End-Stage Renal Disease in a Solitary Kidney: A Complex Clinical Presentation with Multiple Systemic Complications | Chapter 4 | Medical Science: Updates and Prospects Vol. 1

 

Background: End-stage renal disease (ESRD) represents the terminal phase of chronic kidney disease (CKD), characterised by irreversible loss of renal function requiring renal replacement therapy. Patients with a solitary functioning kidney face unique challenges when progressing to ESRD, particularly when multiple comorbidities are present.

 

Case Presentation: The clinical course of a 49-year-old female with ESRD and a solitary kidney who developed numerous life-threatening complications, was presented. The patient had undergone right nephrectomy two decades prior and presented with severe uremia, anuria, and multisystem involvement including hepatic dysfunction, haematological abnormalities, and cardiopulmonary complications. Despite regular hemodialysis and comprehensive medical management, she experienced recurrent pleural effusions requiring multiple interventions, along with persistent electrolyte disturbances and severe anaemia.

 

Clinical Findings: Laboratory investigations revealed markedly elevated serum urea (110-190 mg/dL) and creatinine (8-13 mg/dL) levels, with a glomerular filtration rate of 8 mL/min. Imaging studies demonstrated bilateral massive pleural effusions with septations, and abdominal ultrasonography showed moderate to gross ascites with splenomegaly. The patient also exhibited pancytopenia, hyperkalemia, and hemoptysis, requiring intensive multidisciplinary care.

 

Management and Outcome: The patient received bi-weekly to tri-weekly heparin-free hemodialysis through an arteriovenous fistula, supplemented with erythropoietin therapy and blood transfusions for refractory anaemia. Tube thoracostomy and therapeutic thoracentesis were performed repeatedly to manage recurrent pleural effusions and associated respiratory distress.

 

Conclusion: This case underscores the significant clinical challenges encountered in managing ESRD patients with a solitary kidney and multiple comorbidities. Early recognition of CKD, timely initiation of renal replacement therapy, aggressive management of complications, and patient education remain critical components in improving outcomes. The case highlights the importance of integrated multidisciplinary care and the need for heightened awareness regarding CKD progression in high-risk populations.

 

 

Author(s) Details

Vinay Singh
Department of Medicine, Maulana Azad Medical College, New Delhi, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v1/6543

Quality of Life in ESRD Patients | Chapter 12 | Medical Science: Trends and Innovations Vol. 10

Background and Aim: Assessment of health-related quality of life in end-stage renal disease (ESRD) patients. The quality of life of the patients may be greatly reduced because it necessitates lifelong treatment in the form of renal replacement therapy. Therefore, the main goal of the study is to evaluate the QOL (quality of life) of patients receiving hemodialysis using WHO-QOL criteria.

Methods: At the Dr. B.R. AMCH dialysis unit, a cross-sectional descriptive study involving (n=134) patients (of whom 34 gave negative consent) was carried out over the course of three years, from September 10, 2018, to September 10, 2021.

Results: A total of 100 CKD patients participated in the study, which included 60 males and 39 females and 1 preferred not to say, visiting DR. B.R. AMCH, being treated on OUT patient basis. The quality of life was assessed based on WHOQOL questionnaire, assuming each measurement had same Weightage. The study conducted showed the quality of life was poor and very poor (51%), with neither good nor bad as 22% and only 25% as good.

Conclusion: WHO QOL is a trustworthy tool for assessing QOL in ESRD patients. The research indicates that the progression of the illness has a negative impact on both mental and physical health, as well as causing financial strain and strained relationships with others.

 

Author (s) Details

 

Faseeh K M
Department of Internal Medicine, Dr. B R Ambedkar Medical College and Hospital, India.

