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Bagri N.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | Saha A.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | Dubey N.K.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | Rai A.,Dr Ram Manohar Lohia Hospital | Bhattacharya S.,Dr Ram Manohar Lohia Hospital
Iranian Journal of Kidney Diseases | Year: 2013

Necrotizing fasciitis is a rare complication of nephrotic syndrome in children, with a high mortality rate. We report a case with successful outcome with judicious intravenous antibiotics and skin grafting of the bilateral lower thighs.


Suresh C.P.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | Saha A.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | Kaur M.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | Kumar R.,Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital | And 9 more authors.
Clinical and Experimental Nephrology | Year: 2015

Background: We performed a discovery phase of urinary proteomic profile in children with idiopathic nephrotic syndrome and validated selected biomarkers. Methods: Urinary proteomic profile was performed using isobaric tags for relative and absolute quantitation labeling, coupled with liquid chromatography-matrix assisted laser desorption and ionization analysis. Validation of biomarkers apolipoprotein A1, alpha 2 macroglobulin, orosomucoid 2, retinol binding protein 4 and leucine-rich alpha 2-glycoprotein 1 was done by enzyme-linked immunosorbent assay. Results: Apolipoprotein A1 levels of <0.48 µg/mg of creatinine-differentiated steroid-resistant nephrotic syndrome (SRNS) from first episode nephrotic syndrome, area under curve (AUC) [0.99 (CI 0.9–1.0), 100 % sensitivity and 100 % specificity] and a value of <0.24 µg/mg of creatinine could differentiate SRNS from frequently relapsing nephrotic syndrome/steroid dependent nephrotic syndrome [AUC 0.99 (CI 0.9–1.0), 100 % sensitivity and 100 % specificity]. Alpha 2 macroglobulin could differentiate children with SRNS-focal segmental glomerulosclerosis (FSGS) from SRNS-minimal change disease (MCD) at values >3.3 µg/mg of creatinine [AUC 0.84 (CI 0.62–1.0), 90 % sensitivity and 85 % specificity]. Orosomucoid 2 >1.81 µg/mg of creatinine could distinguish SRNS-FSGS from SRNS-MCD [AUC 0.84 (CI 0.62–1.0), sensitivity 90 % and specificity 85.5 %]. RBP 4 value of >1.54 µg/mg of creatinine differentiated SRNS-FSGS from SRNS-MCD [AUC 0.87 (CI 0.68–1.0), sensitivity 90 % and specificity 85.7 %]. Conclusions: Lower level of apolipoprotein A1 in urine is suggestive of SRNS. Alpha 2 macroglobulin, retinol binding protein 4 and orosomucoid 2 are markers associated with FSGS, with alpha 2 macroglobulin being most predictive. © 2015 Japanese Society of Nephrology


PubMed | GB Pant Hospital, CSIR - Central Electrochemical Research Institute, Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital and All India Institute of Medical Sciences
Type: Journal Article | Journal: Clinical and experimental nephrology | Year: 2016

We performed a discovery phase of urinary proteomic profile in children with idiopathic nephrotic syndrome and validated selected biomarkers.Urinary proteomic profile was performed using isobaric tags for relative and absolute quantitation labeling, coupled with liquid chromatography-matrix assisted laser desorption and ionization analysis. Validation of biomarkers apolipoprotein A1, alpha 2 macroglobulin, orosomucoid 2, retinol binding protein 4 and leucine-rich alpha 2-glycoprotein 1 was done by enzyme-linked immunosorbent assay.Apolipoprotein A1 levels of <0.48 g/mg of creatinine-differentiated steroid-resistant nephrotic syndrome (SRNS) from first episode nephrotic syndrome, area under curve (AUC) [0.99 (CI 0.9-1.0), 100 % sensitivity and 100 % specificity] and a value of <0.24 g/mg of creatinine could differentiate SRNS from frequently relapsing nephrotic syndrome/steroid dependent nephrotic syndrome [AUC 0.99 (CI 0.9-1.0), 100 % sensitivity and 100 % specificity]. Alpha 2 macroglobulin could differentiate children with SRNS-focal segmental glomerulosclerosis (FSGS) from SRNS-minimal change disease (MCD) at values >3.3 g/mg of creatinine [AUC 0.84 (CI 0.62-1.0), 90 % sensitivity and 85 % specificity]. Orosomucoid 2 >1.81 g/mg of creatinine could distinguish SRNS-FSGS from SRNS-MCD [AUC 0.84 (CI 0.62-1.0), sensitivity 90 % and specificity 85.5 %]. RBP 4 value of >1.54 g/mg of creatinine differentiated SRNS-FSGS from SRNS-MCD [AUC 0.87 (CI 0.68-1.0), sensitivity 90 % and specificity 85.7 %].Lower level of apolipoprotein A1 in urine is suggestive of SRNS. Alpha 2 macroglobulin, retinol binding protein 4 and orosomucoid 2 are markers associated with FSGS, with alpha 2 macroglobulin being most predictive.


PubMed | Postgraduate Institute Of Medical Education And Research And Associated Dr Ram Manohar Lohia Hospital
Type: Journal Article | Journal: Journal of emergencies, trauma, and shock | Year: 2011

We present two cases of extreme neglect with injuries. These are perfect examples of gender bias. Our first case is a 20-day-old female neonate was brought to the pediatric emergency department with multiple rat bites to the face. A 9-month-old female infant was brought to the emergency care division with multiple rat bites on the eyes and upper extremities. These cases point towards the existing gender bias and extreme social neglect of females in the Indian society.


PubMed | Postgraduate Institute of Medical Education and Research and associated Dr Ram Manohar Lohia Hospital
Type: Journal Article | Journal: Emergency medicine Australasia : EMA | Year: 2013

We studied the epidemiology of paediatric firework-related injury in the urban population of Delhi during the festival of lights (Diwali).In this prospective observational study, data were collected on the day of Diwali for two consecutive years, 2010 and 2011. All children with firework injuries coming to the emergency room were included in the study. Data were recorded in a predesigned proforma.Of the 65 cases, 75% were males and 25% were females; most children were more than 10 years of age and majority (90%) of them were unsupervised. Half (49%) of the cases were due to misuse of the fireworks or erratic behaviour, among which the most common observed mode was igniting cracker while holding it (18 cases; 24% of total injuries), which led to injuries to the hand and palm. Device failure was the next common cause for firework injuries, including unexpected blast of the crackers and string bomb as the most common. Overall, the most commonly injured body sites were hands (62%), face (32%) and eyes (10%). Crackers and string bomb mainly caused injuries to hands; fountains and gunpowder caused injuries to the face. Sixty (94%) children were managed conservatively and 5 (6%) required skin grafting and tendon repair.We recommend parental supervision especially for males, wearing non-synthetic and non-flowing clothes, promoting branded crackers and educational campaigns in schools to curtail the rising trend in firework-related injuries in the paediatric population.


PubMed | Postgraduate Institute of Medical Education and Research and Associated Dr Ram Manohar Lohia Hospital
Type: Case Reports | Journal: Iranian journal of kidney diseases | Year: 2013

Necrotizing fasciitis is a rare complication of nephrotic syndrome in children, with a high mortality rate. We report a case with successful outcome with judicious intravenous antibiotics and skin grafting of the bilateral lower thighs.

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