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Mishra OP, Singh A, Prasad R. Focal segmental glomerulosclerosis in primary Sjögren's syndrome: a rare presentation. Pediatr Nephrol 2024:10.1007/s00467-024-06315-7. [PMID: 38351371 DOI: 10.1007/s00467-024-06315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/02/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024]
Affiliation(s)
- Om P Mishra
- Department of Pediatrics, Heritage Institute of Medical Sciences, Varanasi, India.
| | - Ankur Singh
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Rajniti Prasad
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Rawat G, Mohan K, Dhamodharan S, Dadhich H, Chingtham P, Sain K, Mishra OP. Geoelectric characterisation of the junction of seismically active Delhi Hardwar Ridge and Delhi Sargodha Ridge. Sci Rep 2023; 13:18488. [PMID: 37898633 PMCID: PMC10613208 DOI: 10.1038/s41598-023-42722-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 09/14/2023] [Indexed: 10/30/2023] Open
Abstract
A magnetotelluric (MT) geophysical survey for the first time has been conducted for the geoelectric characterization of the junction of the contact zone of NNE-SSW striking Delhi Hardwar Ridge (DHR) and NW-SE trending Delhi Sargodha Ridge (DSR) in the Rohtak area, Haryana which has experienced 15 earthquakes of M2.0-M4.4 from April to August 2020. A total of 08 MT sites are acquired along a NW-SE profile of length 50 km. From the 2D MT data inversion, the DHR and DSR are for the first time characterized by equal values of moderate resistivity of 100 Ohm m at two depths. The resistivity variation for DHR corresponds to 100 Ohm m from the surface to the depth of 20 km, whilst DSR is found associated with the same value of resistivity extending in the NW direction. The DHR has been found striking NE-SW with a very shallow central axis (less than 400 m) having a width of 12-15 km forming half grabens on both limbs supported by shallow faults. The DSR has been found bifurcated from DHR at a depth of 12-13 km and extended in the NW direction. The DSR has been generated due to flexure bulging caused by collision and anticlockwise rotation of the Indian plate in the Eocene period. A NE striking steep dipping reverse fault (F1) has also been identified about 15 km west of the DHR. It is inferred that the DSR got upthrusted along this fault and became shallower in the NW region. The seismicity in the Rohtak and surroundings is located at the bifurcation points of DHR and DSR and the contact zone of DSR and reverse fault F1. The reverse fault F1 is also active and has generated microseismicity in the past.
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Affiliation(s)
- Gautam Rawat
- Wadia Institute of Himalayan Geology, 33 GMS Road, Dehradun, 248001, India
| | - Kapil Mohan
- National Center for Seismology, Ministry of Earth Sciences, Lodhi Road, New Delhi, 110003, India.
| | - S Dhamodharan
- Wadia Institute of Himalayan Geology, 33 GMS Road, Dehradun, 248001, India
| | - Harendra Dadhich
- National Center for Seismology, Ministry of Earth Sciences, Lodhi Road, New Delhi, 110003, India
| | - Prasanta Chingtham
- National Center for Seismology, Ministry of Earth Sciences, Lodhi Road, New Delhi, 110003, India
| | - Kalachand Sain
- Wadia Institute of Himalayan Geology, 33 GMS Road, Dehradun, 248001, India
| | - O P Mishra
- National Center for Seismology, Ministry of Earth Sciences, Lodhi Road, New Delhi, 110003, India
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Chopra S, Raut S, Sinha R, Abhinay A, Thakur A, Mishra OP, Yadav M, Saha A. SARS-CoV-2 Infection in Children with Idiopathic Nephrotic Syndrome: A Multicentric Study. Indian Pediatr 2023; 60:407-408. [PMID: 37161958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
A multicenter retrospective study was conducted to assess the clinical spectrum of 30 severe acute respiratory syndrome coronavirus (SARS-CoV-2)-positive children with idiopathic nephrotic syndrome. Difficult to treat nephrotic syndrome was found to be a high-risk group with a high incidence of acute kidney injury and mortality.
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Affiliation(s)
- Sanya Chopra
- Department of Pediatric Nephrology, Lady Hardinge Medical College (LHMC) and associated Kalawati Saran Children Hospital, New Delhi
| | - Sumantra Raut
- Department of Pediatric Nephrology, North Bengal Medical College and Hospital, Siliguri, West Bengal
| | - Rajiv Sinha
- Institute of Child Health, Kolkata, West Bengal
| | - Abhishek Abhinay
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh
| | | | - O P Mishra
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh
| | - Menka Yadav
- Department of Pediatric Nephrology, Lady Hardinge Medical College (LHMC) and associated Kalawati Saran Children Hospital, New Delhi
| | - Abhijeet Saha
- Department of Pediatric Nephrology, Lady Hardinge Medical College (LHMC) and associated Kalawati Saran Children Hospital, New Delhi.
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Mishra OP, Agrawal RK. Renal Ultrasound Screening in Evaluation of Children with First Urinary Tract Infection. Indian J Pediatr 2023:10.1007/s12098-023-04631-8. [PMID: 37133751 DOI: 10.1007/s12098-023-04631-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 04/20/2023] [Indexed: 05/04/2023]
Affiliation(s)
- Om P Mishra
- Department of Pediatrics, Heritage Institute of Medical Sciences, Varanasi, 221311, India.
| | - Ritesh K Agrawal
- Department of Pediatrics, Heritage Institute of Medical Sciences, Varanasi, 221311, India
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Mishra OP, Sidar M, Batra VV, Prasad R, Singh A, Abhinay A, Mishra A, Yadav AK. Outcomes of children with idiopathic steroid resistant nephrotic syndrome: a single centre observational study. J Bras Nefrol 2023; 45:199-209. [PMID: 36179014 PMCID: PMC10627125 DOI: 10.1590/2175-8239-jbn-2022-0073en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/20/2022] [Accepted: 06/20/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Idiopathic steroid resistant nephrotic syndrome (SRNS) has variable outcomes in children. The primary objective of the present study was to assess the cumulative remission rate and the secondary objectives were to assess factors affecting the remission status, kidney function survival, and adverse effects of medications. METHODS One hundred fourteen patients with SRNS were included. Calcineurin inhibitor-based treatment protocol along with prednisolone and angiotensin-converting enzyme inhibitor were used, and patients were followed over 5 years. RESULTS Median age was 4.5 years; 53.5% of cases were between 1 to 5 years of age. Sixty-two patients (54.4%) were at initial stage and 52 (45.6%) were at a late SRNS stage. Median eGFRcr was 83.5 mL/min/1.73m2 at presentation. Of the 110 patients, 63 (57.3%) achieved remission [complete remission 30 (27.3%), partial remission 33 (30%)], and 47 (42.7%) had no remission. Kidney function survival was 87.3% and 14 cases (12.7%) had progression to CKD (G3-8, G4-3, G5-1, and G5D-2). Median duration of follow up was 36 months (IQR 24, 60). Age of onset, cyclosporine/tacrolimus, eGFRcr, and histopathology (MCD/FSGS) did not affect remission. Similarly, remission status in addition to age of onset, drug protocol, and histopathology did not significantly affect kidney function during a period of 5 years. Hypertension, cushingoid facies, short stature, cataract, and obesity were observed in 37.7, 29.8, 25.5, 17.5, and 0.7% of cases, respectively. CONCLUSION About half of the cases achieved remission. Age of onset of disease, cyclosporine/tacrolimus use, and histopathological lesion neither affected remission status nor short-term kidney function survival in SRNS.
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Affiliation(s)
- Om P. Mishra
- Banaras Hindu University, Institute of Medical Sciences, Department
of Pediatrics, Division of Pediatric Nephrology, Varanasi, India
| | - Minketan Sidar
- Banaras Hindu University, Institute of Medical Sciences, Department
of Pediatrics, Division of Pediatric Nephrology, Varanasi, India
| | - Vineeta V. Batra
- G. B. Pant Institute of Post Graduate Medical Education &
Research, Department of Pathology, New Delhi, India
| | - Rajniti Prasad
- Banaras Hindu University, Institute of Medical Sciences, Department
of Pediatrics, Division of Pediatric Nephrology, Varanasi, India
| | - Ankur Singh
- Banaras Hindu University, Institute of Medical Sciences, Department
of Pediatrics, Division of Pediatric Nephrology, Varanasi, India
| | - Abhishek Abhinay
- Banaras Hindu University, Institute of Medical Sciences, Department
of Pediatrics, Division of Pediatric Nephrology, Varanasi, India
| | - Akash Mishra
- Jawahar Lal Institute of Postgraduate Medical Education and
Research, Department of Biostatistics, Puducherry, India
| | - Ashish K. Yadav
- Banaras Hindu University, Institute of Medical Sciences, Center of
Biostatistics, Varanasi, India
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Puri S, Agrawal RK, Singh A, Verma A, Mishra A, Singh A, Narayan R, Mishra OP. Spectrum of Neurodegeneration with Brain Iron Accumulation with PLA2G6 Variation: A Report of Three Cases from Two Families. Journal of Pediatric Neurology 2022. [DOI: 10.1055/s-0042-1758454] [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: 11/17/2022]
Abstract
AbstractNeurodegeneration with brain iron accumulation consists of disorders characterized by progressive neuronal degeneration, cognitive decline, brain iron accumulation in extrapyramidal system, dentate nucleus, and gray and white matters boundary. We present a case series of PLA2G6-associated neurodegeneration (PLAN), with definite PLA2G6 gene mutations in two cases and suspected in one case. Diagnosis was based on clinical presentations, brain magnetic resonance imaging (MRI) findings, and detection of PLA2G6 mutations. Case 1: An 8-year-old boy presented with weakness of lower limbs, subnormal intelligence, scanning speech, spasticity, dysdiadochokinesia, pendular knee jerk, and extensor plantar reflex. MRI of the brain showed diffuse cerebellar atrophy and white matter T2 hyperintensity with iron deposition in bilateral globus pallidi. Case 2: Elder sister of Case 1, who developed ataxia at the age of 6 years and became bedridden at 14 years. She had nocturnal enuresis, seizures, cervical dystonia, dysphagia, and died at 23 years of age. MRI showed cerebral and cerebellar atrophies and iron deposition in basal ganglia and substantia nigra. Case 3 had infantile onset with quadriparesis, optic atrophy, developmental delay, cerebral and cerebellar atrophies, and brain iron accumulation in basal ganglia. Case 1 revealed two heterozygous mutations of PLA2G6 gene in exons 16 (c.2264G > A, p. Arg755Gln) and 12 (c.1637G > A, p. Arg546Gln), classified as likely pathogenic. Elder sister (Case 2) could not be tested for this mutation. Case 3 showed homozygous silent splice site point variation in exon 7 (c.1077 G > A; p. Ser 359 Ser) of PLA2G6 gene. Thus, in patients presenting with neurodegeneration and imaging findings of brain iron accumulation, diagnosis can be established by PLA2G6 gene mutation analysis.
