87 results on '"Rana DS"'
Search Results
2. Histoplasmosis masquerading as hemophagocytic lymphohistiocytosis in renal allograft recipient: a case report
- Author
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Tiwari, Vaibhav, primary, Kumar, Tarun, additional, Bhalla, Anil, additional, and Rana, DS, additional
- Published
- 2023
- Full Text
- View/download PDF
3. Outcomes of ABO–incompatible kidney transplantation with respect to baseline isoagglutinin immunoglobulin G titers
- Author
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Gaur, Lovy, additional, Bhalla, AnilKumar, additional, Shingada, Aakash, additional, Gupta, Ashwani, additional, Malik, Manish, additional, Gupta, Anurag, additional, Bhargava, Vinant, additional, Gupta, Pallav, additional, Joshi, Anant, additional, Ranjan, HarshJauhariVivek, additional, Khillan, Kamini, additional, and Rana, DS, additional
- Published
- 2022
- Full Text
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4. Conservation agriculture for sustainable intensification in South Asia
- Author
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Jat, ML, Jat, ML, Chakraborty, D, Ladha, JK, Rana, DS, Gathala, MK, McDonald, A, Gerard, B, Jat, ML, Jat, ML, Chakraborty, D, Ladha, JK, Rana, DS, Gathala, MK, McDonald, A, and Gerard, B
- Abstract
Agriculture’s contribution to the Sustainable Development Goals requires climate-smart and profitable farm innovations. In the past decade, attention has been given to conservation agriculture as a ‘sustainable intensification’ strategy, although a lack of evidence-based consensus on the merits of conservation agriculture prevails in the context of intensive smallholder farming in South Asia. A meta-analysis using 9,686 paired site–year comparisons representing different indicators of cropping-system performance suggest significant (P < 0.05) benefits when conservation-agriculture component practices are implemented either separately or in tandem. For example, zero tillage with residue retention had a mean yield advantage of 5.8%, a water use efficiency increase of 12.6%, an increase in net economic return of 25.9% and a reduction of 12–33% in global warming potential, with more-favourable responses on loamy soils and in maize–wheat systems. Results suggest that there are opportunities to maximize expected benefits, and policymakers and development practitioners should continue to be appraised of the potential of CA for contributing to the Sustainable Development Goals in South Asia.
- Published
- 2020
5. Hypervitaminosis D and acute interstitial nephritis: Tale of injections
- Author
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Tiwari, Vaibhav, primary, Arora, Veronica, additional, Rajput, Jitendra, additional, Gupta, Anurag, additional, Divyaveer, Smita, additional, Bijarnia-Mahay, Sunita, additional, Gupta, Pallav, additional, Bhargava, Vinant, additional, Malik, Manish, additional, Gupta, Ashwani, additional, Bhalla, AnilKumar, additional, and Rana, DS, additional
- Published
- 2021
- Full Text
- View/download PDF
6. Granulomatosis with polyangiitis masquerading as renal mass: Case report and literature review
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Tiwari, Vaibhav, primary, Raman, Abhishek, additional, Gupta, Anurag, additional, Gupta, Pallav, additional, Joshi, Abhijeet, additional, Bhargava, Vinant, additional, Malik, Manish, additional, Gupta, Ashwani, additional, Bhalla, AnilKumar, additional, and Rana, DS, additional
- Published
- 2021
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7. Evaluation of factors influencing outcomes in pauci-immune crescentic glomerulonephritis: Single centre experience of 51 cases
- Author
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Gupta, Pallav, primary, Dharamdasani, Satyendra, additional, Gupta, Anurag, additional, Bhalla, AK, additional, Gupta, Ashwani, additional, Malik, Manish, additional, Bhargava, Vinant, additional, Tiwari, Vaibhav, additional, Rana, DS, additional, and Sapra, RL, additional
- Published
- 2021
- Full Text
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8. COVID-19 in CKD patients: Report from India
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Tiwari, Vaibhav, primary, Pawar, Nikita, additional, Gupta, Anurag, additional, Bhargava, Vinant, additional, Malik, Manish, additional, Gupta, Ashwani, additional, Bhalla, AnilKumar, additional, and Rana, DS, additional
- Published
- 2021
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9. Etiological spectrum of infective diarrhea in renal transplant patient by stool PCR: An Indian Perspective
- Author
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Tiwari, Vaibhav, primary, Anand, Yogeshman, additional, Gupta, Anurag, additional, Divyaveer, Smita, additional, Bhargava, Vinant, additional, Malik, Manish, additional, Gupta, Ashwani, additional, Bhalla, AnilKumar, additional, and Rana, DS, additional
- Published
- 2021
- Full Text
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10. Chylous ascites after laparoscopic donor nephrectomy: Case report
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Tiwari, Vaibhav, primary, Bhandari, Gaurav, additional, Gupta, Anurag, additional, Bhargava, Vinant, additional, Malik, Manish, additional, Gupta, Ashwani, additional, Bhalla, AnilKumar, additional, and Rana, DS, additional
- Published
- 2021
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11. Immunoadsorption column reuse
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Tiwari, Vaibhav, primary, Gupta, Anurag, additional, Divyaveer, Smita, additional, Bhargava, Vinant, additional, Malik, Manish, additional, Gupta, Ashwani, additional, Bhalla, AnilK, additional, and Rana, DS, additional
- Published
- 2021
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12. Effect of Pr-Ca substitution on the transport and magnetic behavior of LaMnO3 perovskite
- Author
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Thaker, CM, Rayaprol, S, Mavani, Krushna, Rana, DS, Sahasrabudhe, MS, Patil, SI, and Kuberkar, DG
- Published
- 2002
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13. Structural studies and T c dependence in La2−x Dy x Ca y Ba2Cu4+y O z type mixed oxide superconductors
- Author
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Rayaprol, S, Mavani, Krushna, Thaker, CM, Rana, DS, Chakravorty, Keka, Paranjape, SK, Ramanadham, M, Kulkarni, Nilesh A, and Kuberkar, DG
- Published
- 2002
- Full Text
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14. Effect of De novo donor-specific antibodies on graft function in renal allograft recipients
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Singh, RaviKumar, primary, Gupta, Ashwani, additional, Bhargava, Vinant, additional, Gupta, Anurag, additional, Tiwari, Vaibhav, additional, Malik, Manish, additional, Bhalla, AK, additional, Rana, DS, additional, and Jain, Monika, additional
- Published
- 2020
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15. SP427TO STUDY THE EFFECT OF ARTERIAL PULSE ENHANCEMENT TECHNOLOGY (A-PET) THERAPY USING VASCUPUMP(™) FOR RELIEF OF SYMPTOMS IN RESTLESS LEGS SYNDROME (RLS) IN PATIENTS ON DIALYSIS
- Author
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Singh, Ravi Kumar, primary, Bhalla, Anil, additional, Rana, Ds, additional, Gupta, Ashwani, additional, Arijit, Jadiya, additional, and Singh, Deepika, additional
- Published
- 2019
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16. FP797TO STUDY THE GRAFT SURVIVAL AND PATIENT OUTCOME IN ABO INCOMPATIBLE KIDNEY TRANSPLANTS WITH BASELINE HIGH TITERS AND LOW TITERS COMPARED TO ABO COMPATIBLE KIDNEY TRANSPLANT
- Author
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Gaur, Lovy, primary, Bhalla, Ak, additional, Gupta, Ashwani, additional, Malik, M, additional, Shingada, Aakash, additional, Joshi, Anant, additional, Gupta, Anurag, additional, Bhargava, Vinant, additional, and Rana, Ds, additional
- Published
- 2019
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17. Pulmonary calcifications: Is it an entity in the new world dialysis patient?
