Urinary and serum neutrophil gelatinase-associated lipocalin as a biomarker in Egyptian systemic lupus erythematosus patients: Relation to lupus nephritis and disease activity

AbstractBackgroundNeutrophil gelatinase-associated lipocalin (NGAL) is an excellent structural biomarker for the early diagnosis of acute kidney injury, prognosis, dialysis requirement and mortality in several common clinical scenarios.Aim of the workThe aim of this work is to detect the levels of both urinary and serum NGAL in SLE patients with and without lupus nephritis (LN) and to correlate their levels with renal biopsy class and disease activity.Patients and methodsThe study included 35 SLE patients; 22 with LN and 13 without as well as 30 matched controls. The SLE Disease Activity Index (SLEDAI) was assessed and the renal biopsy class determined. Urinary and serum levels of NGAL were assessed by ELISA.ResultsThe 35 patients had a median age of 30years and disease duration of 4years. They were 31 females and 4 males. The SLE patients had an elevated urinary NGAL (UNGAL) (median 19ng/ml, IQR 8–87) as compared to controls (median 2ng/ml, IQR 1–18.3) (p<0.006). Levels of UNGAL were higher in patients with LN than those without (p<0.023). In patients with LN, serum levels of NGAL were not significantly different from controls (p=0.6). The UNGAL level significantly correlated with the renal score of SLEDAI (r=0.54, p=0.001) but serum NGAL level did not (r=0.25, p=0.15). UNGAL significantly correlated with grade III and IV of renal biopsy (r=0.67, p=0.009). The sensitivity of UNGAL levels for the diagnosis of LN was 85.7%, with a specificity of 80%.ConclusionUrinary NGAL is a sensitive marker of proliferative nephritis in SLE and disease activity

Comparative study between early and delayed perforator flaps for reconstruction of soft tissue defects over distal third tibia

Background: Flap is tissue(s) with its own vascular supply, allowing transfer from one site to another. Flaps come in various forms. The purpose of classification is to understand the anatomy and the features that each flap provides; it also allows communication not only with peers but with the patients as well to achieve the common goal of reconstruction. Objective: The aim of this study was to compare the outcome of perforator flaps whether being early in timing in the first 48 hours of trauma or later than 48 hours. Methods: This study was conducted in the period between March 2019 to March 2021 on 40 patients with soft tissue defects in distal third tibia from the outpatient clinic, Emergency department of Plastic Surgery faculty of medicine, Beni-suef University also Surgical and Emergency departments, Agouza Police Authority hospital, Algizah, Egypt. Results: Dehiscence was more frequent in delayed as compared with early group (2 vs. 1 case in both groups respectively); but with no statistically significant difference. Healing complications were more frequent among early vs. delayed group; however, this difference had none statistically significant value.&nbsp