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Background This cross-sectional study aimed to determine the influence of genetic polymorphism in two renin-angiotensin system (RAS)-candidate genes on urinary trefoil family factor 3 (TFF3) levels in children with congenital anomalies of kidney and urinary tract (CAKUT). Methods The study included fifty children with CAKUT (PUV, VUR, and PUJO) and twenty age-matched controls. Urinary TFF3 levels were measured by enzyme-linked immunosorbent assay. Detection of genetic polymorphisms in two genes, i.e., I/D polymorphism (SNP at rs4340) in angiotensin-converting enzyme (ACE) and A/T polymorphism in the angiotensin II receptor type-2 (AT2R) due to point mutation at rs3736556 was performed by polymerase chain reaction. Progressive deterioration in kidney function was defined as fall in GFR to < 60 ml/min/1.73 m.sup.2 and/or progressive scarring. Results In our cohort, the genotypic distribution of patients and controls showed no difference. Progressive functional deterioration was significantly associated with the presence of D allele (p = 0.0004), A allele (p = 0.005), and both (p I/D > I/I; p A/T > TT; p < 0.0001). Also, children with both D/D and A/A allelic genotypes had significantly elevated urinary TFF3 compared to those having either of them. Conclusions The presence of D allele and/or A allele is significantly associated with progressive functional deterioration and elevated urinary TFF3 levels. These findings support the role of angiotensin II-AT2R-NF-[kappa]B interaction in progressive deterioration of kidney function and subsequent TFF3 expression in CAKUT. Graphical abstract, Author(s): Sachit Anand [sup.1] , Minu Bajpai [sup.1] , Tripti Khanna [sup.2] , Alok Kumar [sup.1] Author Affiliations: (1) grid.413618.9, 0000 0004 1767 6103, Department of Pediatric Surgery, All India [...]

Background Children with congenital anomalies of kidney and urinary tract (CAKUT) are at high risk of progressive deterioration of kidney function and further developing stage 5 chronic kidney disease (CKD 5), even after a successful surgery. This prospective study was designed to determine whether urinary biomarkers can predict progressive deterioration of kidney function in children with CAKUT. Methods The study included 50 consecutive children, aged < 14 years, who were diagnosed with congenital uropathies (PUV, VUR, and PUJO) and 20 age-matched controls. Examination of four urinary biomarkers, i.e., trefoil family factors (TFF) 1 and 3, neutrophil gelatinase-associated lipocalin (NGAL) and microalbuminuria (MALB) was done at the beginning of follow-up. Kidney function was assessed, at the beginning and after 12-months of follow-up, by technetium-99m diethylene triamine pentaacetic acid (DTPA) and technetium-99m dimercaptosuccinic acid (DMSA) scans. Progressive deterioration in the kidney function was defined as a fall in the GFR from [greater than or equal to] 60 to < 60 ml/min/1.73 m.sup.2 on comparing the baseline and latest DTPA scans; and/or new-onset cortical scar/scars or increase in the size of previous scar/scars on serial DMSA scans. Group 1 and group 2 included children without and with progressive functional deterioration respectively. Results The median (IQR) age of children with CAKUT and controls was 3 (1.5-5) and 2.3 (1.2-3.6) years, respectively, and showed no significant difference (p = 0.29). Median concentrations of TFF1, TFF3, NGAL, and microalbumin in patients were 44.5, 176.5, 281.2, and 15.5 mcg/gCr, respectively, and were significantly elevated as compared to controls (p < 0.05). Children belonging to group 2 had significantly higher concentration of biomarkers as compared to those in group 1. TFF3 was found have the highest AUC (0.9198) on ROC curve for predicting progressive functional deterioration. Conclusion Urinary TFFs, NGAL, and microalbumin significantly correlate with progressive deterioration of kidney function in children harboring CAKUT. TFF3, with the strongest prediction of functional deterioration, is an emerging peptide showing sufficient potential to be included in the biomarker panel., Author(s): Sachit Anand [sup.1] , Minu Bajpai [sup.1] , Tripti Khanna [sup.2] , Alok Kumar [sup.1] Author Affiliations: (1) grid.413618.9, 0000 0004 1767 6103, Department of Pediatric Surgery, Room No [...]

Byline: Deeksha. Bhalla, Minu. Bajpai, Ankur. Goyal, Manisha. Jana A 3-year-old male child was referred to our department with complaint of multiple soft swellings on the scalp, noticed since 1 [...]

Byline: Mayadhar. Barik, Rahmat. Bano, Minu. Bajpai, Madhavi. Tripathy, Sambhunath. Das, Sadananda. Dwivedi Introduction: Craniosynostosis (CS) syndrome is an autosomal dominant condition (ADC) classically combining with CS and nonsyndromic CS [...]

Byline: Prabudh. Goel, Shikha. Jain, Minu. Bajpai, Puneet. Khanna, Vishesh. Jain, Devendra. Yadav Introduction: Caudal block analgesia is administered to lower the requirements of systemic and inhaled anesthetic drugs during [...]