 

Harshavardhan R
Department of Internal Medicine, Dr. B R Ambedkar Medical College and Hospital, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v10/4749 

False Positive Fourth Generation HIV Screening Tests in Low Prevalence Areas of Saudi Arabia: A Case Study and Literature Review | Chapter 11 | Medical Science: Trends and Innovations Vol. 7

Introduction: HIV screening tests are routinely conducted on dialysis patients as the constant exposure of their blood during the dialysis process makes them a reasonable risk for blood-borne infections. However, in low prevalence settings, where HIV rates are <0.1% of the population, false positive results are more likely. In low prevalence areas, the positive predictive value (the probability of a positive result being truly positive) decreases drastically. This results in apprehension in the dialysis unit as breaches in infectious disease protocols could be presumed. It may also contribute to psychological distress for both the patient and caregivers.  This is illustrated in the case report below.

Case Summary: A 62-year-old male Saudi end-stage kidney disease patient secondary to DM nephropathy began dialysis a year before presentation in a hemodialysis center in Saudi Arabia. Routine screening tests done at the start of dialysis revealed negative Hepatitis C, HIV 1 and 2 screening but a positive Hepatitis B surface antigen screen. The patient went for holiday dialysis at another facility and had a routine fourth-generation HIV test done which was positive. A confirmatory HIV PCR test was negative.

Conclusion: This case highlights the need for caution in interpreting highly sensitive and specific HIV screening tests in a low-prevalence setting. Routine screening beyond the national recommendation may not be necessary in low-prevalence areas. When screening is indicated, positive results must be followed by confirmatory tests. Thus, it may be prudent to avoid conducting routine highly sensitive and specific HIV screening tests in hemodialysis centers with low prevalence rates than what is recommended to reduce the waste of resources.

 

Author (s) Details

 

Ngozi Virginia Aikpokpo
Diaverum AB Saudi Arabia, Riyadh, KSA and Department of Health, University of Bath, Claverton Down, Bath, UK.

 

Ahmed YAHYA Omaysh
Diaverum AB Saudi Arabia, Riyadh, KSA.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v7/4377

Occurrence of Carpal Tunnel Syndrome in Chronic Hemodialysis Patients | Chapter 10 | Medical Science: Trends and Innovations Vol. 7

Background: Despite significant advances in hemodialysis (HD) practice, carpal tunnel syndrome (CTS) remains a clinical concern among patients. Carpal tunnel syndrome (CTS) is a well-known manifestation of dialysis-related amyloidosis, mainly caused by the deposition of β2- microglobulin in the carpal tunnel. It is considered the most common mononeuropathy in endstage renal disease (ESRD) patients.

Aim: This study aimed to evaluate the prevalence of CTS and identify factors associated with its occurrence in chronic HD patients.

Methods: A cross-sectional study was conducted in December 2017, including consenting chronic HD patients with a dialysis vintage of at least three months, at a reference state center in Oujda, Eastern Morocco. CTS diagnosis was based on reported symptoms, clinical signs, and positive Tinel and Phalen manoeuvres. Symptomatic patients underwent electromyography (EMG) on non-dialysis days, performed by the same neurologist under standardized conditions. Data were analyzed using SPSS version 20.0 for Windows. Chi-square or Fisher exact tests were used for analyzing the correlation among categorical variables.

Results: A total of 112 chronic HD patients meeting the inclusion criteria were enrolled. CTS was diagnosed and confirmed by nerve conduction studies in 8.04% of patients. Diabetic nephropathy was the most common underlying nephropathy, observed in 36.3% of CTS cases. Patients with CTS were older (mean age: 52.99 ± 11.32 vs. 48.4 ± 12.6; p=0.002), predominantly male (63.6% vs. 55.4%; p=0.03), and active smokers in 18.5% of cases. CTS patients also had a longer HD duration (95.8 ± 15.75 vs. 82.11 ± 17.22 months; P<0.001). Additionally, CTS was significantly associated with a higher prevalence of diabetes mellitus (36.3% vs. 13.8%; p<0.001), hepatitis C virus (HCV) infection (18.18% vs. 2.97%; p=0.02), and reduced urine output (<100 ml/day: 27.2% vs. 3.98%; P=0.003). Multivariate logistic regression analysis revealed that HCV infection (OR: 1.45, 95% CI: 1.17–1.87, p=0.034), prolonged HD vintage (OR: 1.95, 95% CI: 1.89–3.65, P<0.001), and urine output <100 ml/day (OR: 1.72, 95% CI: 1.03–2.57, P=0.01) were independently associated with CTS.

