Nevin Manimala

Saudi J Kidney Dis Transpl. 2021 Nov-Dec;32(6):1764-1774. doi: 10.4103/1319-2442.352439.

ABSTRACT

The kidney is the most vulnerable organ in coronavirus disease-2019 (COVID-19) patients besides the lungs, with evidence of acute kidney injury (AKI). We aimed to find the prevalence of AKI among COVID-19 patients and further evaluate the association of between COVID-19 and AKI along with an understanding of mortality. A prospective observational study was conducted among COVID-19 patients admitted to a tertiary care hospital, Hayatabad Medical Complex, between March 2020 and June 2020. Chi-square test was applied for comparative analysis, whereas for predictors of mortality, odds ratios (OR) were calculated using logistic regression. A total of 606 patients with COVID-19 were admitted to the dedicated ward, of which 250 (41.3%) had AKI and 190 (31.4%) died, whereas, patients having AKI presented 62.1% of mortality. Our study revealed a statistically significant association between AKI and mortality (OR = 3.5; P <0.0001). Moreover, we observed a greater risk of deaths among patients with AKI stage I-III i.e., AKI stage I (OR = 2.4; P <0.0001), stage II (OR = 5.5; P = 0.0001), and stage III (OR = 6.6; P<0.0001). Our study reported AKI and associated mortality in a considerable number of patients with COVID-19. AKI patients have significantly higher chances of death versus non-AKI patients. Further, the risk of mortality increases with further deterioration in kidney function, i.e., patients with AKI stage III showed a higher mortality rate compared with stage II and stage I.

PMID:35946291 | DOI:10.4103/1319-2442.352439

Saudi J Kidney Dis Transpl. 2021 Nov-Dec;32(6):1700-1706. doi: 10.4103/1319-2442.352431.

ABSTRACT

Complications of chronic kidney disease (CKD) can range from localized to systemic manifestations that can worsen patients’ outcomes. CKD results in irreversible deterioration in renal function, which ultimately progresses to end-stage renal failure and necessitates the need for renal transplantation. Our study aimed to identify patients’ complications postrenal transplant during hospitalization and assess the main factors affecting these patients’ outcomes and survival rates. This study is a single-centered, retrospective cohort chart review conducted from January 2016 to March 2019. The collected data parameters included patients’ characteristics (e.g., gender, age, body mass index), as well as surgical-related details and postoperative complications. Microsoft Excel and IBM SPSS Statistics version 22.0 were used for data entry and analysis. The descriptive statistics were presented as frequency and percentage for the categorical variables (e.g., gender and smoking status), while the mean ± standard deviation was used for numerical variables. A total of 80 posttransplant patients who fulfilled the inclusion criteria were recruited. Urogenital complications were the most commonly seen during the postoperative period, especially developing urinary tract infections by 16%. During our study, the rate of complications was considered minimal and not significant in assessing posttransplant patients.

PMID:35946283 | DOI:10.4103/1319-2442.352431

Saudi J Kidney Dis Transpl. 2021 Nov-Dec;32(6):1655-1665. doi: 10.4103/1319-2442.352426.

ABSTRACT

The Kidney Disease: Improving Global Outcomes (KDIGO) advocates the use of dipstick proteinuria as a primary screening tool. However, the performance of dipstick urinary for proteinuria has been adjudged to be weak, unreliable with poor predictive value. This study aimed to determine and compare significant proteinuria (SP) using spot urinary protein-to-creatinine ratio (UPr/UCr) as a primary screening tools with dipstick proteinuria among the high-risk African children. This study was a cross-sectional study, involving 33 schools in Ogbomoso land, Southwestern Nigeria. A total of 1316 apparently healthy children were recruited through a multistage sampling technique from both rural and urban communities using a semi-structured questionnaire. Dipstick urinalysis was performed on early morning urine samples. Urinary protein was determined using a turbidimetric method, while Jaffe’s reaction was used to measure urinary creatinine concentration. Statistical analysis was performed using IBM SPSS Statistics version 23.0 for Windows. The prevalence of SP using spot UPr/UCr (≥0.2) and dipstick proteinuria (≥1+) was 18.0% and 0.8%, respectively (P <0.001). Of the 224 subjects with SP using UPr/UCr, the females (140; 20.1%) had higher proportion of SP compared to males (84; 15.4% – P = 0.032). Nephrotic range proteinuria was detected in 9/10 (90%) using UPr/UCr, while urinary dipstick method identified only 3/10 (30%). A biserial correlation coefficient (r = 0.092; P =0.001) and inter-rater agreement (Cohen’s Kappa = 0.01) were poor and McNemar’s test was P<0.0001. In the community, UPr/UCr ratio appeared to perform better than dipstick as a primary screening tool for renal disease and may be adopted in the early detection of SP as a marker of kidney disease against the current KDIGO guideline of dipstick proteinuria.

