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Biomedical subjects

A Bagga

Publications and source records attributed to A Bagga.

At least 37 records · Page 2Linked to original sources

An indigenously developed nitrite kit to aid in the diagnosis of urinary tract infection.

OBJECTIVE: To evaluate the utility of an indigenously developed nitrite kit for the rapid diagnosis of urinary tract infection (UTI) METHODS: 1018 urine specimens were collected from all cases where there was clinical suspicion of UTI. Samples were cultured as per standard microbiological protocol. Presence of nitrites was indicated by the development of purple color on addition of color developing solution and compared with the set of graded positive and negative controls also provided in the Kit. RESULTS: The results of the nitrite kit were compared with the semi-quantitative urine culture as the gold standard. The sensitivity, specificity, positive predictive and negative predictive values were 47%, 87%, 31% and 93%, respectively. CONCLUSION: Nitrite kit as a screening test can decrease the work load in the clinical bacteriology laboratory. More importantly in a field set up that is devoid of culture facilities, it can be used to correctly predict the absence of UTI.

Adult↗

Acute renal failure in bilateral urinary tract tuberculosis.

A case of bilateral urinary tract tuberculosis presenting with acute renal failure is reported. It is believed to be the first reported instance of the disease presenting in this form. The patient was managed with preliminary high diversion followed by bilateral replacement of the ureters with ileal loops that were anastomosed end-to-side and then implanted into the bladder.

Acute Kidney Injury↗

Nephronophthisis associated with Ellis-van Creveld syndrome.

Ellis-van Creveld (EvC) and Jeune's asphyxiating thoracic dystrophy (ATD) are related disorders characterized by narrow thoracic cage and short-limbed dwarfism. Some patients have overlapping features of both ATD and EvC, indicating that these syndromes may be a part of a disease spectrum. Nephronophthisis has been occasionally reported in patients with ATD, but not with EvC syndrome. We report a patient who was diagnosed with EvC syndrome at birth. He developed hypertension at 5 months of age and gradually progressive renal failure, requiring renal transplantation at 8 years. Histopathological findings in the nephrectomy specimen were indicative of nephronophthisis. The association of nephronophthisis in a patient with EvC syndrome has not been reported previously. This association further supports the hypothesis that ATD and EvC syndromes are related and represent a spectrum of disorders.

Ellis-Van Creveld Syndrome↗

Urinary net charge in hyperchloremic metabolic acidosis.

OBJECTIVE: (i) To examine the usefulness of urinary net charge (UNa + UK - UCl) in the evaluation of hyperchloremic metabolic acidosis secondary to diarrhea, distal RTA and proximal RTA and (ii) To characterize the type of distal RTA on the basis of the underlying defect. SETTING: Pediatrics division of a tertiary referral center. SUBJECTS: Thirty four children with hyperchloremic metabolic acidosis secondary to diarrhea (n = 16), distal RTA (n = 11) and proximal RTA (n = 7). Ten normal children with ammonium chloride induced acidosis were also studied. METHODS: All subjects underwent urine collection of 30-60 minutes duration for measurement of Na, K, Cl, pH and pCO2. The measurements were also made on the blood samples collected at the midpoint of urine collection. The urinary net charge was calculated by subtracting Cl values from the sum of the Na and K. RESULTS: Patients with proximal and distal RTA had a positive urine net charge. Patients with diarrhea and ammonium chloride induced acidosis showed negative urine net charge. Patients with diarrhea with extremely low urine sodium levels showed an inappropriately high urine pH despite persistent metabolic acidosis. All patients with distal RTA were found to have a secretory type of defect. CONCLUSION: Measurement of urine net charge is helpful in the initial evaluation of a patient with hyperchloremic metabolic acidosis.

Acidosis↗

Parvovirus B19 infection-related complications in renal transplant recipients: treatment with intravenous immunoglobulin.

BACKGROUND: Chronic red cell aplasia can develop in immunocompromised patients including transplant recipients infected with parvovirus B19 (PV B19). Renal involvement with PV B19 infection is not well-recognized. METHODS: We diagnosed erythroid hypoplasia associated with PV B19 infection in three renal transplant recipients; one of them developed de novo collapsing glomerulopathy. These patients were treated with intravenous immunoglobulin (IVIG). RESULTS: In two patients, anemia responded promptly to IVIG therapy. One of them had recurrence of anemia that responded to a second course of IVIG. Despite IVIG treatment, persistent infection with PV B19, recurrent anemia, and de novo collapsing glomerulopathy leading to allograft failure developed in the third patient, who had received the most intense immunosuppression. CONCLUSIONS: These findings indicate that PV B19 infection in transplant recipients can cause chronic red cell aplasia that generally responds to IVIG therapy. In some patients, particularly those who are heavily immunosuppressed, infection may persist despite treatment. As the cellular receptor for PV B19 is expressed in the kidney, persistent infection may result in development of glomerulopathies in these patients.

Adult↗

Urinary excretion of minerals, oxalate, and uric acid in north Indian children.

