Assessment of Glomerular Filtration Rates by Cockcroft-Gault and Modification of Diet in Renal Disease Equations in a Cohort of Omani Patients

Objectives: Glomerular filtration rate (GFR) is the best index of renal function and is frequently assessed by corrected creatinine clearance (CCLcr). The limitations of CCLcr have inspired researchers to derive easy formulas to estimate GFR, with Cockcroft-Gault (C-G) and the modification of diet in renal disease (MDRD) being the most widely used. This study aimed to evaluate the validity of these equations by finding the relation between CCLcr and estimated GFR (eGFR) by C-G, modified C-G and MDRD equations. Methods: From 2007 to 2011, 158 subjects were analysed for serum creatinine and CCLcr at Bowsher Polyclinic, Muscat, Oman. The C-G equation was used to obtain eGFRC-G which was adjusted to body surface area (BSA) to obtain eGFRmC-G, and the MDRD equation was used to obtain eGFRMDRD. The eGFRMDRD, eGFRmC-G and eGFRC-G were then compared to CCLcr. Results: The eGFRMDRD, eGFRmC-G and eGFRC-G significantly correlated with CCLcr, with a slightly stronger correlation with eGFRMDRD (r = 0.701, 0.658 and 0.605, respectively). A receiver operating characteristic curve analysis showed that the diagnostic accuracy of eGFRMDRD for diagnosing chronic kidney disease (CKD) was higher than that of eGFRmC-G, which in turn was higher than that of eGFRC-G (area under the curve was 0.846, 0.831, and 0.791; cut-off limits were 61.9, 58.3 and 59.5, respectively). Conclusion: C-G and MDRD equations can be an alternative to the CCLcr test for assessing GFR, thus avoiding the need for the cumbersome and expensive GFR test. The MDRD formula had greater validity than the C-G equation and the C-G equation validity was improved by an adjustment to BSA

Emergency medicine in Oman: current status and future challenges

The Sultanate of Oman has a relatively young national health care system that could demonstrate its high performance at an international level. Emergency medicine as a specialty has developed rapidly in the country over the last decade. This has involved the parallel development of local emergency residency training, prehospital emergency care, and emergency nursing programs. This article reviews the progress of emergency care practice in this country from a general primary care system toward becoming an established specialty in hospital, prehospital, and private emergency care settings. It also describes aspects of undergraduate, postgraduate, and continuous emergency medicine education in the country. Further, a glimpse into academic emergency medicine and emergency nursing is provided. Since it describes a developing specialty, the article also attempts to address briefly major future challenges and their importance to the future development of the specialty in Oman

Cosupported Tandem Catalysts for Production of Linear Low-Density Polyethylene from an Ethylene-Only Feed

Linear low-density polyethylene (LLDPE) is produced from an ethylene-only feed over a tandem catalyst system consisting of a phenoxy–imine titanium trimerization catalyst and a silylene-linked cyclopentadienyl/amido titanium polymerization catalyst cosupported on the same methylaluminoxane/silica particles. The level of 1-hexene incorporation can be controlled by varying the ethylene pressure

Structural, 57 Fe Mössbauer and XPS studies of mechanosynthesized nanocrystalline Nd0.33Eu0.67Fe1-xCrxO3 particles

We report on the structure and surface composition of Nd0.33Eu0.67Fe1-xCrxO3 (x = 0.0, 0.3, 0.5, 0.7, 0.9 and 1.0) nanoparticles (∼30 nm) mechanosynthesized at temperatures that are ∼ 470– 700 °C lower than those at which the pure and doped pristine materials conventionally form. XRD Rietveld and FT-IR analyses show that with increasing x the lattice parameters decrease and the bond lengths and angles vary in a way that reduces crystalline distortion. Whilst the majority of the Eu3+/Nd3+ and Fe3+/Cr3+ cations occupy the normal perovskite-related A- and B-sites, respectively, ∼ 5% of them exchange sites. 57Fe Mössbauer spectroscopy confirms the presence of these antisites and reveals a superparamagnetic behaviour at 298 K that enhances with increasing x. XPS measurement reveals a complex surface composition of the nanoparticles with traces of Eu2O3, Nd2O3, Cr2O3 and Fe2O3 as well as partial O2--deficiency

