All Articles in March, 2019

Background: Haemodialysis is the commonest method of Renal Replacement Therapy in Nigeria. Despite an advancement in the technicality and better understanding of haemodialysis, a number of complications are known to be associated with this procedure.. Objective: We aimed to highlight our experiences and share some of the uncommon complications encountered during haemodialysis and present the outcome of our patients. Subjects and methods: A retrospective review of 101 patients during the last two years was done. Data extracted include: sociodemographic characteristic, aetiology of kidney disease, type of vascular access, intradialytic complication and outcome of treatment. Results: The total number of dialysis session during the period was 823. Males constituted a higher proportion (64.4%) and were found to be older than female patients 49.8 vs 42.8 years (P=0.001). Majority (89.1%) had chronic kidney disease while chronic glomerulonephritis was the main cause of CKD as seen in about 45% of the patient. Due to the cost implication, only 2(1.98%) were able to undergo 3 sessions of dialysis per week for up to 1 month. Vascular access was femoral (66.3%), internal jugular vein (25.7%), while only 2% used Artero-venous-fistula and one patient had femoral vessel pseudoaneurysm from frequent cannulation. The commonest complication was hypotension which was present in 15.8%. Twenty-eight deaths were recorded, 44(43%) were either lost to follow up or absconded while 5% were transplanted at a referral centre. Conclusion: Challenges of renal replacement therapy is overwhelming in our country due to poor human and financial resources. Early diagnosis and adequate government support are advocated.

The concept of space-matter motion in the new Cartesian physics, based on the identity of space and matter, creates the basis for the study of consciousness as the action of the brain in space inside and outside itself and offers a way of materialistic explanation of life on Earth. She claims that consciousness in living matter arises when the brain begins to create the surrounding space the image of themselves and the world. And since space according to Descartes is identical to matter, the images created by the brain of itself and the external world in the surrounding space have a material basis and therefore the displayed organs interact with each other and the external world.

The use of novel PGPR as bio inoculant is an alternative sustainable agricultural practice to improve soil health, grain quality, increase crop productivity, and conserve biodiversity. The aim of this study is to isolate, and characterized PGP bacteria colonizing tef rhizosphere during the seedling stage. For this concern, 426 samples of tef (Eragrostis tef) rhizosphere soils and roots were collected from East Shewa zone, Oromia regional state. 200 morphologically different bacterial pure colonies were isolated and screened for their PGP traits and biocontrol properties. Among these 40.5% isolates were positive for phosphate solubilization. 36% were positive for IAA production, 4.5% were positive for ammonia production, 19 % were positive for (EXPS), 15.5% were positive for protease production, 12.5% were positive for HCN productions, 9.5 % were positive for cellulase production, 4% were positive for amylase production, 3.5% were positive for chitinase production. For abiotic stress tolerance test, all of the isolates were grown well at 20oc and 30oc and neutral pH, 27% isolates were grown well at 4oc, 25.5% grew at 40oc, 25.5% were grown well on pH-9 and pH-11, 23.5% were tolerated pH-5, 3.5% grew at 50oc and 60oc, 13.5% were grown well on 5% NaCl (w/v), 3.5% were grown well on 10 and 15% NaCl (w/v), which indicated these isolates can survive in some extreme conditions. Totally 15 bacterial species having PGP traits, biocontrol properties, and abiotic stress tolerance ability were identified using the Biolog bacterial identification system. Among these, the majority of the identified PGPR have utilized carbohydrate, carboxylic acid, and amino acid, which are the main components of plant root exudates. The above results indicated that thus PGPR can be used as biofertilizers as well as biocontrol agents to replace agrochemicals to improve crop productivity. Hence, these species can be further formulated and used for greenhouse and field applications.

Purpose: Monolayer passage of chondrocytes results in dramatic phenotypic changes. This “de-differentiation” is expected to restore the chondrogenic properties such as “re-differentiation” in autologous chondrocyte implantation (ACI). The purpose of this study was to compare the chondrogenic re-differentiation potential of chondrocytes, from osteoarthritis (OA) patients and young adult patients, after monolayer culture. Methods: Chondrocytes from five old patients with knee OA (OAC) and five young patients with recurrent shoulder dislocation (non-OAC) were used. The chondrocytes from passages 1 to 3 were analyzed for the expression of cell surface markers (CD73, CD90, CD105, and CD44) by flow cytometric analysis. Chondrocytes of passage 4 were cultured as pellets for re-differentiation and evaluated histologically. Real-time PCR were performed to measure the chondrogenic related genes transcriptional levels. Results: OAC and non-OAC had comparable positive ratios for CD44, CD73, CD90, and CD105. The expression of CD105 was upregulated from passage 1 to passage 3 in OAC, and it increased at the same level as in non-OAC during passage 2 and 3. The expression of COL2 decreased from passage 1 to passage 3 in both the groups. There were no statistical differences in the Bern Scores between OAC and non-OAC. Conclusion: The chondrocytes from OA patients and young adult patients had chondrogenic re-differentiation potential. The changes in cell surface markers and chondrogenic related genes showed similarity for both the groups. Our findings suggest that OAC can become the cell source for ACI.

