Search

Post-streptococcal glomerulonephritis is an immune complex-mediated glomerulonephritis as a result of transient dysregulation of alternate complement pathway along with in situ immune complex formation. Here is a case of a young boy who developed acute nephritic syndrome following traumatic wound over his lower limb. Computed tomography (CT) abdomen is suggestive of Abernethy malformation. He underwent renal biopsy in view of rapidly worsening renal failure showing diffuse proliferative glomerulonephritis with predominant neutrophils, IgG (3+), IgA (3+), C3(3+), kappa (2+), and lambda (2+) on immunofluorescence, suggestive of immune complex glomerulonephritis favoring infection-related glomerulonephritis. He was treated accordingly and showed signs of improvement with normalization of complements within 4 weeks of insult. As the genesis of infection-related glomerulonephritis here in this case is complex due to the hepatic malformation where there is mixing of blood between the systemic and portal systems, the narrative is that congenital anomaly too has a say in the pathogenesis of infection-related glomerulonephritis as it happened in our case.

Malignancies in human immunodeficiency virus (HIV) positive individuals have a larger role in morbidity and mortality. Appropriate clinical acumen is required for a clinician to anticipate the occurrence of lymphoma after starting antiretroviral therapy, especially in patients with CD4

Introduction: Tenofovir remains the cornerstone drug in various antiretroviral regimens and is commonly associated with renal failure in susceptible individuals with a renal biopsy suggestive of proximal tubular injury. Objectives: To investigate clinical, histopathological and outcome findings in tenofovir-induced nephrotoxicity patients. Patients and Methods: Between August 1, 2014, and March 31, 2017, an observational study was conducted in a government-run tertiary care facility in South India. All patients receiving a regimen based on tenofovir disoproxil fumarate (TDF) and testing positive for human immunodeficiency virus (HIV) were included. A renal biopsy was performed when needed. Results: A total of 27 cases were identified, with a mean age of 45.03± 12.95 years, while 19 (70%) of them were men. Mean creatinine and mean proteinuria among the participants were 5.78 ±2.71 mg/dL and 1643.96 ±1056.44 mg/dL, respectively, at the time of the renal biopsy. Interval between TDF treatments to kidney biopsies ranged between 7 to 52 weeks with mean (±SD) of 30.8±22 weeks. Phosphaturia and glycosuria were found in 10 (37.03%) and 8 (29.5%) patients respectively, all of whom had normoglycemia. In contrast to the remaining 13 instances, which all had moderate to severe diffuse inflammation, 14 patients exhibited toxic proximal tubular damage along with mild and localized interstitial inflammation. Hemodialysis was required by 10 individuals. A total of 22 patients were monitored after TDF was stopped, while 17 (77.27%) of them had fully recovered renal function at the end of monitoring period. Conclusion: This study demonstrates that TDF nephrotoxicity is a reversible form of toxic acute tubular necrosis with concurrent interstitial inflammation that affects the proximal tubules. As a result, it is crucial to carefully monitor renal parameters in these patients.

Doublesex and Mab-3-related transcription factor (DMRT) gene family is extensively known for its contribution in sex determination and differentiation across phyla. Here we report the identification of five DM (doublesex and mab-3) domain genes in the Nile tilapia which includes DMRT1, DMRTa2, DMRT2a, DMRT2b and DMRT3a. The full-length sequence of DMRT genes ranges from 3526 (DMRTA2) to 1471bp (DMRT1) which encode putative proteins series from 469 to 372 amino acids. All the DMRT proteins contained at least one conserved DNA-binding DM domain. Sub-cellular localization and gene ontology revealed DMRT1 protein is maximum localized in nuclear region and gene ontology analysis showed the molecular function of 48.2%, biological process 43.6% and cellular component 25%. Chromosomal location and synteny analysis displayed that DMRT genes mostly cluster linkage group 12. Altogether, our findings provide vital genomic information for future studies of biochemical, physiological, and phylogenetic studies on DMRT genes in teleost. Keywords: Sex determination, DMRT, Genes, Nile tilapia

