The Etiology of Kidney Failure in Indonesia: A Multicenter Study in Tertiary-Care Centers in Jakarta.

Background: Despite a large number of patients requiring dialysis, the etiology of kidney failure is poorly documented in Indonesia. With the aim to reduce the disease burden, it is essential to obtain more insight in the etiology of chronic kidney disease (CKD). Objectives: In the present study, we attempted to investigate the primary renal disease of kidney failure patients from five tertiary-care centers in Jakarta. Methods: This is a multicenter, cross-sectional study of kidney failure patients receiving kidney replacement therapy (KRT), from December 2021 to July 2022. We recruited patients aged ≥18 years, had been receiving dialysis for at least three months or a kidney transplantation. Findings: This study included 1,152 patients treated with hemodialysis (68.1%), peritoneal dialysis (7.5%), and kidney transplantation (24.4%). At the start of KRT, the median (interquartile-range [IQR]) age was 48 [37-58] years with low eGFR (median [IQR]: 5.9 [4.0-8.34] ml/minute/1.73 m2). Hypertension was the main comorbidity (74.2%), followed by diabetes mellitus (30.1%). The major primary kidney disease was diabetic kidney disease (27.2%), followed by glomerulonephritis (13.0%), hypertension (11.5%), and urolithiasis (10.3%). Lupus nephritis was the common underlying etiology of secondary glomerulonephritis (91%). A high rate of unknown cause (31.1%) was also observed. Conclusions: Our results suggest that diabetic kidney disease is the leading cause of kidney failure in Jakarta, followed by glomerulonephritis. This study highlights the need for a better approach on primary prevention of diabetes mellitus as well as to better recognize glomerulonephritis at earlier stage might have a significant impact on reduction of the rate of kidney failure in Indonesia.

Integrated structural equation modeling and causal steps in evaluating the role of the mediating variable.

This study proposes an integrated analysis in evaluating the role of a mediating variable. An integrated method of structural equation modeling and causal steps was employed. The procedure commenced with the conceptual model and hypotheses development, followed by validity and reliability tests using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) Statistics 25. Then confirmatory and regression analyses were carried out using Structural Equation Modeling (SEM)-Analysis of Moment Structures (AMOS), for model modification. Finally, the causal steps method was employed to evaluate the role of the mediating variable.•This method integrates the use of SEM and causal steps•It includes the validation of the model, variables, and constructs•Also, it involves model modification.

Low Dermatitis Potential of a Powder-Free, “Accelerator-Free” Non Natural Rubber Latex Gloves Using Modified Draize Study

Introduction: The escalated demand for protective rubber glove in the healthcare industries has resulted in increased prevalence of glove related skin problem, irritant and allergic contact dermatitis and latex sensitivity. The industry has recently introduced a new nitrile glove product using a novel patented non-sulphur system to effect co-valent bond crosslinking to provide the desired elasticity of the gloves. This glove also has ionic crosslinking provided by the zinc oxide used in the formulation and the carboxylic group of the nitrile latex. The main objective of this study is to prove that residual chemical additives at a level that may induce Type IV allergy in the unsensitized general user population are not present in this rubber glove and to compare it with a powder free latex examination glove. Methods: In collaboration with the Islamic University of Gaza, we conduct modified test on a specially formulated and powder free, accelerator free LOW DERMA™ enhanced nitrile rubber glove that has physical properties and barrier integrity similar to that of NRL gloves. This glove does not contain sulphur or sulphur related compound. Two sets of Powder free, accelerator free LOW DERMA™ Nitrile Patient Examination Gloves*, white and blue colour were tested using the modified draize-95’ test. Filter paper soaked in normal saline and powder free latex examination glove were used as control. Results: A total of 209 subjects, 149 subjects, Caucasian (71.29%), 30 subjects, Afro Caribbean (14.35%) and 30 subjects, Asiatic (14.35%) were recruited. All 209 subjects had a final patch testing scoring of not more than 1.5 during both the induction phase and the challenge phase for both types of Powder Free Nitrile Patient Examination Gloves (white and blue) and to the negative control, normal filter paper and the powder free NRL control glove. Conclusion: The skin sensitization test (‘Modified Draize-95’ Test) of Powder Free Nitrile Patient Examination Gloves (white and blue) and the powder free NRL examination glove were negative. There was no clinical evidence on the presence of residual chemical additives at the level that may induce Type IV allergy in unsensitized general user population for both Powder Free Nitrile Patient Examination Gloves, blue and white colored, non-sterile. Both gloves qualify for “Low dermatitis Claim”.

On the taxonomy and phylogeny of the skinks Lipinia sekayuensis Grismer, Ismail, Awang, Rizal, & Ahmad and Lipinia surda Boulenger from Peninsular Malaysia.

An integrative taxonomic analysis based on additional specimens and color photographs of Lipinia sekayuensis and additional color photographs of L. surda from Pulau Tioman and the Gunung Panti Forest Reserve, Peninsular Malaysia confirm the previous hypotheses that L. sekayuensis is a valid species and is the sister species of L. surda. The two species share a 12.8% sequence divergence between them.