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Background: The existing treatments for PD were associated with side effects and does not offer complete cure. Hence there is a need of alternative therapy which can prevent or delay the onset of PD with less or no side effects. Aim and objective: The overall objective of the present study was to assess the effectiveness of electrical vestibular nerve stimulation in the management of Parkinson’s disease. Materials and methods: 60 cases with PD, including both males and females, were recruited in the study by convenient sampling after obtaining written and informed consent. They were randomly grouped with 30 participants in each group. Control group received sham stimulation and the intervention group received electrical vestibular nerve stimulation for 12 weeks. After recording the baseline biochemical parameters, post intervention assessment was performed after 6 weeks and 12 weeks of intervention and compared. Results: Demographic variables were not statistically significant among the control and intervention groups. There was a significant increase in the dopamine and GABA levels followed by the intervention. Conclusion: The present study results support the positive impact of non-invasive electrical vestibular nerve stimulation in modulating neurotransmitters in patients with Parkinson’s disease. A further detailed translational study is required in this area with a larger sample size to generalize the results.

Veress needle, trocar insertion, pneumoperitoneum-related complications, biliary injuries apart from haemorrhage, intestinal injuries and lateral thermal injuries are all well described entities following laparoscopic cholecystectomy. The development of intestinal ischaemia following laparoscopic cholecystectomy is rare; this report describes a case of fatal small bowel ischaemia following laparoscopic cholecystectomy and discusses the various possibilities that led to this event.

Chronic kidney disease of unknown etiology (CKDU) is prevalent and clinically silent until its late stages at which patient may suffer significant irreversible damage, or mortality in the absence of early screening and intervention. CKDU is asymptomatic but may show nonspecific symptoms. Conventional markers are influenced by multiple non-renal factors while Kidney injury molecule-1(KIM-1) and Neutrophil gelatinase-associated lipocalin(NGAL) are promising biomarkers of chronic kidney disease (CKD), there are no studies reported so far on these markers in CKDU. The aim of the study is to assess the sensitivity of biomarkers serum KIM-1 and NGAL in patients with CKDU in comparison with CKD and controls. To achieve this, our objectives are to estimate the level of biochemical parameters like serum creatinine, urea, uric acid, random blood sugar, systolic and diastolic blood pressure and hemoglobin and to compare novel biomarkers KIM-1 and NGAL in CKDU patients with CKD. The serum levels of urea, uric acid, creatinine, KIM-1 and NGAL were estimated in control, CKD and CKDU (n = 35, 46, 79 respectively). Creatinine showed 8.1-fold and 2.7-fold increase (P <0.001), and urea 4.0% and 1.8% increase (P < 0.001), compared to control in CKD and CKDU cohorts, respectively. The sensitivity and specificity of KIM-1 was 73.4% and 67.4%with a cutoff value of 203.5ng/mL using the receiver operating characteristic(ROC) curve. For NGAL they were 82.3%, 73.9% and 255ng/mL. Compared to control, KIM-1 showed a 51.5-fold and 87.2-fold increase in CKD and CKDU, respectively (P < 0.001). NGAL showed a 4.8-fold and 6.7-fold increase in CKD and CKDU, respectively (P < 0.001). Creatinine and urea were higher in CKD than in CKDU, whereas KIM-1 and NGAL were higher in CKDU than CKD. KIM-1 and NGAL are sensitive biomarkers for CKDU. KIM-1 can differentiate CKD and CKDU.

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