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Aim: Adopting a perfect final pose of specific yoga āsanā and obtaining maximum benefits is possible by learning the major to minor details of the āsanā including the preparations, steps and parts of the body involved, benefits, contra-indications, final pose and much more. However, understanding the specific body parts involved and how muscles, bones and joints work together to create movements and shape is through the study of Biomechanics. Anatomically, human body adapts to a specific posture of Yoga āsanā with proper sync of Bones, muscles, and joints. Studies on biomechanics of selected yoga āsanās are found sparsely any in Scientific interfaces. Therefore, with this article, we intended to give an insight on one of the standing poses named as Vrikshāsanā, known as Tree pose. For which, related information was obtained from scientific and non-scientific sources and to postulate the details of practice of Vrikshāsanā, citing the biomechanics. Methodology: Manuscripts related to Vrikshāsanā and its details including Biomechanics were identified from scientific interfaces like PubMed and Google Scholar. Books on Anatomy of Human body and Scriptures describing the steps of adopting the final pose and benefits were referred to extract details specific to the correct position of hip, muscles, and ankle joint for reaching at appropriate posture of Vrikshāsanā. The search was conducted between the month of February and September 2022. Conclusion: This review emphasizes on the importance of practice of Vrikshāsanā on enhancing the wellness of body and brain. But the benefits are obtained only when the practitioner is well aware of the right posture, higher benefits and Biomechanics of the āsanā.

A lot of challenges remain despite the rapid advancement of speaker identification technology for non-electronic disguised or physically disguised voices. This is one of the most difficult components of voice disguised that has yet to be overcome by the experts. With a normal or ideal voice, the identification process is simpler and leads to a more conclusive result. A problem arises when a suspect is identified using speech samples that have been altered to hide their identity. There are both unintended and intentional disguises in this sample content. This way a person speaks can be temporarily altered by stress, anger, concern, anxiousness, or sorrow. It is common for people to disguise themselves when they get unidentified, payment or threat phone calls. The speaker changes their voice purposefully fear of being discovered. This manuscript aims to identify a speaker for multimedia applications using a non-electronically disguised voice. In speech signal processing applications requiring non-electronic disguised voice under physical speech fluctuation, it is challenging to identify the speaker. The primary goal of this study was to regulate whether or not it was conceivable to prompt precise sentiments under disguised speech circumstances. Auditory and spectrographic investigations were used to determine the impact of different disguises on personal identity and speaker recognition performances.

Heterocyclic chemicals are chemical structures which include at least a single carbon molecule plus at least one other element, such as sulphur, oxygen, or nitrogen, within the ring structure. Benzothiazoles are discussed in terms of synthesis methodologies, structural changes, chemical reactivity, and possible pharmaceutical effectiveness. This research relied upon secondary data obtained from the sources. The qualitative method was used to provide a section of such an evaluation which looked flawless and accurate. A handy methodology strategy is used in inquiry research. Heterocyclic compounds have been widely exploited in bioorganic and medical research for medication development. Scientists are interested in such compounds because of their various physicochemical and pharmacological properties. Recognizing heterocycles is advantageous in both industrial and biological processes. Benzothiazole, a molecular heterocyclic structure, is being studied as a candidate for such creation of larger, often medicinal chemicals. It is highly durable due to its aromatic components; however, it has reactive services that offer the synthesis method. The benzothiazole ring becomes an important framework for the production of colours used throughout the identification of lanthanide metal cations in aqueous environments. This identical basic N, S heterocycle, benzothiazoles, seems to be abundant; for example, it is required essential thiamine action (vitamin B1). Thiazole compounds could also be discovered in medications such as Nosiheptide. This chemistry group is used for about simply for antibacterial purposes; its distinctive heteroring linked derivatives have attracted the curiosity of scientists due to their various biological or indeed medicinal properties.

Introduction The increasing esthetic demands from patients have required that clinicians sharpen their skills and adopt newer and more novel techniques to satisfy these demands. In periodontal therapy, periodontal plastic surgery poses a substantial challenge to the clinician, both because it is technique sensitive and also because it includes a wide array of procedures and their variations. Conventional plastic procedures have provided satisfactory results in the treatment of gingival recession but there is, presently, a greater need for more advanced procedures that cause less surgical morbidity as also provide improved results. Minimally invasive surgery has been harnessed in periodontics for this purpose and has been extensively used in multiple indications, including root coverage. Modified-Vestibular Incision Supra-periosteal Tunnel Access (M-VISTA) applies the principles of minimally invasive surgery to provide satisfactory results in root coverage. Case presentation A 28-year-old male patient presented with multiple Miller Class I/II buccal recession defects and associated high labial frenum on right maxillary anterior teeth. M-VISTA technique allowed coronal repositioning of gingival margin, which was then stabilized by orthodontics bracket assisted suturing technique. The V-shaped incision in the region of the frenal attachment allowed for conducting both the M-VISTA and frenectomy techniques simultaneously. Connective tissue graft was inserted in the supra-periosteal tunnel and vertical incision was sutured. Complete root coverage was achieved and maintained at 9 months with excellent esthetic outcomes. Conclusions The use of connective tissue graft along with M-VISTA technique allows the clinician to successfully treat multiple recession defects.

