Self-care for Health for All - An Utopian Vision or a Pragmatic Plan?

The World Health Organization (WHO) identified the importance of self-care interventions in achieving Universal Health Coverage in 2019. It urges every country to include self-care interventions in their policies and guidelines. To guide the countries in this process, it released guidelines in 2019 and revised them in 2022. However, implementation of new interventions is not a path free of thorns. These guidelines have their own set of strengths and limitations that will differ from country to country.

Molecular and Clinical Features of Heterogeneous Vancomycin-Intermediate Staphylococcus aureus in Tertiary Care Hospitals in South India.

Objectives: This study aimed to detect heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) among methicillin-resistant S. aureus (MRSA) isolated from healthcare-associated infections and identify staphylococcal cassette chromosome mec (SCCmec) types. Methods: This study was conducted from February 2019 to March 2020 and included patients admitted in 4 tertiary care hospitals in Karnataka, India. Isolation and identification of MRSA were done using standard bacteriological methods. Antimicrobial susceptibility testing was done using Kirby-Bauer disc diffusion; macrolide-lincosamide-streptogramin B phenotypes were identified using the D test. The minimum inhibitory concentration (MIC) of vancomycin was determined using agar dilution. hVISA were confirmed by the modified population analysis profile-area under the curve test. SCCmec types and the Panton-Valentine leukocidin (pvl) gene were detected using multiplex polymerase chain reaction. Results: Of 220 MRSA stains, 14 (6.4%) were hVISA. None of the MRSA isolates was vancomycin-intermediate or -resistant and all hVISA were susceptible to linezolid and teicoplanin. The macrolide-streptogramin B phenotype was present in 42.9% of hVISA; 92.9% of the hVISA strains had vancomycin MIC in the range of 1-2 µg/mL. Majority of the hVISA and vancomycin-susceptible MRSA were isolated from patients with skin and soft tissue infections. SCCmec III and IV were present in 50% and 35.7% of hVISA, respectively; 14.3% of the hVISA harboured SCCmec V. Conclusion: The prevalence rate of hVISA among MRSA was 6.4%. Therefore, MRSA strains should be tested for hVISA before starting vancomycin treatment. None of the isolates was vancomycin-intermediate or -resistant and all the hVISA strains were susceptible to linezolid and teicoplanin. The majority of the hVISA were isolated from patients with skin and soft tissue infections and harboured SCCmec III and IV.

Nail Society of India (NSI) Recommendations for Pharmacologic Therapy of Onychomycosis.

Onychomycosis (OM) is the commonest cause of dystrophic nails, responsible for upto 50% of cases. Apart from significantly damaging the nails, quality of life, and self-image of the sufferer, it also acts as a reservoir of fungal infections carrying important implications for emerging recalcitrant dermatophytoses. Treatment of OM is based on guidelines released almost a decade back, in addition to published literature and personal preferences. Hence, an expert group of nail society of India (NSI) worked towards drafting these guidelines aimed at compiling recommendations for pharmacologic treatment of OM, based on scientific evidence, along with practical experience. The group did an extensive analysis of available English language literature on OM published during the period 2014-2022. The evidence compiled was graded and discussed to derive consensus recommendations for practice. Special focus was placed on combination therapies and adjunct therapies, including experience of members, to improve treatment outcomes.

No evidence of resistance to itraconazole in a prospective real-world trial of dermatomycosis in India.

BACKGROUND: The prevalence of superficial fungal infections in India is believed to have increased substantially in the past decade. We evaluated the treatment outcomes and risk factors associated with clinical response to a treatment course of itraconazole for the management of dermatomycosis in India. METHODS: In this real-world, prospective pilot study (August 2019 to March 2020), adult participants (18-60 years), diagnosed with T. cruris or T. corporis, received itraconazole 200 mg/day (any formulation) orally for 7 days, and were followed for an additional 7 days. RESULTS: The study was terminated early due to the COVID-19 pandemic. Of 40 enrolled participants (mean [SD] age, 35.5 [12.73] years; {62.5%}] male; 37 received itraconazole and 20 (50%) completed the study. The median (range) Clinical Evaluation Tool Signs and Symptoms total score at baseline was 5.5 (2-10). Clinical response of "healed" or "markedly improved" based on the Investigator Global Evaluation Tool at day 7 (primary objective) was 42.9% (12/28; 95% CI: 24.53%, 61.19%). Itraconazole minimum inhibitory concentration for identified microorganisms, T. mentagrophytes species complex (91.7%) and T. rubrum (8.3%), was within the susceptibility range (0.015-0.25 mcg/mL). At day 14, 8/13 (61.5%) participants achieved a mycological response, 2/13 participants (15.4%) had a mycological failure and 90% showed a clinical response. CONCLUSION: COVID-19 pandemic affected patient recruitment and follow-up, so the findings call for a careful interpretation. Nevertheless, this real-world study reconfirmed the clinical efficacy and microbial susceptibility to itraconazole for the fungi causing dermatophytosis in India. TRIAL REGISTRATION: Trial registration number: Clinicaltrials.gov NCT03923010.

