ABSTRACT
BACKGROUND AND AIMS: There is an increasing burden of kidney diseases in developing countries like India where access to specialist care is available only to a small proportion of patients. Telemedicine, has been relatively less used in India especially in public sector hospitals. The current study was designed to assess the patient's knowledge, attitude and acceptance of telenephrology services at our institute, a public sector hospital in a developing country. METHOD: This study is a cross-sectional survey carried out among patients who had availed our telenephrology services during the preceding three months. A total of 150 patients were selected by stratified random sampling from the list of attendees of telenephrology consultation in the past 3 months. The questionnaire was administered in local language by telephone interview method. The frequency distributions and average and median values for each of the questionnaire variables were calculated using SPSS software. RESULTS: The average age of the study cohort was 42.52±15.1 years (17-83yrs). 68% of the patients were males. The questionnaire was answered by the patient himself/herself in 56% cases, spouse in 14.0% and children in 20.7% cases. 51.3% patients were graduates or post graduates. 40.7% patients belonged to the upper middle and 39.3% belonged to the lower middle socioeconomic class. 54.6% patients were residing in towns, 28.7% in cities and 16.7% in villages. Prior to the telenephrology service, the median distance travelled to attend our OPD was 113.5 (3-2249 km). Attendees incurred loss of work in 54.7% cases. Information about availability of telenephrology services was obtained from institutional helpline number by 59 (39.3%) patients while 50 (33.3%) patients obtained it from the internet. Others got information from friends, television or short message service (SMS). The average number of teleconsultations was 2 per patient. A large majority of patients (99.3%) felt that Telenephrology service was a right approach during the COVID-19 pandemic. On asking how they felt regarding Telenephrology experience, 70.67% said they were very happy, 25.3% were happy and 4.0% said they were apprehensive or doubtful. 96.6% patients said that they were confident discussing their complaints over phone. 92.6% patients were comfortable sharing reports over phone while 7.3% needed help from caretakers. Regarding the problems faced during teleconsultation, 36% patients responded that they wish to see the doctor in person to feel satisfied while 3.3% found difficulty in understanding drug dosages. 86% patients felt that Telenephrology services should continue even after the COVID pandemic. CONCLUSION: In developing countries like India, with the majority of the population residing outside major cities, wherein the accessibility to a specialist is limited and the digital development outscores the physical infrastructure, Telenephrology has huge potential to provide quality nephrology care to the remotest parts of the country.
ABSTRACT
The National Organ and Tissue Transplant Organization (NOTTO) has previously published transplant-specific guidelines with reference to COVID-19.([1]) The mortality is higher in dialysis patients with COVID-19 (12%-30%) than posttransplant COVID-19 patients (11.3%) and both are higher than the general population (<2%) in India.([2-5]) With the resumption of the kidney transplant program in various parts of India, new issues are expected to occur. There is uncertainty, regarding the safety of performing kidney,([ 6-8]) liver,([9-12]) and lunge([13]) transplantation in a recipient recently recovered from COVID-19. At present, we have limited evidence-based information about safety and feasibility of kidney transplantation from living donors, who have recovered from COVID-19.([4]) Recently, Indian Multi-center cohort studies have reported successful kidney transplantation in recipients from living donors with a previous diagnosis of COVID-19.([15, 16])
ABSTRACT
The treatment of COVID-19 has been a source of intense controversy in the past. A variety of clinical trials and retrospective studies have shown mixed findings about the effectiveness of certain repurposed medications proposed to treat COVID-19, highlighting the need for further testing.The aim of this research was to add to the current literature some data on the effectiveness and protection of hydroxychloroquine (HCQ) and azithromycin (AZ) as COVID-19 treatment drugs.The results of a traditional therapy (CT) incorporating HCQ and AZ used in the Democratic Republic of India are recorded in this empirical analysis. We contrasted epidemiological and clinical evidence from 1100 (89%) respondents who received the CT and 135 (11%) who did not obtain the TC. At the start of therapy, survival analyses such as Kaplan-Meier and Cox regression were used to assess health success at day 10 and the probability of survival at day 15.On D10, the clinical result in the TC population is significantly higher than in the reference group (p-0.001). The observed side effects are mild and similar in both categories (3 percent vs. 3 percent). Conclusion: This tentative retrospective analysis shows that traditional medicine has a positive and healthy impact in our region, justifying the protocol's continuity at this period. To improve the power of measurements, broader empirical studies with more rigorous assessment parameters are needed.
ABSTRACT
In December 2019 Novel corona virus (SARS-CoV-2) infection started in Wuhan and resulted in a pandemic within few weeks' time. Organ transplant recipients being at a risk for more severe COVID-19 if they get SARS CoV-2 viral infection, COVID 19 Vaccine has a significant role in these patients. The vaccine is a safer way to help build protection and would either prevent COVID -19 infection or atleast diminish the severity of the disease. It would also reduce the risk of the continuing transmission and enhance herd immunity. Immuno compromised patients should not receive live vaccines as they can cause vaccine related disease and hence the guidelines suggest that all transplant recipients should receive age appropriate 'inactivated vaccine' as recommended for general population. Though trials have not been undertaken on transplant recipients, efficacy and safety of COVID-19 vaccine have been scientifically documented for few vaccines among the general population. © 2021 Indian Journal of Transplantation ;Published by Wolters Kluwer - Medknow.
ABSTRACT
In the post renal transplant setting, pulmonary infections comprise an important set of complications. Microbiological diagnosis although specific is often delayed and insensitive. Radiography is the most common and first imaging test for which patient is referred, however it is relatively insensitive. HRCT is a very useful imaging tool in the scenario where radiography is negative or inconclusive and high clinical suspicion for infection is present. HRCT features vary among the various pathogens and also depend on the level of immunocompromise. Certain HRCT findings are characteristic for specific pathogens and may help narrow diagnosis. In this review article, we will summarize the imaging findings of various pulmonary infections encountered in post renal transplant patients.