Browsing by Author "Abhinay, Abhishek"
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Publication A Child with KMT2B-Related Acute-Onset Dystonia: Clinical Pointers to Molecular Diagnosis(Georg Thieme Verlag, 2023) Singh, Ankur; Sucheta, Sucheta; Abhinay, Abhishek; Prasad, RajnitiDystonia is common extrapyramidal presentation of neurological problems in childhood. The causes could range from infectious, autoimmune, drug-induced, or genetic in origin. Genetic causes are rare in origin but could masquerade the common causes. Recently, KMT2B-related dystonia has been identified as a common genetic cause of dystonia in childhood. We present a case of a 3.5-year-old with 18 months of follow-up, who was diagnosed with KMT2B-related dystonia and managed with antidystonia drugs to an acceptable level where she could perform her day-to-day work with ease. Here, we highlight certain clinical pointers of the disease and the need of special genetic test in diagnosing such cases. We also tabulated the three previously reported Indian cases and compared their parameter with ours. � 2023 Georg Thieme Verlag. All rights reserved.Publication Amebic Meningoencephalitis Mimicking Tubercular Meningitis(Springer, 2021) Rao, Sunil Kumar; Abhinay, Abhishek; Pradhap, K.; Singh, Akanksha; Tilak, Ragini[No abstract available]Publication Blackening of Nails with Pits � A Combination of Nail Psoriasis and Onychomycosis(Springer, 2021) Pradhap, K.; Abhinay, Abhishek; Rao, Sunil Kumar[No abstract available]Publication Cerebrospinal fluid tumor necrosis factor-alpha (TNF-a) levels in children with cerebral malaria(Oxford University Press, 2023) Prasad, Rajniti; Patel, Raghvendra Singh; Mishra, S.P.; Singh, Ankur; Abhinay, Abhishek; Singh, Tej BaliThis prospective cross-sectional study evaluated the diagnostic and prognostic role of cerebrospinal fluid (CSF) tumor necrosis factor-alpha (TNF-a) in children with cerebral malaria (CM) and its role in the differentiation of CM from non-cerebral severe malaria. CSF TNF-a was measured using a human TNF-a enzyme-linked immunosorbent assay kit of 39 cases of CM and 19 cases of non-cerebral severe malaria. CSF TNF-a levels were significantly higher in CM (p < 0.001). Based on the receiver operating characteristics curve, a cutoff value of CSF TNF-a was 5.7 pg/ml for diagnosis of CM with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 87.2%, 94.7%, 97.1% and 78.3% respectively. The cutoff value of CSF TNF-a was 13.7 pg/ml for predicting adverse outcomes in CM with sensitivity, specificity, PPV and NPV of 100%, 96.8%, 88.9% and 100%, respectively. However, the cutoff value of CSF TNF-a was 4.96 pg/ml for predicting adverse outcomes in non-cerebral severe malaria with a sensitivity, specificity, PPV and NPV of 100%, 94.1%, 88.9% and 100% respectively. So, CSF TNF-a is an excellent biomarker and can be used as a diagnostic and prognostic tool. More studies are needed to establish CSF TNF-a as a predictor of neurological sequelae. � The Author(s) [2023]. Published by Oxford University Press. All rights reserved.Publication Comparison of efficacy of first haemodialysis session for correction of metabolic disturbances in acute kidney injury and chronic kidney disease in children(Nepal Paediatric Society (NEPAS), 2021) Verma, Shubham; Abhinay, Abhishek; Mishra, Om Prakash; Singh, Ankur; Prasad, RajnitiIntroduction: Acute kidney injury and chronic kidney disease present with various complications like electrolyte disturbances, metabolic acidosis and fluid overload in children. The objective of the study was to compare the efficacy of the first session of haemodialysis in children with acute kidney injury stage 3 and chronic kidney disease G5 treated by dialysis for immediate recovery of renal functions in terms of reduction in the level of azotemia, correction of fluid and electrolyte imbalances, metabolic acidosis, and improvement in clinical status. Methods: This was a cross-sectional comparative observational study conducted on 13 patients of acute kidney injury stage 3 and 46 patients with chronic kidney disease G5, who required haemodialysis. Their clinical assessment, fluid status, renal function tests, electrolyte, bicarbonate were done at admission and completion of the first session of heamodialysis. Results: The age group of children was six to 16 years (median 11.4 years). There were six males (46%) and seven females (54%) in the acute kidney injury group and 29 (63%) males and 17 (37%) females in chronic kidney disease G5 groups. Sepsis (31%) and glomerulonephritis (31%) were common etiologies detected for acute kidney injury while in chronic kidney disease G5, congenital anomalies of the