scholarly journals A clinico-epidemiological study of cutaneous changes in chronic kidney disease

2016 ◽  
Vol 2 (4) ◽  
pp. 103
Author(s):  
Chirag Maheshwari ◽  
Ajay Kumar ◽  
Sanjeev Gupta
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Public Health Problem ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Urban Background ◽  
Cutaneous Manifestations

<p class="abstract"><strong>Background:</strong> Chronic kidney disease (CKD) has emerged as a major public health problem in South Asia. This is attributable to the increase in prevalence of co-morbidities particularly hypertension and diabetes mellitus. Cutaneous manifestations are observed throughout the course of the disease and serve as markers of the disease and its progression. Early diagnosis and treatment is critical in halting the progression of the disease. The objective was to study the prevalence of co-morbidities as well as cutaneous changes in patients with CKD from a rural or semi-urban background in a tertiary care hospital.</p><p class="abstract"><strong>Methods:</strong> A total of 50 patients with CKD aged 18 years or above detected and managed at a tertiary care teaching hospital in North India were included in the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> The age of the patients ranged from 18 to 78 years. 35 patients (70%) had a rural background while 15 patients (30%) had a semi-urban background. 37 patients (74%) had co-morbidities including hypertension, diabetes mellitus or both. 17 patients (34%) were on conservative management while 33 patients (66%) were undergoing haemodialysis. Skin changes included nephrogenic pruritus in 30 patients (60%), xerosis in 25 patients (50%), cutaneous infections and infestations in 25 patients (50%), pallor in 22 patients (44%), acquired perforating disorders in 6 patients (12%), purpura in 5 patients (10%), hyperpigmentation in 4 patients (8%) and yellow skin in 1 patient (2%). Hair changes were observed in 20 patients (40%), nail changes in 24 patients (48%) and mucosal changes in 20 patients (40%). None of the patients were found to have bullous dermatoses, calcific uraemic arteriolopathy or nephrogenic systemic fibrosis. 4 patients (8%) included in the study initially reported to dermatology OPD with a specific dermatosis and were detected to have CKD.</p><p><strong>Conclusions:</strong> The prevalence of co-morbidities including hypertension and diabetes associated with CKD may be lower in rural and semi-urban populations. Nephrogenic pruritus is the most distressing change which impairs the quality of life in these patients. Cutaneous changes may help in early detection and treatment of CKD. </p>

scholarly journals Clinico-Epidemiological Profile of Viral Sexually Transmitted Infections in Seropositive Patients Attending a Tertiary Care Hospital in North India

2017 ◽  
Vol 16 (4) ◽  
pp. 331-337 ◽  
Author(s):  
Shikha Chugh ◽  
Vijay Kumar Garg ◽  
Rashmi Sarkar ◽  
Kabir Sardana
Keyword(s):  
Sexually Transmitted Infections ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Developed Countries ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Sexually Transmitted ◽  
Hiv Seropositive

Sexually transmitted diseases are a major public health problem both in developing and in developed countries, and especially with the co-synergy with HIV infection, there is an increasing need to have a proper understanding of the clinicodemographic patterns of sexually transmitted infections (STIs) for planning and implementing control strategies. Worldwide, there is an increased preponderance of viral STIs. Increasing incidence and altered clinical presentation of viral STIs in patients with HIV pose a diagnostic challenge; thereby, we studied the demographic profile of HIV-seropositive patients and compared clinical manifestations of viral STIs in HIV-seropositive patients to those in seronegative individuals. Twenty-seven HIV-seropositive patients with viral STI (herpes/molluscum/warts) and same number of age-, sex-, and STI-matched seronegative patients were studied for variability in clinical profile. There were significant differences in the demographic factors (education, income, and migration) and sexual practices (number of contacts and source of infection) in the 2 groups. Lesional symptoms, increased extent of lesions, and resistance to treatment were significantly more common in HIV-seropositive patients.

scholarly journals Epidemiological Profile and Antimicrobial Resistance Pattern of Enteric Fever in a Tertiary Care Hospital of North India – a Seven Year Ambispective Study

2018 ◽  
Vol 61 (4) ◽  
pp. 125-130 ◽  
Author(s):  
Anuradha Makkar ◽  
Shilpi Gupta ◽  
Inam Danish Khan ◽  
Rajiv Mohan Gupta ◽  
KS Rajmohan ◽  
...  
Keyword(s):  
Public Health ◽  
Enteric Fever ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Multidrug Resistant ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Drug Resistant

