Shailesh Soni - Academia.edu (original) (raw)

Papers by Shailesh Soni

PubMed, Jan 4, 2022

Renal tumors comprise a wide spectrum of benign and malignant tumors. The important prognostic fa... more Renal tumors comprise a wide spectrum of benign and malignant tumors. The important prognostic factors in renal cell carcinoma include pathological stage, tumor grade, morphological type, sarcomatoid/rhabdoid differentiation, and tumor necrosis. Therefore, the pathologist needs to be fully aware of how to gross nephrectomy specimens to be able to accurately provide the above prognostic information while reporting adult kidney tumors. With the advent of nephron-sparing surgeries, due diligence should be exercised to assess and sample the parenchymal surgical margin. This article discusses the approach to grossing nephrectomy specimens, elaborates the significance of every step, and also sheds light on the importance of clinical and radiological information in providing a holistic approach to the diagnosis and staging of adult renal tumors.

Indian Journal of Transplantation, 2020

Background: There has been significant advancement in the field of renal transplantation in the l... more Background: There has been significant advancement in the field of renal transplantation in the last few decades. However, the long-term graft survival has not dramatically increased. Among all the infections, viral infections continue to be a major contributor to graft failure as well as severe mortality and morbidity in renal transplant recipients. Materials and Methods: It was a prospective, nonrandomized, observational study of the duration of 1 year that was conducted in live donor renal transplant recipients (n = 96). Blood samples were collected from all live renal allograft recipients at specified intervals and investigated for the viral infections. Glomerular filtration rate (GFR) and tacrolimus levels were measured at follow-ups. Results: Prior to renal transplant, the hepatitis C prevalence was the highest accounting for viral infection in 7.3% of the total study population. The study had pretransplant cytomegalovirus (CMV) and BK virus (BKV) infection rates of 1.04% each. CMV infection had the highest incidence rate occurring in 29.1% of the total population posttransplantation. There was significant incidence of CMV infection (CMV+) after rejection (P = 0.016). The incidence of BKV infection in our study through 1 year was 8.3%. The incidence of CMV infection correlated well with mean tacrolimus trough level of 10.58 ± 1.25 ng/mL. The mean estimated GFR (eGFR) at 12 months in infected patients was 65.12 ± 5.31 ml/min/1.73 m2 which was significantly lower compared to controls which was 75.53 ± 2.24 ml/min/1.73 m2 though they had comparable mean eGFR at baseline (P = 0.008). Conclusions: Hepatitis C was the dominant infection among all pretransplant viral infections. The highest incidence of CMV and BKV infection was after 6 months' posttransplant. Rejection was associated with CMV infection. All patients with BKV viremia had viruria. High level of tacrolimus was associated with CMV incidence. CMV infection was associated with lower eGFR at 1-year postrenal transplant.

Naunyn-schmiedebergs Archives of Pharmacology, Jun 15, 2023

European Journal of Pharmacology, Jun 1, 2023

Indian Journal of Cancer, 2020

The majority of testicular tumors are germ cell tumors (GCTs), but there are numerous other types... more The majority of testicular tumors are germ cell tumors (GCTs), but there are numerous other types, making testicular tumors one of the most diverse areas of human pathology, despite their relative rarity. Testicular tumors are usually diagnosed only after radical surgery, as biopsies are not performed. Further management of the patient is dependent on the diagnosis at microscopy, which itself is based on the sections taken at the time of grossing the specimen. Many pathologists often aren′t well versed with guidelines for handling of orchiectomy specimens and for microscopy. This article discusses, in detail, the approach to grossing of a testicular tumor specimen and elaborates of the reasons as to why we do what we do at the initial “cut-up”. It explains the logic behind the reporting guidelines for testicular tumors and offer a clinical primer to the pathologist as to why we do what we do while grossing testicular tumor specimens.

African Journal of Urology, Jan 3, 2023

Background: Primary renal squamous cell carcinoma is a scarce entity, and its presentation as a d... more Background: Primary renal squamous cell carcinoma is a scarce entity, and its presentation as a discharging sinus is still exceptionally rare. We hereby report a case of a renal cell carcinoma in a young gentleman. Case presentation: We report a case of a 20-year-old gentleman who presented with clinical features suggestive of left side xanthogranulomatous pyelonephritis (XGPN). He had undergone multiple endourological procedures for left side renal calculi in the past. We present the clinical presentation, diagnostic dilemmas and treatment for this patient. We performed an open radical nephrectomy for this patient. Our case report is unique from the point of view of nature of presentation to the final histopathological outcome in terms of age group of the patient. Here we present the clinical management and dilemmas in the management of this unusual and rare case. Conclusions: Our case report and presentation has taught us that we as clinicians must have a high index of suspicion for a renal malignancy when treating patients who present with pyonephrosis associated with long-standing calculi diseases, irrespective of the age group of the patient.

