Rosai Dorfman Disease With Extensive Bony Involvement- A Diagnostic Dilemma.

Previously classified as Non Langerhan cell histiocytosis by the Working Group of Histiocytic Society in 1987 Rosai Dorfman Destombes disease was first described by Destombes in 1965 and later in 1969 by Rosai and Dorfman as a rare histiocytic disorder with sinus histiocytosis and massive lymphadenopathy. They exist in both nodal and extranodal forms. Immunohistochemistry is an essential part of diagnosis to differentiate between Langerhans cell histiocytosis and another malignant histiocytosis.

Challenges in Diagnosis and Management of Glomerular Disease in Resource-Limited Settings.

Introduction: Glomerular diseases are the leading drivers of nondiabetic chronic kidney disease disability-adjusted life years in resource-limited countries. Proper diagnosis and treatment relies on resources including kidney biopsy, ancillary testing, and access to evidence-based therapies.

Methods: We conducted a cross-sectional internet-based survey cascaded through society mailing lists among nephrologists in countries of Asia, Africa, and Eastern Europe.

International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in South Asia.

Information about disease burden and the available infrastructure and workforce to care for patients with kidney disease was collected for the second edition of the International Society of Nephrology Global Kidney Health Atlas. This paper presents findings for the 8 countries in the South Asia region. The World Bank categorizes Afghanistan and Nepal as low-income; Bangladesh, Bhutan, India, and Pakistan as lower-middle-income; and Sri Lanka and the Maldives as upper-middle-income countries.

Catastrophic antiphospholipid antibody syndrome as a first manifestation of primary antiphospholipid antibody syndrome in a middle-aged man.

Catastrophic antiphospholipid antibody syndrome (CAPS) is a severe form of antiphospholipid antibody syndrome (APS) that sometimes represents the first manifestation of the later syndrome. The clinical manifestations of CAPS are relatively non-specific. Hence, the diagnosis may be delayed, resulting in high mortality.

Posttransplant diabetes mellitus among live-related kidney transplant recipients: Sindh Institute of Urology and Transplantation experience.

This cross-sectional study conducted at Sindh Institute of Urology and Transplantation, Karachi, Pakistan aimed to determine the frequency and risk factors of posttransplant diabetes mellitus (PTDM) among live-related kidney transplant recipients and their short-term prognosis and included renal transplant recipients (nondiabetic before transplant) of either gender, aged 18-60 years with transplant duration two to six months. Patients with two reading of fasting plasma glucose ≥126 mg/dL were labeled as diabetic. A total of 191 patients (154 males and 37 females) with the age between 18 to 60 years (31.

Acute tubulointerstitial nephritis/drug induced acute kidney injury; an experience from a single center in Pakistan.

Introduction: There is no information in literature specifically on the prevalence and clinicopathological characteristics of acute tubulointerstitial nephritis/drug induced acute kidney injury (AKI) from Pakistan.

Objectives: We aim to report a series of cases from patients developing AKI after exposure to some medications or finding of interstitial nephritis on histopathology.

Patients And Methods: This is an observational study of patients identified as having AKI after exposure to medications.

Long-term Safety of Living Kidney Donation in an Emerging Economy.

Background: Long-term follow-up and management of donors was undertaken in a specialist kidney transplant unit in Pakistan to identify risk and prevent adverse outcomes in living related kidney donors.

Methods: In an observation cohort study between 1985 and 2012, 3748 donors were offered free medical follow-up and treatment 6 to 12 months after donation and annually thereafter. Each visit included history, physical examination, blood tests for renal, lipid, glucose profiles, and 24-hour urine for proteinuria and creatinine clearance.

Spectrum of glomerular diseases causing acute kidney injury; 25 years experience from a single center.

Introduction: Acute kidney injury (AKI) is common in nephro-urological practice. Its incidence, prevalence and etiology vary widely, mainly due to variations in the definitions of AKI.

