The effect of piezoelectric shockwave lithotripsy with 2- and 8-mm focus sizes on stone disintegration and renal injury.

OBJECTIVES: To compare the efficacy and safety of shockwave lithotripsy (SWL) using a narrow focus or wide focus for renal stones. PATIENTS AND METHODS: A double-blind randomised trial included adult patients with a solitary radio-opaque renal pelvic stone of 1-2 cm. Patients were randomised into two groups: narrow-focus (2 mm) SWL and wide-focus (8 mm) SWL. The stone-free rate (SFR) and presence of complications such as haematuria, fever, pain, and peri-renal haematoma were evaluated. Pre- and postoperative urinary markers (neutrophil gelatinase-associated lipocalin [NGAL] and kidney injury molecule 1 [KIM-1]) concentrations were compared to assess renal injury. RESULTS: A total of 135 patients were recruited for this study. The SFR after the first SWL session was 79.2% and 69.1% in narrow- and wide-focus groups, respectively. There was a comparable rise in the median 2-h NGAL concentration in both groups (P = 0.62). However, the rise in the median (interquartile range [IQR]) 2-h KIM-1 concentration was significantly higher in the narrow-focus group at 4.9 (4.6, 5.8) ng/mL compared with the wide-focus group at 4.4 (3.2, 5.7) ng/mL (P = 0.02). Nevertheless, the 3-day NGAL and KIM-1 urinary marker concentrations were significantly improved (P = 0.263 and P = 0.963, respectively). The overall SFR after three sessions was 86.6% and 86.8% in the narrow- and wide-focus groups, respectively (P = 0.77). Both groups were comparable for complications, apart from the median pain score and the percentage of high-grade haematuria, which were significantly higher in the narrow-focus group (P < 0.001 and P = 0.03, respectively). CONCLUSION: Narrow- and wide-focus SWL were associated with comparable outcomes and re-treatment rates. However, narrow-focus SWL was associated with significantly higher morbidity in terms of pain and haematuria.

Leptin receptor gene (A/G) polymorphism rs1137101 and renal cell carcinoma.

Leptin plays an important role in carcinogenesis as leptin/leptin receptor signaling promotes the angiogenesis, proliferation, and inhibits epithelial cell apoptosis. Variants in the leptin receptor gene have potential associations with renal cell carcinoma (RCC). We aimed to investigate association of rs1137101 (A/G) polymorphism at LEPR gene with risk of RCC and patients survival. 123 individuals were classified into group I: 73 RCC patients and group II: 50 healthy controls. Genotyping of the Gln223Arg (A/G) polymorphism rs1137101 at LEPR gene was analyzed using allelic discrimination assay by Real-Time PCR technique. GG genotype was the most frequent among RCC patients (67.1%), while AA genotype was the most frequent in controls (60%); (p < 0.001). By univariate cox regression: gene polymorphism (GG versus GA +AA), stage, histopathologic subtype, and grade were found to affect survival significantly; however, the multivariate analysis showed that only gene polymorphism (GG versus GA +AA) and tumor stage significantly affect survival. LEPR gene variants rs1137101 might be a candidate risk factor for RCC in Egypt. GG genotype is associated with more aggressive tumor behavior and shorter survival compared with GA & AA genotypes so, genotyping of Gln223Arg (A/G) rs1137101 could also predict RCC outcome.

Effect of combination sildenafil and gemfibrozil on cisplatin-induced nephrotoxicity; role of heme oxygenase-1.

BACKGROUND/AIM: Cisplatin-induced nephrotoxicity in large proportion of patients. The aim of this work is to clarify the effect of combination of sildenafil and gemfibrozil on cisplatin-induced nephrotoxicity either before or after cisplatin treatment and determination of nephrotoxicity predictors among the measured tissue markers. METHODS: Thirty two adult male albino rats were divided into four equal groups (G) GI control, GII received cisplatin, GIII received sildenafil and gemfibrozil before cisplatin, GIV received sildenafil and gemfibrozil after cisplatin. Creatinine and urea were measured and animals were sacrificed and kidney was taken for histopathology. The following tissue markers were measured, heme oxygenase-1 (HO-1) activity, reduced glutathione, quantitative (real-time polymerase chain reaction) RT-PCR for gene expression of tumor necrosis factor alpha (TNF-α) and endothelial nitric oxide synthase (ENOS) level. RESULTS: GII developed AKI demonstrated by significantly high urea and creatinine and severe diffuse (80-90%) tubular necrosis. TNF-α was highly and significantly elevated while the rest of tissue markers were significantly reduced in GI1 compared to other groups. GIV showed better results compared to GIII. There was a significant positive correlation between creatinine and TNF-α when combining GI and GII while there were significant negative correlation between creatinine and other tissue markers in same groups. Linear regression analysis demonstrated that HO-1 was the independent predictor of AKI demonstrated by elevated creatinine among GI and GII. CONCLUSIONS: Combination of sildenafil and gemfibrozil can be used in treatment of cisplatin-induced nephrotoxicity. HO-1 is a promising target for prevention and/or treatment of cisplatin-induced nephrotoxicity.