Conclusion: This cross-sectional study highlights that prolonged dialysis vintage, HCV infection, and loss of residual renal function are key factors associated with CTS in chronic HD patients. The surgical release procedure of the wrist is an effective treatment method. Further research is needed to elucidate the underlying mechanisms and pathogenesis of CTS in this patient population.

 

Author (s) Details

 

Intissar Haddiya
Department of Nephrology, Dialysis and Renal Transplantation, Mohamed VI University Hospital, University Mohamed First, Oujda, Morocco.

 

Hicham Yacoubi
Department of Orthopaedics, Mohamed VI University Hospital, University Mohamed First, Oujda, Morocco.

 

Fatima Zahra Berkchi
Hassan II Center for Chronic Diseases, Oujda, Morocco.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v7/3682

Dialysis Disequilibrium Syndrome: A Red Flag to Check Post Hemodialysis | Chapter 4 | A Case in a Million

 This chapter reports a case where a change in mentation from baseline has been seen after a few sessions of HD in a patient in whom new dialysis was initiated.  Severe dialysis disequilibrium syndrome (DDS) is an increasingly rare complication following the initiation of dialysis treatment. The clinical syndrome is defined by neurological symptoms occurring in close association with haemodialysis and can range from very mild, such that they go unnoticed, to severe. We report a 78-year-old African American female with a past medical history of hypertension and stage 5 chronic kidney disease was referred to ED from the surgery clinic for hypertensive urgency before surgery for dialysis access. Extreme age, high blood urea nitrogen, abrupt dialysis regimen changes, the existence of additional disorders causing cerebral edema, neurological diseases that already exist, and increased blood-brain barrier permeability are common risk factors. As there are now no clear treatment guidelines, it is imperative to comprehend these risk factors and take preventative measures to avoid the syndrome.  Due to the rarity of DDS, there has not been any treatment protocol to date, however, supportive steps to manage the symptoms of DDS are suggested.

Author(s) Details:

Tutul Chowdhury,
One Brooklyn Health, Interfaith Medical Center, New York, USA.

Please see the link here: https://stm.bookpi.org/ACIM/article/view/12575

Potential of Germanium-Titanium- π Polymer Composites as Functional Textiles in Improving Blood Circulation and Sexual Satisfaction | Chapter 5 | New Advances in Medicine and Medical Science Vol. 5

 Far color of blood (FIR) treatment arises as an interesting approach to enhance the microcirculation structure of the human body. FIR performance can be integrated as an alive textile, that provides FIR exposure for constant use and can be so considered as a potential non-pharmacological therapy in sufferers with minor vascular disorders by frequently reconstructing the blood flow. This chapter aims to show the characteristics and kind of germanium-titanium- π (Ge-Ti- π) textile, manufactured as a patch and shorts, as a promising novel polymer composite for better ancestry circulation of patients accompanying end-stage renal disease going through hemodialysis (HD) and experiencing vasculogenic erectile dysfunction (VED), individually. The immediate and unending effects of the applied Ge-Ti- π fabric have been judged. The Ge-Ti- π textile has existed demonstrated to have 0.93 FIR emissivity, 3.05 g/d strength, and 18.98% extension along with a 51.6% microorganisms reduction and negative fungal growth. The Ge-Ti- π patch considerably reduced appendage numbness/pain (p < 0.001) and pain score on the visual parallel scale (p < 0.001) in patients taking HD. Additionally, the Doppler ultrasound assessment data accompanied a significant augmentation of blood flow in the right hand afterwards 1 week of Ge-Ti- π patch situation (p < 0.041). Furthermore, the Ge-Ti- π underpants situation significantly enhanced the value of sexual function and the average penile ancestry flow velocity after 3 months of the situation in VED patients. Summarily, the results desire that the Ge-Ti- π textile application maybe helpful for victims with impaired ancestry circulation.

