scholarly journals Biopsy Proven Kidney Disease From A Rural Tertiary Care Centre — A Social And Epidemiological Perspective

2022 ◽  
Vol 9 (3) ◽  
pp. 68-71
Author(s):  
Rana Fatima ◽  
Rakesh Kumar ◽  
Amitesh Goud ◽  
Srikanth Muddhasani ◽  
Satish Reddy ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Rural Areas ◽  
Kidney Biopsy ◽  
Social Issues ◽  
Dominant Role ◽  
Treatment Plan ◽  
Tertiary Care ◽  
Glomerular Disease ◽  
Tertiary Care Centre ◽  
Glomerular Diseases

Abstract The prevalence of chronic kidney disease (CKD) is rising in rural areas. Screening of high risk cases, early detection and referral by the physicians reduces the prevalence of kidney disease in the population. Hereditary disorders, Glomerular diseases, Obstructive nephropathies are common causes in CKD in rural areas. Kidney biopsy is an essential diagnostic tool in to diagnose glomerular diseases. This prospective study done at tertiary care teaching hospital between 2017 and 2020 to understand the profile of glomerular diseases in rural area. Forty patients were included in the Study. Primary glomerular disease (PGD) was present in 26 patients and Secondary glomerular disease (SGD) in 10 and primary tubulointerstitial pathology in 4 patients. The most common Secondary glomerular disease was lupus. Glomerular diseases are amenable to immunomodulatory therapy leading to change in clinical outcome of the disease. However, Kidney biopsy is underutilized particularly in elderly patients, hypertensive nephropathy patients, suspected non diabetic kidney disease and lupus patients. Financial and social issues play dominant role in the treatment plan of chronic diseases in rural areas. Regional registry of kidney biopsy of urban and rural areas separately helps in paving a way of understanding the profile of glomerular diseases and its prevention.

Assessment of cardiovascular risk in patients with chronic kidney disease –A study from a tertiary care centre in south India

2018 ◽  
Vol 8 (4) ◽  
pp. 195-199
Author(s):  
Sandeep P ◽  
Aparna R. Bitla ◽  
G. Sarvari ◽  
SrinivasaRao PVLN ◽  
N. HariniDevi ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
South India ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre

scholarly journals Region wise referrals to a tertiary care centre: a retrospective analysis

2019 ◽  
Vol 8 (12) ◽  
pp. 4678
Author(s):  
Sirisha Paidi ◽  
Aashritha Thonangi
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Tertiary Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Urban Rural ◽  
King George Hospital ◽  
Tribal Areas

Background: Emergency obstetric care in health care requires a linked referral system to be effective in reducing maternal morbidity and mortality. This review is aimed at summarizing the proportion of referrals from urban, rural and tribal areas of surrounding districts to tertiary care centre, King George Hospital, Visakhapatnam for a 6 month period; from May 2018 to October 2018.Methods: Retrospective study done at a tertiary care teaching hospital, including 3157 cases referred from the surrounding urban, rural and tribal areas.Results: Out of the 3157 referred cases, most of them (1658) were from rural areas, 1030 from urban and 469 from tribal areas. Referrals done in view of post caesarean pregnancies were more in urban and rural areas whereas more preeclampsia and anaemia cases were referred from tribal areas. Various indications of referral are documented. Majority of them were unbooked cases.Conclusions: Specific guidelines regarding whom to refer, how to refer and when to refer would be helpful in making timely referral. These would also help to decrease the burden on the tertiary care centers which deal with a huge caseloads in spite of limited infrastructure and manpower. Adequate attention and better care can be given to complicated cases if the total case load is reduced. Stringent documentation in referral slip and better co-ordination are required for a strong health care system.

scholarly journals Management of Canadian Pediatric Patients With Glomerular Diseases During the COVID-19 Pandemic: Recommendations From the Canadian Association of Pediatric Nephrologists COVID-19 Rapid Response Team

2020 ◽  
Vol 7 ◽  
pp. 205435812097071
Author(s):  
Cal Robinson ◽  
Michelle Ruhl ◽  
Amrit Kirpalani ◽  
Abdullah Alabbas ◽  
Damien Noone ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Peer Review ◽  
Care Delivery ◽  
Rapid Response Team ◽  
Glomerular Disease ◽  
Rapid Response ◽  
Optimal Care ◽  
Glomerular Diseases ◽  
Canadian Association ◽  
Response Team