Introduction: Enteric-fever is a major public-health problem in developing countries emerging as multidrug-resistant, Nalidixic-acid resistant and extremely drug-resistant Salmonella (Pakistan, 2016), has intensified the use of WHO watch/reserve group antimicrobials such as azithromycin and meropenem. Methods: This ambispective-study was conducted on 782 non-repeat blood-culture isolates of S. Typhi, S. Paratyphi A and S. Paratyphi B obtained from 29,184 blood cultures received at a 1000-bedded tertiary-care hospital of North-India from 2011–2017. Identification and antibiograms were obtained by Vitek-2 compact and Kirby-Bauer’s disc diffusion with resistance to ampicillin, chloramphenicol and cotrimoxazole being labeled as multidrug-resistant. Decreased ciprofloxacin-susceptibility and ciprofloxacin-resistance were defined as MIC 0.125–0.5 and >1 μg/ml. Results: S. Typhi and S. Paratyphi A in a ratio of 3.9:1 were seen between July–September predominantly distributed between 6–45 year age group. Resistance to co-trimoxazole, chloramphenicol, ceftriaxone and azithromycin was 6.1%, 13.8%, 16.1 and 5.78% respectively. Multidrug-resistant S. typhi and S. paratyphi A were 2.73% and 1.91% respectively. Conclusion: Enteric-fever is a major public-health problem in India. Emergence of multidrug-resistant, Nalidixic-acid resistant and extremely-drug resistant Salmonella mandates ongoing surveillance for targeted empirical therapy and containment of spread. Repeated epidemics call for water, sanitation, hygiene and vaccination strategies to sustain herd-immunity.

scholarly journals Knowledge, Self-Efficacy, Self-Management Behavior of the Patients With Predialysis Chronic Kidney Disease

2019 ◽  
Vol 42 (2) ◽  
pp. 38-48
Author(s):  
Satchina Moktan ◽  
Sirirat Leelacharas ◽  
Wonnapha Prapaipanich
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Self Efficacy ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Public Health Problem ◽  
Self Management ◽  
Care Hospital ◽  
Global Public Health ◽  
Management Behavior

Background: Chronic kidney disease (CKD) is an emerging global public health problem. Control of risk factors and prevention of complications can delay the progression to end-stage renal disease. Self-efficacy and self-management behavior in patients with predialysis CKD has not been investigated in Nepal. Objectives: To describe knowledge of CKD, self-efficacy, and self-management behavior in patients with predialysis CKD and to determine the relationships between knowledge in CKD and self-efficacy with self-management behavior. Methods: Ninety-seven predialysis CKD patients visiting nephrology clinic of a tertiary care hospital in Kathmandu, Nepal were recruited from November 2016 to December 2016. Questionnaires comprised of sociodemographic data, CKD knowledge, self-efficacy, and self-management behavior questionnaires were used. Data were analyzed, using descriptive statistics and Pearson product moment correlation coefficient. Results: The mean age of 97 participants was 45.67 years. There were 3 stages of CKD among participants: stage G4 (54.64%), stage G3 (42.27%), and stage G2 (3.09%), respectively. Hypertension was the most common comorbidity (81.44%) followed by diabetes mellitus (30.92%). Predialysis CKD patients had a moderate level of knowledge on CKD and self-efficacy and high level of self-management behavior. There were positive relationships between knowledge in CKD and self-management behavior (r = 0.52; P < .05), and between self-efficacy and self-management behavior (r = 0.39; P < .05). Conclusions: This study suggested that education, counseling, workshop to increase the knowledge, self-efficacy, and self-management behavior might be helpful for the predialysis CKD patients. Healthcare providers can educate, motivate, and train the patients to practice self-management behavior to delay the progression of CKD.

scholarly journals Antimicrobial Resistance in Typhoidal Salmonellain a Tertiary Care Teaching Centre in North India

2021 ◽  
Vol 53 (1) ◽  
pp. 1-4
Author(s):  
Juhi Taneja ◽  
Keyword(s):  
Antimicrobial Resistance ◽  
Blood Culture ◽  
Enteric Fever ◽  
Clinical Decision Making ◽  
Tertiary Care ◽  
Herd Immunity ◽  
Public Health Problem ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital

Introduction: Enteric fever continues to carry a high burden of morbidity and mortality in India. There have been reports of emergence of ceftriaxone resistant typhoidal Salmonella from Asia. Monitoring of antimicrobial resistance trends in typhoidal Salmonella is crucial to support in clinical decision making. Aim: To study the current susceptibility pattern of typhoidal salmonella isolates in our setup. Methods: This retrospective study was conducted on 144 non-repeat blood-culture isolates of S. Typhi, and S. Paratyphi A obtained from 3926 blood cultures received at 510-bedded tertiary-care hospital of North-India from 2017-2019. Identification and antibiograms were obtained by Vitek-2 compact and Kirby-Bauer’s disc diffusion with sensitivity to azithromycin, and chloramphenicol. Result:S. Typhi and S. Paratyphi A in a ratio of 5.2:1 were seen between months of June and July predominantly distributed between 1-10 years age group. S. Typhi resistance to co-trimoxazole, chloramphenicol, ceftriaxone and azithromycin was 21.4%, 25.6%, 12.3% and 28% respectively. S. Paratyphi A resistance to co-trimoxazole, chloramphenicol, ceftriaxone and azithromycin was 4.3%, 17.3%, 34.7% and 21.7% respectively. Conclusion: Enteric-fever is a major public-health problem in India. Emergence of ceftriaxone-resistant Salmonella mandates appropriate investigation of all febrile illnesses with blood culture whenever possible. Provision of safe drinking water, good sanitation, hygiene and vaccination strategies are needed to sustain herd-immunity.

Pharmacoeconomic evaluation of chronic kidney disease patients: a study on cost of illness

2020 ◽  
Vol 8 (2) ◽  
pp. 82-88
Author(s):  
Sarada Sheethal Y ◽  
Ch Esther ◽  
Syed Sabiha Sultana ◽  
Mounika M ◽  
Dileep Kumar T ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Direct Cost ◽  
Kidney Diseases ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Care Hospital ◽  
Important Public Health Problem ◽  
Major Barrier ◽  
Life Style Changes

Chronic kidney diseases (CKD) is an important public health problem due to its high prevalence , morbidity and mortality. It is associated with high expenditure among indian patients. Higher stages of CKD have higher economic burden especially on the lower middle class. Hemodialysis, patients habits like alcohol consumption and smoking, treatment support by employer and patients with co morbid conditions and ESRD was found to effect the direct cost of the treatment.. Although CKD is generally Progressive and irreversible patients are advised regarding nutrition, life style changes and compliance with treatment might slow progression, enabling patients to live longer without complication and need for renal replacement therapy. Major barrier in the successful treatment of CKD is high cost of hemodialysis and medication which is difficult for the patient to afford. The main objective is to analyse the direct cost involved in treating Chronic Kidney disease patients in tertiary care hospital. Reimbursement, patients dialysis , social habits and comorbid conditions were found to have a significant effect on the direct cost of treatment.

MO229PROFILE OF TUBERCULOSIS AND ITS MANAGEMENT IN CHRONIC KIDNEY DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Divya Datta ◽  
Ravindra Attur Prabhu ◽  
Indu Ramachandra Rao ◽  
Srinivas Vinayak Shenoy ◽  
Shankar Prasad Nagaraju ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Adverse Drug Reactions ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Reactions ◽  
Case Record ◽  
Incidence And Mortality ◽  
Ckd Stage

Abstract Background and Aims Estimates of Tuberculosis(TB) burden indicate an estimated incidence and mortality of 199 and 32 respectively per 100000 in our country. Risk factors for acquiring TB disease include HIV infection, Diabetes Mellitus, Tobacco consumption and undernutrition. We retrospectively studied profile of TB in Chronic Kidney disease(CKD) in our population. Method Retrospective case record based study of consecutive TB patients visiting a Tertiary care hospital attached to a Medical College diagnosed by standard methods to demonstrate TB bacilli in sputum or affected tissue. CKD was diagnosed based on estimated Glomerular filtration rate less than 60 ml/min/m2 for at least three months. Pattern of TB and adverse drug effects were studied. Statistical analysis was done on SPSS version 20 Results Over ten months, of 746 TB patients seen, 41(5.4%) had CKD, Stage 3b,4 and 5 in 7/41(17.1%), 11(26.8%), 23(56.1%) respectively. Among CKD 24(58.5%) had Diabetes Mellitus, 1(2.4%) HIV and 37(90.2%) hypertension. Pattern of TB is shown in table 1. Adverse drug reactions were significantly higher in CKD 24/41(54.5% vs 17% in non CKD, P &lt; 0.05). Mortality in CKD was 3/41(7.3%) and not significantly higher on multivariable analysis than in those without CKD. Conclusion In this retrospective survey of TB patients CKD constituted 5.4%, was associated with more adverse drug reactions but did not impact on mortality. Pulmonary TB was the common pattern in CKD.

