bluuebunny/crossref_metadata_2025 huggingface dataset:
Monoclonal gammopathy of renal significance; experience of a tertiary care hospital in India
Authors: Mishra Shashank , Tewari Rohit , Chatterjee Tathagata , Panda Sanjay , Katyal Amit , Sood Vivek
Published: May 2022

Introduction: Monoclonal gammopathy of renal significance (MGRS) disorders are indolent B-cell or plasma cell lymphoproliferative neoplasms which do not meet the hematological criteria for malignancy, however they cause renal dysfunction as a result of production of nephrotoxic monoclonal immunoglobulin (MIg). Objectives: To study the clinical presentation, laboratory features, light microscopy and immunofluorescence (IF) characteristics of all cases of MGRS diagnosed at our hospital over a period of five years. Patients and Methods: A record of all renal biopsies performed at our hospital between 2014-2019 was accessed from the database. Out of 1356 kidney biopsies, 68 had evidence of MIg deposition on immunofluorescence. Only six cases met the criteria of MGRS. Histopathological and immunofluorescence characteristics were studied to classify the lesions as per International Kidney and Monoclonal Gammopathy (IKMG) Research Group classification. Results: All six cases presented with deranged renal function. Four had sub-nephrotic and one had nephrotic range proteinuria. MIg was identified in only one case on serum protein electrophoresis and free light chain assay. Using a conjunction of histomorphology of renal lesions, special stains and immunofluorescence all six cases of MGRS were categorized as per IKMG classification into monoclonal immunoglobulin deposition disease (two cases), AL amyloidosis, light chain cast nephropathy, proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) and light chain proximal tubulopathy (LCPT). Conclusion: MGRS presents as renal failure and proteinuria. MIg may not be detected on protein electrophoresis due to low-secretion in serum. A kidney biopsy is essential to study the morphology of renal lesions and identify MIg deposition.
Association between the metabolic syndrome parameters and serum level of uric acid
Authors: Motevally Bashi Mojgan , Davoudi Zahra , Salehi Mohammad , Mirhashemi Seyed Hadi
Published: May 2022

Introduction: It is well-known that metabolic syndrome is a pathophysiological state with increased risks for diabetes mellitus (DM) and the atherosclerotic cardiovascular disease. Moreover, hyperuricemia can be considered as the main component in metabolic syndrome. Objectives: The present research aimed at the investigation of the association between serum level of uric acid with metabolic syndrome parameters. Patients and Methods: The present cross-sectional study population consisted of 200 subjects susceptible to metabolic syndrome. Data related to weight, height, waist circumference, body mass index (BMI), history of the disease, as well as drug consumption were recorded. All patients underwent routine blood tests for C-reactive protein (CRP ) as well as uric acid levels. According to the diagnostic criteria for metabolic syndrome, we divided the patients into two groups. The first group was affected by metabolic syndrome(case) and the second was without metabolic syndrome (control). Then, we utilized Pearson’s correlation coefficient to investigate the correlation of the serum level of uric acid with the continuous metabolic syndrome parameters. Finally, significant level was P<0.05 throughout this survey. Results: In the case group, the level of uric acid was higher (6.55 ± 1.24 mg/dL) than the control level (4.76 ± 1.24 mg/dL) (P<0.001). We found a significant correlation between the uric acid level and hip circumference, waist circumference, fasting blood sugar, and CRP only in obese patients. Conclusion: As demonstrated, a positive association between the level of serum uric acid and BMI ≥30 kg/m2 in the case group suggests greater role of obesity in metabolic syndrome. Since there is a strong correlation between serum CRP and uric acid levels in the case group with BMI ≥30 kg/m2. High plasma concentration of uric acid can be an inflammatory marker and risk factor for obesity. Therefore, obese people with metabolic syndrome are recommended to control their hyperuricemia.
Platelet glycogen synthase kinase 3β regulates plasma β amyloid and phosphorylated tau levels in chronic kidney disease patients with cognitive dysfunction; therapeutic role of erythropoietin
Authors: Ganesan Vinothkumar , Sethuraman Krishnakumar , Sureshkumar Sureshkumar , Prabhu Venkataraman
Published: May 2022

Introduction: Patients with chronic kidney disease (CKD) have increasingly been diagnosed with cognitive impairment. Glycogen synthase kinase 3β (GSK3β) is directly causing both phosphorylated tau (pTau) and amyloid β (Aβ) accumulation in Alzheimer’s disease (AD). GSK3β expression is more abundant in human platelets than in other blood cells. Recombinant human erythropoietin (rHuEPO) is a common medicine for treating anemia in patients with CKD, as well as a neuroprotective agent. Objectives: The goal of this research is to find out how platelet GSK3β regulates plasma Aβ, total Tau and tau phosphorylated at threonine 181 (p-tau181) levels in CKD patients with cognitive dysfunction and also the efficacy of rHuEPO treatment. Patients and Methods: The study included 60 participants, which consist of 30 CKD without cognitive dysfunction and 30 CKD with cognitive dysfunction based on the neuropsychological examination. The expression of GSK3β in platelets was evaluated using a western blot and plasma Aβ, total Tau, pTau 181 levels were quantified by ELISA. The data were compared statistically (P< 0.05) to AD, normocytic normochromic anemic and healthy patients. Results: In CKD with cognitive dysfunction subjects, platelet GSK3β expression and plasma Aβ, total Tau and pTau181 levels were significantly (P< 0.05) altered like AD when compared to normocytic normochromic anemic, healthy and CKD without cognitive dysfunction subjects. In post rHuEPO (100 IU/kg, weekly twice, six months) treatment, the altered protein abnormalities were retrieved significantly (P<0.05) compared to pre-treatment. Conclusion: This study established that platelet GSK3β expression and plasma Aβ, total Tau, pTau181 are the candidate biomarkers for cognitive dysfunction in CKD patients. The clinical utility of rHuEPO as a GSK3β inhibitor and therapeutic agent for cognitive dysfunction in CKD has been determined.
Treatment of class II lupus nephritis with combination therapy of mycophenolic acid and corticosteroid; a case report
Authors: Nugroho Faizal Armando , Shanti Bayu Dharma , Widodo Widodo
Published: May 2022

