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Introduction: Emphysematous pyelonephritis (EPN) is thenecrotizing infection of renal parenchyma with the presence ofgas in the renal parenchyma, collecting system or perinephrictissue. EPN is an uncommon life-threatening conditionprecipitated mainly by poorly controlled blood sugars andurinary tract obstruction. Current research aimed to study theclinical and biochemical factors determining the prognosis ofpatients with acute pyelonephritis.Material and Methods: The study was conducted from June2016 to June 2017 in Tirunelveli Medical college among 50patients of pyelonephritis with classical clinical features. Allbasic blood investigations were done and radiological imaginglike USG, KUB and CT abdomen was done for more detailingand followed up.Results: Females above 50 years of age were more frequentlyaffected by pyelonephritis. Altered sensorium, hypotension,HbA1c values > .5 and thrombocytopenia were noticed ina significant number of cases. Prognosis of cases with thesecomorbid conditions was found to be low. 6 patients died inthis study due to poor glycaemic control, thrombocytopeniaand renal dysfunction.Conclusion: Long-standing and uncontrolled type II diabetesmellitus, hypotension, renal dysfunction, thrombocytopeniaand radiological features of the high-risk disease are allassociated with a poor prognosis.
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Introduction: Diabetic kidney disease (DKD) is one of the primary causes of end-stage renal disease. Early diagnosis is veryimportant in preventing the development of DKD. Urinary albumin excretion rate and glomerular filtration rate (GFR) are widelyaccepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the firstclinical sign of DKD.Aim: The aim of the study was to study the existence of normoalbuminuric diabetic nephropathy in type 1 diabeticsMaterials and Methods: This prospective study was conducted in type 1 diabetic by documenting low c-peptide level. Fastinglipid profile was done in these patients. Serum electrolytes such as potassium, sodium, magnesium, and uric acid were measured.The characteristic profile of patients with duration of diabetes and low GFR was analyzed with respect to the duration of diabetes,serum magnesium level, hypertension, retinopathy, and renal biopsy features.Results: In 95 patients, of 17 patients with renal biopsy-proven normoalbuminuric diabetic nephropathy, 11 patients (65%) hadserum magnesium of <2 mg/dl, and only six patients had serum magnesium of >2 mg/dl. Among the 17 patients, five patients(29%) had hypertension and eight patients (47%) had diabetic retinopathy changes.Conclusion: There exists an entity – normoalbuminuric diabetic nephropathy in type 1 diabetic patients. The incidence ofnormoalbuminuric diabetic nephropathy increases with duration of diabetes.
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Background: The silent epidemic of non-communicable diseases threatens to retard the progress towards curbing catastrophic health expenditure. The present study aimed to describe the level of awareness about and utilisation of health insurance and to measure the healthcare costs for non-communicable diseases.Methods: A total of 354 adult patients suffering from non-communicable diseases, who reside in Villupuram district and attend the NCD clinic in the Government medical college hospital, Villupuram were studied over a period of 6 months.Results: 77% of the subjects were aware of health insurance. The most frequent source of information was local government officials and the hospitals themselves. 74.01% had availed some form of health insurance. There was a moderately strong correlation between loss of wages and total health expenses. The incidence of catastrophic health expenditure due to NCD clinic visits was around 7%.Conclusions: The absence of outpatient costs in the covers of most health insurance schemes may be decreasing their effectiveness in controlling catastrophic health expenditure.
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Aims:The study aims to estimate the lipid parameters among Plasmodium vivaxand mixed malaria (P.falciparum and P. vivax) infected patients. Study Design:This was a prospective observational and comparative study.Place and Duration of Study:The present study was undertaken in the Departments of Medicine and Biochemistry at A.J. Institute of Medical Sciences and Research (AJIMS), Mangaluru, Karnatakabetween Dec 2017 and May 2018.Methods:It was a prospective observational comparative study. A total of 100 patients (50 P. vivaxand 50 mixed malaria cases) were consecutively taken in the study. The lipid profiles of the cases were compared with that of100 healthy volunteers (control group). Data was collected and analysed. Results:Serum total cholesterol, High-Density Lipoprotein (HDL) and Low-Density Lipoprotein (LDL) levels were significantly low(p<0.001) in cases and serum Triglycerides (TG) andVery Low-Density Lipoprotein levels (VLDL) were higher in cases (p<0.001) than in control. There were no significant changes in mean serum lipids profiles between P. vivaxand Mixed Malaria groups. Conclusion:The derangement in lipid profiles in falciparum malaria was characteristic and specific for the disease. Characteristic changes were lower HDL, LDL and total cholesterol levels with higher TG and VLDL levels in comparison to control groups. These findings may be of diagnostic and prognostic value.