Search

Diarrheal disease remains a significant cause of preventable morbidity and mortality in the pediatric population, particularly among children below five years of age. Although the occurrence of diarrheal episodes is on the decline, its impact continues to escalate at a concerning rate among children under the age of five, especially in developing countries. The objective of this paper is to investigate the factors associated with diarrhea in Yemeni children younger than five years, drawing on data from the latest edition of the Multiple Indicator Cluster Survey (MICS) Yemen conducted in 2022–2023. To identify factors associated with the prevalence of childhood diarrhea, bivariate analysis and multivariable logistic regression were utilized. The findings of this study suggest that age group 6–23, unimproved sanitation, and low-income households are associated with high risk of diarrhea in children under five years of age in Yemen. The study contributes additional evidence regarding factors that should be prioritized in public health strategies geared towards reducing diarrheal prevalence among Yemeni children.

Supplemental Digital Content is available in the text.Presentation to the emergency department with renal colic has been reported as between 6.7 and 27.9 per 1000 emergency department visits. Clinicians rely on various radiological investigations for the prompt and accurate diagnosis of urolithiasis. This review assesses the validity of the colour Doppler ultrasonographic twinkling artefact (TA) sign as a diagnostic tool for the presence of urolithiasis. A systematic search of the Cochrane Database of Systematic Reviews, Embase, PubMed, Scopus and Web of Science databases was performed (October 2018) using specific search terms. PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) guidelines and the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2) tool were applied to rank and evaluate selected studies. Twenty-two articles that included 4389 participants were assessed. The median sample size was 102.5 (interquartile range: 47–292.5) and the age range of participants was 4–91 years. Meta-analysis of the studies that provided sufficient data resulted in a pooled sensitivity and specificity for the ultrasonographic TA sign of 88.16 [95% confidence interval (CI): 87.07–89.19%] and 79.22% (95% CI: 73.41–84.26%) respectively, with an estimated summary effect of 3.84 (95% CI: 1.08–6.60, P0.006) in log odds ratio terms. There was significant interstudy heterogeneity as suggested by an I2-statistic of 94.51% (95% CI: 94.51–99.58) and an estimated τ2parameter of 7.21 (SE: 7.44). Despite the suboptimal pooled sensitivity and specificity of the TA sign and the large heterogeneity between published studies, the current body of evidence suggests that the colour Doppler ultrasonographic TA sign may be useful as a complementary tool in the diagnostic workup of patients with suspected urolithiasis.

A study of the effect of the location of the toe of a Bjump (relative to the break in the channel slope) on its characteristics was designed and implemented. The experimental results were used to introduce new expressions for the hydraulic quantities that govern a Bjump. Three slopes were investigated: 1:3, 1:4, and 1:5 (vertical:horizontal). Measurements of the length of the roller and the tailwater depth were also made. Analysis of the experimental data showed the importance of introducing a new parameter representing the effect of the relative location of the toe of the jump along the sloping channel. The proposed expressions were developed for flows with the approach Froude numbers ranging from 2.4 to 7.4.

Progression of renal diseases is related to the abnormal regulation of cellular and extracellular matrix turnover. Other factors in addition to schistosomal antigens may be relevant to the progression of schistosomal nephropathy (SN). The validity of markers of fibroblastic differentiation, alpha smooth muscle actin (alphaSMA), and vimentin, as well as the regenerative activity (PCNA/apoptosis index) in determination of progression of SN in comparison to other forms of non-schistosomal nephropathy (non-SN) is investigated.

A study of the effect of the location of the toe of a B‐jump (relative to the break in the channel slope) on its characteristics was designed and implemented. The experimental results were used to introduce new expressions for the hydraulic quantities that govern a B‐jump. Three slopes were investigated: 1:3, 1:4, and 1:5 (vertical:horizontal). Measurements of the length of the roller and the tail‐water depth were also made. Analysis of the experimental data showed the importance of introducing a new parameter representing the effect of the relative location of the toe of the jump along the sloping channel. The proposed expressions were developed for flows with the approach Froude numbers ranging from 2.4 to 7.4.

Introduction. Acute urinary retention is a rare occurrence in women necessitating further investigation. Potential underlying causes may be broadly classified into obstructive, neurological, pharmacological, and psychogenic categories. Case. A 36-year-old nulliparous female presented to the Emergency Department with a two-day history of acute urinary retention. Point-of-care ultrasonography and CT scan imaging confirmed the presence of a large uterine mass causing compression of the bladder. The acute retention was relieved with urethral catheterization. A Uterine leiomyoma was confirmed on histology after hysterectomy. Discussion. Once the acute urinary retention has been relieved by insertion of a urethral catheter, the underlying cause of the obstruction must be determined. Although uterine leiomyoma is a fairly common finding in the general population, it is an extremely rare cause of acute urinary retention in women with just a handful of reported cases in the literature.

