A rapid supercritical water approach for one-pot synthesis of a branched BiVO4/RGO composite as a Li-ion battery anode.

The application of novel one-dimensional (1D) architectures in the field of energy storage has fascinated researchers for a long time. The fast-paced technological advancements require reliable rapid synthesis techniques for the development of various Multi-metal oxide (MMO) nanostructures. For the first time, we report the synthesis of a single-phase hierarchical one-dimensional (1D) branched BiVO4-Reduced Graphene Oxide (BVONB/RGO) nanocomposite with different weight percent variations of RGO starting from 6, 12, 24, and 26 wt% using the supercritical water method (SCW). The affirmation of the sample characteristics is done through various nano-characterization tools that help in establishing the monoclinic crystal structure, and nano branch morphology along with its physical, and thermal characteristics. Further, the electrochemical behavior evaluations of the fabricated coin cells provide insights into the well-known superior initial cycle capacity of around 810 mA h g-1, showing the superior ability of BVONB structures in storing lithium-ions (Li-ions). Meanwhile, an improved cyclic performance of the pure BVONB/RGO with 260 mA h g-1 is evident after 50 cycles. Finally, the reported rapid single-pot SCW approach has delivered promising results in establishing a material process technique for multimetal oxides and their RGO nanocomposites successfully.

Biosubstitutes for dural closure: Unveiling research, application, and future prospects of dura mater alternatives.

The dura mater, as the crucial outermost protective layer of the meninges, plays a vital role in safeguarding the underlying brain tissue. Neurosurgeons face significant challenges in dealing with trauma or large defects in the dura mater, as they must address the potential complications, such as wound infections, pseudomeningocele formation, cerebrospinal fluid leakage, and cerebral herniation. Therefore, the development of dural substitutes for repairing or reconstructing the damaged dura mater holds clinical significance. In this review we highlight the progress in the development of dural substitutes, encompassing autologous, allogeneic, and xenogeneic replacements, as well as the polymeric-based dural substitutes fabricated through various scaffolding techniques. In particular, we explore the development of composite materials that exhibit improved physical and biological properties for advanced dural substitutes. Furthermore, we address the challenges and prospects associated with developing clinically relevant alternatives to the dura mater.

Defect engineered N-S codoped TiO2 nanoparticles for photocatalytic and optical limiting applications: Experimental and DFT insights.

N-S codoped TiO2 nanoparticles (NPs) were synthesized using a sol-gel cum hydrothermal approach, with ammonium sulfate as the nitrogen and sulfur source compound. The calcination temperature was varied from 500 to 700 °C. The pristine samples exhibited a mixed phase of anatase and brookite, while the doped samples exhibited only the anatase phase, as confirmed by X-ray diffraction (XRD) analysis. Fourier-transform infrared spectroscopy (FTIR) confirmed the presence of N-H vibrations and S-O bidentate complexation with Ti4+ ions. Electron paramagnetic resonance (EPR) revealed the presence of Ti3+ signals, confirming the creation of oxygen defects in the doped samples. The absorption and emission properties of the samples were investigated using ultraviolet-visible (UV-Vis) and photoluminescence (PL) spectroscopy. Vibrating sample magnetometry (VSM) analysis confirms the room-temperature ferromagnetic behavior of the N-S doped TiO2, which was attributed to the presence of oxygen vacancies, as evidenced by the EPR and PL results. The N-S doped TiO2 samples demonstrated superior photocatalytic degradation of Rhodamine B (RhB), Methylene Blue (MB), and Congo Red (CR) dyes under visible light illumination compared to the pristine TiO2. This enhanced performance was attributed to the presence of N and S dopants in TiO2, which create new energy levels within the band structure of TiO2, allowing for efficient absorption of visible light and subsequent generation of reactive species for dye degradation. N-S doping modifies the electronic structure of TiO2, enhancing two-photon absorption (TPA). This increased TPA efficiency suggests promising applications in optical devices, such as laser protection systems and optical limiters. Density Functional Theory (DFT) investigation also confirms that the presence of oxygen vacancies generates energy states below the conduction band. This, in turn, benefits the absorption of more visible light during photocatalytic activities and leads to a notable nonlinear absorption in optical limiting. Overall, the N-S doping strategy significantly improves the photocatalytic and optical limiting performance of TiO2 NPs, making them promising candidates for a wide range of applications.