Research Square (Research Square), Nov 16, 2022

Calcium is the most abundant metabolite involved in the stone matrix. The CaSR gene controls calc... more Calcium is the most abundant metabolite involved in the stone matrix. The CaSR gene controls calcium homeostasis, and genetic variation in the CaSR gene could lead to the development of renal stone disease. Therefore, the current study has been designed to assess the association of genetic variants of CaSR gene polymorphisms with renal stone disease. Method A single-centric prospective study has been carried out on a total of 300 participants (150 cases and 150 controls). Serum levels of calcium, creatinine, parathyroid hormone, and 24 Hour urine metabolites were measured. Two polymorphisms, rs1801725 and rs1042636, of the CaSR gene, have been genotyped for each participant. T-test, Chi-square, and Receiving Operative Curve (ROC) curve analysis were used for statistical analysis. Result Renal stone patients had signi cantly higher levels of serum parathyroid hormone, creatinine, and 24hr urine metabolites in comparison to the controls. CaSR gene variants rs1801725 (GG) and rs1042636 (AA) both have shown signi cant association with renal stone disease. In addition, individuals having speci c genotypes along with metabolic abnormalities such as hypercalcemia, and hyperparathyroidism are found to be at a higher signi cant risk of developing the renal stone disease. Further, ROC analysis also showed a higher risk (54%) for individuals carrying the GG/AA haplotype. Conclusion In the present study, the haplotype of the CaSR gene has shown an association with renal stone disease. Individuals with hyperparathyroidism and hypercalcemia and risk genotype have a higher susceptibility to developing the renal stone disease.

Transplantation, Sep 1, 2022

International journal of molecular and immuno oncology, Jan 21, 2020

This is an open-access article distributed under the terms of the Creative Commons Attribution-No... more This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Gene

Objective: Calcium and oxalate are the most abundant metabolites present in the stone matrix. The... more Objective: Calcium and oxalate are the most abundant metabolites present in the stone matrix. The SPP1 and UMOD gene has specific expression in kidneys and are involved in various stages of stone formation. Therefore, genetic variants in the SPP1 and UMOD genes may enhance the development of renal stone disease. This study has been designed to understand the association of genetic variants of SPP1 and UMOD genes with renal stone disease. Materials and Method: A prospective study has been carried out, including 150 renal stone disease patients and 150 healthy individuals. Biochemical parameters were performed, including serum calcium levels, creatinine, parathyroid hormone, and 24-Hour urine metabolites. The genotyping of SPP1 (rs1126616) and UMOD (rs4293393) gene variants were performed using a customized TaqMan probe. T-test was used for continuous biochemical data analysis. The Chi-square test has been applied to assess the risk of a particular genotype associated with renal stone disease. In addition, correlation analysis for biochemical parameters and genetic variants with the renal stone disease has been performed using Shapley additive explanations (SHAP) values calculated with the help of the pycaret library. Result: Renal stone patients had significantly higher levels of parathyroid hormone (93.37 ± 52.78 pg/ml vs 64.67 ± 31.50 pg/ml, P=<0.0001), serum creatinine (0.94 ± 0.38 mg/dl vs 0.77 ± 0.17 mg/dl, P=<0.0001) and 24hr urine metabolites in comparison to the healthy controls. Heterozygous (CT) variant of SPP1 and homozygous (GG) variant of UMOD genes were significantly associated with an increased risk of developing the renal stone disease (p = 0.0100, OR = 2.06, 95 %CI = 1.13–3.75; p=<0.0001, OR = 5.773, 95 % CI = 2.03–16.38, respectively). Individuals with hyperparathyroidism and CC (SPP1) and GG (UMOD) genotypes have a high risk (P = 0.0055, OR = 2.75, 95 %CI = 1.35–5.67; P = 0.0129, OR = 10.03, 95 %CI = 1.60–110.40, respectively) of developing a renal stone. In addition, individuals with hypercalciuria and TT genotype of SPP1 (P = 0.0112, OR = 2.92, 95 % CI = 1.33–6.35), AG genotype of UMOD (P=<0.0001, OR = 5.45, 95 %CI = 2.24–13.96) and GG genotype of UMOD (P=<0.0001, OR = 10.02, 95 %CI = 3.53–24.63) have high risk of developing renal stones. Moreover, Individuals with hyperoxaluria and AG + GG (UMOD) genotype have a greater risk (P=<0.0001, OR = 7.35, 95 % CI = 3.83–13.68) of developing a renal stone. The renal stone risk was persistent (P=<0.0002, OR = 2.44, 95 % CI = 1.52–3.86) when analyzed for the synergistic effect of risk genotypes of SPP1 (CT) and UMOD (GG) gene. Further, correlation analysis also confirmed the strong association between genetic variants and renal stone development. Conclusion: Genetic variants of the SPP1 and UMOD genes were associated with renal stone disease. In the presence of risk genotype and hyperparathyroidism, hypercalciuria, and hyperoxaluria, the susceptibility to develop the renal stone disease risk gets modulated.

