Cardiac surgery is unique in using cardiopulmonary bypass in various clinical scenarios. Injury of vital organs is unavoidable in the perioperative period. Acute kidney injury is a consequence of the systemic inflammatory response after bypass, emboli, ischemia, and low cardiac output states, reportedly occurring in 30%-40% of open heart surgeries. Acute kidney injury is associated with increased morbidity, mortality, and cost. Many preventive measures (off-pump procedures, decreased crossclamp time, pulsatile flow, adequate hydration) are taken in the perioperative period to avoid organ injury, but in vain. Traditionally, blood urea, serum creatinine, and creatinine clearance rate were applied for prediction of acute kidney injury. The recent emergence of biomarkers such as neutrophil gelatinase-associated lipocalin, cystatin C, liver-type fatty acid binding protein, interleukin-18, kidney injury molecule-1, and tetrahydrobiopterin have helped in detecting acute kidney injury long before the rise of serum creatinine. These biomarkers can also be used as tools for predicting therapeutic effects in acute kidney injury and for monitoring drug toxicity. This review consolidates the knowledge of biomarkers and their application in acute kidney injury management.

Objective: Pregnancy is characterized by profound changes in the function of

Background: Pregnancy leads to profound alterations in the respiratory system of the mother, leading to alteration in the normal course of common pulmonary diseases. However there is insufficient information regarding the changes in respiratory parameters of smaller airways in different trimesters of pregnancy. Objective: This study was designed to evaluate the pulmonary function tests in 1 st , 2 nd and 3 rd trimesters of pregnancy & compare them with non-pregnant control group. Methods: A cross-sectional study was carried in 200 healthy women in the age range of 19-35 years. The subjects were distributed in four groups, i.e control (non-pregnant) group and 1 st , 2 nd & 3 rd trimester pregnant groups. Number of subjects in each group was 50. We recorded respiratory parameters in control and study groups. Statistical analysis was done by 'Z' test. Results: There is significant decrease in FEV1, FEV1%, FEF25-75%, FEF25%, FEF50%, FEF75% in all trimesters of pregnancy with maximum decrease in 1 st trimester. Conclusion: The changes in pulmonary functions are attributed to the marked changes in the respiratory parameters during pregnancy. This knowledge of pulmonary function changes during pregnancy may be helpful in the prevention of gestational complications associated with an inadequate maternal respiratory adaptation.