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Arunachalam B, Manavalan R, Gopalakrishnan N. Effects of multi-atom doping into Pt13 cluster using Ab initio method. Theor Chem Acc 2022. [DOI: 10.1007/s00214-022-02908-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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2
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Rajarathinam V, Gopalakrishnan N, Senthilkumaran G, Vs J, Murugesan V, Balasubramanian C, Devaraju P, Thanigachalam D, Solomon D, Moses Lamech T, Palaniselvam S. POS-021 COVID VACCINE ASSOCIATED GLOMERULAR DISEASES- A CASE SERIES. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Jayaprakash V, Kumar TD, Gopalakrishnan N, Kurien AA. 'Snapshot' of an annual data from a large South Indian Renal Biopsy Registry. Saudi J Kidney Dis Transpl 2022; 32:522-529. [PMID: 35017347 DOI: 10.4103/1319-2442.335465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Results from biopsy registries are important to know about the prevalence of renal diseases. In large studies done over several years, significant interobserver variability could have existed. Single-year biopsy registry data are analyzed in this study. The study included 481 renal biopsy specimens including 65 from allografts. Primary glomerulonephritis constituted 37.74% and secondary glomerular diseases constituted 32.21% of native kidney biopsies. Minimal change disease was the most common primary glomerular disease, followed by membranous nephropathy (MN). Lupus nephritis was the most common secondary glomerular disease. This study included specimens from 34 geriatric patients and MN was the most common lesion in that age group. Acute cellular rejection was the most common diagnosis in renal allograft biopsies.
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Affiliation(s)
- V Jayaprakash
- Department of Nephrology, SRM Medical College and Research Centre, Tamil Nadu, India
| | - T Dinesh Kumar
- Institute of Nephrology, Madras Medical College, Chennai, India
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Prasad N, Behera MR, Bhatt M, Agarwal SK, Gopalakrishnan N, Fernando E, Chaudhary AR, Sahay M, Singh S, Jain A, Tapiawala S, Kamble A, Khanna U, Bohra R, Gupta A, Anandh U, Jha V. Outcomes of symptomatic coronavirus disease 19 in maintenance hemodialysis patient in India. Semin Dial 2021; 34:360-367. [PMID: 34259363 PMCID: PMC8447077 DOI: 10.1111/sdi.13000] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/23/2021] [Accepted: 06/15/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Maintenance hemodialysis (MHD) patients face disadvantages with higher risk of acquiring SARS-CoV-2 infection, atypical manifestations, and associated multiple comorbidities. We describe patients' outcomes with symptomatic COVID-19 on MHD in a large cohort of patients from India. METHODS Data were collected prospectively from hemodialysis units in 11 public and private hospitals between March 15, 2020, and July 31, 2020. The survival determinants were analyzed using stepwise backward elimination cox-regression analysis. RESULTS Of the 263 total patients (mean age 51.76 ± 13.63 years and males 173) on MHD with symptomatic COVID-19, 35 (13.3%) died. Those who died were older (p = 0.01), had higher frequency of diabetic kidney disease (p = 0.001), comorbidities (p = 0.04), and severe COVID-19 (p = 0.001). Mortality was higher among patients on twice-weekly MHD than thrice-weekly (p = 0.001) and dialysis through central venous catheter (CVC) as compared to arteriovenous fistula (p = 0.001). On multivariate analysis, CVC use (HR 2.53, 95% CI 1.26-5.07, p = 0.009), disease severity (HR = 3.54, 95% CI 1.52-8.26, p = 0.003), and noninvasive ventilatory support (HR 0.59, 95% CI 0.25-0.99, p = 0.049) had significant effect on mortality. CONCLUSION The adjusted mortality risk of COVID-19 in MHD patients is high in patients associated with severe COVID-19 and patients having CVC as vascular access.
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Affiliation(s)
- Narayan Prasad
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Mansi Bhatt
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | | | | | | | | | | | | | | | | | | | - Rubina Bohra
- Shri Aurobindo Medical College and Postgraduate Institute, Indore, India
| | | | | | - Vivekanand Jha
- George Institute India, University of New South Wales, Sydney, New South Wales, Australia
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Agarwal N, Meena CS, Raj BP, Saini L, Kumar A, Gopalakrishnan N, Kumar A, Balam NB, Alam T, Kapoor NR, Aggarwal V. Indoor air quality improvement in COVID-19 pandemic: Review. Sustain Cities Soc 2021; 70:102942. [PMID: 33889481 PMCID: PMC8049211 DOI: 10.1016/j.scs.2021.102942] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 05/14/2023]
Abstract
INTRODUCTION The advent of COVID-19 has impinged millions of people. The increased concern of the virus spread in confined spaces due to meteorological factors has sequentially fostered the need to improve indoor air quality. OBJECTIVE This paper aims to review control measures and preventive sustainable solutions for the future that can deliberately help in bringing down the impact of declined air quality and prevent future biological attacks from affecting the occupant's health. METHODOLOGY Anontology chart is constructed based on the set objectives and review of all the possible measures to improve the indoor air quality taking into account the affecting parameters has been done. OBSERVATIONS An integrated approach considering non-pharmaceutical and engineering control measures together for a healthy indoor environment should be contemplated rather than discretizing the available solutions. Maintaining social distance by reducing occupant density and implementing a modified ventilation system with advance filters for decontamination of viral load can help in sustaining healthy indoor air quality. CONCLUSION The review paper in the main, provides a brief overview of all the improvement techniques bearing in mind thermal comfort and safety of occupants and looks for a common ground for all the technologies based on literature survey and offers recommendation for a sustainable future.
