Background: Prevalence of malnutrition in Chronic Kidney Disease (CKD) patients is due to their lower appetite level. Diabetic patients experience polyphagia. Hence it is necessary to understand the impact of diabetes on the nutritional status of CKD patient.
Aim: To compare the nutritious status between the CKD patients with and without diabetes.
Objectives: To find out the impact of diabetes on the nutritional status of CKD patients.
Method and Materials: A prospective random sampling method was adopted to select the subjects. Eighty CKD patients were divided equally into two groups. Tool which has been used to collect the data was SOAP format.
Results: While comparing BMI between group 1(CKD without diabetes) and group 2(CKD with diabetes) it was noticed that the percentage of normal nourished subjects in group 2 were greater than that of group1. About 63% and 25% of subjects with CKD in group1 had normal BMI and grade 1 undernourished respectively. In group 2, about 75% and 10% of patients had normal BMI and grade 1 over nourished respectively. About 80% of subjects in group 2 were on insulin treatment. About 88% of subjects in group1 were anorexic and about 55% and 25% of subjects in group 2 had polyphagia and normal appetite respectively. The difference in the energy and protein intake between the two groups was statistically significant at p<0.01 level.
Conclusions: It can be concluded from the above study that a better nutritional status was found in the CKD patients with Diabetes Mellitus (DM) than the CKD patients without DM which may be due to their normal appetite/ polyphagia, hence allowing a better food intake among group2 subjects. Weight gain in CKD with DM patients may be due to increase in fat mass which is subsequent to lipogenic effect of insulin.
Sheng Wang#, Nan Lu, Yongchuan Li, Xiaohuang Tu* and Aimin Chen*
Published on: 25th November, 2024
Background and importance: Sacral fractures often lead to injuries of the lumbosacral nerve, which will cause tremendous damage to the patient’s motor and sensory functions. At present, the most commonly used surgical method is the posterior median approach, the extent and degree of neurolysis are often insufficient, so the effect of neurolysis is not well, and the functional recovery of patients after operation is often incomplete.Clinical presentation: The patient was a 17-year-old male who accidentally fell from a height and landed on his hip. The main clinical feature of the patient was persistent radiating pain in the right lower extremity with right lower limb sensorimotor disorder. The results of the X-ray examination indicated a sacral fracture and a right pubic fracture. After the injury, the patient underwent pelvic internal fixation surgery within 72 hours. Then 6 months after the surgery, there was no significant improvement in right lower limb function, and the patient came to our hospital seeking treatment. Considering the severe lumbosacral plexus injury and the history of surgery, we performed an “Anterior surgery approach combined with posterior approach for lumbosacral neurolysis” for the patient, postoperative radiation pain disappeared completely, and there were significant improvements in the muscle strength of some muscles and sensory function.Conclusion: The relaxation of the lumbosacral plexus is usually performed through a single surgical approach, which has great limitations in the effect of relaxation. Here, we demonstrate a case in which posterior lumbar incision and anterior laparoscopic lumbosacral plexus neurolysis can benefit the patient, the lumbosacral nerve was released to a great extent. We aim to bring this case to the attention of our worldwide neurosurgical colleagues and share our surgical approach to assist those who may encounter this case in the future.
Chayma Ouhibi*, Majd Darwish, Laurent Urban, Mokhtar Lachaal and Jawad Aarrouf
Published on: 6th November, 2023
Background information: Cultural practices play an important role on the development of pathogens (Datnoff, et al. 2007). In this context, several authors have been interested in studying the effects of mineral nutrition on the resistance of vegetables and fruits to fungi during storage, especially nitrogen.The purpose of the study: In this work we tested the effects of three contrasted regimes of nitrogen supply, with nitrate concentrations in the nutrient solutions of 2 mM (low), 10 mM (normal) and 20 mM (high) on the susceptibility of Lactuca sativa L towards Botrytis cinerea (BC87) and Sclerotinia minor (SM) during storage.Once harvested, the outerleaves of the plants derived from the three nitrogen regimes were inoculated with either Botrytis cinerea (BC87) or Sclerotinia minor (SM). Data showed that the resistance to this two pathogens increase when plants were developed under low nitrogen concentration. This resistance observed is correlated with low values in oxidative stress indicators (MDA and H2O2) and high values in total phenols.
