Acute Motor Axonal Neuropathy in Lupus Nephritis.

A prevalent clinical scenario is provided in this case study, in which a 22-year-old lady with a five-year history of lupus nephritis with acute motor axonal neuropathy presents for therapy. The patient received immunomodulator medication and steroids to control her symptoms to keep up with her everyday life despite the absence of comorbidities such as hypertension, diabetes, and hypothyroidism. No laboratory measures were changed, including hemoglobin, serum creatinine, or thyroid function. Examining the nervous system indicated a potentially harmful consequence, underscoring the significance of prompt investigation and treatment. This research highlighted the importance of attention in cases with lupus nephritis, showing how early medical care can prevent serious neurological problems and contribute to the patient's general well-being.

Acute Stylet Peritoneal Dialysis in Acute Kidney Injury: The Soul Never Dies.

BACKGROUND: Acute Kidney Injury (AKI) has a significant mortality rate. In developing countries, mortality due to AKI is high due to lack of access to dialysis facilities and related cost. The main goal of International Society of Nephrology (ISN) 0 by 25 initiative is to eliminate deaths due to AKI. Peritoneal dialysis is an underutilized modality in such a scenario. The aim of this study was to look into effectiveness of starting Acute stylet Peritoneal Dialysis (PD) in a resource constraint settings. METHODS: In this prospective study conducted over a year, patients with AKI due to various aetiologies were subjected to Acute stylet PD. The clinical Outcome, demographic, biochemical and treatment data was assessed. Descriptive statistics was used to analyze the data. RESULTS: A total of 79 (41 anuric, 33 oliguric and 5 nonoliguric) patients were included in the study. Sepsis was the predominant cause of AKI. Recovery was seen in 34% of patients. Patients with relatively preserved urine output recovered with PD in comparison to the anuric patients (p value <0.01). 58% of patients, majority of whom were anuric needed Hemodialysis (HD) in due course (7 ± 3 days) of time. The mortality in our study was 7.5%. CONCLUSIONS: Acute stylet PD can be considered as a modality of Renal Replacement Therapy (RRT) to treat a selected (oliguric, nonoliguric) group of AKI patients and as a bridge therapy for HD in those AKI patients in anuria.

Profile of glomerular diseases associated with hepatitis B and C: A single-center experience from India.

Hepatitis B and C are known to affect kidneys in a number of ways. Glomerular diseases associated with hepatitis B and C include membranous nephropathy (MN), membranoproliferative glomerulonephritis (MPGN), focal segmental glomerulosclerosis, immunoglobulin A nephropathy, rarely amyloidosis, and fibrillary and immunotactoid glomerulopathy. In a retrospective analysis of kidney biopsy of 534 patients, we found 16 (2.9%) patients of hepatitis B and 11 (2.05%) patients of hepatitis C with glomerular disease. The most common form of glomerulonephritis in hepatitis B patient was MN and in hepatitis C patient was MPGN.

Therapeutic dilemma in a case of acute coronary syndrome (ACS).

An adult male labourer, a smoker and alcoholic was admitted to our hospital with a short history of fever, myalgia, breathlessness and oliguria. On examination he was icteric and hypotensive. Calf muscle tenderness was present. A provisional diagnosis of leptospirosis was made and he was started on treatment with crystalline penicillin. Blood pressure (BP) did not improve with fluids. Inotropes were started. The patient was taken for Slow Low Efficiency Daily Dialysis (SLEDD) during which he developed chest pain. ECG showed an anterolateral myocardial infarction (MI). He also complained of breathlessness and haemoptysis. Antiplatelets were withheld in view of thrombocytopaenia and haemoptysis; heparin could not be given because of the deranged coagulation parameters. The patient was managed symptomatically with nitrates. After the BP improved SLEDD was restarted. On day 3 of admission the patient became tachypnoeic and hypoxic, bilateral coarse crackles were present on auscultation. He was intubated and mechanically ventilated. Suctioning of endotracheal tube revealed fresh blood, and chest CT revealed alveolar haemorrhage. In spite of aggressive resuscitative measures, mechanical ventilation and antibiotics, the patient expired on the 12th day following admission.