Formulation and evaluation of the effective microorganisms in sewage treatment.

Effective microorganisms pose a great potential in wastewater treatment. In the present study, effective microorganisms' formulations were developed using different organic substrates that support the growth of more beneficial microorganisms for sewage treatment. Based on the metagenomic analysis and biochemical profile information, the fish waste-based effective microorganisms' formulation was identified as the effective formulation.

Referral Versus Embedded Palliative Care Consultation Among People Hospitalized With Heart Failure: A Report From a Single Center Pilot Program.

Context: Despite calls for integration into routine heart failure (HF) care, optimal palliative care delivery for people living with HF remains unclear.

Objectives: Describe an innovative model of an embedded palliative care nurse practitioner (NP) within a HF team. Compare demographics and utilization among people hospitalized with HF receiving referral or embedded consultation.

Reply to a letter to the editor written by Phansalkar et al, regarding publication entitled "Do we need a simplified model to predict outcomes in patients hospitalized with Acute Decompensated Heart Failure? Results from The Role of Sodium in Heart Failure Outcomes Prediction ('SHOUT-PREDICTION') study. Indian Heart J. 2021;73(4):458-463. doi:10.1016/j.ihj.2021.06.007".

This is the Reply to a letter to the Editor written by Phansalkar et al, regarding publication entitled "Do we need a simplified model to predict outcomes in patients hospitalized with Acute Decompensated Heart Failure? Results from The Role of Sodium in Heart Failure Outcomes Prediction ('SHOUT-PREDICTION') study. Indian Heart J. 2021; 73(4):458-463.

Do we need a simplified model to predict outcomes in patients hospitalized with Acute Decompensated Heart Failure? Results from The Role of Sodium in Heart Failure Outcomes Prediction ('SHOUT-PREDICTION') study.

Context: Hyponatremia is associated with high in-hospital mortality in patients with acute decompensated Heart Failure (ADHF) and is one of the components in various risk scores in heart failure (HF). However, some risk scores predict outcomes in these patients without using hyponatremia as its component.

Aim: The study was aimed to evaluate the relationship between serum sodium levels at admission and clinical outcomes during the in-hospital course and three months' follow-up, in patients admitted in the intensive cardiac care unit (ICCU) with ADHF.

Prevalence of hypertension and prehypertension in schoolchildren from Central India.

Background: Epidemiological transition with increasing burden of cardiovascular risk factors is evident not only in adults but also in children. The data on the prevalence of prehypertension and hypertension in children show large regional differences in India and such data are not available from Central India. We, therefore, conducted a large cross-sectional study in Indore to determine the distribution of blood pressure (BP) and the prevalence of hypertension and prehypertension among schoolchildren.

Distal renal tubular acidosis secondary to vesico-ureteric reflux: A case report with review of literature.

Vesicoureteric reflux (VUR) is the most common congenital anomaly of the urinary tract that occurs in 30%-50% of children presenting with recurrent urinary tract infections. Long-standing untreated VUR results in renal scarring and hydronephrotic changes ultimately leading to chronic renal failure and arterial hypertension. However, it may also result in diffuse tubulopathy compromising the concentrating capacity of tubules and urinary acidification defects.

Distal renal tubular acidosis in sickle cell anemia.

We report a rare case of two young male siblings with sickle cell anemia who presented with bilateral lower limb deformities, failure to thrive, polyuria, and polydipsia. On investigations, they were found to have normal anion gap metabolic acidosis, hypokalemia, and nephrocalcinosis were seen on ultrasonography of the kidneys. These reports were suggestive of distal renal tubular acidosis (dRTA).

Disseminated Cryptococcosis Mimicking Miliary Tuberculosis with Generalized Lymphadenopathy in Immunocompetent Host.

Cryptococcosis is a rare opportunistic infection in the immunocompromised host.1,2 Diagnosis of disseminated fungal infections is rarely thought of in immunocompetent hosts. In developing countries where tuberculosis is endemic, Cryptococcosis is often misdiagnosed as tuberculosis.

