BackgroundAltered regulation of the complement system is associated with multiple kidney diseases. CD35, CD55 and CD59 regulate the complement system, and changes in their expression have previously been linked with kidney disease. This study assessed whether changes in the expression levels of these proteins are associated specifically with chronic kidney disease (CKD) to understand its pathogenesis.Materials and methodsSixty CKD patients and 60 age-matched controls were enrolled and divided into two groups: Group I (n=30 pediatric patients and n=30 controls) and Group II (n=30 adult patients and n=30 controls). The expression of CD35, CD55 and CD59 on peripheral blood cells was evaluated by flow cytometry as the proportion of positive cells expressing the marker and mean fluorescence intensity (MFI), also the relation of these markers to the stage of CKD was also evaluated.ResultsPediatric and adult CKD patients had significantly lower proportion of erythrocytes expressing CD35, CD55 and CD59 than healthy controls (P<0.001). In pediatric CKD patients, there was no significant difference in the three studied markers on neutrophils, lymphocytes and monocytes. The changes in expression of CD35, CD55 and CD59 on leukocytes were more pronounced in adult patients, who had lower proportion of CD59-positive neutrophils, CD35- and CD59-positive lymphocytes, and CD59-positive monocytes, as well as lower expression of CD59 on neutrophils and monocytes than adult controls (P<0.001, P=0.019, P<0.001, P=0.026, P<0.001 and P=0.003, respectively). The eGFR directly correlated with the proportion of positivity of some of those markers on peripheral leukocytes while there was inverse correlation between the disease stage and the same markers.ConclusionThere are alterations in the patterns of expression of complement regulatory proteins CD35, CD55 and CD59 on peripheral blood cells of patients with CKD compared with healthy controls.

Smallholding farms spread throughout the world, and they consider the cornerstone of agriculture production in Africa and Asia. Smallholder farms produce over 80 % of the food used in most of the developing countries. However, smallholder farmers face many problems, including the lack of appropriate mechanization (AM), labor shortage, increase wages, climate change, and poor access to modern inputs, credit, and markets. The paper focuses on analyzing and proposing the criteria to select and design AM for smallholder farmers through the linkage between farm size, machine scale, and productivity. The machine designers and manufacturers should take some environmental and social implications and machinery support services into consideration to deliver AM to smallholder. The adoption of AM with appropriate planting systems such as CA will ensure sustainability in the production of smallholder farmers. The adherence to these standards with overcoming smallholding challenges will lead to growth and sustainability for smallholder farmers.

Purpose To investigate the multifactorial effects of chronic kidney disease (CKD) and hemodialysis (HD) on subjects’ voices by examining correlations between laboratory investigations, respiratory function, and acoustic voice parameters. Methods This case–control study was conducted on 60 participants aged 18−50 years, divided equally into three groups: controls (no health problems or voice disorders), cCKD (stage 3–5, no HD HD]), HD, and CKD stage 5. The study took 21 months. All participants underwent general and otolaryngological examinations, followed by laboratory investigations (hemoglobin, uric acid, HCO 3 , estimated glomerular filtration rate, urea, urea-reduction ratio, and creatinine), respiratory function tests, and acoustic voice analysis. Results There were significant differences between the control and HD groups for jitter, shimmer, and harmonic:noise (HNR) ratio ( P =0 and between the control and CKD groups for shimmer and HNR ( P =0), with no significant difference between HD and CKD. There were statistically significant correlations between duration of HD and HNR, jitter percentage, and shimmer percentage ( P =0. Conclusion Systemic effects of CKD and HD were found to impair the acoustic characteristics of voice in both groups. Regression analysis revealed that hemoglobin, uric acid, and expiratory time were the most significant predictors of impaired acoustic characteristics.

Background: Optimizing volume status of hemodialysis patients is an important clinical challenge because volume expansion is a critical deadly complication of chronic kidney disease. The use of thoracic ultrasound to detect cases of volume overload and depletion has gained great attention by several studies that are because of its advantage as a rapid, available, non-invasive and free of radiation imaging method. Aim: To evaluate the usefulness of thoracic ultrasound for the assessment of extravascular lung water and intravascular volume in hemodialysis patients. Patients and Methods: This prospective observational study was conducted on 30 patients on regular hemodialysis. Assessment of extravascular lung water (EVLW) by number of B -lines, and intravascular volume by measurement of inferior vena cava (IVC) diameter and collapsibility index, was done pre-and post-dialysis. Results: There was statistically highly significant reduction in number of B-lines and highly significant decrease of IVC minimum and maximum diameters post-dialysis (P value < 0.001). There was also highly significant increase in IVC collapse index following hemodialysis (P value < 0.001). Conclusion:Lung ultrasound is a useful method for the assessment of both EVLW and intravascular volume. EVLW as represented by B-lines number was highly significantly reduced post-hemodialysis. Intravascular volume assessed by IVC ultrasound was improved by 53% following hemodialysis.