Status of Serum Magnesium, Serum Zinc and C-reactive Protein in Hospitalized Patients with Chronic Kidney Disease in Mymensingh Locality.

Chronic Kidney Disease (CKD) is an important public health issue, with a leading cause of death and disability around the world. This cross-sectional study was conducted from January 2021 to December 2021 in the department of Biochemistry in Mymensingh Medical College in cooperation with the Department of Nephrology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh. The study was carried out to evaluate the status of serum magnesium, zinc and CRP in patients with CKD not on dialysis for monitoring the disease progression. For this purpose, 110 subjects were included, where 55 Hospitalized CKD patients were considered as Group I and 55 normal healthy individuals as Group II. Study subjects were selected on the basis of inclusion and exclusion criteria by purposive and convenient sampling method. Serum magnesium and zinc were determined by colorimetric method while CRP was measured by CRP-Latex Test (Slide Agglutination Test) from each sample. SPSS windows package, version 21.0 was used to perform the statistical analysis. Statistical significance of difference between Group I and Group II were evaluated by using student's unpaired 't'-test and the significance was defined as p<0.05. Correlation was done by using Pearson's correlation coefficient test. Mean age of Group I was 52.65±4.93 and Group II was 51.15±6.32 years. P-value was 0.165 which is statistically insignificant. The mean ±SD of BMI was 24.46±1.84 Kg/m² for Group I and 24.50±1.05 Kg/m² for Group II. P-value was 0.886 which is statistically insignificant. Among the study groups the mean serum magnesium were 2.25±0.17 and 1.95±0.05mg/dl, zinc were 88.64±9.21 and 102.11±12.93µg/dl, CRP were 24.00±16.73 and <6.0±0.00mg/L in Group I and Group II respectively. Analysis showed that, the mean serum magnesium and CRP were significantly increased while serum zinc was significantly decreased in CKD patients in comparison to that of healthy individual. There was negative correlation between serum zinc and CRP. This study was done within the context of the facilities available to us.

Effect of Supplementation of Oral Zinc on Serum Lipid Profile Status in Patients with Type 2 Diabetes Mellitus: A Prospective Study.

Diabetes mellitus is one of the most widespread endocrine disorders that have effects on lipid metabolism. Supplementation of oral zinc may improve the abnormalities of lipid metabolism in patients with type 2 diabetes mellitus. To evaluate the effects of oral supplementation of zinc on serum lipid profile levels in patients with type 2 diabetes mellitus. This prospective interventional study was conducted in the Department of Physiology, Dhaka Medical College (DMC), Bangladesh from January 2016 to December 2016. After fulfilling the ethical aspect, during the study a total number of 51 diagnosed type 2 diabetic patients of both sexes were selected with age ranging from 40 to 55 years. Among them, 26 type 2 diabetic patients with supplementation of oral zinc (40mg/day) for 12 weeks were considered as study group (Group B). Another 25 age matched type 2 diabetic patients without supplementation of oral zinc were considered as control group (Group A) for comparison. The subjects were selected from Outpatient Department of Endocrinology, Dhaka Medical College Hospital, Dhaka and personal contacts from Dhaka city on the basis of inclusion and exclusion criteria. Serum lipid profile levels were estimated by enzymatic endpoint method in auto-analyzer. The study parameters were measured 2 times in all subjects of control and study groups i.e. at the beginning of study (base line) and after 12 weeks of study period. For statistical analysis, paired Student's 't' test and unpaired Student's 't' test were performed as applicable using SPSS for windows version 22.0 In this study, serum TC, TG and LDL levels were significantly decreased (p<0.001) and serum HDL level was significantly increased (p<0.001) in diabetic patients after supplementation with oral zinc in comparison to that of their baseline value. Again, after 12 weeks, serum TC, TG, LDL levels were significantly lower (p<0.05) and HDL (p<0.05) level was significantly higher in diabetic patients supplemented with oral zinc in comparison to that of diabetic control group. In control group, there was no significant change in serum TC, TG, HDL and LDL levels between baseline and after 12 weeks of follow-up. From the results of the study, it can be concluded that oral zinc may improve serum TG and TC levels in patients with type 2 diabetes mellitus and may be helpful to minimize the complications in type 2 diabetes mellitus.

