Incidence of acute kidney injury in patients with acute myocardial infarction

AIM OF THE STUDY: This study was undertaken in a tertiary care hospital to assess the incidence of Acute Kidney Injury (AKI) in patients admitted with Acute Myocardial Infarction (AMI), to study the co-morbidities associated with acute kidney injury & to study the 5-day in-hospital mortality of MI patients. SUBJECTS AND METHODS: This cohort study included 150 patients who were admitted with acute myocardial infarction in intensive care unit. History of diabetes, hypertension and coronary artery disease was obtained from medical records. History of chest pain, electrocardiographs and cardiac biomarkers were used to diagnose acute myocardial infarction. Serum Creatinine was used as a marker of acute kidney injury, which was measured at the time of admission and after 48 hours. These patients were followed up during their hospital stay and 5-day in-hospital mortality was also studied. RESULTS: Out of 150 patients admitted with MI, 43 patients (28.6%) developed AKI. the mean±S.D. of serum creatinine value at the time of admission of AKI patients was 0.9±0.3 mg/dL, which was same as that of non-AKI patients. And the mean±S.D. of serum creatinine value after 48 hours in AKI patients was 1.6±0.5 mg/dL, which was higher than that of non-AKI group, which was 0.9±0.2 mg/dL. Patients with AKI had higher mortality rate (30.2%) than the non AKI patients (9.3%). History of diabetes, hypertension and diabetes, personal habits such as smoking and alcohol consumption was not found to be significantly associated with development of AKI. CONCLUSION: Acute Kidney injury is an important and common complication occurring in acute MI patients. Development of AKI was associated with poor outcome in terms of 5-day in-hospital mortality, highlighting the importance of monitoring renal parameters during the management of patients with acute myocardial infarction

An Insight to Micropropagation of Freshwater Aquatic Medicinal Plants

Freshwater aquatic plants include medicinal and ornamental species: have limited demand and rarely micropropagated. Most of them are found in Southeast Asian environments as amphibians or fully submerged or floating in lakes, streams, and watercourses that are ignored as weeds. These plants have never been central focuses and were not looked for characteristic proliferation. It is difficult to multiply these plants using traditional techniques through seeds or natural proliferation of rhizomes or cuttings by maintaining quality. Rare and fragmented but important information about micropropagation of these neglected plants has been discussed in this chapter. There are certain aquatic or semiaquatic medicinal plants for which no effort has been made to propagate in vitro. Contrarily, plants like water hyssop have extensive in vitro regeneration protocols due to its high demand. This study compares methodologies used by researchers to micropropagate these plants. It is concluded that this study will help in understanding and establishing systems for scientific propagation of these plants. © Springer Nature Switzerland AG 2019

Thrombotic Microangiopathy in Renal Transplant Recipients

Background and Aim: Thrombotic microangiopathy (TMA) is a disease of microvasculature, triggered by numerous immunological and nonimmunological factors. The aim of this study is to identify the incidence, etiology, and clinical characteristics of posttransplant TMA in renal allografts and its impact on graft outcome. Patients and Methods: In this retrospective study, the records of patients who underwent renal transplantation between January 2013 and December 2017 were reviewed, and those recipients who had allograft biopsy-proven TMA were analyzed. Based on the clinical characteristics and investigations, the recipients were divided into two groups: those with systemic features of TMA and those with allograft-limited TMA. The clinical course and graft outcome of both the groups were compared and analyzed. Results: The number of patients who underwent renal transplantation during the study period was 212. Out of them, 16 patients had biopsy-proven TMA. Five patients had TMA with systemic features and the remaining 11 patients had allograft-limited TMA. In this study, the incidence of TMA among postrenal transplant recipients was 7.5%. The most common cause for TMA was acute antibody-mediated rejection (ABMR), followed by TMA due to tacrolimus toxicity. In one patient, TMA was secondary to disseminated tuberculosis (TB). TB as a cause of TMA is rarely reported. One-year graft survival in patients with allograft-limited TMA was 72.7% when compared to 50% in patients with systemic TMA, but this difference was statistically insignificant (P = 0.2). The graft loss was high in patients with TMA secondary to ABMR in both the groups. Conclusion: One-year graft survival is better in patients with allograft-limited TMA. Diligent search for an etiology for TMA should be made in all patients with TMA, as the treatment differs between each category