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  Access statistics : Table of Contents
   2018| April-June  | Volume 5 | Issue 2  
    Online since October 11, 2018

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A comparative analysis of formulae used for the estimation of glomerular filtration rate to determine the kidney function test in patients with chronic kidney disease
Prabhat Agrawal, Ashish Gautam, Nikhil Pursnani, Maaz Farooqui, Jitendra Doneria
April-June 2018, 5(2):49-53
There are many equations available for estimation of creatinine clearance, but regrettably, most of the formulae have many limitations. Prabhat's formula is a novel equation which provides appropriate values of creatinine clearance with the lesser or no limitations. The calculation can be done using the formula as follows: (i) CrCl = 100/(1.3 × S. Creatinine) × (0.8 if female) when age is between 30 and 40 years; (ii) CrCl = 100/(1.5 × S. Creatinine) × (0.8 if female) when age is between 41 and 50 years; and (iii) CrCl = 100/(1.8 × S. Creatinine) × (0.8 if female) if age >51 years. On the other hand, it is evident that using Prabhat's formula the calculated creatinine clearance is quite similar to the one that we get using other formulae for the same. Unlike other methods, this equation has no such limitations. The formula is quite reliable for calculating the creatinine clearance and estimating the kidney function test. However still, future studies with this formula in this field are very important and should focus on issues such as the elderly patients with decreased GFR and modification of this formula to get more accurate results.
  4,674 426 -
Pharmacoeconomic evaluation of hemodialysis patients: A study of cost of illness
S Fathima, Uday Venkat Mateti, Malona Lilly Philip, Janardhan Kamath
April-June 2018, 5(2):54-59
Objective: The objective of the study is to analyze the health-care costs of the hemodialysis (HD) patients in a charitable hospital. Subjects and Methods: A prospective observational study was carried out in an outpatient HD unit of nephrology department in a charitable hospital for a period of 8 months from August 2016 to March 2017. The collected direct medical and nonmedical cost data were analyzed for the median interquartile (Q3–Q1) cost incurred in treating the HD patients. Results: A total of 39 outpatients were included in the study. Of 39 patients, majority of the HD patients were males (66.2%) followed by females (33.8%). Most of the patients underwent HD for twice a week (89.7%) followed by thrice a week (10.3%). The median direct medical costs (85,999.2 Indian rupee [INR]) were found to be higher than direct nonmedical costs (14,437.1 INR). Conclusions: The study revealed that the total median direct cost was found to be uppermost for the age group of 41–60 years (1,12,438.8 INR) when compared to all other age groups, and it was also observed that the total median direct cost for males (1,07,522.4 INR) was higher than females (1,03,170.7 INR). The factors such as type of comorbidities, age, and number of HD per week may affect the cost of illness.
  3,668 406 1
Response of calcineurin inhibitors therapy in frequently relapsing and steroid resistent nephrotic syndrome: A single-center experience
Umesh Godhani, Manish R Balwani, Dinesh Gera, Praveen Ghule, Rajesh Singh, Vivek Kute
April-June 2018, 5(2):66-73
Background and Objectives: This observational study was conducted to evaluate and compare the efficacy of calcineurin inhibitors in frequently relapsing nephrotic syndrome (FRNS) and steroid-resistant nephrotic syndrome (SRNS). Subjects and Methods: Each group comprised 15 patients who were studied prospectively. These patients were treated with tacrolimus (Tac) or cyclosporine (CSA) concomitant with prednisone, which was subsequently tapered off and stopped. The primary outcome variable was the number of patients who attained a complete remission (CR) or partial remission (PR). Results: Out of 15 patients with FRNS, 11 were children and 4 were adults. In SRNS, out of total 15 patients 7 were children and 8 were adults. There was male preponderance in FRNS children, whereas in SRNS, gender distribution was almost equal. Hypertension was more common in steroid-resistant group (80%) as compared to FRNS (33%). In FRNS, focal segmental glomerulosclerosis (FSGS), and immunoglobulin M variant of minimal change disease were the most common cause, each accounting for 5 patients, whereas FSGS (8 patients) was the most common etiology in SRNS. In FRNS, out of total 4 patients who were treated with CSA, 2 achieved CR and 2 achieved PR. Mean time to achieve remission was 3.2 months. In FRNS, out of 13 patients who were treated by Tac, 7 patients achieved CR and 6 patients achieved PR. Mean time to achieve remission was 2.1 months. In SRNS, out of 3 patients treated with CSA, 1 achieved PR whereas 2 patients did not respond. Time to achieve remission was 5 months. In SRNS, 11 of 14 patients achieved CR and 2 achieved PR. Mean time to achieve remission was 2.5 months. Among 2 patients resistant to CSA 1 achieved CR with Tac and one did not respond to Tac also. Conclusion: Thus, in FRNS patients, both CSA and Tac are almost equally effective whereas in SRNS patients Tac was more effective than CSA and was also effective in 1 patient resistant to CSA.
