ORCID Profile
0000-0003-0752-4651
Current Organisation
Royal Brisbane and Women's Hospital
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Publisher: Wiley
Date: 08-06-2018
DOI: 10.1111/AJD.12860
Abstract: Co-infection with human immunodeficiency virus-1 (HIV) and syphilis is associated with rapid progression to tertiary syphilis. This case report describes the early development of gummatous skin disease and suspected neurosyphilis in a patient with untreated HIV and approaches to treatment.
Publisher: Springer Science and Business Media LLC
Date: 02-2017
Publisher: Science Repository OU
Date: 08-06-2021
DOI: 10.31487/J.JCMCR.2021.01.01
Abstract: Background: Near-to-peer teaching involves more experienced learners acting as tutors for junior colleagues and has significant theoretical benefits for both teachers and learners [1-3]. Aim: Development, implementation, and assessment of a weekend examination preparation workshop by Royal Australasian College of Physicians Advanced Trainees (ATs) for Basic Physician Trainees (BPTs), using a near-to-peer framework. Methods: A two-day offsite course was designed by ATs. Day 1 - subspecialty short-case demonstrations, followed by small-group examination practice. Shared downtime was organized for the evening. Day 2 - two exemplar long-case presentations by ATs with consultant examiner feedback, followed by interactive small-group sessions focusing on presenting long-cases. Results: A post-course survey was completed by 72% of BPTs (13/18) and 88% of ATs (8/9). Responses demonstrated that all BPTs would recommend this workshop to peers. 84% (11/13) found the course material very useful. 62% (5/8) ATs felt their leadership and teaching skills had significantly improved. BPTs reported that the AT long-case demonstrations were highly useful. Negative feedback included the venue, course timing, and lack of patients with clinical signs. Conclusion: This innovative AT-led examination preparation workshop significantly enhanced training culture and candidate well-being. ATs benefited with increased confidence in their ability to lead and teach.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Springer Science and Business Media LLC
Date: 17-11-2020
DOI: 10.1186/S12882-020-02100-4
Abstract: Pregnancy-related Atypical Haemolytic Uremic Syndrome (P-aHUS) is a rare condition affecting genetically predisposed women during pregnancy. It is often difficult to diagnose and has a significant impact on maternal and foetal outcomes. It is characterised by microangiopathic haemolytic anaemia and kidney injury from thrombotic microangiopathy. A 27-year-old female of Lebanese descent presented at 36 weeks’ gestation with foetal death in-utero (FDIU) with placental abruption on a background of previously normal antenatal visits. She was coagulopathic and anaemic with anuric acute kidney injury, requiring emergency Caesarean section, intubation and dialysis. Her coagulopathy rapidly resolved, however, her anaemia and renal dysfunction persisted. A diagnosis of P-aHUS was made, and she was empirically treated with Eculizumab. Her ADAMTS13 level was normal, effectively excluding thrombotic thrombocytopenic purpura. Within 2 weeks of treatment her haematological parameters improved, and her renal function began to recover and within 2 months she became dialysis independent. This case highlights the challenges of a timely diagnosis of P-aHUS from other pregnancy-related diseases. Although our patient is dialysis-independent, her risk of relapse remains high with subsequent pregnancies. Currently we are awaiting her genetic sequencing to complete her assessment for underlying mutations and are determining the safest approach to a future planned pregnancy.
Publisher: Science Repository OU
Date: 18-05-2020
DOI: 10.31487/J.JCMCR.2020.01.06
Abstract: Background: Acute interstitial nephritis is often associated with drug therapy. It can be a common cause of acute kidney injury, traditional chemotherapy agents have been associated with various forms of renal damage, but this is not commonly seen with anti-hormone therapy. Here we report a case of aromatase inhibitor associated acute interstitial nephritis with the use of letrozole. Case Presentation: We present the case of an 84-year-old female commended on letrozole for the management of estrogen sensitive breast cancer. The patient developed oliguric acute kidney injury 3-weeks after initiation, with a creatinine rise to 1069µmol/L, from a previously normal baseline. She had no response to hydration and underwent a renal biopsy which demonstrated acute interstitial nephritis. She was commended on 4 weeks of oral prednisone starting at 20mg with a tapering dose. Renal function returned to baseline on discharge and her aromatase inhibitor was ceased. Conclusions: This is the first reported case of letrozole induced acute interstitial nephritis. It appears the disease was steroid responsive however it is unclear if this is a class effect of aromatase inhibitors or letrozole alone.
