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Abstract Introducing Energy hubs (EHs) is a beneficial strategy for incorporating quickly expanding renewable energies. However, the stochastic nature of renewable energy sources (RESs) and fluctuating energy demand have produced a number of difficulties, including unstable voltage/frequency, challenging energy management, and difficult network interaction. Additionally, the changing in response time of electrical and heat demands will make control challenging. This paper proposes a distributed control system for use with dynamic EHs. The RESs and loads present in the multi-carrier system cause the dynamics considering here. In order to optimise system performance, this research suggests a distributed model predictive control strategy that considers expected behaviour and operational restrictions. The strategy’s potential is demonstrated via simulations in which the proposed scheme is applied to a benchmark system.

This paper addresses the critical problem of fault detection in DC zonal shipboard microgrids, which is essential for ensuring system reliability and operational safety. The proposed method detects faults by utilizing the high-frequency characteristics of estimated impedance. The technique involves Fast Fourier Transform analysis of current and voltage waveforms to extract high-frequency components before and after a fault. These features help identify the system’s high-frequency impedance via a communication system. Fault detection is achieved by comparing the estimated impedance with a predefined threshold. The performance of the method is evaluated using MATLAB/Simulink simulations and experimental implementations under various scenarios. Communication between components in the DC zonal microgrid is managed using the IEC 61850 standard. Results demonstrate the method’s effectiveness in detecting faults under diverse conditions, including variations in fault resistance, dynamic load behavior, changes in photovoltaic irradiation, system configuration alterations, noise immunity, and multi-fault scenarios. The method achieves fault clearance times ranging from 0.17 ms in MATLAB/Simulink simulations to 33–45 ms in experimental tests, showing its capability to enhance fault detection in complex DC microgrid environments.

For a few decades, operators of energy systems have sought to achieve appropriate frameworks due to energy crises and rapid growth in energy requirements. In this regard, this study presents a multi-objective optimization model for an energy hub (EH) designed to manage a diverse energy portfolio. The EH receives electricity, natural gas, hydrogen, seawater, and solar energy as inputs, aiming to satisfy electricity, heating, and freshwater demands at the output port while considering a limited available area. The model incorporates the selection of the optimal solar energy technology (photovoltaics, parabolic dish, or parabolic trough collector) through a comprehensive evaluation encompassing technical, economic, and environmental aspects. To achieve optimal scheduling of the EH’s production units, the model factors in forecasts of solar energy availability alongside electrical, heat, and water load demands. The evaluation of the EH’s performance is conducted through a multi-objective framework considering social welfare, CO2 emissions, voltage stability margin (VSM), a newly proposed simplified fast temperature stability index (SFTSI), and a similarly novel simplified fast pressure stability index (SFPSI). The optimization problem is formulated within a MATLAB environment and solved using a multi-objective Archimedes optimization algorithm across five distinct case studies, each characterized by a varying designated area for solar energy generation. The effectiveness of the proposed model and optimization technique is validated through test systems, with the obtained results demonstrating significant improvements compared to a baseline scenario. These improvements include a 36.18% reduction in CO2 emissions, a 14.22% increase in total social welfare, and reductions in the average values of VSM, SFTSI, and SFPSI when incorporating all solar energy technologies.

Phasor measurement units (PMU) are currently considered as an essential step toward the future smart grid due to their capability in increasing the power system's situation awareness. Due to their high costs and limited resources, optimal placement of PMUs (OPP) is an important challenge to compute the minimum number of PMUs and their optimal distribution in the power systems for achieving full monitoring. The coronavirus herd immunity optimizer (CHIO) is a novel optimization algorithm that emulates the flock immunity strategies for the elimination of the coronavirus pandemic. In this research, the CHIO is adapted for the OPP problem for full fault observability. The proposed algorithm is implemented on power systems considering the zero injection bus impacts. A program is created in MATLAB® environment to implement the proposed algorithm. The algorithm is applied to different test systems including; IEEE 9-bus, 14-bus, 30-bus, 118-bus, 300-bus, New England 39-bus and Polish 2383-bus. The proposed CHIO-based OPP is compared to some exact and metaheuristic-based OPP techniques. Compared to these techniques, the promising results have proved the effectiveness and robustness of the proposed CHIO to solve the OPP problem for full fault observability.

This paper introduces an innovative adaptive scheme for detecting and locating faults in DC-zonal shipboard microgrids (SBMGs). This scheme relies on the estimation of high-frequency impedance. The proposed scheme is implemented in an intelligent electronic device (IED) in which the Fast Fourier Transform is applied to obtain the high-frequency components of the current and voltage at each node. Then, these components are exchanged between the two IEDs that protect the same line by using IEC 61850 GOOSE-based communication system. The estimated high-frequency impedance of the line is calculated and compared to the prescribed settings to detect and locate the fault. After fault detection and localization, communication signals are exchanged between the two IEDs positioned at each end of the line. This exchange precedes the transmission of tripping signals to the relevant circuit breakers for the accurate isolation of the faulty line. The proposed protection scheme is tested through MATLAB/Simulink Ⓡ environment. The scheme can detect and locate the fault under different uncertainty conditions, such as fault impedances, various system configurations, changes in system loads and generations, multi-faults’ existence, contingency conditions, and the presence of noise on the communication signals. The results proved its efficient performance and superiority. The scheme can detect and locate the faults quickly and accurately within 0.125 ms.

