Nutrient profile of five freshwater fish species

The nutrient profile of five freshwater fish species viz., Mystus vittatus, Ompok bimaculatus, Channa striata, Wallago attu and Pangasianodon hypophthalmus were studied. The proximate composition data shows that the moisture and fat content differed significantly (P<0.01) among the fish species. The fat content was significantly higher in P. hypophthalmus and M. vittatus. The moisture was significantly higher in C. striata. The potassium content was significantly (p<0.01) higher in C.striata. M.vittatus shows higher content of calcium. The other trace minerals like iron, copper and zinc contents of fish did not differ significantly among the species. The vitamin A content is maximum in O.bimaculatus whereas vitamin D content is higher in Mystus vittatus. The palmitic acid was significantly (p<0.01) higher in M. vittatus. The oleic acid was significantly (p<0.01) higher in C. striata and W. attu. The linoleic acid content was significantly (p<0.05) higher in P. hypophthalmus. One of the important PUFA i.e. DHA was significantly higher in O. bimaculatus and C.striata. The PUFA content was significantly (p<0.05) higher in O.bimaculatus and P.hypophthalmus. Among the amino acids, arginine, histidine, threonine and isoleucine were higher in P.hypophthalmus. C.striata and W. attu contain high amount of Tryptophan. Glutamic acid was high in O.bimaculatus and Aspartic acid was high in C. striata. The energy content was maximum in P. hypophthalmus. The nutrient profile of these fish species revealed that they were rich in all the essential nutrients required by human being. The information on nutrient profile of fish will give a guideline to dieticians, nutritionists, medical practitioners, researchers to advice consumers to take fish in their daily diet as a health food. SAARC J. Agri., 16(2): 25-41 (2018)

Clinical Profile and Outcome of Posterior Reversible Encephalopathy Syndrome in Hemodialysis Patients

Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiologic entity characterized by headache, altered level of consciousness, seizures, visual disturbances, and reversible vasogenic subcortical edema. Hypertension and renal failure are well known principal risk factors for the development of PRES. However, risk factors and outcome of PRES has not been studied in patients on maintenance hemodialysis (MHD). The objective of this study is to characterize the factors predisposing to the development of PRES in patients on MHD. We performed a retrospective analysis in patients of MHD who were diagnosed with PRES between August 1, 2013, and July 31, 2015. Those with a history of cerebrovascular accidents/stroke, and epilepsy were excluded. We analyzed the clinical details, course, and laboratory data. One year follow-up data were noted in recurrence of PRES and mortality. A total of 18 patients were included for the final analysis. Of these, 13 (72%) patients were males. Majority of these patients were young and mean age was 21.1 years (6–50 years). Most of the PRES episodes developed shortly after initiation of MHD with mean duration of 2 months after initiation of MHD (1 month–3 years). All 18 patients had resistant hypertension. Eight (45%) patients had infection at the time of PRES episodes. Four patients had catheter-related bloodstream infection, 1 had pneumonia and 3 patients were recently diagnosed with pulmonary tuberculosis. Four (22%) patients developed recurrence of PRES and all these episodes developed within 2 months of index event. Seven (39%) patients underwent renal transplantation, and all received triple immune suppression and had uncontrolled hypertension in the perioperative period. However, none of these patients developed PRES after transplantation. All these patients had been maintaining stable graft function in the follow-up. All episodes of PRES were of generalized tonic–clonic seizure type and 6 of them presented as status epilepticus. None of them had any neurological sequel and no mortality at the end of 1 year. PRES is not uncommon in patients on MHD. Uncontrolled hypertension and infection are common predisposing factors. Renal transplantation is safe and not adversely affected by prior episodes of PRES in MHD.

Nutrient profile of Indian climbing perch, Anabas testudineus

The proximate composition, fatty acid, amino acid and fat soluble vitamins of Indian climbing perch, Anabas testudineus, locally called “Koi” were assayed in relation to its body weight. The fish samples were collected from different geographical locations and were grouped as small (10-50g) and big (52-150g) sizes. The proximate composition, essential amino acid (EAA) and non-essential amino acid (NEAA) contents in Koi did not differ significantly between the groups. The monounsaturated fatty acid (MUFA) content was significantly (P<0.05) higher in bigger sized Koi. The polyunsaturated fatty acid (PUFA) content was 23.67±0.85 and 13.62±1.02 (%) respectively in the small and big sizes of Koi, while the docosahexaenoic acid (DHA) was significantly higher in small Koi. The vitamin A content was 85.77±0.35 and 93.90 ±1.34 (I.U./100g) respectively in small and big Koi. Vitamin D content was significantly higher in small Koi compared to big one. Vitamin E and K were significantly (P<0.05) higher in big Koi. The results indicated that Anabas testudineus is a good source of protein, fat, vitamins, amino acids and fatty acids.SAARC J. Agri., 15(1): 99-109 (2017)