PMID:35946278 | DOI:10.4103/1319-2442.352426

Saudi J Kidney Dis Transpl. 2021 Nov-Dec;32(6):1593-1599. doi: 10.4103/1319-2442.352420.

ABSTRACT

Resistant Gram-negative bacteria (GNB) constitute a severe threat to public health by becoming increasingly prevalent worldwide; they are challenging to treat and highly adaptive pathogens that develop resistance to antibiotics through several mechanisms with high morbidity and mortality rates. This study aimed to determine the incidence and outcome of children with GNB infections at a tertiary hospital in Jeddah, Saudi Arabia. A retrospective cohort study was done in 2019 on a total of 278 patients aged from one month to 16 years. Data were collected from patient medical records by using a data collection sheet without exclusion criteria. Among patients with GNB, more than half were males with 57.9% (161), while 42.1% (117) were females. However, the most GNB isolated were Staphylococcus in 31.7% (88) of the patient then Klebsiella in 18% (50). Organisms isolated from urine were 46.1% (117), which was the primary site of isolation, where blood was 26.6% (74). About 20.1% (56) were primarily diagnosed with sepsis. The length of stay was around one month or less, with more than half of patients 56.5% (157). The mortality rate was 9.4% (26/278). A patient between one and 5 years of age was the most age affected by multidrug-resistant (MDR) (11/16). No statistically significant differences were observed between the MDR and non-MDR patients with GNB infections concerning age, length of stay, and mortality rate. Conversely, there were statistically significant differences in primary diagnosis, isolated organisms, and site of isolation with MDR and non-MDR. Staphylococcus and Klebsiella were the most abundant GNB, and the mortality rate was 9.4%. However, additional studies in other settings with a larger sample size are needed to compare between different healthcare facilities.

PMID:35946272 | DOI:10.4103/1319-2442.352420

Saudi J Kidney Dis Transpl. 2021 Nov-Dec;32(6):1577-1585. doi: 10.4103/1319-2442.352418.

ABSTRACT

Higher body mass index (BMI) is associated with various comorbidities. In hemodialysis (HD) patients, BMI affects dialysis adequacy and blood pressure (BP) control and is associated with serious comorbidities. This is a cross-sectional observational study that took place at King Abdulaziz Medical City, Riyadh, Saudi Arabia. A total of 262 adult patients on HD for at least six months were recruited to this study. Chart review was used to retrospectively collect patients’ data. Categorical variables were compared using Chi-square test of proportions, whereas analysis of variance was used between categorical and continuous variables. P <0.05 was considered statistically significant. Only 17 (6.5%) patients were underweight, 90 (34.4%) had normal weight, 65 (24.8%) were overweight, and 90 (34.4%) were obese. Diabetes mellitus was the most common cause of chronic kidney disease. A significant relationship was found between BMI and dialysis adequacy (P = 0.004) with 54 (60%) obese patients having inadequate dialysis. The mean postdialysis systolic BP was the lowest in the obese BMI category (129.71 ± 18.38 mmHg, P = 0.037). The obese category scored least on the Charlson Comorbidity Index (CCI) reflecting lower risk of mortality than the other three BMI categories. Despite having the lowest overall rate of hospitalization in the previous 12 months, obese patients had higher rates of hospitalization from sepsis compared to the other three groups (P = 0.048). Despite having reduced dialysis adequacy, obese HD patients scored less on CCI, had better postdialysis BP, and had fewer hospital admissions in the previous 12 months compared to the other BMI groups. These findings distinctly contrast with what is seen among obese persons in the general population.

