Obstructive Sleep Apnea and Its Cardiac Implications in the United States: An Age-Stratified Analysis Between Young and Older Adults.

BACKGROUND: Obstructive sleep apnea (OSA) is a common sleep disorder associated with cardiovascular risks. This study aimed to assess the prevalence of probable OSA and its relationship with cardiovascular risks and diseases focusing on age-stratified young adults (20-40 years) and older (>40 years). METHODS AND RESULTS: The study used a cross-sectional design, analyzing data from the National Health and Nutrition Examination Survey conducted between 2013 and 2018, comprising 9887 community-dwelling adults aged ≥20 years. Probable OSA was determined on the basis of self-report of OSA-related symptoms (eg, snoring, gasping/breath cessation while sleeping). Cardiovascular risk factors, including hypertension, diabetes, hyperlipidemia, and metabolic syndrome, were evaluated according to established guidelines. Cardiovascular diseases (CVDs) included self-reported heart conditions, including congestive heart failure, coronary heart disease, angina, heart attacks, and strokes. Individuals with probable OSA showed a significantly higher prevalence of health conditions, including hypertension (adjusted prevalence ratio [aPR], 1.19; P<0.001), diabetes (aPR, 1.17; P: 0.01), metabolic syndrome (aPR, 1.14; P<0.001), heart attack (aPR, 1.63; P<0.01), stroke (aPR, 1.41; P: 0.03), and any CVD event (aPR, 1.36; P: 0.01) after adjusting for relevant factors. Young adults with probable OSA showed higher prevalence rates of any CVD events (aPR, 3.44; P<0.001), hypertension (aPR, 1.45; P<0.001), metabolic syndrome (aPR, 1.25; P<0.001), and angina (aPR, 10.39; P<0.001). CONCLUSIONS: The study suggests early identification and management of OSA in individuals at risk for CVD. While cross-sectional, it emphasizes that health care providers should recognize OSA as significantly associated with CVDs and its precursor risks in young adults, stressing proactive care and screening to reduce CVD risk in this population.

Support based metal incorporated layered nanomaterials for photocatalytic degradation of organic pollutants.

An effective approach to producing sophisticated miniaturized and nanoscale materials involves arranging nanomaterials into layered hierarchical frameworks. Nanostructured layered materials are constructed to possess isolated propagation assets, massive surface areas, and envisioned amenities, making them suitable for a variety of established and novel applications. The utilization of various techniques to create nanostructures adorned with metal nanoparticles provides a secure alternative or reinforcement for the existing physicochemical methods. Supported metal nanoparticles are preferred due to their ease of recovery and usage. Researchers have extensively studied the catalytic properties of noble metal nanoparticles using various selective oxidation and hydrogenation procedures. Despite the numerous advantages of metal-based nanoparticles (NPs), their catalytic potential remains incompletely explored. This article examines metal-based nanomaterials that are supported by layers, and provides an analysis of their manufacturing, procedures, and synthesis. This study incorporates both 2D and 3D layered nanomaterials because of their distinctive layered architectures. This review focuses on the most common metal-supported nanocomposites and methodologies used for photocatalytic degradation of organic dyes employing layered nanomaterials. The comprehensive examination of biological and ecological cleaning and treatment techniques discussed in this article has paved the way for the exploration of cutting-edge technologies that can contribute to the establishment of a sustainable future.

Improved Electrochemical Performance of Aqueous Hybrid Supercapacitors Using CrCo2O4 Mesoporous Nanowires: An Innovative Strategy toward Sustainable Energy Devices.

