Background: Worldwide, diabetic nephropathy-DN is the leading cause of end-stage kidney disease-ESKD, DN is a common cause of renal failure with a reported frequency of 10% - 15% in type-2-diabetes-mellitus-T2DM patie...Background: Worldwide, diabetic nephropathy-DN is the leading cause of end-stage kidney disease-ESKD, DN is a common cause of renal failure with a reported frequency of 10% - 15% in type-2-diabetes-mellitus-T2DM patients, however there is a great discrepancy between countries. The aim of the pre-sent study is to evaluate the findings of kidney biopsies performed on diabetic patients. Materials and Methods: We studied native kidney histopathological findings in the period from January 2016 till end of December 2018 done for patients with T2DM with chronic kidney diseases-CKD. Results: A total of 82 DM-patients, 50 males (61%) and 32 females (39%) with age mean (95% CI) of 50.8 (47.1 - 55.2) years for all patients, ranged between 15 to 65 years. Histological findings showed that 57.3% of patients had DN. While focal-segmental-glomerulosclerosis-FSGS was present in 20.7%—primary in 8.6% and secondary in 12.1%. IgA represented 4.9%, while Lupus nephritis, Membranous and drug induced interstitial nephritis were each present in 3.7%. MCD was present in 2.4%. Lastly diffuse proliferative GN, ANCA associated glomerulonephritis, and hypertensive nephrosclerosis accounted for 1.2%. Conclusion: The prevalence of NDKD is remarkably frequent in DM patients who underwent kidney biopsy and FSGS was the most frequent diagnosis. To get a proper histopathological diagnosis, an adequate tissue biopsy is needed with an adequate number of glomeruli. There is a great need for more consideration to biopsy diabetic patients, as the finding of NDKD requires a different therapeutic approach. This, hopefully, will help to manage these patients better and therefore, ameliorate the progression to ESKD over time and therefore delay the need for RRT.展开更多
<strong>Background and objective:</strong> Nasal obstruction is the most frequent presentation to the otolaryngologist all over the world. Symptoms are multisystem involvement such as headache, epistaxis, ...<strong>Background and objective:</strong> Nasal obstruction is the most frequent presentation to the otolaryngologist all over the world. Symptoms are multisystem involvement such as headache, epistaxis, ophthalmological, otological, upper and lower respiratory tract infections;and many more. Septoplasty is commonly performed for nasal septal deviation as a primary indication of nasal airway obstruction. Physical examination, anterior rhinoscopy and nasal endoscopy are considered the gold standard for detecting septal deviation. Computed tomography (CT) can also be used to evaluate the nasal septum, anatomical variants and unveils the associated sinonasal diseases. This study aimed to find out the advantages of CT in endoscopic septoplasty for all out benefits to the patients. <strong>Patients and methods:</strong> 168 patients of nasal septal deviation were selected from 2015 to 2018 in the Bangladesh Medical and Popular Medical College Specialized Hospital. Age ranged between 10 years to 70 years of age. CT scanning in both coronal, axial and sagittal sections had been done in all patients after proper history taking, physical examination, anterior rhinoscopy and nasal endoscopy. Endoscopic septoplasty alone and/or other ancillary procedures were performed in all 168 patients under general anesthesia. <strong>Results:</strong> Amongst 168 patients, male was 116 (69%) and female was 52 (31%) with a ratio 2.2:1. Maximum 58 (35%) reported in 31 to 40 years and 48 (29%) was found in 21 to 31 years of age. Hypertrophied inferior turbinate (HIT) 54 (32%) and 48 (29%) concha bullosa (CB) were associated with 168 septal deviation. Associated pathologies like maxillary antral cyst 68 (40%) and maxillary sinusitis 62 (37%) were documented. <strong>Conclusion:</strong> CT scanning unveils the abnormal anatomic variants and associated sinonasal pathologies along with nasal septal deviation. Endoscopic septoplasty, correction of the anatomical variants and complete surgical clearance of the sinonasal pathologies can give t展开更多
文摘Background: Worldwide, diabetic nephropathy-DN is the leading cause of end-stage kidney disease-ESKD, DN is a common cause of renal failure with a reported frequency of 10% - 15% in type-2-diabetes-mellitus-T2DM patients, however there is a great discrepancy between countries. The aim of the pre-sent study is to evaluate the findings of kidney biopsies performed on diabetic patients. Materials and Methods: We studied native kidney histopathological findings in the period from January 2016 till end of December 2018 done for patients with T2DM with chronic kidney diseases-CKD. Results: A total of 82 DM-patients, 50 males (61%) and 32 females (39%) with age mean (95% CI) of 50.8 (47.1 - 55.2) years for all patients, ranged between 15 to 65 years. Histological findings showed that 57.3% of patients had DN. While focal-segmental-glomerulosclerosis-FSGS was present in 20.7%—primary in 8.6% and secondary in 12.1%. IgA represented 4.9%, while Lupus nephritis, Membranous and drug induced interstitial nephritis were each present in 3.7%. MCD was present in 2.4%. Lastly diffuse proliferative GN, ANCA associated glomerulonephritis, and hypertensive nephrosclerosis accounted for 1.2%. Conclusion: The prevalence of NDKD is remarkably frequent in DM patients who underwent kidney biopsy and FSGS was the most frequent diagnosis. To get a proper histopathological diagnosis, an adequate tissue biopsy is needed with an adequate number of glomeruli. There is a great need for more consideration to biopsy diabetic patients, as the finding of NDKD requires a different therapeutic approach. This, hopefully, will help to manage these patients better and therefore, ameliorate the progression to ESKD over time and therefore delay the need for RRT.
文摘<strong>Background and objective:</strong> Nasal obstruction is the most frequent presentation to the otolaryngologist all over the world. Symptoms are multisystem involvement such as headache, epistaxis, ophthalmological, otological, upper and lower respiratory tract infections;and many more. Septoplasty is commonly performed for nasal septal deviation as a primary indication of nasal airway obstruction. Physical examination, anterior rhinoscopy and nasal endoscopy are considered the gold standard for detecting septal deviation. Computed tomography (CT) can also be used to evaluate the nasal septum, anatomical variants and unveils the associated sinonasal diseases. This study aimed to find out the advantages of CT in endoscopic septoplasty for all out benefits to the patients. <strong>Patients and methods:</strong> 168 patients of nasal septal deviation were selected from 2015 to 2018 in the Bangladesh Medical and Popular Medical College Specialized Hospital. Age ranged between 10 years to 70 years of age. CT scanning in both coronal, axial and sagittal sections had been done in all patients after proper history taking, physical examination, anterior rhinoscopy and nasal endoscopy. Endoscopic septoplasty alone and/or other ancillary procedures were performed in all 168 patients under general anesthesia. <strong>Results:</strong> Amongst 168 patients, male was 116 (69%) and female was 52 (31%) with a ratio 2.2:1. Maximum 58 (35%) reported in 31 to 40 years and 48 (29%) was found in 21 to 31 years of age. Hypertrophied inferior turbinate (HIT) 54 (32%) and 48 (29%) concha bullosa (CB) were associated with 168 septal deviation. Associated pathologies like maxillary antral cyst 68 (40%) and maxillary sinusitis 62 (37%) were documented. <strong>Conclusion:</strong> CT scanning unveils the abnormal anatomic variants and associated sinonasal pathologies along with nasal septal deviation. Endoscopic septoplasty, correction of the anatomical variants and complete surgical clearance of the sinonasal pathologies can give t