scholarly journals Retinal Detachment Associated With AIDS-Related Cytomegalovirus Retinitis: Risk Factors in a Resource-Limited Setting

2015 ◽  
Vol 159 (1) ◽  
pp. 185-192 ◽  
Author(s):  
Michael Yen ◽  
Jenny Chen ◽  
Somsanguan Ausayakhun ◽  
Paradee Kunavisarut ◽  
Pornpattana Vichitvejpaisal ◽  
...  
2007 ◽  
Vol 55 (5) ◽  
pp. 464-469 ◽  
Author(s):  
Weerawat Manosuthi ◽  
Achara Chaovavanich ◽  
Somsit Tansuphaswadikul ◽  
Wisit Prasithsirikul ◽  
Yoawarat Inthong ◽  
...  

2008 ◽  
Vol 12 (6) ◽  
pp. 582-586 ◽  
Author(s):  
Weerawat Manosuthi ◽  
Wisit Prasithsirikul ◽  
Noppanath Chumpathat ◽  
Bussakorn Suntisuklappon ◽  
Chatiya Athichathanabadi ◽  
...  

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Rajesh Rajasekharan Nair ◽  
Venkatram Murugesan ◽  
George Kurian ◽  
Anil Mathew ◽  
Zachariah Paul Polachirakal ◽  
...  

Abstract Background and Aims Acute kidney Injury (AKI) is a serious medical condition estimated to affect more than 10 million people around the world annually, resulting in a 1.7- to 6.9-fold increased risk of hospital mortality. Out of 1.7 million deaths per year caused by AKI globally, around 1.4 million occur in low- and middle-income countries, sepsis being the leading cause. AKI occurs in 40–50% of patients with sepsis and increases the mortality six- to eight-fold. By comparing the prevalence of potential risk factors in populations of patients who had developed AKI with control groups with no AKI, several risk assessment tools have been proposed and generated for specific clinical settings such as intensive care units, cardiac surgery, general surgery, those undergoing radiological investigations involving intravenous contrast and those presenting to the emergency department. The AKI Risk Assessment (ARA F4) model incorporated newer biomarkers of kidney injury (TIMP-2, IGFBP7) along with clinical parameters to detect patients at risk for AKI as fast as possible and to prevent further damage. However, they are yet to be available freely in our country. To the best of our knowledge, no risk assessment tool in the setting of tropical fever associated AKI has been proposed till date. The aim of this study is to provide a practical model to identify patients at high risk for tropical fever associated AKI in a resource limited setting in the absence of newer biomarkers. Method Ours is a retrospective, single center study. Patients who had an increase in serum creatinine (S.Cr) ≥0.3 mg/dL within 48 hours; or an increase in S.Cr to ≥1.5 times baseline, which is known or presumed to have occurred within the prior 7 days or a urine volume of <0.5 mL/kg/h for 6 hours were included. We recruited 342 consecutive admissions with tropical fever associated AKI and evaluated them based on clinical and biochemical profiles. Results We analyzed data of 342 patients. Our population of patients had representation from all age groups, 72% were between 21 to 60 years, 20.4% were >60years and 34.7% were females. There was a clear relationship between age and the number of AKI risk factors. Baseline serum creatinine was available for 117 patients, the average S.cr was 0.9591mg/dL and the average rise in S.cr was 1.22mg/dL. Leptospirosis (11.98%), dengue (84.79%), malaria (2.63%) and complicated malaria (0.29%) were the etiologies for AKI. 19,21 and 2 patients with leptospirosis had <=5, 6 to 10 and >10 risk factors respectively. 258,32 and 0 patients with dengue had <=5, 6 to 10 and >10 risk factors respectively. 8,1 and 0 patients with malaria had <=5, 6 to 10 and >10 risk factors respectively. One patient with complicated malaria had <=5 risk factors. 15/42 with leptospirosis, 2/290 with dengue, none with malaria and 1/1 with complicated malaria required renal replacement therapy. Five patients expired, out of which three were on renal replacement therapy. 3/286 with total risk score <5, 14/53 with total risk score between 6-10 and one out of two with total risk score >10 required renal replacement therapy. Conclusion Tropical fever associated AKI is a major public health burden in southern India. Our aim was to propose a risk stratification model to assess severity of tropical fever associated AKI and dialysis requirement in a resource limited setting. In our study, the number of risk factors, incidence of AKI and dialysis requirement were more in people with leptospirosis. We also observed that as the risk scores went up, the need for hemodialysis increased irrespective of the etiology. In the absence of availability of newer biomarkers this risk prediction score is quite useful. Ours is the first risk assessment tool in tropical fever associated AKI in resource limited setting. We are planning on a prospective evaluation of the same in the near future to validate our Tropical fever associated Acute Kidney Injury Risk assessment (TAKIR) tool. Figure In-lined.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Weerawat Manosuthi ◽  
Lantharita Charoenpong ◽  
Chalor Santiwarangkana

Abstract Background The availability and accessibility of effective antiretroviral therapy (ART) for people living with HIV (PLWH) has substantially improved in the past two decades in resource-limited settings. Therefore, evaluation of survival is needed in the current setting. Method We retrospectively analyzed secondary data of the national AIDS program database from national health security region number 4 among PLWH who were ART-naive between January 2014 and December 2018. All PLWH were followed until December 2019 to evaluate their survival status and possible risk factors related to death. Results A total of 42,229 PLWH were identified, of which 14,053 were ART-naive and thus enrolled in the study. Sixty-seven percent were male, the mean ± SD age was 35 ± 12 years, and the median (IQR) baseline CD4 count was 162 (44–353) cells/mm3. Regarding medical care benefits, 46% had a universal health coverage scheme, 34% had a national social security scheme, and 2% had a civil servants medical benefit scheme. A total of 2142 (15%) mortalities occurred during the total follow-up period of 28,254 patient-years. The mortality rate was 7.5 (95% CI 7.2–7.9) per 100 person-years. Survival rates at 1, 2, 3, 4 and 5 years after HIV registration were 88.2% (95% CI 87.6–88.7%), 85.3% (95% CI 84.6–85.9%), 82.9% (95% CI 81.9–83.4%), 81.3% (95% CI 80.5–82.0%) and 75.1% (95% CI 73.5–76.8%), respectively. The Cox proportional hazards model showed that all-cause mortality was associated with a history of ART switching (HR = 7.06, 95% CI 4.53–11.00), major opportunistic infections during ART (HR = 1.93, 95% CI 1.35–2.77), baseline CD4 count ≤ 200 vs. > 500 cells/mm3 (HR = 4.00, 95% CI 1.45–11.11), age ≥ 50 vs. < 30 years (HR = 1.77, 95% CI 1.12–2.78), and receiving nevirapine-based regimens(HR = 1.43, 95% CI 1.04–1.97). Conclusions This study demonstrated the substantial mortality rate over the consecutive 5 years of the follow-up period among PLWH who received ART in a resource-limited setting. Early case finding and prompt initiation of ART as well as continuous HIV care are a cornerstone to improve survival.


2019 ◽  
Vol 25 ◽  
pp. 117
Author(s):  
S Chandraprabha ◽  
T Jayalakshmi ◽  
Reshma Vijay ◽  
Kavitha Muniraj ◽  
Muralidhara Krishna ◽  
...  

2018 ◽  
Vol 56 (08) ◽  
pp. e354-e354
Author(s):  
A Ebigbo ◽  
M Schlander ◽  
G Anigbo ◽  
U Ijoma ◽  
H Messmann

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