High-rate aqueous hybrid supercapacitors (AHSCs) have attracted relevant scientific significance owing to their expected energy density, supercapacitor-level power density, and battery-level energy density. In this work, a bimetallic nanostructured material with chromium-incorporated cobalt oxide (CCO, i.e., CoCr2O4) was prepared via a hydrothermal method to form a stable cubic obelisk structure. Compared with CCO materials prepared using traditional methods, CCO displayed a nanowire structure (50 nm diameter), suggesting an enhanced specific surface area and a large number of active sites for chemical reactions. The electrode possessed a high specific capacitance (2951 F g-1) at a current density of 1 A g-1, minimum Rct (0.135 Ω), and the highest capacitance retention (98.7%), making it an ideal electrode material for AHSCs. Ex situ analysis based on X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) showed a favorable stability of CCO after 10,000 cycles without any phase changes being detected. GGA and GGA + U methods employed in density functional theory (DFT) also highlighted the enhanced metallic properties of CCO originating from the synergistic effect of semiconducting Cr2O3 and Co3O4 materials.

Investigation of antimicrobial and anti-cancer activity of thermally sensitive SnO2 nanostructures with green-synthesized cauliflower morphology at ambient weather conditions.

A tin oxide (SnO2) nanostructure was prepared using Matricaria recutita leaf extract to investigate its anticancer activity against SK-MEL-28 cells. The tetragonal crystal structure of tin oxide nanoparticles with an average crystal size of 27 nm was confirmed by X-ray diffraction (XRD) analysis. The tetragonal crystal structure of the tin oxide nanoparticles, with an average crystallite size of 27 nm, was confirmed by XRD an absorbance peak at 365 nm was identified by UV-visible spectroscopy analysis as belonging to the bio-mediated synthesis of SnO2 nanoparticles. The SnO2 NPs are capped and stabilized with diverse functional groups derived from bioactive molecules, including aldehydes, benzene rings, amines, alcohols, and carbonyl stretch protein molecules. Fourier transform infrared spectroscopy (FTIR) analysis validated the presence of these capping and stabilizing chemical bonds. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) studies revealed the cauliflower-shaped morphology of the SnO2 nanoparticles with an average particle size of 28 nm. The antimicrobial activity of both prepared and encapsulated samples confirmed their biological activities. Furthermore, both prepared and encapsulated tin oxide samples exhibited excellent anticancer activity against SK-MEL-28 human cancer cells. The present study introduces a reliable and uncomplicated approach to produce SnO2 nanoparticles and demonstrates their effectiveness in various applications, including cancer therapy, drug administration, and disinfectant.

Synthesis and Antimicrobial Analysis of High Surface Area Strontium-Substituted Calcium Phosphate Nanostructures for Bone Regeneration.

Continuous microwave-assisted flow synthesis has been used as a simple, more efficient, and low-cost route to fabricate a range of nanosized (<100 nm) strontium-substituted calcium phosphates. In this study, fine nanopowder was synthesized via a continuous flow synthesis with microwave assistance from the solutions of calcium nitrate tetrahydrate (with strontium nitrate as Sr2+ ion source) and diammonium hydrogen phosphate at pH 10 with a time duration of 5 min. The morphological characterization of the obtained powder has been carried out by employing techniques such as transmission electron microscopy, X-ray diffraction, and Brunauer-Emmett-Teller surface area analysis. The chemical structural analysis to evaluate the surface properties was made by using X-ray photoelectron spectroscopy. Zeta potential analysis was performed to evaluate the colloidal stability of the particles. Antimicrobial studies were performed for all the compositions using four bacterial strains and an opportunistic human fungal pathogen Macrophomina phaseolina. It was found that the nanoproduct with high strontium content (15 wt% of strontium) showed pronounced antibacterial potential against M. luteus while it completely arrested the fungal growth after 48 h by all of its concentrations. Thus the synthesis strategy described herein facilitated the rapid production of nanosized Sr-substituted CaPs with excellent biological performance suitable for a bone replacement application.

Photocatalytic Degradation Studies of Organic Dyes over Novel Cu/Ni Loaded Reduced Graphene Oxide Hybrid Nanocomposite: Adsorption, Kinetics and Thermodynamic Studies.