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Affiliation(s)
- Nehul Agarwal
- CSIR-Central Building Research Institute (CBRI), Roorkee, 247667, India
- School of Energy and Environment, Thapar Institute of Engineering and Technology, Patiala, 147001, India
| | - Chandan Swaroop Meena
- CSIR-Central Building Research Institute (CBRI), Roorkee, 247667, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Binju P Raj
- CSIR-Central Building Research Institute (CBRI), Roorkee, 247667, India
- School of Energy and Environment, Thapar Institute of Engineering and Technology, Patiala, 147001, India
| | - Lohit Saini
- CSIR-Central Building Research Institute (CBRI), Roorkee, 247667, India
- School of Energy and Environment, Thapar Institute of Engineering and Technology, Patiala, 147001, India
| | - Ashok Kumar
- CSIR-Central Building Research Institute (CBRI), Roorkee, 247667, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - N Gopalakrishnan
- CSIR-Central Building Research Institute (CBRI), Roorkee, 247667, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Anuj Kumar
- CSIR-Central Building Research Institute (CBRI), Roorkee, 247667, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Nagesh Babu Balam
- CSIR-Central Building Research Institute (CBRI), Roorkee, 247667, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Tabish Alam
- CSIR-Central Building Research Institute (CBRI), Roorkee, 247667, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Nishant Raj Kapoor
- CSIR-Central Building Research Institute (CBRI), Roorkee, 247667, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Vivek Aggarwal
- CSIR-Central Building Research Institute (CBRI), Roorkee, 247667, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
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LAMECH T, Arumugam V, Bhagavatula VRH S, Govindasamy N, Dhanapalan A, Sakthirajan R, Natarajan M, Padmaraj R, Gopalakrishnan N. POS-198 ACUTE KIDNEY INJURY IN PEOPLE LIVING WITH HIV/AIDS. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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SASTRY B, Govindasamy N, Dhanapalan A, Lamech Moses T, Arumugam V, Thanikachalam D, Dakshinamoorthy S, p S, Gopalakrishnan N. POS-160 CLINICAL AND HISTOMORPHOLOGICAL SPECTRUM OF CRESCENTIC GLOMERULONEPHRITIS FROM SOUTHERN INDIA-A SINGLE CENTER EXPERIENCE. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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DHANAPALAN A, Govindasamy N, Lamech Moses T, Arumugam V, Bhagavatula VRH S, Alavudeen Sulthan S, Jayachandran D, p S, Gopalakrishnan N. POS-140 SPECTRUM OF BIOPSY PROVEN RENAL DISEASES IN SOUTH INDIA- A SINGLE CENTER EXPERIENCE. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Prasad N, Bhatt M, Agarwal SK, Kohli H, Gopalakrishnan N, Fernando E, Sahay M, Rajapurkar M, Chowdhary AR, Rathi M, Jeloka T, Lobo V, Singh S, Bhalla A, Khanna U, Bansal S, Rai P, Bhawane A, Anandh U, Singh AK, Shah B, Gupta A, Jha V. The Adverse Effect of COVID Pandemic on the Care of Patients With Kidney Diseases in India. Kidney Int Rep 2020; 5:1545-1550. [PMID: 32838077 PMCID: PMC7336912 DOI: 10.1016/j.ekir.2020.06.034] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/22/2020] [Accepted: 06/26/2020] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has affected the care of patients with noncommunicable diseases, including those suffering from kidney-related ailments. Many parts of the world, including India, adopted lockdown to curb community transmission of disease. The lockdown affected transportation, access to health care facilities, and availability of medicines and consumables as well as outpatient and inpatient services. We aimed to analyze the effect of lockdown imposed due to the COVID-19 pandemic on the care of patients with kidney diseases in India. METHODS We surveyed 19 major hospitals (8 in the public and 11 in the private sector) to determine the effect of lockdown on the care of patients with kidney disease, including those on dialysis after the first 3 weeks of lockdown. RESULTS The total number of dialysis patients in these centers came down from 2517 to 2404. Approximately 710 (28.2%) patients missed 1 or more dialysis sessions, 69 (2.74%) required emergency dialysis sessions, 104 (4.13%) stopped reporting for dialysis, and 9 (0.36%) were confirmed to have died. Outpatient attendance in the surveyed hospital came down by 92.3%, and inpatient service reduced by 61%. Tele-consultation was started but was accessed by only a small number of patients. CONCLUSION Lack of preparedness before lockdown resulted in an interruption in health care services and posed an immediate adverse effect on the outcome of dialysis patients and patients with kidney disease in India. The long-term impact on the health of patients with less severe forms of kidney disease remains unknown.
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Affiliation(s)
- Narayan Prasad
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Mansi Bhatt
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sanjay K. Agarwal
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - H.S. Kohli
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Edwin Fernando
- Department of Nephrology, Government Stanley Medical College, Chennai, India
| | - Manisha Sahay
- Department of Nephrology, Osmania General Hospital, Hyderabad, India
| | - Mohan Rajapurkar
- Department of Nephrology, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India
| | - Arpita Roy Chowdhary
- Department of Nephrology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Manish Rathi
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tarun Jeloka
- Nephrology, Aditya Birla Hospital, Pune, Maharashtra, India
| | - Valentine Lobo
- Nephrology, King Edward Memorial Hospital, Pune, Maharashtra, India
| | - Shivendra Singh
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - A.K. Bhalla
- Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | - Umesh Khanna
- Department of Nephrology, Lancelot Kidney Centre, Mumbai, Maharashtra, India
| | - S.B. Bansal
- Nephrology and Kidney Transplantation, Medanta-Medicity, Gurgaon, Haryana, India
| | - P.K. Rai
- Department of Nephrology, Opal Hospital, Varanasi, Uttar Pradesh, India
| | - Amol Bhawane
- Department of Nephrology, Acharya Vinoba Bhave Rural Hospital, Wardha, Maharashtra, India
- Department of Nephrology, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
| | - Urmila Anandh
- Department of Nephrology, Yashoda Hospitals, Secunderabad, Telangana, India
| | - Ajit Kumar Singh
- Department of Nephrology, Neotia Getwel Healthcare Centre, Siliguri, Darjeeling, West Bengal, India
| | - Bharat Shah
- Department of Nephrology, Global Hospital, Mumbai, Maharashtra, India
| | - Amit Gupta
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vivekanand Jha
- The George Institute for Global Health, University of New South Wales, India
- Nephrology, University of Oxford, Oxford, UK
- Department of Nephrology, Manipal Academy of Higher Education, Manipal, India
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Arivazhagan S, Rajasekar D, Gopalakrishnan N, Sakthirajan R, Dhanapriya J, Kumar TD, Balasubramanian T, Malathy N. Clinicopathological profile and outcome of adult infection-related glomerulonephritis: A prospective follow-up study. Natl Med J India 2020; 33:260-264. [PMID: 34213450 DOI: 10.4103/0970-258x.317465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background . Infection-related glomerulonephritis (IRGN) in adults is witnessing a dramatic shift in its epidemiology and outcome. Adult IRGN studies are all retrospective in nature, and Indian studies are scarce. Methods . We did this prospective study (September 2016-April 2018) on all patients with biopsy-proven IRGN and age ≥18 years satisfying three of five diagnostic criteria. Patients with persistent hypocomplementaemia (>3 months) were excluded. We did electron microscopy in those without a minimum of three diagnostic criteria and did an extensive search for any occult infection in every patient. Results . Forty-five patients were studied with a mean (SD) follow-up of 45.7 (20) weeks. Their mean age was 41.5 years (18-70 years), with a female preponderance (1:1.25). At presentation, the majority had oedema (100%), oliguria (84.4%), hypertension (80%) and haematuria (77.8%). Of them, 86.7% had renal insufficiency and 35.6% required dialysis. Only 53.3% of them had evidence of antecedent/ current infection, with skin/subcutaneous focus being the most common site. Hypocomplementaemia was present in 82.2% of patients. Salient pathological features were endocapillary proliferation (93.3%), neutrophilic infiltration (88.9%), presence of crescents (17.8%), interstitial infiltration (24.4%), moderate-to-severe interstitial fibrosis with tubular atrophy (IFTA; 15.5%) and underlying diabetic glomerulosclerosis (8.9%). Only 66.7% of patients made complete renal recovery. By logistic regression analysis, the predictors of poor outcome were a requirement for dialysis at presentation (p=0.04) and presence of IFTA (p = 0.03). Conclusion . A proportion of adult IRGN patients progress to chronic kidney disease.
