29 research outputs found

    A renal biopsy-based clinicopathological study of primary tubulointerstitial nephritis in children

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    Background: Inflammation of the tubular and interstitial compartment without involving the glomeruli and vessels is called as primary tubulointerstitial nephritis (TIN), which may be due to varied etiologies. This is relatively uncommon in children as compared to primary glomerular disorders. Infections and drugs are the most common causes of primary TIN worldwide. Objectives: The objectives of the study were to assess primary TIN in pediatric patients using findings from renal biopsies at a tertiary care center of Western India. Materials and Methods: All biopsy-proven cases of primary TIN in pediatric patients over a period of 10 years were included in the study. All cases with glomerular or vascular diseases, or where data were inadequate were excluded from the study. The cases were reviewed in detail for epidemiological data, clinical presentation, etiology, and histomorphological features. Depending on their clinical and morphological features, the cases were categorized into acute, chronic, and granulomatous TIN. Results: A total of 30 cases of primary TIN were assessed with a mean age of 12.4 years and range of 6–18 years. Pedal edema and facial puffiness were the most common symptoms followed by oliguria. The common causes of TIN were drugs, namely antibiotics and non-steroidal anti-inflammatory drugs and infections. Acute TIN was more common than chronic TIN. Conclusion: Primary TIN is an uncommon renal disease in pediatric patients with varied presentations and etiologies. However, early diagnosis by renal biopsy, detailed history, and withdrawal of the offending agent along with prompt treatment helps in recovery and avoids chronic renal damage

    Paraoxonase activity in metabolic syndrome in children and adolescents

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    Background: Metabolic syndrome (MetS) is a collection of various interrelated risk factors that appear to have an impact as development of atherosclerotic cardiovascular disease (CVDs). Epidemic of childhood and adolescent’s obesity has increased interest in the metabolic syndrome (MS) due to the potential projection into adulthood. The prevalence of MS in adolescents has been estimated to be 6.7% in young adults and 4.2% in adolescents. We aimed to study the MetS in children and adolescents with respect to metabolic changes. Methods: The international Diabetes Federation criteria were used for the selection of cases. Serum paraoxonase 1 (PON1) activities were measured using spectrophotometer. Statistical analysis was done using MyStat statistical software. Results: Serum PON1 arylesterase (ARE) and lactonase (LACT) activities were found to be reduced significantly in patients with MetS than in controls. Regression analysis showed a significant correlation between PON1 activities and body mass index. Area under curve (AUC) found to increase from HDL to PON1 ARE to PON1 LACT. Conclusions: From the present study, it is clear that in children and adolescents, reduction in PON1 activities in MetS is mainly due either to abnormalities with synthesis or secretion of HDL cholesterol or oxidative stress as a consequence of excess production of the free radicals. This study also iterates that it is the quality and not the quantity of HDL cholesterol which is important while studying the pathophysiology of MetS

    Trends of Poisoning Cases in Tertiary Care Teaching Hospitals in Western Indian Population

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    Background: Any substance, which makes life better, if not used wisely and with proper care, would become dangerous to human life. These chemical substances can be termed poisons. A poison can be defined as a substance (solid, liquid, or gas), which if introduced into a living body or brought into contact with any part thereof would produce disease or even death by its constitutional or local effects or both. Pattern of poisoning in a particular region depends on various factors like availability and access to the poison, socioeconomic status of an individual, educational status, knowledge on pesticides, and their proper usage. In India, due to variations in geographical conditions and differences in religious and cultural practices, the incidence and pattern of poisoning vary from place to place, hence it is better to perform regional studies periodically to recognize the extent and evolution of the problem.Methods: This is a cross-sectional and observational study, which was conducted in tertiary care teaching institutes in Western India. The study includes 318 deceased persons due to poison consumption brought for postmortem examination. Results: Incidence of death due to poisoning was more in the third (31.7%) and second decade (22.6%) of life as compared to both extremes of age. The majority of victims were males (64.2%) as compared to females (35.8%). It was also observed that most victims belonged to lower socioeconomic class (58.8%) with educational status from illiteracy to primary education. Majority were farmers commonly due to insecticidal poisoning.Conclusion: Pattern of poisoning in the present study corresponds with the pattern found in most other studies. Majority of victims were male and agricultural poisons were the most common type. Our study suggests that establishment of poison information centers, availability of antidotes in rural area, and creating awareness among people help effectively to resolve the problem