Xanthogranulomatous pyelonephritis (XGPN) mimicking a “renal cell carcinoma with renal vein throm... more Xanthogranulomatous pyelonephritis (XGPN) mimicking a “renal cell carcinoma with renal vein thrombus and paracaval

Gene, May 1, 2023

Objective: Calcium and oxalate are the most abundant metabolites present in the stone matrix. The... more Objective: Calcium and oxalate are the most abundant metabolites present in the stone matrix. The SPP1 and UMOD gene has specific expression in kidneys and are involved in various stages of stone formation. Therefore, genetic variants in the SPP1 and UMOD genes may enhance the development of renal stone disease. This study has been designed to understand the association of genetic variants of SPP1 and UMOD genes with renal stone disease. Materials and Method: A prospective study has been carried out, including 150 renal stone disease patients and 150 healthy individuals. Biochemical parameters were performed, including serum calcium levels, creatinine, parathyroid hormone, and 24-Hour urine metabolites. The genotyping of SPP1 (rs1126616) and UMOD (rs4293393) gene variants were performed using a customized TaqMan probe. T-test was used for continuous biochemical data analysis. The Chi-square test has been applied to assess the risk of a particular genotype associated with renal stone disease. In addition, correlation analysis for biochemical parameters and genetic variants with the renal stone disease has been performed using Shapley additive explanations (SHAP) values calculated with the help of the pycaret library. Result: Renal stone patients had significantly higher levels of parathyroid hormone (93.37 ± 52.78 pg/ml vs 64.67 ± 31.50 pg/ml, P=<0.0001), serum creatinine (0.94 ± 0.38 mg/dl vs 0.77 ± 0.17 mg/dl, P=<0.0001) and 24hr urine metabolites in comparison to the healthy controls. Heterozygous (CT) variant of SPP1 and homozygous (GG) variant of UMOD genes were significantly associated with an increased risk of developing the renal stone disease (p = 0.0100, OR = 2.06, 95 %CI = 1.13–3.75; p=<0.0001, OR = 5.773, 95 % CI = 2.03–16.38, respectively). Individuals with hyperparathyroidism and CC (SPP1) and GG (UMOD) genotypes have a high risk (P = 0.0055, OR = 2.75, 95 %CI = 1.35–5.67; P = 0.0129, OR = 10.03, 95 %CI = 1.60–110.40, respectively) of developing a renal stone. In addition, individuals with hypercalciuria and TT genotype of SPP1 (P = 0.0112, OR = 2.92, 95 % CI = 1.33–6.35), AG genotype of UMOD (P=<0.0001, OR = 5.45, 95 %CI = 2.24–13.96) and GG genotype of UMOD (P=<0.0001, OR = 10.02, 95 %CI = 3.53–24.63) have high risk of developing renal stones. Moreover, Individuals with hyperoxaluria and AG + GG (UMOD) genotype have a greater risk (P=<0.0001, OR = 7.35, 95 % CI = 3.83–13.68) of developing a renal stone. The renal stone risk was persistent (P=<0.0002, OR = 2.44, 95 % CI = 1.52–3.86) when analyzed for the synergistic effect of risk genotypes of SPP1 (CT) and UMOD (GG) gene. Further, correlation analysis also confirmed the strong association between genetic variants and renal stone development. Conclusion: Genetic variants of the SPP1 and UMOD genes were associated with renal stone disease. In the presence of risk genotype and hyperparathyroidism, hypercalciuria, and hyperoxaluria, the susceptibility to develop the renal stone disease risk gets modulated.