Glomerular parietal epithelial expression of CD44 in minimal change nephrotic syndrome and primary focal segmental glomerulosclerosis: A clinico-pathological study.

Introduction: Minimal change nephrotic syndrome (MCNS) and focal segmental glomerulosclerosis (FSGS) are the two common causes of nephrotic syndrome (NS) in both children and adults with overlapping clinical features, but with distinct prognostic and therapeutic implications. The distinction between these relies entirely on histopathology, which can sometimes be difficult. CD44 is expressed by activated parietal epithelial cells, plays a role in matrix deposition and thus in the pathogenesis of FSGS. Aims: To assess the expression of CD44 in MCNS and FSGS and to evaluate its association with the known clinical and histopathological prognostic factors. Materials and Methods: Thirty cases each of MCNS and FSGS were studied. The clinical, laboratory, histopathological, and CD 44 immunohistochemical data were recorded. The findings were analyzed and correlated. A P value of < 0.05 was considered statistically significant. Results: Statistical association was noted between CD44 positivity and serum creatinine (p = 0.031), estimated glomerular filtration rate (p = 0.040), segmental sclerosis (p < 0.001), tubular atrophy (p = 0.027), interstitial fibrosis (p = 0.027), and histological diagnosis (p < 0.001). The sensitivity, specificity, positive predictive, and negative predictive values were 90%, 76.67%, 79.41% and 88.46%, respectively. Conclusions: CD44 immunostain can effectively distinguish MCNS from FSGS. The congruent results of CD44 positivity with known prognostic factors support the possibility of using the CD44 marker as a predictive tool in selecting high-risk patients and offering appropriate therapeutic measures.

Shear wave elastography: usefulness in chronic kidney disease.

Purpose: Chronic kidney disease (CKD) is recognized as a major worldwide health problem. For all CKD, intra-renal fibrosis is a final common pathway that can be correlated with disease severity. Tissue stiffness can be measured non-invasively using shear wave elastography. This study evaluates the use of Young's modulus derived by SWE as a biomarker that can distinguish normal from diseased kidneys. Also, Young's modulus was correlated with Doppler findings and estimated glomerular filtration rate (eGFR). Material and methods: This prospective study was performed in 2 phases, in which initially 50 CKD patients and 50 controls were studied to arrive at a median Young's modulus value in both the groups. In the later phase, a cross-sectional comparative study was conducted on 58 diabetic and 56 non-diabetic patients with SWE and renal Doppler, and the findings were correlated in various stages of CKD. Results: Using Young's modulus, the renal cortex elasticity of CKD patients was shown to be considerably reduced as compared to normal kidneys. There was significant correlation between Young's modulus, eGFR, and renal resistive index. Young's modulus values did not show significant differences between diabetic and non-diabetic groups, revealing its inability to arrive at the aetiopathogenesis of CKD. Conclusions: Correlation of renal tissue Young's modulus with eGFR suggests that SWE may be used as an indicator of renal tissue injuries in CKD patients. SWE can never replace the gold standard biopsy, but it can be used for staging of CKD. Even though SWE cannot predict the aetiopathogenesis of CKD, it may be a low-cost way to provide additional diagnostic information in CKD.

Renal Resistive Index: Revisited.

Introduction Chronic kidney disease (CKD) is universally considered a public health burden and the majority of cases are found to be diabetic at the time of diagnosis. Renal biopsy is the prime modality for the complete evaluation of renal injuries but is invasive. Duplex Doppler sonography can help to determine renal resistive index (RRI), which is an excellent marker for demonstrating dynamic or structural changes of intrarenal vessels. In this study, we evaluated the intrarenal hemodynamic abnormalities with RRI in diabetic and non-diabetic kidney disease patients. Also, RRI was correlated with the established parameters of renal dysfunction, i.e., estimated glomerular filtration rate (eGFR) and other biochemical parameters. Results There was a significant correlation of RRI with eGFR and serum creatinine indicating its role as a Doppler parameter, which can be used as complementary to biochemical parameters. A remarkable difference was noted in the RRI values between diabetic and non-diabetic groups in the early stages of CKD, revealing its ability to arrive at etiopathogenesis in the early stages. The renal resistive index increases in a sequential pattern and is an indicator of declining renal function. Conclusions The addition of sonographic parameters like renal resistive index could help in the complete evaluation of chronic kidney disease in diabetic and non-diabetic groups. A sequential increase in renal resistive index is a better indicator of the progressive worsening of renal function as opposed to an absolute cut-off value.