The effect of physical activity on vitamin D: A systematic review and meta-analysis of intervention studies in humans.

Objectives: Cross-sectional studies demonstrate a positive association between higher physical activity and serum 25-hydroxyvitamin D (25(OH)D) concentration. However, whether this association is causal is unclear. We conducted a systematic review to identify intervention studies that examined the effect of physical activity on serum 25(OH)D concentration in humans. Study design: Systematic review and meta-analysis. Methods: We searched PubMed, Scopus and Web of Science to identify full-text peer-reviewed articles published in English from inception until January 2023. Eligible studies were randomised controlled trials or quasi-experimental studies. We used random effects meta-analysis to calculate the weighted mean difference (WMD) in the change in 25(OH)D concentration between physical activity and control groups. We used the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) to assess the methodological quality of included studies. Results: We included 32 articles in the systematic review and 24 in the meta-analysis. The intervention varied from resistance and weight-bearing exercises (n = 13) to aerobic exercises (n = 10), moderate and moderate-to-vigorous exercises (n = 5), aquatic exercise (n = 2), and multicomponent traditional exercises (n = 2) (Tai Chi and Yijinjing). The WMD in 25(OH)D in the physical activity and control groups was 9.51 and 4.87, respectively (between-group mean difference 4.64, p = 0.002). However, the difference was only evident in studies that implemented the intervention outdoors (n = 3; between-group mean difference 17.33, p < 0.0001); when the intervention was indoors there was no significant effect of physical activity on 25(OH)D (n = 16; between-group mean difference 1.80, p = 0.113). Conclusions: This meta-analysis of physical activity interventions in humans showed that physical activity does not lead to increased 25(OH)D independently of time outdoors. However, most studies were under-powered, in many the exercise was low intensity, and vitamin D was not the primary outcome.

Evaluation of Intradialytic Complications and Protein Catabolic Rate on Maintenance Hemodialysis Patients in Bangladesh.

Among patients with chronic kidney disease stage-5 who are treated with dialysis, intradialytic complications commonly occur during routine hemodialysis (HD). It could be either patient related or mechanical. Protein catabolic rate during hemodialysis is a determinant of the mortality. nPCR was aimed to targets according to International guideline. This observational study was conducted in the Department of Nephrology, Mymensingh Medical College Hospital, Bangladesh from January 2020 to December 2020 to compare two groups of nPCR and different value of biochemical parameters. This study was involving all patients and inclusion criteria were patients who underwent routine HD for at least three months. All patients under-went conventional intermittent HD with low-flux dialyser. A total of 179 patients enrolled. Serum albumin, serum calcium, phosphate, hemoglobin and pre-dialysis urea, post dialysis urea were measured from blood sample. The nPCR was calculated by the standard international equation. nPCR value of 14.0% patients was more than 1.0 gm/kg/day and average nPCR (mean±SD) of all patients was 0.903±0.09gm/kg/day and 86.0% patients nPCR was less than 1.0 gm/kg/day. Biochemical parameters were not significantly differing between two groups. The nPCR is an indicator, can help the determination of nutritional status. This study aimed to find out the intradialytic complications, mean value of nPCR and correlation of biochemical parameters among ESRD patients on maintenance hemodialysis.

Risk Factors of Patients with Postpartum Acute Kidney Injury: An Observational Study.

Postpartum acute kidney injury (AKI) is a condition characterized by a sudden and rapid decline in kidney function that occurs shortly after childbirth. Several risk factors may be associated with postpartum acute kidney injury (AKI). Understanding the possible risk factors is essential for timely intervention and improved maternal healthcare. The aim of the study was to assess the risk factors of postpartum acute kidney injury patients. This prospective observational study took place at Mymensingh Medical College Hospital, from March 2020 to April 2021. It was carried out in the Departments of Nephrology and Departments of Obstetrics & Gynecology, where 153 postpartum acute kidney injury (AKI) patients were enrolled through purposive sampling. The study collected data on patient demographics, etiology and presentation. Statistical analysis was conducted using SPSS (Statistical Package for the Social Sciences) version 26.0, with a significance threshold set at p<0.05 for all tests. Among participants, puerperal sepsis (77.8%) and toxemia of pregnancy (58.8%) were prevalent risk factors. Intrauterine death was rare (1.3%). Other risk factors such as postpartum hemorrhage 22.2%, HELLP syndrome 11.1%, and antepartum hemorrhage 15.0% were found. A statistically significant difference in postpartum hemorrhage prevalence (p=0.038) was noted between hemodialysis and non-hemodialysis patients. Puerperal sepsis is the most common risk factor for postpartum acute kidney injury, closely followed by toxemia of pregnancy. Intrauterine death is rare, while postpartum hemorrhage significantly affects subjects, with variations noted between hemodialysis and non-hemodialysis patients.