Authorea (Authorea), Feb 11, 2023

This a preprint and has not been peer reviewed. Data may be preliminary.

Indian Journal of Cancer, 2020

The majority of testicular tumors are germ cell tumors (GCTs), but there are numerous other types... more The majority of testicular tumors are germ cell tumors (GCTs), but there are numerous other types, making testicular tumors one of the most diverse areas of human pathology, despite their relative rarity. Testicular tumors are usually diagnosed only after radical surgery, as biopsies are not performed. Further management of the patient is dependent on the diagnosis at microscopy, which itself is based on the sections taken at the time of grossing the specimen. Many pathologists often aren′t well versed with guidelines for handling of orchiectomy specimens and for microscopy. This article discusses, in detail, the approach to grossing of a testicular tumor specimen and elaborates of the reasons as to why we do what we do at the initial “cut-up”. It explains the logic behind the reporting guidelines for testicular tumors and offer a clinical primer to the pathologist as to why we do what we do while grossing testicular tumor specimens.

European Journal of Pharmacology

African Journal of Urology

Background Primary renal squamous cell carcinoma is a scarce entity, and its presentation as a di... more Background Primary renal squamous cell carcinoma is a scarce entity, and its presentation as a discharging sinus is still exceptionally rare. We hereby report a case of a renal cell carcinoma in a young gentleman. Case presentation We report a case of a 20-year-old gentleman who presented with clinical features suggestive of left side xanthogranulomatous pyelonephritis (XGPN). He had undergone multiple endourological procedures for left side renal calculi in the past. We present the clinical presentation, diagnostic dilemmas and treatment for this patient. We performed an open radical nephrectomy for this patient. Our case report is unique from the point of view of nature of presentation to the final histopathological outcome in terms of age group of the patient. Here we present the clinical management and dilemmas in the management of this unusual and rare case. Conclusions Our case report and presentation has taught us that we as clinicians must have a high index of suspicion for ...

F1000Research, 2016

Kikuchi-Fujimoto disease (KFD) is an extremely rare disease with a worldwide distribution and hig... more Kikuchi-Fujimoto disease (KFD) is an extremely rare disease with a worldwide distribution and higher prevalence in Asians. It is a benign and self-limiting disorder, characterized by regional cervical lymphadenopathy accompanied with mild fever and night sweats. Lymph node histopathology is diagnostic and treating physicians should be aware of this entity as it may mimic other systemic diseases like systemic lupus erythematosus, tuberculosis, malignant lymphoma, and more rarely adenocarcinoma. Key features on lymph node biopsy are fragmentation, necrosis and karyorrhexis. Treatment includes symptomatic care, analgesics-antipyretics, corticosteroids and spontaneous recovery occurs in 1 to 4 months. We report a case of adult polycystic kidney disease (ADPKD) with end stage renal disease and episodes of fever and cervical lymphadenopathy. The infectious screen was negative and on extensive workup, the patient was found to have histiocytic-necrotizing lymphadenitis, which clinched the d...

International Journal of Molecular & Immuno Oncology

Azathioprine is a commonly used immunosuppressive agent in renal transplantation. Thiopurine ther... more Azathioprine is a commonly used immunosuppressive agent in renal transplantation. Thiopurine therapy is associated with an increased risk of solid organ malignancies after renal transplantation. There are few reported cases of azathioprine therapy-related myelodysplastic syndrome/acute myeloid leukemia. We describe a case of post-renal transplant patients developing chronic myelomonocytic leukemia-1 associated with monosomy of chromosome 7, possibly related to prolonged exposure of azathioprine.

Clinical Kidney Journal

A 22-year-old healthy man was admitted for oedema 15 days after the first injection of the COVISH... more A 22-year-old healthy man was admitted for oedema 15 days after the first injection of the COVISHIELD coronavirus disease 2019 (COVID-19) vaccine (Oxford AstraZeneca) vaccine. Nephrotic syndrome was diagnosed and a kidney biopsy showed minimal change disease. Oral prednisolone was started at 1 mg/kg/day resulting in complete remission within 1 week.

