The Banff 2015 Kidney Meeting Report: Current Challenges in Rejection Classification and Prospects for Adopting Molecular Pathology.

The XIII Banff meeting, held in conjunction the Canadian Society of Transplantation in Vancouver, Canada, reviewed the clinical impact of updates of C4d-negative antibody-mediated rejection (ABMR) from the 2013 meeting, reports from active Banff Working Groups, the relationships of donor-specific antibody tests (anti-HLA and non-HLA) with transplant histopathology, and questions of molecular transplant diagnostics. The use of transcriptome gene sets, their resultant diagnostic classifiers, or common key genes to supplement the diagnosis and classification of rejection requires further consensus agreement and validation in biopsies. Newly introduced concepts include the i-IFTA score, comprising inflammation within areas of fibrosis and atrophy and acceptance of transplant arteriolopathy within the descriptions of chronic active T cell-mediated rejection (TCMR) or chronic ABMR. The pattern of mixed TCMR and ABMR was increasingly recognized. This report also includes improved definitions of TCMR and ABMR in pancreas transplants with specification of vascular lesions and prospects for defining a vascularized composite allograft rejection classification. The goal of the Banff process is ongoing integration of advances in histologic, serologic, and molecular diagnostic techniques to produce a consensus-based reporting system that offers precise composite scores, accurate routine diagnostics, and applicability to next-generation clinical trials.

Assessment of antifouling efficacy of polyhedral oligomeric silsesquioxane based poly (urea-urethane-imide) hybrid membranes.

UNLABELLED: A series of polyhedral oligomeric silsesquioxane (POSS) based poly(urea-urethane-imide) (PUUI-POSS) membranes were synthesized by varying the proportions of imide using 2,4-toluene diisocyanate (TDI) and bis(aminopropyl) terminated polydimethylsiloxane (PDMS). The molecular structures of poly(urea-urethane-imide)s were characterized by Attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopic technique. Incorporation of imide domain and its influence on surface roughness was investigated by atomic force microscopy (AFM). Hydrophobicity of polymeric membrane surfaces was determined by contact angle measurement. The thermal properties of the polymers were studied by thermogravimetric analysis. The antimicrobial activities and inhibition of bacterial attachment of these polymeric membranes were studied on Gram-positive (Staphylococcus aureus) and Gram-negative bacteria (Escherichia coli) by the disc-diffusion method. SIGNIFICANCE AND IMPACT OF THE STUDY: The antifouling performance has been evaluated for the polymeric membranes against two bacteria (Staphylococcus aureus (ATCC 6538)) (Escherichia coli (ATCC 8739)). The polymeric membranes were incorporated with imide moiety to improve thermal stability of the polymeric materials. The synthesized polymeric membranes have shown good morphological properties for better antifouling activities. This study found that these membranes are capable of preventing micro-organisms besides offering excellent bio-fouling resistance.

Anticancer activity of fungal L-asparaginase conjugated with zinc oxide nanoparticles.

Demand for developing novel delivery system for cancer treatment has increased due to the side effects present in intravenous injection of L-asparaginase. Nanoparticles are used for delivering the drugs to its destination in cancer cure. Nanobiocomposite of zinc oxide nanoparticles conjugated with L-asparaginase was produced by Aspergillus terreus and was confirmed using maximum UV-Vis absorption at 340 nm in the present work. The presence of functional groups like OH, C-H, -C=N and C=O on the surface of nanobiocomposite was found from Fourier transform infrared spectrum analysis. Size of the produced nanocomposite was found in the range of 28-63 nm using scanning electron microscope. The crystalline nature of the synthesized nanobiocomposites was confirmed by X-ray diffraction analysis. The presence of zinc oxide on synthesized nanobiocomposite was confirmed by energy dispersive spectrum analysis. The anti-cancerous nature of the synthesized zinc oxide conjugated L-asparaginase nanobiocomposite on MCF-7 cell line was studied using MTT assay. The viability of the MCF-7 cells was decreased to 35.02 % when it was treated with L-asparaginase conjugated zinc oxide nanobiocomposite. Hence it is proved that the synthesized nanobiocomposites of zinc oxide conjugated L-asparaginase has good anti-cancerous activity.

