ABSTRACT
@#Haemodialysis is a continuous treatment provided to patients with chronic kidney disease as a replacement for renal function. It is important to assess the quality of life among these patients. The aim of this study was to evaluate quality of life among patients on haemodialysis using an Indonesian version of the KDQoL-SF24 questionnaire. This is a cohort observational study that included 145 haemodialysis patients in a haemodialysis centre in Jakarta, Indonesia. A translated and validated version of the KDQoL-SF24 was used in this survey. The participants in this study had lower mean scores than the standard form in the following 6 components: burden of kidney disease (44.22±33.23), cognitive function (74.94±20.32), sleep (57.07±24.15), patient satisfaction (60.11±18.56), role-physical (26.21±44.01), emotional well-being (69.19±24.25) and role-emotional (40.69±49.18). A significant relationship was found between sexual function, physical functioning, role emotional and age among haemodialysis patients (P <0.05). Based on the overall health rating from the KDQoL-SF24, the mean and standard deviation for the 21- to 30-year-old age group was lower than the standard form. The burden of kidney disease, cognitive function, sleep, patient satisfaction, role-physical, emotional well-being and role-emotional component scores were low for haemodialysis patients in Indonesia compared to the standard form. Additionally, age significantly affected sexual function, physical functioning and role-emotional.
ABSTRACT
Infective endocarditis (IE) is the one of the most important causes of increased mortality and morbidity among haemodialysis patients. The reason for this increasing prevalence of infection among these patients is the use of haemodialysis catheters during dialysis, as these patients are highly susceptible to infections that are easily transmitted via blood access points. The present case was a geriatric end stage renal disease (ESRD) patient who was readmitted to the hospital two days after her scheduled haemodialysis session with symptoms of nosocomial endocarditis. Her concurrent medical complications were hypertension, non-insulin dependent diabetes mellitus, and ischemic heart disease. Based on her previous medical history and current examination, the patient was suspected to have IE due to catheter related infection. The goal of therapy is to manage the comorbidities and infection by provision of appropriate treatment based on close monitoring of the patient condition.
ABSTRACT
Dengue Viral Infection [DVI] imperils an estimated 2.5 billion people living in tropical and subtropical regions. World Health Organization [2011] guidelines also classified dengue as 'Expanded Dengue Syndrome' to incorporate wide spectrum of unusual manifestations of dengue infection affecting various organ systems - including liver, kidney, heart and brain. Renal involvements are least appreciated area of dengue infection, therefore, we systematically reviewed studies describing renal disorders in dengue infection, with emphasis on Acute Kidney Injury [AKI]. The purpose of current review is to underscore clinicians' attention to this neglected intricacy of DVI. It suggests that dengue induced renal involvements vary from glomerulonephritis, nephrotic range proteinuria and AKI. We observed great disparity in incidence of AKI among dengue patients, based upon criteria used to define AKI. AKI among dengue patients was found to be associated with significant morbidity, mortality and longer hospitalization, adding financial burden to patients and healthcare system. Additionally, we identified several predictors of AKI in dengue patients including old age, obesity, severe dengue infection and concurrent bacterial or viral infection. Direct viral injury and deposition of antigen-antibody complex in glomerulus were found to be possible causes of renal disorders in dengue infection. Prior knowledge of clinico-laboratory characteristics and risk factors with early detection of AKI by using appropriate criteria would not only reduce morbidity and mortality but also decrease burden to patients and healthcare system
ABSTRACT
To evaluate the incidence, treatment and clinical outcomes of tuberculous [TB] lymphadenitis at Penang General Hospital, Malaysia. Penang General Hospital is the referral center for all tuberculosis patients in the state of Penang. Patient records were reviewed to identify patients with confirmed diagnosis of TB lymphadenitis between January 2006 and December 2008. Data were analyzed using SPSS version 15. Of 1,548 tuberculosis cases, 109 [7.0%] patients had TB lymphadenitis. The mean age was 36.4 +/- 12.87 years and of the 109 patients with TB lymphadenitis, 35 [33.0%], 37 [34.0%] and 36 [33.0%] were observed for 2006, 2007 and 2008, respectively. Ethnically, 45 [41.3%] were Malay followed by 37 Chinese [33.9%]. Among risk factors for TB lymphadenitis, HIV and diabetes mellitus were seen in 17 [15.6%] and 11 [10.0%] patients, respectively. Cough and fever were the most frequently reported symptoms. In a majority of cases [n = 90, 82.5%] positive results were obtained for fine-needle aspiration [FNA]. Directly observed therapy was given to all patients. Sixty-two [56.9%] patients were successfully treated, and 5 [4.6%] patients died during the treatment. There was no increase in the incidence of TB lymphadenitis over the 3-year study period. The incidence was slightly higher in male than female gender and in Malay [ethnic group]. Diabetes mellitus and HIV were the most commonly reported risk factors. FNA is the most reliable diagnostic test