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Article ; Online: Interpreting Estimated GFR Variability and Its Clinical Significance.

Malhotra, Rakesh / Chopra, Tushar / Ix, Joachim H

Kidney medicine

2023 Volume 5, Issue 2, Page(s) 100599

Language	English
Publishing date	2023-01-11
Publishing country	United States
Document type	Editorial
ISSN	2590-0595
ISSN (online)	2590-0595
DOI	10.1016/j.xkme.2023.100599
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Article ; Online: Dialysate Calcium: A Lot More Than 'Set It and Forget It'.

Garimella, Pranav S / Malhotra, Rakesh

Kidney medicine

2019 Volume 1, Issue 5, Page(s) 238–241

Language	English
Publishing date	2019-09-12
Publishing country	United States
Document type	Editorial ; Comment
ISSN	2590-0595
ISSN (online)	2590-0595
DOI	10.1016/j.xkme.2019.05.005
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Article ; Online: Understanding migraine

Rakesh Malhotra

Annals of Indian Academy of Neurology, Vol 19, Iss 2, Pp 175-

Potential role of neurogenic inflammation

2016 Volume 182

Abstract: Neurogenic inflammation, a well-defined pathophysiologial process is characterized by the release of potent vasoactive neuropeptides, predominantly calcitonin gene-related peptide (CGRP), substance P (SP), and neurokinin A from activated peripheral ... ...

Abstract	Neurogenic inflammation, a well-defined pathophysiologial process is characterized by the release of potent vasoactive neuropeptides, predominantly calcitonin gene-related peptide (CGRP), substance P (SP), and neurokinin A from activated peripheral nociceptive sensory nerve terminals (usually C and A delta-fibers). These peptides lead to a cascade of inflammatory tissue responses including arteriolar vasodilation, plasma protein extravasation, and degranulation of mast cells in their peripheral target tissue. Neurogenic inflammatory processes have long been implicated as a possible mechanism involved in the pathophysiology of various human diseases of the nervous system, respiratory system, gastrointestinal tract, urogenital tract, and skin. The recent development of several innovative experimental migraine models has provided evidence suggestive of the involvement of neuropeptides (SP, neurokinin A, and CGRP) in migraine headache. Antidromic stimulation of nociceptive fibers of the trigeminal nerve resulted in a neurogenic inflammatory response with marked increase in plasma protein extravasation from dural blood vessels by the release of various sensory neuropeptides. Several clinically effective abortive antimigraine medications, such as ergots and triptans, have been shown to attenuate the release of neuropeptide and neurogenic plasma protein extravasation. These findings provide support for the validity of using animal models to investigate mechanisms of neurogenic inflammation in migraine. These also further strengthen the notion of migraine being a neuroinflammatory disease. In the clinical context, there is a paucity of knowledge and awareness among physicians regarding the role of neurogenic inflammation in migraine. Improved understanding of the molecular biology, pharmacology, and pathophysiology of neurogenic inflammation may provide the practitioner the context-specific feedback to identify the novel and most effective therapeutic approach to treatment. With this objective, the present review summarizes the evidence supporting the involvement of neurogenic inflammation and neuropeptides in the pathophysiology and pharmacology of migraine headache as well as its potential significance in better tailoring therapeutic interventions in migraine or other neurological disorders. In addition, we have briefly highlighted the pathophysiological role of neurogenic inflammation in various other neurological disorders.
Keywords	Migraine ; neurogenic inflammation ; neuropeptides ; Neurology. Diseases of the nervous system ; RC346-429 ; Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571 ; Internal medicine ; RC31-1245 ; Medicine ; R
Subject code	610
Language	English
Publishing date	2016-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Race, Sex, and Kidney Disease Trial Participation.

Alahamadi, Ziad / Agarwal, Krishna / Wen, Alexander / Gupta, Vineet / Chopra, Tushar / Khan, Adnan / Malhotra, Rakesh

Kidney medicine

2022 Volume 5, Issue 3, Page(s) 100594

Language	English
Publishing date	2022-12-24
Publishing country	United States
Document type	Journal Article
ISSN	2590-0595
ISSN (online)	2590-0595
DOI	10.1016/j.xkme.2022.100594
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Article: Dynamics of

Manhas, Prem Lata / Sharma, Megha / Mewara, Abhishek / Sachdeva, Man Updesh / Sehgal, Rakesh / Malhotra, Pankaj

Indian journal of microbiology

2023 Volume 63, Issue 3, Page(s) 380–385

Abstract: Introduction: Malaria in pregnancy causes a dual brunt on the mother as well as the foetus. Upregulation of T-regulatory cells (Tregs) during pregnancy allows tolerance towards the growing foetus, their suppression predisposes the mother to infections. ... ...

