tissues, periodontal ligament, and apical papilla. Oral stem cells were useful for both the regeneration of soft tissue components in the dental pulp and mineralized structure regeneration, such as bone or dentin, and can be a viable substitute for traditionally used bone marrow stem cells. In recent years, several studies have reported that plant extracts or compounds promoted the proliferation, differentiation, and survival of different oral stem cells. This review is carried out by following the PRISMA guidelines and focusing mainly on the effects of bioactive compounds on oral stem cell-mediated dental, bone, and neural regeneration. It is observed that in recent years studies were mainly focused on the utilization of oral stem cell-mediated regeneration of bone or dental mesenchymal cells, however, the utility of bioactive compounds on oral stem cell-mediated regeneration requires additional assessment beyond in vitro and in vivo studies, and requires more randomized clinical trials and case studies.


Assuntos
Células-Tronco Mesenquimais , Células-Tronco , Células da Medula Óssea , Células-Tronco Mesenquimais/metabolismo , Ligamento Periodontal , Extratos Vegetais/metabolismo
7.
J Ethnopharmacol ; 296: 115467, 2022 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-35738470

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Tribal migratory shepherds (Gaddi) living in the Northwestern Himalayan region are well known for their nomadic lifestyle in which tribal migratory shepherds along with their livestock which mainly include sheep and goat migrate seasonally in the Northwestern Himalayan region from high hills to low hills for the survival of their livestock from cold winters and hot summer. Due to harsh environmental conditions, heavy snowfall, heavy rainfall, wild animal attacks, no medical facilities, no transportation, and no electricity facilities tribal migratory shepherds mostly rely on plant species mentioned for ethnoveterinary use to treat livestock disease. AIM OF STUDY: The aim of our study is to conduct ethnoveterinary survey for the first time to document the contemporary oral ethnoveterinary knowledge of Gaddi shepherds living in Northwestern Himalayan region. METHODOLOGY: The documentation of plant species mentioned for ethnoveterinary use was executed through extensive field surveys from 2017 to 2019. Data were collected through direct interviews by administrating questionnaire among tribal migratory shepherds. RESULTS: A total of 181 plant species mentioned for ethnoveterinary use belonging to the same or different families were documented during the seasonal migration of shepherds from Northwestern Himalayan region. Most frequently occurring family of plant species mentioned for ethnoveterinary was Poaceae, leaves and roots were reported to be the most frequently used plant parts. Most frequently documented plant species for ethnoveterinary use were Cynodon dactylon, Chenopodium album, Zanthoxylum armatum, Aloe vera, Azadirachta indica and Cannabis sativa. Chrysopogon serrulatus, Cynodon dactylon, and Vitex negundo were reported with high use reports. Some of the endemic species of Northwestern Himalayan region such as Elymus himalayanus and Euphorbia pilosa and one endangered species Picrorhiza kurrooa were reported in current study. CONCLUSION: It is observed that there is a need to raise awareness among the tribal migratory shepherds about the sustainable use and conservation of some of the plant species mentioned for ethnoveterinary use. This study provided an inventory of plant species mentioned for ethnoveterinary use having significant ethnoveterinary potential, however there is need of scientific evaluations by in vitro, in vivo and clinical studies.


Assuntos
Medicina Tradicional , Plantas Medicinais , Animais , Conhecimentos, Atitudes e Prática em Saúde , Gado , Fitoterapia/veterinária , Ovinos , Inquéritos e Questionários
8.
Antioxidants (Basel) ; 11(5)2022 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-35624686