Objective: To assess the awareness of periodontal disease, its treatment modalities and its possible association with systemic diseases/conditions, in medical students. Materials and Methods: A customized questionnaire was designed for circulating among medical students (Interns & post-graduates) of colleges in Andhra Pradesh and the data collected was analyzed. Results: 493 medical students responded to the survey. Of these, a significant number understood that there could be a probable link between periodontal disease and systemic illness/conditions, role of smoking in periodontal disease as well as the treatment modalities of this disease. Conclusion: The medical students surveyed demonstrated a moderate knowledge of periodontal disease, and its role in the etiology and progression of systemic diseases. Key Messages: To Evaluate the awareness of significance of periodontal health and disease in medical students. Results demonstrate a moderate knowledge of periodontal disease in medical students. Keywords: Survey, Periodontal medicine, Questionnaire.

\textit{Background} The proposed watermarking framework is based on the multi-resolution Walsh-Hadamard Transform (MR-WHT) along with Schur factorization. For embedding, the cover image is converted into a frequency domain using MR-WHT before Schur factorization is applied. \textit{Methods} The upper triangle's highest stable eigenvalues in the Schur factorization are employed as reliable embedding locations for the watermark. The singular values of these coefficients are updated with the singular values of the watermark, and the matrix array generated by the biggest eigenvalues is further factorised by singular value decomposition using multiple scaling factors and Differential evolution (DE). Later, an inverse SVD, inverse Schur, and inverse multiresolution Walsh-Hadamard transform is executed to obtain a watermarked image. \textit{Results} The simulation results show that the proposed method is imperceptible and robust against existing watermarking algorithms used in the literature.

A series of novel diketoquinoline acid derivatives as potential anti-HIV-1 Integrase inhibitors were docked, synthesized and characterized by IR, NMR , CHN and MS spectral analysis. Many compounds were identified and docked in integrase pocket. The target diketoquinolines were prepared from substituted oxoquinoline-3-carboxylate. In vitro biological evaluation revealed that some of the titled compounds exhibited moderate to good anti-HIV-1 Integrase inhibitory activity in comparison with the reference drugs i.e. raltegravir and nevirapine. The cytotoxicity of most of testing compounds on C8166 were very low, the CC50 value of them were higher than 200 μM, except the few compounds. Compounds 1-5 showed weak anti-HIV-1 activity, its therapeutic index was 457, 531, 583, 869 and 909 respectively. As a positive control drug, Nevirapine has the best anti-HIV-1 activity (EC50 = 0.015-0.016 μM) in vitro and the CC50 of was higher than 200 μM, its therapeutic index was higher 12418.50. In integrase assay compound 6 and 7 showed EC50 value 0.08 μM as compared with standard drug raltegravir.

MRI segmentation is a crucial task in many clinical applications. A variety of approaches for brain analysis rely on accurate segmentation of anatomical regions. Quantitative analysis of brain MRI has been used extensively for the characterization of brain disorders such as Alzheimer’s, epilepsy, schizophrenia, multiple sclerosis, cancer, and many infectious, degenerative diseases. Manual Segmentation requires outlining structures slice-by-slice, it is not only expensive and tedious but also inaccurate due to human error. Also, manual segmentation is extremely time-consuming and initial hours of brain tumor and strokes are crucial to diagnose it. Therefore, automated segmentation procedures are needed to ensure accuracy close to that of experts with high consistency. We propose to create a Deep Learning based Brain Segmentation solution that would fully automate the process of Brain Tumor Segmentation to solve those cases which are generally missed by the human eye and save time.

Cognitive radio (CR) is an emergent approach used to address the upcoming spectrum crunch by increasing the spectrum efficiency by resourceful use of the existing licensed band. Also, data traffic in air has increased beyond limits. So, this ultimately increases the demand for accommodation of high data rate by the user. Transmitting multimedia demands high data rate and spectral efficiency. OFDM is a multi-carrier modulation technique which proves effective in CR. The results generated in this paper are taken from the experimentation performed on SDR-Lab using OFDM technique with the flow graphs designed in GNU Radio for real-time transmission of video. The focus of this paper is on the transmission of real-time video signal captured by webcam using OFDM modulation and simulation results generated with GNU radio along with software-defined radio (SDR). The main goal here is to provide effective solution to difficulties arising from transmission of video in CR environment and finding the best-suited modulation technique.

This paper considers implementation of audio compression using the lossless compression techniques like dynamic Huffman coding and Run Length Encoding (RLE). Audio file is firstly preprocessed to find sampling frequency and the encoded data bits in sample audio file. After that dynamic Huffman and RLE is applied. The design of dynamic Huffman coding technique involves evaluation of the probabilities of occurrence “on the fly”, as the ensemble is being transmitted and RLE is based on finding the runs of the data i.e. repeating strings and replacing it by single data element and its count. These techniques work with a common goal to obtain the utmost possible compression ratio and less Time Elapsed to compress. The competence of the proposed methods is verified by applying these techniques to variety of audio data. Stimulus behind this work is to offer a detail analysis of lossless compression methods and finding the one which is best suited for compression of multimedia data in cognitive radio environment.

