Examining the Perinatal Results in Patients Suffering from Acute Fatty Liver of Pregnancy | Chapter 1 | Achievements and Challenges of Medicine and Medical Science Vol. 13

Introduction: Acute fatty liver of pregnancy (AFLP) is a rare obstetric emergency requiring immediate attention and intensive care to avoid adverse outcomes for the mother and fetus. High morbidity and mortality are seen among women with AFLP. As this condition poses many complications and is varied in its clinical presentation, the perinatal outcomes in women diagnosed with AFLP were studied.

Materials and Methods: This was a retrospective study that involved all patients over the past 6 years who presented with AFLP. Clinical signs and other altered biochemical parameters were included.

Results: In the study, 19 women were diagnosed to have AFLP. The mean age of the study population was 25.74±3.7 years. 14 ( 73.68% ) women were below the age of 30 years. A gestational age of more than 37 weeks was seen in 13 ( 68.42% ) women. Ten primigravidae ( 52.63% ) and nine multiparous (47.3%) women were found to present with AFLP. The mean blood loss at the time of delivery for a lower-section cesarian section and vaginal delivery was 787.5±494.07 mL and 280±44.72 mL, respectively. The preferred treatment at the time of admission was transfusion of fresh frozen plasma (FFP) (Mean: 7.00±9 pints), followed by transfusion of platelet (Mean: 2.37±3.515 pints), transfusion of packed red blood cells (Mean: 2.21±3.691 pints) and cryoprecipitate (Mean: 0.0±2 pints). Nine ( 47.37% ) women were delivered through emergency lower segment cesarean section (LSCS) and all 4 (21.05%) pregnant women who succumbed to AFLP underwent an LSCS. Among the newborns, 13 (65%) of them were low birth weight and 2 (10.53%) had fetal distress.

Conclusion: This study showed a higher maternal mortality rate of 21% in comparison to other studies. Health professionals should be sensitized about this condition and the use of the existing scoring system available to help in detecting AFLP at an early stage to reduce maternal mortality and adverse fetal outcomes. Blood loss at the time of delivery makes it imminent to arrange for appropriate treatment and supportive care in the management of the patient, which includes fresh frozen plasma transfusion which was found beneficial in the patients.

 

Author (s) Details

 

Christy Vijay
Department of Obstetrics and Gynecology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India.

 

Annamma Thomas
Department of Obstetrics and Gynecology, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India.

 

Angeline Yvette Mascarenhas
Department of Emergency Medicine, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India.

 

Naveen Ramesh
Department of Community Medicine, St. John’s Medical College and Hospital, Bengaluru, Karnataka, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v13/4088

Kidney Manifestations of Covid-19 | Chapter 12 | Clinical Manifestations of Covid-19: A Multi-Disciplinary Approach

 

Infection with the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) virus causes the coronavirus disease 2019 (COVID-19). The disease is primarily a pulmonary disease but with multisystem (extra-pulmonary) manifestations, of which the kidneys are involved. Affection of the kidney is caused by the direct invasion of the virus or as a consequence of the immunological response to the presence of the virus. The resultant manifestation could range from an asymptomatic proteinuria to an acute kidney injury requiring kidney replacement therapy. The presence of kidney dysfunction in COVID-19 increases the severity of the disease and the risk of mortality.

 

Author(s) Details:

 

Abdul-Karim Olayinka Shitu
Department of Medicine, Faculty of Clinical Sciences, College of Health Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria.

 

Daniel Gilbert Uchendu
Department of Internal Medicine, Jos University Teaching Hospital, Jos, Nigeria.

 

Please see the book here:  https://doi.org/10.9734/bpi/mono/978-81-973195-5-6/CH12

Spectrum of Renal Involvement in Patients of Obstetrical and Gynaecological Disorders associated with Renal Abnormalities | Chapter 1 | New Visions in Medicine and Medical Science Vol. 1

Background: The prevalence and effects of renal diseases in obstetrical and gynecological patients vary. Acute kidney injury (AKI), rapidly progressive glomerulonephritis (RPGN), chronic kidney disease (CKD), or nephrotic syndrome can all occur in patients.

