Impact of COVID-19 on heart failure hospitalization and outcome in India - A cardiological society of India study (CSI-HF in COVID 19 times study - "The COVID C-HF study").

OBJECTIVES: The presentation and outcomes of acute decompensated heart failure (ADHF) during COVID times (June 2020 to Dec 2020) were compared with the historical control during the same period in 2019. METHODS: Data of 4806 consecutive patients of acute HF admitted in 22 centres in the country were collected during this period. The admission patterns, aetiology, outcomes, prescription of guideline-directed medical therapy (GDMT) and interventions were analysed in this retrospective study. RESULTS: Admissions for acute heart failure during the pandemic period in 2020 decreased by 20% compared to the corresponding six-month period in 2019, with numbers dropping from 2675 to 2131. However, no difference in the epidemiology was seen. The mean age of presentation in 2019 was 61.75 (±13.7) years, and 59.97 (±14.6) years in 2020. There was a significant decrease in the mean age of presentation (p = 0.001). Also. the proportion of male patients decreased significantly from 68.67% to 65.84% (p = 0.037). The in-hospital mortality for acute heart failure did not differ significantly between 2019 and 2020 (4.19% and 4.,97%) respectively (p = 0.19). The proportion of patients with HFrEF did not change in 2020 compared to 2019 (76.82% vs 75.74%, respectively). The average duration of hospital stay was 6.5 days. CONCLUSION: The outcomes of ADHF patients admitted during the Covid pandemic did not differ significantly. The length of hospital stay remained the same. The study highlighted the sub-optimal use of GDMT, though slightly improving over the last few years.

COVID-19 infected ST-Elevation myocardial infarction in India (COSTA INDIA).

OBJECTIVE: To find out differences in the presentation, management and outcomes of COVID-19 infected STEMI patients compared to age and sex-matched non-infected STEMI patients treated during the same period. METHODS: This was a retrospective multicentre observational registry in which we collected data of COVID-19 positive STEMI patients from selected tertiary care hospitals across India. For every COVID-19 positive STEMI patient, two age and sex-matched COVID-19 negative STEMI patients were enrolled as control. The primary endpoint was a composite of in-hospital mortality, re-infarction, heart failure, and stroke. RESULTS: 410 COVID-19 positive STEMI cases were compared with 799 COVID-19 negative STEMI cases. The composite of death/reinfarction/stroke/heart failure was significantly higher among the COVID-19 positive STEMI patients compared with COVID-19 negative STEMI cases (27.1% vs 20.7% p value = 0.01); though mortality rate did not differ significantly (8.0% vs 5.8% p value = 0.13). Significantly lower proportion of COVID-19 positive STEMI patients received reperfusion treatment and primary PCI (60.7% vs 71.1% p value=< 0.001 and 15.4% vs 23.4% p value = 0.001 respectively). Rate of systematic early PCI (pharmaco-invasive treatment) was significantly lower in the COVID-19 positive group compared with COVID-19 negative group. There was no difference in the prevalence of high thrombus burden (14.5% and 12.0% p value = 0.55 among COVID-19 positive and negative patients respectively) CONCLUSIONS: In this large registry of STEMI patients, we did not find significant excess in in-hospital mortality among COVID-19 co-infected patients compared with non-infected patients despite lower rate of primary PCI and reperfusion treatment, though composite of in-hospital mortality, re-infarction, stroke and heart failure was higher.

Pulmonary Hypertension Registry of Kerala, India (PRO-KERALA): One-year outcomes.