Metabolic changes in overweight and obese women above 35 years using Ethinylestradiol/drosperinone combined contraceptive pills: a 3-year case-control study.

OBJECTIVE: To assess metabolic changes in overweight and obese women above 35 years using ethinylestradiol/drosperinone combined contraceptive pills for 36 cycles. METHODS: A prospective case-control study over 3 years recruiting 202 overweight and obese women above the age of 35 years who were divided into two groups, study group (n = 90) who received Ethinylestradiol/drospirenone for 36 cycles, and control group (n = 112) to whom intrauterine device was inserted. Recording of the body weight, waist circumference, blood pressure, fasting blood glucose and fasting blood lipids including triglycerides, total cholesterol, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol before starting the method and repeated at 12, 24 and 36 cycles of use. RESULTS: No significant change was observed in body weight, waist circumference, blood pressure and fasting blood glucose between the two groups (p > 0.05).There was a significant reduction in triglycerides, total and LDL cholesterol with elevation in HDL cholesterol in the study group after 24 and 36 cycles of use (p < 0.05). CONCLUSION: Ethinylestradiol/drospirenone combined contraceptive pills do not alter blood pressure or affect the body weight, with favorable effects on blood lipids in overweight and obese women above the age of 35 years when used for 24-36 cycles.

Correction to "Nanotechnology Impact on Chemical-Enhanced Oil Recovery: A Review and Bibliometric Analysis of Recent Developments".

[This corrects the article DOI: 10.1021/acsomega.3c06206.].

Phenol-Formaldehyde/Pyrazole Composite: Synthesis, Characterization, and Evaluation of its Chromate Removal Efficiency.

In this study, we report the successful synthesis of a phenol-formaldehyde-pyrazole (PF-PYZ) compound through the surface functionalization of phenol-formaldehyde (PF) with pyrazole (PYZ). The resulting mixture was subjected to comprehensive characterization using a range of analytical techniques, including X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and thermogravimetric analysis (TGA). The newly synthesized PF-PYZ material effectively removes Cr(VI) ions. Notably, a substantial elimination efficiency of 96% was achieved after just 60 min of contact time. The strategic incorporation of pyrazole (PYZ) as the principal functionalizing agent contributed to this exceptional performance. Notably, the functionalized PYZ sites were strategically positioned on the surface of PF, rendering them readily accessible to metal ions. Through rigorous testing, the optimal sorption capacity of PF-PYZ for Cr(VI) ions was quantified at 0.872 mmol Cr(VI)/g, highlighting the material's superior adsorption capabilities. The practical utility of PF-PYZ was further established through a reusability test, which demonstrated that the chromate capacity remained remarkably stable at 0.724 mequiv Cr(VI)/g over 20 consecutive cycles. This resilience underscores the robustness of the resin, indicating its potential for repeated regeneration and reuse without a significant capacity loss. Our work presents a novel approach to functionalizing phenol-formaldehyde with pyrazole, creating PF-PYZ, a highly efficient material for removing Cr(VI) ions. The compound's facile synthesis, exceptional removal performance, and excellent reusability collectively underscore its promising potential for various water treatments, especially oil field and environmental remediation applications.

Molecular Epidemiology of Foot-and-Mouth Disease Viruses in the Emirate of Abu Dhabi, United Arab Emirates.