RESUMO

Periodontal diseases are caused mainly by inflammation of the gums and bones surrounding the teeth or by dysbiosis of the oral microbiome, and the Global Burden of Disease study (2019) reported that periodontal disease affects 20-50% of the global population. In recent years, more preference has been given to natural therapies compared to synthetic drugs in the treatment of periodontal disease, and several oral care products, such as toothpaste, mouthwash, and dentifrices, have been developed comprising honeybee products, such as propolis, honey, royal jelly, and purified bee venom. In this study, we systematically reviewed the literature on the treatment of periodontitis using honeybee products. A literature search was performed using various databases, including PubMed, Web of Science, ScienceDirect, Scopus, clinicaltrials.gov, and Google Scholar. A total of 31 studies were reviewed using eligibility criteria published between January 2016 and December 2021. In vitro, in vivo, and clinical studies (randomized clinical trials) were included. Based on the results of these studies, honeybee products, such as propolis and purified bee venom, were concluded to be effective and safe for use in the treatment of periodontitis mainly due to their antimicrobial and anti-inflammatory activities. However, to obtain reliable results from randomized clinical trials assessing the effectiveness of honeybee products in periodontal treatment with long-term follow-up, a broader sample size and assessment of various clinical parameters are needed.

9.
Int J Biol Macromol ; 209(Pt A): 763-778, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35421412

RESUMO

Owing to numerous biological activities of different parts of Moringa oleifera Lam., various studies have been carried out to isolate and explore the activities of its various bioactive compounds including polysaccharides. Polysaccharides of M. oleifera have been reported to possess a variety of biofunctionalities including antihyperlipidemic, anti-diabetic, immunomodulatory, antihypertensive and gastrointestinal protection. In addition to bioactive polysaccharides, the gum exudated by stem of this plant is of commercial importance with wide range of applications in pharmaceutical industries. Various extraction and purification methods as well as combination of methods have been used to isolate and purify moringa polysaccharides. Studies suggest that extraction methods influence the structure of polysaccharides and thus their biological activity. This review summarizes all the available literature to provide updated information related to extraction, purification, modification, structural characterization, bioactivities and potential applications of moringa polysaccharides. This review will provide novel insights for future research and applications of moringa polysaccharides.


Assuntos
Moringa oleifera , Moringa , Antioxidantes/química , Moringa oleifera/química , Extratos Vegetais/química , Folhas de Planta/química , Polissacarídeos/análise , Polissacarídeos/farmacologia
10.
Antioxidants (Basel) ; 10(11)2021 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-34829718

RESUMO

Garlic (Allium sativa L.) is a bulbous flowering plant belongs to the family of Amaryllidaceae and is a predominant horticultural crop originating from central Asia. Garlic and its products are chiefly used for culinary and therapeutic purposes in many countries. Bulbs of raw garlic have been investigated for their role in oral health, which are ascribed to a myriad of biologically active compounds such as alliin, allicin, methiin, S-allylcysteine (SAC), diallyl sulfide (DAS), S-ally-mercapto cysteine (SAMC), diallyl disulphide (DADS), diallyl trisulfide (DATS) and methyl allyl disulphide. A systematic review was conducted following the PRISMA statement. Scopus, PubMed, Clinicaltrials.gov, and Science direct databases were searched between 12 April 2021 to 4 September 2021. A total of 148 studies were included and the qualitative synthesis phytochemical profile of GE, biological activities, therapeutic applications of garlic extract (GE) in oral health care system, and its mechanism of action in curing various oral pathologies have been discussed. Furthermore, the safety of incorporation of GE as food supplements is also critically discussed. To conclude, GE could conceivably make a treatment recourse for patients suffering from diverse oral diseases.

11.
Antioxidants (Basel) ; 10(9)2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34572990

RESUMO

Oral cancer continues to be a leading cause of death worldwide, and its prevalence is particularly high in developing countries, where people chew tobacco and betel nut on a regular basis. Radiation-, chemo-, targeted-, immuno-, and hormone-based therapies along with surgery are commonly used as part of a treatment plan. However, these treatments frequently result in various unwanted short- to long-term side effects. As a result, there is an urgent need to develop treatment options for oral cancer that have little or no adverse effects. Numerous bioactive compounds derived from various plants have recently attracted attention as therapeutic options for cancer treatment. Antioxidants found in medicinal plants, such as vitamins E, C, and A, reduce damage to the mucosa by neutralizing free radicals found in various oral mucosal lesions. Phytochemicals found in medicinal plants have the potential to modulate cellular signalling pathways that alter the cellular defence mechanisms to protect normal cells from reactive oxygen species (ROS) and induce apoptosis in cancer cells. This review aims to provide a comprehensive overview of various medicinal plants and phytoconstituents that have shown the potential to be used as oral cancer therapeutics.