Background: The IL-12/23/ISG15-IFN-γ pathway is the main immunological pathway for controlling intra-macrophagic microorganisms such as Mycobacteria, Salmonella, and Leishmania spp. Consequently, upon mutations in genes of the IL-12/23/ISG15-IFN-γ pathway cause increased susceptibility to intra-macrophagic pathogens, particularly to Mycobacteria. Therefore, the purpose of this study was to characterize the mutations in genes of the IL-12/23/ISG15-IFN-γ pathway in severe tuberculosis (TB) patients. Methods: Clinically suspected TB was initially confirmed in four patients (P) (P1, P2, P3, and P4) using the GeneXpert MTB/RIF and culturing techniques. The patients' Peripheral blood mononuclear cells (PBMCs) were then subjected to ELISA to measure Interleukin 12 (IL-12) and interferon gamma (IFN-γ). Flow cytometry was used to detect the surface expressions of IFN-γR1 and IFN-γR2 as well as IL-12Rβ1and IL-12Rβ2 on monocytes and T lymphocytes, respectively.The phosphorylation of signal transducer and activator of transcription 1(STAT1) on monocytes and STAT4 on T lymphocytes were also detected by flow cytometry. Sanger sequencing was used to identify mutations in the IL-12Rβ1, STAT1, NEMO, and CYBB genes. Results: P1's PBMCs exhibited reduced IFN-γ production, while P2's and P3's PBMCs exhibited impaired IL-12 induction. Low IL-12Rβ1 surface expression and reduced STAT4 phosphorylation were demonstrated by P1's T lymphocytes, while impaired STAT1 phosphorylation was detected in P2's monocytes. The impaired IκB-α degradation and abolished H2O2 production in monocytes and neutrophils of P3 and P4 were observed, respectively. Sanger sequencing revealed novel nonsense homozygous mutation: c.191 G>A/p.W64 * in exon 3 of the IL-12Rβ1 gene in P1, novel missense homozygous mutation: c.107 A>T/p.Q36L in exon 3 of the STAT1 gene in P2, missense hemizygous mutation:: c.950 A>C/p.Q317P in exon 8 of the NEMO gene in P3, and nonsense hemizygous mutation: c.868 C>T/p.R290X in exon 8 of CYBB gene in P4. Conclusion: Our findings broaden the clinical and genetic spectra associated with IL-12/23/ISG15-IFN-γ axis anomalies. Additionally, our data suggest that TB patients in Pakistan should be investigated for potential genetic defects due to high prevalence of parental consanguinity and increased incidence of TB in the country.

Syphilis, caused by Treponema pallidum, is resurging globally. Molecular typing allows for the investigation of its epidemiology. In Pakistan and other nations, T. pallidum subsp. pallidum has developed widespread macrolide resistance in the past decade. A study at the Peshawar Regional Blood Centre from June 2020-June 2021 analyzed serum samples from 32,812 blood donors in Khyber Pakhtunkhwa, Pakistan, to assess circulating T. pallidum strains and antibiotic resistance. Blood samples were initially screened for T. pallidum antibodies using a chemiluminescent microparticle immunoassay (CMIA). CMIA-reactive samples underwent polymerase chain reaction (PCR) targeted the polA, tpp47, bmp, and tp0319 genes. PCR-positive samples were further analyzed for molecular subtyping using a CDC-developed procedure and tp0548 gene examination. All PCR-positive samples were analyzed for the presence of point mutations A2058G and A2059G in 23S rRNA, as well as the G1058C mutation in 16S rRNA. These mutations are known to impart antimicrobial resistance to macrolides and doxycycline, respectively. Out of 32,812 serum samples, 272 (0.83%) were CMIA-reactive, with 46 being PCR-positive. Nine T. pallidum subtypes were identified, predominantly 14d/f. The A2058G mutation in 23S rRNA was found in 78% of cases, while G1058C in 16S rRNA and A2059G in 23S rRNA were absent. The research found donor blood useful for assessing T. pallidum molecular subtypes and antibiotic resistance, especially when chancres are not present. The prevalent subtype was 14d/f (51.85%), and the high macrolide resistance of 36 (78%) indicates caution in using macrolides for syphilis treatment in Khyber Pakhtunkhwa, Pakistan.

Abstract Voltage imbalance (VI) is caused by the difference in connected single-phase load or generation in a low voltage distribution network (DN).VI increase in a smart distribution grid is due to the current practice of increasing single-phase distributed generators such as photovoltaic (PV) systems. This paper proposes a decentralized control method to mitigate VI using distributed batteries included in smart grid interfaced residential PV systems. To mitigate VI using the batteries in this way, five challenges must be overcome, i.e., equalizing all battery stress currents within the DN, mitigating VI in abnormal conditions such as signal loss among bus controllers, being immune from the distorted feedback measurements, minimizing the steady-state error at different loads, and overcoming the insufficient number or capacity of the distributed batteries at the same bus. Three fuzzy logic controllers (FLC) are proposed at each bus to overcome these five tasks based on a decentralized control scheme. The proposed decentralized control based on FLC is compared with centralized control based on a PI controller. The proposed control method is tested and verified using simulations in the MATLAB/Simulink software, and the results validate the ability of the scheme to alleviate VI on a smart distribution network under both normal and abnormal conditions.

Shipboard microgrids (SBMGs) are becoming increasingly popular in the power industry due to their potential for reducing fossil-fuel usage and increasing power production. However, operating SBMGs poses significant challenges due to operational and environmental constraints. To address these challenges, intelligent control, management, and protection strategies are necessary to ensure safe operation under complex and uncertain conditions. This paper provides a comprehensive review of SBMGs, including their classifications, control, management, and protection, as well as the most recent research statistics in these areas. The state-of-the-art SBMG types, propulsion systems, and power system architectures are discussed, along with a comparison of recent research contributions and issues related to control, uncertainties, management, and protection in SBMGs. In addition, a bibliometric analysis is performed to examine recent trends in SBMG research. This paper concludes with a discussion of research gaps and recommendations for further investigation in the field of SBMGs, highlighting the need for more research on the optimization of SBMGs in terms of efficiency, reliability, and cost-effectiveness, as well as the development of advanced control and protection strategies to ensure safe and stable operation.

Increasing environmental concerns, scarcity of fossil fuel resources, and uncontrolled demand growth have led to upgrading and restructuring existing energy systems. Sustainable multi-energy systems (MESs) will dominate energy production in the future. Integrated management systems must be provided to plan and control the sustainable MESs for optimal operation. Energy hubs (EHs) represent one of the most promising concepts for optimal management systems in sustainable MESs. They can play a great role in moving towards sustainable MES models. This paper provides a comprehensive review of the concepts of EHs and their applications, also benefits gained from the integration of different energies. In addition, the paper discusses the effect of other related options like renewable energy resources, MESs, demand-side management, and energy storage systems. Finally, the paper presents the most common research areas, methods of solving the EHs' associated problems, presents real applications of EHs and explores the future challenges that face the EHs.

