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Dsylipidemia is considered as a significant risk factor for progressive renal dysfunction in diabetic patients. Present study was designed with intent to compare two different statin agents with moderate dose intensity in preventing the progression of kidney dysfunction in diabetic patients among local population. Objective: To assess comparative effects of atorvastatin and rosuvastatin on renal functions in diabetic patients presenting to Pakistan Institute of Medical Sciences, Islamabad. Randomized controlled trial spanned at Six months (08-05-2018 to 07-11-2018) at Department of Nephrology and Internal Medicine, PIMS, Islamabad. Subjects and Methods: A total of one hundred and fifty six (n=156) diagnosed patients of diabetes mellitus with GFR >60 ml/min/1.73 m2 requiring statin treatment were enrolled in the present study. All the patients were randomly assigned to two groups by lottery method. Group A was given atorvastatin 10-20 mg/day and group B was given rosuvastatin 5-10 mg/day. The GFR was calculated using 24 hour urinary creatinine clearance at baseline and at six months after initiation of therapy. The study outcome was determined in terms of change in GFR values at six months in both groups. Treatment was considered efficacious if the decline in GFR at six months after therapy was <2% from baseline Results: Demographic features were similar in both groups. There were 65.4% (n=51/78) males and 34.6% (n=27/78) females in group A and there were 62.8% (n=49/78) males and 37.2% (n=29/78) females in group B. In group A, mean age was 40.8 years ± 7.6 SD, mean height was 1.6 m ± 0.06 SD, mean weight was 73.4 Kg ± 10.4 SD and mean BMI was 27.1 Kg/m² ± 4.2 SD. In group B, mean age was 41.2 years ± 7.2 SD, mean height was 1.7 m ± 0.06 SD, mean weight was 73.6 Kg ± 9.4 SD and mean BMI was 26.1 Kg/m² ± 4.1 SD. (p>0.05 in all cases). In group A, mean TG was 167.5 mg/dL ± 3.5 SD, mean total cholesterol was 219.1mg/dL ± 11.2 SD, mean HDL-C was 44.5 mg/dL ± 3.5 SD and LDL-C was 137.1 mg/dL ± 3.4 SD. In group B, mean TG was 166.5 mg/dL ± 4.5 SD, mean total cholesterol was 217.8 mg/dL ± 9.4 SD, mean HDL-C was 44.8 mg/dL ± 2.9 SD and LDL-C was 138.6 mg/dL ± 5.5 SD (p>0.05 in all cases). In group A, mean Hb was 12.9 g/dL ± 2.3 SD, mean HbA1c was 8.7% ± 0.94 SD, mean serum creatinine was 1.24 mg/dL ± 0.15 SD and mean GFR was 77.1 ml/min ± 10.9 SD. In group B, mean Hb was 13.4 g/dL ± 1.7 SD, mean HbA1c was 8.6% ± 1.02 SD, mean serum creatinine was 1.28 mg/dL ± 0.13 SD and mean GFR was 74.3 ml/min ± 10.4 SD. (p>0.05 in all cases). Six months after start of treatment lipid profile showed significant reductions in TG, total cholesterol and LDL-C in group A (Atrovastatin) when compared with group B (Rosuvastatin). Mean TG was 143.5 mg/dL ± 2.9 SD, versus 145.9 mg/dL ± 3.9 SD (P=0.001), mean total cholesterol was 187.7/dL ± 9.6 SD versus 190.9 mg/dL ± 8.2 SD (P=0.025) and mean LDL-C was 113.3 mg/dL ± 2.8 SD versus 117.3 mg/dL ± 4.6 SD (p=0.001) in group A and B respectively. Decline in GFR and mean percent change in GFR was significantly lower in group A (Atrovastatin) when compared with group B (Rosuvastatin). Mean GFR was 75.7 ml/min ± 10.8 SD, versus 72.7 ml/min ± 10.5 SD (P=0.007) and mean percent change in GFR was 1.81% ± 1.03 SD versus 2.27 ml/min ± 1.07 SD (P=0.004) in group A and B respectively. Efficacy was present in 52.6% (n=41/78) patients in atrovastatin group compared to 33.3% (n=26/78) in Rosuvastatin group (P=0.015). Efficacy data were further stratified with respect to gender, age, BMI and glycemic control. Efficacy of treatment was better in non obese patients with adequate glycemic control (P<0.05). Conclusions: Treatment with Atrovastatin resulted in significant improvement in lipid profile at six months after treatment when compared with Rosuvastatin. Mean decline in GFR at six months after therapy was significantly lesser with Atrovastatin compared with Rosuvastatin. Efficacy (<2% decline in GFR from baseline at six months after therapy) was significantly better with treatment with Atrovastatin compared to Rosuvastatin. Treatment response was better in non obese patients with adequate glycemic control. [ABSTRACT FROM AUTHOR]