Lernaea cyprinacea infection in a new host Puntius pulchellus in intensive culture system and its control by doramectin

The present study explored the susceptibility of Puntius pulchellus subadults to Lernaea cyprinacea infection subsequent upon their first introduction to an intensive culture system that had a previous history of Lernaea infection and evaluated the efficacy of doramectin against the parasite. All the P. pulchellus introduced to the culture pond got infected demonstrating 100 % susceptibility of this species to Lernaea infection. Pathological changes caused by the parasite as evidenced by the extensive hemorrhage and tissue necrosis of the host at the point of parasite attachment was most severe in P. pulchellus. On the contrary, among the fish species already present in the pond and were previously exposed to the infection before the start of the present study, only Labeo fimbriatus developed mild to moderate infection. Cirrhinus mrigala, Ctenopharyngodon idella and Cyprinus carpio from the same culture pond did not develop Lernaea infection. Doramectin administration at 1 mg/kg b.wt. of fish incorporated in feed and given orally for 10 days or by a single intramuscular injection at 200 μg/kg b.wt. was found to be effective in controlling L. cyprinacea adult parasite infection in P. pulchellus. Doramectin hastened healing of the wounds caused by L. cyprinacea and did not cause any noticeable adverse reactions or toxicity to the fish host during the present study. In conclusion, P. pulchellus was observed to be highly susceptible to L. cyprinacea upon its first exposure to the infective stages of the parasite and a single intramuscular injection of doramectin at 200 μg/kg b.wt. was more effective than oral administration of the drug in controlling L. cyprinacea infection.

Micronutrient Composition of 35 Food Fishes from India and Their Significance in Human Nutrition

The micronutrients (vitamins and minerals) are required in small amounts but are essential for health, development, and growth. Micronutrient deficiencies, which affect over two billion people around the globe, are the leading cause of many ailments including mental retardation, preventable blindness, and death during childbirth. Fish is an important dietary source of micronutrients and plays important role in human nutrition. In the present investigation, micronutrient composition of 35 food fishes (includes both finfishes and shellfishes) was investigated from varying aquatic habitats. Macrominerals (Na, K, Ca, Mg) and trace elements (Fe, Cu, Zn, Mn, Se) were determined by either atomic absorption spectroscopy (AAS) or inductively coupled plasma mass spectrometry (ICP-MS)/atomic emission spectrometry (ICP-AES). Phosphorus content was determined either spectrophotometrically or by ICP-AES. Fat-soluble vitamins (A, D, E, K) were analyzed by high-performance liquid chromatography (HPLC). The analysis showed that, in general, the marine fishes were rich in sodium and potassium; small indigenous fishes (SIFs) in calcium, iron, and manganese; coldwater fishes in selenium; and the brackishwater fishes in phosphorous. The marine fishes Sardinella longiceps and Epinephelus spp. and the SIFs were rich in all fat-soluble vitamins. All these recommendations were made according to the potential contribution (daily value %) of the species to the recommended daily allowance (RDA). Information on the micronutrients generated would enhance the utility of fish in both community and clinical nutrition.

An In Vitro Study on Effect of Ceramic Thickness and Multiple Firings on Colour of Metal Ceramic Restorations