Urinary excretion of calcium, magnesium, phosphate, uric acid, oxalate, and creatinine was measured in 208 children (aged 8-15 years, 124 boys, 84 girls), living in a residential school near New Delhi. Levels were reduced compared with those reported from developed countries. The 95th percentile value of 24-h creatinine excretion was 33.4 mg/kg, calcium 2.2 mg/kg, magnesium 2.9 mg/kg, phosphate 9.4 mg/kg, uric acid 4.4 mg/kg, and oxalate 1.5 mg/kg. The 95th percentile value of the urine calcium/creatinine ratio was 0.15 and oxalate/creatinine 0.06. The dietary intake of proteins, calcium, and other nutrients in these children was less than recommended and explained the reduced urinary excretion observed. Physicians need to be aware of the regional patterns of normal urinary excretion of these constituents.

Adolescent↗

Levamisole therapy in corticosteroid-dependent nephrotic syndrome.

The effect of prolonged treatment with levamisole was examined in 43 patients (30 boys) with steroid-dependent nephrotic syndrome (SDNS). The mean age at institution of treatment was 4.0 +/- 2.0 years. Fourteen patients had previously received cyclophosphamide with an ensuing remission of 8.5 +/- 10 months. Following induction of remission with prednisolone, levamisole was administered at a dose of 2.5 mg/kg body weight on alternate days. Prednisolone was tapered by 2.5-5 mg every 4 weeks to 0.5 mg/kg on alternate days. The duration of levamisole therapy ranged from 6 to 31 months (mean 17.4 +/- 8.4 months); 15 patients received levamisole for more than 18 months and 10 for more than 24 months. Prednisolone was discontinued in 18 patients after a mean duration of 11.7 +/- 7.1 months, whereas in 21 patients its dose was reduced to 0.2-0.4 mg/kg on alternate days. The mean relapse rate prior to levamisole therapy was 3.0 +/- 1.5 relapses/year, which reduced to 0.9 +/- 0.7 relapses/year during levamisole treatment (P < 0.001). A comparison of the response in 14 patients who had previously received cyclophosphamide with the other 29 patients did not show any significant difference. There were no side effects of levamisole therapy. Our findings suggest that prolonged treatment with levamisole is beneficial and safe in SDNS, with a marked steroid-sparing effect. A significant proportion of these patients can be kept in remission on levamisole alone.

Adjuvants, Immunologic↗

Single- versus divided-dose prednisolone therapy for relapses of nephrotic syndrome.

Relapses of nephrotic syndrome are usually treated with prednisolone, initially in three to four daily divided doses. The divided-dose regimen may cause poor patient compliance and greater adrenal suppression. In a prospective randomized controlled trial, we compared the efficacy of prednisolone in inducing remission of nephrotic syndrome, when given either as a single dose or in divided doses. Patients with steroid-responsive nephrotic syndrome with relapse were randomized to receive prednisolone 2 mg/kg per day, either as a single morning dose or in three divided doses for 2 weeks, followed by 1.5 mg/kg on every alternate day for 4 weeks. Parents tested the urine for protein daily until remission (nil proteinuria for 3 consecutive days). The duration between initiation of treatment and achievement of remission was recorded. Of 106 patients, 94 (47 each in single-dose and divided-dose groups) completed the study. The patients in the two groups were similar in relation to age, sex, number of relapses in the preceding year, and blood levels of creatinine, albumin, and cholesterol. The mean time for achievement of remission in the single- and divided-dose groups was 8.6 and 8.5 days, respectively (P = 0.94, power 96%). After 9 months' follow-up, there were no differences in the frequency of relapses and cumulative dose of prednisolone received in the two groups. The observations suggest that prednisolone administered in a single daily dose or in divided doses is equally effective in inducing remission in patients with relapsing nephrotic syndrome.

Adolescent↗

Peripheral blood lymphocyte subsets in idiopathic nephrotic syndrome of childhood.

Lymphocyte subsets in the peripheral blood were examined in 34 patients with nephrotic syndrome [27 with minimal change nephrotic syndrome (MCNS), 7 with significant lesions] and 10 normal children. The investigations were done at the onset of disease before administering corticosteroids (n = 34), during the subsequent remission (n = 27), and the first relapse (n = 12). The proportions of T cell subsets (CD3, CD4 and CD8) were determined by immuno-alkaline phosphatase staining; interleukin-2 receptor (IL-2 R) positive cells, natural killer (NK) cells and B cells were studied by indirect immunofluorescence. No significant differences were found in the proportion of CD3, CD4, CD8 and IL-2 R positive cells in patients with MCNS as compared to controls. An increased proportion of NK and B cells was not specific to MCNS and was detected even in those with significant renal lesions. Our findings suggest that T lymphocyte subsets in MCNS are similar to those in normal children.

Adolescent↗

Aetiology of nephrolithiasis in north Indian children.

The aetiology of nephrolithiasis was investigated in 32 north Indian children (25 boys, 7 girls, mean age 7.9 +/- 3.3 years). An underlying disorder was detected in 16 (50%) patients and included idiopathic hypercalciuria (8 patients), hyperoxaluria (3 patients) and renal tubular acidosis, primary hyperparathyroidism and hyperuricosuria (1 patient each). Magnesium ammonium phosphate calculi were found in 2 patients with recurrent urinary tract infections, 1 of whom had a duplex pelvic collecting system. In 16 patients (50%) a cause for renal calculi was not identified. Our findings suggest that an underlying disorder is present in a large proportion of children with nephrolithiasis where appropriate treatment may be beneficial.

Calcium↗

Sarcoidosis.

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Child↗