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Occult Adrenal Insufficiency in Patients with Chronic Renal Disease

International Journal of Clinical Medicine 2024年第8期15卷 375-381页

作者： Kamel El-Reshaid abdulmohsen al-bader Hossameldin Tawfik Sallam Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Department of Otolaryngology Farwania Hospital Ministry of Health Kuwait City Kuwait Department of Medicine Al-Amiri Renal Center Ministry of Health Kuwait City Kuwait

Background: Addison’s disease is a rare disorder of the adrenal cortex that leads to inadequate production of cortisol initially followed by aldosterone and androgens. Its manifestations are usually slow and non-specific with potential for life-threatening adrenal crisis following hypermetabolic demands (infection, trauma, surgery). Patients: Over the past 10 years, 19 CRD-patients were diagnosed with occult PAI in our center. Results: Unprovoked hypotension was the most common manifestations of occult PAI and was the unmasking event in 11 (58%). It was without significant cardiac and/or severe systemic sepsis and was refractory to isotonic saline infusions. Equal number of the remaining patients (n = 2) presented with persistent and inexplicable electrolytes abnormalities viz. 1) hyponatremia despite restricted oral fluid intake, lack of dehydration and massive fluid overload, as well as 2) hyperkalemia despite potassium-restricted diet, hyperkalemic drugs and adequate therapy with Furosemide and low-potassium dialysis-baths. On the other hand, similar proportions presented with unprovoked 3) progressive weight loss, decrease appetite and cachexia as well as 4) frequent hypoglycemic attacks. all patients were treated and were medically stable after 29 (2 - 60) months of follow up. Autoantibodies to 21-hydroxylase enzyme were positive in 16 (90%). At diagnosis, and subsequent follow up, only 7 patients (37%) had multi-endocrine dysfunction of whom 2 with type 1 and 5 with type 2. Conclusion: High index of suspicion should be exerted in diagnosis of PAI in patients with CRD, since its clinical picture is similar to CRD manifestations and complications. In those patients, confirmatory tests and specific management can save their lives. .

关键词： Addison’s Disease Autoimmune Adrenalitis Chronic Renal Disease Multiple Endocrine Dysfunctions Primary Adrenal Insufficiency

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Diarrhea and Acute Renal Injury Culminating in Metformin-Induced Lactic Acidosis

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Open Journal of Nephrology 2023年第3期13卷 195-200页

作者： Kamel El-Reshaid abdulmohsen al-bader Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Department of Otolarygology Ministry of Health Kuwait City Kuwait

Background: Metformin (M) is an effective first-line hypoglycemic agent in obese type 2 diabetes mellitus due to its low cost and safety profile. The Case: A 66-year-man presented with shock due to lactic acidosis induced by M-supersaturation subsequent to acute renal failure following infective diarrhea. The drug has been used, by this patient, for >10 years without complication. Physical examination, laboratory tests, radiological investigations and blood cultures did not show evidence of new cardiac, hepatic and septic insult. Despite discontinuation of M and 2-days of aggressive hydration, bicarbonate infusions and pressors;toxic levels of the drug persisted and shock-state culminated in severe and oliguric renal failure with serum urea and creatinine up to 50 mmol/L and 1270 umol/L, respectively. Hence, continuous venovenous hemodiafiltration (CVVHDF) was used, for 16-hours, to remove the drug, correct his acidosis and support his severe renal complications. Hours after the procedure;drug level, lactic acidosis and its associated shock improved followed by gradual renal recovery. The patient was discharged after 6 days and serum creatinine reached his base line (180 umol/L) 2 weeks later. The drug was not recommended for his future use. Conclusion: M-induced lactic acidosis, should be considered in assessment of shock in M-treated patients and management of unstable patients indicates early-use of CVVHDF.

关键词： CVVHDF Diabetes Mellitus Diarrhea Lactic Acidosis Metformin Shock

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The Beneficial Effect of 3-Month-Induction Therapy with Corticosteroids and Mycophenolate Mofetil Followed by Maintenance Therapy with Yearly Rituximab Infusions as Sole Maintenance Therapy in Cryptogenic Chronic Hypersensitivity Pneumonitis

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International Journal of Clinical Medicine 2023年第8期11卷 338-346页

作者： Kamel El-Reshaid abdulmohsen al-bader Sana S. almutairi Sayed H. M. Mohamad Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Department of Otolaryngeology Farwania Hospital Ministry of Health Kuwait City Kuwait Department of Medicine Respiratory Unit Amiri Hospital Ministry of Health Kuwait City Kuwait Department of Radiology Al Salam Hospital Kuwait City Kuwait