Inhibitory Effect of Traditional Endodontic Irrigants versus LED activated Photosensitizer Curcumin Microbes of Saudi Arabian Infected Dental Pulp.

The success of an endodontic therapy is combinational, dependent on mechanical preparation of canal and chemically detriment of microbial load. Therefore the use of an efficient irrigant is necessary having potential for eradicating the population dependent endodontic microbes. The main aim of the study was to evaluate and compare the antimicrobial potential of commonly used endodontic irrigants and LED light activated curcumin against the endodontic microbial variants of Saudi Arabian population. The 170 infected pulp samples were collected in nutrient broth and streaked on four types of agar plates for each sample after 24 hours of incubation at 37°C. Later after incubation for one day, the microbes were identified under the microscope and the number of microbial colonies. Using well method anti-microbial efficacy of three experimental groups with traditional endodontic irrigants (5.25% NaOCl, 2.0% CHX and 17.0% EDTA), LED light activated photosensitizer and one negative control (NaCl) was evaluated. The photosensitizer and 17.0% EDTA displayed to have efficient anti-microbial potential against E. fecalis and Streptococcal species reducing the colony count and increased radius of 4.3mm (Curcumin)/ 4.1mm (17.0% EDTA) and 3.2mm (Curcumin)/ 3.0mm (17.0% EDTA) showing anti-bacterial effect on the agar plates trailed by 5.25% NaOCl but statistically no significant difference was observed. On contrary 5.25% NaOCl showed strong potential against Staphylococcus and C. albicans species. Overall it can be concluded from the results 5.25% of NaOCl have stronger anti-microbial potential than 17.0% EDTA, CHX and NaCl against endodontic species of Saudi Arabian population.

Impact of baseline fluorescent antinuclear antibody positivity on the clinical outcome of patients with primary autoimmune hemolytic anemia.

INTRODUCTION: Autoimmune haemolytic anaemia (AIHA) is an autoimmune disorder that can present in primary or secondary forms. The literature looking at impact of baseline fluorescent antinuclear antibody (FANA) positivity on outcomes of AIHA patients is infrequent. OBJECTIVE: To study the impact of baseline FANA positivity in patients with primary AIHA. METHOD: A prospective cohort study involving 29 consecutive primary AIHA patients presenting to the Haematology department from 2013 to 2015 was analysed. After recording baseline investigations including fluorescent ANA, all patients were treated as per the standard therapeutic protocols. Clinical remission, disease free survival, relapse, mortality were compared between the FANA positive and FANA Negative AIHA groups. RESULTS: Baseline FANA positivity was found in 17 patients (58.62%). Both the groups were comparable in terms of age, sex, Hemoglobin, LDH at presentation, number of lines of treatment needed and duration of follow up. Evan's syndrome was seen in six of FANA positive patients which was statistically significant (0 v/s 6, p = 0.023). FANA positive patients had significantly higher rates of relapse per patient month follow up (1.22 v/s 3.57, p = 0.023) and lower rates of complete response (83.33% v/s 35.29%, p = 0.0118) and relapse free survival at five years. Morbidity and mortality were numerically higher in FANA positive patients. CONCLUSION: Baseline FANA positivity among AIHA patients was found to be associated with lower complete response rates and higher relapse rates with possible higher rates of morbidity. Presence of FANA will give us prognostic value and help us in deciding the treatment options.

Ni/Ni(OH)2-rGO nanocomposites sensor for the detection of long forgotten mycotoxin, xanthomegnin.

