Role of Zinc Supplementation in Reducing Relapses in Steroid Sensitive Nephrotic Syndrome

2021 ◽  
Vol 17 (3) ◽  
pp. 236-240
Author(s):  
Fatima Hashmi ◽  
Shahzadi Sumbal Ghazi ◽  
Hassan Mumtaz ◽  
Maryum Amjad ◽  
Nahdia Zaman ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Zinc Supplementation ◽  
Controlled Trial ◽  
Steroid Sensitive Nephrotic Syndrome ◽  
Steroid Sensitive ◽  
Random Number Table ◽  
Group 2 ◽  
To Receive ◽  
Group 1

Objective: To evaluate and compare the effectiveness of zinc and B-Complex supplementation to prevent the recurrence of nephrotic syndrome in the cases priory responsive to corticosteroid therapy. Methodology It is a randomized controlled trial conducted at OPD Pediatric medicine, Shaheed Zulfiqar Ali Bhutto University, PIMS Children Hospital Islamabad from October 3, 2016 to April 2, 2017. 192 patients (96 in each group) were included in the study after obtaining informed consent from parents or guardians taken before determining the population. Patients were randomly assigned to two groups (Group 1: Zinc and Group 2: B-Complex) to receive oral zinc sulphate (10 mg / day) or B-Complex using a random number table. The patients were followed up after 4 months. All data were collected by the researchers themselves in a structured form. Results: The age of 192 participants of the trial averaged 6.38±3.42 years of age ranging from 1-12 years. There were 88 (45.8%) men and 104 (54.2%) women cases. In group 1, there were 22 (22.9%) and in group 2, there were 47 (49%) cases that had been pardoned. The recurrence of nephrotic syndrome was significantly higher in group 1 than group 2 (p = <0.001). Conclusion: The findings of this study suggest that Zinc supplementation is more preferrable to B-Complex supplementation as the rate of continuous remission was higher in the zinc group, so in the future may be added to the treatment regimen to treat steroid-sensitive nephrotic syndrome.

scholarly journals A descriptive retrospective study on children with newly diagnosed nephrotic syndrome presented to Tripoli Children Hospital during the period between Jan. to Dec. 2014

2016 ◽  
Author(s):  
Naziha Ramadan Rhuma ◽  
Awatif S El Boeshi ◽  
Laila T Sabei ◽  
Azza M Kara
Keyword(s):  
Nephrotic Syndrome ◽  
Retrospective Study ◽  
Family History ◽  
Steroid Therapy ◽  
Idiopathic Nephrotic Syndrome ◽  
Newly Diagnosed ◽  
Steroid Sensitive Nephrotic Syndrome ◽  
Steroid Sensitive ◽  
Group 2 ◽  
Group 1

Introduction: Nephrotic syndrome is a clinical picture characterized by severe proteinuria, hypoalbuminemia, edema and hypercholesterolemia. A retrospective study was carried out in order to describe disease pattern in newly diagnosed nephrotic syndrome of children admitted to Tripoli children hospital during the year 2014.Methods: The medical data of 56 patients aged between 1 year and 11 years diagnosed with idiopathic nephrotic syndrome were analysed using SPSS software. The data included gender differences, sensitivity to steroid therapy, relapses during six months of follow up and the effect of variable factors such as family history, hypertension, hematuria, serum urea on the degree of relapse.Results: Out of 56 patients with newly diagnosed nephrotic syndrome (NS), 60.7% were boys and 39.3% were girls, with a mean age 4.2±2.2 years. Age  was related significantly to the response to steroid therapy, where 79.5% of patients aged between 2-8 years (group 1) had steroid sensitive nephrotic syndrome (SSNS) compared with only 41.7% of patients aged less than 2 years or more than 8 years (group 2)  (P<0.001).  Although girls relapsed more than boys (70.5% versus 57.1%) during six months of therapy, this difference was not statistically significant. Similarly, no other factors measured such as family history of NS, hypertension, hematuria, serum complement and urea had any effect on the percentage of relapse in patients with newly diagnosed NS.  Conclusion: NS is one of the commonest reasons for admission to nephrology ward. It is more common in boys than girls. The age at presentation related significantly to the response to steroidal therapy. Regarding relapses, girls seems to relapse more frequent than boys and relapses was seen more in age group 1 than group 2, however, these differences were not significant. Other factors studied seems to have no effect on the relapse rate of children with newly diagnosed NS.Key-words: Idiopathic nephrotic syndrome, Steroid sensitive nephrotic syndrome, Steroid resistant nephrotic syndrome, Proteinuria.

