ABSTRACT
Background:Newonset diabetes after transplantation (NODAT) refers to diabetes that occurs in previously nondiabetic persons after solid-organ transplantation, bone marrow and hematopoietic stem cells. New Onset Diabetes After Transplantation (NODAT) is one of the metabolic complications after kidney transplantation which affects adversely the allograft kidney and patient outcomes. Methods: This study was conducted in Department of Nephrology at Sher I Kashmir Institute Of Medical Sciences (SKIMS ) , a tertiary care center in Srinagar , Jammu and Kashmir , India, between July 2013 to June 2016.All the patients who underwent renal transplantation during this period in our institute were enrolled in this study.In the post renal transplant period , patients were classified as those who developed NODAT and as normal patients. Effect of NODAT on the graft survival was studied by comparing the serum urea, creatinine and urinary protein between the NODAT and the normal patients. Results: A total of 100 patients of End Stage Renal Disease (ESRD) who underwent renal transplantation in department of nephrology were enrolled in our study.Out of 100patients, 79 were males and 21 were females. A total of 17 patients developed NODAT in our study. It was observed that the patients developing NODAT in post renal transplantation period were having a higher values of serum creatinine and urea as compared to normal patients. Moreover proteinuria was more commonly present in NODAT patients than normal patients. Conclusion: The development of NODATis associated with a poor graft function in the post transplant period.
ABSTRACT
Background: Ventricular Tachycardia (VT) constitutes an important manifestation of coronary artery disease (CAD). VT can occur in the immediate acute myocardial infarction (MI) period, further complicating the management. VT also occurs after long duration of acute coronary syndrome (ACS) in the healed MI. Aim: The aim of our study was to evaluate the epidemiology, clinical presentation, hemodynamic status, treatment received and finally the outcome of CAD patients manifesting as sustained VT. Materials and methods: This prospective study was conducted at Sher I Kashmir Institute of Medical Sciences (SKIMS), a tertiary care center in Srinagar, Jammu and Kashmir, India, between August 2013 to May 2016. All the cases of definite sustained VT already admitted in the hospital or Rahul Sudan, Mehroz Ahmed, Khursheed Aslam, Irfan Yaqoob, Gunjan Gupta, Shantanu Aggarwal. Sustained ventricular tachycardia (VT) in coronary artery disease (CAD): A study from tertiary care center in north India. IAIM, 2018; 5(2): 160- 167. Page 161 presenting in the emergency department including those who developed VT during the course of acute MI were evaluated. Results: In our study, a total of 35 patients of CAD manifesting as sustained VT were observed. Majority of these patients were males. The most common presenting symptom was chest pain seen in a total of 14 patients. A total of 23 patients (66%) were hemodynamically stable at the time of VT. A decreased Left Ventricular Ejection Fraction (LVEF <50%) was seen in 18 patients (51%). Monomorphic VT was seen in a total of 28 patients (80%) and the rest of 7 patients showed polymorphic VT. Mortality was seen in 8 patients (23%). Conclusion: Polymorphic pattern of sustained VT, hemodynamic instability at the time of VT and a decreased LVEF are associated with increased mortality in patients of CAD manifesting as VT.
ABSTRACT
Background: Chronic Kidney Disease (CKD) is one of the most common causes of morbidity and mortality due to renal causes. There are multiple causes of CKD with diabetes, hypertension and chronic glomerulonephritis among the most common causes. All of these causes gradually lead to the final common pathway of End stage renal disease (ESRD). Chronic Kidney Disease (CKD) is defined as Kidney damage for ≥3 months, as defined by structural or functional abnormalities of the kidney, with or without decreased GFR or GFR <60 mL/min/1.73m2 for ≥3 months, with or without kidney damage. Aim: To study the profile of Chronic Kidney disease (CKD) patients presenting in a tertiary care center. Rahul Sudan, Mehroz Ahmed, Imtiyaz Ahmed Wani, Muzaffar Maqsood Wani, Khurshid Ahmed Banday, Gunjan Gupta. Profile of Chronic Kidney Disease (CKD) patients presenting in a tertiary care center in north India. IAIM, 2018; 5(8): 72- 80. Page 73 Materials and methods: This study was conducted at Sher I Kashmir Institute of Medical Sciences (SKIMS), a tertiary care center in Srinagar, Jammu and Kashmir, India, from July 2013 to January 2016. All the patients of CKD visiting our institute were enrolled in this study. This included patients on follow up at the Out Patient Department (OPD), patients presenting to emergency with complications of CKD, patients referred from other departments who were detected in initial stages of CKD during the routine investigations. A total of 300 patients were enrolled in this study. Results: In our study, a total of 300 patients were enrolled. CKD was more common in males. The most common aetiology of CKD was diabetic nephropathy which was seen in 102 patients (34%) followed by chronic glomerulonephritis seen in 80 patients (27%). Volume overload was the most common cause of morbidity in these patients. Patients in the initial stages of CKD were managed with symptomatic treatment and 230 patients (76.66%) received peritoneal dialysis at some stage of their management. It was in the stage of ESRD that patients were offered some definitive form of renal replacement therapy in the form of renal transplantation or hemodialysis. Out of 160 patients of ESRD, only 12 patients (7.5%) received renal transplantation and the remaining 148 patients (92.5%) were managed with hemodialysis. Conclusion: CKD is one of the leading causes of morbidity and mortality due to renal causes. The early stages of CKD which are managed by conservative methods gradually lead to the development of ESRD. It is therefore necessary to diagnose the patients of CKD in the early asymptomatic stages. At these stages it is feasible to slow down the loss of nephrons by controlling the underlying factors like diabetes and hypertension but once the stage of ESRD sets in, renal transplantation is the preferred modality of renal replacement therapy