PMID:35946270 | DOI:10.4103/1319-2442.352418

Saudi J Kidney Dis Transpl. 2021 Nov-Dec;32(6):1570-1576. doi: 10.4103/1319-2442.352417.

ABSTRACT

End-stage renal disease (ESRD) introduces physical, psychological, social, emotional, and spiritual challenges into patients’ lives. Spirituality has been found to contribute to improved health outcomes, mainly in the areas of quality of life (QoL) and well-being in especially in terminal, life-threatening, and chronic diseases. The current study was planned to assess the effect of Spiritual therapy in patient undergoing hemodialysis (HD). Post approval from Ethics Committee, the study was commenced at Dialysis Center, Bhaktivedanta Hospital and Research Institute and conducted for 12 weeks. Participants were divided into two groups (one with spiritual intervention and other being control). Spiritual chanting and listening to it was the intervention. The outcome was assessed by kidney diseases QoL (KDQoL), spiritual well-being [Functional assessment of chronic illness therapy (FACIT) Sp 12] score, certain components of ESRD targeted area, 36 item health survey, and laboratory and nutritional parameters. Statistical analysis was done using IBM SPSS Statistics version 20.0 at 5% significance. A total of 100 participants were included in study; males were outnumbered. KDQoL, ESRD targeted areas, components of 36-item health survey, and FACIT Sp 12 scores were significantly different on better side in interventional group at six weeks and 12 weeks. There was no significant difference in laboratory and nutritional parameters. The findings from this study contribute knowledge to increase our understanding of the influence of spirituality on the health outcomes and general well-being of patients with ESRD currently receiving HD treatment. The current study adds to the evidence in support of the use of spiritual therapy in chronic kidney disease patients on HD.

PMID:35946269 | DOI:10.4103/1319-2442.352417

Saudi J Kidney Dis Transpl. 2021 Nov-Dec;32(6):1562-1569. doi: 10.4103/1319-2442.352416.

ABSTRACT

Itching along with other problems can be one of the factors exacerbating the sufferings and disturbing the comfort of patients with chronic renal failure. The present research aimed to study the effects of omega-3 on the treatment of uremic pruritus in hemodialysis (HD) patients. In this crossover randomized clinical trial study, 52 HD patients with pruritus were evaluated. After the random assignment of the participants to Group 1 (treatment mode A) (omega-3 plus cetirizine) and Group 2 (treatment mode B) (cetirizine), they received the treatments for six weeks and then after one week washout period, treatments were changed between the two groups. The pruritus severity was measured using the Yosipovitch pruritus questionnaire before the intervention and at the end of each treatment period. The obtained data were analyzed using descriptive statistics, analysis of variance with repeated measures, and Pearson correlation coefficient. The results of this study showed that pruritus severity reduced in both groups, but it was more significant in Group 1 (omega-3 plus cetirizine). The study findings indicated that omega-3 is effective in the reduction of uremic pruritus. Therefore, this supplement can be used as a convenient method for reducing pruritus in HD patients.

PMID:35946268 | DOI:10.4103/1319-2442.352416

Genome Biol Evol. 2022 Aug 10:evac129. doi: 10.1093/gbe/evac129. Online ahead of print.

ABSTRACT

Over the last decade, molecular systematics has undergone a change of paradigm as high-throughput sequencing (HTS) now makes it possible to reconstruct evolutionary relationships using genome-scale datasets. The advent of ‘big data’ molecular phylogenetics provided a battery of new tools for biologists, but simultaneously brought new methodological challenges. The increase in analytical complexity comes at the price of highly specific training in computational biology and molecular phylogenetics, resulting very often in a polarized accumulation of knowledge (technical on one side, and biological on the other). Interpreting the robustness of genome-scale phylogenetic studies is not straightforward, particularly as new methodological developments have consistently shown that the general belief of ‘more genes, more robustness’ often does not apply, and because there is a range of systematic errors that plague phylogenomic investigations. This is particularly problematic because phylogenomic studies are highly heterogeneous in their methodology, and best practices are often not clearly defined. The main aim of this article is to present what I consider as the ten most important points to take into consideration when planning a well-thought-out phylogenomic study and while evaluating the quality of published papers. The goal is to provide a practical step-by-step guide that can be easily followed by non-experts and phylogenomic novices in order to assess the technical robustness of phylogenomic studies or improve the experimental design of a project.