scholarly journals Outcome of Urgent Hemodialysis in Chronic Kidney Disease in a Rural Tertiary Care Hospital

KYAMC Journal ◽  
2013 ◽  
Vol 3 (2) ◽  
pp. 277-281
Author(s):  
Sheik Salahuddin Ahmed ◽  
Md. Zulfikar Ali ◽  
Tarafdar Runa Laila ◽  
Moniruzzaman
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Care Hospital ◽  
Dialysis Unit ◽  
End Stage Renal Failure ◽  
End Stage

Chronic kidney disease is a worldwide public health problem with an increasing incidence and prevalence. Outcomes of chronic kidney disease include not only complications of decreased kidney function and cardiovascular disease but also end stage renal failure causing increased morbidity and mortality. The development of acute but serious uremic complications in advanced kidney disease may put the patient's life at risk requiring immediate dialysis. The objective of this study was to find out the outcomes of urgent hemodialysis in advanced kidney disease, the minimum number of hemodialysis required for satisfactory clinical improvement, and to detect uremic emergencies associated with those patients. Twenty two patients with end stage renal failure admitted in a rural tertiary care private hospital of Bangladesh for emergency and short term dialysis were included in this study. For each patient hemodialysis was done at one day interval three times in a week in a dialysis unit. Results show that two sessions of hemodialysis produced 72 % and three sessions, almost 100% clinical recovery at satisfactory level. Urgent hemodialysis was found to be life saving in observed uremic emergencies like acute pulmonary edema, cerebral encephalopathy, metabolic acidosis, hyperkalemia, gross fluid overload and pericardial effusion. Dialysis therapy ameliorates many of the clinical manifestations of renal failure and postpones otherwise imminent death and for these logical reasons it is recommended that dialysis should not be delayed in uremic emergencies for the best interest of clinical outcomes. KYAMC Journal Vol. 3, No.-2, January 2013, Page 277-281 DOI: http://dx.doi.org/10.3329/kyamcj.v3i2.15167

Correlation of Iron Profile with Different Stages of Chronic Kidney Disease in Children Presenting at a Tertiary Care Hospital

2021 ◽  
Vol 15 (8) ◽  
pp. 2013-2016
Author(s):  
Shahid Ishaq ◽  
Muhammad Imran ◽  
Hashim Raza ◽  
Khuram Rashid ◽  
Muhammad Imran Ashraf ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Iron Overload ◽  
Serum Ferritin ◽  
Serum Iron ◽  
Tertiary Care ◽  
Transferrin Saturation ◽  
Maintenance Hemodialysis ◽  
Care Hospital ◽  
Iron Profile

Aim: To determine correlation of iron profile in children with different stages of chronic kidney disease (CKD) presenting to tertiary care hospital. Methodology: A total of 81 children with chronic kidney disease stage having glomerular filtration rate (GFR) less than 90 (ml/min/m2) aged 1 – 14 years of either sex were included. Three ml serum sample was taken in vial by hospital duty doctor for serum ferritin level, serum iron, transferrin saturation and total iron binding capacity. The sample was sent to hospital laboratory for reporting. Iron profiling was done evaluating hemoglobin (g/dl), serum iron (ug/dl), serum ferritin (ng/ml), transferrin saturation (%) and total iron binding capacity (ug/dl) while iron load was defined as serum ferritin levels above 300 ng/ml. Correlation of iron profile with different stages of CKD was determined applying one-way analysis of variance (ANOVA). Results: In a total 81 children, 46 (56.8%) were boys while overall mean age was 7.79±2.30 years. Mean duration on hemodialysis was 11.52 ± 9.97 months. Iron overload was observed in 26 (32.1%) children. Significant association of age above 7 years (p=0.031) and residential status as rural (p=0.017) was noted with iron overload whereas iron overload was increasing with increase in stages of CKD (p=0.002). Hemoglobin levels decreased significantly with increase in stages of CKD (p<0.001). Serum iron levels increased significantly with increase in the CKD stages (p=0.039). Serum ferritin levels were increasing significantly with the increase in CKD stages (p=0.031). Transferrin saturation also increased significant with increase in CKD stages (p=0.027). Conclusion: High frequency of iron overload was noted in children with CKD on maintenance hemodialysis and there was linear relationship with stages of CKD and iron overload. Significant correlation of hemoglobin, serum iron, serum ferritin and transferrin saturation was observed with different stages of CKD. Keywords: Iron overload, maintenance hemodialysis, ferritin level.

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