A study of lipid profile and glycemic status in patients with chronic kidney disease of unknown etiology in Sri Lanka

Background: Dyslipidemia and impaired glucose tolerance are common complications of chronic kidney disease (CKD) and are responsible for increased cardiovascular risk. Studies on lipid profile and glycemic status in CKD of unknown origin (CKDu) are scarce. The objective of this study was to evaluate the lipid profile and glycemic status of the patients with CKDu and to aid in preventing morbidity and mortality.Methods: The descriptive, cross sectional study was conducted in a rural CKDu endemic area, Girandurukotte.  Data was collected from February 2018 to June 2019. For the diagnosis of CKDu, history and clinical features with supportive biochemical, renal biopsy and radiological evidence were taken as criteria. Blood samples were taken for serum creatinine, lipid profile and HbA1C. Already diagnosed patients with diabetes mellitus and dyslipidemia were excluded.Results: A total of 168 patients within the age range of 32-66 years (mean 50.3±7.7) were participated. There were 106 males (63%) 46.4% were farmers. Majority of the patients (65.5%) had normal body mass index (BMI) (mean 22.9 kg/m2, normal range 18.5-23.5%) followed by overweight (23.5-30 kg/m2) in 55 (32.7%) patients. The prevalence of dyslipidemia in CKDu was found to be 55.9%.  Majority of the abnormality was seen in the HDL group with 68 (40.5%) patients having low HDL cholesterol (mean 44.7 mg/dl, SD=12.3).  There was a significant rise in the serum triglyceride concentration (>150 mg/dl) in 53 (31.5%) (mean 152.4 mg/dl, SD=73.5) and total cholesterol (>200 mg/dl) in 30 (18%) patients (mean 182 mg/dl, SD=36.9). LDL cholesterol abnormality (>130 mg/dl) was seen in only 9 patients (mean 88.7 7658mg/dl, SD=25.4). From the total, 144 (85.7%) patients had abnormal HbA1C levels; 27 (16.1%) patients had HbA1C levels between 5.7% and 6.4% (pre-diabetes), and 117 (69.6%) patients had HbA1C level more than 6.5% (diabetes mellitus). There was no statistically significant association between HbA1C levels and BMI (p=0.29) or HbA1C and lipid abnormalities (p=0.32)Conclusions: The high prevalence of dyslipidemia, pre-diabetes and diabetes mellitus in patients with CKDu may accelerate the progression of chronic kidney disease and increase the risk of cardiovascular disease. Early detection, initiation of appropriate medication and early referral to the expertise will ameliorate morbidity and mortality.

Estimating process capability index Cpm using a bootstrap sequential sampling procedure

Construction of a confidence interval for process capability index CPM is often based on a normal approximation with fixed sample size. In this article, we describe a different approach in constructing a fixed-width confidence interval for process capability index CPM with a preassigned accuracy by using a combination of bootstrap and sequential sampling schemes. The optimal sample size required to achieve a preassigned confidence level is obtained using both two-stage and modified two-stage sequential procedures. The procedure developed is also validated using an extensive simulation study.<br /

Refined families of Dothideomycetes: orders and families incertae sets in Dothideomycetidae

The class Dothideomycetes is the largest and most ecologically diverse class of fungi, comprising endophytes, epiphytes, saprobes, human and plant pathogens, lichens, and lichenicolous, nematode trapping and rock-inhabiting taxa. Members of this class are mainly characterized by bitunicate asci with fissitunicate dehiscence, and occur on broad range of hosts in aquatic and terrestrial habitats. Since the last monograph of families of Dothideomycetes in 2013, numerous novel species, genera, families and orders have been discovered. This has expanded information which has led to the modern classification in Dothideomycetes. In this paper, we provide a refined updated document on families of Dothideomycetes with emphasis on Dothideomycetidae and Pleosporomycetidae. We accept three orders with 25 families and four orders with 94 families in Dothideomycetidae and Pleosporomycetidae, respectively. The new family Paralophiostomataceae is introduced in Pleosporales. Each family is provided with an updated description, notes, including figures to represent the morphology, list of accepted genera, and economic and ecological significances. We also provide an overall phylogenetic tree of families in Dothideomycetes based on combined analysis of LSU, SSU, rpb-2 and tef1 sequence data, and phylogenetic trees for each order in Dothideomycetidae and Pleosporomycetidae. Family-level trees are provided for the families which include several genera such as Mycosphaerellaceae and Teratosphaeriaceae. Two new genera (Ligninsphaeriopsis and Paralophiostoma) are introduced. Five new species (Biatrisopora borsei, Comoclathris galatellae, Ligninsphaeriopsis thailandica, Paralophiostoma hysterioides and Torula thailandica) are introduced based on morphology and phylogeny, together with nine new reports and seven new collections from different families. © 2020, Guizhou Key Laboratory of Agricultural Biotechnology