Multicystic nephroma: a rare benign renal tumor with diagnostic predicament

Multi cystic Nephroma is a rare benign tumor of kidney occurring in adults which has clinical, radiological and morphological features causing diagnostic dilemma as it mimicks other cystic renal lesions. Distinguishing it from a cystic renal carcinoma is very important. Multicystic nephroma is usually unilateral, more common in females, presenting as a well capsulated mass lesion with multiple non communicating cysts lined by hobnailing epithelium. A similar lesion occurring in children represents a well differentiated nephroblastoma. The case presented here was a female patient complaining of pain in the left flank and had a mass lesion which was diagnosed as cystic renal cell carcinoma radiologically. The nephrectomy specimen showed a multilocular cystic mass well delineated from adjacent renal parenchyma. Histopathologically the cysts were lined by hobnail type of epithelium and separated by fibrocollagenous stroma. The stroma had hyalinised areas, chronic inflammatory cell infiltration and foci of mature adipose tissue. No atypia or mitoses were seen in the epithelium or stromal cells. Based on the histological criteria a diagnosis of multicystic nephroma was made. It is important to make a diagnosis of multicystic nephroma based on histomorpholgical criteria as it relieves the patient from the burden of a malignant lesion

Polymicrobial therapy induced nephrotoxicity: more is not always better

Polymicrobial induced nephrotoxicity (PIN) occurs more commonly in critically ill patients. Exposure to drugs often results in toxicity in kidney which represents a major control system maintaining homeostasis of body and thus is especially susceptible to xenobiotics. We present here an adverse drug reaction which is additive nephrotoxicity with combined antimicrobial use in critically ill patient. Blood urea and serum creatinine levels were raised much above the baseline after a fortnight of therapy. The suspected drugs were withdrawn leading to a gradual improvement and normalization of blood urea and serum creatinine levels This suggested a causal relationship which was possibly due to the administration of nephrotoxic antimicrobials. The present case highlights that critically ill patients on prolonged Polymicrobial therapy should be closely monitored, and dose increments should be made cautiously

Role of prophylactic use of timolol maleate (0.5%) in preventing rise of intraocular pressure (iop) post Neodymium: Yttrium Aluminum Garnet (Nd: Yag) capsulotomy

Purpose: To evaluate the role of prophylactic use of Timolol maleate (0.5%) eye drop in preventing rise of intraocular pressure (IOP) post Nd: YAG capsulotomy.Materials and Methods: A randomized, single-blinded, parallel group study conducted in 220 eyes, over a period of 18 months. Precapsulotomy baseline IOP, Slitlamp examination and grading of PCO was done. After instilling the test medication Nd: YAG laser capsulotomy performed. Post capsulotomy patients were assessed immediately, after 1 hour and 3 hours for IOP.Result: Precapsulotomy, mean IOP in Group I (use of placebo) was 15.30 ± 2.83 mm Hg as compared to 16.15 ± 2.48 mmHg in Group II (use of Timolol eyedrop), Group II mean IOP was significantly higher (P = 0.019). However, immediately after the procedure mean IOP in Group I was 14.55 ± 2.87 mmHg as compared to 13.16 ± 3.72 mmHg in Group II thus showing mean IOP in Group II to be significantly lower (P = 0.002). One hour and 3 hours after the procedure too, mean IOP in Group II was significantly lower as compared to that in Group I (P < 0.001). With increasing grade of PCO reduction in post-procedure IOP was lower and reduction in IOP was maximum in patients requiring <30 milliJoules of total energy.Conclusion: A judicious control over energy use and post laser IOP monitoring can influence the trend of IOP rise in a positive manner. Whenever anticipated that >60 mJ of laser energy is required as in higher grades and younger age, prophylactically Timolol maleate 0.5% eye drop should be instilled before Nd: YAG capsulotomy while all other patients in which Timolol is not used, should be kept under observation after laser capsulotomy.Keywords: Capsulotomy, grade of posterior capsular opacification, intra ocular pressure, Nd: YAG laser, Timolol maleat

Computational inference of a genomic pluripotency signature in human and mouse stem cells

Distribution of distance to TSS for selected features (A) human and (B) mouse. (PDF 376 kb

Mycobacterium tuberculosis H37Ra: a surrogate for the expression of conserved, multimeric proteins of M.tb H37Rv

Additional file 3. Details of primers used, experimental and theoretical molecular weights, pI values and details of post-translational modifications in GAPDH