Xanthomegnin, a known fungal toxin, secondary metabolite, and pigment diffuses from the dermatophytes has gained attention as local virulence factor because of the mutagenicity, toxicity, cytocidal, and immunosuppressive properties. Not only as a dermatophyte in skin related disorders, the production of xanthomegnin is implicated as a powerful diagnostic marker in patients suffering from ocular mycoses. Incidentally also attributed to death in livestock's majorly by exposing themselves to food-borne fungi like Aspergillus and Penicillium. The production of xanthomegnin in dermetophytic species Trichophyton rubrum, found commonly in infected skin and nails. In this study nickel/nickel hydroxide nanoparticles decorated reduced graphene oxide (Ni/Ni(OH)2-rGO) modified glassy carbon electrode has been successfully used for non-enzymatic detection of xanthomegnin. The Ni/Ni(OH)2-rGO composites were synthesized through a simple microwave assisted technique with less harmful reducing agent. The UV-visible spectroscopy (UV-vis), X-ray photoelectron spectroscopy (XPS), Scanning electron microscopy - energy dispersive X-ray spectroscopy (SEM-EDS), and electrochemical investigations demonstrated the robust formation of the sensor. The sensor exhibited improved electrochemical properties with enhanced electrochemical active area and excellent electrochemical behavior towards xanthomegnin detection with a limit of detection of 0.12 µM. The selectivity, stability, and analytical recovery studies proved the potential use of the sensor for the detection of xanthomegnin in real samples. Further, the sensor successfully detected xanthomegnin produced by the Trichophyton rubrum, the most common superficial fungus, accounting for at least 60% of all superficial fungal infections in humans. Validation studies showed satisfiable and quantifiable amount of xanthomegnin in comparison with common bench mark UV-Vis studies meant for fungal mycotoxin detection.

Impact of baseline fluorescent antinuclear antibody positivity on the clinical outcome of patients with primary autoimmune hemolytic anemia

Abstract Introduction Autoimmune haemolytic anaemia (AIHA) is an autoimmune disorder that can present in primary or secondary forms. The literature looking at impact of baseline fluorescent antinuclear antibody (FANA) positivity on outcomes of AIHA patients is infrequent. Objective To study the impact of baseline FANA positivity in patients with primary AIHA. Method A prospective cohort study involving 29 consecutive primary AIHA patients presenting to the Haematology department from 2013 to 2015 was analysed. After recording baseline investigations including fluorescent ANA, all patients were treated as per the standard therapeutic protocols. Clinical remission, disease free survival, relapse, mortality were compared between the FANA positive and FANA Negative AIHA groups. Results Baseline FANA positivity was found in 17 patients (58.62%). Both the groups were comparable in terms of age, sex, Hemoglobin, LDH at presentation, number of lines of treatment needed and duration of follow up. Evan's syndrome was seen in six of FANA positive patients which was statistically significant (0 v/s 6, p= 0.023). FANA positive patients had significantly higher rates of relapse per patient month follow up (1.22 v/s 3.57, p= 0.023) and lower rates of complete response (83.33% v/s 35.29%, p= 0.0118) and relapse free survival at five years. Morbidity and mortality were numerically higher in FANA positive patients. Conclusion Baseline FANA positivity among AIHA patients was found to be associated with lower complete response rates and higher relapse rates with possible higher rates of morbidity. Presence of FANA will give us prognostic value and help us in deciding the treatment options.

Use of photosensitizers activated by photodynamic therapy on the canal disinfection of radicular dentin bonded to Dimethacrylate-based glass fiber post: an assessment of pushout bond strength.

OBJECTIVE: The present lab-based investigation aimed at evaluating the canal disinfectants using photodynamic therapy (PDT) using different photosensitizers, conventional NaOCl, a mixture of doxycycline, citric acid, and a detergent (MTAD) and their impact on the bond strength of glass fiber post to radicular dentin. MATERIALS AND METHODS: Forty extracted human premolars were gathered and disinfected. The decoration was performed up to the cementoenamel junction. Using the crown down technique cleaning of the canal was done following rinse with distilled water. All canals were dried with paper points and obturated with gutta-percha. Post space was prepared using peso reamers and samples were randomly allocated into four groups following different disinfection regimes: Group 1 - Methylene blue photosensitizer (MBP) + MTAD; Group 2 - RBP (Rose Bengal photosensitizer) + MTAD; Group 3 - CP (curcumin photosensitizer) + MTAD and Group 4 - 2.25% NaOCl + MTAD (control). Following disinfection, the canals were dried and the post was placed and cemented within the canal. Samples were dissected at coronal, middle, and apical third and placed in a universal testing machine for push-out bond strength (PBS). Debonded surfaces were evaluated for failure modes. PBS was examined using a one-way analysis of variance (ANOVA). The means of PBS were compared using Tukey multiple comparison tests with a significance threshold of (p<0.05). RESULTS: Group 3 canals disinfected with CP and MTAD had the highest PBS at two levels: cervical (9.57±1.21 MPa), middle (6.37±0.79 MPa), and group 2 canal space disinfected by RBP and MTAD had the maximum PBS in apical portion (5.35±0.42 MPa). No significant difference at all root levels between group 2 (RBP + MTAD) and group 3 (p>0.05). Canal irrigation with group 1 (MBP + MTAD) and group 4 control (2.25% NaOCl + MTAD) exhibited comparable PBS at all three levels of the root. CONCLUSIONS: CP, MTAD, RBP and MTAD for canal disinfection and bonding of glass fiber post to radicular dentin demonstrated comparable bond values at all three root levels and can be recommended in clinical settings after further investigations.

