scholarly journals Assessment of Renal Functions in Infants with Acute Gastroenteritis and Dehydration

2020 ◽  
Vol 8 (2) ◽  
pp. 94-99
Author(s):  
sandeep S

Background: Acute gastroenteritis is a very common illness in neonates and infants and it is one of the important causes of morbidity and mortality in third world countries. Most of the complications are due to excessive fluid loss and electrolyte imbalance adversely affecting kidney functions. Renal failure is one of the critical causes of morbidity in these children. Aim: We in the present study tried to evaluate the renal functions in infants with acute gastroenteritis reporting to our tertiary care teaching Hospital. Methods: This cross-sectional prospective study was performed on n=100 infants with gastroenteritis admitted into the Emergency service room of Prathima Institute of Medical Sciences and Hospital, Naganoor, Karimnagar. The degree Dehydration was assessed both clinically and hematologically. Blood samples for estimation of leucocyte count, Urea, Creatinine, and electrolyte estimation were drawn initially on admission and subsequently, blood culture, urine culture, and radiologic procedures were undertaken whenever indicated. Result: There are 16 cases with Blood urea more than 84 mg, indicating 16% of renal failure in the total number of cases studied, taking blood urea more than 20 mg as the criterion. But considering urinary output there are 18 cases with urinary output less than 300 ml/1.73 M 2 /24-hours. All these cases show creatinine values of more than 1.5 mg%. The glomerular filtration rate is decreasing as the severity of dehydration is increasing and fractional excretion of Sodium is diminishing with an increase in the severity of dehydration. Conclusion: The biochemical parameters like serum creatinine, blood urea, the urinary volume must be routinely in all cases of dehydration along with urinary indices like FeNa and R.F.I to detect the early onset of acute tubular necrosis. Prompt administration of intravenous fluids in acute gastroenteritis will go a long way in minimizing the mortality and morbidity among the infants

2012 ◽  
Vol 19 (06) ◽  
pp. 905-908
Author(s):  
MIRZA MUHAMMAD ILYAS BAIG ◽  
NAUMAN TARIF ◽  
FAWAD AHMAD RANDHAWA

Objective: Acute renal failure is one of the important complications of acute gastroenteritis. Early intervention and proper fluidreplacement may lessen this risk. We conducted this observational study to see the renal involvement and its outcome in patients with acutegastroenteritis. Design: Observational study. Setting: This study was done in three different hospitals which are tertiary care and teachinghospitals. Period: May 2009 to September 2009. Material and Method: A total of 200 patients were included in this study who presented withacute gastroenteritis. All patients were assessed properly for their clinical examination and laboratory tests including renal functions,electrolytes and other routine tests were done and evaluated. These patients were treated either in Emergency department or indoordepartments. Only those patients were included in our study who met our inclusion criteria which was set before conducting study. Results: Atotal of 200 patients were included in our study, among them 160 were male patients and 40 were female patients. At presentation 32 (16%)patients had deranged renal functions, 18 (09%) patients had urea in range of 50-100mg/dL and creatinine in the range of 1.4-2.0mg/dL. 10(05%) patients had urea in range of 101-150mg/dL and creatinine 2.1-3.5mg/dL. 04 (02%) patients had urea in range of 151-200mg/dL andcreatinine 3.6-7.0mg/dL. 12 patients were received in hypovolemic shock at presentation. After one week of follow up most of these patientsimproved but 04 patients were deteriorated and put on renal replacement therapy. Patients who had their renal functions in normal range weredischarged from hospital and follow up of all these patients were continued for 6 months. It was observed that those patients which presentedlate had more chances of renal involvement. Conclusions: Early referral and timely management with fluids and antimicrobials may reducerisk of renal failure in patients with acute gastroenteritis.


