Effect of Concentrate: Roughage Ratio and the Addition of Kefir on the Production Characteristics of Ruminant in vitro.

The stability of the gut ecosystem, especially the rumen, is an important area of research that has an impact on the use of feed additives and is associated with a number of diseases. The current study aimed to survey the effect of concentrate: roughage (C: R) ratio and the addition of kefir on the production characteristics of in vitro ruminant fermentation. In a 5x6 factorial order, six ratios of C: R (100:0, 80:20, 60:40, 40:60, 20:80 and 0:100) and five doses of kefir (0, 0.8, 1.6, 2.4, and 3.2 ml) were used, respectively. Gas production during incubation was estimated at 0- 96 h. During inoculation, the rumen fluid was obtained at 0, 4, 8, 12, and 24 h of incubation. Cumulative gas production, GPDM, GPOM, and GPNDF at 24 h was highest at the C: R ratio of 100:0 (67.82 mL, 75.92 mL/ 200 mg, 1979.15 mL/200 mg, and 11.11 mL/ 200 mg, respectively). The kefir addition improved the kinetics and gas production significantly. The highest in vitro dry matter and organic matter digestibility (IVDMD and IVOMD) were obtained at the C: R ratio of 100:0 (9.26% and 182.2% higher than those in C: R ratio of 0:100, respectively). The increase of concentrate diet ratio improved the overall volatile fatty acids (TVFA). No interaction effect on the gas production was detected between the C: R ratio and kefir. The microorganism populations were influenced neither by the level of concentrate nor by the level of kefir. Consequently, the high concentrate-to-roughage ratio and the addition of 1.6 mL kefir to the overall dietary substrate could promote rumen fermentation and feed digestibility without affecting microbe counts.

The Prevalence of Chronic Kidney Disease and Albuminuria in Patients With Type 1 and Type 2 Diabetes Attending a Single Centre.

Background Diabetes is the leading cause of chronic kidney disease worldwide. Diabetic kidney disease is one of the microvascular complications of diabetes and it involves changes in glomerular hemodynamics, interstitial fibrosis, and tubular atrophy. Early detection and management of Diabetic kidney disease (DKD) help to reduce morbidity and mortality. This study aims to assess the prevalence of nephropathy and albuminuria in the diabetic population attending an Irish tertiary care center. Methods Retrospective data collection and analysis of patients diagnosed with Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM) through the Development and Integration of Accurate Mathematical Operations in Numerical Data-Processing (DIAMOND) database in a single Irish tertiary care center. An audit tool was used to collect patients' information including gender, age, type of diabetes, serum creatinine, urinary albumin excretion, albumin creatinine ratio (ACR), body mass index, and last available glycated hemoglobin (HbA1c). Results Out of 7394 subjects with T2DM, 3139 (42%) were identified with chronic kidney disease (CKD). There were 1866 subjects with positive ACR out of 3139 subjects with CKD in the T2DM cohort. This shows that 25% of subjects have diabetic kidney disease and 17% have CKD of undetermined etiology. In the T1DM cohort with 1166 subjects, 209 (18%) were identified with CKD. Out of these 209 subjects with CKD, 164 (14%) were ACR-positive. The prevalence of CKD and albuminuria were related to age in both T1DM and T2DM populations. Albuminuria showed a linear relationship with age in subjects with no known CKD, which shows that age causally relates to albuminuria independent of type and duration of diabetes. Conclusion CKD is more prevalent in patients with T2DM as compared to T1DM, whereas the prevalence of albuminuria is higher in the T1DM population.

A Retrospective Study Assessing the Effect of Diabetes on Mortality in Patients With COVID-19 at a Teaching Hospital in the United Kingdom.

Aim The aim of the study was to compare the clinical characteristics and outcomes (mortality, intensive care admission, mechanical ventilation, and length of stay, LoS) of patients with and without diabetes with confirmed COVID-19.  Methods This retrospective study evaluated clinical and laboratory variables in adult inpatients from Brighton and Sussex University Hospitals NHS Trust with laboratory-confirmed COVID-19 between March 10, 2020, and June 30, 2020. Univariate and multivariate analyses were performed to compare the outcomes of patients with and without diabetes.  Results Over 457 patients were included in this study (140 with diabetes and 317 without diabetes), of which 143 (31.9%) died. The median age was 80 years and were predominantly males (59.1%). Baseline characteristics at the time of COVID-19 diagnosis demonstrated that the patients with diabetes were younger than those without diabetes (p=0.008). Mortality increased with age. There was no difference in adverse outcomes in those with and without diabetes. However, subgroup analysis of patients aged ≤60 years demonstrated a significantly increased mortality in those with diabetes (p=0.016). Patients with diabetes had an increased length-of-stay compared to those without diabetes, which was more evident in those aged ≤60 years. Conclusion Age is the most important predictor of mortality. Patients with diabetes did not have increased mortality from COVID-19, which is likely due to their younger age in our cohort. More patients with diabetes stayed in the hospital longer than seven days than those without diabetes.