Observations and properties of the first laboratory fusion experiment to exceed a target gain of unity.

An indirect-drive inertial fusion experiment on the National Ignition Facility was driven using 2.05 MJ of laser light at a wavelength of 351 nm and produced 3.1±0.16 MJ of total fusion yield, producing a target gain G=1.5±0.1 exceeding unity for the first time in a laboratory experiment [Phys. Rev. E 109, 025204 (2024)10.1103/PhysRevE.109.025204]. Herein we describe the experimental evidence for the increased drive on the capsule using additional laser energy and control over known degradation mechanisms, which are critical to achieving high performance. Improved fuel compression relative to previous megajoule-yield experiments is observed. Novel signatures of the ignition and burn propagation to high yield can now be studied in the laboratory for the first time.

Refining shape and size of silver nanoparticles using ion irradiation for enhanced and homogeneous SERS activity.

We present green synthesis of silver nanoparticles in water using unirradiated and Ag 15 + ion irradiated phytoextracts of Bergenia Ciliata leaf, Eupatorium adenophorum leaf, Rhododendron arboreum leaf and flower. The use of different plant extracts and their subsequent ion irradiation allow for successful refinement of nanoparticle size and morphology. Due to changes in reducing and capping agents the nanoparticle surface functionalization also varies which not only controls the morphology but also allows for surface oxidation and aggregation processes. In this work, we have synthesized silver nanoparticles which exhibit sizes in the range from 13 to 24 nm and having shapes like spherical, quasispherical, trigonal, hexagonal, cylindrical, dendritic assemblies, and porous nanoparticles. Owing to changes in the size and shape of the nanoparticles, their direct bandgap (2.05 eV - 2.48 eV) and local surface plasmon resonance (420 nm - 490 nm) could also be tuned. These nanoparticles are examined as SERS substrates, where their enhancement factors, limit of detection for methylene blue, and SERS substrate homogeneity have been tested. It has been observed the nanoparticles synthesized using unirradiated plant extracts present an enhancement factor of 10 6 with a limit of detection 10 - 8 M. Whereas nanoparticles with refined morphology and shapes upon irradiation present high enhancement factors of >10 7 and detection limit down to 10 - 9 M. In addition, uniformity in Raman spectra over the SERS substrates has been obtained for selected Ag NPs substrates synthesized using irradiated extracts with minimum relative standard deviation in enhancement factor < 12%.

Hyperbilirubinemia screening and treatment in neonates born prior to 35 weeks of gestation.

BACKGROUND: Guidelines on when to screen for neonatal hyperbilirubinemia apply to infants born at 35 weeks or later of gestation. It is unknown whether infants born earlier would benefit from similar guidelines. Our objective was to examine hyperbilirubinemia screening and phototherapy prescription among early preterm infants during the first 6 days of life. METHODS: We reviewed the charts of 193 infants born prior to 35 weeks of gestation who were admitted to a tertiary care NICU in Southeastern Ontario in 2018-2019. Information on total serum bilirubin (TSB) measurements over each 12-hour interval during the first six days of life and the treatment decision (no treatment, initiate, continue, or stop phototherapy) was extracted. We also examined what proportion of infants were prescribed phototherapy during each 12-hour interval. RESULTS: Of 1006 TSB measurements performed over the first 6 days of life, 605 were done to determine whether phototherapy should be initiated. Treatment was prescribed in 275 instances (45%). A higher proportion of infants born prior to 28 weeks of gestation required phototherapy in the first 12 hours of life (37%) compared to those born at 28-32 weeks (20%) and 33-34 weeks (5.7%). CONCLUSIONS: Our results suggest that TSB measurements are often poorly timed to detect treatment need in infants born prior to 35 weeks of gestation. This unnecessarily increases the risk of complications from phlebotomy and is an ineffective use of health care resources. There is a need to develop guidelines to optimize hyperbilirubinemia screening among early preterm infants.