Comparative study of the effects of organic selenium on hen performance and productivity of broiler breeders.

1. A 10-week experiment was conducted with Ross 308 broiler breeder chickens in cages to evaluate the influence of organic and inorganic sources of selenium (Se) supplementation. A total of 600 birds at 29 weeks of age were divided at random into 4 groups and fed on a maize-soya basal diet supplemented with different forms of Se. 2. The first (control) group was given the basal diet without Se supplementation, whereas the second, third and fourth groups were given, respectively, the basal diet with 0.3 mg/kg of inorganic Se in the form of sodium selenite or 0.3 and 0.5 mg/kg of organic Se in the form of Se enriched yeast (Se-yeast). 3. The experiment was carried out for 10 weeks to compare and evaluate the influence of Se supplementation on breeder performance, egg production, hatchability and the quality of eggs. Samples were collected for analysis at weeks 0, 5 and 10 of the experimental period. 4. At the end of the experiment (39 weeks), there was a reduction in mortality in breeders given diets supplemented with 0.5 mg/kg of Se-yeast. Supplementation of feed with 0.5 mg/kg organic Se increased egg production, percentage of settable eggs and hatchability. 5. Selenium supplementation increased egg weight and specific gravity compared to the control diet. However, no significant variation was found in albumen or yolk protein content at the end of week 10. 6. Selenium accumulation and glutathione peroxidase (GSHPx) activity were lower in the egg albumen and yolk of control compared with Se-supplemented treatments. Se accumulation and GSHPx activity were higher in the group given 0.3 mg/kg organic compared to 0.3 mg/kg of inorganic Se. 7. The results favour the use of Se-yeast at the dose of 0.5 mg/kg in broiler breeder diets for better productivity of eggs, settable eggs, hatchability and higher Se accumulation and antioxidant status in eggs.

Impact of microfiber pollution on aquatic biota: A critical analysis of effects and preventive measures.

The widespread use of Personal protective equipments (PPEs) by the healthcare professionals and public due to Corona Virus Disease (COVID-19) pandemic has become a new source for MFs pollution. Mismanaged plastic wastes and random dispose of used surgical face mask end up in large aquatic bodies via small waterways and waste water treatment plants (WWTPs). Microplastics/Microfibres (MPs/MFs) have recently been reported in a variety of aquatic and terrestrial ecosystems, including water, deep sea sediments, air and soil. Natural components like UV radiation and temperature play a major role in weathering of surgical masks. High loads of MPs/MFs emitted into the aquatic environment are easily consumed by organism's habitat in such ecosystem by disrupting the food chain and causing chronic health problems in the organisms including humans. The aim of this review article is to shed light on these issues and compile the most recent information available regarding the deterioration of surgical face masks in the environment as well as other contaminants and their presence in various environments, particularly with regard to methods that make use of exposure models, biomarkers of exposure, and their limitations. Along with this, the study focuses on identifying gaps in current understanding and highlighting prospective research directions. The literature on surgical face mask pollution and its effects on the biological and physiological systems of various organisms and ecosystems is critically analysed in this review. It also raises awareness of how to properly dispose of used surgical face masks and other PPEs.

Mental health of hypertensive patients and its association with their blood pressure in a rural area of Kancheepuram District, Tamil Nadu.

