What do we know about chronic kidney disease in India: first report of the Indian CKD registry

<p>Abstract</p> <p>Background</p> <p>There are no national data on the magnitude and pattern of chronic kidney disease (CKD) in India. The Indian CKD Registry documents the demographics, etiological spectrum, practice patterns, variations and special characteristics.</p> <p>Methods</p> <p>Data was collected for this cross-sectional study in a standardized format according to predetermined criteria. Of the 52,273 adult patients, 35.5%, 27.9%, 25.6% and 11% patients came from South, North, West and East zones respectively.</p> <p>Results</p> <p>The mean age was 50.1 ± 14.6 years, with M:F ratio of 70:30. Patients from North Zone were younger and those from the East Zone older. Diabetic nephropathy was the commonest cause (31%), followed by CKD of undetermined etiology (16%), chronic glomerulonephritis (14%) and hypertensive nephrosclerosis (13%). About 48% cases presented in Stage V; they were younger than those in Stages III-IV. Diabetic nephropathy patients were older, more likely to present in earlier stages of CKD and had a higher frequency of males; whereas those with CKD of unexplained etiology were younger, had more females and more frequently presented in Stage V. Patients in lower income groups had more advanced CKD at presentation. Patients presenting to public sector hospitals were poorer, younger, and more frequently had CKD of unknown etiology.</p> <p>Conclusions</p> <p>This report confirms the emergence of diabetic nephropathy as the pre-eminent cause in India. Patients with CKD of unknown etiology are younger, poorer and more likely to present with advanced CKD. There were some geographic variations.</p

Large-area growth of MoS2 at temperatures compatible with integrating back-end-of-line functionality

Direct growth of transition metal dichalcogenides over large areas within the back-end-of-line (BEOL) thermal budget limit of silicon integrated circuits is a significant challenge for 3D heterogeneous integration. In this work, we report on the growth of MoS2 films (~1-10 nm) on SiO2, amorphous-Al2O3, c-plane sapphire, and glass substrates achieved at low temperatures (350 C-550 C) by chemical vapor deposition in a manufacturing-compatible 300 mm atomic layer deposition reactor. We investigate the MoS2 films as a potential material solution for BEOL logic, memory and sensing applications. Hall-effect/4-point measurements indicate that the ~10 nm MoS2 films exhibit very low carrier concentrations (1014-1015 cm-3), high resistivity, and Hall mobility values of ~0.5-17 cm2 V-1 s-1, confirmed by transistor and resistor test device results. MoS2 grain boundaries and stoichiometric defects resulting from the low thermal budget growth, while detrimental to lateral transport, can be leveraged for the integration of memory and sensing functions. Vertical transport memristor structures (Au/MoS2/Au) incorporating ~3 nm thick MoS2 films grown at 550 C (~0.75 h) show memristive switching and a stable memory window of 105 with a retention time >104 s, between the high-low resistive states. The switching set and reset voltages in these memristors demonstrate a significant reduction compared to memristors fabricated from pristine, single-crystalline MoS2 at higher temperatures, thereby reducing the energy needed for operation. Furthermore, interdigitated electrode-based gas sensors fabricated on ~5 nm thick 550 C-grown (~1.25 h) MoS2 films show excellent selectivity and sub-ppm sensitivity to NO2 gas, with a notable self-recovery at room temperature. The demonstration of large-area MoS2 direct growth at and below the BEOL thermal budget limit, alongside memristive and gas sensing functionality, advances a key enabling technology objective in emerging materials and devices for 3D heterogeneous integration

Involvement of microRNA Lethal-7a in the Regulation of Embryo Implantation in Mice