Aim: The study was conducted to see the spectrum of renal involvement in patients of obstetrical and gynaecological disorders associated with renal abnormalities at our centre.

Methods: The present study was conducted in the Department of Nephrology, Gauhati Medical College and Hospital, Guwahati, Assam, India over a period of 5 years (2011 – 2015). A total of 60 patients were included in the study.

Results: Of the 60 patients, 32 (53.3%) had AKI- mostly pregnancy related, 11(18.3%) patients had obstructive uropathy, 4 (6.6%) patients were diagnosed with CKD in the antenatal period, 3 (5%) patients each of RPGN and nephrotic syndrome, 5 (8.3%) patients were diagnosed with lupus nephritis and 2 (3.3%) patients were diagnosed with genitourinary tuberculosis. Renal biopsy was done in 14 patients and showed lupus nephritis in 5 patients, cortical necrosis in 2 patients, and 1 patients each with acute tubular necrosis (ATN), minimal change disease (MCD), IgA nephropathy (IgAN), Cresentric IgAN, Pauci immune glomerulonephritis, Diffuse proliferative glomerulonephritis (DPGN) and Membranous glomerulonephritis (MGN). Acute kidney injury was quite common in the pregnant females, with septic abortion and puerperal sepsis contributing to a significant number of cases. Hence, there is a need to halt the practice of illegal abortions and improve antenatal and also post natal care to reduce morbidity and mortality.

Conclusion: AKI associated to pregnancy is rather common. If left untreated, cortical necrosis could develop. Another illness that is encountered is cervical cancer, which can lead to obstructive uropathy and chronic kidney disease. To minimize morbidity and death, an early diagnosis and suitable treatment are crucial.

Author(s) Details:

Sharma M.,
Department of Nephrology, Gauhati Medical College, Guwahati, Assam, India.

Bordoloi P.,
Department of Nephrology, Gauhati Medical College, Guwahati, Assam, India.

Das H. J.,
Department of Nephrology, Gauhati Medical College, Guwahati, Assam, India.

Barman A. K.,
Department of Nephrology, Gauhati Medical College, Guwahati, Assam, India.

Doley P.,
Department of Nephrology, Gauhati Medical College, Guwahati, Assam, India.

Pegu G.,
Department of Nephrology, Gauhati Medical College, Guwahati, Assam, India.

Please see the link here: https://stm.bookpi.org/NVMMS-V1/article/view/13648

Correlation Analysis of Serum Magnesium Levels with Renal Parameters in AKI Patients | Chapter 1 | Advancement and New Understanding in Medical Science Vol. 2

This chapter aimed to correlate serum magnesium levels with renal parameters in patients with Acute kidney injury (AKI) patients.

AKI is a prevalent condition with a range of causes and effects, including electrolyte imbalances that can manifest as hyperkalemia, hypocalcemia, or hypocalcemia depending on the stage. One of the most frequent electrolyte abnormalities seen in hospitalized patients, particularly in the critically ill, is hypomagnesemia. As a result, we made the decision to investigate the relationship between serum magnesium levels and AKI.

A total of 100 patients from those attending medicine OPD and getting admitted in medicine ward, Victoria &Bowring hospital, attached to Bangalore medical college and research institute, during the period of November 1st 2016 to august 30th 2018 was taken for the study. The decrease in magnesium <1.7 mg/L was defined as hypomagnesaemia. AKI was defined as per AKIN criteria. Day 1, day 3 and day 6 magnesium levels were measured.

Prevalence of hypomagnesemia was 53%, 30% and 36% on day 1, day 3 and day 6 respectively. Out of 120 cases, 20 cases were excluded out of which 4 were due to obstructive uropathy, 6 were suffering from multi-organ dysfunction syndrome and 10 were diabetic. 66patients recovered from AKI and 34 did not recover, all 34 patients were treated with haemodialysis. It was observed that there was a positive correlation between serum magnesium, and serum creatinine. Normomagnesemia and hypermagnesemia on day 1,3 and 6 were significantly associated with recovery of AKI (p=<0.001).