The human immunodeficiency virus (HIV) has now been established as the causative agent of the acquired immunodeficiency syndrome (AIDS). The Food and Drug Administration (FDA) approved anti-HIV drugs and divided into seven groups. However, the use of these drugs has been relatively limited by their toxicity, drug resistance development. New anti-HIV drugs with acceptable toxicity, less resistance profiles and with novel mechanisms of action are clearly needed. Here HIV replication cycle, Possible HIV Targets and Interventions, Global situation and trends, approved antiretroviral drugs are discussed. This marked the beginning of the era of highly active antiretroviral therapy (HAART). However future anti-HIV drug research efforts focused on new HIV targets such as HIV proteins and RNase H. Various modifications done on quinoline scafold, to search for lead molecule is also described.

Vesicoureteral reflux (VUR) has a prevalence of 30-40 % post-febrile urinary tract infection (UTI). If not detected early and treated, renal scarring, hypertension, and renal failure may occur. Micturating cystourethrography (MCU) is an invasive procedure associated with radiation exposure. Hence, this study aimed at evaluating the utility of ureteric jet Doppler waveform (UJDW) as a screening tool in detecting VUR, and at assessing the feasibility of performing it in children aged 2-4 years.Any child 2-18 years old who needed an MCU was included. Exclusion criteria were active UTI, indwelling catheter, and inability to drink the required amount of fluid. The UJDW was performed prior to the MCU.One hundred eighty-two ureteric units were analyzed. Sensitivity and specificity of UJDW in detecting VUR was 80.3 and 87.9 %. Twenty-three children (45 ureteric units), aged 2-4 years were compared with 73 children (137 ureteric units), aged 5-18 years. Sensitivity and specificity of UJDW in detecting VUR in 2-4 years was 77.3 and 91.3 %, respectively; while in children ≥5 years, it was 81.8 and 87.1 %, respectively.UJDW has a uniformly high specificity regardless of age or etiological groups, making it a good tool for follow-up. UJDW is a feasible technique, even in children aged 2-4 years.

Information on current practices in India for management of renal replacement therapy (RRT) in acute kidney injury (AKI) is lacking. We mailed a questionnaire to 26 pediatric nephrology centers across India to obtain information on the current choice of dialysis modality for management of AKI in children. Acute intermittent peritoneal dialysis was available at all centers surveyed, whereas intermittent hemodialysis and continuous RRT were available in 86% and 17% centers, respectively. Peritoneal dialysis was the predominant modality (accounting for more than 80% of all dialysis) in 14 of the 22 centers, while 4 centers used hemodialysis more commonly. The most important factors influencing the modality choice were patient size, hemodynamic stability, and duration of AKI. These results provide insight into the choice of modality and factors influencing their selection in the management of pediatric AKI in our country.

Acute renal failure (ARF) is an uncommon but alarming complication of idiopathic nephrotic syndrome. The renal failure could be secondary to causes evident from the history and evaluation, such as severe intravascular volume depletion, acute tubular necrosis, allergic interstitial nephritis, bilateral renal vein thrombosis, acute pyelonephritis, or rapid progression of the original glomerular disease. It may be termed idiopathic if the underlying cause is undetermined. We present three children with idiopathic nephrotic syndrome who were admitted with acute renal failure. One case was due to drug-induced allergic interstitial nephritis. The other two were idiopathic in nature. Improvement in renal function occurred in the three patients over a variable period of 10 days to 4 weeks. After careful exclusion of well-known causes of acute renal failure, idiopathic acute renal failure (IARF) should be considered as a diagnostic possibility in these patients. The exact pathophysiology of IARF is not understood. Possible proposed explanations include interstitial edema, tubular obstruction, altered glomerular permeability, and unrecognized hypovolemia.

Nephrotic syndrome in children is a common recurrent disease. Most of the cases are due to minimal change disease with a favourable outcome. More than 90% of children with minimal change disease respond to corticosteroid therapy (steroid sensitive nephrotic syndrome). 40-60% experience frequent relapses or have steroid dependence. These children require frequent corticosteroid therapy and/or immunomodulators or treatment with immunosuppressants, and are at high risk of cumulative steroid toxicity and side effects of cytotoxic therapy. Children with frequent relapses or steroid dependence should be managed in consultation with a pediatric nephrologist. Despite relapsing course, progression of minimal change nephrotic syndrome to end stage renal disease is extremely rare.