12.
Plants (Basel) ; 10(9)2021 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-34579373

RESUMO

The study was performed in the mid hills of the Dharampur region in Solan district of Himachal Pradesh, India. At the study site, a total of 115 medicinal plants were documented (38 trees, 37 herbs, 34 shrubs, 5 climbers, 1 fern, and 1 grass). In the study region, extensive field surveys were performed between March 2020 and August 2021. Indigenous knowledge of wild medicinal plants was collected through questionnaires, discussions, and personal interviews during field trips. Plants with their correct nomenclature were arranged by botanical name, family, common name, habitat, parts used, routes used, and diseases treated. In the present study, the predominant family was Rosaceae, which represented the maximum number of plant species, 10, followed by Asteraceae and Lamiaceae, which represented 8 plant species. The rural inhabitants of the Dharampur region in the Solan district have been using local plants for primary health care and the treatment of various diseases for a longer time. However, information related to the traditional knowledge of medicinal plants was not documented. The rural inhabitants of the Dharampur region reported that the new generation is not so interested in traditional knowledge of medicinal plants due to modernization in society, so there is an urgent need to document ethnomedicinal plants before such knowledge becomes inaccessible and extinct.

13.
Antioxidants (Basel) ; 10(7)2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34209152

RESUMO

Plant-derived phytochemicals have been touted as viable substitutes in a variety of diseases. All over the world, dentists have turned to natural remedies for dental cure due to the negative possessions of certain antibacterial mediators used in dentistry. Antimicrobial and other drugs are currently in use, but they show some side effects. Since ancient times, antioxidant EOs have been used for different ailments and have grown in popularity over time. Several in vitro, in vivo, and clinical trials have shown the safety and effectiveness of antioxidant essential oils (EOs) in oral health obtained from medicinal plants. The current review of literature provides a summary of secondary metabolites, more specifically EOs from 20 most commonly used medicinal plants and their applications in maintaining oral health. Dental caries and periodontal diseases are the most common and preventable global infectious diseases, with diseases of the oral cavity being considered major diseases affecting a person's health. Several clinical studies have shown a connection between oral diseases and oral microbiota. This review discusses the role of antioxidant secondary metabolites in inhibiting the growth of oral pathogens and reducing the formation of dental plaque, and as well as reducing the symptoms of oral diseases. This review article contributes a basic outline of essential oils and their healing actions.

14.
Rev Sci Instrum ; 92(5): 053302, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-34243304

RESUMO

Brightness is an important parameter for any synchrotron radiation source. Correcting the emittance coupling is one of the ways to increase photon beam brightness in the operational storage ring. The main source of this effect is betatron coupling, resulting from the skew quadrupolar errors. Tune split and Linear Optics from Closed Orbit (LOCO) techniques are used to measure the betatron coupling. We discuss the measurement result of betatron coupling and its correction in the Indus-2 storage ring using available four power supplies, as the knobs, driving the skew quadrupole windings located on sextupoles. The measured coupling ratio of ∼0.8% closely matches with the coupling ratio obtained from the LOCO fit model. Based on LOCO correction, the coupling ratio can be reduced to ∼0.4%, which is limited by the degrees of freedom and not by the field strengths. To achieve a smaller and controlled value of coupling, simulation studies based on the LOCO fit model and using the multi-objective differential evolution algorithm with more skew quadrupole power supplies are performed in Indus-2. With sixteen independent power supplies, the emittance ratio can be reduced to <0.04% and the brightness enhances by an order of magnitude. Besides, the optimization method used provides quantitative trade-offs between coupling related parameters such as beam tilt angle, emittance ratio, vertical emittance, and vertical beam size, and desired values can be chosen from the Pareto optimal front.