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Affiliation(s)
- Shivangi Puri
- Department of Pediatrics, Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
| | - Ritesh K. Agrawal
- Department of Pediatrics, Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
| | - Ankur Singh
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ashish Verma
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Arpita Mishra
- Department of Pediatrics, Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
| | - Ashok Singh
- Department of Pediatrics, Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
| | - Raghvendra Narayan
- Department of Pediatrics, Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
| | - Om P. Mishra
- Department of Pediatrics, Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
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Mishra OP, Sidar M, Batra VV, Prasad R, Singh A, Abhinay A, Mishra A, Yadav AK. Desfechos de crianças com síndrome nefrótica idiopática córtico-resistente: um estudo observacional de centro único. J Bras Nefrol 2022. [DOI: 10.1590/2175-8239-jbn-2022-0073pt] [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: 11/22/2022] Open
Abstract
RESUMO Introdução: A síndrome nefrótica idiopática córtico-resistente (SNICR) apresenta desfechos variáveis em crianças. O objetivo principal deste estudo foi avaliar a taxa de remissão cumulativa. Os objetivos secundários foram avaliar fatores que afetam status de remissão, sobrevida da função renal e efeitos adversos de medicamentos. Métodos: Foram incluídos 114 pacientes com SNCR. Utilizou-se protocolo de tratamento baseado em inibidores de calcineurina juntamente com prednisolona e inibidor da enzima conversora de angiotensina. Os pacientes foram acompanhados durante 5 anos. Resultados: A idade mediana foi 4,5 anos; 53,5% dos casos tinham entre 1 e 5 anos. 62 pacientes (54,4%) estavam em estágio inicial; 52 (45,6%) em estágio tardio da SNCR. A TFGecr mediana foi 83,5 mL/min/1,73 m2 na apresentação. Dos 110 pacientes, 63 (57,3%) alcançaram remissão [remissão completa 30 (27,3%), remissão parcial 33 (30%)], e 47 (42,7%) não apresentaram remissão. A sobrevida da função renal foi 87,3%; 14 casos (12,7%) progrediram para DRC (G3-8, G4-3, G5-1, G5D-2). A duração mediana do acompanhamento foi 36 meses (IIQ 24, 60). Idade no início, ciclosporina/tacrolimus, TFGecr e histopatologia (DLM/GESF) não afetaram a remissão. Igualmente, status de remissão, além da idade no início, protocolo de medicamentos e histopatologia não afetaram significativamente a função renal por 5 anos. Observou-se hipertensão, fácies cushingoide, baixa estatura, catarata e obesidade em 37,7; 29,8; 25,5; 17,5; e 0,7% dos casos, respectivamente. Conclusão: Aproximadamente metade dos casos alcançou remissão. Idade no início, uso de ciclosporina/tacrolimus e lesão histopatológica não afetaram o status de remissão nem a sobrevida da função renal a curto prazo na SNICR.
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Affiliation(s)
| | | | - Vineeta V. Batra
- G. B. Pant Institute of Post Graduate Medical Education & Research, India
| | | | | | | | - Akash Mishra
- Jawahar Lal Institute of Postgraduate Medical Education and Research, India
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Singh G, Mishra OP, Abhinay A, Agarwal V, Mishra SP, Dwivedi AD, Singh A, Prasad R, Mishra RN. Fibroblast Growth Factor 23 Level and Cardiovascular Parameters in Children with Chronic Kidney Disease. Indian J Pediatr 2022; 89:865-871. [PMID: 34767187 DOI: 10.1007/s12098-021-03927-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 06/09/2021] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To find out the serum fibroblast growth factor 23 (FGF-23) levels in different grades of CKD, and the prevalence of abnormal left ventricular mass index (LVMI), carotid intima-medial thickness (cIMT), and central pulse wave velocity (cPWV) and the risk factors including FGF-23 for these abnormalities. METHODS Fifty-nine patients of CKD with G2 to G5, aged 2-18 y were included. The LVMI, cIMT, and cPWV were measured using standard techniques, and serum intact FGF-23 levels were estimated at enrollment. RESULTS Median FGF-23 levels were significantly raised in all the grades of CKD than controls (p < 0.001), and also in G4 and G5 in comparison to G2&3 and in G5D than G5. Increased LVMI in 42 (71.2%), elevated cIMT in 30 (57.7%), and cPWV in 14 (26.9%) patients were found. The FGF-23 showed significant negative correlation with eGFRcr and positive with serum iPTH, phosphate and alkaline phosphatase levels, but had no correlations with LVMI, cIMT SDS, and cPWV SDS. Only systolic BP SDS (odds ratio 1.5, 95% CI 1.008-2.231, p = 0.046) was observed as a significant predictor for increased cIMT, while no variables had any association with abnormal LVMI and cPWV. CONCLUSIONS Serum FGF-23 showed higher levels with increasing grades of CKD, but no significant association with cardiovascular parameters. Systolic BP SDS was found as a significant risk factor for increased cIMT in children with CKD.
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Affiliation(s)
- Gaurav Singh
- Division of Pediatric Nephrology, Department of Pediatrics, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
| | - Om P Mishra
- Division of Pediatric Nephrology, Department of Pediatrics, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India.
| | - Abhishek Abhinay
- Division of Pediatric Nephrology, Department of Pediatrics, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
| | - Vikas Agarwal
- Department of Cardiology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Surendra P Mishra
- Department of Biochemistry, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Amitnandan D Dwivedi
- Department of Radiodiagnosis and Imaging, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ankur Singh
- Division of Pediatric Nephrology, Department of Pediatrics, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
| | - Rajniti Prasad
- Division of Pediatric Nephrology, Department of Pediatrics, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
| | - Rabindra N Mishra
- Center of Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Abhinay A, Singh A, Rajniti P, Mishra OP. Response to Chemical Pleurodesis in Children with Frequent Relapsing Nephrotic Syndrome Having Refractory Unilateral Pleural Effusion. Saudi J Kidney Dis Transpl 2022; 33:726-729. [PMID: 37955464 DOI: 10.4103/1319-2442.389432] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023] Open
Abstract
Idiopathic nephrotic syndrome is one of the most common chronic renal disorders in children. Associated bilateral pleural effusion is common due to the transudative process as a result of hypoalbuminemia. However, unilateral pleural effusion is a rare phenomenon and at times, unresponsive even when the patients are in remission. Here, we report two cases of frequent relapse nephrotic syndrome presented as persistent unilateral pleural effusion responsive to chemical pleurodesis, which was done with bleomycin along with normal saline.
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Affiliation(s)
- A Abhinay
- Department of Pediatrics, Division of Pediatric Nephrology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Chandrakar C, Shakya S, Patyal A, Jain A, Ali SL, Mishra OP. ERIC-PCR based molecular typing of multidrug resistant Escherichia coli isolated from houseflies (Musca domestica) in the environment of milk and meat shops. Lett Appl Microbiol 2022; 75:1549-1558. [PMID: 36038146 DOI: 10.1111/lam.13821] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 12/01/2022]
Abstract
The emergence and spread of antimicrobial resistance has become a major global public health concern. A component of this problem is the spread of the antibiotic resistant bacteria. Flies move freely between habitats of food-producing animals and human beings and thus have great potential for dissemination of antimicrobial resistant bacteria from a contaminated environment to milk and meat markets, posing potential hazards for the consumers. During the present study, a total of 150 houseflies were captured from milk and meat shops located in Durg and Raipur city of Chhattisgarh, India. The E. coli were isolated from houseflies and characterized on the basis of cultural and molecular tests. Further, the isolates were subjected to antimicrobial susceptibility testing against frequently used antibiotics using disk diffusion method. The antibiotic resistance genes and int1 gene were detected using polymerase chain reaction (PCR). A total of 45 E. coli isolates were obtained from the fly samples with overall prevalence rate of 30.0%. Antibiogram results confirmed that E. coli isolates were resistant to multiple antibiotics. Out of the (45) isolates of E. coli, 17 (37.8%) isolates were extended spectrum beta-lactamase (ESBL) producer and multi-drug resistant (MDR). Out of the ESBL and MDR E.coli isolates, blaCTX-M (24.4%), blaTEM (11.1%), tetA (28.8%), tetB (26.7%), gyrA (26.7%), parC (31. 1%) and int1 genes (15.5%) were detected but none of the isolates were found positive for blaSHV gene. Findings of the present study confirm that MDR E. coli are widely distributed in houseflies and play an important role in transmission of antibiotic-resistant bacteria from contaminated environment to milk and meat shop environment.
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Affiliation(s)
- Choodamani Chandrakar
- Department of Veterinary Public Health and Epidemiology, Dau Shri Vasudev Chandrakar Kamdhenu Vishwavidyalaya, Durg, 491001, India
| | - Sanjay Shakya
- Department of Veterinary Public Health and Epidemiology, Dau Shri Vasudev Chandrakar Kamdhenu Vishwavidyalaya, Durg, 491001, India
| | - Anil Patyal
- Department of Veterinary Public Health and Epidemiology, Dau Shri Vasudev Chandrakar Kamdhenu Vishwavidyalaya, Durg, 491001, India
| | - Asit Jain
- Department of Animal Genetics and Breeding, Dau Shri Vasudev Chandrakar Kamdhenu Vishwavidyalaya, Durg, 491001, India
| | - Syed L Ali
- Department of Veterinary Medicine, Dau Shri Vasudev Chandrakar Kamdhenu Vishwavidyalaya, Durg, 491001, India
| | - O P Mishra
- Department of Veterinary Physiology and Biochemistry, Dau Shri Vasudev Chandrakar Kamdhenu Vishwavidyalaya, Durg, 491001, India
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Singh P, Mishra OP, Upadhyay SK, Prasad R, Singh A, Abhinay A, Mishra A, Schaefer F. Persistence of behavioral abnormalities following corticosteroid therapy in children with initial episode of idiopathic nephrotic syndrome: a prospective longitudinal observation. J Bras Nefrol 2021; 44:58-67. [PMID: 34590671 PMCID: PMC8943879 DOI: 10.1590/2175-8239-jbn-2021-0043] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/06/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction: Treatment of nephrotic syndrome with corticosteroid can cause several side- effects including behavioral abnormalities. The objectives of the study were to observe the proportion of non-relapsers having persistence of behavioral abnormalities after completion of treatment of initial episode and compare the abnormalities with relapsers, and to determine risk factors for persistence. Methods: Seventy-five children with a first episode of idiopathic nephrotic syndrome and 60 normal children were rated by parents for behavioral problems using the Child Behavior Checklist. The Parenting Stress Index was also evaluated. The children were rated before treatment and 12 and 36 weeks after. Results: Both relapsers and non-relapsers showed abnormalities in internalizing and externalizing domains at 12 weeks of steroid therapy. Non-relapsers had abnormal scores in the internalizing domain in 63.5 % and externalizing domain in 48.1% of cases at 36 weeks. Relapsers had abnormal scores in all the three behavior domains, but a significantly higher proportion of relapsers had abnormal scores regarding total behavior (65.2% vs 28.8%, p<0.01) and child domains (100% vs 57.7%, p<0.001) of Parenting Stress Index in comparison to non-relapsers at 36 weeks. Occurrence of relapse increased the risk (odds ratio 5.76, 95% CI 1.35-10.76, p< 0.001) for persistence of abnormal total behavior at 36 weeks follow-up. Conclusion: Persistence of abnormalities was observed not only in relapsers but also in non-relapsers. Relapse was found to be a significant risk factor for persistence of abnormal behaviors in these patients.