- Author
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Bhargava, V, primary, Kauntia, R, additional, Gupta, P, additional, and Rana, DS, additional
- Published
- 2019
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18. Bladder carcinoma associated with BK virus in a renal allograft recipient
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Gaur, L, primary, Gupta, A, additional, Meena, P, additional, Shingada, A, additional, Gupta, P, additional, and Rana, DS, additional
- Published
- 2019
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19. Norovirus-associated hemolytic uremic syndrome in a renal transplant recipient
- Author
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Gaur, Lovy, primary, Gupta, Anurag, additional, Shingada, Aakash, additional, Bhalla, AK, additional, Gupta, Ashwani, additional, Malik, Manish, additional, Bhargava, Vinant, additional, and Rana, DS, additional
- Published
- 2018
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20. Magnetic, transport and 151Eu Mössbauer studies on partially doped La1 - x Eux Sr0.2 MnO3 ( 0.04 ≤ x ≤ 0.32) compounds
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RAKESH KUMAR, RANA, DS, TOMY, CV, PAULOSE, PL, and MALIK, SK
- Subjects
MöSsbauer Effect ,Colossal Magnetoresistance ,Magnetization - Abstract
Electrical resistivity, magnetic susceptibility and 151Eu Mössbauer studies have been carried out on La1-xEuxSr0.2MnO3 (0.04≤ x 0.32) compounds. As Eu substitution for La increases, the Curie temperature (TC) decreases from 261 K for x=0.04 to 187 K for x=0.16 along with a decrease in the metal–insulator transition temperature. However, the x=0.32 sample shows an increase in TC to 224 K along with an increase in the metal–insulator transition. The 151Eu Mössbauer studies show that all the Eu are in 3+(4f6,J=0) nonmagnetic state. Broadening of the Mössbauer spectra below TC indicates a transferred magnetic hyperfine field at the Eu site., © Elsevier
- Published
- 2006
21. Magnetic, specific heat and 151Eu Mössbauer studies on Ba2EuRu1-xCuO6(0≤x≤0.2) compounds
- Author
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RAKESH KUMAR, RANA, DS, TOMY, CV, PAULOSE, PL, NAGARAJAN, R, MIN, C, and OH, S-J
- Subjects
Mossbauer Effect ,Thermal Variables Measurement ,Antiferromagnetism ,Data Acquisition ,Specific Heat ,Magnetization - Abstract
Magnetic, 151Eu Mössbauer and specific heat measurements have been carried out on image compounds. From the magnetization data, all the compounds are found to be antiferromagnetically ordered near 40 K, independent of Cu content. A sharp peak at 40 K in the specific heat data also confirms the magnetic ordering. The Eu ions in all the compounds are in the 3+ state as inferred from the 151Eu Mössbauer isomer shift values. However, a well split, six line pattern is observed in the 151Eu Mössbauer spectra of these compounds below 40 K. This is rather rare for image which is a nonmagnetic ion. The magnetic hyperfine field at the Eu site is found to be image at 4.2 K and is presumed to arise due to the strong Ru–O–Eu exchange interaction., © Elsevier
- Published
- 2006
22. Effect of Pr-Ca substitution on the transport and magnetic behavior of LaMnO3 perovskite
- Author
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Thaker, CM, Rayaprol, S, Mavani, Krushna, Rana, DS, Sahasrabudhe, MS, Patil, SI, and Kuberkar, DG
- Abstract
Abstract: The effect of simultaneous substitution of a fluctuating cation and a divalent cation in LaMnO
3 perovskite modifies the properties of the material to exhibit large valence colossal magnetoresistance (CMR) effect. A good example of these properties is (La1−2x Prx Cax )MnO3 (LPCMO) type CMR material. In this communication it is reported that, with the increase in x (for x=0.1, 0.15, 0.2), the Tc varies between 100 and 120 K with improvisation in metal-insulator transition. Interestingly, resistance increases with x from few hundred ohms to few kilo ohms with corresponding decrease in the unit cell volume. The results of the studies using X-ray diffraction (XRD), electrical resistivity, magnetoresistance and ac susceptibility measurements on LPCMO samples for understanding the structural, transport and magnetic properties are discussed in detail.- Published
- 2002
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23. Structural studies and Tc dependence in La2−xDyxCayBa2Cu4+yOz type mixed oxide superconductors
- Author
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Rayaprol, S, Mavani, Krushna, Thaker, CM, Rana, DS, Chakravorty, Keka, Paranjape, SK, Ramanadham, M, Kulkarni, Nilesh, and Kuberkar, DG
- Abstract
Abstract: A new series of mixed oxide superconductors with the stoichiometric composition La
2−x Dyx Cay Ba2 Cu4+y Oz (x=0.0 − 0.5, y=2x) has been studied for structural and superconductiong properties. Our earlier studies on La2−x (Y/Er)x Cay Ba2 Cu4+y Oz series, show a strong dependence of Tc on hole concentration (psh ). In the present work, the results of the analysis of the neutron diffraction measurements at room temprerature on x=0.3 and 0.5 samples are reported. It is interesting to know that Ca substitutes for both La and Ba site with concomitant displacement of La onto Ba site. Superconductivity studies show that maximum Tc is obtained for x=0.5, y=1.0 sample (Tc ∼ 75 K), for La1.5 Dy0.5 Ca1 Ba2 Cu5 Oz (La-2125).- Published
- 2002
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24. A novel mouth guard in endoscopy suite for limited oral access.
- Author
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Rana DS, Singh A, Swami AC, and Atolia NK
- Abstract
Competing Interests: There are no conflicts of interest.
- Published
- 2024
- Full Text
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25. Enhancing Success in the ABO-Incompatible Kidney Transplantation: A Case Report.
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Rana DS, Bhalla AK, Gupta A, Malik M, and Gupta A
- Abstract
Kidney transplantation is the preferred treatment for end-stage renal disease (ESRD); however, ABO incompatibility (ABOi) poses challenges due to increased graft rejection risk. Desensitization strategies, including immunoadsorption (IA), aim to overcome ABOi barriers. The objective of this case report was to present the initial findings and patient outcomes of ABOi kidney transplantation (KT) using two different brands of IA columns (Glycosorb
® ABO and SECORIM® -ABO) in reducing isoagglutinin titers to the desired target level. We present a case report of a 51-year-old male with ESRD secondary to diabetic kidney disease who underwent desensitization for ABOi KT, involving rituximab administration followed by IA using Glycosorb® and Vitrosorb SECORIM® -ABO columns and plasmapheresis (PP). Glycosorb® ABO column decreased anti-B titers from an initial level of 1:128/1:128 to 1:64/1:64 (target range ≤1:8); however, the titers rebounded to 1:64 following the fourth session of PP. Subsequent use of Vitrosorb SECORIM® -ABO column achieved target titers of 1:4, enabling successful transplantation with satisfactory graft function. Monitoring included anti-B IgG/IgM titer levels post IA columns, IA column reuse, kidney function, and adverse events. The IA columns were well tolerated. Desensitization using IA columns effectively reduced anti-B titers, facilitating successful ABOi KT., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Rana et al.)- Published
- 2024
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26. Parthenium hysterophorus derived nanostructures as an efficient carbocatalyst for the electrochemical sensing of mercury(II) ions.
