Role of light and immunofluorescence microscopy to differentiate primary and secondary membranous nephropathy

Context: Membranous nephropathy (MN) causes nephrotic syndrome, mostly primary but may be associated with SLE, infections, cancer, or drug. Aims: To estimate clinical, serological, light microscopic, and direct immunofluorescence (DIF) findings to differentiate primary and secondary MN. Settings and Design: Prospective, cross-sectional, single-center study in a tertiary care hospital. Methods and Material: Total 51 cases from September 2019 to February 2020. Laboratory Data: Blood glucose, urine analysis, urea, creatinine, albumin, cholesterol, HBsAg, Anti HCV, ASO, ANA, MPO ANCA, PR3 ANCA, dsDNA, PLA2R, C3, and C4. Clinical parameters: age, sex, BP, skin lesions, arthralgia, edema, obesity. Renal biopsies examined with H and E, PAS, silver methanamine, MT stains. DIF done with IgG, IgM, IgA, C3c, C1q, kappa, and lambda. Statistical Analysis Used: Statistical software (Graph Pad PRISM 6) and Chi-square test). Results: Among 51 cases, 25 are primary and 26 are secondary MN with 22 being lupus nephritis, with 2 being post-infectious and the remaining 2 being proliferative glomerulonephritis with monoclonal immunoglobulin deposition (PGNMIDD) with kappa chain restriction. Mean age was 37 ± 12.18 and 30.69 ± 13.92 years for primary and secondary MN, respectively. Significant male preponderance in primary MN. Serum C4 significantly low in secondary MN (15.34 ± 9.59). Microscopic hematuria present in secondary MN. Mesangial and endocapillary hypercellularity are significant in secondary MN. IgG and kappa are significantly intense in primary whereas IgA, C3c, and C1q are significantly intense in secondary MN. Conclusions: Reliable differentiation between primary and secondary MN has important therapeutic implications.

A Study of Skin Sensitivity for Common Allergens in Patients of Nasobronchial Allergy in North India

Objective: The present study is designed to investigate the profile of different allergen sensitivities by skin prick test in patients with nasobronchial allergy (NBA). Materials and methods: A total of 130 patients of NBA were included in the study. Each NBA patient was subjected to the skin prick test with 44 allergens. Results: Out of 130 patients, 98 patients (75.4%) had both bronchial asthma and allergic rhinitis, 11 patients (8.5%) had allergic rhinitis, and 21 patients (16.2%) had bronchial asthma alone. The age of patients ranged from 12 to 60 years, with mean age 26.4 � 10.24 years. The most common allergen came out to be insects (26.2%) followed by dust mites (20.7%), dusts (7.4%), pollens (5.9%), fungi (5.2%), danders (3.8%), and silk (2.2%). Common insect antigens were moth and mosquito (28.9%) followed by the cockroach, housefly (24.4%), and honeybee (18.9%). Common dust allergens were grain dust and house dust. Among pollens, Amaranthus spinosus and Cassia siamea (13.3%) followed by Brassica campestris (12.2%) and Holoptelea integrifolia (10%) were common. Among fungi, Aspergillus fumigatus and Aspergillus niger were common allergens. Conclusion: Common allergens in patients of NBA were identified. Allergen-specific immunotherapy can be a viable option for these patients.

Pharmacological studies on the venomous spotted butterfish (Scatophagus argus Linn) sting extract on experimental animals.

A sting of the fish S. argus, a venomous edible spotted butterfish, produces tremendous local pain, severe swelling, rise of body temperature, throbbing sensation etc. To establish the pharmacological activities of S. argus sting extract, the present investigation, was carried out on experimental animals. The LD50 of extract was found to be 9.3 mg/kg (iv) in male albino mice. The extract showed loss of sensation, urination and salivation in mice. It potentiated pentobarbitone induced sleeping time in male albino mice and produced hypothermia. Extract produced a fall of cat and guinea pig blood pressure, which was completely abolished by mepyramine. It produced a transient reduction of respiratory rate in rat, but decreased respiratory amplitude in cat, which was abolished after vagotomy. On isolated toad heart, the extract increased both the amplitude and rate of contraction. On isolated guinea pig heart, the sting extract decreased both the rate and amplitude of contraction leading to cardiac arrest, but it had no effect on isolated guinea pig auricle. The extract produced a reversible blockade of electrically induced twitch response of isolated chick biventer cervices preparation, but it had no effect on the isolated rat phrenic nerve diaphragm preparation. It produced a slow contractile response on isolated guinea pig ileum, rat uterus and rat fundal strip preparations but produced slow relaxation on isolated rat duodenum preparation. The contractile response on isolated guinea pig ileum and rat fundal strip was antagonised by SC19220. It did not produce any significant cutaneous haemorrhage in mice and did not produce any haemolysis on saline washed erythrocytes. The sting extract significantly increased capillary permeability of guinea pig dorsal flank and produced oedema in mice hind paw.