Preparation of porcelain restorations that match the natural dentition has been a subject of great concern for many years. An understanding of the process by which the colour and translucency of fixed restorations are planned and obtained so as to replicate the colour of its adjacent teeth is important for achieving an esthetic restoration. This study was done to study the effect of fabrication procedures such as ceramic thickness and number of firing cycles on the colour of metal ceramic restorations. Metal ceramic samples with three different ceramic thicknesses; 0.5, 1 and 1.5 mm (N = 30, n = 10 per group) were fabricated. A3 shade of [VMK 95, VITA Zahnfabrik, Bad Sackingen, Germany] ceramic was used for the fabrication of samples. Samples were subject to multiple firing cycles and colour was measured after 2nd, 3rd, 4th, 6th, 8th and 10th firing cycle. Colour measurement was done objectively using spectrolino (Gretag Macbeth Inc., Germany) spectrophotometer. 'Repeated measures ANOVA' test was used for doing statistical analysis. No significant change was noticed in any of the four colour parameters between the baseline reading after second firing uptil the tenth firing for any of the three groups with different ceramic thicknesses. There was a consistent rise in L* or lightness of colour as the thickness of ceramic increased. Between group I and group III there was a consistent shift of a* axis towards the blue green side and there was a consistent shift in b* axis towards purple-blue with an increase in ceramic thickness. It was observed that there was a change in ΔE with a change in ceramic thickness. There was a change of about two units between group I and group II and a change of about one unit between group II and group III. Change in ΔE between group I and group III was the most significant, being about three units. It was concluded from the study that multiple firing cycles during fabrication of metal ceramic restorations do not have any effect on colour while colour varies with change in ceramic thickness.

Multiphysics modelling, quantum chemistry and risk analysis for corrosion inhibitor design and lifetime prediction

Organic corrosion inhibitors can provide an effective means to extend the life of equipment in aggressive environments, decrease the environmental, economic, health and safety risks associated with corrosion failures and enable the use of low cost steels in place of corrosion resistant alloys. To guide the construction of advanced models for the design and optimization of the chemical composition of organic inhibitors, and to develop predictive tools for inhibitor performance as a function of alloy and environment, a multiphysics model has been constructed following Staehle's principles of “domains and microprocesses”. The multiphysics framework provides a way for science-based modelling of the various phenomena that impact inhibitor efficiency, including chemical thermodynamics and speciation, oil/water partitioning, effect of the inhibitor on multiphase flow, surface adsorption and self-assembled monolayer formation, and the effect of the inhibitor on cathodic and anodic reaction pathways. The fundamental tools required to solve the resulting modelling from a first-principles perspective are also described. Quantification of uncertainty is significant to the development of lifetime prediction models, due to their application for risk management. We therefore also discuss how uncertainty analysis can be coupled with the first-principles approach laid out in this paper.

A Clinical and Radiographic Evaluation of Periodontal Regenerative Potential of PerioGlas®: A Synthetic, Resorbable Material in Treating Periodontal Infrabony Defects

BACKGROUND

Study of the clinical application of bioactive glass in treating periodontal defects has been gaining momentum. Studies in the past have hypothesized that bioactive glass resulted in an improvement of bony lesion when compared with open flap debridement. Considering that there were very few studies in the Indian dental literature involving the analysis of PerioGlas®- A particulate Bioglass in intrabony defects, the present clinical trial aimed to clinically and radiographically evaluate the efficacy of PerioGlas® and compare it to open debridement as control in the treatment of human periodontal osseous (three and two wall) defects in South Indian population.

MATERIALS AND METHODS

Ten patients with chronic periodontitis within the age group of 30-45 years having at least two pockets with depth of ≥6 mm exhibiting vertical osseous defects were selected for the study. A total of 20 defect sites were randomly assigned to one of the two treatment modalities such that 10 sites (experimental) received PerioGlas® material after open flap debridement and 10 sites with open flap debridement (controls). Plaque index and gingival index (GI) were recorded at baseline, 6 weeks, 3 months, 6 months and 9 months, whereas probing pocket depth (PPD), clinical attachment level and gingival recession (GR) were recorded at baseline, 6 and 9 months postoperatively. Linear radiographic measurements were carried out at baseline, 6 and 9 months to evaluate the defect fill, defect resolution and change in the alveolar crest height (ACH).

RESULTS

Both experimental and control site showed a significant reduction in plaque and GI, and a slight increase in GR. The mean reduction in PPD for experimental and control site was 4.4 ± 0.34 mm and 3.2 ± 0.1 mm, respectively. Gain in clinical attachment at experimental and control site was 4.4 ± 0.21 and 3.4 ± 0.11, respectively which on comparison was statistically non-significant for both sites. The radiographic mean defect fill for experimental site was 1.73 mm. The mean defect resolution was 46.5% and 15.3% for the experimental group and control group, respectively, with a slight increase in the ACH at the experimental site.