Chemosensetizing and cardioprotective effects of resveratrol in doxorubicin- treated animals

BACKGROUND: Doxorubicin (DOX), an anthracycline antibiotic is one of the most effective anticancer drug used in the treatment of variety of cancers .Its use is limited by its cardiotoxicity. The present study was designed to assess the role of a natural product resveratrol (RSVL) on sensitization of mammary carcinoma (Ehrlich ascites carcinoma) to the action of DOX and at the same time its protective effect against DOX-induced cardiotoxicity in rats. METHODS: Ehrlich ascites carcinoma bearing mice were used in this study. Percent survival of tumor bearing mice was used for determination of the Cytotoxic activity of DOX in presence and absence of RSVL. Uptake and cell cycle effect of DOX in tumor cells in the presence of RSVL was also determined. Histopatholgical examination of heart tissues after DOX and/or RSVL therapy was also investigated. RESULTS: DOX at a dose level of 15 mg/kg increased the mean survival time of tumor bearing mice to 21 days compared with 15 days for non tumor-bearing control mice. Administration of RSVL at a dose level of 10 mg/kg simultaneously with DOX increased the mean survival time to 30 days with 70% survival of the tumor-bearing animals. RSVL increased the intracellular level of DOX and there was a strong correlation between the high cellular level of DOX and its cytotoxic activity. Moreover, RSVL treatment showed 4.8 fold inhibition in proliferation index of cells treated with DOX. Histopathological analysis of rat heart tissue after a single dose of DOX (20 mg/kg) showed myocytolysis with congestion of blood vessels, cytoplasmic vacuolization and fragmentation. Concomitant treatment with RSVL, fragmentation of the muscle fiber revealed normal muscle fiber. CONCLUSION: This study suggests that RSVL could increase the cytotoxic activity of DOX and at the same time protect against its cardiotoxicity

Laying performance, digestibility and plasma hormones in laying hens exposed to chronic heat stress as affected by betaine, vitamin C, and/or vitamin E supplementation

Heat stress had a negative effect on laying hens' performance, thus this research was to study the influences of betaine (Bet, 1000 mg/kg betaine), vitamin C (VC, 200 mg/kg ascorbic acid), and vitamin E (VE, 150 mg/kg a-Tocopherol acetate) and their possible combinations on egg production, digestibility of nutrients, plasma hormones and reproductive organs of dual-purpose hens exposed to chronic heat stress. Two hundred and eighty eight hens and thirty-six cocks from 32 to 48 weeks of age were divided into nine treatment groups of four replicates, each containing eight hens and one cock. One group was kept under thermo-natural condition and the eight others were kept under chronic heat stress (CHS). One of these eight was used as a negative control, while the others were supplemented with VC, VE and/or betaine and their possible combinations. Body weights, laying rate, feed intake, and feed conversion ratio in hens reared under CHS rooster without any supplementation during 32 to 48 weeks of impairment (P = 0.0052) were recorded. Hens reared under heat stress and fed a diet supplemented with either Bet, VC, VE or combination of the supplements increased production traits. However, hens supplemented with VC showed the greatest production traits. Plasma glucose, estradiol-17 (E-2), progesterone (P-4), tri-iodothyronine (T-3) and thyroxine (T-4) decreased in hens reared under CHS and fed a diet with no supplementation compared to the other treatments (P = 0.001). Liver weights, spleen weights, thyroid gland weights, ovary weights, oviduct weights and oviduct lengths were lowest in hens reared under CHS and fed a diet with no supplementation (P = 0.0480). In conclusion, dual purpose hens reared under CHS and supplemented with VC at 200 mg/kg diet and Bet at 1000 mg/kg enhanced the laying performance and combated CHS

A modified empirical criterion for strength of transversely anisotropic rocks with metamorphic origin

A modified empirical criterion is proposed to determine the strength of transversely anisotropic rocks. In this regard, mechanical properties of intact anisotropic slate obtained from three different districts of Iran were taken into consideration. Afterward, triaxial rock strength criterion introduced by Rafiai was modified for transversely anisotropic rocks. The criterion was modified by adding a new parameter α for taking the influence of strength anisotropy into consideration. The results obtained have shown that the parameter α can be considered as the strength reduction parameter due to rock anisotropy. The modified criterion was compared to the modified Hoek–Brown (Saroglou and Tsiambaos) and Ramamurthy criteria for different anisotropic rocks. It was concluded that the criterion proposed in this paper is a more accurate and precise criterion in predicting the strength of anisotropic rocks