15.
J Assoc Physicians India ; 67(11): 18-21, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31793263

RESUMO

INTRODUCTION: Crescentic Glomerulonephritis (CGN) is most aggressive structural phenotype and accounts for 2%-7% of renal biopsy in most series. The aim of study was to assess the clinical feature and outcome of CGN at our centre. MATERIAL AND METHODS: The renal biopsy performed during the period of January 2015 to January 2018 was studied and patients showing crescentic glomerulonephritis on histology were selected for this study. The clinical presentation, immunological assay, biochemical and haematological investigations, treatment protocol and final outcome at three month of these patients were analysed in the present study. RESULTS: Of 380 biopsy, 26 (male=17, female=9) patients had histological evidence of CGN (6.8%). The age of patients ranged between 13-75 (mean=43) years. Fibro cellular and cellular crescent was noted in 84.61% and 15.38% of patients respectively. Small vessels vasculitis and granuloma was observed in 5 (19.23%) cases. Based on immunohistopathology, we observed type I (n=3), type II (n=8), type III (n=5), type IV (n=3), and type V (n=7) crescentic GN in 11.53%, 30.76%, 19.23%, 11.53% and 26.92% of patients respectively. Haemodialysis was given to 22(84.61%) and 4(15.38%) patients were treated with immunosuppressive therapy. Plasmapheresis was used in two double positive (ANCA + Anti GBM Ab) patients. Remaining 21(80.76%) has progressed to ESRD over a period of 2-3 months. CONCLUSION: Type II (immune complex) CGN was most common type followed by type V (immune negative) and type III (pauci-immune) CGN. The crescentic GN had worse prognosis with >80% of patients progressed to ESRD within 3 month of time from onset of illness. Early diagnosis and treatment is associated with favourable outcome.


Assuntos
Glomerulonefrite , Vasculite , Anticorpos Anticitoplasma de Neutrófilos , Biópsia , Feminino , Glomerulonefrite/complicações , Glomerulonefrite/etiologia , Glomerulonefrite/terapia , Humanos , Masculino , Estudos Retrospectivos , Vasculite/etiologia
16.
Saudi J Kidney Dis Transpl ; 30(5): 1118-1130, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31696851

RESUMO

The incidence of acute kidney injury in pregnancy (P-AKI) has markedly decreased over the last three decades in India, particularly due to decreased incidence of postabortion AKI. However, P-AKI still accounts for 3%-5% of cases of total AKI. Postabortion sepsis has decreased to between 0.9% and 1.5% in 2014 from 9.4% in 1980-1990 in the new millennium. Currently, in India, majority of P-AKI (70%-90%) occurs in the postpartum period and in late 3rd trimester similar to the developed countries, but causes are different. We observed that preeclampsia/eclampsia is the most common cause of P-AKI in the late 3rd trimester and postpartum period followed by puerperal sepsis and postpartum hemorrhage (PPH). Both puerperal sepsis and PPH are treatable and preventable etiologies of P-AKI. Timely and aggressive management of antepartum hemorrhage (APH/PPH) and puerperal sepsis are required to reduce the burden of P-AKI in developing countries. Specific-pregnancy disorders such as P-aHUS/thrombotic thrombocytopenic purpura, pregnancy-associated thrombotic microangiopathy, and acute fatty liver of pregnancy are the uncommon/rare causes of P-AKI in India and possibly also because of the lack of awareness toward diagnosis. Despite decreasing incidence of P-AKI, fetal mortality remained high and unchanged. However, maternal mortality has decreased to 5% from initial high mortality of 20%-25%. The incidence and severity of renal cortical necrosis have significantly decreased at our center.


Assuntos
Injúria Renal Aguda/epidemiologia , Países em Desenvolvimento , Complicações na Gravidez/epidemiologia , Aborto Induzido/efeitos adversos , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/mortalidade , Injúria Renal Aguda/terapia , Feminino , Humanos , Incidência , Índia/epidemiologia , Mortalidade Materna , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/mortalidade , Complicações na Gravidez/terapia , Medição de Risco , Fatores de Risco , Fatores de Tempo
17.
J Assoc Physicians India ; 67(9): 18-22, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31561682