- Author
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Sharma R, Rana DS, Gupta N, Thakur S, Thakur KK, and Singh D
- Subjects
- Parthenium hysterophorus, Carbon chemistry, Ions, Nitrogen chemistry, Oxygen, Mercury, Biosensing Techniques methods, Nanostructures chemistry
- Abstract
The sustainable utilization of resources motivate us to create eco-friendly processes for synthesizing novel carbon nanomaterials from waste biomass by minimizing chemical usage and reducing energy demands. By keeping sustainability as a prime focus in the present work, we have made the effective management of Parthenium weeds by converting them into carbon-based nanomaterial through hydrothermal treatment followed by heating in a tube furnace under the nitrogen atmosphere. The XPS studies confirm the natural presence of nitrogen and oxygen-containing functional groups in the biomass-derived carbon. The nanostructure has adopted a layered two-dimensional structure, clearly indicated through HRTEM images. Further, the nanomaterials are analyzed for their ability towards the electrochemical detection of mercury, with a detection limit of 6.17 μM, while the limit of quantification and sensitivity was found to be 18.7 μM and 0.4723 μM μA
-1 cm-2 , respectively. The obtained two-dimensional architecture has increased the surface area, while the nitrogen and oxygen functional groups act as an active site for sensing the mercury ions. This study will open a new door for developing metal-free catalysts through a green and sustainable approach by recycling and utilization of waste biomass., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)- Published
- 2024
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27. Clinicopathologic Spectrum and Outcomes of Infections Diagnosed on Graft Biopsies and Nephrectomy in Live Renal Allograft Recipients: An Institutional Experience.
- Author
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Gupta P, Bhargava V, Malik M, Gupta A, Bhalla AK, Gupta A, Tiwari V, Chadha S, and Rana DS
- Subjects
- Humans, Retrospective Studies, Male, Female, Middle Aged, Adult, Biopsy, Treatment Outcome, Time Factors, Risk Factors, Allografts, Living Donors, Graft Survival, Turkey epidemiology, Aged, Pyelonephritis microbiology, Pyelonephritis diagnosis, Pyelonephritis mortality, Polyomavirus Infections diagnosis, Polyomavirus Infections mortality, Polyomavirus Infections virology, Polyomavirus Infections epidemiology, Polyomavirus Infections immunology, Kidney Transplantation adverse effects, Kidney Transplantation mortality, Nephrectomy adverse effects, Opportunistic Infections immunology, Opportunistic Infections mortality, Opportunistic Infections diagnosis, Opportunistic Infections microbiology, Opportunistic Infections virology, Opportunistic Infections epidemiology
- Abstract
Objectives: Modern immunosuppressive regimens have reduced rejection episodes in renal allograft recipients but have increased the risk of opportunistic infections. Infections are considered to be the second leading cause of death after cardiovascular complications in renal allograft recipients. Data on opportunistic infections affecting the allograft itself are scarce. The present study describes the spectrum of renal opportunistic infections and their outcomes diagnosed on renal allograft biopsies and nephrectomy specimens., Materials and Methods: Our retrospective observational study was conducted from December 2011 to December 2021. We analyzed infectious episodes diagnosed on renal allograft biopsies or graft nephrectomy specimens. We obtained clinical, epidemiological, and laboratory details for analyses from hospital records., Results: BK virus nephropathy was the most common opportunistic infection affecting the allograft, accounting for 47% of cases, followed by bacterial graft pyelonephritis (25%). Mucormycosis was the most common fungal infection. The diagnosis of infection from day of transplant ranged from 14 days to 39 months. Follow-up periods ranged from 1 to 10 years. Mortality was highest among patients with opportunistic fungal infection (62%), followed by viral infections, and graft failure rate was highest in patients with graft pyelonephritis (50%). Among patients with BK polyomavirus nephropathy, 45% had stable graft function compared with just 33% of patients with bacterial graft pyelonephritis., Conclusions: BK polyoma virus infection was the most common infection affecting the renal allograft in our study. Although fungal infections caused the highest mortality among our patients, bacterial graft pyelonephritis was responsible for maximum graft failure. Correctly identifying infections on histology is important so that graft and patient life can be prolonged.
- Published
- 2024
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28. High-value crops' embedded groundnut-based production systems vis-à-vis system-mode integrated nutrient management: long-term impacts on system productivity, system profitability, and soil bio-fertility indicators in semi-arid climate.
- Author
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Bana RS, Choudhary AK, Nirmal RC, Kuri BR, Sangwan S, Godara S, Bansal R, Singh D, and Rana DS
- Abstract
The current study identified two new climate-resilient groundnut-based cropping systems (GBCSs), viz ., groundnut-fenugreek cropping system (GFCS) and groundnut-marigold cropping system (GMCS), with appropriate system-mode bio-compost embedded nutrient management schedules (SBINMSs) for semi-arid South Asia. This 5-year field study revealed that the GMCS along with leaf compost (LC) + 50% recommended dose of fertilizers (RDF
50 ) in wet-season crop (groundnut) and 100% RDF (RDF100 ) in winter-season crop (marigold) exhibited the highest system productivity (5.13-5.99 t/ha), system profits (US$ 1,767-2,688/ha), and soil fertility (available NPK). Among SBINMSs, the application of 5 t/ha leaf and cow dung mixture compost (LCMC) with RDF50 showed the highest increase (0.41%) in soil organic carbon (SOC) followed by LC at 5 t/ha with RDF50 and RDF100 . Legume-legume rotation (GFCS) had significantly higher soil microbial biomass carbon (SMBC) and soil microbial biomass nitrogen (SMBN) than legume-non-legume rotations (groundnut-wheat cropping system (GWCS) and GMCS). Among SBINMSs, the highest SMBC (201 µg/g dry soil) and SMBN (27.9 µg/g dry soil) were obtained when LCMC+RDF50 was applied to groundnut. The SMBC : SMBN ratio was the highest in the GWCS. LC+RDF50 exhibited the highest SMBC : SOC ratio (51.6). The largest increase in soil enzymatic activities was observed under LCMC+RDF50 . Overall, the GMCS with LC+RDF50 in the wet season and RDF100 in the winter season proved highly productive and remunerative with better soil bio-fertility. SBINMSs saved chemical fertilizers by ~25%' in addition to enhanced system productivity and system profits across GBCSs in semi-arid regions of South Asia. Future research needs to focus on studying the potential of diversified production systems on water and environmental footprints, carbon dynamics, and energy productivity under semi-arid ecologies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Bana, Choudhary, Nirmal, Kuri, Sangwan, Godara, Bansal, Singh and Rana.)- Published
- 2024
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29. Comparison of Clinico-pathologic features and outcomes of ANCA negative and ANCA positive pauci immune crescentic glomerulonephritis: A single centre study.