BACKGROUND: Short term outcomes of patients with pulmonary hypertension are not available from low and middle-income countries including India. METHODS: We conducted a prospective study of 2003 patients with pulmonary hypertension, from 50 centres (PROKERALA) in Kerala, who were followed up for one year. Pulmonary hypertension (PH) was mainly diagnosed on the basis of Doppler echocardiography. The primary outcome was a composite end-point of all-cause death and hospital admission for heart failure. All cause hospitalisation events constituted the secondary outcome. RESULTS: Mean age of study population was 56 ± 16 years. Group 1 and Group 2 PH categories constituted 21.2% and 59% of the study population, respectively. Nearly two-thirds (65%) of the study participants had functional class II symptoms. 31% of Group 1 PH patients were on specific vasodilator drugs.In total, 83 patients (4.1%) died during the one-year follow-up period. Further, 1235 re-hospitalisation events (61.7%) were reported. In the multivariate model, baseline NYHA class III/IV (OR 1.87, 95% C.I. 1.35-2.56), use of calcium channel blockers (OR 0.18, 95% C.I. 0.04-0.77), vasodilator therapy (OR 0.5, 95% C.I. 0.28-0.87) and antiplatelet agents (OR 1.80, 95% C.I. 1.29-2.51) were associated with primary composite outcome at one-year (p < 0.05). CONCLUSION: In the PROKERALA registry, annual mortality rate was 4%. More than half of the patients reported re-hospitalisation events on follow up. Uptake of guideline directed therapies were suboptimal in the study population. Quality improvement programmes to improve guideline directed therapy may improve clinical outcomes of PH patients in India.

Pitfalls in comparison of coronary artery measurements of Indian population with different geographical area studies.

INTRODUCTION: Coronary artery disease (CAD) is the most common cause of morbidity and mortality especially in the developing countries. Coronary artery measurements (CAM) are the most important factor affecting the procedure and outcome of coronary angioplasty (PCI) as well as coronary by-pass operations (CABG). In this study, we aimed to establish a database for the normal CAM as well as for gender difference among the Indian population using quantitative coronary angiography (QCA) with an objective of assessing normal coronary vessel morphology of patients with normal coronaries. MATERIALS AND METHODS: Four thousand angiograms from patients of Indian origin were studied prospectively after procuring the sanction for the same from the ethical committee of the pre-selected hospitals of four states in India. Informed consents were obtained. Post CABG, post PCI patients and patient being diabetic for ≥5 years were also excluded from the study. RESULTS: Ten segments from right and left coronary arteries were taken for diameter measurements. These coronary diameters were indexed to body surface area (BSA) (mean diameter mm/m2 BSA). Among, 4000 patients, 933(23.3%) [M:F-521:412] had normal coronaries and 3067 (76.7%) were diseased. DISCUSSION AND CONCLUSION: The dimensions of the coronary artery segments of Indians were smaller (in BSA indexed and non-indexed data), compared to studies from other continents which can be due to their smaller BSA.

Sex and Medium-term Outcomes of ST-Segment Elevation Myocardial Infarction in Kerala, India: A Propensity Score-Matched Analysis.

BACKGROUND: Sex-based differences have been found in outcomes following ST-segment myocardial infarction (STEMI). Studies assessing sex-based differences in STEMI among Indian patients have reported conflicting results. METHODS: A prospective multicenter registry of consecutive patients with STEMI who presented to percutaneous coronary intervention (PCI)-capable hospitals in the Indian state of Kerala between June 2013 and March 2017 was used to assess 1-year outcomes. The primary endpoint was a composite of major adverse cardiac events (MACE), including death, stroke, nonfatal myocardial infarction, and rehospitalization for heart failure. Outcomes of 2 sex-based propensity score-matched groups were compared. RESULTS: We included 3194 patients (19.4% women). Women presenting with STEMI were older, had more traditional cardiovascular risk factors, and were more likely to be classified as living in poverty. After propensity-score matching, women experienced greater incidence of MACE (20.9% vs 14.3%, P < 0.01), primarily driven by increased 1-year mortality (14.3% vs 8.6%, P < 0.01). Women were more likely to experience prehospital delays, compared with men. Although reperfusion rates were similar between the groups, men were more likely than women to undergo reperfusion within the first 12 hours of chest pain onset. Among patients undergoing primary PCI, women were more likely to have delayed PCI than were men (80.2% vs 72.9%, P = 0.03). Procedural characteristics were similar between groups. CONCLUSIONS: Women in this cohort experienced higher incidence of MACE at 1 year, compared to men, primarily owing to increased mortality. Timeliness of reperfusion appears to be the primary factor impacting differences in outcomes between the 2 groups and may represent an attractive target for quality-improvement initiatives.

