In-silico analysis of interacting pathways through KIM-1 protein interaction in diabetic nephropathy.

BACKGROUND: Human Kidney Injury Molecule-1, also known as HAVCR-1 (Hepatitis A virus cellular receptor 1), belongs to the cell-surface protein of immunoglobulin superfamily involved in the phagocytosis by acting as scavenger receptor epithelial cells. The study focused on pinpointing the mechanisms and genes that interact with KIM-1. METHODS: This in-silico study was done from March 2019 to December 2019. The Enrichment and protein-protein interaction (PPI) network carefully choose proteins. In addition, the diagramed gene data sets were accomplished using FunRich version 3.1.3. It was done to unveil the proteins that may affect the regulation of HAVCR1 or may be regulated by this protein. These genes were then further considered in pathway analysis to discover the dysregulated pathways in diabetic nephropathy. The long list of differentially expressed genes is meaningless without pathway analysis. RESULTS: Critical pathways that are dysregulated in diabetic nephropathy patients have been identified. These include Immune System (Total = 237, P < 0.05), Innate Immune System (Total = 140, P < 0.05), Cytokine Signaling Immune system (Total = 116, P < 0.05), Adaptive Immune System (Total = 85) and Neutrophil degranulation (Total = 78). CONCLUSION: The top 5 genes that are interacting directly with HIVCR1 include CASP3, CCL2, SPP1, B2M, and TIMP1 with degrees 161, 144, 108, 107, and 105 respectively for Immune system pathways (Innate Immune System, Cytokine Signaling Immune system, Adaptive Immune System and Neutrophil degranulation).

Preparation of mesoporous activated carbon from palm-date pits: optimization study on removal of bentazon, carbofuran, and 2,4-D using response surface methodology.

Palm-date pits were used to prepare activated carbon by physiochemical activation method, which consisted of potassium hydroxide (KOH) treatment and carbon dioxide (CO(2)) gasification. The effects of variable parameters, activation temperature, activation time and chemical impregnation ratios (KOH: char by weight) on the preparation of activated carbon and for removal of pesticides: bentazon, carbofuran and 2,4-dichlorophenoxyacetic acid (2,4-D) were investigated. Based on the central composite design (CCD), two factor interaction (2FI) and quadratic models were respectively employed to correlate the effect of variable parameters on the preparation of activated carbon used for removal of pesticides with carbon yield. From the analysis of variance (ANOVA), the most influential factor on each experimental design response was identified. The optimum conditions for preparing activated carbon from palm-date pits were found to be: activation temperature of 850 °C, activation time of 3 h and chemical impregnation ratio of 3.75, which resulted in an activated carbon yield of 19.5% and bentazon, carbofuran, and 2,4-D removal of 84, 83, and 93%, respectively.

Evaluation of in vitro anticancer potential of pharmacological ethanolic plant extracts Acacia modesta and Opuntia monocantha against liver cancer cells.

Acacia modesta (AM) and Opuntia monocantha (OM) are distributed in Pakistan, Afghanistan and India. Both of these plants have different pharmacological properties. This study was designed to evaluate anticancer potential of Acacia modesta (AM) and Opuntia monocantha (OM). Liver cancer cell line HepG2 was used for assessment of anticancer activity. For the evaluation of anti-proliferative effects, cell viability and cell death in all groups of cells were evaluated via MTT, crystal violet and trypan blue assays. For the evaluation of apoptosis ELISA of p53 performed. Furthermore, LDH assay to find out the ability of malignant cells to metabolize pyruvate to lactate and antioxidant enzymes activity (GSH, CAT and SOD) at the end HPLC was performed to find active compound of AM and OM. Cytotoxicity (MTT), Viability assays (trypan blue, crystal viability, MUSE analysis) showed more dead, less live cells in plant treated groups with increase of concentration. Scratch assay for the anti-migratory effect of these plants showed treated groups have not ability to heal scratch/wound. ELISA of p53 for cellular apoptosis showed more release of p53 in treated groups. Antioxidant assay via glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) showed less anti-oxidative potential in treated cancer groups. LDH assay showed more lactate dehydrogenase release in treated groups compared with untreated. HPLC analysis showed the presence of phytochemicals such as steroids, alkaloids, phenols, flavonoids, saponins, tannins, anthraquinone and amino acids in AM and OM plant extracts. Based on all these findings, it can be concluded that ethanolic extracts of Acacia modesta and Opuntia monocantha have promising anti-cancer potential.

Syndromic approach to sexually transmitted infections in Tunisian women: bacteriological validation.