Publisher: Wiley
Date: 09-2021
DOI: 10.1002/RAI2.12010
Abstract: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease characterized by extraordinary heterogeneity, due to the complex pathogenesis and erse manifestations. Stratification of patients for therapy and prognosis represents a major challenge to manage SLE. Conventional biomarkers for disease diagnosis and activity assessment provide very limited insight into immunological pathogenesis and therapeutic response rates. The advancement of “omics” technologies including genomics, transcriptomics, proteomics, and metabolomics has constituted an unprecedented opportunity to characterize the immunopathological landscape in in idual patients with SLE. Indeed, genomic studies reveal a subset of SLE patients carrying one or more functional single nucleotide polymorphisms (SNPs) underlying immune dysregulation while transcriptomic studies have revealed subgroups in SLE patients showing distinct signatures for Type I interferon (TI‐IFN) pathway activation or aberrant differentiation of B cells into plasma cells. This review will summarize results from the latest studies using omics technology to understand SLE heterogeneity. In addition, we propose that the application of artificial intelligence, such as by machine learning‐based nonlinear dimensionality reduction method uniform manifold approximation and projection (UMAP) can further strengthen the analysis of omics big data. The combination of new technology and novel analysis pipeline can lead to breakthroughs in stratifying SLE patients for a better monitoring of disease activity and more precise design of treatment regime, not only for conventional immunosuppression but also novel immunotherapies targeting B‐cell activating factor (BAFF), TI‐IFN, and interleukin 2 (IL‐2).
Publisher: Springer Science and Business Media LLC
Date: 11-07-2020
DOI: 10.1186/S12882-020-01923-5
Abstract: C3 glomerulonephritis is a recently described entity with heterogeneous histopathological features. This study was conducted to assess the effect of reclassification of C3 glomerulopathies on renal outcomes, mortality, and response to therapy. We undertook a retrospective analysis of 857 renal biopsies collected at The Canberra Hospital. S les with predominant C3 staining were reviewed by a renal histopathologist. Of 31 biopsies with predominant C3 staining, 10 fulfilled histological criteria for C3 glomerulonephritis, while the remaining 21 cases were used as C3 Controls. Aside from a higher incidence of C3 glomerulonephritis in Torres Strait islanders (40% vs 5% C3 Controls, p = 0.04), presentation demographics were similar between the two groups. Median creatinine at diagnosis was higher in patients with C3 glomerulonephritis (253 umol/L IQR 103–333 vs 127 umol/L C3 Controls, IQR 105–182, p = 0.01). Prior to reclassification, a majority of C3 glomerulonephritis cases were diagnosed as membranoproliferative glomerulonephritis (60% vs 5% (C3 Controls) p 0.01). Electron microscopy demonstrated all C3 glomerulonephritis patients had C3 deposition (100% vs 38% p = 0.02), these deposits were amorphous in nature (50% vs 5% respectively p = 0.007). C3 glomerulonephritis patients had shorter median follow-up (405 days IQR 203–1197 vs 1822 days respectively, IQR 1243–3948, p = 0.02). Mortality was higher in C3 glomerulonephritis patients (30% vs 14% in C3 Controls (log rank p = 0.02)). We have devised a diagnostic and treatment algorithm based on the results of literature review and our current study. Further prospective assessment is required to review diagnostic and treatment outcomes for this disease in Australian centres.
No related grants have been discovered for Prianka Puri.