CONCLUSION

Comparison of experimental and control sites revealed a statistically significant improvement in both clinical and radiographic parameters, but experimental sites showed better results when compared with control. How to cite the article: Chacko NL, Abraham S, Rao HN, Sridhar N, Moon N, Barde DH. A clinical and radiographic evaluation of periodontal regenerative potential of PerioGlas®: A synthetic, resorbable material in treating periodontal infrabony defects. J Int Oral Health 2014;6(3):20-6.

Prevalence and severity of periodontal disease in type 2 diabetes mellitus (non-insulin-dependent diabetes mellitus) patients in Bangalore city: An epidemiological study

Background:

Our objective was to study the prevalence and severity of periodontal disease in type 2 diabetes mellitus (DM) patients in Bangalore city.

Materials and Methods:

Four hundred and eight type 2 DM patients (Study Group) and 100 non-diabetic patients (Control Group) among the age group of 35-75 years were included in the study. The study group was divided based on Glycated hemoglobin levels into well, moderately and poorly controlled. Relevant information regarding age, oral hygiene habits and personal habits was obtained from the patients. Diabetic status and mode of anti-diabetic therapy of the study group was obtained from the hospital records with consent from the patient. Community periodontal index (CPI) was used to assess the periodontal status. The results were statistically evaluated.

Results:

The mean CPI score and the number of missing teeth was higher in diabetics compared with non-diabetics, and was statistically significant (P=0.000), indicating that prevalence and extent of periodontal disease was more frequent and more severe in diabetic patients. The risk factors like Glycated hemoglobin, duration of diabetes, fasting blood sugar, personal habits and oral hygiene habits showed a positive correlation with periodontal destruction, whereas mode of anti-diabetic therapy showed a negative correlation according to the multiple regression analysis. The odds ratio of a diabetic showing periodontal destruction in comparison with a non-diabetic was 1.97, 2.10 and 2.42 in well, moderately and poorly controlled diabetics, respectively.

Conclusion:

Our study has made an attempt to determine the association between type 2 DM (NIDDM) and periodontal disease in Bangalore city. It was found that type 2 DM (non–insulin-dependent diabetes mellitus [NIDDM]) subjects manifested relatively higher prevalence and severity of periodontal disease as compared with non-diabetics.

Horizontal ridge augmentation using a combination approach

Resorption of alveolar bone - a common sequel of tooth loss jeopardizes the functional and esthetic outcome of treatment, especially in the maxillary anterior areas. Therefore, augmentation of deficient alveolar ridges is an important aspect of dental implant therapy. A case of severe maxillary ridge deficiency successfully treated with horizontal ridge augmentation to facilitate implant placement is described. Ridge augmentation was achieved using a combination of autogenous block graft, particulate grafting, and guided bone regeneration (GBR). Follow-up was done next day, after ten days, three months, and six months. Various approaches can be followed in order to achieve an increase in the ridge width. In our case, we used a combination of different techniques for ridge augmentation. A significant improvement in ridge width was noticed at six months thus facilitating the placement of implants.

Comparative susceptibility of carp fingerlings to Lernaea cyprinacea infection

Study was conducted to find out the comparative susceptibility of fingerlings of seven species of carps (Labeo fimbriatus, L. rohita, L. calbasu, Catla catla, Ctenopharyngodon idella, Cyprinus carpio and Hypophthamichthys molitrix) grown under both mono and polyculture to Lernaea cyprinacea infection. Under monoculture, C. carpio, L. rohita and L. calbasu, did not acquire Lernaea infection and were thus considered resistant, whereas C. idella, H. molitrix, C. catla and L. fimbriatus were susceptible. Even challenge with higher infective doses of copepodids under monoculture did not result in infection in the resistant fish species. The resistance of L. rohita and C. carpio to Lernaea infection under monoculture was not sustained when these two fish species were maintained in polyculture along with susceptible fish species. Labeo calbasu, even under polyculture, however, did not acquire Lernaea infection indicating that this fish species is the most resistant and least preferred host for this parasite. Similarly, C. carpio, L. rohita and L. calbasu when grown together in polyculture and exposed to a higher infective dose (120 copepodids/fish) also did not develop the infection. The possible reasons for differences in susceptibility shown by these carp species in monoculture and the loss of resistance by rohu and common carp while in polyculture with susceptible species are discussed. The ability of resistant fish species to prevent establishment of anchor worms on them under monoculture can be utilized to control this parasitic infection commonly encountered in culture ponds.