Author(s) Details:

Yu-Cing Juho,
Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei -114, Taiwan

Shou-Hung Tang,
Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei -114, Taiwan.

Yi-Hsin Lin,
Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.

Chen-Xi Lin,
School of Nursing, National Defense Medical Center, Taipei -114, Taiwan.

Tenson Liang,
Graduate Institute of Life Sciences, National Defense Medical Center, Taipei -114, Taiwan and Department and Graduate Institute of Biology and Anatomy, National Defense Medical Center, Taipei-114, Taiwan.

Juin-Hong Cherng ,
Graduate Institute of Life Sciences, National Defense Medical Center, Taipei -114, Taiwan and Department and Graduate Institute of Biology and Anatomy, National Defense Medical Center, Taipei-114, Taiwan.

En Meng,
Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei -114, Taiwan.

Please see the link here: https://stm.bookpi.org/NAMMS-V5/article/view/10864

Sleep Disturbances Linked to Kidney Function Decline| Chapter 1 | Perspective of Recent Advances in Medical Research Vol. 3

 This member aims to describe the predominance and risk factors of Sleep disorders (SDs) among incessant hemodialysis patients in the Nephrology and Dialysis Department of the Rabat Military Hospital, Morocco. All hemodialysis subjects in the nephrology division of the Rabat Military Hospital were enrolled in the trial, that was designed as a potential single-center study. We judged four SDs—insomnia, sleep apnea, disturbed legs condition, and excessive sunshine sleepiness—for each patient. All the 52 chronic hemodialysis sufferers were recruited for this study. Multivariate logistic reversion was performed to determine the traits connected to miscellaneous SDs in 40 individuals accompanying a prevalence of insomnia and sleep interruption of activity syndrome (SAS). Anemia, overdone daytime torpor, and irritability were all associated with restlessness; whereas, SAS was guide age ≥50 years, obesity, and overdone daytime torpor. Restless legs condition was linked to advanced age, overdone daytime torpor, and the presence of a organic inflammatory syndrome. Sleep disorders have a important impact on the feature of life of dialysis victims, so it is critical to expect them and, more basically, identify the associated determinants to control them.

Author(s) Details: Wafaa Arache, Department of Nephrology, Dialysis and Renal Transplantation, Military Hospital Mohammed V, Morocco and Department of Nephrology, Faculty of Medicine and Pharmacy, Mohammed V University, Morocco. Fouad Laboudi, Department of Psychiatric Emergencies, Faculty of Medicine and Pharmacy, Arrazi de Salé University Hospital, Mohammed V University, Rabat, Morocco. Driss El-Kabbaj, Department of Nephrology, Dialysis and Renal Transplantation, Military Hospital Mohammed V, Morocco and Department of Nephrology, Faculty of Medicine and Pharmacy, Mohammed V University, Morocco. Please see the link here: https://stm.bookpi.org/PRAMR-V3/article/view/9059

Sleep Disturbances Linked to Kidney Function Decline| Chapter 1 | Perspective of Recent Advances in Medical Research Vol. 3

 This episode aims to describe the predominance and risk factors of Sleep disorders (SDs) among never-ending hemodialysis patients in the Nephrology and Dialysis Department of the Rabat Military Hospital, Morocco. All hemodialysis inmates in the nephrology division of the Rabat Military Hospital were enrolled in the trial, that was designed as a potential single-center study. We judged four SDs—insomnia, sleep apnea, anxious legs condition, and excessive sunshine sleepiness—for each patient. All the 52 chronic hemodialysis subjects were recruited for this study. Multivariate logistic reversion was performed to determine the traits connected to differing SDs in 40 individuals accompanying a prevalence of insomnia and sleep interruption of activity syndrome (SAS). Anemia, overdone daytime torpor, and irritability were all associated with restlessness; whereas, SAS was guide age ≥50 years, obesity, and overdone daytime torpor. Restless legs disease was linked to advanced age, overdone daytime torpor, and the presence of a organic inflammatory syndrome. Sleep disorders have a important impact on the characteristic of life of dialysis subjects, so it is critical to expect them and, more basically, identify the associated determinants to control them.