Nowadays, for environmental remediation, photocatalytic process involving graphene-based semiconductors is considered a very promising oxidation process for water treatment. In the present study, nanocomposite (Cu/Ni/rGO) has been synthesized by Dypsis lutescens leaf extract. Characterization of the sample was carried out by UV-visible spectroscopy, scanning electron microscopy (SEM), energy dispersive X-ray (EDX) analysis, Fourier transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD). Different parameters like contact time, nanocatalyst amount, dye concentration, effect of temperature. and pH factor were optimized to examine the maximum removal efficiency for dyes rhodamine B and alizarine R with and without visible light source. In both cases, i.e., with or without light, maximum removal was observed at 20 mg of nanocatalyst for 5 ppm concentration of both dyes at 45 °C temperature and pH 10 for rhodamine B and pH 4 for alizarine R, respectively with a 20 min contact time. Maximum removal of dyes 93% rhodamine B and 91% alizarine R were observed under a tungsten lamp as compared to without a tungsten lamp, i.e., 78% of RhB and 75% of AR from mixture solution of these dyes. To assess the rate of reaction, spontaneity, and nature of reaction thermodynamics, kinetics and adsorption isotherms were studied. Thermodynamic values indicated that both dyes depicted endothermic and spontaneous degradation processes. Isotherm data fitted best to a Freundlich isotherm, while results of kinetic studies of both dyes followed the pseudo 2nd order kinetic equation. In the end, scavenging radical studies concluded that hydroxyl radicals were the main active specie involved in the photocatalytic degradation process, and regeneration experiments resulted that Cu/Ni/rGO nanocomposites were re-utilized for about four times.

Effects of posture changes on dynamic cerebral autoregulation during early pregnancy in women with obesity and/or sleep apnea.

The incidence of syncope during orthostasis increases in early human pregnancy, which may be associated with cerebral blood flow (CBF) dysregulation in the upright posture. In addition, obesity and/or sleep apnea per se may influence CBF regulation due to their detrimental impacts on cerebrovascular function. However, it is unknown whether early pregnant women with obesity and/or sleep apnea could have impaired CBF regulation in the supine position and whether this impairment would be further exacerbated in the upright posture. Dynamic cerebral autoregulation (CA) was evaluated using transfer function analysis in 33 women during early pregnancy (13 with obesity, 8 with sleep apnea, 12 with normal weight) and 15 age-matched nonpregnant women during supine rest. Pregnant women also underwent a graded head-up tilt (30° and 60° for 6 min each). We found that pregnant women with obesity or sleep apnea had a higher transfer function low-frequency gain compared with nonpregnant women in the supine position (P = 0.026 and 0.009, respectively) but not normal-weight pregnant women (P = 0.945). Conversely, the transfer function low-frequency phase in all pregnancy groups decreased during head-up tilt (P = 0.001), but the phase was not different among pregnant groups (P = 0.180). These results suggest that both obesity and sleep apnea may have a detrimental effect on dynamic CA in the supine position during early pregnancy. CBF may be more vulnerable to spontaneous blood pressure fluctuations in early pregnant women during orthostatic stress compared with supine rest due to less efficient dynamic CA, regardless of obesity and/or sleep apnea.

Alumina supported copper oxide nanoparticles (CuO/Al2O3) as high-performance electrocatalysts for hydrazine oxidation reaction.

Direct hydrazine liquid fuel cell (DHFC) is perceived as effectual energy generating mean owing to high conversion efficiency and energy density. However, the development of well-designed, cost effective and high performance electrocatalysts is the paramount to establish DHFCs as efficient energy generating technology. Herein, gamma alumina supported copper oxide nanocatalysts (CuO/Al2O3) are synthesized via impregnation method and investigated for their electrocatalytic potential towards hydrazine oxidation reaction. CuO with different weight percentages i.e., 4%, 8%, 12%, 16% and 20% are impregnated on gamma alumina support. X-ray diffraction analysis revealed the cubic crystal structure and nanosized particles of the prepared metal oxides. Transmission electron microscopy also referred to the cubic morphology and nanoparticle formation. Electrochemical oxidation potential of the CuO/Al2O3 nanoparticles is explored via cyclic voltammetry as the analytical tool. Optimization of conditions and electrocatalytic studies shown that 16% CuO/Al2O3 presented the best electronic properties towards N2H2 oxidation reaction. BET analysis ascertained the high surface area (131.2546 m2 g1) and large pore diameter (0.279605 cm³ g-1) for 16% CuO/Al2O3. Nanoparticle formation, high porosity and enlarged surface area of the proposed catalysts resulted in significant oxidation current output (600 µA), high current density (8.2 mA cm-2) and low charge transfer resistance (3.7 kΩ). Electrooxidation of hydrazine on such an affordable and novel electrocatalyst opens a gateway to further explore the metal oxide impregnated alumina materials for different electrochemical applications.