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Affiliation(s)
- Parichay Singh
- Banaras Hindu University, Institute of Medical Sciences, Department of Pediatrics, Division of Pediatric Nephrology, Varanasi, India
| | - Om P Mishra
- Banaras Hindu University, Institute of Medical Sciences, Department of Pediatrics, Division of Pediatric Nephrology, Varanasi, India
| | - Shashi K Upadhyay
- Banaras Hindu University, Institute of Medical Sciences, Department of Pediatrics, Division of Pediatric Nephrology, Varanasi, India
| | - Rajniti Prasad
- Banaras Hindu University, Institute of Medical Sciences, Department of Pediatrics, Division of Pediatric Nephrology, Varanasi, India
| | - Ankur Singh
- Banaras Hindu University, Institute of Medical Sciences, Department of Pediatrics, Division of Pediatric Nephrology, Varanasi, India
| | - Abhishek Abhinay
- Banaras Hindu University, Institute of Medical Sciences, Department of Pediatrics, Division of Pediatric Nephrology, Varanasi, India
| | - Akash Mishra
- Jawaharlal Postgraduate Institute of Medical Education and Research, Department of Biostatistics, Puducherry, India
| | - Franz Schaefer
- Heidelberg University Medical Centre, Centre for Pediatrics and Adolescent Medicine, Division of Pediatric Nephrology, Heidelberg, Germany
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Mishra OP, Verma AK, Abhinay A, Singh A, Singh A, Prasad R. Risk factors for mortality in critically ill infants with acute kidney injury: A resource-limited setting experience. Ther Apher Dial 2021; 26:297-305. [PMID: 34296516 DOI: 10.1111/1744-9987.13712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/01/2021] [Revised: 07/08/2021] [Accepted: 07/19/2021] [Indexed: 11/28/2022]
Abstract
Infants with acute kidney injury (AKI) who are critically ill often will have multiorgan dysfunctions. Objective of the present study was to find out mortality, recovery of kidney function at discharge and at 3 months, and to determine risk factors for mortality. Fifty-two infants (24 newborns and 28 postneonatal) with AKI were included. Staging was done as per Kidney Disease Improving Global Outcomes classification. Patients were subjected to medical treatment and peritoneal dialysis (PD), wherever indicated. Kidney function tests were performed at admission, discharge, and at 3 months follow-up. Median age of neonates was 8 days and postneonatal infants were 4.5 months. Stage 1, 2, and 3 AKI were present in 14 (26.9%), 16 (30.7%), and 22 (42.3%) cases, respectively. PD was required in 22 (42.3%) infants, and significantly higher in postneonatal than in neonates (57.1% vs. 25%, p < 0.05). Significant recovery of kidney function occurred at discharge and cases had normal parameters at 3 months. Mortality was 17.3%. Patients had significantly higher risk of mortality, if they had metabolic acidosis (OR 13.22, CI 2.33-74.94, p = 0.002) and needed ventilation (OR 14.93, 95% CI 1.7-130.97, p = 0.006) and PD (OR 6.53, 95% CI 1.20-35.48, p = 0.026). In logistic regression analysis, fluid overload (p < 001), hypotension (p < 0.01), and higher PRISM-III score (p < 0.05) were found as significant risk factors for mortality. Medical management including PD led to good recovery of kidney function. Presence of fluid overload, hypotension, and higher PRISM-III score adversely affected the outcome.
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Affiliation(s)
- Om P Mishra
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Avdhesh Kumar Verma
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Abhishek Abhinay
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Akanksha Singh
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Ankur Singh
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Rajniti Prasad
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Mishra OP, Prasad R. Acute Kidney Injury in Children with Diabetic Ketoacidosis: Risk Factors and Outcome. Indian J Pediatr 2021; 88:542-543. [PMID: 33860885 DOI: 10.1007/s12098-021-03762-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Om P Mishra
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India.
| | - Rajniti Prasad
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
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Mishra OP, Prasad R. Microalbuminuria and Serum Cystatin C: Biomarkers for Early Detection of Kidney Injury in Children with Obesity. Indian J Pediatr 2020; 87:991-992. [PMID: 33047256 DOI: 10.1007/s12098-020-03526-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/05/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Om P Mishra
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
| | - Rajniti Prasad
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Mishra OP. Urinary CD 80 in Nephrotic Syndrome: A Biomarker to Distinguish Minimal Change Disease From Other Glomerular Diseases. Kidney Int Rep 2020; 5:1851-1852. [PMID: 33165400 PMCID: PMC7610000 DOI: 10.1016/j.ekir.2020.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Om P. Mishra
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Vasudevan A, Mantan M, Krishnamurthy S, Pais P, Mathew G, Hari P, Kanitkar M, Gulati S, Bagga A, Mishra OP. Managing Children With Renal Diseases During the COVID-19 Pandemic. Indian Pediatr 2020; 57:641-651. [PMID: 32727941 PMCID: PMC7387253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
The coronavirus outbreak is a rapidly evolving pandemic, placing unprecedented strain on health-care systems. COVID-19 presents challenges for management of children with renal diseases, especially those receiving long-term immunosuppressive medications, including renal transplant recipients and those with chronic kidney disease and acute kidney injury requiring dialysis. Our preparedness for managing this vulnerable group of children is the need of the hour. The purpose of this article is to provide guidance to caregivers and health care personnel involved in management of children with renal diseases and to ensure patient well-being, while protecting staff from infection.
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Affiliation(s)
- Anil Vasudevan
- Department of Pediatric Nephrology, St. John's Medical College Hospital, Bengaluru, Karnataka, India
| | - Mukta Mantan
- Department of Pediatrics, Maulana Azad Medical College, New Delhi, India
| | | | - Priya Pais
- Department of Pediatric Nephrology, St. John's Medical College Hospital, Bengaluru, Karnataka, India
| | - Georgie Mathew
- Division of Pediatric Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - Pankaj Hari
- Division of Pediatric Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Sanjeev Gulati
- Department of Nephrology, Fortis Group of Hospitals, New Delhi, India
| | - Arvind Bagga
- Division of Pediatric Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - Om P Mishra
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India. Correspondence to: Dr Om P Mishra, Professor, Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221 005, Uttar Pradesh, India.
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Mishra OP, Popov AV, Pietrofesa RA, Hwang WT, Andrake M, Nakamaru-Ogiso E, Christofidou-Solomidou M. Radiation activates myeloperoxidase (MPO) to generate active chlorine species (ACS) via a dephosphorylation mechanism - inhibitory effect of LGM2605. Biochim Biophys Acta Gen Subj 2020; 1864:129548. [PMID: 32035161 PMCID: PMC8413008 DOI: 10.1016/j.bbagen.2020.129548] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/16/2020] [Accepted: 02/03/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Radiation exposure of tissues is associated with inflammatory cell influx. Myeloperoxidase (MPO) is an enzyme expressed in granulocytes, such as neutrophils (PMN) and macrophages, responsible for active chlorine species (ACS) generation. The present study aimed to: 1) determine whether exposure to γ-irradiation induces MPO-dependent ACS generation in murine PMN; 2) elucidate the mechanism of radiation-induced ACS generation; and 3) evaluate the effect of the synthetic lignan LGM2605, known for ACS scavenging properties. METHODS MPO-dependent ACS generation was determined by using hypochlorite-specific 3'-(p-aminophenyl) fluorescein (APF) and a highly potent MPO inhibitor, 4-aminobenzoic acid hydrazide (ABAH), and confirmed in PMN derived from MPO-/- mice. Radiation-induced MPO activation was determined by EPR spectroscopy and computational analysis identified tyrosine, serine, and threonine residues near MPO's active site. RESULTS γ-radiation increased MPO-dependent ACS generation dose-dependently in human MPO and in wild-type murine PMN, but not in PMN from MPO-/- mice. LGM2605 decreased radiation-induced, MPO-dependent ACS. Protein tyrosine phosphatase (PTP) and protein serine/threonine phosphatase (PSTP) inhibitors decreased the radiation-induced increase in ACS. Peroxidase cycle results demonstrate that tyrosine phosphorylation blocks MPO Compound I formation by preventing catalysis on H2O2 in the active site of MPO. EPR data demonstrate that γ-radiation increased tyrosyl radical species formation in a dose-dependent manner. CONCLUSIONS We demonstrate that γ-radiation induces MPO-dependent generation of ACS, which is dependent, at least in part, by protein tyrosine and Ser/Thr dephosphorylation and is reduced by LGM2605. This study identified for the first time a novel protein dephosphorylation-dependent mechanism of radiation-induced MPO activation.
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Affiliation(s)
- Om P Mishra
- University of Pennsylvania Perelman School of Medicine, Department of Medicine, Pulmonary, Allergy, and Critical Care Division, Philadelphia, PA 19104, United States of America.
| | - Anatoliy V Popov
- University of Pennsylvania Perelman School of Medicine, Department of Radiology, Philadelphia, PA 19104, United States of America.
| | - Ralph A Pietrofesa
- University of Pennsylvania Perelman School of Medicine, Department of Medicine, Pulmonary, Allergy, and Critical Care Division, Philadelphia, PA 19104, United States of America.
| | - Wei-Ting Hwang
- University of Pennsylvania Perelman School of Medicine, Department of Biostatistics, Epidemiology, and Informatics, Philadelphia, PA 19104, United States of America.
| | - Mark Andrake
- Molecular Modeling Facility, Fox Chase Cancer Center, Philadelphia, PA 19111, United States of America.
| | - Eiko Nakamaru-Ogiso
- Children's Hospital of Philadelphia, Department of Pediatrics, Philadelphia, PA 19104, United States of America.
| | - Melpo Christofidou-Solomidou
- University of Pennsylvania Perelman School of Medicine, Department of Medicine, Pulmonary, Allergy, and Critical Care Division, Philadelphia, PA 19104, United States of America.
