bluuebunny/crossref_metadata_2025 huggingface dataset:
Regulation of Renal Urea Transportersa
Authors: SANDS JEFF M.
Published: April 2021

Urea is important for the conservation of body water due to its role in the production of concentrated urine in the renal inner medulla. Physiologic data demonstrate that urea is transported by facilitated and by active urea transporter proteins. The facilitated urea transporter (UT-A) in the terminal inner medullary collecting duct (IMCD) permits very high rates of transepithelial urea transport and results in the delivery of large amounts of urea into the deepest portions of the inner medulla where it is needed to maintain a high interstitial osmolality for concentrating the urine maximally. Four isoforms of the UT-A urea transporter family have been cloned to date. The facilitated urea transporter (UT-B) in erythrocytes permits these cells to lose urea rapidly as they traverse the ascending vasa recta, thereby preventing loss of urea from the medulla and decreasing urine-concentrating ability by decreasing the efficiency of countercurrent exchange, as occurs in Jk null individuals (who lack Kidd antigen). In addition to these facilitated urea transporters, three sodium-dependent, secondary active urea transport mechanisms have been characterized functionally in IMCD subsegments: (1) active urea reabsorption in the apical membrane of initial IMCD from low-protein fed or hypercalcemic rats; (2) active urea reabsorption in the basolateral membrane of initial IMCD from furosemide-treated rats; and (3) active urea secretion in the apical membrane of terminal IMCD from untreated rats. This review focuses on the physiologic, biophysical, and molecular evidence for facilitated and active urea transporters, and integrative studies of their acute and long-term regulation in rats with reduced urine-concentrating ability.
Inducible Nitric Oxide Synthase Can Be Induced in the Absence of Active Nuclear Factor-κB in Rat Mesangial Cells
Authors: NAKASHIMA OSAMU , TERADA YOSHIO , INOSHITA SEIJI , KUWAHARA MICHIO , SASAKI SEI , MARUMO FUMIAKI
Published: April 2021

The contribution of nuclear factor-κB (NF-κB) and interferon-γ (IFN-γ) signaling to nitric oxide generation is not completely understood. The effect of NF-κB release and its inhibition on nitrite production and the involvement of Janus kinase 2 (JAK2) in inducible nitric oxide synthase (iNOS) induction were investigated. The following assays were performed. (1) Nitrite produced by rat mesangial cells in primary culture was measured in incubations with tumor necrosis factor-α (TNF-α) or lipopolysaccharide (LPS), with or without IFN-γ. Cells were stimulated with TNF-α or LPS plus IFN-γ in the presence of NF-κB inhibitors, herbimycin A (HerA), or the more specific JAK2 inhibitor AG490. (2) Immunoblotting was performed against the p65 and p50 subunits of NF-κB and iNOS. (3) Electrophoretic mobility shift assays were performed against NF-κB in the presence of NF-κB inhibitors or AG490. (4) iNOS promoter activity was measured in the presence of AG490 or JAK2 antisense oligonucleotides. TNF-α or LPS alone did not induce nitrite production, but with IFN-γ these compounds did induce nitrite production. Pyrrolidine dithiocarbamate (PDTC), N-acetyl-L-cysteine, dexamethasone (Dex), HerA, and AG490 partially inhibited LPS/IFN-γ- or TNF-α/IFN-γ-induced nitrite production. p65 was inhibited by the three NF-κB inhibitors described above, whereas p50 was not. PDTC and Dex completely inhibited the p65/p50 heterodimer, but HerA and AG490 had little effect on p65/p50. AG490 and JAK2 antisense oligonucleotides suppressed iNOS promoter activity. It can be concluded that (1) iNOS can be induced without active NF-κB; (2) Dex, acetylsalicylic acid, and PDTC inhibit only p65; and (3) JAK2 is involved in iNOS induction, and the contribution of JAK2 to nitrite production is greater than that of NF-κB.
Serum Levels and Metabolic Clearance of the Isoflavones Genistein and Daidzein in Hemodialysis Patients
Authors: FANTI PAOLO , SAWAYA B. PETER , CUSTER LAURIE J. , FRANKE ADRIAN A.
Published: April 2021

Genistein and daidzein are biologically active isoflavones that are especially abundant in soybeans. After intestinal absorption, circulating genistein and daidzein are eliminated primarily by the kidneys. This study was undertaken to assess the metabolism of genistein and daidzein in patients with end-stage renal disease (ESRD) on hemodialysis therapy, and to test whether this treatment modality can replace the lack of kidney function, with respect to the elimination of the isoflavones. Twenty-three hemodialysis patients and 10 healthy subjects were studied. While consuming a self-selected low isoflavone diet, baseline blood levels were undetectable in eight of 10 healthy subjects and in 14 of 23 dialysis patients. The remaining participants had detectable levels, with the nine dialysis patients displaying much higher blood concentrations than the two healthy control subjects. After the evening intake of one dose of an isoflavone-rich soy protein isolate drink, the early morning blood levels of genistein and daidzein were higher in seven dialysis patients than in eight healthy subjects (genistein 1271 ± 321 versus 425 ± 104, P < 0.05; daidzein 1304 ± 352 versus 292 ± 78, P < 0.05). The blood clearance of the isoflavones was studied in two healthy subjects and in three dialysis patients. Genistein and daidzein were eliminated within 2 d in the healthy subjects, but had not returned to baseline in two of three ESRD patients, 7 d after intake. The half-life of both compounds was estimated to be 10-fold longer in the ESRD patients than in the healthy subjects. Finally, genistein and daidzein levels were measured before and after dialysis in five patients, both while on their regular diet and after one dose of a soy protein isolate drink. In both instances, the dialysis treatment did not affect the blood isoflavone levels. In conclusion, approximately one-third of hemodialysis patients eating the standard American renal diet experience high blood levels of the isoflavones genistein and daidzein, while the remaining two-thirds have undetectable levels. After ingestion of isoflavone-rich food such as soy products, all patients have detectable levels that remain very high for several days due to lack of renal excretion.
TT Virus
Authors: BONIS PETER A. L.
Published: April 2021

