Unmasking Renal Complications of Immunotherapy: A Case of Nivolumab-induced FSGS
Published on: 7th February, 2025
Immune Checkpoint Inhibitors (ICPIs), while revolutionizing cancer therapy through potentiation of anti-tumour responses via targeted blockade of T-lymphocyte inhibitory receptors, are associated with immune-related adverse events (irAEs), including diverse renal manifestations. This report presents a case of a 69-year-old male with urothelial carcinoma who developed Acute Kidney Injury (AKI) and nephrotic-range proteinuria following initiation of nivolumab, an anti-PD1 antibody, necessitating renal biopsy to clarify the aetiology. The biopsy revealed Focal Segmental Glomerulosclerosis (FSGS) with endotheliopathy, suggesting a direct ICPI-induced glomerular injury. This case underscores the need for heightened awareness of ICPI-associated glomerular disease, alongside more common renal adverse events such as Acute Interstitial Nephritis (AIN), and for the need for renal biopsy in such cases. While the incidence of ICPI-associated AKI is approximately 17%, and AIN is a more frequent finding, FSGS and other glomerular pathologies should also be considered. Current treatment for such renal events involves discontinuation of the ICPI agent and initiation of immunosuppression with glucocorticoids. The management of these cases requires prompt detection, timely diagnosis, and often interdisciplinary collaboration, thus highlighting the need for more case reports, research, and better treatment strategies.
GELS as Pharmaceutical Form in Hospital Galenic Practice: Chemico-physical and Pharmaceutical Aspects
Published on: 10th February, 2025
This work aims to describe the chemical-physical properties of various GELS used as galenic forms in hospital pharmacy practice. After an overview of the excipients and method used three preparations are reported. LAT GEL is used as an anesthetic in an emergency (pediatry ) in treating little Traumatic lacerations of the skin and scalp, calcium gel is used as an antidote for fluoride acid burns, and Lidocaine viscose 2% oral gel is used in some pathological conditions like severe esophagitis in onco - hematological patients after radiotherapy or chemotherapy. The galenic role in the situation of some drug shortages was also analyzed.
Pneumothorax as Complication of CT Guided Lung Biopsy: Frequency, Severity and Assessment of Risk Factors
Published on: 12th February, 2025
Background: CT-guided lung biopsy is routinely performed minimally invasive procedure. Imaging findings in the lung can have a broad differential diagnosis; therefore, it is indicated for definitive determination of pulmonary nodules or masses. Post-biopsy complications are common with most of them manageable in daycare. As pneumothorax is the most common complication, frequency and severity of pneumothorax with assessment of risk factors and follow-up for resolution is necessary.Methods: A prospective evaluation of 123 biopsies with automated coaxial biopsy of 18 gauge was done. Post-biopsy pneumothorax was evaluated for its incidence and resolution. The studied risk factors were; patient age, sex, lesion location, lesion size, shortest pleural lesion depth, traversed lung parenchymal distance, presence of emphysema, fissure penetration, needle thoracic wall angle, and lesion characteristics.Results: Reported immediate post-procedural pneumothorax was 22% with 19% of mild, 4% of moderate and 2.4% of severe cases. 51.9% of cases showed resolution within 24 hours. The intervention was required in only 4.8% of biopsy cases. A significant p - value of pneumothorax with the nodule depth increased traversed lung parenchymal distance, acute needle angle, fissure puncture, and presence of emphysema was seen. Emphysema was an independent variable in pneumothorax in multivariate analysis.Conclusion: Pneumothorax is an unamenable consequence of CT-guided lung biopsy and a cautious approach should be kept in view of the variables that are associated with it to reduce its incidence and severity in patients.