Effect of Chlorhexidine Cleansing of Umbilical Cord for Prevention of Infection

2018 ◽  
Vol 4 (2) ◽  
pp. 35-39
Author(s):  
Md Khairuzzaman ◽  
MA Mannan ◽  
Abdul Matin ◽  
Mst Monjuman Ara Sarker ◽  
Nihar Ranjan Sarker ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Controlled Trial ◽  
Care Group ◽  
Cord Care ◽  
Randomized Controlled ◽  
Group 3 ◽  
Group 2 ◽  
To Receive ◽  
Level Hospital ◽  
Group 1

Background: Chlorhexidine cleansing of the cord can reduce neonatal mortality among newborns.Objective: The aim of study was to determine the effect of cord cleansing with chlorhexidine in reduction of umbilical infection among newborns in hospital settings.Methodology: This randomized controlled trial was carried out between April 2013 to July 2014 and 510 newborns were randomly assigned within a tertiary level hospital in Bangladesh to receive 1 of 3 cord care regimens single cord cleansing with 4% chlorhexidine(Group-1), multiple cord cleansing with 4% chlorhexidine (Group-2)  and clean and dry cord care (Group-3 : control).Results: The risk of umbilical cord infection (omphalitis) was significantly reduced in both the single (Relative risk [RR] 0.15 [95% CI] 0.008-0.93) and multiple chlorhexidine cleansing group (RR 0.37 [95% CI] 0.04- 0.99) compared to the dry cord care group.  The risk of omphalitis was not significantly different between multiple and single chlorhexidine cleansing group (RR 3.14 [0.13-76.54]). Conclusion: Chlorhexidine significantly reduce the risk of umbilical infection in both single and multiple cord cleansing neonates.Bangladesh Journal of Infectious Diseases 2017;4(2):35-39

Role of intermittent pneumatic compression in the treatment of breast cancer–related lymphoedema: a randomized controlled trial

2019 ◽  
Vol 34 (2) ◽  
pp. 220-228 ◽  
Author(s):  
Engin Tastaban ◽  
Aykut Soyder ◽  
Elif Aydin ◽  
Omer Faruk Sendur ◽  
Yasemin Turan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trial ◽  
Excess Volume ◽  
Controlled Trial ◽  
Intermittent Pneumatic Compression ◽  
University Hospital ◽  
Randomized Controlled ◽  
Group 2 ◽  
Group 1

Objective: To evaluate the role of intermittent pneumatic compression in the treatment of breast cancer–related lymphoedema. Design: Randomized controlled trial. Setting: Physical medicine and rehabilitation clinic at a university hospital. Subjects: Seventy-six patients with lymphoedema. Interventions: Patients were allocated into Group 1 (complex decongestive treatment, n = 38) and Group 2 (complex decongestive treatment + intermittent pneumatic compression, n = 38). The complex decongestive treatment involved skin care, manual lymphatic drainage, compression bandaging, and exercise for 20 sessions. Group 2 additionally received intermittent pneumatic compression. Main measures: Quantitative outcomes consisted of volumetric measures prior to and after the treatment. Clinical assessments included severity of pain, heaviness and tightness, disability, grip strength, and depression. Results: Lymphoedema was similar at baseline, but treatments significantly reduced the excess volume (from 373 mL to 203 mL in Group 1 and 379.5 mL to 189.5 mL in Group 2). Percentage excess volumes (PEVs) decreased in both groups. The percentage reduction of excess volume was better in Group 2 than Group 1, but the intergroup difference was not significant. The clinical scores reflected improvements, but the heaviness and tightness read significantly lower in Group 2 than Group 1. Conclusion: Intermittent pneumatic compression seems to add no benefit when combined with complex decongestive treatment of lymphoedema, but, may be functional in reducing the sensations of heaviness and tightness for the patients with pitting oedema.