TT virus (TTV) is a newly described DNA virus that was first detected in the blood of three patients with elevated serum aminotransferases following transfusion who tested negatively for all known hepatitis viruses. The virus has been found worldwide with a high prevalence in the general population. However, accumulating evidence suggests that the virus is not a significant cause of acute or chronic liver disease. No other disease associations with infection have been described.
Stimulation of NADPH Oxidase by Oxidized Low-Density Lipoprotein Induces Proliferation of Human Vascular Endothelial Cells
Authors: HEINLOTH ALEXANDRA , HEERMEIER KATHRIN , RAFF ULRIKE , WANNER CHRISTOPH , GALLE JAN
Published: April 2021

Oxidized low-density lipoprotein (OxLDL) exerts proliferation and apoptosis in vascular cells, depending on its concentration and the duration of exposure. Recent studies indicate that O2
- is involved in cell cycle regulation and that OxLDL stimulates endothelial cells to produce O2
-. This study examined the role of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase as a potential source for O2
- in the proliferation-inducing activity of OxLDL in cultured human umbilical vein endothelial cells (HUVEC). Human LDL was oxidized by Cu++, and proliferation of HUVEC was detected by 3H-thymidine incorporation. OxLDL (5 μg/ml) caused an increase in proliferation of HUVEC of 250 to 300%. OxLDL-induced proliferation was blocked by addition of the antioxidants superoxide dismutase and catalase, suggesting that enhanced O2
- formation was involved. Diphenylene iodonium (DPI, 1 μM), an inhibitor of NADPH oxidase, also prevented OxLDL-induced proliferation of HUVEC, indicating that NADPH oxidase was the source for enhanced O2
- formation. The OxLDL effect was mimicked by lysophosphatidylcholine (LPC, 10 μM), a compound formed during oxidation of LDL. LPC-induced proliferation was also prevented by coincubation with DPI. Treatment of HUVEC with O2
- generated by the xanthine/xanthine oxidase reaction resulted in proliferation as did treatment with OxLDL. As expected, this stimulation could not be blocked by DPI. With the use of the cytochrome c-assay, it was demonstrated that OxLDL and LPC enhanced O2
- formation in HUVEC (by factor 3.2 and by factor 3.5, respectively). Supporting the assumption that NADPH oxidase was the enzyme responsible for O2
- formation, cells transfected with antisense oligonucleotides for NADPH oxidase showed a significantly reduced O2
- formation after stimulation with OxLDL and LPC. OxLDL and its compound LPC induce proliferation of HUVEC through activation of NADPH oxidase. The active NADPH oxidase generates O2
-, which mediates the proliferative effects.
1,25-Dihydroxy-19-nor-vitamin D2, a Vitamin D Analog with Reduced Bone Resorbing Activity In Vitro
Authors: HOLLIDAY L. SHANNON , GLUCK STEPHEN L. , SLATOPOLSKY EDUARDO , BROWN ALEX J.
Published: April 2021

1,25-Dihydroxy-19-nor-vitamin D2 (19-norD2), a new analog of 1,25(OH)2D3, suppresses parathyroid hormone in renal failure patients and in uremic rats but has less calcemic activity than 1,25(OH)2D3. Although 19-norD2 has high affinity for the vitamin D receptor and similar pharmacokinetics to those of 1,25(OH)2D3, it has much less bone resorbing activity in vivo. The intrinsic activity of 19-norD2 on osteoclastogenesis and activation of bone resorption in mouse bone marrow cultures was examined to determine the mechanism involved. 19-norD2 and 1,25(OH)2D3 (10 nM) were equivalent in stimulating the formation and maintenance of large multinucleated, tartrate-resistant acid phosphatase-positive cells. However, the amount of bone resorbed by osteoclasts stimulated by 10 nM 19-norD2, as measured by pit-forming assays, was reduced 62% compared with 10 nM 1,25(OH)2D3-stimulated osteoclasts (P < 0.05). This difference could not be attributed to enhanced catabolism or to downregulated vitamin D receptor. The rate of degradation of 19-norD2 in cultures was approximately 20% greater than 1,25(OH)2D3, not enough to account for the different effects on bone resorption. The VDR levels were identical in cultures that were treated with 19-norD2 and 1,25(OH)2D3. In summary, 19-norD2 is less effective than 1,25(OH)2D3 in stimulating mouse marrow osteoclasts to resorb bone. The reason for this difference is not clear but seems to involve the late maturation and/or activation of osteoclasts as the number of pits produced by each tartrate-resistant acid phosphatase-positive cell is reduced under stimulation by 19-norD2 compared with 1,25(OH)2D3.
Localization of Inward Rectifier Potassium Channel Kir7.1 in the Basolateral Membrane of Distal Nephron and Collecting Duct
Authors: OOKATA KAYOKO , TOJO AKIHIRO , SUZUKI YOSHIRO , NAKAMURA NOBUHIRO , KIMURA KENJIRO , WILCOX CHRISTOPHER S. , HIROSE SHIGEHISA
Published: April 2021