CONTEXTE: Des différences entre les sexes ont été constatées dans les résultats obtenus à la suite d'un infarctus du myocarde avec élévation du segment ST (STEMI). Des études évaluant les différences entre les sexes parmi des patients indiens ayant subi un STEMI ont produit des résultats contradictoires. MÉTHODOLOGIE: Un registre multicentrique et prospectif de patients consécutifs qui ont subi un STEMI et se sont présentés dans des hôpitaux où pouvait être pratiquée une intervention coronarienne percutanée (ICP) dans l'État indien du Kerala entre juin 2013 et mars 2017 a été utilisé pour évaluer les résultats à 1 an. Le paramètre d'évaluation principal regroupait des événements cardiaques indésirables majeurs (ECIM) comprenant le décès, l'accident vasculaire cérébral, l'infarctus du myocarde non fatal et la réhospitalisation pour cause d'insuffisance cardiaque. Les résultats de deux groupes appariés selon les scores de propension en fonction du sexe ont été comparés. RÉSULTATS: Nous avons inclus 3 194 patients (19,4 % de femmes). Les femmes qui avaient subi un STEMI étaient plus âgées, présentaient des facteurs de risque cardiovasculaire plus classiques et étaient plus susceptibles d'appartenir à la catégorie des personnes vivant dans la pauvreté. Après l'appariement selon les scores de propension, l'incidence des ECIM était plus élevée chez les femmes (20,9 % vs 14,3 %, p < 0,01), surtout en raison d'une mortalité accrue à 1 an (14,3 % vs 8,6 %, p < 0,01). Les femmes étaient plus susceptibles de subir des retards avant l'hospitalisation que les hommes. Bien que les taux de reperfusion étaient semblables dans les groupes étudiés, les hommes étaient plus susceptibles que les femmes de subir une reperfusion dans les 12 premières heures suivant l'apparition de la douleur thoracique. Parmi les patients ayant subi une ICP primaire, les femmes étaient plus susceptibles d'être touchées par un retard d'intervention que les hommes (80,2 % vs 72,9 %, p = 0,03). Les caractéristiques de l'intervention étaient similaires dans les groupes étudiés. CONCLUSIONS: L'incidence des ECIM à 1 an au sein de cette cohorte était plus élevée chez les femmes que chez les hommes, surtout en raison d'une mortalité accrue. La rapidité de la reperfusion semble être le principal facteur ayant des répercussions sur les différences de résultats entre les deux groupes et pourrait représenter une cible intéressante dans le cadre d'initiatives d'amélioration de la qualité.

A milestone in prediction of the coronary artery dimensions from the multiple linear regression equation.

BACHGROUND /AIM: Coronary artery imaging is one of the most commonly used diagnostic methods. We aimed to investigate whether there is a correlation between left main coronary artery (LMCA), left anterior descending artery (LAD) and left circumflex artery (LCx) artery dimensions in normal cases and a possibility to express the coronary dimensions by multiple linear equations. MATERIALS AND METHODS: Images of coronary angiograms of 925 normal cases selected from 3855 cases made up the study population (515 men and 410 women; age range, 30-75 years). The mean age of the patients was 55.50 ± 6.49 years. The mean body mass index was 24.79 ± 1.45 kg/m2 (range, 31.30-21.26 kg/m2). The mean dimensions of LMCA, LAD and LCx were 4.18 ± 0.65 mm, 3.22 ± 0.63 mm and 3.07 ± 0.65 mm, respectively. Correlation between LMCA, LAD and LCx diameters was investigated. Multiple linear regression analysis was used to develop a model to elucidate the relationship between LMCA, LAD and LCx diameters. RESULTS: There was a strong correlation between LMCA dimensions and LAD and LCx dimensions (r = 0.526**, p < 0.001* and r = 0.469**, p < 0.001*, respectively). The positive correlation indicated that a regression analysis can be carried out by incorporating the measurements. Coronary artery dimensions were gender specific. CONCLUSION: The present study explored the possibility of explaining the relationship with the LMCA and its branches by multiple linear equations, which may then be used to estimate the reference diameter of a stenosed coronary artery when the other two arteries are normal.