kidney and the urinary tract were the commonest (50%). There were significant reductions in the levels of serum urea and creatinine and a rise in blood pH, bicarbonate level, and base excess following the first session of haemodialysis in comparison to pre-dialysis values in both AKI and CKD. Conclusions: The study demonstrated improvement in the clinical parameters and biochemical parameters equally after the first dialysis sessions in both groups. This is one of the effective renal replacement therapy and should be instituted wherever indicated to improve the immediate outcome of the patients. � 2021, Nepal Paediatric Society (NEPAS). All rights reserved.Publication Corona Virus Disease-19 Presented with Acute Pancreatitis(Springer, 2021) Abhinay, Abhishek; Pradhap, K.; Singh, Ankur; Rao, Sunil Kumar; Prasad, Rajniti; Mishra, O.P.[No abstract available]Publication Desfechos de crian�as com s�ndrome nefr�tica idiop�tica c�rtico-resistente: um estudo observacional de centro �nico; [Outcomes of children with idiopathic steroid resistant nephrotic syndrome: a single centre observational study](Sociedade Brasileira de Nefrologia, 2023) Mishra, Om P.; Sidar, Minketan; Batra, Vineeta V.; Prasad, Rajniti; Singh, Ankur; Abhinay, Abhishek; Mishra, Akash; Yadav, Ashish K.Introduction: Idiopathic steroid resistant nephrotic syndrome (SRNS) has variable outcomes in children. The primary objective of the present study was to assess the cumulative remission rate and the secondary objectives were to assess factors affecting the remission status, kidney function survival, and adverse effects of medications. Methods: One hundred fourteen patients with SRNS were included. Calcineurin inhibitor-based treatment protocol along with prednisolone and angiotensin-converting enzyme inhibitor were used, and patients were followed over 5 years. Results: Median age was 4.5 years; 53.5% of cases were between 1 to 5 years of age. Sixty-two patients (54.4%) were at initial stage and 52 (45.6%) were at a late SRNS stage. Median eGFRcr was 83.5 mL/min/1.73m2 at presentation. Of the 110 patients, 63 (57.3%) achieved remission [complete remission 30 (27.3%), partial remission 33 (30%)], and 47 (42.7%) had no remission. Kidney function survival was 87.3% and 14 cases (12.7%) had progression to CKD (G3-8, G4-3, G5-1, and G5D-2). Median duration of follow up was 36 months (IQR 24, 60). Age of onset, cyclosporine/tacrolimus, eGFRcr, and histopathology (MCD/FSGS) did not affect remission. Similarly, remission status in addition to age of onset, drug protocol, and histopathology did not significantly affect kidney function during a period of 5 years. Hypertension, cushingoid facies, short stature, cataract, and obesity were observed in 37.7, 29.8, 25.5, 17.5, and 0.7% of cases, respectively. Conclusion: About half of the cases achieved remission. Age of onset of disease, cyclosporine/tacrolimus use, and histopathological lesion neither affected remission status nor short-term kidney function survival in SRNS. � 2023 The Author(s).Publication Fibroblast Growth Factor 23 Level and Cardiovascular Parameters in Children with Chronic Kidney Disease(Springer, 2022) Singh, Gaurav; Mishra, Om P.; Abhinay, Abhishek; Agarwal, Vikas; Mishra, Surendra P.; Dwivedi, Amitnandan D.; Singh, Ankur; Prasad, Rajniti; Mishra, Rabindra N.Objective: To find out the serum fibroblast growth factor 23 (FGF-23) levels in different grades of CKD, and the prevalence of abnormal left ventricular mass index (LVMI), carotid intima�medial thickness (cIMT), and central pulse wave velocity (cPWV) and the risk factors including FGF-23 for these abnormalities. Methods: Fifty-nine patients of CKD with G2 to G5, aged 2�18 y were included. The LVMI, cIMT, and cPWV were measured using standard techniques, and serum intact FGF-23 levels were estimated at enrollment. Results: Median FGF-23 levels were significantly raised in all the grades of CKD than controls (p < 0.001), and also in G4 and G5 in comparison to G2&3 and in G5D than G5. Increased LVMI in 42 (71.2%), elevated cIMT in 30 (57.7%), and cPWV in 14 (26.9%) patients were found. The FGF-23 showed significant negative correlation with eGFRcr and positive with serum iPTH, phosphate and alkaline phosphatase levels, but had no correlations with LVMI, cIMT SDS, and cPWV SDS. Only systolic BP SDS (odds ratio 1.5, 95% CI 1.008�2.231, p = 0.046) was observed as a significant predictor for increased cIMT, while no variables had any association with abnormal LVMI and cPWV. Conclusions: Serum FGF-23 showed higher levels with increasing grades of CKD, but no significant association with cardiovascular parameters. Systolic BP SDS was found as a significant