RESUMO

INTRODUCTION: The safe and effective treatment of HIV-associated renal diseases with cART can decrease the progression to ESRD and also improve the morbidity and mortality secondary to renal failure. MATERIAL AND METHODS: HIV positive patients with clinical kidney disease were the subjects of this study. The diagnosis of HIV was established using immunochromatographic assays. The patients were subjected to meticulous history, physical examination, laboratory investigations and kidney biopsy. Patients were treated with combined antiretroviral therapy and enalapril. They were followed at 3 months interval for one year. Short term outcome was assessed using changes in serum creatinine and proteinuria. Long term outcome assessments were done using progression to end stage renal disease and patients survival. RESULT: Ten (Male=7; Female=3) HIV patients with clinical renal disease were included in this study. Their age ranged between 26-55 (Mean=40.5±8.8) years. The mean serum creatinine at the baseline, three, six, nine and twelve months was 2.46, 2.09, 2.43, 2.46 and 2.58 mg/dl respectively. The mean e-GFR by MDRD equation at 0, 3, 6, 9 and 12 months was 40.9, 45.5, 48.2, 51.1 and 52.5 ml/ min/1.73m2 respectively. The mean twenty four hour urinary protein excretion at 0, 3, 6, 9 and 12 months was 3.01, 2.82, 2.22, 2.02 and 1.79 grams respectively. Six patients showed improvement in creatinine and e-GFR, whereas worsening of renal function was seen in four patients. Proteinuria decreased in seven patients, whereas it remained unchanged in three patients. There was no mortality at the end of one year of follow up. CONCLUSION: Treatment with combined ART and ACEIs slows the progression of HIV-associated kidney disease, decreases proteinuria and improves the GFR.


Assuntos
Antirretrovirais/uso terapêutico , Quimioterapia Combinada , Infecções por HIV/complicações , Nefropatias/terapia , Adulto , Creatinina , Feminino , Seguimentos , Taxa de Filtração Glomerular , HIV , Humanos , Rim , Falência Renal Crônica , Masculino , Pessoa de Meia-Idade , Proteinúria
18.
J Nephrol ; 31(1): 79-85, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29302904

RESUMO

INTRODUCTION: There are numerous reports in the literature describing acute kidney injury in pregnancy (P-AKI) due to various obstetric complications. However, there is a dearth of studies on AKI related to pregnancy-specific disorders from India. We aimed to analyze clinical features and outcome of P-AKI related to pregnancy-specific disorders compared to total pregnancy, in India. METHOD: All pregnant women attending the department of Obstetrics and Gynecology from November 2014 to July 2016 were screened for AKI based on: (1) sudden elevation of serum creatinine ≥ 1 mg/dl; (2) oligoanuria for > 12 h; and (3) need for dialysis. The detailed clinical profile of AKI in patients with preeclampsia/eclampsia (PE/E), hemolysis/elevated liver enzymes/low platelet count (HELLP) syndrome, acute fatty liver of pregnancy (AFLP), and pregnancy-associated thrombotic microangiopathy (P-TMA) was analyzed. Laboratory investigations included: complete blood count, renal function tests, urinalysis, coagulation profile (platelet count, INR, prothrombin time and activated partial thromboplastin time), and immunological assay (C3, C4, ANA, anti-dsDNA antibody, antiphospholipid antibody). Contrast-enhanced CT scan of kidney ureter and bladder (KUB) and renal biopsy were performed in selected cases. Maternal and fetal outcome were analyzed individually. The patients were followed for 3 months or longer to determine the recovery of renal function or progression to chronic kidney disease (CKD). RESULTS: Overall, 4741 pregnant women (mean age 26.8 ± 4.8 years) were evaluated for AKI. P-AKI was found in 132/4741 (2.78%) patients. In the majority (91.6%), AKI developed in the late 3rd trimester and post-partum period. P-AKI was related to obstetric complications (in 61.4%), pregnancy-specific disorders (in 57.5%) and miscellaneous factors (7.5%). Puerperal sepsis, ante-partum and post-partum hemorrhage were contributing factors for P-AKI in 34 (25.8%), 11 (8.3%) and 28 (21.2%) patients, respectively. P-AKI due to pregnancy-specific disorders developed in 76/4741 patients, i.e. in 1:62 pregnancies. PE/E was the cause of P-AKI in 62 patients (46.9%) followed by HELLP syndrome in 9 (6.8%) and AFLP in 05 (3.8%). P-TMA causing AKI was not observed. Complete recovery of renal function occurred in 89.4% of patients while 6 (4.6%) progressed to CKD (ESRD: 3 and CKD stage IV: 3). Maternal mortality was 6%. Puerperal sepsis was the sole cause of patchy cortical necrosis in 5 (3.7%) cases. Premature delivery occurred in 40.9% patients and full-term delivery in 35.6%. Perinatal mortality was 23.5%, mainly due to intrauterine death (17.5%) and prematurity (6%). CONCLUSION: PE/E was the commonest cause of P-AKI in our study, similar to the situation in developed countries. Post-partum hemorrhage was the second-most common (21.5%) cause. Puerperal sepsis contributed to AKI in one-fourth of pregnant women. P-TMA was not recorded in this study and AFLP was an uncommon cause of P-AKI in our country. Renal function returned to normal in all patients with P-AKI due to pregnancy-specific disorders. However, perinatal mortality was high despite the good prognosis of P-AKI.