Rosai-Dorfman disease (RDD) is an idiopathic, benign proliferation of histiocytes that can be present in multiple organs such as lymph node, skin, soft tissue, orbit, central nerve system and bone; however, it rarely occurs in the breast. In general, RDD is a painless, firm and poorly defined lesion, which can radiologically mimic a breast cancer and is therefore an important differential consideration. The diagnosis of breast RDD is challenging, especially on a small biopsy specimen. We report a unique case of breast RDD with a literature review including common presentation, differential diagnosis, and recommended management. A high index of suspicion for this rare entity is essential to render a correct diagnosis, thereby avoiding unnecessary diagnostic tests and treatment.

Introduction: Chronic kidney disease is a costly and burdensome public health concern. Delayed recognition and treatment of CKD may predispose patients to unfavorable future outcomes and burden the healthcare services. The early detection of disease via screening programs is widely recommended. The present study is a hospital camp-based screening for detecting patients with chronic kidney disease in Varanasi from 2014-18. Methods: The study subjects constituted 436 apparently healthy adults (age ≥18 years) of Varanasi. Information on socio-demographic profile, personal characteristics and clinical investigations were recorded. Stepwise binary logistic regression analysis was applied to find the significant predictors of chronic kidney disease. Results: Median age of the study subjects was 40.5 years. There were 39.7% males and 60.3% females. Chronic kidney disease was found in 23.9% subjects. Underweight, diabetes mellitus, hypertension, smoking status and higher creatinine levels came out as significant predictors of chronic kidney disease. Conclusion: We screened apparently healthy individuals and found very high percentages of chronic kidney disease and its predictors. Henceforth, understanding the preventable and modifiable risk factors of chronic kidney disease becomes a prerequisite to intervene before risk populations reaches to irreversible stages of adverse future outcomes.

Ilex paraguariensis, also known as ‘Yerba mate’, occurs naturally in Argentina, Brazil and Paraguay and is also grown in these countries with different intensities. Leaves and branches of this plant are used in the preparation of a stimulant beverage that beside social importance has notorious health impact. However, the cultivated herbs present low productivity, due to deficiencies in cultivation and harvesting techniques, as well as due to the abiotic stresses that this species is subject to. The discovery and characterization of cold response mechanisms in plants such as Arabidopsis thaliana, began research in order to unravel the physiological and molecular mechanisms in response to cold in other plant species. In this work, we studied the physiological response observed in Ilex paraguariensis plants submitted to low temperatures (0°C), with or without a pre-moderate acclimatization treatment period of (8°C). Our results suggest the existence of an acclimation response in Ilex paraguariensis, similar to that described in other species of the same temperature.

The purpose of the present study was to define the period of time in which aerobic training does not increase further serum S-Klotho levels in untrained young adult males, and to examine the relation between plasma S-Klotho concentration and maximal oxygen uptake (VO2max). Methods: Sixty (60) untrained subjects (27.05±1.1 years) were divided into 2 groups, both exercised six months 4×wk-1 for the duration of 45 min×session. One group (LTI) exercised below the anaerobic threshold at 40-50% of VO2max, while the second group (HTI) worked above the anaerobic threshold at 65-70% of VO2max. Testing sessions were performed at 0, 2, 4, and 6 months. Blood samples were drawn after overnight fasting; S-Klotho was analyzed using an ELISA kit. Results: Following 2 and 4 months, significant (p≤0.05) increases were noted in the HTI group, at the fourth testing session, S-Klotho leveled off. In the LTI group, S-Klotho remained almost unchanged. Findings of the present study, support emerging evidence suggesting that a relation between plasma S-Klotho concentration and VO2max exists. Conclusion: Data suggest that increases in S-Klotho is tidally associated with VO2max levels. In addition, the S-Klotho increase levels-off following 4 months of aerobic training. Exercising below the anaerobic threshold does not increase VO2max and thus, does not increase S-Klotho.  