New liquid crystalline hydrogen bonded 3- (or 4)-n-alkanoyloxy benzoic acids were synthesized and probed theoretically and experimentally. The molecular structures of these compounds were elucidated by proton NMR, carbon-13 NMR and elemental analyses. Differential scanning calorimetry (DSC) was used to investigate the thermal and mesomorphic properties of all the symmetrical dimers that bearing identical alkanoyloxy chains. Moreover, polarized optical microscopy (POM) was used to determine their mesophases. The findings show that all the designed symmetrical dimers exhibit the smectic mesophase with relative thermal stability that depends on the length of their terminal side chain. Additionally, the experimental findings of the mesomorphic behavior are further supported by DFT calculations. The alkanoyloxy benzoic acid para-derivatives (In) were shown to be more stable than their meta-substituted (IIn) analogues due to stronger hydrogen bonding interactions. The computed reactivity parameters showed that the position of ester moiety has a significant impact on the acids reactivity. The absorbance spectra of both the 3- (or 4)-n-alkanoyloxy benzoic acids revealed a blue shift with the increment of the of alkyl chain size; however, the energy band gaps of 3-n-alkanoyloxy benzoic derivatives were found to be slightly higher than those of the 4-n-alkanoyloxy benzoic acids. Moreover, the photoluminescence spectrum of the prepared materials is rather broad, and exhibited a red shift as the alkyl chain length increases. The fluorescence lifetime shown to rise as alkyl chain length grows longer, and 3-n-alkanoyloxy benzoic acids have slightly longer lifetime compared to their 4-n-alkanoyloxy benzoic analogues.

Abstract Background This case report highlights the importance of recognizing that ventricular ectopy may be a cause for syncope and sudden cardiac death, through triggered disorganized arrhythmia. In the context of syncope, ventricular ectopy should be carefully assessed for coupling interval and morphology. Case presentation A 39-year-old woman, who had presented with recurrent syncope, had a cardiac arrest shortly after admission that required emergency defibrillation. Review of her cardiac monitoring revealed an episode of polymorphic ventricular tachycardia which had degenerated into ventricular fibrillation. The dysrhythmia had been initiated by a short-coupled (R-on-T) ventricular ectopic (VE) beat. Anti-arrhythmic therapy was initiated in the form of hydroquinidine, but the patient continued to have frequent VEs of right bundle branch block (RBBB) morphology with a relatively narrow QRS complex and a variation in frontal axis. A cardiac MRI revealed late gadolinium enhancement of the posterior papillary muscle (indicative of focal scarring). The patient underwent electrophysiological mapping and catheter ablation of her ectopy. The patient made a good recovery and was discharged from hospital with a secondary prevention implantable cardioverter-defibrillator (ICD) in situ. Conclusions Short-couped VEs that are superimposed onto the preceding T wave (R-on-T) are indicative of electrical instability of the heart and should prompt urgent investigation. By studying the morphologies and axes of the QRS complexes produced by VEs, we can identify their likely origins and ascertain their clinical significance.

Due to its high price, increased consumption, and limited production, honey has been a main target for economically motivated adulteration (EMA). An approach combining Fourier-Transform infrared spectroscopy (FTIR) and chemometrics was evaluated to develop a rapid screening tool to detect potential EMA of honey with either rice or corn syrup. A single-class soft independent modeling of class analogy (SIMCA) model was developed using a diverse set of commercial honey products and an authentic set of honey samples collected at four different U.S. Department of Agriculture (USDA) honey sample collection locations. The SIMCA model was externally validated with a set of calibration-independent authentic honey, typical commercial honey control samples, and those spiked with rice and corn syrups in the 1–16% concentration range. The authentic honey and typical commercial honey test samples were correctly predicted with an 88.3% classification rate. High accuracy was found in predicting the rice and corn syrup spiked samples above the 7% concentration range, yielding 97.6% and 94.8% correct classification rates, respectively. This study demonstrated the potential for a rapid and accurate infrared and chemometrics method that can be used to rapidly screen for either rice or corn adulterants in honey in less than 5 min.

It is well known that polycystic ovarian syndrome (PCOS) may elevate psychological problems in patients, but there is a scarcity of the studies among Saudi Arabian population. This research was designed to investigate the influence of PCOS on the development of psychological load in terms of depression, anxiety, and stress in comparison to normal women who have no PCOS. Further, a correlation of psychological distress in PCOS females was done with their educational level. This is case-control research carried out in one of Riyadh's multispecialty hospitals. In the PCOS patients and control groups (each with 84 samples), samples were collected using convenience sampling and a simple random approach, respectively. The psychological burden was determined using DASS-21. The data obtained were analyzed using SPSS-IBM 25. Most participants (52.9%) were between the ages of 26 and 35 and had a university education (68.4%). A significantly higher percentage of PCOS patients (P = 0.001) had irregular menses, hirsutism, infertility, and acne in comparison to the mothers without PCOS. There was a significantly higher possibility of depression (P = 0.003), anxiety (P = 0.016), and stress (P = 0.001) among PCOS patients than in control subjects. Among the psychological domain tested in the study, the risk of developing stress (odds ratio, OR = 8.32) was high when compared to depression (OR = 3.12) and anxiety (OR = 2.127) in PCOS patients. Furthermore, when compared to PCOS females with less education, a significantly lower number of university-educated PCOS females developed depression. The study demonstrates a high prevalence of psychological burden among the PCOS population. Higher education has been shown to help in alleviating depression in PCOS females. Meeting PCOS women's psychological needs will improve their overall health status.

Background: Seminal plasma contains several microelements like Zn, Fe, Se, and Cu that affect sperm motility and male fertility. Biochemical evaluation of seminal plasma trace elements is important for assessing fertility and diagnosing male infertility. Aims: The present study was designed to evaluate the effect of seminal fluid trace elements on sperm parameters and fertility in Arabian horses. Methods: Ninety-four ejaculates from 25 Arabian stallions (4–27 years old) were used to investigate the effect of seminal fluid trace elements on semen parameters and fertility. Data divided according to season, stallion age, and fertility of stallions. The concentrations of Zn, Fe, Se, Cu, Cr and Mo were determined using an atomic absorption spectrophotometer. Percentage stallion fertility estimated by mares that conceived on their first cycle. Data were analyzed by ANOVA using SPSS statistical software program (2013), version 22.0. Results: There was a significant effect of season on semen volume, pH, Fe, Se, Cu, Cr, and Mo. Stallion age had a significant effect on pH, sperm motility, concentration, total motile sperm count, sperm abnormalities, Zn, and Fe. Sperm motility was higher (P < 0.05) and sperm abnormalities were lower (P < 0.05) in group IV (>70% fertility) than in group I (infertile) and group II (