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Mishra OP, Prasad R. Acute Peritoneal Dialysis in Neonates with Acute Kidney Injury. Indian Pediatr 2020; 57:399-400. [PMID: 32444511] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Om P Mishra
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
| | - Rajniti Prasad
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Mishra OP, Prasad R. Acute Peritoneal Dialysis in Neonates with Acute Kidney Injury. Indian Pediatr 2020. [DOI: 10.1007/s13312-020-1810-1] [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]
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Aggarwal P, Jain A, Mishra OP, Gupta V. Variable Phenotypic Presentation of Two Siblings with Hemoglobin SD Disease. Indian J Pediatr 2020; 87:229-230. [PMID: 31933134 DOI: 10.1007/s12098-019-03168-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 12/23/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Priyanka Aggarwal
- Division of Hematology-Oncology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
| | - Anubha Jain
- Division of Hematology-Oncology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - O P Mishra
- Division of Hematology-Oncology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Vineeta Gupta
- Division of Hematology-Oncology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Chandrakar K, Jain A, Khan JR, Jain T, Singh M, Mishra OP. Molecular characterization and expression profile of interferon-stimulated gene 15 (ISG15) in the endometrium of goat (Capra hircus). Theriogenology 2019; 142:348-354. [PMID: 31711698 DOI: 10.1016/j.theriogenology.2019.10.013] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 09/17/2019] [Accepted: 10/13/2019] [Indexed: 11/28/2022]
Abstract
Interferon-stimulated gene 15 (ISG15), a ubiquitin-like protein, is responsible for uterine receptivity, implantation and conceptus development in different ruminant species, but in goat (Capra hircus) its role is yet to be explicated. In the present study, the ISG15 gene was cloned, characterized and its temporal expression profile was examined in the endometrium of caprine (cp). A fragment of cpISG15 gene, 1033 bp in length, was amplified, cloned and sequenced from genomic DNA covering the coding region. Sequence analysis of cpISG15 gene revealed that it was comprised of two exons of 59 bp and 496 bp encoding a peptide of 157 amino acids. Complementary DNA (cDNA) and deduced amino acid sequences of cpISG15 exhibited 99 and 98, 93 and 88, 94 and 89, 76 and 66, and 73 and 62% identity with that of sheep, cattle, buffalo, human and mice, respectively. Further, relative expression of cpISG15 mRNA and protein was determined by quantitative real-time PCR (qPCR) and Western blot, respectively, in the endometrium of pregnant and cyclic does. Both cpISG15 mRNA and protein were expressed maximally (P < 0.05) in the endometrium during early stage of pregnancy (16-24 d) as compared to cyclic does, but no significant difference was observed in cpISG15 mRNA and protein expression in the endometrium between the later stage of pregnancy (25-40 d) and cyclic does. It is concluded that cpISG15 is almost similar in structure and probably in function also to other species as it has been found significantly upregulated during early pregnancy.
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Affiliation(s)
- K Chandrakar
- Veterinary Assistant Surgeon, Govt. of Chhattisgarh, Mahasamund, Chhattisgarh, India
| | - A Jain
- Molecular Genetics Laboratory, Department of Animal Genetics and Breeding, College of Veterinary Science and Animal Husbandry, CGKV, Anjora, Durg, Chhattisgarh, India.
| | - J R Khan
- Department of Veterinary Physiology and Biochemistry, College of Veterinary Science and Animal Husbandry, CGKV, Anjora, Durg, Chhattisgarh, India
| | - T Jain
- Animal Biotechnology Centre, CGKV, Durg, Chhattisgarh, India
| | - M Singh
- Molecular Genetics Laboratory, Department of Animal Genetics and Breeding, College of Veterinary Science and Animal Husbandry, CGKV, Anjora, Durg, Chhattisgarh, India
| | - O P Mishra
- Department of Veterinary Physiology and Biochemistry, College of Veterinary Science and Animal Husbandry, CGKV, Anjora, Durg, Chhattisgarh, India
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Abstract
INTRODUCTION Childhood tuberculosis (TB) is now a global priority. With the advent of Xpert MTB/RIF, more TB cases in children are being reported. This study was undertaken to evaluate the performance of Xpert in diagnosis of pulmonary and extra-pulmonary TB in children. METHODS Specimens from 171 suspected TB cases in children aged <15 years were tested with Xpert, culture and smear microscopy in the Department of Microbiology, Institute of Medical Sciences, India. RESULTS The specimens included 106 gastric aspirates, 51 cerebrospinal fluids, 8 induced sputum and 6 lymph node aspirates. Xpert detected Mycobacterium tuberculosis in 19 cases (14 pulmonary and 5 extra-pulmonary), 7 of which were rifampicin-resistant. Sensitivity, specificity, positive predictive value and negative predictive value of Xpert compared with culture were 88.89, 98.04, 84.21 and 98.68%, respectively. The sensitivity was 100% in children aged 1-5 years and 6-10 years and in gastric aspirates. CONCLUSION Xpert is an efficient diagnostic tool in childhood tuberculosis.
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Affiliation(s)
- Arghya Das
- Department of Microbiology, Institute of Medical Sciences Banaras Hindu University, Varanasi, India
| | - Shampa Anupurba
- Department of Microbiology, Institute of Medical Sciences Banaras Hindu University, Varanasi, India
| | - Om P Mishra
- Department of Pediatrics, Institute of Medical Sciences Banaras Hindu University, Varanasi, India
| | - Tuhina Banerjee
- Department of Microbiology, Institute of Medical Sciences Banaras Hindu University, Varanasi, India
| | - Rajneesh Tripathi
- Department of Microbiology, Institute of Medical Sciences Banaras Hindu University, Varanasi, India
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Mishra OP, Prasad R. Role of Automated Urine Flow Cytometry for the Diagnosis of Urinary Tract Infection in Children. Indian J Pediatr 2018; 85:961-962. [PMID: 30097846 DOI: 10.1007/s12098-018-2759-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 07/25/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Om P Mishra
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India.
| | - Rajniti Prasad
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
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Agarwal N, Abhinay A, Mishra RN, Prasad R, Singh A, Mishra OP. Validation of Predictors of Relapse in Steroid Sensitive Idiopathic Nephrotic Syndrome. Indian J Pediatr 2018. [PMID: 29536367 DOI: 10.1007/s12098-018-2656-6] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Neha Agarwal
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India
| | - Abhishek Abhinay
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India.
| | - Rabindra N Mishra
- Division of Bio-Statistics, Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Rajniti Prasad
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India
| | - Ankur Singh
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India
| | - Om P Mishra
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221 005, India
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Mishra OP, Popov AV, Pietrofesa RA, Nakamaru-Ogiso E, Andrake M, Christofidou-Solomidou M. Synthetic secoisolariciresinol diglucoside (LGM2605) inhibits myeloperoxidase activity in inflammatory cells. Biochim Biophys Acta Gen Subj 2018; 1862:1364-1375. [PMID: 29524540 PMCID: PMC5970065 DOI: 10.1016/j.bbagen.2018.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 03/02/2018] [Accepted: 03/05/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Myeloperoxidase (MPO) generates hypochlorous acid (HOCl) during inflammation and infection. We showed that secoisolariciresinol diglucoside (SDG) scavenges radiation-induced HOCl in physiological solutions. However, the action of SDG and its synthetic version, LGM2605, on MPO-catalyzed generation of HOCl is unknown. The present study evaluated the effect of LGM2605 on human MPO, and murine MPO from macrophages and neutrophils. METHODS MPO activity was determined fluorometrically using hypochlorite-specific 3'-(p-aminophenyl) fluorescein (APF). The effect of LGM2605 on (a) the peroxidase cycle of MPO was determined using Amplex Red while the effect on (b) the chlorination cycle was determined using a taurine chloramine assay. Using electron paramagnetic resonance (EPR) spectroscopy we determined the effect of LGM2605 on the EPR signals of MPO. Finally, computational docking of SDG was used to identify energetically favorable docking poses to enzyme's active site. RESULTS LGM2605 inhibited human and murine MPO activity. MPO inhibition was observed in the absence and presence of Cl-. EPR confirmed that LGM2605 suppressed the formation of Compound I, an oxoiron (IV) intermediate [Fe(IV)O] containing a porphyrin π-radical of MPO's catalytic cycle. Computational docking revealed that SDG can act as an inhibitor by binding to the enzyme's active site. CONCLUSIONS We conclude that LGM2605 inhibits MPO activity by suppressing both the peroxidase and chlorination cycles. EPR analysis demonstrated that LGM2605 inhibits MPO by decreasing the formation of the highly oxidative Compound I. This study identifies a novel mechanism of LGM2605 action as an inhibitor of MPO and indicates that LGM2605 may be a promising attenuator of oxidant-dependent inflammatory tissue damage.
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Affiliation(s)
- Om P Mishra
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States.
| | - Anatoliy V Popov
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States.
| | - Ralph A Pietrofesa
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States.
| | - Eiko Nakamaru-Ogiso
- Department of Biochemistry and Biophysics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States.
| | - Mark Andrake
- Molecular Modeling Facility, Fox Chase Cancer Center, Philadelphia, PA 19111, United States.
| | - Melpo Christofidou-Solomidou
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States.
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Mishra OP, Kumar R, Narayan G, Srivastava P, Abhinay A, Prasad R, Singh A, Batra VV. Toll-like receptor 3 (TLR-3), TLR-4 and CD80 expression in peripheral blood mononuclear cells and urinary CD80 levels in children with idiopathic nephrotic syndrome. Pediatr Nephrol 2017; 32:1355-1361. [PMID: 28210837 DOI: 10.1007/s00467-017-3613-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 01/09/2017] [Accepted: 01/16/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND The aims of this study were (1) to detect toll-like receptor (TLR)-3, TLR-4 and CD80 expression in peripheral blood mononuclear cells (PBMCs) and estimate urinary CD80 levels in children with idiopathic nephrotic syndrome and (2) to investigate the utility of these markers to differentiate between biopsy-proven minimal change disease (MCD) and focal segmental glomeruloscelerosis (FSGS). METHODS The study included 70 patients with idiopathic nephrotic syndrome (NS), of whom 40 had steroid-sensitive NS (SSNS; 25 with active NS, 15 in remission) and 30 had steroid-resistant NS (SRNS) patients, and 23 healthy controls. TLR-3, TLR- 4 and CD80 mRNA expression levels in PBMCs were determined and the urinary CD80 level estimated. RESULTS Median TLR-3, TLR-4 and CD80 mRNA expression levels were higher in patients with active SSNS than in those with SRNS, and the latter patient group also had significantly lower expression levels than the controls. The expression levels of these markers were associated with reductions in remission. Patients with biopsy-proven MCD had higher median expression levels of these markers than those with FSGS, but the differences were not statistically significant. Median urinary CD80/creatinine values were significantly higher in patients with SSNS and SRNS than in the controls and steroid-sensitive patients in remission (p < 0.001). CD80 levels were also significantly higher in patients with MCD than in those with FSGS (p = 0.002). A cut-off level of >914.5 ng/g had a sensitivity of 86.6%, specificity 71.4% and area under the curve of 0.828 (95% confidence interval 0.678-0.978, p = 0.002) for the diagnosis of MCD. CONCLUSIONS Increased expressions of TLR-3, TLR-4 and CD80 mRNA and the level of urinary CD80/creatinine could be useful markers to differentiate patients of SSNS in relapse from those with SRNS. Further these markers can also distinguish biopsy proven MCD from FSGS in SRNS patients.