Green synthesized Ag decorated CeO2 nanoparticles: Efficient photocatalysts and potential antibacterial agents.

Implication of natural resources for manufacturing of nanoparticles is sustainable, economical and contaminant free approach towards ecological and medical applications. Herein, CeO2 and Ag/CeO2 nanoparticles are green synthesized from Morinda tinctoria plant extract. The phase structure, surface morphology, optical identity, Ce(III) and Ce(IV) valency of the synthesized CeO2 and Ag/CeO2 nanoparticles are explored. The X-ray diffraction analysis indicated the formation of cubic phase CeO2 and cubic silver decorated CeO2 nanoparticles. Fourier transform infrared (FTIR) spectroscopy revealed the metal decoration of CeO2 nanoparticles, metal-oxygen stretching, indicating the plant molecules reduction and stabilization. UV-visible spectroscopy shown the decreased band gap owing to silver modification. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) micrographs displayed spherical morphology of the nanoparticles. Elemental composition and sample purity is assessed by energy dispersive spectroscopy (EDS). Double oxidation of Ce, double splitting energy of Ag and lattice oxygen are observed from X-ray photoelectron spectroscopy (XPS). Photocatalytic activity of Ag/CeO2 exposed the enhanced photocatalytic activity up to 94% where CeO2 nanoparticles gave 60% degradation of bromophenol blue (BB). The plasmonic decoration of silver on the ceria surface induced the charge separations and free radical reactions. Moreover, Ag/CeO2 nanoparticles are seen as superior antibacterial agents than CeO2 towards both E.coli and S.aureus. Hence, the silver decorated metal oxide photocatalyst successfully degraded the BB dye and inactivated the bacterial strains. This report established a future research in green synthesis of multipurpose metal nanoparticles.

Rhabdomyosarcoma in children: Retrospective analysis from a single tertiary care center in Saudi Arabia.

BACKGROUND: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children occurring most commonly in the head and neck region. The treatment involves using a multimodality approach including chemotherapy, surgery, and radiation therapy. Survival for patients with localized disease has improved markedly, but the treatment of advanced disease remains a challenge. We report the clinical characteristics and outcome for patients treated at a tertiary care center in Saudi Arabia. METHODS: Patients aged 0-14 years diagnosed with RMS between 2005 and 2018 were included. Statistical analysis was performed using SPSS software. Kaplan-Meier method was used to calculate overall and event free survival. Cox proportional hazards model was used for multivariate analysis. RESULTS: One hundred and twenty-four patients were analyzed. The median age was 5.7 years with male predominance (2.4:1). The most common primary sites were head/neck (30%) and the genitourinary tract (25%). Embryonal RMS was present in 81%; alveolar in 19%. Most patients had intermediate risk disease (60%). The 5-year overall and event free survivals were 64.3% and 53.3%, respectively. Survival was influenced by primary tumor site, histology, and clinical risk group. Unfavorable primary site, high risk stratification, and poor initial response to therapy predicted a poor outcome. CONCLUSION: This study provides an insight on the current management outcomes for our patients with RMS. Cytogenetics and molecular diagnostics need to be incorporated as standard of care in the therapeutic approach of our patients. In addition, there is a need for national collaborative efforts to improve the outcome of RMS in children and adolescents.

Sol-Gel Synthesized High Entropy Metal Oxides as High-Performance Catalysts for Electrochemical Water Oxidation.