Acute dizziness/vertigo is among the most common causes for visiting the emergency department or primary care physician. Although the majority of these presentations represent an acute peripheral vestibulopathy (APV), lateral medullary, lateral pontine, and inferior cerebellar infarctions can mimic APV very closely. We present an atypical presentation of an aggressive APV and outline how a well-constructed bedside neurotologic evaluation can distinguish central from peripheral vertigo in the acute setting.

Aim of this work is to verify the effect of some neurotoxins, physical factors and geography in presentation of some Relevant Neurological disorder like some form of ASL, PD, AD. The geographic diffusion of the ASL/PD in west pacific (GUAM foci), and mutation of SOD 1 and other mutations are interesting facts to verify the recent literature about the neurotoxic process. Related to the references presented a global conclusion about the pathogenetic progression of some neurological disease will be produced as instrument for new hypothesis and for the introduction of new innovative therapeutic strategies.

Worldwide, Canine Distemper Virus (CDV) infection is a highly prevalent disease with high morbidity and mortality. CDV causes a multisystemic disease in a wide range of hosts including 9 families of mammals among them some primates, cetaceans and numerous carnivores. It presents a high tropism for lymphoid, neurological and epithelial tissue, leading to an infection of almost all systems, so the clinical signs observed are very varied. The diagnosis is made based on the clinical presentation of the disease, which considers a variety of signs and must be confirmed by a laboratory diagnostic method. The molecular technique called Reverse Transcription Polymerase Chain Reaction (RT-PCR) has been used to characterize viral strains based on the basis of genetic differences on the hemagglutinin (H) gene of CDV has allowed the identification of 14 circulating lineages in the world. Two lineages, namely the America-1 and the Europe-1/South America-1 have been described in Chile. The goal of this work was to implement a multiplex RT-PCR protocol, which was built on the in silico design of primers based on the H gene nucleotide sequences stored in the Genbank® database. This method was capable of detecting the previously described two circulating genetic lineages of CDV in a differential way providing a supporting diagnostic tool for epidemiological studies in the country. These results suggest that the primers described here are extremely selective for the above-mentioned lineages. In addition, our initial screening indicated that most analyzed clinical samples corresponded to the America-1 lineage, stressing the need for a continuous surveillance in order to properly address the prevalence of both lineages in Chile.

The broad spectrum of heterozygous versus homozygous JAK2V617F mutated MPN consists ET, ET with early features of PV (prodromal PV), classical PV, masked PV, advanced PV and post-PV myelofibrosis. Combined use of bone marrow histology and increased erythrocyte counts above 5.8x1012/L can replace increased red cell mass at time of presentation as the pathognomonic clue for the correct diagnosis of hetero/homozygous or homozygous mutated PV. Erythrocyte counts are in the normal range below 5.8x1012/L in heterozygous JAK2V617F mutated ET and prodromal PV but above 5.8x1012/L in heterozygous-homozygous or homozygous mutated PV. The bone marrow cellularity and morphology in pre-fibrotic ET, prodromal PV and PV carrying the JAK2V617F mutation are overlapping showing clustered increase of large mature pleomorphic megakaryocytes (M) with no increase of cellularity (<60%) in ET. The bone marrow is hypercellular (60%-80%) due to increased erythropoiesis megakaryopoiesis (EM) in prodromal and classical PV and trilinear hypercellular (80%-100% due increased megakaryopoiesis, erythropoiesis and granulopoiesis (EMG) in advanced PV and masked PV. Bone marrow cellularity ranging from normal (<60%) in ET to increased erythropoiesis (EM) in prodromal PV to hypercellular (80-100%) in advanced PV and masked PV largely depends on increasing JAK2V617F mutation load from low to high on top of other biological MPN variables like constitutional symptoms during long-term follow-up. MPL515 mutated ET is featured by an increase of clustered small and giant megakaryocytes with hyper-lobulated staghorn-like nuclei in a normal cellular bone marrow. The third entity of pronounced JAK2/MPL wild type ET associated with primary megakaryocytic granulocytic myeloproliferation (PMGM) without PV features proved to be caused by calreticulin (CALR) mutation. CALR mutated thrombocythemia is characterized by dual proliferation of megakaryocytic and granulocytic bone marrow proliferation of dense clustered large to giant immature dysmorphic megakaryocytes with bulky (bulbous) hyperchromatic nuclei, which are not seen in MPL515-mutated Thrombocythemia and JAK2V617F-Thrombocythemia, prodromal PV and classical PV.