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Affiliation(s)
- S Arivazhagan
- Department of Nephrology, Institute of Nephrology, Madras Medical College, Park Town, Chennai 600009, Tamil Nadu, India
| | - D Rajasekar
- Department of Nephrology, Institute of Nephrology, Madras Medical College, Park Town, Chennai 600009, Tamil Nadu, India
| | - N Gopalakrishnan
- Department of Nephrology, Institute of Nephrology, Madras Medical College, Park Town, Chennai 600009, Tamil Nadu, India
| | - R Sakthirajan
- Department of Nephrology, Institute of Nephrology, Madras Medical College, Park Town, Chennai 600009, Tamil Nadu, India
| | - J Dhanapriya
- Department of Nephrology, Institute of Nephrology, Madras Medical College, Park Town, Chennai 600009, Tamil Nadu, India
| | - T Dinesh Kumar
- Department of Nephrology, Institute of Nephrology, Madras Medical College, Park Town, Chennai 600009, Tamil Nadu, India
| | - T Balasubramanian
- Department of Nephrology, Institute of Nephrology, Madras Medical College, Park Town, Chennai 600009, Tamil Nadu, India
| | - N Malathy
- Department of Nephrology, Institute of Nephrology, Madras Medical College, Park Town, Chennai 600009, Tamil Nadu, India
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Prasad N, Gopalakrishnan N, Sahay M, Gupta A, Agarwal SK. Epidemiology, Genomic Structure, the Molecular Mechanism of Injury, Diagnosis and Clinical Manifestations of Coronavirus Infection: An Overview. Indian J Nephrol 2020; 30:143-154. [PMID: 33013059 PMCID: PMC7470209 DOI: 10.4103/ijn.ijn_191_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 12/15/2022] Open
Abstract
COVID-19 is caused by a novel beta coronavirus (SARS-CoV-2) strain that was first discovered in 2019 in the Wuhan city of China. Based on virus genome sequencing studies, the bat is suspected as the natural host of virus, and infection might be transmitted from bats via unknown intermediate hosts like reptiles and snakes etc., to infect humans. COVID-19 is transmitted from person to person contact, primarily via droplet infection within the incubation period or after clinical manifestations of fever, cough, sneezing, sputum, dyspnea, and pneumonia and through contaminated fomites. COVID-19 enters the respiratory tract through the ACE2 receptor on alveoli through binding of s-protein of the virus and causes injuries though the cytopathic effect, as well as cytokines and other mediators, released after developing sepsis. ACE 2 is almost 100-fold higher in kidneys than lung, and the virus can also involve the kidney in the same manner. Kidney involvement manifests in the form of proteinuria, hematuria, and an acute rise in serum creatinine. Kidney involvement is an independent risk factor for mortality. Diagnosis is primarly made by detecting viral RNA by reverse transcriptase polymerase chain reaction (rtPCR) in nasopharyngeal swab samples. Role of antibodies, both IgM and IgG are still evolving and at best restricted for epidemiological purpose. Though a large number of treatments, including hydroxychloroquine, anti-viral, convalescent plasma etc., are being tried, as of now treatment is symptomatic only.
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Affiliation(s)
- Narayan Prasad
- Professor of Nephrology, SGPGIMS, Lucknow, Uttar Pradesh, India
| | | | - Manisha Sahay
- Osmania Medical College, Hyderabad, Telangana, India
| | - Amit Gupta
- Professor of Nephrology, SGPGIMS, Lucknow, Uttar Pradesh, India
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Gopalakrishnan N, Gandhi S, Dineshkumar T, Dhanapriya J, Sakthirajan R, Aravinthkumar R, manoj K, Gandhi S. SAT-021 Epidemiologic Trend Changes In Acute Kidney Injury Over The Past Four Decades – An Indian Centre Experience. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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KUMAR M, Maasila Thanjan A, Gopalakrishnan N, Balasubramaniyan T, Dinesh Kumar T, Dhanapriya J, Sakthirajan R, Malathy N. SAT-020 SNAKE BITE INDUCED ACUTE KIDNEY INJURY - A CLINICAL STUDY. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Jayaprakash V, Dineshkumar T, Dhanapriya J, Rajasekar D, Sakthirajan R, Balasubramaniyan T, Kurien A, Gopalakrishnan N. End of induction treatment outcomes with a novel cyclophosphamide-based regimen for severe lupus nephritis: Single-center experience from South India. Indian J Rheumatol 2020. [DOI: 10.4103/injr.injr_160_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gowrishankar S, Koshy P, Mathew M, Gopalakrishnan N, Kumar VS, Abraham G. Pathology of Uddanam Endemic Nephropathy. Indian J Nephrol 2019; 30:253-255. [PMID: 33273789 PMCID: PMC7699660 DOI: 10.4103/ijn.ijn_363_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/28/2019] [Accepted: 05/07/2019] [Indexed: 11/04/2022] Open
Abstract
In the last decade, pockets of endemic nephropathy have been recognized worldwide, in regions of Central America, Sri Lanka, and India. In India, the nephropathy has been recognized in the Uddanam area of north Andhra Pradesh and has been termed the Uddanam endemic nephropathy (UEN). The disease is distinctive in that besides the geographic distribution, it affects rural populations engaged in farm labor and agriculture, often silent in the initial phase with most patients presenting with advanced renal failure. The renal biopsy findings in all geographic areas including UEN have been one of a chronic tubulointerstitial nephritis with varying degrees of tubular injury, interstitial inflammation, tubular atrophy, and interstitial fibrosis with nonspecific glomerular obsolescence and lack of immune deposits. More recently, the demonstration of dysmorphic lysosomes in renal biopsies has favored a toxic etiology. There are thus many gaps in the understanding of this serious disease prevalent among poorer populations.
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Affiliation(s)
| | - Priyanka Koshy
- Department of Pathology, Madras Medical Mission Hospital, Chennai, Tamil Nadu, India
| | - Milly Mathew
- Department of Nephrology, Madras Medical Mission Hospital, Chennai, Tamil Nadu, India
| | - N Gopalakrishnan
- Institute of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India
| | - V Siva Kumar
- Department of Nephrology, Sri Venkateshwara Institute of Medical Sciences, Tirupathi, Andra Pradesh, India
| | - Georgi Abraham
- Department of Nephrology, Madras Medical Mission Hospital, Chennai, Tamil Nadu, India
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Nagarajan M, Maasila AT, Dhanapriya J, Dineshkumar T, Sakthirajan R, Rajasekar D, Balasubramaniyan T, Gopalakrishnan N. Systemic Lupus Erythematosus and Myasthenia Gravis: A Rare Association. Indian J Nephrol 2019; 29:62-64. [PMID: 30814797 PMCID: PMC6375012 DOI: 10.4103/ijn.ijn_12_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Systemic lupus erythematosus (SLE) and myasthenia gravis (MG) are two autoimmune diseases that have a higher incidence in young females, relapsing-remitting course, and positive antinuclear antibodies. SLE and MG are two different clinical syndromes, which can coexist or precede each other; however, their occurrence in the same patient is rare. We report a 38-year-old female with biopsy-proven lupus nephritis on steroids and cyclophosphamide, later developed MG. Nerve conduction studies showed the decremental response of 15%-25% over facial muscles with no decremental response over limb muscles. Although antianticholinesterase receptor (AchR) antibodies were negative, she was treated with oral pyridostigmine 60 mg twice daily and clinical improvement of ocular symptoms was seen within 48 h. At present, she is on oral prednisolone and mycophenolate mofetil with follow-up creatinine of 1.4 mg/dl and no neurological symptoms.