Hexanary high-entropy oxides (HEOs) were synthesized through the mechanochemical sol-gel method for electrocatalytic water oxidation reaction (WOR). As-synthesized catalysts were subjected to characterization, including X-ray diffraction (XRD), Fourier transforms infrared (FTIR) analysis, and scanning electron microscopy (SEM). All the oxide systems exhibited sharp diffraction peaks in XRD patterns indicating the defined crystal structure. Strong absorption between 400-700 cm-1 in FTIR indicated the formation of metal-oxide bonds in all HEO systems. WOR was investigated via cyclic voltammetry using HEOs as electrode platforms, 1M KOH as the basic medium, and 1M methanol (CH3OH) as the facilitator. Voltammetric profiles for both equiatomic (EHEOs) and non-equiatomic (NEHEOs) were investigated, and NEHEOs exhibited the maximum current output for WOR. Moreover, methanol addition improved the current profiles, thus leading to the electrode utility in direct methanol fuel cells as a sequential increase in methanol concentration from 1M to 2M enhanced the OER current density from 61.4 to 94.3 mA cm-2 using NEHEO. The NEHEOs comprising a greater percentage of Al, ([Al0.35(Mg, Fe, Cu, Ni, Co)0.65]3O4) displayed high WOR catalytic performance with the maximum diffusion coefficient, D° (10.90 cm2 s-1) and heterogeneous rate constant, k° (7.98 cm s-1) values. These primary findings from the EC processes for WOR provide the foundation for their applications in high-energy devices. Conclusively, HEOs are proven as novel and efficient catalytic platforms for electrochemical water oxidation.

Graphene based composite membranes for environmental toxicology remediation, critical approach towards environmental management.

Graphene-based composite membranes, as laminated, stacked, and assembled architectures of graphene, have surpassed other conventional membranes with their advanced and preeminent structural specialization and potential use in a wide range of sustainable and environmental applications. The characteristic membrane features such as distinct laminar morphology, tailored physicochemical properties, as well as extraordinary molecular properties have fascinated scientists. Due to remarkable mechanical properties, these membranes can be easily fabricated. Recent progress has been achieved by graphene and its derivatives-based membranes to purify water and gases for environmental remediation. This review explained the latest and groundbreaking advances in chemical design, fabrication, and application of graphene-based membranes. Special attention is paid to the recent developments on graphene-based composites into membranes with various forms: free-standing, layered, and graphene-based nanocomposite membranes. Furthermore, a unique approach on environmental management with as-fabricated membranes is provided by discussing the effect of physicochemical properties. Consequently, their full-scale use for environmental management, water purification, gas purification, and biological treatments will pave the way for their promising features and realize their future prospects.

The shallow cognitive map hypothesis: A hippocampal framework for thought disorder in schizophrenia.

Memories are not formed in isolation. They are associated and organized into relational knowledge structures that allow coherent thought. Failure to express such coherent thought is a key hallmark of Schizophrenia. Here we explore the hypothesis that thought disorder arises from disorganized Hippocampal cognitive maps. In doing so, we combine insights from two key lines of investigation, one concerning the neural signatures of cognitive mapping, and another that seeks to understand lower-level cellular mechanisms of cognition within a dynamical systems framework. Specifically, we propose that multiple distinct pathological pathways converge on the shallowing of Hippocampal attractors, giving rise to disorganized Hippocampal cognitive maps and driving conceptual disorganization. We discuss the available evidence at the computational, behavioural, network, and cellular levels. We also outline testable predictions from this framework, including how it could unify major chemical and psychological theories of schizophrenia and how it can provide a rationale for understanding the aetiology and treatment of the disease.

MXene/Ag2CrO4 Nanocomposite as Supercapacitors Electrode.