The World Health Organization emphasizes an integrated primary care approach using syndromic management of sexually transmitted infections. The objective of our study was to evaluate the quality of care of the syndromic management of sexually transmitted disease in women in Rabta hospital in Tunisia. Algorithms have been developed for: cervicitis due to Neisseria gonorrhoeae or Chlamydia (algorithm 3a), vaginitis due to Trichomonas vaginalis or Chlamydia trachomatis (algorithm 3b) and vaginitis due to Candida (algorithm 3c). A total of 116 women were enrolled in the study during February 2003 to April 2004. The prevalence of each bacterium was Chlamydia (10%), N. gonorrhoeae (1%), Treponema pallidum (1%), T. vaginalis (5%) and Candida (21%). Algorithm '3a' had a sensitivity of 45%, a specificity of 42% and positive predictive value (PPV) of 11.9%. Algorithm '3b' had a sensitivity of 35.7%, a specificity of 68.9% and PPV of 20.8%. Algorithm '3c' had a sensitivity of 12%, a specificity of 88% and PPV of 33.3%. To improve the sensitivity of the syndromic approach, we suggest improving the quality of history taking.

[Diverticulum of the left atrium detected antenatally. Management of a case]. / Diverticule de l'oreillette gauche découvert en anténatal. Conduite a tenir a propos d'un cas.

Cardiac diverticulae are rare, most often affecting the ventricles rather than the atria. We report the case of a diverticulum of the left atrium discovered during routine fetal echocardiography. The diagnosis was confirmed at birth with cardiac echography and an MRI. In view of the patient's age and asymptomatic nature, it was decided to defer surgery and to observe the infant with regular echocardiography. Surgery was eventually performed via a left thoracotomy after the appearance of signs of cardiac compression, and there were no complications in the post-operative period.

Management of subacute acetabular osteomyelitis in a child.

Clinical manifestations of subacute osteomyelitis may lead to delayed diagnosis. Acetabular subacute osteomyelitis is an uncommon disease. Bone tumors are usually suggested first. Diagnosis is often made based on radiological findings. We report on the case of a 9-year-old girl who consulted at the emergency department because of limping and pain in her left limb lasting 2 weeks. No fever was reported. Physical examination found a clear, painful reduction in hip mobility. X-ray findings revealed a posterior loss of bone in the acetabular wall. MRI found a mild invasion of the periarticular hip joint and muscles. The surgical exploration of the hip found a collection in the posterior acetabular wall suggesting septic disease. Bacteriological and pathological exams confirmed acetabular subacute osteomyelitis. Nine months after surgery, antibiotic therapy, and physiotherapy, the patient was painless and the hip mobility showed near normal values with a reduction in external rotation and flexion. The aim of this case report is to review the characteristics of subacute acetabular osteomyelitis, including therapeutic modalities, underlining surgical debridement as a rule for both diagnosis and treatment.

Moebius syndrome, peripheral neuropathy and hypogonadotrophic hypogonadism.

The association of congenital ophthalmoplegia and facial paresis (Moebius syndrome) with a variety of other developmental somatic defects has been widely recognised. Its co-existence with hypogonadism of hypothalamic/pituitary origin and subclinical peripheral neuropathy has been reported and in this paper we describe the second case of the Moebius syndrome in association with hypogonadotrophic hypogonadism and a progressive peripheral neuropathy of mixed axonal and demyelinating type.

Closed mitral valvotomy in pregnancy--a study of seven cases.

Between 1977 and 1987, seven pregnant women (mean age 28 years) had closed mitral valvotomy through a left lateral thoracotomy during their first (3 cases), second (2 cases) or third (2 cases) trimester. Surgery was necessary either because of acute heart failure with pulmonary edema not responding to medical treatment (4 cases) or to prevent the complications of severe mitral stenosis affecting either the mother or the fetus in three patients with desired pregnancies. There were neither maternal nor fetal deaths. The only complication was bleeding from a low insertion of the placenta identified in the early postoperative period in one patient that required a caesarean section, which produced a normal baby. Six pregnancies continued until term with uneventful delivery and produced normal children. We conclude that closed mitral valvotomy is a simple and a low risk procedure in pregnant women. It prevents complications of severe mitral stenosis occurring in either the mother or the fetus during pregnancy and delivery.

Aortic valve replacement in children under 16 years of age with congenital or rheumatic valvular disease. A study of 64 cases.

