30 research outputs found

    Proportion of urinary tract infection in neonatal sepsis

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    Background: Urinary tract infection (UTI) in neonates might be associated with bacteremia and congenital anomalies of the kidney and urinary tract (CAKUT), that in complicated situations can lead to renal parenchymal scarring and chronic kidney disease. Aim: To determine occurrence of UTI in neonatal sepsis. Methods: This cross sectional study was conducted on 500 term, extramural hospitalized neonates, suspected to have infection underwent, a detailed history, physical examination and a comprehensive sepsis workup. The diagnosis of neonatal UTI was based, on positive urine culture, obtained by suprapubic aspiration (SPA).  Results: Out of 500 neonates included in our study (324 boys and 176 girls), blood culture was positive in 84 (36.5%) neonates in early-onset sepsis group (n=230), while in late-onset sepsis group (n=270) blood culture was positive in130 (48.1%), p-value < 0.05. In both early-onset sepsis (EOS) and late-onset sepsis (LOS) groups, blood culture was found to be positive in a greater proportion of male (41.3%) than female (29.3%) patients, p-value <0.05.  The most common organism isolated from blood and urine culture was Klebsiella, followed by E-coli. Urine culture was positive in 34 (6.8%) patients, among whom 29 (85%) culture-positive cases were from the LOS group, a p-value of <0.05.  Conclusions: UTI is not uncommon among the hospitalized neonates, and UTI evaluation among septic neonates can prove beneficial for the prevention of long-term sequelae of neonatal UTI

    Effect of quercetin on steroidogenesis and folliculogenesis in ovary of mice with experimentally-induced polycystic ovarian syndrome

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    IntroductionPolycystic Ovary syndrome (PCOS) affects the health of many women around the world. Apart from fundamental metabolic problems connected to PCOS, focus of our study is on the role of quercetin on genes relevant to steroidogenesis and folliculogenesis.MethodsEighteen mature parkes strain mice (4-5 weeks old) weighing 18–21 g were randomly divided into three groups of six each as follows: Group I serves as the control and was given water and a regular chow diet ad lib for 66 days; group II was given oral gavage administration of letrozole (LETZ) (6 mg/kg bw) for 21 days to induce PCOS and was left untreated for 45 days; For three weeks, Group III received oral gavage dose of LETZ (6 mg/kg), after which it received Quercetin (QUER) (125 mg/kg bw orally daily) for 45 days.ResultsIn our study we observed that mice with PCOS had irregular estrous cycle with increased LH/FSH ratio, decreased estrogen level and decline in expression of Kitl, Bmp1, Cyp11a1, Cyp19a1, Ar, lhr, Fshr and Esr1 in ovary. Moreover, we observed increase in the expression of CYP17a1, as well as increase in cholesterol, triglycerides, testosterone, vascular endothelial growth factor VEGF and insulin levels. All these changes were reversed after the administration of quercetin in PCOS mice.DiscussionQuercetin treatment reversed the molecular, functional and morphological abnormalities brought on due to letrozole in pathological and physiological setting, particularly the issues of reproduction connected to PCOS. Quercetin doesn’t act locally only but it acts systematically as it works on Pituitary (LH/FSH)- Ovary (gonad hormones) axis. the Side effects of Quercetin have to be targeted in future researches. Quercetin may act as a promising candidate for medical management of human PCOS

    Polycythemia, increased erythropoietin levels in a patient with renal lymphoma

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    A young male presented to our clinic with 3 months history of shortness of breathness and progressive distension of abdomen. On investigations, patient had renal failure, polycythemia and nephromegaly. A diagnosis of non-Hodgkin′s lymphoma was made on renal and lymph node biopsy. Serum erythropoietin concentrations were physiologically inappropriate. - Erythropoietin immunohistochemistry on renal tissue samples demonstrated positive staining for tumor cells. This patient was managed as a case of infiltrative lymphoproliferative disorder with kidney involvement having polycythemia owing to paraneoplastic Erythropoietin production and possibly local hypoxia produced by tumor cells. With maximum efforts, we could not find such an association in the literature

    Pattern of glomerulonephritis in the Kashmir valley

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    Glomerulonephritis (GN) is a common cause of end-stage kidney disease (ESKD) that can affect patients at any age. With respect to ESKD, there are significant global variations in the percentage of the incident and prevalent patients secondary to GN. The present study was therefore conducted to know the pattern of GN in the Kashmir valley. Retrospective study was conducted in the tertiary center Sher-I-Kashmir Institute of Medical Sciences of Kashmir valley which included cases of different types of GN diagnosed on histopathology over a period of three years. Basic demographic profile including age, sex, clinical presentation, relevant investigations, and the histopathological type of GN was noted for each patient. Histopathological examination due to various nonneoplastic renal diseases was done in 336 cases and out of these, glomerular diseases were diagnosed in 298 cases. Proteinuria and edema was the most common presentation. Primary GN was observed in 81% of cases and secondary GN in 16% of cases. IgA nephropathy was the most common primary GN 42% and nephropathy due to lupus was the most common secondary GN. The study concluded that primary GN is the most common primary renal disease with IgA as the most common primary GN and most presented as renal failure, highest until date recorded in India and lupus nephritis as the most common secondary GN which is similar to other studies from India and other regions of the world. This study may be useful to pathologists, nephrologists, and health care providers to formulate a basic platform for effective diagnostic, therapeutic, and research base for glomerular diseases so as to prevent its complications