PubMed, Jan 4, 2022

Renal tumors comprise a wide spectrum of benign and malignant tumors. The important prognostic fa... more Renal tumors comprise a wide spectrum of benign and malignant tumors. The important prognostic factors in renal cell carcinoma include pathological stage, tumor grade, morphological type, sarcomatoid/rhabdoid differentiation, and tumor necrosis. Therefore, the pathologist needs to be fully aware of how to gross nephrectomy specimens to be able to accurately provide the above prognostic information while reporting adult kidney tumors. With the advent of nephron-sparing surgeries, due diligence should be exercised to assess and sample the parenchymal surgical margin. This article discusses the approach to grossing nephrectomy specimens, elaborates the significance of every step, and also sheds light on the importance of clinical and radiological information in providing a holistic approach to the diagnosis and staging of adult renal tumors.

Indian Journal of Transplantation, 2020

Background: There has been significant advancement in the field of renal transplantation in the l... more Background: There has been significant advancement in the field of renal transplantation in the last few decades. However, the long-term graft survival has not dramatically increased. Among all the infections, viral infections continue to be a major contributor to graft failure as well as severe mortality and morbidity in renal transplant recipients. Materials and Methods: It was a prospective, nonrandomized, observational study of the duration of 1 year that was conducted in live donor renal transplant recipients (n = 96). Blood samples were collected from all live renal allograft recipients at specified intervals and investigated for the viral infections. Glomerular filtration rate (GFR) and tacrolimus levels were measured at follow-ups. Results: Prior to renal transplant, the hepatitis C prevalence was the highest accounting for viral infection in 7.3% of the total study population. The study had pretransplant cytomegalovirus (CMV) and BK virus (BKV) infection rates of 1.04% each. CMV infection had the highest incidence rate occurring in 29.1% of the total population posttransplantation. There was significant incidence of CMV infection (CMV+) after rejection (P = 0.016). The incidence of BKV infection in our study through 1 year was 8.3%. The incidence of CMV infection correlated well with mean tacrolimus trough level of 10.58 ± 1.25 ng/mL. The mean estimated GFR (eGFR) at 12 months in infected patients was 65.12 ± 5.31 ml/min/1.73 m2 which was significantly lower compared to controls which was 75.53 ± 2.24 ml/min/1.73 m2 though they had comparable mean eGFR at baseline (P = 0.008). Conclusions: Hepatitis C was the dominant infection among all pretransplant viral infections. The highest incidence of CMV and BKV infection was after 6 months' posttransplant. Rejection was associated with CMV infection. All patients with BKV viremia had viruria. High level of tacrolimus was associated with CMV incidence. CMV infection was associated with lower eGFR at 1-year postrenal transplant.

Naunyn-schmiedebergs Archives of Pharmacology, Jun 15, 2023

European Journal of Pharmacology, Jun 1, 2023

Indian Journal of Cancer, 2020

The majority of testicular tumors are germ cell tumors (GCTs), but there are numerous other types... more The majority of testicular tumors are germ cell tumors (GCTs), but there are numerous other types, making testicular tumors one of the most diverse areas of human pathology, despite their relative rarity. Testicular tumors are usually diagnosed only after radical surgery, as biopsies are not performed. Further management of the patient is dependent on the diagnosis at microscopy, which itself is based on the sections taken at the time of grossing the specimen. Many pathologists often aren′t well versed with guidelines for handling of orchiectomy specimens and for microscopy. This article discusses, in detail, the approach to grossing of a testicular tumor specimen and elaborates of the reasons as to why we do what we do at the initial “cut-up”. It explains the logic behind the reporting guidelines for testicular tumors and offer a clinical primer to the pathologist as to why we do what we do while grossing testicular tumor specimens.

African Journal of Urology, Jan 3, 2023

Background: Primary renal squamous cell carcinoma is a scarce entity, and its presentation as a d... more Background: Primary renal squamous cell carcinoma is a scarce entity, and its presentation as a discharging sinus is still exceptionally rare. We hereby report a case of a renal cell carcinoma in a young gentleman. Case presentation: We report a case of a 20-year-old gentleman who presented with clinical features suggestive of left side xanthogranulomatous pyelonephritis (XGPN). He had undergone multiple endourological procedures for left side renal calculi in the past. We present the clinical presentation, diagnostic dilemmas and treatment for this patient. We performed an open radical nephrectomy for this patient. Our case report is unique from the point of view of nature of presentation to the final histopathological outcome in terms of age group of the patient. Here we present the clinical management and dilemmas in the management of this unusual and rare case. Conclusions: Our case report and presentation has taught us that we as clinicians must have a high index of suspicion for a renal malignancy when treating patients who present with pyonephrosis associated with long-standing calculi diseases, irrespective of the age group of the patient.