Foot-and-mouth disease (FMD) is an endemic disease in the United Arab Emirates (UAE) in both wild and domestic animals. Despite this, no systematic FMD outbreak investigation accompanied by molecular characterisation of FMD viruses (FMDVs) in small ruminants or cattle has been performed, and only a single report that describes sequences for FMDVs in wildlife from the Emirate has been published. In this study, FMD outbreaks that occurred in 2021 in five animal farms and one animal market in the Emirate of Abu Dhabi were investigated. Cases involved sheep, goats, and cattle, as well as Arabian oryx (Oryx leucoryx). Twelve samples were positive for FMDV via RT-qPCR, and four samples (Arabian oryx n = 1, goat n = 2, and sheep n = 1) were successfully genotyped using VP1 nucleotide sequencing. These sequences shared 88~98% identity and were classified within the serotype O, Middle East-South Asia topotype (O/ME-SA). Phylogenetic analysis revealed that the Arabian oryx isolate (UAE/2/2021) belonged to the PanAsia-2 lineage, the ANT-10 sublineage, and was closely related to the FMDVs recently detected in neighbouring countries. The FMDV isolates from goats (UAE/10/2021 and UAE/11/2021) and from sheep (UAE/14/2021) formed a monophyletic cluster within the SA-2018 lineage that contained viruses from Bangladesh, India, and Sri Lanka. This is the first study describing the circulation of the FMDV O/ME-SA/SA-2018 sublineage in the UAE. These data shed light on the epidemiology of FMD in the UAE and motivate further systematic epidemiological studies and genomic sequencing to enhance the ongoing national animal health FMD control plan.

Nanotechnology Impact on Chemical-Enhanced Oil Recovery: A Review and Bibliometric Analysis of Recent Developments.

Oil and gas are only two industries that could change because of nanotechnology, a rapidly growing field. The chemical-enhanced oil recovery (CEOR) method uses chemicals to accelerate oil flow from reservoirs. New and enhanced CEOR compounds that are more efficient and eco-friendly can be created using nanotechnology. One of the main research areas is creating novel nanomaterials that can transfer EOR chemicals to the reservoir more effectively. It was creating nanoparticles that can be used to change the viscosity and surface tension of reservoir fluids and constructing nanoparticles that can be utilized to improve the efficiency of the EOR compounds that are already in use. The assessment also identifies some difficulties that must be overcome before nanotechnology-based EOR can become widely used in industry. These difficulties include the requirement for creating mass-producible, cost-effective nanomaterials. There is a need to create strategies for supplying nanomaterials to the reservoir without endangering the formation of the reservoir. The requirement is to evaluate the environmental effects of CEOR compounds based on nanotechnology. The advantages of nanotechnology-based EOR are substantial despite the difficulties. Nanotechnology could make oil production more effective, profitable, and less environmentally harmful. An extensive overview of the most current advancements in nanotechnology-based EOR is provided in this paper. It is a useful resource for researchers and business people interested in this area. This review's analysis of current advancements in nanotechnology-based EOR shows that this area is attracting more and more attention. There have been a lot more publications on this subject in recent years, and a lot of research is being done on many facets of nanotechnology-based EOR. The scientometric investigation discovered serious inadequacies in earlier studies on adopting EOR and its potential benefits for a sustainable future. Research partnerships, joint ventures, and cutting-edge technology that consider assessing current changes and advances in oil output can all benefit from the results of our scientometric analysis.

Validation of acute kidney injury prediction scores in critically ill patients.

Prediction of acute kidney injury (AKI) in critically ill patients allows prompt intervention that improves outcome. We aimed for external validation of two AKI prediction scores that can be bedside calculated. A prospective observational study included patients admitted to medical and surgical critical care units. Performance of two AKI prediction scores, Malhotra score and acute kidney injury prediction score (APS), was assessed for their ability to predict AKI. The best cutoff point for each score was determined by Youden index. Area under the receiving operation characteristic curve, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were used to assess performance of each score. Univariate and multivariate regression analyses were done to detect the predictability of AKI. Goodness-of-fit and kappa Cohen agreement tests were done to show whether the expected score results fit well and agree with the observed results. AKI prevalence was 37.6%. The best cutoff values were 5 and 4 for Malhotra score and APS, respectively. Area under the curve for Malhotra 5 was 0.712 and for APS 4 was 0.652 with nearly similar sensitivity and specificity. Regression analysis demonstrated that Malhotra 5 was the independent predictor of AKI. Goodness-of-fit test showed significant results denoting lack of fit between the scores and the actual results. Kappa test showed moderate agreement for Malhotra 5 and fair agreement for APS 4. Both scores showed moderate performance for AKI prediction. Malhotra 5 showed better performance compared to APS 4. Multicenter international study is warranted to develop a universal model that can predict AKI in critically ill patients.

