METHODS: A retrospective review of medical records was done to investigate the demographic variables, and biochemical and histological changes in children with INS aged 12 months to 18 years between 2001 and 2016 at Hospital Universiti Sains Malaysia. The median renal survival time for progression to CKD stage III or higher was determined using survival curve analysis. Multiple Cox regression analysis was used to identify predictive factors for CKD.

RESULTS: The total number of participants was 112 (boys: n = 71; girls: n = 41) and a majority had steroid-sensitive INS. Only about 10% of INS progressed to CKD Stage III or higher, with an overall median renal survival time of 19 years. Median renal survival time in steroid-resistant nephrotic syndrome (SRNS) was 13 years. Focal segmental glomerulosclerosis was predominant in SRNS. The predictors of progression to CKD were steroid resistance (adjusted hazard ratio [HR] [95% confidence interval (CI)] 23.8 [2.8-200.9]) and the presence of hypertension at presentation (adjusted HR [95% CI] 8.1 [1.2-55.7]).

METHODS: Studies of adult patients with biopsy-proven SDNS/FRNS, administered any immunosuppressive agents and reported complete remission results as one of the clinical outcomes were included. Articles were independently screened by two researchers. ROBINS-I was used for risk of bias assessment. Random-effects model was used for statistical analysis and corresponding 95% confidence intervals (CIs) were calculated.

RESULTS: 574 patients across 28 studies were included in the analysis. Patients receiving rituximab have a complete remission rate of 89% (95% CI = 83% to 94%; τ2 = 0.0070; I2 = 62%; overall p < 0.01, low certainty) and adverse event rate of 0.26, cyclosporine (CR 40%; 95% CI = 21% to 59%; τ2 = 0.0205; I2 = 55%; overall p = 0.08, low certainty), tacrolimus (CR 84%; 95% CI = 70% to 98%; τ2 = 0.0060; I2 = 33%; overall p = 0.21, moderate certainty), mycophenolate mofetil (CR 82%; 95% CI = 74% to 90%; τ2 < 0.0001; I2 = 15%; overall p = 0.32, moderate certainty) and cyclophosphamide (CR 79%; 95% CI = 69% to 89%; τ2 = 0; I2 = 0%; overall p = 0.52, moderate certainty).

METHODS: A self-administered standard questionnaire was distributed to parents of children attending the Paediatric Asthma Clinic. All these children required inhaled steroids for treatment.

RESULTS: One-hundred and twelve of 170 parents (66%) surveyed were concerned with inhaled therapy. The most common concern with its use was medication side effects (91%), followed by 'inhaler dependency' (86%), cost of the inhaler (34%) and difficulty in using the inhaler (15%). Parental perception that the oral route was superior to the inhaled route, preference for the oral route for asthma prophylaxis and a higher steroid dose required for prophylaxis were more likely to be associated with concerns towards inhaled therapy. More importantly, these children were also more likely to miss > 25% of their prescribed doses of inhaled steroids (46 vs 22% in the group concerned about inhaled therapy compared with the group that was not concerned, respectively; P = 0.007) and had a higher mean number of nebulization treatments in the last year (3.2 +/- 2.9 vs 1.8 +/- 1.3 in the group concerned about inhaled therapy compared with the group that was not concerned, respectively; P = 0.01).

METHODOLOGY/PRINCIPAL FINDING: Rats were divided into 8 groups. The negative control and ethanol control groups were administered Tween 20 (10%v/v) orally. The reference control group, 20 mg/kg omeprazole (10% Tween 20, 5 mL/kg), was administrated orally. The experimental groups received 1, 5, 10, 15 or 20 mg/kg of the AMDCP compound (10% Tween 20, 5 mL/kg). After 60 min, Tween 20 and absolute ethanol was given orally (5 mL/kg) to the negative control group and to the rest of the groups, and the rats were sacrificed an hour later. The acidity of gastric content, gastric wall mucus and areas of mucosal lesions were assessed. In addition, histology and immunohistochemistry of the gastric wall were assessed. Prostaglandin E2 (PGE2) and malondialdehyde (MDA) content were also measured. The ethanol control group exhibited severe mucosal lesion compared with the experimental groups with fewer mucosal lesions along with a reduction of edema and leukocyte infiltration. Immunohistochemical staining of Hsp70 and Bax proteins showed over-expression and under-expression, respectively, in the experimental groups. The experimental groups also exhibited high levels of PGE2 as well as a reduced amount of MDA. AMDCP decreased the acidity and lipid peroxidation and increased the levels of antioxidant enzymes.