apid advances in the field of pediatric nephrol- ogy—particularly over the last four decades in the areas of dialysis and transplantation—have revo- lutionized the care of children with renal failure. Chil- dren with renal failure in the developed world have a good chance for survival and a reasonably good qual- ity of life. Unfortunately, the benefits of technological progress have yet to reach the developing world. The present paper narrates the experience of deal- ing with children with renal failure at the Children's Kidney Care Center, St. John's Medical College Hos- pital, Bangalore, India. Strategies to possibly improve the outcomes of children with renal failure in devel- oping countries are discussed. PATIENTS We reviewed and analyzed the case records of chil- dren requiring dialysis therapy over the past 20 months at the Children's Kidney Care Center, St. John's Medical College Hospital, Bangalore, In- dia. A total of 50 children received acute dialysis therapy during the period. Of those 50 children, 36 children received peritoneal dialysis (PD), 7 re- ceived hemodialysis (HD), and 7 received both PD and HD. The male:female ratio was 4:1. The mean age of the children who received PD was 6.7 years (range: 1 month to 15 years), and of those who received HD, 9.2 years (range: 4 - 17 years). Two children were dialyzed for severe metabolic acidosis owing to an inborn error of metabolism. The rest had renal failure: acute renal failure (ARF) in 47.9%; end-stage renal failure (ESRF) in 35.4%; and acute on chronic renal failure in 16.7%. In the cases of acute on chronic renal failure, the main causes for acute worsening of renal function were volume deple- tion and drug nephrotoxicity. The causes of ARF and chronic renal failure (CRF) are depicted in Tables 1 and 2. The main reasons for dialyzing the children were fluid overload (20%), hyperkalemia (14%), severe metabolic acidosis (8%), encephalopathy (18%), and biochemical azotemia (40%). The mean pre-dialysis levels of blood urea and serum creatinine were 204.9 mg/dL and 6.76 mg/dL respectively. Acute PD was performed using acute PD catheters and available standard PD solutions containing 1.5% dextrose. The volume of dialysate infused per cycle

Membrane filtration is a cost-effective alternative to heat pasteurization of corn steep water. Trials were done in an operating ethanol plant with commercial spiral-wound modules. Flux increased with transmembrane pressure and became independent of pressure at >10 psi (69 kPa) with flux being higher at higher cross-flow velocities. Average flux at 4× concentration factor over 24-hr operating cycles was 34 L/m2/hr under optimum conditions. Capital cost of the membrane system is expected to be lower because it eliminates the heat pasteurizer and centrifuge and reduces cooling requirements. Operating cost of the microfilter are about one-third of a heat pasteurization system and provides the opportunity to recover insoluble protein and starch for use in corn gluten feed. Microfiltered steep water could improve ethanol fermentation efficiency and reduce fouling of heat exchangers in the fermenters, beer still, and steep evaporators.

Congenital Nephrotic Syndrome (CNS) with adrenal calcification and CNS with congenital heart disease (CHD) have rarely been reported. However, CNS with both these rare associations has never been previously reported. Here we report a case of CNS with both rare associations, perhaps the first report from India to the best of our knowledge.

To estimate the burden of ocular complications like posterior subcapsular cataract (PSCC) and raised intra ocular pressure (IOP) in children with nephrotic syndrome on long term steroid therapy and to assess the correlation of cumulative dosage and duration of consumption of steroids with these ocular complications. Children between 4-18 y with nephrotic syndrome, who received steroids for at least six months, were included in this cross sectional study. Demographic, clinical and treatment details were obtained from case records. Detailed ocular evaluation was performed to detect PSCC and to measure IOP. One hundred and eighteen children were screened and 82 with a median (IQR=Interquartile range) follow up of 4.2 y (2.4, 6.3 y) were included in the final analysis. The median (IQR) age of children was 9.3 y (6, 12.5 y) at recruitment. The proportion of children with PSCC and raised IOP were 22/82 (26.8 %) and 9/82 (10.97 %) respectively. PSCC was associated with older age (p = 0.009). The median cumulative dose of steroids in those with and without cataract was 338.4 mg/kg and 343.2 mg/kg respectively (p = 0.58). The median duration of steroid theraphy was 58 wk and 59 wk in the two groups respectively (p = 0.73). Of children with PSCC, 9 (42.8 %) had mild diminution of vision. One in 4 and 1 in 9 children with nephrotic syndrome in the present study had PSCC and raised IOP respectively. Cumulative dose and duration of steroid therapy were not significantly associated with PSCC or raised IOP. The present study emphasizes the need for regular ocular evaluation and also to explore additional factors in causation of steroid induced ocular complications.

This chapter provides an approach to “a child with renal disease” and the “evaluation” that will help in management of the child. Manifestations of renal disease may be vague, nonspecific, and subtle in a child. General guidelines regarding history and physical examination are given. The kidney involvement may be part of a systemic disease, and knowledge of the association between the kidney disease and the involvement of other organs and systems is helpful. Some of these associations are described. Laboratory evaluation is a major component in assessment of renal diseases, as clinical examination is often not enough to make a diagnosis. A few aspects of urine analysis and some glomerular as well as tubular function tests are described. Expert interpretation of renal histology is important in the diagnosis of various renal parenchymal diseases involving glomeruli, the tubulointerstitial region, and small blood vessels. Some histopathological aspects of different renal diseases are given. Also, the role of imaging in making a diagnosis has been emphasized. Technological advances, especially in the area of molecular genetics, have improved our understanding of renal diseases. A brief insight is given in to “renal genetics.”