Research Square (Research Square), Nov 16, 2022

Calcium is the most abundant metabolite involved in the stone matrix. The CaSR gene controls calc... more Calcium is the most abundant metabolite involved in the stone matrix. The CaSR gene controls calcium homeostasis, and genetic variation in the CaSR gene could lead to the development of renal stone disease. Therefore, the current study has been designed to assess the association of genetic variants of CaSR gene polymorphisms with renal stone disease. Method A single-centric prospective study has been carried out on a total of 300 participants (150 cases and 150 controls). Serum levels of calcium, creatinine, parathyroid hormone, and 24 Hour urine metabolites were measured. Two polymorphisms, rs1801725 and rs1042636, of the CaSR gene, have been genotyped for each participant. T-test, Chi-square, and Receiving Operative Curve (ROC) curve analysis were used for statistical analysis. Result Renal stone patients had signi cantly higher levels of serum parathyroid hormone, creatinine, and 24hr urine metabolites in comparison to the controls. CaSR gene variants rs1801725 (GG) and rs1042636 (AA) both have shown signi cant association with renal stone disease. In addition, individuals having speci c genotypes along with metabolic abnormalities such as hypercalcemia, and hyperparathyroidism are found to be at a higher signi cant risk of developing the renal stone disease. Further, ROC analysis also showed a higher risk (54%) for individuals carrying the GG/AA haplotype. Conclusion In the present study, the haplotype of the CaSR gene has shown an association with renal stone disease. Individuals with hyperparathyroidism and hypercalcemia and risk genotype have a higher susceptibility to developing the renal stone disease.

Transplantation, Sep 1, 2022

International journal of molecular and immuno oncology, Jan 21, 2020

This is an open-access article distributed under the terms of the Creative Commons Attribution-No... more This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Gene

Objective: Calcium and oxalate are the most abundant metabolites present in the stone matrix. The... more Objective: Calcium and oxalate are the most abundant metabolites present in the stone matrix. The SPP1 and UMOD gene has specific expression in kidneys and are involved in various stages of stone formation. Therefore, genetic variants in the SPP1 and UMOD genes may enhance the development of renal stone disease. This study has been designed to understand the association of genetic variants of SPP1 and UMOD genes with renal stone disease. Materials and Method: A prospective study has been carried out, including 150 renal stone disease patients and 150 healthy individuals. Biochemical parameters were performed, including serum calcium levels, creatinine, parathyroid hormone, and 24-Hour urine metabolites. The genotyping of SPP1 (rs1126616) and UMOD (rs4293393) gene variants were performed using a customized TaqMan probe. T-test was used for continuous biochemical data analysis. The Chi-square test has been applied to assess the risk of a particular genotype associated with renal stone disease. In addition, correlation analysis for biochemical parameters and genetic variants with the renal stone disease has been performed using Shapley additive explanations (SHAP) values calculated with the help of the pycaret library. Result: Renal stone patients had significantly higher levels of parathyroid hormone (93.37 ± 52.78 pg/ml vs 64.67 ± 31.50 pg/ml, P=<0.0001), serum creatinine (0.94 ± 0.38 mg/dl vs 0.77 ± 0.17 mg/dl, P=<0.0001) and 24hr urine metabolites in comparison to the healthy controls. Heterozygous (CT) variant of SPP1 and homozygous (GG) variant of UMOD genes were significantly associated with an increased risk of developing the renal stone disease (p = 0.0100, OR = 2.06, 95 %CI = 1.13–3.75; p=<0.0001, OR = 5.773, 95 % CI = 2.03–16.38, respectively). Individuals with hyperparathyroidism and CC (SPP1) and GG (UMOD) genotypes have a high risk (P = 0.0055, OR = 2.75, 95 %CI = 1.35–5.67; P = 0.0129, OR = 10.03, 95 %CI = 1.60–110.40, respectively) of developing a renal stone. In addition, individuals with hypercalciuria and TT genotype of SPP1 (P = 0.0112, OR = 2.92, 95 % CI = 1.33–6.35), AG genotype of UMOD (P=<0.0001, OR = 5.45, 95 %CI = 2.24–13.96) and GG genotype of UMOD (P=<0.0001, OR = 10.02, 95 %CI = 3.53–24.63) have high risk of developing renal stones. Moreover, Individuals with hyperoxaluria and AG + GG (UMOD) genotype have a greater risk (P=<0.0001, OR = 7.35, 95 % CI = 3.83–13.68) of developing a renal stone. The renal stone risk was persistent (P=<0.0002, OR = 2.44, 95 % CI = 1.52–3.86) when analyzed for the synergistic effect of risk genotypes of SPP1 (CT) and UMOD (GG) gene. Further, correlation analysis also confirmed the strong association between genetic variants and renal stone development. Conclusion: Genetic variants of the SPP1 and UMOD genes were associated with renal stone disease. In the presence of risk genotype and hyperparathyroidism, hypercalciuria, and hyperoxaluria, the susceptibility to develop the renal stone disease risk gets modulated.

