Systemic Lupus Erythematosus (SLE) is an autoimmune chronic inflammatory disease which affects multiple organs of the body. Lupus nephritis is one of the serious complications of SLE and it is the predictor of poor outcome. The incidence of Lupus Nephritis (LN) in patients with SLE is quite common. In SLE, females outnumber males. While in Lupus nephritis both genders are equally affected. Circulating Immune complexes and in situ formation in Glomeruli will lead to pathogenesis in LN. Clinical presentations in LN range from asymptomatic haematoproteinuria on urine analysis with normal renal function to nephritic and/or nephrotic syndrome and Rapidly progressive glomerulonephritis with renal failure and hypertension. Screening panels including noninvasive work like urine analysis, biochemical and autoimmune profile necessitating invasive approach by doing kidney biopsy. Autoantibodies production are hallmarks of SLE.The firm diagnosis of LN cannot be made in the absence of Antinuclear antibodies.Antibodies against dsDNA is more specific but are less sensitive. SM antibodies are strongly associated with Lupus. C1q is more related to Lupus activity. Classification of Lupus Nephritis is classified into VI classes based on kidney biopsy revised by International Society of Nephrology. Not all Kidney disease with LN need to be treated aggressively with immunosuppression. Class III and class IV need to be treated aggressively. While, class II, chronic changes with little active inflammation do not. Moreover, not all kidney diseases in lupus is lupus Nephritis few cases with lupus nephritis have other glomerular disease most commonly Minimal change disease and Focal segmental glomerulosclerosis Therefore, kidney biopsy is vital not only for diagnosis, it also help to determine the treatment modality along with the prognosis. In general, patients with class I and class II LN need no therapy other than extra renal therapy. Treatment of severe active Lupus Nephritis is separated into an induction phase to induce remission and maintenance phase. Based on clinical trials the therapeutic options available are steroid, Cyclophosphamide and Mycophenolate mofetil. The decision of therapy is based on patient choice, available facilities, consideration of side effect profile and monitoring facilities. Lupus nephritis needs long term surveillance with consideration of socioeconomic and pharmacogenetics aspects of disease and treatment related complication.

Background: Bed sore (BS) (also known as pressure sore (Ps) , pressure injury (PI), decubitus ulcer(du), pressure ulcer (Pu), defined as an area of localized damage to the skin and underling tissue caused by pressure. (1). PU leads to ischemia, cell death and tissue necrosis, capillaries are compressed and the blood flow is restricted, the cutaneous tissue became broken or destroyed, leading to progressive destruction and necrosis of underling soft tissues.

Objective: To assess prevalence of bed sore and its associated factors among hospitalized patients in medical and surgical wards at yekatit 12 hospital medical college, Addis Ababa ,Ethiopia 2018.

Method: Institution-based, cross-sectional quantitative study design was conducted on a representative sample of 94 hospitalized patients in the study area from March15, 2018 to May 13, 2018

Result: A total of 7 beds sore were detected from 226 patients, with the prevalence rate of 3.0%. Majority of respondent 6 (2.65%) developed bed sore who came from the urban area and 3(1.32%) patients developed ulcer was not educated, and participants who had been very poor in nutrition was 2(0.88%) patients

Conclusion and recommendation: Prevalence of the pressure ulcer was low among hospitalized patients in this study, age, bedridden, position change, moisture, and nutrition were significant associated with the prevalence of pressure ulcer so the prevalence of pressure ulcer was low because the patients and health care professionals have knowledge about bed sore and they practiced it. Key words: bed sore, prevalence and associated factors.

Episodic macroscopic hematuria is the hallmark clinical feature of IgA nephropathy. Visible hematuria is often synpharyngitic meaning it occurs concurrently with an infection often of the upper respiratory tract. COVID 19 is well documented now to be associated with acute kidney injury and also with glomerulonephritis particularly collapsing FSGS. We here describe a case of a young male who developed gross hematuria and fever. He had no flank pain, weight loss or palpable abdominal swelling. Workup was suggestive of COVID19 positivity and hematuria was glomerular on microscopic examination. During workup he developed facial puffiness and leg swelling and noticed decreased urine output. His creatinine shot upto to 2.5mg/dl from a baseline of 0.8 mg/dl 15 days back. USG showed normal sized kidneys, normal cortico-medullary differentiation with no obstruction. Serological workup was negative for hypocomplementemia, ANA, ANCA(pr3 and mpo), anti GBM antibodies. Biopsy done was suggestive of crescentric IgA nephropathy, HAAS class4 and OXFORD MEST- M0E0S0T0 C2. He had history of NSAID intake and severe myalgias but workup was negative to substantiate contribution of these etiologies. There was recent case series from UK suggesting possible role of COVID19 and increased prevalence of anti-GBM disease. We here propose possible role of COVID 19 in triggering the IgA crescentric glomerulonephritis.