- Author
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Gupta P, Bhargava V, Malik M, Gupta A, Bhalla AK, Gupta A, Tiwari V, Rana DS, and Sapra RL
- Subjects
- Humans, Antibodies, Antineutrophil Cytoplasmic, Kidney pathology, Kidney Glomerulus pathology, Acute Disease, Retrospective Studies, Glomerulonephritis pathology, Glomerulonephritis, Membranoproliferative pathology, Kidney Failure, Chronic pathology
- Abstract
Introduction: Pauci-immune crescentic glomerulonephritis (PICN) is an important cause of rapidly progressive renal failure. 10-40% of PICN cases have ANCA (antineutrophil cytoplasmic antibody) negative serology. The present study compared clinico-pathologic features, Brix's renal risk score, Berden's histopathological classes and differences in outcome between ANCAnegative vs ANCA positive PICN patients., Materials and Methods: Sixty-one patients of biopsy-proven PICN were studied. Biochemical findings and ANCA serology were recorded. Renal biopsy slides were reviewed along with direct immunofluorescence. Clinical and histological features were compared between ANCA negative and positive PICN using the Man Whitney U test and Chi-square test. Patients were compared for distribution in Berden's histological classes and Brix's renal risk categories. Patient and renal survival were compared using Kaplan-Meier survival analysis., Results: ANCA negative PICN patients were younger (44.9 ± 16.5 years vs 53.6 ± 15.1 years, P = 0.049). Nasal (0 vs 18%, P = 0.035) and pulmonary involvement (9% vs 38%, P = 0.014) were lower in ANCA negative group. Both ANCA groups had similar renal biochemical profiles, percentage normal glomeruli, 16.3 ± 18.2 vs 21.7 ± 20.4 and percentage glomeruli with crescents, 64.5 ± 28.1 vs 64.3 ± 27.1. Twenty-seven per cent of ANCA negative cases fell in the sclerotic class in Berden's classification vs just 2.5% in ANCA positive group (p = 0.037) without significant difference in Brix's renal risk categories (p = 0.329). Thirteen per cent of ANCA negative patients achieved complete remission on treatment compared to 33% in ANCA positive patients. Patient survival and overall probability of progressing to ESRD were similar in the two groups., Conclusion: ANCA negative PICN cases present at younger ages. Nasal and pulmonary involvement is uncommon in these patients. Patient survival and progression to ESRD are similar in both ANCA groups.
- Published
- 2024
- Full Text
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30. ABO-Incompatible Renal Transplant: A Single-Center Experience from India.
- Author
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Pawar N, Tiwari V, Gupta A, Divyaveer S, Rather I, Chadha S, Bhargava V, Malik M, Gupta A, Bhalla AK, Rana DS, and Gupta P
- Abstract
Introduction: In view of ever-increasing end-stage renal disease (ESRD) population but inadequate availability of suitable donors, ABO-incompatible (ABOi) transplantation can be an important void filler. However, at present, ABOi transplantation is limited to a few centers in India and there is a lack of adequate experience and expertise to guide this program to other centers in the country., Methods: Data of all the ABOi transplants performed from 2012 to 2021 in a tertiary care hospital was retrospectively analyzed. The anti-ABO antibody (IgG) titers (≤1:4) were considered safe before transplantation. Desensitization included rituximab, plasma exchange, or selective immunoadsorption column. Tacrolimus and mycophenolate mofetil were initiated at day -7. Induction agents included ATG, ATLG, basiliximab, or no induction. Postoperatively, anti-ABO titers were done daily for 2 weeks., Results: A total of 202 patients underwent transplantation; of these, 195 patients whose data were for available for 12 months were included in the study. Mean duration of follow-up was 28.9 ± 21.7 months. UTI was the most common source of infection, occurring in almost half (46.1%) of the patients. Antibody-mediated rejection (ABMR; 15%) was common in the first year. Patient survival was 86.6% (169/195) at 1 year. Sepsis was the most common of death in more than two-thirds of the population, including coronavirus disease 2019 (COVID-19)-associated mortality in nine patients (4.6%). Death-censored graft survival was 89.3% (174/195). AMR was the leading cause of graft loss in almost half of the patients., Conclusion: ABOi should be considered in ESRD patients for whom suitable ABO-compatible donor is not available. Higher rate of rejection and infection are still a major concern., Competing Interests: There are no conflicts of interest., (© 2024 Indian Journal of Nephrology | Published by Scientific Scholar.)
- Published
- 2024
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31. Nitrogen and sulfur functionalized microporous carbon nanomaterial derived from waste coconut husk for the efficient detection and removal of ofloxacin.
- Author
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Sharma R, Thakur J, Jaryal VB, Rana DS, Thakur S, Gupta N, and Singh D
- Subjects
- Cocos, Nitrogen chemistry, Sulfur, Carbon chemistry, Nanostructures
- Abstract
This study uses waste coconut husk to synthesize carbon quantum dots decorated graphene-like structure for sustainable detection and removal of ofloxacin. The XRD spectrum shows the carbon nanomaterial's layered structure with turbostratic carbon stacking on its surface. The FESEM and HRTEM studies claim the successful development of quantum dots decorated 2D layered structure of carbon nanomaterial. The functionalization of sulfur and nitrogen is well observed and studied through XPS, while Raman spectra have provided insight into the surface topology of the as-synthesized nanostructure. The BET surface area was found to be 1437.12 m
2 /g with a microporous structure (pore width 2.0 nm) which interestingly outcompete many reported carbon-based nanomaterials such as graphene oxide, reduced graphene oxide and quantum dots. The detection and removal processes are monitored through UV-visible spectroscopy and the obtained detection limit and adsorption capacity were 2.7 nM and 393.94 mg/L respectively. Additionally, 1 mg carbon nanomaterial has removed 49 % ofloxacin from water in just 1 h. In this way, this study has successfully managed the coconut husk waste after its utilization for environmental remediation purposes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)- Published
- 2024
- Full Text
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32. Prevalence, risk, and outcomes of venous thromboembolic events in kidney transplant recipients: a nested case-control study.
- Author
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Bhargava V, Meena P, Bhalla AK, Rana DS, Gupta A, Malik M, Gupta A, and Tiwari V
- Subjects
- Adult, Humans, Case-Control Studies, Prevalence, Risk Factors, Retrospective Studies, Venous Thromboembolism epidemiology, Kidney Transplantation adverse effects, Venous Thrombosis etiology
- Abstract
Introduction: Thromboembolism is more common in kidney transplant recipients (KTRs) than in the general population. Studies evaluating arterial and venous thromboembolism (VTE) in KTRs are scarce and the magnitude and risk factors are mostly undefined., Methods: A nested control study was conducted from January 1, 2007, to December 31, 2019. Adult KTRs who were detected to have VTE events during this period were included. The primary outcome was to assess the prevalence of VTE in this population. Secondary outcomes were the assessment of the time to occurrence of the thromboembolic events after transplantation and assessing the risk factors and patient survival. For each subject studied, 4 controls were matched from the data set., Results: Amongst 2158 patients, 97 (4.5%) were found to have VTE. The median follow-up time was 3.9 years (6-156 months). A total of 101 VTE events were recorded. The most common site of VTE was the lower limb deep vein thrombosis in 79 patients (0.03%)).In multivariate Cox regression analysis, serum creatinine of more than 3 mg/dl [HR 1.30, 95% CI (1.03-1.38)] was independently associated with increased VTE risk. Patients who developed a VTE had higher mortality as compared to patients who did not develop VTE. No increased risk of graft failure was found in VTE patients., Conclusion: This study suggests that kidney transplantation surgery is a moderate risk factor for VTE, and VTE is associated with higher morbidity and mortality. However, prospective studies are needed to establish a definite role of VTE in outcomes in KTRs.