Objectives: We aim to report the spectrum of glomerular diseases presenting as AKI at a kidney referral center in Pakistan.

From diamonds to black stone; myth to reality: Acute kidney injury with paraphenylene diamine poisoning.

Aim: We report here, a case series of patients with acute kidney injury (AKI) after ingestion of paraphenylene diamine (PPD) a derivative of analine. It is used as a colouring agent to dye hair, fur and plastic and in photographic films.

Methods: Subjects for the study reported here comprised a cohort of 100 patients coming to this institution with AKI following PPD poisoning.

Factors predicting the outcome of acute renal failure in pregnancy.

Objective: To determine the factors predicting renal outcome in patients developing acute renal failure in pregnancy.

Study Design: Descriptive cohort study.

Place And Duration Of Study: Study was conducted at Nephrology Unit of Sindh Institute of Urology and Transplantation, Karachi, from October 2006 to March 2007.

Range for normal body temperature in hemodialysis patients and its comparison with that of healthy individuals.

Background/aims: Patients with chronic kidney disease undergoing hemodialysis have an altered homeostasis leading to altered body temperatures. We aimed to determine the range for normal body temperature in hemodialysis patients and compared it to healthy individuals. Also, we determined how much axillary temperatures differed from oral temperatures in both groups and whether axillary temperature is affected by the presence of an arteriovenous fistula (AVF) in hemodialysis patients.

Use of isoniazid chemoprophylaxis in renal transplant recipients.

Background: The use of isoniazid (INH) as chemoprophylaxis for tuberculosis (TB) in renal transplant recipients has not been widely studied or reported from a country where TB is endemic. We are reporting here the results of the largest ever-reported randomized, prospective study of the use of INH in renal transplant recipients.

Methods: Four hundred consecutive live related renal transplant recipients between April 2001 and September 2004, from this single center, were randomized to receive or not receive INH for 1 year after transplantation.

Prevalence of metabolic syndrome in renal transplant recipients--a single centre experience.

Objective: To determine the prevalence of metabolic syndrome (MS) in renal transplant recipients (RTR) using the modified Asian National Cholesterol Education Programme-Adult Treatment Panel III (NCEP-ATP III) criteria.

Methods: A cross-sectional study was conducted on 200 RTRs between January 2008-August 2008. All were more than six months post transplant and above 18 years of age.

Commercial transplants in local Pakistanis from vended kidneys: a socio-economic and outcome study.

Donor shortage and absence of transplant law lead to unrelated commercial transplants in Pakistan. We report the socio-economic and outcome parameters of 126 local recipients of unrelated kidney vendor transplants presenting to our institute between 1997 and 2007. Their outcome was compared with 180 recipients of living-related donor transplants matched for age, gender and transplant duration as controls.

Living kidney donor follow-up in a dedicated clinic.

Background: Long-term effects of uninephrectomy for kidney donation are of particular interest in the currently increasing practice of living-donor transplantation. We have retrospectively analyzed the general health status and renal and cardiovascular consequences of living-related kidney donation.

Methods: Data of living-related kidney donors who were regularly followed up in a dedicated clinic at the Sindh Institute of Urology and Transplantation between July 2000 and January 2004 was retrieved.

Outcome in severe acute renal failure associated with malaria.

Background: Malaria, a common health problem in certain parts of the world, has a considerable morbidity and mortality. This study reports its occurrence with a serious complication, acute renal failure (ARF), at a Third World tertiary care centre.

Methods: All registered patients with ARF who had history and clinical findings suggestive of malaria and had malarial parasites on peripheral blood smears were included in this study.

Renal transplantation in developing countries.

Healthcare in developing countries less funded than developed nations (0.8 to 4% vs. 10 to 15%, respectively), and must contend against approximately 1/3 of the population living below the poverty line ($1US/day), poor literacy (58% males/29% females), and less access to potable water and basic sanitation.