Assessment of South Asian Pediatric Acute Kidney Injury: Epidemiology and Risk Factors (ASPIRE)-a prospective study on "severe dialysis dependent pediatric AKI".

BACKGROUND: Pediatric acute kidney injury (AKI) is a global health concern with an associated mortality risk disproportionately pronounced in resource-limited settings. There is a pertinent need to understand the epidemiology of pediatric AKI in vulnerable populations. Here, we proposed a prospective study to investigate the epidemiology and associated risk factors of "severe dialysis dependent AKI" in children among South Asian nations which would be the first and largest of its kind. METHODS: The ASPIRE study (part of PCRRT-ICONIC Foundation initiative) is a multi-center, prospective observational study conducted in South Asian countries. All children and adolescents ≤ 18 years of age who required dialysis for AKI in any of the collaborating medical centers were enrolled. Data collection was performed until one of the following endpoints was observed: (1) discharge, (2) death, and (3) discharge against medical advice. RESULTS: From 2019 to 2022, a total of 308 children with severe AKI were enrolled. The mean age was 6.17 years (63% males). Secondary AKI was more prevalent than primary AKI (67.2%), which predominantly occurred due to infections, dehydration, and nephrotoxins. Common causes of primary AKI were glomerulonephritis, hemolytic uremic syndrome, lupus nephritis, and obstructive uropathy. Shock, need for ventilation, and coagulopathy were commonly seen in children with severe AKI who needed dialysis. The foremost kidney replacement therapy used was peritoneal dialysis (60.7%). The mortality rate was 32.1%. CONCLUSIONS: Common causes of AKI in children in South Asia are preventable. Mortality is high among these children suffering from "severe dialysis dependent AKI." Targeted interventions to prevent and identify AKI early and initiate supportive care in less-resourced nations are needed.

Clinical correlation and prognostic significance of immunofluorescence in renal biopsies of patients having Glomerulonephritis.

OBJECTIVE: To correlate the immunofluorescence (IF) findings on renal biopsies of patients of glomerulonephritis (GN) with the clinical course of the disease. METHODS: This retrospective descriptive study was done at the Department of Pediatrics Medicine Unit-I, Nishtar Hospital Multan, from January 2008 to January 2019. A total of 387 cases of both gender, aged up to 16 years, diagnosed having GN on the basis of renal biopsies by light microscopy (LM) and IF findings, were included. Outcome as remission, partial remission, no remission with stable kidney disease, no remission with progressive kidney disease and end-stage kidney disease (ESKD) were computed. Chi square test was applied to see the correlation of IF findings and outcome by taking p value less than 0.05 as statistically significant. RESULTS: Focal segmental glomerulosclerosis (FSGS) was found to be the commonest histopathology finding noted in 158 (40.8%) followed by mesangioproliferative GN 74 (19.1%) and membranous nephropathy 42 (10.9%). Complete remission was observed in 145 (37.5%) cases whereas ESKD was seen in 26 (6.7%). Distinct pattern of IF findings were shown when distribution of IF findings were seen with respect to all study variables (p value < 0.001). For outcome, 134 (51.3%) IF negative cases had complete remission while 93 (35.6%) negative IF findings also had partial remission. ESKD was seen among 14 (25.9%) IgM positive and three (33.3%) IgA positive cases. CONCLUSION: Immunofluorescence proved an important diagnostic tool in reaching the exact diagnosis in various types of GN. Distinct correlation between IF findings and clinical course of various types of GN was observed. IF negative cases had better outcome and was not having progressive course of disease so prognosis remained better than IF positive cases in this study.

Focal Segmental Glomerulosclerosis in Paediatric Population of South Punjab Pakistan: A Tertiary Care Hospital Experience.