    Pattern of urinary albumin excretion in normotensive young and adolescent Indian women with polycystic ovary syndrome

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    Objective: Polycystic ovarian syndrome (PCOS) is a clinically heterogeneous endocrine disorder affecting up to 4-8% of women of reproductive age. The aim of this study was to evaluate the presence of microalbuminuria in women with PCOS and study its correlation with the various metabolic, clinical, and hormonal parameters. Materials and Methods: A cross-sectional study involving 69 PCOS women was carried out in a tertiary care center hospital. The diagnosis of PCOS was made according to the Rotterdam criteria. Blood samples were collected in the follicular phase of the menstrual cycle and analyzed for fasting luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), 17-hydroxyprogesterone (17-OHP), total testosterone (T), glucose, insulin, and lipid profile. Urinary albumin was measured in the first void spot urine sample. Results: The mean age of the subjects was 22.0 ± 4.1 years and 21.8 ± 4.7 years in normoalbuminuric and microalbuminuric groups, respectively. Urinary albumin excretion (UAE) varied from 5 mg/l to 100 mg/ml, with a median of 5 mg/l. Microalbuminuria was observed in 17/69 (24.6%) of subjects. The mean UAE was 3.65 ± 4.44 mg/l in the normoalbuminuria group versus 45.29 ± 22.74 mg/l in the microalbuminuria group. Upon univariate analysis, hip circumference, diastolic blood pressure, and fasting blood glucose showed significant correlations with urinary albumin concentration (r = 0.264, 0.264, and 0.551, respectively; P = 0.028, 0.029, and 0.000, respectively). No association between UAE and the usual cardiovascular risk factors could be found upon regression analysis. Conclusion: About 24.6% of women with PCOS showed presence of microalbuminuria in the first void spot urine sample. Screening for the presence of microalbuminuria can help in early identification of a subset of PCOS women with a high risk for future CVD, who can be subjected to preventive strategies at the earliest. However, further studies are needed before recommending routine use of UAE in PCOS cases for the detection of CVD risk

    Drug-induced acute interstitial nephritis: Prospective randomized trial comparing oral steroids and high-dose intravenous pulse steroid therapy in guiding the treatment of this condition

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    The most important aspect of treating drug-induced acute interstitial nephritis (AIN) is timely discontinuation of the offending drug. Steroids, oral as well as intravenous (IV), are used in the treatment of drug-induced AIN. The present study was undertaken to compare the efficacy of oral prednisolone versus IV suprapharmacological doses of corticosteroids in the treatment of drug-induced AIN. This prospective randomized controlled study included drug-induced AIN diagnosed on histopathology over a period of two years. Patients were randomized to oral prednisolone (Group A) 1 mg/kg for two weeks or pulse methylprednisolone (Group B) 30 mg/kg for three days (maximum 1 g) followed by oral prednisolone 1 mg/kg for two weeks, tapered over two weeks. Response was reported as complete remission (CR) [improvement in estimated glomerular filtration rate (eGFR) to ≥60 mL/min/1.73 m2], partial remission (PR) (improvement but eGFR <60 mL/min/1.73 m2), or nonresponders to steroids (no CR/PR). Steroid therapy was instituted to 31 biopsy-proven AIN cases (Group A - 16 and Group B - 15). Drugs implicated in the causation of AIN included pantoprazole, diclofenac, rifampicin, naproxen, aspirin, imipenem, piroxicam, cefixime, lornoxicam, Chinese herbs, etoricoxib, ciprofloxacin, and phenytoin. There was no difference in the baseline parameters between the two groups. At the end of follow-up, 58.06% achieved CR and 41.93% achieved PR. In Group A, nine (56.2%) achieved CR and seven (43.7%) achieved PR. In Group B, nine (60%) achieved CR and six (40%) achieved PR. There was no significant difference between the two groups. Pulses of high doses of corticosteroids have a significant but transient anti-inflammatory effect. Both oral and IV suprapharmacological doses of corticosteroids are equally effective in the treatment of drug-induced AIN, if used early

    Conservative management of emphysematous pyelonephritis

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    Emphysematous pyelonephritis, though uncommon, is a severe necrotizing kidney infection common in patients with diabetes. Surgical treatment has been advocated as the treatment of choice in most of the patients. We present the clinical course of an elderly lady who presented with emphysematous pyelonephritis and was successfully managed with medical treatment despite the presence of adverse prognostic factors like acute renal failure and thrombocytopenia
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