Activity

519, p < 0.001) and creatinine level (r = 0.167,p = 0.034). The multivariate regression analysis found that the severity of proteinuria was independently correlated to MHR (p < 0.001). According to the receiver operating characteristic curve analysis, the optimal cut-off level for MHR in NS was 10.08 (area under the curve of 0.704, sensitivity of 68%, and a specificity of 62%).

Our study is the first to compare the severity of proteinuria and renal functions with MHR in patients with primary NS. We believe that MHR can be used as a biomarker to determine inflammation, endothelial injury, and the level of oxidative stress, and may be useful to predict prognosis in patients with primary NS.

Our study is the first to compare the severity of proteinuria and renal functions with MHR in patients with primary NS. We believe that MHR can be used as a biomarker to determine inflammation, endothelial injury, and the level of oxidative stress, and may be useful to predict prognosis in patients with primary NS.Routine surgery may be postponed if a patient has high white blood cells (WBC) and/or pyrexia. However, postponement carries the risk of myocardial ischaemia or infarction in a patient having coronary artery bypass graft (CABG) surgery. Our case raises this dilemma in a high-risk patient that was further compromised by acute right ventricular (RV) dysfunction. A 51-year-old diabetic with end-stage renal failure, chest pain, and a recent non-ST elevation myocardial infarction (NSTEMI) who had previously refused surgery now presented for urgent CABG. During central line insertion, he started shivering and stated that he felt cold. His temperature was not measured pre-intubation, but he felt warm to the touch with no chest pain. Blood pressure (BP) 190/80 mmHg and HR 110 bpm. Iv glyceryl nitrate (GTN) and fentanyl controlled the BP. Cerebral oximetry was used to measure brain regional saturation (rSO2) with probes placed on the forehead pre-induction. Post-intubation his temperature was 38.1°C, end-tidal carbon dioxide (EtCO2) 9.2 kPa, heart rate (HR) 120 bpm. His recent NSTEMI and surgical referral two years previously meant that his ischaemic risk was high, and we decided to proceed with the surgery. During the internal mammary artery (IMA) harvesting and use of a retractor (IMAR), there was a steady fall in the rSO2 readings along with hypotension and an increase in central venous pressure (CVP) becoming critical after 60 minutes. At this point, the patient went onto cardiopulmonary bypass (CPB). The patient required triple vasoactive support to wean off CPB. In the intensive care unit (ICU), he required immediate support for RV failure, including nitric oxide. The next day, the patient grew Gram-negative blood cultures. In hindsight, we should have checked his temperature before induction and postponed or postponed post-induction. Regarding the IMAR or any retractor, the operating team will pay much closer attention to any haemodynamic changes resulting from their use and act accordingly.Fahr’s syndrome is a rare, genetically dominant, inherited, neurological disorder characterized by abnormal deposits of calcium in the basal ganglia and the cerebral cortex. Symptoms include motor dysfunction, dementia, headache, spastic paralysis, abnormal ocular findings and seizures. Hypoparathyroidism is the most common endocrine disorder related to this syndrome, however, there are other metabolic, infectious and genetic causes. This is a case report of a Fahr’s syndrome patient presenting a three-month history of self-limited partial epileptic seizures. His cranial CT had bilateral symmetrical calcifications of the basal ganglia, subcortical tissue and dentate nucleus whereas his laboratory findings were compatible with hypoparathyroidism.The abdominal cocoon is a rare clinical entity characterized by a thick fibrocollagenous membrane encasing the intestinal loops. Despite its rarity, the abdominal cocoon is one of the most serious complications of peritoneal dialysis. We report the case of a 45-year-old man, with end-stage renal disease on peritoneal dialysis resulting from systemic lupus erythematosus, who presented to the emergency department with progressive abdominal pain for the last two weeks. The pain was associated with nausea, vomiting, abdominal distension, and decreased bowel motion. Upon examination, the vital signs were within the normal limits. Abdominal examination revealed a distended abdomen with generalized tenderness. There was evidence of ascites as indicated by the positive shifting dullness test. The bowel sounds were of increased frequency and intensity. The laboratory findings were non-contributory. The patient underwent an abdominal computed tomography scan that demonstrated a cluster of small intestinal loops in the middle of the abdomen with a surrounding thick and calcified membrane. This made the diagnosis of the abdominal cocoon. The patient underwent an operation to resect the fibrocollagenous membrane. The patient reported improvement after the operation. No recurrence was noted after three months of follow-up. Abdominal cocoon is a very rare complication of peritoneal dialysis. The diagnosis of abdominal cocoon should be kept in mind when the physician encounters a patient with peritoneal dialysis who presented with non-specific and unexplained gastrointestinal symptoms.Large bowel obstruction is a surgical emergency that requires prompt diagnosis and management. It is frequently caused by colon cancer. However, the common benign etiologies include volvulus, hernia, adhesions, and strictures. Imaging studies are essential to establish the diagnosis and identify the etiology. We present the case of a 44-year-old female who presented to the