An Evaluation of Socio-Demographic and Risk Factor Profile in End-Stage Renal Disease Patients: A Cross-Sectional Assessment.

Background The global incidence and prevalence of chronic kidney disease (CKD) is skyrocketing. In Asia, the prevalence of CKD varies from 10%-18%. However, as Asia is largely populated by developing countries with nascent health care systems, there is a dearth of research and data. It is estimated that a large number of cases go unreported. As a result, the exact disease burden remains unclear. The knowledge about risk factors and their proportionate role in CKD is indispensable in regards to patient management and care.  Objective The early recognition of the most important risk factors for end-stage renal disease (ESRD) is key to early diagnosis, successful treatment, and general heightened awareness regarding CKD. In developing countries, the provision of medical services, in general, and nephrological services, in particular, is wholly inadequate. The insufficiency of solid and regularly updated data compounds the problem. This research study aims to partake in catering to that need. Methodology A structured questionnaire was used to obtain quantitative and categorical data from 119 ESRD patients in the nephrology ward, Allied Hospital, Faisalabad through non-probability sampling. Socio-demographic profile of the patients and information regarding the presence or absence of risk factors were collected. The resulting dataset was analyzed using R version 3.6.3 (R Foundation for Statistical Computing, Vienna, Austria) for data visualization and descriptive analysis. Results The most common age group for ESRD presentation was 46-60 years (52.1%). Among the 119 ESRD patients, the most frequent risk factor was hypertension with 85.7% of the patients presenting with the condition, followed by diabetes mellitus (DM) in 54.6%, renal calculi in 28.6%, glomerulonephritis (GN) in 31.1%, Family history of CKD in 24.4%, and polycystic kidney disease (PKD) in 5% of the patients. Gender-wise distribution of the patients shows that the proportion of patients with hypertension, renal calculi, and family history of CKD varied very little among the two groups. Conclusion In conclusion, our study has reinforced the existing body of knowledge and brought some fresh evidence regarding the prevalence of risk factors in ESRD to light. Hypertension and DM, together, represent the vast majority of cases with ESRD. However, hypertension far outpaces DM as the leading risk factor. Nephrolithiasis was also present in a considerable minority, with a figure much higher than previously reported. Finally, a relatively younger age group (45-60 years) formed the majority of the ESRD patients which is a concerning development. It points to early progression of CKD to ESRD. Long-term adequate control of these risk factors limits disease progression.

Gut Microbiota and Development of Vibrio cholerae-Specific Long-Term Memory B Cells in Adults after Whole-Cell Killed Oral Cholera Vaccine.

Cholera is a diarrheal disease caused by Vibrio cholerae that continues to be a major public health concern in populations without access to safe water. IgG- and IgA-secreting memory B cells (MBC) targeting the V. cholerae O-specific polysaccharide (OSP) correlate with protection from infection in persons exposed to V. cholerae and may be a major determinant of long-term protection against cholera. Shanchol, a widely used oral cholera vaccine (OCV), stimulates OSP MBC responses in only some people after vaccination, and the gut microbiota is a possible determinant of variable immune responses observed after OCV. Using 16S rRNA sequencing of feces from the time of vaccination, we compared the gut microbiota among adults with and without MBC responses to OCV. Gut microbial diversity measures were not associated with MBC isotype or OSP-specific responses, but individuals with a higher abundance of Clostridiales and lower abundance of Enterobacterales were more likely to develop an MBC response. We applied protein-normalized fecal supernatants of high and low MBC responders to THP-1-derived human macrophages to investigate the effect of microbial factors at the time of vaccination. Feces from individuals with higher MBC responses induced significantly different IL-1ß and IL-6 levels than individuals with lower responses, indicating that the gut microbiota at the time of vaccination may "prime" the mucosal immune response to vaccine antigens. Our results suggest the gut microbiota could impact immune responses to OCVs, and further study of microbial metabolites as potential vaccine adjuvants is warranted.

Workplace Violence Among Health Care Professionals in Public and Private Health Facilities in Bangladesh.