Direct Measurements of Thermal Stress Distributions in Large Die Bonds for Power Electronics

Large semiconductor devices can be subject to significant mechanical stress resulting from thermal expansion mismatch between the devices and packaging materials. This stress can either cause mechanical failure or change the operational characteristics of the device. Furthermore, this stress governs the reliability of the system during use. Therefore, a complete understanding is required of the nature of stress evolution during packaging, and its time and temperature dependence during subsequent service. In the present investigation, the absolute magnitudes and spatial distributions of time-dependent thermal residual stress are measured directly by piezospectroscopic techniques. These measurements are performed with high stress (±15 MPa) and spatial (1 μm) resolution in silicon specimens attached to substrates. Measurements are performed at room temperature on 25 mm square specimens, with continuous, layered solder joints in model specimens of silicon/solder/copper. Room temperature creep relaxation is also investigated. The stress data are then analyzed according to fundamental micromechanical models.

Continued root-end growth and apexification using a calcium hydroxide and iodoform paste (Metapex®): three case reports

AIM

The aim of these case reports is to present a treatment to promote root-end growth and apexification in nonvital immature permanent teeth in children.

METHODS AND MATERIALS

Three cases were presented where the calcium hydroxide and iodoform paste Metapex® was placed in the root canals of immature permanent teeth using disposable plastic tips. The teeth involved were evaluated radiographically at regular intervals for the first 12 months after placement of the paste. At the end of 12 months all the cases showed continued root growth and apical closure (apexification) with no evidence of periapical pathology. Conventional endodontic treatment was then performed.

RESULTS

In all three of the clinical cases presented, a combination of calcium hydroxide and iodoform paste (Metapex®) was used and showed promising results in inducing root-end growth and closure after 12 months.

CONCLUSION

In these three clinical cases, the calcium hydroxide and iodoform paste Metapex® (Meta Biomed Co. Ltd., South Korea) was found to induce apical closure when assessed radiographically. Over a period of 12 months all the cases showed continued root growth.

CLINICAL SIGNIFICANCE

The calcium hydroxide and iodoform paste Metapex® promoted continued root-end growth with apexification in the nonvital immature permanent teeth treated.

Preliminary mechanistic studies on the smooth muscle relaxant effect of hydroalcoholic extract of Curcuma caesia

BACKGROUND AND OBJECTIVES

Curcuma caesia (family Zingiberaceae) is widely used in India as both an anti-inflammatory and anti-asthmatic in Ayurvedic medicine. However, there are no published pharmacological data on Curcuma caesia on its potential anti-asthmatic activity. Hence, the objective of the present investigation is to study the mechanisms by which the hydroalcoholic extract of Curcuma caesia relaxes the smooth muscle in the bronchioles and vasculature of the respiratory tract.

METHODS

The hydroalcoholic extract of Curcuma caesia (CC extract) was tested for its per se relaxant effect in guinea pig trachea and also in the presence of various receptor antagonists and enzyme inhibitors namely propranalol, 2', 5'-dideoxyadenosine, methylene blue, glibenclamide, N(omega)-nitro-L-arginine (L-NNA) and alpha-chymotrypsin. Furthermore, the possible role of hydroalcoholic extract in calcium channel modulation was investigated in depolarized rabbit aorta.

RESULTS

The CC extract concentration dependently relaxed the carbachol (1 microM)-induced pre-contractions; the IC50 value was found to be 239.36 microg/ml and the incubation of either receptor antagonists or enzyme inhibitors did not exhibit any effect on the relaxation. In the isotonic Ca2+-free high-K+ (60 mM) depolarized aorta, CC extract (30 microg/ml) inhibited concentration-response curves of cumulative Ca2+ (0.1-30 mM) and the PD'2 value was found to be 4.11 microg/ml.

INTERPRETATION AND CONCLUSION

The extract showed a dose-dependent, non-specific relaxation of pre-contracted isolated guinea pig trachea. The non-specific relaxant effect of the extract may be due to its ability to modulate calcium activity.

