Shankar Gadwal

Obesity in Renal Transplantation : Indian Journal of Transplantation journals.lww.com/ijjt/fulltext/…

💥Honoured to share an excellent editorial written by my mentor Dr.Sree Bhushan Raju @bhushan_sree highlighting interesting case reports in nephrology. @manirath @sreebhushan @HydNephForum @gadwal_sg @AVarmudy @mukeshgoyalneph @sonu_manuel 💥frontiersin.org/articles/10.33…

Between February 2023 and June 2023 kidney doctors at Aster MIMS Hospital, Kottakkal, in Kerala started getting a series of patients with a rare and strange type of kidney disease. They were baffled. They called it Neural epidermal growth factor-like 1 protein (NELL-1) associated membranous nephropathy - a weird disease where the the body's immune system was attacking the filtering membranes of the kidney. The disease was characterized by massive loss of protein in urine (>3.5 g/day) and clinically presented with severe leg and face swelling, high blood pressure, frothy urine, and clot formation in blood vessels of legs or lungs and sometimes strokes. The first patient was a 14 year old girl, followed by her relative. Both their kidney biopsies were positive for NELL-1 kidney disease. Then came a completely unrelated 29 year old man. The doctors were alarmed. And they looked at their records. There were five more such patients within the past 4 months. They looked at published literature and found a common culprit among most NELL-1 cases recorded. Mercury. Blood levels of mercury in patients were checked and the doctors were stunned. Levels were 100 times more than normal limits of detection. But what was common to all these mercury poisoned unrelated patients? And a thorough clinical history in retrospect found the culprit. Fairness creams. All patients were using locally made fairness creams to lighten their "naturally-beautiful dark skin." Fairness creams contaminated with mercury, causing chronic mercury poisoning and NELL-1 kidney disease is well known. See this report from Akola and Mumbai - tandfonline.com/doi/abs/10.108… Another cause for Nell-1 kidney damage is presence of lipoic acid which can by itself cause membranous nephropathy. Lipoic acid is a common constituent of fairness creams and many oral antioxidant supplements - be wary of this. Check your supplements. See here sciencedirect.com/science/articl… Not only fairness creams, but traditional herbal medicines, especially Ayurveda & Siddha formulations which Indian "wellness gurus" such as Sadhguru so passionately promote, have been implicated in multiple cases of mercury-induced severe Nell-1 kidney disease. See here kidney-international.org/article/S0085-… here kireports.org/article/S2468-… and here ncbi.nlm.nih.gov/pmc/articles/P… Be wary of locally made cosmetics, lipoic acid based oral supplements and Ayurvedic and Siddha herbal products. Know what is good for you. And more importantly, know what is not. Avoid unwanted troubles. Use the knowledge from medical science as a shield to defend yourself against unscientific practices and bad science. Sources: 2023 Kerala: Want To Become Fair? Beware Of MN Syndrome - timesofindia.indiatimes.com/blogs/tracking… 2022 Mumbai: Mumbai doctors link fairness cream to kidney illness in family - timesofindia.indiatimes.com/city/mumbai/mu…

🔷Original Article: Rituximab, Use and B Cell Depletion in Patients with Membranous Nephropathy– A Retrospective, Observational Study ✅ Acceptable remission rates with Rtx in both Rx naïve and Rx resistant pts ✅No significant association btw B-cell depletion and remission

The serum free light chain FLC assay. Tutorial. #MedTwitter #MyelomaVR Frequently ordered and frequently abnormal. This thread will reduce unnecessary headaches and referrals. 1/ Don’t order it unless you are suspecting myeloma, amyloid or related disorder

Perils of dialysis with out proper Nephrologist supervision

💫 Prof @sreebhushan 's lecture on "ABMR - Rejection to recovery" was highly impactful 🎓His in-depth analysis shed light on approaches to overcome rejection Thank you, sir #TransplantConclave. 🌟 @ainuindia @ainunephrology