risk factor for increased cIMT in children with CKD. � 2021, Dr. K C Chaudhuri Foundation.Publication Maternal and fetal outcomes of COVID-19 infection in pregnant women with chronic rheumatic heart disease in a South Asian population: A case series(John Wiley and Sons Inc, 2022) Rajan, Mamta; Sachan, Shikha; Abhinay, Abhishek; Verma, BhupendraRheumatic heart disease (RHD) is associated with an increased risk of adverse maternal, fetal, and neonatal outcomes, particularly in developing countries. The current COVID-19 pandemic has also affected pregnant women, probably increasing the adverse effects. It is speculated that COVID-19 infection in pregnant women would further increase the risk of complications. However, factual data is still lacking, especially from resource-constrained countries. We conducted a case series of 20 pregnant women with RHD and COVID-19 infection and compared their outcomes with 40 with RHD but without COVDI-19. We observed a high risk of adverse cardiac and pregnancy effects across the whole cohort of 60 patients. However, the comparative study between the two groups failed to show any incremental risk of complications due to COVID-19 infection. Although the sample size was limited; the results are encouraging, particularly for developing countries. � 2022 Japan Society of Obstetrics and Gynecology.Publication Maternal and neonatal outcomes of COVID-19 co-infection in pregnant women with chronic hepatitis B virus infection: A prospective cohort study(John Wiley and Sons Ltd, 2022) Rajan, Mamta; Sachan, Shikha; Abhinay, Abhishek; Yadav, Dawesh Prakash; Verma, Bhupendra[No abstract available]Publication Nephrogenic Diabetes Insipidus in a 10-mo-old Infant: Complication of Nephropathic Cystinosis(Springer, 2023) Singh, Ankur; Patel, Raghvendra; Abhinay, Abhishek; Prasad, Rajniti; Mishra, Deepak; Mishra, Om Prakash[No abstract available]Publication Outcomes of children with idiopathic steroid resistant nephrotic syndrome: a single centre observational study; [Desfechos de crian�as com s�ndrome nefr�tica idiop�tica c�rtico-resistente: um estudo observacional de centro �nico](Sociedade Brasileira de Nefrologia, 2023) Mishra, Om P.; Sidar, Minketan; Batra, Vineeta V.; Prasad, Rajniti; Singh, Ankur; Abhinay, Abhishek; Mishra, Akash; Yadav, Ashish K.Introduction: Idiopathic steroid resistant nephrotic syndrome (SRNS) has variable outcomes in children. The primary objective of the present study was to assess the cumulative remission rate and the secondary objectives were to assess factors affecting the remission status, kidney function survival, and adverse effects of medications. Methods: One hundred fourteen patients with SRNS were included. Calcineurin inhibitor-based treatment protocol along with prednisolone and angiotensin-converting enzyme inhibitor were used, and patients were followed over 5 years. Results: Median age was 4.5 years; 53.5% of cases were between 1 to 5 years of age. Sixty-two patients (54.4%) were at initial stage and 52 (45.6%) were at a late SRNS stage. Median eGFRcr was 83.5 mL/ min/1.73 m2 at presentation. Of the 110 patients, 63 (57.3%) achieved remission [complete remission 30 (27.3%), partial remission 33 (30%)], and 47 (42.7%) had no remission. Kidney function survival was 87.3% and 14 cases (12.7%) had progression to CKD (G3-8, G4-3, G5-1, and G5D-2). Median duration of follow up was 36 months (IQR 24, 60). Age of onset, cyclosporine/tacrolimus, eGFRcr, and histopathology (MCD/FSGS) did not affect remission. Similarly, remission status in addition to age of onset, drug protocol, and histopathology did not significantly affect kidney function during a period of 5 years. Hypertension, cushingoid facies, short stature, cataract, and obesity were observed in 37.7, 29.8, 25.5, 17.5, and 0.7% of cases, respectively. Conclusion: About half of the cases achieved remission. Age of onset of disease, cyclosporine/tacrolimus use, and histopathological lesion neither affected remission status nor short-term kidney function survival in SRNS. � 2023 Sociedade Brasileira de Nefrologia. All rights reserved.Publication Pediatric Renal Rickets at a Tertiary Center(Springer, 2023) Singh, Ankur; Sucheta; Gupta, Rupal; Abhinay, Abhishek; Prasad, Rajniti; Mishra, Om PrakashWe report clinical and etiological profile of 19 children (10 males) with renal rickets managed in the years 2021�2022. Median (IQR) age of presentation was 60 (18�96) months. The commonest cause was renal tubular acidosis (n=8). Genetic analysis revealed the diagnosis in 83% subjects (5 out of 6 tested). � 2023, Indian Academy of Pediatrics.Publication Persistence of behavioral abnormalities following corticosteroid