Early and severe hyperparathyroidism associated with hypercalcemia after renal transplant treated with cinacalcet

Bone disease is a common clinical problem following renal transplantation. In renal transplant recipients, multiple underlying factors determine the extent of bone loss and the subsequent risk of fractures. In addition to the well-recognized risk to bone disease posed by steroids, calcineurin inhibitors and pre-existing bone disease, persistent hyperparathyroidism (HPT) contributes to post-transplant bone loss. HPT is usually treated with vitamin D supplements combined with calcium. Patients whose HPT is associated with hypercalcemia pose a difficult therapeutic dilemma which often requires parathyroidectomy. Cinacalcet, a calcium mimetic agent, offers a unique pharmacologic approach to the treatment of patients with post-transplant hypercalcemia and HPT. In this paper, we describe the clinical course and biochemical changes in 10 renal transplant recipients with hypercalcemia and severe HPT early after renal transplantation treated with cinacalcet. Cinacalcet therapy corrected hypercalcemia and decreased parathyroid hormone (PTH) levels in all cases. A transient rise in the level of alkaline phosphatase was noted following initiation of cinacalcet therapy. In this patient population, correction of HPT was not permanent as discontinuing cinacalcet therapy led to a rapid rise in PTH level.

In vitro pharmacological investigations of Sapindus trifoliatus in various migraine targets

Phytotherapies have offered alternative sources of therapy for migraine and gained much importance in prophylactic treatment. The aqueous extract of pericarp of fruits of Sapindus trifoliatus Linn (ST), family Sapindaceae was evaluated for its affinity for 5-HT(1B/1D) receptors in rabbit saphenous vein, alpha-adrenoceptors in rabbit aorta, GABA receptors in guinea pig ileum, 5-HT(2B) receptors in rat fundus and vanilloid receptors in guinea pig trachea. The calcium blocking effect was studied in rabbit aorta while the modulatory role of ST on platelet serotonin release was evaluated in human platelets. The aqueous extract of Sapindus trifoliatus exhibited significant 5-HT(2B) receptor inhibition and moderate platelet serotonin release inhibition.

5-HT3 receptors in selective animal models of cognition

Role of 5-HT3 receptors in cholinergic hypofunctional models of cognitive impairment in the elevated plus maze model and a passive avoidance model is studied. Cognitive impairment was caused by scopolamine (1 mg/kg, ip) in mice and 5-HT3 ligands mCPBG (1 and 5 mg/kg, ip) and ondansetron (0.5 and 5 mg/kg, ip) were administered before the pre-learning phase to study the effects on acquisition, while post-learning administration was used to determine the effects on consolidation. Ondansetron improved acquisition and retention in cholinergic hypofunctional models while mCPBG potentiated selected impaired cognitive indices. The results indicate the role of 5-HT3 receptors in cognition and that an ideal evaluation of 5-HT3 ligands in cognition should distinguish true cognitive effects from locomotor, motivational and emotional effects.

Synthesis of new arylaminoquinoxalines and their antimalarial activity in mice

2-Arylaminoquinoxalines were prepared by the condensation of 2-chloroquinoxaline with the appropriate Mannich bases in the presence of HCl. To synthesize the Mannich bases, 4-acetamidophenol was reacted with formaldehyde and dialkylamine to yield 3-[(dialkylamino) methyl]-4-hydroxyacetanilide, followed by hydrolysis. Antimalarial activities of the new arylaminoquinoxalines were evaluated against the rodent malaria parasite Plasmodium yoelii at a dose of 75 mg kg(-1). Three compounds synthesized (2-[3-[(diethylamino) methyl]-4-hydroxyanilino]-quinoxaline dihydrochloride (2b), 2-[3-[(pyrrolidinyl) methyl]-4-hydroxyanilino]-quinoxaline dihydrochloride (2f), and 2-[3-[(piperidinyl) methyl]-4-hydroxyanilino]-quinoxaline dihydrochloride (2g)) showed moderate antimalarial activity.

A pilot study of twin dialyzers in parallel to enhance delivered KT/V

BACKGROUND

Adequacy of delivered dialysis is important in preventing morbidity in patients on hemodialysis for end-stage renal disease. A satisfactory KT/V is often difficult to obtain in patients with a large body mass despite optimization of remediable factors.

AIM

This pilot study was performed to examine the hypothesis that twin dialyzers in parallel enhance delivered KT/V.