Inward rectifier potassium channels (Kir) play an important role in the K+ secretion from the kidney. Recently, a new subfamily of Kir, Kir7.1, has been cloned and shown to be present in the kidney as well as in the brain, choroid plexus, thyroid, and intestine. Its cellular and subcellular localization was examined along the renal tubule. Western blot from the kidney cortex showed a single band for Kir7.1 at 52 kD, which was also observed in microdissected segments from the thick ascending limb of Henle, distal convoluted tubule (DCT), connecting tubule, and cortical and medullary collecting ducts. Kir7.1 immunoreactivity was detected predominantly in the DCT, connecting tubule, and cortical collecting duct, with lesser expression in the thick ascending limb of Henle and in the medullary collecting duct. Kir7.1 was detected by electron microscopic immunocytochemistry on the basolateral membrane of the DCT and the principal cells of cortical collecting duct, but neither type A nor type B intercalated cells were stained. The message levels and immunoreactivity were decreased under low-K diet and reversed by low-K diet supplemented with 4% KCl. By the double-labeling immunogold method, both Kir7.1 and Na+, K+-ATPase were independently located on the basolateral membrane. In conclusion, the novel Kir7.1 potassium channel is located predominantly in the basolateral membrane of the distal nephron and collecting duct where it could function together with Na+, K+-ATPase and contribute to cell ion homeostasis and tubular K+ secretion.
Deoxycorticosterone Suppresses the Effects of Losartan in Nitric Oxide—Deficient Hypertensive Rats
Authors: DE GRACIA MARIA C. , OSUNA ANTONIO , O'VALLE FRANCISCO , DEL MORAL RAIMUNDO G. , WANGENSTEEN ROSEMARY , DEL RIO CIPRIANO GARCIA , VARGAS FELIX
Published: April 2021

Chronic inhibition of the renin angiotensin system prevents increased BP and renal injury in NG-nitro-L-arginine methyl ester (L-NAME) hypertension. However, a relationship between plasma renin activity and the protective effect of chronic angiotensin II (Ang II) blockade has not been established. With this background, this study was undertaken to evaluate how the chronic administration of deoxycortisone acetate (DOCA) modifies the effects of losartan on BP, renal injury, and other variables in L-NAME hypertensive rats. The following groups were used: Control, DOCA, L-NAME, L-NAME + losartan, L-NAME + DOCA, and L-NAME + DOCA + losartan. Tail systolic BP was measured twice a week. After 4-wk evolution, mean arterial pressure and metabolic, morphologic, and renal variables were measured. The final mean arterial pressure values were 116 ± 6 mmHg for control, 107 ± 2 mmHg for DOCA, 151 ± 5 mmHg for L-NAME, 123 ± 2 mmHg for L-NAME + losartan, 170 ± 3 mmHg for L-NAME + DOCA, and 171 ± 5.5 mmHg for L-NAME + DOCA + losartan. Losartan prevented microalbuminuria, hyaline arteriopathy, and glomerulosclerosis of L-NAME hypertension but was ineffective in L-NAME + DOCA—treated rats. Plasma protein was significantly reduced in the L-NAME + DOCA group when compared with control and L-NAME groups, whereas no significant differences were observed in the other groups. Plasma renin activity was suppressed in the DOCA (0.55 ± 0.2) and L-NAME + DOCA (0.60 ± 10.2) groups but unsuppressed in the L-NAME + DOCA + losartan group (5.8 ± 1). The conclusion is that DOCA blocks the preventive effect of losartan on the increased BP and renal injury of L-NAME hypertension, which suggests that DOCA transforms L-NAME hypertension into an Ang II—independent model of hypertension. These data also suggest that losartan prevents L-NAME hypertension by blocking the activity of systemic Ang II.
Telomere Shortening in Kidneys with Age
Authors: MELK ANETTE , RAMASSAR VIDO , HELMS LISA M. H. , MOORE RON , RAYNER DAVID , SOLEZ KIM , HALLORAN PHILIP F.
Published: April 2021

The histology and function of the kidney deteriorates with age and age-related diseases, but the mechanisms involved in renal aging are not known. In vitro studies suggest that telomere shortening is important in replicative senescence, and is accelerated by stresses that increase replication. This study explored the relationship between age and telomere length in surgical samples from 24 human kidneys, which were either histologically normal (17) or displayed histologic abnormalities (7). Telomere loss was assessed by two independent methods: Southern blotting of terminal restriction fragments (TRF) and slot blotting using telomere-specific probes. The results of these methods correlated with each other. The mean TRF length determined by Southern blotting in cortex was about 12 kb pairs (kbp) in infancy and was shorter in older kidneys. The slope of the regression line was about 0.029 kbp (0.24%, P = 0.023) per year. Telomere DNA loss in cortex by the slot blot method was 0.25% per year (P = 0.011). By both methods, the telomere loss in medulla was not significant and was less than in cortex. Comparisons of TRF length from 20 paired samples from cortex and medulla showed that TRF was greater in cortex than medulla, with the differences being greater in young kidneys and lessening with age due to telomere loss in cortex. These findings indicate that telomeres shorten in an age-dependent manner in the kidney, either due to developmental factors or aging, particularly in renal cortex.
Effect of Angiotensin-Converting Enzyme Inhibition on Glomerular Basement Membrane Permeability and Distribution of Zonula Occludens-1 in MWF Rats
Authors: MACCONI DANIELA , GHILARDI MARINA , BONASSI MARIA ENRICA , MOHAMED EHAB I. , ABBATE MAURO , COLOMBI FRANCESCA , REMUZZI GIUSEPPE , REMUZZI ANDREA
Published: April 2021

