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Incidence, Risk Factors and Short Term Outcome of Acute Kidney Injury among Patients with Acute Coronary Syndrome

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Journal of Biosciences and Medicines 2020年第5期8卷 177-188页

作者： Md. Kabir Hossain Muhammad rafiqul Alam Asia Khanam A. K. M. Shahidur Rahman rafi Nazrul Islam Syed Fazlul Islam Mohammad Kamrul Ahsan S. K. Mamun-Ar-Rashid Tanvir Rahman Md. Nazmul Hasan Department of Nephrology Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Nephrology & Dialysis BIRDEM General Hospital Dhaka Bangladesh Holy Family Red Crescent Medical College Hospital (HFRCMCH) Dhaka Bangladesh Department of Medicine Khulna Medical College Hospital Khulna Bangladesh Department of Nephrology United Hospital Limited Dhaka Bangladesh Department of Cardiology Ad-din Medical College Hospital Dhaka Bangladesh

Background: Cardio-renal syndrome is the leading cause of death globally. Acute kidney injury (AKI) is a major complication among patients admitted in Coronary Care Unit (CCU) with acute coronary syndrome (ACS). AKI in ACS patients is associated with higher morbidity, mortality and prolong hospital stay. Objective: To determine the incidence, risk factors and short term outcome of acute kidney injury (AKI) among the patients admitted in CCU with ACS. Methods: This cross sectional study was conducted at Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2013 to December 2013. Following selection criteria a total of two hundred (200) patients with ACS were studied. AKI was defined according to the KDIGO guideline and further categorized by RIFLE criteria. Data of patients with AKI and those without AKI were analyzed and compared by statistical tests. Results: Majority of the study patients were male (79.5%). AKI was developed in 40 of the 200 study patients (20.0%). The mean (±SD) age of the study patients was 60.1 ± 11.1 years in patients with AKI and 55.9 ± 10.1 years in patients without AKI. Our data analysis showed that older age (>65 years), diabetes mellitus, dyslipidemia and smoking were significantly correlated to the development of AKI. Mortality was significantly high in AKI group (7.15%) compared to no AKI group (1.25%). Out of 27 patients who achieved renal recovery most (80.8%) belonged to risk class. Severity of AKI showed significant effect on renal recovery and final outcome. Conclusion: This study demonstrated that, incidence of AKI among patients with ACS was 20%. Elderly patients, diabetes mellitus, dyslipidemia, and exposure to smoking were significantly associated with development of AKI in ACS.

关键词： Acute Kidney Injury (AKI) Acute Coronary Syndrome (ACS) Cardio-Renal Syndrome

In vivo analysis of intestinal permeability following hemorrhagic shock

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World Journal of Critical Care Medicine 2015年第4期4卷 287-295页

作者： Tom Alsaigh Marisol Chang Michael Richter rafi Mazor Erik B Kistler Department of Bioengineering the Institute of Engineering in Medicine University of California San Diego Department of Anesthesiology and Critical Care VA San Diego Healthcare System