Introduction: Chronic diseases, such as type 2 diabetes mellitus and hypertension, are often associated with psychiatric comorbidities such as anxiety, depression, and somatization. Approximately, one-fourth of the adults were diagnosed with hypertension, and the proportion will reach about one-third by 2025. The prevalence of hypertension throughout India is 29.8% and the burden of hypertension in a rural area of Tamil Nadu is 25.2%. The compliance of drug intake depends on the mental health of the patient and this study intends to take care of patients with chronic illnesses. This study is designed to assess the mental health of hypertensive patients and its association with their blood pressure. Materials and Methods: A cross-sectional descriptive study was conducted among hypertensive patients in the field practice of a tertiary care medical college in the Kancheepuram district for a period of 3 months using a semi-structured validated schedule after obtaining the informed consent. The depression anxiety stress scale (DASS) scale was used to assess the mental health of hypertensive patients. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 23.0. Results: Most hypertensive patients were found in the age group of 40 to 60 years. About 53.4% of hypertensive patients with normal blood pressure were suffering from depression. In addition, about 44.6% of pre-hypertensive patients and 44.6% of stage II hypertensive patients were found to have severe depression. Conclusion: Overall, pre-hypertensive patients were suffering from depression when compared to other hypertensive patients. Family history and tobacco and alcohol intake were other factors associated with depression in hypertensive patients.

Classical and unusual imaging appearances of melorheostosis.

This comprehensive review will discuss the classical and unusual radiological features of melorheostosis, which is an uncommon, non-hereditary, benign, sclerosing mesodermal disease with an incidence of 0.9 cases per million. The presentation of melorheostosis in the appendicular skeleton (more commonly involved) and in the axial skeleton (very few documented case reports) will be discussed. The aim of the review is to illustrate the associations and rare, but recognized, complications of the disorder. The role of cross-sectional imaging in the form of magnetic resonance imaging (MRI) and computed tomography (CT) in revealing the spectrum of disease manifestation and differentiation from other disease entities and malignancy will be explored.

Chromium Accumulation in Medicinal Plants Growing Naturally on Tannery Contaminated and Non-contaminated Soils.

Herbal preparations used to treat human ailments globally can be contaminated with various heavy metals (HMs) originating from the raw materials or from the manufacturing processes. Therefore, we assessed 22 medicinal plants growing naturally on tannery pollutant contaminated (Site-C) and non-contaminated (Site-NC) sites for their ability to accumulate chromium (Cr). The Cr contents in soil and various plant parts were estimated using an atomic absorption spectrophotometer. Translocation and bioconcentration factors were calculated. The soil at Site-C had 27-fold higher concentration of total Cr than at Site-NC. Chromium accumulation is reported for the first time in 50 % of the medicinal plants examined and varied significantly among the sites. Shoots of Ricinus communis and Amaranthus viridis had maximum concentrations of Cr at Site-C, whereas in Site-NC, none of the plants had Cr accumulation >30 ppm. Ricinus communis, Amaranthus viridis, and Amaranthus spinosus had translocation factor (TF) greater than the one in the Site-C and Lantana camara had TF >1 in Site-NC. The bioconcentration factor (BCF) was >1 only for Ricinus communis at both the sites. The majority of the medicinal plants at Site-NC had Cr content exceeding the permissible limit of 2 ppm suggested for herbal raw material. The results of the study clearly emphasize the need for screening plants of therapeutic value for the presence of HMs even when collected from non-contaminated soils. Moreover, proportional allocation of Cr in different plant parts provided an insight on the safety of these parts when specifically used in herbal preparations.

Visual impairment among 10-14-year school children in Puducherry: A cross-sectional study.

INTRODUCTION: According to the 2010 estimates by the World Health Organization, nearly 285 million (4.24% of total population) people of all ages worldwide are visually impaired. Almost 18.9 million children under 15 years of age are visually impaired globally. In developing countries, 7%-31% of childhood blindness and visual impairment is avoidable. MATERIALS AND METHODS: The study was conducted as a cross-sectional study among 1884 school students in Puducherry, in the age group of 10-14 years. A child with presenting maximum vision ≤6/12 Snellen equivalent in the better eye is considered visually impaired. Data were entered in Microsoft Excel 2013 and analyzed using the statistical software SPSS version 21.0. Chi-square test was applied for testing difference in proportion and a P < 0.05 was considered statistically significant. RESULTS: The overall prevalence of visual impairment (vision ≤6/12) among the study participants was 6.37% (95% confidence interval = 5.27-7.47). The prevalence of visual impairment increased with age and it was found to be high among male students (6.6%) when compared to female students (6%). Presenting vision of 6/6 was observed in 79.8% of the children while with pinhole correction, the proportion increased to 94.6%. CONCLUSION: The prevalence of visual impairment in our study population was found to be 6.37% and the prevalence was even higher among children who belonged to schools of urban region or private schools. Children with a positive family history of spectacle use were more likely to have visual impairment.