MXene/Ag2CrO4 nanocomposite was synthesized effectively by means of superficial low-cost co-precipitation technique in order to inspect its capacitive storage potential for supercapacitors. MXene was etched from MAX powder and Ag2CrO4 spinel was synthesized by an easy sol-gel scheme. X-Ray diffraction (XRD) revealed an addition in inter-planar spacing from 4.7 Å to 6.2 Å while Ag2CrO4 nanoparticles diffused in form of clusters over MXene layers that had been explored by scanning electron microscopy (SEM). Energy dispersive X-Ray (EDX) demonstrated the elemental analysis. Raman spectroscopy opens the gap between bonding structure of as-synthesized nanocomposite. From photoluminence (PL) spectra the energy band gap value 3.86 eV was estimated. Electrode properties were characterized by applying electrochemical observations such as cyclic voltammetry along with electrochemical impedance spectroscopy (EIS) for understanding redox mechanism and electron transfer rate constant Kapp. Additionally, this novel work will be an assessment to analyze the capacitive behavior of electrode in different electrolytes such as in acidic of 0.1 M H2SO4 has specific capacitance Csp = 525 F/g at 10 mVs-1 and much low value in basic of 1 M KOH electrolyte. This paper reflects the novel synthesis and applications of MXene/Ag2CrO4 nanocomposite electrode fabrication in energy storage devices such as supercapacitors.

Discovery of cytotoxic natural products from Red Sea sponges: Structure and synthesis.

Marine ecosystem continues to produce a great wealth of molecules endowed with cytotoxic activity towards a large panel of tumor cells. Marine sponges, apparently defenseless organisms are endowed through evolution with a range of cytotoxic metabolites for self protection against predators and space competition. Interestingly, high biodiversity of sponges with Demospongiae and Calcarea species that have yielded numerous bioactive compounds have been accorded in different regions of the Red Sea. This review for the first time provides a comprehensive overview of 123 cytotoxic agents derived from Red Sea sponges with diverse chemical structures covered till mid 2020 showing activities ranging from mildly active to very active against different panels of cancer cell lines. It has been divided according to the different classes of compounds including alkaloids, terpenoids (sesquiterpenes, diterpenes, triterpenes, sesterterpenes, norsesterterpenes), peptides and macrolides, lipids (steroids, fatty acids/amides and glycerides) etc. The enhancement in the cytotoxicity with respect to the molecular structure changes have been described in detail. We have also accounted for the total synthesis of cytotoxic molecules, subereamolline A, aerothionin, asmarine B, norrsolide and latrunculin B showing interesting activity against different cancer cell lines.

Induction-remission response in peadiatric acute lymphoblastic leukaemia, Lahore protocol versus UKALL 2011 interim guidelines.

OBJECTIVE: To compare the outcome of induction-remission in acute lymphoblastic leukaemia patients treated according to two different guidelines. METHODS: The descriptive retrospective cohort study was conducted at The Children's Hospital Lahore, Pakistan, and comprised clinical information sheets of acute lymphoblastic leukaemia patients from September 2014 to August 2015. Data regarding demographics, risk categorisation, rapid early response and induction-remission assessment was collected separately for Group 1 patients treated with Lahore protocol and Group 2 patients using United Kingdom acute lymphoblastic leukaemia-2011 interim guidelines. Data was analysed using SPSS version 20.0. RESULTS: Of the 98 patients who had a median age of 6.4 years (interquartile range: 1.5-16 years), 48(49%) were in Group 1 and 50(51%) in Group 2. There were 14(29%) patients with standard risk in Group 1 while 34(71%) were high-risk. The corresponding numbers in Group 2 were 30(60%) and 20(40%) in Group 2. Rapid early response was noted in 18(37.5%) patients in Group 1 and 11(28%) in Group 2. Remission was achieved in 38(79%) patients in Group 1 and 36(72%) in Group 2. There was significant association of rapid early response with induction-remission in Group 2 (p<0.05) but not in Group 1 (p>0.05). CONCLUSIONS: Induction-remission rate was comparable in the two treatment groups, but significant association of rapid early response with induction-remission was observed only in patients treated using United Kingdom acute lymphoblastic leukaemia-2011 interim guidelines.