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Affiliation(s)
- Om P Mishra
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
| | - Ravindra Kumar
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Gopeshwar Narayan
- Department of Molecular and Human Genetics, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Pradeep Srivastava
- Department of Biochemical Engineering, Indian Institute of Technology, Banaras Hindu University, Varanasi, India
| | - Abhishek Abhinay
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Rajniti Prasad
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Ankur Singh
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Vineeta V Batra
- Department of Pathology, G.B.Pant Hospital, New Delhi, India
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Mishra OP, Rai AK, Srivastava P, Pandey K, Abhinay A, Prasad R, Mishra RN, Schaefer F. Predictive ability of urinary biomarkers for outcome in children with acute kidney injury. Pediatr Nephrol 2017; 32:521-527. [PMID: 27387432 DOI: 10.1007/s00467-016-3445-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 05/16/2016] [Accepted: 05/16/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND Urinary neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-beta-D-glucosaminidase (NAG), and interleukin 18 (IL-18) were found to be useful for early detection of acute kidney injury (AKI). The objective of this study was to determine the predictive ability of biomarkers for mortality and variation in levels in relation to different stages of AKI, need for dialysis, etiologies, and with duration of hospital stay. METHODS Urinary NGAL, NAG, and IL-18 levels were measured in 50 children with AKI and 30 age- and gender-matched healthy controls. AKI was classified as per pediatric Risk, Injury, Failure, Loss, and End-stage (RIFLE) criteria. RESULTS Median NGAL, NAG, and IL-18 values were significantly increased in AKI patients compared with controls (p < 0.001), with significant increase among risk, injury, and failure stages. Nonsurvivors had significantly higher median levels of NGAL (p = 0.008) and NAG (p = 0.018) than survivors. NGAL had highest area under the curve (AUC) at 0.750 [confidence interval (CI) 0.580-0.920], followed by NAG at 0.724 (CI 0.541-0.907), with sensitivity and specificity of 75 % each; and IL-18 (AUC 0.688, CI 0.511-0.864), with sensitivity 62.5 % and specificity 70.8 %, for predicting mortality. Values were significantly higher in patients who required peritoneal dialysis (PD) than in those in whom it was not indicated. Levels were comparable among different etiologies. Only NGAL level was found to be a significant risk factor associated with longer duration of hospital stay. CONCLUSIONS Urinary NGAL and NAG had modest predictive ability for mortality. Children requiring dialysis had significantly raised levels, and the NGAL level had significant association with duration of hospital stay.
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Affiliation(s)
- Om P Mishra
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
| | - Avinash K Rai
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Pradeep Srivastava
- School of Biochemical Engineering, Indian Institute of Technology, Banaras Hindu University, Varanasi, 221005, India
| | - Khushaboo Pandey
- Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi, 221005, India
| | - Abhishek Abhinay
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Rajniti Prasad
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Rabindra N Mishra
- Division of Biostatistics, Department of Community Medicine, Institute of Medical Sciences,Banaras Hindu University, Varanasi, 221005, India
| | - Franz Schaefer
- Division of Pediatric Nephrology, Centre for Pediatrics and Adolescent Medicine, Heidelberg University Medical Centre, 69120, Heidelberg, Germany
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Pietrofesa RA, Velalopoulou A, Lehman SL, Arguiri E, Solomides P, Koch CJ, Mishra OP, Koumenis C, Goodwin TJ, Christofidou-Solomidou M. Novel Double-Hit Model of Radiation and Hyperoxia-Induced Oxidative Cell Damage Relevant to Space Travel. Int J Mol Sci 2016; 17:ijms17060953. [PMID: 27322243 PMCID: PMC4926486 DOI: 10.3390/ijms17060953] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 06/06/2016] [Accepted: 06/09/2016] [Indexed: 12/14/2022] Open
Abstract
Spaceflight occasionally requires multiple extravehicular activities (EVA) that potentially subject astronauts to repeated changes in ambient oxygen superimposed on those of space radiation exposure. We thus developed a novel in vitro model system to test lung cell damage following repeated exposure to radiation and hyperoxia. Non-tumorigenic murine alveolar type II epithelial cells (C10) were exposed to >95% O₂ for 8 h only (O₂), 0.25 Gy ionizing γ-radiation (IR) only, or a double-hit combination of both challenges (O₂ + IR) followed by 16 h of normoxia (ambient air containing 21% O₂ and 5% CO₂) (1 cycle = 24 h, 2 cycles = 48 h). Cell survival, DNA damage, apoptosis, and indicators of oxidative stress were evaluated after 1 and 2 cycles of exposure. We observed a significant (p < 0.05) decrease in cell survival across all challenge conditions along with an increase in DNA damage, determined by Comet analysis and H2AX phosphorylation, and apoptosis, determined by Annexin-V staining, relative to cells unexposed to hyperoxia or radiation. DNA damage (GADD45α and cleaved-PARP), apoptotic (cleaved caspase-3 and BAX), and antioxidant (HO-1 and Nqo1) proteins were increased following radiation and hyperoxia exposure after 1 and 2 cycles of exposure. Importantly, exposure to combination challenge O₂ + IR exacerbated cell death and DNA damage compared to individual exposures O₂ or IR alone. Additionally levels of cell cycle proteins phospho-p53 and p21 were significantly increased, while levels of CDK1 and Cyclin B1 were decreased at both time points for all exposure groups. Similarly, proteins involved in cell cycle arrest was more profoundly changed with the combination challenges as compared to each stressor alone. These results correlate with a significant 4- to 6-fold increase in the ratio of cells in G2/G1 after 2 cycles of exposure to hyperoxic conditions. We have characterized a novel in vitro model of double-hit, low-level radiation and hyperoxia exposure that leads to oxidative lung cell injury, DNA damage, apoptosis, and cell cycle arrest.
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Affiliation(s)
- Ralph A Pietrofesa
- Division of Pulmonary, Allergy, and Critical Care Medicine and the Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3450 Hamilton Walk, Edward J. Stemmler Hall 2nd Floor, Office Suite 227, Philadelphia, PA 19104, USA.
| | - Anastasia Velalopoulou
- Division of Pulmonary, Allergy, and Critical Care Medicine and the Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3450 Hamilton Walk, Edward J. Stemmler Hall 2nd Floor, Office Suite 227, Philadelphia, PA 19104, USA.
| | - Stacey L Lehman
- Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.
| | - Evguenia Arguiri
- Division of Pulmonary, Allergy, and Critical Care Medicine and the Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3450 Hamilton Walk, Edward J. Stemmler Hall 2nd Floor, Office Suite 227, Philadelphia, PA 19104, USA.
| | - Pantelis Solomides
- Division of Pulmonary, Allergy, and Critical Care Medicine and the Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3450 Hamilton Walk, Edward J. Stemmler Hall 2nd Floor, Office Suite 227, Philadelphia, PA 19104, USA.
| | - Cameron J Koch
- Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.
| | - Om P Mishra
- Division of Pulmonary, Allergy, and Critical Care Medicine and the Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3450 Hamilton Walk, Edward J. Stemmler Hall 2nd Floor, Office Suite 227, Philadelphia, PA 19104, USA.
| | - Constantinos Koumenis
- Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.
| | - Thomas J Goodwin
- The National Aeronautics and Space Administration (NASA) Johnson Space Center, Houston, TX 77058, USA.
| | - Melpo Christofidou-Solomidou
- Division of Pulmonary, Allergy, and Critical Care Medicine and the Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3450 Hamilton Walk, Edward J. Stemmler Hall 2nd Floor, Office Suite 227, Philadelphia, PA 19104, USA.
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Mishra OP, Popov AV, Pietrofesa RA, Christofidou-Solomidou M. Gamma-irradiation produces active chlorine species (ACS) in physiological solutions: Secoisolariciresinol diglucoside (SDG) scavenges ACS - A novel mechanism of DNA radioprotection. Biochim Biophys Acta Gen Subj 2016; 1860:1884-97. [PMID: 27261092 PMCID: PMC5253237 DOI: 10.1016/j.bbagen.2016.05.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/13/2016] [Accepted: 05/26/2016] [Indexed: 11/28/2022]
Abstract
Background Secoisolariciresinol diglucoside (SDG), the main lignan in whole grain flaxseed, is a potent antioxidant and free radical scavenger with known radioprotective properties. However, the exact mechanism of SDG radioprotection is not well understood. The current study identified a novel mechanism of DNA radioprotection by SDG in physiological solutions by scavenging active chlorine species (ACS) and reducing chlorinated nucleobases. Methods The ACS scavenging activity of SDG was determined using two highly specific fluoroprobes: hypochlorite-specific 3′-(p-aminophenyl) fluorescein (APF) and hydroxyl radical-sensitive 3′-(p-hydroxyphenyl) fluorescein (HPF). Dopamine, an SDG structural analog, was used for proton 1H NMR studies to trap primary ACS radicals. Taurine N-chlorination was determined to demonstrate radiation-induced generation of hypochlorite, a secondary ACS. DNA protection was assessed by determining the extent of DNA fragmentation and plasmid DNA relaxation following exposure to ClO− and radiation. Purine base chlorination by ClO− and γ-radiation was determined by using 2-aminopurine (2-AP), a fluorescent analog of 6-aminopurine. Results: Chloride anions (Cl−) consumed >90% of hydroxyl radicals in physiological solutions produced by γ-radiation resulting in ACS formation, which was detected by 1H NMR. Importantly, SDG scavenged hypochlorite- and γ-radiation-induced ACS. In addition, SDG blunted ACS-induced fragmentation of calf thymus DNA and plasmid DNA relaxation. SDG treatment before or after ACS exposure decreased the ClO− or γ-radiation-induced chlorination of 2-AP. Exposure to γ-radiation resulted in increased taurine chlorination, indicative of ClO− generation. NMR studies revealed formation of primary ACS radicals (chlorine atoms (Cl•) and dichloro radical anions (Cl2−•)), which were trapped by SDG and its structural analog dopamine. Conclusion We demonstrate that γ-radiation induces the generation of ACS in physiological solutions. SDG treatment scavenged ACS and prevented ACS-induced DNA damage and chlorination of 2-aminopurine. This study identified a novel and unique mechanism of SDG radioprotection, through ACS scavenging, and supports the potential usefulness of SDG as a radioprotector and mitigator for radiation exposure as part of cancer therapy or accidental exposure.