Optimization of RNA yield, purity and mRNA copy number by treatment of urine cell pellets with RNAlater.

BACKGROUND: We have shown that measurement of mRNA for cytotoxic attack proteins perforin and granzyme B in urinary cells is a noninvasive means of diagnosing acute rejection of human renal allografts. Urinary cell mRNA studies have yielded useful information in other patient populations such as patients with cancer. The isolation of sufficient and high quality ribonucleic acid (RNA) from urinary cells however is problematic. RNAlater, an RNA stabilization solution, has been reported to optimize RNA isolation from tumor tissues stored at room temperature and from pigment-rich ocular tissues. METHODS: We explored whether the addition of RNAlater to urine cell pellets improves RNA yield, enhances purity and facilitates measurement of low abundance mRNAs. We measured, with the use of real-time quantitative polymerase chain reaction (PCR) assay, levels of expression of a constitutively expressed gene 18S rRNA and mRNA for granzyme B and transforming growth factor-beta(1) (TGF-beta(1)) in urine specimens and renal biopsies obtained from renal allograft recipients. RESULTS: RNA yield (P<0.01, Wilcoxon signed rank test) and the A260/A280 ratio (P<0.01) were both higher with urine cell pellets treated with RNAlater prior to snap freezing compared to cell pellets that were not treated with RNAlater prior to snap freezing. Levels (copy number per 1 microg of total RNA) of 18S rRNA (P<0.02), granzyme B mRNA (P=0.002) and TGF-beta(1) (P=0.02) were all higher with treated urine cell pellets compared to untreated cell pellets. Kruskall-Wallis one way analysis of variance and pair-wise comparisons with Student-Newman-Keuls test showed that the levels of mRNA for granzyme B (P<0.05) and TGF-beta(1) (P<0.05) are significantly different between renal allograft biopsies and untreated urine cell pellets but not between the biopsy specimens and RNAlater-treated urine cell pellets. CONCLUSIONS: The addition of RNAlater to urine cell pellets improves RNA isolation from urinary cells and facilitates measurement of low abundance mRNAs.

Impact of cyclosporine withdrawal on living related renal transplants: a single-center experience.

High treatment costs force the discontinuation of cyclosporine (CSA) in a vast majority of renal transplant recipients in India. The impact of CSA withdrawal among 108 living related renal transplant recipients 12.54 +/- 4.2 months after transplantation was studied retrospectively. In 83 patients, CSA was withdrawn over a 12-week period (group I). Azathioprine dosage was increased to 2 to 2.5 mg/kg/d, and prednisolone, to 30 mg/d 2 weeks and 1 week before starting CSA withdrawal, respectively. In the other 25 patients, CSA had to be withdrawn faster (mean, 28.52 +/- 14.18 days; group II). Twenty-nine rejection episodes (26.9%) were noted in 22 patients (20.4%; 19% in group I and 52% in group II; P: = 0.008). Fifteen group-I patients (18%) and 11 group-II patients (44%) died or lost their grafts (P: = 0.017). There was no difference in age, donor source, HLA matches, pretransplantation cross-match positivity, delayed graft function, immunosuppressive drug doses, rejection episodes, or prewithdrawal serum creatinine levels between the patients who did or did not develop acute rejection after CSA withdrawal. On follow-up, 10 patients (50%) died or returned to dialysis among the rejection group compared with 16 patients (18%) in the nonrejection group (P: = 0.007). The mean creatinine level at last follow-up was greater in the rejection group (3.97 +/- 2.54 versus 1.65 +/- 1.1 mg/dL; P: < 0.001). CSA withdrawal because of economic constraints carries a significant risk for acute rejection and death and/or graft loss in Indian living donor renal transplant recipients, even after 12 months.

