Isolated Renal Sarcoidosis: a Rare Cause for Granulomatous Interstitial Nephritis

Introduction: Granulomatous interstitial nephritis (GIN) is a rare histological diagnosis that can be the first manifestation of systemic disease. It has been associated with medications, infections, sarcoidosis, crystal deposits, paraproteinemia and Wegnere's granulomatosis. It can also be seen in an idiopathic form. Case report: A 37 year-old female patient presented to our nephrology service with lethargy and weight loss of three months duration. Her past medical history and clinical examination were not remarkable. She had impaired renal function tests and hypercalcemia associated with elevated angiotensin converting enzyme levels and sonographically normal kidneys. Extensive investigations revealed no other organ involvement and no evidence of infection or malignancy. Renal biopsy showed extensive interstitial non-necrotizing granulomata. Accordingly, she was diagnosed as a case of isolated renal sarcoidosis and started on steroid therapy. Within one month of treatment, she recovered normal renal function. Steroids were successfully tapered after another six months, and she shows no evidence of recurrence 24 months after steroid withdrawal. Conclusion: The possibility of isolated renal sarcoidosis should be considered in any case of impaired kidney function and hypercalcemia even in the absence of systemic manifestation. The finding of non-caseating interstitial granulomata in renal biopsy supports this diagnosis. Keywords: granulomatous interstitial nephritis, non-caseating granuloma, renal insufficiency, renal sarcoidosis

A 2X2 MIMO Patch Antenna for Multi-Band Applications

In this paper, a Multiple Input Multiple Output (2x2MIMO)  patch antenna for  multiband applications has been proposed. It has been designed using groups of rings nearby the stepped cut at four corners of the patch and a separation in mid slot. This modification is proposed in order to increase the resonant frequencies and reduce the mutual coupling. The proposed 2x2 MIMO patch antenna is simulated using Computer Simulation Technology (CST), fabricated and tested. With such small geometrical dimensions, the proposed antenna is suitable for LTE (1.8 GHz), WiFi (2.4 GHz), and WiMax (3.5 GHz, 5.2 GHz and 5.5 GHz) application

Automatic Optic Disc Abnormality Detection in Fundus Images: A Deep Learning Approach

Optic disc (OD) is a key structure in retinal images. It serves as an indicator to detect various diseases such as glaucoma and changes related to new vessel formation on the OD in diabetic retinopathy (DR) or retinal vein occlusion. OD is also essential to locate structures such as the macula and the main vascular arcade. Most existing methods for OD localization are rule-based, either exploiting the OD appearance properties or the spatial relationship between the OD and the main vascular arcade. The detection of OD abnormalities has been performed through the detection of lesions such as hemorrhaeges or through measuring cup to disc ratio. Thus these methods result in complex and inflexible image analysis algorithms limiting their applicability to large image sets obtained either in epidemiological studies or in screening for retinal or optic nerve diseases. In this paper, we propose an end-to-end supervised model for OD abnormality detection. The most informative features of the OD are learned directly from retinal images and are adapted to the dataset at hand. Our experimental results validated the effectiveness of this current approach and showed its potential application

Autozygome-guided exome sequencing in retinal dystrophy patients reveals pathogenetic mutations and novel candidate disease genes

Retinal dystrophy (RD) is a heterogeneous group of hereditary diseases caused by loss of photoreceptor function and contributes significantly to the etiology of blindness globally but especially in the industrialized world. The extreme locus and allelic heterogeneity of these disorders poses a major diagnostic challenge and often impedes the ability to provide a molecular diagnosis that can inform counseling and gene-specific treatment strategies. In a large cohort of nearly 150 RD families, we used genomic approaches in the form of autozygome-guided mutation analysis and exome sequencing to identify the likely causative genetic lesion in the majority of cases. Additionally, our study revealed six novel candidate disease genes (C21orf2, EMC1, KIAA1549, GPR125, ACBD5, and DTHD1), two of which (ACBD5 and DTHD1) were observed in the context of syndromic forms of RD that are described for the first time

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Power Factor Control of PV Generators in Local Distribution Networks using Fuzzy Logic Concept

ABSTRACT: One of the most important operational requirements for any electrical power network for both distribution and transmission level is voltage control. Many studies have been carried out to improve or develop new voltage control techniques to facilitate safe connection of distributed generation. In Saudi Arabia, due to environmental, economic and development perspectives a wide integration of photovoltaic (PV) generation in distribution network is expected in the near future. This development in the network may cause voltage regulation problems due to the interaction with the existing conventional control system. In a previous paper [1] a control system has been described using a fuzzy logic control to set the on-line tap changer for the primary substation. In this paper a new control system is proposed for controlling the power factor of individual PV invertors based on observed correlation between net active and reactive power at each connection. A fuzzy logic control has been designed to alter the power factor for the remote invertors from the secondary substation to keep the feeder voltage within the permissible limits. In order to confirm the validity of the proposed method, simulations are carried out for a realistic distribution network with real data for load and solar radiation. Results showing the performance of the new control method are presented and discussed. KEYWORDS: Grid connected PV system, Dnetwotk, Power factor, Fuzzy logic, Control. I.INTRODUCTION This paper presents an approach for solving the feeder voltage regulation problem in a local manner, with the goal of fulfilling the plug-and-play feature desired by manufacturers and regulatory bodies. The plug-and-play feature will enable customers to simply connect their PV systems to the distribution feeder, and through a fuzzy logic control (FLC) the power flow from the PV system through the inverters will be controlled to help maintain the feeder voltage level within limits at minimum cost. The chapter paper by the proposed controller objectives. The proposed controller design is based on FLC and the architecture is then presented. Test results of this system are shown to prove that the proposed controller can successfully regulate the voltage of a distribution feeder with PV systems connected to it. Finally the interaction between two controllers at the same feeder has been investigated and a simulation is carried out under MATLAB /Simulink environment to evaluate the stability of the control algorithm. II. CONTROL OF THE REACTIVE POWER OF PV GENERATION USING FLC Consider a voltage source V S ∟δ connected to a utility grid V G ∟0° through a coupling impedance Z=R+jX, as shown i

System for rogue voip phone detection and managing voip phone mobility

The quickly propelling Voice over Internet Protocol (VoIP) innovation, is picking up customer fascination in the business today. Its uses, including IP communication frameworks, includes the transmission of voice as information bundles which after achieving the getting side, reassembles and deciphers according to necessity. This encourages open just as private IP frameworks. The real drawback, keeping numerous organizations off from utilizing VoIP advances is related to the security of this framework. This paper examines a strategy and the following framework that get to arrange data for approved system gadgets. The entrance insights and data empower to follow gadget development all through the system. In addition, it offers to recognize unapproved gadgets making false endeavors to get to the system, presenting to be an approved access gadget