Decreased level of recent thymic emigrants in CD4+ and CD8+T cells from CML patients

<p>Abstract</p> <p>Background</p> <p>T-cell immunodeficiency is a common feature in cancer patients, which may relate to initiation and development of tumor. Based on our previous finding, to further characterize the immune status, T cell proliferative history was analyzed in CD4+ and CD8+ T cells from chronic myeloid leukemia (CML) patients.</p> <p>Methods</p> <p>Quantitative analysis of δRec-ψJα signal joint T cell receptor excision circles (sjTRECs) was performed in PBMCs, CD3+, CD4+ and CD8+T cells by real-time PCR, and the analysis of 23 <it>TRBV-D1 </it>sjTRECs was performed by semi-nested PCR. Forty eight CML cases in chronic phase (CML-CP) were selected for this study and 17 healthy individuals served as controls.</p> <p>Results</p> <p>The levels of δRec-ψJα sjTRECs in PBMCs, CD3+, CD4+, and CD8+ T cells were significantly decreased in CML patients, compared with control groups. Moreover, the numbers of detectable <it>TRBV </it>subfamily sjTRECs, as well as the frequency of particular <it>TRBV-BD</it>1 sjTRECs in patients with CML were significantly lower than those from healthy individuals.</p> <p>Conclusions</p> <p>We observed decreased levels of recent thymic emigrants in CD4+ and CD8+ T cells that may underlay the persistent immunodeficiency in CML patients.</p

PCR Targeting Plasmodium Mitochondrial Genome of DNA Extracted from Dried Blood on Filter Paper Compared to Whole Blood.

Monitoring mortality and morbidity attributable to malaria is paramount to achieve elimination of malaria. Diagnosis of malaria is challenging and PCR is a reliable method for identifying malaria with high sensitivity. However, blood specimen collection and transport can be challenging and obtaining dried blood spots (DBS) on filter paper by finger-prick may have advantages over collecting whole blood by venepuncture. DBS and whole blood were collected from febrile children admitted at the general paediatric wards at a referral hospital in Dar es Salaam, Tanzania. DNA extracted from whole blood and from DBS was tested with a genus-specific PCR targeting the mitochondrial Plasmodium genome. Positive samples by PCR of DNA from whole blood were tested with species-specific PCR targeting the 18S rRNA locus, or sequencing if species-specific PCR was negative. Rapid diagnostic test (RDT) and thin blood smear microscopy was carried out on all patients where remnant whole blood and a blood slide, respectively, were available. Positivity of PCR was 24.5 (78/319) and 11.2% (52/442) by whole blood and DBS, respectively. All samples positive on DBS were also positive on Plasmodium falciparum species-specific PCR. All RDT positive cases were also positive by DBS PCR. All but three cases with positive blood slides were also positive by DBS. In this study, PCR for malaria mitochondrial DNA extracted from whole blood was more sensitive than from DBS. However, DBS are a practical alternative to whole blood and detected approximately the same number of cases as RDTs and, therefore, remain relevant for research purposes

HIV/HCV Co-infection: Pathogenesis, Clinical Complications, Treatment, and New Therapeutic Technologies

World-wide, hepatitis C virus (HCV) accounts for approximately 130 million chronic infections, with an overall 3% prevalence. Four to 5 million persons are co-infected with HIV. It is well established that HIV has a negative impact on the natural history of HCV, including a higher rate of viral persistence, increased viral load, and more rapid progression to fibrosis, end-stage liver disease, and death. Whether HCV has a negative impact on HIV disease progression continues to be debated. However, following the introduction of effective combination antiretroviral therapy, the survival of coinfected individuals has significantly improved and HCV-associated diseases have emerged as the most important co-morbidities. In this review, we summarize the newest studies regarding the pathogenesis of HIV/HCV coinfection, including effects of coinfection on HIV disease progression, HCV-associated liver disease, the immune system, kidney and cardiovascular disease, and neurologic status; and effectiveness of current anti-HIV and HCV therapies and proposed new treatment strategies