Assessment of Renal Function in Post-Liver Transplant HCV-Positive Patients Treated with Direct Acting Antivirals.

PURPOSE: Direct acting antiviral agents (DAAs) have greatly improved the clearance of hepatitis C virus (HCV) infection. The effect of DAAs on renal function in post-liver transplant HCV-positive patients remains questionable, especially considering the possibility of drug interactions between immunosuppressants and DAAs. PATIENTS AND METHODS: A retrospective observational study included 84 post-liver transplant patients with HCV infection. Patients were divided into two groups: group I received sofosbuvir plus ribavirin for 24 weeks, group II received sofosbuvir plus daclatasvir for 12 weeks. Laboratory data and eGFR were determined before, at the end, and 6 months after completion of treatment. RESULTS: The treatment was well tolerated with 100% sustained virologic response (SVR 12). There was no statistically significant difference between the two groups regarding clinical and laboratory data before treatment. Mean eGFR significantly reduced from 87.36 mL/min to 76.16 mL/min in group I (P=0.001). However, within 6 months after treatment, mean eGFR recovered to 81.51 mL/min, which was not significant when compared to baseline eGFR (P=0.09). Mean eGFR in group II showed non-significant change. There were no significant changes in immunosuppressive drug levels and eGFR in either group of patients, who received either ciclosporin or tacrolimus before and at the end of treatment. CONCLUSION: DDAs in post-liver transplant patients with HCV infection were well tolerated and associated with stable renal function. Moreover, sofosbuvir plus daclatasvir regimen showed relatively better renal safety compared to sofosbuvir plus ribavirin.

How to best define patients with moderate chronic kidney disease.

BACKGROUND: The objective of this study was to identify which formula may best identify moderate chronic kidney disease (CKD) (glomerular filtration rate (GFR) cut-off of 60 ml/min/1.73 m(2)). METHODS: We compared the performances of 14 serum creatinine (S(cr)) and 11 cystatin C (Cys C) estimated GFR equations using inulin clearance (Cl(in)) as the reference test in a stable CKD population of 101 patients. Scatter, coefficient of variation, bias, precision, accuracy within 30% ranges from the reference method, agreements and receiving operating characteristics (ROC) of each test were compared. RESULTS: ROC analysis identified Davis, Salzar, Virga and Cockcroft-Gault as the most sensitive (>or=85%) and the isotope dilution mass spectrometry (IDMS), Edwards, MacIsaac as the most specific (95%) to define the GFR cut-off level of 60 ml/min/1.73 m(2). Area under the ROC curve (AUC) was generally >0.8 (p

Validation of the Virga GFR equation in a renal transplant population.

BACKGROUND: Virga and colleagues derived a glomerular filtration rate (GFR) equation which demonstrated a superior performance over Cockcroft-Gault (C-G) and modified diet in renal disease-isotope dilution mass spectrometry (MDRD-IDMS) formulas in chronic kidney disease (CKD) patients. AIM: To validate the performance of the Virga equation on 103 renal transplant patients. METHODS: We compared the performances of the MDRD-IDMS, C-G and Virga equations using inulin clearance as a reference test. Error, accuracy, relative accuracy, precision, scatter, and coefficient of variance of each equation were tested. RESULTS: The mean absolute percentage error in estimated GFR by the new equation was 39.8 +/- 36.34% (mean +/- SD). Relative accuracy at 10, 30 and 50% range were 18.44, 48.54 and 73.78%, respectively. It has a bias of 0.09 +/- 0.169 and a precision of 19.69. Inulin clearance (GFR) in stages 1-4 were 106.19 +/- 14.11, 71.17 +/- 7, 42.37 +/- 8.40 and 22.92 +/- 3.48 ml/min/1.73 m(2), respectively. Comparative statistics in the overall population and in patients with transplant CKD stage 3T showed that the MDRD-IDMS equation had better accuracy. The performance of MDRD-IDMS over the Virga equation was clearly superior for males. In patients with CKD stage 2T, the Virga equation showed superiority over MDRD-IDMS. In the overall and subpopulations, the Virga equation performed better than the C-G equation. CONCLUSION: Among renal transplant patients, the results suggest that the best GFR estimate is probably obtained using the MDRD-IDMS equation in moderate kidney failure whilst the Virga formula was superior to MDRD-IDMS for patients with mild kidney failure. As in untransplanted patients, estimating GFR with the MDRD-IDMS equation is not advisable in the range of normal renal function because of its known underestimation of renal function.