The mechanism(s) by which angiotensin-converting enzyme (ACE) inhibitors prevent glomerular membrane loss of permselective function is still not understood. In male MWF rats, which develop spontaneous proteinuria with age, ACE inhibitors prevent proteinuria and increase glomerular ultrafiltration coefficient. These renoprotective effects are not associated with ultrastructural changes of capillary wall components. This study was undertaken to investigate whether ACE inhibitors modulate functional properties of glomerular basement membrane (GBM) and/or of epithelial cells, both of which have been suggested to play a role in the maintenance of the glomerular filtration barrier. The hydraulic and macromolecular permeability of the GBM were determined, by an in vitro filtration system, in untreated or lisinopril-treated rats and in Wistar rats taken as controls. By indirect immunofluorescence and immunoelectron microscopy, glomerular distribution of the tight junction protein zonula occludens-1 (ZO-1), a component of the slit diaphragm, was also studied. Results document that spontaneous proteinuria in MWF rats develops without significant changes in the permeability of the GBM to water and albumin, or in the ultrastructure of the podocyte foot processes, but is associated with an important alteration in the distribution of ZO-1 at the glomerular level. Lisinopril, which prevented proteinuria, also prevented glomerular redistribution of the protein. Thus, renoprotective effects of ACE inhibitors are not associated with changes in intrinsic functional properties of GBM, or ultrastructural changes of the epithelial cells, but rather with preservation of glomerular ZO-1 distribution and slit diaphragm function, which are essential for maintaining the filtration barrier.
Predictors of Loss of Residual Renal Function among New Dialysis Patients
Authors: MOIST LOUISE M. , PORT FRIEDRICH K. , ORZOL SEAN M. , YOUNG ERIC W. , OSTBYE TRULS , WOLFE ROBERT A. , HULBERT-SHEARON TEMPIE , JONES CAMILLE A. , BLOEMBERGEN WENDY E.
Published: April 2021

Residual renal function (RRF) in end-stage renal disease is clinically important as it contributes to adequacy of dialysis, quality of life, and mortality. This study was conducted to determine the predictors of RRF loss in a national random sample of patients initiating hemodialysis and peritoneal dialysis. The study controlled for baseline variables and included major predictors. The end point was loss of RRF, defined as a urine volume <200 ml/24 h at approximately 1 yr of follow-up. The adjusted odds ratios (AOR) and P values associated with each of the demographic, clinical, laboratory, and treatment parameters were estimated using an “adjusted” univariate analysis. Significant variables (P < 0.05) were included in a multivariate logistic regression model. Predictors of RRF loss were female gender (AOR = 1.45; P < 0.001), non-white race (AOR = 1.57; P = <0.001), prior history of diabetes (AOR = 1.82; P = 0.006), prior history of congestive heart failure (AOR = 1.32; P = 0.03), and time to follow-up (AOR = 1.06 per month; P = 0.03). Patients treated with peritoneal dialysis had a 65% lower risk of RRF loss than those on hemodialysis (AOR = 0.35; P < 0.001). Higher serum calcium (AOR = 0.81 per mg/dl; P = 0.05), use of an angiotensin-converting enzyme inhibitor (AOR = 0.68; P < 0.001), and use of a calcium channel blocker (AOR = 0.77; P = 0.01) were independently associated with decreased risk of RRF loss. The observations of demographic groups at risk and potentially modifiable factors and therapies have generated testable hypotheses regarding therapies that may preserve RRF among end-stage renal disease patients.
Microstructures and Phase Transformations of Melt-Spun Ti-V-Al High Temperature Shape Memory Alloys with Addition of Zr
Authors: BAĞ Öznur , YILMAZ Fikret , KÖLEMEN Uğur , ERGEN Semra
Published: April 2021

In this study, the effects of Zr addition on phase transformation temperatures, microstructure of Ti-12V-4Al (wt. %) high temperature shape memory alloys (HTSMAs) manufactured using melt-spinning technique were investigated. During heating, differential scanning calorimetry (DSC) curves showed that austenite transformation temperature of Ti-12V-4Al (wt. %) melt-spun ribbon was single-stage transformation and Ti-12V-4Al-0.5Zr (wt. %) melt-spun ribbon was two-stage transformation. In the scanning electron microscopy (SEM) and X-ray diffraction (XRD) analyzes, unveiled that the melt-spun ribbons consisted of martensite, austenite and R phases. Transmission electron microscopy (TEM) analysis showed that the thickness of martensite plates in ribbons was thinned by the addition of Zr.
New Climate Activism between Politics and Law: Analyzing the Strategy of the KlimaSeniorinnen Schweiz
Authors: Keller Seline , Bornemann Basil
Published: April 2021

Since 2016, a group of senior women organized in the association KlimaSeniorinnen Schweiz have been trying to legally force the Swiss government to take stronger climate protection measures. Parallel to the pursuit of a climate lawsuit, the KlimaSeniorinnen have developed into a growing social movement that is present in the media and participates in the public debate on climate change. Building on this specific climate litigation case, the present article analyzes the strategy formation of new actors in the field of climate governance. Based on existing concepts of social movement research, the strategy formation of the KlimaSeniorinnen is reconstructed in terms of a strategic actor who pursues certain strategic orientations in given strategic contexts. The empirical analysis of the strategic context (by means of opportunity structures), the strategic orientations (via collective action frames), and the strategic actor (by means of interviews) shows a double strategy. On the one hand, the KlimaSeniorinnen attempt to address a specific legal opportunity structure with an ‘injustice frame,’ which emphasizes human rights and the special vulnerability of older women to intense heat waves. On the other hand, they want to mobilize public support for an ambitious climate policy by additionally promoting a ‘grandchildren frame,’ which articulates altruistic values, such as responsibility towards future generations. Based on this analysis, both practical implications and consequences for future research on a new climate politics, which is increasingly taking shape between and across different arenas, are discussed.
Clashing Tactics, Clashing Generations: The Politics of the School Strikes for Climate in Belgium
Authors: Kenis Anneleen
Published: April 2021