AIM: To determine the time course of intestinal permeability changes to proteolytically-derived bowel peptides in experimental hemorrhagic shock. METHODS: We injected fluorescently-conjugated casein protein into the small bowel of anesthetized Wistar rats prior to induction of experimental hemorrhagic shock. These molecules, which fluoresce when proteolytically cleaved, were used as markers for the ability of proteolytically cleaved intestinal products to access the central circulation. Blood was serially sampled to quantify the relative change in concentration of proteolytically-cleaved particles in the systemic circulation. To provide spatial resolution of their location, particles in the mesenteric microvasculature were imaged using in vivo intravital fluorescent microscopy. The experiments were then repeated using an alternate measurement technique, fluorescein isothiocyanate(FITC)-labeled dextrans 20, to semi-quantitatively verify the ability of bowel-derived low-molecular weight molecules(< 20 k D) to access the central ***: Results demonstrate a significant increase in systemic permeability to gut-derived peptides within 20 min after induction of hemorrhage(1.11 ± 0.19 vs 0.86 ± 0.07, P < 0.05) compared to control animals. Reperfusion resulted in a second, sustained increase in systemic permeability to gut-derived peptides in hemorrhaged animals compared to controls(1.2 ± 0.18 vs 0.97 ± 0.1, P < 0.05). Intravital microscopy of the mesentery also showed marked accumulation of fluorescent particles in the microcirculation of hemorrhaged animals compared to controls. These results were replicated using FITC dextrans 20 [10.85 ± 6.52 vs 3.38 ± 1.11 fluorescent intensity units(× 105, P < 0.05, hemorrhagic shock vs controls)], confirming that small bowel ischemia in response to experimental hemorrhagic shock results in marked and early increases in gut membrane permeability. CONCLUSION: Increased small bowel permeability in hemorrhagic shock may all

关键词： Small bowel ischemia Hemorrhagic shock Peptides Microcirculation Proteolysis

Ocular Fundus Abnormalities in Pre-Dialytic Chronic Kidney Disease Patients

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Journal of Biosciences and Medicines 2019年第11期7卷 20-35页

作者： Mohammad Kamrul Ahsan Muhammad rafiqul Alam Asia Khanam A. H. Hamid Ahmed Md. Omar Faroque K. B. M. Hadiuzzaman A. K. M. Shahidur Rahman rafi Nazrul Islam Manik Chandra Mondal Md. Azizur Rahman Holy Family Red Crescent Medical College Hospital (HFRCMCH) Dhaka Bangladesh Department of Nephrology Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Nephrology & Dialysis BIRDEM General Hospital Dhaka Bangladesh Bangladesh Eye Hospital & Institute Dhaka Bangladesh

Background: Chronic kidney disease (CKD) affects 10% - 16% of the adult population. Although ocular findings related to renal insufficiency include cataract, conjunctival calcification, lid edema, conjunctival pallor and xanthalesma, by far the most important is retinopathy. Objective: To evaluate the ocular fundus abnormalities in pre-dialytic chronic kidney disease patients of the adult population. Methodology: This cross-sectional observational study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from April 2012 to March 2014. A total of 100 hospital admitted CKD patients were purposively selected for this study. Age, gender, blood pressure, Body Mass Index (BMI), 24 hours Urinary Total Protein (UTP), haemoglobin level, serum creatinine, serum cholesterol, serum triglyceride and color fundus photography findings of both eyes were recorded for each patient. Inter-group comparisons were made between patients with retinopathy and those without retinopathy. Results: Out of 100 adult non-dialytic CKD patients, 43 (43%) had ocular fundus abnormalities, among them 27 (62.8%) were male and 16 (37.2%) were female. The risk of development of retinopathy was significantly higher among older patients (p = 0.006), those with low haemoglobin level (p = 0.0001) and high blood pressure. Retinopathy was significantly (p = 0.0001) increased with reduction of e-GFR. There was no relationship between BMI and high serum triglyceride level with retinal abnormality. Among 43 (43%) patients with retinal abnormality, 30 (69.76%) patients showed only hypertensive retinopathy and 5 (11.6%) patients showed only diabetic retinopathy. Mixed hypertensive and diabetic retinopathy was found in 8 (18.6%) patients. Maculopathy was seen in 11 (25.58%) patients, of whom 3 (6.98%) had hypertensive retinopathy and 8 (18.87%) had diabetic retinopathy. Optic atrophy was seen in 2 (4.6%) patients and drusen like retinal deposits were

关键词： Chronic Kidney Disease (CKD) Ocular Fundus Retinopathy

Outcome of Leflunomide in the Treatment of Proliferative Lupus Nephritis Compared to Cyclophosphamide

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Journal of Biosciences and Medicines 2021年第3期9卷 64-76页