Effect of photosensitizers on modulating bond strength of different luting cements used for cementation of resin modified composite fiber posts.

OBJECTIVE: The aim of the study was to evaluate the tensile BS of FPs luted with conventional and self-adhesive resin modified GIC cement on disinfection of post-space radicular dentin with various photo-activated photosensitizer (chitosan, TB and Clp6). MATERIALS AND METHODS: Sixty-six orthodontically extracted mandibular pre-molars were selected on specific exclusion/inclusion criteria, trailed by thorough debridement of plaque/calculus and disinfected by immersion in Chloramine T trihydrate solution for 48 hrs. The selected teeth were sectioned from the cement-enamel junction removing the crown. The radicular region of the samples was entrenched perpendicularly in heat cure resin modified acrylic. The pulpal tissue was detached using K-files trailed by canal shaping with ProTaper Next rotary NiTi (Dentsply Sirona, Gloucestershire, UK) files under continuous irrigation with NaOCl. The canals were dried using paper points trailed by obturation by Pro Taper Next Obturators gutta-percha points (Dentsply, UK) coated with ADSEAL (Meta Biomed, Chungcheongbuk-do, South Korea). After incubation for seven days in an environment mimicking oral cavity, post space was created using peso reamers. The space was disinfected by G1: chitosan 3 mg/mL; G2: 13-15 mg/mL TB and G3: Clp6. After photo-irridation the FPs were luted with conventional (n=11) and resin modified self-adhesive cement (n=11) for each group respectively. The specimens were incubated for 48 hrs prior to tensile BS testing. The type of bond fracture/failure was evaluated under 30x magnification. The tensile BS was statistically analyzed using ANOVA trailed by Tukey's test to respective groups. RESULTS: FPs luted using self-adhesive resin modified cement with prior to disinfection by TBs displayed highest tensile BS 291.47 N ± 5.36. On the contrary, post-space disinfected by Clp6 displayed statistically significant (p ≤ 0.05) lowest bond strength (276.62 N ± 4.31). Intra-group analysis displayed statistically significant difference in bond strength of the luting dental materials (p ≤ 0.05). CONCLUSIONS: The self-adhesive resin modified cement revealed utmost bond strength on pre-treatment of post-space with respective photo-activated photosensitizer (chitosan, TB & Clp6) in contrast to conventional GIC.

Comparing the disinfecting efficacy of pomegranate peel extract oil, Garlic oil, Tulsi leaf oil, and Clove leaf oil with standard autoclaving on dental round burs tested against Enterococcus faecalis: An in vitro study.

Background: The study was conducted to compare and evaluate the disinfecting efficacy of four different herbal oils with standard autoclaving against Enterococcus faecalis (E. faecalis). Fifty round burs were infected with E. faecalis and dipped into the chemical test solution for 10 min. The disinfecting efficacy for each test chemical was checked using culture method on blood agar plate and peptone water test to check for turbidity. Clove leaf oil and Tulsi leaf oil have very good antimicrobial efficacy against E. faecalis which are similar and comparable to that of autoclaving. Aim: This stusy aimed to compare the efficacy of pomegranate peel extract (PPE) oil, Garlic oil, Tulsi leaf oil, and Clove leaf oil with standard autoclaving on dental round burs tested against E. faecalis. Settings and Design: The disinfecting capability of four different experimental oils against autoclave was evaluated on 50 round burs exposed to E faecalis in an In-vitro study. Materials and Methods: A total of 50 round dental burs were exposed to E. faecalis and the disinfecting capability of four different experimental oils against autoclave was evaluated by counting colony-forming units (CFUs) and turbidity test. Statistical Analysis: Statistical analysis was performed using SPSS version 20.0 (IBM), Chicago. The CFUs between the five groups (I, II, III, IV, V) were compared using the Chi-square test. The level of significance was kept at 5%. Results: Clove leaf oil showed the best disinfection efficacy comparable to autoclaving, followed by Tulsi leaf oil with no statistically significant difference between them, whereas garlic oil and PPE oil were significantly less effective against E. faecalis. Conclusion: Clove leaf oil and Tulsi leaf oil can be used for disinfecting dental burs, infected with E. faecalis, as alternatives to autoclaving.