In AKI patients, hypomagnesemia was far more common, and recovery was correlated with normal magnesium and hypermagnesium levels on days 1, 3, and 6. Hypomagnesemia was linked to non recovery rather than improvement.

Author(s) Details:

Raveendra K. R.,
Department of Medicine, Bangalore Medical College and Research Institute, KR Road, Bangalore, Karnataka, India.

Avinash H. R.,
Department of Medicine, Bangalore Medical College and Research Institute, KR Road, Bangalore, Karnataka, India.

Nitish Ashok Gurav,
Department of Medicine, Bangalore Medical College and Research Institute, KR Road, Bangalore, Karnataka, India.

Please see the link here: https://stm.bookpi.org/ANUMS-V2/article/view/13087

Prevention, Recognition, and Treatment of Acute Kidney Injury in ICU | Chapter 2 | Advancement and New Understanding in Medical Science Vol. 1

Acute Kidney Injury (AKI) is a prevalent and severe complication in Intensive Care Units (ICUs), with a significant impact on patient outcomes. Early prevention, recognition, and intervention are crucial for improving patient prognosis. This chapter delves into the prevention strategies, recognition techniques, and treatment approaches for AKI in the ICU setting.

Prevention of AKI encompasses identifying and addressing risk factors, such as hypovolemia, nephrotoxic medications, hypotension, and sepsis. Early recognition of AKI hinges on utilising the Kidney Disease Improving Global Outcomes (KDIGO) classification system, which categorises AKI based on serum creatinine levels and urine output. Treatment strategies for AKI involve fluid management, electrolyte management, nutrition, and renal replacement therapy (RRT) in severe cases.

In conclusion, AKI management in the ICU requires a comprehensive approach encompassing prevention, early recognition, and prompt intervention. By implementing these strategies, clinicians can significantly improve patient outcomes and reduce the morbidity and mortality associated with AKI.

Author(s) Details:

Ahmed Muhammad Bashir,
Mogadishu Somalia Turkiye Training and Research Hospital, Mogadishu, Somalia.

Please see the link here: https://stm.bookpi.org/ANUMS-V1/article/view/12999

An Overview on Neonatal Acute Kidney Injury: A Case Study from Tertiary Care Hospital in Jammu and Kashmir, India | Chapter 7 | Advanced Concepts in Medicine and Medical Research Vol. 4

 This member aimed to know the occurrence rate of AKI and its mixed risk factors among the NICU subjects to depict the ailment burden and its impact. Acute kidney harm (AKI) is a clinical condition that complicates the course and worsens the consequence in a significant number of hospitalised sufferers. Recent advances in clinical and basic research will help accompanying a more accurate description of this syndrome and in the illustration of its pathogenesis. Neonates the one suffer hypoxic ischemic encephalopathy often evolve multiorgan failure, which impacts essentially every means system. The findings plan that the incidence of neonatal AKI would have happened even higher if more rigorous AKI following protocols were executed. The most common cause for neonatal admission in our NICU was perinatal unconsciousness followed by neonatal infection of blood. The findings are limited by our description of AKI, which depends SCr changes to diagnose AKI in addition to the reality that we did not take excretion output as a marker of AKI.

Author(s) Details:

Mohammad Ashraf,
Government Medical College, Srinagar, J&K, India.

Please see the link here: https://stm.bookpi.org/ACMMR-V4/article/view/12476

Nephrotoxicity of Immune Checkpoint Inhibitors: A Diagnostic Challenge | Chapter 12 | Novel Research Aspects in Medicine and Medical Science Vol. 6

 Immune checkpoint inhibitors have transformed cancer treatment but are not complexity-free. Nephrotoxicity is relatively exceptional but often underestimated. The occurrence of acute sort injury related to checkpoint prevention therapy is increasing accompanying the widespread use of these novel antagonistic-cancer agents. Diagnosis maybe challenging and postponed, which increases the risk of complications.  Management consistently consists of treatment stop and corticosteroid therapy as determined. Vigilance and early diagnosis are the keys to better continuation and outcome.