Psychological problems affect a sizable portion of the population, and they require special care. In the current study, we aimed to assess patient satisfaction with the healthcare system at one of the multispecialty hospitals in Riyadh, Saudi Arabia, as well as to identify potential factors that can have an impact on patient satisfaction. A validated pre-tested questionnaire including features to evaluate general hospital services (HS-6 items), nursing services (NS-3 items), pharmacy services (PS-7 items), and a standard patient satisfaction questionnaire (PSQ-18 item) was administered to patients who had been receiving therapy for their psychological disease for the past 3 months. Using binary and multiple regression analysis, the strengths of the associations between sociodemographic factors and patient satisfaction measures were evaluated. The results were expressed as adjusted odds ratios (AOR), which were deemed significant when the P value was < 0.05. Sixty-six percent of the 258 study participants were men, and sixty percent of them were between the ages of 18 and 35 years. The bulk of survey respondents (74%) were employed, married, and well–educated. Our research revealed that those who were employed (AOR, HS-2.5; NS-2.65, PS-2.32), have a higher education (AOR, HS-2.23, NS-2.63, PS-2.82), male gender (AOR, HS-1.12, NS-1.08, PS-1.86) and between the ages of 18 and 35 years (AOR, HS-1.48, NS-1.53, PS-1.67) were more likely to be satisfied with general hospital, nursing, and pharmacy services. Further, those who were married had 1.43 and 1.21 times more chance of satisfaction with the pharmacy and nursing services, respectively, compared to singles. Additionally, those with employment had odds of being satisfied that were 2.4 times higher, highly educated individuals had odds that were 2.1 times higher, participants between the ages of 18 and 35 had odds that were 1.51 times higher, and men had odds that were 1.41 times higher on the patient satisfaction questionnaire scale (PSQ-18). Overall, the study participants' satisfaction with general hospital, nursing, and pharmacy services was 70, 76.3, and 83.3%, respectively, compared to only 61.2% on the PSQ-18. Participants in the survey awarded the hospital amenities, pharmacy services, and nursing care high ratings. The medical care, however, fell short of expectations. The study's findings suggest that action needs to be taken to enhance healthcare system services, particularly in the psychological departments of the medical organization.

Percutaneous catheter ablation is an effective and safe therapy that can eliminate ventricular tachycardia, reducing the risks of both recurrent arrhythmia and shock therapies from a defibrillator. Successful ablation requires accurate identification of arrhythmic substrate and the effective delivery of energy to the targeted tissue. A thorough pre-procedural assessment is needed before considered 3D electroanatomical mapping can be performed. In contemporary practice, this must combine traditional electrophysiological techniques, such as activation and entrainment mapping, with more novel physiological mapping techniques for which there is an ever-increasing evidence base. Novel techniques to maximise energy delivery to the tissue must also be considered and balanced against their associated risks of complication. This review provides a comprehensive appraisal of contemporary practice and the evidence base that supports recent developments in mapping and ablation, while also considering potential future developments in the field.

Objectives: We sought to investigate the nutritional and hematological status of Sudanese women of childbearing age with sickle cell anemia (SCA). Anthropometry and hematology were used to assess nutritional status and health and disease conditions, respectively. Methods: Women with steady-state (HbSS, n = 39; age = 19.0±2.7) and without (HbAA, n = 36; age, 19.8±2.7) SCA were recruited during a routine visit to the Hematology Clinic, Ibn-Auf Teaching Hospital, Khartoum, Sudan. Results: The two groups of women lived in similar environmental conditions and ate similar diets three times a day. However, despite taking regular meals, the women with sickle anemia were thinner and lighter (p < 0.001) and shorter (p =0.002) compared with those who do not have the disease. Also, they had higher levels of mean corpuscular hemoglobin (Hb) concentration and white cell count (p < 0.001), mean corpuscular volume (p =0.003), and platelet (p =0.002) and lower packed cell volume and Hb (p < 0.001). There was no difference in levels of anthropometric and hematological variables between the hydroxyurea treated and untreated SCA patients (p > 0.050). Conclusions: The low anthropometric (height, weight, and body mass index) and abnormal hematological values in the women with SCA in steady-state reflect sustained nutritional insults inflected by the disease and poverty. Tailored nutritional counseling/advice must be an integral part of managing patients with SCA. Such advice is particularly vital for women of childbearing age because of the adverse effects of prepregnancy nutritional deficiency on birth outcomes.

This study aimed to investigate the antidepressant property of crocin (Crocetin digentiobiose ester) using a chronic mild stress (CMS)-induced depression model in experimental mice. The tail suspension test (TST) and the sucrose preference test were used to evaluate the antidepressant effect on albino mice of either sex after three weeks of CMS. The period of immobility in the TST and percentage preference for sucrose solution were recorded. By monitoring brain malondialdehyde (MDA) level, catalase (CAT) activity, and reduced glutathione (GSH) level, the antioxidant potential was assessed. Three dosages of crocin (4.84, 9.69, and 19.38 mg/kg) were evaluated. When compared to controls, animals that received crocin administration during three periods of CMS had considerably shorter immobility times during the TST. Crocin treatment also raised the percentage preference for sucrose solution in a dose-dependent manner, bringing it to parity with the conventional antidepressant, imipramine. Animals that received a high dose of crocin had a much greater spontaneous locomotor activity. Furthermore, a high dose of crocin remarkably lowered plasma corticosterone and nitrite levels brought on by CMS. Additionally, high doses of crocin given during CMS greatly enhanced reduced glutathione levels while considerably reducing the brain’s MDA and catalase activities. In conclusion, high doses of crocin may have an antidepressant effect in an animal model through several mechanisms. However, further studies should be carried out to explore the role of neurotransmitters for their antidepressant property.

New 1:2 liquid crystalline supramolecular H-bonded complexes (SMHBCs) were synthesized through double H-bond interactions between 4-(nicotinoyloxy) phenyl nicotinate as the base component and two molecules of 4-n-alkoxybenzoic acid (An). The base component was expected to be in two conformers according to the orientation of the N atom and the carboxylate group, syn conformer (I) and anti-conformer (II). DFT calculations revealed that only one of the two possible conformers of I exists, and the addition of the two molecules of the alkoxy acids (An) did not affect its conformation. The mesomorphic properties of all of the prepared complexes (I/An), bearing different terminal flexible alkoxy chains were investigated, and the formation of the H-bonds were confirmed by differential scanning calorimetry (DSC), and the phases were identified by polarized optical microscopy (POM), and FT-IR spectroscopy. Highly thermally stable mesophases possessing broad temperature ranges were observed for all investigated complexes compared to their individual components. Depending on the length of the terminal flexible alkoxy chain, the prepared SMHBCs were shown to exhibit di- or tri-morphic enantiotropic mesophases. The effect of replacing one of the –COO– connecting units by an azo group (-N=N-) in the basic molecule (I), on the mesomorphic properties has been investigated experimentally (via DSC) and theoretically (via DFT). The DFT calculations revealed that the polarizability, the dipole moment, and the aspect ratio of the investigated SMHBCs are lower than those of their corresponding ester/azo analogs. All these factors rationalize the enhanced smectic mesophase ranges of the complexes compared with those of the ester/azo analogs. The high aspect ratios and dipole moments of the SMHBCs of the azo derivative enforces the lateral intermolecular attraction that permits the formation of the more ordered smectic C mesophase with respect to the enhanced polymorphic mesophases of the diester derivative.