Objectives: The main objectives of this study were to examine the prevalence of workplace violence (WPV), its associated factors and explore the experiences of healthcare workers. Methods: A hospital-based cross-sectional study design used a nationally representative sample of 1,081 healthcare workers covering eight administrative divisions of Bangladesh. Logistic regression analysis was employed to estimate the adjusted effect of independent factors on WPV among healthcare workers. Results: Of the participants, 43% (468) experienced some form of WPV. Of those, 84% reported experiencing nonphysical violence, and 16% experienced physical violence in the past year. About 65% of victims claimed no action was taken to investigate the incident, and 44% reported no consequence for perpetrators. Four factors: being married (AOR = 1.63; CI: 1.12-2.39); public sector healthcare worker (AOR = 2.74; CI:1.99-3.76); working in an emergency department (AOR = 2.30; CI:1.03-5.12); and undertaking shift work (AOR = 1.52; CI: 1.10-2.11) were found to be significantly associated with WPV. One-third of the participants were worried about violence in their workplace. Conclusion: WPV is highly prevalent among healthcare workers in Bangladesh. Formal guidelines for reporting and managing WPV are urgently needed at the individual, hospital, and national levels.

Methylene-bearing sulfur-containing cyanopyrimidine derivatives for treatment of cancer: Part-II.

In continuation of our previous work on anticancer and anti-inflammatory agents, a series of 22 novel methylene-bearing sulfur-containing cyanopyrimidine derivatives was synthesized by Biginelli condensation reaction, which was followed by nucleophilic substitution of the chloro group with secondary or tertiary amines. Structural confirmation of these derivatives was attained through different spectral techniques. Then, anticancer evaluation of these compounds was done at the National Cancer Institute. Compounds 4g, 4j, 4k, and 4v demonstrated appreciable results against different cell lines. Among the synthesized compounds, 4g (NSC: 795475) exhibited a growth inhibition (GI) of 81.34% against the NCI-H460 lung cancer cell line, 72.64% against the ACHN renal cancer cell line, and 112.17% against the OVCAR-4 ovarian cancer cell line. Compound 4j (NSC: 795746) was active against U-251 CNS cancer, OVCAR-4 ovarian cancer, and 786-0 and ACHN renal cancer cell lines, with GI of 78.84%, 150.38%, 75.64%, and 86.45%, respectively. The literature supporting the association between cancer and underlying inflammation prompted us to evaluate the four compounds, 4g, 4j, 4k, and 4v, with appreciable anticancer activity for their in vitro anti-inflammatory activity. Cyclooxygenase (COX)-2 inhibition studies were also performed to study the molecular target. To validate the target study, molecular docking studies in the ligand-binding domain of COX-2 (PDB ID: 1CX2) were also performed. Compounds 4g, 4j, and 4k did not show cytotoxicity on RAW 264.7 cells up to 10 µM concentration; however, compound 4v showed cytotoxic effects at 10 µM concentration.

Synthesis of novel benzimidazole acrylonitriles for inhibition of Plasmodium falciparum growth by dual target inhibition.

Antimalarial drug resistance has emerged as a threat for treating malaria, generating a need to design and develop newer, more efficient antimalarial agents. This research aimed to identify novel leads as antimalarials. Dual receptor mechanism could be a good strategy to combat developing drug resistance. A series of benzimidazole acrylonitriles containing 18 compounds were designed, synthesized and evaluated for cytotoxicity, heme binding, ferriprotoporphyrin IX biomineralisation inhibition, and falcipain-2 enzyme assay. Furthermore, in silico docking and MD simulation studies were also performed.The tests revealed quite encouraging results. Three compounds, viz. R-01 (0.69 µM), R-04 (1.60 µM), and R-08 (1.61 µM), were found to have high antimalarial activity. These compounds were found to be in bearable cytotoxicity limits and their biological assay suggested that they had inhibitory activity against falcipain-2 and hemozoin formation. The docking revealed the binding mode of benzimidazole acrylonitrile derivatives and MD simulation studies revealed that the protein-ligand complex was stable. The agents exhibit good hemozoin formation inhibition activity and, hence, may be utilized as leads to design a newer drug class to overcome the drug resistance of hemozoin formation inhibitors such as chloroquine.

Mediating role of body mass index in knee osteoarthritis.