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Affiliation(s)
- M Nagarajan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - A T Maasila
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - J Dhanapriya
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Dineshkumar
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - R Sakthirajan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - D Rajasekar
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Balasubramaniyan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - N Gopalakrishnan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
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Tandon N, Anjana RM, Mohan V, Kaur T, Afshin A, Ong K, Mukhopadhyay S, Thomas N, Bhatia E, Krishnan A, Mathur P, Dhaliwal RS, Shukla DK, Bhansali A, Prabhakaran D, Rao PV, Yajnik CS, Kumar GA, Varghese CM, Furtado M, Agarwal SK, Arora M, Bhardwaj D, Chakma JK, Cornaby L, Dutta E, Glenn S, Gopalakrishnan N, Gupta R, Jeemon P, Johnson SC, Khanna T, Kinra S, Kutz M, Muraleedharan P, Naik N, Odell CM, Oommen AM, Pandian JD, Parameswaran S, Pati S, Prasad N, Raju DS, Roy A, Sharma M, Shekhar C, Shukla SR, Singh NP, Thakur JS, Unnikrishnan R, Varughese S, Xavier D, Zachariah G, Lim SS, Naghavi M, Dandona R, Vos T, Murray CJL, Reddy KS, Swaminathan S, Dandona L. The increasing burden of diabetes and variations among the states of India: the Global Burden of Disease Study 1990-2016. Lancet Glob Health 2018; 6:e1352-e1362. [PMID: 30219315 PMCID: PMC6227383 DOI: 10.1016/s2214-109x(18)30387-5] [Citation(s) in RCA: 227] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/18/2018] [Accepted: 08/10/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND The burden of diabetes is increasing rapidly in India but a systematic understanding of its distribution and time trends is not available for every state of India. We present a comprehensive analysis of the time trends and heterogeneity in the distribution of diabetes burden across all states of India between 1990 and 2016. METHODS We analysed the prevalence and disability-adjusted life-years (DALYs) of diabetes in the states of India from 1990 to 2016 using all available data sources that could be accessed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, and assessed heterogeneity across the states. The states were placed in four groups based on epidemiological transition level (ETL), defined on the basis of the ratio of DALYs from communicable diseases to those from non-communicable diseases and injuries combined, with a low ratio denoting high ETL and vice versa. We assessed the contribution of risk factors to diabetes DALYs and the relation of overweight (body-mass index 25 kg/m2 or more) with diabetes prevalence. We calculated 95% uncertainty intervals (UIs) for the point estimates. FINDINGS The number of people with diabetes in India increased from 26·0 million (95% UI 23·4-28·6) in 1990 to 65·0 million (58·7-71·1) in 2016. The prevalence of diabetes in adults aged 20 years or older in India increased from 5·5% (4·9-6·1) in 1990 to 7·7% (6·9-8·4) in 2016. The prevalence in 2016 was highest in Tamil Nadu and Kerala (high ETL) and Delhi (higher-middle ETL), followed by Punjab and Goa (high ETL) and Karnataka (higher-middle ETL). The age-standardised DALY rate for diabetes increased in India by 39·6% (32·1-46·7) from 1990 to 2016, which was the highest increase among major non-communicable diseases. The age-standardised diabetes prevalence and DALYs increased in every state, with the percentage increase among the highest in several states in the low and lower-middle ETL state groups. The most important risk factor for diabetes in India was overweight to which 36·0% (22·6-49·2) of the diabetes DALYs in 2016 could be attributed. The prevalence of overweight in adults in India increased from 9·0% (8·7-9·3) in 1990 to 20·4% (19·9-20·8) in 2016; this prevalence increased in every state of the country. For every 100 overweight adults aged 20 years or older in India, there were 38 adults (34-42) with diabetes, compared with the global average of 19 adults (17-21) in 2016. INTERPRETATION The increase in health loss from diabetes since 1990 in India is the highest among major non-communicable diseases. With this increase observed in every state of the country, and the relative rate of increase highest in several less developed low ETL states, policy action that takes these state-level differences into account is needed urgently to control this potentially explosive public health situation. FUNDING Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
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Gopalakrishnan N, Dhanapriya J, Padmakumar C, Dineshkumar T, Kurien AA, Sakthirajan R, Balasubramaniyan T. Collapsing Glomerulopathy and Thrombotic Microangiopathy in Postpartum Period: Two Case Reports. Indian J Nephrol 2018; 28:157-159. [PMID: 29861567 PMCID: PMC5952455 DOI: 10.4103/ijn.ijn_242_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Collapsing glomerulopathy (CG) is a distinct histopathologic pattern of glomerular injury characterized by global/segmental wrinkling of the glomerular basement membrane with podocyte hyperplasia and hypertrophy along with tubulointerstitial changes. There is no specific treatment for CG due to etiological heterogeneity, and newer insights into the pathogenesis may lead to the development of targeted therapy. The most common form of CG is the primary or idiopathic followed by secondary (due to viral infections, autoimmune disease, drugs, etc.) and genetic causes. Thrombotic microangiopathy (TMA) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ failure of variable severity. We here present two young women with preeclampsia who presented with acute kidney injury, anemia, and schistocytes in peripheral smear suggestive of TMA. Renal biopsy showed interesting histopathology of CG in addition to TMA in the first patient and CG alone in the second. Both the patients received supportive therapy while the first patient also received plasmapheresis. One patient had complete recovery, and other had partial recovery of renal function at last follow-up. Combined histopathological lesion of CG with TMA has never been reported in postpartum period so far in literature.
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Affiliation(s)
- N Gopalakrishnan
- Institute of Nephrology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - J Dhanapriya
- Institute of Nephrology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - C Padmakumar
- Institute of Nephrology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Dineshkumar
- Institute of Nephrology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - A A Kurien
- Center for Renal and Urological Pathology Pvt Ltd, Renopath, Chennai, Tamil Nadu, India
| | - R Sakthirajan
- Institute of Nephrology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Balasubramaniyan
- Institute of Nephrology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
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Chandramohan G, Dineshkumar T, Arul R, Seenivasan M, Dhanapriya J, Sakthirajan R, Balasubramaniyan T, Gopalakrishnan N. Spectrum of Hypokalemic Paralysis from a Tertiary Care Center in India. Indian J Nephrol 2018; 28:365-369. [PMID: 30270997 PMCID: PMC6146732 DOI: 10.4103/ijn.ijn_225_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Hypokalemic paralysis is an important and reversible cause of acute flaccid paralysis. The treating physician faces unique diagnostic and therapeutic challenges. We did a prospective study and included all patients with acute flaccid weakness and documented serum potassium of <3.5 mEq/L during the period between January 2009 and August 2015. We studied the incidence, etiology, clinical profile, and acid-base disturbances in patients presenting with hypokalemic paralysis and analyzed the significance of periodic and non-periodic forms of hypokalemic paralysis on patient's outcome. Two hundred and six patients were studied with a mean follow-up of 3.6 ± 1.2 years. Mean age was 37.61 ± 2.2 years (range 18-50 years). Males were predominant (M:F ratio 2.1:1). The nonperiodic form of hypokalemic paralysis was the most common (61%). Eighty-one (39%) patients had metabolic acidosis, 78 (38%) had normal acid-base status, and 47 (23%) patients had metabolic alkalosis. The most common secondary cause was distal renal tubular acidosis (RTA) (n = 75, 36%), followed by Gitelman syndrome (n = 39, 18%), thyrotoxic paralysis (n = 8, 4%), hyperaldosteronism (n = 7, 3%), and proximal RTA (n = 6, 4%). Patients with non-periodic paralysis had more urinary loss (40.1 vs. 12.2 mmol, P = 0.04), more requirement of potassium replacement (120 vs. 48 mmol, P = 0.05), and longer recovery time of weakness (48.1 vs. 16.5 h, P = 0.05) than patients with periodic paralysis. Non-periodic form of hypokalemic paralysis was the most common variant in our study. Patients with periodic paralysis had significant incidence of rebound hyperkalemia.