scholarly journals Circulating extracellular vesicles of steroid sensitive nephrotic syndrome patients have higher RAC1 and induce recapitulation of nephrotic syndrome phenotype in podocytes

2021 ◽  
Author(s):  
Fehime Kara Eroglu ◽  
Volkan Yazar ◽  
Ulku Guler ◽  
Muzaffer Yıldırım ◽  
Tugce Yildirim ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Extracellular Vesicles ◽  
Particle Number ◽  
Biologically Active ◽  
Soluble Mediator ◽  
Steroid Sensitive Nephrotic Syndrome ◽  
Steroid Sensitive

Since previous research suggests a role of a circulating factor in the pathogenesis of steroid-sensitive nephrotic syndrome (SSNS), we speculated that circulating plasma extracellular vesicles (EVs) are a candidate source of such a soluble mediator. Here, we aimed to characterize and try to delineate the effects of these EVs in vitro. Plasma EVs from 20 children with SSNS in relapse and remission, 10 healthy controls and 6 disease controls were obtained by serial ultracentrifugation. Characterization of these EVs was performed by electron microscopy, flow cytometry and western blotting. The major proteins from the plasma EVs were identified via mass spectrometry. A Gene Ontology classification analysis and integuinity pathway analysis were performed on selectively expressed EV proteins during relapse. Immortalized human podocyte culture was used to detect the effects of EVs on podocytes. The protein content and the particle number of plasma EVs were significantly increased during NS relapse. Relapse NS EVs selectively express proteins which involved actin cytoskeleton rearrangement. Among these, the level of RAC-GTP was significantly increased in relapse EVs compared to remission and disease control EVs. Relapse EVs were efficiently internalized by podocytes and induced significantly enhanced motility and albumin permeability. Moreover, relapse EVs induced significantly higher levels of RAC-GTP and phospho p38 (p-p38) and decreased levels of synaptopodin in podocytes. Circulating relapse EVs are biologically active molecules that carry active RAC1 as cargo and induce recapitulation of the nephrotic syndrome phenotype in podocytes in vitro.

scholarly journals Polymorphic variants of MIF gene and prognosis in steroid therapy in children with idiopathic nephrotic syndrome.

2014 ◽  
Vol 61 (1) ◽  
Author(s):  
Monika Świerczewska ◽  
Danuta Ostalska-Nowicka ◽  
Bartosz Kempisty ◽  
Aleksandra Szczepankiewicz ◽  
Michał Nowicki
Keyword(s):  
Nephrotic Syndrome ◽  
Linkage Disequilibrium ◽  
Steroid Therapy ◽  
Molecular Mechanisms ◽  
Statistical Significance ◽  
Steroid Resistance ◽  
Steroid Sensitive Nephrotic Syndrome ◽  
Steroid Sensitive ◽  
Polymorphic Variants

Nephrotic syndrome (NS) is the most common reason of proteinuria in children and can be caused by the pathology of renal glomeruli. Steroid therapy is typically used in this disorder. It has been shown that MIF is a cytokine which counteracts the immunosuppressive properties of glucocorticoids. The aim of this study was looking for a correlation between MIF polymorphisms and genetic susceptibility to steroid resistance in children with INS (Idiopathic NS). The study was performed in 71 patients with INS including SRNS (steroid resistance nephrotic syndrome) (41) and SSNS (steroid sensitive nephrotic syndrome) (30) and in 30 control subjects. We employed Sanger sequencing and capillary electrophoresis. Linkage disequilibrium was made using Haploview and PHASE. We didn't observe a statistical significance between SNPs detected in patients with INS and controls. Our studies revealed statistical significance for two polymorphisms: rs2070767C > T and rs2000466T > G between patients with SRNS and SSNS. The results for rs34383331T > A are close to being statistically significant. Statistical significance was revealed for CATT5/CATT6 genotype in SRNS group vs SSNS group (OR=4.604, 95%CI=1.356-15.632, p=0.0168). We found that the frequency of 5/X-CATT genotype compared with X/X-CATT genotype was significantly higher in SRNS patients vs SSNS (OR=3.167, 95%CI=1.046-9.585, p=0.0426). In linkage disequilibrium analysis we didn't show involvement in susceptibility to INS and steroid sensitive phenotype. Our results suggest that the role of MIF polymorphisms in the susceptibility to positive response to steroid therapy is still unresolved. It indicates that MIF may be involved in indirect and complex molecular mechanisms of steroid activity in hormone-dependent metabolic pathways in children with INS. Because of ambiguous findings, pleiotropic features of this cytokine require that more research should be undertaken.