Sixty-four children have had a single aortic valve replacement under 16 years of age, 50 for rheumatic disease (47) or bacterial endocarditis (3) (group I) and 14 for a congenital aortic valve lesion (group II), 38 were disk prostheses and 26 were ball prostheses. Associated procedures had to be performed 31 times, with widening of a small aortic annulus by a patch in 7 patients. The early mortality was 12.5%. Of 56 survivors, 55 were followed postoperatively for a mean period of 7 years (group I: 44, group II: 11). Forty of the 55 patients were anticoagulated (correctly maintained in only 24 patients), 15 were not anticoagulated. A high rate of late complications was observed. Thrombo-embolic accidents in 5 patients with inefficient anticoagulant treatment, 2 haemorrhagic episodes, 7 prosthetic leaks; specific problems related to this group of young patients were: recurrence of rheumatic fever with increasing severity of mitral valve disease requiring mitral valve replacement in 5 patients and outgrowth of the prosthesis, which affected 7 patients; this complication is the result of either fibrous deposit around the valve annulus or such a small annulus that the surgeon could only implant a small prosthesis. Ten patients required 11 reoperations for various reasons. The main reason for reoperation was mitral valve replacement for worsening of mitral valve disease caused by recurrence of rheumatic fever. A high late mortality 10/55 (18%) was noted. The main cause of death was a perivalvular leak (5); 1 late death was caused by a stenotic number 17 Björk-Shiley valve.(ABSTRACT TRUNCATED AT 250 WORDS)

[Late thromboses of prosthetic heart valves. Apropos of 15 cases]. / Thromboses tardives sur prothèses valvulaires. A propos de 15 cas.

15 patients developed late thrombosis of their prosthetic heart valves: --9 mitral, 4 tricuspid and 2 aortic valve prostheses. --12 thromboses occurred on Starr-Edwards ball prostheses (7M, 3T and 2 Ao), 2 on Starr-Edwards disc prostheses (1M, 1T) and one on a Björk-Shiley valve. 14 patients were on anticoagulant drugs but treatment was only effective in 5 patients; only 1 patient was not anticoagulated. Thrombosis of mitral and aortic valves presented with signs of pulmonary oedema and/or systemic (especially cerebral) embolism and tricuspid valve thromboses presented with signs of right heart failure or were discovered on routine examination. Paraclinical investigations, when performed, showed valve movement to be an unreliable sign but phonocardiography was useful. Differing pathological appearances were observed, either peroperatively (7 cases) or at autopsy (8 cases). Late thrombosis is a rare but dangerous complication which should be avoided by effective anticoagulation and diagnosed at an early stage.

[Late thromboses on tricuspid valve prostheses. Apropos of 6 cases]. / Thromboses tardives sur prothèses tricuspidiennes. A propos de 6 cas.

Six out of 24 patients with tricuspid valve prostheses, operated between 1968 and 1978, followed-up from 1 to 10 years (average 4,2 years) developed thrombosis. This complication occurred between 15 and 59 months after operation (average 37 months). All patients were female with ages ranging from 18 to 44 years (average 38 years). Starr-Edwards prostheses were used in all cases. Five of these patients were on anticoagulants therapy, which was well within therapeutic limits in 3 patients. In contrast to thrombosis of mitral or aortic valve prostheses, the presenting symptoms were slowly progressive and discreet in 4 patients; in 1 case, the thrombosis was diagnosed on routine follow-up examination. The slow clinical presentation allows time for useful complementary investigations, catheterisation and angiocardiography being the most reliable methods of confirming this difficult diagnosis: these investigations were carried out in 2 patients, and in both cases, very high right atrial pressure with diastolic gradients between the right atrium and right ventricle of over 10 mm Hg were recorded. Cineangiography showed tricuspid regurgitation in both cases with reflux in the vena cavae and very dilated right atria, stagnation of contrast and poor right ventricular filling. Five patients were reoperated with two postoperative deaths. Particular anatomical appearances were observed at operation or autopsy with fibrin and platelet deposits at different levels of the prosthesis (sewing ring and/or struts) interfering and even blocking the function of the ball or disc. Organized thrombus on the cage was only observed in one patient. In this case, the struts on the prosthesis were set in the right ventricular cavity. Thrombosis of tricuspid valve prostheses is generally a slowly progressive complication and may be diagnosed in time by regular follow-up, so that reoperation may be considered without unnecessary delay.

[Predictive factors for late complete atrio-ventricular block after surgical treatment for congenital cardiopathy]. / Facteurs prédictifs de bloc auriculo-ventriculaire complet tardif après traitement chirurgical des cardiopathies congénitales.