OBJECTIVES: To find out frequency, clinicopathological features, response of treatment and outcome among children with primary focal segmental glomerulosclerosis (FSGS). METHODS: This retrospective, non-interventional medical charts review study was conducted from a period of January 2011 to January 2020 at Pediatric Department of Nishtar Medical University Hospital, Multan, Pakistan. During the nine years study period, children of both genders, aged less than 16 years, with renal biopsies proven FSGS were included. Patient's demographic along with clinical and laboratory data, urine dipstick for proteinuria, renal functions, 24 hours urinary protein and ultrasonography findings of kidneys, ureters and bladder (KUB) were noted from case records. Response rates of various treatment options and their outcome like remission, partial remission, no remission with stable kidney disease & no remission with progression of kidney disease were noted. RESULTS: During the study duration, out of 307 renal biopsies performed in glomerulonephritis cases, 124 (40.4%) had primary FSGS. In 124 primary FSGS cases, mean age was 8.83±3.05 years while most of the children, 70 (56.5%) were above 10 years of age. Majority of the cases, 64 (51.6%) were male. Mean follow up duration was noted to be 28.35+18.47 months. Most of the cases, 68 (54.8%) were found to have complete remission, 22 (17.7%) partial remission while 11 (8.9%) progressed to ESKD. CONCLUSIONS: Among children, frequency of primary FSGS was high at our setting. Most of the cases achieved sustained remission rates with the help of immunosuppressive drugs. Cyclosporine and tacrolimus were found to be the most effective drugs.

Circumstances leading to intimate partner violence against women married as children: a qualitative study in Urban Slums of Lahore, Pakistan.

BACKGROUND: Child marriage (<18 years) is prevalent in Pakistan which is associated with negative health outcomes including intimate partner violence (IPV). Our aim is to describe the types and circumstances of IPV against women who were married as children in urban slums of Lahore, Pakistan. METHODS: Women of reproductive age (15-49 years) who were married prior to 18 years, for at least 5 years were recruited from most populous slum areas of Lahore, Pakistan. Themes for the interview guide were developed using published literature and everyday observations of the researchers. Interviews were conducted by trained interviewers in Urdu language and were translated into English. The interviews were tape-recorded, transcribed, analyzed and categorized into themes. RESULTS: All 19 participants were married between 11 and 17 years. Most respondents were uneducated, poor and were working as housemaids. Majority of participants experienced verbal abuse, and threatened, attempted and completed physical violence by their husbands. A sizeable number of women reported unwanted sexual encounters by their husbands. Family affairs particularly issues with in-laws, poor house management, lack of proper care of children, bringing insufficient dowry, financial problems, an act against the will of husband, and inability to give birth to a male child were some of the reasons narrated by the participants which led to IPV against women. CONCLUSIONS: Women married as children are vulnerable to IPV. Concerted efforts are needed from all sectors of society including academia, public health experts, policy makers and civil society to end the child marriage practice in Pakistan.

Knowledge and attitude towards child marriage practice among women married as children-a qualitative study in urban slums of Lahore, Pakistan.

BACKGROUND: Child marriage (<18 years) is prevalent in Pakistan which is associated with negative health outcomes. Our aim is to describe women's knowledge and attitude towards child marriage practice who themselves were married as children. METHODS: Women of reproductive age (15-49 years) who were married prior to 18 years, for at least 5 years and had at least one child birth were recruited from most populous slum areas of Lahore, Pakistan. Themes for the interview were developed using published literature and everyday observations of the researchers. Interviews were conducted by trained interviewers in Urdu language and were translated into English. The interviews were tape-recorded, transcribed, analyzed and categorized into themes. RESULTS: Nineteen of 20 participants who agreed to participate were married between 11-17 years. Most respondents were uneducated, poor and were working as housemaids. The majority participants were unaware of the negative health outcomes of child marriages. They appeared satisfied by the decision of their parents of marrying them before 18 years, and even condemned banning child marriages in Pakistan. Strong influence of culture and community perceptions, varying interpretation of religion, and protecting family honor are some of the reasons that were narrated by the participants, which seems playing a role in continuation of child marriage practice in Pakistan. CONCLUSION: Raising awareness of the negative health outcomes of child marriage, implementing and enforcing strict laws against child marriage practice, promoting civil, sexual and reproductive health rights for women, can help eliminate child marriages in Pakistan.

