BackgroundLupus Nephritis, one of the commonest manifestation of SLE, seen in 60% of adult SLE patients at some point of time, carries poor prognosis when compared to those with no renal involvement. ...The natural course of the LN has recurrent flares, necessitating the need for early detection and treatment. Despite being the gold standard in diagnosing Lupus nephritis and its severity, renal biopsy is an invasive procedure with potential complications, and difficult to repeat. Hence, a novel biomarker, reflecting the disease activity and severity is needed to predict flare. Monocyte chemoattractant Protein 1, a chemokine produced locally during Lupus Nephritis flare, was shown in many previous studies as a promising biomarkerObjectivesWe studied the role of Urinary MCP-1 as a biomarker of disease activity in LN and compare its value among different histological classes of Lupus nephritisMethodsThis is a case-control study conducted at a tertiary care centre in North India from July 2016 to December 2017. Cases were those patients undergoing renal biopsy satisfying the inclusion criteria set for SLE with LN(n=36). Controls were patients of SLE without active LN Control I-prior LN (n=11) and Control II-never had LN (n=15). Urinary MCP-1 measurement was done using Sandwich ELISA kitResultsThe mean age in cases was 31.1±10.2 years and mean age in control-I was 34.6±8.0 and in control II was 36.3±10.4. Urinary MCP-1 values in cases (1214±1467.1 pg/mg) was significantly higher compared to Controls (184.5±186.8). However, no significant difference was observed between Control I (170.5±150.8) and Control II (194±214). Urinary MCP-1 levels show significant correlation when compared with classical disease markers like 24 hour proteinuria, 24 hour PCR, Spot PCR and SLEDAI. Cut off value (339 pg/mg, p<0.001) obtained from ROC curve has sensitivity and specificity of 80% and 92% respectively. However, there was no significant difference of Urinary MCP-1 levels was observed among different classes of LN (p=0.593). ROC curve comparison of urinary MCP-1 (AUC=0.879) with 24 hour urine protein to creatinine ratio (AUC=0.964) and spot urine protein to creatinine ratio (AUC=0.872) showed that it is not a better marker of disease activity than both of them. Urinary MCP-1 levels didn’t show significant correlation with Renal activity index calculated on renal biopsy.ConclusionsIn this study we found higher Urinary MCP-1 levels in active LN compared to Inactive LN and its level was correlated well with the presently used disease markers. However there was no significant difference among different histological classes of LN.Disclosure of InterestNone declared
A new bispyrenyl azadiene derivative has been synthesized and examined for its cation recognition abilities toward different cations. The ligand shows strong affinity for Hg(2+) ions over other ...cations such as Cu(2+), Pb(2+), Zn(2+), Ni(2+), Cd(2+), Ag(+), K(+), Na(+) and Li(+). An "Off-On" type of fluorescent behaviour was observed with simultaneous presence of Cu(2+) and Hg(2+) ions. An ion selective electrode (ISE) is also formed which showed excellent selectivity to Hg(2+) over all the other cations tested. The lower limit of detection is 7.08 x 10(-6) M.
This study was done by collecting the retrospective data from 1994 to 2009 of patients attending the urban leprosy centre attached to the department of dermatology, STD & leprosy of PGIMER & Dr. R M ...L Hospital, New Delhi. The data was analysed according to age, sex, type of leprosy, leprosy reactions, deformities and relapse and compared with the national figures by comparison of proportions after taking the national data per 10,000 population. A total of 3659 patients attended our ULC (Urban Leprosy Centre) among which 2741 were male and 945 females (M:F-3:1). 669 patients (18.2%) were children. The data analysed show a gradual decline in new case detection rate with a marginal rise in 2005 and 2008. Percentage of MB cases was falling consistently till 2005 after which it showed an abrupt rise. The incidence of type 1 reaction varied from 21% in 1994 to 10% in 2009 in PB patients and from 6% in 1994 to 8% in 2009 in MB patients. The trend of type 2 reactions in MB patients showed a slow declining trend. MDT completion rate showed an impressive improvement from 56% in 1994 to 90% in 2009. The number of patients revisiting the ULC with features of relapse also showed a decrease in number. The pattern of visible deformities showed an almost constant trend similar to national figures. Improved MDT completion rate helps in reducing the disease transmission, severity, reactions and disabilities.