Spectroscopic and Biophysical Interaction Studies of Water-soluble Dye modified poly(o-phenylenediamine) for its Potential Application in BSA Detection and Bioimaging.

Ultrasound-assisted synthesis of water soluble poly(o-phenylenediamine) (POPD) and its doping with Acid Orange (AO), Fluorescein (Fluo) and Rhodamine-6G (R6G) dyes was carried out with a view to enhance the photophysical properties of POPD. XPS studies confirmed that doping of POPD occured through hydrogen bonding between NH group of POPD and C=O/SO-, S=O groups of the dyes. The presence of strong hydrogen bonding was also confirmed via UV-vis studies by the addition of urea and sodium chloride to the dye modified POPD adducts. Molar extinction coefficient of these adducts was found to bear a close relationship with the molecular structure. Fluorescence life time, (τf,) was found to be lowest (1.8 ns) for AO-POPD and highest (3.2 ns) for Fluo-POPD. The structure of AO-POPD was more strained, while that of Fluo-POPD was least strained. Intrinsic fluorescence decay constant, (k0f) showed increasing values for POPD, AO-POPD, Fluo-POPD, R6G-POPD as 0.071, 0.072, 0.153, and 0.172 (108 s-1), which could be correlated to the increasing strain-free molecular structure of the adducts. Circular dichroism spectra (CD) of BSA in presence of POPD and R6G- POPD revealed that it partially broke its helical structure, while Fluo-POPD and AO-POPD showed enhancement in the helical content. The 3-D fluorescence studies confirmed enhancement in hydrophobicity of POPD and R6G- POPD and increase in hydrophylicity of AO-POP and Fluo-POPD in the microenvironment of tryptophan residue-213 of BSA. Fluo-POPD and R6G-POPD adducts were chosen to find out the lowest detection limit (LOD) of BSA by differential pulse voltammetry (DPV) which was found to be 1.35 nM, and 1.65 nM using Fluo-POPD and R6G -POPD respectively. The binding constant of BSA with Fluo-POPD- and R6G-POPD was obtained as 3.98 × 106 Lmol-1 and 5.27 × 102 Lmol-1. These polymers could therefore, be used for the detection of BSA. Live cell imaging revealed that POPD nanoparticles were bound to the outer membrane of E. coli, while R6G-POPD, showed penetration into the cytoplasm and excellent labeling of E. coli. This facile technique could be used to design tunable biomarkers by tailoring the conjugated polymer with a desired dye molecule.

Pulmonary hypertension registry of Kerala, India (PRO-KERALA) - Clinical characteristics and practice patterns.