Much has been written about the challenges of tackling climate change in post-political times. However, times have changed significantly since the onset of the debate on post-politics in environmental scholarship. We have entered a politicised, even polarised world which, as this article argues, a number of voices within the climate movement paradoxically try to bring together again. This article scrutinises new climate movements in a changing world, focusing on the School Strikes for Climate in Belgium. It shows how the movement, through the establishment of an intergenerational conflict line and a strong politicisation of tactics, has succeeded in putting the topic at the heart of the public agenda for months on end. By claiming that we need mobilisation, not studying, the movement went straight against the hegemonic, technocratic understanding of climate politics at the time. However, by keeping its demands empty and establishing a homogenised fault line, the movement made itself vulnerable to forms of neutralisation and recuperation by forces which have an interest in restoring the post-political consensus around technocratic and market-oriented answers to climate change. This might also partly explain its gradual decline. Instead of recycling post-political discourses of the past, this article claims, the challenge is to seize the ‘populist moment’ and build a politicised movement around climate change. One way of doing that is by no longer projecting climate change into the future but reframing the ‘now’ as the moment of crisis which calls on us to build another future.
PERFIL EPIDEMIOLÓGICO E CLÍNICO DE PACIENTES COM REAÇÃO HANSÊNICA ACOMPANHADOS EM UM HOSPITAL DE REFERÊNCIA
Authors: E Silva Maite De Souza , Trindade Luciana Cavalcante , Teixeira Duanra Christi Queiroz , Albuquerque Raul José Almeida , Barreto Bruna Braga Nóbrega de Holanda
Published: April 2021

A hanseníase é uma doença infecciosa, granulomatosa, de caráter crônico, causada pelo Mycobacterium leprae, que tem predileção pela pele e nervos periféricos. Alguns pacientes apresentam episódios inflamatórios, conhecidos como estado reacional ou reação hansênica, que é um dos maiores problemas no manejo dos portadores da doença. O objetivo desse estudo foi caracterizar o perfil epidemiológico e clínico de pacientes com reação hansênica em um hospital de referência na Paraíba. Trata-se de uma pesquisa epidemiológica do tipo documental retrospectiva. Entre os anos 2016 a 2017, foram diagnosticados 392 casos novos de hanseníase no Complexo Hospitalar Clementino Fraga (CHCF), localizado no município de João Pessoa. Destes, 138 (35,2%) foram acometidos por um ou mais estado reacional. Identificou-se que a maioria dos que apresentaram reação hansênica eram homens (73,20%), da raça parda (58%), com baixo nível de escolaridade (78,3%) e na faixa etária entre 18 e 45 anos (47,8%). A frequência de reações foi mais elevada entre pacientes multibacilares (81,10%), principalmente com as formas clínicas dimorfa e virchowiana, baciloscopia positiva e algum grau de incapacidade física instalada. Foi percebida associação entre baciloscopia positiva e o desenvolvimento da crise reacional (p=0,003). Houve, ainda, associação entre a reação reversa e forma multibacilar e entre neurite e a forma clínica dimorfa. Tais características devem ser consideradas no acompanhamento desses pacientes, com vistas à prevenção de complicações clínicas decorrentes da doença e dos estados reacionais, além de deformidades/incapacidades físicas permanentes.
STUDY OF THE FLOW AND HEAT TRANSFER OF A VISCOELASTIC FLUID USING HYBRID NEURAL NETWORK-PARTICLE SWARM OPTIMIZATION (HNNPSO)
Authors: MİRZAEİ Reza , GHALAMBAZ Mohammad , NOGHREHABADİ Aminreza
Published: April 2021

Fluid flow and heat transfer of a second-order viscoelastic fluid in an axisymmetric channel with a porous wall for turbine cooling applications are studied. The nonlinear differential equations of the fluid flow and heat transfer arising from similarity solutions are computed employing a Hybrid Neural Network-Particle Swarm Optimization algorithm (HNNPSO). A trial function, satisfying the boundary conditions, as a possible solution for the governing equations is introduced. The trial functions incorporate a multi-layer perceptron neural network with adjustable parameters (the weights and biases). The Particle Swarm Optimization algorithm (PSO) is applied to find the adjustable parameters of the trial solution to satisfy the governing equations. Finally, comparisons are made between the results of the present method (HNNPSO) and the results of the fourth order Runge–Kutta method, finite difference method, and Variational Iteration Method. The results indicate that HNNPSO method conveniently produces a polynomial analytic solution with remarkable accuracy, and the accuracy of the solution improves as the number of neurons of the neural network increases.
The Determinants of Musharaka Financing in Indonesia
Authors: Fathurrahman Ayif , Devi Abriani Sita
Published: April 2021

The purpose of this study is to determine the determinants of Musharaka Financing in Islamic commercial banks in Indonesia, which was carried out using secondary data or quantitative data from the period of January 2015 to August 2019. The model used to analyze the results of this regression was the Multiple Linear The dependent variable used in the object of this study was musharaka financing, while the independent variables used in this study consisted of inflation, exchange rates (exchange rates), Return on Assets (RoA), and third-party funds. From the results of the multiple linear regression analysis that has been processed, it can be explained that simultaneously the inflation, exchange rates (exchange rates), RoA, and TPF have a significant effect on Musharaka Financing. However, partially the exchange rate (exchange rate), RoA and TPF have a positive and significant effect on Musharaka financing, while inflation has a positive and insignificant effect on musharaka financing at Islamic Commercial Banks in Indonesia
Clinico-hematological evaluation in cases of pancytopenia at tertiary care centre: largest cross-sectional study
Authors: Munde Haridas S. , Shende Nitin Y. , Nagare Swati D.
Published: April 2021