Disorders of fluids, electrolytes, and acid–base regulation are commonly encountered when dealing with children with renal diseases. The underlying cause is often obvious, and mild disorders can be easily corrected. Complex disorders involving tubular defects are sometimes seen and require careful diagnostic evaluation. This chapter is intended to give a stepwise approach to evaluate disorders of fluids; electrolytes such as sodium, potassium, calcium, phosphate, and magnesium; and interpretation of an arterial blood gas and an approach to metabolic acidosis and alkalosis. This chapter contains a lot of tables, boxes, and algorithms to facilitate easy understanding of this complex subject.

Citric acid yields of Yarrowia lipolytica (NRRL Y-1095) grown on glucose ranged from 0.38–0.77 g/g and were dependent on both biomass and nitrogen concentration (as NH4Cl and yeast extract). Increasing the biomass concentration by 3% (w/v) increased fermentor productivities from 0.6 to 1.22 g citric acid/L h.

cute kidney injury (AKI), formerly known asacute renal failure (ARF) is an importantcontributor to mortality and morbidityespecially in critically ill children.Understanding the burden of AKI and its implication hasbeen hampered by the lack of a precise definition of AKI.More than 30 definitions in literature have led toreporting of wide variation in incidence and outcomes[1]. A minor acute reduction in kidney function (whichmay be clinically not apparent and may be just a subtlerise in serum creatinine) has been consistently shown tohave an adverse prognosis. Hence the term acute kidneyinjury (AKI) was proposed to encompass the entirespectrum not limited to those who need renal replacementtherapy (RRT). Two similar definitions based oncreatinine and urine output for diagnosis andclassification of AKI; the pediatric Risk, Injury, Failure,Loss, End-Stage Renal Disease criteria (pRIFLE) and theAcute Kidney Injury Network (AKIN) staging systemhave been proposed [2,3].The spectrum and burden of AKI in developingcountries may be different from that of developedcountries. The patients from developing countries areyounger, infection associated AKI is more common and asignificant proportion may have already developed AKIat the time of hospitalization. In addition resourcelimitations in managing children who require RRT add tothe burden.Mehta and her colleagues must be congratulated fortaking the first step toward understanding the naturalhistory of AKI in hospitalized children in our countryusing the AKIN criteria [4]. They observed that one thirdof critically ill children developed AKI in hospital and theincidence was four fold higher compared to the non-critically ill. The authors have validated findings fromworld wide literature that AKI is common. They haveshown that AKI occurs very early in hospitalization

The rates of oxygen uptake and oxygen transfer during cell growth and citric acid production by Candida lipolytica Y 1095 were determined. The maximum cell growth rate, 1.43 g cell/L · h, and volumetric oxygen uptake rate, 343 mg O2/L · h, occurred approximately 21 to 22 h after inoculation. At the time of maximum oxygen uptake, the biomass concentration was 1.3% w/v and the specific oxygen uptake rate was slightly greater than 26 mg O2/g cell · h. The specific oxygen uptake rate decreased to approximately 3 mg O2/g cell · h by the end of the growth phase. During citric acid production, as the concentration of dissolved oxygen was increased from 20% to 80% saturation, the specific oxygen uptake and specific citric acid productivity (mg citric acid/g cell · h) increased by 160% and 71%, respectively, at a biomass concentration of 3% w/v. At a biomass concentration of 5% w/v, the specific oxygen uptake and specific citric acid productivity increased by 230% and 82%, respectively, over the same range of dissolved oxygen concentrations. The effect of dissolved oxygen on citric acid yields and productivities was also determined. Citric acid yields appeared to be independent of dissolved oxygen concentration during the initial production phase; however, volumetric productivity (g citric acid/L · h) increased sharply with an increase in dissolved oxygen. During the second or subsequent production phase, citric acid yields increased by approximately 50%, but productivities decreased by roughly the same percentage due to a loss of cell viability under prolonged nitrogen-deficient conditions. © 1994 John Wiley & Sons, Inc.

As the waiting list of patients requiring organ transplantation grows, there is a subtle but noticeable shift in society towards accepting organs as a commodity which can be paid for. Although nowhere is the organ trade legal, the commerce of organs goes on in different parts of the world, especially in developing countries such as India. This is largely due to societal and governmental failure to implement the existing "transplant laws". It is high time the medical profession ceased being an accomplice to this unscrupulous trade, which exploits the poor, deters altruism retarding the living-related and cadaver transplant programs, commercializes the human body and jeopardizes human dignity.