Author(s) Details:

Wafaa Arache,
Department of Nephrology, Dialysis and Renal Transplantation, Military Hospital Mohammed V, Morocco and Department of Nephrology, Faculty of Medicine and Pharmacy, Mohammed V University, Morocco.

Fouad Laboudi,
Department of Psychiatric Emergencies, Faculty of Medicine and Pharmacy, Arrazi de Salé University Hospital, Mohammed V University, Rabat, Morocco.

Driss El-Kabbaj,
Department of Nephrology, Dialysis and Renal Transplantation, Military Hospital Mohammed V, Morocco and Department of Nephrology, Faculty of Medicine and Pharmacy, Mohammed V University, Morocco.

Please see the link here: https://stm.bookpi.org/PRAMR-V3/article/view/9059

Use of Enalapril to Prevent Myointimal Hyperplasia in Upper Extremity Arteriovenous Fistula for Hemodialysis Access: A Descriptive, Longitudinal, Cross-sectional, Case-control Study| Chapter 4 | Current Innovations in Medicine and Medical Science Vol. 10

 This branch aims to evaluate the effect of Enalapril in barring Myointimal Hyperplasia (MIH) in arm’s arteriovenous fistula (AVF) for hemodialysis access. The current explanatory, longitudinal, cross-localized case-control study was carried out in our emergency room by the vascular resection service as one with the radiology duty from January to May of 2017. In our study main causes of early AVF thrombosis, were diabetes and alive smoking; further presenting bigger MIH within those sufferers. Our findings on Enalapril as a risk determinant for MIH are inconclusive, still patients in the Enalapril group had lower myointimal complex calculations and less AVF early failure.

Author(s) Details:

Javier Ismael Hernández-Vázquez,
PueblaMed Medical Group in Puebla, Mexico.

Héctor Bizueto-Rosas,
Vascular Surgery and Angiology Department, Specialties Hospital, “La Raza” National Medical Center, Mexican Institute of Social Security, México City, México.

Pablo Martín Boada Sandoval,
Vascular Surgery and Angiology Department, Specialties Hospital, “La Raza” National Medical Center, Mexican Institute of Social Security, México City, México.

Please see the link here: https://stm.bookpi.org/CIMMS-V10/article/view/8864

Assessing the Effectiveness of Foot Reflexology on Anxiety of Patients Undergoing Hemodialysis in Tertiary Care Hospital, Karad, India| Chapter 8 | Challenges and Advances in Pharmaceutical Research Vol. 10

 Chronic sort disease (CKD) is a term used to depict a permanent deficit of kidney function. In renal collapse, there is a decrease in glomerular filtration rate. The number of fitness problems and additional ailments may cause either form of renal misstep to occur. The Objectives concerning this study: (1) To assess the level of worry among exploratory and control groups of patients going through hemodialysis. (2) To determine the influence of foot reflexology on tension among exploratory group of patients enduring hemodialysis. (3) To find the association middle from two points level of anxiety and picked sociodemographical variables between experimental and control groups of sufferers undergoing hemodialysis. The evaluative research approach was secondhand for this study, and the research design was a quasi-exploratory design. The research was carried out in the being apart unit of Krishna Hospital in Karad. The sample composes of 40 hemodialysis patients detached into two groups: 20 in the experimental group and 20 in the control group. The sample was preferred using a handy sampling process. The experimental group taken pad reflexology twice a period for three weeks, with each meeting lasting 20 notes of meeting, whereas the control group taken hospital consistent care. The mean post-test anxiety score in the exploratory group was 16.6, while it was 22.55 in the control group, which was significantly higher. The t-test advantage was 3.50, which was regarded to be important at the p<0.001level. In the post-test, the values manifested a statistically important difference in tension levels between the exploratory and control groups. According to the findings of the study, pad reflexology was efficient in lowering anxiety levels.