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Affiliation(s)
- G Chandramohan
- Department of Nephrology, Government Mohan Kumaramangalam Medical College, Salem, Tamil Nadu, India
| | - T Dineshkumar
- Institute of Nephrology, Madras Medical College, The Tamilnadu Dr MGR Medical University, Chennai, Tamil Nadu, India
| | - R Arul
- Institute of Nephrology, Madras Medical College, The Tamilnadu Dr MGR Medical University, Chennai, Tamil Nadu, India
| | - M Seenivasan
- Institute of Nephrology, Madras Medical College, The Tamilnadu Dr MGR Medical University, Chennai, Tamil Nadu, India
| | - J Dhanapriya
- Institute of Nephrology, Madras Medical College, The Tamilnadu Dr MGR Medical University, Chennai, Tamil Nadu, India
| | - R Sakthirajan
- Institute of Nephrology, Madras Medical College, The Tamilnadu Dr MGR Medical University, Chennai, Tamil Nadu, India
| | - T Balasubramaniyan
- Institute of Nephrology, Madras Medical College, The Tamilnadu Dr MGR Medical University, Chennai, Tamil Nadu, India
| | - N Gopalakrishnan
- Institute of Nephrology, Madras Medical College, The Tamilnadu Dr MGR Medical University, Chennai, Tamil Nadu, India
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Kawaskar K, Balasubramaniyan T, Gopalakrishnan N, Kumar TD, Chandrasekaran K, Sakthirajan R, Dhanapriya J. Incidence and outcome of transplant renal artery stenosis: A single-center experience. Indian J Transplant 2018. [DOI: 10.4103/ijot.ijot_31_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abraham G, Arun KN, Gopalakrishnan N, Renuka S, Pahari DK, Deshpande P, Isaacs R, Chafekar DS, Kher V, Almeida AF, Sakhuja V, Sundar S, Gulati S, Abraham A, Padmanaban R. Management of Hypertension in Chronic Kidney Disease: Consensus Statement by an Expert Panel of Indian Nephrologists. J Assoc Physicians India 2017; 65:6-22. [PMID: 28829108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Georgi Abraham
- Consultant Nephrologist, Madras Medical Mission, Chennai
| | - K N Arun
- Consultant Nephrologist, Mallya Hospital, Bangalore
| | - N Gopalakrishnan
- Professor and Head, Nephrology Dept., Madras Medical College, Chennai
| | - S Renuka
- Professor and Head, Nephrology Dept., St. John's Medical College & Hospital, Bangalore
| | - Dilip Kumar Pahari
- Director, Medical Institute of Kidney Diseases Medica Superspecialty Hospital, Kolkata
| | | | - Rajan Isaacs
- Consultant Nephrologist, Deep Kidney Care Hospital, Ludhiana
| | | | - Vijay Kher
- Chairman Division of Nephrology & Renal Transplant Medicine, Fortis Escorts Heart Institute & Research Centre, Delhi
| | - Alan Fernandes Almeida
- Consultant Nephrologist and Transplant Physician, PD Hinduja National Hospital & Research Centre, Mumbai
| | - Vinay Sakhuja
- Director, Nephrology & Transplant Medicine, Max Superspeciality Hospital, Mohali
| | - Sankaran Sundar
- Director & Chief Nephrologist, Karnataka Nephrology and Transplant Institute, Columbia Asia Medical Center- Hebbal, Bangalore
| | | | - Abi Abraham
- Senior Consultant Nephrologist, Lakeshore Hospital, Kochi
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Dineshkumar T, Dhanapriya J, Sakthirajan R, Thirumalvalavan K, Kurien AA, Balasubramaniyan T, Gopalakrishnan N. Thrombotic microangiopathy due to Viperidae bite: Two case reports. Indian J Nephrol 2017; 27:161-164. [PMID: 28356675 PMCID: PMC5358163 DOI: 10.4103/0971-4065.196936] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Snake bite is mainly an occupational hazard and causes serious health problems in rural India. Acute kidney injury (AKI) occurs in 5-30% cases. Renal pathologic findings include acute tubular necrosis, cortical necrosis, interstitial nephritis, glomerulonephritis, and vasculitis. Thrombotic microangiopathy (TMA) occurrence after a snake bite is reported rarely. Here, we present two patients who developed TMA after viper bite treated with hemodialysis and plasmapheresis. Renal biopsy showed fibrin thrombi in glomeruli and arterioles with cortical necrosis. One patient progressed to end-stage renal disease and other was lost to follow-up. TMA should be considered as a possible pathogenesis of AKI after snake bite. The role of plasma exchanges in snake bite TMA is yet to be defined.
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Affiliation(s)
- T Dineshkumar
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - J Dhanapriya
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - R Sakthirajan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - K Thirumalvalavan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - A A Kurien
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Balasubramaniyan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - N Gopalakrishnan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
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Dhanapriya J, Balasubramaniyan T, Maharajan SP, Dineshkumar T, Sakthirajan R, Gopalakrishnan N, Nagarajan M. IgA-dominant Infection-related Glomerulonephritis in India: A Single-center Experience. Indian J Nephrol 2017; 27:435-439. [PMID: 29217879 PMCID: PMC5704407 DOI: 10.4103/ijn.ijn_337_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IgA-dominant infection-related glomerulonephritis (IRGN) is a distinct morphologic variant of IRGN, characterized by dominant or codominant glomerular deposits of IgA, mostly in elderly and patients with diabetes. More cases are being reported in recent times due to increased awareness of the disease entity and increased rate of Staphylococcus infection. It usually presents as rapidly progressive renal failure with proteinuria, and treatment guidelines for this disease entity are not well defined. We report here 12 cases of IgA-dominant IRGN seen over a period of 5 years from a single center. Clinical features, biopsy findings, treatment, and outcomes were analyzed. Out of 12 patients, eight were males. The mean age of presentation was 52.4 ± 21 years. Skin was the most common site of infection seen in six patients. Gross hematuria was seen in 4 patients and 11 had nephrotic proteinuria. Eleven had low serum C3. Only two patients had diabetes. Methicillin-resistant Staphylococcus aureus (MRSA) was the most common organism isolated in six patients. Most common histopathology was crescentic glomerulonephritis seen in seven patients, followed by endocapillary proliferation in three and diffuse proliferative glomerulonephritis in two. Hemodialysis was done in eight patients and six patients received steroid therapy. End-stage renal disease developed in three patients, chronic kidney disease in three, and three patients died due to sepsis. Various infections including MRSA and Escherichia coli were associated with IgA-dominant IRGN both in patients with diabetes and nondiabetics. Suspicion and recognition of the disease is important as it has therapeutic and prognostic implications.