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Affiliation(s)
- Om P Mishra
- Department of Medicine, Pulmonary, Allergy and Critical Care Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States.
| | - Anatoliy V Popov
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States.
| | - Ralph A Pietrofesa
- Department of Medicine, Pulmonary, Allergy and Critical Care Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States.
| | - Melpo Christofidou-Solomidou
- Department of Medicine, Pulmonary, Allergy and Critical Care Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States.
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Prasad R, Mishra OP. Acute Kidney Injury in Children with Plasmodium falciparum Malaria: Determinants for Mortality. Perit Dial Int 2016; 36:213-7. [PMID: 26429418 PMCID: PMC4803368 DOI: 10.3747/pdi.2014.00254] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 05/03/2015] [Indexed: 02/03/2023] Open
Abstract
UNLABELLED ♦ BACKGROUND Acute kidney injury (AKI) in P. falciparum malaria infection is an important morbidity in children. The purpose of the present study was done to observe the renal involvement, associated morbidities and outcome. ♦ METHODS Out of 156 patients with severe P. falciparum malaria, diagnosed on the basis of compatible clinical presentations and positive malarial parasites in the peripheral blood smear and/or histidine rich protein 2 antigen, 31 had AKI at presentation and were analyzed. ♦ RESULTS Of 31 (19.9%) patients with AKI, 4 were classified at risk, 11 injury, and 16 failure stage, as per pRIFLE criteria (pediatric version of RIFLE [R = risk, I = injury, F = failure, L = loss E = end-stage kidney disease]). Mean age of children with AKI was 7.7 ± 3.2 years. A significantly higher proportion of patients with AKI had hypoglycemia (41.9%), pulmonary edema (32.2%), and disseminated intravascular coagulation (DIC) (29.0%) compared to those without AKI (18.4%, 4.8%, and 3.2%, respectively). Twelve patients (38.7%) required peritoneal dialysis (PD), 8 (25.8%) died, and all were in failure stage. The non-survivors had significantly higher blood urea (p = 0.005) and serum creatinine levels (p = 0.042), lower glomerular filtration rate (p < 0.001), longer duration of illness (p = 0.003), and oliguria/anuria (p = 0.001) than survivors at admission. On logistic regression analysis, the disseminated intravascular coagulation (DIC), jaundice and parasite density (≥ 3+) were found to be significant factors contributing to mortality in children with AKI. ♦ CONCLUSIONS Acute kidney injury in falciparum malaria is one of the severe systemic complications. Duration of illness and presence of comorbidities adversely affected the outcome.
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Affiliation(s)
- Rajniti Prasad
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Om P Mishra
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
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Upadhyay A, Mishra OP, Prasad R, Upadhyay SK, Schaefer F. Behavioural abnormalities in children with new-onset nephrotic syndrome receiving corticosteroid therapy: results of a prospective longitudinal study. Pediatr Nephrol 2016; 31:233-8. [PMID: 26416481 DOI: 10.1007/s00467-015-3216-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/12/2015] [Accepted: 08/13/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Corticosteroid therapy can cause behavioural abnormalities in children with nephrotic syndrome. The objective of this study was to explore the timing of the appearance of abnormalities in their first episode. METHODS Forty-five children with a first episode of idiopathic nephrotic syndrome (30 aged 2-5 and 15 aged 6-14 years) were assessed for behavioural problems using the Child Behaviour Checklist (CBCL) before, and after 6 and 12 weeks of oral steroid treatment. Sixty healthy children were included as controls. RESULTS In both age groups, marked abnormalities of externalising behaviour were noticed, specifically in the domains of aggressive behaviour and attention problems. Clinical range or borderline externalising abnormalities were present in 73% of the younger children and 60% of the schoolchildren after 6 weeks of treatment. In the schoolchildren, abnormal internalising behaviour was also noted at 6 weeks, in 40% at borderline level and in 20% within the clinical range. Elevated scores were observed for the anxious/depressed and withdrawn/depressed domains. Most changes persisted at the 12-week observation. CONCLUSIONS Children of both age groups showed significant attention problems and aggressive and abnormal externalising behaviour within 6 weeks of starting treatment. Parents should be informed and counselled about this potential adverse effect of steroid therapy.
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Affiliation(s)
- Aishvarya Upadhyay
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Om P Mishra
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
| | - Rajniti Prasad
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Shashi K Upadhyay
- Division of Pediatric Nephrology, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Franz Schaefer
- Division of Pediatric Nephrology, Centre for Pediatrics and Adolescent Medicine, Heidelberg University Medical Centre, Heidelberg, Germany
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Abstract
Introduction: Malnutrition is a common problem in developing countries and often associated with co-morbidities. The present study was undertaken with objectives of to find out the comorbidities in children with severe acute malnutrition (SAM).Materials and Methods: This was a hospital based study carried in 77 children with SAM, diagnosed on the basis of WHO criteria.Results: The age group of children was 1- 5 years (median age 23 months) with about 39% between 1- 2 years. There were 38 males (49.3%). Low maternal education (60%), overcrowding (60%), lower- middle socioeconomic status (87%) were some of the predisposing factors observed. Pneumonia (51%), acute gastroenteritis (21%) and bacterial meningitis (8%) were common co- morbidities found. Associated abnormal laboratory parameters found were anemia (60%), leucocytosis (38%), hyboalbuminemia (36%) hyponetremia (31%), and hypokalemia (17%).Conclusion: Presence of infections and biochemical abnormalities require urgent attention in SAM cases and appropriate treatment in a hospital setting to improve their survival.J Nepal Paediatr Soc 2015;35(2):99-102
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Sukla KK, Jaiswal SK, Rai AK, Mishra OP, Gupta V, Kumar A, Raman R. Role of folate-homocysteine pathway gene polymorphisms and nutritional cofactors in Down syndrome: A triad study. Hum Reprod 2015; 30:1982-93. [PMID: 26040482 DOI: 10.1093/humrep/dev126] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [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: 07/01/2014] [Accepted: 04/24/2015] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Do gene-gene and gene-environment interactions in folate-homocysteine (Hcy) pathway have a predisposing role for Down syndrome (DS)? SUMMARY ANSWER The study provides evidence that in addition to advanced age, maternal genotype, micronutrient deficiency and elevated Hcy levels, individually and in combination, are risk factors for Down syndrome. WHAT IS KNOWN ALREADY Polymorphisms in certain folate-Hcy-pathway genes (especially the T allele of MTHFR C677T), elevated Hcy and poor folate levels in mothers during pregnancy have been shown to be risk factors for Down syndrome in certain Asian populations (including the eastern region of India), while the same SNPs are not a risk factor in European populations. This conflicting situation alludes to differential gene-environment (nutrition) interactions in different populations which needs to be explored. STUDY DESIGN, SIZE, DURATION Between 2008 and 2012, 151 Down syndrome triads and 200 age-matched controls (Control mothers n = 186) were included in the study. Seven polymorphisms in six genes of folate-Hcy metabolic pathway, along with Hcy, cysteine (Cys), vitamin B12 (vit-B12) and folate levels, were analysed and compared among the case and control groups. PARTICIPANTS/MATERIALS, SETTING, METHODS Genotyping was performed by the PCR-RFLP technique. Levels of homocysteine and cysteine were measured by HPLC while vitamin B12 and folate were estimated by chemiluminescence. MAIN RESULTS AND THE ROLE OF CHANCE We demonstrate that polymorphisms in the folate-Hcy pathway genes in mothers collectively constitute a genotypic risk for DS which is effectively modified by interactions among genes and by the environment affecting folate, Hcy and vitamin B12 levels. The study also supports the idea that these maternal risk factors provide an adaptive advantage during pregnancy supporting live birth of the DS child. LIMITATIONS AND REASONS FOR CAUTION Our inability to obtain genotype and nutritional assessments of unaffected siblings of the DS children was an important limitation of the study. Also, its confinement to a specific geographic region (the eastern part) of India, and relatively small sample size is a limitation. A parallel investigation on another population could add greater authenticity to the data. WIDER IMPLICATIONS OF THE FINDINGS For mothers genetically susceptible to deliver a DS child (particularly in South Asia), peri-conceptional nutritional supplementation and antenatal care could potentially reduce the risk of a DS child. Additionally, nutritional strategies could possibly be used for better management of the symptoms of DS children. STUDY FUNDING/COMPETING INTERESTS The work is funded through Programme support for Genetic disorders by Department of Biotechnology, Government of India to R.R. The authors declare no conflict of interest.
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Affiliation(s)
- K K Sukla
- Cytogenetics Laboratory, Department of Zoology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - S K Jaiswal
- Centre for Genetic Disorders, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - A K Rai
- Centre for Genetic Disorders, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - O P Mishra
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - V Gupta
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - A Kumar
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - R Raman
- Cytogenetics Laboratory, Department of Zoology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Mishra OP, Prasad R. Myocardial dysfunction in children with scorpion sting envenomation. Indian Pediatr 2015; 52:291-292. [PMID: 25929624] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- O P Mishra
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University,Varanasi, India.
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Abstract
Serum IgE and IL-13 levels were estimated in 40 idiopathic nephrotic syndrome and 16 controls. There were 15 first episode nephrotic syndrome (FENS), 15 infrequent relapsing nephrotic syndrome (IRNS) and 10 patients belonged to frequent relapsing nephrotic syndrome (FRNS). Serum IgE and IL-13 levels were significantly increased in active nephrotic syndrome and its sub-groups as compared to controls and remission (p < 0.001). IgE levels did not differ significantly among different subgroups, while Il-13 was significantly higher in FRNS in comparison with FENS (p = 0.041). Both IgE and IL-13 levels were comparable in nephrotic patients with and without bronchial asthma. Serum IL-13 had significant positive correlation with IgE (r = 0.605, p < 0.001). Thus, raised levels of IgE and IL-13 are found in nephrotic syndrome and could have a role in the pathogenesis of disease.