  3,361 283 -
Etiological variability affecting the clinical outcomes of patients admitted with acute kidney injury in a tertiary care hospital
Maniyar Iqbal Anvar, Bellara Raghavendra
April-June 2018, 5(2):60-65
Objectives: The objectives are to study the clinical profile of patients admitted with acute kidney injury (AKI) and to study the determinants of the outcomes of patients with AKI. Subjects and Methods: The study was done in setting of tertiary care hospital in Department of Nephrology. It is a prospective observational study. A total of 220 patients who were admitted with community AKI in a tertiary care hospital were evaluated, and data were collected and analyzed. Patients were evaluated and followed up and if indicated were dialyzed until recovery. Primary outcomes were in-hospital mortality, complete recovery, and dialysis dependency at 3 months. Apart from these etiological profile, mortality of patients with various etiology, their RIFLE staging was assessed. Results: of 220 patients studied, 191 (86.81%) survived and 29 (13.19%) expired, 93 (42.27%) patients required dialysis and 123 (57.7%) did not require dialysis with oligoanuria being the most common (24.5%) indication for dialysis and gastroenteritis was the most common etiology of AKI in 60 (27.3%) reflecting the high incidence of disease in community, followed by sepsis 31 (14.1%), pyelonephritis 27 (12.3%), and snakebite and obstetrics 19 (8.6%) each. Among patients who died, patients with sepsis had highest mortality 11 (35.5%) and gastroenteritis and acute febrile illness had least mortality (1.7% and 0%), respectively, majority of patients (59.5%) were in RIFLE Stage 3 and they had the highest mortality 23 (17.6%). A significant association was observed between the etiology and mortality (P < 0.005). Conclusions: We conclude that underlying cause of AKI is important determinant of the clinical outcome where we found that patients with gastroenteritis had better outcome than other etiology of AKI.
  3,227 329 2
A clinicodemographic analysis of patients with genital warts treated at Sohag University Hospital, Egypt
Mohammed Abu El-Hamd, Soha Aboeldahab
April-June 2018, 5(2):74-79
Objectives: This study aimed to evaluate the demographic features, clinical presentations, sexual aspects, and possible risk factors of genital warts (GWs) among patients treated at Outpatient Clinics of the Dermatology, Venereology, and Andrology Department, Faculty of Medicine, Sohag University, Egypt. Patients and Methods: In a prospective cross-sectional clinical study, it conducted on 85 patients with clinically evident GWs. All patients were subjected to clinical assessments included a detailed medical history and full general and local examinations. All patients were investigated to exclude other sexually transmitted diseases (STDs). Results: This study included 85 patients with clinically evident GWs; 65 (76.5%) were male and 20 (23.5%) were female. Of male patients, 44.5% were university graduate, 73.8% were urban, 90.8% were smoker, 64.6% had a single sexual partner, 75.4% preferred intravaginal sex, 100% were circumcised, 80% had occasional history of condom use, and 95.4% had a history of illegal sexual relation. Of female patients, 40% were university graduate, 55% were suburban, 100% were nonsmoker, 45% had a single sexual partner, 65% preferred intravaginal sex, 100% were circumcised, 50% had an occasional history of partner use of condom, and 35% had a history of illegal sexual relation. All patients had neither other STDs nor warts in other body sites. Conclusion: Like all STDs , GWs have important effects on the health of society and quality of life. So, awareness of clinical presentations, sexual aspects, and possible risk factors of GWs leads to the use of effective protection measures and decrease the cost of treatment.
  3,082 297 -
Aggressive angiomyxoma of scrotum in a man: A case report and literature review of 73 cases of aggressive angiomyxoma in men
Yu Xi Terence Law, Jing Hong Nicholas Tan, King Chien Joe Lee
April-June 2018, 5(2):80-84
Aggressive angiomyxoma is a mesenchymal tumor arising from the pelvis and perineum, classically seen in women and rarely found in men. Due to its rarity, there is a low index of suspicion for diagnosis. We describe an unusual case of aggressive angiomyxoma in a male with intellectual disability. A thorough review of existing 73 cases was also conducted. This report affirms vimentin as the most sensitive marker and S-100 is the most specific marker. Desmin seems to stain positively and negatively in a sporadic fashion, making it less reliable as an immunohistochemical marker. Wide excision is commonly regarded as the treatment for aggressive angiomyxoma in men. To date, there are no established clinical guidelines on the optimal duration of follow-up. Long-term follow-up may be required even up to 10 years to detect local recurrences.
  3,017 260 1
Erectile dysfunction in type 2 diabetics: Does it need more attention?
Jayanta Chakraborty, Semanti Chakraborty, Rita Maitra Chakraborty
April-June 2018, 5(2):45-48
The obesity, metabolic syndrome, type 2 diabetes, and non-alcoholic fatty liver disease are the menace of this century. Their complications are also tantamount to peril. Erectile dysfunction which affects large number of type 2 diabetics is uncared for and requires more attention before it would cause irreversible damage. The present article will discuss the importance of more research on this subject.
  2,936 339 -