Membranous nephropathy (MN) is the most common cause of nephrotic syndrome in adults. It may be idiopathic or due to secondary causes. Among the secondary causes, heavy metals like mercury are the one among others. Here is a male with nil comorbidities who, upon exposure to mercury-containing skin cream, developed proteinuria, which, on evaluation, was found to have dual renal lesions like membranous nephropathy and chronic interstitial nephritis. The uniform PLA2R staining within the glomerular capillary walls shows the ability of mercury to induce inflammation and autoimmunity. This case strengthens the findings of in vitro studies about mercury-induced inflammatory processes.

Acute porphyria is a group of metabolic disorders characterized by a deficiency in enzymes involved in heme biosynthesis. A 21-year-old female with abdominal pain and an altered sensorium, eventually leading to a diagnosis of acute porphyria. Glucose treatment and supportive measures improved her general condition. Renal biopsy showed persistent renal dysfunction, which revealed acute tubulointerstitial nephritis with 5-10% interstitial fibrosis and tubular atrophy. This highlights a unique manifestation of acute porphyria involving the kidney and emphasizes the importance of considering acute tubulointerstitial nephritis as a cause of renal dysfunction in acute porphyria.

Background: Depressive disorders can present with psychotic features, which warrants a different diagnosis and a different phenomenological study. Aim: To study the phenomenology of depressive disorders with and without psychotic features. Methodology: One hundred and forty-eight patients presenting to psychiatry outpatient department of a tertiary care center were screened using Mini International Neuropsychiatric Interview questionnaire to select patients for our study. Sociodemographic data and some clinical variables of these patients were collected. These patients were further assessed for depression severity and psychotic symptoms by using Montgomery and Asberg Depression Rating Scale (MADRS) and Modified Psychotic Symptoms Ratings Scale (PSYRATS), respectively. Results: Mean MADRS score for patients with depression without psychotic features was 38.38 and for patients with depression with psychotic features was 44.51. Result was found to be significant. Suicidality was found to be on a higher side in patients of depression with psychotic features. Conclusion: Main finding related to our study was that depression severity was found to be more in patients of depression with psychotic features. There are certain phenomenological differences which warrant a separate diagnosis of depression with psychotic features. These include the increased intensity of suicidality, visible sadness, inner stress, difficulty in concentration, lassitude, altered ability to feel, and thoughts of suicide present in patients of depression with psychotic features.

Background: During the COVID-19 pandemic, migrant workers in India have gone through many hardships. After the lockdown, many construction sites, factories, and workplaces shut down, and innumerable migrant workers faced a loss of income, shortage of food, and uncertain future. This massive change in their living conditions made them vulnerable to psychological problems. Aim: To screen for depression, anxiety, stress, alcohol dependence, and resilience in migrant workers during the COVID-19 crisis. Materials and Methods: Migrant workers at seven camps in the Pimpri Chinchwad Municipal Corporation, Maharashtra, were surveyed with the help of the Depression Anxiety Stress (DASS-21) Scale to assess depression, anxiety, and stress levels, AUDIT C for assessing alcohol use disorders, and Connor–Davidson resilience scale short form (CD RISC) for assessing resilience. Results: A total of 1053 migrant workers were surveyed. It showed that 57.54% of workers had depressive symptoms, 64.96% had anxiety symptoms, and 39.32% had subjective stress. Female migrant workers had more severe depression, anxiety, and stress symptoms as compared to males while male workers were more at risk of alcohol use disorder as compared to females. Migrants without family had more symptoms of severe depression and alcohol use disorder as compared to those with family. Regression analysis showed that levels of anxiety were independently associated with female gender, unmarried status, stress, depression, and alcohol use disorder while resilience negatively predicted anxiety in these migrant workers. Conclusion: During the COVID-19 pandemic, migrant workers were at risk of depression, anxiety, stress, and alcohol use disorder. Females and migrants without families came out to be more vulnerable to these psychological problems. Hence during the pandemic situation, identifying this vulnerable population and special preventive or therapeutic programs for them can be of crucial importance.