Assuntos
Injúria Renal Aguda/epidemiologia , Taxa de Filtração Glomerular , Rim/fisiopatologia , Complicações na Gravidez/epidemiologia , Injúria Renal Aguda/mortalidade , Injúria Renal Aguda/fisiopatologia , Injúria Renal Aguda/terapia , Adulto , Biomarcadores/sangue , Creatinina/sangue , Progressão da Doença , Feminino , Humanos , Índia/epidemiologia , Lactente , Mortalidade Infantil , Recém-Nascido , Rim/diagnóstico por imagem , Mortalidade Materna , Gravidez , Complicações na Gravidez/mortalidade , Complicações na Gravidez/fisiopatologia , Complicações na Gravidez/terapia , Resultado da Gravidez , Prevalência , Estudos Prospectivos , Recuperação de Função Fisiológica , Diálise Renal , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Regulação para Cima , Adulto Jovem
19.
Ann Vasc Surg ; 39: 236-241, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27554692

RESUMO

BACKGROUND: Compensation may be a significant factor for academic vascular surgeons seeking or changing employment. We compared compensation for academic and private practice vascular surgeons practicing for approximately similar duration. METHODS: Compensation data for academic and private practice vascular surgeons were obtained from the Association of American Medical Colleges (AAMC) and Medical Group Management Association (MGMA), respectively. Comparisons of nominal annual compensation data were made between Group 1 (assistant professor vascular surgeons versus private practice vascular surgeons in practice for 1-7 years), Group 2 (associate professor vascular surgeons versus private practice vascular surgeons in practice for 8-17 years), and Group 3 (professor vascular surgeons versus private practice vascular surgeons in practice for ≥18 years) from 2003 to 2012. RESULTS: In Group 1, there was a $54,500 difference in 2003 (P = 0.043) which increased to $110,500 by 2012 (P = 0.001). In Group 2, there was a $44,200 difference in 2007 (P = 0.016) which increased to $53,400 by 2010 (P = 0.034). In Group 3, there was no statistically significant difference in compensation (P ≥ 0.999). CONCLUSIONS: There is a significant and increasing disparity in compensation in favor of private practice vascular surgeons compared with assistant professor vascular surgeon faculty. Differences equalized with increasing seniority and experience. Compensation plans should be market based and in line with nonacademic benchmarks as well.


Assuntos
Academias e Institutos/economia , Corpo Clínico Hospitalar/economia , Prática Privada/economia , Salários e Benefícios/economia , Cirurgiões/economia , Procedimentos Cirúrgicos Vasculares/economia , Academias e Institutos/tendências , Competência Clínica/economia , Escolaridade , Humanos , Corpo Clínico Hospitalar/tendências , Prática Privada/tendências , Salários e Benefícios/tendências , Cirurgiões/tendências , Fatores de Tempo , Procedimentos Cirúrgicos Vasculares/tendências
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