MicroRNAs interact with multiple mRNAs resulting in their degradation and/or translational repression. This report used the delayed implantation model to determine the role of miRNAs in blastocysts. Dormant blastocysts in delayed implanting mice were activated by estradiol. Differential expression of 45 out of 238 miRNAs examined was found between the dormant and the activated blastocysts. Five of the nine members of the microRNA lethal-7 (let-7) family were down-regulated after activation. Human blastocysts also had a low expression of let-7 family. Forced-expression of a family member, let-7a in mouse blastocysts decreased the number of implantation sites (let-7a: 1.1±0.4; control: 3.8±0.4) in vivo, and reduced the percentages of blastocyst that attached (let-7a: 42.0±8.3%; control: 79.0±5.1%) and spreaded (let-7a: 33.5±2.9%; control: 67.3±3.8%) on fibronectin in vitro. Integrin-β3, a known implantation-related molecule, was demonstrated to be a target of let-7a by 3′-untranslated region reporter assay in cervical cancer cells HeLa, and Western blotting in mouse blastocysts. The inhibitory effect of forced-expression of let-7a on blastocyst attachment and outgrowth was partially nullified in vitro and in vivo by forced-expression of integrin-β3. This study provides the first direct evidence that let-7a is involved in regulating the implantation process partly via modulation of the expression of integrin-β3. (200 words)

2, 8 Dihydroxyadenine urolithiasis: A case report and review of literature

Adenine phosphoribosyl transferase deficiency is a rare metabolic abnormality presenting with 2,8 dihydroxyadenine urolithiasis. The stones are characteristically radiolucent and therefore need to be differentiated from uric acid stones which are also radiolucent and have identical chemical reactivity. No cases of 2, 8- dihydroxyadenine urolithiasis have been reported from India. We report a 3 year old child with 2, 8- dihydroxyadenine urolithiasis and acute renal failure

Evaluation of Green Manure Amendments for the Management of Fusarium Basal Rot (Fusarium oxysporum f.sp. cepae) on Shallot

Shallot (Allium cepa L. var. ascalonicum) is the most traditional vegetable crop in Ethiopia. Shallot is susceptible to a number of diseases that reduce yield and quality, among which fusarium basal rot (FBR) caused by Fusarium oxysporum f.sp. cepae (Foc) is one of the most important yield limiting factors in Ethiopia. The present study was designed to evaluate the effectiveness of Brassica crops for the management of shallot FBR on shallot. The experiments were carried out at Debre Zeit Agricultural Research Center using cabbage (Brassica oleracea), garden cress (Lepidium sativum), Ethiopia mustard (B. carinata), and rapeseed (B. napus). The evaluations were done under in vitro and greenhouse conditions. Under in vitro test condition it was confirmed that extracts of Ethiopian mustard and rapeseed showed higher inhibition on the growth of Foc pathogen compared to control. Data on seedling emergence, plant height, plant stand, disease incidence, severity, cull bulbs, and bulb weight were collected in greenhouse experiment. The green manure amendments of rapeseed and Ethiopian mustard significantly reduced disease incidence by 21% and 30% and disease severity by 23% and 29%, respectively. However the plant emergency was not significantly different among treatments in greenhouse test. These results indicated that Ethiopian mustard and rapeseed crops have potential as green manure for the management of FBR disease of shallot crop

Indian childhood cirrhosis – down but not out: Report of a rare case with a practical clinicopathological diagnostic approach

Indian childhood cirrhosis is an entity believed to be on the verge of extinction. We present the case of a 13-month-old girl presenting acutely with jaundice, fever, and persistently increasing bilirubin. Investigations revealed direct hyperbilirubinemia, elevated transaminases, anemia, a blood with few schistocytes, positive direct coombs test, and deranged prothrombin time. Viral, autoimmune, and metabolic workup was unremarkable. Ultrasonography showed chronic liver disease, portal hypertension, and ascites. Due to numerous confounding factors and a low index of suspicion, the diagnosis of Indian childhood cirrhosis remained elusive and was clinched only on liver biopsy, albeit more than three weeks later, shortly after which the child expired. The timing and technique of the liver biopsy may have profound impact on the ultimate clinical outcome. Close coordination between the clinical and pathological teams is essential for deciphering acute presentations where the etiology is uncertain. We highlight the clinical considerations, varied morphological pointers, and offer a diagnostic algorithm facilitating the consideration of this disease