作者： Shahida Mullah Muhammad rafiqul Alam Shamim Ahmed Amanur Rasul Md. Faisal Anirban Kishor Singha A. K. M. Shahidur Rahman Diwakar Manandhar Asif Mahmud Bikram Bir Bajracharya S. M. Shamsuzzaman rafi Nazrul Islam Md. Rezaul Alam Ferdous Jahan Department of Medicine Sarkari Karmachari Hospital Dhaka Bangladesh Department of Nephrology Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Rheumatology Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka Bangladesh Department of Nephrology Dhaka Medical College Hospital (DMCH) Dhaka Bangladesh Department of Nephrology Kurmitola General Hospital Dhaka Bangladesh Lecturer of Nephrology Kist Medical College and Teaching Hospital Kathmandu Nepal Clinical Fellow ST3+ Medicine and Specialties Worcestershire Royal Hospital Worcester UK Goshairhat Upazila Health Complex Shariatpur Bangladesh Department of Nephrology & Dialysis BIRDEM General Hospital Dhaka Bangladesh

Background: Lupus nephritis (LN) is one of the most common presentations of Systemic lupus erythematosus (SLE). Cyclophosphamide is one of the key immunosuppressive agents for the management of LN. Leflunomide is an isoxazole immunomodulatory agent has been shown to be safe, well tolerated and effective in SLE and LN. Objective: To evaluate the outcome of leflunomide in the treatment of proliferative lupus nephritis compared to cyclophosphamide. Method: This randomized clinical trial was held in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2017 to August 2019. A total of 66 patients of proliferative lupus nephritis who need induction therapy were enrolled in this study. Leflunomide 100 mg/day for consecutive 3 days followed by 0.5 mg/kg/day in divided dose was given in experimental group (n = 32) and intravenous cyclophosphamide 0.5 gm/m2 of body surface area monthly pulse was given in control group (n = 34). All study patients have received prednisolone and hydroxychloroquine according to KDIGO guideline then followed up monthly for 6 months. Outcomes were measured at 6th month by renal function [S. Creatinine, 24 hours urinary total protein (24-hr UTP)], changes in SELENA-SLEDAI score, anti-ds DNA level, serum complement levels (serum C3 & C4), remission (complete/partial) and adverse drug responses. Result: In experimental group, remission occurred in 18 (56.3%) patients and no remission in 14 (43.7%) patients. In control group, remission occurred in 24 (70.6%) patients and no remission in 10 (29.4%) patients. Adverse effects in experimental group were: elevated ALT (6.3%), hypertension (12.5%), infection (6.3%) and amenorrhea (12.5%). In control group, adverse effects were mainly leucopenia (5.9%), infection (17.7%) and amenorrhea (29.4%). Intergroup analysis for treatment responses and adverse effects showed no significant difference (p > 0.05). Concl

关键词： Cyclophosphamide Leflunomide Lupus Nephritis (LN) Systemic Lupus Erythematosus (SLE)

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不要被价格愚弄

新营销 2013年第12期15卷 17-17页

作者： rafi Mohammed

消费者喜欢优惠。对于我们中间的许多人，通常一个大幅度折扣就能触动他们的情感，迅速激起他们条件反射式的购买欲望。

关键词：价格购买欲望条件反射消费者

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品牌傲慢时代的终结

新营销 2012年第7期14卷 47-47页

作者： rafi Mohammed

现在营销者面临一个拐点，企业越来越难以操纵市场，取而代之的是强而有力的消费者声音主导市场一出现这些声音的主要平台是推特、Facebook等新兴的社交媒体。

关键词： Facebook 傲慢品牌操纵市场主导市场营销者消费者声音

A fatal case of Degos' disease which presented with recurrent intestinal perforation

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World Journal of Gastrointestinal Surgery 2011年第10期3卷 156-158页

作者： Mona Ahmadi Sevil Agabalaey rafi Zhale Faham Ramin Azhough Samad Beheshty Rooy Omid Rahmani Department of General Surgery and Pathology Imam Reza Hospital

Degos' disease,otherwise known as "malignant atrophic papulosis" is a rare vasculopathy with an unknown etiology characterized by typical cutaneous *** of the gastrointestinal(GI) tract is observed in approximately half of patients and small infarctions in the mucosa can cause perforation and resulting peritonitis,the leading cause of *** present a fatal case of Degos' disease with skin and GI involvement,manifesting as recurrent intestinal perforations and peritonitis,in a 15-year-old Iranian boy.