Background Single nucleotide polymorphisms (SNPs) are the most common forms of sequence variations in the human genome. They contribute to the human phenotypic spectrum and are associated with variations in response to pathogens, drugs and vaccines. Recently, SNPs in three human genes involved in kidney development (RET, PAX2 and ALDH1A2) have been reported to be associated with variation in renal size and function. These known SNPs could potentially be used in the clinic as markers for identifying babies who may have smaller kidneys and permit close follow up for early detection of hypertension and acquired renal dysfunction. The aim of this study was to evaluate the use of High Resolution Melting technique (HRM) as a tool for detecting the known SNPs in these three genes in comparison to sequencing which is the gold standard. Methods High resolution melting analysis was performed on 75 DNA samples that were previously sequenced for the known polymorphisms in RET (rs1800860), PAX2 (rs11190688) and ALDH1A2 (rs7169289) genes. The SNPs were G > A transitions in RET and PAX2 and A > G in ALDH1A2 gene. A blinded assessment was performed on these samples for evaluation of the HRM technique as compared to sequencing. Results Each variant had a unique melt curve profile that was reproducible. The shift in melting temperature (Tm) allowed visual discrimination between the homozygous alleles (major and minor) in all three genes. The shape of the melting curve as compared to the major allele homozygous curve allowed the identification of the heterozygotes in each of the three SNPs. For validation, HRM was performed on 25 samples for each of the three SNPs. The results were compared with the sequencing results and 100% correct identification of the samples was obtained for RET, PAX2, and ALDA1H2 gene. Conclusion High Resolution Melting analysis is a simple, rapid and cost effective technique that could be used in a large population to identify babies with the risk alleles. These high risk children could be followed up for early detection of hypertension and acquired renal dysfunction.

The study was done to validate the use of automated devices (Datascope Duo) as a screening tool for measuring blood pressure. A cross sectional study was conducted in school children from urban slums of Bangalore. Blood pressure was recorded according to standard guidelines using a mercury sphygmomanometer and an automated device (Datascope Duo). The readings obtained using the two instruments were compared. One thousand four hundred eighty nine school children, both males and females, aged 5–16 y were included in the study. Readings with the Datascope Duo varied significantly when compared to the gold standard. The blood pressure measurements using Datascope Duo cannot be recommended as an accurate substitute for manual readings.

The effects of temperature and initial pH on growth of Candida guilliermondii Y 488, Candida lipolytica Y 1095, Yarrowia lipolytica Y 7576, and Saccharomycopsis lipolytica DRL 99 were evaluated. All four yeasts exhibited maximum biomass production at 27°C. Except for S. lipolytica DRL 99, increased agitation nearly doubled the amount of biomass produced at 27°C. The growth of S. lipolytica DRL 99 was also affected by initial medium pH. Based on the results of these experiments, C. lipolytica Y 1095 was selected for citric acid production studies in a 2-1 batch fermentor. At a glucose concentration of 3% w/v, the maximum specific growth rate of C. lipolytica Y 1095 was 0.38 h-1. During the production phase, citric acid yields ranged from 0.50 to 0.79 g citric acid produced per gram glucose consumed and the volumetric productivity ranged from 0.27 to 0.60 g citric acid per liter per hour. Final citric acid concentrations ranged from 13.6 to 78.5 g citric acid per liter and were dependent on the initial glucose concentration in the production medium.

Chitosan is a novel biopolymer with numerous industrial, food, and biomedical applications. Our studies examined the production of chitosan from mycelia of Absidia coerulea, Mucor rouxii, Gongronella butieri, Phvcomyces blakesleeanus and Absidia blakesleeana. In batch culture, strains were screened to determine the fastest growing and greatest chitosan‐yielding fungi. Optimum chitosan yields were observed for most cultures at 21°and 26°C in 1% yeast extract, 0.4% glucose, and 0.3% peptone. A. coerulea ATCC 14076 and NRRL 1315 were the best producers of chitosan of the strains examined. Chitosan yields of A. coerulea, M. rouxii, G. butieri, P. blakesleeanus and A. blakesleeana were 47–50, 29–32, 21–25, 6 and 7 mg/100 mL of medium, respectively. The degree of acetylation of chitosan ranged from 6 to 15%; the lowest was from strains of A. coerulea. Viscosity average molecular weights of fungal chitosans were equivalent, approximately 4.5 x 10s daltons. A. coerulea 14076 yielded the most chitosan, 51...

Chitosan extractions of mycelia from Absidia coerulea ATCC 14076 were examined using hot alkaline and acid treatments. Alkaline treatments were carried out at 95°C and 121°C using sodium hydroxide with varying extraction times. Acid treatments were carried out at 95°C using hydrochloric, formic and acetic acids with various extraction times. The highest yields of chitosan were obtained with alkaline extraction at 121°C for 30 min and hydrochloric acid extraction at 95°C for 12 h. The effects on the degree of acetylation and viscosity of the chitosan of various treatments were also examined.