Storey extensions are an increasingly popular way to crowded cities. Lack experience and knowledge concerning strengthening of structures are major challenges for engineers. This paper presents strengthening practice adopted for foundations of existing building when storey extension is needed. Literature concerning strengthening techniques commonly adopted and some historical cases were reviewed. A complex hall building in university of Khartoum which was rehabilitated in 2009 by strengthening the structural members of the existing building to accommodate additional floors was undertaken as a case study. The records and reports of the original design and last rehabilitation of the building were reviewed. Field inspection of the building condition before rehabilitation was carried out. The study results showed that the appropriate design, the strengthening materials used and the procedure followed are the key factors for economical and successful strengthening.

The dosimetric characteristics of hydrogel dosimeters based on polyacrylamide (PAC) as a capping agent incorporating silver nitrate as a radiation-sensitive material are investigated using UV-Vis spectrophotometry within the dose range 0–100 Gy. Glycerol was used in the hydrogel matrix to promote the dosimetric response and increase the radiation sensitivity. Upon exposing the PAC hydrogel to γ-ray, it exhibits a Surface Plasmon Resonance (SPR) band at 453 nm, and its intensity increases linearly with absorbed doses up to 100 Gy. The results are compared with the silver nitrate gel dosimeter. Glycerol of 15% in the hydrogel matrix enhances the radiation sensitivity by about 30%. PAC hydrogel dosimeter can be considered a near water equivalent material in the 400 keV–20 MeV photon energy range. At doses less than 15 Gy, the PAC hydrogel dosimeter retains higher radiation sensitivity than the gel dosimeter. The total uncertainty (2σ) of the dose estimated using this hydrogel is about 4%. These results may support the validity of using this hydrogel as a dosimeter to verify radiotherapy techniques and dose monitoring during blood irradiation.

The physical and chemical properties of three new liquid crystalline derivatives, based on an azomethine core with low-temperature mesophase—namely (4-methoxybenzylideneamino) phenyl palmitate (I), (4-methoxybenzylideneamino) phenyl oleate (II), and (4-methoxybenzylideneamino) phenyl linoleate (III)—were prepared and physically examined using experimental methodologies. Elemental analysis, FT-IR, and NMR spectroscopy were used to confirm their molecular structure. Differential scanning calorimetry (DSC) and polarized optical microscopy (POM) were used to investigate their mesomorphic activity. The results revealed that compound (I) is monotropic smectogenic, possessing the smectic A mesophase, whereas the other two analogues were shown to possess the SmA phase enantiotropically. Two of the saturated and unsaturated prepared derivatives (namely I and II) were used to construct their phase diagram. The eutectic composition of the mixture examined showed a slight enhancement of the stability of the smectic A phase. Polymorphic phases were produced at the eutectic composition of the binary phase diagram of the derivative II with the 4-n-dodecyloxy benzoic acid component.

Distributed generations (DGs) have been utilized in some electric power networks. Power loss reductions, voltage improvement, increasing reliability, postponement of system upgrading and environmental friendliness are some advantages of DG-unit applications. This paper presents a new optimization approach that employs a flower pollination algorithm (FPA) to determine the optimal DG-unit’s size and location in order to minimize the total system real power loss and improve the system buses voltage. The FPA is a new metaheuristic optimization technique and it is inspired by the reproduction strategy of the flow pollination process of flowering plants. To reveal the validity of the FPA algorithm, IEEE 33-bus, 69-bus and 136-bus radial distribution test systems are examined with different test cases of the objective function using the MATLAB. Furthermore, the results obtained by the proposed FPA algorithm are compared with other metaheuristic optimization techniques such as backtracking search optimization algorithm, artificial bee colony, and selection algorithm. The outcomes verify that the FPA algorithm is efficient, robust, and capable of handling mixed integer nonlinear optimization problems.

Abstract Background Membranous nephropathy (MN) is the leading cause of nephrotic syndrome in adults. MN is a clinically heterogeneous disease and it is difficult to accurately predict outcomes (including end stage renal failure) at presentation and whom to treat with potentially toxic therapies. We aimed to identify factors predicting outcome in MN in our cohort from two large tertiary London units by undertaking a retrospective data analysis of 148 biopsy-proven MN patients from North East and Central London between 1995 and 2015. Methods Review of clinical and biochemistry databases. Results Surprisingly, patients that reached end stage renal failure (ESRF) had a less severe nephrosis compared to those that did not develop ESRF; serum albumin 33 g/L (3.3 g/dL) versus 24 g/L (2.4 g/dL), p = 0.002 and urinary protein creatinine ratio (uPCR) 550 mg/mmol (5500 mg/g) versus 902 mg/mmol (9020 mg/g), p = 0.0124. The correlation with ESRF was strongest with the presenting creatinine; 215 μmol/L (2.43 mg/dL) compared to 81 μmol/L (0.92 mg/dL), p 120 μmol/L (1.36 mg/dL; corresponding to an eGFR of ≤60 ml/min in non-Black males) had an increased rate of ESRF and a faster decline. Other traditional risk factors for progression were not significantly associated with ESRF. Black patients presented with higher serum creatinine but no statistically significant difference in the estimated glomerular filtration rate, a higher rate of progression to ESRF and had a poorer response to treatment. Conclusions This ethnically diverse cohort does not demonstrate the traditional risk profile associated with development of ESRF. Thus, careful consideration of therapeutic options is crucial, as current risk modelling cannot accurately predict the risk of ESRF. Further studies are required to elucidate the role of antibodies and risk genes.