Background:  Pancytopenia is characterised by a reduction in all the three cellular elements of blood (erythrocytes, leukocytes and platelets) below the normal reference range leading to anaemia, leucopenia and thrombocytopenia. It is a feature of many serious conditions. The present study was conducted to assess aetiology, clinical profile and bone marrow morphology of conditions presenting with pancytopenia.Methods: A two years cross-sectional study from July 2017 to June 2019 was conducted in the Department of Pathology. Total of 300 pancytopenia patient were studied and their clinical features, peripheral smear finding and bone marrow morphology were studied by using marrow aspiration and biopsy.Results: Among 300 cases studied, maximum patients were in the age group 11-20 years (19.66%) with male (50.66%) predominance. Most of the patients presented with weakness (91.66%) and fever (56.66%) as chief complains. The commonest physical finding was pallor (94%) followed by splenomegaly (27.33%). Macrocytic anaemia (43.66%) was commonest peripheral finding. The commonest cause of pancytopenia was megaloblastic anaemia (32.66%) followed by dimorphic anaemia (21%), aplastic anaemia (16%) and acute leukaemia (13.33%).Conclusions: The present study concludes that detailed clinical history, primary haematological investigations along with bone marrow examinations is essential to determine the cause of pancytopenia.
Effect of sitagliptine and vildagliptine on carotid intima/media thickness in patients with type 2 diabetes mellitus
Authors: Sethy Ganeswar , Sethy Geetanjali , Rout Ranjit , Panda Abinash , Anwesha Adya , Purohit Prasanta
Published: April 2021

Background: Atherosclerosis is a known macro-vascular complication of diabetes mellitus. Gliptins, as a drug class have non-glycemic beneficial action on blood vessels and in addition to their anti-diabetic effects. This study was carried out to find out the effects of sitagliptin and vildagliptin on common carotid intima-media thickness in patients with type 2 diabetes mellitus.Methods: The observational longitudinal study was carried out on 100 patients with 80 patients with confirmed clinical diagnosis of type 2 diabetes mellitus. They were divided in 3 groups. Group A and Group B received drugs, either sitagliptine or vildagliptin and Group C control group did not receive any drug. High resolution B-mode ultrasonography was carried out for the measurement of intima-media thickness (IMT) of both the common carotid arteries (CCA). Data analysis was done using Microsoft excel spreadsheet and GraphPad Prism version 7.0 (free trial version) software package. A p value of ≤ 0.05 was considered as statistically significant.Results: The baseline value for the control group was 0.812±0.0748 mm for both the right and left CCA. At 52 weeks the CCA IMT for the right and left CCA were 1.0185± 0.272 mm and 0.936±0.149 mm respectively. At 104 weeks the CCA IMT for the right and left CCA were 0.923±0.243 mm and 0.859±0.123 mm respectively.Conclusions: There was a significant decrease in carotid intima-media thickness in patients of type-2 diabetes mellitus treated with sitagliptin and vildagliptin.
A prospective comparative study of outcome between open lichtenstein versus laparoscopic repair of inguinal hernia
Authors: Choudhary Sushila , Soni Hitesh , Mehta Jagdish M. , Kalia Saurabh
Published: April 2021

Background: Laparoscopic hernia repair is technically difficult and has long learning curve than open repair. Moreover, with increased cost of procedure do patient really get benefited in terms of intraoperative time duration, post-operative pain and complications, length of hospital stays, and time taken to return to usual activity needs to be studied.Methods: In this prospective observational study of 100 patients including unilateral, bilateral, direct and indirect inguinal hernia and excluding obstructed and strangulated hernia, 61 patients underwent open repair and 39 patients underwent laparoscopic hernia repair. Pain analysis was done with visual analogue scale. Unpaired student T test and Chi square test used (p<0.05).Results: Baseline characteristics age, sex of the two groups were similar. Mean operative time in laparoscopic group was 105.38±35.13 minutes and in open group was 79.95±31.12 minutes (p<0.001). There was statistically significant difference in mean pain score of laproscopic verses open techniques (p<0.001). Urinary retention was the most common post-operative complication in both groups but was statistically not significant. Mean hospital stay in laparoscopic group was 1.56±0.50 days and in open group was 1.9±0.50 days (p-0.002). Mean time taken to return to usual activity in open repair was 41.10±27.15 days and in laparoscopic group was 16.23±6.37 days (p-0.001).Conclusions: This study showed that in laparoscopic repair of inguinal hernia patients have less post-operative pain, shorter hospital stays and early return to work. However, the laparoscopic technique had longer operative time duration.
Perceptions and practices on malaria in a rural population of Koraput district, Odisha
Authors: Padhan Prakash , Bindhani Basanta Kumar , Nayak Jayanta Kumar
Published: April 2021