Impact of Exercise on Fatigue in Patients Undergoing Dialysis in a Tertiary Care Hospital.

Background Chronic kidney disease (CKD) is a current public health problem associated with progression to end-stage renal disease (ESRD), cardiovascular disease, and increased mortality rates. The disease is progressive. It is estimated that there are about 20-25 patients with milder kidney damage for every patient on renal replacement therapy. Physical activity is one of the critical elements for the prevention of chronic diseases and exercises in CKD help to improve muscular strength, cardiorespiratory endurance, overall function, and quality of life. Fatigue can cause an inability to perform exercises and can affect physiological and psychological function. There is a need to analyze the effects of exercises on fatigue in outpatients undergoing dialysis in the Indian rural population. Methods This study was a randomized, controlled, interventional, single-center trial. The participants diagnosed with ESRD and who were on hemodialysis were randomly assigned to group A, the exercise group (EG), which had exercise training during dialysis, and group B, the control group (CG), which had no added exercises during dialysis or at home and followed a standard routine method. The outcome measure of fatigue was evaluated through the total Fatigue Assessment Scale (FAS) score at 0, 12, 24, and 36 weeks. The exercise was pilot tested and planned based on the guidelines and carried out during hemodialysis two days a week. It was followed up with a five-day home exercise program when the patients did not undergo dialysis. Results A total of 48 participants were chosen for the study, of which 30 participants completed 36 weeks of training, with exercise adherence of more than 60%. There was a statistically significant difference in FAS between the two groups (F (3, 84) = 10.513, P < 0.001) at a 95% confidence interval (P < 0.05). Post hoc comparisons between groups at baseline and at 12 weeks indicated that there was no significant difference in FAS (P = 0.271 and P = 0.08), but recorded a significant difference (P = 0.001) at 24 and 36 weeks, respectively, between the EG and CG. Conclusions The results indicate that the intradialytic exercise intervention was effective in reducing the level of fatigue in outpatients undergoing dialysis on a long-term exercise program.

Thrombotic microangiopathy with pulmonary hemorrhage: A rare case report.

Thrombotic microangiopathy (TMA) includes various diseases with different etiologies which ultimately results in endothelial damage to the small vasculature leading to thrombosis in the micro vessels, this causes mechanical hemolysis, thrombocytopenia due to platelet consumption and ischemic organ damage. Untreated cases carry high mortality, so identifying the cause for TMA assumes importance. We report a 47-year old hypertensive lady presenting with accelerated hypertension (HTN) and TMA picture with rapidly progressive renal failure. She underwent hemodialysis followed by renal biopsy. Biopsy showed patchy cortical necrosis with hypertensive changes. The patient remained dialysis dependent and succumbed to pulmonary edema and alveolar hemorrhage three weeks after initial diagnosis. TMA in this patient could be due to malignant HTN or atypical hemolytic-uremic syndrome, and finding the exact cause is many times difficult. TMA is a medical emergency; a high index of suspicion is needed especially when there is multisystem involvement on background hemolysis and thrombocytopenia. Finding out the cause for TMA is important for prompt initiation of treatment.

Intensive monitoring of adverse drug reactions in nephrology unit of tertiary care teaching hospital.

Adverse drug reactions (ADRs) are one of the common causes of morbidity and mortality. Renal insufficiency is considered as one of the risk factors for the development of ADR. The study determined the occurrence of ADRs in patients with renal failure and their incidence of hospital admission. The study also evaluated the nature and severity of ADRs. This was a prospective study conducted in the nephrology unit at a tertiary care teaching hospital for a period of nine months. Patients receiving regular hemodialysis and those either referred or admitted to the nephrology ward were included. ADRs were intensively monitored throughout the study. The causality of suspected ADRs was assessed with the WHO probability scale, Naranjo algorithm, and Karch and Lasagna's scale. The predictability and preventability of ADRs were also determined. A total of 45 ADRs were identified in 369 patients; incidence was 12.19%. Nine ADRs (20%) needed hospitalization. A total of 27 (60%) and 17 (37.8%) ADRs were found to be probable and possible, respectively when assessed by the WHO probability scale. On the contrary, 33 (73.3%) and 26 (57.8%) ADRs were possible in causality when assessed by Karch and Lasagna's scale and Naranjo scale, respectively. Most of the ADRs [26 (57.8%)] were predictable in nature. A wide range of ADRs was noticed in patients with renal impairment, and our study has systematically assessed the nature and severity of ADRs.