Contribution of diminished kidney transplant GFR to increased circulating chemokine ligand 27 level.

BACKGROUND: Inflammatory chemokine ligands (CCLs) play an important role in cardiovascular disease and allograft injury. CCLs may independently associate with diminished estimated glomerular filtration rate (eGFR) in stable renal transplant recipients (RTR). METHODS: Plasma levels of 19 CCLs (1, 2, 3, 4, 5, 8, 11, 13, 15, 17, 21, 24, 26, 27, CXCL5, 8, 10, 12 and 13) were measured in a cohort of 101 RTR. The cohort was divided according to CKD-EPI equation into three groups; group 1: eGFR ≥ 60 ml/min, group 2: eGFR 30-59.9 ml/min and group 3 eGFR ≤ 29.9 ml/min. ANOVA, Krusklwallis, Mann- Whitney Spearman correlation and regression analysis tests were used to determine association between reduced eGFR and inflammatory CCLs plasma levels measured by multiplex techniques. 20 healthy subjects with eGFR above 90 ml/min were included as control. Significance was sat at < 0.05. RESULTS: Levels of CCLs 1, 4, 15, 27, CXCL8 and CXCL10 were significantly different among the four studied groups. Multivariate regression analysis (MVA) between eGFR and all CCLs demonstrated that CCL27 was the only ligand to remain significantly associated with diminished eGFR {P = 0.021 and r = - 0.35,(P = 0.001)}. In a second MVA between CCL 27 and patient's demographics and laboratory variables, diminished eGFR, and elevated PTH, out of the twenty one available variables remained significantly associated with elevated CCL27levels. CONCLUSION: Diminished eGFR in stable RTR is associated with elevated plasma levels of CCL27. This association may explain, at least in part, the independent contribution of reduced eGFR to enhanced inflammation in RTR.

Accuracy to estimate rates of decline in glomerular filtration rate in renal transplant patients.

BACKGROUND: We examined the use of the Cockroft Gault (C-G) test, Modified Diet in Renal Disease 2 (MDRD2) test, and inverse serum creatinine (Delta1/Scr) to estimate rates of decline in renal transplant function using isotope glomerular filtration rate (GFR) as a reference test. METHODS: Percent changes in estimated GFR (DeltaeGFR) were compared to simultaneous changes in isotope GFR (DeltaiGFR) in 72 patients. RESULTS: The number of iGFR was 508 with a mean of 7.15+/-3.15 scans per patient. There was a decline in iGFR of 16.14+/-21.37 ml/min over the study duration of 88.9+/-57.6 months. DeltaeGFR and Delta1/Scr correlated significantly with DeltaiGFR. Accuracy to predict DeltaiGFR from the eGFRs was limited to <65% concordance within 30% range from changes in iGFR. Slope analyses showed a significantly lower percent annual loss in mean iGFR of 6.03% than that of the C-G of 8.62% and MDRD2 of 8.96% (P<0.001). The within patient variability measured from the standard deviation (ml/min) of root mean square of 4.69 for iGFR was significantly higher than that for C-G and MDRD2 of 2.46 and 2.94, respectively. iGFR and eGFR at first observation correlated significantly (P<0.001) with last observation. CONCLUSIONS: iGFR is significantly more variable within patient than the other predictors, and the two estimators predict the iGFR with a high sensitivity but low specificity. This is a clinically reasonable combination. Predicted percent of annual loss in iGFR appears to be smaller than that using the two estimators.

Can cystatin C replace creatinine to estimate glomerular filtration rate? A literature review.

BACKGROUND: With the increasing knowledge that estimation of glomerular filtration rate (GFR) from serum creatinine (Scr) has limited value, researchers have developed new equations based on serum cystatin C (Cys C). AIM: To compare the performance of serum Cys C and Cys C-based GFR equations to Scr and Scr-based GFR equations. METHODS: A Medline literature search for studies in English. RESULTS: Fourteen studies in kidney transplant patients and 29 in patients with native kidney disease were identified. 70% of studies on transplants favored Cys C over Scr while 60% favored serum Cys C over Scr in patients with native kidney disease. Three studies in transplant patients and 6 in patients with native kidney disease compared the performances of Cys C- and Scr-based equations. 70% of the studies performed on transplantation favored Cys C, while 85% the studies performed in native kidney diseases showed superiority of Cys C-based equations. CONCLUSION: A large number of studies favor Cys C over Scr for the estimation of GFR. Still, many reports show no superiority of Cys C over Scr. Consistent with this, more studies are needed to study the performance of Cys C-based GFR equations.