Effect of gasotransmitters treatment on expression of hypertension, vascular and cardiac remodeling and hypertensive nephropathy genes in left ventricular hypertrophy.

BACKGROUND: Cardiac and renal dysfunction are often co-morbid pathologies leading to worsening prognosis resulting in difficulty in therapy of left ventricular hypertrophy (LVH). The aim of the current study was to determine the changes in expression of human ortholog genes of hypertension, vascular and cardiac remodeling and hypertensive nephropathy phenotypes under normal, disease and upon treatment with gasotransmitter including H2S (hydrogen sulphide), NO (nitric oxide) and combined (H2S + NO). METHODS: A total of 72 Wistar Kyoto rats (with equivalent male and female animals) were recruited in the present study where LVH rat models were treated with H2S and NO individually as well as with both combined. Cardiac and renal physical indices were recorded and relative gene expression were quantified. RESULTS: Both cardiac and renal physical indices were significantly modified with individual as well as combined H2S + NO treatment in control and LVH rats. Expression analysis revealed, hypertension, vascular remodeling genes ACE, TNFα and IGF1, mRNAs to be significantly higher (P ≤ 0.05) in the myocardia and renal tissues of LVH rats, while individual and combined H2S + NO treatment resulted in lowering the gene expression to normal/near to normal levels. The cardiac remodeling genes MYH7, TGFß, SMAD4 and BRG1 expression were significantly up-regulated (P ≤ 0.05) in the myocardia of LVH where the combined H2S + NO treatment resulted in normal/near to normal expression more effectively as compared to individual treatments. In addition individual as well as combined H2S and NO treatment significantly decreased PKD1 expression in renal tissue, which was up-regulated in LVH rats (P ≤ 0.05). CONCLUSIONS: The reduction in hemodynamic parameters and cardiac indices as well as alteration in gene expression on treatment of LVH rat model indicates important therapeutic potential of combined treatment with H2S + NO gasotransmitters in hypertension and cardiac hypertrophy when present as co-morbidity with renal complications.

Interaction between nitric oxide and renal α1-adrenoreceptors mediated vasoconstriction in rats with left ventricular hypertrophyin Wistar Kyoto rats.

Left ventricular hypertrophy (LVH) is associated with decreased responsiveness of renal α1-adrenoreceptors subtypes to adrenergic agonists. Nitric oxide donors are known to have antihypertrophic effects however their impact on responsiveness of renal α1-adrenoreceptors subtypes is unknown. This study investigated the impact of nitric oxide (NO) and its potential interaction with the responsiveness of renal α1-adrenoreceptors subtypes to adrenergic stimulation in rats with left ventricular hypertrophy (LVH). This study also explored the impact of NO donor on CSE expression in normal and LVH kidney. LVH was induced using isoprenaline and caffeine in drinking water for 2 weeks while NO donor (L-arginine, 1.25g/Lin drinking water) was given for 5 weeks. Intrarenal noradrenaline, phenylephrine and methoxamine responses were determined in the absence and presence of selective α1-adrenoceptor antagonists, 5- methylurapidil (5-MeU), chloroethylclonidine (CeC) and BMY 7378. Renal cortical endothelial nitric oxide synthase mRNA was upregulated 7 fold while that of cystathione γ lyase was unaltered in the NO treated LVH rats (LVH-NO) group compared to LVH group. The responsiveness of renal α1A, α1B and α1D-adrenoceptors in the low dose and high dose phases of 5-MeU, CEC and BMY7378 to adrenergic agonists was increased along with cGMP in the kidney of LVH-NO group. These findings suggest that exogenous NO precursor up-regulated the renal eNOS/NO/cGMP pathway in LVH rats and resulted in augmented α1A, α1B and α1D adrenoreceptors responsiveness to the adrenergic agonists. There is a positive interaction between H2S and NO production in normal animals but this interaction appears absent in LVH animals.

Demographics and Outome in Paediatric Non-Hodgkin Lymphoma: Single Centre Experience at The Children Hospital Lahore, Pakistan.