Isolated Cricoid Fracture and Thyroid Hematoma in Blunt Injury of the Neck.

Introduction Blunt trauma to the neck may result in life threatening injuries due to airway compromise. Thyroid Injury in a previously normal gland is rare, so is Isolated Cricoid Fracture. The expanding thyroid hematoma and an unstable larynx compound the effects of compression and lead to sudden deterioration of the patient. Case Report We report the case of young male, who sustained a blunt injury in front of the neck. He developed a swelling in the front of his neck and suddenly deteriorated, needing intubation and airway management. Computed Tomographic imaging of the neck showed thyroid hematoma and fracture of the cricoid ring requiring an emergency hemi thyroidectomy and fixation of the cricoid fracture. Discussion This case brings forth the occurrence of two rare entities, Thyroid hematoma and Isolated Cricoid fracture in the same patient needing expert airway management and exploration.

Compact setup to determine size and concentration of spherical particles in a turbid medium.

We propose a compact setup to determine the size and concentration of spherical particles in a turbid medium. A pair of plane mirrors is used to multifold the undeviated laser beam, and measure it at a detector placed close to the sample, to determine the interaction coefficient. The size of particles is uniquely determined by comparison of the scattered light from the medium, measured at two separate detectors placed at two different angular positions, with that from Monte Carlo simulations. The methodology is verified using measurements with turbid samples comprising polystyrene spheres.

Research Note: Characterization of antibiotic resistant phenotypes and linked genes of Escherichia coli and Klebsiella pneumoniae from healthy broiler chickens, Karnataka, India.

The study was carried out to estimate the burden and pattern of antibiotic resistance and to identify antibiotic resistance genes with focus on ESBL producers, plasmid mediated quinolone resistance, and tetracycline efflux genes, in faecal bacterial isolates collected from poultry farms of coastal Southern Karnataka, India. High resistance to fluoroquinolones was observed with 94% Escherichia coli and 80% Klebsiella pneumoniae being resistant to both ciprofloxacin and levofloxacin. All the Escherichia coli strains were resistant to tetracycline (100%). qnrB (38%) was the most common gene detected followed by qnrS (27%) and qnrA (21.5%). All Klebsiella pneumoniae isolates resistant to tetracycline harbored tetA gene. Most of the isolates in our study had high MAR indices indicating rampant use of antibiotics.

Validity of a CB-NAAT assay in diagnosing tuberculosis in comparison to culture: A study from an urban area of South India.

•CB-NAAT performance compared in 831 suspected pulmonary and extrapulmonary suspected cases.•The conventional stained smear and CB-NAAT results were compared to the MGIT culture.•Sensitivity and specificity of CB-NAAT was 84.43% and 94.93%.•The rapid results from CB-NAAT confirms its use in the tuberculosis diagnostic algorithm.•The benefits of disease diagnosis and prevention outweighs the price tag of the CB-NAAT tests.•This is more so for the resource poor countries where the burden of the disease is high.

Mycotic keratitis due to Cylindrocarpon lichenicola: Successful salvage of the eye.

We hereby report a successfully salvaged eye due to mycotic keratitis by Cylindrocarpon lichenicola in a 60-year-old female from Kasaragod (Kerala). The patient came with a history of pain, photophobia and decreased vision of the right eye. The microbiological investigations of the corneal scraping revealed C. lichenicola. C. lichenicola is a soil saprophyte. Since the ulcer worsened paracentesis followed by therapeutic keratoplasty and adjunct therapy with natamycin drops, voriconazole drops and oral ketoconazole was given. We stress that evidence-based timely medical and surgical intervention helped in the restoration of the vision in an infected eye.

Endovascular Intervention for Central Venous Stenosis in Hemodialysis Patients: A Single-center Experience.

