A rare presentation of the Klinefelter's syndrome

A 16 years old boy with Chronic Renal Failure (CRF) was not suspected of having Klinefelter's syndrome until he complained of painful gynecomastia. He was under haemodialysis for 2 years. At first, he was in an approximately full pubertal development (P5, G5), but he had a small and a firm testis (length 2.2cm) and some degree of facial male pattern hair. He also had a decreased upper to lower body segment ratio and despite having chronic renal failure, he was taller than his parents and siblings. His laboratory tests showed high levels of FSH and normal levels of LH and testosterone. With regards to all these findings, we suspected that there might be an occult Klinefelter's syndrome. So, we made his karyotype that showed a 47XXY pattern. Because there are only a few number of cases that have occult Klinefelter's syndrome in the basis of chronic renal failure, we decided to report this case

A rare presentation of the Klinefelter's syndrome

A 16 years old boy with Chronic Renal Failure (CRF) was not suspected of having Klinefelter's syndrome until he complained of painful gynecomastia. He was under haemodialysis for 2 years. At first, he was in an approximately full pubertal development (P5, G5), but he had a small and a firm testis (length 2.2cm) and some degree of facial male pattern hair. He also had a decreased upper to lower body segment ratio and despite having chronic renal failure, he was taller than his parents and siblings. His laboratory tests showed high levels of FSH and normal levels of LH and testosterone. With regards to all these findings, we suspected that there might be an occult Klinefelter's syndrome. So, we made his karyotype that showed a 47XXY pattern. Because there are only a few number of cases that have occult Klinefelter's syndrome in the basis of chronic renal failure, we decided to report this case

Pulmonary tuberculosis and some underlying conditions in Golestan Province of Iran, during 2001-2005

Context: Pulmonary tuberculosis has been a major health problem in Golestan province of Iran. Aims: This descriptive cross-sectional study was performed to evaluate the frequency of coexisting medical conditions and their effects on some epidemiologic factors in patients with pulmonary tuberculosis. Setting and Design: This was a descriptive cross-sectional study. Methods and Material: Demographic information, time of admission in the hospital and coexisting medical conditions (diabetes, chronic renal failure/hemodyalysis, corticosteroids consumption and malignancies) were extracted from the patient's file. Statistical analysis used: Chi-square test was used to assess the relationship between variables. Results: Two hundred forty three patients with pulmonary tuberculosis during 5 years were studied. Out of all, 162 cases (66.7%) did not have any co-morbidities. Diabetes mellitus was found to be the most prevalent condition (23.05%) followed by chronic renal failure, corticosteroid consumption and malignancy ranking second, third and forth in the list (5.8%, 2.5% and 2 respectively). The mean age of the patients was 50.15±19 years old. In the group without co morbidities, male/ female ratio was 1.41/1, but co morbidity with diabetes was significantly more prevalent in females (p<0.05). Conclusions: We suggest screening of tuberculosis in patients with chronic renal failure and diabetes mellitus in our area. Also for patients with pulmonary tuberculosis, diabetes screening should be considered essential

Weekly irinotecan in a patient with metastatic colorectal cancer on hemodialysis due to chronic renal failure

Background: The cytotoxic treatment of patients suffering from advanced or metastatic cancer undergoing hemodialysis due to chronic renal failure still remains a problem, since for those patients pharmacokinetic and pharmacodynamic data on most cytotoxic agents are lacking. Case Report: We report a 45-year-old male who suffered from chronic renal failure and was diagnosed with stage-3 colorectal cancer (CRC) in February 2000. After surgical removal of the tumor an adjuvant chemotherapy of dose-reduced i.v. bolus 5-fluorouracil and folinic acid was begun (Mayo protocol). Due to excessive gastrointestinal toxicity, therapy was discontinued after the first cycle. In April 2000 liver metastases were diagnosed. The patient was then put on a weekly schedule of dose-reduced CPT-11 (50 mg/m(2), 80 mg total). No hematological or non-hematological toxicity grade 3/4 was observed. Due to excellent tolerability and lack of severe side effects the dose was increased up to 80 mg/m2 (140 mg total) weekly. A dose escalation to 100 mg/m(2) (180 mg total) resulted in severe diarrhea (grade 4). Within 2 months of treatment the patient achieved a lasting partial remission until April 2001 (12 months). A significant progression of hepatic metastases required an alternative treatment regimen beginning in July 2001 (HAI, hepatic artery infusion). Conclusion: This case report demonstrates the feasibility and efficacy of a weekly treatment with dose-reduced CPT-11 in a patient with metastatic CRC on hemodialysis due to chronic renal failure

Perbedaanindeks Massa Tubuh (IMT) Pada Pasien Gagal Ginjal Kronik Dengan DM Dan Tanpa DM Yang Menjalani Hemodialisis Rutin Di RSUD Dr. Moewardi

