Case report of a male child with lupus nephritis

Systemic lupus erythematosus is a chronic autoimmune inflammatory disease of unknown etiology that affects various organs, most frequently the skin, joints, kidneys, nervous, hematologic and cardiovascular systems. It affects females more often as compared to males. The kidneys are one of the most serious organs involved. Lupus nephritis may present as hypertension, proteinuria, and renal failure or it may also be asymptomatic. The recent reports suggest that childhood-onset lupus nephritis could be more severe than the late-onset disease. The occurrence of SLE in pediatric patients is very rare, especially in a male child. Here author report a case of an 8-year-old male child clinically misdiagnosed as a case of henoch schonlein purpura, who was thoroughly investigated and finally confirmed as a case of lupus nephritis.

Developmental and Morphological Variations of Frontal Sinus in Pediatric Age Group in Gurugram Region of Haryana – A Study

Background: The aim is to know gender wise development and morphological variation of the frontal sinus in the pediatric age group of Gurugram district of Haryana. The development and pneumatisation of the frontal sinus is the predictor of skeletal growth pattern. The craniofacial structures grow proportionately with the normal development of the body structures. Methods: In this prospective study, a total of 36 subjects were studied. The study was conducted in the Department of Radiodiagnosis of SGT Medical College, Budhera (Gurugram) Haryana from January 2019 to March 2019. This included 12 females and 24 males falling in the age group of 8-18 years. The frontal sinuses were evaluated on various morphological features. Plain X-Ray of paranasal sinus was evaluated by Caldwell’s view. The sinuses were evaluated for width, height, number of scallops, septations and supraorbital cells. Results: Average width and height of left frontal sinuses were 23.8 mm with the range of 5.5 – 43 mm and 28.4 mm with the range of 13-45 mm respectively. Average width and height of right frontal sinuses were 20.4 mm with the range of 9.8 – 39 mm and 20 mm with the range of 13-38 mm respectively. The average number of scalloping on right and left were 1.9 and 2.19 respectively. The septations were noticed in 13 (36.11%) on left and in 16 (44.44%) on right side. Supraorbital cells were found in 16 (44.44%) on left side and 17 (47.22%) on right side. Conclusion: There is a lot of variation in the appearance and development of the frontal sinus in pediatric age group. The dimensions had been found smaller on right side as compared to left side. Scalloping and supraorbital cells had been found more on right side than on the left side. Septations were more on left side as compared to right side.

Evaluation of Ossification of Iliac Crest in Children as Per Risser’s Sign in Gurugram Region of Haryana

Background: Risser’s sign is a good indicator of skeletal maturity in pediatric age group. The observations drawn from this can be well documented for the age verification and in relation to some pathologies. Ossification centers are evaluated with their further fusion. Methods: We carried out the evaluation by this sign in judging the exact skeletal maturity. Twenty one individual group comprising of eight females and thirteen males were included in this study. All children underwent pelvic radiography with antero-posterior view. Their iliac crest ossification and fusion was evaluated. Results: Grading of ossification of ileal cartilage was done as per the percentage extent of the ossification from Grade I to V. Conclusion: It was observed that there is delay of skeletal maturity in females as compared to males of the same age group in Gurugram region of Haryana which is contrary to the earlier studies conducted in general.

Normal Functioning Pelvic Lump Kidney: Isolated Anomaly - Radiological Evaluation.

There is wide spectrum of Mullerian dysgenesis presenting in different ways. Routine ultrasound done of a child for pain abdomen discovered a pelvic mass supero-posterior to the urinary bladder. This was diagnosed as fused pelvic kidneys by various cross sectional imaging modalities like Computerized tomography (CT) and Magnetic resonance imaging (MRI).We present a 4-years male child who was diagnosed as a case of “lump kidneys” by plain sonography coupled with color flow imaging (CFI). The entity usually falls in the common group of VATER (vertebral, anorectal malformation, esophageal and renal) anomalies. But our present case was having isolated anomaly and this entity is of a great rarity as seen in literature.