Computational technique of thermal comparative examination of Cu and Au nanoparticles suspended in sodium alginate as Sutterby nanofluid via extending PTSC surface.

Current research underscores entropy investigation in an infiltrating mode of Sutterby nanofluid (SNF) stream past a dramatically expanding flat plate that highlights Parabolic Trough Solar Collector (PTSC). Satisfactory likeness factors are utilized to change halfway differential conditions (PDEs) to nonlinear conventional differential conditions (ODEs) along with relating limit requirements. A productive Keller-box system is locked in to achieve approximated arrangement of decreased conventional differential conditions. In the review, two sorts of nanofluids including Copper-sodium alginate (Cu-SA) and Gold-sodium alginate (Au-SA) are dissected. Results are graphically plotted as well as talked about in actual viewpoints. As indicated by key discoveries, an improvement in Brinkmann, as well as Reynolds number, brings about expanding the general framework entropy. Sutterby nanofluid boundary improves heat rate in PTSC. Additionally, Copper-sodium alginate nanofluid is detected as a superior thermal conductor than Gold-sodium alginate nanofluid. Further to that, the reported breakthroughs are beneficial to updating extremely bright lighting bulbs, heating and cooling machinery, fiber required to generate light, power production, numerous boilers, and other similar technologies.

The flow, thermal and mass properties of Soret-Dufour model of magnetized Maxwell nanofluid flow over a shrinkage inclined surface.

A mathematical model of 2D-double diffusive layer flow model of boundary in MHD Maxwell fluid created by a sloping slope surface is constructed in this paper. The numerical findings of non-Newtonian fluid are important to the chemical processing industry, mining industry, plastics processing industry, as well as lubrication and biomedical flows. The diversity of regulatory parameters like buoyancy rate, magnetic field, mixed convection, absorption, Brownian motion, thermophoretic diffusion, Deborah number, Lewis number, Prandtl number, Soret number, as well as Dufour number contributes significant impact on the current model. The steps of research methodology are as followed: a) conversion from a separate matrix (PDE) to standard divisive calculations (ODEs), b) Final ODEs are solved in bvp4c program, which developed in MATLAB software, c) The stability analysis part also being developed in bvp4c program, to select the most effective solution in the real liquid state. Lastly, the numerical findings are built on a system of tables and diagrams. As a result, the profiles of velocity, temperature, and concentration are depicted due to the regulatory parameters, as mentioned above. In addition, the characteristics of the local Nusselt, coefficient of skin-friction as well as Sherwood numbers on the Maxwell fluid are described in detail.

Numerical Case Study of Chemical Reaction Impact on MHD Micropolar Fluid Flow Past over a Vertical Riga Plate.

The purpose of this article is to investigate the mass and heat transport phenomena associated with micropolar fluid flow created by a vertically stretched Riga surface. This is constructed using an array of irregular electrodes and permanent magnets that are oriented spanwise. Additionally, we investigate the particles' micro rotational impacts. Furthermore, the flow behaviour of the modeled problem has been numerically calculated with bvp4c solver and the obtained results are presented graphically. Numerical data are used to illustrate physical parameters such as skin friction, Nusselt, and Sherwood numbers. For precise values of different flow parameters, the characteristics of fluid velocity, angular velocity, temperature, and concentration gradients are investigated graphically. The flowing parallel to the Riga plate in a positive x-path is aided by Lorentz forces introduced into the flowing simulation by the electro-magnetic poles of the Riga plate, which produces a rapidity greater than the inner speed. It is confirmed that the numerical calculations fit well with the results of earlier published investigations. Due to the participation of the Riga plate, the updated Hartmann number has a considerable effect on flow profiles.