Purpose: The goal of these recommendations is to provide guidance on the optimal care of children with glomerular diseases during the COVID-19 pandemic. Patients with glomerular diseases are known to be more susceptible to infection. Risk factors include decreased vaccine uptake, urinary loss of immunoglobulins, and treatment with immunosuppressive medications. The Canadian Society of Nephrology (CSN) recently published guidelines on the care of adult glomerulonephritis patients. This guideline aims to expand and adapt those recommendations for programs caring for children with glomerular diseases. Sources of information: We used the CSN COVID-19 Rapid Response Team adult glomerulonephritis recommendations, published in the Canadian Journal of Kidney Health and Disease, as the foundation for our guidelines. We reviewed documents published by nephrology and non-nephrology societies and health care agencies focused on kidney disease and immunocompromised populations. Finally, we conducted a formal literature review of publications relevant to pediatric and adult glomerular disease, chronic kidney disease, hypertension, and immunosuppression in the context of the COVID-19 pandemic. Methods: The leadership of the Canadian Association of Pediatric Nephrologists (CAPN), which is affiliated with the CSN, identified a team of clinicians and researchers with expertise in pediatric glomerular diseases. The aim was to adapt Canadian adult glomerulonephritis guidelines to make them applicable to children and discuss pediatric-specific considerations. The updated guidelines were peer-reviewed by senior clinicians with expertise in the care of childhood glomerular diseases. Key findings: We identified a number of key areas of glomerular disease care likely to be affected by the COVID-19 pandemic, including (1) clinic visit scheduling, (2) visit types, (3) provision of multidisciplinary care, (4) blood work and imaging, (5) home monitoring, (6) immunosuppression, (7) other medications, (8) immunizations, (9) management of children with suspected COVID-19, (10) renal biopsy, (11) patient education and support, and (12) school and child care. Limitations: There are minimal data regarding the characteristics and outcomes of COVID-19 in adult or pediatric glomerular disease patients, as well as the efficacy of strategies to prevent infection transmission within these populations. Therefore, the majority of these recommendations are based on expert opinion and consensus guidance. To expedite the publication of these guidelines, an internal peer-review process was conducted, which may not have been as rigorous as formal journal peer-review. Implications: These guidelines are intended to promote optimal care delivery for children with existing or newly diagnosed glomerular diseases during the COVID-19 pandemic. The implications of modified care delivery, altered immunosuppression strategies, and limited access to existing resources remain uncertain.

scholarly journals A prospective evaluation of the availability and utility of the Ambulance Call Record in the emergency department

CJEM ◽  
2016 ◽  
Vol 19 (2) ◽  
pp. 81-87 ◽  
Author(s):  
Natalie Cram ◽  
Shelley McLeod ◽  
Michael Lewell ◽  
Matthew Davis
Keyword(s):  
Emergency Department ◽  
Patient Management ◽  
Treatment Plan ◽  
Tertiary Care ◽  
Relevant Information ◽  
Care Centre ◽  
Prospective Evaluation ◽  
Tertiary Care Centre ◽  
Handover Process ◽  
Collection Form

AbstractObjectiveTo determine how often the Ambulance Call Record (ACR) was available to emergency department (ED) physicians and whether it contained information that changed the ED management of patients.MethodsThis was a prospective cohort study of adult patients transported to one of two tertiary care centre EDs. Physicians completed a data collection form for each patient regarding ACR availability and the perceived value of the ACR. This study began shortly after the implementation of a new electronic ACR (eACR) handover process (Round 1). To control for any confounding factors related to this new eACR handover process, the study was repeated 6 months after its implementation (Round 2).ResultsTotal of 869 forms were collected: 545 in Round 1, and 324 in Round 2. The ACR was available at first physician assessment for 82 (15.7%) patients in Round 1, and 76 (24.4%) patients in Round 2 (Δ8.7%, 95% CI: 3.1%, 14.5%). The ACR was available at some point during patients’ ED stay for 154 (28.9%) patients in Round 1, compared to 111 (34.5%) patients in Round 2 (Δ5.6%, 95% CI: 0.0%, 12.1%). When the ACR was available for a patient (n=265), physicians believed that information in the ACR changed their treatment plan in 76 (28.8%) cases.ConclusionPhysicians who review the ACR believe that the ACR contains relevant information that may influence patient management; however, physicians commonly manage patients without reviewing the ACR.

scholarly journals A tertiary care centre profile of heart diseases among diagnosed cases of chronic kidney disease

2020 ◽  
Vol 8 (2) ◽  
pp. 652
Author(s):  
Vijay Bakhtar ◽  
Niyati Bakhtar ◽  
Neha Pandey ◽  
Nikhil Bakhtar
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiovascular Diseases ◽  
Kidney Disease ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cardiac Evaluation