Utility of physical examination and comparison to echocardiography for cardiac diagnosis.

Objective: To find out the accuracy of cardiac auscultation using non-digital stethoscope in physical diagnosis of cardiac diseases.

Methods: We enrolled 104 consecutive patients with abnormal cardiac auscultatory findings attending cardiology clinic and not previously evaluated by echocardiography. One time detailed cardiac physical examination followed by echocardiography within 1 month was undertaken.

Endothelium-dependent vasodilation is impaired in healthy offspring of hypertensive parents.

Objectives: Impaired endothelium-dependent vasodilation has been demonstrated in asymptomatic normotensive offspring of hypertensive parents in Caucasians and Chinese population. The study was designed to determine whether impaired endothelium-dependent vasodilation is present in Indian normotensive offspring with hypertensive parents.

Methods And Results: We conducted this study in non smoker, healthy, young volunteers with a positive (n = 45) or a negative parental history (n = 30) of essential hypertension in a case-control, blinded design.

Efficacy and safety of PDE-5 inhibitor tadalafil in pulmonary arterial hypertension.

Background: Pulmonary arterial hypertension (PAH) is a life threatening disease for which phosphodiesterase-5 inhibitor sildenafil is recently approved. We aimed to evaluate the efficacy and safety of tadalafil, a long acting congener of sildenafil, in treatment of PAH related to previous left to right shunt lesions.

Methods: In this blinded, cross over study, 11 patients with severe PAH related to congenital left to right shunt lesions (Eisenmenger syndrome) were randomly assigned to tadalafil (20 mg daily) or placebo for 4 weeks period, separated by a wash out period of at least 2 weeks.

Congestive heart failure in a male with "carcinoma tongue": a case of mistaken identity.

We present a case of primary amyloidosis with macroglossia and restrictive cardiomopathy, that was mistakenly diagnosed as carcinoma of the tongue. He had characteristic echocardiographic findings, and bone marrow plasmacytosis but with normal serum electrophoresis and no Bence Jones proteins in the urine.

Terminalia arjuna reverses impaired endothelial function in chronic smokers.

Background: Smoking, largely through increased oxidative stress, causes endothelial dysfunction which is an early key event in atherosclerosis. Smoking cessation and antioxidant vitamin therapy are shown to have beneficial role by restoring altered endothelial physiology. The present study was aimed to determine whether Terminalia arjuna, an Indian medicinal plant with potent antioxidant constituents, would improve endothelial dysfunction in smokers.

The efficacy and tolerability of sildenafil in patients with moderate-to-severe pulmonary hypertension.

Background: Pulmonary arterial hypertension is a life-threatening disease for which continuous intravenous infusion of prostacyclin has proved effective. However, it carries the risk of serious complications arising from the complex delivery system. Prostacyclin analogs, endothelin antagonists, and the phosphodiesterase-5 inhibitor sildenafil are emerging promising therapies.

Post-trauma electrocardiogram mimicking myocardial infarction.

A case of roadside accident victim is discussed who had electrocardiographic changes of hypothermia wrongly interpreted as "evolving myocardial infarction", which completely reverted after increasing core body temperature.

Efficacy of Terminalia arjuna in chronic stable angina: a double-blind, placebo-controlled, crossover study comparing Terminalia arjuna with isosorbide mononitrate.

Background: Terminalia arjuna, an Indian medicinal plant, has been reported to have beneficial effects in patients with ischemic heart disease in a number of small, open studies. The need for a double-blind, randomized, placebo-controlled study with adequate sample size has long been felt. The bark extract (IPC-53) contains acids (arjunic acid, terminic acid), glycosides (arjunetin arjunosides I-IV), strong antioxidants (flavones, tannins, oligomeric proanthocyanidins), minerals.