Construction of Ag/CdZnS QDs nanocomposite for enhanced visible light photoinactivation of Staphylococcus aureus.

With increasing use of antibiotics, the development of antibiotic-resistant pathogens poses a serious threat to human health and the environment. Photocatalytic inactivation of these harmful pathogens is one of the novel and non-antibiotic treatments. The study fabricated Ag NPs decorated CdZnS QDs via a facile and biological co-precipitation method using L. camara plant extract as a green alternative to treat the toxic chemicals. The fabricated Ag/CdZnS QDs (NCs) were prepared for the efficient treatment of antibiotic-resistant pathogens as they raise a major global concern. The fabricated NCs were characterized with various characterization techniques to verify its physicochemical properties. The fabricated NCs have shown excellent photo-sterilization performance of 97 % against S. aureus. The excellent activity was attributed to the decoration of Ag NPs on CdZnS QDs as it helped in shortening band gap, improved visible light absorption ability, increased active sites, and boosted photogenerated electron/hole pairs stability. Radical trapping experiment and ESR analysis indicated the involvement of •OH and h+ in the photoinactivation of bacteria. The photo sterilization reaction of NCs was carried out under different environmental conditions, including light and dark conditions and different pH conditions. The experiment was carried out in sewage-treated water in order to test the real-time application, and the fabricated NCs achieved excellent 95.9 % photo-inactivation of S. aureus cells in sewage treated water and the Chemical Oxygen Demand (COD) of the system was increased after photo inactivation treatment. The fabricated NCs have also shown excellent reusable efficiency of 95% after six runs and the photostability and anti-corrosive nature of NCs were confirmed. The study provides an insight for the employment of photocatalysis for the sterilization of pathogens in real time aquatic environment across the globe.

Metal to semiconductor switching in the AgTe monolayer via decoration with alkali metal and alkaline earth metal atoms: a first-principles perspective.

In this work, employing first-principles calculations, we systematically investigate the atomic structure and electronic and optical properties of the AgTe monolayer, as well as the impact of alkali metal (Li, Na, K) and alkaline earth metal (Be, Mg, Ca) atoms decoration. The AgTe monolayer exhibits metallic characteristics. When Li, Na, K, and Mg atoms are decorated on the AgTe monolayer, the decorated AgTe monolayers are dynamically stable. In contrast, with Be and Ca atoms, the decorated structures are found to be dynamically unstable. Interestingly, the decoration of Li, Na, and K atoms into the AgTe monolayer can open the band gaps in the decorated Li-, Na- and K-AgTe monolayers around the Fermi level, leading to the actualization of metal-to-semiconductor transitions. In contrast, the decorated Mg-AgTe monolayer maintains its metallic characteristic. The highest electron and hole mobilities are achieved in the Na-AgTe monolayer among the decorated structures, suggesting the applicability of this structure in photovoltaic applications. The optical study shows that Li-, Na- and K-decorated AgTe monolayers have improved light absorption in the visible light region. Consequently, our findings shed light on the decoration of these 2D material monolayers and can potentially enhance and motivate studies in producing these monolayers for current nanodevices and future applications.

Enhanced visible light driven photodegradation of rifampicin and Cr(VI) reduction activity of ultra-thin ZnO nanosheets/CuCo2S4QDs: A mechanistic insights, degradation pathway and toxicity assessment.

In this study, we focused on fabrication of porous ultra-thin ZnO nanosheet (PUNs)/CuCo2S4 quantum dots (CCS QDs) for visible light-driven photodegradation of rifampicin (RIF) and Cr(VI) reduction. The morphology, structural, optical and textural properties of fabricated photocatalyst were critically analyzed with different analytical and spectroscopic techniques. An exceptionally high RIF degradation (99.97%) and maximum hexavalent Cr(VI) reduction (96.17%) under visible light was achieved at 10 wt% CCS QDs loaded ZnO, which is 213% and 517% greater than bare ZnO PUNs. This enhancement attributed to the improved visible light absorption, interfacial synergistic effect, and high surface-rich active sites. Extremely high generation of ●OH attributed to the spin-orbit coupling in ZnO PUNs@CCS QDs and the existence of oxygen vacancies. Besides, the ZnOPUNs@CCS QDs, forming Z-scheme heterojunctions, enhanced the separation of photogenerated charge carriers. We investigated the influencing factors such as pH, inorganic ions, catalyst dosage and drug dosage on the degradation process. More impressively, a stable performance of ZnO PUNs@CCS QDs obtained even after six consecutive degradation (85.9%) and Cr(VI) reduction (67.7%) cycles. Furthermore, the toxicity of intermediates produced during the photodegradation process were assessed using ECOSAR program. This work provides a new strategy for ZnO-based photocatalysis as a promising candidate for the treatment of various contaminants present in water bodies.