Isolation of a haemorrhagic protein toxin (SA-HT) from the Indian venomous butterfish (Scatophagus argus, Linn) sting extract.

A haemorrhagic protein toxin (SA-HT) was isolated and purified from the spine extract of the Indian venomous butterfish, S. argus Linn, by two step ion exchange chromatography. The toxin was homogeneous in native and SDS-PAGE gel. SDS-molecular weight of the toxin was found to be 18.1 +/- 0.09 kDa. SA-HT produced severe haemorrhage on stomach wall but devoid of cutaneous haemorrhage. UV, EDTA, trypsin, protease, cyproheptadine, indomethacin, acetylsalicylic acid and BW755C treatment significantly antagonized the haemorrhagic activity of SA-HT. The toxin produced dose and time dependent oedema on mice hind paw, which was significantly encountered by cyproheptadine, indomethacin and BW755C. SA-HT increased capillary permeability on guinea pig dorsal flank. On isolated guineapig ileum, rat fundus and uterus, SA-HT produced slow contraction which was completely antagonised by prostaglandin blocker SC19220. On isolated rat duodenum, SA-HT produced slow relaxation. SA-HT significantly increased plasma plasmin, serum MDA level and decreased serum SOD level indicating the possible involvement of cyclooxygenase and lipooxygenase pathway.

Isolation and partial structural evaluation of a cardiotoxic factor from Indian common murrel (Channa striatus L.) skin extract.

It was earlier reported from this laboratory that, Channa striatus, L a common edible fish, whose skin extract (CSSE) was pharmacologicaclly potent and contains several bioactive compounds. In the present communication a cardiotoxic factor was isolated and purified by thin layer chromatography followed by silica gel and neutral alumina column chromatography. Spectroscopic studies (UV, IR, 1H and 13C NMR, FAB-MS) indicated that the lethal cardiotoxic factor (CSS-CTF II) was an aromatic alkaloid compound with -NH, > C = C < and -OH functional groups. The molecular weight was found to be 413 dalton. LD50 of CSS-CTF II was found to be 42.5 mg/kg (i.v) in Swiss albino male mice. Pharmacological studies showed that CSS-CTF II possesses hypotensive and cardiotoxic activities and produced death through apnoea in experimental animals but had no effect on nerve muscle preparations. The haematological and biochemical data also indicated the toxic nature of CSS-CTF II, through significant fall in haemoglobin, total RBC, WBC, platelet count and increased cardiac marker enzyme CPK and CPK-MB value in experimental animals. The present investigation thus established the toxic nature of CSS-CTF II isolated from edible fish C. striatus skin extract. Further work is needed to identify CSS-CTF II's mechanism of action and its antagonism for therapeutic purpose.

Year of leprosy control a short analytical study in a colony hospital at West Delhi.

The study was conducted from the patients attending mainly the Medical OPD revealed some fascinating facets. 56.66 % of patients were migrants settled in Delhi from endemic zones, rest of the patients were indigenous. Influx of migrants seemed likely to be risk factors to infection in a densely populated city like Delhi.43.33 % of patients harboured the disease for more then 2 years before initiation of treatment. It denotes the pathetic attitude of the patients. Relapse in 6.66 of case within I year of ALT in PB cases requires review as there is no justification in difference of treatment schedule for PB and MB cases. Chaulmoogra oil dressing in trophic ulcers was found to be very useful and may be extensively tried.