Isoniazid does not affect bioavailability of cyclosporine in renal transplant recipients.

Transplant recipients are predisposed to develop opportunistic infections such as tuberculosis, and isoniazid (INH) is used in most antitubercular therapeutic and prophylactic protocols. Cyclosporine (CyA) bioavailability increases with the concomitant use of drugs that inhibit hepatic cytochrome P-450 enzymes. There are conflicting reports on a possible interaction between the two drugs. Seven renal transplant recipients on CyA (Sandimmun Neoral) with slow acetylation status and also requiring concomitant INH prophylaxis (300 mg/day) against tuberculosis were studied. There were no significant changes in CyA pharmacokinetic parameters including CyA trough levels, total CyA exposure and CyA clearance before and 2 weeks after instituting INH prophylaxis. There was also no statistically significant correlation between INH levels and changes in CyA pharmacokinetic parameters before and after administration of INH. Even after all post-INH pharmacokinetic parameters were adjusted for INH levels, the differences in the above pre- and post-INH parameters did not reach statistical significance. Renal function during the study period remained constant and there were no episodes of CyA toxicity or acute rejection during and up to 4 weeks of INH treatment. We conclude that concomitant administration of INH and CyA is safe and is not associated with any appreciable alterations in the bioavailability of CyA.

Prognostic factors in immunoglobulin-A nephropathy.

AIM: To study the course, identify prognostic factors and a model predictive for development of end stage renal failure (ESRF) in adults with immunoglobulin-A nephropathy (IgA-N). DESIGN: Retrospective cohort. SETTING: Madras Medical College and Government General Hospital, Chennai, Tamil Nadu. PARTICIPANTS: Ninety eight adult patients with diagnosis of primary IgA nephropathy. RESULTS: Out of 98 patient 64 (65.3%) were men. Mean age of presentation was 25.7 years. The predominant renal lesions included nephrotic syndrome in 25 (25.5%), rapidly progressive renal failure and accelerated malignant hypertension in 21 (21.4%) each, chronic renal failure in 13 (13.3%), hypertension in nine (9.2%) haematuria in five (5.1%) and acute renal failure in four (4.1%). Sixty (61%) had renal failure at diagnosis. Age > 25 years, glomerular histology of Hass subclass V and interstitial fibrosis were significant factors. Forty (48.2%) (IR) patients developed ESRF during follow up. Serum creatinine > 5 mg/dl (hazard ratio: 5.37, 95% confidence interval CI 2.49-11.58) Hass-V (3.74, 1.60-8.76), crescents (4.08, 1.52-10.94) and IF (6.15, 2.0-19.0) were associated with disease progression in the multivariate analysis. Five years renal survival (CI) was 38.5% (24.6%-52.3%). Among those with no risk factor, 95% had not reached ESRF by 42 months. The median ESRF-free survival with one, two and three or four risk factors was 65, 16 and four months, respectively. CONCLUSIONS: Serum creatinine > 5 mg/dl, crescents: Hass-V histology and interstitial fibrosis predict the progression to ESRF. Renal biopsies should include a detailed assessment of the tubulointerstitium.

Biomimetic mineralization of novel silane crosslinked collagen.

Studies on the mechanisms of mineralization of connective tissues, have gained momentum in the recent past. In the present study, Biomimetic mineralization of modified fish scale collagen in vitro is reported. The fish scale collagen was crosslinked with 3-Aminopropyl triethoxysilane and the crosslinked collagen (FCSi) was characterized using conventional methods. The biomimetic mineralization capacity of FCSi was evaluated in SBF solution for 7 days. Formation of hydroxyapatite crystals on the matrix in vitro has been confirmed by FTIR, XRD and SEM-EDAX techniques. The FCSi may be used as a scaffold in bone tissue engineering and as an osteoinductive material in experimental animal models before applying clinically.