    Pattern of head injury in central India population

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    Background: In India, the developing economy and growing population simultaneously made a strong impact on increase in motor vehicle population. This increase in motorization has some adverse effects such as increase in road accidents with economic and functional loss. Head injury is the most common cause of mortality in road traffic accidents. The aim of this study was to know the incidence, pattern, mechanism, mode of head injury along with its distribution in relation to site of vault fracture and intracranial hemorrhage.Methods: Total 391 post-mortem cases of head injury were enrolled during study period. The information regarding age, sex, residence, marital status, date and time of time of accident and of death was gathered from police inquest report, relatives, dead body challan and clinical details from hospital records. During autopsy, detailed examination was carried out and data regarding both external and internal injuries were carefully recorded and analyzed.Results: The peak incidence of head injury was observed in the age group of 21-30 years. Most of deceased were from early age group and the male deceased were more than females. Majority victims of head injury were from road Traffic Accidents followed by fall from height, railway accidents and assault. Fissured fracture of vault was found in almost half cases. Subdural and subarachnoid hemorrhage were the most common one we encountered.Conclusions: Head injury due to RTA is well known public health problem causing death and disability. It is required from concerned government authority to take appropriate and immediate measures for reducing the incidence of head injury

    Paraoxonase in Nervous System

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    The paraoxonase (PON) family consists of—PON1, PON2 and PON3 which are anti-oxidative, any dysfunction in their action, has been suggested to play a role in the pathobiology of diseases having a chronic inflammatory component. PON1 is the most studied which has paraoxonase, arylesterase, thiolactonase, and anti-oxidant actions. Studies have shown the association between lowered PON1 activity and increased incidence of ischemic stroke, dementia, Parkinson disease, multiple sclerosis, and amyotrophic lateral sclerosis. It may occur due to increased oxidative stress and/or prolonged exposure to organophosphates, and reduced capacity of the body to counter these stresses due to reduced PON1 function. PON2 has arylesterase, lactonase, and antioxidant properties. Under-expression of PON2 is associated with Parkinson Disease and Amyotrophic Lateral Sclerosis, and over-expression with tumors with glioblastoma. Various mechanisms have been proposed for the role of PON2 in the pathobiology of the said diseases. PON3 is least studied. The PON family, to some extent, interacts with acetylcholine esterase (AChE), as both share the same locus, and PONs degrade the inhibitors of AChE, especially the organophosphates. This could probably have significant role in the development of Parkinson disease and the prognosis of the treatment of Alzheimer disease by AChE inhibitors

    Sinonasal Teratocarcinosarcoma

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    Sinonasal Teratocarcinosarcoma (SNTCS) is an extremely rare and unusual malignant neoplasm of the sinonasal tract with an aggressive behaviour. Till date, there are less than a hundred cases reported in literature. A 52 year old patient presented with a large, reddish brown, right sided nasal mass with epistaxis since 1 month. Histopathology revealed a highly malignant tumor with diverse histomorphological features and was labelled SNTCS. These unique tumors show diverse histomorphological features of a carcinosarcoma with teratoid elements. Immunohistochemistry was positive for cytokeratin, vimentin, GFAP, NSE, S-100. Chemotherapy with cisplatin and etoposide was given followed by a debulking surgery. The patient is well seven months after diagnosis and scheduled for radiotherapy. Diagnosis of SNTCS requires an adequate representative biopsy and extensive sampling on Histopathology. Treatment required included surgery, chemotherapy and radiotherapy


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    A newborn with a unique condition, known as “collodion baby,” is born with a rare translucent skin sheet that resembles parchment. This condition is extremely uncommon, occurring in approximately 1 out of 3,00,000 live births. Symptoms may include a collodion membrane with cracks, ectropion and eclabium. The shedding of the membrane can raise the risk of dehydration and infection