Stress among medical students of Gorgan (South East of Caspian Sea), Iran

Objective: This study aims to estimate the prevalence of psychological stress and association between the levels of stress and study variables among Gorgan medical students. Materials and methods: All three year medical students (129 basic sciences students) in Gorgan Faculty of Medicine, Golestan University of medical Sciences, were asked to complete the Kessler 10 questionnaire. Results: The findings showed mild, moderate and severe stress among 26.22%, 20.50% and 14.75% study subjects. 39.35% of medical students had no stress. There was statistically significant association between year of study and stress levels (p= 0.040). Conclusion: The results indicate that there is a decrease in the psychological health of first year medical students. Provided that stress management courses are organised by medical schools, when the students arrive, they will cope up with the stress in coming years. These courses may reduce the negative effects of stress on medical students. By providing such courses and reducing stress level, medical students may improve their medical education

Prevalence of chronic kidney disease and its associated risk factors: The first report from Iran using both microalbuminuria and urine sediment

Background: The incidence of major risk factors of chronic kidney disease (CKD) in the world is on the rise, and it is expected that this incidence and prevalence, particularly in developing countries, will continue to increase. Using data on urinary sediment and microalbuminuria, we aimed to estimate the prevalence of CKD in northeast Iran. Methods: In a cross-sectional study, the prevalence of CKD in a sample of 1557 regionally representative people, aged � 18 years, was analyzed. CKD was determined based on glomerular filtration rate (GFR) and microalbuminuria. Life style data, urine and blood samples were collected. Urine samples without any proteinuria in the initial dipstick test were checked for qualitative microalbuminuria. If the latter was positive, quantitative microalbuminuria was evaluated. Results: 1557 subjects with a mean age of 56.76 ± 12.04 years were enrolled in this study. Based on the modifcation of diet in renal disease (MDRD) equation, 137 subjects (8.89%) were categorized as CKD stages III-V. Based on urine abnormalities, the prevalence of combined CKD stages I and II was 10.63%, and based on macro- and microalbuminuria it was 14.53%. The prevalence of CKD was significantly associated with sex, age, marital status, education, diabetes mellitus (DM), hypertension (HTN), ischemic heart disease (IHD), waist to hip ratio, myocardial infarction (MI), and cerebrovascular accident (CVA). Conclusion: CKD and its main risk factors are common and represent a definite health threat in this region of Iran. Using and standardizing less expensive screening tests in low resource countries could be a good alternative that may improve the outcome through early detection of CKD

Prevalence of Cryptosporidium spp. infection in renal transplant and hemodialysis patients

Transplanted and hemodialysis patients are frequently affected by parasitic diseases such as cryptosporidiosis. Cryptosporidium is a parasite causing self-limited diarrhea and enteritis in healthy individuals. The presence of Cryptosporidium infection was studied in three groups including 87 renal transplant patients, 103 hemodialysis patients, and 60 healthy individuals as the control group. Two stool specimens were obtained from each case. The specimens were concentrated by the formalin-ether method and two smears were prepared from each. The smears were stained by modified acid-fast method and were observed under a light microscope. Ten (11.5) renal transplant and 4 (3.88) hemodialysis patients were positive for Cryptosporidium infection. No positive results were obtained in the control group. The results showed a statistically significant difference between renal transplant and control groups (P=0.02), but the difference between hemodialysis and control groups was not significant (P=0.2). The results also showed that the rate of Cryptosporidium infection in renal transplant patients was much higher than hemodialysis patients. The susceptibility of renal transplant patients to Cryptosporidium infection is much more than other studied groups and this could be due to immunosuppressive therapy in these patients

Unconventional Reservoir Characterization and Formation Evaluation: A Case Study of a Tight Sandstone Reservoir in West Africa

Unconventional reservoirs, including gas shales and tight gas sands, have gained prominence in the energy sector due to technological advancements and escalating energy demands. The oil industry is eagerly refining techniques to decipher these reservoirs, aiming to reduce data collection costs and uncertainties in reserve estimations. Characteristically, tight reservoirs exhibit low matrix porosity and ultra-low permeability, necessitating artificial stimulation for enhanced production. The efficacy of the stimulation hinges on the organic material distribution, the rock’s mechanical attributes, and the prevailing stress field. Comprehensive petrophysical analysis, integrating standard and specialized logs, core analyses, and dynamic data, is pivotal for a nuanced understanding of these reservoirs. This ensures a reduction in prediction uncertainties, with parameters like shale volume, porosity, and permeability being vital. This article delves into an intricate petrophysical evaluation of the Nene field, a West African unconventional reservoir. It underscores the geological intricacies of the field, the pivotal role of data acquisition, and introduces avant-garde methodologies for depth matching, rock typing, and the estimation of permeability. This research highlights the significance of unconventional reservoir exploration in today’s energy milieu, offering a granular understanding of the Nene field’s geological challenges and proffering a blueprint for analogous future endeavours in unconventional reservoirs