Lupus nephritis (LN) is one of the most serious manifestations of systemic lupus erythematosus (SLE). Despite available guidelines recommendations on appropriate therapeutic agents, up to one-third of LN patients still do not meet expected response to initial corticosteroid or immunosuppressive treatment. We report a 17-year-old Indonesian female who was diagnosed LN with persistent proteinuria manifestations. Renal biopsy was suggestive of class II LN. Corticosteroid was given for a month without therapeutic response, and the patient was given combination of moderate dose methylprednisolone and mycophenolic acid resulted in complete remission after nine months therapy. Despite the existing guidelines, choices of LN treatment might be individual depends on disease severity (clinical, laboratory and histopathological findings) and demographic factors. The combination of mycophenolic acid and corticosteroid might be better option than high dose corticosteroid to treat class II LN for minimizing the adverse event of corticosteroid.
Successful treatment with intense immunosuppressive therapy in an initially 100% crescentic lesion of anti-GBM nephritis
Authors: Phongphithakchai Atthaphong , Praditau-Krit Suntornwit , Dandecha Phongsak , Boonsrirat Ussanee , Wetwittayakhlung Poowadon
Published: May 2022

Anti-glomerular basement membrane (anti-GBM) nephritis is uncommon glomerular disease caused by autoantibodies targeting the capillary beds of the kidney. The clinical presentation of the disease is a variable nephritic syndrome, rapidly progressing to glomerulonephritis. Treatment outcomes are dependent on predictors at first diagnosis. We presented a case of 58-year-old man who did not have underlying disease presented with marked abdominal distension and acute kidney injury. He had no evidence of chronic renal disease before admission however, laboratory test showed microscopic haematuria (RBC 30-50 per high-powered field), proteinuria (2.9 g/d), and renal failure (serum creatinine 610 µmol/L) compatible with rapidly progressive glomerulonephritis; hence, a renal biopsy was conducted. The pathology showed 100% crescentic glomerulonephritis with IgG deposits in a linear pattern at the GBM. The initial serum anti-GBM titre was 105.59 RU/mL. This patient had poor renal prognosis factors for treatment response. After a discussion regarding treatment option with the patient, we decided to give intensive immunosuppressive therapy and plasmapheresis due to his good baseline functional status. The patient achieved partial remission and is not dialysis dependent. In conclusion, despite a poor renal prognosis with 100% crescents and serum creatinine ≥ 600 µmol/L, the treated patient had a good survival status and did not become dialysis-dependent. However, immunosuppressive treatment should be performed along with careful monitoring for infection to avoid infection-related morbidity and mortality.
Evaluation of the influential factors on the mortality of patients with acute myocardial infarction
Authors: Hoseinian Adalat , Bahadoram Mohammad , Amani Firouz , Hakimian Sajjad , Attar-Madraki Saba , Jafarizadeh Raana
Published: May 2022

Introduction: Death caused by myocardial infarction (MI) usually occurs during the first hours after the onset of symptoms. Therefore, to manage, treat and decrease the mortality rate of these patients, early hospital admission is important. Objectives: We aimed to investigate the impact of the influential factors on mortality of patients with MI. Patients and Methods: In this case-control study, MI patients who were referred to the Ardabil Alavi Hospital, Ardabil university of medical sciences, Ardabil, Iran between April 2017 and April 2018 were included. The patients that had died due to MI were considered as the case group (n=27) and 27 matched patients that had died due to other causes were selected as the control group. Linear logistic regression was employed to analyze the data. Results: The mean age of the patients in the case group was significantly higher than in the control group (75.1±11.7 versus 63.;1±11.6, P=0.001). The history of non-cardiac diseases in the case group (44.4%) was significantly higher than in the control group (7.4%; P=0.002). The number of PCIs (percutaneous coronary interventions) that were conducted in the case group (40.7%) was significantly lower than in the control group (74.1%; p=0.013). The time distance between hospital admission and PCI performance in the case group (110.9 minutes) was significantly higher than in the control group (56 minutes; P=0.001). However, the mean of delay time from the onset of symptoms to hospital admission (the patient delay) and from hospital admission to receiving treatment (the health system delay) was similar between the two groups. Conclusion: This study showed that the number of performed PCIs, history of non-cardiac disorders and the interval between the onset of symptoms and PCI performance are significantly associated with the morality of MI patients.
The effect of educational intervention based on encourage autonomous self-enrichment program on dialysis adequacy in patients undergoing hemodialysis
Authors: Jafarizadeh Hossein , Moradi Yaser , Rasouli Javad , Khezrzadeh Naseh
Published: May 2022