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Affiliation(s)
- J Dhanapriya
- Department of Nephrology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, Tamil Nadu, India
| | - T Balasubramaniyan
- Department of Nephrology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, Tamil Nadu, India
| | - S P Maharajan
- Department of Nephrology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, Tamil Nadu, India
| | - T Dineshkumar
- Department of Nephrology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, Tamil Nadu, India
| | - R Sakthirajan
- Department of Nephrology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, Tamil Nadu, India
| | - N Gopalakrishnan
- Department of Nephrology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, Tamil Nadu, India
| | - M Nagarajan
- Department of Nephrology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai, Tamil Nadu, India
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Dhanapriya J, Dineshkumar T, Sakthirajan R, Murugan S, Jayaprakash V, Balasubramaniyan T, Gopalakrishnan N. Scrub typhus meningitis in a renal transplant recipient. Indian J Nephrol 2017; 27:151-153. [PMID: 28356672 PMCID: PMC5358160 DOI: 10.4103/0971-4065.181883] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Scrub typhus is a rickettsial infection commonly seen in Asia. The clinical presentation ranges from nonspecific febrile illness to potentially fatal multiorgan involvement such as liver, kidney, or lung. Central nervous system involvement is uncommon. We report a 45-year-old female renal transplant recipient who presented with fever, headache, meningeal signs, graft dysfunction, and eschar. IgM antibodies against Orientia tsutsugamushi were positive by enzyme-linked immunosorbent assay. Despite oral doxycycline therapy for 5 days, she did not improve but responded well to intravenous azithromycin. To the best of our knowledge, scrub typhus as a cause of meningitis in a renal transplant recipient has not been reported so far.
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Affiliation(s)
- J Dhanapriya
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Dineshkumar
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - R Sakthirajan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - S Murugan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - V Jayaprakash
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Balasubramaniyan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - N Gopalakrishnan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
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Gopalakrishnan N, Dineshkumar T, Dhanapriya J, Sakthirajan R, Balasubramaniyan T, Srinivasa Prasad ND, Thirumalvalavan K, Murugananth S, Kawaskar K. Deceased donor renal transplantation: A single center experience. Indian J Nephrol 2017; 27:4-8. [PMID: 28182043 PMCID: PMC5255989 DOI: 10.4103/0971-4065.179206] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Deceased donor renal transplantation (DDRT) constitutes less than 5% of all kidney transplantats in India. A retrospective analysis of 173 deceased donor renal transplants performed in a public funded government hospital was done. Mean age of the recipients was 36 years (male:female ratio 2.4:1), and that of the donors was 32.3 years (male:female ratio 6:1). The cold ischemic time was 340 ± 170 minutes. Mean follow-up period was 36 months. Forty one patients died, 75% of them in the first post - transplant year. Sepsis and cardiovascular disease were the most common causes of death. Twenty two percent had acute rejection. There was no significant difference in the incidence in the rate of acute rejection, bacterial, fungal infections and death rate between the cohorts of induction and non induction immunosuppression. The patient and death censored graft survival at 1 year were 80 and 82.6% and at 5 years were 76 and 80% respectively.
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Affiliation(s)
- N Gopalakrishnan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Dineshkumar
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - J Dhanapriya
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - R Sakthirajan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Balasubramaniyan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - N D Srinivasa Prasad
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - K Thirumalvalavan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - S Murugananth
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - K Kawaskar
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
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Sakthirajan R, Dhanapriya J, Dineshkumar T, Gopalakrishnan N, Murugan S, Balasubramaniyan T. Thrombotic microangiopathy: An unusual cause of renal failure in rheumatoid arthritis. Indian J Nephrol 2017; 27:81-83. [PMID: 28182045 PMCID: PMC5255999 DOI: 10.4103/0971-4065.179207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Rheumatoid arthritis (RA) is one of the commonest rheumatological diseases. Renal involvement is not common but can occur as a result of chronic inflammation as part of disease process or drug toxicity. Thrombotic microangiopathy (TMA) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ failure of variable severity. Only a few cases of TMA in patients with RA were reported to date. We describe a 45-year-old female patient with RA who presented with oliguria and edema. Renal biopsy showed TMA with patchy cortical necrosis. She improved with hemodialysis and plasmapheresis.
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Affiliation(s)
- R Sakthirajan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - J Dhanapriya
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Dineshkumar
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - N Gopalakrishnan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - S Murugan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Balasubramaniyan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
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Gopalakrishnan N, Murugananth S, Dineshkumar T, Dhanapriya J, Sakthirajan R, Balasubramaniyan T. Two consecutive recurrences of crescentic immunoglobulin A nephropathy in a renal transplant recipient. Indian J Nephrol 2016; 26:376-378. [PMID: 27795636 PMCID: PMC5015520 DOI: 10.4103/0971-4065.169565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report a 21-year-old male who developed end-stage renal disease, probably due to immunoglobulin A nephropathy (IgAN), received a renal transplant from his mother, which was lost due to crescentic IgAN after 18 months. Two years later, he received a second transplant from a deceased donor. He developed rapidly progressive graft dysfunction 3 years later. Allograft biopsy revealed crescentic IgAN, which was successfully treated with intravenous steroids and cyclophosphamide. Recurrence of IgAN in two successive allografts in one patient has not been reported previously.
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Affiliation(s)
- N Gopalakrishnan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - S Murugananth
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Dineshkumar
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - J Dhanapriya
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - R Sakthirajan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Balasubramaniyan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
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Gopalakrishnan N, Arul R, Dhanapriya J, Kumar TD, Sakthirajan R, Balasubramaniyan T. Familial Lecithin Cholesterol Acyl Transferase Deficiency with Chronic Kidney Disease. J Assoc Physicians India 2016; 64:90-91. [PMID: 27766813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Familial lecithin-cholesterol acyltransferase (LCAT) deficiency is a rare autosomal recessive (AR) disease caused by mutation in the LCAT gene. LCAT enzyme esterifies cholesterol molecules in high-density lipoprotein(HDL) and low density-lipoprotein (LDL) particles. This enzyme deficiency is characterised by progressive corneal opacification, glomerulopathy, mild - moderate haemolytic anaemia and very low plasma levels of HDL. We here report a 34 year-old lady who presented with hypertension, nephrotic proteinuria, renal failure, corneal ring opacities, anemia and dyslipidemia. The diagnosis of familial LCAT deficiency was confirmed by clinical examination, characteristic dyslipidemia, undetectable LCAT levels in plasma and positive family history.