A complex inflammatory process mediated by proinflammatory cytokines and prostaglandins commonly occurs in the synovial tissue of patients with joint trauma (JT), osteoarthritis (OA), and rheumatoid arthritis (RA). This study systematically investigated the distinct expression profile of prostaglandin E2 (PGE2), its processing enzymes (COX-2), and microsomal PGES-1 (mPGES-1) as well as the corresponding prostanoid receptor subtypes (EP1-4) in representative samples of synovial tissue from these patients (JT, OA, and RA). Quantitative TaqMan®-PCR and double immunofluorescence confocal microscopy of synovial tissue determined the abundance and exact immune cell types expressing these target molecules. Our results demonstrated that PGE2 and its processing enzymes COX-2 and mPGES-1 were highest in the synovial tissue of RA, followed by the synovial tissue of OA and JT patients. Corresponding prostanoid receptor, subtypes EP3 were highly expressed in the synovium of RA, followed by the synovial tissue of OA and JT patients. These proinflammatory target molecules were distinctly identified in JT patients mostly in synovial granulocytes, in OA patients predominantly in synovial macrophages and fibroblasts, whereas in RA patients mainly in synovial fibroblasts and plasma cells. Our findings show a distinct expression profile of EP receptor subtypes and PGE2 as well as the corresponding processing enzymes in human synovium that modulate the inflammatory process in JT, OA, and RA patients.

This study introduces a proposed control method for microgrids (MGs) in islanded (off-grid) mode. The proposed control method is developed by modifying the droop control method using H-infinity controller. In this control method, the droop control loop, current and voltage control loops are adjusted to respond to system load variation. The proposed method is an adaptive control one as it regulates the system voltage and frequency to their nominal values after system load variations. Also, it is a repetitive control method as it depends on the internal model principle that provides good performance for voltage and current error tracking. To prove the applicability and effectiveness of the proposed method, it is applied to a test system using MATLAB/Simulink under three different loading conditions. The results are compared with those of droop control and they prove the effectiveness of the proposed method in adjusting MGs under the off-grid mode of operation. Also, a system stability analysis is performed based on root locus and system step response. Robustness analysis is performed to prove the ability of the proposed controller to restore the system performance after the fault clearance.

Annexin A1 (ANXA1) is an endogenously produced anti-inflammatory protein, which plays an important role in the pathophysiology of diseases associated with chronic inflammation. We demonstrate that patients with type-2 diabetes have increased plasma levels of ANXA1 when compared to normoglycemic subjects. Plasma ANXA1 positively correlated with fatty liver index and elevated plasma cholesterol in patients with type-2 diabetes, suggesting a link between aberrant lipid handling, and ANXA1. Using a murine model of high fat diet (HFD)-induced insulin resistance, we then investigated (a) the role of endogenous ANXA1 in the pathophysiology of HFD-induced insulin resistance using ANXA1−/− mice, and (b) the potential use of hrANXA1 as a new therapeutic approach for experimental diabetes and its microvascular complications. We demonstrate that: (1) ANXA1−/− mice fed a HFD have a more severe diabetic phenotype (e.g., more severe dyslipidemia, insulin resistance, hepatosteatosis, and proteinuria) compared to WT mice fed a HFD; (2) treatment of WT-mice fed a HFD with hrANXA1 attenuated the development of insulin resistance, hepatosteatosis and proteinuria. We demonstrate here for the first time that ANXA1−/− mice have constitutively activated RhoA. Interestingly, diabetic mice, which have reduced tissue expression of ANXA1, also have activated RhoA. Treatment of HFD-mice with hrANXA1 restored tissue levels of ANXA1 and inhibited RhoA activity, which, in turn, resulted in restoration of the activities of Akt, GSK-3β and endothelial nitric oxide synthase (eNOS) secondary to re-sensitization of IRS-1 signaling. We further demonstrate in human hepatocytes that ANXA1 protects against excessive mitochondrial proton leak by activating FPR2 under hyperglycaemic conditions. In summary, our data suggest that (a) ANXA1 is a key regulator of RhoA activity, which restores IRS-1 signal transduction and (b) recombinant human ANXA1 may represent a novel candidate for the treatment of T2D and/or its complications.

New non-symmetrical 1:1 supramolecular H-bonded (SMHB) interactions, Ix/II, were designed between the non-mesomorphic fatty acids (palmitic, oleic and linoleic acids) and 4-tetradecyloxyphenylazo pyridine. Mesophase behaviors of the formed complexes were examined via differential scanning calorimetry (DSC) and polarizing optical microscopy (POM). In order to confirm the H-bond interaction formations within the prepared SMHB complexes, FT-IR spectroscopy was established whereby Fermi bands confirm these interactions. Mesomorphic investigations for all complexes indicated that, independent of the terminal alkenyl chains of the natural acids, induced dimorphic smectic phases were observed. The stability of formed mesophases was found to depend on the degree of un-saturation of the terminal alkenyl group of acid component.

Two new homologues series, based on two rings of the azomethine central group bearing the terminal alkoxy group of various chain lengths, were prepared. The alkoxy chain length varied between 6 and 16 carbons. The other terminal wing in the first series was the F atom, and the compound is named N-4-florobenzylidene-4-(alkoxy)benzenamine (In). The second group of compounds included a lateral NO2 substituent in addition to the terminal F atom, named N-(4-fluoro-3-nitrobenzylidene)-4-(alkyloxy)aniline (IIn). Mesomorphic and optical properties were carried out via differential scanning calorimetry (DSC) and polarized optical microscopy (POM). Elemental analyses, FT-IR, and NMR spectroscopy were carried out to elucidate the molecular structures of the synthesized groups. Mesomorphic investigations indicated that all the synthesized homologues (In) were monomorphic, possessing the smectic A (SmA) phase monotropically, while the second group (IIn) members were non-mesomorphic. The experimental data indicated that the formation of the mesophase is affected by the protrusion of the lateral nitro group. The disruption of the mesophase in the second group was attributed to the increase of its molecular width, which affects its lateral intermolecular interactions. The computational simulations were in agreement with the experimental data. On the other hand, the location of NO2 group within the molecular geometry increased the melting temperature of the molecule, and thus, affected their thermal and physical properties. By discussing the estimated parameters, it was found that the molecular architecture, the dipole moment, and the polarizability of the investigated compounds are highly affected by the electronic nature and position of the terminal and lateral substituents as well as their volumes.

