Introduction: Minimal change disease (MCD) is a common subtype of primary nephrotic syndrome in adults. The pathogenesis of MCD is still not well understood, but some studies suggest that MCD is a T cell-mediated disease related to podocyte dysfunction. Previous research has also indicated the crucial role of B cells in the pathogenesis of MCD. Rituximab (RTX) is a recombinant chimeric mouse/human antibody targeting CD20 antigen. In recent years, RTX has been increasingly used in adult MCD patients.Methodology: We searched the PubMed database using the keywords “Minimal change disease”, “Nephrotic syndrome”, and “Rituximab” and obtained a total of 140 articles. We will now provide a literature review based on these 140 articles, according to our research topic.Discussion: This article provides an overview of the mechanisms and clinical research progress of RTX in the treatment of adult MCD. We have also discussed the current treatment methods for MCD, exploring the potential of using RTX as a first-line therapy for refractory adult MCD.Conclusion: MCD is a common pathological type of nephrotic syndrome, and the exact mechanisms are still not fully understood. Although RTX as a treatment of adult MCD has shown promising clinical results in patients with refractory adult MCD, the safety and efficacy of RTX still lack high-quality clinical evidence. Further research is needed to explore the pathogenesis of MCD and the RTX treatment for MCD.
Noura Ali Moosa Al Balushi, Shabib Sulaiman Ali Al Rashdi*, Nageswara Rao Lakkimsetty and Fatema Almarhoon
Published on: 28th December, 2022
Due to the adverse environmental impacts of synthetic plastics, biodegradable plastics development for both industrial and commercial applications is essential for the present scenario. In addition to the non-degradability of petroleum-based plastic and its impacts, so it is very important to find an alternative to petroleum-based plastic. Starch-based bioplastics are an excessive substitute for petroleum-based plastics due to their significant properties compared with natural sources. This research aims to formalize five new formulas of bioplastic by combining two sources of starch, extracted from various biomass sources, its properties and comparison between them. The moisture content shows 2.07% and 0.984% for samples F and B respectively and that indicates that the samples which contain a high amount of corn starch have less moisture content. The highest results of biodegradation percentages were 68.27% and 52.6% which are for samples A and D respectively, and the lowest biodegradation percentage were 34.33% and 31.29% which are for samples F and B respectively.
A knee arthroscopy in spinal anaesthesia was performed on a 67 years old male patient. During the procedure the patient was hemodynamically stable, until he suddenly turned pale and started complaining of severe pain in lower abdomen with signs of guarding. The procedure was finished as urgently as possible and after releasing the tourniquet we noticed significant difference in volume of the leg, with redness distal to tourniquet. Urgent lab results were essentially unremarkable and the patient was sent for the urgent radiological diagnostics.
CD of the left leg described fluid in the soft tissues of the thigh, scrotum, and abdomen; and the unenhanced CT of the abdomen showed free fluid along the entire femoral shaft of the left thigh, extending towards pelvis and abdomen to perihepatic and perisplenic space, and retroperitoneum, with gas bubbles tracking along anterior aspect of the left thigh into the left retroperitoneum.
He was admitted to the ICU, and within few hours all symptoms have resolved and his further recovery was without complications.
Laparoscopic approach in emergency theatre is an irreplaceable tool to manage patients with acute surgical pathology. We retrospectively reviewed surgical access records from the Emergency Department for acute right iliac fossa pathology. We considered 51 patients (16 male, 35 female, mean age 23.8 years) access for acute right iliac fossa pathology over the last year. 44 patients underwent laparoscopic approach (86%); 8 patients were treated with an open approach. Outcomes evaluation was based on data comparison from open appendicectomy over 4 year time period.
Variables considered for data analyses were: role of laparoscopic surgery for gangrenous/perforated appendicitis, Conversion rate, Laparoscopy appendicectomy for elderly patients.
Our study demonstrated that a laparoscopic approach at acute right iliac fossa pathology is feasible, safe and can offer a low incidence of infectious complications, less post-operative pain, rapid recovery, and represent a valid diagnostic tool in doubtful cases, at the expense of longer operating time than OA. We suggest that LA should be the initial choice for all patients with acute right iliac fossa pathology.