Chronic kidney disease (CKD) is a global public health concern attracting international attention due to the rapid spread. However, CKD of unknown etiology is also prevalent and creates rapid progress in certain regions of the world, particularly in Africa, Central America, and Asia. An intimate relationship between the quality of the water, soil, and food and the underlying geology has been recorded repeatedly in different geographical regions of the world. Many risk factors are hypothesized for prevailing CKDu, such as unidentified environmental toxins, chronic pesticide exposure, increased levels of nephrotoxic heavy metals in water and soil, high fluoride levels, and potential impacts of AlFx on soil and water, and growth of cyanobacteria in water resources. Our investigation's overall intention is to risk assessment of drinking water, agricultural soil, rice (Oryza sativa), and fish species (Etroplus suratensis) by evaluating the toxic metal contents in CKDu endemic areas in Sri Lanka. Further, findings were compared with a CKDu non-endemic area to grab better clarifications. With the Ministry of Health's aid in Sri Lanka, CKDu hotspots have been identified for the sampling process. An adequate number of drinking water, paddy soil, rice, and fish samples were collected in a dry season (August 2019). As CKDu hotspots, Eppawala GN (Grama Niladhari) division, Medirigiriya GN division, Giradurukotte GN division were selected, and Dambethalawa division was selected as the reference site in Sri Lanka. Results depict that, Mean concentrations of heavy metals/metalloids such as Mn, Co, As, Cd, Pb, Cu, Zn, Fe in drinking water of selected CKDu endemic areas were far below Sri Lankan water quality standards. Besides, all sampling locations dropped below the medium range of the Heavy Metal Pollution Index of water (HPI 15 – 40). Geo accumulation indexes (Igeo) of paddy soil reveal that agricultural soil in selected CKDu endemic areas is moderately polluted with toxic metals/metalloids such as As, Pb, Cu, Ni, and Cr, Zn, and Cd. However, the concentrations of Cr (p=0.44), As (p=0.36), and Cd(p=0.37) of paddy soil in CKDu hotspots were significantly higher than the reference. Among the trace metals analyzed in rice grains in the CKDu endemic areas, mean Cr, Cd, As, and Pb contents were recorded as 0.342 mg/kg, 0.011 mg/kg, 0.035 mg/kg, 0.112 mg/kg, respectively. The mean concentrations of Cd, Pb, As, and Cr in Etroplus suratensis were 84.31, 45.20, 206.85, and 115.62 μg/kg, respectively, in the Ulhitiya reservoir (in CKDu endemic area). But significantly lower Cd levels contents were observed in the CKDu hotspot than the reservoir in the reference area. Application of fertilizers that contained high doses of toxic metals could be the driving force for the agricultural soil pollution with heavy metals and long term exposure to the toxic metals via drinking water and frequently consumed foods may generate a risk for kidney tissue damage.

Prolonged exposure to some materials used by artisans has been reported to be harmful to health. However, there is a lack of information regarding their associations with functional biomarkers among artisans in Jos. To establish this, we collected urine and blood samples from 400 artisans and 200 age-matched non-artisan control group. Urinary microalbumin, heavy metals and some haematological variables were analysed using standard methods and haematology autoanalyser (MYTHIC 22 CT) respectively. Data were analysed using Statistical Package for Social Sciences (SPSS) version 23 and student t-test was used to compare mean values between the control and study groups. We reported significant differences in average values of MCV, per cent monocytes & neutrophils, total WBC counts, ESR and platelet counts among welders, petrol hawkers, and battery repairers compared to the control group. Significantly higher PTT and PTTK average values were observed among test subjects (24.23±2.45, 42.45±9.79) when compared to the control group (18.97±3.26, 35.05±15.61) respectively (p=0.00). Also, urinary microalbumin levels were significantly higher (P<0.05) among petrol hawkers (16.11±15.63), car painters (13.10±5.00) compared to the control (5.10±4.97). Our study revealed significantly (P<0.05) high levels of WBC, Monocytes, Neutrophils, ESR, Platelets, and Microalbumin among welders, car spray workers, battery repairers and petrol hawkers in Jos when compared to control. Data suggest a high probability of abnormal coagulation and susceptibility to metabolic diseases such as Diabetes mellitus, atherosclerosis among others in the test population.

Keywords: Artisans, Haematological variables, Urinary Microalbumin, and Heavy Metals

The effect of turmeric rhizome powder (Curcuma longa) on water-mineral balance, morphological structure, and kidney functions was studied in experiments on rats with an alloxan-induced model of type 1 diabetes mellitus. Three groups of animals were studied: control ones (C) and diabetic rats: on standard diet (D) and animals, which got Curcuma longa at the amount of 2% of the food mass (D+Cl). It was found that in diabetic rats the plasma sodium and potassium concentrations did not change, while urea concentration (from 18.2±1.6 to 29.5±3.2 mmol/L) and creatinine level (from 0.8±0.01 to 1.4±0.08 mmol/L) significantly increased compared to similar parameters of healthy animals (C). The other plasma parameters between diabetic animals on a standard feed (D) and the rats, consuming turmeric (D+Cl), did not differ. The study of the basal hydro- and ionouretic renal function in diabetic rats did not reveal a significant increase in urine output in the experimental groups. Glomerular filtration rate and level of tubular reabsorption did not significantly differ between groups as well as the fractional potassium (22.2±4.9 and 27.3±3.0 %) and sodium (0.4±0.11 0.6±0.09%) excretion. But in rats with DM the characteristic damage of renal tissue consisting in occurrence of protein, fibers, collagen, sulfatic glycosaminoglycans and a sclerosis of nephritic little bodies between leafs of Shumljansky-Boumen’ capsule was marked. The use of turmeric optimized the morphological processes in the kidney of animals with diabetes mellitus and reduced structural damage in the renal bodies. These results of morphohistochemical and functional analysis of kidneys suggest that the consumption of turmeric by animals with diabetes reduces the level of structural disorders in the nephrons, but does not cause significant changes in kidney functions in conditions of spontaneous urination.