Can donor implantation renal biopsy predict long-term renal allograft outcome?

BACKGROUND: Donor kidney implantation biopsy (IB) is performed on a regular basis, particularly as part of clinical studies. OBJECTIVE: To determine the utility of donor implantation renal biopsy to predict the long-term renal allograft outcome. METHODS: A Medline search for studies in English was performed with the following key words: implantation biopsy, renal transplantation and long-term outcome. RESULTS: Sixteen trials involving 8,122 kidney transplants were identified, of which 6 were prospective studies. The histological abnormalities were scored mainly by the Banff schema and the graft outcome was defined either by delineating the delta changes in the pathology score or glomerular filtration rate. Normal histology with a well-functioning renal allograft had a favorable outcome. The extent to which the baseline tubular atrophy, interstitial fibrosis, glomerulosclerosis and vascular changes had on the long-term outcome varied from one study to another. CONCLUSION: Abnormal IB has a better chance of predicting early graft outcome. The review questions the current wisdom for routine IB on all donors. In some donor kidneys, a biopsy provides significant prognostic information, such as older donor kidney, those with history of hypertension, diabetes, cardiovascular disease, and kidneys with abnormal creatinine. Future research on IB is necessary to find a more useful method to predict the long-term transplant outcome.

Phytotherapeutic effects of Echinacea purpurea in gamma-irradiated mice.

Echinacea (E.) purpurea herb is commonly known as the purple coneflower, red sunflower and rudbeckia. In this paper, we report the curative efficacy of an Echinacea extract in gamma-irradiated mice. E. purpurea was given to male mice that were divided into five groups (control, treated, irradiated, treated before irradiation & treated after irradiation) at a dose of 30 mg/kg body weight for 2 weeks before and after irradiation with 3 Gy of gamma-rays. The results reflected the detrimental reduction effects of gamma-rays on peripheral blood hemoglobin and the levels of red blood cells, differential white blood cells, and bone marrow cells. The thiobarbituric acid-reactive substances (TBARs) level, Superoxide dismutase (SOD) and glutathione peroxidase (GSPx) activities and DNA fragmentation were also investigated. FT-Raman spectroscopy was used to explore the structural changes in liver tissues. Significant changes were observed in the microenvironment of the major constituents, including tyrosine and protein secondary structures. E. purpurea administration significantly ameliorated all estimated parameters. The radio-protection effectiveness was similar to the radio-recovery curativeness in comparison to the control group in most of the tested parameters. The radio-protection efficiency was greater than the radio-recovery in hemoglobin level during the first two weeks, in lymphoid cell count and TBARs level at the fourth week and in SOD activity during the first two weeks, as compared to the levels of these parameters in the control group.

Hepatitis C virus status in hemodialysis patients in Menoufia Government, Egypt, five years apart: Do we have any improvement?

There is a high prevalence of hepatitis C virus (HCV) infection in hemodialysis (HD) patients in Menoufia Governorate, Egypt. The aim of this cross-sectional study was to assess current HCV status and its seroconversion in HD patients after implementing preventative measures to limit transmission of HCV. All data were compared with our previous data collected in 2011 before implementation of isolation policy. There was a significant decrease in HCV infection in HD patients from 49.6% in year 2011 to 41.9% in year 2016 (P = 0.001). The seroconversion rate was significantly reduced from 14.5% in year 2011 to 4.9% in year 2016 (P = 0.001). Age, gender, body mass index, hemoglobin, and calcium did not show any significant difference whereas blood transfusion, serum phosphate, and urea reduction ratio showed a significant difference with much improvement in year 2016. When comparing seroconversion group with HCV-negative patients, blood transfusion did not show significant difference whereas seroconverted group showed significantly longer duration of dialysis (94.94 ± 82.87 months vs. 38.21 ± 31.55 months). Same result was obtained in year 2011; however, when all data analyzed the duration of dialysis and blood transfusion were higher significantly in seroconverted group. Binary logistic regression analysis for all data demonstrated that isolation reduced the likelihood of seroconversion while longer duration of dialysis increased the risk for seroconversion. HCV infection and its seroconversion in HD patients were significantly reduced in year 2016 compared to year 2011. Isolation policy is recommended for HD patients with HCV in dialysis units with high HCV prevalence in developing countries.

