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Introduction : Drug-induced acute kidney injury (DI-AKI) is a common renal event with long-term sequelae. However, pathological profile and recovery rate are scarcely reported from north-east India. Thus, we evaluated the commonly implicated nephrotoxic drugs, pathological findings on renal biopsy, and recovery following treatment in patients with DI-AKI. Materials and MethodsThis retrospective, observational study involved the review of Nephrology AKI registry of a tertiary care institute. The review involved data of the adult patients diagnosed with DI-AKI over a period of 24 months (August 2020 to July 2022). Results : During the study period, a total of 182 patients developed DI-AKI. AKI was predominantly caused by antimicrobials (33.52%), alternative medicine (15.38%), and NSAIDs (11.54%).The younger and elderly patients were involved in significantly higher consumption of NSAIDs and alternative medicine, respectively (p-values<0.05). Biopsy was performed in 79 (43.41%) patients, and findings included mainly acute interstitial nephritis (AIN, 37.97%), allergic interstitial nephritis (ALIN, 18.99%), and acute tubular nephropathy (ATN, 12.66%). Steroid therapy and hemodialysis were required in 66 (36.26%) and 105 (57.69%) patients, respectively. At a mean follow-up of 124.78 ± 30.15 days, complete and partial recovery was observed in 136 (74.73%) and 12 (6.59%) patients, respectively. Recovery rate did not differ significant according to class of drugs (p-value=0.194). Conclusion : Antimicrobials, alternative medicine, and NSAIDs were predominantly implicated in DI-AKI. AIN, ALIN, and ATN were the most common biopsy findings with absence of any correlation with the offending agents. Around three quarters of the patients recovered completely.

Background and Aims SLE is a chronic autoimmune disorder that can affect all organ systems. Clinically evident renal disease known as Lupus Nephritis (LN) occurs in upto 50% patients of SLE and upto 10% of LN patients develop ESRD. LN carries a significant morbidity and mortality and requires an early aggressive management. Our Aim is to study the effect of IV Cyclophosphamide (CYC) vs Mycophenolate Mofetil (MMF) as Induction regimen in proliferative Lupus Nephritis patients of North- East India. Method This is a prospective observational study conducted in the department of Nephrology, Gauhati Medical College, over a period of 1 year. Haematological and biochemical assay including serum creatinine, blood urea, serum albumin, ANA, Anti ds DNA, C3 and C4,24h urinary protein, estimated glomerular filtration rate (eGFR) of all patients were taken into account. Renal biopsy was performed under ultrasonographic guidance. SLEDAI Score and Activity and Chronicity Indexes were calculated for all patients. Statistical analysis was done by SPSS Version 22 for windows. Two tailed p&lt;0.05 was considered to be statistically significant. A total of 64 biopsy proven LN patients of Class III, Class IV and Class V (Plus Class III/ Class IV) were enrolled in the study. We randomly assigned 34 patients with Class III through V lupus nephritis to IV CYC (NIH protocol/monthly) and 30 patients to MMF (2 gm/day) for 24 weeks as Induction Regimen. Both the groups received prednisone, tapered from a maximum starting dosage of 60 mg/day. All the patients were followed up for 6 months. Complete Response (CR) was considered when proteinuria&lt;0.5g/g and Partial Response (PR) when proteinuria&lt; 3g/g or there is reduction in proteinuria by at least 50%. Baseline characteristics and CR and PR were compared between the two groups. Results Of the total 64 patients, 57 patients (89%) were female, and 7 patients were male (11%) with the mean age of 31± 9.45 years. 24% patients had Class III LN and 76% had class IV LN. Complete Response was achieved in 13 patients (43%) in the MMF group and in 15 patients (44%) in CYC group. Partial Response was achieved in 11 patients (36.67%) in the MMF group and in 12 patients (35%) in the CYC group. There was a non-significant statistical difference between the two groups (p value ≥0.05 for both CR and PR). Conclusion The Northeastern population of India consists of various ethnic groups and there are records of variation in response to the Regimens in different geographical areas. In our study from North-east India, IV Cyclophosphamide and Mycophenolate Mofetil showed similar efficacy as Induction Regimen in proliferative Lupus Nephritis. However, there were higher rates of infection in the Cyclophosphamide group.

The ecological balance of an ecosystem has a relation to its biodiversity. Although it has been established that biodiversity and ecological stability are related, generalization about the exact nature of this relation remains elusive and more so in microbial diversity. A growing volume of studies has indicated that anthropogenic activities impact biodiversity, but it is difficult to generalize the impact of anthropogenic activities on microbial diversity. Landfilling by municipal solid waste is one such activity where microbes play a major role, and leachates are released from the landfill, altering the soil’s physical and chemical nature. Change in factors like carbon source, pH, and toxicity of the soil is most likely to affect the indigenous microflora of the soil. The present study was undertaken to compare the microbial diversity of soil receiving landfill leachate with that of the soil not receiving any landfill leachate to assess the impact of the landfilling activity on microbial diversity. The landfill site selected for the study was that of Kamrup Metro District of Assam, located at Boragaon, near the Ramsar wetland called Deeporbeel. By using the Denaturing Gradient Gel Electrophoresis (DGGE) method, it has been found that the microbial diversity of the soil receiving leachate was higher than that of the soil not receiving any leachate from the landfill.

Introduction: Drug-induced acute kidney injury (AKI)/acute tubule-interstitial nephritis (ATIN) is an important cause of AKI. There is little information about drug-induced AKI in our part of the world (north-east India). Aim:To determine the clinico-etiological profile of drug-induced AKI and their outcome in our part of the world and correlation with the histological pattern. Materials and methods:This is a retrospective observational study of patients who developed AKI following intake of some medications. AKI was defined as per risk' injury faiure less and end-stage kidney (RIFLE) criteria. On ultrasonography, kidney size was normal without any evidence of obstruction. Kidney biopsy was done in patients who didn't improve or had a history of multiple drugs or unknown drugs. Patients' clinical data were correlated with offending drug and histopathology findings Results: A total of 97 patients were included in this study, 60% were males and 40% were females. Mean age of patients was 45 ± 12.09 years. Herbal medication (29%) was the most common cause of drug-induced AKI, followed by nonsteroidal anti-inflammatory drugs (NSAIDs) (26%). Renal biopsy was done in 54 patients, 59.6% had acute tubulointerstitial nephritis (ATIN), 35% of patients had acute on the chronic TIN. Renal replacement therapy was required in 57.7% patients. Full renal recovery occurred in 38% patients while as, partial recovery occurred in 30% patients. Out of 29 patients with herbal medication intake,17% had full recovery compared to 56% in NSAID group.Conclusion: Drug-induced AKI is an important cause of renal dysfunction and can be under-diagnosed. AKI may occur with many drugs. Herbal medications were the most common cause of drug-induced AKI and had poor renal outcome compared to NSAIDs.Clinical significance: In our study, herbal medications intake was a common cause of AKI and was associated with poor renal recovery. Early suspicion and withdrawal of the offending drug are needed to prevent renal damage.