OBJECTIVE: This study explores the role of knee circumference, body mass index (BMI), and range of motion (ROM) in predicting knee osteoarthritis (KOA). The objective is to elucidate the mediating role of BMI in influencing the relationship between age, knee circumference and pain in knee osteoarthritis, as measured with the help of the knee outcome survey (KOS) questionnaire. METHODS: The design used in this study was causal comparative. The study consisted of 66 patients with symptomatic KOA and 60 matched asymptomatic individuals. RESULT: BMI was significantly and positively correlated with both pain and knee girth for the symptomatic KOA group. This finding signifies a relationship between KOA and other indicators, such as age and knee circumference. CONCLUSIONS: The results of the study would indicate an important milestone in clinical rehabilitation, especially for physical therapists, enabling them to plan, modify, and design interventions to improve the health status of KOA patients.

High Quality CdS Thin Film Growth by Avoiding Anomalies in Chemical Bath Deposition for Large Area Thin Film Solar Cell Application.

Many high efficiency thin-film solar cells incorporate a thin layer of CdS in the device structure to form a heterojunction. Chemical bath deposition (CBD) is the most preferred method of deposition especially for large area thin film solar cells. This study explored the effects of ammonium sulfate on the CdS film produced by CBD using cadmium sulfate as the cadmium source. The concentration of ammonium sulfate was varied from 0 M up to 0.006 M. The resulting optical, structural and surface morphological properties of the films were characterized. Results have shown that the films obtained at higher concentrations of ammonium sulfate were smoother and the occurrence of pinholes was also reduced. Agglomeration of CdS particles that is usually present in films deposited using cadmium sulfate as a precursor was also noticeably reduced. It was also observed that the rate of deposition also increased, resulting in a thicker film for identical deposition time and temperature. The average thickness of the films produced ranged from 60 nm to 180 nm.

Numerical simulation of Dean number and curvature effects on magneto-biofluid flow through a curved conduit.

A numerical study is performed to investigate the magnetohydrodynamic viscous steady biofluid flow through a curved pipe with circular cross section under various conditions. A spectral method is applied as the principal tool for the numerical simulation with Fourier series, Chebyshev polynomials, collocation methods and an iteration method as secondary tools. The combined effects of Dean number, Dn , magnetic parameter, Mg , and tube curvature, δ, are studied. The flow patterns have been shown graphically for large Dean numbers as well as magnetic parameter and a wide range of curvatures, 0.01 ≤δ≤ 0.2. Two-vortex solutions have been found. Axial velocity has been found to increase with an increase of Dean number, whereas it is suppressed with greater curvature and magnetic parameters. For high magnetic parameter and Dean number and low curvature, almost all the fluid vortex strengths are weak. The study is relevant to magnetohydrodynamic blood flow in the cardiovascular system.

New biocompatible thermo-reversible hydrogels from PNiPAM-decorated amyloid fibrils.

New biocompatible temperature-responsive hydrogels have been obtained by using unprecedented low concentration of amyloid fibril-PNiPAM hybrids. The viscoelasticity of the hydrogels can be finely controlled by tuning the PNiPAM layers without changing the structure or concentration of the amyloid fibrils.

Bid activation in kidney cells following ATP depletion in vitro and ischemia in vivo.

Bid is a proapoptotic Bcl-2 family protein, which on activation translocates to mitochondria and induces damage to the organelles. Activation of Bid depends on its proteolytic processing into truncated forms of tBid. Bid is highly expressed in the kidneys; however, little is known about its role in renal pathophysiology. In this study, we initially examined Bid activation in cultured rat kidney proximal tubular cells following ATP depletion. The cells were depleted of ATP by azide incubation in the absence of metabolic substrates and then returned to normal culture medium for recovery. Typical apoptosis developed during recovery of ATP-depleted cells. This was accompanied by Bid cleavage, releasing tBid of 15 and 13 kDa. Bid cleavage was abolished in cells overexpressing Bcl-2, an antiapoptotic gene. It was also suppressed by caspase inhibitors. Peptide inhibitors of caspase-9 were more effective in blocking Bid cleavage compared with inhibitors of caspase-8 and caspase-3. Provision of glucose, a glycolytic substrate, during azide incubation inhibited Bid cleavage as well, indicating that Bid cleavage was initiated by ATP depletion. Consistently, Bid cleavage was also induced following ATP depletion by hypoxia or mitochondrial uncoupling. Of significance, cleaved Bid translocated to mitochondria, suggesting a role for Bid in the development of mitochondrial defects in ATP-depleted cells. Finally, Bid cleavage was induced during renal ischemia-reperfusion in the rat. Together, these results provide the first evidence for Bid activation in kidney cells following ATP depletion in vitro and renal ischemia in vivo.