A retrospective analysis was performed on 33 pediatric renal transplants performed over last 8 years. The mean age and weight at the time of transplantation was 12.5 +/- 3.86 years and 28.75 +/- 9.04 kg, respectively. Twenty-six children were boys and 7 were girls. Thirteen children had underlying glomerular disease and 17 had tubulointerstitial disease. All transplants were living related except two, which were from deceased donors. The median duration of hemodialysis and peritoneal dialysis before transplantation were 2.75 and 4 months, respectively. The most common posttransplant complication was urinary tract infection. Immunosuppression medications in the majority included cyclosporine, azathioprine, and corticosteroids. Actuarial graft survivals at 1, 3, and 5 years were 94%, 90%, and 82%, respectively.

In 2001, the Indian Pediatric Nephrology Group formulated guidelines for management of patients with steroid sensitive nephrotic syndrome. In view of emerging scientific evidence, it was felt necessary to review the existing recommendations.Following a preliminary meeting in March 2007, a draft statement was prepared and circulated among pediatric nephrologists in the country to arrive at a consensus on the evaluation and management of these patients.To revise and formulate recommendations for management of steroid sensitive nephrotic syndrome.The need for adequate cortico-steroid therapy at the initial episode is emphasized. Guidelines regarding the initial evaluation, indications for renal biopsy and referral to a pediatric nephrologist are updated. It is proposed that patients with frequently relapsing nephrotic syndrome should, at the first instance, be treated with long-term, alternate-day prednisolone. The indications for use of alternative immunosuppressive agents, including levamisole, cyclophosphamide, mycophenolate mofetil and cyclosporin are outlined. The principles of dietary therapy, management of edema, and prevention and management of complications related to nephrotic syndrome are described. These guidelines, formulated on basis of current best practice, are aimed to familiarize physicians regarding management of children with steroid sensitive nephrotic syndrome.

Nephron endowment ranges widely in normal human populations. Recent autopsy studies have drawn attention to the possibility that subtle congenital nephron deficits may be associated with increased risk of developing hypertension later in life. Since modest maternal vitamin A deficiency reduces nephron number in rats, we designed a pilot study to determine the prevalence of maternal vitamin A deficiency in Montreal (Canada) and Bangalore (India) and the usefulness of newborn renal volume as a surrogate for nephron endowment. Among 48 pregnant Montreal women, two (4%) had one isolated mid-gestation retinol level slightly below the accepted limit of normal (0.9 mumol/L), whereas 25 (55%) of 46 pregnant women in Bangalore had at least one sample below this limit. Average estimated retinoid intake was correlated with mean serum retinol in pregnant women from Bangalore. In Montreal where maternal vitamin A deficiency was negligible, we found that newborn renal volume (estimated by renal ultrasonography at 2-6 weeks of age) was correlated with surface area at birth and was inversely correlated with serum creatinine at 1 month. Interestingly, renal volume adjusted for body surface area in Montreal (184+/-44 ml/m(2)) was significantly greater than in Bangalore (114+/-33 ml/m(2)) (p0.01). Definitive studies are needed to establish whether maternal vitamin A deficiency accounts for subtle renal hypoplasia in Indian newborns. If so, there may be important public health implications for regions of the world where maternal vitamin A deficiency is prevalent.

Investigations on plants are revealing the potential therapeutic benefits of medicinal herbs in treating immunological disorders. Nephrotic syndrome has emerged as an immunological disorder. Steroid dependence poses a therapeutic challenge in the management of nephrotic syndrome. Our pilot study compares the efficacy of an ayurvedic polyherbal preparation ‘Shathavaryadi Yoga (NS001)' with oral cyclophosphamide in maintaining remission in steroid-dependent nephrotic syndrome.

During recent years, there has been an increasing demand for specialized care for children with kidney diseases, even in developing countries with limited resources. It is imperative to provide suitable facilities for appropriate and relevant training in pediatric nephrology to promote growth of pediatric nephrology in these areas. The training should give emphasis on preventive aspects, early diagnosis of common diseases and their optimum management with available resources. It should focus on locally prevalent renal diseases. The training programs should take into consideration the socioeconomic and cultural framework of the local community when designing curricula. To overcome the shortage of pediatric nephrology health professionals in the developing countries, the International Pediatric Nephrology Association has taken initiatives to support development of such training programs.

Snakebite is not an uncommon cause of acute renal failure (ARF) in developing countries. We report a12-year-old boy who presented with oliguric ARF following snakebite. He had pallor, icterus, generalized edema, hypertension, and was oliguric. Investigations revealed severe azotemia, microangiopathic hemolytic anemia, thrombocytopenia, prolonged coagulation parameters, and raised fibrin degradation products, suggesting disseminated intravascular coagulation as the cause of ARF. The patient improved with antisnake venom, dialysis, and other supportive treatment.

Acute interstitial nephritis (AIN) should be ruled out in children with unexplained acute renal failure. We present a 4 1/2 year old girl who presented with oliguric acute renal failure preceded by a febrile illness. Renal histopathology revealed features of drug induced AIN. She recovered with dialysis, other supportive treatment and a course of steroids.