Dahl salt sensitive (DS) rats are a paradigm of salt sensitive hypertensive humans. OMA is a dual vasopeptidase inhibitor that inhibits neutral endopeptidase and angiotensin converting enzyme, thus concomitantly preventing degradation of natriuretic and other hypotensive peptides, inhibiting synthesis of angiotensin II and increasing bioavailability of nitric oxide (NO). DS rats have abnormal pressure natriuresis and develop hypertension accompanied by decreased vascular NO synthesis, endothelial dysfunction and cardiovascular injury, when fed high (4%) NaCl diet (HS)(Cir-97). We designed a 12 week study to investigate the effect of OMA (given by gavage 40 mg/kg/day) in DS-hypertensive rats. DS rats were fed (4% NaCl) for 4 weeks and then divided into 3 groups (n=6/group): 1- (HS) was kept on 4% NaCl, 2- (HS+OMA) kept on 4% NaCl and given OMA and 3- (HS/Lo+OMA) kept on 4% NaCl and given OMA; but switched to a 0.5% NaCl diet for the last 4 weeks. A 4th group (NS) was fed 0.5% NaCl for the whole duration of the study. Systolic blood pressure (SBP) was measured every two weeks. At the end of the study, the rats were sacrificed and LV and Aortic (Ao) hypertrophy were calculated. HS developed impaired endothelium dependent relaxation to ACh in aortic rings (ED50, HS 5.42+ 0.4 vs. NS 7.09+ 0.1*) - see table GroupNSHSHS+OMAHS/Lo+OMAMortality %0%83%0%0%SBP (mmHg)152 ± 6*222 ± 8220 ± 2139 ±3*LVH (gm/100gBW)0.18 ± .01*0.34 ± .020.26 ± .01*0.18 ± .00*Ao Hyp. (mg/cm/100gBW)3.5 ± .1*8.0 ± .36.2 ± .6*3.6 ± .1*ED50 (-LogM ACh)7.09 ± .1*5.42 ± .47.23 ± .2*8.15 ± .1** (p<0.05, in comparison to HS). OMA dramatically improved survival, decreased LVH and Ao hypertrophy and normalized endothelial function (ED50) independent of blood pressure. In addition, once switched to 0.5%NaCl(HS/Lo+OMA), OMA normalized blood pressure as well as end-organ injury. These data suggest that in salt sensitive hypertension Omapatrilat improves vascular remodeling, endothelial dysfunction and end-organ injury in-addition to, but independent of its blood pressure lowering effect. We attribute these salutary effect of vasopeptidase inhibition to the restitution of the balance between natriuretic peptides, nitric oxide and the renin angiotensin system.

Studies in humans have shown that pancreatic transplantation not only arrests but can reverse diabetic nephropathy (NEJM 98). Experimentally studies have suggested that in chronic renal failure due to either renal ablation (5/6 Nx) or toxic nephropathy due to puromycin, interruption of the renin angiotensin system (RAS) may not only arrest progression but may in fact reverse glomerular injury (KI 91, 94). Dahl salt sensitive (DS) rats fed high dietary salt develop hypertension and severe renal injury. We designed a 12 week study to evaluate whether the treatment with an angiotensin receptor-1 (AT1-R) blocker {Candesartan (Cande) given by gavage 10 mg/kg/day} may reverse glomerular injury. DS rats were fed 4% NaCl for 6 weeks and then divided into 3 groups: 1- (HS) was sacrificed, 2- (HS/LS) switched to Low salt (0.5% NaCl), 3- (HS/LS+Cande) switched to 0.5% NaCl and treated with Cande. A 4th group was kept on 0.5% NaCl for the duration of the study. Systolic blood pressure (SBP), 24-hr urinary protein excretion (U-Pr) and kidney weight (KW) were measured. Glomerular injury (GIS) was scored semi-quantitatively to assess the severity and the distribution of lesions as previously described (KI 84). Results: (See Table) GroupsTime of sacrifice (Weeks)SBP (mmHg)KW (g)U-Pr (mg/24hrs)GISHS (n=6)6223±131.7±0.06130±2587±14HS/LS (n=6)12202±31.7±0.07ϕ104±14 #,ϕ50±8ϕ,#,dHS/LS+Cande (n=6)12143±6*1.5±0.05*35±10*20±3*LS (n=6)12154±2*1.4±0.03*53±2*10±7* (p < 0.05 * * in comparison to HS ϕ to LS # to HS/LS+Cande d to HS) Thus, reduction of dietary salt (HS/LS) did not significantly reduce SBP or U-Pr, although it modestly reduced GIS. On the other hand, AT1-R blockade (HS/LS+Cande) normalized SBP, U-Pr, and not only arrested, but reversed glomerular injury. Clinically, longitudinal studies with serial renal biopsies should reveal a) whether AT1-R blockade can reverse glomerular injury and b) whether doses beyond those necessary for blood pressure control are required for this effect.