Obinutuzumab in Difficult to Treat Phospholipase A2 Receptor Positive Membranous Nephropathy: Our Experience at a Tertiary Care Center in North India.

Obinutuzumab is a glycoengineered type II anti-CD20 monoclonal antibody with superior B cell cytotoxicity compared to rituximab. Various case reports suggest that in refractory phospholipase A2 receptor (PLA2R) positive membranous nephropathy (MN) patients, Obinutuzumab led to immunologic remission and improvement in proteinuria. In the present case series, we present six cases of difficult-to-treat PLA2R-associated MN refractory to prednisolone, calcineurin inhibitor (CNI), cyclophosphamide, and rituximab but subsequently responded to Obinutuzumab.

Proof of concept study - alternative pharmacoprophylaxis for high-altitude pulmonary edema: A hospital-based randomized controlled trial.

Background: High-altitude pulmonary edema (HAPE) is noncardiogenic pulmonary edema caused by exaggerated hypoxic pulmonary vasoconstriction and abnormally high pulmonary artery pressure. Some patients who develop HAPE have more chances to develop HAPE again on reinduction to high altitude (HA). This was a pilot project to look for a suitable drug (acetazolamide, nifedipine, or tadalafil) that could be used prophylactically in HAPE patients on reinduction to HA.