PMID:35946263 | DOI:10.1093/gbe/evac129

Indian J Dent Res. 2022 Jan-Mar;33(1):94-99. doi: 10.4103/ijdr.ijdr_45_22.

ABSTRACT

BACKGROUND: Many studies explained the importance of remineralisation of early carious lesions with various remineralising agents. In the present study, we incorporated the remineralising agents in a dentifrice, applied that in artificial enamel caries and evaluated their remineralising potential and compared the efficacy among the three.

AIM: To evaluate and compare the remineralisation potential of a dentifrice containing bioactive glass, casein phosphopeptide-amorphous calcium phosphate and novel laboratory synthesised strontiumdoped nanohydroxyapatite paste in artificial enamel caries.

METHODS AND MATERIALS: 120 enamel specimens were divided into 4 groups of 30 specimens each, based on the type of dentifrice applied: GI – conventional toothpaste (control group), GII – calcium sodium phosphosilicate (Novamin), GIII – casein phosphopeptide-amorphous calcium phosphate (GC tooth mousse) and GIV- Novel strontiumdoped nanohydroxyapatite paste (SrnHAp paste). Specimens in all the groups were subjected to demineralisation, and calcium/phosphorous ratio was analysed followed by remineralisation and the mean calcium-phosphorus ratio was assessed using a scanning electron microscope and energy dispersing X-ray analysis.

STATISTICAL ANALYSIS: Data were analysed using IBM SPSS Statistics for Windows Software, version 22 (IBM Corp., Armonk, NY, USA). Descriptive statistics were used to calculate the mean and standard deviation. Kruskal-Wallis, ANOVA and Mann-Whitney tests were used. The level of significance was set at 5%.

RESULTS AND CONCLUSION: All except the control group showed a net increase in calcium and phosphorous values after application of the respective remineralising agents in respective groups. Inter-group comparison revealed that Group IV – SrnHAp paste yields higher net calcium and phosphorous values than other groups. Hence, novel SrnHAp can be considered as the material of choice in remineralising early enamel carious lesions.

PMID:35946253 | DOI:10.4103/ijdr.ijdr_45_22

Indian J Dent Res. 2022 Jan-Mar;33(1):85-89. doi: 10.4103/ijdr.ijdr_770_21.

ABSTRACT

CONTEXT (BACKGROUND): Resin composites are the most widely used material for restoring cervical defects. However, the high failure rate of these restorations is still a concern.

AIMS: The aim of this in vitro study was to evaluate, using microtomography (μCT), the interfacial gap and voids formation in Class V cavities in premolars restored with materials with lower polymerization shrinkage combined with different restorative techniques.

SETTINGS AND DESIGN: Cervical defects were created in 30 intact premolar and were randomly distributed to be restored by one of the following techniques (n = 6): Composite resin with two increments (CR), organic modified polymer (ORMOCER) with single (OR1) or two increments (OR2, or low viscosity bulk-fill composite resin with single (BF1) or two increments (BF2).

METHODS AND MATERIAL: Each tooth was scanned before filling to determine the volume of interest (VOI) to be applied in the second μCT after restoration and to control the cavity volume among the groups. In the μCT after filling, the volume of interfacial gaps and voids was calculated for each group.

STATISTICAL ANALYSIS: The groups were compared using one-way and Tukey HSD post hoc test (α = 0.05).

RESULTS: It was possible to identify higher gap formation in the OR1 group and higher void formation in CR group (P < 0.05). OR2 group showed better results than the group with one increment. BF2 showed the best filling capacity.

CONCLUSIONS: It was possible to conclude that the material and the number of increments directly influenced the internal adaptation and voids formation of Class V restorations.

PMID:35946251 | DOI:10.4103/ijdr.ijdr_770_21