Chronic kidney disease (CKD) is a disease that leads to progressive kidney function decline, and usually ends with renal failure. The prevalence of CKD in Indonesia is 0.2% and increases with age. DM ranks second as the cause of CKD. Hemodialysis becomes a therapy for patients with chronic renal failure to replace damaged kidney function. BMI is an important predictor that can describe the survival of chronic renal failure patients undergoing routine hemodialysis. To know the difference of BMI in patients with chronic renal failure with DM and without DM undergoing routine hemodialysis in RSUD Dr. Moewardi. Observational analytic research with cross sectional study design. The subjects of the study were patients suffering from chronic renal failure with DM and without DM undergoing routine hemodialysis in RSUD Dr. Moewardi. Sampling technique is done by purposive sampling technique. Data were obtained from medical records of patients who began undergoing routine hemodialysis in August 2016 to January 2017. Statistical analysis of this study using the Mann-Whitney test. This study used 48 samples, consisting of 24 patients with chronic renal failure with DM undergoing routine hemodialysis and 24 patients with chronic renal failure without DM undergoing routine hemodialysis. The difference in BMI in patients with chronic renal failure with DM undergoing routine hemodialysis 19.62 ± 4.21 kg / m2 compared with patients with chronic renal failure without DM undergoing routine hemodialysis 20.65 ± 1.60 kg / m2 with p <0.001. There is a difference of BMI in patients with chronic renal failure with DM and without DM undergoing routine hemodialysis

Hubungan Asupan Zat Gizi Makro (Energi, Protein, Lemak, Karbohidrat) terhadap Status Gizi Pasien Gagal Ginjal Kronik Rawat Jalan dengan Hemodialisis di RSUD dr. Moewardi

Introduction : The most used replacement therapy for chronic renal failure patients in Indonesia is hemodialysis. Hemodialysis in patients with chronic renal failure has impacts, including a decrease in food intake that can cause malnutrition in patients. Objective : The purpose of this research was to asses the correlations between macro nutrient intakes and nutritional status of chronic renal failure with hemodialysis outpatients at dr. Moewardi State Hospital. Research Method : This research used analytic observational with cross-sectional design. The respondents were selected through by consecutive sampling method. There were 46 chronic renal failure patients participated in this study. Nutritional status data were obtained through Body Mass Index measurements, macro nutrient intake data were obtained using 24 hour food recall form. Result : Most patients had poor energy, protein, fat, and carbohydrate intakes which were 41 patients (89,1%), 40 patients (87%), 40 patients (87%), and 43 patients (93,5%), respectively. There was not any correlation between nutritional status and intakes of energy (p=0,163), protein (p=1,000), fat (p=0,390), and carbohydrate (p=0,585). Conclusion : There was not any correlation between macro nutrient intakes and nutritional status of chronic renal failure with hemodialysis outpatients ar dr. Moewardi State Hospital. Further research needs to be done with due regard to all factors that may affect the incidence of malnutrition in chronic renal failure with hemodialysis patients. Keywords : chronic renal failure, macro nutrient intake, nutritional status Bibliography : 51 : 1990-201

Gambaran Kepatuhan Diet Pasien Gagal Ginjal Kronik yang Menjalani Hemodialisa Rawat Jalan di RSUD Kayen Kabupaten Pati Tahun 2015 The Description Of The Dietary Pursuance Cronical Renal Failure Patients Undergoing Hemodialysis Outp

Dietary therapy is one very important factor in the management of patients with chronic renal failure by hemodialysis. Compliance in implementing the diet be hope for hospital medical team. The study aims to describe dietary compliance of patients with chronic renal failure undergoing hemodialysis outpatients in hospitals Pati Kayen 2015. exploratory research using qualitative method by conducting in-depth interviews. The samples were all patients with chronic renal failure undergoing hemodialysis outpatients in 2015, amounting to 8 respondents. The survey results revealed that image data obtained demographic characteristics of the majority of respondents are male ( 62.5 % ) , respondents aged 45-50 years ( 75 % ) , final Education Junior High School ( 50 % ) , working as farm laborers ( 62.5 % ) , adherence to the diet ( 75 % ) and undergoing hemodialysis duration &gt; 12 months ( 75 % ) . BMI calculation results obtained 5 people (62.5%) of respondents are in the category of malnutrition , results of laboratory data obtained six respondents or 75% levels ureumnya 40.1 to 100 mg / dl or above the normal range. And 4 respondents or 50% of blood creatinine levels of 5,1- 10 mg / dl or above the normal range. Especially for Dietician on the Nutrition Installation Kayen Pati Regency Hospital to provide the time and schedule for nutritional counseling for patients with chronic renal failure undergoing hemodialysis outpatients in order to maximize the expected results

Efektifi Tas Huknah Tinggi dalam Menurunkan Kadar Ureum Darah pada Pasien dengan Gagal Ginjal Kronik di RSUD. Prof. Dr. Margono Soekarjo Purwokerto

Background: Chronic renal failure is a disorder function of renal with increase of ureum level in the blood. the therapy of this disease today is by used dialisa ( hemodialisys and peritoneal dialisys) which needed expensive cost. Thus, its very necessary to found new method for decrease the ureum level. As specialy lavement therapy.Objectives: This study aimed to know about the effect of High enema to decrease the blood ureum level of chronic renal failure patients.Method: This study used quasi experiment with pre test and post test with control group design. The cronic renal failure patient took with purposive sampling teknics consist of15 person for control and 15 person for treated group. T-test was applied to analyze the data.Result: The average of blood ureum level before and after treated by 3 days High Enema are 257,40 and 355,98 respectively. Thus the average of blood ureum level before and after in control group are 353,86 and 398,97 respectively. Base on the t-test the diff erence of blood ureum level before and after treated by 3 days High Enema, found that t value was 0.309 (p = 0.003). Thus the diff erence of blood ureum level before and after 3 days in control group, found that t value was -2.157 (p = 0.025). That's mean the High Enema has an eff ect to decrease the blood ureum level of chronic renal failure patients signifi canthy.Conclusion: The High Enema has an eff ect to decrease the blood ureum level of chronic renal failure patients