Aims: To find cytology changes among women attending obstetrics and gynaecology clinic with complaints of vaginal discharges. Settings and Design: This descriptive hospital-based cytological study was conducted at the outpatient clinic of the obstetrics and gynaecology department. Materials and Methods: Two hundred women with complaints of vaginal discharge were selected. Their detailed histories were documented on a special request form. Pap smears were then obtained and sent for cytological examination to the cytopathology department. All low-grade squamous intraepithelial lesion (LSIL) cases were advised to follow-up with Pap smears in the next 6–12 months. Those with high-grade squamous intraepithelial lesion (HSIL) were further investigated by a cervical biopsy and managed accordingly. Statistical analysis used: The statistical analysis was performed using, the Statistical Package for Social Science (SPSS). Chi-square and cross-tabulation were used in this study. Results: The cytological examination of Pap smears showed no changes (i.e. negative findings) in 88 (44%) cases, while Candida species infection was the most prevalent, which was found in 67 (33.5%) of the cases. Bacterial vaginosis was found in 39 women (19.5%); 6 women (3%) were reported with dyskaryotic changes. Two cases were found to have LSIL and 4 women had HSIL. Conclusion: Infection is common among the illiterate group of women. Women with vaginal discharges should undergo screening tests for evaluation by cervical smear for the early detection of cervical precancer conditions. There is an urgent need to establish a screening program for cervical cancer in Sudan.

Two new 1:2 supramolecular H-bonded liquid crystalline complexes (SMHBCs) were prepared through double H-bond interactions between either isophthalic acid (A) or terephthalic acid (B) and a nicotinate Schiff base (I6). The formed complexes were thermally investigated by differential scanning calorimetry (DSC), and their phases were identified by polarized optical microscopy (POM) and UV-spectroscopy. The formation of 1:2 hydrogen-bonded complexes was confirmed through their Fermi-bands observed by FT-IR spectroscopy. The first system (I6/A) was found to possess enantiotropic smectic A and nematic mesophases. Induced broad range of smectic A phase was observed in I6/A complex which is not shown by their individual components. The second complex system (I6/B) was purely nematogenic. Density functional theory (DFT) calculations were applied to predict their geometrical parameters. Theoretical studies revealed that the isophthalic complex adopted the W-shape; while the U-shape was adopted by the terephthalic acid complex (I6/B). The linear geometry of the complex based on the isophthalic acid enhanced the mesomorphic behavior observed by the terephthalic complex; I6/B. Actually; the orientation of the two carboxylic groups was shown to highly affect the softness of the derived complex. On the other hand; the mapping orientation of the charge distribution can be used to explain the mesophase behavior. The photophysical characterization of isophthalic complex (I6/A) is also discussed

Binary mixtures of the laterally substituted Schiff base/ester derivatives, namely 4-((2- or 3-) substituted phenyl imino methyl) phenyl-4”-alkoxy benzoates, Ia–d, were prepared and mesomorphically studied by differential scanning calorimetry (DSC) and their mesophases identified by polarized optical microscopy (POM). The lateral group (1-naphthyl, 2-F, 2-Br, 3-F in Ia–d, respectively) is attached to different positions of the phenyl Schiff moiety. The mixtures investigated were made from two differently shaped compounds that differ from each other in the polarity, size, orientation, and relative positions of the lateral group. The results revealed that the binary mixture Ia/Ib (bearing the naphthyl and 2-flouro substituents) exhibited the SmA phase, which covered the whole composition range. For the mixtures Ib/Id (2-F and 2-Br), the isomeric lateral F-group in compound Ib distributed the SmA arrangement of Id. In the Ic/Id mixture bearing two positionally and structurally different substituents, the addition of Ic to Id resulted in solid binary mixtures where its behavior may be attributed to the negligible steric effect of the small electronegative fluorine atom compared to the Br atom. Density functional theory (DFT) theoretical calculations were carried out to estimate the geometrical parameters of individual components and to show the effect of these parameters in the mesophase behavior of the binary system, where the higher dipole moment of Id (6 Debye) may be the reason for its high π–π molecular stacking, which influences its mesophase range and stability.

Three binary systems were prepared by mixing of two different mesogenic derivatives, homologues, the first is azo/ester, namely 4-alkoxyphenylazo-4′-phenyl-4″-alkoxybenzoates (IIn+m) and the second is Schiff base/ester, namely 4-(arylideneamino)phenyl-4″-alkoxy benzoates (In+m). The two corresponding analogues from both series in the binary mixtures investigated are of the same terminal alkoxy chain length. Mesomorphic properties were investigated by differential scanning calorimetry (DSC) and phases identified by polarized optical microscope (POM). Photophysical studies were investigated by UV spectroscopy connected to a hot stage. Results were discussed based on constructed binary phase diagrams. All mixtures were found to exhibit eutectic compositions, with linear or slightly linear nematic and smectic A stability/composition dependences. Geometrical parameters were predicted applying density functional theory (DFT) calculations. Twist angle (θ), aspect ratio, dipole moment and the polarizability of the individual compounds were discussed and correlated with the experimental results to illustrate the enhanced the mesophase stability and the mesophase range of the mixture at the eutectic composition compared with those of their individual components.

A new simple spectrophotometric method was developed for the determination of binary mixtures without prior separation. The method is based on the generation of ratio spectra of compound X by using a standard spectrum of compound Y as a divisor. The peak to trough amplitudes between two selected wavelengths in the ratio spectra are proportional to concentration of X without interference from Y. The method was demonstrated by determination of two drug combinations. The first consists of the two antihyperlipidemics: atorvastatin calcium (ATV) and ezetimibe (EZE), and the second comprises the antihypertensives: candesartan cilexetil (CAN) and hydrochlorothiazide (HCT). For mixture 1, ATV was determined using 10 μg/mL EZE as the divisor to generate the ratio spectra, and the peak to trough amplitudes between 231 and 276 nm were plotted against ATV concentration. Similarly, by using 10 μg/mL ATV as divisor, the peak to trough amplitudes between 231 and 276 nm were found proportional to EZE concentration. Calibration curves were linear in the range 2.5â40 μg/mL for both drugs. For mixture 2, divisor concentration was 7.5 μg/mL for both drugs. CAN was determined using its peak to trough amplitudes at 251 and 277 nm, while HCT was estimated using the amplitudes between 251 and 276 nm. The measured amplitudes were linearly correlated to concentration in the ranges 2.5â50 and 1â30 μg/mL for CAN and HCT, respectively. The proposed spectrophotometric method was validated and successfully applied for the assay of both drug combinations in several laboratory-prepared mixtures and commercial tablets. Keywords: Spectrophotometric analysis, Ratio spectra, Atorvastatin, Ezetimibe, Candesartan, Hydrochlorothiazide