Background: The available data on cryptogenic chronic hypersensitivity pneumonitis (ccHP) indicate an inherited predisposition to disease with triggering autoimmune phenomena. Hence, we evaluated prospectively the role of a new autoimmune regimen in treatment of its severe and progressive disease. Patients and Methods: A total of 9 patients were included in the study. They had criteria for ccHP viz. 1) clinical features of cryptogenic progressive restrictive lung disease, 2) high-resolution computed tomographic pulmonary abnormalities, and 3) bronchoalveolar lavage lymphocytosis (>30%). The regimen consisted of an initial induction phase of 3-month Solumedrol 1 g IV daily for 3 days followed by 1 month of Prednisone (P) 60 mg/day to tapered down to discontinuation by 3rd month. They also had received Mycophenolate mofetil (MMF) 1 g twice daily for 3 months. This stage was followed by a maintenance phase of yearly Rituximab infusions (1 g followed by 1 g 2 weeks later). Results: compared to their previous 6 months deterioration;all patients showed significant improvement in their forced vital volume, diffusion capacity for carbon monoxide, 6-minutes-walk after the induction phase (at 3 months) which improved further at 15 months with Rituximab therapy. Conclusion: After 3-month induction therapy with P and MMF;yearly R treatment is a safe, practical and effective long-term therapy for ccHP.

关键词： Hypersensitivity Pneumonitis Mycophenolate Mofetil Rituximab Spirometry HRCT Bal

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Enhanced Steganalysis for Color Images Using Curvelet Features and Support Vector Machine

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Computers, Materials & Continua 2024年第1期78卷 1311-1328页

作者： Arslan Akram Imran Khan Javed Rashid Mubbashar Saddique Muhammad Idrees Yazeed Yasin Ghadi abdulmohsen algarni Faculty of Computer Science and Information Technology Department of Computer ScienceSuperior UniversityLahore54000Pakistan Machine Learning Code(MLC)Lab Meharban HouseHouse Number 209Zafar ColonyOkara56300Pakistan Information Technology Services University of OkaraOkara56310Pakistan Department of Computer Science&Engineering University of Engineering&Technology LahoreNarowal CampusNarowal51601Pakistan Department of Computer Science and Software Engineering Al Ain UniversityAl Ain11671Abu Dhabi Department of Computer Science King Khalid UniversityAbha61421Saudi Arabia

algorithms for steganography are methods of hiding data transfers in media *** machine learning architectures have been presented recently to improve stego image identification performance by using spatial information,and these methods have made it feasible to handle a wide range of problems associated with image *** with little information or low payload are used by information embedding methods,but the goal of all contemporary research is to employ high-payload images for *** address the need for both low-and high-payload images,this work provides a machine-learning approach to steganography image classification that uses Curvelet transformation to efficiently extract characteristics from both type of *** Vector Machine(SVM),a commonplace classification technique,has been employed to determine whether the image is a stego or *** Wavelet Obtained Weights(WOW),Spatial Universal Wavelet Relative Distortion(S-UNIWARD),Highly Undetectable Steganography(HUGO),and Minimizing the Power of Optimal Detector(MiPOD)steganography techniques are used in a variety of experimental scenarios to evaluate the performance of the *** WOW at several payloads,the proposed approach proves its classification accuracy of 98.60%.It exhibits its superiority over SOTA methods.

关键词： Curvelets fast fourier transformation support vector machine high pass filters steganography

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Diet in Renal Diseases: An Art of Science

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Open Journal of Nephrology 2024年第3期14卷 361-374页

作者： Kamel El-Reshaid Shaikha al-bader Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Department of Nephrology Jaber Hospital Ministry of Health Kuwait City Kuwait

Purpose of Review: Chronic kidney disease (CKD) is associated with a limited ability to excrete fluids, electrolytes, uremic toxins and other end-products of catabolism. Studies on adverse renal outcomes with dietary patterns are limited. Methods: Comprehensive search in PubMed of papers published until June 2024 describing prospective cohort studies on renal nutritional therapy (RNT) with at least 3 years of follow up. Results: RNT should include adequate yet limited amounts of calories, fluids, protein, lipids, sodium, potassium, and phosphorus. RNT is an adjuvant to specific drug-therapy in 1) certain complications viz. fluid overload, anemia and renal osteodystrophy, and 2) specific kidney diseases viz. glomerulopathies, tubulopathies, polycystic kidney disease, calcium oxalates urolithiasis and cystinuria, as well as 3) types of renal failure viz acute and chronic and its treatment viz. hemodialysis, peritoneal and transplantation. Conclusion: RNT is patient-specific and should be systematically planned to delay the progression of CKD as well as to prevent and treat its complications.