Background: Chronic Kidney Disease (CKD) is a risk factor for development of cardiovascular diseases. Cardiovascular diseases are the predominant cause of morbidity and mortality in patients with CKD. There is limited data on cardiovascular diseases among CKD patients from developing countries including India. With the present study, the prevalence and patterns of cardiac diseases among patients with CKD were profiled.Methods: This was a cross sectional study in which 217 patients with CKD were studied over a period of two years and six months. Data on demographic characteristics and risk factors for cardiovascular diseases were collected using a standardized questionnaire. Cardiac evaluation was done using resting ECG and echocardiography.Results: One hundred eighteen (54.4%) patients had either eccentric or concentric LVH. Patients with LVH were more likely to be hypertensive (p<0.001) or anemic (p=0.034). Up to 9.2% of study subjects had valvular heart disease (rheumatic or degenerative) and 22% had pericarditis. Patients with pericarditis were more likely to have a serum urea concentration greater than 60mg/dl (p=0.327). Forty-one patients (18.9%) had left ventricular systolic failure (EF<50%). There was a statistically insignificant higher prevalence of systolic failure in patients with LVH (21% vs. 16%), (p=0.346). Thirty-eight participants (17.5%) had diastolic failure while 2% had cardiac rhythm abnormalities.Conclusions: Cardiac abnormalities are common in a relatively young Indian population with CKD. Clinicians should routinely screen and manage cardiovascular disease in CKD patients.

scholarly journals Study of social and demographic determinants of severe acute malnutrition in children aged 6-59 months in a tertiary care centre of Odisha, India

2018 ◽  
Vol 6 (1) ◽  
pp. 46
Author(s):  
Pravati Jena ◽  
Soumini Rath ◽  
Manas Kumar Nayak ◽  
Diptirekha Satapathy
Keyword(s):  
Low Socioeconomic Status ◽  
Rural Areas ◽  
Health Care Services ◽  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Acute Malnutrition ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Study Population

Background: The objective is to study the various social and demographic determinants of severe acute malnutrition in children aged 6 months to 59 months in a tertiary care centre of Odisha, India.Methods: This is a hospital based prospective observational study done in a tertiary care centre of Odisha during the period of Nov 2015 to Oct 2017 in which all children with severe acute malnutrition as per WHO criteria in the age group 6 months to 59 months were enrolled and their socioeconomic and demographic details were evaluated.Results: Present study revealed a prevalence of severe acute malnutrition as 2.8%. Males (54.2%) were more affected than females (45.8%). Most common age group affected was 6-12 months (37.4%). Most of the children were from low socioeconomic status (96.4%) and from rural areas (84.8%).63.7% of the study population were unimmunised. Only 12.6% of the participants were exclusively  breast fed.100% of the children in the study population received top feeding with cow’s milk.Conclusions: The prevalence of malnutrition is high in Odisha but most of the causative factors are preventable. Adequate education regarding exclusive breastfeeding, complementary feeding, immunisation, promotion of proper referral and health care services can help to improve nutritional status in the state of Odisha.

scholarly journals Clinico-biochemical profile of chronic kidney disease patients in elderly age group in a tertiary care centre

2019 ◽  
Vol 7 (11) ◽  
pp. 4227
Author(s):  
Atul V. Rajkondawar ◽  
Amit Yele
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Tertiary Care ◽  
P Value ◽  
Age Group ◽  
Elderly Age ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Significant Difference

Background: Chronic kidney disease (CKD) remains one of the major health problems in India. Renal function steadily deteriorates as age advances and advancing age has been indicted to have adverse implications in the disease progression to end stage renal disease (ESRD). With the present study, clinico-biochemical profiling of chronic kidney disease patients in geriatric age group as well as comparison with non-elderly patients was undertaken.Methods: In this cross-sectional observational study, 100 patients of CKD admitted in the tertiary care study centre were enrolled consecutively and assessed for symptoms, signs and biochemical parameters over two years. Study subjects were divided into two groups:- Group 1: Elderly patients- aged 60 years or more, and Group 2: Non-elderly patients- less than 60 years of age. Relevant comparisons were drawn statistically and tested for significance.Results: Pallor and pedal edema were observed to be the commonest clinical features across groups. Elderly group shows higher prevalence of severe anaemia (mean hemoglobin- 7.4 gm%). Higher prevalence of clinical and biochemical derangement was found in patients with relatively lower GFR. Elderly age group also had more prevalence of electrolyte abnormalities compared with non-elderly population, with statistically significant difference observed for hyponatremia (p value- 0.023), hypoproteinemia (p value- 0.0078) and blood urea level (p value- 0.0054).Conclusions: Understanding beforehand the biochemical abnormalities associated with old age in CKD patients helps in appropriate modifications in patient management.

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