BACKGROUND: Epidemiological data on pulmonary hypertension (PH) are scarce from developing countries including India. METHODS: We established a multi-center registry of PH, the PRO-KERALA registry, in Kerala, India. Fifty hospitals enrolled consecutive adult (>18 years) patients for one year. Echocardiographic criteria (right ventricular systolic pressure - RVSP > 50 mmHg) or invasively obtained mean pulmonary artery pressure > 25 mmHg was the criteria for entry. RESULTS: There were 2003 patients (52% Women, mean age 56 ±â€¯16.1 years) enrolled. The mean RVSP was 68.2 (SD = 17.9) mmHg. Majority of the study participants (59%) belonged to group 2 of the WHO Nice Classification 2013 (PH secondary to left heart disease). One-fifth (21.2%) belonged to group 1, while 13.3%, 3.8% and 2.4% of the study population belonged to groups 3, 4 and 5 respectively. More than a quarter (27%) reported PH due to left heart disease with valvular disease etiology; while 20.7% had coronary artery disease. The other common etiological factors were chronic obstructive pulmonary disease (10.6%), congenital heart disease (14.6%), idiopathic pulmonary hypertension (5.8%), and chronic thromboembolic pulmonary hypertension (3.8%). Only one of two patients with pulmonary artery hypertension was receiving PH specific therapies. The use of combination therapy was negligible and PH-specific therapies were prescribed off-label to a small proportion of patients too. CONCLUSION: PRO-KERALA is the first PH registry from South Asia and the second largest globally. Left heart diseases attribute to three fifths of patients with PH. Utilization rates of PH specific drug therapies are remarkably lower than the Western population.

Gender-associated dimensional differences among normal to non-flow limiting coronary artery dimensions.

AIM AND OBJECTIVES: To study gender-specific differences in coronary artery diameters among subjects with normal to non-flow limiting disease (NFLD) coronary arteries (up to 0 - 20% of stenosis) and to assess the possible association of body-mass index (BMI) with coronary dimensions, among the west coastal population of Karnataka and Kerala. MATERIALS AND METHODS: A prospective cohort study was conducted for a period of one year. Two thousand angiograms samples were collected and assessed from two study centers (one from each state), after obtaining the ethical clearance. Patients with past history of myocardial infarction and those with recanalized normal looking coronary arteries and those who had diabetes for more than five years were excluded. Ten segments of coronary arteries- left main coronary artery, ostial and proximal segments of left anterior descending artery and its first diagonal branch, ostial and proximal segments of left circumflex coronary artery and its obtuse marginal branch, ramus intermedius and the ostial and proximal segments of the right coronary artery- were included in diameter measurement. BMI values of the patients were calculated. RESULTS: Out of 2000 patients included in the study, 454 (22.7%; mean age 53.4 ± 14.2 years) had normal to NFLD coronaries of which 253 (55.7%) were males and 201 (44.3%) were females. As compared to women, men had larger diameters of coronary arteries for eight segments, except the obtuse marginal branch and the proximal right coronary artery. A weak, yet statistically significant, negative correlation existed between BMI and coronary artery diameters in total cohort, indicating that an increase in BMI was associated with a decrease in artery diameters. No such association was seen when men and women were assessed separately. CONCLUSIONS: The present study indicates that men have higher caliber for coronary arteries compared to women. The study also indicates that when BMI increases there is a relative decrease in the coronary artery diameter.

Influence of Luminol Doping of Poly(o-phenylenediamine) on the Spectral, Morphological, and Fluorescent properties: A Potential Fluorescent Marker for Early detection and Diagnosis of Leishmania donovani.

There has been a steady progress in the development of doped conjugated polymers to remarkably improve their photo physical properties for their application as biomarkers. With a view to enhance the spectral, morphological, and photo physical properties of poly(o-phenylenediamine) (POPD), the present work reports the synthesis of poly(o-phenylenediamine) and doping of this polymer using luminol. The formation of luminol-doped POPD was confirmed by infrared and ultraviolet-visible spectroscopies and X-ray diffraction studies. The energy band gap values and oscillator strength of luminol in acidic, basic, and neutral media were computed by density functional theory calculations using the B3LYP/6-31G (d) basis set and were compared with experimental data. The luminol doped POPDs show significant in vitro anti-leishmanial activity. Live cell imaging also proved that these molecules bind with the organelle of Leishmania also. These luminol doped POPDs were found non-toxic at the used concentrations on THP-1 derived human macrophage cells through methyl tetrazolium (MTT) assay. The results revealed that luminol doped POPDs were potentially non-toxic to human cells though exhibited immense potential to be used as a fluorescent marker to label Leishmania donovani for diagnostic and other studies.