Construction of p-n-p nano heterojunction through coupling La2O3, (BiO)2CO3 and Ag3PO4 for effective photocatalytic degradation of doxycycline: Insights into mechanism, pathway and intermediate toxicity evaluation.

The present work is centred around the development of La2O3/(BiO)2CO3/Ag3PO4 (LBA), a p-n-p nano-heterojunction to photodegrade doxycycline under visible light irradiation. Here, ultrasonication assisted co-precipitation method was employed to synthesize the photocatalyst. The photocatalyst was characterized using different analysis such as SEM, TEM, elemental mapping, XRD, XPS, FTIR, Raman, BET, DRS, PL and EIS which confirmed the successful fabrication of LBA and their excellent ability to refrain the e-/h+ recombination owing to the construction of the heterojunction. LBA was found to degrade DOX by 91.75 % with the high mineralization of 87.23%. The impact of the reaction parameters influencing the photodegradation process including the concentration of the NCs and DOX, pH and the influence of the commonly present anions were studied. The stability and reusability of the LBA was assessed through subjecting it to four cycles of photodegradation of DOX. In addition, the recovered LBA was characterized through XPS and XRD analysis to confirm the particles stability and reusability. The active participation of the photogenerated charges and the reactive oxygen species were identified through the scavenging assay and ESR analysis. Further, GC-MS/MS analysis was performed to put forward a plausible photodegradation pathway. The toxicity of the end products as well as the intermediates was predicted through ECOSAR software.

Correlation of severity & clinical outcomes of COVID-19 with virus variants: A prospective, multicentre hospital network study.

BACKGROUND OBJECTIVES: The clinical course of COVID-19 and its prognosis are influenced by both viral and host factors. The objectives of this study were to develop a nationwide platform to investigate the molecular epidemiology of SARS-CoV-2 (Severe acute respiratory syndrome Corona virus 2) and correlate the severity and clinical outcomes of COVID-19 with virus variants. METHODS: A nationwide, longitudinal, prospective cohort study was conducted from September 2021 to December 2022 at 14 hospitals across the country that were linked to a viral sequencing laboratory under the Indian SARS-CoV-2 Genomics Consortium. All participants (18 yr and above) who attended the hospital with a suspicion of SARS-CoV-2 infection and tested positive by the reverse transcription-PCR method were included. The participant population consisted of both hospitalized as well as outpatients. Their clinical course and outcomes were studied prospectively. Nasopharyngeal samples collected were subjected to whole genome sequencing to detect SARS-CoV-2 variants. RESULTS: Of the 4972 participants enrolled, 3397 provided samples for viral sequencing and 2723 samples were successfully sequenced. From this, the evolution of virus variants of concern including Omicron subvariants which emerged over time was observed and the same reported here. The mean age of the study participants was 41 yr and overall 49.3 per cent were female. The common symptoms were fever and cough and 32.5 per cent had comorbidities. Infection with the Delta variant evidently increased the risk of severe COVID-19 (adjusted odds ratio: 2.53, 95% confidence interval: 1.52, 4.2), while Omicron was milder independent of vaccination status. The independent risk factors for mortality were age >65 yr, presence of comorbidities and no vaccination. INTERPRETATION CONCLUSIONS: The authors believe that this is a first-of-its-kind study in the country that provides real-time data of virus evolution from a pan-India network of hospitals closely linked to the genome sequencing laboratories. The severity of COVID-19 could be correlated with virus variants with Omicron being the milder variant.

Interstitial decoration of Ag linking 3D Cu2O octahedron and 2D CaWO4 for augmented visible light active photocatalytic degradation of rifampicin and genotoxicity studies.

