Background : Amongst the diverse etiologies of severe acute kidney injury (AKI), Lassa fever (LF) occupies a prominent position in endemic areas of West Africa. However, there is a paucity of studies that compare the characteristics of LF and non-LF-associated cases.
Objectives : To determine the contribution of LF to severe AKI in an endemic area, and compare the illness characteristics and factors associated with mortality in LF versus non-LF-associated AKI.
Methods : We reviewed the records of patients admitted with severe AKI from 1st January 2019 to 30th September 2022 at Irrua Specialist Teaching Hospital (ISTH), and retrieved data on patients’ demography, clinical presentation, treatment, and outcome. We compared the frequencies of categorical data and means of continuous data between patients with LF and those without LF using chi-square test, t-test,and Mann-Whitney U test as appropriate, with the level of statistical significance set at p <0.05.
Results : Fifty-four (41.5%) of 130 patients with severe AKI had LF. LF was associated with a significantly lower mean age (p = 0.013), platelet count (p = 0.010), and mean levels of indices of renal dysfunction (p = 0.02 - <0.001) but there was no significant difference in mortality rates (LF 27.8%; non-LF 39.5%; p = 0.1674). The overall mortality was associated with need for inotropes, requirement for supplemental oxygen, and hemodialysis, and length of admission while the association of mortality with the latter and need for supplemental oxygen was only significant among patients without LF.
Conclusions : LF is a major cause of severe AKI in endemic areas, but it is not associated with any differential risk of mortality perhaps because the associated renal dysfunction is not as severe as in non-LF AKI.

We present the preliminary outcomes of robotic-assisted surgical treatment for bladder neck contracture (BNC), using the innovative Robot-Assisted Laparoscopic Retzius-Sparing Bladder Neck Reconstruction (RAL-RSBNR), technique. Between August and October 2024, three adult male patients underwent RAL-RSBNR at our institution. All patients developed BNC following transurethral resection of the prostate (TURP), for benign prostatic hyperplasia (BPH), and had previously undergone multiple urethral dilation procedures. One patient had experienced recurrent TURP interventions. All RAL-RSBNR procedures were performed using a transperitoneal six-port approach with a four-arm robotic system. No significant intraoperative or postoperative complications were observed. At two weeks postoperatively, all three patients successfully had their catheters removed without notable voiding difficulties. Current literature identifies the RAYV technique as the predominant robotic-assisted approach for treating BNC. In contrast, our novel RAL-RSBNR technique addresses BNC at its root, effectively preventing recurrence often associated with endoscopic surgeries, while maintaining a favorable safety profile with no major complications. These preliminary results indicate that RAL-RSBNR holds significant potential as a promising option for BNC treatment. Nevertheless, given the short study period, further clinical data and extended follow-up are required to thoroughly evaluate the long-term outcomes and efficacy of RALRSBNR.

Diuretics are established fall-risk increasing drugs. However, not all diuretics users experience fall incidents. Due to interindividual
heterogeneity in older populations, it is difficult to identify which older adults are at highest risk of medication-related falls. Therefore, we assessed if diuretic plasma concentrations are associated with fall risk in users. We analyzed plasma samples of 307 hydrochlorothiazide and 110 furosemide users from a cohort of older community-dwelling adults. Cox proportional hazard and logistic regression models were used to analyze associations between diuretic concentration at baseline, changes over time and fall risk. There was no significant association between fall risk and plasma concentration of either hydrochlorothiazide or furosemide at baseline. Nor was a change in concentration over time associated with fall risk. Thus, diuretic plasma concentration is not associated with fall risk in older communitydwelling adults.

Introduction : This study aimed to explore the changes in ferroptosis markers and their relationship with fundus lesion severity in chronic kidney disease (CKD).

Methods : We enrolled 118 CKD patients and collected clinical, renal function, fundus imaging data, and ferroptosis markers. We performed correlation and regression analyses between renal dysfunction and fundus lesions, and assessed the changes and mediating roles of serum iron (Fe), malondialdehyde (MDA), and reduced glutathione (GSH) in CKD deterioration and retinal damage.

Results : Levels of Fe, MDA, and GSH showed significant differences across CKD stages (P<0.001). Logistic regression identified sex, mean arterial pressure, total cholesterol, hemoglobin, ferritin, Fe, MDA, and GSH as significant factors in CKD-related fundus lesions (P<0.05). MDA (β=0.15, 95%CI: 0.03–0.26) and GSH (β=0.33, 95%CI: 0.16–0.54) significantly mediated the link between renal decline and retinal damage (P≤0.001).

Conclusions : Early fundus screening is clinically valuable for managing CKD progression. Fundus damage severity in CKD closely tracks renal decline, with ferroptosis likely playing a key role. MDA and GSH are promising biomarkers for early detection and intervention in CKD-related retinal pathology.