The late occurrence of complete atrio-ventricular block (CAVB) after cardiac surgery is rare but potentially responsible for cases of late sudden death. We searched for factors allowing prediction of this complication, retrospectively reviewing the case notes of 11 patients in hospital with complete AVB, 2 months to 10 years after correction of a cardiac malformation. All had a normal pre-operative ECG. The diagnosis had been made based on symptoms in 8 patients: syncope or collapse (4 cases) symptoms on effort (3 cases) or fatigue (1 case). In the others the diagnosis had been made on ECG. The block was infra-His in 5 patients who had electrophysiology. ECG analysis showed that all the patients had CAVB immediately post-operatively lasting 3-14 days. After restoration of conduction the ECGs showed the following anomalies compared to the pre-operative ECGs: long PR (1 case), long PR + right bundle branch block (2 cases), long PR + left axis deviation (1 case), RBBB + left deviation or rotation of the QRS axis (3 cases), long PR + RBBB + left axis deviation (4 cases). All of these patients had been fitted with a cardiac stimulator. In conclusion, the children who had CAVB immediately post-operatively lasting more than 48 hours and who then had an ECG showing different QRS compared to the pre-operative QRS and/or long PR had a risk of late complete AVB. These patients should have electrophysiology and a stimulator must be implanted in those who have an infra-His block.

[Infectious endocarditis surgically-treated in the active phase. Apropos of 46 cases]. / Endocardites infectieuses opérées à la phase active. A propos de 46 cas.

The clinical and microbiological characteristics, the surgical indications and procedures, the evolution and the principal prognostic factors were reviewed in 46 cases of infectious endocarditis operated in the active phase. Using this date, the authors try to determine the optimal time for surgery during the acute active phase of infectious endocarditis. The study population comprised 28 men and 18 women aged 7 to 64 years (average age: 30). The patients were selected on strict criteria: positive blood cultures during the 48 hours prior to surgery (29 cases), positive valve or valve prosthesis culture (15 cases), the presence of an active cardiac abscess at surgery (7 cases), the presence of a large number of bacteria on histological examination of the valve (17 cases). The patients were divided into two groups: those with endocarditis of native valves (27 cases) and those with endocarditis on prosthetic valves (19 cases). The preoperative clinical features included all the classical signs of IE but congestive cardiac failure was particularly prevalent (62% of cases). Microbiologically, most cases of native valve endocarditis (67%) were due to sensitive organisms (streptococci) whilst the more virulent organisms (staphylococci, gram-negative bacteria and fungi) were observed in prosthetic valve endocarditis (64% of cases). The commonest surgical indication was haemodynamic deterioration (30 cases). The indications were mixed in 15 cases but only one case was operated for uncontrolled infection alone in this series. The surgical procedure was technically complex in 6 cases. Operative mortality was high (18 cases, 39%). The main cause of death was low cardiac output (13 cases).(ABSTRACT TRUNCATED AT 250 WORDS)

[Superior caval syndrome caused by chronic mediastinitis in Behçet's disease]. / Syndrome cave supérieur par médiastinite chronique au cours d'une maladie de Behçet.

We report a case of Behçet disease complicated by superior vena cava syndrome secondary to extrinsic compression by mediastinal fibrosis. This association is not reported in literature. The habituel etiology of vena cava syndrome in Behçet disease is venous thrombosis. Radiological investigations of this syndrome are necessary to avoid an useless anticoagulant therapy.

[Mitral valve prosthesis without anticoagulant treatment. Apropos of 46 cases]. / Prothèses valvulaires mitrales sans traitement anticoagulant. A propos de 46 cas.

Out of a total of 90 patients with valvular prosthesis not treated with anti-coagulants, 46 only had a prosthesis in the mitral position. These patients were treated in Professor Ben Ismail's department for an average of 58 months (extreme limits 26 and 116 months). The average age of these patients at the time of the operation was 13.6 years. It is important to note that these patients greatly improved as attested to by the evolution of the functional symptoms, cardiac volume, capillary and pulmonary arterial pressure. 7 patients had a thromboembolism (15.5 per cent or 3 embolisms per 100 patient-years). Three cases were minor or rapidly regressed and out of four major cases, one died. This complication is much more frequent in patients treated with anti-coagulants as is the risk of haemorrhage which is sometimes serious or even mortal. In view of these results, it seems legitimate, in these young patients, especially when they are in sino-astrial rhythm, have a good clinical history and are haemodynamic to forego anti-coagulant treatment which may be dangerous in these undisciplined patients under irregular and unusual treatment.