A case report of Hypocomplementemic urticarial vasculitic syndrome presenting with Renal failure
Published on: 12th September, 2018
OCLC Number/Unique Identifier: 7856112439
We present a case of hypocomplementemic urticarial vasculitic syndrome (HUVS) who developed severe renal failure requiring ICU-level care. Our patient is a 66-year-old man who presented with abdominal pain, rash, confusion, oliguria, and shortness of breath. He was found to be in acute renal failure with leukocytosis and elevated lactate. Work-up for infectious, autoimmune, and hematologic malignant diseases was negative. The presence of chronic urticaria, abdominal pain, hypocomplementemia, and leukocytoclastic vasculitis on skin biopsy confirmed the diagnosis of HUVS. He required hemodialysis for renal failure as well as gastrostomy tube placement for nutritional support secondary to the development of mucosal ulcers, a rare finding in HUVS. He recovered with several months of high-dose steroids and hemodialysis. This case highlights the effectiveness of steroids for initial treatment of HUVS, and the relapsing and remitting nature of the disease. Providers should also be aware of the broad range of presenting symptoms such as mucosal lesions that may require nutritional support. Interestingly, unlike many previously reported cases of HUVS, our patient had not yet developed signs and symptoms of systemic lupus erythematosus, which often overlaps with HUVS.
Consequence of birth year, type, sex, season and flock on birth weight trait of Kajli sheep
Published on: 10th August, 0220
OCLC Number/Unique Identifier: 8652201950
The liaison of birth weight to neonatal and mature vigor is especially given important if have the acquaintance of factors distressing in birth weight. Unbiased Best linear prediction of breeding values was estimated from pedigree birth weight records of 13715 Kajli sheep of livestock Experiment Station Khizerabad born 1994 to 2010, and Livestock Experimental Station, Khushab. Data records were statistically analyzed by means of using computer programmed Mixed Model Harvey’s Least Squares and Maximum Likelihood. An animal model was used for heritability estimation following Maximum Likelihood procedure. Estimates of birth weight heritability in Kajli sheep were 0.05 ± 0.019. The estimated breeding values of both forms for males, females, and sire were calculated with significant variation. Both farms data were analyzed by using an animal model program. The squares mean slightest for weight at birth (kg), remained 4.13 ± 0.01 kg. In addition, birth of the year, the birth of type, flock and sex significantly affects the (p < 0.001) trait of birth weight. The domino effect of the current study has rational implications not only for sheep husbandry nevertheless as well as for amplified acquaintance of parameters which drastically persuade deviation of weight in birth as weight in birth has become itself noteworthy forecaster of anon fitness outcomes. These results showed the decreasing genetic and static phenotypic at birth weight. It is likely that there are complex interactions between genetics and environmental factors of parental, placental and fetal origin. Birth weight is highly influenced trait by maternal nutrition, genes, care, management, climate, seasonal variation and type of birth.
Mass Serological Screening in the Armed Forces Using the Serum-Pooling Method. Analytical Evaluation of the Chemiluminescence Method
Published on: 18th February, 2025
Mass serological screening in the Armed Forces involves detecting serological markers of chronic infections, particularly viral hepatitis B and C, syphilis, and HIV among young militaryrecruits. The objective of this study is to evaluate the analytical performance of the chemiluminescence technique (CMIA-Architect i2000 SR) in mass serological screening using the serum-pooling method at the virology laboratory of the Mohammed V Military Teaching Hospital.Samples with known serological results (positive/negative) were grouped into pools of different sizes (2, 5, 10, and 15 sera). These pools were tested using chemiluminescence (CMIA-Architect i2000 SR). A cost analysis was conducted to assess potential savings based on seroprevalence and pool size.Results showed that the pooling method maintained 100% specificity. Overall sensitivities for detecting positive samples were 93.1% for HBV, 83.33% for HCV, and 86.36% for HIV. Positive and negative predictive values were high for all three viral markers, highlighting the reliability of the pooling method. Additionally, this approach generated significant cost savings, ranging from 46% to 80%. Conclusion: This study demonstrated the solid analytical performance of the chemiluminescence technique (CMIA-Architect i 2000 SR) using the serum-pooling method for detecting HBV, HCV, and HIV serological markers in low-seroprevalence regions.