Tuning the spectral, morphological and photophysical properties of sonochemically synthesized poly(carbazole) using acid Orange, fluorescein and rhodamine 6G.

The lifetimes and quantum yields of organic dyes are widely investigated due to their potential application in organic light emitting diodes (OLEDs). With a view to explore the possibility of enhancing the fluorescent properties of organic conjugated polymers such as polycarbazole, the present preliminary study reports for the first time, dye modification of polycarbazole using as acid orange (AO), fluorescein (Fluo) and Rhodamine 6G (R6G) for improving its fluorescence properties. The modification of PCz via doping was confirmed by FTIR, UV-visible, XRD and TEM analyses. The fluorescence studies and confocal microscopy were carried out both in solution and solid states to investigate the behavior of the dye modified PCz. Doping was found to be governed by the chemical structure of the dye. PCz-AO revealed intense doping which was confirmed by FTIR and UV-visible studies. PCz-Fluo and PCz-R6G exhibited the highest quantum yield and fluorescence emission in the solid state. Hence, by tailoring the structure of these conjugated polymers, stable fluorescence emitting materials can be designed for their potential application in OLEDs.

Double layered hydroxides as potential anti-cancer drug delivery agents.

The emergence of nanotechnology has changed the scenario of the medical world by revolutionizing the diagnosis, monitoring and treatment of cancer. This nanotechnology has been proved miraculous in detecting cancer cells, delivering chemotherapeutic agents and monitoring treatment from non-specific to highly targeted killing of tumor cells. In the past few decades, a number of inorganic materials have been investigated such as calcium phosphate, gold, carbon materials, silicon oxide, iron oxide, and layered double hydroxide (LDH) for examining their efficacy in targeting drug delivery. The reason behind the selection of these inorganic materials was their versatile and unique features efficient in drug delivery, such as wide availability, rich surface functionality, good biocompatibility, potential for target delivery, and controlled release of the drug from these inorganic nanomaterials. Although, the drug-LDH hybrids are found to be quite instrumental because of their application as advanced anti-cancer drug delivery systems, there has not been much research on them. This mini review is set to highlight the advancement made in the use of layered double hydroxides (LDHs) as anti-cancer drug delivery agents. Along with the advantages of LDHs as anti-cancer drug delivery agents, the process of interaction of some of the common anti-cancer drugs with LDH has also been discussed.

Measles with acute disseminated encephalomyelitis (ADEM).

We report a seven year old male with measles associated acute disseminated encephalomyelitis (ADEM) despite having received measles vaccination in infancy. The diagnosis was based on serum antimeasles antibodies and MRI brain. The patient was managed with high dose corticosteroids along with supportive measures. There was a complete neurologically and physica recovery.

Evaluation of antibacterial activity of nanostructured poly(1-naphthylamine) and its composites.

The present study reports some preliminary investigations on the antibacterial activity of nanostructured poly(1-naphthylamine) (PNA) and its composites with polyvinyl alcohol (PVA) and polyvinylchloride (PVC). The antibacterial activity was evaluated against Escherichia coli and Staphylococcus aureus. The particle size and morphology of PNA and its composites was found to play a significant role in deciding the antimicrobial efficiency. A mechanism of antimicrobial activity has been suggested.

Synthesis, characterization, antibacterial and corrosion protective properties of epoxies, epoxy-polyols and epoxy-polyurethane coatings from linseed and Pongamia glabra seed oils.

