Rajesh Varma
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Massive transfusion protocol
No full textHemorrhage from trauma, surgery, obstetric emergencies, and gastrointestinal bleeds remain a cause of potentially preventable deaths for patients. However, transfusions of large amounts of blood products may lead to complications. The development of Massive Transfusion Protocols (MTP), a proactive treatment protocol to manage profound blood loss, has shown improved outcomes for patients requiring immediate and multiple blood transfusions. These guidelines help to recognize hemorrhagic patients in need of an MTP as well as how to best manage this complex protocol. </p
Repercussions of the use of probiotics in the treatment of chronic kidney disease
No full textThe dysbiotic microbiota is one of the clinical findings in patients with Chronic Kidney Disease (CKD), and this intestinal imbalance is associated with inflammation and oxidative stress. With this, probiotic supplementation presents itself as a possible adjuvant therapy to improve this dysbiosis, due to the contribution to the integrity of the intestinal barrier. In this context, this study aims to explain the relationship between the intestinal microbiota and CKD and the repercussions of the use of probiotics on the prognosis of these patients. For this, a narrative review was developed, using the LILACS, MEDLINE, Embase, and PubMed databases, in which articles available in full from the last 5 years, in Portuguese and English, were included. The indication of probiotics as a complementary therapy in renal patients was verified due to the disturbed intestinal microbiome, which aggravates the patient’s inflammatory state. Thus, the supplementation of probiotics, such as Bifidobacterium longum, Lactobacillus rauteri LRE02, Lactobacillus rhamnosus GG, and Lactobacillus casei shirota, acts in the reduction of nephrotoxic substances derived from metabolism in the dysbiotic intestine, in the reduction of urea levels and creatinine levels, in addition to lower levels of C-reactive protein. Thus, the administration of probiotics has been shown to be a precursor in the modulation of toxins derived from the altered microbiota in these patients. On the other hand, there is still controversy about the use of this therapy, because despite improvements in biochemical manifestations, the effective impact on the preservation of glomerular filtration rate is still poorly understood.</p
Role of Diagnostic procedures in managing human Bacterial infections: A comprehensive overview
No full textThe study of human illnesses brought on by microbes falls under the wide category of infectious diseases. Among all other challenges, infectious diseases have a profound influence on human existence. From local epidemics to global pandemics, infectious diseases have had a huge impact on civilization growth, country destiny, and human history. Only in the late 1800s did scientists discover that infections are caused by microorganisms, leading to the development of the microbe-specific medical diagnostic technique. If identified and treated properly, many infections have mild consequences. Others, however, including pneumonia and meningitis, etc. can be fatal if neglected. With its capacity to pinpoint the precise source of infection and combat varied and widespread outbreaks, diagnostic procedures play a special role in the management of infectious diseases. Diagnosis-aid therapies work better and help the infected patient avoid long-term consequences. The most appropriate course of medication can also be decided through diagnostic testing. Patients who go undiagnosed may unintentionally spread the illness to others. A prompt diagnosis can thus contribute to the control or prevention of outbreaks. In summary, the novelty and contributions of the study lie in its recognition of the pivotal role played by diagnostic procedures in understanding, managing, and controlling infectious diseases. It also acknowledges the historical discovery of microorganisms as the root cause of infections and the development of specific diagnostic techniques, both of which have had a profound impact on the field of medicine and public health.</p
Textile industry as a major source of microplastics in the environment
No full textThis review brings together data on the impact of (micro)plastics, on the environment. Critically evaluates studies on the use of various techniques for recycling textile plastic, which is a major polluter of the environment. In this review, let’s focus a bit more on industrial waste in the textile industry since it would be easiest possible to capture and recycle it again. We also discuss LCA studies, bottlenecks, and future perspectives, for a lower impact on the environment. The main challenges which make further recycling progress difficult are discussed, such as the lamination of textile fibers with metal, new textile fibers that appear as a result of rapid development, the difference in the density of textile fibers, low recycling efficiency, etc. Finally, the possible uses of more environmentally friendly polymers are shown, which can be an alternative to the current synthetic polymers. The results of the literature review showed that for the development of a sustainable textile industry, which would mitigate the impact of microplastics on the environment, from a long-term perspective, the integration of more intensive, complex decisions into the business models of manufacturing companies is necessary.The environmental consequences will be even more intense due to the massive releases of textile microfibers into the environment and excessive accumulation, therefore, in order to achieve the specific goals of sustainable development, a reduction in the production of microplastics is first required, which is only possible with a global partnership of all countries to achieve a specific goal on a global level.</p
Polar and extrahilar renal arteries: A case report
