Recurrence Rate of Early Hepatitis C Virus Infection After Renal Transplantation Following Successful Treatment of Patients on Dialysis With Direct-Acting Antiviral Agents.

OBJECTIVES: Recurrence of hepatitis C virus after organ transplant has dreadful complications. An excellent response has been shown with direct-acting antiviral agents in transplant recipients. Although a sustained virological response is considered as the virological cure, it requires patients to be on dialysis for 3 months more before undergoing renal transplant, thus increasing the risk of hepatitis C virus reinfection and associated complications. We aimed to determine hepatitis C virus recurrence in renal transplant recipients who had achieved endof-treatment response before transplant. MATERIALS AND METHODS: Per our institutional dialysis protocol, patients who do not achieve rapid virological response are treated with 6 months of direct-acting antiviral agents. All patients who achieve end-of-treatment response are then referred for renal transplant. Our study included kidney transplant recipients who were treated with directacting antiviral agents and had a hepatitis C virus polymerase chain reaction test 3 months after renal transplant. We obtained demographic and clinical data of patients and used SPSS version 20.0 for statistical analyses. RESULTS: Our study included 48 transplant recipients; most were males (81.1%) with mean age of 28.7 ± 9.4 years. All patients received sofosbuvir, daclatasvir, and ribavirin combination before transplant. Most patients (70%) received treatment for 3 months. The polymerase chain reaction test for hepatitis C virus was conducted after a mean of 8.3 ± 3.3 months posttransplant. Laboratory parameters showed total bilirubin of 3.6 ± 17.5 mg/day, alanine aminotransferase of 51.5 ± 80.2 IU/L, and gammaglutamyltransferase of 133.9 ± 220 IU/L. Two recipients (4.2%) had posttransplant recurrence of hepatitis C virus infection. CONCLUSIONS: To our knowledge, this study is the first to document excellent response of direct-acting antivirals in renal transplant recipients who had been referred early for transplant. Thus, dialysis patients can undergo transplant after achieving end-oftreatment response.

Techno-economic analysis of ethanol production from lignocellulosic biomass-a comparison of fermentation, thermo catalytic, and chemocatalytic technologies.

Bioethanol produced from 2nd generation biomass comprising of agricultural residues and forest wastes is a viable alternate fuel. Besides fermentation and biomass gasification to syngas and its further conversion to ethanol, a direct chemocatalytic conversion of lignocellulosic biomass into ethanol is being investigated as a viable route which avoids the emission of greenhouse gases. In this work, a detailed configuration of chemocatalytic route is simulated and optimized for minimizing the cost of ethanol production. The economic feasibility of ethanol production through the chemocatalytic pathway is analyzed. The techno-economic analysis is conducted in terms of ethanol selectivity and ethanol production cost. The obtained results show that biomass feedstock and catalyst have major contributions to the production cost. The proposed route is found to be giving a lower ethanol selling price as compared to the well-researched routes of biomass fermentation to ethanol and biomass gasification followed by syngas conversion to ethanol.

Epidemiology and clinico-investigative study of organisms causing vaginal discharge.

BACKGROUND: Abnormal vaginal discharge is a common clinical problem in reproductive age group. It is the second most common problem after abnormal uterine bleeding. It is a neglected health problem, most commonly caused due to vulvovaginal candidiasis, trichomoniasis, and bacterial vaginosis (BV). OBJECTIVES: The present study was conducted to determine the prevalence of common organisms causing vaginal discharge and also to know the variety of clinical presentation. MATERIALS AND METHODS: A cross-sectional descriptive study was conducted in the Skin and STD Outpatient Department of Vinayaka Mission Kirupananda Variyar Medical College Hospital, Salem, who presented with abnormal vaginal discharge between September 2012 and September 2014. A total of 100 women in the reproductive age group who had symptoms of vaginitis were examined. Data were coded and analyzed. RESULTS: Out of the 100 patients examined, 77 (77%) cases were organism positive. Among the positive cases, BV (27%) was the most common microbiological cause of abnormal vaginal discharge, followed by trichomoniasis (25%), vaginal candidiasis (22%), combined infection (Candida and BV) (3%), and nonspecific cases (23%). CONCLUSION: Out of 100 cases, few cases showed discordance between clinical and laboratory diagnosis. This discordance can be due to pitfalls in identifying the causative agent clinically or obscuring of the findings due to improper treatment received for other ailments. Thus, clinico-investigative correlation is more important than other clinical findings alone.

Grape seed proanthocyanidin extract (GSPE) and antioxidant defense in the brain of adult rats.

BACKGROUND: Proanthocyanidin (PA) is a naturally occurring antioxidant from grape seed extract. The present study aims at assessing the neuroprotective effects of grape seed proanthocyanidin (GSPE) on the cerebral cortex (CC), cerebellum (CB), and hippocampus (HC) in the adult rat brain. MATERIAL/METHODS: GSPE was orally administered at 25, 50, and 75 mg per kg body weight daily and for a total period of 9 weeks. Antioxidant enzymes (AOEs), superoxide dismutase (SOD), and catalase (CAT) were analyzed along with malondialdehyde (MDA) and protein carbonyl content (PCC) as markers of lipid peroxidation (LPO) and protein oxidation (PO). The cholinergic system was studied by analyzing choline acetyl tranferase (ChAT) and acetylcholine esterase (AChE) activites along with acetylcholine content (ACh). RESULTS: The results obtained revealed an increased SOD activity in the 75-mg PA-supplemented animals, with a substantial decrease in MDA and PCC. The cholinergic neurotransmittary system analysis showed increased ChAT activity indicative of increased Ach content in the supplemented animals and the increase was more in the 75-mg PA group with a concomitant and moderate decrease in AChE activity. Regional changes were more with reference to HC. CONCLUSIONS: Our study shows that PA intake in moderately low quantity is effective in up-regulating the antioxidant defense mechanism by attenuating LPO and PO. Changes in the cholinergic system, however, indicate an increase in the ACh concentration with a moderate reduction in AChE activity, suggesting further that PA may have a potent role in enhancing cognition in older rats.