Abstract	Introduction: Malaria in pregnancy causes a dual brunt on the mother as well as the foetus. Upregulation of T-regulatory cells (Tregs) during pregnancy allows tolerance towards the growing foetus, their suppression predisposes the mother to infections. This study analyzed the levels of CD3 Methodology: Total of 114 mice, non-pregnant non-infected (n = 6), non-pregnant infected (n = 12), pregnant non-infected (n = 48) and pregnant infected (n = 48) were included in the study. Infected groups were inoculated intra-peritoneally with 1 × 10 Results: The parasitaemia was significantly higher among early pregnancy infected mice (≥ 70%) than mid-pregnancy infected (40-70%), late pregnancy infected (50-65%), and non-pregnant infected mice (≤ 50%) ( Conclusion: In contrast to non-pregnant mice, the levels of Tregs among pregnant mice decrease when malaria infection is acquired thereby leading to adverse pregnancy outcomes. Supplementary information: The online version contains supplementary material available at 10.1007/s12088-023-01089-2.
Language	English
Publishing date	2023-08-26
Publishing country	India
Document type	Journal Article
ZDB-ID	413422-9
ISSN	0973-7715 ; 0046-8991
ISSN (online)	0973-7715
ISSN	0046-8991
DOI	10.1007/s12088-023-01089-2
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Article: Violence Within Food Deserts: A Block-Group Examination of Food Access, Racial Composition, and Violent Crime.

Boehme, Hunter M / Kaminski, Robert J / Mulrooney, Timothy / Brown, Robert A / Malhotra, Rakesh

Violence and victims

2023 Volume 38, Issue 3, Page(s) 435–456

Abstract: While there is substantial public health literature that documents the negative impacts of living in "food deserts" (e.g., obesity and diabetes), little is known regarding whether living in a food desert is associated with increased criminal ... ...

Abstract	While there is substantial public health literature that documents the negative impacts of living in "food deserts" (e.g., obesity and diabetes), little is known regarding whether living in a food desert is associated with increased criminal victimization. With the block group as the unit of analysis, the present study examines whether there is a relationship between food deserts and elevated crime counts, and whether this relationship varies by racial composition. Results from multiple count models suggest that living in a food desert is not associated with higher levels of violent or property crime. But multiplicative models interacting percent Black with food deserts revealed statistically significant associations with violent crime but not property crime. Alternatively, multiplicative models interacting percent White with food deserts revealed statistically significant associational reductions in violent crimes. Several policy and research implications are discussed.
MeSH term(s)	Humans ; Food Deserts ; Violence ; Crime ; Crime Victims ; Aggression
Language	English
Publishing date	2023-05-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	639280-5
ISSN	1945-7073 ; 0886-6708
ISSN (online)	1945-7073
ISSN	0886-6708
DOI	10.1891/VV-2022-0007
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Article: Coverage of a Population-Based Non-Communicable Disease Screening Program Using Lot Quality Assurance Sampling in Rural North India: A Mixed Methods Study.

Lognathan, Vignesh / Malhotra, Sumit / Kumar, Rakesh / Krishnan, Anand / Gupta, Sanjeev K / Nongkynrih, Baridalyne

Cureus

2023 Volume 15, Issue 2, Page(s) e35330

Abstract: Aim: We aimed to estimate the coverage of a population-based Non-communicable Disease (NCD) screening program using lot quality assurance sampling (LQAS) and identify factors affecting its implementation in district Nuh of Haryana, India.: Method: A ... ...

Abstract	Aim: We aimed to estimate the coverage of a population-based Non-communicable Disease (NCD) screening program using lot quality assurance sampling (LQAS) and identify factors affecting its implementation in district Nuh of Haryana, India. Method: A mixed-methods study was conducted with an initial LQAS coverage survey, followed by in-depth interviews. Thirty lots (villages or towns) were sampled in the district, and 20 people aged ≥ 30 years were randomly sampled from each lot. Participants were asked about receiving services under the program. Weighted coverage estimates, which is the proportion of people who had received screening services, were estimated. Using a decision value of more than nine negative responses out of 20 persons, all 30 lots were classified as good or poor performing. In-depth interviews of healthcare providers of good performing lots and district-level health officials were conducted, and factors affecting program implementation were identified. Findings: Six hundred participants were interviewed (mean age of 44.8 years, 57.2% women). The proportion of people who reported having undergone screening for diabetes or hypertension was 2.1%, and all lots performed poorly based on decision value. Key factors affecting the program were leadership, prioritization of NCD activities, ensuring human resource and material requirements, regular incentives, qualities of workers, and community engagement. Conclusion: The screening coverage under the population-based NCD screening program was low in district Nuh, Haryana. This needs to be improved by addressing the identified health system and community-related factors.
Language	English
Publishing date	2023-02-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.35330
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Article ; Online: Risk of de novo proteinuria following hospitalization with acute kidney injury.