In this work an efficient method developed for the synthesis of 125I-benzofuran-2-yl) pyridin-2-amine (125IBPA), followed by radioiodination with 125I by using Chloramine-T at pH 8. The reaction proceeds within 10 min at room temperature (20-25°C). The radiochemical yield determined by Thin-Layer Chromatography (TLC) using hexane:ethyl acetate (1:6 v/v) and the purity analyzed by high-performance liquid chromatography using a reversed-phase RP18column and acetonitrile:0.1 M ammonium bicarbonate (pH 7.5) (1:1) as the mobile phase at a flow rate of 1 ml×min−1. The radiochemical yield using aH2O2 oxidant found equal to 96.5% with a radiochemical purity of 125I-BPA of over 96.5%. The biodistribution data in normal mice indicated a high initial uptake of 6.54±0.10 (% ID/g±SD) in the brain within 30 min post-injection. These results promote a further the use of 125I-BPA as a novel agent for brain imaging.
Testing the antimicrobial efficiency of plastics with good precision and repeatability remains a challenge in the plastic industry, as commonly used standards can provide unreliable data. In this paper, we show that the “Bacterial Liquid Suspension Test” is a reliable method that allows for the measurement of antimicrobial activity of poor to very potent biocides. We used this technique to discriminate the performance of two Cu-based biocides, either in nanoparticle (NP) or macroparticle (MP) size, at three different loadings (0.02, 0.2 and 2 wt.%) in PP. With this technique, we also tested the antibacterial performance of PP as powders, pellets, and injection molded disks. As anticipated, the technique shows that both the increased loading and the smaller particle size showed higher antimicrobial activity than the larger particle size due to their increased surface area. Also, PP powders showed greater bacterial reduction than pellets and disks. While the PP with 2 wt.% Cu NPs showed the best antimicrobial performance, the detection of Cu at the surface (using SEM-EDX) and in the water leachate (using ICP-MS) were below the LODs, indicating their ability to kill bacteria.
The Cloquet’s canal (CC) is the remnant of the primary vitreous and it disappears in the intrauterine developmental period of an eye. Rarely it can persist in mature eyes and cause low visual acuity. We detected a persistent CC and low visual acuity in a 36 year-old patient. Fundus fluorescein angiography and optical coherence tomography examinations were completely normal in our case and low visual acuity was directly associated with opacification of the fibrovascular persistent CC tissue. Persistent CC can cause low visual acuity due to directly media opacity effect of fibrovascular tissue without any complication.
A 21 year-old woman presented with cervical lymphadenopathy and night sweats. Initially, lymphoma was suspected and one of the enlarged lymph nodes was excised in order to make a diagnosis. Histopathological examination revealed Kikuchi’s disease, which is usually a benign syndrome with spontaneous resolution. The disease is very rare, particularly in Caucasian populations. A higher incidence is seen in patients of Asian descent.
The patient had persistent swelling of cervical lymph nodes over several months and further lymph nodes were removed as malignant transformation was suspected. However examinations showed only Kikuchi’s disease. There was given no specific treatment. Follow-up appointments were performed biannually and the patient is currently awaiting removal of yet another swollen lymph node on suspicion of relapse of her Kikuchi’s disease.
Obesity is a chronic and metabolic disease with a high increasing prevalence worldwide. It has multifactorial pathogenesis including genetic and behavioral factors [1-5]. Overweight and obesity have been defined and classified by the World Health Organization (WHO) and the National Institutes of Health (NIH) [2,3]. A person with a normal weight has Body Mass Index (BMI) of 18.5-24.9. A person with a BMI under 18.5 is called underweight. An adult having a BMI of 25-29.9 is overweight and pre-obese. Class 1 obesity is defined as a BMI between 30.00-34.99. Class 2 (Severe) Obesity is to have a BMI between 35.00-39.99. Morbid (Extreme, Class 3) obesity is to have a BMI over 40 [1-5]. Obesity is significantly associated with enhanced morbidity and mortality rates. It has also various economic, medical and psychological effects and causes health problems including many systemic diseases, economic costs and burdens, social and occupational stigmatization and discrimination and productivity loss [4-6]. Obesity carries the increased risk of development of many systemic and chronic diseases, including sleep apnea, depression, insulin resistance, Type 2 (adult-onset) diabetes, Gout and related arthritis, degenerative arthritis, hypertension, dyslipidemia, heart disease such as myocardial infarction, congestive heart failure, or coronary artery disease, polycystic ovary syndrome and reproductive disorders, Pickwickian syndrome (obesity, red face and hypoventilation), metabolic syndrome, non-alcoholic fatty liver disease, cholecystitis, cerebrovascular accident, colonic and renal cancer, rectal and prostatic cancer in males, and gallbladder, uterus and breast cancer in females [6-12].
