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Thrombotic microangiopathy after kidney transplantation: Expanding etiologic and pathogenetic spectra

World Journal of Transplantation 2024年第1期14卷 84-95页

作者： Muhammed Mubarak amber raza Rahma Rashid Fnu Sapna Shaheera Shakeel Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Nephrology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Pathology Montefiore Medical CenterThe University Hospital for Albert Einstein School of MedicineBronxNY 10461United States

Thrombotic microangiopathy(TMA)is an uncommon but serious complication that not only affects native kidneys but also transplanted *** review is specifically focused on post-transplant TMA(PT-TMA)involving kidney transplant *** reported prevalence in the latter population varies from 0.8%to 14%with adverse impacts on both graft and patient *** has many causes and associations,and the list of etiologic agents and associations is growing *** pathogenesis is equally varied and a variety of pathogenetic pathways lead to the development of microvascular injury as the final common ***-TMA is categorized in many ways in order to facilitate its ***,more than one causes are contributory in PT-TMA and it is often difficult to pinpoint one particular cause in an individual ***,the hallmark lesions are endothelial cell injury and intravascular thrombi affecting the *** diagnosis and classification of PT-TMA are imperative for optimal outcomes but are challenging for both clinicians and *** Banff classification has addressed this issue and has developed minimum diagnostic criteria for pathologic diagnosis of PT-TMA in the first *** of the condition is also challenging and still largely *** varies from simple maneuvers,such as plasmapheresis,drug withdrawal or modification,or dose reduction,to lifelong complement blockade,which is very expensive.A thorough understanding of the condition is imperative for an early diagnosis and quick treatment when the treatment is potentially *** review aims to increase the awareness of relevant stakeholders regarding this important,potentially treatable but under-recognized cause of kidney allograft dysfunction.

关键词： Thrombotic microangiopathy Microvascular injury Anemia Thrombocytopenia Kidney allograft failure

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Evolution of human kidney allograft pathology diagnostics through 30 years of the Banff classification process

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World Journal of Transplantation 2023年第5期13卷 221-238页

作者： Muhammed Mubarak amber raza Rahma Rashid Shaheera Shakeel Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Nephrology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan

The second half of the previous century witnessed a tremendous rise in the number of clinical kidney transplants *** activity was,however,accompanied by many issues and *** accurate diagnosis and appropriate management of causes of graft dysfunction were and still are,a big *** allograft biopsy played a vital role in addressing the above ***,its interpretation was not standardized for many years until,in 1991,the Banff process was started to fill this ***,regular Banff meetings took place every 2 years for the past 30 *** changes have taken place in the interpretation of kidney allograft biopsies,diagnosis,and classification of rejection and other non-rejection pathologies from the original Banff 93 *** review attempts to summarize those changes for increasing the awareness and understanding of kidney allograft pathology through the eyes of the Banff *** will interest the transplant surgeons,physicians,pathologists,and allied professionals associated with the care of kidney transplant patients.

关键词： Banff process Rejection Kidney allograft biopsy Transplant pathology Review

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The correlation of spot urinary protein-to-creatinine ratio with 24-h urinary protein excretion in various glomerulopathies

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World Journal of Nephrology 2023年第5期12卷 159-167页

作者： amber raza Syed Haider Nawaz Rahma Rashid Ejaz Ahmed Muhammed Mubarak Department of Nephrology Sindh Institute of Urology and TransplantationSindhKarachi 74200Pakistan Department of Pathology Sindh Institute of Urology and TransplantationSindhKarachi 74200Pakistan

BACKGROUND Proteinuria is an important and well-known biomarker of many forms of kidney *** quantitation is of particular importance in the diagnosis and management of glomerular *** quantification can be done by several *** these,the measurement of 24-h urinary protein excretion is the gold standard ***,it is cumbersome,time-consuming,and inconvenient for patients and is not completely *** alternative methods have been tested over time albeit with conflicting *** the latter,the measurement of urine protein-to-creatinine ratio(uPCR)in singlevoided urinary samples is widely *** majority of studies found a good correlation between uPCR in single urine samples with 24-h urinary protein estimation,whereas others did *** To investigate the correlation of spot uPCR with 24-h urinary protein estimation in patients suffering from different forms of glomerulopathies at a single largevolume nephrological center in *** This cross-sectional,observational study was conducted at the Department of Nephrology,Sindh Institute of Urology and Transplantation,Karachi,Pakistan from September 2017 to March *** newly presenting adult patients with proteinuria who were being investigated for suspected glomerulonephritis and persistent proteinuria with ages between 18 to 60 years were *** patients were given detailed advice regarding 24-h urine collection starting at 7:00 AM for total protein and creatinine excretion estimations.A spot urine sample was collected the next day at the time of submission of a 24-h urine sample for measuring uPCR along with a blood *** data of patients were collected in a *** version 20.0 was used for statistical *** A total of 157 patients were *** mean age was 30.45±12.11 *** were 94(59.8%)males and 63(40.2%)*** mean 24-h urinary protein excretion was 3192.78±1959.79 mg and the mean spot uPCR was 3.16±1.52 in al

关键词： Glomerulopathies 24-h proteinuria Spot urinary protein-to-creatinine ratio Correlation Proteinuria Agreement

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Prevalence of viral HBV and HCV among different group patients in Gujrat Pakistan

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Advances in Bioscience and Biotechnology 2012年第4期3卷 423-436页

作者： Muhammad Irshad Muhammad Naem raza Zahid Anwar Nadia Ikram amber Afroz Hafiz Muhammad Nasir Iqbal Department of Biochemistry and Molecular Biology University of Gujrat Pakistan Department of Biochemistry NSMC University of Gujrat Pakistan Department of Chemistry and Biochemistry University of Agriculture Faisalabad Pakistan

In this study we analyzed blood samples collected from 400 high risk patients for the prevalence of an inflammatory viral disease hepatitis B virus (HBV) and hepatitis C virus (HCV) with the help of standard kit assay and Enzyme-linked immunosorbent assay (ELISA). All the samples were selected randomly from the various places of District Gujrat, Pakistan. All the selected cases were first divided into four groups according to the age and sex (Group 1, Male below age 35 years;Group 2, Male above age 35 years;Group 3, Female below age 35 years;Group 4, Female above age 35 years), each group was comprised of 100 individual patients and analyzed for different parameters for the presence of HBV and HCV in comparison with positive and negative controls. The prevalence of HBV and HCV was higher in groups 2 (22%) and 4 (39%) respectively. Assay profile revealed that the incidence of HCV was higher in female patients as compare to the male patients. The present study indicates that more than 60% of the cirrhosis and hepatocellular carcinoma in the Region is attributable to hepatitis B virus (HBV) or hepatitis C virus (HCV) infection.

关键词： HBV HCV Liver Inflammation LFTs ELISA ALP Bilirubin

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