Laleye Flora Tinouade Founmilayo* and Fanou Fogny Nadia and Kayode Polycarpe
Published on: 10th August, 2023
In developing countries, malnutrition represents a public health problem, which affects many children under five, during their complementary feeding period. One way to overcome this problem is through the supplementation of complementary flours with locally available food resources, such as Moringa oleifera leaf (MOL). An experimental study was conducted from June through November 2019 in the southern-Benin, with moderately acutely malnourished (MAM) children, using a porridge made of a mixture of corn, malted sorghum, soybean, peanut, milk, and moringa leaf powder. A total of 150 MAM children aged 12-59 months were recruited and divided into two groups, an intervention group (48) and a control group (75). The intervention group received the test food, a porridge made of maize flour supplemented with Moringa oleifera leaf flour (MOL-flour), at least 5 times/week for 6 months. The control group, whose mothers received nutritional education sessions on food diversification as well as the different ways of preparing MOL meals. Sensory evaluation, anthropometric and dietary diversity data were collected. Z-scores Weight/Height, Weight/Age et Height/Age were determined before and right after the intervention. Results showed that 70% of the children and more than 75% of the mothers assessed the porridge as palatable. A significant average weight gain of 1.720 g (p < 0.005) was observed in the intervention group at the end of the experimentation, with a reduction of the prevalence of underweight by 1,33% (p > 0.05), and the number of acute Malnutrition children by 10,42% (p < 0.005).
It was investigated contractility and adrenoreactivity of intact myocardium strips of right ventricular in experiment with 60 rats. They were assessed by the force of induce contraction and its changes under the influence of adrenaline (10-9 or 10-5 g / ml). Found that these indicators do not depend on the phases of the estrous cycle and the presence of pregnancy. Histidine (10-10-10-4 g / ml) did not increase the response to adrenalin (10-9 g / ml), but increased the force of the contractions in rats in progesterone dominance (trend) and pregnancy (statistically significant). Against the background of propranolol (10-8 g / mL) or atenolol (10-8, 10-6 g / mL), adrenaline (10-5 g / mL) instead of increasing the force of contraction reduced it (probably due to activation of beta3-, alpha1 - and alpha1 a2- adrenergic receptors), and histidine (10-4 g / mL) prevented this reduction, but does not restore full ability of adrenaline to exert a positive inotropic effect. On the background of nicergoline (10-8 g / mL or nicergoline and propranolol (10-8 g / mL), adrenaline (10-5 g / mL) did not alter the force of contraction, and histidine (10-4 g/mL) restore ability of adrenaline to exert a positive inotropic effect but only in the experiments with nicergoline. Concluded that histidine increases the efficiency of the activation of all three (beta1-, beta2- and beta3-) populations of myocardial beta-adrenoceptoprs, including at lower by adrenergic blockers. Therefore, histidine proposed as an antagonist of beta-adrenergic blockers and as resensitizator of these receptors.
Core Tip: In the experiments with strips of the right ventricle of 40 nonpregnant and 20 pregnant rats histidine (10-10-10-4 g /mL) did not increase the response to adrenaline (10-9 g / ml), but increased the force of contractions in pregnant rats. On the background of propranolol (10-8 g / mL) or atenolol (10-8, 10-6 g / mL), adrenaline (10-5g/mL) showed a negative inotropic effect, and histidine (10-4 g / mL) prevented it, but does not restore the ability of adrenaline to show positive inotropic effect,. i.e histidine exhibits the properties of the antagonist of beta-blockers and of resensitizator of beta-adrenoceptors
Akmal Shams, Ikramullah Ibrahimi* and Hayatullah Ahmadzai
Published on: 27th August, 2024
Myocardial infarction is the leading cause of morbidity and mortality worldwide. The overall aim of the study was to evaluate community awareness about myocardial infarction.It was a community-based cross-sectional study conducted during one month including both male and female participants aged 18 years and over in Nangarhar province of Afghanistan. The percentage of awareness for risk factors was as follows: Diabetes (56.4%), Hypertension (43.4%), Elderly (42.1%), Obesity (39.8%), Physical inactivity (38.5%), Hyperlipidemia (37.6%), and Family history (33.8%). Furthermore, knowledge about symptoms and signs was as the following: chest pain (67.4%), pain in neck and jaw (57.8%), Dyspnea (50.7%), pain in arms (46.1%), weakness/fainting (40.1%), cold sweats (38.2%), nausea and vomiting (34.5%), anxiety (29.6%), fever (22.7%), hypotension/shock (20.1%), and silent myocardial infarction (11.3%). Moreover, 24% of participants did not know about the prevention strategies for myocardial infarction. Regarding treatment, 80.3% of participants exactly knew to go to the emergency room, 11.9% of participants would intend to go to a general practitioner (GP), 5.6% of participants would ask others for advice on what to do, and 2.2% of participants would wait to see if the symptoms go away spontaneously or if the symptoms were due to other diseases. The current awareness level about myocardial infarction especially atypical symptoms, risk factors, prevention, and treatment strategies in Nangarhar residents was insufficient, especially in females and healthy individuals, and warrants designing and implementing immediate awareness programs in order to avoid delay of treatment-seeking, misbeliefs about the disease and subsequent morbidity and mortality.