METHODS

Three compliant patients on maintenance hemodialysis with post-dialysis weights greater than 95 kg who had a KT/V between 1.0 and 1.3 despite optimization of duration of dialysis, blood flow rates and anticoagulation and absence of access recirculation were studied using twin dialyzers in parallel after in vitro experiments demonstrated the safety of this technique. After a run-in period lasting over six months, during which the technique was perfected, three study treatments with twin dialyzers were compared to three treatments before and three treatments after study treatments. Both study and control treatments were performed under identical, rigidly standardized conditions. There was a wash-out period before the control and the study treatments. KT/V was calculated using the post-dialysis blood urea nitrogen (BUN) obtained by the stop-flow technique.

RESULTS

KT/V was higher with twin dialyzers in parallel than with single dialyzers (mean +/- SD 1.54 +/- 0.32 for twin dialyzers vs 1.33 +/- 0.11 for single dialyzers) despite the lack of significant differences in potentially confounding variables.

CONCLUSIONS

Using twin dialyzers in parallel appears to enhance delivered KT/V and is a safe and potentially useful technique especially in patients with a large body mass.

Synthesis and preliminary pharmacological investigations of 1-(1,2-dihydro-2-acenaphthylenyl)piperazine derivatives as potential atypical antipsychotic agents in mice

In research towards the development of new atypical antipsychotic agents, one strategy is that the dopaminergic system can be modulated through manipulation of the serotonergic system. The synthesis and preliminary pharmacological evaluation of a series of potential atypical antipsychotic agents based on the structure of 1-(1,2-dihydro-2-acenaphthylenyl)piperazine (7) is described. Compound 7e, 5-{2-[4-(1,2-dihydro-2-acenaphthylenyl)piperazinyl]ethyl}-2,3-dihy dro-1H- indol-2-one, from this series showed significant affinities at the 5-HT1A and 5-HT2A receptors and moderate affinity at the D2 receptor. 7e exhibits a high reversal of catalepsy induced by haloperidol indicating its atypical antipsychotic nature.

Nursery outbreak of neonatal fungal arthritis treated with fluconazole

Eight preterm infants with mean gestational age of 31.6 +/- 1.16 weeks and a mean birth weight of 1310 +/- 201.7 g presented at a mean postnatal age of 26 +/- 11.4 days with knee joint swellings and pedal oedema. There was no other clinical, haematological or microbiological evidence of bacterial sepsis. Fungal cultures yielded growth of Candida spp. from blood in five, from urine in four, from cerebrospinal fluid in one, and from all the three babies in whom the joints were aspirated. Radiographic changes of metaphysitis of the involved joints were noted in all. All infants had received prior antibiotic therapy. No infant had received total parenteral nutrition or had central lines inserted. All infants were treated with fluconazole in doses of 7.5 mg/kg/day for 6 weeks. Six of eight were thriving well at 3 months of age without any evidence of residual joint disease. One infant succumbed to disseminated disease and one was lost to follow-up. Candidial arthritis is an uncommon presentation of neonatal candidiasis. Fluconazole therapy proved effective.

Clinical correlations of cyclosporine-specific and -nonspecific assays in stable renal transplants, acute rejection, and cyclosporine nephrotoxicity

Accurate and early diagnosis of the cause of renal transplant dysfunction is important in successful patient management. Controversy exists as to whether a cyclosporine-specific or -nonspecific method is more predictive of clinical events. In an attempt to answer this question, all episodes of acute renal dysfunction were reviewed in 322 stable renal transplant recipients over a 20-month period. To diagnose the cause of each episode of renal dysfunction, an analysis was made of patient demographics; weight; serum creatinine; cyclosporine dose; cyclosporine level, using a specific method--high-performance liquid chromatography (HPLC)--and a nonspecific method--fluorescent polarization immunoassay (FPIA); changes in cyclosporine dose; renal biopsy; and response to any therapeutic intervention. There were 138 patients, who developed 279 episodes of renal dysfunction. Causes of renal dysfunction were cyclosporine-related (n = 103), acute rejection (n = 63), extracellular fluid volume depletion (n = 27), other (n = 59), and unknown (n = 27). The mean HPLC cyclosporine level was significantly different in patients with acute cyclosporine toxicity (p < 0.001) and patients with acute rejection (p < 0.001) when compared to those with stable renal function; the mean FPIA cyclosporine levels were not significantly different between the three groups. However, a larger percentage of patients with rejection were subtherapeutic when measured by HPLC, while a higher proportion of patients with nephrotoxicity were above the therapeutic range measured by FPIA.(ABSTRACT TRUNCATED AT 250 WORDS)