Benzene, toluene and xylene (BTX) pollution in ambient air: a case study.

Volatile Organic Compounds (VOCs) in presence of sunlight and oxides of nitrogen in atmosphere are considered as precursors for ozone production at the ground level. Concentration of Benzene, Toluene and Xylene (BTX) in ambient air was measured near seven traffic junctions in the city of Nagpur. Air samples were collected using Organic Vapour Sampler and analyzed by Gas Chromatograph equipped with Flame Ionization Detector (FID). Benzene concentration was found to be in the range 9.3 to 28.7 microg/m3, Toluene 3.26 to 21.0 microg/m3 and Xylene 4.9 to 15.0 microg/m3. These values are lower than those found in Metropolitan cities like Mumbai.

Steroid sensitive nephrotic syndrome.

Nephrotic syndrome in children is a common recurrent disease. Most of the cases are due to minimal change disease with a favourable outcome. More than 90% of children with minimal change disease respond to corticosteroid therapy (steroid sensitive nephrotic syndrome). 40-60% experience frequent relapses or have steroid dependence. These children require frequent corticosteroid therapy and/or immunomodulators or treatment with immunosuppressants, and are at high risk of cumulative steroid toxicity and side effects of cytotoxic therapy. Children with frequent relapses or steroid dependence should be managed in consultation with a pediatric nephrologist. Despite relapsing course, progression of minimal change nephrotic syndrome to end stage renal disease is extremely rare.

Pediatric renal transplantation--Indian experience.

OBJECTIVE: To analyze our experience with renal transplantation in children with end-stage renal disease (ESRD) in India. DESIGN: Retrospective study. METHODS: Over the last 7.5 years, 27 renal transplants were performed on children below 12 years of age, 8 children were less than 6 years old, 19 were between 6 and 12 years of age. Sixteen children had underlying glomerular disease while eleven had tubulointerstitial renal disease. Transperitoneal approach was used in smaller recipients weighing less than 12 kg. Extraperitoneal approach was used in the remainder. Triple immunosuppression with Cyclosporine, Azathioprine and Steroids was used in all cases. RESULTS: Follow-up period ranged from 6 months to 7.5 years (mean 3.7 years). There were 10 episodes of acute rejection. Three cases of acute rejection failed to respond to therapy. No surgical complications were encountered. Graft survival was 73.2% at one year and 71% at two years. Satisfactory rehabilitation was achieved in children with functioning grafts. CONCLUSIONS: Renal transplantation in children in India offers an acceptable choice in ESRD as anywhere in the world.

Cyclosporine experience in nephrotic syndrome.

OBJECTIVE: To analyze the use of Cyclosporine (CyA) in nephrotic syndrome. METHODS: Thirty five children of mean age of 5.9 years with steroid dependent (n = 26) or steroid resistant (n = 9) primary nephrotic syndrome with normal renal functions and who received CyA were studied. CyA was used at a dosage of 6-7 mg/kg/day orally in two divided doses. The mean duration of therapy was 9.6 weeks. All received a minimum of 8 weeks of CyA therapy. In a few who received longer therapy, the dose was reduced to 4 mg/kg/day. All patients were monitored serially for hepatotoxicity and nephrotoxicity. The nephrotic state was evaluated serially with biochemical tests and followed up for a mean period of 2.55 years. RESULTS: Thirty one patients completed the study. The response to therapy was categorized into 5 groups-no response (4 patients), good response (4 patients), partial response (4 patients), cyclosporine dependence (16 patients), and infrequent relapsers (3 patients). Good response was defined as complete remission lasting for at least one year after cessation of therapy. Patients who showed partial response had reduction in quantitative proteinuria and needed less diuretics. Sixteen patients went into complete remission while on therapy but relapsed within 3 months of discontinuation (CyA dependence). The response to CyA correlated more with steroid-responsiveness than with the underlying histopathology. The drug was well tolerated. CONCLUSION: In steroid-dependent or steroid-resistant nephrotic children with normal renal functions, CyA therapy may be considered as one of the possible therapeutic options. Our results suggest that a longer duration of CyA therapy may possibly be indicated in these cases.