TECHNIQUE: Under fluoroscopy, needle entry site and pathway are drawn according to the spinal anatomy. The needle is advanced toward the lateral recess and the needle tip is placed medially to the medial border of the pedicle under anteroposterior view and posteriorly to the posterior border of the upper endplate under lateral view. After checking optimal contrast spread, steroids and local anesthetics are injected.

CASE ILLUSTRATION: An 86-year-old woman who suffered from lower back pain with radiculopathy received interventional treatment. Comparing the "traditional" supraneural approach with the FLLR approach, the difference in contrast enhancement to lateral recess is clearly shown.

DISCUSSION: Compared to the pre-existing approaches, the FLLR approach may provide better ventral epidural and lateral recess enhancement. Furthermore, with the advanced needle tip, the injectate may enhance not only the at-level nerve root but also the nerve root of adjacent level during their existence in a single injection. With blunt needle usage, no nerve root injury or dura puncture was noted so far.

OBJECTIVE: The authors aimed to compare the rate of vascular complications and outcomes between patients with and without CS use after TAVR.

METHODS: The authors conducted a comprehensive literature search in PubMed, Embase, and Cochrane databases from their inception until 18th April 2022 for relevant studies. Endpoints were described according to Valve Academic Research Consortium-2 definitions. Effect sizes were pooled using DerSimonian and Laird random-effects model as risk ratio (RR) with 95% CI.

RESULTS: Five studies with 6136 patients undergoing TAVR were included in the analysis. The included studies were published between 2015 and 2022. The mean ages of patients in both study groups were similar, with the CS group averaging 80 years and the nonsteroid group averaging 82 years. Notably, a higher proportion of patients in the CS group were female (56%) compared to the nonsteroid group (54%). CS use was associated with a significantly higher risk of major vascular complications (12.5 vs. 6.7%, RR 2.32, 95% CI: 1.73-3.11, P <0.001), major bleeding (16.8 vs. 13.1%, RR 1.61, 95% CI: 1.27-2.05, P <0.001), and aortic annulus rupture (2.3 vs. 0.6%, RR 4.66, 95% CI: 1.67-13.01, P <0.001). There was no significant difference in terms of minor vascular complications (RR 1.43, 95% CI: 1.00-2.04, P =0.05), in-hospital mortality (2.3 vs. 1.4%, RR 1.86, 95% CI: 0.74-4.70, P =0.19), and 30-day mortality (2.9 vs. 3.1%, RR 1.14, 95% CI: 0.53-2.46, P =0.74) between both groups.

Materials and Methods: Fresh aerial parts of four plant species (Artemisia herba alba, Cotula cinerea, Asphodelus tenuifolius, and Euphorbia guyoniana) were collected for the preparation of aqueous extracts. Two levels of dilution (10% and 20%) of the pure extracts were evaluated against Fusarium graminearum and Fusarium sporotrichioides.

Results: The results of this study revealed that the A. herba alba, C. cinerea, A. tenuifolius, and E. guyoniana aqueous extracts are effective at both concentrations of 10% and 20% for the Fusarium mycelia growth inhibition. In particular, A. tenuifolius extract is effective against F. graminearum, whereas F. sporotrichioides mycelium growth is strongly affected by the E. guyoniana 20% extract. The phytochemical characterization of the compositions of the aqueous extracts has revealed that the presence of some chemical compounds (tannins, flavonoids, saponins, steroids, and alkaloids) is likely to be responsible for the antifungal activities sought.