Background: Malaria is a mosquito-borne disease caused by a protozoan parasite i.e. Plasmodium parasites. It is one of the most prevalent disorders worldwide. India ranked the fourth-highest number of death cases. In Odisha, more than two-thirds of malaria cases are reported from ten southern districts. A high risk of malaria infection is found in Koraput district of Odisha. The present study aims to access the knowledge, attitude, and practices (KAP) about malaria among the individuals of Koraput district, Odisha.Methods: This is a cross-sectional study and 258 respondents were taken randomly from five villages of Koraput district. Data on demographics as well as knowledge, attitude, and practices about malaria was collected by using self-modified and pretested schedules.Results: A significant number of the respondent (97.29%) have reported that they had heard about malaria. 37.60% of respondents answered that they knew it from television, followed by health workers (23.26%) and friends (20.54%). The majority (98.06%) of the sample reported that it is caused by mosquito bites. Almost 63% of the respondents were consulted with a doctor whereas 24.81% consulted first to traditional healers of that region. The majority (99.22%) has a mosquito net and 98.83% of them were used it after a proper wash.Conclusions: Although the study found good knowledge on malaria, still further awareness is required to elevate the present status. In this study most of the respondents had a good level of knowledge about malaria, however, attitude and practices about malaria prevention still need to be improved.
Brain natriuretic peptide in differentiating cardiogenic and non- cardiogenic dyspnoea in patients with renal dysfunction: a single centre study
Authors: Renganathan Sruthi Meenaxshi Subbiah , Rai Madhukar , P. Tiwari J. , Singh Tej Bali
Published: April 2021

Background: Both BNP (Brain Natriuretic Peptide) and renal function are prognostic indicators of survival in patients with congestive heart failure. However, relationship between BNP, renal function and heart failure as an emergency diagnosis are unknown. The usefulness of BNP as a diagnostic tool in patients with renal dysfunction is thus explored in this study.Methods: The present study was prospectively designed diagnostic test evaluation study conducted in Banaras Hindu University, Varanasi. Out of 166 participants with renal dysfunction defined as creatinine >1.5mg/dl who presented with acute dyspnoea, clinical history, BNP, 2D Echo and baseline estimated glomerular filtration rate were assessed. Patients with severe anaemia, eGFR less than 15 ml/min/1.73 m2 and those on dialysis therapy were excluded from the study. The final diagnosis was adjudicated by cardiologist who was blinded to BNP values.Results: The final diagnosis of CHF was in 104 (62.7%). The correlation between BNP and eGFR values were r=-0.49 for those with CHF (p<0.001) and r=-0.279 (p<0.028) for those without CHF. Median BNP in patients with renal dysfunction with CHF was 1206 pg/ml and without CHF was 186 pg/ml. The area under the receiver operating characteristic curve and optimal cutpoints for EGFR categories 59-30 ml /min/1.73 m2 and EGFR less than 30 ml/min/1.73m2 were 0.992 and 491.5 pg/ml (sensitivity 97% and specificity 95%) and 1.000 and 512pg/ml (sensitivity 100% and specificity  95.5%) respectively.Conclusions: Renal function weakly correlates with BNP in patients without CHF (congestive heart failure). BNP is an important bed side tool for distinguishing cardiogenic and non-cardiogenic dyspnoea in patients with renal dysfunction requiring higher diagnostic cut points. Thus the present study emphasises BNP is the strong and independent predictor of CHF even after taking renal function into considerations.
Role of sonomammography and its diagnostic accuracy for evaluating benign and malignant breast lesions
Authors: Khan M. Dawood , Banerjee Subhra , Tarafdar Swarnadeep , Kundu Debabrata
Published: April 2021

Background: Mammography and ultrasound are the best-known techniques used for screening and diagnosis of breast cancer. This study evaluated the accuracy of sonomammography in diagnosing breast lesions, both benign and malignant separately and confirmation of the findings by histopathology.Methods: A prospective study was conducted for 18 months in women aged above 15 years with breast lesions or symptoms of breast diseases. The diagnosis protocol consisted of clinical breast examination, mammography, ultrasound and histopathological examination. Mammograms were interpreted according to the breast imaging reporting and data system (BI-RADS) diagnostic categories on a five-point scale. This was followed by ultrasound imaging of the breast and axilla with ultrasound-guided fine needle aspiration cytology (sonomammography-FNAC) from the breast lump.Results: Among the 52 patients, three patients were divorced, 40 were married and nine were unmarried. Eight had a history of oral contraceptive pills (OCP) use and one patient had a family history of breast lesions. The mammography report revealed 31 patients suspected to be malignant and 21 patients to be benign. According to the sonomammography report, 32 patients were suspected to be malignant while 20 patients were suspected to be benign. Correlation between mammography report, sonomammography report and grade versus histopathological finding also showed significance with p<0.0001.Conclusions: Sonomammography reveals good sensitivity and specificity for detecting all breast lesions. Hence it can be considered as a suitable means of investigation than mammography especially in patients less than 40 years of age.
Knowledge, attitude and practices towards COVID-19 among people living with HIV in Pune, India: a cross-sectional study
Authors: Ghate Manisha V. , Shidhaye Pallavi R. , Gadhe Keshav R. , Gurav Shraddha G. , Deoraj Pramod
Published: April 2021

