Cyclophosphamide as a Treatment for Focal Segmental Glomerular Sclerosis Recurrence in a Kidney Transplant Patient.

BACKGROUND Primary focal segmental glomerular sclerosis (FSGS) frequently causes recurrence after kidney transplantation, leading to graft loss in half of the patients. Conservative treatment of FSGS is the main acceptable method due to the lack of randomized clinical trials. A few strategies are known to treat FSGS recurrence, such as plasmapheresis and intravenous immunoglobulin (IVIG), but failure to achieve remission may occur. In addition, some of these treatment strategies are more established in pediatric patients and lack evidence in adult patients. CASE REPORT We describe the case of a 24-year-old woman who had a kidney transplant due to FSGS and was admitted to the hospital for an evaluation of lower-limb and facial swelling. Her kidney biopsy showed segmental glomerulosclerosis compatible with recurrence of FSGS. Her FSGS relapses were further confirmed by increase in serum creatinine and proteinuria. The patient had several FSGS relapses that were treated by different combinations of plasmapheresis, pulse steroid, mycophenolic acid, tacrolimus, prednisolone, IVIG, and IV rituximab. She did not respond to conventional therapy and was eventually treated successfully using cyclophosphamide and remained in remission afterward. CONCLUSIONS FSGS has a high recurrence rate after kidney transplantation. A few options to achieve remission have been investigated. In this report, we present the case of a young woman with FSGS recurrence after a kidney transplant, achieving remission successfully with cyclophosphamide. Cyclophosphamide can be used a treatment of FSGS recurrence in a transplanted kidney when all other options have been exhausted. Additional research is needed to assess the efficacy and safety profile of cyclophosphamide in such cases.

Knowledge and attitude about sexually transmitted diseases among youth in Saudi Arabia.

BACKGROUND: Sexually transmitted diseases (STDs) are one of the most serious diseases in the world. Our aim was to explore the knowledge and attitude about STDs among the youth. PATIENTS AND METHODS: This cross-sectional survey was conducted from August 1 to August 13, 2016. Male and female youth between 18 and 25 years were invited to participate in the survey using social media open to all Internet users consisting of questions and statements about STDs, and then the data were analyzed. RESULTS: We received 5040 responses to the survey; out of these participants 76.6% were females and 23.4% were males with a mean age 21.5 and most of them were single (85.1%). We noticed that most of the respondents selected the Internet (71.7%) as the main source of their knowledge about STDs followed by school, television, and others, respectively. In spite of, 94.08% knew that human immunodeficiency virus/AIDS is an STD, only 43.61% knew that herpes simplex virus is an STD, and only 31.03% knew that Chlamydia is an STD. A high percent (93.1%) agreed that sexual intercourse transmits STDs. Only 59.6% agreed that condom does not provide complete protection from STDs. To our surprise, only 55% considered themselves capable of protecting themselves against STDs. About 95.8% of the participants agreed that STDs should be taught in schools, while 4.2% disagreed. CONCLUSION: We noticed a lack of participant's knowledge regarding the types, mode of transmission, and the ways of protections from STDs and their desire to find out information about STDs. Hence, awareness programs about STDs should be started that aim at encouraging youth to follow our religion and culture.

Evaluation of anti-resistant activity of Auklandia(Saussurea lappa) root against some human pathogens

Objective:The antimicrobial activity of the ethanol extract of the Auklandia (Saussurea lappa) root plant was investigated to verify its medicinal use in the treatment of microbial infections. Methods:The antimicrobial activity of the ethanol extract was tested against clinical isolates of some multidrug-resistant bacteria using the agar well diffusion method. Commercial antibiotics were used as positive reference standards to determine the sensitivity of the clinical isolates. Results:The extracts showed significant inhibitory activity against clinical isolates of methicillin resistant Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumonia, Extended Spectrum Beta-Lactemase, Acinetobacter baumannii. The minimum inhibitory concentration values obtained using the agar dilution test ranged from 2.0 μg/μL-12.0 μg/μL. In the contrary the water extract showed no activity at all against the tested isolates. Furthermore, the results obtained by examining anti-resistant activity of the plant ethanolic extract showed that at higher concentration of the plant extract (12 μg) all tested bacteria isolates were inhibited with variable inhibition zones similar to those obtained when we applied lower extract concentration using the well diffusion assay. Conclusion:The results demonstrated that the crude ethanolic extract of the Auklandia (Saussurea lappa) root plant has a wide spectrum of activity suggesting that it may be useful in the treatment of infections caused by the above clinical isolates (human pathogens).