Leprosy & gangrene: A rare association; role of anti phospholipid antibodies

BACKGROUND: Leprosy still remains an important public health problem for many parts of the world. An association of gangrene with leprosy is a rare one & can have a number of causative mechanisms. We present a case with Leprosy & gangrene with positive anti phopholipid antibody titers. CASE PRESENTATION: A 50-year-old non-diabetic, non-hypertensive lady presented with 2 months history of progressive gangrene of bilateral toes. She was found to have madarosis & hypopigmented, hypoaesthetic macular lesions on the upper limb & thighs. Bilateral ulnar & popliteal nerves were thickened. A skin biopsy of the lesions revealed borderline tuberculoid leprosy, slit skin smears revealed a bacteriological index of 1+. She did not have any evidence of thromboembolic episode or atherosclerosis. ACLA was positive at presentation & also on another occasion 6 weeks later. ACLAs were of the IgM type on both occasions. Lupus Anticoagulant & β2 GPI antibody were negative. DOPPLER of the lower limb arteries did not reveal any abnormality. Patient was successfully treated with multi-drug antileprotics & anticoagulants. CONCLUSION: Infectious APLAs should be recognized as a cause of thrombosis in Leprosy. Appropriate anticoagulation can salvage limb function

Phenotypic expansion of DGKE-associated diseases.

Atypical hemolytic uremic syndrome (aHUS) is usually characterized by uncontrolled complement activation. The recent discovery of loss-of-function mutations in DGKE in patients with aHUS and normal complement levels challenged this observation. DGKE, encoding diacylglycerol kinase-ε, has not been implicated in the complement cascade but hypothetically leads to a prothrombotic state. The discovery of this novel mechanism has potential implications for the treatment of infants with aHUS, who are increasingly treated with complement blocking agents. In this study, we used homozygosity mapping and whole-exome sequencing to identify a novel truncating mutation in DGKE (p.K101X) in a consanguineous family with patients affected by thrombotic microangiopathy characterized by significant serum complement activation and consumption of the complement fraction C3. Aggressive plasma infusion therapy controlled systemic symptoms and prevented renal failure, suggesting that this treatment can significantly affect the natural history of this aggressive disease. Our study expands the clinical phenotypes associated with mutations in DGKE and challenges the benefits of complement blockade treatment in such patients. Mechanistic studies of DGKE and aHUS are, therefore, essential to the design of appropriate therapeutic strategies in patients with DGKE mutations

Molecular and Serological Techniques to Determine the Acute and Chronic Phase of Toxoplasmosis in HIV Patients

BACKGROUND AND OBJECTIVE: Toxoplasma gondii is associated with several complications including neurological problems, ocular damage and encephalitis in immunodeficiency individuals. Early diagnosis of this infection can lead to better management of this disease. Therefore, this study was conducted to determine the presence of Toxoplasma gondii with two serologic and molecular methods in HIV-infected individuals. METHODS: In this cross-sectional study, 102 male patients with HIV with a mean age of 40 ± 9.2 years were examined. The serum sample was used for ELISA to determine the acute and chronic phase and cellular samples using Real Time-PCR for determining the acute phase of the disease. The relationship between age groups and the HIV transmission pathway, as well as the age group, was compared with the results of the Toxoplasma gondii test. FINDINGS: Out of 102 samples tested for IgM anti-Toxoplasma gondii antigen by ELFA, all (100%) samples were negative, but for anti-IgG anti-parasite, 44 samples (43.1%) were positive and 58 Sample (56.9%) was negative. Out of 102 samples tested by RT-PCR, all (100%) samples were negative for Toxoplasma DNA. There was a statistically significant relationship between age groups and transmission pathways (p<0.001), as well as between age groups with anti-Toxoplasma gondii IgG levels (p<0.001). CONCLUSION: According to the results of this study, the use of IgM-ELFA and PCR-RT methods for the diagnosis of acute phase and IgG-ELFA in the chronic phase of the disease is important. With the diagnosis of chronic form of toxoplasmosis, preventive treatments can be used in HIV + patients

Localization of a gene for nonsyndromic renal hypodysplasia to chromosome 1p32-33.

Nonsyndromic defects in the urinary tract are the most common cause of end-stage renal failure in children and account for a significant proportion of adult nephropathy. The genetic basis of these disorders is not fully understood. We studied seven multiplex kindreds ascertained via an index case with a nonsyndromic solitary kidney or renal hypodysplasia. Systematic ultrasonographic screening revealed that many family members harbor malformations, such as solitary kidneys, hypodysplasia, or ureteric abnormalities (in a total of 29 affected individuals). A genomewide scan identified significant linkage to a 6.9-Mb segment on chromosome 1p32-33 under an autosomal dominant model with reduced penetrance (peak LOD score 3.5 at D1S2652 in the largest kindred). Altogether, three of the seven families showed positive LOD scores at this interval, demonstrating heterogeneity of the trait (peak HLOD 3.9, with 45% of families linked). The chromosome 1p32-33 interval contains 52 transcription units, and at least 23 of these are expressed at stage E12.5 in the murine ureteric bud and/or metanephric mesenchyme. These data show that autosomal dominant nonsyndromic renal hypodysplasia and associated urinary tract malformations are genetically heterogeneous and identify a locus for this common cause of human kidney failure

A guided tour of asynchronous cellular automata

Research on asynchronous cellular automata has received a great amount of attention these last years and has turned to a thriving field. We survey the recent research that has been carried out on this topic and present a wide state of the art where computing and modelling issues are both represented.Comment: To appear in the Journal of Cellular Automat