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Affiliation(s)
- N Gopalakrishnan
- Head of Department, Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu
| | - R Arul
- Assistant Professor, Department of Nephrology, Coimbatore Medical College, Coimbatore, Tamil Nadu
| | | | | | | | - T Balasubramaniyan
- Professor, Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu
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Surendar D, Dineshkumar T, Dhanapriya J, Sakthirajan R, Balasubramanian T, Gopalakrishnan N. Deceased donor renal transplant graft survival – A single center experience. Indian Journal of Transplantation 2016. [DOI: 10.1016/j.ijt.2016.09.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Gopalakrishnan N, Abeesh P, Dineshkumar T, Murugananth S, Sakthirajan R, Raman GS, Dhanapriya J, Balasubramaniyan T, Haris M. Prevalence of serum anti M-type phospholipase A2 receptor antibody in primary membranous nephropathy: A single center experience. Indian J Nephrol 2016; 26:257-61. [PMID: 27512297 PMCID: PMC4964685 DOI: 10.4103/0971-4065.160334] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We conducted a prospective study to assess utility of detection of antibodies to phospholipase A2receptor (PLA2R) in the serum of patients with membranous nephropathy. Seventy five patients with biopsy proven membranous nephropathy admitted between January 2011 and September 2014 were studied. Serum anti- PLA2R was tested by indirect immunofluorescence. The test was positive in 45 out of 60 patients with primary membranous nephropathy (PMN) and in none of the 15 patients with secondary membranous nephropathy, with a sensitivity of 75% and specificity of 100% for PMN. Anti PLA2R positivity also showed a significant correlation with quantum of proteinuria and negative correlation with serum albumin. This study has validated detection of serum anti PLA2R in PMN as a non invasive diagnostic tool in Indian patients.
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Affiliation(s)
- N Gopalakrishnan
- Department of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India
| | - P Abeesh
- Department of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India
| | - T Dineshkumar
- Department of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India
| | - S Murugananth
- Department of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India
| | - R Sakthirajan
- Department of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India
| | | | - J Dhanapriya
- Department of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India
| | - T Balasubramaniyan
- Department of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India
| | - Md Haris
- Department of Nephrology, Madras Medical College, Chennai, Tamil Nadu, India
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Bhuvaneshwari S, Gopalakrishnan N. Hydrothermally synthesized Copper Oxide (CuO) superstructures for ammonia sensing. J Colloid Interface Sci 2016; 480:76-84. [PMID: 27416288 DOI: 10.1016/j.jcis.2016.07.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 07/01/2016] [Accepted: 07/04/2016] [Indexed: 10/21/2022]
Abstract
According to environmental protection agencies (EPA), the emission threshold of NH3 in air is 1000kg/yr which is now about 20Tg/yr. Hence, there is a rapid increase in need of NH3 sensors to timely detect and control NH3 emissions. Metal oxide nanostructures such as CuO with special features are potential candidates for NH3 sensing. In the present study, morphology controlled 3-dimensional CuO superstructures were synthesized by surfactant-free hydrothermal method for NH3 detection. In addition to conventional hydrothermal method where water as solvent, a modified approach using a mixture of water and ethylene glycol (EG) was used as solvent to control the growth process. Hierarchical superstructures namely, snowflake-like, flower-like, hollow-sphere-like and urchin-like feature with particle dimensions ranging from 0.3 to 1μm were obtained by varying water/EG ratio and reaction temperature. The synthesized nanostructures exhibited morphology dependent luminescence and gas sensing properties. The surface area and pore distribution determined by BET surface analysis also largely influenced by the presence of EG in the reaction system. The average pore diameter enhanced from 6nm to 14nm by the addition of 10ml EG as solvent. The room temperature ammonia sensing behavior of all samples was studied using an indigenous gas sensing set-up. It was found that hollow-sphere like CuO nanostructures showed a maximum sensitivity of 150% towards 600ppm ammonia with a response and recovery time of 6min. The hydrothermal synthesis strategy reported here has the advantage of producing shape controlled hierarchical materials are highly suitable for various technological applications.
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Affiliation(s)
- S Bhuvaneshwari
- Thin Film Lab, Department of Physics, National Institute of Technology, Tiruchirappalli 620 015, India
| | - N Gopalakrishnan
- Thin Film Lab, Department of Physics, National Institute of Technology, Tiruchirappalli 620 015, India.
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Dhanapriya J, Gopalakrishnan N, Arun V, Dineshkumar T, Sakthirajan R, Balasubramaniyan T, Haris M. Acute kidney injury and disseminated intravascular coagulation due to mercuric chloride poisoning. Indian J Nephrol 2016; 26:206-8. [PMID: 27194836 PMCID: PMC4862267 DOI: 10.4103/0971-4065.164230] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Mercury is a toxic heavy metal and occurs in organic and inorganic forms. Inorganic mercury includes elemental mercury and mercury salts. Mercury salts are usually white powder or crystals, and widely used in indigenous medicines and folk remedies in Asia. Inorganic mercury poisoning causes acute kidney injury (AKI) and gastrointestinal manifestations and can be life-threatening. We describe a case with unknown substance poisoning who developed AKI and disseminated intravascular coagulation (DIC). Renal biopsy showed acute tubular necrosis. Later, the consumed substance was proven to be mercuric chloride. His renal failure improved over time, and his creatinine normalized after 2 months.
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Affiliation(s)
- J Dhanapriya
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - N Gopalakrishnan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - V Arun
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Dineshkumar
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - R Sakthirajan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - T Balasubramaniyan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
| | - M Haris
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
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Gopalakrishnan N, Dhanapriya J, Seenivasan M, Dineshkumar T, Sakthirajan R, Balasubramaniyan T. Secondary Hyperkalemic Paralysis and Acute Kidney Injury Due to Rhabdomyolysis Caused by Sea-Snake Envenomation. Toxicol Int 2016. [DOI: 10.22506/ti/2016/v23/i1/146678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Bhuvaneshwari S, Gopalakrishnan N. Facile synthesis of low dimensional CuO nanostructures and their gas sensing applications. Crystal Research and Technology 2016. [DOI: 10.1002/crat.201500243] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- S. Bhuvaneshwari
- Thin film lab; Department of Physics; National Institute of Technology; Tiruchirappalli 620 015 India
| | - N. Gopalakrishnan
- Thin film lab; Department of Physics; National Institute of Technology; Tiruchirappalli 620 015 India
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Dhanapriya J, Dineshkumar T, Gopalakrishnan N, Sakthirajan R, Balasubramaniyan T. Clinicopathological correlation and treatment response of primary focal segmental glomerulosclerosis in adults and adolescents. Indian J Nephrol 2016; 26:347-351. [PMID: 27795629 PMCID: PMC5015513 DOI: 10.4103/0971-4065.167283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The incidence of focal segmental glomerulosclerosis (FSGS) is approximately 10% in children <6 years, 20% in adolescents, and 20-25% in adults. A retrospective observational study was done to document clinicopathological correlation, treatment response, and risk factors in the progression of chronic kidney disease (CKD) of primary FSGS in adults and adolescents. A total of 170 patients were studied with a mean follow-up of 4.32 ± 1.2 years. FSGS not otherwise specified was the most common subtype (56%) followed by tip variant (24%). About 32% had complete remission (CR) at a mean time of 6.4 months, 23% had partial remission (PR) at a mean time of 5.7 months, and 45% had no response to steroids. Persistent nephrotic proteinuria at 3rd and 6th month and presence of interstitial fibrosis and tubular atrophy >30% in renal biopsy are the independent predictors of poor response to treatment. Presence of anemia, interstitial fibrosis, and tubular atrophy of >30% in renal biopsy and the absence of remission after treatment were the independent predictors of CKD progression. Overall renal survival was 78% at 3 years and 54% at 5 years. Renal survival difference with or without nephrotic proteinuria at onset was 39% and 69% at 5 years. Renal survival was higher in patients with normal renal function (66%) compared with those who had renal failure (42%) at 5 years. Renal survival at 5 years for CR was 69%, PR was 49%, and no remission was 42%.
