Role of medical thoracoscopy in the diagnosis of pleural effusions.

Background: Medical thoracoscopy (semi-rigid and rigid thoracoscopy) have revolutionized the management of undiagnosed pleural effusions. Though semi-rigid thoracoscopy has a good diagnostic yield in malignant and tubercular effusions, its role in the management of a complicated pleural effusions is debatable. Hence, rigid thoracoscopy becomes handy in these cases.

Accuracy of TB-PCR using endobronchial ultrasound guided trans-bronchial needle aspiration (EBUS-TBNA) samples in mediastinal granulomatous lymphadenopathy.

Introduction: Mediastinal granulomatous lymphadenopathies, such as tuberculous lymphadenitis, sarcoidosis, are frequently encountered by respiratory physicians, and their diagnosis is based on histological and microbiological tests. Endobronchial ultrasound-guided Trans bronchial needle aspiration (EBUS-TBNA) is widely used to perform mediastinal lymph node sampling. However, very limited data is available on the yield of polymerase chain reaction for Mycobacterium tuberculosis (TB-PCR) using EBUS-TBNA samples in patients with mediastinal granulomatous lymphadenopathy.

Incidence, Risk Factors and Clinical Outcomes of Patients with Hypermucoviscoid in a Tertiary Intensive Care Unit.

Background And Objectives: Hypermucoviscoid (hvKP), a dreaded variant of Klebsiella, so far, fewer cases were reported from the community. This study was designed to evaluate the incidence of hvKP isolates, risk factors for hvKP infections, antibiotic sensitivity pattern and clinical outcome including morbidity and mortality.

Patients And Setting: Patients who have got admitted under medical intensive care unit (MICU) and had positive culture of infections.

Multidisciplinary team obviates biopsy in most patients with diffuse parenchymal lung diseases-A retrospective study from India.

Introduction: The inflammation and fibrosis in diffuse parenchymal lung diseases (DPLDs) in varied proportions give rise to different patterns in radiology and histopathology. The radiological pattern on CT of the thorax most often allows us to make a diagnosis with varying levels of confidence, to optimize management. With a multidisciplinary team bringing the strengths of their individual domains of knowledge, clinical, radiological, histopathological, and in many cases rheumatological, the level of confidence in making this diagnosis increases, often to the stage where the diagnosis is most often right, is concordant with the diagnosis achieved at histopathology and therefore obviates the need for lung biopsy which carries its own costs and risks of complications.

Role of medical thoracoscopy in the treatment of complicated parapneumonic effusions.

Objective: The role of medical thoracoscopy in the treatment of pleural infections is increasingly being recognized. This study was done to assess the role of medical thoracoscopy in the management of carefully selected subset of patients with complicated parapneumonic effusions (PPEs).

Materials And Methods: We analyzed retrospective data of 164 thoracoscopic procedures performed at our center on patients with complicated PPE in the past 10 years.

Post-transplant complications, patient, and graft survival in pediatric and adolescent kidney transplant recipients at a tropical tertiary care center across two immunosuppression eras.

Background: We report pediatric PAKT patient and graft outcomes at a large tropical tertiary center spanning two transplant eras.

Methods: In this retrospective cohort study, all children ≤18 years who underwent kidney transplantation at our center between 1991 and 2016 were included. Data pertaining to their baseline characteristics, post-transplant events, and outcome were retrieved from transplant records and compared between transplant eras (1991-2005 and 2006-2016).

Quantification of Liver Iron Overload: Correlation of MRI and Liver Tissue Biopsy in Pediatric Thalassemia Major Patients Undergoing Bone Marrow Transplant.

Determination of the magnitude of body iron stores helps to identify individuals at risk of iron-induced organ damage in Thalassemia patients. The most direct clinical method of measuring liver iron concentration (LIC) is through chemical analysis of needle biopsy specimens. Here we present a noninvasive method for the measurement of LIC in vivo using magnetic resonance imaging (MRI).

Impact of Anemia and Red Cell Indices on the Diagnosis of Pre-Diabetes and Diabetes in Indian Adult Population: Is there a Cut-off Guide for Clinicians?

Background: It is well known that anemia and red cell turn over affects the HbA1c value. Iron deficiency anemia increases the HbA1c and haemolytic anemia lowers it. However, the cut-off of haemoglobin (Hb) or red-cell indices when the HbA1c value becomes unreliable is not known.

urinary tract infection.