2021 ◽  
Vol 28 (05) ◽  
pp. 640-646
Author(s):  
Shaheena Zafar ◽  
Riffat Jaleeel ◽  
Kouser Karim Lodhani

Objective: To determine the frequency of factors leading to acute renal failure in obstetric patients. Study Design: Cross Sectional study. Setting: Department of Obstetrics and Gynecology, Civil Hospital Karachi, Tertiary Care Hospital. Period: July 2015- Jan 2016. Material & Methods: Total 250 women during pregnancy and within 42 days after delivery who were diagnosed as ARF were included. Serum creatinine was done on admission and then after 24 hours of delievery. Those with urine output < 30ml / hour and serum creatinine > 1.5 mg / dl were recruited. All data was recorded on proforma. Results: The average age of the women was 29.36±5.87 years. Post-partum hemorrhage was the important and common factor i.e. 40.4%, followed by placental abruption 25.6%, Severe pre-eclampsia 18.4%, puerperal sepsis 8.4% and eclampsia 7.2%. Conclusion: Ante partum hemorrhage like placental abruption, eclampsia and preeclampsia, and postpartum hemorrhages’ are the major causes of obstetrical ARF. Good antenatal care and provision of universal health facility can prevent this dangerous condition. Though it is a treatable and curable complication, but if not diagnosed and treated timely, it can lead to significant maternal morbidity and mortality.


2012 ◽  
Vol 52 (187) ◽  
Author(s):  
R K Agrawal ◽  
S Khakurel ◽  
R Hada ◽  
D Shrestha ◽  
A Baral

Introduction: Hemodialysis is the preferred method of treatment for Nepalese patients with End Stage Renal Disease. Despite the technological advances and better understanding of physiology associated with hemodialysis, a number of complications are known to be associated with hemodialysis. This study was undertaken to study the frequency of acute intradialytic complications in patients undergoing hemodialysis. Methods: A cross-sectional study was conducted at Nephrology unit of a tertiary care hospital from 15 June, 2007 to 15 December, 2007. A total of 28 patients were included in the study. Patients with acute renal failure and acute on chronic renal failure were excluded from the study. Results: Total sessions of hemodialysis during the period were 1455. Hypotensive episode were 66 (4.5%) and was the commonest complication and followed by hypertensive episodes were 58 (3.8%). Other problems encountered were transfusion reactions were 23 episodes (1.5%), rigors not related to transfusions were 13 episodes (0.8%), nausea/vomiting were 20 episodes (1.4%), muscle cramps were 12 episodes (0.8%), hypoglycemia were 6 episodes 5(0.4%). Conclusions: The frequency of intradialytic complications is low and many of them are not life threatening. Keywords: complications; end stage renal disease; hemodialysis; hypertension; hypotension.


2020 ◽  
Vol 27 (06) ◽  
pp. 1285-1290
Author(s):  
Ahmed Ali Kanhar ◽  
Waseem Raja Memon ◽  
Nasrullah Aamer ◽  
Bahkat Ali Sial ◽  
Abdul Aziz Sahito ◽  
...  

Objective: To determine the frequency of acute renal failure in patients presented with Blackstone poisoning in a tertiary care Hospital. Study Design: Cross sectional study. Setting: Medical wards and ICU at Peoples Medical College Hospital, Nawabshah. Period: September 2017 to March 2018. Material & Methods: All the patients of age 20 to 50 years having Paraphenylenediamine (PPD) poisoning (kala-patthar) during ≥6 hours after ingestion and either of gender were included. AKI was labelled as positive if either of any stage was present on the basses of urine output measurement for 24 hours through urine beg r urine output (UO) criteria. All the data was documented in self-made proforma. Results: The mean age for patients was 24.9±8.9 years, 46(19.08%) subjects were male and 195(80.91%) were female. 18(7.5%) study subjects had acute renal failure, out of them 6 study subjects had ARF of stage I, 5 patients had stage II and 7 study subjects had acute renal failure stage III. Conclusion: Acute renal injury is a common complication following PPD ingestion 7.5%. Paraphenylenediamine toxicity is a threat to the region of Asia and is evolving as a substitute to the poisoning of organophosphorus due to its easy accessibility and low cost.