Author(s) Details:

Amulya Prakash,
Haywood Regional Medical Center, Edward Via College of Osteopathic Medicine, USA.

Please see the link here: https://stm.bookpi.org/NRAMMS-V6/article/view/12149

Advances in Renal Diseases and Dialysis | Book Publisher International

 This book primarily covers key areas of kidney diseases and recent developments in dialysis. The contributions by the authors include acute kidney injury, chronic kidney disease, newer biomarkers of AKI, epidemiology, hepatorenal syndrome, cirrhosis, liver transplantation, acute tubular necrosis, vasopressors, newer biomarkers of HRS, diabetic kidney disease, microvascular damage, microalbuminuria, progression of CKD, RAS mechanism of action, continuous renal replacement therapy, intermittent hemodialysis, hemofiltration, hemodiafiltration, solute removal, electrolyte disorders, uremia, hyperammonemia, diffusion. This book contains various materials suitable for students, researchers and academicians in the field of medicine and medical research.

Author(s) Details:

Maheshwari Kata,
Department of Internal Medicine, MNR Medical College and Hospital, Telangana, India.

Harkesh Arora,
Department of Internal Medicine, Lovelace Medical Center, Albuquerque, New Mexico, USA.

Rajeshwari Ramachandran,
Department of Gastroenterology, Brooklyn Hospital Center, Brooklyn, New York, USA.

Varun Victor,
Department of Cardiology, Canton Medical Education Foundation/Aultman Hospital, Canton, Ohio, USA.

Nihar Jena,
Department of Cardiology, Trinity Health Oakland/Wayne State University, Pontiac, Michigan, USA.

Abid Rizvi,
Department of Behavioural Health and Psychiatry, West Virginia University, Morgantown, West Virginia, USA.

Prashanth Reddy Yella,
Department of Internal Medicine, Yuma Regional Medical Center, Yuma, Arizona, USA.

Atul Bali,
Department of Internal Medicine/Nephrology, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, USA.

Deepak Chandramohan,
Department of Internal Medicine/Nephrology, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Roopa Naik,
Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, Pennsylvania, USA.

Please see the link here: https://stm.bookpi.org/ARDD/article/view/11830

Clinical Profile and Outcomes of Acute Kidney Injury Patients in an Intensive Care Unit in India: A Retrospective Study | Chapter 17 | New Frontiers in Medicine and Medical Research Vol. 1

 Background: Epidemiology and outcome data on acute renal damage are scarce in underdeveloped countries (AKI). By attempting to identify the presenting symptoms, etiologies, treatment methods, and disease prognosis in patients admitted to intensive care units at a tertiary care institution in Mangalore, India, the current single-site study aims to define the clinical profile of AKI in patients admitted to intensive care units.

Between October 2001 and October 2003, 70 AKI patients with serum creatinine levels greater than 1.4 mg/dl and blood urea levels greater than 53 mg/dl were enrolled in this retrospective study at Wenlock district hospital in Mangalore, KMC hospital in Attawar, Mangalore, and KMC hospital in Jyothi circle in Mangalore.

Results: Of the enrolled patients, 45.7 percent were between the ages of 40 and 60, with 49 males and no significant gender difference (p=0.412). Reduced micturition was the most prevalent presenting symptom, which was present in 47.1 percent of patients, and sepsis was the most common aetiology of AKI, which was also related with the greatest fatality rate (17.1 percent). Patients who got conservative treatment (n=52) had a mortality rate of 42.8 percent, while those who had hemodialysis (n=18) had a mortality rate of 4.2 percent. The study's overall survival rate was 52.9 percent.

Conclusions: The epidemiological data in this study is consistent with previous studies in India, with hemodialysis appearing to be more effective than conservative therapy in terms of illness outcomes.

Author (s) Details

Vivek S. Narayan Pillai
Department of Cardiology, Government Medical College, Kannur, Kerala, India.

C. Joe Verghese
Department of Medicine, KMC, Mangalore, Karnataka, India.

Christopher C. Pais
Department of Medicine, KMC, Mangalore, Karnataka, India.