Myroides species formerly known as Flavobacterium odoratum, a rare clinical isolate often considered as nonpathogenic. Myroides odoratimimus commonly found in the environment and frequently isolated from the immunocompromised patients. The incidence of urinary tract infection (UTI) caused by Myroides species is a rare phenomenon.

Spectrum of biopsy proven renal disease in South Asian children: Two decades at a tropical tertiary care centre.

Aim: We report findings from a large single centre paediatric renal biopsy cohort in South Asia.

Methods: We analyzed all renal biopsies performed on children aged ≤18 years between 1996 and 2015 at our centre. The clinical characteristics and histological diagnosis pertaining to each case, distribution of renal diseases in children with various clinical presentations, and changes in the pattern of kidney disease during the study period were analyzed.

Case Report of Salmonella gallinarum Urinary Tract Infection in a Renal Allograft Recipient.

Urinary tract infections (UTIs) caused by nontyphoidal Salmonella in a renal allograft recipient are a rare occurrence. Although there is some existing literature on Salmonella typhi bacteriuria and non-typhoidal bacteriuria, none of the cases has been reported in a renal transplant patient. This case report describes a rare instance in which group D Salmonella was isolated from a renal allograft recipient's urine culture and the patient was successfully treated with antibiotics.

Antidiabetic Activity of Polar and Nonpolar Solvent Extracts from (Willd.) Link Leaves.

Background: Diabetes mellitus is a chronic illness, and the management of diabetes is a global problem. Successful treatment is required to prevent complications and organ damages. Herbal medicines are having minimal adverse effects when compared to the available synthetic drugs to treat such chronic diseases and disorders.

A possible simplification for the estimation of area under the curve (AUC₀₋₁₂) of enteric-coated mycophenolate sodium in renal transplant patients receiving tacrolimus.

Enteric-coated mycophenolate sodium (EC-MPS) is widely used in renal transplantation. With a delayed absorption profile, it has not been possible to develop limited sampling strategies to estimate area under the curve (mycophenolic acid [MPA] AUC₀₋₁₂), which have limited time points and are completed in 2 hours. We developed and validated simplified strategies to estimate MPA AUC₀₋₁₂ in an Indian renal transplant population prescribed EC-MPS together with prednisolone and tacrolimus.

Can mycophenolic acid dose requirement during the first transplant help predict dosing for the second transplant?

We describe the pharmacokinetic profile of mycophenolic acid (MPA) in a patient receiving Mycophenolate mofetil (MMF) during her first and second renal transplantations. The MMF dose required to achieve a therapeutic range of MPA-AUC(0)(-)(12)(h) early following the second transplantation was 10 times greater than that required late following the first transplantation. Her MMF requirement then declined and continued to decrease even beyond 1 year.

Mycophenolic acid area under the curve recovery time following rifampicin withdrawal.

Renal transplant patients prescribed mycophenolate mofetil (MMF) may require treatment for tuberculosis with a regimen including the tuberculocidal drug rifampicin. MMF is an ester prodrug which is rapidly hydrolysed to the active compound, mycophenolic acid (MPA). Therapeutic drug monitoring of mycophenolate involves the measurement of MPA area under the curve (MPA-AUC(0-12)).

A reliable limited sampling strategy for the estimation of mycophenolic acid area under the concentration time curve in adult renal transplant patients in the stable posttransplant period.

In renal transplant patients, there is an established relationship between mycophenolate area under the curve and clinical outcome. The authors have developed and validated a limited sampling strategy to estimate mycophenolic acid area under the curve to 12 hours (MPA AUC0-12) in a stable renal transplant Indian population prescribed a formulation of mycophenolate mofetil (Mofilet) along with prednisolone and tacrolimus. Intensive pharmacokinetic sampling was performed in 29 patients to measure mycophenolate concentration from trough to 12 hours postdose.

A limited sampling strategy for tacrolimus in renal transplant patients.

Aims: To develop and validate limited sampling strategy (LSS) equations to estimate area under the curve (AUC(0-12)) in renal transplant patients.

Methods: Twenty-nine renal transplant patients (3-6 months post transplant) who were at steady state with respect to tacrolimus kinetics were included in this study. The blood samples starting with the predose (trough) and collected at fixed time points for 12 h were analysed by microparticle enzyme immunoassay.