Background: Diabetic kidney disease (DKD) may cause renal failure, in up to 26% of the patients who are undergoing dialysis for kidney disease. The gene transmission process is not completely understood but it is supposed to be polygenic mechanism and expresses itself in preferable environment suggesting gene-environment interaction. Genome wide-association (GWAS) studies have provided mixed results about gene expression. Methodology: A case-control study methodology was be implemented in this study. 1050 patients of diabetes mellitus type 2 (DMT2) were selected from Pakistan Institute of Medical Sciences PIMS, department of medicine. The cases were divided into two groups of early and advanced DKD (albuminuria 30-299mg/24h and ≥300mg/24h respectively). There were 370 controls, 352 cases with early DKD and 328 cases with advanced DKD. DNA was isolated from peripheral blood and FRMD3 expression in kidney tissue samples was studies through kidney biopsy samples. Results: Among all types of SNPs one was significantly associated with the particular disease and that was rs1888747, rs10868025 did not show any association on statistical analysis. The associations were observed in recessive models. To perform regression, the model wars adjusted for diabetes typeII duration, gender of the patient, BP readings and lipid file, the association still persisted. None of the other NSPs were found associated with this disease Conclusion: The FRMD3 protein expression negatively correlates with FRMD3 genes, so it is good candidate gene for the development of albuminuria. Further exploration is suggested to determine the exact mechanisms for correlation. [ABSTRACT FROM AUTHOR]

Chronic kidney disease is defined as kidney damage for more than 3 months, as defined by structural and functional abnormalities of the kidney with or without decreased GFR, manifested by either, Pathological abnormalities; or makers of kidney damage, including abnormalities in the composition of the blood or urine, abnormalities in imaging testing. GFR < 60ml/min/1.73 m2 for > 3 months, with or without kidney damage is also described as CKD Anxiety is an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure. Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Diabetes and high blood pressure, or hypertension, are responsible for two-thirds of chronic kidney disease cases. There are a few other conditions or circumstances that can cause kidney disease. Glomerulonephritis, autoimmune diseases and other causes: Obstructions caused by kidney stones or tumors can cause kidney damage. An enlarged prostate gland in men or repeated urinary infections can also cause kidney damage. Risk factors are diabetes, high blood pressure, family history of kidney failure, old age and ethnic groups, such as African Americans, Hispanic Americans, Asian, Pacific Islanders, and American Indians. Most people may not have any severe symptoms until their kidney disease is advanced. However, patient may feel more tired and have less energy, trouble in concentrating, a poor appetite and troubled sleep, muscle cramps at night, swollen feet and ankles, puffiness around eyes, especially in the morning, dry, itchy skin. Patient may need to urinate more often, especially at night. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has seriously influenced all over the world and affectedthe health of people. In COVID-19 patients, physiological disorders develop like stress, anxiety, and insomnia. This study aimed to investigate sleep quality in COVID19hospitalized patients of Muzaffarabad, Azad Jammu, and Kashmir. Pittsburg Sleep Quality Index (PSQI) was used to measure sleep quality. PSQI was a self-rated questionnaire scale that contained seven components generated by the combination of 19 individual items. The components included were subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication and, daytime dysfunction. All components score from “0” to “3”. The score “0” indicates no problem and the sum of the score 3 indicates severe difficulty. The seven components score was added to yield one global score. A score of 0 to 5 indicated no sleep disturbance and a score of more than 5 indicated sleep disturbance. The mean global score was 8.88±4.716 (Mean±SD). Current research revealed that 72.2% (n=73) ofpatients who had a global score of 5 or more than 5 had poor sleep quality and 27.8% (n=31) who had a score of less than 5 had good sleep quality (n=31) 13 male patients hada good quality of sleep and 36 male patients experienced a bad quality of sleep. In females, 18 female patients had a good quality of sleep and 37 female patients had a bad quality of sleep current study revealed that there was no association between gender and global PSQI, so sleep quality is independent of gender (χ² =6.497, P =0.090, df = 3). Thisstudy also showed association between PSQI global score and age group. The 1st age group 15-32 year had a total of 48 patients. The study revealed that 54.16% (n=26) patients had bad sleep quality and 45.83% (n=22) patients had good sleep quality. The second age group from 33 to 55 years in which 76% (n=19) patients had bad sleep quality and 24% (n=06) patients had good sleep quality (r=0.342, P=0.001, df=6) showed that there is high relationship difference between increase group and sleep quality which showed that increase in age group, sleep quality become bad. The 3rd age group was over. [ABSTRACT FROM AUTHOR]

Background: Various factors lead to hypovitaminosis (decreased vitamin D levels in serum/blood), in general population, sunlight being one of the major factors. Doctors and staff nurses are particularly at risk due to long working hours indoors, which deprives them of adequate Ultraviolet light exposure Methods: It was a prospective descriptive cross sectional study conducted at Ziauddin University Hospital, Keamari campus, from August 2018 to July 2019. The objective of this study was to determine the status of vitamin D deficiency among doctors and staff nurses working at Ziauddin University Hospital. All those doctors and staff nurses were included in the study, who were already advised by physicians to get serum vitamin D levels done for their symptoms. Results: A total sample of 118 was collected. 56 doctors and 62 staff nurses participated in the survey. 85 out of 118 (72%) subjects were either deficient or insufficient of vitamin D. Conclusion: Even though doctors and nurses are considered to have better understanding of vitamin D deficiency symptoms and morbidity it causes; still this study found out that majority of the healthcare providers working at Ziauddin hospital were deficient of this vitamin. [ABSTRACT FROM AUTHOR]