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Affiliation(s)
- Om P Mishra
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Akkatai S Teli
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Usha Singh
- Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Abhishek Abhinay
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Rajniti Prasad
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Prasad R, Shambhavi, Mishra OP, Upadhyay SK, Singh TB, Singh UK. Cognitive and behaviour dysfunction of children with neurocysticercosis: a cross-sectional study. J Trop Pediatr 2014; 60:358-62. [PMID: 24929075 DOI: 10.1093/tropej/fmu029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Eighty-three confirmed cases of neurocysticercosis diagnosed as per modified delBrutto criteria were enrolled in the study (Group-I) to observe cognitive and behavioural changes. Controls consisted of two groups: children with idiopathic generalized tonic-clonic seizure (Group-II) and normal children with non-specific cough (Group-III). Cases and controls were subjected to cognitive and behaviour assessment. There was significant difference in the intelligence quotient (IQ) of cases in domains of visual perception, immediate recall, analysis synthesis and reasoning, verbal ability, memory and spatial ability. In the age group of 6-18 years, cases had significantly more behaviour problems than control without seizure, in domains of anxious depressed, withdrawn depressed, somatic problems, social problems and rule-breaking behaviour. Neurocysticercosis causes decline in cognitive function and behaviours in older children, which should be recognized early for appropriate management and to avoid undue parental anxiety.
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Affiliation(s)
- Rajniti Prasad
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, India
| | - Shambhavi
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, India
| | - Om P Mishra
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, India
| | - Shashi K Upadhyay
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, India
| | - Tej B Singh
- Department of Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, India
| | - Utpal Kant Singh
- Department of Pediatrics, Nalanda Medical College, Patna 800013, Bihar, India
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Mishra OP, Pietrofesa R, Christofidou-Solomidou M. Novel synthetic (S,S) and (R,R)-secoisolariciresinol diglucosides (SDGs) protect naked plasmid and genomic DNA From gamma radiation damage. Radiat Res 2014; 182:102-10. [PMID: 24945894 DOI: 10.1667/rr13635.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Secoisolariciresinol diglucoside (SDG) is the major lignan in wholegrain flaxseed. However, extraction methods are complex and are associated with low yield and high costs. Using a novel synthetic pathway, our group succeeded in chemically synthesizing SDG (S,S and R,R enantiomers), which faithfully recapitulates the properties of their natural counterparts, possessing strong antioxidant and free radical scavenging properties. This study further extends initial findings by now investigating the DNA-radioprotective properties of the synthetic SDG enantiomers compared to the commercial SDG. DNA radioprotection was assessed by cell-free systems such as: (a) plasmid relaxation assay to determine the extent of the supercoiled (SC) converted to open-circular (OC) plasmid DNA (pBR322) after exposure of the plasmid to gamma radiation; and (b) determining the extent of genomic DNA fragmentation. Exposure of plasmid DNA to 25 Gy of γ radiation resulted in decreased supercoiled form and increased open-circular form, indicating radiation-induced DNA damage. Synthetic SDG (S,S) and SDG (R,R), and commercial SDG at concentrations of 25-250 μM significantly and equipotently reduced the radiation-induced supercoiled to open-circular plasmid DNA in a dose-dependent conversion. In addition, exposure of calf thymus DNA to 50 Gy of gamma radiation resulted in DNA fragments of low-molecular weight (<6,000 bps), which was prevented in a dose-dependence manner by all synthetic and natural SDG enantomers, at concentrations as low as 0.5 μM. These novel results demonstrated that synthetic SDG (S,S) and SDG (R,R) isomers and commercial SDG possess DNA-radioprotective properties. Such properties along with their antioxidant and free radical scavenging activity, reported earlier, suggest that SDGs are promising candidates for radioprotection for normal tissue damage as a result of accidental exposure during radiation therapy for cancer treatment.
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Affiliation(s)
- Om P Mishra
- University of Pennsylvania Perelman School of Medicine, Pulmonary, Allergy and Critical Care Division, Philadelphia, Pennsylvania 19104
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Mishra OP, Kakani N, Singh AK, Narayan G, Abhinay A, Prasad R, Batra VV. NPHS2 R229Q polymorphism in steroid resistant nephrotic syndrome: is it responsive to immunosuppressive therapy? J Trop Pediatr 2014; 60:231-7. [PMID: 24519673 DOI: 10.1093/tropej/fmu006] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Steroid-resistant nephrotic syndrome (SRNS) patients with NPHS2 gene mutations have been reported as non-responsive to immunosuppressive therapy. Inter-ethnic differences can have influence over the frequency of mutations. The present study was undertaken to find out the incidence and treatment response. Mutational analysis of NPHS2 gene was performed in 20 sporadic idiopathic SRNS, 90 steroid-sensitive nephrotic syndrome (SSNS) and 50 normal controls. NPHS2 gene analysis showed R229Q polymorphism in six SRNS (30%), four SSNS (4.4%) and 13 controls (26%). The polymorphism (G→A) showed Hardy-Weinberg distribution and risk allele (G) had strong association with the disease (odds ratio 3.14, 95% CI 1.33-7.43) than controls. Five cases of SRNS having polymorphism showed partial remission to cyclosporine and prednisolone. Overall, partial remission was achieved in 14(70%), complete remission in four (20%), one(5%) patient had no response and one(5%) died. Thus, NPHS2 gene showed R229Q polymorphism and patients achieved partial remission to therapy.
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Affiliation(s)
- Om P Mishra
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Neha Kakani
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Arun K Singh
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Gopeshwar Narayan
- Department of Molecular and Human Genetics, Faculty of Science, Banaras Hindu University, Varanasi 221005, India
| | - Abhishek Abhinay
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Rajniti Prasad
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
| | - Vineeta V Batra
- Department of Pathology, G.B. Pant Hospital, New Delhi 110002, India
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Mishra OP, Singh AK. Galactose treatment in focal and segmental glomerulosclerosis. Pediatr Nephrol 2014; 29:935. [PMID: 24442765 DOI: 10.1007/s00467-013-2731-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 11/22/2013] [Accepted: 12/12/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Om P Mishra
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India,
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Goyal S, Dixit VK, Jain AK, Mishra OP, Jena SK, Ghosh J. Revisiting extra hepatic portal vein obstruction in children from the north Indian gangetic plain. Indian J Pediatr 2014; 81:429-33. [PMID: 24113883 DOI: 10.1007/s12098-013-1257-7] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 09/20/2013] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To study the demographic features, etiology, clinical, radiology and laboratory findings in children with Extra hepatic portal vein obstruction (EHPVO) from the North Indian Gangetic Plain. METHODS A prospective analysis of 53 patients of EHPVO (<14 y of age) was done. Data for clinical presentation, laboratory workup, endoscopic procedures, growth and development, management and outcome were analyzed. RESULTS A total of 53 patients (32 male, 21 female) with mean age of 8.66 ± 3.32 y at presentation were included. Growth retardation was present in 30 (56.60 %) patients at time of diagnosis. The most common presenting symptoms were upper gastrointestinal bleeding (86.80 %) and an incidental finding of splenomegaly (13.2 %). Hematological parameters of hypersplenism were present in 9 (17 %) patients. Protein C (PC), Protein S (PS), antithrombin III (AT) deficiency were found in 8 (20 %), 4 (10 %) and 6 (15 %) of the patients respectively in 40 patients tested. On first endoscopy, esophageal varices were present in all patients. Endoscopic sclerotherapy (EST)/band ligation (EBL) was performed in 46 bleeder patients and success rate was 83.3 % for sclerotherapy and 90 % for band ligation. CONCLUSIONS The etiology of EHPVO in the majority of patients remains elusive. It results in impaired somatic growth. Sclerotherapy and endoscopic banding are effective means for treatment for bleeding varices. It is still not clear whether deficiency of anticoagulant proteins is a primary event or secondary to disease process.
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Affiliation(s)
- Sundeep Goyal
- Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India,
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Abstract
Introduction: Jaundice is an important problem during neonatal period. When total serum bilirubin (TSB) level exceeds a critical limit, it crosses the blood brain barrier and results into bilirubin encephalopathy. The main aim of therapy for neonatal hyperbilirubinemia is prevention of bilirubin encephalopathy by phototherapy and/or exchange transfusion. The aims of this study were to evaluate the efficacy of exchange transfusion (ET) and observe the adverse events during and following three days of ET in neonates with hyperbilirubinemia. Materials and Method: Hospital based cross-sectional descriptive study. All neonates admitted to neonatal intensive care unit and /or paediatric wards of a tertiary- care centre between September 2010 to March 2012, requiring ET were enrolled. Results: A total of 139 ETs were performed in 120 neonates. The common causes were ABO incompatibility (30.8%), prematurity (30.8%), idiopathic (27.5%), Rh isoimmunization (6.7%) and cephalhematoma (4.2%). Mean pre- ET total serum bilirubin (TSB) was 24.2 mg% dL. There was 58% reduction in TSB in post ET and 31% net reduction in 6 hr post ET. Term and preterm neonates showed equal percentage of TSB reduction. Respiratory distress (10.8%) and bradycardia (6.7%) were the common adverse events during, and hypocalcemia (98.3%) and thrombocytopenia (34.2%) in 3 days following ET. The sick neonates had significantly higher incidence of thrombocytopenia (p= 0.031), respiratory distress (p=0.009), apnea (p<0.001) and cardiorespiratory arrest (p<0.001). Overall mortality was 4.2%, and non-survivors were mostly low birth weight, born outside the present hospital and had higher incidence of adverse events. Conclusion: Exchange transfusion is an effective intervention in reducing the serum bilirubin level. However, these neonates require monitoring of ionised calcium and thrombocytopenia. Sick neonates had higher incidence of adverse events than healthy and close clinical monitoring is needed to improve the outcome. DOI: http://dx.doi.org/10.3126/jnps.v34i1.9030 J Nepal Paediatr Soc 2014;34(1):7-13
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Mishra OP, Singh AK, Pohl M, Kumar B, Batra VV, Narayan G. Oral galactose in children with focal and segmental glomerulosclerosis: a novel adjunct therapy. Clin Kidney J 2014; 7:83-5. [PMID: 25859361 PMCID: PMC4389160 DOI: 10.1093/ckj/sft147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Om P Mishra
- Department of Pediatrics , Institute of Medical Sciences , Banaras Hindu University , Varanasi, Uttar Pradesh , India
| | - Arun K Singh
- Department of Pediatrics , Institute of Medical Sciences , Banaras Hindu University , Varanasi, Uttar Pradesh , India
| | - Martin Pohl
- Division of Pediatric Nephrology , Freiburg University Hospital , Freiburg , Germany
| | - Brijesh Kumar
- Department of Pharmacology , Institute of Medical Sciences , Banaras Hindu University , Varanasi, Uttar Pradesh , India
| | - Vineeta V Batra
- Department of Pathology , G.B. Pant Hospital , New Delhi , India
| | - Gopeshwar Narayan
- Molecular and Human Genetics, Faculty of Science , Banaras Hindu University , Varanasi, Uttar Pradesh , India
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Abstract
The objective of the present study was to find out the predictors of relapse. One hundred fifty children with a first episode of idiopathic nephrotic syndrome were followed for 12 months after initial treatment. Sixty-one (40.7%) children had no relapse, and 89 (59.3%) had relapses. A significantly higher proportion of children with disease onset between 1 and 3 years were relapsers in comparison with those with disease onset at 4-6 (p < 0.03) and 7-13 (p < 0.001) years. Risk of relapse was 2.99 times higher in this 1-3 year age-group as compared with patients aged >6 years (p = 0.001). Children responding between 1 and 2 weeks after start of treatment had a 0.423 times lesser risk of relapse than those who responded after 4 weeks (p = 0.023). Relapsers had significantly higher incidence of infection at relapse than at other time points (p < 0.001). Onset of disease in younger age and delayed response to prednisolone therapy were found as significant predictors for relapse.
