Spectrum of Biopsy Proven Renal Diseases in the Paediatric Age Group between 1997-2006 from a Tertiary Center of India.

BACKGROUND : The incidence of renal diseases among paediatric age group is not uncommon and nephrotic syndrome is considered as the most common clinical and histopathological diagnosis among all types of renal diseases in children. However, there is a limited data on the distribution of various histopathological spectrum of biopsy proven renal diseases in the paediatric population from developing countries. PATIENTS AND METHODS : A retrospective as well as prospective study was performed from January 1997 to December 2006 at our center involving 1480 children ( age 1 month to 18 years) who have undergone renal biopsy. The data was complete in 887 patients and this was analyzed. AIM AND OBJECTIVES : 1. To study the distribution of various renal diseases in pediatric age group in our center 2. To analyze patient characteristics, clinical and biochemical parameters among each group of biopsy proven renal diseases. 3. To study the various modality of treatment and its out come among these patients. RESULTS : The study included 887 children for whom biopsy reports were available. There were 554 males and 333 females. The distribution of various diseases were as follows: Minimal change disease in 303 (34.16%), Mesangial proliferative GN in 146 (16.45%), Lupus nephritis in 98(11.05%), Proliferative glomerulonephritis in 81(9.13%), IgA nephropathy in 61 (6.87%), Focal segmental glomerulosclerosis in 59(6.65%), Diffuse mesangial hypercellularity in 53(5.97%), Membranous glomerulonephropathy in 24(2.70%), Crescentic glomerulonephritis in 15(1.69%), Membrano proliferative glomerulonephritis in 8(0.9 %),Hemolytic uremic syndrome in 5 (0.56 %),Vasculitis in 3(0.33 %), acute interstitial nephritis in 3 (0.33 %),acute tubular necrosis in 2(0.22 %), granulomatous interstitial nephritis in 3(0.33%), end stage etiology of unknown etiology in 17(1.92 %) and inadequate sample in 2 (0.22%) children. Mean age at onset of MCD was 8.48 ± 4.7, 1-18 yrs years. In our patients, haematuria was seen in 9 % patients with MCD, 12.8 % patients with FSGS and 28.6% patients with MPGN. Hypertension was seen in 7% patients with MCD, 21.1%patients with FSGS and 12.1 % patients with MPGN. CONCLUSION : In children under 8 years of age, minimal change disease was the most common entity, whereas Focal segmental glomerulosclerosis predominated in children with age at onset greater than 8 years. The age at onset of nephrotic syndrome was significantly higher in the non-MCD group than the MCD group. The incidence of hypertension, microhematuria, gross hematuria and was significantly lower in the MCD group. MCD remains the most common histopathological subtype in Indian children with idiopathic nephrotic syndrome and the incidence of Membranoproliferative glomerulonephritis has been found to have declined. The incidence of lupus nephritis has increased. This study provides descriptive epidemiological biopsy data and highlights some important trends in changing prevalence of renal disease

Application of dynamic expansion tree for finding large network motifs in biological networks

Network motifs play an important role in the structural analysis of biological networks. Identification of such network motifs leads to many important applications such as understanding the modularity and the large-scale structure of biological networks, classification of networks into super-families, and protein function annotation. However, identification of large network motifs is a challenging task as it involves the graph isomorphism problem. Although this problem has been studied extensively in the literature using different computational approaches, still there is a lot of scope for improvement. Motivated by the challenges involved in this field, an efficient and scalable network motif finding algorithm using a dynamic expansion tree is proposed. The novelty of the proposed algorithm is that it avoids computationally expensive graph isomorphism tests and overcomes the space limitation of the static expansion tree (SET) which makes it enable to find large motifs. In this algorithm, the embeddings corresponding to a child node of the expansion tree are obtained from the embeddings of a parent node, either by adding a vertex or by adding an edge. This process does not involve any graph isomorphism check. The time complexity of vertex addition and edge addition are O(n) and O(1), respectively. The growth of a dynamic expansion tree (DET) depends on the availability of patterns in the target network. Pruning of branches in the DET significantly reduces the space requirement of the SET. The proposed algorithm has been tested on a protein–protein interaction network obtained from the MINT database. The proposed algorithm is able to identify large network motifs faster than most of the existing motif finding algorithms

Epidemiology, baseline characteristics and risk of progression in the first South-Asian prospective longitudinal observational IgA nephropathy cohort