emergency department with abdominal pain and distension for a one-week duration. The pain was associated with decreased bowel motions and vomiting. Her past medical history was significant for diabetes mellitus, dyslipidemia, polycystic ovarian syndrome, and recurrent episodes of biliary colic. Upon examination, she had tachycardia, normal temperature, and normal blood pressure. Abdominal examination revealed a distended abdomen with generalized tenderness and increased intensity of bowel sounds. The laboratory markers were noncontributory. Abdominal computed tomography (CT) scan of the abdomen with intravenous contrast demonstrated the prewith gallbladder disease.The disease burden of tuberculosis (TB) has been declining in the developed world but the goal of eradicating TB seems like a daunting task in the developing regions. Patients with unrecognized TB or those receiving inappropriate treatment pose the greatest risk to the global burden of the disease. The aim of this article is to share the first-hand experience of a doctor, the author, contracting TB and the associated psychological impact. This change in role from a doctor to a patient came as an enlightening experience for the author and would give an insight into the psychological aspect when planning to find effective ways in the fight to eradicate TB.Green nail syndrome is a form of chromonychia, discoloration of the nail plate, that describes fingernails or toenails that are green in appearance. Bacterial-associated green nail syndrome, referred to as chloronychia, is most common; however, fungal and polymicrobial etiologies have been reported. Two 70-year-old women presented with green discoloration of their nails for over five months; both women had prior unsuccessful treatments and were referred for further evaluation and treatment. The affected nails were biopsied and cultured. Bacterial cultures did not yield any organisms; however, fungal cultures grew Candida parapsilosis after four weeks. Both women were treated with a topical alcohol-based solution and ketoconazole cream with improvement in their nail discoloration after two months. We introduce a term that specifically describes fungal etiology-associated green nail syndrome viridionychia.Male breast cancer (MBC) is a rare malignancy with an overall incidence of less than 1%. The epidemiological data of MBC is very limited owing to its rarity, particularly data from India. Hence, it is important to study different aspects of this rare malignancy. This paper reports a single-center experience from India that evaluated the clinicopathological behavior of MBC, their management, and outcomes. This was a retrospective review, which included 18 patients managed between 2013 to 2021. Seventeen out of the 18 patients were aged ≥50 years; the median age was 60 years. Left sides were affected more than right (left 11, right seven), and the most commonly affected quadrant was central (n=15/17, 88.2%). The most common (n=14) surgery was modified radical mastectomy (MRM), and the invasive ductal carcinoma was the most common (n=14) histological finding. Most cases were estrogen-receptor (ER) and progesterone-receptor-positive (n=15/18, 83.3%). The present study, though with a small sample size, adds valuable information to the literature about this rare occurrence in men.In recent years, natural deep eutectic solvents (NADESs) have gained increasing attention as promising nontoxic solvents for biotechnological applications, due to their compatibility with enzymes and ability to enhance their activity. Betaine-based NADESs at a concentration of 25 wt % in a buffered aqueous solution were used as media to inhibit thermal inactivation of POXA1b laccase and its five variants when incubated at 70 and 90 °C. All the tested laccases showed higher residual activity when incubated in NADES solutions, with a further enhancement achieved also for the most thermostable variant. Furthermore, the residual activity of laccases in the presence of NADESs showed a clear advantage over the use of NADESs’ individual components. Molecular docking simulations were performed to understand the role of NADESs in the stabilization of laccases toward thermal inactivation, evaluating the interaction between each enzyme and NADESs’ individual components. A correlation within the binding energies between laccases and NADES components and the stabilization of the enzymes was demonstrated. These findings establish the possibility of preincubating enzymes in NADESs as a facile and cost-effective solution to inhibit thermal inactivation of enzymes when exposed to high temperatures. This computer-aided approach can assist the tailoring of NADES composition for every enzyme of interest.The latest epidemic of extremely infectious coronavirus disease 2019 (COVID-19) has created a significant public health concern. Despite substantial efforts to contain severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within a specific location, shortcomings in the surveillance of predominantly asymptomatic infections constrain attempts to identify the epidemiological spread of the virus. Continuous surveillance of wastewater streams, including sewage, offers opportunities to track the spread of SARS-CoV-2, which is believed to be found in fecal waste. ZCL278 To demonstrate the feasibility of SARS-CoV-2 detection in wastewater systems, we herein present a novel facilely constructed fluorescence sensing array based on a panel of three different lanthanide-doped carbon nanoparticles (LnCNPs). The differential fluorescence response pattern due to the counterion-ligand interactions allowed us to employ powerful pattern recognition to effectively detect SARS-CoV-2 and differentiate it from other viruses or bacteria.