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- 2023
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33. Donor-Derived Cell-Free DNA as a Non-Invasive Biomarker for Graft Rejection in Kidney Transplant Recipients: A Prospective Study among the Indian Population.
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Kumar N, Tandon A, Rana R, Rana DS, Bhalla AK, Gupta A, Sachdeva MP, Huirem RS, Chauhan K, Yashavarddhan MH, Basnal A, Gupta R, Mallick PK, and Ganguly NK
- Abstract
Monitoring graft health and detecting graft rejection is crucial for the success of post-transplantation outcomes. In Western countries, the use of donor-derived cell-free DNA (dd-cfDNA) has gained widespread recognition as a diagnostic tool for kidney transplant recipients. However, the role of dd-cfDNA among the Indian population remains unexplored. The recipients were categorized into two groups: the post-transplant recipient (PTR) group ( n = 16) and the random recipient (RR) group ( n = 87). Blood samples were collected daily from the PTR group over a 7-day period, whereas the RR group's samples were obtained at varying intervals. In this study, we used a targeted approach to identify dd-cfDNA, which eliminated the need for genotyping, and is based on the minor allele frequency of SNP assays. In the PTR group, elevated dd-cfDNA% levels were observed immediately after transplantation, but returned to normal levels within five days. Within the RR group, heightened serum creatinine levels were directly proportional to increased dd-cfDNA%. Sixteen recipients were advised to undergo biopsy due to elevated serum creatinine and other pathological markers. Among these sixteen recipients, six experienced antibody-mediated rejection (ABMR), two exhibited graft dysfunctions, two had active graft injury, and six (37.5%) recipients showed no rejection (NR). In cases of biopsy-proven ABMR and NR, recipients displayed a mean ± SD dd-cfDNA% of 2.80 ± 1.77 and 0.30 ± 0.35, respectively. This study found that the selected SNP assays exhibit a high proficiency in identifying donor DNA. This study also supports the use of dd-cfDNA as a routine diagnostic test for kidney transplant recipients, along with biopsies and serum creatinine, to attain better graft monitoring.
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- 2023
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34. Heparin-Induced Thrombocytopenia in Hemodialysis Patients- The First Study from India.
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Sivaprakasam Y, Chadha S, Kotwal J, Gupta A, Tiwari V, Bhargava V, Mallik M, Gupta A, Bhalla AK, and Rana DS
- Abstract
Heparin-induced thrombocytopenia (HIT), a rare complication of heparin therapy, presents with thrombocytopenia. It leads to paradoxical thromboembolism and has high mortality if untreated. It is less recognized, especially in hemodialysis (HD) patients who are frequently exposed to heparin during dialysis because patients with renal failure may have many other causes of thrombocytopenia. We describe the clinical presentation, diagnosis, and treatment of five cases of confirmed HIT in hemodialysis (HD) patients at our center. The initial suspicion was made based on a high 4T score and positive gel card test followed by confirmation using the functional assay with heparin-induced platelet aggregation. These patients were treated according to the recent American Society of Hematology guidelines 2018 for HIT., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Nephrology.)
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- 2023
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35. Nocardiosis in Renal Transplantation: Case Series from India.
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Bhandari G, Tiwari V, Gupta A, Bhargava V, Malik M, Gupta A, Bhalla AK, and Rana DS
- Abstract
Nocardiosis is a rare opportunistic infection seen in kidney transplant patients and is caused by aerobic actinomycete. Disease manifestations can vary from a localized infection to multisystem organ failure. In this retrospective case series, we present 16 cases of Nocardiosis. The median age of the patients was 44 years. The median time from transplant to nocardiosis was 21 months. Acute rejection episodes and CMV infection within 6 months of nocardiosis were found in 12.5% and 25%, respectively. The most common organ involvement was the lungs (75%), followed by the brain (12.5%). Only one patient showed cutaneous involvement (6.25%). Mean creatinine at presentation was 0.7 mg/dL (mean eGFR: 92 ± 27 mL/min/1.73 m
2 ). Trimethoprim/sulfamethoxazole resistance was found in 25% of patients. Five patients (31.25%) succumbed to the infection. Nocardiosis has a very low incidence but a high rate of mortality., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Nephrology.)- Published
- 2023
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36. Development of metal free carbon catalyst derived from Parthenium hysterophorus for the electrochemical detection of dopamine.
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Rana DS, Sharma R, Gupta N, Sharma V, Thakur S, and Singh D
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- Humans, Reproducibility of Results, Electrochemical Techniques methods, Metals, Plant Extracts, Carbon, Dopamine chemistry
- Abstract
Parthenium hysterophorus, one of the seven most hazardous weeds is widely known for its allergic, respiratory and skin-related disorders. It is also known to affect biodiversity and ecology. For eradication of the weed, its effective utilization for the successful synthesis of carbon-based nanomaterial is a potent management strategy. In this study, reduced graphene oxide (rGO) was synthesized from weed leaf extract through a hydrothermal-assisted carbonization method. The crystallinity and geometry of the as-synthesized nanostructure are confirmed from the X-ray diffraction study, while the chemical architecture of the nanomaterial is ascertained through X-ray photoelectron spectroscopy. The stacking of flat graphene-like layers with a size range of ∼200-300 nm is visualized through high-resolution transmission electron microscopy images. Further, the as-synthesized carbon nanomaterial is advanced as an effective and highly sensitive electrochemical biosensor for dopamine, a vital neurotransmitter of the human brain. Nanomaterial oxidizes dopamine at a much lower potential (0.13 V) than other metal-based nanocomposites. Moreover, the obtained sensitivity (13.75 and 3.31 μA μM
-1 cm-2 ), detection limit (0.6 and 0.8 μM), the limit of quantification (2.2 and 2.7 μM) and reproducibility calculated through cyclic voltammetry/differential pulse voltammetry respectively outcompete many metal-based nanocomposites that were previously used for the sensing of dopamine. This study boosts the research on the metal-free carbon-based nanomaterial derived from waste plant biomass., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)- Published
- 2023
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37. NOTTO Guidelines for Vaccine Induced Thrombotic Thrombocytopenia in Organ Donation and Transplantation.
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Kute V, Asthana S, Gupta S, Agarwal SK, Swarnalatha G, Sahay M, Pal S, Sudhindran S, Sharma A, Seth S, Gokhale AGK, Hote MD, Chaudhury AR, Soin AS, Rela M, Malhotra R, Bansal VK, Rana DS, and Ramesh V
- Abstract
From the context of organ donation, COVID-19 vaccine-induced thrombotic thrombocytopenia (VITT) is important as there is an ethical dilemma in utilizing versus discarding organs from potential donors succumbing to VITT. This consensus statement is an attempt by the National Organ and Tissue Transplant Organization (NOTTO) apex technical committees India to formulate the guidelines for deceased organ donation and transplantation in relation to VITT to help in appropriate decision making. VITT is a rare entity, but a meticulous approach should be taken by the Organ Procurement Organization's (OPO) team in screening such cases. All such cases must be strictly notified to the national authorities like NOTTO, as a resource for data collection and ensuring compliance withprotocols in the management of adverse events following immunization. Organs from any patient who developed thrombotic events up to 4 weeks after adenoviral vector-based vaccination should be linked to VITT and investigated appropriately. The viability of the organs must be thoroughly checked by the OPO, and the final decision in relation to organ use should be decided by the expert committee of the OPO team consisting of a virologist, a hematologist, and atreating team. Considering the organ shortage, in case of suspected/confirmed VITT, both clinicians and patients should consider the risk-benefit equationbased on available experience, and an appropriate written informed consent of potential recipients and family members should be obtained before transplantation of organs from suspected or proven VITT donors., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Nephrology.)