A clinico-pathological study of lupus nephritis based on the International Society of Nephrology-Renal Pathology Society 2003 classification system.

INTRODUCTION: Lupus nephritis (LN) is a major complication of systemic lupus erythematosus (SLE). Renal involvement is a major determinant of the prognosis of SLE. The histological classification of LN is a key factor in determining the renal survival of patients with LN. Prompt recognition and treatment of renal disease are important, as early response to therapy is correlated with better outcome and renal biopsy plays an important role in achieving this. OBJECTIVES: The objective of this study was to correlate the clinical and laboratory findings with histopathological classes of LN as per the 2003 International Society of Nephrology-Renal Pathology Society (ISN/RPS) classification system. PATIENTS AND METHODS: Fifty-six patients with SLE, undergoing a renal biopsy for renal dysfunction were studied. The comparison of data from multiple groups was made by Pearson's Chi-square test and between two groups by independent samples t-test. The values of P < 0.05 were considered statistically significant. RESULTS: Of the 56 cases studied, 51 (91.1%) were females. The most common presenting symptoms were edema, arthralgia, and hypertension. Class IV (55.4%) was the most common class. Thirty-nine (69.6%) cases showed full house immunostaining. Hypertension, hematuria, proteinuria, and tubulo-interstitial disease showed a significant correlation (P < 0.05) with ISN/RPS classification, 2003. CONCLUSION: Assessment and management of patients with suspected LN are greatly facilitated through information obtained by renal biopsy. Since renal morphology may predict long-term prognosis, and no clinical or laboratory feature uniformly predicts prognosis, it is important to study the constellation of features in LN for better patient management.

A Comparative Study on Clinical and Biochemical Parameters in Amlodipine and Cilnidipine Treated Hypertensive Patients.

INTRODUCTION: Hypertension is a major health issue worldwide. Calcium Channel Blockers (CCBs) are the most commonly used antihypertensive agents. CCBs act on voltage-dependent calcium channels and they were categorized into two subclasses, Dihydropyridine (DHP) and non-Dihydropyridine (non-DHP) derivative. Amlodipine is a third generation L-type of DHP and Cilnidipine is a novel L/N-type of DHP CCB, both drugs have excellent pharmacological profiles with the unique actions. AIM: To study the clinical and biochemical profile in Amlodipine and Cilnidipine treated mild to moderate hypertensive patients. MATERIALS AND METHODS: The present study was a cross-sectional study. A total of 140 mild to moderate hypertensive patients (HTN classified according to Joint National Committee-8 (JNC-8) HTN guideline), 70 were in Amlodipine group (Group-A), and other 70 patients were in Cilnidipine group (Group-B). Group-A receiving Tab Amlodac 5 mg/day and Group-B receiving Tab Cilacar 10 mg/day, and both the group receiving respective medications since more than six months. Patients enrolled into the study with due consideration of eligibility criteria. Demographic, clinical and biochemical parameters were noted and compared. RESULTS: Demographic parameters are matched, there was no significant difference seen between two study groups. Systolic and Diastolic Blood Pressure (SBP and DBP) showed a significant difference (p<0.001). There was no significant difference in pulse rate between the two groups, both QT/QTc showed statistically significant difference (p<0.001). The biochemical parameters like serum creatinine, albumin, globulin, total protein, serum Na+, fractional excretion of Na+, serum osmolality, vanillyl mandelic acid, were compared between two study groups, there was no significant difference seen between the two groups. CONCLUSION: The Amlodipine and Cilnidipine both are equally effective antihypertensive drugs. Cilnidipine treated group showed more reduction in blood pressure than the Amlodipine treated group and there was no significant change in heart rate between the two groups. Cilnidipine group showed comparatively shortened QT/QTc interval than the Amlodipine group.

Primary Testicular Carcinoid Tumor presenting as Carcinoid Heart Disease.

Primary carcinoid tumors of the testis are very rare, and they seldom present with carcinoid syndrome. We report a hereto unreported instance, where a patient with a long-standing testicular mass presented with carcinoid heart disease, an uncommon form of carcinoid syndrome. He presented with symptoms of right heart failure, episodic facial flushing and was found to have severe right-sided valvular heart disease. His urinary 5-hydroxy indole acetic acid level was elevated. He underwent orchidectomy and the histopathology confirmed a testicular carcinoid tumor.