Bonde, Saniya S / Zaman, Warda / Cuomo, Raphael / Malhotra, Rakesh / Macedo, Etienne

BMC nephrology

2023 Volume 24, Issue 1, Page(s) 176

Abstract: Background: Acute Kidney Injury (AKI) incidence has continued to rise and is recognized as a major risk factor for kidney disease progression and cardiovascular complications. Early recognition of factors associated with post-AKI complications is ... ...

Abstract	Background: Acute Kidney Injury (AKI) incidence has continued to rise and is recognized as a major risk factor for kidney disease progression and cardiovascular complications. Early recognition of factors associated with post-AKI complications is fundamental to stratifying patients that could benefit from closer follow-up and management after an episode of AKI. Recent studies have shown that proteinuria is a prevalent sequela after AKI and a strong predictor of complications post-AKI. This study aims to evaluate the frequency and timing of the development of de-novo proteinuria after an AKI episode in patients with known kidney function and no prior history of proteinuria. Methods: We retrospectively analyzed data from adult AKI patients with pre- and post-kidney function information between Jan 2014 and March 2019. The presence of proteinuria determined before and after index AKI encounter was based on ICD-10 code and/or urine dipstick and UPCR during the follow-up period. Results: Of 9697 admissions with AKI diagnoses between Jan 2014 and March 2019, 2120 eligible patients with at least one assessment of Scr and proteinuria before AKI index admission were included in the analysis. The median age was 64 (IQR 54-75) years, and 57% were male. 58% (n-1712) patients had stage 1 AKI, 19% (n = 567) stage 2 AKI, and 22% (n = 650) developed stage 3 AKI. De novo proteinúria was found in 62% (n = 472) of patients and was already present by 90 days post-AKI in 59% (209/354). After adjusting for age and comorbidities, severe AKI (stage 2/3 AKI) and diabetes, were independently associated with increased risk for De novo proteinuria. Conclusion: Severe AKI is an independent risk factor for subsequent de novo proteinuria post-hospitalization. Further prospective studies are needed to determine whether strategies to detect AKI patients at risk of proteinuria and early therapeutics to modify proteinuria can delay the progression of kidney disease.
MeSH term(s)	Adult ; Humans ; Male ; Middle Aged ; Female ; Retrospective Studies ; Glomerular Filtration Rate ; Proteinuria/diagnosis ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Hospitalization ; Risk Factors
Language	English
Publishing date	2023-06-15
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2041348-8
ISSN	1471-2369 ; 1471-2369
ISSN (online)	1471-2369
ISSN	1471-2369
DOI	10.1186/s12882-023-03209-y
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Article: Spectrum of Non diabetic kidney disease in patients with type 2 diabetes and its clinicopathological correlation.

Agarwal, Megha / Dabas, Geeta / Agrawal, Dhananjai / Gupta, Rakesh / Malhotra, Vinay

The Journal of the Association of Physicians of India

2022 Volume 70, Issue 4, Page(s) 11–12

Abstract: Diabetes mellitus (DM) is the leading cause of chronic kidney disease worldwide chiefly attributable to diabetic nephropathy (DN). In these patients, non diabetic kidney disease (NDKD) can also occur either alone or superimposed on diabetic nephropathy. ... ...