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- 2023
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38. An update on SARS-CoV-2 immunization and future directions.
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Rana R, Kant R, Kumra T, Gupta S, Rana DS, and Ganguly NK
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Millions of people have died as a result of SARS-CoV-2, which was first discovered in China and has since spread globally. Patients with SARS-CoV-2 infection may show a range of symptoms, including fever, coughing, and shortness of breath, or they may show no symptoms at all. To treat COVID-19 symptoms and avoid serious infections, many medications and vaccinations have been employed. However, to entirely eradicate COVID-19 from the world, next-generation vaccine research is required because of the devastating consequences it is having for humanity and every nation's economy. Scientists are working hard to eradicate this dangerous virus across the world. SARS-CoV-2 has also undergone significant mutation, leading to distinct viral types such as the alpha, beta, gamma, delta, and omicron variants. This has sparked discussion about the effectiveness of current vaccines for the newly formed variants. A proper comparison of these vaccinations is required to compare their efficacy as the number of people immunized against SARS-CoV-2 globally increases. Population-level statistics evaluating the capacity of these vaccines to reduce infection are therefore being developed. In this paper, we analyze the many vaccines on the market in terms of their production process, price, dosage needed, and efficacy. This article also discusses the challenges of achieving herd immunity, the likelihood of reinfection, and the importance of convalescent plasma therapy in reducing infection., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Rana, Kant, Kumra, Gupta, Rana and Ganguly.)
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- 2023
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39. Clinicopathological investigation of nutritional osteodystrophia fibrosa in a flock of young stall-fed goats.
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Faslu Rahman AT, Sharma M, Mariappan AK, Vinay Kumar SD, Rana DS, Pankaj DK, Kumar N, Nair PM, Thamizhan P, Saikumar G, Singh V, and Kumar P
- Abstract
Background: Osteodystrophia fibrosa (ODF) is a metabolic disorder affecting the skeletal system, causing progressive loss of calcified bone mass and its replacement with fibrous tissue, which may be a sequel to primary or secondary hyperparathyroidism. This report intends to document the clinicopathological findings of ODF in a flock of young goats fed primarily on a wheat bran-rich diet., Case Description: In a flock of 50 stall-fed goats aged 1 to 2 years, seven were clinically presented with bilateral facial enlargement, leading to dyspnea and difficulty in prehension and mastication. Among the seven clinically affected goats, four died in 2 months., Findings/treatment and Outcome: The clinical examination revealed bilateral mandibular enlargement and limb deformities. On radiography, the maxilla and mandible had decreased radiopacity. Fine needle aspiration cytology (FNAC) from the affected bones showed occasional fibroblasts and individual osteoclasts clusters. On necropsy, the enlarged mandible revealed a meaty consistency. Undecalcified histological sections of the mandible showed severe osteopenia, multiple osteoclasts, Howship's lacunae, and extensive fibroplasia. Dietary corrective measures led to the prevention of ODF in the rest of the flock., Conclusion: Excessive wheat bran feeding in stallfed goats might have led to calcium and phosphorus imbalance, resulting in nutritional secondary hyperparathyroidism and subsequent skeletal deformities. FNAC of the affected bones, gross and histological findings provide a clinicopathological diagnosis of ODF., Competing Interests: Authors have no conflict of interest to declare.
- Published
- 2023
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40. Atypical HUS Triggered by COVID-19: A Case Report.
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Tiwari V, Bhandari G, Gupta A, Gupta P, Bhargava V, Malik M, Gupta A, Bhalla AK, and Rana DS
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We hereby present a case of an atypical hemolytic uremic syndrome (aHUS) precipitated by coronavirus disease 2019 (COVID-19). A 26-year-old male was diagnosed with COVID-19 and acute kidney injury. His kidney biopsy was suggestive of thrombotic microangiopathy. Five sessions of plasmapheresis were done but were discontinued in view of nonrecovery of kidney function. He was then referred for a kidney transplant. On genetic analysis, he was found to have mutations in the complement system (CFHR1 and CFHR3), which suggested this was a case of aHUS precipitated by COVID-19. In view of the high risk of recurrence of the primary disease in live-related kidney donor transplantation, he was advised for simultaneous liver and kidney transplants., Competing Interests: There are no conflicts of interest., (Copyright: © Indian Journal of Nephrology.)
- Published
- 2022
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41. Anti-T-Lymphocyte Immunoglobulin (Grafalon) as an Induction Agent for Renal Transplantation: A Real-World, Retrospective, Single-Center Experience.
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Gupta A, Bhalla AK, Malik M, Gupta A, Bhargava V, Tiwari V, Gaur L, Gupta P, Jain M, and Rana DS
- Subjects
- Adolescent, Adult, Aged, Female, Graft Rejection, Humans, Immunosuppressive Agents, Male, Middle Aged, Retrospective Studies, T-Lymphocytes, Treatment Outcome, Young Adult, Antilymphocyte Serum adverse effects, Kidney Transplantation methods
- Abstract
Objectives: Polyclonal antithymocyte globulins are widely used in the induction regimens of solid-organ transplant recipients; however, their doses and outcomes remain to be standardized in Indian patients. We report our clinical experience from the real-world use of Grafalon (an anti-T-lymphocyte globulin; ATG-Fresenius) as an induction agentin renal transplant recipients from India., Materials and Methods: In this retrospective, single- center, observational study, we analyzed the medical records of 177 consecutive, kidney-only transplant recipients who received induction therapy with Grafalon from September 2016 to March 2018 at our center. Incidences of biopsy-proven acute rejection and graft dysfunction, immunosuppression protocol, Grafalon dosage, 18-month post-transplant graft and patient survival, treatment-related adverse events, and infective complications were reported., Results: Mean age of patients was 41.46 years (range, 14-68 years), (85% were males). The average dose of Grafalon was 5.81 ± 1.95 mg/kg (range, 2.41 to 10.07 mg/kg). Graft dysfunction (ie, at least 20% increase in serum creatinine from baseline) was observed in 26 patients (14%): 11 patients (6.2%) had biopsy-proven acute rejections, 11 patients (6.2%) had acute tubular necrosis, and 4 patients (2.2%) had calcineurin inhibitor toxicity. Seven deaths were recorded: 2 each from fungal pneumonia, bacterial pneumonia, and acute coronary syndrome and 1 with urinary tract infection with septicemia. Death-censored graft survival was 100% at 12 months and 98% at 18-month follow-up; overall patient survival was 96%. Infective complications occurred in 40 patients (22.5%), with the most common being urinary tract infection in 32 patients (18%). No malignancies were reported., Conclusions: Use of a potent induction therapy like anti-T-lymphocyte globulin (Grafalon) is often restricted by the risk of side effects and lack of local clinical evidence supporting its role in long-term graft survival. Real-world evidence support the safe and effective use of anti-T-lymphocyte globulin as an induction agent in renal transplant recipients with an individualized dosing approach.