Introduction: Glomerular Research And Clinical Experiments-IgA Nephropathy in Indians (GRACE-IgANI) is the first prospective South Asian IgAN cohort with protocolized follow-up and extensive biosample collection. Here we report the baseline clinical, biochemical, and histopathologic characteristics of GRACE IgANI and calculate baseline risk of progression for the cohort. Methods: 201 incident adults with kidney biopsy-proven primary IgAN were recruited into GRACE-IgANI between March 2015 and September 2017. As of April 30, 2020, the cohort had completed a median followup of 30 months (interquartile range [IQR] 16-39). Results: The commonest clinical presentation in GRACE IgANI was hypertension, with or without proteinuria, and nephrotic-range proteinuria was present in 34%, despite Conclusions: The predicted risk of progression in this cohort was considerable. Over the next 5 years, we will dissect the pathogenic pathways that underlie this severe South Asian IgAN phenotype

Interactions between thyroid disorders and kidney disease

There are several interactions between thyroid and kidney functions in each other organ's disease states. Thyroid hormones affect renal development and physiology. Thyroid hormones have pre-renal and intrinsic renal effects by which they increase the renal blood flow and the glomerular filtration rate (GFR). Hypothyroidism is associated with reduced GFR and hyperthyroidism results in increased GFR as well as increased renin – angiotensin – aldosterone activation. Chronic kidney disease (CKD) is characterized by a low T3 syndrome which is now considered a part of an atypical nonthyroidal illness. CKD patients also have increased incidence of primary hypothyroidism and subclinical hypothyroidism. The physiological benefits of a hypothyroid state in CKD, and the risk of CKD progression with hyperthyroidism emphasize on a conservative approach in the treatment of thyroid hormone abnormalities in CKD. Thyroid dysfunction is also associated with glomerulonephritis often by a common autoimmune etiology. Several drugs could affect both thyroid and kidney functions. There are few described interactions between thyroid and renal malignancies. A detailed knowledge of all these interactions is important for both the nephrologists and endocrinologists for optimal management of the patient

Screen Dependency Disorders in children under two years of age: A Parent Report Measure

Screen dependency disorder is a growing concern. The rising trend in use of digital devices among young children being less researched, the study was done to find out the prevalence and pattern of total and device-specific screen viewing (SV), in a well baby clinic among children less than two years of age, Data was collected through in-person interviews from mothers of the children. Increasing child age and type of family were found to be significantly associated with higher prevalence of SV. Smart phones had similar usage rates at par with TVs; reiterating the fact that mobile devices have become widely available in the entire population, being second source of SV. Parental knowledge and parental practices were also found to influence the SV and screen-time in children. Modifiable factors like parental knowledge on SV, parental SV practices can help in designing health promotion strategies and recommendations on S

Immunoglobulin G4-related tubulointerstitial nephritis: A not to be missed diagnosis

Immunoglobulin G4-related tubulointerstitial nephritis (IgG4-TIN) is a newly recognized clinicopathological entity characterized by a dense interstitial infiltrate of IgG4-positive plasma cells accompanied by fibrosis and obliterative phlebitis causing acute or chronic renal dysfunction amenable to corticosteroid therapy. IgG4-TIN is the dominant manifestation of renal involvement in IgG4-related disease (IgG4-RD) which is a novel, immune-mediated, fibroinflammatory and multiorgan disorder. We describe a case of IgG4-TIN with isolated renal involvement in an elderly male patient with poor response to corticosteroid therapy. The distinctive serological, histopathological, and ultrastructural features of this condition which can facilitate differential diagnosis of TIN are highlighted to emphasize the need for early diagnosis and preservation of kidney function

Modified Ring Routing Protocol for Mobile Sinks in a Dynamic Sensor Network in Smart Monitoring Applications

The stationary hierarchical network faces considerable challenges from hotspots and faster network breakdowns, especially in smart monitoring applications. As a solution to this issue, mobile sinks were recommended since they are associated with huge and balanced ways to transfer data and energy across the network. Again, due to the mobile sink node advertisement around the network latency and the energy utilization overheads introduced across the network, ring routing reduces the control overhead while preserving the benefits of the mobile sink, thereby optimizing the energy and improving the network life span. Consequently, we suggested a novel, distributed advanced ring routing strategy, in this work, for the mobile wireless sensor network. Extensive simulations and performance evaluation, in comparison to previous distributed mobile approaches, reveal a 37% and 40% boost in the network throughput and end-to end delay, respectively. Additionally, the lifespan of a network is determined by the control overhead and energy demand