Introduction: One of the essential criteria for managing the disease in a hemodialysis patient is the adequacy of dialysis. Patient education, as an alternative method, can be useful to improve the adequacy of dialysis. Objectives: The present study aimed to investigate the effect of educational intervention based on EASE (Encourage Autonomous Self-Enrichment) program on dialysis adequacy in patients undergoing hemodialysis. Patients and Methods: The target population included the patients referred to the hemodialysis ward of Imam Khomeini hospital of Piranshahr. A total of 74 hemodialysis patients were randomly allocated into the intervention (n=37) and the control (n=37) groups. Data collection was conducted using a researcher-made checklist including demographic information and dialysis adequacy. Independent t-test and repeated measures ANOVA were used to test statistical differ. Results: We found a significant difference in dialysis adequacy between the two groups (P<0.05). Furthermore, the difference between the mean scores of dialysis adequacy before and after the intervention was statistically significant in the intervention group. Repeated measures ANOVA at four-time points of pre-test and one month, two months and three months after the intervention showed that the difference in dialysis adequacy mean scores were not similar in the two groups and also showed improvement in dialysis adequacy mean score in the intervention group compared to the control group. Conclusion: Based on the results of our study, EASE program made improvements in dialysis adequacy.
Kidney transplantation registry program in Mashhad university of medical sciences; design and rationale
Authors: Miri Maryam , Akbari Masoumeh , Ghoreishi Narges , Kimiafar Khalil , Hami Maryam
Published: May 2022

Introduction: Kidney transplantation was conducted in Mashhad University of Medical Sciences (MUMS) for more than 20 years. In recent years, about 160 kidney transplantation has been conducted here annually, that consisted of both cadaveric and living donor programs. Objectives: Since transplant outcomes have not been systematically monitored, we try by registration of this group of patients, donors and recipients, to analyze and share kidney transplantation outcomes. Patients and Methods: The kidney transplant registry program in Mashhad, Khorasan Razavi, started in 2016. This registry is a prospective, single center, longitudinal program, designed as a dynamic observational cohort that enrolls all transplant recipients and donors. Demographic data, etiology of chronic kidney disease and patient and graft survival were analyzed. Results: Baseline characteristics, treatment data, patient and donor condition before and after surgery, potential clinical events including hospitalization, co-morbidities and graft failure are all collected. Follow-up visits in recipients have been conducted in 1st, 3rd months and every year after operation. Data quality is ensured by automatic software validation and a manual data review process. Conclusion: By this system, it is easy to adhere to input. Likewise data is adequate for rapid statistical processing.
Evaluation of the neutrophil to lymphocyte ratio in lupus patients with and without nephritis
Authors: Pourlak Tala , Abediazar Sima , Maroufi Parham , Emami Leila , Jafari Nakhjavani Mohammadreza , Zununi Vahed Sepideh
Published: May 2022

Introduction: Lupus nephritis (LN) is a significant source of morbidity in cases with systemic lupus erythematosus (SLE). The efficiency of neutrophil-to-lymphocyte ratio (NLR) as an inflammatory marker has been investigated in many diseases. Objectives: In the present study, the clinical significance of NLR in SLE patients with nephritis was investigated. Patients and Methods: A total of 100 SLE patients including 20 and 80 patients with and without nephritis, respectively, and 140 controls were included in this investigation. Clinical findings and laboratory data of whole participants were reported. Inflammatory indices [e.g., erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and NLR] were compared between patients and healthy controls and also between SLE patients with and without nephritis. Results: NLR value was significantly higher in SLE patients [2.81 (1.57-16.07)] compared to controls [1.45 (1.01-4.43)] and in SLE without nephritis [2.60 (1.50-13)] compared to SLE with nephritis [5.82 (3.75-16.07)] (P < 0.001). Based on the ROC/area under curve (AUC) analysis, NLR reflected SLE disease with AUC of 0.904, cut off value of 1.98, 86.2% sensitivity, and 82% specificity. Additionally, NLR with a cut-off value of 3.64 and AUC of 0.935 indicated good sensitivity of 100% and specificity of 81.25% for discriminating SLE patients with and without nephritis. Conclusion: NLR could be considered as a discriminative parameter for SLE patients and for LN. Further investigations are required to consider NLR as an inflammatory parameter.
The effect of ginger on blood sugar and urine protein in patients with type 2 diabetes mellitus; a clinical trial
Authors: Foroutan Majid , Yarmohammadi Maliheh , Ghorbani Raheb , Movahhed Hanieh
Published: May 2022