Author(s):  
Sanjana Ramakrishnan ◽  
Sourabh Radhakrishnan ◽  
Sonu Lazar Cyriac

Background: Opportunistic bacterial infections remain a serious morbidity among cancer patients. This study was aimed to determine the bacteriological and antibiotic profile of cancer patients admitted to the ICU of a tertiary care centre.Methods: Cross sectional study was done among cancer patients admitted in the Oncology neutropenic ICU during the period from August 2017 to July 2019. All patients admitted with a proven diagnosis of cancer for whom at least one bacterial culture was sent from any site were included in the study. Laboratory on culture reports were obtained from patient files and analysed.Results: A total of 278 samples from 256 patients (60±11.6 years) were analysed. Among the 111/278 positive cultures, 29 were blood samples and 1 was a pleural fluid sample. Gram negative organisms were 62.1% with Escherichia coli (25, 36.2%) as prevalent. Among the 37.8% gram positives, Staphylococcus aureus (18. 42.8%) was prevalent. Most of the E. coli strains showed highest resistance to ceftazidime (96%) and highest sensitivity to amikacin. The commonest gram-positive organism, Staphylococcus species were 100 % sensitive to vancomycin and linezolid and 100 % resistance to penicillin.  Conclusions: E. coli (gram negative) showed highest resistance to ceftazidime and sensitivity to amikacin. S. aureus (gram positive) was sensitive to vancomycin and linezolid and resistance to penicillin. An antibiogram for cancer patients helps the clinician to initiate an appropriate empirical antibiotic therapy to reduce mortality and morbidity.


Author(s):  
Nisha Murmu ◽  
Pushpa . ◽  
Anit Kujur ◽  
Vidya Sagar ◽  
Vivek Kashyap

Background: Infectious diseases have a major contribution in the mortality and morbidity among children in India. The aim of our study was to assess the infectious diseases and the sociodemographic characteristics along with the assessment of awareness on mode of transmission of these diseases among the family members.Methods: This was a cross-sectional study done in Department of Pediatrics, RIMS, Ranchi, for a period of 6 months by consecutive sampling. Pre-tested, semi structured questionnaire was used for data collection and analysed in SPSS version 20.Results: A total of 220 children were included in the study. Majority of patients (60%) comprised of under 5 age group with male predominance (55%), with 84.1% children fully immunized, among which 54.1% were institutional deliveries and approx. 85.9% children were breast fed for more than 6 months. Malaria, being an endemic disease of Jharkhand affected maximum children (38.2%). Sanitation, (toilet facilities) was about 27% and hand hygiene was only 5% in the family members of the patients admitted. Thus lack of awareness and poor hand hygiene was an important finding in our result.Conclusions: Health education among the community should be the prime concern for the reduction of the diseases.


Author(s):  
Shakthi R ◽  
Venkatesha D ◽  
Dhanalakshmi T. A

Pyogenic wound infections are the one of the leading cause of morbidity and mortality worldwide. Some of the common etiological agents responsible are ., and . The antimicrobial resistance has become a global challenge and the resistant pathogen poses a grave threat to the public health worldwide. Pyogenic bacteria producing biofilm has a potential to cause significant mortality and morbidity in human. The present study was carried out to determine the bacteriological spectrum of wound infections and their antibiogram to commonly used antibiotics and to detect the biofilm production by the isolates. This cross sectional study was carried out in the department of Microbiology, Adichunchanagiri institute of Medical sciences from September 2016 to August 2017. Two hundred and forty samples from various wounds were collected and processed as per standard procedures and biofilm production was detected by Congo red agar method.Out of 240 pus isolates, species were the most commonly isolated (48.85%) followed by species (11.7%). Biofilm was produced by 49.2% isolates .Majority of Gram negative bacilli were susceptible to Colistin (100%) followed by Tigecycline (Biofilm producers 75%, biofilm non producers 66.7%).All Gram positive isolates were susceptible to Vancomycin and Teicoplanin (100%) followed by Linezolid (biofilm producer 98.8%, biofilm non producer 97.8%) . Routine surveillance for wound infections along with early identification and adopting efficient control protocol against biofilm forming organism plays an important role in the prevention of the most serious infections.