Central venous stenosis (CVS) refers to a significant stenosis of a large intrathoracic vein, such as the subclavian, brachiocephalic, or the superior vena cava (hemodialysis, HD). Percutaneous transluminal angioplasty (PTA) with or without stent placement has been the recommended as the preferred approach to CVS. A total of 10 consecutive HD patients with documented CVS over a 2-year time period from April 2017-April 2019 underwent percutaneous angioplasty and stent insertions under sedation. The procedure was performed by the interventional cardiologist in the institute. One patient underwent only PTA, whereas nine (90%) had PTA with primary stent insertion. Primary patency was 90% at 3 months, 80% at 6 months while at 12 months, it was 70% and remained at 70% at 24 months. We did not find any association between age, gender, diabetic status, dialysis vintage, or previous catheter infection with procedural patency. Central venous stenosis can be treated successfully with percutaneous angioplasty and primary stenting. Despite advances, prevention of CVS should be the primary approach.

Long-term outcomes in primary male epispadias.

PURPOSE: The authors present a case series of 30 male patients who presented with primary epispadias between 1989 and 2002 and looked at their long-term outcomes. OBJECTIVES: (1) What procedures and operations did these patients require following their original surgery? (2) What were their outcomes as adults in terms of continence, cosmesis, and sexual function? MATERIALS AND METHODS: Primary male epispadias patients who had gone through transition into Adolescent and Adult Urology services were identified retrospectively from electronic patient records. RESULTS: The authors identified 30 male patients with a median follow-up of 18.5 years. Twenty-four had penopubic epispadias, and six had penile epispadias. All initial surgery took place between 9 and 48 months. Twenty-eight patients needed further surgery over the follow-up period, 26 had surgery for continence, and 12 required revision surgery. At follow-up, 15 patients were continent voiding per urethra, nine patients reported stress leakage with volitional urethral voiding, six patients were using a Mitrofanoff to void, and four of these had an ileocystoplasty. Nineteen patients had documentation on their feelings toward cosmetic outcome; 17 expressed concern. Twenty-one patients had documentation about sexual function; 20 had normal erections with six reporting chordee and nine reporting retrograde ejaculation. No patients were recorded to have fathered any children. DISCUSSION: There are only a few published studies looking at long-term outcomes of genitourinary reconstruction in primary male epispadias and their sexual function in adulthood. The majority of this patient cohort required surgery to improve their continence and had more than one continence procedure. There is limited data on continence outcomes in the literature with small cohorts and rates varying between 40 and 100% at 10-year follow-up. Despite corrective surgery, nearly all the patients were concerned about their genital appearance. Other studies have shown similar outcomes in terms of patient satisfaction and sexual function. The limitations of this work are that the information was gathered retrospectively from the electronic patient record and validated instruments on outcomes were not used. CONCLUSIONS: The study outcomes will be useful for clinicians who are counseling patients and parents regarding what to expect as adults.

Prevalence of use of complementary and alternative medicine in chronic kidney disease: A cross-sectional single-center study from South India.

The prevalence of chronic kidney disease (CKD) has increased substantially in India over the past two decades commensurate with the global trend and has currently emerged as a significant cause of mortality and morbidity. Use of complementary and alternative medicine (CAM), especially ayurvedic medication, is widespread in CKD although accurate data on the prevalence of use are lacking. A cross-sectional study was conducted from January to June 2017 in the nephrology outpatient clinic of a medical college hospital in Mangalore, South-West India. Adult patients (>18 years) with CKD (estimated glomerular filtration rate ≤60 mL/min) were considered potentially eligible and approached to participate in the survey. A 17-item semi-structured questionnaire adapted from the National Health Interview Survey Adult CAM Supplement was used for the study. A total of 278 patients (194 males and 84 females) with a mean age of 49.04 ± 12.06 years were included in the study; 67.3% were unemployed and married (83.8%), 35.6% had primary school education, more than 2/3rd of the patients had CKD Stage 5, and 110 patients were on renal replacement therapy with hemodialysis. Comorbidities such as hypertension were present in 46.8%, whereas 36.7% of the patients were diabetic. One hundred and eighty-four patients interviewed (66.3%) reported the use of one or more types of CAM therapy in the previous six months. Herbal and dietary supplements were used by 13 (7.1%); ayurvedic medication by 117 (63.6%); naturopathic, homeopathic, and Unani systems by 30 (16.3%), while spiritual/faith healing and acupuncture were used by 16 (8.7%) and eight (4.3%) of the patients, respectively. A multiple regression analysis between CAM users and non-users revealed that older age (P = 0.004), occupational status (P = 0.035), and income (P = 0.006) correlated strongly with CAM use. The present study highlights the high prevalence (66%) of use of alternative medication in patients with CKD.