Pilot plant trials were conducted in a corn wet mill with a 7000-L membrane recycle bioreactor (MRB) that integrated ceramic microf iltration membranes in a semi-closed loop configuration with a stirred-tank reactor. Residence times of 7.5–10 h with ethanol outputs of 10–11.5% (v/v) were obtained when the cell concentration was 60–100 g/L dry wt of yeast, equivalent to about 109–1010 cells/mL. The performance of the membrane was dependent on the startup mode and pressure management techniques. A steady flux of 70 L/(m2 h) could be maintained for several days before cleaning was necessary. The benefits of the MRB include better productivity; a clear product stream containing no particulates or yeast cells, which should improve subsequent stripping and distillation operations; and substantially reduced stillage handling. The capital cost of the MRB is $21-$34/(m3 yr) ($0.08-$0.13/[gal yr]) of ethanol capacity. Operating cost, including depreciation, energy, membrane replacement, maintenance, labor, and cleaning, is $4.5–9/m3 ($0.017–$0.034/gal) of ethanol.

Antiphospholipid antibody syndrome (APS) is characterized by recurrent thrombosis with the presence of circulating antiphospholipid antibodies. A diagnosis of APS requires the presence of at least one clinical and one laboratory criteria (detection of aCL IgG or IgM antibodies or the presence of lupus anticoagulant on two or more consecutive occasions 6 weeks apart). A severe, rapidly progressive form characterized by clinical involvement of at least three different organ systems with histopathological evidence of small and large vessel occlusion is termed catastrophic antiphospholipid syndrome. Early recognition of APS is crucial since aggressive management can result in a favorable outcome. We present the case of a 12-year-old boy who presented with a devastating illness with multiple thrombotic episodes and rapidly progressive renal failure.

Cyclosporine A (CyA) is an effective agent for the treatment of glucocorticoid-dependent idiopathic nephrotic syndrome (GCDNS), but costs are prohibitive in resource-poor societies. The objectives of this study were to evaluate the efficacy and safety of reducing the dose of CyA by co-administering ketoconazole. A prospective study targeting children 2-18 years of age with GCDNS in remission with CyA monotherapy was conducted. CyA dose was reduced by 50% and ketoconazole was added at 25% of the recommended therapeutic dose, and the drug levels and therapeutic and adverse effects (AE) were monitored. Continued combined therapy after completion of the 4-week trial period was offered. Ten patients (median age 9.5 years, range 3.0-16.0 years) were enrolled in the study. At week 4, the CyA dose was 2.2 ± 0.7 mg/kg/day compared with 5.6 ± 0.9 mg/kg/day at enrolment ( P < 0.0001). No AE were noted. All patients continued ketoconazole treatment for at least 3 months. CyA drug cost savings were 61%, and approximately 60% with ketoconazole cost included. The combination of an expensive immunosuppressive drug with a cheap metabolic inhibitor reduced the treatment costs by> 50% without increased adverse events or drug monitoring needs. This intervention demonstrates how access of patients with limited resources to needed drugs can be improved by interference with physiological drug elimination.

Sirs, Post renal transplantation thrombocytopenia is a rare but serious complication that can be due to underproduction of platelets or excessive destruction of platelets secondary to drugs, hemolytic uremic syndrome (HUS), infections, or autoimmune disorders [1, 2]. We report a patient with cyclosporine-induced thrombocytopenia secondary to HUS where mycophenolate mofetil (MMF) was used as an alternative immunosuppressant. A 16-year-old boy had end-stage renal disease secondary to focal segmental glomerulosclerosis. After being on continuous ambulatory peritoneal dialysis for 3 months he underwent cadaver renal transplantation in November 2001.

The effect of dissolved oxygen on citric acid production and oxygen uptake by Candida lipolytica Y 1095 was evaluated in cell recycle and fed-batch fermentation systems. The maximum observed volumetric productivity, which occurred at a dilution rate of 0.06 h(-1), a dissolved oxygen concentration of 80%, and a biomass concentration of 5% w/v, in the cell recycle system, was 1.32 g citric acid/L . h. At these same conditions, the citric acid yield was 0.65 g/g and the specific citric acid productivity was 24.9 mg citric acid/g cell . h. In the cell recycle system, citric acid yields ranged from 0.45 to 0.72 g/g. Both the volumetric and specific citric acid productivities were dependent on the dilution rate and the concentration of dissolved oxygen in the fermentor. Similar productivities (1.29 g citric acid/L . h) were obtained in the fed-batch system operated at a cycle time of 36 h, a dissolved oxygen concentration of 80%, and 60 g total biomass. Citric acid yields in the fed-batch fermentor were consistently lower than those obtained in the cell recycle system and ranged from 0.40 to 0.59 g/g. Although citric acid yields in the fed-batch fermentor were lower than those obtained in the cell recycle system, higher citric:isocitric acid ratios were obtained in the fed-batch fermentor. As in the cell recycle system, both the volumetric and specific citric acid productivities in the fed-batch fermentor were dependent on the cycle time and dissolved oxygen concentration. (c) 1995 John WileySons, Inc.