Abstract	Diabetes mellitus (DM) is the leading cause of chronic kidney disease worldwide chiefly attributable to diabetic nephropathy (DN). In these patients, non diabetic kidney disease (NDKD) can also occur either alone or superimposed on diabetic nephropathy. This study aimed to identify the prevalence and the etiology of NDKD in our center and also the clinical and laboratory parameters to help distinguish these two entities. Material: This was a cross sectional observational study. A total of 47 patients were enrolled in the study during the study period. In all the patients, kidney biopsy was done because of atypical presentations and was examined by light and immunofluorescence microscopy. The clinical & laboratory parameters and the biopsy findings were recorded in a standard proforma. Observation: A total of 47 patients (male/female: 34/13 and mean age 52.11±9.36) were included in the study. The chief co morbidity was hypertension which was present in 61.7% of patients. The most common indication of biopsy was nephrotic presentation (38.3%) followed by nephritic illness (25.5%). The prevalence of NDKD in our study cohort was 85.1% of which isolated NDKD was 57.4% and NDKD + DN was 27.7%. The most common histological lesion were membranous glomerulopathy and focal segmental glomerulosclerosis (FSGS) each with a frequency of 15% followed by chronic tubulointerstitial nephritis (CTIN), IgA nephropathy and others. There was significant difference in the median duration of diabetes in these groups and it was around 5 years less in the NDKD group. There was no difference among three groups in term of eGFR, HbA1C and proteinuria. Conclusion: Our study demonstrated a high prevalence of NDKD in the patients with type 2 diabetes. The duration of diabetes was the strongest predictor of NDKD. Kidney biopsy should be undertaken liberally whenever there is strong clinical suspicion especially in the presence of atypical features. The exact histological diagnosis can clarify the further treatment planning as well as the prognosis.
MeSH term(s)	Adult ; Biopsy ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/epidemiology ; Diabetic Nephropathies/diagnosis ; Diabetic Nephropathies/epidemiology ; Female ; Glomerulonephritis, IGA/complications ; Glomerulonephritis, IGA/epidemiology ; Glomerulonephritis, IGA/pathology ; Humans ; Kidney/pathology ; Kidney Diseases/diagnosis ; Male ; Middle Aged ; Proteinuria ; Retrospective Studies
Language	English
Publishing date	2022-04-20
Publishing country	India
Document type	Journal Article ; Observational Study
ZDB-ID	800766-4
ISSN	0004-5772
ISSN	0004-5772
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Article: Role of Rituximab in Patients with Resistant Nephrotic Syndrome.

Singh, Seetaram / Agarwal, Dhananjai / Gupta, Rakesh / Malhotra, Vinay / Bhardwaj, Shashank

The Journal of the Association of Physicians of India

2022 Volume 70, Issue 4, Page(s) 11–12

Abstract: Resistant nephrotic syndrome is a group of disorders with diverse histological findings, which are by definition resistant to corticosteroids given in adequate dose for adequate duration and many are resistant to other therapy as well. In many patients ... ...

Abstract	Resistant nephrotic syndrome is a group of disorders with diverse histological findings, which are by definition resistant to corticosteroids given in adequate dose for adequate duration and many are resistant to other therapy as well. In many patients progression to end-stage renal disease is the ultimate outcome. The role of B cells has not been fully explained in man, agents that specifically interfere with B cells would ideally represent the first step toward selective therapy. We studied short term and long term effects of rituximab in patients with resistent primary nephrotic syndrome. Material: Study was conducted at SMS-medical college and Hospital Jaipur, four doses of rituximab were given weakly, in fixed dose of 500 mg per dose and proteinuria was evaluated before start of therapy and at 3 months, 6 months and 12 months of therapy. Patients with resistant primary nephrotic syndrome who failed to respond to other therapies, with stable eGFR >30, and controlled BP were included in study. Patients with Active infection, Uncontrolled hypertension, pregnancy were excluded from study. Observation: 10 patients were enrolled in study out of which 7 FSGS (focal segmental glomeruloscllerosis) and 3 were IMN (idiopathic membranous nephropathy), 5 were female and 5 were male, age 17-61years (average 34.6), weight were 48-70 kg (avg 57.9), BMI 19.4-23 (AVG 21.18), all patients have normal renal function (average creatinine value of 0.8, range= 0.5 to 1.1). At 3 months 1 patient had partial response and 9 had no response. At 6 months of treatment 2 patients had partial response, 3 had complete response and 5 no response. At 12 months of treatment 4 had partial response, 5 had complete response and 1 no response. Out of 10 patients no one had relapse of Nephrotic syndrome at 12 month of therapy. Renal function remain normal in all patients over 12 months followup. Conclusion: This prospective, observational study evaluated 3 month, 6 month, and 12 month outcome of 3 IMN and 7 FSGS patients, with persistent nephrotic range proteinuria and showed that rituximab promoted sustained remission in proteinuria in resistent nephrotic syndrome with normal renal function.
MeSH term(s)	Adolescent ; Adult ; Female ; Glomerulonephritis, Membranous/chemically induced ; Glomerulonephritis, Membranous/drug therapy ; Glomerulosclerosis, Focal Segmental/chemically induced ; Glomerulosclerosis, Focal Segmental/drug therapy ; Humans ; Immunosuppressive Agents/therapeutic use ; Male ; Middle Aged ; Nephrotic Syndrome/drug therapy ; Prospective Studies ; Proteinuria/drug therapy ; Proteinuria/etiology ; Rituximab/therapeutic use ; Treatment Outcome ; Young Adult
Chemical Substances	Immunosuppressive Agents ; Rituximab (4F4X42SYQ6)
Language	English
Publishing date	2022-04-20
Publishing country	India
Document type	Journal Article ; Observational Study
ZDB-ID	800766-4
ISSN	0004-5772
ISSN	0004-5772
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