2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2259-2265
Author(s):  
Rakesh KS ◽  
Santosh Kumar K

Knowledge of Breastfeeding and its practice among lactating mothers is an essential factor which determines the breastfeeding rates. Exclusive breastfeeding helps in preventing neonatal and infant mortality and morbidity and is one of the most important public health intervention, which can reduce the under-five mortality also. This study was conducted in Saveetha medical college hospital between March 2020 and June 2020. To assess the knowledge, attitude, Practice of Breastfeeding among lactating mothers. Descriptive cross-sectional study. 100 lactating mothers admitted to our hospital after delivery were selected randomly. They were interviewed based on a questionnaire which was prepared to assess the knowledge attitude and practice of breastfeeding. Informed consent was obtained after explaining the objective of the study. Out of 100 mothers, 71.38% had good knowledge, 66.6% showed a positive attitude towards breastfeeding, and 63.33% had acceptable breastfeeding practices. The breastfeeding practices followed in our hospital can be improved further by proper counselling and nutritional education of the mothers in the antenatal and immediate postnatal period. The comprehensive lactation management programme which has recently been started in our hospital could aid in the same. Dedicated lactation counsellor and lactation nurse could also help achieve improved breastfeeding practices and attitude towards breastfeeding.


2021 ◽  
Vol 10 (37) ◽  
pp. 3213-3219
Author(s):  
Jagaragallu Amrutha ◽  
Narasimha Rao Netha Gurram ◽  
Padmaja Pinjala ◽  
Bhumesh Kumar Katakam ◽  
Rajeev Singh Thakur

BACKGROUND Erythroderma is a clinical entity that may cause severe systemic manifestations. The difficulty with erythroderma lies in finding the underlying aetiology. It is imperative to demonstrate precise aetiology whenever possible so that distinct therapy may be initiated. At times, despite finding the aetiology, relapses constitute a great menace. The purpose of our study was to assess the clinical profile and aetiology of erythroderma. Besides, the study also illustrated factors leading to relapses; such studies are rare in literature. METHODS This hospital-based, cross-sectional study included 88 patients of erythroderma of either sex and age more than 18 years; their clinical, laboratory, histopathological findings, treatment and outcome were studied. RESULTS The mean age of onset was 47.3 ± 12.35 years with the male to female ratio being 2.38:1. The most common cause of erythroderma was pre-existing dermatoses (67 %) followed by drugs (10.2 %), infections (3.4 %), malignancies (4.54 %), and idiopathic (14.7 %). Psoriasis was the predominant aetiology (45.4 %) among the pre-existing dermatoses with a maximum number of relapses (P = 0.02). Psoriasis was significantly associated with pruritus (P = 0.001), subungual hyperkeratosis (P = 0.0001), palmoplantar keratoderma (P = 0.001). Clinicohistological association was found in 64.6 % of cases. Mortality was seen in 6.8 % of cases. CONCLUSIONS As in previous studies, pre-existing dermatoses were the most common causes in our study; albeit, a special emphasis on factors leading to relapses was given to prevent further episodes. The most common factor of relapse was uncontrolled comorbid disorders (diabetes and hypertension) followed by medication nonadherence. Hence, our study suggests a need for more effective comorbidity management and creating awareness regarding judicial use of drugs which can go far in preventing mortality and morbidity. KEY WORDS Erythroderma, Adults, Aetiology, Relapses, Comorbidities.


Author(s):  
Nabanita Chakraborty ◽  
Gautam Kumar Joardar

Background: Immunization is one of the most effective public health measures for disease prevention and when administered timely leads to substantial reduction in child mortality and morbidity. However, timely administration of vaccines remains neglected putting the children at risk of acquiring the infections.  Methods: The study is a cross-sectional, observational study, conducted in the immunization clinic of KPC Medical College and Hospital from January to March 2019 among children below the age of 2 years. The sample size was 332. The mothers were interviewed with a pre-designed and pre-tested schedule regarding socio-demographic details and records were reviewed for scheduled date of immunization and to find any delay.Results: Total 33.7% children had some delay in receiving vaccines. The delay was found to be more in mothers <20 years of age, female children, children belonging to Hindu religion, children from joint family, children belonging to class 4 SES, children where maternal education is up to primary level and children with birth order≥3. Significant association was found between vaccine delay birth and order. (p<005). Sickness of the child accounted for 41% of the delays followed by both parents working, which accounted for 25.9% of delays.Conclusions: Delay in vaccination was found in approximately one-third of children. Thus more awareness generation is required among mothers regarding the timeliness of vaccinations and risk it poses on the children making them more susceptible to diseases in the period of delay.  


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