A morphological oriented highly active Cu2O-Ag-CaWO4 (CAC) nano-heterojunction was fabricated for the visible light driven degradation of rifampicin (RFP). Octahedron shaped Cu2O being a base material, where the Tagetes shaped CaWO4 and Ag were embedded on it. The shape-controlled morphology of Cu2O and CaWO4 as well as Ag decoration influence high degree of adsorption of RFP and interfacial charge transfer between the nano-heterojunction. Further, the larger specific surface area (129.531 m2/g) and narrow band gap energy (2.57 eV) of CAC nano-heterojunction than the controls support the statement. Positively, CAC nano-heterojunction following Z-scheme-type charge transport mechanism attained 96% of RFP degradation within 100 min. O2•- and •OH are the primarily involved reactive oxidation species (ROS) during the photocatalytic reactions, determined by scavenger study and ESR analysis. The stability and reusability of the CAC nano-heterojunction was assessed through performing cyclic experiment of RFP degradation and it holds 96.8% of degradation even after 6th cycle. The stability of CAC nano-heterojunction after photodegradation was further confirmed based on crystalline pattern (XRD analysis) and compositional states (XPS analysis). Intermediates formed during RFP degradation and its toxicity was discovered by using GC-MS/MS and ECOSAR analysis respectively. The end-product toxicity against bacterial system and genotoxicity of CAC nano-heterojunction against Allium cepa were evaluated and the results were seemed to have no negative causes for the aquatic lives.

Genome-wide association study identifies human genetic variants associated with fatal outcome from Lassa fever.

Infection with Lassa virus (LASV) can cause Lassa fever, a haemorrhagic illness with an estimated fatality rate of 29.7%, but causes no or mild symptoms in many individuals. Here, to investigate whether human genetic variation underlies the heterogeneity of LASV infection, we carried out genome-wide association studies (GWAS) as well as seroprevalence surveys, human leukocyte antigen typing and high-throughput variant functional characterization assays. We analysed Lassa fever susceptibility and fatal outcomes in 533 cases of Lassa fever and 1,986 population controls recruited over a 7 year period in Nigeria and Sierra Leone. We detected genome-wide significant variant associations with Lassa fever fatal outcomes near GRM7 and LIF in the Nigerian cohort. We also show that a haplotype bearing signatures of positive selection and overlapping LARGE1, a required LASV entry factor, is associated with decreased risk of Lassa fever in the Nigerian cohort but not in the Sierra Leone cohort. Overall, we identified variants and genes that may impact the risk of severe Lassa fever, demonstrating how GWAS can provide insight into viral pathogenesis.

Unravelling the enhanced rifampicin photocatalytic degradation over green-synthesized SrO2@SnIn4S8 p-n heterojunction: Pathway, toxicity evaluation and mechanistic insights.

In recent years, the discharge of pharmaceutical drugs into aquatic ecosystems has become a growing concern, posing a significant threat to aquatic life. In response to this environmental challenge, advanced oxidation processes have gained prominence in wastewater treatment due to their efficacy in eliminating pharmaceutical pollutants and their potential for reusability. In this study, we have fabricated SnIn4S8 coupled SrO2 nano-heterojunction (NH) using a greener co-precipitation approach using leaf extract derived from Acaphyla wilkesiana. The resulting NH exhibited exceptional photocatalytic activity against rifampicin (RIF), achieving a remarkable 97.4% degradation under visible light, surpassing the performance of its individual components. The morphological characteristics of the NH were thoroughly analyzed through SEM, TEM, XRD, and XPS techniques, while EIS, DRS, and BET techniques provided valuable insights into its photocatalytic and optical properties. Furthermore, radical scavenging assays and ESR analysis identified hydroxyl radicals (•OH) and superoxide radicals (O2•-) were the species contributing to the visible light-driven photocatalytic degradation. The study also elucidated the potential degradation pathways and intermediates of RIF through GC-MS analysis. Additionally, the toxicity of the produced intermediates was assessed using the ECOSAR model. The findings have significant implications for the treatment of pharmaceutical pollutants and underscore the importance of eco-friendly synthesis methods in addressing environmental challenges.

[Indications and technique of open vascular surgical revascularization of visceral arteries in mesenteric ischemia]. / Indikation und Technik der offen-gefäßchirurgischen Revaskularisation der Viszeralarterien bei mesenterialer Ischämie.