关键词： Calories Diet Disease Electrolytes Fluid Kidney Lipids Nutrition Protein Vitamins

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Hydroxychloroquine: A Safe, Effective and Inexpensive Maintenance Therapy for Chronic Spontaneous Urticaria

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International Journal of Clinical Medicine 2024年第6期15卷 225-232页

作者： Kamel El-Reshaid Shaima al-bader Abdulla al-Refaee Department of Medicine Faculty of Medicine Kuwait University Kuwait Kuwait Asad al-Hamad Dermatology Center Ministry of Health Kuwait Kuwait

Background: Chronic spontaneous urticaria (CSU) is an autoimmune skin disorder that lasts for >6 weeks and may last for years. It is a disabling skin disease that impairs quality of life. Set-up treatment with antihistamines, immunosuppressives, immune modulators and lately Omalizumab are expensive or have significant side effects. In this retrospective study, we describe our experience with the use of hydroxychloroquine (HCQ) as a maintenance therapy for those with severe forms of CSU after Corticosteroids (C) induction phase. Patients and Methods: 16 adult patients (aged 44 ± 7) with severe CSU for 5 ± 1 months, were included in the study. Eight patients had attacks of angioneurotic oedema. Their previous treatments were antihistaminic and short-courses of C. Results: After 2 weeks of remission with C and HCQ 200 mg twice daily, the dose of C was tapered down and discontinued by the end of the first month. The seven days Urticaria Activity Score decreased from 30 ± 3 to 6 ± 1 by the first month and remained low at 3 ± 1 by the end of 2 years of follow-up. Moreover, IgE levels and CRP had similar trends. Remission persisted after 37 ± 9 months of follow-up. Conclusion: HCQ is a safe, efficacious and inexpensive drug for the treatment of CSU.

关键词： Autoimmune Disease Chronic Spontaneous Urticaria Corticosteroids Hydroxychloroquine Omalizumab

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Systemic Amyloidosis Secondary to Psoriasis: A Rare, Autoimmune and Genetically-Determined Disorder That Is Amenable to Treatment with Cyclosporin A—Cyclosporin A for Psoriasis-Induced Amyloidosis

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Open Journal of Nephrology 2024年第2期14卷 226-232页

作者： Kamel El-Reshaid Shaima al-bader John Patrick Madda Department of Medicine Faculty of Medicine Kuwait University Kuwait City Kuwait Asad al-Hamad Dermatology Center Kuwait City Kuwait Department of Pathology Amiri Hospital Kuwait City Kuwait

Background: Systemic secondary amyloidosis (SSA) is associated with chronic inflammatory disorders and/or chronic infections. Patients and Methods: Over the past 10 years;a total of 21 patients, with long-term (17 months) and extensive psoriasis (P) with psoriasis area severity index (PASI) >29, were evaluated. Results: Two patients had nephrotic syndrome (proteinuria 3.9 and 3.6 g/day) and decrease creatinine clearance (46 and 62 ml/minute). Their renal biopsy revealed Congo-red (+) nodular glomerulosclerosis that lacked immune-deposits and resisted wash with K-permanganate wash indicating SSA. Three months subsequent to Cyclosporin A (CyA) therapy with 100 mg twice daily;psoriasis improved in all patients with decrease in (PASI) from 29.5 to 3.5 1. In the 2 patients with SSA;proteinuria decreased to 2.1 and 1.8 g/day and creatinine clearance improved to 51 and 69 ml/minute. Such improvement persisted up to 2 years of follow up and up to 78 months in patients with SSA. Conclusion: psoriasis-induced SSA is an autoimmune disease, with genetic predisposition that is amenable to CyA therapy.

关键词： Amyloidosis Psoriasis Nephrotic Syndrome Cyclosporin A

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Single image super-resolution:a comprehensive review and recent insight

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Frontiers of Computer Science 2024年第1期18卷 139-156页

作者： Hanadi al-MEKHLAFI Shiguang LIU College of Intelligence and Computing Tianjin UniversityTianjin 300350China

Super-resolution(SR)is a long-standing problem in image processing and computer vision and has attracted great attention from researchers over the *** main concept of SR is to reconstruct images from low-resolution(LR)to high-resolution(HR).It is an ongoing process in image technology,through up-sampling,de-blurring,and *** neural network(CNN)has been widely used to enhance the resolution of images in recent *** alternative methods use deep learning to improve the progress of image super-resolution based on ***,we review the recent findings of single image super-resolution using deep learning with an emphasis on distillation knowledge used to enhance image super-resolution.,it is also to highlight the potential applications of image super-resolution in security monitoring,medical diagnosis,microscopy image processing,satellite remote sensing,communication transmission,the digital multimedia industry and video ***,we present the challenges and assess future trends in super-resolution based on deep learning.