Introduction: The prevalence of diabetes mellitus has been increasing exponentially and its complications are a major cause of morbidity and mortality. Ginger is one of the herbal remedies which has preventive effects on nephropathy in animal models in some studies. Objectives: We aimed to investigate the effect of ginger on urine protein analysis and blood glucose levels in diabetic patients. Patients and Methods: In a clinical trial, 98 patients with type 2 diabetes were randomly divided into two groups; the intervention group received 500 mg of Zingiber as capsule, daily in addition to routine therapies, since control group received only conventional treatments for diabetes. Before and after intervention, blood glucose, urine microalbumin and hemoglobin A1c (HbA1c) were measured. Results: The findings showed that Zingiber decreased HbA1c levels in diabetic patients (P=0.006), however, it did not have a significant effect on fasting blood glucose (P=0.179), 2 hours post-prandial glucose levels (P= 0.272), and the microalbuminuria quantity in urine (P=0.109). Conclusion: In our study, the hypoglycemic short-term effects of ginger observed as a reduction of HbA1c, however its effect on reducing blood glucose levels [FBS and 2 hours postprandial glucose (2hpp)] was not significant, therefore ginger can be considered as a supplementary agent in the treatment of diabetes. However it is recommended to conduct more studies to obtain results with more reliability. Trial registration: The trial protocol was approved by the Iranian Registry of Clinical Trial (identifier: IRCT2017103025732N27; https://www.irct.ir/trial/21503, ethical code; IR.SEMUMS.REC.1395.207).
Effects of dietary advanced glycation end-products restriction on renal function in patients with diabetic nephropathy; a randomized, double-blind clinical trial
Authors: Dashtabi Arash , Mazloom Zohreh , Ezzatzadegan Jahromi Shahrokh , Fararouei Mohammad
Published: May 2022

Introduction: It has been proposed that advanced glycation end-products (AGEs) are contributory factors in diabetic nephropathy (DN) pathogenesis. Interventions regarding restriction dietary AGEs (dAGEs) intake indicate improvement in clinical outcomes. Objectives: The present study aimed to compare the effects of 10-week low AGEs diet (LAGEsd) based on recommended diabetic diet (DD) versus DD alone on glycemic status, lipid profile, serum creatinine (sCr), blood urea nitrogen (BUN), urine albumin to creatinine ratio, eGFR and urine albumin in patients with DN. Patients and Methods: This randomized, double-blind clinical trial was conducted on 62 patients with DN. Patients were assigned randomly to LAGEsd (n=31) and DD (n=31) groups for 10 weeks. All patients were prescribed calorie adjusted diet in regards to American Diabetes Association’s recommendation. In addition, patients in the LAGEsd group were instructed how to reduce dAGEs intake based on established guidelines. Demographic data were collected and dietary intakes, physical activity level, fasting blood sugar (FBS), hemoglobin A1C (HbA1c), lipid profile, sCr, blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), urine albumin to creatinine ratio (Alb/Cr), and urine albumin were measured before and after of 10-weeks intervention, and compared between the two groups. Results: The results showed that dAGEs intake decreased significantly in the LAGEsd group compared with the DD group (P<0.001). In the LAGEsd group, eGFR improved significantly compared with the DD group (18.77±20.99 mL/min/1.73 m2 versus 1.57±21.06 mL/min/1.73 m2 , P=0.002); however there were no significant difference in FBS, HbA1c, lipid profile, sCr, BUN, urine Alb/Cr, and urine albumin between the two groups (P>0.05). Conclusion: In sum, dAGEs restriction plus DD is superior to DD alone in improvement of renal function marker in patients with DD. Trial Registration: This study was registered at Iranian Registry of Clinical Trials (identifier: IRCT20191004044979N1, https://en.irct.ir/trial/42914, ethical code #IR.SUMS.REC.1398.798).
The relationship between serum magnesium and bio-electrical impedance variables in patients undergoing dialysis
Authors: zeraati Abbasali , sharifipour farzaneh , hami maryam , ataee zahra , samadi mohamad , samadi katayoun , zeraati tina
Published: May 2022

Introduction: The relationships between serum magnesium(Mg) levels and body composition or clinical outcomes of incident dialysis patients remain unclear. The aim of this study was to evaluate the possible correlations between magnesium and bio-electrical impedance variables, a method of determining body composition in two groups of hemodialysis(HD) and peritoneal dialysis(PD) patients. Methods: This prospective observational study examined the relationships between Serum Mg levels and Bio-impedance variables including total body fat, body cell mass, extra cellular mass, total body water (TBW), intra and extra cellular water (ICW and ECW), ECW/ICW and phase angle (PA) in incident 38 HD and 34 PD patients since December of 2012 in Mashhad Imam Reza Hospital dialysis center. The correlation between Mg and bio-impedance variables was assessed applying the student test and Pearson’s correlation coefficient. Results: the average concentration of serum Mg was 1.22 mmol/L in HD patients and 1.20 mmol/L in PD patients which is well above the reference range in normal population. the average amount of body water and also ICW in patients were significantly higher than HD patients. Our statistical analysis showed no significant relation between serum Mg and Bio-electrical impedance variables in HD patients, however in PD patients, a statistically significant correlation was found between serum Mg and ECW (r = 0.48, p = 0.02), ICW (r =- 0.48, p = 0.02), and ECW/ICW (r = 0.43, p = 0.02). Conclusion: we speculated that there is a link between serum Mg level and intravascular and extravascular water content in PD patients, however we cannot prove any correlation between serum Mg level and Bio-impedance variables in such patients. This could be considered as a sign of Mg role in healthy cell function in PD patients.
Investigation of acute kidney injury and related risk factors in patients with COVID-19
Authors: Hadian Babak , Zafarmohtashami Azita , Razani Mahdi
Published: May 2022