No full textIntroduction: The vascular system has a high frequency of variations, which are of interest to both anatomists and clinicians, as well as surgeons. The renal vasculature is quite variable and given the significant number of variations, the latter has proven difficult to classify. The conflicting terminology is often the cause of a poor understanding of the clinical implications of the presence of such variations. We present a case of bilateral accessory arteries, which can be classified as polar and extrahilar.Background: Variants of the renal artery are a common finding with additional vessels in up to 30% of cases. The supernumerary arteries are of end type and often enter the kidney outside the hilum. The arteries that enter the kidney in its upper or lower pole are referred to as polar arteries. Case report: During a routine dissection of a 73-year-old, female, formalin-fixed cadaver at the department of Anatomy, Histology and Embryology at the Medical University of Sofia, we discovered a right inferior polar artery and a left extrahilar renal artery, both originating from the abdominal aorta. The right kidney was located at the level of L1- L2. Conclusion: Accessory renal vessels have been an object of multiple cadaveric and in vivo studies. The terminology and classification of such variations in regard to their origin, course, and site of entrance in the kidney are conflicting and often prove inadequate to convey the clinical and surgical importance of their presence. Knowledge of such variants is of great significance when performing an explorative laparotomy, kidney transplantation, and assessing kidney injury. Such vessels are as well associated with cases of hypertension, hydronephrosis and other conditions.</p
Principles and concepts of occlusion in restorative dentistry
No full textThe importance of occlusion to practicing dentists is immense as it plays a key role in the success or failure of restorative procedures. This article attempts to demystify and present an overview of the complex topic of occlusion and its principles which are important for the success of restorative procedures. The article discusses the principles of occlusion as these apply to restorative dentistry. It provides a guide as to what is required to optimize the occlusion for restorative treatment outcomes, including conformative and reorganized approaches. Occlusion and its effect on the temporomandibular joint are also presented. The topic is clinically relevant as it will help the practitioners to understand the key concepts of occlusion and help improve the outcome of their restorative dental procedures. </p
The possible clinical correlation between preterm neurodevelopment and alterations in gut eubiosis
No full textIn the literature, the topic of neurocognitive development of preterm infants is of current interest. For more than a century, efforts have been made to study and demonstrate what factors may facilitate or interfere with normal neurodevelopment in preterm infants. Recently, attention seems to have focused on the role of gut microbiota. Several studies have shown that the cognitive performance of infants born preterm is lower in general and specific skills; behavior is also reduced in the first year of life; and, by school age, the cognitive development of infants born preterm is lower than that of full-term infants (these deficits are evident in the areas of learning, reading, writing, and mathematical skills, fine motor skills, communication, memory, and attention); however, there is currently no scientific evidence to confirm the existence of premature alterations in the gut microbiota concerning these morbid conditions, although there is evidence for the existence of the gut-brain axis and adverse outcomes on neurobiological function following physical afflictions, such as sepsis, necrotizing enterocolitis and other diseases. Supplementation of prebiotics and probiotics does not appear to correlate with improvement or worsening of future neurobiological and cognitive status, except in the ability to positively influence pathological conditions that indirectly may interfere with healthy neurodevelopmental outcomes of the premature infant.</p
Managing anxiety disorders in bipolar patients
No full textAnxiety disorders are among the main comorbidities encountered in patients with bipolar disease. Numerous clinical and epidemiological studies show an increased prevalence of anxiety pathologies (generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, panic disorder, and post-traumatic stress disorder) in bipolar subjects compared to the frequencies in the general population. Anxiety disorders are not without consequences on the evolutionary course of the mood disorder, including a significant reduction in euthymia time and less sensitivity to conventional medicinal therapies. </p
Tandem Architectures for Artificial Thylakoid Membranes
No full textIn this concept paper, new layered materials, such as multilayer hybrid systems, are described. These materials can be implemented into novel biomimetic devices, which can act as artificial photosystems or as “artificial thylakoid membranes” e.g. for the splitting of water. The architecture can be based on active nanoparticles or small catalytic clusters which can be synthesized from robust, inexpensive, and abundant material precursors. These multi-layered architectures can act as “artificial thylakoid membranes”, which can mimic the photosynthetic apparatus on the nanoscale. The development of “artificial thylakoid membranes” and tandem devices promises a strong impact and benefits for the field of artificial photosynthesis and the development of artificial leaves.</p
Enhancing immunity against carcinogens through probiotics: A literature review
No full textThis literature review explores various aspects of using probiotics as a dietary practice to mitigate the effects of toxic compounds. The discussion highlights the importance of considering factors such as timing and composition of probiotic consumption for maximum benefits. Studies have demonstrated the potential of probiotics to inhibit Deoxyribonucleic Acid (DNA) damage and reduce the occurrence of aberrant crypts in animal models when administered before exposure to toxicants. Furthermore, probiotics have been found to metabolize genotoxic compounds into inactive forms, indicating their potential role in detoxification processes. The binding activity of probiotics against toxicants has been widely studied, but there is a need for further research on the metabolites produced during these interactions. Additionally, the presence of other compounds in the food matrix and their competitive effects on probiotic binding should be investigated to understand the full picture. The strain-dependent nature of the probiotic activity and the variability of their antimutagenic properties for different mutagens further highlight the complexity of their functionality. Considering these findings, it is recommended to conduct a careful risk assessment to evaluate the safety of probiotics and their metabolites, taking into account the potential risks and benefits associated with their use. This will help ensure the responsible application of probiotics in food safety and human health initiatives.</p