Treatment outcome in childhood steroid resistant nephrotic syndrome with different therapeutic regimens

To determine the efficacy of different treatment strategies in children with steroid resistant nephrotic syndrome [SRNS] and to find the impact of histopathological lesions on the treatment outcome. Retrospective observational. This study was conducted at Paediatric Nephrology Department, the Children's Hospital and the Institute of Child Health, Multan from January, 2006 to July, 2014. Medical record of 77 patients with SRNS was reviewed. For the purpose of treatment patients were divided into two groups depending upon the initial renal function tests [RFTs]. Group 1 included patients with normal RFTs. They received cyclosporine A [CsA], mycophenolate mofetil [MMF], combined CsA and MMF, and intravenous methylprednisolone [MP] pulses as step 1, 2, 3, and 4 respectively. Group 2 included patients with deranged RFTs and they were given either MMF, or MP pulses. Long-term follow up was done ranging from 1-5 years. Treatment outcome with different therapeutic regimens was determined. The role of histopathology in predicting final outcome was also evaluated. In group 1, 44/61[72%] patients achieved complete remission with successive treatment steps1-4.Two [3.4%] patients were partial responders whilst 15[24.6%] patients failed to respond to all treatment regimens. Out of the 16 patients in group 2, only 02 [12.5%] achieved remission. Patients with focal segmental glomerulosclerosis [FSGS] were least likely to respond to treatment [12/28; 42.8%],followed by mesangioproliferative glomerulonephritis [MesPGN][15/23;65.2%], and minimal change disease [MCD][14/18;77.8%]. SRNS patients with normal initial RFTs are much more likely to respond to immunosuppressives than those with deranged RFTs at presentation. FSGS is more difficult lesion to treat compared with non-FSGS lesions

Histopathological patterns in childhood steroid resistant nephrotic syndrome

To determine the frequency of various histopathological lesions in children with steroid resistant nephrotic syndrome [SRNS] presenting to the Children's Hospital and the Institute of Child Health, Multan. Retrospective observational study. This study was conducted at the Department of Paediatric Nephrology, The Children's Hospital and The Institute of Child Health, Multan, Pakistan from October 2005 to December 2012. Medical record of 152 children with SRNS, who were biopsied was reviewed all SRNS patients, both initial steroid resistant and late non-responders were included in the study out of the total 152 patients, 98[64.5%] were males and 54[35.5%] females, with a male to female ratio of +/- 1.8: 1. Mean age and standard deviation of patients was micro 8.11 +/- 3.58 years with age range of 1 to 15 years. Histopathological spectrum showed focal segmental glomerulosclerosis [FSGS] as the commonest [59; 38.81%] lesion followed by mesangioproliferative glomerulonephritis [MesPGN] [40; 26.31%], minimal change disease [MCD] [35; 23.02%] and mesangiocapillary glomerulonephritis [MCGN] [13; 08.55%]. Four [2.63%] patients had membranous nephropathy. One patient of renal amyoidosis was also diagnosed on renal biopsy. Overall FSGS was the commonest lesion followed by MesPGN, MCD, and MCGN. IgMN was an associated finding in 25% cases of MesPGN. FSGS was significantly more common among children >10 years. MCD was significantly more common among children 1-5 years. MesPGN and MCGN were significantly more common among children >5 years

Somatic embryogenesis in wild relatives of cotton (Gossypium Spp.) / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Wild cotton species can contribute a valuable gene pool for agronomically desirable cultivated tetraploid cultivars. In order to exploit diploid cotton a regeneration system is required to achieve transformation based goals. The present studies aimed at optimizing the conditions for regeneration of local varieties as well as wild species of cotton. Different callus induction media were tested with varying concentrations of hormones in which sucrose was used as nutritional source. Different explants (hypocotyls, cotyledon, root) were used to check the regeneration of both local cotton plants and wild relatives using T & G medium, BAP medium, CIM medium, EMMS medium, and cell suspension medium. Different stages of embryogenicity such as early torpedo stage, late torpedo stage, heart stage, globular stage and cotyledonary stage were observed in wild relatives of cotton. The results of this study pave the way for establishing future transformation methods.

Stroke in hypertensive patients

To find the incidence of hypertension in stroke patients comparing it with other common risk factors and to determine the frequency of occurrence of reactive rise in blood pressure in the acute stage of stroke in normotensive patients. A prospective study. The study was conducted in Medical Unit III B V Hospital Bahawalpur from Feb 2001 to May 2002. One hundred consecutive CT Scan confirmed patients of stroke from emergency department were evaluated for various risk factors by using a proforma to record the bio-data, history of hypertension, diabetes mellitus, ischemic heart disease, transient ischemic attacks, smoking and past history of stroke. After segregating the hypertensive stroke patients, the reactive rise in blood pressure due to acute stage of stroke was also studied in the normotensive patients. Out of the 1334 admitted patients 7.49% [100 patients] accounted for acute stroke. There were 64 [64%] males and 36 [36%] Female patient. 78 patients [78%] had cerebral infarction while 22 [22%] were having hemorrhagic stroke. 49 patients [49%] were hypertensive. Out of these 30 [61.22%] were males and 19 [38.77%] were females. 35 patients [7l.42%] had cerebral infarction while 14 [28.57%] patients had hemorrhagic stroke. Hypertension was a risk factor in 35 out of 78 patients [44.87%] with cerebral infarction, while it was present in 14 out of 22 patients [63.63%] with hemorrhagic stroke. Comparing hypertension 49% to the other commonly encountered risk factors in the study, smoking was found in 30%, diabetes mellitus in 19%, ischemic heart disease in 18%, atrial fibrillation in 6% and other cardiac diseases in 4% of all the cases of stroke. Reactive rise in blood pressure in normotensive patients with acute stroke was found in 51% [26 out of 51] cases. Hypertension is the most common risk factor for all types of strokes and a significantly high proportion of normotensive patients show a reactive rise in blood pressure in the acute stage of stroke, which usually becomes normal within a week, without any anti-hypertensive therapy.