Author(s) Details:

Samir K. Choudhari,
Department of Nursing Sciences, Krishna Institute of Nursing Sciences, Karad, Maharashtra, India.

Nutan Potdar,
Department of Nursing Sciences, Krishna Institute of Nursing Sciences, Karad, Maharashtra, India.

Prabhuswami Hiremath,
Department of Nursing Sciences, Krishna Institute of Nursing Sciences, Karad, Maharashtra, India.

Dhanraj Kharat,
Department of Nursing Sciences, Krishna Institute of Nursing Sciences, Karad, Maharashtra, India.

Please see the link here: https://stm.bookpi.org/CAPR-V10/article/view/8802

Intradialytic Cardiovascular Exercise Training Alters Redox Status, Reduces Inflammation and Improves Physical Performance in End Stage Renal Disease Patients under Hemodialysis | Chapter 3 | Recent Developments in Medicine and Medical Research Vol. 13

 Introduction: Chronic kidney disease (CKD) is characterised by redox status (RS) disturbances and inflammation, which are significantly aggravated in end-stage renal disease (ESRD) (ESRD).

The goal of this study was to see how effective a 6-month intradialytic exercise training programme was at reducing RS, inflammation, and physical performance in ESRD patients.

Materials and Procedures: For six months, twenty hemodialysis (HD) patients (17 males, 3 females) were randomly allocated to either an intradialytic training (bedside cycling) group (TR; n = 10) or a control group (CON; n = 10) for intradialytic training (bedside cycling). Physical performance (VO2peak), functional capacity [North Staffordshire Royal Infirmary (NSRI) walk test, sit-to-stand test (STS-60)], quality of life [(short form-36 (SF-36)], RS [thiobarbituric acid reactive substances (TBARS), protein carbonyls (PC), reduced (GSH) and oxidised (GSSG) glutathione, GSH/GSSG ratio, total antioxidant capacity (TAC), catalase activity (

Results: Only in TR (p 0.01) did peak oxygen consumption (VO2peak) increase by 15%. Only TR's performance improved by 4–13% in NSRI, STS-60, and SF-36 (p 0.01). Exercise training decreased TBARS by 28%, PC by 31%, and hs-CRP by 15%, while increasing GSH by 52%, GSH/GSSG ratio by 51%, TAC by 59 percent, and CAT by 15% (p 0.01).

Conclusion: Chronic intradialytic cardiovascular exercise modifies RS, decreases inflammation, and improves performance in patients with ESRD, according to these data. Future research will need to look into this circumstance with a larger sample size in order to draw safe conclusions.

Author(S) Details

Apostolos Sovatzidis
Department of Nephrology, Faculty of Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece.

Athanasios Chatzinikolaou
School of Physical Education and Sport Sciences, Democritus University of Thrace, 69100 Komotini, Greece.

Ioannis G. Fatouros
School of Physical Education and Sport Sciences, University of Thessaly, Karies, 42100 Trikala, Greece.

Stylianos Panagoutsos
Department of Nephrology, Faculty of Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece.

Dimitrios Draganidis
School of Physical Education and Sport Sciences, University of Thessaly, Karies, 42100 Trikala, Greece.

Eirini Nikolaidou
Department of Plastic, Reconstructive and Hand Surgery & Burns ICU, General Hospital of Thessaloniki “G. Papanikolaou”, 57010 Thessaloniki, Greece.

Alexandra Avloniti
School of Physical Education and Sport Sciences, Democritus University of Thrace, 69100 Komotini, Greece.

Yiannis Michailidis
School of Physical Education and Sport Sciences, Democritus University of Thrace, 69100 Komotini, Greece.