Background: Studies on knowledge, attitude, and practices (KAP) are important for implementation of interventions. This cross-sectional study was conducted among HIV infected individuals attending antiretroviral therapy (ART) centre at Pune, India, to assess KAP towards COVID-19.Methods: The study conducted between June and December 2020 consisted of twelve, five and seven questions pertaining to knowledge, attitude, and practices respectively towards COVID-19. Frequencies and percentages of correct knowledge, attitude and practices were calculated. Overall knowledge scores were categorized into poor, moderate and good using class width equation.Results: Of the total 1175 participants enrolled, 649 (55.2%) were females. Mean age and CD4count of participants at study entry were 44 years (SD: 9.1) and 637 cells/mm3 (SD: 297) respectively. Overall, 400 (34.0%, 95% CI: 31.33-36.83), 612 (52.1%, 95% CI: 49.18-54.98) and 163 (13.9%, 95% CI: 11.95-15.98) participants had good, moderate and poor knowledge respectively regarding COVID-19. Illiterate participants had six times higher probability of having poor knowledge as compared to their counterparts (OR 5.70, 95% CI: 3.94-8.23; p<0.001). Majority of people living with (PLHIV) had correct attitude towards adherence to government prevention and control measures. Healthy preventive practices of social distancing (99.5%), wearing masks at public places (99.7%) and frequent washing hands with soap and water (98.7%) were followed by PLHIV.Conclusions: PLHIV have average knowledge, correct attitude towards adherence to government prevention and control measures, and appropriate practices towards prevention of COVID-19. Counselling sessions at ART centres should include information for improving knowledge related to COVID-19 especially targeting illiterate individuals.
The effect of percutaneous nephrolithotomy in patients with chronic kidney disease in northeast India population
Authors: Deka Phanindra Mohan , Rajput Manharsinh , Sarma Priyanku
Published: April 2021

Background: Renal stone disease is a recognized precursor for renal deterioration, if untreated, it can lead to renal failure. With advances in the PCNL, the effect on patients with established renal insufficiency remains under reported. So, we aimed to evaluate the efficacy as well as safety of PCNL in chronic kidney disease patients.Methods: This retrospective cohort study included patients admitted in our hospital from January 2016 to December 2018, which were diagnosed with urolithiasis and chronic kidney disease and treated by PCNL. Patients with GFR <60 ml/min/1.73 m2 in non-obstructed renal stone disease who underwent PCNL were included. We studied the change in renal function, complete stone free rate (SFR) complications stone composition, operative time and hospital stay.Results: The study comprised 50 patients (M/F-32/18) of CKD who underwent PCNL. Mean operative time was 90.50±12.57minutes in group 1 and 98.00±12.35 minutes in group 2. One or more complications were noted in 12 patients (24%) after PCNL. At a mean follow-up of 18 months, renal function stage had improved in 24 patients (48%) and it was maintained in 13 (26%). Worse CKD with an increase in disease stage was noted in 13 patients (26%). Association between hypertension, diabetes and postoperative deterioration in kidney function wasn’t significant statistically (p=0.9). The stone-free rate at postoperative month 3 was 76%.Conclusions: PCNL has a favourable outcome in patients with chronic kidney disease stage III/IV, with a good calculus clearance rate and improved kidney function.
The association between laboratory risk indicator for necrotizing fasciitis score with clinical signs and symptoms of necrotizing fasciitis: a retrospective study
Authors: Chauhan Ajay , Patel Yashashvi , Chauhan Amit S. , Mehta Fateh S.
Published: April 2021

Background: The term necrotizing soft tissue infection encompassing simple pyoderma to life threatening infection, varying with regards to anatomical location, tissue involvement and offending organism. Early diagnosis of necrotizing-STI is important for timely surgical intervention, but physical findings can vary, so misdiagnosis is common. By using WBC, CRP, haemoglobin, Na, creatinine, glucose and clinical examination we can distinguish NF from other STI.Methods: This was a retrospective and randomized study in the Geetanjali Medical College and Hospital affiliated to Geetanjali University from January 2017 to January 2019 during this period total 66 patients with soft tissue Infection were admitted and included. Clinical details and investigations were recorded from the case sheet and were analyzed with WBC, CRP, Hb, Na, creatinine and glucose.Results: The most commonly affected age group was 46-60 years with male preponderance. Most common cause of STI was Trauma 66.66% of the patients having Primary Site Lower Limb in 12.12%  and as per LRINEC score 50% of the patients have low risk, 37.87% of the patients have high risk and strongly in favour of NF and 12.12% of the patients have intermediate risk.Conclusions: The LRINEC score is a good tool for NF risk stratification and patients are advised to be careful for presence of NF if LRINEC score is≥6.
Extrapulmonary manifestations of COVID-19 patient presenting with abdominal pain and skin lesions as primary symptoms
Authors: Kumar Abhishek , Prasad Dinesh , Gahlot Vishnu
Published: April 2021

COVID-19 is basically a respiratory disease and pulmonary manifestations constitute main presentations of the disease however in some patients SARS-CoV-2 infection is not limited to the respiratory system and other organs can also be affected and may be the primary manifestations of the disease.Renal dysfunction, gastrointestinal complications, liver dysfunction, cardiac manifestations, neurological abnormalities, haematological and thrombotic manifestations are among the reported extrapulmonary features. Given that ACE2, the entry receptor for the causative coronavirus SARS-CoV-2, is expressed in multiple extrapulmonary tissues, direct viral tissue damage is a plausible mechanism of injury. In addition, endothelial damage and thrombo-inflammation, dysregulation of immune responses, and maladaptation of ACE2-related pathways might all contribute to these extrapulmonary manifestations of COVID-19. Considering the broad spectrum of clinical manifestations and the increasing worldwide burden of the disease, there is an urgent need to evaluate patients presenting with abdominal symptoms and skin lesions even without respiratory complaints to increase the diagnostic accuracy to detect COVID-19 and its complications in early stage. Our case report documents a patient who presented with abdominal symptoms and skin lesions whose RT-PCR was positive for COVID-19. It remains to be seen whether these patients will eventually develop respiratory symptoms. Further studies are needed to elaborate and confirm the causative relationship between SARS-CoV-2 and the reported extrapulmonary manifestations of COVID-19.