关键词： super-resolution deep learning single-image interpolation-based learning-based reconstruction-based

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RoGRUT: A Hybrid Deep Learning Model for Detecting Power Trapping in Smart Grids

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Computers, Materials & Continua 2024年第5期79卷 3175-3192页

作者： Farah Mohammad Saad al-Ahmadi Jalal al-Muhtadi Center of Excellence in Information Assurance(CoEIA) King Saud UniversityRiyadh11543Saudi Arabia College of Computer&Information Sciences King Saud UniversityRiyadh11543Saudi Arabia

Electricity theft is a widespread non-technical issue that has a negative impact on both power grids and electricity *** hinders the economic growth of utility companies,poses electrical risks,and impacts the high energy costs borne by *** development of smart grids is crucial for the identification of power theft since these systems create enormous amounts of data,including information on client consumption,which may be used to identify electricity theft using machine learning and deep learning ***,there also exist different solutions such as hardware-based solutions to detect electricity theft that may require human resources and expensive ***-based solutions are presented in the literature to identify electricity theft but due to the dimensionality curse,class imbalance issue and improper hyper-parameter tuning of such models lead to poor *** this research,a hybrid deep learning model abbreviated as RoGRUT is proposed to detect electricity theft as amalicious and non-malicious *** key steps of the RoGRUT are data preprocessing that covers the problem of class imbalance,feature extraction and final theft *** advanced-level models like RoBERTa is used to address the curse of dimensionality issue,the near miss for class imbalance,and transfer learning for *** effectiveness of the RoGRUTis evaluated using the dataset fromactual smartmeters.A significant number of simulations demonstrate that,when compared to its competitors,the RoGRUT achieves the best classification *** performance evaluation of the proposed model revealed exemplary results across *** accuracy achieved was 88%,with precision at an impressive 86%and recall reaching 84%.The F1-Score,a measure of overall performance,stood at 85%.Furthermore,themodel exhibited a noteworthyMatthew correlation coefficient of 78%and excelled with an area under the curve of 91%.

关键词： Electricity theft smart grid RoBERTa GRU transfer learning

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Developing a Model for Parkinson’s Disease Detection Using Machine Learning algorithms

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Computers, Materials & Continua 2024年第6期79卷 4945-4962页

作者： Naif al Mudawi Department of Computer Science College of Computer Science and Information SystemNajran UniversityNajran55461Saudi Arabia

Parkinson’s disease(PD)is a chronic neurological condition that progresses over *** start to have trouble speaking,writing,walking,or performing other basic skills as dopamine-generating neurons in some brain regions are injured or *** patient’s symptoms become more severe due to the worsening of their signs over *** this study,we applied state-of-the-art machine learning algorithms to diagnose Parkinson’s disease and identify related risk *** research worked on the publicly available dataset on PD,and the dataset consists of a set of significant characteristics of *** aim to apply soft computing techniques and provide an effective solution for medical professionals to diagnose PD *** research methodology involves developing a model using a machine learning *** the model selection,eight different machine learning techniques were adopted:Namely,Random Forest(RF),Decision Tree(DT),Support Vector Machine(SVM),Naïve Bayes(NB),Light Gradient Boosting Machine(LightGBM),K-Nearest Neighbours(KNN),Extreme Gradient Boosting(XGBoost),and Logistic Regression(LR).Subsequently,the concentrated models were validated through 10-fold Cross-Validation and Receiver Operating Characteristic(ROC)—Area Under the Curve(AUC).In addition,GridSearchCV was utilised to measure each algorithm’s best parameter;eventually,the models were trained through the hyperparameter tuning *** 98%accuracy,LightGBM had the highest accuracy in this ***,KNN,and SVM came in second with 96%***,the performance scores of NB and LR were recorded to be 76%and 83%,*** is to be mentioned that after applying 10-fold cross-validation,the average performance score of LightGBM accounted for 93%.At the same time,the percentage of ROC-AUC appeared at 0.92,which indicates that this LightGBM model reached a satisfactory ***,we extracted meaningful insights and figured out potential gaps on top of *** extracting meaningful in

关键词： Light GBM cross-validation ROC-AUC Parkinson’s disease(PD) SVM and XGBoost

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