A mathematical model of blood flow in a stenosed artery with post-stenotic dilatation and a forced field.

Arterial stenosis is a common cardiovascular disease that restricts blood flow. A stenotic blood vessel creates tangent stress pressure, which lessens the arterial side and causes an aneurysm. The primary purpose of this study is to investigate blood flowing via an inclination pipe with stricture and expansion after stricture (widening) underneath the influence of a constant incompressible Casson liquid flowing with the magnetism field. The relations for surface shearing stress, pressure drop, flow resistance, and velocity are calculated analytically by applying a mild stenosis approximation. The effect of different physical characteristics on liquid impedance to flowing, velocity, and surface shearing stress are studied. With a non-Newtonian aspect of the Casson liquid, the surface shearing stress declines, and an impedance upturn. Side resistivity and shear-stress increase with the elevations of stricture, whilst together decreasing with a dilatation height.

Solar energy optimization in solar-HVAC using Sutterby hybrid nanofluid with Smoluchowski temperature conditions: a solar thermal application.

In solar heating, ventilation, and air conditioning (HVAC), communications are designed to create new 3D mathematical models that address the flow of rotating Sutterby hybrid nanofluids exposed to slippery and expandable seats. The heat transmission investigation included effects such as copper and graphene oxide nanoparticles, as well as thermal radiative fluxing. The activation energy effect was used to investigate mass transfer with fluid concentration. The boundary constraints utilized were Maxwell speed and Smoluchowksi temperature slippage. With the utilization of fitting changes, partial differential equations (PDEs) for impetus, energy, and concentricity can be decreased to ordinary differential equations (ODEs). To address dimensionless ODEs, MATLAB's Keller box numerical technique was employed. Graphene oxide Copper/engine oil (GO-Cu/EO) is taken into consideration to address the performance analysis of the current study. Physical attributes, for example, surface drag coefficient, heat move, and mass exchange are mathematically processed and shown as tables and figures when numerous diverse factors are varied. The temperature field is enhanced by an increase in the volume fraction of copper and graphene oxide nanoparticles, while the mass fraction field is enhanced by an increase in activation energy.

Thermal analysis for [Formula: see text]-sodium alginate magnetized Jeffrey's nanofluid flow past a stretching sheet embedded in a porous medium.

The magnetohydrodynamics (MHD) viscous Jeffrey heat transport flow past a permeable extending sheet is analyzed. The Alumina ([Formula: see text]) is chosen as nanoparticles immersed in sodium alginate ([Formula: see text]) as the based fluid. The effect of heat generation, Ohmic heating and viscous dissipation are also being investigated adopting Tiwari and Das model. The adequate similarity transformation is used to convert the governing equations to non-linear of higher-order ordinary differential equations (ODEs). The numerical solution of the transformed ODEs is accomplished using a finite-difference technique. The results are described in graphs according to selected parameters' values provided. The flow velocity reductions when the porosity parameter is augmented. The thermal distribution is affected by the presence of [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text]. Deborah number and the volume fraction of nanoparticles affect the skin friction coefficient in opposite ways. A higher volume percentage of nanoparticles and a higher Deborah number are both shown to boost the rate of heat transfer. These findings suggest that the concentration of nanoparticles can be used to manipulate heat transport and nanofluid motions.

Effectiveness of Nonuniform Heat Generation (Sink) and Thermal Characterization of a Carreau Fluid Flowing across a Nonlinear Elongating Cylinder: A Numerical Study.

