The clinical presentation of chronic kidney disease of unknown origin (CKDu) is consistent with tubulointerstitial disease. Tests for tubular function, such as fasting urine osmolality, may be impaired in residents of endemic areas before GFR declines. This study describes fasting urine osmolality in individuals residing in areas endemic for CKDu who visited the All India Institute of Medical Sciences (AIIMS), Raipur. This cross-sectional study was conducted at AIIMS, Raipur, Chhattisgarh, India, between June 2021 and May 2022. Adults >18 years, who had resided in endemic areas for at least 10 years, and were relatives of patients with CKDu admitted to the Department of Nephrology, were invited to participate in the study. Fasting urine osmolality was measured after 12 hours of overnight fasting, by the depression of freezing point method. An impaired urine concentration ability was defined as fasting urine osmolality <600 mOsm/kg. The study included 93 admitted relatives of 108 CKDu patients. The median age and eGFR of participants were 35 (IQR: 28, 46) years and 105 (IQR: 95, 116.5) mL/min/1.73m 2 , respectively. The median fasting plasma and urine osmolality were 290 mOsm/Kg (IQR: 286, 294) and 620 mOsm/kg H 2 O (IQR: 484, 850), respectively. Fasting urine osmolality was ≤600 mOsm/kg H 2 O in 46 patients (49.5%), 23 had (24.7%) values between 601 and 800 mOsm/kg H 2 O, and 24 (25.8%) had values >800 mOsm/kg H 2 O; 43 (46.2%) participants had hypokalemia, 15 (16.1%) had hyponatremia, and 14 (15.1%) had hypochloremia. Almost 50% of seemingly healthy participants from the endemic CKDu belt visiting AIIMS Raipur have low mean fasting urine osmolality after 12-hour overnight water deprivation, suggesting a defect in concentrating ability.
To evaluate the wound-healing properties of Lobelia inflata extract through in-vivo assessments using incision and excision wound models in Wistar rats. To determine the effectiveness of Lobelia inflata ointment at different concentrations (5% and 10%) in promoting wound contraction, tensile strength, and tissue remodeling, and to compare its efficacy with a standard wound-healing agent (1% Betadine). Wound healing is a critical biological process involving a series of intricate steps, including hemostasis, inflammation, proliferation, and remodeling, to restore tissue integrity. Interest in natural wound-healing agents has surged due to their potential therapeutic benefits and fewer side effects. This study investigates the efficacy of Lobelia inflata, a plant known for its medicinal properties, in enhancing wound healing. Thirty adult male Wistar rats with age group more than 9 weeks were randomly divided into five groups (n=6 per group): Group I served as the normal control (untreated), Group II received a simple ointment base (vehicle control), Group III was treated with 1% Betadine ointment (standard group), Group IV was treated with 5% Lobelia inflata ointment, and Group V with 10% Lobelia inflata ointment. Two wound models were employed: in the incision model, a linear full-thickness dorsal skin incision was created, and wound contraction and tensile strength were assessed over time. In the excision model, full-thickness circular wounds were developed on the back, with wound closure rate and epithelialization evaluated. Additionally, histological analysis of healed tissues was conducted to assess collagen deposition, angiogenesis, and re-epithelialization. Treatment with Lobelia inflata ointment (5% and 10%) significantly improved wound healing, with the 10% ointment (Group V) showing the fastest wound closure and healing. Increased tensile strength was observed in the treated groups, with Group V outperforming Group IV. Histopathological analysis revealed enhanced collagen deposition, angiogenesis, and re-epithelialization, particularly in the 10% Lobelia inflata group, highlighting its superior wound-healing efficacy. Lobelia inflata extract, particularly at a 10% concentration, demonstrates significant potential as a wound-healing agent. It promotes faster wound contraction, improved tensile strength, and enhanced tissue remodeling, making it a promising natural alternative for wound care.
Abstract Subacute progressive ataxia can have varied differential diagnosis, including structural, metabolic, infective, inflammatory, toxic, and degenerative causes. Creutzfeldt–Jakob disease is a rare degenerative disease, and its presentation with predominant ataxia is even rarer. Herein, we report such a case and review its literature.
This report presents an exceptional discovery of a butterfly depiction in rock paintings from the Chhattisgarh state of India, marking the first-ever evidence of butterflies in ancient rock art. The finding provides valuable insights into the cultural significance and artistic representation of butterflies in the region's prehistoric societies. The study also revealed significant butterfly diversity in the study area dominating by Nymphalidae with 19 species, closely followed by Lycaenidae with 17 species, followed by Papilionidae five species, Pieridae four species and Hesperiidae with one species.
Background: Combination of endophthalmitis and retinopathy of prematurity (ROP) in preterm infants is less commonly reported but is a logistically and surgically difficult clinical condition to manage. [1-5] Purpose: To describe the management of neonatal endogenous endophthalmitis (NEE) and post anti-vascular endothelial growth factor (VEGF) injection endophthalmitis (PIE) in two preterm infants with ROP. Synopsis: The first infant was suspected to have right-eye NEE at first ROP screening and treated with empirical intravitreal vancomycin (0.5mg) and ceftazidime (1.25 mg) and dexamethasone. Subsequent fundus examination revealed retinochoroidal exudates and a string-of-pearls appearance in the vitreous. Further treatment was continued with topical fluconazole and intravitreal vancomycin, ceftazidime, and amphotericin B. Intravitreal injections were repeated weekly until the infant was fit to undergo a vitrectomy under general anesthesia (GA). After lens-sparing vitrectomy, the endophthalmitis resolved, and the ROP in the right eye (Zone 2 stage 1 without plus disease) resolved spontaneously, while ROP in the left eye progressed to prethreshold (zone 2 stage 3+) and was treated with laser. The second infant had received intravitreal ranibizumab for prethreshold ROP (zone 2 stage 3+) in both eyes elsewhere and was referred for treatment of right-eye PIE. The infant underwent PPV with anterior capsular sparing lensectomy. The capsular remnant fibrosed and needed a membranectomy. Following membranectomy and removal of contracted posterior hyaloid, the retina remained attached, and endophthalmitis resolved. Highlights: Preterm infants can have NEE and ROP concurrently. [1,2] After treatment with anti-VEGF, PIE can present around a week after treatment with injection. [3-5] Intravitreal antibiotics may not resolve endophthalmitis, but they are still useful to buy time till vitrectomy can be performed under GA. Vitrectomy in preterm infants with endophthalmitis may appear aggressive, but if done carefully, it can help to deliver a satisfactory anatomical result. Video link: https://youtu.be/XGvN5rgZsqM
