Glomerulonephritis: How to Diagnose and Prevent It at Various Levels

Glomerulonephritis is an inflammation of the glomeruli in the kidney. The glomeruli is constellation of small blood vessels in the kidney that act as a filter to remove excess fluid, electrolytes and nitrogenous wastes from the blood into the urine.

It is divided into:

Acute Glomerulonephritis- The symptoms develop suddenly.

Chronic Glomerulonephritis- The symptoms develop gradually.

In glomerulonephritis, the glomeruli lose their filtering capacity thus blood proteins and red cells are excreted in the urine in various quantities depending on the severity of the glomerular damage.

DIAGNOSIS OF GLOMERULONEPHRITIS
Accurate diagnosis is essential in the successful treatment of glomerulonephritis.

Diagnosis is highly dependent on the clarity of symptoms, examination and investigation findings.

SYMPTOMS
· Passage of coca-colored urine due to the presence of red blood cells in the urine. This is called haematuria.

· Passage of foamy urine due to excess amount of proteins in the urine. This is called proteinuria.

· Presence of peri-orbital and ankle swelling.

EXAMINATION FINDINGS
· Peri-orbital and pedal edema.

· Elevated blood pressure.

INVESTIGATIONS
· Urinalysis-This reveals diagnostic findings such as red blood cells, casts, white blood cells and proteins in the urine.

· Blood test- Blood level of electrolytes, urea and creatinine. This is mainly done to assess the extent of kidney damage.

· Radiological imaging tests-This is done usually when the blood tests suggest some level of kidney damage. E.g Renal scan or abdominal CT scan is done.

· Kidney biopsy- This entails using a clinical procedure to extract some pieces of kidney tissues for microscopic examination. This is the only test that confirms glomerulonephritis.

TREATMENT
This is based on the following principles:

· Treat underlying health conditions quickly.

· Use of corticosteroids to reduce the degree of inflammation and immunological responses.

· Dialysis- This is used for individuals with acute kidney injury or kidney failure.

· Anti-hypertensives such as ACEI, ARBs- This is used to control hypertension in some selected individuals.

PREVENTION STRATEGIES
There are 3 levels of prevention namely: primary, secondary and tertiary.

PRIMARY PREVENTION
The aim of this is to prevent the onset of glomerulonephritis.

It entails the following

· Throat swab should be done for suspected bacteria cause of sore throat. If streptococcus is suspected, oral penicillin should be commenced as soon as possible.

· Prompt treatment of individuals with bacteria endocarditis.

SECONDARY PREVENTION
This involves early diagnosis and prompt treatment of glomerulonephritis.

It specifically entails the following:

· Routine urinalysis to be done periodically for individuals at risk of streptococci infections and for individuals greater than 40 years.

· Periodic monitoring of blood urea and creatinine levels should be done for individuals with compromised kidney function.

TERTIARY PREVENTION
This involves activities and interventions put in place for individuals with glomerulonephritis from developing complications such as kidney failure and to reduce the disease progression.

· Optimal control of co-morbidities like hypertension and diabetes mellitus.

· Reduce intake of high protein diet.

· Restrict salt intake.

· Cessation of smoking.

· Regular clinic follow up by a Nephrologist.

Finally, glomerulonephritis is a very lethal kidney disease of which the onset and progression can be prevented if an individual adheres to the activities in the various levels of prevention highlighted above.

Analysis to Next Generation Sequencing Technology

With the development of science, traditional Sanger sequencing has failed to meet new requirements of low cost, high throughput and fast in speed.

Recent years, with the discovery and promotion of second-generation sequencing technology, the gene sequencing speed has increased greatly while achieving a substantial decline in costs, making large-scale application of genome sequencing possible. Now, the cost of personal whole genome sequencing is about 5,000$, and is expected to decreased to less than $ 1,000 in the next few years.