Introduction: The 2019 recent coronavirus disease (COVID- 19) is a novel pandemic disease in the world. The main organ involved in this viral sepsis is the respiratory system. Objectives: Regarding the expression of angiotensin-converting enzyme (ACE) receptors as entering route for virus’ particles into cells, the kidney organ is another important target in this catastrophic sepsis. There is little data about renal complications and related risk factors in victims. Patients and Methods: All patients with COVID-19 admitted to a referral and tertiary center (Shohada hospital, Khorramabad, Iran) were included in the study. The research was performed from February 20 to April 19, 2020. Diagnosis of patients was confirmed by COVID-19 upper respiratory sampling using real-time PCR. Patients’ demographic data, clinical and laboratory variables were included in pre-designed questionnaires according to the considered factors; then all collected data was entered into SPSS-26 software and statistical analysis was performed. Results: All COVID-19 patients included in the study were 232 cases. Out of them, 99 cases were female (42.7%) and 133 males (57.3%). Among patients, 19 cases had AKI (acute kidney injury); of these cases. Out of AKI patients, 12 (63.2%) were admitted to the ICU, whereas the mortality rate in patients with AKI was 63.2%. AKI was significantly associated with older age, ICU admission, and lower lymphocyte count. AKI occurrence was associated with the history of hypertension, or underlying kidney disease but hadn’t a significant relationship with diabetes. Conclusion: According to this study, age is an important risk factor for renal disease and poor outcomes in COVID-19 patients. Hence, old age patients should be given more attention. Concerning more prevalence of potassium disorders, further monitoring of hypokalemia or hyperkalemia is recommended. Considering, poor outcomes in patients with COVID-19 and AKI, nephrologist’s consultation is necessary.
Prevalence of acute renal failure in pediatrics admitted to the emergency department
Authors: Sadeghi-Bojd Simin , Soleimani Gholamreza , Soleimanzadeh Mousavi Seyed Hosein , Yaghoubi Saeedeh
Published: May 2022

Introduction: Causes of acute renal failure in children vary in developed and developing countries. Prevention plays an important role in reducing the complications of acute renal failure (ARF), while changes in fluid therapy management and infection control can reduce the incidence and severity of renal failure. Objectives: The aim of this study was to investigate the prevalence and causes of ARF in children. Patients and Methods: A prospective descriptive-analytical study was conducted in Ali-Ibn-Abitaleb hospital in Zahedan during a period of one year from April to March 2017 in patients aged one month to 15 years who were admitted to the pediatric emergency department. Results: Among 201 patients with acute kidney injury (AKI), the highest number was 112 patients (28.3%) between one month and one year, followed by 80 patients (7.9%), one year to five years, and 9 patients (3.1%) above 5 years. Gender did not play a significant role in the development of acute kidney disease. The most common causes of AKI were sepsis (87.2%), underlying renal disease (64.9%), heart disease (37.5%), and gastrointestinal disease (19.5%), respectively. The most common laboratory findings in patients with AKI were hypokalemia (56.7%) and hypernatremia (57.1%). Conclusion: ARF is one of the most problems in medical system, but its exact cause is not well established. Knowing ARF epidemiology by standard definitions can help to measure high-risk pediatrics, as the first step for treatment and improving outcomes. A future study may benefit from better identification of risk factors and early detection of AKI using novel biomarkers to prevent the progression of AKI.
The impact of our acquired experience on endoscopic injection treatment outcomes of vesicoureteral reflux during the first ten years of practice
Authors: Roupakias Stylianos , Sinopidis Xenophon , Spyridakis Ioannis , Karatza Ageliki , Varvarigou Anastasia , Tsikopoulos George
Published: May 2022

Introduction: Endoscopic injection treatment (EIT) for vesicoureteral reflux (VUR) correction is widely accepted as an optimal method for more than thirty years. However, it is still in its infancy in many pediatric surgical centers. It presents variable cure rates, with many factors affecting its successfulness. Objectives: We aimed to identify how accumulated endoscopic experience affected the VUR resolution success rates, in association with a variety of characteristics, since the beginning of practicing the technique. We attempt to improve patient selection. Patients and Methods: The outcomes of 53 children, corresponding to 78 refluxing ureteral units (RUUs), treated with endoscopic injection during the first years of practice (2010-2016), and 26 children with 42 RUUs during the latest years (2017-2020), were compared. Characteristics such as age, gender, VUR grades, preoperative voiding cystogram and dimercaptosuccinic acid scintigraphy, side, laterality were analyzed in relation with outcome of the groups of the study population. Outcomes presenting statistically significant differences were considered related to experience. Results: Refluxing ureters of the second group presented significant improved endoscopic treatment success rates and also significant reduced need for open surgery. The second group of experienced performance presented significant improved success rates in younger children, in girls, in children with bilateral VUR or duplex ureteral system, and when reflux presented at the filling phase of voiding cystourethrogram. Furthermore, the second group of experienced performance presented significant improved success rates in ureteral units of a duplex system or with grade III and high grades IV-V VUR. Conclusion: Our initial experience with EIT has been promising. Boys, and children with bilateral VUR or duplex ureteral system should be treated by more experienced endoscopic surgeons. Furthermore, high grade VUR is a predisposing factor for endoscopic treatment failure, performing by less experienced surgeons. Pediatric surgeons must upgrade their learning curve, initiating their experience, and developing their surgical skills with more simple cases before expanding their practice to more complicated.
Identifying the optimal timing of renal replacement therapy initiation among critically ill patients on extracorporeal membrane oxygenation therapy
Authors: Boonsrirat Ussanee , Ouejiaraphant Chokethawee , Phongphithakchai Atthaphong
Published: May 2022