Ioannis Mantzouridis
School of Physical Education and Sport Sciences, Democritus University of Thrace, 69100 Komotini, Greece.

Alexios Batrakoulis
School of Physical Education and Sport Sciences, University of Thessaly, Karies, 42100 Trikala, Greece.

Ploumis Pasadakis
Department of Nephrology, Faculty of Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece.

Vassilis Vargemezis
Department of Nephrology, Faculty of Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece.

View Book:- https://stm.bookpi.org/RDMMR-V13/article/view/5024

Study on Bacteremia in Hemodialytic Patients and Antibiotics Susceptibility Pattern | Chapter 11 | Innovations in Microbiology and Biotechnology Vol. 1

 Bacteremia is a condition in which bacteria are found in the bloodstream. Because hemodialysis patients are immunocompromised, the most common cause of death is bacterial bloodstream infection. Gram-positive cocci are the most common cause of bloodstream infections in hemodialysis users. Patients on hemodialysis are particularly vulnerable if the infection is caused by Staphylococcus aureus, which has a death rate of greater than 8%.

Methods: For six months, a cross-sectional study was conducted at Nepal's National Kidney Center. Individuals having hemodialysis treatment had their blood samples taken. The collected blood samples were inoculated in a blood culture bottle with BHI biphasic medium and incubated aerobically at 37°C for 18-24 hours (up to 1 week if necessary). The colony shape and hemolytic reactions were detected after it was sub-cultured on blood agar plate. A variety of biochemical experiments were carried out in attempt to identify the isolate species. The antimicrobial susceptibility test was performed using a modified Kirby Bauer technique. All of the data was recorded and analysed using the SPSS software.

The study enlisted the participation of a hundred patients. Gram-positive bacteria were discovered to be the most common (61.5 percent ). Gram-positive bacteria like Staphylococcus aureus (26.9%) and CoNS (88.4%) were often isolated, as were Gram-negative bacteria including Escherichia coli (3.8%), Klebsiella pneumoniae (3.8%), and Pseudomonas aeruginosa (3.8%). The most common Gram-positive isolate among hemodialysis patients was found to be Staphylococcus aureus. Methicillin resistance was found in 37.5 percent of the 16 S. aureus isolates, despite the fact that the majority of these bacteria were amoxicillin resistant. Amoxicillin was found to be the least effective antibiotic against most Gram-positive bacteria, whereas ciprofloxacin was found to be the most effective.

Conclusion: The goal of this study is to learn more about the prevalence of bacteria in hemodialysis patients, as well as the antibiogram of the isolates, because it is Nepal's first investigation into bloodstream infections in hemodialysis patients. These findings could serve as a springboard for further research into bacteriological infection in hemodialysis patients and antibiogram.

Author (S) Details

Shrestha Prasansah
Department of Microbiology, National College, Kathmandu, Nepal.

Pokharel Nabaraj
Department of Microbiology, National College, Kathmandu, Nepal.

Pant Anil Dev
National Kidney Center, Kathmandu, Nepal.

View Book :- https://stm.bookpi.org/IMB-V1/article/view/3769

Metastatic High-grade Ovarian Sarcoma: Complete Response with Trabectedin in a Haemodialyzed Patient. A Case Report and Review of the Literature | Chapter 12 | New Frontiers in Medicine and Medical Research Vol. 12