During thermal radiation treatments, heat therapies, and examination procedures like scans and X-rays, the cylindrical blood vessels may get stretched; meanwhile, the blood flow through those blood vessels may get affected due to temperature variations around them. To overcome this issue, this work was framed to explore the impact of heat transmission in a Carreau fluid flow (CFF) through a stretching cylinder in terms of the nonlinear stretching rate and irregular heat source/sink. Temperature-dependent thermal conductivity and thermal radiation are taken into consideration in this study. To tranform complicated partial differential equations into ordinary differential equations, appropriate similarity variables are used. For a limited set of instances, the derived series solutions are compared to previously published results. For linear and nonlinear stretching rates, graphs and tables are used to examine the influence of an irregular heat source/sink on fluid movement and heat transfer. The research outcomes demonstrate that the heat source and nonlinear stretching rate cause a disruption in the temperature distribution in the fluid region, which can alter the blood flow through the vessels. In all conditions except for the heat in an internal heat sink, the nonlinear stretching situation improves the velocity and heat profile. Furthermore, with the increase in the values of the Weissenberg number, the temperature profile shows opposing features in a shear-thickening fluid and shear-thinning fluid. For the former n > 1, the blood fluidity gets affected, restricting the free movement of blood. For the latter, n < 1, the phenomenon is reversed. Other industrial applications of this work are wire coating, plastic coverings, paper fabrication, fiber whirling, etc. In all of those processes, the fluid flow is manipulated by thermal conditions.

Thermal cooling efficacy of a solar water pump using Oldroyd-B (aluminum alloy-titanium alloy/engine oil) hybrid nanofluid by applying new version for the model of Buongiorno.

Solar radiation, which is emitted by the sun, is required to properly operate photovoltaic cells and solar water pumps (SWP). A parabolic trough surface collector (PTSC) installation model was created to investigate the efficacy of SWP. The thermal transfer performance in SWP is evaluated thru the presence of warmth radiation and heat cause besides viscid dissipation. This evaluation is performed by measuring the thermal transmission proportion of the selected warmth transmission liquid in the PTSC, known as a hybrid nano-fluid. Entropy analysis of Oldroyd-B hybrid nano-fluid via modified Buongiorno's model was also tested. The functions of regulating parameters are quantitatively observed by using the Keller-box approach in MATLAB coding. Short terms define various parameters for tables in velocity, shear pressure and temperature, gravity, and Nusselt numbers. In the condition of thermal radiation and thermal conductivity at room temperature, the competence of SWP is proven to be enhanced. Unlike basic nano-fluids, hybrid nano-fluids are an excellent source of heat transfer. Additionally, with at least 22.56% and 35.01% magnitude, the thermal efficiency of AA7075-Ti-6Al-4 V/EO is higher than AA7075-EO.

Mixed convection flow of an electrically conducting viscoelastic fluid past a vertical nonlinearly stretching sheet.

The study of hydromagnetic mixed convection flow of viscoelastic fluid caused by a vertical stretched surface is presented in this paper. According to this theory, the stretching velocity varies as a power function of the displacement from the slot. The conservation of energy equation includes thermal radiation and viscous dissipation to support the mechanical operations of the heat transfer mechanism. Through the use of an adequate and sufficient similarity transformation for a nonlinearly stretching sheet, the boundary layer equations governing the flow issue are converted into a set of ordinary differential equations. The Keller box technique is then used to numerically solve the altered equations. To comprehend the physical circumstances of stretching sheets for variations of the governing parameters, numerical simulations are made. The influence and characteristic behaviours of physical parameters were portrayed graphically for the velocity field and temperature distributions. The research shows that the impact of the applied magnetic parameter is to improve the distribution of the viscoelastic fluid temperature and reduce the temperature gradient at the border. Temperature distribution and the associated thermal layer are shown to have improved because of radiative and viscous dissipation characteristics. Radiation causes additional heat to be produced in liquid, raising the fluid's temperature. It was also found that higher velocities are noticed in viscoelastic fluid as compared with Newtonian fluid (i.e., when K = 0).

Flow and heat transport phenomenon for dynamics of Jeffrey nanofluid past stretchable sheet subject to Lorentz force and dissipation effects.

