Publications by authors named "Parekh R"

Background: There remains a lack of diversity among those pursuing clinical academic careers. Structural inequalities, discrimination and a paucity of relatable role models can disadvantage minoritised students, hindering their educational experiences and career opportunities. Innovative and effective approaches are needed at an undergraduate level to address this problem, ensuring the pipeline is representative, diverse and inclusive.

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Objectives: To determine incidence and risk factors for hypertension in childhood nephrotic syndrome.

Study Design: Using data from the Insight into Nephrotic Syndrome (INSIGHT) study, a prospective observational childhood nephrotic syndrome cohort from Toronto, Canada, we evaluated hypertension incidence and time-to-hypertension overall and stratified by 1) steroid-resistance or steroid-sensitivity, and 2) frequently-relapsing, steroid dependent, or infrequently-relapsing. Hypertension was defined as stage 1-2 hypertensive blood pressure on two consecutive visits or anti-hypertensive medication initiation.

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Introduction: This work aimed to evaluate the safety and efficacy of hydroxypropyl guar-hyaluronic acid (HPG-HA) dual-polymer lubricating drops in Indian subjects with dry eye disease (DED).

Methods: This prospective, open-label, single-arm, phase IV study was conducted in India.

Inclusion Criteria: Adults (18-65 years) with an average total ocular surface staining (TOSS) score ≥ 4, best-corrected visual acuity of ≥ 20/40 in each eye, tear break-up time (TBUT) ≤ 10 s, and dry eye questionnaire (DEQ-5) score ≥ 6.

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Background: Steroid-sparing immunosuppression is used in 50% of children with nephrotic syndrome, to prevent relapses and steroid-related toxicity. However, rates and predictors of prolonged remission after cyclophosphamide and tacrolimus are uncertain.

Methods: Retrospective analysis of children (1-18 years) enrolled in a longitudinal cohort.

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Introduction: Diabetic foot ulcers (DFUs) have become a common and serious outcome of diabetes mellitus (DM). Diabetic peripheral neuropathy (DPN) is often underdiagnosed, which impairs the capacity to prevent foot ulceration. The clinical manifestations typically include sensory complaints, which leave patients vulnerable to increased risk of injury without their awareness.

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Article Synopsis
  • The study explored the connection between depression, anxiety, and alcohol use disorder (AUD) in individuals diagnosed with Type 2 diabetes mellitus (T2DM) within an English primary care population.
  • Researchers analyzed data from nearly 480,000 people diagnosed with T2DM from 2004 to 2019 to see how these mental health conditions occur in those with and without prior AUD.
  • Results indicated that individuals with AUD were significantly more likely to experience new episodes of depression and anxiety after their T2DM diagnosis compared to those without AUD, even after adjusting for various confounding factors.
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Background: Apolipoprotein L1 gene () variants are risk factors for chronic kidney disease (CKD) among Black Americans. Data are sparse on the genetic epidemiology of CKD and the clinical association of variants with CKD in West Africans, a major group in the Black population.

Methods: We conducted a case-control study involving participants from Ghana and Nigeria who had CKD stages 2 through 5, biopsy-proven glomerular disease, or no kidney disease.

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Introduction: Diabetic foot ulcers (DFUs) stand out as a prevalent and debilitating condition. Furthermore, the progression of diabetes-related hyperglycemia and associated conditions such as peripheral arterial disease exacerbates the risks of DFUs, including complications like infection and gangrene. Given the significant burden of DFUs, there is a pressing need to improve preventive and therapeutic strategies.

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Purpose: Electronic health records (EHR) are valuable resources for health research; however, their use is challenging. A validated alcohol use disorder (AUD) codelist for UK primary care is needed to improve population-based research in this patient group. We aimed to develop an AUD codelist for use in the Clinical Practice Research Datalink (CPRD) Aurum database, a UK EHR primary-care database.

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  • Patients recovering from COVID-19 often experience lingering symptoms known as Long COVID, which can manifest weeks or months after their initial infection, but the prevalence of this condition is not well understood.
  • To address this, a collaborative initiative called the Long COVID Computational Challenge (L3C) was launched to develop effective risk prediction tools for identifying individuals at risk of Long COVID using extensive healthcare data from over 75 institutions in the U.S.
  • The challenge resulted in 74 teams creating 35 predictive models, with the top models achieving high accuracy scores, demonstrating the potential for machine learning to enhance the identification of patients at risk for Long COVID.
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A Meckel's diverticulum is a true congenital diverticulum arising from the ileum, approximately 2 feet from the ileocaecal junction. Named after Johann Meckel, who first described its embryological origins, the anomaly remains asymptomatic for most. Uncommonly, it is found to be the cause of serious complications such as interstitial obstruction and/or gangrene, bowel perforation, and, in rare cases, internal bowel herniations.

