Unusual presentation of childhood Systemic Lupus Erythematosus

Bullous systemic lupus erythematosus is a rare blistering condition with a distinctive combination of clinical, histological and immunopathologic features that together constitute a unique bullous disease phenotype. It is often associated with autoimmunity to type VII collagen. Here we report a child who presented with bullous systemic lupus erythematosus. Rapid resolution of the blisters occurred following treatment with dapsone

Understanding Community Colleges in the Indian Context

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136494/1/cc20242.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136494/2/cc20242_am.pd

Drosophila Argonaute-1 is critical for transcriptional cosuppression and heterochromatin formation

Argonaute-1 (Ago-1) plays a crucial role in gene regulation and genome stability via biogenesis of small non-coding RNAs. Two “Argonaute” family genes, piwi and Ago-2 in Drosophila are involved in multiple silencing mechanisms in the nucleus, transgene cosuppression, long-distant chromosome interaction, nuclear organization and heterochromatin formation. To investigate whether Ago-1 also plays a similar role, we have generated a series of Ago-1 mutations by excising P element, inserted in the Ago-1 promoter (Ago-1k08121). AGO-1 protein is distributed uniformly in the nucleus and cytosol in early embryos but accumulated predominantly in the cytoplasm during the gastrulation stage. Repeat induced silencing produced by the mini-white (mw) array and transcriptional cosuppression of non-homologous transgenes Adh-w/w-Adh was disrupted by Ago-1 mutation. These effects of Ago-1 are distict from its role in microRNA processing because Dicer-1, a critical enzyme for miRNA biogenesis, has no role on the above silencing. Reduction of AGO-1 protein dislodged the POLYCOMB, EZ (enhancer of zeste) and H3me3K27 binding at the cosuppressed Adh-w transgene insertion sites suggesting its role in Polycomb dependent cosuppression. An overall reduction of methylated histone H3me2K9 and H3me3K27 from the polytene nuclei precisely from the mw promoters was also found that leads to concomitant changes in the chromatin structure. These results suggest a prominent role of Ago-1 in chromatin organization and transgene silencing and demonstrate a critical link between transcriptional transgene cosuppression, heterochromatin formation and chromatin organization. We propose Drosophila Ago-1 as a multifunctional RNAi component that interconnects at least two unrelated events, chromatin organization in the nucleus and microRNA processing in the cytoplasm, which may be extended to the other systems

Approximate controllability of a semilinear elliptic problem with robin condition in a periodically perforated domain

In this article, we study the approximate controllability and home-genization results of a semi-linear elliptic problem with Robin boundary condition in a periodically perforated domain. We prove the existence of minimal norm control using Lions constructive approach, which is based on Fenchel-Rockafeller duality theory, and by means of Zuazua's fixed point arguments. Then, as the homogenization parameter goes to zero, we link the limit of the optimal controls ( the limit of fixed point of the controllability problems) with the optimal control of the corresponding homogenized problem.SERB-DST Bhopal, YSS-2014-000732 / CREST, IISER Bhopal / CeBiB, PFBasal-01 / CMM, PFBasal-03 / Fondecyt, 1140773 / Regional Program STIC-AmSud Project Mosco

Incidence of Acute Renal Failure in Preterm Babies in a Tertiary Care Centre from Southern India: A Cross-sectional Study

