Dr. Rajesh Jhorawat did his MBBS from prestigious All India Institute of Medical Sciences (AIIMS) New Delhi, MD from PGI Chandigarh & DM (Nephrology) from SMS Medical College Jaipur.
Dr Jhorawat has Experience in Clinical Immunology (including Transplant Immunology) from SGPGI (Lucknow) & published many papers in index journal. His study & his work have been selected for presentation both in national & international Nephrology Meet.
He is active member of-
Indian Society of Nephrology (ISN)
American Society of Nephrology (ASN)
European Renal Association (ERA - EDTA)
International Society of Nephrology (ISN)
Primary Affiliation: SMS Medical College and Hospital, Jaipur - Jaipur, Rajasthan , India
Background & objectives: Adriamycin though considered as an effective anticancer drug, leads to
irreversible cardiomyopathy (CMP) and congestive heart failure (CHF). The aim of this study was to
determine the protective effect of carvedilol in adriamycin (ADR)-induced cardiomyopathy (CMP) in
Methods: Patients with lymphoreticular malignancy in whom ADR therapy was planned were randomized
into two groups: carvedilol and control. Twenty seven patients each were enrolled in carvedilol and
control groups. In the carvedilol group, 12.5 mg once daily oral carvedilol was given during six months.
The patients were evaluated by echocardiography before and after chemotherapy. Left ventricular
ejection fraction (EF) and systolic and diastolic diameters were calculated.
Results: At six months of follow up, six patients in the carvedilol group and five in the control group
had died. The mean EF (63.19 vs. 63.88%) and fraction shortening (FS) (34 vs. 34.6) of the carvedilol
group were similar at follow up, but in the control group, the mean EF (67.27 vs. 60.82%, P=0.003) and
FS (38.48 vs. 34.6, P<0.05) at control echocardiography were significantly lower. In carvedilol group,
both systolic and diastolic diameters were not changed, but in control group, systolic diameters were
significantly increased compared with basal measures (left ventricular end systolic diameter = 28.26±5.50
mm vs. 31.25± 6.50 mm; P< 0.05).
Interpretation & conclusions: Prophylactic use of carvedilol in patients receiving anthracycline protected
systolic functions of the left ventricle. Carvedilol can be a potential drug which can ameliorate ADRinduced
Saudi Journal for Health Sciences. 2016 Sep-Dec;5(3):138-41
Saudi Journal for Health Sciences
Context: There has been an unexplained increase in the number of cases with multiorgan
dysfunction including acute kidney injury (AKI), attributed to Plasmodium vivax monoinfection.
Only a few case reports in literature have published the renal biopsy findings in these patients.
Aims: The aim of this study was to evaluate the clinical and histopathologic profile of patients
with P. vivax malaria monoinfection and AKI. Settings and Design: A prospective study was
performed in a tertiary care hospital in North‑Western India. Subjects and Methods: The
study included patients diagnosed with P. vivax monoinfection on peripheral smear blood
films and rapid diagnostic test (positive for P. vivax specific lactate dehydrogenase). AKI was
defined based on the WHO criteria for complicated malaria, i.e. serum creatinine >265 μmol/l
or 3 mg/dl. The patients were initiated on hemodialysis for persistent hyperkalemia, fluid
overload, severe metabolic acidosis, or uremic symptoms. Renal biopsy was performed in
the presence of active urinary sediments (proteinuria, hematuria) or persistence of renal
failure >14 days. Results: A total of thirty patients fulfilled AKI criteria. The patients with
AKI were older (mean age 42.1 ± 10.9 years), male, with a longer duration of illness (mean
12.3 ± 10 days) and associated with multisystem dysfunction. The mean serum creatinine
was 7.58 ± 3.2 mg/dl, thrombocytopenia was seen in 47%. Thirty percent had severe
anemia requiring a blood transfusion. Renal biopsy was performed in six patients for various
indications. The most common pattern was acute tubular necrosis (four patients), followed by
acute cortical necrosis (1), and thrombotic microangiopathy (one patient). The complete renal
recovery was seen in 24 (80%). Two patients became dialysis‑dependent. Conclusions: AKI
associated with P. vivax monoinfection is not rare as previously thought. Therefore, it should
be considered in the differential diagnosis of any patient presenting with AKI.
Indian journal of transplantation 2014 July-September 8(3);75-79
Indian journal of transplantation
To assess the level of hormones in chronic kidney disease (CKD) patients and the effect of renal transplantation (RTx) on these hormones.
Materials and methods
17 patients enrolled and levels of 11 hormones i.e. FT3, FT4, TSH, FSH, LH, prolactin, testosterone, cortisol, growth hormone, PTH and insulin were measured in every patient before and at 1st, 3rd and 6th month after RTx with correlation to serum creatinine. Patients with underlying endocrine disorders were excluded.
At 1st and 3rd month of follow up after RTx, there was no statistical significant change in the hormones level except in PTH, which normalised (Pre transplant levels: 262.542 ± 239.706 and 1 month levels: 101.412 ± 66.615 p = 0.024 at 3rd month level: 113.02 ± 95.960 p = 0.036). At 6th month, along with PTH, LH level decreased significantly (LH level pre-RTx 8.387 ± 4.536 and 3.091 ± 2.139 at 6th month p = 0.024). Levels of other hormones also normalised. Mean serum creatinine at 6th month had increased from its nadir level post RTx (1.149 ± 0.164 mg/dl to 1.386 ± 0.323 mg/dl p = 0.034), due to rise of serum creatinine in 4 patients. FT3, cortisol, prolactin and insulin levels also increased in parallel with serum creatinine, however insulin level correlated significantly (r = 0.759 with 95% CI = 0.015–0.962).
RTx corrects most of the hormonal disturbances in CKD patients, particularly abnormalities in PTH and LH levels in early post transplant period. Even mild allograft dysfunction significantly affects the hormonal levels in a manner which is similar to the changes seen in CKD.