Nephroprotective Effects of Mycophenolate Mofetil and Glibenclamide on Streptozotocin-induced Diabetic Renal Injury in Rats: An Experimental Study.

Diabetic renal injury is a microvascular complication associated with inflammation and oxidative stress, culminating in renal dysfunction. Conventionally, it is treated with hypoglycemic agents to address metabolic perturbations. However, the way to mitigate immunological, inflammation, and oxidative stress have seldom been studied. Hence, in the present study, the nephroprotective role of immunosuppressive and anti-inflammatory drugs, mycophenolate mofetil (MMF) in combination with the oral hypoglycemic agent glibenclamide, on streptozotocin (STZ)- induced diabetic renal damage was studied. Bodyweight, fasting blood glucose, and glycosylated hemoglobin levels were altered in the diabetic rats. Furthermore, renal injury was indicated by abnormal levels of urinary protein and creatinine and serum markers of renal function in diabetic rats. Hyperglycemia-induced oxidative stress and inflammation were also observed in the diabetic rats. The combination of MMF and glibenclamide treatment significantly attenuated the abnormal effects of hyperglycemia, oxidative stress, and inflammation-induced renal injury in diabetic rats. Histopathological studies confirmed the nephroprotective role of MMF and glibenclamide by reversing renal injury in diabetic rats. The present study suggests that MMF and glibenclamide have a protective role in STZ-induced diabetic renal damage.

Cerebral abscess and calvarial osteomyelitis caused by Burkholderia pseudomallei in a renal transplant recipient.

Melioidosis is an infection of humans caused by the saprophytic bacterium Burkholderia (previously Pseudomonas) pseudomallei. We present a patient of cerebral abscess and calvarial osteomyelitis caused by B. pseudomallei in a renal transplant recipient. We treated the patient with ceftazidime for 3 weeks, followed by trimethoprim-sulfamethoxazole (TMP-SMX) for 6 months. The superficial abscess reduced in size at the end of first month and subsided gradually. A repeat MRI showed reduction in intracranial abscess. The patient had no neurological deficit.

Nephrotic syndrome after scorpion sting.

Scorpion venom is a water soluble, antigenic and heterogeneous mixture. The venom is composed of varying concentration of neurotoxin, cardiotoxin, nephrotoxin, haemolytic toxin, phosphodiesterase, phospholipases, hyaluronidases, glycosaminoglycans, histamine, serotonins, and tryptophan and cytokine releasers. The reported incidence of scorpion sting in India is 0.6 %. Scorpion sting resulting in acute renal failure has been reported in the past, but not the nephrotic syndrome. We report a patient of nephrotic syndrome after scorpion sting. The lacunae in the present knowledge linking scorpion sting venom with nephrotic syndrome would only be replete with publications of similar reports.

Knowledge and awareness about benefits of Kangaroo Mother Care.

OBJECTIVE: To determine mothers' prior knowledge of Kangaroo Mother Care (KMC) and awareness about benefits of KMC for preterm babies. METHODS: Mothers of a consecutive sample of 46 preterm babies, eligible for KMC admitted to a teaching hospital, from June through August 2009, were studied to determine the attitude and knowledge about KMC. A structured questionnaire was prepared. Mothers were asked questions to determine their baseline knowledge about KMC. Then each mother was explained about KMC and instructed to do KMC. After one hour of KMC, mothers were asked questions again to know their feelings and difficulties regarding KMC and feasibility of breast feeding during KMC. RESULTS: Most of the mothers could understand what was explained to them (97.8 %; 95 % CI 88.5-99.9 %) in a single session. Positive feelings like closeness to baby (93.5 %) and sense of goodness (97.8 %) were noted amongst mothers. Though statistically not significant, the proportion of mothers who felt it impracticable to give breast feeding while doing KMC was considerable (39.1 %; 95 % CI 25.1-54.6 %) compared to those who felt no difficulty in breast feeding (60.9 %; 95 % CI 45.4-74.9 %). Practicable duration of KMC is 1, 2 and 12 h as felt by 52 %, 19.6 % and 6.5 % of mothers respectively. All the mothers expressed their willingness to continue KMC at home. CONCLUSIONS: Mothers can understand and implement KMC with simple and clear oral instructions in local language. Positive feelings arise in mothers even with 1 h of KMC. KMC of 24 h is not practicable to almost all of the mothers. There is a need for special emphasis on breast feeding the child while doing the KMC.

Short spell kangaroo mother care and its differential physiological influence in subgroups of preterm babies.

In routine practice, 4-6 h of kangaroo mother care (KMC) is adopted. Many mothers feel the duration impracticable. In 86 preterm babies, pre and post 1 h KMC changes in heart rate (HR), respiratory rate (RR), axillary temperature and SpO(2) are measured, in each baby. Postnatal age at the time of the study is 7.7 ± 5.2 days. Significant changes observed are decrease in mean HR by 3 bpm, RR by 3 min(-1) and increase in mean axillary temperature by 0.4 F and SpO(2) by 1.1%. In SGA babies, post KMC decrease in mean HR by 5 bpm, increase in mean axillary temperature by 0.6 F and SpO(2) by 2.1% are significant. In female babies, post KMC decrease in mean RR by 6 min(-1) and increase mean axillary temperature by 0.3 F and SpO(2) by 1.5% are significant. We conclude that preterm babies are benefited by 1 h KMC. SGA and female preterm babies showed different and greater response.