scholarly journals Steroid treatment for the first episode of childhood nephrotic syndrome: comparison of the 8 and 12 weeks regimen using an individual patient data meta-analysis

2021 ◽  
Author(s):  
Anne M. Schijvens ◽  
Nynke Teeninga ◽  
Eiske M. Dorresteijn ◽  
Steven Teerenstra ◽  
Nicholas J. Webb ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Steroid Treatment ◽  
First Episode ◽  
Childhood Nephrotic Syndrome ◽  
Steroid Sensitive Nephrotic Syndrome ◽  
Steroid Sensitive ◽  
First Relapse ◽  
Steroid Regimen

AbstractSteroids are the cornerstone of the treatment of childhood nephrotic syndrome. The optimal duration for the first episode remains a matter of debate. The aim of this study is to determine whether the 8 weeks International Study of Kidney Disease in Children (ISKDC) regimen is equally effective as the 12 weeks steroid regimen from the German society of pediatric nephrology (Arbeitsgemeinschaft für Pädiatrische Nephrologie [APN]). An individual patient data (IPD) meta-analysis of randomized controlled trials reporting on prednisolone treatment for a first episode of childhood nephrotic syndrome was conducted. European trials aimed at investigating the ISKDC and/or APN steroid regimen were selected. The lead investigators of the selected trials were requested to provide the IPD of the specific treatment groups. Four trials included European cohorts using dosing schedules according to the regimens studied. IPD of two trials were available. A significant difference was found in time to first relapse after cessation of steroid treatment between the 8 and 12 weeks treatment group with a median time to relapse of 29 and 63 days, respectively. Moreover, relapse rate ratios during total follow-up were 51% higher for the 8 weeks regimen. Finally, younger children have a significantly lower time to first relapse and frequently relapsing nephrotic syndrome.Conclusions: The results of this IPD meta-analysis suggest that the 8 weeks steroid regimen for a first episode of steroid-sensitive nephrotic syndrome may not be equally effective as the 12 weeks steroid regimen. Moreover, this study highlights the importance of using uniform definitions to enable accurate comparison and interpretation of trial results.Trial registration: Registration number: CRD42020199244, date of registration 16-08-2020 What is Known:• Steroids are the cornerstone of the treatment of childhood nephrotic syndrome, however the optimal duration for the first episode remains a matter of debate.• Currently, the 8 weeks ISKDC protocol and 12 weeks APN protocol are among the most frequently used protocols in Europe. What is New:• The 8 weeks steroid regimen for a first episode of steroid-sensitive nephrotic syndrome may not be equally effective as the 12 weeks steroid regimen for the treatment of a first episode of nephrotic syndrome.• Younger children have a significantly shorter time to first relapse and time to frequent relapsing nephrotic syndrome.

scholarly journals The role of inhibition of osteocyte apoptosis in mediating orthodontic tooth movement and periodontal remodeling: a pilot study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Michele Kaplan ◽  
Zana Kalajzic ◽  
Thomas Choi ◽  
Imad Maleeh ◽  
Christopher L. Ricupero ◽  
...  
Keyword(s):  
Bone Density ◽  
Alveolar Bone ◽  
Tooth Movement ◽  
Orthodontic Tooth Movement ◽  
Tartrate Resistant Acid Phosphatase ◽  
Osteocyte Apoptosis ◽  
Saline Administration ◽  
Group 2 ◽  
Group 1