Comprehensive Acceptance Testing and Performance Evaluation of the Symbia Intevo Bold SPECT/CT System for Clinical Use
Published on: 19th February, 2025
Aim: This prospective study reports the acceptance testing of the Symbia Intevo Bold SPECT/CT scanner (Siemens Healthineers), recently installed at SQCCCRC, University Medical City, Muscat, Oman, before its clinical implementation.Materials and methods: The acceptance tests were performed using a Low Energy High Resolution (LEHR) collimator and Technetium-99m (Tc-99m) as the radioactive source, following the manufacturer’s protocols. The tests included physical inspection, peaking and tuning, intrinsic and extrinsic uniformity calibration, intrinsic energy resolution, and planar spatial resolution without scatter. Key performance parameters such as full-width at half-maximum (FWHM), system sensitivity, and count rate performance were evaluated.Results: All critical acceptance tests, including intrinsic energy resolution, energy calibration (symmetric curve), and extrinsic uniformity with the LEHR collimator, were completed and met the required specifications. System sensitivity and count rate performance were within the expected ranges, confirming the system’s readiness for clinical use.Conclusion: The Symbia Intevo Bold SPECT/CT system passed all performance tests successfully. The acceptance testing validated the system’s optimal performance following international standards, ensuring its suitability for clinical operations.
Lessons from the success and failures of peritoneal Dialysis-Related Brucella Peritonitis in the last 16 years: Case report and Literature review
Published on: 31st December, 2018
OCLC Number/Unique Identifier: 7964745961
Brucellosis is a zoonotic infection that is endemic in some Mediterranean countries, North Africa and the Middle East. Brucella is a rare cause of peritonitis in Peritoneal Dialysis (PD) population and in non-dialysis patients alike. We report here a challenging case of PD-related Brucella peritonitis in a 45-year-old Saudi male with late peritonitis that delivered some key learning throughout its course from presentation, diagnosis and treatment to catheter salvage attempts so as to circumvent PD failure. We provide an in-depth review of limited published literature on PD-related Brucella peritonitis (seven cases, and present case) and summarized the data on key clinical characteristics, management and PD technique outcome to benefit nephrologists when encountered with this rare presentation.
Survey of Advanced Image Fusion Techniques for Enhanced Visualization in Cardiovascular Diagnosis and Treatment
Published on: 6th March, 2025
Cardiovascular Diseases (CVDs) remain a major global health concern, necessitating accurate and comprehensive diagnostic techniques. Traditional medical imaging modalities, such as CT angiography, PET, MRI, and ultrasound, provide crucial but limited information when used independently. Image fusion techniques integrate complementary modalities, enhance visualization, and improve diagnostic accuracy. This paper presents a theoretical study of advanced image fusion methods applied to cardiovascular imaging. We explore wavelet-based, Principal Component Analysis (PCA), and deep learning-driven fusion models, emphasizing their theoretical underpinnings, mathematical formulation, and potential clinical applications. The proposed framework enables improved coronary artery visualization, cardiac function assessment, and real-time hemodynamic analysis, offering a non-invasive and highly effective approach to cardiovascular diagnostics.MSC Codes: 68U10,94A08,92C55,65T60,62H25,68T07.
Catalytic Oxidation-like Nuclear Nano-fusion; Fractal Involving of Room Temperature Magnetically Induced μ-Catalyzed Fusion
Published on: 24th July, 2024
The nuclear fusion reaction can be catalyzed in a suitable fusion fuel by muons (heavy electrons). “For the fractal relations, ranging from DNA knots to solar neutrino flux signals”, ever derived of scale-invariant properties distinguished between classical invariant theory & quantum invariant theory subfactors. Accompanying isomorphic & Connes FusionTensor Product retrieved to μ-catalyzed fusion where surroundings of room temperature fusion driven by the balance in mtDNA fusion & fission. On behalf of the nanometer dimension of the radius of heavy electrons & wavelength of UV-light, it assumed that muons can be produced by oxidation-like decay when UV-light impinging water.
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