The aim of this paper is to investigate the structures and properties of epoxidized linseed and Pongamia glabra oils (LOE/POE), their derived products-epoxy-polyols (HLOE/HPOE), epoxy-polyurethanes (EU=LOPU/POPU) and EU coatings. Changes in epoxy equivalent, iodine value, hydroxyl value and percent saturation of oil backbone in due course of epoxidation and hydroxylation reactions, were plotted as a function of time. Spectral (IR, (1)H NMR and (13)C NMR), physico-chemical and thermal (TGA and DSC) analyses of aforementioned resins were performed by standard methods. Physico-mechanical and chemical resistance tests reveal that coatings of LOPUs perform better than those of POPUs. It was found that properties of oil epoxy-polyurethane coatings are mainly governed by: (i) fatty acid composition and nature of starting oils, (ii) extent of epoxidation, (iii) number and location of hydroxyls and residual double bonds in the final product and (iv) the presence of long dangling chains. PO, HLOE and LOPUs exhibit good antibacterial activity against Escherichia coli at very small MIC. These EU systems can be safely employed unto 220 degrees C.

Waterborne diseases of bacterial origin in relation to quality of water in a suburb of Uttar Pradesh.

Waterborne disorders of bacterial origin, e.g. typhoid, bacillary dysentery and diarrhea are one of the major global health problems, especially in developing countries like India. The prevalence of these diseases is largely dependent on the quality of water consumed by people. The quality of water in India is still below the WHO recommendation of zero fecal coliform/100 ml of water. The present study was conducted in a suburb of Aligarh District of U.P. (India). A total of 1270 persons were selected by paying home visits and followed up for a period of one year. The study revealed that morbidity was higher in standpost group, i.e., 88.3% while in piped water group it was 51.8%. The average episode of typhoid for both source of water was one while dysentery had 3 average episodes. The average episodes of diarrhea was 4 in stand post and 3 in piped water group. In standpost group the majority of people, (87.6%) were using unsatisfactory water as compared to 74.4% for piped water supply. The frequency of typhoid was 1.4% bacillary dysentery 3.4% and diarrhea 7.7%. The occurrence of waterborne disorders of bacterial origin was common for typhoid in the 5-12 years age group bacillary dysentery for the 1-5 years, and diarrhea for the 0-5 years age group. The morbidity rate in standpost group was comparatively higher, i.e., 79.6%. The frequency for the standpost group and piped water group for different diseases were, typhoid 1.1% and 0.7%, bacillary dysentery 2.7% and 2.2%, and diarrhea 6.1% and 5.1%, respectively.

Interaction of decavanadate polyanions with proteins.

The binding of polymeric decavanadate anion [V10O28]6- with bovine serum albumin and gelatin was studied at pH 4.0 and 3.0, the region of thermodynamic stability of oligomeric vanadate anion. The binding of decavanadate anion at pH 4.0 with bovine serum albumin (BSA) and gelatin was found to be 9 and 32 gmol of decavanadate per gram mole of the proteins. The binding at pH 3.0 was found to be 12 and 38 gmol, respectively. Freshly formed BSA decavanadate precipitate was particulate in nature while that of gelatin-decavanadate made a gummy mass. This indicates a different mode of binding of decavanadate anions with globular and fibrillar proteins. Infrared spectra of the adducts endorses electrostatic binding between proteins and decavanadate. Scanning electron microscopy micrographs reveal extended crosslinked binding between decavanadate and gelatin and aggregation of the uncharged BSA-decavanadate molecules to make a granular adduct. The mode of binding was also correlated with the structure of decavanadate anions, BSA, and gelatin.

Effect of acute occlusion of left renal vein on the kidney: an experimental study in dogs.

To study the effects of acute ligation of the left renal vein an experimental study was carried out on 16 Mongrel dogs out of 18 of which 2 had died postoperatively. The right kidney served as control. Changes immediately after ligation were recorded; subsequently the dogs were sacrificed in 4 groups comprising 4 in each at intervals of 24 hours, one week, 4 weeks and 6 weeks. Both the kidneys were removed and gross and microscopic changes were noted. In all cases atrophy of the ligated kidney due to tubular atrophy and fibrosis were seen in spite of good collaterals. It is concluded that left renal vein ligation in dogs is not safe for the kidney, though it is not fatal.