A highly focused and highly cost-effective failure-oriented-accelerated-testing (FOAT) suggested about a decade ago as an experimental basis of the novel probabilistic design for reliability (PDfR) concept is intended to be carried out at the design stage of a new electronic packaging technology and when high operational reliability (like the one required, e.g., for aerospace, military, or long-haul communication applications) is a must. On the other hand, burn-in-testing (BIT) that is routinely conducted at the manufacturing stage of almost every IC product is also of a FOAT type: it is aimed at eliminating the infant mortality portion (IMP) of the bathtub curve (BTC) by getting rid of the low reliability “freaks” prior to shipping the “healthy” products, i.e., those that survived BIT, to the customer(s). When FOAT is conducted, a physically meaningful constitutive equation, such as the multi-parametric Boltzmann-Arrhenius-Zhurkov (BAZ) model, should be employed to predict, from the FOAT data, the probability of failure and the corresponding useful lifetime of the product in the field, and, from the BIT data, as has been recently demonstrated, - the adequate level and duration of the applied stressors, as well as the (low, of course) activation energies of the “freaks”. Both types of FOAT are addressed in this review using analytical (“mathematical”) predictive modeling. The general concepts are illustrated by numerical examples. It is concluded that predictive modeling should always be conducted prior to and during the actual testing and that analytical modeling should always complement computer simulations. Future work should be focused on the experimental verification of the obtained findings and recommendations.
Introduction: Myopia is a refractive disorder commonly diagnosed in childhood that follows a progressive course. It is considered a global epidemic with nearly 23% of the world’s population being diagnosed with this condition. Moreover, myopia is increasing in prevalence worldwide, demonstrated by studies in Asian and Western populations. This has important implications as myopic progression to high myopia is associated with significant morbidity and visual disability if left untreated. Of these treatments, the pharmacologic agent atropine has demonstrated the greatest efficacy in reducing myopia progression.Case report: This is a case report of an 11-year-old male treated with 0.01% atropine drops for myopia progression that developed new-onset seizures. The seizures were characterized as benign epilepsy with central temporal spikes and ceased when drops were discontinued. Discussion: Atropine 1% drops have previously been associated with new or increased seizure activity in a handful of case reports, however, it is our knowledge that this is the first report associated with 0.01% drops. This is important given the growing use of 0.01% drops as well as higher concentrations such as 0.025 % and 0.05% for the treatment of pediatric myopia. Conclusion: While it cannot be proven that the drops were causative in the seizure events, it is important to consider prior seizures as a relative contraindication to the use of these drops. Atropine has the potential to exacerbate seizure activity, so it is possible that the 0.01% atropine drops played a role in the patient’s seizures. Also, any diagnosis of new-onset seizures in pediatric patients should prompt discontinuation of drops at seizure onset.
Introduction: Congenital heart diseases (CHD) are leading causes of childhood morbidity and mortality especially in developing countries. Community-based studies are important in ascertaining the burden of the disease.
Objectives: The study was set out to determine the prevalence and types of CHD among primary school children in Port Harcourt Local Government Area (PHALGA) of Rivers State, Niger Delta, Nigeria.
Methods: A total of 1,712 primary school pupils were selected by multistage sampling from twelve schools in PHALGA. A questionnaire was used to obtain information from pupil’s parents on their child’s biodata and symptoms suggestive of heart disease. General physical and cardiovascular system examinations were carried out on each selected pupil, following which those with symptoms and/or signs suggestive of heart disease had echocardiographic confirmation of their cardiac status.
Results: The 1,712 subjects were aged 5-14 (mean 8.48 ± 2.30) years. 874 (51.1%) were females while males were 838 (48.9%). The study revealed that 31 pupils had congenital heart diseases confirmed by echocardiography, giving a prevalence of 18.1 per 1,000 pupils. The commonest cardiac defects seen were acyanotic CHD in 30 (96.8%) pupils while cyanotic CHD was seen in only one (3.2%) pupil. Among the acyanotic CHD, atrial septal defects (83.9%) followed by ventricular septal defects (9.7%) were the commonest. CHD occurred with higher frequency among females (64.5%) and among the younger age group of 5-9 years (61.3%) though these were not statistically significant (p > 0.005).
Conclusion: Cardiac examination as part of compulsory health screening at primary school entry will help detect children with CHD, reduce delay in diagnosis for intervention, avert debilitating morbidity and assure a better quality of life.
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