The rapid development of sequencing technology will promote the massive accumulation of DNA sequencing data, accompanied by the accumulation of the corresponding individual diseases, signs and other data at the same time. When we accumulate enough data, how to understand these data will be critical. On the micro level, generations of molecular biologists’ studying the effects of apparent biological traits genes exert on utilizing technologies like gene knockout have made breakthroughs in many crucial aspects. On the macro level, statistics and other data analysis techniques are introduced to study the relationship between gene sequences and biological phenotype. The accumulation of basic scientific research gradually brings breakthroughs in clinical applications.

There are now two types of clinical applications mainly, one aims at disease screening of ordinary people. It infers people’s future risks of getting cancer by measuring the known genes associated with a disease loci. The other aims at the diagnosis cancer and other deadly diseases. It finds in a series of drugs or plans the most effective one for certain patients by testing the loci of certain genes.

Data from BBC research shows that total global gene sequencing market increased from $ 7.941million in 2007 to $ 4.5 billion in 2013, and will reach $ 11.7 billion in the year of 2018 with the CAGR up to 21.2%.

Currently, the market of de novo sequence platform is mainly taken by several major manufacturers, including the Illumina, Ion Torrent / Life Technologies (was the acquisition of Thermo Fisher in 2014), 454 Life Sciences / Roche, etc.

Under such a circumstance, the next generation sequencing technology (second-generation sequencing) appears. As an emerging industry, the next-generation sequencing technology can be applied in clinical testing like antibody discovery, health industry, industrial and agricultural use of gene-oriented study as well as scientific research and development.

To stimulate the next generation sequencing market, we need to start by investing more small and medium size industry focusing on this field.

Anti-Ageing – Dermal Fillers Help to Keep The Signs of Ageing to a Minimum

Dermal fillers are very effective in both men and women, filling depressions on the face, hands and body. Injectable fillers are the perfect way to enhance your facial features, because they can help to fill hollows, plump up thin lips, soften folds and wrinkles on the face and improve scars and other facial defects.

Fillers can help to fill out smokers lines around the lips, the nasolabial lines that run from the nose to the corners of the mouth, smile lines, crows feet and forehead furrows. Fillers are also ideal to add volume to sunken cheeks and weak chins, as well as reshaping the tip of the nose, and filling out deeper acne scars.

The ageing process begins when we are about 25 and over the next decade:

Skin cell turnover slows down and dead cells remain on the skin creating a dull appearance
Early wrinkles can begin to appear around the eyes
The lines from the nose to mouth become more prominent
The jaw line begins to soften

From age 35 to 45

Lines and wrinkles will deepen, and frown lines can give your face an angry look
Your skin type may change, from oily to dry or vice versa
Pigmentation changes on your skin

From age 45 onwards

In menopause, oestrogen levels decrease, causing collagen to deplete
Volume loss causes sunken cheeks
The skin can become dry and dehydrated
Pigmentation will become more visible
The face begins to drop and sag
The jaw area loses definition

Getting wrinkles and creases on the face is part of the ageing process, and they begin to appear as the collagen and elastin fibres break down, but they can also result from excessive frowning, smiling or squinting.

Dynamic lines

Dynamic are when lines, wrinkles and other signs of ageing occur on the face when it’s in motion. They’re also called expression lines; laughter lines, frown lines and bunny lines, which are harmless at a younger age but will often contribute to where the deeper set wrinkles and folds will remain in later life.

Static lines

Static lines are noticeable wrinkles, lines, sagging and folds which are present on the resting face; sagging jaw line, nasal folds, sunken cheeks and horizontal forehead lines. These lines, if left untreated, will stay on the face and will progressively worsen.

Dermal Fillers are a temporary solution, as the hyaluronic acid in the fillers is naturally degradable, and is naturally broken down and eventually absorbed by the body. Fillers are effective at restoring hydration to the skin, smoothing lines and wrinkles and can also restore and enhance the facial shape. The fillers last around 9 to 12 months, although this may vary from person to person, depending on their lifestyle and which part of the face gets injected.

If you need help choosing a cosmetic procedure, we provide an extensive range of cosmetic procedures for the face and body: Botox, Vaser Lipo, Lip Augmentation, Dermal Fillers and many more treatments, to help create a younger, slimmer, more youthful looking you!