In recent years, some publications reported that obesity has been strongly associated with some ocular diseases including age-related cataract and maculopathy, glaucoma, and diabetic retinopathy [13-16].
The recent reports demonstrated that the central corneal thickness and intraocular pressure were increased while as mean thickness of RNFL and retinal ganglion cell and choroidal thickness (CT) were decreased in the morbidly obese subjects [17-19]. However, another study has reported that CT increased in obese children [20]. On the other hand, a recent study reported that all values of the specific tests used to evaluate the ocular surface were within the normal range [21]. In some experimental studies, it has been demonstrated that obesity may cause retinal degeneration [22,23]. Additionally, in a past meeting presentation, it has been speculated that keratoconus is associated with severe obesity [24]. Teorically, idiopathic intracranial hypertension, and papilledema may also be associated with obesity [25]. Obesity may be also a cause of mechanical eyelid abnormalities such as entropion [26]. However, further investigations are needed to detect the significant relationship between these diseases and obesity.
On the other hand, the ocular surgeries of obese patients are difficult compared to normal weight-subjects. The posterior capsule rupture and vitreous loss may easily develop during cataract surgery of these patients because obese patients have an elevated vitreous pressure and operating table cannot often be lowered or surgeon’s chair cannot be elevated sufficiently to provide the clear viewing of the operating area and tissues. So, some different surgical manipulations such as standing phacoemulsification technique and reverse Trendelenburg position have been developed. Additionally, the standing vitrectomy technique has been used for vitreoretinal interventions in morbidly obese patients [27,28].
In conclusion, all obese subjects should be subjected to a completed ophthalmological examination and to relevant clinics for the detection of possible comorbidities and diseases
Coroner and medical examiner offices are charged with the medicolegal investigation of deaths to determine the cause and manner of death. We describe the recent high-profile case of Otto Warmbier, who tragically died shortly after his return in a coma from North Korea and in which the coroner failed to conduct a complete autopsy, and failed to satisfy the needs of the local, national, and international communities.
Medico legal death investigation offices, including both medical examiner and coroner offices, have a legal responsibility and duty to investigate deaths in the public interest for public safety and public health purposes. Although, they serve the families of the deceased as they can, their raison d’être and priority is service to the greater public good. Thus, they may conduct investigations and even autopsies over the objections of the next-of-kin. Full investigations include a complete forensic autopsy. The utilitarian public interest should, within the constraints of the office resources, drive the decision of whether to autopsy or not. Failure to autopsy can sometimes constitute a breach of faith that the public entrusts in these offices. Empirically, this seems to be a greater problem in coroner jurisdictions than in medical examiner offices. Specifically, we believe the recent case of Otto Warmbier is such a case.
Background: Faba bean (Vicia faba L.) is one of the most important grain legume crops in Egypt and many other countries of the world because the seeds offer a low-cost source of protein, lysine, carbohydrates, minerals, and vitamins. Chocolate spot disease is a stress-related fungal disease produced by Botrytis fabae that causes plant damage, limits photosynthetic activity, and reduces yield. Results: Trichoderma atroviride greatly reduced mycelial growth by 90.00% in vitro, followed by T. harzianum (86.67%) and T. album (83.89%) on average. In vivo, all studied antagonists dramatically reduced Botrytis fabae disease incidence and severity in both seasons 2021/22 and 2022/23. T. atroviride showed the highest efficacy bioagent (73.55 and 85.15%), followed by T. harzianum (72.55 and 81.22%), in controlling B. fabae of faba bean plants in both seasons. In addition, the results also showed that all tested biological treatments had an impact on yield components and increased levels of chlorophyll, protein%, phenols, flavonoids, Peroxidase (PO), polyphenol Oxidase (PPO), chitinase, and -1, 3-glucanase activities compared to control treatment in both seasons. In this regard, spraying T. atroviride showed the highest efficacy as a bioagent, followed by T. harzianum. Contrary, T. hamatum showed the lowest efficacy compared to other treatments in both seasons. Conclusion: This investigation was carried out to determine the effectiveness of several different antagonists, i.e., T. album, T. atrovirde, T. hamatum, and T. harzianum (30 x 106 spore/ml), Blight Stop, and Bio Zeid, for controlling Botrytis fabae on bean plants and evaluating their effect on yield parameters, components, and quality.
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