Bilateral primary Non-Obstructive and Non-Refluxing Megaureter in Child: Diagnosis by Non-Radiation Imaging Modalities.

Bilateral megaureters can present as asymptomatic or symptomatic pathology in the form of flank pain or urinary tract infection. The entity can also be diagnosed in antenatal ultrasound scan. We present 12-year old male child who presented with both flank vague pain and was subjected to ultrasonography (US) and Magnetic Resonance Urography (MRU). There was no evidence of any reflux or obstruction noticed as uretero-vasical junctions were normal on both sides. He was diagnosed as a case of bilateral primary non obstructive megaureters. Base line study was carried out by non radiation modalities in our institute for further follow up.

Choroidal Fissure Cysts in Children - Pediatrician Dilemma for Follow-up.

Background: Choroidal fissure cyst is a small cyst present in the choroidal fissure and this is a developmental variant. These are location based cysts and can either be of neuroglial or neuroepithelial, or of arachnoid in nature. These are seen as incidental finding in routine radiological cross sectional imaging studies. There is dilemma in follow up of these cysts because of their asymptomatic nature or of some vague complaints and invites a lot of debate on their follow-up. Methods: Five children of age group 10-16 years who reported to the outpatient department with vague headache, vertigo or unexplained seizures were subjected to non contrast computerized tomography (NCCT) or magnetic resonance imaging (MRI) of the head to rule out any intracranial pathology. Results: Three cases were having pure cysts in the brain while other two were found to be having various sizes and types of tuberculomas resembling with that of cystic appearances. One of the brain cyst cases was 14 years old female where NCCT head findings revealed a small cyst in the right choroid fissure location. This was subsequently confirmed as choroidal fissure cyst on multiplanar and multisectional plain MRI study. The other two cystic pathologies were vesicular stage of cysticercosis and posterior fossa arachnoid cyst. Rest of the two were tuberculomas with ring enhancement, which were confirmed on MR spectroscopy. Conclusion: The case with choroidal fissure cyst required special attention because of the concern of patient as well as clinician for the follow up. We reviewed the literature for the fate and follow up of these types of cases.

Split Cord Syndrome (Type 1 Diastematomyelia): A Case Report.

Spinal dysraphism can present in various ways in the form of severity. Split cord is one of the presentations where two hemi cords are separated either by a fibrous septum or calcific spur. This may be accompanied with different other vertebral anomalies like block vertebra, hemi vertebra or spina bifida. We present a 8-years old girl who presented with weakness and gait disturbances since she started walking. She also had a tuft of hair on the back in the lumbar region. She underwent computerized tomography (CT) and magnetic resonance imaging (MRI) and was diagnosed as diastematomyelia with other associated anomalies.

Neonatal Aerophagia Dilemma – A Gastrointestinal Functional Disorder: Role of Imaging Studies.

Aerophagia is excessive swallowing of air which goes to stomach through oesophagus and causes abdominal distention. This may alert the parents of pediatric age group especially neonates and causes anxiety. Although it’s a functional condition, the clinical presentation can suggest malabsorption or obstruction, leading to unnecessary tests and investigations. We present a 15 days -old neonate who was brought to the pediatric surgical emergency with one such condition and was managed conservatively after imaging studies ruled out any underlying pathology. The case was discharged without any surgical intervention.

A hospital based study of biochemical markers of bone turnovers & bone mineral density in north Indian women.