Xanthogranulomatous pyelonephritis (XGPN) mimicking a “renal cell carcinoma with renal vein throm... more Xanthogranulomatous pyelonephritis (XGPN) mimicking a “renal cell carcinoma with renal vein thrombus and paracaval

Gene, May 1, 2023

Objective: Calcium and oxalate are the most abundant metabolites present in the stone matrix. The... more Objective: Calcium and oxalate are the most abundant metabolites present in the stone matrix. The SPP1 and UMOD gene has specific expression in kidneys and are involved in various stages of stone formation. Therefore, genetic variants in the SPP1 and UMOD genes may enhance the development of renal stone disease. This study has been designed to understand the association of genetic variants of SPP1 and UMOD genes with renal stone disease. Materials and Method: A prospective study has been carried out, including 150 renal stone disease patients and 150 healthy individuals. Biochemical parameters were performed, including serum calcium levels, creatinine, parathyroid hormone, and 24-Hour urine metabolites. The genotyping of SPP1 (rs1126616) and UMOD (rs4293393) gene variants were performed using a customized TaqMan probe. T-test was used for continuous biochemical data analysis. The Chi-square test has been applied to assess the risk of a particular genotype associated with renal stone disease. In addition, correlation analysis for biochemical parameters and genetic variants with the renal stone disease has been performed using Shapley additive explanations (SHAP) values calculated with the help of the pycaret library. Result: Renal stone patients had significantly higher levels of parathyroid hormone (93.37 ± 52.78 pg/ml vs 64.67 ± 31.50 pg/ml, P=<0.0001), serum creatinine (0.94 ± 0.38 mg/dl vs 0.77 ± 0.17 mg/dl, P=<0.0001) and 24hr urine metabolites in comparison to the healthy controls. Heterozygous (CT) variant of SPP1 and homozygous (GG) variant of UMOD genes were significantly associated with an increased risk of developing the renal stone disease (p = 0.0100, OR = 2.06, 95 %CI = 1.13–3.75; p=<0.0001, OR = 5.773, 95 % CI = 2.03–16.38, respectively). Individuals with hyperparathyroidism and CC (SPP1) and GG (UMOD) genotypes have a high risk (P = 0.0055, OR = 2.75, 95 %CI = 1.35–5.67; P = 0.0129, OR = 10.03, 95 %CI = 1.60–110.40, respectively) of developing a renal stone. In addition, individuals with hypercalciuria and TT genotype of SPP1 (P = 0.0112, OR = 2.92, 95 % CI = 1.33–6.35), AG genotype of UMOD (P=<0.0001, OR = 5.45, 95 %CI = 2.24–13.96) and GG genotype of UMOD (P=<0.0001, OR = 10.02, 95 %CI = 3.53–24.63) have high risk of developing renal stones. Moreover, Individuals with hyperoxaluria and AG + GG (UMOD) genotype have a greater risk (P=<0.0001, OR = 7.35, 95 % CI = 3.83–13.68) of developing a renal stone. The renal stone risk was persistent (P=<0.0002, OR = 2.44, 95 % CI = 1.52–3.86) when analyzed for the synergistic effect of risk genotypes of SPP1 (CT) and UMOD (GG) gene. Further, correlation analysis also confirmed the strong association between genetic variants and renal stone development. Conclusion: Genetic variants of the SPP1 and UMOD genes were associated with renal stone disease. In the presence of risk genotype and hyperparathyroidism, hypercalciuria, and hyperoxaluria, the susceptibility to develop the renal stone disease risk gets modulated.