Introduction: Acute kidney injury (AKI) is one of the most frequent complications in patients with severe cardiopulmonary dysfunction on extracorporeal membrane oxygenation (ECMO) therapy. Although renal replacement therapy (RRT) is the standard of care for AKI, the timing of initiation of RRT remains controversial. Objectives: This study aimed to determine the optimal timing of RRT initiation among patients receiving ECMO therapy. Patients and Methods: We conducted a retrospective cohort study of 40 patients in a tertiary hospital centre from March 2014 until December 2019. The patients were divided into two groups according to the timing of RRT initiation, i.e. early RRT (within 72 hours) or late RRT after ECMO treatment. The primary outcome was 60-day mortality. The secondary outcomes were survival predictors of these patients. Results: The 60-day mortality was not significantly different between the two groups (76.9% in the early RRT initiation and 88.9% in the late group; P=0.321). The predictors of survival were RRT start within 72 hours of ECMO initiation (HR: 0.067, 95%, CI: 0.010-0.457), age ≥ 60 years (HR: 6.334, 95% CI: 1.268-31.625), fluid balance on day seven of ECMO (HR: 1.093, 95% CI: 1.007-1.187), and eGFR-EPI ≥ 60 mL/min/1.73 m2 (HR: 0.970, 95% CI: 0.946-0.996). Conclusion: Among patients with ECMO and RRT, early RRT within 72 hours of ECMO initiation was significantly associated with a decreased risk of death. Our findings suggest the survival benefit of early RRT in critically ill patients treated with ECMO.
Assessment of the prevalence of latent tuberculosis infection in hemodialysis patients using tuberculin skin test
Authors: Zafar Mohtashami Azita , Amiri Ali , Hadian Babak , Nasiri Pardis
Published: May 2022

Introduction: Patients undergoing dialysis are suffering from some degree of cellular immunity impairment which predispose them to develop latent tuberculosis infection (LTBI) which can turn into active tuberculosis (TB). Diagnosing LTBI in dialysis patients is helpful in preventing disease evolution. Objectives: The aim of this study was to estimate the frequency of LTBI in a group of hemodialysis patients. Patients and Methods: We studied all patients undergoing hemodialysis in Khorramabad teaching hospitals. Data were collected by completing a questionnaire through observation and interview. The Mantoux tuberculin skin test (TST) was performed, then 48 to 72 hours later, the induration was measured in millimeters. Results equal to or greater than 10 mm were considered positive. Results: One hundred and nineteen patients undergoing hemodialysis participated in the study. The mean age of patients in this study was 58.55 ± 16.04 years. The induration size at the TST site was equal to or greater than 10 mm for 97 patients (81.5%) and less than 10 mm for 22 patients (18.5%). More than 81% of participants had LTBI. Until about two years later, none developed active tuberculosis without preventive treatment. Conclusion: Several studies indicate the uncertainty of TST results in hemodialysis patients. Eighty-two percent positive is too much, and makes it difficult to consider all of them to be true positives. Therefore, it will be challenging to decide on starting preventive treatment. We recommend World Health Organization (WHO) to focus on a new affordable accessible efficient test for LTBI screening which does not require to be repeated or be confirmed by another diagnostic method, especially, for the expanded screening of the general population in the future.
The nephroprotective effect of Eryngium caucasicum extract alone and in combination with metformin in adult male diabetic rats
Authors: Golestaneh Elnaz , Hasanpour Dehkordi Ali , Yalameha Banafsheh , Noorshargh Pegah , Nasri Parto , Baradaran Azar
Published: May 2022

Introduction: Diabetes mellitus (DM) is a metabolic disease associated with the disorders in the metabolism of carbohydrates, proteins, and lipids that affect insulin action. Objectives: The present study was designed to evaluate the nephroprotective effect of Eryngium caucasicum (Eryngo) extract alone and in combination with metformin (MET) in adult male diabetic rats. Materials and Methods: Thirty male Wistar rats randomly were designated into five groups (n = 6) including; group I (Control); rats received normal saline by gavage for 15 days. Group II; rats received a single injection of STZ at a dose of 60 mg/kg intraperitoneally. Group III; rats, after STZ injection, received 30 mg/kg of MET by gavage for 15 days. Group IV; rats, after STZ injection, received 30 ml/kg of Eryngo extract by gavage for 15 days. Group V; rats, after STZ injection, received the combination of MET and Eryngo extract at a dose of 30 mg/kg by gavage for 15 days. The kidneys were removed immediately after sacrificing and prepared for morphological examination. Kidney sections were examined for the intensity of kidney damage (vacuolization, flattening, degeneration, and necrosis). Results: Significant differences were observed in types of morphologic injury to renal tubular cells between groups (P < 0.05). Eryngo extract had more protective effect against kidney damage due to DM compared to MET and the combination of MET+Eryngo. Additionally, in pairwise comparisons of groups, the relationship between group II (DM group) and group IV (DM + Eryngo) was significant (P < 0.05). Conclusion: The administration of MET and Eryngo extract alone and their combination ameliorate types of morphologic injury to renal tubular cells in diabetic rats, however, the renoprotective effect of Eryngo extract alone is more remarkable.
Molecular docking study of Momordica charantia Linn phytoconstituent with caspase 3 and implications for renoprotective actions in diabetes mellitus
Authors: Ghanta Mohan Krishna , Nayaka Swapna R , Nuthalapati Poojith , Afzal Khan Afzal Khan , Elango Panchanathan , Lakkakula Bhaskar VKS
Published: May 2022