Open revascularization for mesenteric ischemia has retained a significant value despite the increasing importance and use of endovascular techniques. Surgical procedures such as retrograde embolectomy, thromboendarterectomy and visceral bypass are indispensable components of the therapeutic armamentarium, particularly in cases of multisegmental vascular involvement, failure of previous endovascular treatment and concomitant presence of peritonitis, shock or multiorgan failure. In this context, preoperative multiphase computed tomography (CT) angiography is essential for the planning and outcome of visceral revascularization. This article summarizes the indications, technique, and results of the most important open surgical procedures.

Assessment of Dialysis Adequacy Using Small Solute Clearance Indices among Twice versus Thrice Weekly Maintenance Hemodialysis Patients in a Tertiary Care Hospital of Bangladesh.

This observational study was carried out in the Department of Nephrology, Mymensingh Medical College Hospital, Bangladesh from January 2020 to December 2020. A total of 179 patients were included in this study according to inclusion and exclusion criteria. Informed written consent was taken from each patient. All patients were underwent detail history taking, thorough physical examination and relevant investigations. Data collection was conducted through a structured questionnaire. Collected data were analyzed using the statistical software SPSS 23.0. Mean age ±SD of the study patients was 47.06±14.1 with a majority in age group 41-50 years. Male predominance was observed with a male: female ratio of 2.19:1 and 68.7% male patients. Level of pre-dialysis, post-dialysis urea in the study population was 123.77±26.86mg/dl, 50.27±15.70mg/dl respectively and mean ±SD of Urea Reduction Ratio (URR) in hemodialysis (target >65.0%) was 67.2±1.9. Most of the 8 hours (two times) per week hemolysis patients could not achieve the target value of dialysis adequacy parameters. On the other hand, maximum people in 12 hours (three times) per week hemodialysis group achieved the target value of dialysis adequacy parameters. It is important to calculate Kt/V or URR and individualize the dialysis doses for each patient.

Status of C-reactive protein, Serum Albumin and Serum Zinc in Hospital Admitted Patients with Chronic Kidney Disease.

Chronic Kidney Disease (CKD) is one of the most concerned non-communicable diseases now a day. Multiple complications arise and different biochemical parameters change in this disease. This cross-sectional study was conducted from January to December, 2021 in the Department of Biochemistry, Mymensingh Medical College with the help of the Department of Nephrology, Mymensingh Medical College Hospital, Bangladesh. The motive of this study was to explore the status of C-reactive protein (CRP), serum albumin and serum zinc in patients with CKD for monitoring the disease progression. In this study, 110 subjects were included, where 55 Hospital admitted CKD patients act as Group I and 55 normal healthy individuals act as Group II. The subjects were selected on the basis of inclusion and exclusion criteria by purposive and convenient sampling method. In this study, CRP levels, serum albumin and serum zinc were measured. All values were expressed as Mean±SD. All statistical analysis was done by using SPSS (statistical package for social science) windows package version 21.0. Statistical significance of difference between Group I and Group II were evaluated by using Student's unpaired 't'-test and the significance was defined as p<0.05. Correlation was done by using Pearson's correlation coefficient test. Mean age of Group I was 52.65±4.93 and Group II was 51.15±6.32. P value was 0.165 which is statistically insignificant. The mean±SD of BMI was 24.46±1.84 for Group I and 24.50±1.05 for Group II. P value was 0.886 which is statistically insignificant. The mean±SD values of CRP were 24.00±16.73mg/L and <6.0±0.00mg/L in Group I and Group II respectively. So, we found significant (p<0.05) increase in CRP levels. The mean±SD values of serum albumin were 3.62±0.26g/dl and 4.16±0.69g/dl in Group I and Group II respectively. We found highly significant (p<0.001) decrease in serum albumin. Among the study groups the mean serum zinc was 88.64±9.21µg/dl and 102.11±12.93µg/dl in Group I and Group II respectively. The mean serum zinc was highly significantly (<0.001) decreased. There was negative correlation between CRP and serum albumin, CRP and serum zinc. There was positive correlation between serum albumin and serum zinc. Analyzing the findings of present study, significant increase in CRP levels, significant decrease in serum albumin and serum zinc were observed in CKD patients.