Abstract Background Orthodontic tooth movement (OTM) has been shown to induce osteocyte apoptosis in alveolar bone shortly after force application. However, how osteocyte apoptosis affects orthodontic tooth movement is unknown. The goal of this study was to assess the effect of inhibition of osteocyte apoptosis on osteoclastogenesis, changes in the alveolar bone density, and the magnitude of OTM using a bisphosphonate analog (IG9402), a drug that affects osteocyte and osteoblast apoptosis but does not affect osteoclasts. Material and methods Two sets of experiments were performed. Experiment 1 was used to specifically evaluate the effect of IG9402 on osteocyte apoptosis in the alveolar bone during 24 h of OTM. For this experiment, twelve mice were divided into two groups: group 1, saline administration + OTM24-h (n=6), and group 2, IG9402 administration + OTM24-h (n=6). The contralateral unloaded sides served as the control. The goal of experiment 2 was to evaluate the role of osteocyte apoptosis on OTM magnitude and osteoclastogenesis 10 days after OTM. Twenty mice were divided into 4 groups: group 1, saline administration without OTM (n=5); group 2, IG9402 administration without OTM (n=5); group 3, saline + OTM10-day (n=6); and group 4, IG9402 + OTM10-day (n=4). For both experiments, tooth movement was achieved using Ultra Light (25g) Sentalloy Closed Coil Springs attached between the first maxillary molar and the central incisor. Linear measurements of tooth movement and alveolar bone density (BVF) were assessed by MicroCT analysis. Cell death (or apoptosis) was assessed by terminal dUTP nick-end labeling (TUNEL) assay, while osteoclast and macrophage formation were assessed by tartrate-resistant acid phosphatase (TRAP) staining and F4/80+ immunostaining. Results We found that IG9402 significantly blocked osteocyte apoptosis in alveolar bone (AB) at 24 h of OTM. At 10 days, IG9402 prevented OTM-induced loss of alveolar bone density and changed the morphology and quality of osteoclasts and macrophages, but did not significantly affect the amount of tooth movement. Conclusion Our study demonstrates that osteocyte apoptosis may play a significant role in osteoclast and macrophage formation during OTM, but does not seem to play a role in the magnitude of orthodontic tooth movement.

scholarly journals Distribution of serum adiponectin isoforms in pediatric patients with steroid-sensitive nephrotic syndrome

2021 ◽  
Author(s):  
Tetsuro Tamai ◽  
Kaori Kamijo ◽  
Yoshifusa Abe ◽  
Satoshi Hibino ◽  
Shunsuke Sakurai ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Nephrotic Syndrome ◽  
Pediatric Patients ◽  
Serum Adiponectin ◽  
Total Serum ◽  
Control Subjects ◽  
Remission Period ◽  
Total Adiponectin ◽  
Steroid Sensitive Nephrotic Syndrome ◽  
Steroid Sensitive

Abstract Background Serum adiponectin circulates in three multimeric isoforms: high-molecular-weight (HMW), middle-molecular-weight (MMW), and low-molecular-weight (LMW) isoforms. Potential change in the circulating adiponectin levels in patients with nephrotic syndrome (NS) remain unknown. This study aimed to assess the levels of total adiponectin and the distribution of its isoforms in pediatric patients with NS. Methods We sequentially measured total adiponectin and each adiponectin isoform levels at the onset of NS, initial remission, and during the remission period of the disease in 31 NS patients. We also calculated the ratios of HMW (%HMW), MMW (%MMW), and LMW (%LMW) to total adiponectin incuding 51 control subjects. Results The median of total serum adiponectin levels in patients were 36.7, 36.7, and 20.2 μg/mL at the onset, at initial remission, and during the remission period of NS, respectively. These values were significantly higher than those in control subjects. The median values of %HMW, %MMW, and %LMW values were 56.9/27.0/14.1 at the onset, 62.0/21.8/13.4 at the initial remission, and 58.1/21.7/17.5 at during the remission period of NS, respectively. Compared with control subjects, %HMW at initial remission and %MMW at the onset were high, and the %LMW values at the onset and at initial remission were low. Conclusions In patients with NS, total serum adiponectin levels increase at the onset of the disease, and the ratio of adiponectin isoforms changes during the course of the disease. Further studies are needed to delineate the mechanisms between proteinuria and adiponectin isoforms change.

Sign in / Sign up

Export Citation Format

Share Document