Introduction: Caspase 3, an apoptosis executioner, inhibition may be beneficial for diabetes, nephropathies, neurodegenerative disease treatments and in areas of regenerative medicine. Since early traditional medicine, plant extracts comprised the major treatments of many ailments. Phytoconstituents have been a prime source for therapeutics, which are abundantly available resources. Therefore, with the interest to identify potential anti-apoptotic agents in plant extracts, D-galacturonic acid (DGA) was selected for screening anti-caspase 3 activity as it is the major constituent in Momordica charantia (bitter melon) and many other fruits’ pectin composition. Objectives: The present study aimed to evaluate activity of major phytoconstituent of M. charantia extract, DGA against caspase 3. Materials and Methods: The chemical structure of the ligand was from obtained PubChem database, and the protein structure was procured from PDB database. Molecular docking study was performed using AutoDock version 4.2. Results: This study states the interactions of DGA with GLU’124, LYS’137 and ARG’164 amino acids of caspase 3, where GLU’124, LYS’137 amino acid interactions are important for stability of caspase 3 enzyme. Conclusion: The interactions between DGA and caspase 3 revealed in this study may be helpful in characterizing the medicinal property of this phytoconstituent in the bitter melon extract by future studies.
Acute oxalate nephropathy associated with herbal remedies
Authors: Bashardoust Bahman , Asgari Mojgan
Published: May 2022

The use of herbal remedies has grown in recent years, largely due to their increased production and the media advertisements which target their use for the cure of almost all symptoms. Herbal remedies have also become popular in multi-plant forms and have recently become available in both industrial and condensed formulations, with higher doses being administered. We report a 68-year-old woman presenting with symptoms of flank pain, nausea, vomiting, anuria, and hematuria. She has history diabetes mellitus, hypertension and use of herbal including Achillea millefolium and Thymus migricus, Nasturtium for the last four months. Kidney biopsy was performed and was diagnosed with oxalate nephropathy. After the use of herbals was stopped, creatinine levels returned toward normal value in the following months with no complications. Herbal remedies would cause severe organ failures if administered in high-doses and should be considered as a possible cause in patients presenting with AKI.
A Comparison of Deep Learning Architectures for the 3D Generation Data
Authors: Yasmin da Silva Bonfim  , Gabriel Sete Ribeiro Lago dos Santos  , Gustavo Oliveira Ramos Cruz  , Flávio Santos Conterato
Published: May 2022

There is a need to identify the best artificial images for each use case faced with several Deep Learning architectures for generating them. Twelve models with different hyperparameters were created to compare several networks with the generative architectures Autoencoder, Variational Autoencoder, and Generative Adversarial Networks in the 3D MNIST dataset. After training, the models were compared with loss functions to assess the difference between the original and artificial data, so that greater complexity did not translate into better performance, indicating the Autoencoder models as the best cost-benefit.
Dunaliella salina Biorefinary: An Evaluation of the State-of-the-Art
Authors: Stephanie de Melo Santana  , Ana Lucia Barbosa de Souza  , Fernando Luiz Pellegrini Pessoa
Published: May 2022

Biorefinery is an important concept that can be applied to improve the industrial processes, making them more sustainable, and reducing waste, and costs of operation. Algal biomass is too onerous to be exploited, and only a few microalgae have products that are feasible to commercialize. Combining this concept and other ones, such as intensification and integration procedures, can also help reduce the costs and become more attractive to industries. Dunaliella salina is one of the most critical microalgae studied nowadays. Currently, its process exploits only 10% of its compounds in beta-carotene production. Studies show that different compounds can be exploited and the processes can be combined in a biorefinery approach.
Technical Feasibility Analysis of the Patent Ondomotric Energy Generations System With Code BR 10 2016 016119 3 A2
Authors: Kelson Mascarenhas Cirne  , Gabriel Pereira Ugucioni Rocha  , Alex Álisson Bandeira Santos
Published: May 2022

With the industrial expansion arising from the national development process, and the current global trend towards the search for clean and renewable energy sources, the diversification of the energy matrix becomes vital in the process of renovation and strengthening of energy generating sources to meet the SIN (National Interconnected System). This work presents the technical feasibility analysis of the wave power generation prototype with patent code BR 10 2016 016119 3 A2. The simulations carried out in modeling software to evaluate the constructive aspects of the prototype allowed the analysis of data on the mass of the components, gravity centers, and moments of inertia. Finally, the positive and negative aspects and points for improvement of the project were presented, aiming to raise interest in the topic presented and develop new studies for the electricity sector.
Modeling of an Extreme Flooding Event in the Amazon Basin Using the WRF-Hydro Model
Authors: Carolina Sacramento Vieira  , José Roberto Dantas da Silva Júnior  , Daniel Guimarães Silva  , Filipe Milani de Souza  , Diogo Nunes da Silva Ramos  , Yasmin Kaore Lago Kitagawa  , Davidson Martins Moreira
Published: May 2022