Background & objectives: The osteoporotic risk for women increases soon after menopause. Bone turnover markers are known to be associated with bone loss and fracture risk. This study was aimed to assess bone turnover using bone markers and their correlation with bone mineral density (BMD) in pre- and post-menopausal women. Methods: A total of 255 healthy women (160 pre- and 95 post-menopausal) were enrolled. Serum bone alkaline phosphatase (sBAP) and serum N-terminal telopeptide of type I collagen (NTX) were measured to evaluate the bone formation and resorption, respectively. Bone mineral density was determined at lumbar spine (L2-L4) anteroposteriorly, femoral neck and Ward’s triangle using Prodigy dual-energy X-ray absorptiometry (DXA) system. The comparison of years since menopause with respect to BMD and bone markers was also evaluated. Results: NTX and sBAP showed significant negative correlation with BMD of femur neck and Ward’s triangle in postmenopausal women. BMD of all three sides were significant variables for NTX and BMD of femur neck and Ward’s triangle for sBAP in postmenopausal women. BMD lumbar spine was a significant variable for sBAP in premenopausal women. The mean values of NTX increased significantly with increase in the duration of years since menopause. The BMD of all three sides decreased significantly with increase in the duration of years since menopause. Interpretation & conclusions: Serum NTX and sBAP were inversely correlated to BMD of femur neck and Ward’s triangle in post-menopausal women. Simultaneous measurements of NTX and BMD in the north Indian women, suggest that bone resorption in women with low BMD remains high after menopause.

Antagonistic effect of polyamines on ABA-induced suppression of mitosis in Allium cepa L.

Effect of abscisic acid (ABA) and polyamines (PAs) [putrescine (Put), spermidine (Spd) and spermine (Spm)] on mitosis in root tips of A. cepa was studied. Treatment with ABA (0.1 to 100 microM) for 24 hr suppressed the mitosis, measured as mitotic index (MI), in a concentration-dependent manner with approx. 50% suppression at 10 microM of ABA. Treatment with different PAs (1 to 100 microM) had differential mitosis suppression effect. Spm was most inhibitory followed by Spd and Put, respectively. The higher concentrations of PAs (1 mM Put; 0.1 and 1 mM Spd or Spm) caused cell distortion. Remarkably, a 24 hr pretreatment of root tips with PAs prior to ABA (100 microM) treatment resulted in a general concentration-dependent reversal of ABA-induced suppression of MI. Catalase (CAT) activity in the root tips, an indicator of redox metabolism, increased due to ABA treatment in a concentration-dependent manner, remained unaltered in response to Put and declined due to Spd and Spm (> or = 0.1 mM). However, all PAs, irrespective of their individual effects, generally antagonized the ABA-dependent increase in CAT activity. Data indicate the possibility of ABA-PA interaction in the regulation of mitosis.

Overexpression of c-erbB-2 oncoprotein and associated pathobiological factors in invasive primary breast cancer.

Breast cancer tissues from 271 cases were analyzed immunologically for c-erbB-2 oncoprotein (HER-2/neu), epidermal growth factor receptor (EGF-R) and estrogen receptor (ER). Overexpression of both c-erbB-2 oncoprotein and EGF-R showed an inverse association with ER and a direct association with metastatic involvement of lymph node and high histological grade. The frequency of c-erbB-2 and EGF-R overexpression was significantly higher among postmenopausal cases in comparison with premenopausal cases. Further, only in postmenopausal patients, c-erbB-2 oncoprotein (chi2 = 6.4, P < 0.05) and EGF-R (chi2 = 6.4, p < 0.05) as well as their concomitant expression (chi2 = 11.5, p < 0.01) revealed a statistically significant association with ER.

Modulation by phenolic compounds of ABA-induced inhibition of mustard (Brassica juncea L. cv. RLM 198) seed germination.

Exogenous abscisic acid (ABA) inhibited the germination of B. juncea seeds in a concentration dependent manner. As revealed in a time-course study, the ABA-induced inhibition got progressively alleviated with the lapse of time following ABA treatment possibly due to metabolic conversion of applied ABA in the seed tissue. A simultaneous application of certain phenolic compounds namely, p-coumaric-, vanillic-, gallic-, and chlorogenic acid (but not caffeic acid) also caused an alleviation of ABA effect. Of the above two patterns of recovery, the phenolic-dependent alleviation of ABA effect was apparent much earlier (24-48 hr treatment) than the time-dependent one (72 hr). It is likely that phenolics could accelerate ABA metabolism in the seed tissue leading to an early recovery from ABA-induced inhibition.