Influence of surface characteristics on biofouling formed on polymers exposed to coastal sea waters of India.

Biofouling on six different (silicone rubber, polydimethylsiloxane, polypropylene, high density polyethylene, polyvinylchloride, and polycarbonate) substrata with varying surface energy (18-40 mN/m) and surface roughness (R(a) 45-175 µm) was studied in the Eastern coastal waters of India over a short period of time (3 days). The results showed that the substrata surface energy (SE) followed by the surface roughness (R(a)) had profound effect on attachment of fouling organisms. After one day of immersion, viable count of bacteria in the biofilm was positively correlated with surface energy (r=0.69, p<0.05) and not with surface roughness (r=-0.02) of the substratum. Whereas, Pseudomonas count was inversely correlated with surface energy (r=-0.66, p<0.05) and surface roughness (r=-0.52, p<0.05). The attachment of macrofouler and the surface characteristics were also well correlated with SE 0.48 and with roughness 0.62, p<0.05. A positive correlation was observed amongst the various biofouling constituents such as bacteria, ATP, carbohydrates and organic matter on almost all the substrata. However after the first day, the surface characteristics of the substratum became less important and the conditioning film that was formed on the substrata appeared to directly influence further fouling on the surfaces, as evidenced by poor correlation between surface energy and macrofouler attachment (r=-0.11). The observation of high numbers of Hydroides elegans on PVC could be solely due to the influence of surface roughness (r=0.62). Though there is no marked difference in the 'primary film', and the composition of the biofilm, the amount of attached macrofouler is minimal on silicone rubber and polydimethylsiloxane on subsequent days of immersion, which reveals the foul release quality of these substrata probably due to their flexible nature.

Cauda equina syndrome presentation of sacral insufficiency fractures.

INTRODUCTION: Sacral insufficiency fractures are a well recognised cause for low back, buttock and groin pain in the elderly. However, over a 4 year period, four patients have presented with symptoms of cauda equina syndrome, who were found on investigation to have acute sacral insufficiency fracture without any other aetiological spinal abnormality. PATIENTS AND METHOD: Four patients who presented to the spinal surgeons of our institution with symptoms of cauda equina syndrome were referred for spinal MR. Sagittal and axial T1 and T2 weighted turbo spin echo sequences of the lower thoracic and lumbar spine were performed on all patients. Subsequent studies included MR of the sacrum supplemented where appropriate by CT and technetium MDP bone scintigraphy. RESULTS: No evidence of a compressive lesion of the lower thoracic or lumbar spine was present in any of the four patients. Dedicated MR examination of the sacrum in these patients revealed unilateral acute insufficiency fractures involving zone 1 from S1 to S3 extending from the sacro-iliac joint to the lateral margin of the sacral foramen. There was no evidence of compression of the sacral nerve roots. The possible mechanism for the symptomatic presentation is discussed. CONCLUSION: Sacral insufficiency fractures should be excluded in elderly or osteoporotic patients presenting with cauda equina syndrome who have no evidence of compression in the thoraco-lumbar MR studies.

Arbuscular mycorrhizal morphology and dark septate fungal associations in medicinal and aromatic plants of Western Ghats, Southern India.

We investigated roots of 107 medicinal and aromatic plants (MAPs) in the Western Ghats region of Southern India for arbuscular mycorrhizal (AM) and dark septate endophyte (DSE) associations. Of the 107 MAPs belonging to 98 genera in 52 families examined, 79 were AM and 38 harbored a DSE association. Typical Arum- and Paris-type mycorrhizas are first reported in the presumed nonmycorrhizal family Amaranthaceae. Similarly, DSE associations are recorded for the first time in nine plant families and 37 plant species. Thirty MAPs had both AM and DSE associations. The number of MAPs having Arum-type mycorrhiza was greater than those having Paris-type. This was more prominent among herbaceous plants than in trees where the Paris-type was predominant. Similarly, the Arum-type was more prevalent in annuals than in perennials. DSE associations were more frequent in herbs and perennials compared to other MAPs.