Background: Mental well-being is important for medical students to perform effectively. The COVID-19 pandemic posed different stressors to medical students increasing their vulnerability to distress and impaired well-being. Aim: To assess the effect of the COVID-19 pandemic on the well-being of medical students and its relation with COVID-related psychological distress and fear as well as sleep quality. Materials and Methods: We planned a cross-sectional study on medical students with the help of an online Google Form including sociodemographic data, medical students well-being index (MSWBI), Psychological Distress Scale, fear of COVID-19 Scale (FCV-19S), and Pittsburgh Sleep Quality Index (PSQI). Results: 48.13% of students reported higher distress and impaired mental well-being. Impaired well-being is correlated with COVID-related psychological distress, fear of COVID-19, and disturbed sleep quality. Regression analysis showed that joint family and sleep disturbances significantly predicted distress or poor well-being in medical students. Conclusion: Almost half of the medical students revealed impaired mental well-being underlining the role of COVID-related stressors in worsening the psychological health of students. In this situation, it is important to take prompt measures to identify vulnerable students and help them.

Aim: To study psychiatric co-morbidities, anxiety, depression, and quality of life in patients of chronic obstructive pulmonary disease (COPD). Materials and Methods: A cross-sectional, case-control study was conducted on 122 cases of COPD and equal number of age- and sex-matched controls in a tertiary care hospital. They were assessed with the Mini-International Neuropsychiatric Interview (MINI), depression, anxiety stress scale-42 (DASS-42), St. George Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT). Results: COPD patients and control subjects were matched with respect to age, sex, education, employment, domicile, and socioeconomic status. Psychiatric disorders were diagnosed in 56% of cases and 14% of controls. Major depressive disorder, alcohol dependence, and anxiety disorders were the most common psychiatric diagnoses. There was significantly higher prevalence of smoking in cases with COPD compared to control subjects suicidality was present in two patients. The mean scores on depression, anxiety, and stress on DASS-42 of COPD patients were significantly higher than normal controls. On the CAT majority of the COPD patients belonged to the high-impact group followed by the very high-impact group. Mean scores on the SGRQ were in the range expected in COPD patients. A multiple regression analysis revealed that significant predictors of SGRQ scores were age, gender, economic status, domicile, alcohol habits, depression, anxiety, and stress. Conclusion: COPD patients have a significantly higher prevalence of psychiatric co-morbidities compared to healthy controls. Common psychiatric disorders were major depression, alcohol dependence, and anxiety disorders along with smoking.

The Massarosa wildfire, which occurred in July 2022 in Northwestern Tuscany (Italy), burned over 800 hectares, leading to significant environmental and geomorphological issues, including an increase in soil erosion rates. This study applied the Revised Universal Soil Loss Equation (RUSLE) model to estimate soil erosion rates with a multi-temporal approach, investigating three main scenarios: before, immediately after, and one-year post-fire. All the analyses were carried out using the Google Earth Engine (GEE) platform with free-access geospatial data and satellite images in order to exploit the cloud computing potentialities. The results indicate a differentiated impact of the fire across the study area, whereby the central parts suffered the highest damages, both in terms of fire-related RUSLE factors and soil loss rates. A sharp increase in erosion rates immediately after the fire was detected, with an increase in maximum soil loss rate from 0.11 ton × ha−1 × yr−1 to 1.29 ton × ha−1 × yr−1, exceeding the precautionary threshold for sustainable soil erosion. In contrast, in the mid-term analysis, the maximum soil loss rate decreased to 0.74 ton × ha−1 × yr−1, although the behavior of the fire-related factors caused an increase in soil erosion variability. The results suggest the need to plan mitigation strategies towards reducing soil erodibility, directly and indirectly, with a continuous monitoring of erosion rates and the application of machine learning algorithms to thoroughly understand the relationships between variables.