Vijay Gopal Rai
Department of Medicine, KMC, Mangalore, Karnataka, India.

Mahabala Chakrapani
Department of Medicine, KMC, Mangalore, Karnataka, India.

View Book :- https://stm.bookpi.org/NFMMR-V1/article/view/2796

Acute Kidney Injury in Children: A 3-Year Retrospective Analysis at Komfo Anokye Teaching Hospital, Ghana| Chapter 5 | Highlights on Medicine and Medical Research Vol. 14

 Background/Aims: Acute kidney injury (AKI) is a fairly common condition seen in pediatric practice. It continues to be a significant contributor to preventable deaths, particularly in resource-constrained regions of the world, owing to a lack of dialysis services. AKI continues to be a major cause of death in critically ill children. Aetiology, medical setting, co-morbidities, and the availability of dialysis therapy all influence mortality outcomes. The purpose of this three-year data analysis (2010-2012) was to determine the aetiology and treatment/mortality outcomes of children with AKI who presented to a Teaching Hospital in Ghana.

Out of a total of 664 renal cases, 206 cases of AKI were recorded over the course of the study. The most common causes of AKI were hemoglobinuria, obstructive uropathy, and tumor infiltration of the kidneys (37.8 percent ). Diarrhoea accounted for 9.2 percent of cases, with glomerulonephritides accounting for 12.1 percent. Seventy-one (34.5%) of the 206 AKI cases required dialysis, which could only be provided to 25 (35.2%) of them, 16 (64%) of whom survived. 43 children (20.9 percent) died, while 144 (69.9 percent) survived. Thirty-one (72%) of the patients who died required dialysis. Conclusion: When compared to previous studies conducted around the world, there is a significant burden of AKI among hospitalized children in Kumasi, Ghana. Most cases of AKI were caused by haemoglobinuria and tumor-related conditions, rather than diarrhoea-associated conditions and postinfectious glomerulonephritis, as previously reported or postulated. The majority of AKI deaths were caused by a lack of dialysis services. Peritoneal dialysis should be promoted throughout Africa to prevent unnecessary deaths from AKI due to its lower technical requirements when compared to other modalities of renal replacement therapy.

Author (S) Details

Prof. Sampson Antwi
School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Ghana and Komfo Anokye Teaching Hospital, Ghana.

Anima Sarfo
Komfo Anokye Teaching Hospital, Ghana.

Abigail Amoah
Komfo Anokye Teaching Hospital, Ghana.

Anna Serwaa Appia
Komfo Anokye Teaching Hospital, Ghana.

Esther Obeng
Komfo Anokye Teaching Hospital, Ghana.

View Book :- https://stm.bookpi.org/HMMR-V14/article/view/1651

Perspectives of Therapeutic Apheresis in Acute Kidney Injury | Chapter 2 | Highlights on Medicine and Medical Research Vol. 5

 Acute kidney failure is a significant side effect of a variety of inflammatory diseases of the abdominal and thoracic cavities, extreme injuries and burns, eclampsia and sepsis, and a variety of infectious diseases. Considering the wide range of etiologies, there is a common pathogenesis function that is dependent on endoxemia and the accumulation of a number of toxic products that cause perivascular edoema, decreased renal blood flow, glomerular filtration, tubular necrosis, and oligoanuria, as well as disruptions in the vessels endothelium permeability. The most popular treatment strategy is to use kidney replacement therapy, which consists primarily of various hemofiltration methods. However, not all hazardous substances are eliminated, and the mortality rate remains high. When hemosorption and plasmapheresis are used in a complex of therapeutic steps, the outcomes are more beneficial and stable, with a substantial reduction in mortality.

Author (s) Details

V. A. Voinov
I.P. Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russia.

M. G. Kovalev
I.P. Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russia.

K. S. Karchevsky
I.P. Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russia.

O. V. Isaulov
I.P. Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russia.

Y. V. Voinova
I.P. Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russia.

View Book :- https://stm.bookpi.org/HMMR-V5/article/view/689