Cardiac functions in children with steroid-sensitive nephrotic syndrome

BACKGROUND

The aim of the present study was to evaluate the presence of cardiac systolic and diastolic dysfunction in pediatric patients with steroid-sensitive nephrotic syndrome (NS).

METHODS

The study population consisted of 19 patients with debut-relapse of NS aged 1-18 years and 30 sex and age-matched healthy controls. Blood and urine samples, two M-mode conventional echocardiograms and tissue Doppler velocity imaging were evaluated in both attack and remission periods.

RESULTS

With regard to conventional pulse wave Doppler (cPWD), steroid-sensitive NS patients (both in debut / relapse and in remission periods) had a higher peak of late diastolic flow velocities (A peak), and patients in debut / relapse had a lower E/A ratio than the control group, indicating diastolic dysfunction (overall P = 0.003 and P = 0.006, respectively). Based on tissue Doppler velocity imaging echocardiography results, patients in debut/relapse had a higher A' and a lower E'/A' ratio (overall P < 0.001 and P = 0.001, respectively). There was also a significant difference in the cPWD E/TDI E' ratio between the patients showing an increased cPWD E/TDI E' ratio in remission periods compared to in debut/relapse periods (P = 0.09). The albumin levels were positively correlated with E'/A' and E/ E' ratio (r = 0.609; P = 0.007, r = 0.472; P = 0.041 respectively).

CONCLUSIONS

Systolic cardiac functions are preserved but diastolic functions are affected in steroid-sensitive NS patients both in debut/relapse and in remission periods in a relatively short time. The persistence of left ventricular (LV) dysfunction during the remission period requires special attention during the follow up for early detection of cardiac abnormalities.

Influence of mercury from fly ash on cattle reared nearby thermal power plant

Cattle grazing nearby coal-fired power stations are exposed to fly ash. The present investigation aims to assess the environmental and health impacts of fly ash containing mercury emitted from thermal power plant. The health effect of fly ash were studied using 20 lactating cattle reared within a 5-km radius of s thermal power plant for the possible effect of fly ash such as the alterations in hematological and biochemical parameters of blood, milk, and urine. Results indicated that the hemoglobin levels (6.65 ± 0.40 g/dl) were significantly reduced in all the exposed animals. Biochemical parameters viz., blood urea nitrogen (27.35 ± 1.19 mg/dl), serum glutamate oxaloacetate transaminase (43.39 ± 3.08 IU/l), albumin, and creatinine were found to be increased, whereas serum glutamate pyruvic transaminase (29.26 ± 2.02) and Ca(2+) were observed to be statistically insignificant in exposed animals. Mercury concentrations estimated in the blood, milk, and urine of exposed (n = 20) and control (n = 20) animals were 7.41 ± 0.86, 4.75 ± 0.57, 2.08 ± 0.18, and 1.05 ± 0.07, 0.54 ± 0.03, 0.20 ± 0.02 μg/kg, respectively. The significant increase (P < 0.01) in the levels of mercury in blood, milk, and urine of exposed animals in comparison to control indicated that the alterations of biochemical parameters in exposed cattle could be due to their long term exposure to fly ash mercury which may have direct or indirect impact on human populations via food chain.