关键词： Degos’disease Malignant atrophic papulosis Small bowel perforation

Brazilin Content, Antioxidative and Lipase Inhibition Effects of Sappanwood （Caesa/pinia Sappan） from Indonesia

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Journal of Chemistry and Chemical Engineering 2010年第10期4卷 50-55页

作者： Irmanida Batubara Mohamad rafi Siti Sa＇diah M. Agung Zaim Susi lndariani Tohru Mitsunaga Department of Chemistry Faculty of Mathematics and Natural Sciences Bogor Agricultural University Darmaga Bogor 16880 Indonesia Biopharmaca Research Center Bogor Agricultural University Taman Kencana Bogor 16151 Indonesia Department of Applied Biological Science Faculty of Applied Biological Sciences Gifu University Gifu 501-1193 Japan

Climatic Changes and Their Effect on Wildlife of District Dir Lower, Khyber Pakhtunkhwa, Pakistan

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Journal of Atmospheric Science Research 2020年第4期3卷 38-43页

作者： Asad Ullah Sayyed Iftekhar Ahmad rafi Ullah Atta Ullah Khan Sikandar Khan Waheed Ullah Abdul Waris Department of Environmental Sciences Government Degree College Gulabad ChakdaraDir LowerPakistan Plant Ecology and Dendroecology Labartory Department of BotanyUniversity of MalakandPakistan Department of Biotechnology University of Malakand ChakdaraDir LowerPakistan Pakistan forest Institute University of PeshawarPakistan Department of Environmental Science COMSATS University IslamabadAbbotabad CampusPakistan Department of Biotechnology Quaid-i-Azam University IslamabadPakistan

Climatic changes and their impact are increasingly evident in Pakistan,especially in the mountainous regions. Mountain ecosystems are consideredto be sensitive indicators of global warming;even slight variationsin temperature can lead to significant shifts in local climate, which can,in turn, drastically affect the natural environment, subsequently alteringpeople’s lifestyle and wildlife habitats. The targeted area for the presentresearch was Lower Dir District, Pakistan. The study gathered the requiredinformation from primary and secondary sources. Secondary dataon temperature and precipitation were obtained from various sources,i.e., local CBO, including WWF Pakistan. Based on information gatheredon climate change and wildlife, a detailed questionnaire was *** showed that no regular pattern of the increase was found in temperaturefrom 2010 to 2018;the same was noticed in the rainfall decreasepattern. Results also showed that the leading causes behind climaticchanges are an increase in greenhouse gases due to pollution by industries,vehicles, crushing plants, deforestation, and some natural phenomenasuch as floods. The study showed that more than 80% of the respondentsagreed that climatic effects have a significant impact on wildlife, i.e.,the existence of wildlife falls in danger due to climatic changes as it maylead to habitat change, making it difficult for the survival and adaptationof the wildlife. Hence, in consequence, it leads to migration, low growthrate, an increase in morbidity and mortality rate, and finally leading to theextinction of the species or population. It is concluded from the study thatpeople are severely noticing the climatic change and its leading causesare greenhouse gases and deforestation. To control climatic changes andwildlife extinction, we need an appropriate policy for forest conservation,wildlife conservation, prevent hunting, industrial pollution control, vehiclepollution control, increase in plantation, awareness of

关键词： Climate change Wildlife Temperature Rainfall Lower Dir Pakistan