Antibodies to m‐type phospholipase A2 receptor in children with idiopathic membranous nephropathy

Idiopathic membranous nephropathy (IMN), the commonest cause of adult nephrotic syndrome (NS), accounts for only a minority of paediatric NS. Antibodies to m‐type phospholipase A2 receptor (PLA2R) are seen in two‐thirds of adult IMN cases. PLA2R staining in glomerular deposits is observed in 74% and 45% of adult and paediatric IMN cases, respectively. However, there are no reports of anti‐PLA2R in paediatric IMN. We evaluated anti‐PLA2R levels and PLA2R in gloemrular deposits in paediatric IMN seen at our center. Five cases were enrolled, all the cases stained for PLA2R in glomeruli and three (60%) had antibodies to PLA2R antigen. There was a parellel reduction in proteinuria and anti‐PLA2R titer. The present report suggests that PLA2R has a contributory role in the pathogenesis of paediatric IMN.     

Acute coronary syndrome in patients with hemophilia: a delicate balancing act

Journal of Thrombosis and Thrombolysis - Therapeutic advances have resulted in increased life expectancy in patients with hemophilia. Consequently, the prevalence of coronary artery disease in this...     

CT-based evaluation of the acetabulum for age estimation in an Indian population

Age estimation constitutes an important aspect of forensic research, investigation and human identification. For the purpose of age estimation, various markers within the skeletal framework are employed. Degenerative morphological changes in the skeleton can be used for age estimation in adults. Amongst the various bones, age-progressive changes in the innominate bone are of particular significance in age estimation. Within the pelvis, the acetabulum presents as a durable and well-preserved evidence, characteristic manifestations of which can be employed for age estimation. The present study aimed at a CT-based evaluation of acetabular changes for the purpose of age estimation in an Indian population. CT images of 250 individuals aged 10–88 years were scrutinized according to the features defined in the Calce method of acetabular age estimation. Scores were allotted to the various features and a cumulative score was calculated. No significant bilateral and sex differences were observed. Significant correlation was obtained between the scores for these defined characteristics and the chronological age of individuals. Population-specific regression models were generated for age estimation. The scoring method devised in the present research requires further validation as it represents a new tool for age estimation in medico-legal cases.

     

Alterations in Gallbladder Emptying and Bile Retention in the Absence of Changes in Bile Lithogenicity in Postmenopausal Women on Hormone Replacement Therapy

The role of female sex hormones in the pathogenesis of gallstones is well established. Pregnancy, contraceptive use, estrogen replacement therapy in postmenopausal women, and estrogen therapy in men for the treatment of prostatic carcinoma have been found to be associated with increased risk of cholesterol gallstones. Alterations in gallbladder emptying and in bile lithogenicity in postmenopausal women receiving hormone replacement therapy (HRT) have not been studied to date. The present study was undertaken to study the effect of HRT on gallbladder emptying and bile lithogenicity. Sixteen postmenopausal women were included in the study. None of the patients had gallstone disease and none had received prokinetic drugs, such as, erythromycin, metoclopramide, domperidone or cisapride, aspirin, and nonsteroidal antiinflammatory drugs. Gallbladder emptying (n = 16), bile microscopy (n = 7), cholesterol saturation index (CSI) (n = 7), and nucleation time (n = 7) were studied before and 3 months after HRT (conjugated estrogen, 0.625 mg, + medroxyprogesterone acetate, 2.5 mg, everyday). Fasting and residual volumes increased (fasting volume, 18.2 +/- 2.2 mL pre-HRT vs 27.6 +/- 3.2 mL post-HRT, P = 0.0003; residual volume, 3.9 +/- 0.6 mL pre-HRT vs 10.3 +/- 2.0 mL post-HRT, P = 0.00009) and ejection fraction decreased (78.2 +/- 2.5% pre-HRT vs 62.2 +/- 3.8% post-HRT; P = 0.0017) after 3 months of HRT. There was no change in CSI (2.32 +/- 0.36 pre-HRT vs 2.60 +/- 0.51 post-HRT; P = NS) or in nucleation time (19.0 +/- 1.2 days pre-HRT vs 17.6 +/- 1.3 days post-HRT; P = NS). None of the bile samples either pre-HRT or post-HRT showed cholesterol monohydrate crystals. Though impairment of gallbladder emptying occurs in the short term with HRT in postmenopausal women, there is no change in CSI and nucleation time.     

Homology Modeling,Molecular Docking and Molecular Dynamics Based Functional Insights into Rice Urease Bound to Urea

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Urease (EC 3.5.1.5) is an important member of most popular amidohydrolases superfamily that is well known for...     

Compound composite odontoma with unusual number of denticles – A rare entity

Compound odontoma is stated to be a hamartomatous lesion rather than a true odontogenic tumour. It has an unknown etiology and often suspected when there are retained deciduous teeth in children. Early detection and surgical enucleation of the tumour is recommended to prevent impaction of unerupted teeth. In this index case, multiple denticles or rudimentary teeth, numbering 37 were enucleated from the maxillary anterior region of a 17-year old male, which makes this case unusual. Evidence of concrescence, fusion and dilaceration were observed in the denticles enucleated, the size of which varied from 4 mm to 12.5 mm.     

Autonomic dysfunction in psoriatic arthritis

Autonomic nervous system (ANS) involvement has been studied in systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, Sjogren’s syndrome, and ankylosing spondylitis but still has not been studied in psoriatic arthritis (PsA). The aim of this study was to investigate the prevalence and the nature of autonomic neuropathy in patients with PsA. Sixteen patients of PsA and 15 age and sex matched control subjects were studied prospectively using a battery of noninvasive tests. Cardiovascular autonomic neuropathy (CAN) was diagnosed by applying four cardiovascular reflex tests, and peripheral sympathetic autonomic function was assessed by Sudoscan. Patients with PsA had significantly higher heart rate response to standing (p?=?0.01), blood pressure response to standing (p?=?0.02), and Sudoscan (p?=?0.01) when compared with healthy controls. Fifty percent (n?=?8) of the patients with PsA had at least two or more abnormal CAN parasympathetic dysfunction; of these, 18.75 % (n?=?3) of the patients had abnormal parasympathetic and sympathetic dysfunction, 68.7 % (n?=?11) and 25 % (n?=?4) of the patients had at least one abnormal parasympathetic and sympathetic parameters, respectively, and 37.5 % (n?=?6) of the patients had moderate sudomotor dysfunction. About 18.7 % (n?=?3) of our parasympathetic dysfunction patients had autonomic symptoms. None of healthy volunteers had abnormal ANS dysfunction. Heart rate response significantly correlated with erythrocyte sedimentation rate (p?<?0.05) and C-reactive protein (p?<?0.05) levels. In conclusion, cardiovascular autonomic and peripheral sympathetic neuropathy occurs in PsA. Parasympathetic function is more commonly found to be abnormal than sympathetic function. There is no correlation of peripheral sympathetic dysfunction with cardiovascular autonomic neuropathy.