The pathophysiology of the placental malaria is not fully understood. If there is a fetal sex-specific susceptibility to malaria infection, this might add to the previous knowledge on the immunology, endocrinology and pathophysiology of placental malaria infections.This study was conducted to assess whether the sex of the fetus was associated with placental malaria infections.A cross-sectional study was performed including a secondary analysis of a cohort of women who were investigated for prevalence and risk factors (including fetal sex) for placental malaria in eastern Sudan. Placental histology was used to diagnose placental malaria infections.Among 339 women enrolled, the mean (SD) age was 25.8 (6.7) years and parity was 2.7 (2.2). Among the new born babies, 157 (46.3%) were male and 182 (53.7%) were female. Five (1.5%), 9 (2.7%) and 103 (30.4%) of the 339 placentas had active, active-chronic, past-chronic malaria infection on histopathology examination respectively, while 222 (65.5%) of them showed no malaria infection. Logistic regression analyses showed no associations between maternal age or parity and placental malaria infections. Women who have blood group O (OR = 1.95, 95% CI = 1.19-3.10; P = 0.007) and women who had female new born were at higher risk for placental malaria infections (OR = 2.55, 95% CI = 1.57-4.13; P< 0.001).Fetal gender may be a novel risk factor for placental malaria. In this work the female placentas were at higher risk for malaria infections than the male placentas.

The massive meat production of broiler chickens make them continuously exposed to potential stressors that stimulate releasing of stress-related hormones like corticosterone (CORT) which is responsible for specific pathways in biological mechanisms and physiological activities. Therefore, this research was conducted to evaluate a wide range of responses related to broiler performance, immune function, plasma biochemistry, related gene expressions and cell death morphology during and after a 7-day course of CORT injection. A total number of 200 one-day-old commercial Cobb broiler chicks were used in this study. From 21 to 28 d of age, broilers were randomly assigned to one of 2 groups with 5 replicates of 20 birds each; the first group received a daily intramuscular injection of 5 mg/kg BW corticosterone dissolved in 0.5 ml ethanol:saline solution (CORT group), while the second group received a daily intramuscular injection of 0.5 ml ethanol:saline only (CONT group). Growth performance, including body weight (BW), daily weight gain (DG), feed intake (FI) and feed conversion ratio (FC), were calculated at 0, 3 and 7 d after the start of the CORT injections. At the same times, blood samples were collected in each group for hematological (TWBC's and H/L ratio), T- and B-lymphocytes proliferation and plasma biochemical assays (total protein, TP; free triiodothyronine hormone, fT3; aspartate amino transaminase, AST; and alanine amino transaminase, ALT). The liver, thymus, bursa of Fabricius and spleen were dissected and weighed, and the mRNA expression of insulin-like growth factor 1 gene (IGF-1) in liver and cell-death-program gene (caspase-9) in bursa were analyzed for each group and time; while the apoptotic/necrotic cells were morphologically detected in the spleen. From 28 to 35 d of age, broilers were kept for recovery period without CORT injection and the same sampling and parameters were repeated at the end (at 14 d after initiation of the CORT injection). In general, all parameters of broiler performance were negatively affected by the CORT injection. In addition, CORT treatment decreased the plasma concentration of fT3 and the mRNA expression of hepatic IGF-1. A significant increase in liver weight accompanied by an increase in plasma TP, AST and ALT was observed with CORT treatment, indicating an incidence of liver malfunction by CORT. Moreover, the relative weights of thymus, bursa and spleen decreased by the CORT treatment with low counts of TWBC's and low stimulation of T & B cells while the H/L ratio increased; indicating immunosuppressive effect for CORT treatment. Furthermore, high expression of caspase-9 gene occurred in the bursa of CORT-treated chickens, however, it was associated with a high necrotic vs. low apoptotic cell death pathway in the spleen. Seven days after termination of the CORT treatment in broilers, most of these aspects remained negatively affected by CORT and did not recover to its normal status. The current study provides a comprehensive view of different physiological modulations in broiler chickens by CORT treatment and may set the potential means to mount a successful defense against stress in broilers and other animals as well.

Dialysis patients with troponin-I levels above the cut-off value diagnostic for acute myocardial event (AME) are sometimes labeled as having "renal cause" of elevated troponin-I. Patients with troponin-I levels above 0.0 ng/mL, but below the cut-off level for an AME, are reported to have increased risk for coronary heart disease and mortality. Single pre-dialysis blood samples were taken from 150 asymptomatic dialysis patients (on hemo- or peritoneal dialysis) for troponin-I, cardiac enzymes, C-reactive protein (CRP) and lipid parameters. Troponin-I was measured by a chemiluminescent microparticle immunoassay (CMIA), of which the cut-off value for AME was set at ≥0.4 ng/mL. Patients with troponin-I levels of 0.0 ng/mL, and those with levels between 0.1 and 0.3 ng/mL, were compared regarding their cardiovascular risk profile. None of the patients had troponin-I concentrations above the cut-off level diagnostic for an AME, with 85.3% of the patients having levels of 0.0 ng/mL. While there was no difference in the "traditional" risk factors such as age, body mass index, prevalence of diabetes mellitus, hypertension, total cholesterol and low-density lipoprotein cholesterol between patients with troponin-I levels of 0.1-0.3 ng/mL and those with levels of 0.0 ng/mL, CRP concentrations were higher in the former. In peritoneal dialysis patients, the weekly Kt/V was lower in the patients with troponin levels between 0.1 and 0.3 ng/mL. The findings should add strong support in settling the debate of whether or not in patients on dialysis, falsely elevated levels of troponin-I "commonly" occur. An increased level of CRP and lower Kt/V might add to the cardiovascular risk in patients with troponin-levels between 0.1 and 0.3 ng/mL.

Although recently completed controlled trials failed to demonstrate a significant effect of rituximab on the clinical outcome in non-renal and renal lupus, there is growing evidence from case reports and open-label trials that the use of this medication is successful in certain subgroups of patients including refractory cases and helps in reducing the dose of steroids. We present a 26-year-old female who failed to respond to a long-course treatment with prednisolone, cyclophosphamide, mycophenolate mofetil and azathioprine and who went on to develop end-stage renal disease requiring commencement of regular maintenance hemodialysis. Ten days before starting dialysis, she was given rituximab, and a second dose was given 17 days after starting dialysis. After 7 months on dialysis, the patient began to regain kidney function and is now off dialysis for 11 months. To the best of our knowledge, this is the first case report of a lupus patient on dialysis treated with rituximab in whom dialysis could be stopped and who remained off this therapy up till now, after an observation period of 1 year.