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Dhanapriya J, Gopalakrishnan N, Sakthirajan R, Dineshkumar T, Balasubramaniyan T, Md. Haris. Angiomyolipoma of donor kidney: Successful transplantation and 5-year follow-up. Indian J Nephrol 2016; 26:131-3. [PMID: 27051138 PMCID: PMC4795429 DOI: 10.4103/0971-4065.159552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Angiomyolipomas (AML) of the kidney are non-encapsulated benign neoplasms with the incidence of 45-80% in patients with tuberous sclerosis and 1-3% in sporadic cases. There are very few case reports in the literature in which kidneys with AML have been used for transplantation. We report here a 27-year-old female patient who received a live related renal transplant from her mother with isolated angiomyolipoma in donor kidney and on follow-up after 5 years, has stable graft function and tumor size.
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Dhanapriya J, Kumar TD, Gopalakrishnan N, Balasubramaniyan T. Lymphomatous Infiltration of Kidneys. J Assoc Physicians India 2015; 63:74-76. [PMID: 26591152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Renal involvement in lymphoma usually occurs late in the course of the disease and is clinically silent. Acute kidney injury (AKI) is rare, with the reported incidence of 0.5% in the literature. We describe here a 20 years old female patient who presented with non-dialysis requiring AKI and renal biopsy showed lymphomatous infiltration of kidneys. Though renal function improved, patient died due to central nervous system involvement.
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Murugananth S, Arul R, Dineshkumar T, Dhanapriya J, Sakthirajan R, Gopalakrishnan N. Clinical spectrum of tuberculosis in renal transplant recipients. Indian Journal of Transplantation 2015. [DOI: 10.1016/j.ijt.2015.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Gopalakrishnan N, Hannam R, Casoni GP, Barriet D, Ribe JM, Haug M, Halaas Ø. Infection and immunity on a chip: a compartmentalised microfluidic platform to monitor immune cell behaviour in real time. Lab Chip 2015; 15:1481-1487. [PMID: 25608968 DOI: 10.1039/c4lc01438c] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Cells respond to their environments and self-organise into multicellular assemblies with dedicated functions. The migratory and homing response of cells to soluble ligands can be studied by using different techniques, but for real time studies of complex multicellular self-organisation, novel and simpler systems are required. We fabricated a flexible open access microsystem and tested the design by studying cell recruitment from an immune cell reservoir towards an infectious compartment. The two compartments were connected by a network of bifurcated microchannels allowing diffusion of signalling molecules and migration of cells. Bacterial filters were incorporated in the design to prevent bacteria and activated cells from entering the network, permitting migration only from the recruitment reservoir. The fabricated microsystem allows real-time continuous monitoring of cellular decision-making based on biologically produced gradients of cytokines and chemokines. It is a valuable tool for studying cellular migration and self-organisation in relation to infections, autoimmunity, cancer, stem cell homing, and tissue and wound repair.
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Affiliation(s)
- N Gopalakrishnan
- Dept. of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, 7489 Trondheim, Norway.
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Balamonica K, Ramamohan Rao A, Nimala Sundaran M, Chellapandi P, Gopalakrishnan N. Experimental studies on CSRDM specimen to validate the use of Ritz vectors for the response evaluation of structures subjected to multi-support excitation. Nuclear Engineering and Design 2015. [DOI: 10.1016/j.nucengdes.2014.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Gopalakrishnan N, Bhuvaneshwari S, Balakrishnan L, Gowrishankar S. Hydrothermal Synthesis and Gas Sensing Properties of CuO Nanorods. ACTA ACUST UNITED AC 2013. [DOI: 10.1166/sl.2013.3078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Gopalakrishnan N, Abraham A, Balasubramaniyan T, Dineshkumar T, Dhanapriya J, Malathy N, Haris M, Prasad NDS. IgG4 related interstitial nephritis: A case report and review of literature. Indian J Nephrol 2013; 23:308-11. [PMID: 23960352 PMCID: PMC3741980 DOI: 10.4103/0971-4065.114489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
IgG4 interstitial nephritis is a recently described entity. A middle-aged gentleman with bilateral parotid enlargement, hepatosplenomegaly and generalized lymphadenopathy was referred to us for evaluation of renal failure. He had trace proteinuria and large kidneys. Kidney biopsy revealed interstitial nephritis with characteristic storiform fibrosis. Immunohistochemistry demonstrated intense staining for IgG4-secreting plasma cells in the interstitium.
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Affiliation(s)
- N Gopalakrishnan
- Department of Nephrology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, India
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Jayalakshmi G, Gopalakrishnan N, Panigrahi BK, Balasubramanian T. Grain boundary defects induced room temperature ferromagnetism in V doped ZnO thin films. Cryst Res Technol 2011. [DOI: 10.1002/crat.201100226] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Gopalakrishnan N, Balakrishnan L, Brindha A, Jayalakshmi G. Thickness and substrate orientation dependence of ferromagnetism in Mn doped ZnO thin films. Cryst Res Technol 2011. [DOI: 10.1002/crat.201100425] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Gopalakrishnan N, Shin BC, Bhuvana KP, Elanchezhiyan J, Balasubramanian T. Fabrication of GaN doped ZnO nanocrystallines by laser ablation. J Nanosci Nanotechnol 2008; 8:4168-4171. [PMID: 19049196 DOI: 10.1166/jnn.2008.an19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Here, we present the fabrication of pure and GaN doped ZnO nanocrystallines on Si(111) substrates by KrF excimer laser. The targets for the ablation have been prepared by conventional ceramic method. The fabricated nanocrystallines have been investigated by X-ray diffraction, photoluminescence and atomic force microscopy. The X-ray diffraction analysis shows that the crystalline size of pure ZnO is 36 nm and it is 41 nm while doped with 0.8 mol% of GaN due to best stoichiometry between Zn and O. Photoluminescence studies reveal that intense deep level emissions have been observed for pure ZnO and it has been suppressed for the GaN doped ZnO structures. The images of atomic force microscope show that the rms surface roughness is 27 nm for pure ZnO and the morphology is improved with decrease in rms roughness, 18 nm with fine crystallines while doped with 1 mol% GaN. The improved structural, optical and morphological properties of ZnO nanocrystalline due to GaN dopant have been discussed in detail.
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Affiliation(s)
- N Gopalakrishnan
- Department of Physics, National Institute of Technology, Tiruchirappalli 620015, India
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Kumar KS, Muthumani K, Gopalakrishnan N, Sarma BS, Reddy G, Parulekar Y. Reduction of Large Seismic Deformations using Elasto-plastic Passive Energy Dissipaters. DEFENCE SCI J 2003. [DOI: 10.14429/dsj.53.2134] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Jayakumar M, Gopalakrishnan N, Vijayakumar R, Rajendran S, Muthusethupathi MA. Systemic fungal infections in renal transplant recipients at Chennai, India. Transplant Proc 1998; 30:3135. [PMID: 9838385 DOI: 10.1016/s0041-1345(98)01290-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- M Jayakumar
- Department of Nephrology, Chennai Medical College, India
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