Protective role of hesperidin against γ-radiation-induced oxidative stress and apoptosis in rat testis.

BACKGROUND: Gamma (γ) ray, an electromagnetic radiation, is occasionally accompanying the emission of an alpha or beta particle. Exposure to such radiation can cause cellular changes such as mutations, chromosome aberration and cellular damage which depend upon the total amount of energy, duration of exposure and the dose. Ionizing radiation can impair spermatogenesis and can cause mutations in germ cells. In general, type B spermatogonia are sensitive to this type of radiation. The current study was carried out to evaluate the protective role of hesperidin (H), as a polyphenolic compound, on rat testis injury induced by γ-radiation. METHODS: Rats were divided into groups including C group (control rats), R (irradiated) group (rats irradiated with γ-radiation), Vehicle (V) group (rats administered with dimethylsulfoxide "DMSO"), H group (rats administered with H only), HR and RH groups (rats treated with H before and after exposure to γ-radiation, respectively). Malondialdehyde (MDA: the end product of lipid peroxidation "LPO") and xanthine oxidase (XO: it generates reactive oxygen species "ROS") in testes homogenate as well as nitric oxide (NO: as ROS) in mitochondrial matrix were determined. The apoptotic markers including DNA-fragmentation (DNAF) in testes homogenate and calcium ions (Ca2+) in mitochondrial matrix were determined. Superoxide dismutase (SOD) and catalase (CAT) activities in testes homogenate, while reduced glutathione "GSH" in nuclear matrix were determined. Also histopathological examination for testes tissues through electron microscope was studied. RESULTS: Exposure of rats to γ-radiation (R group) increased the levels of MDA, NO, DNAF, Ca2+ and XO activity, while it decreased GSH level, SOD and CAT activities as compared to the C groups; γ-radiation increased oxidative stress (OS), LPO, apoptosis and induced testes injuries. These results are in agreement with the histopathological examination. In contrast, treatment with H before or after exposure to γ-radiation (HR and RH groups, respectively) decreased the levels of MDA, NO, DNAF and Ca2+ but increased GSH level and the activities of SOD, CAT and XO as compared to R group and this indicates that H decreased OS, LPO and apoptosis. Also, the histopathological results showed that H improved testis architecture and this is related to the antioxidant and anti-apoptotic activities of H contents. Protection is more effective when H is given before rather than after exposure. Finally, administration of H to healthy rats for a short period had no adverse affect on testes cells. CONCLUSION: Hesperidin showed antioxidant and anti-apoptotic activities. It has a protective role against OS, injury and apoptosis induced by γ-radiation in testes. Protection is more effective when H is given before rather than after exposure.Graphical Abstract.

Predictors of poor obstetric outcome in women with systemic lupus erythematosus: a 10-year experience of a university hospital.

OBJECTIVE: To compare the maternal and fetal outcome in patients with systemic lupus erythematosus (SLE) by a retrospective analysis from 2005 to 2010, and a prospective follow-up of pregnant SLE patients from 2010 to 2015 to find out predictors of poor obstetric outcome. METHODS: The study included 236 SLE pregnant females (retrospective group) whose data were viewed retrospectively from their medical records, and 214 SLE pregnant females (prospective group) who were followed prospectively to record their maternal and fetal outcome. RESULTS: There was a highly significant difference between the two groups regarding abortion, venous thromboembolism, prematurity, and intrauterine fetal death (p < 0.001) with more occurrence in retrospective group. Also, the frequency of lupus flares, worsening of renal functions, blood transfusion, maternal mortality, admission to NICU, and neonatal death was higher in the retrospective group (p < 0.05). Predictors of poor obstetric outcome included Last flare before pregnancy <6 months, number of antenatal hospital admissions ≥ 6, use of immunosuppressive therapy, the presence of anti-SSA/Ro and anti-SSB/La, and SLE with nephritis (p < 0.05). CONCLUSION: Improved maternal and fetal outcome in women with SLE has occurred following integrated multidisciplinary approach. This emphasizes the importance of postponing pregnancy when predictors of poor outcome are encountered.