therapy in children with initial episode of idiopathic nephrotic syndrome: A prospective longitudinal observation; [Persist�ncia de anormalidades comportamentais ap�s corticoterapia em crian�as com epis�dio inicial de s�ndrome nefr�tica idiop�tica: Uma observa��o longitudinal prospectiva](Sociedade Brasileira de Nefrologia, 2022) Singh, Parichay; Mishra, Om P.; Upadhyay, Shashi K.; Prasad, Rajniti; Singh, Ankur; Abhinay, Abhishek; Mishra, Akash; Schaefer, FranzIntroduction: Treatment of nephrotic syndrome with corticosteroid can cause several side- effects including behavioral abnormalities. The objectives of the study were to observe the proportion of non-relapsers having persistence of behavioral abnormalities after completion of treatment of initial episode and compare the abnormalities with relapsers, and to determine risk factors for persistence. Methods: Seventy-five children with a first episode of idiopathic nephrotic syndrome and 60 normal children were rated by parents for behavioral problems using the Child Behavior Checklist. The Parenting Stress Index was also evaluated. The children were rated before treatment and 12 and 36 weeks after. Results: Both relapsers and non-relapsers showed abnormalities in internalizing and externalizing domains at 12 weeks of steroid therapy. Non-relapsers had abnormal scores in the internalizing domain in 63.5 % and externalizing domain in 48.1% of cases at 36 weeks. Relapsers had abnormal scores in all the three behavior domains, but a significantly higher proportion of relapsers had abnormal scores regarding total behavior (65.2% vs 28.8%, p<0.01) and child domains (100% vs 57.7%, p<0.001) of Parenting Stress Index in comparison to non-relapsers at 36 weeks. Occurrence of relapse increased the risk (odds ratio 5.76, 95% CI 1.35-10.76, p< 0.001) for persistence of abnormal total behavior at 36 weeks follow-up. Conclusion: Persistence of abnormalities was observed not only in relapsers but also in non-relapsers. Relapse was found to be a significant risk factor for persistence of abnormal behaviors in these patients. Copyright � 2021 Metallurgia Italiana. All rights reserved.Publication Risk factors for mortality in critically ill infants with acute kidney injury: A resource-limited setting experience(John Wiley and Sons Inc, 2022) Mishra, Om P.; Verma, Avdhesh Kumar; Abhinay, Abhishek; Singh, Akanksha; Singh, Ankur; Prasad, RajnitiInfants with acute kidney injury (AKI) who are critically ill often will have multiorgan dysfunctions. Objective of the present study was to find out mortality, recovery of kidney function at discharge and at 3�months, and to determine risk factors for mortality. Fifty-two infants (24 newborns and 28 postneonatal) with AKI were included. Staging was done as per Kidney Disease Improving Global Outcomes classification. Patients were subjected to medical treatment and peritoneal dialysis (PD), wherever indicated. Kidney function tests were performed at admission, discharge, and at 3�months follow-up. Median age of neonates was 8 days and postneonatal infants were 4.5�months. Stage 1, 2, and 3 AKI were present in 14 (26.9%), 16 (30.7%), and 22 (42.3%) cases, respectively. PD was required in 22 (42.3%) infants, and significantly higher in postneonatal than in neonates (57.1% vs. 25%, p < 0.05). Significant recovery of kidney function occurred at discharge and cases had normal parameters at 3�months. Mortality was 17.3%. Patients had significantly higher risk of mortality, if they had metabolic acidosis (OR 13.22, CI 2.33�74.94, p�=�0.002) and needed ventilation (OR 14.93, 95% CI 1.7�130.97, p�=�0.006) and PD (OR 6.53, 95% CI 1.20�35.48, p�=�0.026). In logistic regression analysis, fluid overload (p < 001), hypotension (p < 0.01), and higher PRISM-III score (p < 0.05) were found as significant risk factors for mortality. Medical management including PD led to good recovery of kidney function. Presence of fluid overload, hypotension, and higher PRISM-III score adversely affected the outcome. � 2021 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.Publication SARS-CoV-2 Infection in Children with Idiopathic Nephrotic Syndrome: A Multicentric Study(Springer, 2023) Chopra, Sanya; Raut, Sumantra; Sinha, Rajiv; Abhinay, Abhishek; Thakur, Archana; Mishra, O.P.; Yadav, Menka; Saha, AbhijeetA multicenter retrospective study was conducted to assess the clinical spectrum of 30 severe acute respiratory syndrome coronavirus (SARS-CoV-2)-positive children with idiopathic nephrotic syndrome. Difficult to treat nephrotic syndrome was found to be a high-risk group with a high incidence of acute kidney injury and mortality. � 2023, Indian Academy of Pediatrics.