Introduction: Preterm babies are a vulnerable population group who are more susceptible to multiple end-organ damage due to an immature immune system and incomplete organogenesis/ organ function. There is scanty data on preterm Acute Kidney Injury (AKI) in India. Aim: To investigate the incidence of acute renal failure and the risk factors predisposing preterm babies to renal failure in an inborn at a tertiary care centre in Southern India. Additionally, we aimed to evaluate the usefulness of a biomarker, Neutrophil Gelatinase Associated Lipocalin (NGAL), as both a marker of renal function and a predictor of AKI in preterm babies. Materials and Methods: A cross-sectional study was conducted in the Neonatal Intensive Care Unit (NICU) at Christian Medical College, Vellore, Tamil Nadu, India, between May 2014 and August 2014. The study included babies born <33 weeks of gestation, while those with abnormal antenatal renal scans, major systemic congenital anomalies, and chromosomal anomalies were excluded. Demographic details and clinical features were noted. Weekly monitoring included urine output, assessment of clinical deterioration, details of interventions, unexpected events, and the use of nephrotoxic drugs. Blood samples for serum creatinine and urine samples for NGAL were collected once a week starting from 72 hours of age. The data was statistically analysed using Statistical Package for the Social Sciences (SPSS) software, version 16.0. Descriptive statistics were reported using mean±SD for continuous variables. Repeated measures Analysis of Variance (ANOVA) and Chi-square test/Fisher’s-exact test were used for categorical variables. Risk factor analysis was done using log binomial to estimate the Relative Risks (RR), considering values greater than 1 as significant. Results: During the study period, a total of 4823 live births were recorded. Among them, 80 babies had a gestational age <33 weeks (10.14%). One baby was not recruited as the parents did not provide consent, leaving a total of 79 babies included in the study. Five babies did not complete the study (three died and two were discharged against medical advice). The incidence of AKI in babies <32±6 weeks in this study was 10 out of 79 (12.6%). It was higher in babies <28 weeks, with 4 out of 10 (40%) affected, and all 10 babies (100%) weighed less than 1500 gm at birth. Risk factors for AKI included oliguria, Patent Ductus Arteriosus (PDA), nephrotoxic drugs, low APGAR score, mechanical ventilation, Continuous Positive Airway Pressure (CPAP), and abnormal antenatal scans. Urine NGAL was estimated in 30 babies, and it was found that NGAL levels were high in week 1 or rose by week 2 in those with AKI, while creatinine levels increased in week 2 or 3. NGAL was inversely proportional to gestational age and birth weight. Both NGAL rise and creatinine levels were observed in babies with AKI associated with Non-Steroidal Anti-Inflammatory Drugs (NSAIDS), umbilical lines, and asphyxia. Conclusion: The incidence of AKI was found to be 10%. Although NGAL levels were noted to rise earlier than creatinine levels in those with AKI, a definitive cutoff value for NGAL to define AKI could not be calculated. Due to the small study population, the sensitivity and specificity of NGAL could not be determined

A comparative study of induction of preterm vaginal delivery at 20 to 28 weeks gestation in previous one lower segment caesarean section by foley catheter and prostaglandin E2 gel

Background: The aim of the study to assess the maternal outcome and safety of induced preterm vaginal birth after a previous one lower segment caesarean delivery.Methods: In this study, 100 women who had singleton pregnancies with a previous one term lower segment caesarean section, in whom induction of labour was required in between 20 to 28 wks of gestation, were included. Group A (n= 50) were induced by transcervical foley catheter and group B (n= 50) were induced by prostaglandin E2 gel and then progression of labour was monitored. Both groups were compared in terms of induction delivery interval, efficacy and safety.Results: In our study, all women were delivered vaginally and hysterotomy was not required. The mean induction delivery interval in Foley catheter group (20.180±3.3499 hrs) was significantly shorter (p-value &lt;0.001) than PGE2 gel group B (24.050±3.6537 hrs). There was no case of uterine rupture, puerperal pyrexia, postpartum haemorrhage and uterine hyperstimulation.Conclusions: Women with previous lower segment caesarean section in whom premature induction of labour is required for any reason can be done easily, safely and effectively without maternal morbidity. Induction can be done more effectively by using transcervical foley catheter than intracervical prostaglandin E2 gel. It has shorter induction delivery interval and low complication. Hence, I suggest that every woman with previous one lower segment caesarean section who requires premature induction should go for trial of labour before repeating caesarean section