- Published
- 2022
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42. Double whammy: anticoagulant-related nephropathy with leukocytoclastic vasculitis due to warfarin.
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Bhandari G, Tiwari V, Gupta A, Gupta P, Bhargava V, Malik M, Gupta A, Bhalla AK, and Rana DS
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- Anticoagulants adverse effects, Female, Humans, Male, Middle Aged, Renal Dialysis, Vasculitis, Leukocytoclastic, Cutaneous, Vasculitis drug therapy, Warfarin adverse effects
- Abstract
Anticoagulation-related nephropathy (ARN) is a rare form of acute kidney injury where the use of anticoagulation causes hemorrhage in various compartments of nephron including glomerulus, renal tubules, and interstitial compartment. Also, warfarin-induced vasculitis is an extremely rare condition characterized by the appearance of purpuric lesions on the skin which on biopsy are suggestive of leukocytoclastic vasculitis (LV). We hereby report a case presenting with coexistent warfarin-induced nephropathy and cutaneous vasculitis. A 64-year-old male, on warfarin for 10 years, presented with complaints of palpable purpuric rashes over lower limbs, hematuria, and decrease urine output. INR was in the supratherapeutic range (INR-6.3). Skin biopsy of the lesion was suggestive of LV and kidney biopsy showed RBCs in Bowman's capsule, RBCs and RBC casts in tubules suggestive of ARN. All vasculitic markers were negative. Thus, a diagnosis of warfarin-induced nephropathy and cutaneous vasculitis was made. Warfarin was discontinued and oral steroids were started. Gradually, his skin lesions improved, and he became dialysis independent. He was then discharged on apixaban. On follow-up after 3 months, his skin lesions had disappeared with partial recovery of kidney function (cr-5.49)., (© 2021. Japanese Society of Nephrology.)
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- 2022
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43. Hypervitaminosis D and Acute Interstitial Nephritis: Tale of Injections.
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Tiwari V, Arora V, Rajput J, Gupta A, Divyaveer S, Bijarnia-Mahay S, Gupta P, Bhargava V, Malik M, Gupta A, Bhalla AK, and Rana DS
- Abstract
A 33-year-old man came with nausea, vomiting and abdominal pain due to hypercalcaemia and renal dysfunction following two doses of intramuscular vitamin D injections. Levels of vitamin D were repeatedly above 300 ng/ml over a period of 10 months. Whole-body PET CT scan revealed a thin-walled collection in the right gluteal region. The patient refused a surgical intervention for the same. After 7 months of follow-up, the abscess ruptured spontaneously and was then surgically debrided. At this point, a history of pentazocine addiction was uncovered. One month later, vitamin D levels began to fall along with improvement in serum calcium and creatinine. This case unravels a diagnostic odyssey which ended with a simple surgical debridement. We aim to highlight that vitamin D supplementation in 'megadoses' in the presence of active infection can have an exaggerated response and may take months to resolve., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Nephrology.)
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- 2022
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44. Clinical characteristics, outcomes, and management of COVID-19 in kidney transplant recipients across Asia: an ASTREGO report.
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Kee T, Jeong JC, Ur-Rashid H, Begum NAS, Arakama MH, Danguilan R, Od-Erdene L, Yahya R, Kim Y, Sran HK, Ma B, Ma M, Rana DS, Ahn C, and Ahmad G
- Abstract
Background: Asia is the global epicenter of the coronavirus disease 2019 (COVID-19) pandemic; however, COVID-19-related mortality in Asia remains lower than in other parts of the world. It is uncertain whether the mortality of COVID-19-infected kidney transplant recipients (KTXs) from Asia follows the lower mortality trends of the younger Asian population., Methods: Specific transplant centers from countries in the Asian Society of Transplantation were invited to participate in a study to examine the epidemiology, clinical features, natural history, and outcomes of COVID-19 infections in KTXs. Data were analyzed and compared with those of large cohort studies from other countries., Results: The study population was 87 KTXs from nine hospitals in seven Asian countries. Within the study population, 9% were aged 60 years and older, and 79% had at least one comorbidity. The majority of patients (69%) presented with mild-to-moderate COVID-19 severity. Disease progression was more frequently encountered among those with moderate or severe infection (23%) and non-survivors (55%). The mortality rate was 23% (n=20) and differed according to the level of care 12% (n=1/8), 15% (n=10/67), and 100% (n=9/9) of patients managed as outpatients, in the general ward, and in the intensive care unit, respectively. Disease severity at the time of presentation was an independent predictor of mortality. Compared with the mortality rates in other studies worldwide, mortality rates in the current study were comparable., Conclusions: Mortality in Asian KTXs who were infected with COVID-19 remains high and could be related to comorbidity burden and the constraints of the general healthcare system when the COVID-19 caseload is high., (Copyright © 2021 The Korean Society for Transplantation.)
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- 2021
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45. Crop and water productivity, energy auditing, carbon footprints and soil health indicators of Bt-cotton transplanting led system intensification.
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Rajpoot SK, Rana DS, and Choudhary AK
- Subjects
- Agriculture, Carbon, Crops, Agricultural, Ecosystem, Water, Carbon Footprint, Soil
- Abstract
Direct-seeded-cotton (DSC) leads to low crop and water productivity and energy-output with higher carbon-footprints besides impairing system-intensification under conventional cotton-wheat cropping system (CWCS). Hence, we evaluated two methods of Bt-cotton establishment [transplanted cotton (TPC) & DSC)] at three planting geometries/densities in four Bt-cotton based cropping-systems [DSC-wheat (DSC-W), TPC-wheat-mungbean (TPC-W-M), DSC-onion (DSC-O), TPC-onion-fodder cowpea + fodder maize (TPC-O-FC + FM)] in semi-arid region of south Asia. Poly-glass nursery-raised TPC exhibited significantly higher germination (96.5%), seedling-survival (96.1%) and 14.1% higher plant-stand owing to lower seedling-mortality (3.2%). TPC used ∼60% less irrigation-water but exhibited significantly higher seed-cotton, seed and lint yield, net-returns, radiation-use-efficiency and water-productivity by 11.4, 9.9, 14.3, 17.3, 10.7 and 260.6%, respectively over DSC. Planting geometry/density of 60 × 45 cm (37,037 plants ha
-1 ) exhibited significantly higher crop and water productivity and economic-returns. Bt-cotton transplanting led system-intensification enhanced the system-productivity (26.1%), profitability (30.5%), water-productivity (19.3%) and land-use-efficiency (8.5%) over the DSC-based systems with significantly higher values under TPC-O-FC + FM. Energy-use pattern reveled that farm inputs viz. Fertilizers (54-60%), water (15-25%) and diesel (6-10%) consumed bulk of the input-energy in different cropping systems with greatest values under TPC-O-FC + FM. TPC-W-M exhibited highest system energy-output (604.6 × 103 MJ ha-1 ) and energy-returns (566.2 × 103 MJ ha-1 ). TPC-O-FC + FM exhibited significantly higher carbon-consumption (668.9 kg CE ha-1 ) and carbon-output (21431.3 kg CE ha-1 ) while maintaining significantly higher carbon-efficiency (32.0) and carbon sustainability index (31.0). TPC-O-FC + FM had least carbon-footprints (0.07 kg CE kg-1 SCEY) while conventional-CWCS exhibited 2-folds higher carbon-footprints. Legume-imbedded TPC-based cropping systems markedly increased the soil physical (bulk-density, water-stable-aggregates), chemical (SOC, available-NPK) and biological properties (soil-microbial-biomass-carbon, dehydrogenase and ergosterol activity) over the conventional CWCS and DCS-O systems. Overall, Bt-cotton transplanting led system-intensification upholds great importance in enhancing the system crop and water-productivity, profitability, energy-productivity, resource-use-efficiency and soil-health with minimal carbon-footprints in semi-arid agro-ecosystems of south Asia., (Copyright © 2021 Elsevier Ltd. All rights reserved.)- Published
- 2021
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46. Clinical Remission of Immunoglobulin A Nephropathy after Bariatric Surgery in a Young Morbidly Obese Patient.