OBJECTIVE: To describe the patient demographics and outcome analysis in paediatric non-Hodgkin lymphoma (NHL) patients. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: The Hematology/Oncology Unit of The Children's Hospital and Institute of Child Health, Lahore, from January 2012 till December 2014. METHODOLOGY: Demographics including age, gender, histopathology, stage and outcome data, in biopsy proven NHL patients were analyzed. Burkitts/B Cell and Diffuse Large B Cell lymphoma patients were treated with MCP 842 Protocol while T/B-cell lymphoblastic lymphoma (LL) patients were treated with EURO-LB 02 protocol. RESULTS: Ninety-one patients were treated during the study period at CHL. Data was insufficient in 18 patients, so they were excluded from the study. Patients included were 73. Males were 53 (72.6%). Thirty-seven (50.7%) were 5-10 years of age, and 22 (30.1%) 10-16 years old. Abdominal mass was the commonest presentation seen in 32 (43.8%), lymphadenopathy in 27 (37%), intussusception in 5 (6.8%), while intestinal obstruction, obstructive uropathy, nasopharyngeal mass, gastric mass, primary bone lymphoma, pericardial effusion, jaw swelling, cheek swelling and paraspinal mass present in one (1%) each. Histopathological subtypes consist of Burkitt's lymphoma (BL) in 32 (43.8%), B cell NHL in 10 (13.7%), lymphoblastic lymphoma (LL) in 26 (35.6%), diffuse large B cell lymphoma (DLBCL) in 2 (2.8%), and anaplastic large cell lymphoma (ALCL) in 1 (1.4%). Sixty-seven (91%) presented in stage III, and six (8.4%) in stage IV. Forty-eight (65.8%) patients had completed treatment and are well to date, 16 (21.9%) died, 5 (6.8%) left against medical advice (LAMA), and 4 (5.5%) patients relapsed. CONCLUSION: Burkitts lymphoma was the commonest type of NHL seen in this cohort that predominantly presented with an abdominal mass. Children usually presented in advanced stage with delayed diagnosis. Better supportive care can improve the prognosis significantly. Training of pediatricians is equally important along with increasing parental/family knowledge about the disease symptoms so that they can seek early medical care, and earlier diagnosis is possible.

INCREASED OXIDATIVE STRESS AND DOWN REGULATION OF ENDOTHELIAL NITRIC OXIDE SYNTHASE (ENOS) IN THE KIDNEY ATTEN- UATE THE RESPONSIVENESS OF (XlB ADRENERGIC RECEPTORS IN THE KIDNEY OF RATS WITH LEFT VENTRICULAR HYPERTROPHY.

Present study explored endothelial nitric oxide synthase/nitric oxide (eNOS/NO) pathway in the kidney and role of αIB adrenergic receptor in the regulation of renal vasculature in the rats with left ventricular hypertrophy (LVH). LVH was induced by administering isoprenaline 5 mg/kg (s.c. 72 h. apart) and caffeine (62 mg/L in drinking water) for 14 days. Quantification of molecular expression of eNOS in kidney was performed by quantitative Real Time Polymerase Chain Reaction (qPCR). Renal vasoconstrictor responses were measured by administering noradrenaline (NA), phenylephrine (PE) and methoxamine (ME) in pre-drug phase, low dose and high dose phases of chloroethylelonidine (CEC), a selective of (αIB adrenergic receptor antagonist. In the kidney of LVH male Wistar Kyoto (WKY) rats eNOS was significantly down regulated (p < 0.05) by 74% relative to Control WKY (taken as 100%). The high dose 5 CEC attenuated the vasoconstrictor responses to NA by 41%, PE by 43% and ME by 33% in the LVH-WKY when compared to the same dose phase in Control WKY group. In LVH, increased oxidative stress in kidney and increased ACE activity in the plasma resulted in down regulation of eNOS/NO in the kidney. The renal vasoconstrictor responses to adrenergic agonist are blunted in LVH and (αIB adrenergic receptor is functional subtype in renal vasculature in LVH.