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  • Mirizzi syndrome is a rare complication of gallstones that occurs when they compress the common bile duct, usually requiring surgical intervention like cholecystectomy.
  • A case report details a 62-year-old woman with abdominal pain who was diagnosed with Mirizzi syndrome after undergoing ERCP.
  • The surgical approach taken in her case involved a subtotal cholecystectomy combined with a choledochoduodenostomy to address the condition.
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Objective: Explore the perceptions of senior medical students on the relationship between gender and pain and examine how formal and hidden curricula in medical education shape their experiences.

Design: We conducted a cross-sectional qualitative interview study, using individual semistructured interviews and adhering to interpretative description methodology. We used Braun and Clarke's reflexive approach to thematic analysis to analyse our data.

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Key Points: Among 4173 children with AKI, 18% had major adverse kidney events (death, kidney failure, or CKD) during a median 10-year follow-up. AKI survivors were at 2–4 times higher risk of major adverse kidney events, hypertension, and subsequent AKI versus matched hospitalized comparators. This justifies improved surveillance after pediatric AKI to detect CKD and hypertension early and improve long-term kidney health.

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Since the start of the SARS-CoV-2 pandemic, which is otherwise known as the worldwide coronavirus disease, 2019, has had a well-established pro-thrombotic character. Patients often first exhibit respiratory symptoms, and those whose severity increases eventually develop acute hypoxic respiratory failure. The systemic hypercoagulable condition and arterial/venous thrombosis related to COVID-19 have a poor prognosis.

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Introduction: Transportation barriers can affect travel needs and quality of life.

Methods: This survey examined transportation, routine activities, and unmet travel needs among older Vietnamese immigrants, focusing on gender differences.

Results: Women were more likely to ride with others, less likely to drive, had fewer types of routine activities, and went out for activities less than men.

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  • In complex nervous systems like those of insects, the neck connective serves as a crucial link between the brain and the ventral nerve cord, facilitating sensorimotor control through various types of neurons.
  • This study integrates multiple electron microscopy datasets to provide a detailed map of ascending and descending neurons in the female nervous system, while also making comparisons to the male nerve cord.
  • The findings highlight specific neuron types linked to sex-related behaviors, including those involved in female egg-laying and male courtship, marking a groundbreaking analysis of the animal's entire central nervous system at the electron microscopy level.
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Background: As of 2021, more than 6000 children and youth in Canada were living with end-stage kidney disease (ESKD), for which kidney transplantation is considered the preferred treatment by health professionals. Research shows that living donor kidney transplantation (LDKT) has superior allograft and recipient survival compared to deceased donor kidney transplantation (DDKT). However, in a pediatric setting, the choice of LDKT or DDKT is a summative consideration of factors weighed carefully by the patient's family, health care team, and patient.

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High-resolution electron microscopy of nervous systems has enabled the reconstruction of synaptic connectomes. However, we do not know the synaptic sign for each connection (i.e.

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Poly(vinylidene fluoride) (PVDF) shows excellent chemical and thermal resistance and displays high dielectric strength and unique piezoelectricity, which are enabling for applications in membranes, electric insulators, sensors, or power generators. However, its low polarity and lack of functional groups limit wider applications. While inert, PVDF has been modified by grafting polymer chains by atom transfer radical polymerization (ATRP), albeit via an unclear mechanism, given the strong C-F bonds.

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  • Children with nephrotic syndrome are at increased risk for both obesity and short stature, particularly those with frequently relapsing or steroid-dependent forms of the condition.
  • A study of 531 children showed that at diagnosis, 23.5% were obese, 51.8% were overweight, and 4.9% had short stature, with incidence rising during follow-up.
  • Key findings indicate that children experiencing multiple relapses are more likely to develop obesity and short stature over time, emphasizing the need for preventative care strategies in this population.
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The International Society of Nephrology Global Kidney Health Atlas charts the availability and capacity of kidney care globally. In the North America and the Caribbean region, the Atlas can identify opportunities for kidney care improvement, particularly in Caribbean countries where structures for systematic data collection are lacking. In this third iteration, respondents from 12 of 18 countries from the region reported a 2-fold higher than global median prevalence of dialysis and transplantation, and a 3-fold higher than global median prevalence of dialysis centers.

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