Effect of ethanolic extract of Acacia auriculiformis leaves on learning and memory in rats.

BACKGROUND: The effects and benefits of Acacia auriculiformis on health are not well established. This study was planned to evaluate the effect of ethanolic extract of Acacia auriculiformis leaves on learning and memory in rats. MATERIALS AND METHODS: Learning and memory were evaluated using passive avoidance paradigm and rewarded alternation test (T-maze) after the oral administration of two doses (200mg/kg and 400mg/kg) of ethanolic extract of Acacia auriculiformis with rivastigmine as positive control. Forty eight rats were divided into 4 groups in each study model. Estimation of brain cholinesterase activity was done to substantiate the results of the above mentioned tests. Data was analyzed using one way Analysis of Variance (ANOVA) followed by Tukey's post-hoc test using GraphPad InStat software, version 3.06. RESULTS: The extract produced a dose-dependent improvement in the memory score namely the step through latency in passive avoidance model (P < 0.001) and the percentage of correct responses in rewarded alternation test (P < 0.05). Dose-dependent inhibition of brain cholinesterase activity (P < 0.001) was also noted. CONCLUSION: The acetylcholinesterase inhibiting property of Acacia auriculiformis contributes to its memory enhancing potential. Further large scale studies are required to elucidate its benefits on cognitive function. This may offer a promising new option for the treatment of dementia and other cognitive deficits.

Correlation of carotid intimal-medial thickness with estimated glomerular filtration rate and cardiovascular risk factors in chronic kidney disease.

Carotid intimal-medial thickness (CIMT) predicts future vascular events in the general population. However, the correlation of traditional cardiovascular risk factors and stages of chronic kidney disease (CKD) with CIMT is not studied extensively. To determine the correlation of CIMT with traditional cardiovascular risk factors like age, body mass index (BMI), dyslipidemia and various stages of CKD patients, CIMT was measured by means of high-resolution B-mode ultrasonography in 70 CKD patients and compared with the 30 healthy controls. The mean CIMT in patients was 0.86 ± 0.21 mm vs 0.63 ± 0.17 mm in healthy age- and sex-matched controls (P <0.001). There was a significant univariate positive correlation between CIMT and age (r = 0.605, P <0.001), BMI (r = 0.377, P = 0.001), total cholesterol (r = 0.236, P ≤0.018) and serum triglyceride (r = 0.387, P ≤0.001). No statistically significant correlation was found between mean CIMT and estimated glomerular filtration rate (eGFR) (r = -0.02, P = 0.30), very low-density lipoprotein and high-density lipoprotein-cholesterol. Atherosclerotic changes very well correlate with the traditional cardiovascular risk factors like age, BMI, serum total cholesterol and serum triglyceride level in CKD patients. Even though CIMT was marginally more in the late stages of CKD patients, no statistically significant correlation was found with CIMT and eGFR.

Effect of nutritional intervention on malnutrition indicators in patients on haemodialysis.

OBJECTIVE: To formulate a nutrient supplement using low cost, commonly available food ingredients and test its efficacy on various nutritional parameters in haemodialysis (HD) subjects. DESIGN: Prospective intervention study. SUBJECTS: 15 subjects who did not have diabetes were recruited for the study. The subjects served as self controls. APPROACH: The subjects received a multi-nutrient formulation for a period of 3 months. Somatic status [weight, mid upper arm circumference (MUAC), mid upper arm muscle circumference (MUAMC), waist and hip measurements], biochemical parameters [blood urea nitrogen (BUN), total iron binding capacity (TIBC),serum levels of creatinine, albumin, triglycerides, sodium, potassium, calcium, phosphorus and high sensitive C-reactive protein(HsCRP)], dietary intake and malnutrition inflammation score (MIS) were assessed. RESULTS: Significant increments (P ≤ 0.01) in anthropometric measurements. Significant increases (P ≤ 0.01) in Hb, BUN, serum creatinine, albumin and total protein and a significant decrease (P ≤ 0.01) in HsCRP and MIS were observed at the end of the study. An increase in baseline food/nutrient intake was also observed. CONCLUSION: Nutritional supplementation designed for haemodialysis, improved their nutritional status in the short term study.