Authorea (Authorea), Feb 11, 2023

This a preprint and has not been peer reviewed. Data may be preliminary.

Indian Journal of Cancer, 2020

The majority of testicular tumors are germ cell tumors (GCTs), but there are numerous other types... more The majority of testicular tumors are germ cell tumors (GCTs), but there are numerous other types, making testicular tumors one of the most diverse areas of human pathology, despite their relative rarity. Testicular tumors are usually diagnosed only after radical surgery, as biopsies are not performed. Further management of the patient is dependent on the diagnosis at microscopy, which itself is based on the sections taken at the time of grossing the specimen. Many pathologists often aren′t well versed with guidelines for handling of orchiectomy specimens and for microscopy. This article discusses, in detail, the approach to grossing of a testicular tumor specimen and elaborates of the reasons as to why we do what we do at the initial “cut-up”. It explains the logic behind the reporting guidelines for testicular tumors and offer a clinical primer to the pathologist as to why we do what we do while grossing testicular tumor specimens.

European Journal of Pharmacology

African Journal of Urology

Background Primary renal squamous cell carcinoma is a scarce entity, and its presentation as a di... more Background Primary renal squamous cell carcinoma is a scarce entity, and its presentation as a discharging sinus is still exceptionally rare. We hereby report a case of a renal cell carcinoma in a young gentleman. Case presentation We report a case of a 20-year-old gentleman who presented with clinical features suggestive of left side xanthogranulomatous pyelonephritis (XGPN). He had undergone multiple endourological procedures for left side renal calculi in the past. We present the clinical presentation, diagnostic dilemmas and treatment for this patient. We performed an open radical nephrectomy for this patient. Our case report is unique from the point of view of nature of presentation to the final histopathological outcome in terms of age group of the patient. Here we present the clinical management and dilemmas in the management of this unusual and rare case. Conclusions Our case report and presentation has taught us that we as clinicians must have a high index of suspicion for ...

F1000Research, 2016

Kikuchi-Fujimoto disease (KFD) is an extremely rare disease with a worldwide distribution and hig... more Kikuchi-Fujimoto disease (KFD) is an extremely rare disease with a worldwide distribution and higher prevalence in Asians. It is a benign and self-limiting disorder, characterized by regional cervical lymphadenopathy accompanied with mild fever and night sweats. Lymph node histopathology is diagnostic and treating physicians should be aware of this entity as it may mimic other systemic diseases like systemic lupus erythematosus, tuberculosis, malignant lymphoma, and more rarely adenocarcinoma. Key features on lymph node biopsy are fragmentation, necrosis and karyorrhexis. Treatment includes symptomatic care, analgesics-antipyretics, corticosteroids and spontaneous recovery occurs in 1 to 4 months. We report a case of adult polycystic kidney disease (ADPKD) with end stage renal disease and episodes of fever and cervical lymphadenopathy. The infectious screen was negative and on extensive workup, the patient was found to have histiocytic-necrotizing lymphadenitis, which clinched the d...

International Journal of Molecular & Immuno Oncology

Azathioprine is a commonly used immunosuppressive agent in renal transplantation. Thiopurine ther... more Azathioprine is a commonly used immunosuppressive agent in renal transplantation. Thiopurine therapy is associated with an increased risk of solid organ malignancies after renal transplantation. There are few reported cases of azathioprine therapy-related myelodysplastic syndrome/acute myeloid leukemia. We describe a case of post-renal transplant patients developing chronic myelomonocytic leukemia-1 associated with monosomy of chromosome 7, possibly related to prolonged exposure of azathioprine.

Clinical Kidney Journal

A 22-year-old healthy man was admitted for oedema 15 days after the first injection of the COVISH... more A 22-year-old healthy man was admitted for oedema 15 days after the first injection of the COVISHIELD coronavirus disease 2019 (COVID-19) vaccine (Oxford AstraZeneca) vaccine. Nephrotic syndrome was diagnosed and a kidney biopsy showed minimal change disease. Oral prednisolone was started at 1 mg/kg/day resulting in complete remission within 1 week.