Survey of literature unveils that nanofluids are more efficient for heat transport in comparison to the traditional fluids. However, the enlightenment of developed techniques for the augmentation of heat transport in nanomaterials has considerable gaps and, consequently, an extensive investigation for aforementioned models is vital. The ongoing investigation aims to study the 2-D, incompressible Jeffrey nanofluid heat transference flow due to a stretchable surface. Furthermore, the effect of dispersion of graphene nanoparticles in base liquid ethylene glycol (EG) on the performance of flow and heat transport using the Tawari-Das model in the existence of Ohmic heating (electroconductive heating) and viscous heat dissipation is contemplated. The boundary-layer PDEs are reconstituted as ODEs employing appropriate similarity transformation. Keller-Box Method (KBM) is utilized to determine the numerical findings of the problem. Graphene conducts heat greater in rate than all of the other materials and it is a good conductor of electrical energy. Graphene/EG nanofluid is employed to look out the parametric aspects of heat transport flow, drag coefficient, and heat transference rate phenomena with the aid of graphs and tables. The numerical outcomes indicate that concentration and magnetic field abate the shear stresses for the nanofluid. An increase of Graphene nanoparticle volume fraction parameter can boost the heat transport rate. The effect of Prandtl Number is to slow down the rate of heat transport as well as decelerate the temperature. Additionally, the rate of heat transportation augments on a surface under Deborah's number. Results indicate that the temperature of the graphene-EG nanofluid is greater than the convectional fluid hence graphene-EG nanofluid gets more important in the cooling process, biosensors and drug delivery than conventional fluids.

Influence of entropy on Brinkman-Forchheimer model of MHD hybrid nanofluid flowing in enclosure containing rotating cylinder and undulating porous stratum.

The current article aims to discuss the natural convection heat transfer of Ag/Al2O3-water hybrid filled in an enclosure subjected to a uniform magnetic field and provided with a rotating cylinder and an inner undulated porous layer. The various thermo-physical parameters are investigated such as Rayleigh number ([Formula: see text]), Hartmann number ([Formula: see text]), and the nanoparticles concentration ([Formula: see text]). Likewise, the rotational speed of the cylinder ([Formula: see text]), as well as several characteristics related to the porous layer, are examined li its porosity ([Formula: see text]), Darcy number ([Formula: see text]) which indicates the porous medium permeability and the number of undulations ([Formula: see text]). The calculations are carried out based on the Galerkin Finite element method (GFEM) to present the streamlines, isotherms, entropy generation, and average Nusselt numbers in details. The main results proved that increment of Rayleigh number and Darcy number enhances heat transfer convection within the enclosure. Whilst, the porosity presents a minimal impact. Also, the rotational speed in a positive direction has a favorable influence on the heat transfer dispersion across the cavity.

Thermal growth in solar water pump using Prandtl-Eyring hybrid nanofluid: a solar energy application.

Nowadays, with the advantages of nanotechnology and solar radiation, the research of Solar Water Pump (SWP) production has become a trend. In this article, Prandtl-Eyring hybrid nanofluid (P-EHNF) is chosen as a working fluid in the SWP model for the production of SWP in a parabolic trough surface collector (PTSC) is investigated for the case of numerous viscous dissipation, heat radiations, heat source, and the entropy generation analysis. By using a well-established numerical scheme the group of equations in terms of energy and momentum have been handled that is called the Keller-box method. The velocity, temperature, and shear stress are briefly explained and displayed in tables and figures. Nusselt number and surface drag coefficient are also being taken into reflection for illustrating the numerical results. The first finding is the improvement in SWP production is generated by amplification in thermal radiation and thermal conductivity variables. A single nanofluid and hybrid nanofluid is very crucial to provide us the efficient heat energy sources. Further, the thermal efficiency of MoS2-Cu/EO than Cu-EO is between 3.3 and 4.4% The second finding is the addition of entropy is due to the increasing level of radiative flow, nanoparticles size, and Prandtl-Eyring variable.