Ovarian sarcomas are extremely rare tumours with a dismal prognosis. Surgical treatment is primarily based on debulking procedures used in epithelial ovarian cancer, whereas chemotherapy is based on data extrapolated from research in sarcomas of various primary sites. In the second-line situation, trabectedin has been established as a standard of care for the treatment of soft-tissue sarcomas. There are currently no randomised clinical trials that support a specific maximum number of trabectedin cycles for any gynaecological sarcoma. Furthermore, there is limited evidence in the literature that trabectedin administration in haemodialyzed individuals is feasible and safe. The case of a 48-year-old woman with metastatic high-grade undifferentiated sarcoma of the right ovary is presented in this report. She had primary surgery and first-line chemotherapy with doxorubicin and ifosfamide, and after cycle three, she achieved a partial response. Treatment tolerance was poor, with hematologic and non-hematologic toxicities ranging from grade 3 to 4, including the development of chronic renal failure necessitating permanent haemodialysis. Treatment was switched to trabectedin, which resulted in a full response that has lasted for almost four years, with fifteen months off-treatment. In a hemodialyzed patient, our case demonstrates the safety of long-term trabectedin administration with the accomplishment of a lasting full disease response in the metastatic situation.

Author(s) Details

Efthymiadis, Konstantinos
Department of Medical Oncology, Aristotle University of Thessaloniki, “Papageorgiou” General Hospital, Nea Efkarpia, Thessaloniki, Greece.

Adamidis, Christos
Department of Medical Oncology, Aristotle University of Thessaloniki, “Papageorgiou” General Hospital, Nea Efkarpia, Thessaloniki, Greece.

Koukoutzeli, Chrysanthi
Department of Medical Oncology, Aristotle University of Thessaloniki, “Papageorgiou” General Hospital, Nea Efkarpia, Thessaloniki, Greece.

Tzelepi, Vassiliki
Department of Medical Oncology, Aristotle University of Thessaloniki, “Papageorgiou” General Hospital, Nea Efkarpia, Thessaloniki, Greece.

Timotheadou, Eleni
Department of Medical Oncology, Aristotle University of Thessaloniki, “Papageorgiou” General Hospital, Nea Efkarpia, Thessaloniki, Greece.

View Book :- https://stm.bookpi.org/NFMMR-V12/article/view/3669

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

Reporting a Case Study with Minireview: Exceptional Fertility and Poor Fetal Outcome in a Female with 17-Year Hemodialysis | Chapter 1 | Highlights on Medicine and Medical Research Vol. 2

Context: Chronic kidney disease may affect various aspects of the life of female patients, including menstrual pattern, marital status and sexuality, fertility, outcome of pregnancy, and prescribed contraceptive methods, particularly when HD is initiated. It is an underrated concern for both sexes and has not been adequately assessed. It has been noted in Egypt that it is rare for a female hemodialysis (HD) to start her marriage after HD initiation; this can be attributed to a negative self-image faced and viewed by the patient by the group. In addition, marrying another HD partner is also less common for an HD patient and it is odd for them to conceive during. In addition, the marriage of another HD partner is also less common for an HD patient and it is odd for them to conceive during HD.

Objective: To explain the prospect of starting a family and to prepare for a healthy pregnancy in patients with ESRD during HD therapy.

Patient Scenario: Our case is an Egyptian girl, 36 years old, who began HD in 1999 and continued for 17 years on HD. She was married four times and born by three partners five times. Her second HD husband gave her a live birth just once, but unfortunately, the baby died within a couple of days. During her last four years of life, the woman used Implanon - with its potential side effects - as a form of contraception. She decided to withdraw from her dialysis program after 17 hectic years of HD and tragic marital and fertility incidents, opted to live in isolation, and died as a result of cerebral hemorrhage within five days.

Results and Conclusions: If appropriate, with a multi-disciplinary discussion between the obstetrician, the patient, the family, and the nephrologist, contraceptive methods must be carefully selected. If they receive adequate treatment, pregnancy and healthy pregnancies are believed to be possible in HD couples.

Author (s) Details

Dr. Abir Farouk Megahed
Mansoura Military Hospital, Mansoura, Egypt.

Al Zahraa Ahmed Gamal Ammar
HD Unit in Alexandria Fever Hospital, Alexandria University, Alexandria, Egypt.

Dr. Ehab Hussein Hashish
Department of Ob/Gyn, Mansoura University, Mansoura, Egypt.

Prof Dr. Nagy Sayed-Ahmed
Mansoura Nephrology and Dialysis Unit (MNDU), Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.

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