💥Glad to share our experience on "Rituximab and B cell depletion in MN" 🌟 500mg Rtx, 2 doses. 🌟66.7% Remission rates. 🌟No association between B cell depletion and remission. @bhushan_sree @SwarnalathaGud2 @GangadharTaduri @Shankurology @gadwal_sg @Vijay100912

If you know sugar is the new alcohol, and protein is the building block of muscle and immunity, then you'll know how you have been taken for a ride, at least now: Bournvita 100g contain 37g of sugar (sucrose) 100g contain 7g of protein Boost 100g contain 35g sugar of which 9.5g is added sugar 100g contains 7.5g protein Ovaltine 100g contain 40.4g sugar 100g contain 11.5g protein Horlicks 100g contain 79g carbs of which 13.5g is table sugar 100g contain 11g protein Complan 100g contain 62g carbs of which sugar is 21.8g 100g contain 18g protein Ensure Protein 57g contain 13g sugar 57g contain 9g protein Pediasure 100g contain 67.7 carbs of which sugar is 17.1g 100g contain 14g of protein All of the above, advertised as muscle growth, increased height, immunity building and better overall health In comparison🔽 100ml of Coca cola contains 10.6g sugar 100ml of Fanta contains 10.9g sugar 100ml Ginger Beer contains 10.8g sugar 100g of Five Star chocolate 48g sugar 100g McDonald's Cheeseburger 6g of sugar 100g KFC Chicken 0g sugar Sucrose and fructose are the worst causes for non-alcoholic fatty liver and fatty liver disease in children. Open your minds to advertised "healthy" food products!

At WCN 2023 with ISN president Prof Fogo

Hyderabad Nephrology Forum is pleased to announce “Workshop on Nuclear Medicine in Nephrology” 🗓️ Friday 24th Feb 2023, 10 AM Onwards @SwarnalathaGud2 @drmanishasahay @myadla @DrPSVali

"Nephrology and SoMething More" an eloquent article on SoMe by my guide prof @bhushan_sree @sreebhushan sir in ISNSCCON 2023 souvenir 📝 @faizansari88 @Shashikirankb @mukeshgoyalneph @AVarmudy @Vijay100912 @DocGaggar @isnsccon23

My plea in the Lok Sabha today urging the Government to reintroduce comprehensive legislation to outlaw violence against healthcare professionals. No one knows why they withdrew their 2019 Bill, but it’s needed more than ever. IMA says 75% of doctors have suffered assault!

In a rare feat at NIMS Hospital, doctors performed 4 Kidney Transplants in 24 hours providing a new lease of life to 4 patients suffering from end stage kidney failure. Congratulations to the doctors at NIMS for their services poor and needy patients. 1/2

Thank you & Congratulations all seniors/teachers/mentors 💐💐💐 all of us will be indebted for lifelong for your teachings, guidance & support 🙏🏿🙏🏿🙏🏿 #isncon22 @bhushan_sree @isn_india @vjha126 @sgulati2002

Dr Shreebhusan Raju @bhushan_sree, speaks on " Ultrafiltration in PD" UF Failure - Definition Rule of 4s Failure of 400ml UF after 4hrs with 4.25% Dextrose @isncon22 #isncon22 @bhushan_sree @tjeloka @drprabhunephro @iSPD @InformNephro @isn_india @ISPD1 @PDI_Journal

Wonderful Talk by @bhushan_sree #isncon22 "UF in PD" @isncon22

Words of wisdom - dr Fogo President of ISN

𝗜𝗦𝗡 𝗩𝗜𝗗𝗘𝗢 𝗔𝗕𝗦𝗧𝗥𝗔𝗖𝗧 𝗦𝗘𝗥𝗜𝗘𝗦: Efficacy of corticosteroids in infection-related glomerulonephritis – A randomized controlled trial. From 2022 @KIReports kireports.org/article/S2468-… #VideoAbstract by @Gawad_Nephro and @acssjr

Follow for regular updates 📺 Like and Share with your friends & colleagues 🔢 #isncon22 @bhushan_sree @gollaanvesh @gadwal_sg @sindhu_kaza @dwivedi03_rohan @Shashikirankb @muzamilkidney @abidkuchay @NephPrasad @dr_sourabha