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Affiliation(s)
- Om P Mishra
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
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Abstract
Osteopetrosis is a rare disease characterised by an increase in bone mass, skeletal malformations and bone marrow failure due to defective bone resorption. We report a 3-month-old male child presented with chest infections, failure to thrive and hepatosplenomegaly and diagnosed with osteopetrosis associated with acute myeloid leukaemia M3 type (AML-M3). The patient died on day 7 of admission due to respiratory failure. To our knowledge, this is the first case where both osteopetrosis and AML is diagnosed in a patient.
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Affiliation(s)
- Rajniti Prasad
- Department of Pediatrics, Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
| | - B P Jaiswal
- Department of Pediatrics, Nalanda Medical College, Patna, Bihar, India
| | - O P Mishra
- Department of Pediatrics, Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
| | - Utpal Kant Singh
- Department of Pediatrics, Nalanda Medical College, Patna, Bihar, India
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Mishra OP, Simmons N, Tyagi S, Pietrofesa R, Shuvaev VV, Valiulin RA, Heretsch P, Nicolaou KC, Christofidou-Solomidou M. Synthesis and antioxidant evaluation of (S,S)- and (R,R)-secoisolariciresinol diglucosides (SDGs). Bioorg Med Chem Lett 2013; 23:5325-8. [PMID: 23978651 DOI: 10.1016/j.bmcl.2013.07.062] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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: 06/04/2013] [Revised: 07/23/2013] [Accepted: 07/25/2013] [Indexed: 01/15/2023]
Abstract
Secoisolariciresinol diglucosides (SDGs) (S,S)-SDG-1 (major isomer in flaxseed) and (R,R)-SDG-2 (minor isomer in flaxseed) were synthesized from vanillin via secoisolariciresinol (6) and glucosyl donor 7 through a concise route that involved chromatographic separation of diastereomeric diglucoside derivatives (S,S)-8 and (R,R)-9. Synthetic (S,S)-SDG-1 and (R,R)-SDG-2 exhibited potent antioxidant properties (EC50=292.17±27.71 μM and 331.94±21.21 μM, respectively), which compared well with that of natural (S,S)-SDG-1 (EC50=275.24±13.15 μM). These values are significantly lower than those of ascorbic acid (EC50=1129.32±88.79 μM) and α-tocopherol (EC50=944.62±148.00 μM). Compounds (S,S)-SDG-1 and (R,R)-SDG-2 also demonstrated powerful scavenging activities against hydroxyl [natural (S,S)-SDG-1: 3.68±0.27; synthetic (S,S)-SDG-1: 2.09±0.16; synthetic (R,R)-SDG-2: 1.96±0.27], peroxyl [natural (S,S)-SDG-1: 2.55±0.11; synthetic (S,S)-SDG-1: 2.20±0.10; synthetic (R,R)-SDG-2: 3.03±0.04] and DPPH [natural (S,S)-SDG-1: EC50=83.94±2.80 μM; synthetic (S,S)-SDG-1: EC50=157.54±21.30 μM; synthetic (R,R)-SDG-2: EC50=123.63±8.67 μM] radicals. These results confirm previous studies with naturally occurring (S,S)-SDG-1 and establish both (S,S)-SDG-1 and (R,R)-SDG-2 as potent antioxidants and free radical scavengers for potential in vivo use.
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Affiliation(s)
- Om P Mishra
- Department of Medicine, Pulmonary Allergy and Critical Care Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
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Mishra OP, Gupta AK, Pooniya V, Prasad R, Tiwary NK, Schaefer F. Peritoneal dialysis in children with acute kidney injury: a developing country experience. Perit Dial Int 2013; 32:431-6. [PMID: 22859842 DOI: 10.3747/pdi.2012.00118] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Peritoneal dialysis (PD) is the preferred and convenient treatment modality for acute kidney injury (AKI) in children and hemodynamically unstable patients. METHODS The outcome of acute PD was studied in 57 children (39 boys) with AKI, aged 1 month to 12 years, at a tertiary care center of a teaching hospital in India. RESULTS Hemolytic uremic syndrome (36.8%) was the most common cause of AKI, followed by septicemia (24.6%) and acute tubular necrosis (19.3%). Treatment with PD was highly effective in lowering retention markers (p < 0.001). Overall mortality was 36.8%. The risk of mortality by multi-variate analysis was higher when patients were anuric [odds ratio (OR): 8.2; 95% confidence interval (CI): 1.3 to 49; p < 0.05], had septicemia (OR: 3.79; 95% CI: 1.55 to 25.8; p < 0.05), or severe infectious complications (OR: 8.2; 95% CI: 1.5 to 42.9; p < 001). CONCLUSIONS Because of its simplicity and feasibility, acute PD is still an appropriate treatment choice for children with AKI in resource-poor settings. Septicemia and severity of AKI are contributory factors to high mortality in pediatric acute kidney injury.
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Affiliation(s)
- Om P Mishra
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
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Abstract
Encephalitis following purified chick embryo rabies vaccination is rare and only a few cases have been reported. A 6-year-old boy is reported who developed features consistent with encephalitis following a third dose of the vaccine and made a complete recovery.
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Affiliation(s)
- Rajniti Prasad
- Departments of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
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Parakh P, Bhatta NK, Mishra OP, Shrestha P, Budhathoki S, Majhi S, Sinha A, Dhungel K, Prabhakar R, Haldhar N. Urinary screening for detection of renal abnormalities in asymptomatic school children. Nephrourol Mon 2013; 4:551-5. [PMID: 23573484 PMCID: PMC3614293 DOI: 10.5812/numonthly.3528] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 11/14/2011] [Revised: 12/15/2011] [Accepted: 01/07/2012] [Indexed: 11/28/2022] Open
Abstract
Background Urinary screening tests for early detection of renal diseases in asymptomatic school children and adolescents are important in the detection of silent renal diseases. Objectives The purpose of the study was to determine the prevalence of occult renal diseases by dipstick test (reagent strips) in asymptomatic Nepalese children. Patients and Methods A total of 2,243 school children, aged 5–15 years, were screened for urinary abnormalities using dipstick test screening. The children who tested positive in the first screening were re-tested after 2–4 weeks. Results In the first screening, 123 children (5.5%) tested positive for isolated hematuria and proteinuria and for combined hematuria and proteinuria. Of these children, 16 (0.71%) cases tested positive in a second screening. Subsequently, 1 child from the secondary screening group was lost to follow up, 5 tested normal and 10 revealed abnormalities. Glomerulonephritis was the most commonly detected disorder (50%). Conclusions Urinary screening was found to be useful in identifying occult renal diseases in asymptomatic children. Urinary screening would therefore not only help in early detection but also in the prevention of the deterioration of renal function later in life.
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Affiliation(s)
- Prince Parakh
- Departments of Pediatrics and Adolescent Medicine 1, B. P. Koirala Institute of Health Sciences (BPKIhS), Dharan, Nepal
| | - Nisha K Bhatta
- Departments of Pediatrics and Adolescent Medicine 1, B. P. Koirala Institute of Health Sciences (BPKIhS), Dharan, Nepal
- Corresponding author: Nisha K Bhatta, Department of Pediatrics and Adolescent Medicine, BPKIhS, Dharan, Nepal. Tel.: +977-9852047918,+977-25525555,Ext: 5332, 5260, Fax: +977-25-520251, E-mail:
| | - Om P Mishra
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Pramod Shrestha
- Departments of Pediatrics and Adolescent Medicine 1, B. P. Koirala Institute of Health Sciences (BPKIhS), Dharan, Nepal
| | - Sunil Budhathoki
- Departments of Pediatrics and Adolescent Medicine 1, B. P. Koirala Institute of Health Sciences (BPKIhS), Dharan, Nepal
| | - Shankar Majhi
- Departments of Biochemistry, B. P. Koirala Institute of health Sciences (BPKIhS), Dharan, Nepal
| | - Arvind Sinha
- Departments of Pathology, B. P. Koirala Institute of health Sciences (BPKIhS), Dharan, Nepal
| | - Kanchan Dhungel
- Departments of Radiodiagnosis and Imaging, B. P. Koirala Institute of health Sciences (BPKIhS), Dharan, Nepal
| | - Rahul Prabhakar
- Departments of Pediatrics and Adolescent Medicine 1, B. P. Koirala Institute of Health Sciences (BPKIhS), Dharan, Nepal
| | - Niladri Haldhar
- Departments of Pediatrics and Adolescent Medicine 1, B. P. Koirala Institute of Health Sciences (BPKIhS), Dharan, Nepal
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Abstract
Disseminated cysticercosis is an uncommon presentation of cysticercosis. Less than 10 cases of disseminated cysticercosis have been reported worldwide in children. We report the case of an 8-year-old boy with disseminated cysticercosis, who had presented with a swelling of the body for 1 month and proptosis of the eyeballs for 14 days. On examination, he had bilateral proptosis, subcutaneous nodules and hypertrophy of muscles of the limbs, neck and face. The CT cranium was normal, but the orbit showed bilateral bulky extraocular muscles heterogeneous in their whole length. The MRI cranium and whole body showed multiple non-enhancing vesicular cysts involving the brain, extraocular muscle, heart, trunk and muscles of the extremities and subcutaneous tissues. A Doppler study of the femoral vein showed thrombosis of the right common femoral vein. He was managed with corticosteroid, albendazole, phenytoin sodium, low-molecular-weight heparin followed by warfarin for 6 months and recovered completely.
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Affiliation(s)
- Utpal Kant Singh
- Department of Pediatrics, Nalanda Medical College, Patna, Bihar, India.
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