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Tiwari V, Gupta A, Arora V, Gupta P, John S, Divyaveer S, Bhargava V, Malik M, Gupta A, Bhalla AK, and Rana DS
- Subjects
- Adolescent, Adult, Child, Female, Gastrectomy adverse effects, Humans, Mycophenolic Acid therapeutic use, Treatment Outcome, Weight Loss, Young Adult, Bariatric Surgery adverse effects, Diabetes Mellitus, Glomerulonephritis, IGA complications, Glomerulonephritis, IGA diagnosis, Glomerulonephritis, IGA surgery, Laparoscopy, Obesity, Morbid complications, Obesity, Morbid diagnosis, Obesity, Morbid surgery
- Abstract
A 23-year-old girl with morbid obesity, diabetes mellitus, hypertension, obstructive sleep apnea, and immunoglobulin A nephropathy (IgAN) attended a bariatric clinic after multiple failed attempts at weight loss. In the past, she was diagnosed with IgAN with nephrotic syndrome and raised blood pressure at the age of 11 years. Apart from optimization of blood pressure with angiotensin receptor blocker, she required steroid to maintain her remission in initial four years which was later switched to mycophenolate mofetil (MMF). She was diagnosed with diabetes at the age of 13 years; her blood sugars remained poorly controlled despite therapy with oral hypoglycemic agents and insulin. She underwent sleeve gastrectomy with no post-operative complications. During the follow-up, she showed a steady reduction in her weight, along with maintaining normal blood sugars and pressure without medications. At 18 months of follow-up, IgAN remained in remission after stopping MMF at four months after the surgery. Obesity is considered an important cofactor in the progression of IgAN. This case highlights the importance of weight reduction to halt the progression of the disease.
- Published
- 2021
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47. COVID-19 in CKD Patients: Report from India.
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Pawar N, Tiwari V, Gupta A, Bhargava V, Malik M, Gupta A, Bhalla AK, and Rana DS
- Abstract
Background: COVID-19 is a novel acute infection that is mainly manifested as acute respiratory disease. Information on coronavirus disease-2019 (COVID-19) in CKD patients who are not on dialysis is very limited. We are reporting a single-center observational study on the effect of COVID-19 in CKD patients., Methods: A single-center retrospective study with consecutive patients who had eGFR <60 mL/min/1.73 m
2 (CKD-EPI) admitted with COVID-19, from April to July 2020 were included., Result: A total of 30 patients were included in the study. Patients of CKD stage 5, 4 and 3 were 50%, 13.3%, and 36.6%, respectively. The mortality rate was 53.3%. Category wise, 9 were in mild; 3 in moderate, and 18 were in the severe COVID category. Twenty-five patients (83.3%) developed acute on CKD. Twenty patients (67%) required renal replacement therapy (RRT). The prognosis of patients who required RRT was poor. High LDH and IL-6 were significantly associated with mortality. Lymphopenia, present in 50% of cases was associated with fatal outcome. There was a 100% survival rate in mild to moderate cases and 11% in severe cases., Conclusion: Mortality among hospitalized CKD patients is high., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Nephrology.)- Published
- 2021
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48. Tacrolimus-induced Epidermoid Cysts in the Renal Transplant Patient.
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Tiwari V, Gupta A, Gothwal C, Rana DS, Bhargava V, Malik M, Gupta A, and Bhalla AK
- Abstract
Epidermal cysts are common benign cystic lesions that occur mostly sporadically. Common sites involved are arms, face, and trunk. The cyst may progress slowly and remain for years. These cysts arise as a result of the plugging of the follicular orifice. Etiology has largely remained unknown although local trauma, ultraviolet rays, and human papilloma virus (HPV) have been implicated in a few cases. Calcineurin inhibitors (CNIs) especially cyclosporine has been discredited for cutaneous side effects such as hirsutism and gingival hyperplasia. Epidermoid cysts have been also associated with patients with solid organ transplant recipients on cyclosporine. Tacrolimus is considered to be free of dermatological side effects. Herein, we report a case of 56-year-old renal allograft recipient on tacrolimus, who develop more than >100 epidermoid cysts over the face, trunk, back, and extremities. The lesions ceased to progress once the tacrolimus was stopped., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Nephrology.)
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- 2021
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49. Chylous Ascites after Laparoscopic Donor Nephrectomy: Case Report.
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Bhandari G, Tiwari V, Gupta A, Bhargava V, Malik M, Gupta A, Bhalla AK, and Rana DS
- Abstract
Chylous ascites refers to the accumulation of chyle in the abdominal cavity. Postoperative chylous ascites is most commonly associated with abdominal aortic surgeries. However, it is a rare complication following laparoscopic nephrectomy. It causes loss of fat, protein, and antibodies causing malnutrition and immunodeficiency. Thus, it is important to treat it as early as possible. We hereby report a case of chylous ascites following laparoscopic donor nephrectomy. A 55-year-old female was admitted at our center 2 weeks after undergoing left laparoscopic donor nephrectomy with abdominal distension and constipation. USG abdomen revealed free fluid in the abdomen. Paracentesis revealed chylous ascites. The patient was started on conservative treatment, including a diet rich in proteins and low in fats; conservative treatment, however, was unsuccessful. Lymphangiography and subsequent embolization of the defect were done, and she made a full recovery., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Nephrology.)
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- 2021
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50. IgA Nephropathy with Wilson's Disease: A Case Report and Literature Review.
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Bhandari G, Tiwari V, Gupta A, Gupta P, Bhargava V, Malik M, Gupta A, Bhalla AK, and Rana DS
- Abstract
The most common glomerulonephritis seen in the world is immunoglobulin A nephropathy (IgAN). It can be primary or secondary associated with various conditions like Chronic Liver disease, Crohn's disease, neoplasms, etc. However, IgAN secondary to Wilson's disease is very rare. A 9 year old boy presented with gross hematuria and proteinuria. He had a history of recurrent jaundice in the past. Ultrasonography (USG) whole abdomen showed altered echotexture of the liver with normal-sized kidneys. An extended workup for liver disease was done, and the diagnosis of Wilson's disease was confirmed with decreased serum ceruloplasmin levels, increased urinary copper, and the Kayser-Fleischer ring. Urine routine microscopy showed numerous red blood cells, few red blood cell casts, and mild proteinuria. Renal biopsy showed IgAN. The patient was started on D-penicillamine. On follow-up at 3 months, he showed complete resolution of proteinuria and hematuria. Thus, we suggest that Wilson's disease should be considered as one of the causes of secondary IgAN in pediatric patients with hematuria, proteinuria with liver dysfunction., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Nephrology.)
- Published
- 2021
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