The use of a caudal block in laparoscopic surgery in children is limited to minor procedures like inguinal hernia repair, and intravenous opioids remain the analgesic modality of choice in major laparoscopic surgery. However, a caudal block is frequently performed at our institute even for laparoscopic surgery. Therefore, we planned to evaluate the analgesic efficacy of caudal bupivacaine and morphine in major laparoscopic surgery as compared to intravenous opioids. Our hypothesis was that a single-shot caudal block would increase the duration of analgesia and minimize the hemodynamic response to pneumoperitoneum. After institutional ethics committee clearance, data were collected for 65 ASA I-II children aged 6 months to 12 years who underwent laparoscopic surgery in the last 14 months. Demographic, surgical, and perioperative anesthetic and analgesic data were noted and analyzed. Twenty-four children received a caudal block with 0.25 % bupivacaine (1-1.25 ml/kg) with morphine (30-50 mcg/kg). In the caudal group, the time to first analgesic request was increased (165 vs. 45 min; p = 0.00) and tachycardia response to port site incision was less observed (33 vs. 63 % children; p = 0.019). Hemodynamic response to pneumoperitoneum was equal in both of the groups. Single-shot caudal injection of local anesthetic with morphine reduces port site skin incision response and increases the duration of postoperative analgesia but fails to prevent hemodynamic response to pneumoperitoneum. Electronic supplementary material The online version of this article (doi:10.1007/s00540-015-1983-2) contains supplementary material, which is available to authorized users., Author(s): Riddhi Kundu[sup.1] , Dalim K. Baidya[sup.1] , Mahesh Kumar Arora[sup.1] , Souvik Maitra[sup.1] , Vanlal Darlong[sup.1] , Devalina Goswami[sup.1] , S. Mohanaselvi[sup.1] , Minu Bajpai[sup.2] Author Affiliations: (1) Department [...]

Byline: Mayadhar. Barik, Minu. Bajpai, Arun. Malhotra, Jyotish. Samantaray, Sadananda. Dwivedi, Sambhunath. Das Background: Craniosynostosis (CS) conditions are included with the premature fusion of one or more multiple cranial sutures. [...]

Background Long-term renal deterioration is common in patients with posterior urethral valves (PUV), and early identification of detrimental factors can help in counselling patients as well as in guiding future therapy. The aim of our study was (1) to evaluate urinary transforming growth factor-[β.sub.1] (TGF-[β.sub.1]), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) levels and microalbuminuria before and after ablation of PUV and (2) to examine the effect of early induction of angiotensin-converting enzyme inhibitors (ACE-I) on renal recovery. Methods The study included 30 patients with diagnosed PUV. Urinary cytokines were measured pre-operatively and postoperatively for 1 year. The study group was subdivided into two subgroups at 6 months after surgery. Group 1 included 16 patients whose urinary TGF-[β.sub.1] level showed a declining trend. Group 2 included 14 patients whose urinary TGF-[β.sub.1] showed a rising trend or plateaued; these patients were started on ACE-I therapy, which they received for at least 6 months. Results Urinary TGF-[β.sub.1], TNF-α and microalbumin levels were high in patients with PUV. In Group 1 patients, urinary TGF-[β.sub.1], TNF-α and microalbumin levels fell significantly following valve ablation and continued to decline for 12 months. In Group 2 patients, after an initial fall following valve ablation, urinary TGF-[β.sub.1], TNF-α and microalbumin showed a continued rise until 6 months post-surgery. After ACE-I therapy, there was 53.43 % fall in urinary TGF-[β.sub.1], 43.15 % fall in microalbuminuria, 28.57 % improvement in split renal function and 35.80 % improvement in GFR. Conclusions Based on our results, urinary TGF-[β.sub.1], urinary TNF-α and microalbuminuria can be used as biomarkers for the early recognition of ongoing renal damage in patients with PUV. ACE-I plays a role in retarding renal damage in these patients. Keywords Posterior urethral valves * Urinary transforming growth factor-[β.sub.1] * Urinary tumor necrosis factor-α * Urinary interleukin-6 * Renin-angiotensin system * Microalbuminuria * Angiotensin-converting enzyme inhibitors, Introduction Posterior urethral valves (PUV) is the most common cause of obstructive uropathy leading to renal failure, and the condition accounts for 16.8 % of children with end-stage renal disease [...]

Byline: Rajeev. Pandey, Abid. Ali, Amit. Singh, Sukanya. Gayan, Minu. Bajpai Background: 677C to T allele in the 5, 10-methylenetetrahydrofolate reductase (MTHFR) gene has been implicated in the etiology of [...]

Byline: Shasanka. Panda, Minu. Bajpai, Manisha. Jana, Dalim. Baidya, Rakesh. Kumar Objective: The objective of this study was to evaluate the results of Anderson-Hynes pyeloplasty with isthmotomy and lateropexy in [...]

Byline: Rajeev. Pandey, Minu. Bajpai, Abid. Ali, Sukanya. Gayan, Amit. Singh Objective: The Objective of this study was to identify the association of mutation of fibroblast growth factor receptor 1 [...]

Byline: Mayadhar. Barik, Minu. Bajpai, Rashmi. Das, Shasanka. Panda Background: Craniosynostosis is a congenital defect that causes one or more sutures on an infant's skull to close earlier than normal. [...]