In the Amazon, the frequency of extreme events has been increasing notably in recent decades. In April, May, and June 2021, the city of Manaus faced the greatest flood in 119 years, and the Rio Negro reached at a level of 29.98 m. Because of this, the present work aims to evaluate the performance of the WRF-Hydro model in simulating precipitation during an extreme flood event in the Amazon Basin. The simulations were performed with 1 km spatial resolution and a 250 m channel network from April 30 to June 5, 2021. Such applications were evaluated using comparisons of the variability of accumulated precipitation with observed data from National Water Agency rainfall stations. The results showed a tendency for the model to underestimate the accumulated precipitation, slightly reproducing some observed precipitation patterns. We concluded that the tool presents a capacity for precipitation estimation, with potential for operational purposes.
Building Information Modeling Integrated With Life Cycle Analysis in Plumbing Projects: A Preliminary Systematic Review
Authors: Diogenes Oliveira Senna  , Larissa da Silva Paes Cardoso  , Alex Álisson Bandeira Santos
Published: May 2022

Many studies point out that the modeling of construction information (BIM) integrated with life cycle analysis (LCA) can be launched as an alternative, to identify and quantify the environmental impact generated by the construction industry. However, most studies are based on architectural and structural projects, there are few works in plumbing installations. The objective of this study was to evaluate, through a systematic literature review (SLR), the scientific contribution from 2015 to 2021 in articles on free access to BIM integrated with LCA in plumbing facilities projects. In the RSL, 128 articles were found, and we selected 5 articles for analysis and extraction of information that identified gaps and potential studies.
Theory-Based Studies of Maritime Networks: A Literature Review
Authors: Carlos César Ribeiro Santos  , Hernane Borges de Barros Pereira
Published: May 2022

This article reviews the literature regarding maritime networks, including identifying the essential articles and authors and suggesting a categorization of associated topics. Network theory in logistics demonstrates strategic information about and competitive advantages of maritime transport between regions. We analyzed 145 technical/scientific studies of maritime networks, including articles, theses, patents, dissertations, and conference proceedings. After defining the inclusion and exclusion criteria, we selected 103 technical and scientific studies, whose analysis allowed us to suggest six categories of interest: Ports, Economy, Containerized Cargo, Maritime Safety, Clusters, and Technological Solutions and Innovations.
Biological Systems of Exposed Fishing Communities in Thuraivan Novel
Authors: K.S Anbukala
Published: May 2022

All literature that is visualized from the sangam period till the modern period, is centered and reflection of human life. Tamil landscape (Ainthinaai pagupadu) is divided into five thinai. Among the divisions sea and sea related land called neithal is unique among the literatures. Novel literature tells about the human life and their culture. Thuraivan novel written by Christoper Anthony depicts the life of the fisherman. In this novel we will look at the lifestyle, culture, history, language style, fishing methods and beliefs of the fishing community. Christoper Anthony is from a fisherman community. He has lived the life of fisherman. So in his novel biography of fishing community is given without changes. In this article will see the living style of fisherman community that is depicted in thuraivan novel.
Periyar and Prominent Figures who paved the way for Human Emancipation
Authors: Y Samraj
Published: May 2022

Dravidam is the social movement, created by the greatest leader Periyar, that is meant as ‘People Centred Movement’. This movement has sown a seed for a complete freedom from any sort of slavery. This also disseminates rationalism among the oppressions by whipping the darkness from their minds. It emancipates the hardships of women and flourishes the flower of honour, to them. By eradicating Castism, one is able to be vigilant towards equality. Man enslaved man in the guise of religion and to demolish this flith through the teaching “Love is the Source of life”. Education makes a poor illiterate to become a historical important person. It is the language ‘Tamil’ that proves to be the base in equality argumentation when compared to all other languages. Dravidam reveals and clarifies that “Tamilans” do not depent on anyother favour to withstand. Not only rectifying the mistakes in the history, but also makes the people to have a correct view and also to get their previlges and rights, is the focus of Dravidam. Thanthai Periyar, stand as a successful leader to lead Tamilians in the correct Path. This paper focuses on the above and to bring the effects of the movement ant its followers.
Resalts of Treatment of Patients with Basal Cell Carcinoma of the Lids
Authors: Пастух И.В. , Гончарова Н.А. , Ковтун М.И. , Недзвецкая О.В. , Чубенко И.О. , Шкиль Е.А. , Зубкова Д.А.
Published: May 2022

В статье представлены результаты хирургического лечения пациентов с различными формами базалиом (базальноклеточного рака (БКР)) кожи век. Во всех случаях производилась полнослойная резекция базалиом в пределах здоровых тканей. Выбор оперативной техники зависел от размеров, локализации, прогрессирования опухолевого процесса, близости к краям век. При значительных размерах новообразований, превышающих половину длины века, выбирался метод пластики, позволяющий минимизировать послеоперационные рубцовые изменения тканей и получить удовлетворительный косметический результат.

The article presents the results of surgical treatment of patients with various forms of basal cell carcinoma of the eyelid skin. In all cases, a full-layer basal cell resection was performed within healthy tissues. The choice of the surgical technique depended on the size, localization, progression of the tumor process, proximity to the edges of the eyelids. With a significant size of neoplasms exceeding half the length of the eyelid, a plastic method is chosen that minimizes postoperative scar tissue changes and obtain a satisfactory cosmetic result.