During the manufacture of Portland cement, dust is generated composed of particles of feedstock and condensed volatilised inorganic salts. Due to its highly alkaline soluble fraction, the dust can be ...used as an activator in blends containing pozzolanic materials or hydraulic slags, allowing them to undergo cementitious reactions. The inclusion of Portland cement in such blends enhances strength development further, although careful proportioning of materials will be required to obtain optimum performance. Ternary systems containing cement kiln dust, pulverised-fuel ash and Portland cement were characterised in this paper in terms of strength development and hydration products. For a given Portland cement content, optimum strength was achieved in blends containing approximately 10% cement kiln dust for Portland cement levels up to 80%. Beyond this level a CKD/PFA ratio of one was optimal. Isothermal conduction calorimetry results and measurements of calcium hydroxide levels indicated that this was due to an acceleration of the reactions of the blend constituents by the dust. Additionally, the chemical composition of the optimal blends promoted the production of calcium aluminate and ferrite hydrates of a type conducive to maintaining the integrity of the cementitious matrix.
Objective
Deficiency of adenosine deaminase 2 (DADA2) is a potentially fatal monogenic syndrome characterized by variable manifestations of systemic vasculitis, bone marrow failure, and ...immunodeficiency. Most cases are diagnosed by pediatric care providers, given the typical early age of disease onset. This study was undertaken to describe the clinical phenotypes and treatment response both in adults and in children with DADA2 in India.
Methods
A retrospective analysis of pediatric and adult patients with DADA2 diagnosed at various rheumatology centers across India was conducted. Clinical characteristics, diagnostic findings, and treatment responses were analyzed in all subjects.
Results
In total, 33 cases of DADA2 were confirmed in this cohort between April 2017 and March 2020. Unlike previous studies, nearly one‐half of the confirmed cases presented during adulthood. All symptomatic patients exhibited features of vasculitis, whereas constitutional symptoms and anemia were more common in pediatric patients. Cutaneous and neurologic involvement were common, and 18 subjects had experienced at least one stroke. In addition, the clinical spectrum of DADA2 was expanded by recognition of novel features in these patients, including pancreatic infarction, focal myocarditis, and diffuse alveolar hemorrhage. Treatment with tumor necrosis factor inhibitors (TNFi) was initiated in 25 patients. All of the identified disease manifestations showed marked improvement after initiation of TNFi, and disease remission was achieved in 19 patients. Two cases were complicated by tuberculosis infection, and 2 deaths were reported.
Conclusion
This report presents the first case series of patients with DADA2 from India, diagnosed by adult and pediatric care providers. The findings raise awareness of this syndrome, particularly with regard to its presentation in adults.
PFA concrete mixes were designed to optimise resistance to chloride ingress. Chloride binding capacity, intrinsic permeability and their concomitant influence on the coefficient of chloride diffusion ...have been investigated. PFA replacements up to 67% and exposure concentrations of 0.1, 0.5, 1.0 and 5.0 mole/litre were used. Chloride binding capacity was found to increase with increasing PFA replacement up to 50% and to then decline. It increased with chloride exposure concentration as well as water/binder ratio. The coefficient of chloride diffusion of concrete samples was found to be dependent on both the intrinsic permeability of the concrete and the ability of its cement matrix to bind chlorides.
Aim
To describe the clinical features, treatment and long‐term outcomes in north Indian patients with granulomatosis with polyangiitis (GPA).
Methods
Clinical details, Birmingham Vasculitis Activity ...Score (BVAS‐v3), laboratory data, histopathology findings, treatment details and outcomes of all consecutive patients diagnosed as having GPA between April 2005 and April 2016 were retrieved. European Vasculitis Study Group definitions were used to classify patients into localized, early systemic, generalized, severe and refractory categories. The findings were compared with large single center cohorts from USA, Germany and France.
Results
One hundred and five patients (median age 40 years; 60 females and 45 males) were diagnosed as having GPA. Median duration of follow up was 28 months. Upper respiratory tract, renal and lung involvement were seen in 76.19%, 51.43% and 67.62% of patients, respectively. Ocular, ear, central nervous system, peripheral nervous system, heart, gastrointestinal and skin involvement were seen in 40.95%, 18.1%, 26.67%, 11.43%, 5.71%, 12.38% and 29.52%, respectively. The median BVAS v3 score was 17. Localized, early systemic, generalized, severe and refractory disease were seen in three, 44, 38, 17 and one patient, respectively. Eighteen patients expired and the cause of death was disease activity in 11, disease activity plus sepsis in four and sepsis alone in three patients. Twenty‐six patients experienced relapses. No hemorrhagic cystitis or bladder cancers were observed; however, one patient developed myelodysplastic syndrome during follow up.
Conclusion
Indian patients are younger and have less arthritis, renal and peripheral nerve involvement as compared to the patients in Western cohorts.
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