ABSTRACT
Background: The most common, non –renal, chronic disorder in patients with ESRD is gastro intestinal disorders, accompanying ESRD including those receiving renal replacement therapy. Among upper gastrointestinal lesions caused by chronic kidney disease- gastritis, esophagitis, gastric ulcer are the most prevalent lesions. Here an attempt is being made to study the upper gastro intestinal changes in chronic kidney disease and evaluate their relationship with the stage of CKD or GFR. Materials and methods: A cross sectional study on 50 patients of, who were diagnosed to have chronic kidney disease and being presented to OPD and admission in Malla Reddy Institute of Medical Sciences, Suraram over a period of one year. All patients with chronic kidney disease who underwent upper gastrointestinal endoscopy were included in the study. Results: 50 patients were included in the study with mean age and males 28 and 22 females. Among 50 patients 42 patients manifested with upper gastrointestinal lesion among them erosive gastritis 13(26%) was most common upper gastrointestinal lesion followed by gastro esophageal reflux disease with or without duodenitis 8 (16%), duodenal ulcer, gastric ulcer 4(8%) each, pangastritis 3(6%), GERD with gastritis, erosive duodenitis, erosive esophagitis, pale gastric mucosa 2(4%) each, angiodysplasia and hiatus hernia 1(2%) each. Conclusion: Majority of the patients with chronic kidney disease have upper gastrointestinal involvement on endoscopic evaluation. Erosive gastritis is the most common lesion Esophageal and duodenal involvement is less common than the gastric lesions. Upper gastrointestinal findings are frequently observed in chronic kidney disease patients on dialysis. Early diagnosis and managementof these upper gastrointestinal lesions in CKD can reduce mortality and morbidity and prevent fatal complication like massive upper gastrointestinal bleed.
ABSTRACT
Subclavian steal syndrome is a relatively rare condition that results from occlusion of the subclavian artery proximal to the origin of the vertebral artery. This causes a reversal in the direction of the blood flow in the vertebral artery, leading to symptoms of vertebrobasilar insufficiency. In this article, we report a case of subclavian steal syndrome in a 55 year old male, who presented with giddiness, and variation in blood pressures in both upper limbs, was investigated with doppler and MR angiography. This article emphasises physical examination with discrepancy in pulse and blood pressure should bring attention to diagnosis of this syndrome.
ABSTRACT
Superior Mesenteric Artery (SMA) syndrome (known as Wilkie’s syndrome) is a rare cause of upper gastrointestinal obstruction. It is an acquired disorder, causes compression of the third part of the duodenum between the SMA and the aorta, due to loss of fatty tissue as a result of a variety of debilitating conditions. We report a case of 18 year old female presented with history of intermittent abdominal pain, vomiting of 6 months duration followed by significant weight loss for which she is hospitalized. Patient underwent extensive invasive and non-invasive tests, thereafter revealed her diagnosis. This case emphasizes the challenges in the diagnosis of SMA syndrome and the need for increased awareness of this entity.
ABSTRACT
Background: Epilepsy is a common disorder with co-morbidities. It affects physical, emotional, psychological, social, financial and cognitive functioning of the patients. Identification and management of psychosocial problems are important in holistic treatment of epilepsy. There is paucity of literature in psychosocial functioning in epilepsy. Aim: To find out the occurrence of psychosocial problems in patients with epilepsy. Materials and methods: One hundred consecutive patients attending the OPD of Internal Medicine were evaluated with a questionnaire subserving seven domains of psychosocial functioning with inclusion and exclusion criteria. Results: The occurrence of depression, emotional instability, inter personal relationship and vocational difficulties were higher in patients with epilepsy. Conclusion: Psychosocial co-morbidities are higher in patients with epilepsy and are likely to be missed unless carefully evaluated.