Chronic Kidney Disease (CKD) is a public health problem and many studies support the link between kidney dysfunction and cardiovascular events. Aldosterone has been shown for decades that a plasma aldosterone concentration is elevated in CKD. Whilst, Osteoprotegerin (OPG), after its capacity to protect bone, also osteoprotegerin is elevated in patients with chronic kidney disease (CKD), where it could predict the deterioration of kidney function, cardiovascular, vascular events and all-cause mortality. On the other hand, fibroblast growth factors (FGFs), in patients with CKD, its levels seem to increase progressively as kidney function worsens. The aim of the present study is to assess the correlations between serum osteoprotegerin, aldosterone and fibroblast growth factor-23 levels in patients with chronic kidney disease stage (II-IV) with and without cardiovascular events.
The study includes fifty-nine patients with chronic kidney disease(CKD) and according to CKD-EPI /Creatinine/ 2009 equation to be allocated as stage II-IV, patients were divided into three groups: Group1 (29 patients) with chronic kidney disease(CKD) stage (II-IV) with cardiovascular events. Group2 (30 patients) with chronic kidney disease stage (II-IV) without cardiovascular event, to be compared with Group 3(23 apparently healthy subjects), age and sex matched to that of patients. Serum obtained from their blood specimens to measure; glucose, urea, creatinine, calcium, phosphate, sodium, potassium, aldosterone, FGF-23, Osteoprotergen.
Data analysis showed that fasting serum glucose levels of CKD patients (with and without CV disorder) had significantly higher values as compared to the controls (76.5% and 29% respectively).
Serum Aldosterone, FGF-23, OPG levels were presented with no significant variation among studied groups with CV events or those without CV events.
Background Counselling, education and support from health professionals is key to increasing breastfeeding practices. Aim To evaluate the effectiveness of a breastfeeding educational workshop on Jordanian nurses' and midwives' knowledge, attitudes and practices towards breastfeeding. Methods A convenience sample of 82 nurses and midwives were recruited and randomly assigned into intervention and control groups. A pre-test was conducted for both groups and a post-test was conducted 2 weeks after the intervention for both groups. Findings The results showed significantly higher mean and standard deviation in the intervention group (M=11.73; SD=2.6), compared to the control group (M=8.38; SD=2.59) after conducting the workshop (P<0.001), indicating that the workshop was beneficial in improving knowledge and practice towards the importance of breastfeeding. Conclusion The 2-hour educational workshop increased health professionals' knowledge and this may lead to improvements in practice and better breastfeeding outcomes.
PVC is a thermoplastic and amorphous polymer with no fixed melting point. Since the glass transition temperature (Tg) of PVC is 78 °C and degradation temperature is 120 °C, The PVC manufactured by addition of heat stabilizer agents at 200 °C. The heat stabilizer agents are added to restrict degradation process. Generally, lead based heat stabilizers are being used in PVC pipe industry. While the efforts in the world are focused on minimizing the use of Lead from PVC pipe industry because of its hazardous nature, the focus of the study is to evaluate the operational parameters for PVC pipe manufacturing process by substituting the lead based heat stabilizer with Ca-Zn based stabilizer. The effect of Bearlocher, Sunace and Dansuk were selected for study. PVC pipes and other products were manufactured and tested as per standard. The quality of finished product is tested and ensured as per P.S. 3051/91 standard. The results of successful trials of each stabilizer are compared and final recommendations are made on the basis of technical and economical advantage.
In this paper introduces a technique for rendering effect of the volumetric lighting in dusty atmosphere using particle systems. Despite numerous techniques has been proposed for rendering these effects but still lack realism in the interactive applications. This technique is based on the sampling planes to compute radiance transport equation and use dynamic model of the dust. The scattering of light is computed by using fragment shaders and 2D texture by making use of the graphics hardware, while using ParticleEngine technique generates the dust. The technique is efficient and accurate to mimic a realistic scenes have effect such as scattering of light in dust molecules. In addition to, volumetric shadows are created resulting of density and size particles within participating media. Therefore, scattering of light is generated in presence dusty media that lead to provide visual clue closer to realistic.
Abstract The dams’ spillway and its stilling basin are the hydraulic structures that are subjected to very fast water flow, which exposes them to the impact of water and water-dragged materials. To produce an appropriate concrete mixture that is capable to resist such loads, three hybrid fiber-reinforced mixes were prepared using the same materials and a constant total fiber volume fraction of 2.5%, while the fiber hybridization scheme was the only variable. All mixtures had a quantity of 0.5% polypropylene fiber (PP) with length of 18 mm. The first mixture (M1) involved 2% steel fibers with length of 6 mm, while M2 contains 2% of 15 mm steel fibers. A quantity of 1% was added form the two steel fibers for M3. The water-jet impact and drop-weight impact tests were conducted to compare the impact response of the mixtures. The obtained results showed that the abrasion resistance of M2 was higher than that of M1 and M3 by 42 and 21%, respectively. Furthermore, its impact resistance was greater than the average value of that for the other mixes by 43.8%. Finally, the splitting tensile strength can be considered an acceptable scale to describe the abrasion resistance of concrete.
Cardiovascular risk is independently increased by plasma lipids abnormalities (low- density and high density lipoprotein -cholesterol and triglycerides). Most patients have more than one lipid abnormality. Combination therapy with lipid-modifying agents could offer an important therapeutic option for improving the overall lipid profile. Combinations have demonstrated to provide additive efficacy and significant reductions in coronary events . This study was designed to evaluate the effect of ezetimibe, when used in combination with other hypolipidaemic agents ( statins) on lipid profile as well as on liver function ,renal function, oxidative stress, and platelets function when given to dyslipidaemic patients . Forty four patients (24 males and 20 females) with age ranged between 40-70 years (54 ±14.6) with dyslipidaemia on statins therapy for at least 6 month were involved in this clinical trials. They were randomized into two groups treated with either a combination of 20 mg/day simvastatin or a combination of 20mg/day atorvastatin and 10mg/day of ezetimibe.The study also included 22 apparently healthy subjects with age ranged (40-70years) and sex(11males and 11 females) matching that of the patients group. Serum lipid profile (total cholesterol -TC, triglycerides -TG, low density lipoprotein-cholesterol –LDL-C, very low density lipoprotein-cholesterol-VLDL-C, and high density lipoprotein-cholesterol –HDL-C), oxidative stress marker (Malondialdehyde-MDA), liver functions indices (Alanin aminotransferase -ALT,Aspartate aminotransferase- AST, total bilirubin), renal function parameters (urea, creatinine, and microalbuminuria) and platelets function test (bleeding time)were evaluated before and after 4 and 6 weeks of starting ezetimibe treatment . Treatment with ezetimibe plus simvastatin or atrovostatin resulted in significant lowering in TC, TG, LDL-C levels with elevation in HDL-C also the LDL/HDL ratio lowered significantly ( by 38.16%). This effect was associated with significant changes in liver function , and oxidative stress without changes in platelets function nor in renal function. The results presented in this study indicated that ezetimibe can be used in clinical practice for the treatment of dyslipidaemia, when combined with other hypolipidaemic agents like simvastatin and atorvastatin to improve the therapeutic profile with ameliorating some of their adverse effects.
Keywords : Ezetimibe , Statins , Dyslipidemia