A study on dietary recall among the maintenance haemodialysis patients in East Godavari district.

Introduction: Individuals with end-stage renal diseases are usually at an increased risk of nutritional disorders. Protein-energy malnutrition is observed in a significant number of maintenance haemodialysis (MHD) patients. Hence a study was conducted to find whether dietary intake meets recommended dietary allowance (RDA) among MHD individuals. Materials and methods: This was cross-sectional research conducted in the department of Nephrology, GSL Medical College, for 18 months. Individuals are aged 18 years or more, metabolically stable and undergoing MHD were included. Software called Dietsoft was used to know the dietary calculations. Parameters including energy, carbohydrates, proteins, fats, vitamins, minerals and essential amino acids (EAA) were evaluated. Mann Whitney U test was used to find the significant difference, and P < 0.05 was considered statistically significant. Results: Of the 31 patients, 18 were male, and 13 were female. The calorie intake was as recommended, but statistically, there was no significant difference. But the intake of the macronutrients and dietary fibre was higher than the recommended, which was statistically significant. In females, there was a considerable difference. The difference was statistically not significant in minerals intake. Conclusion: There was considerable malnutrition among the patients undergoing MHD. Hence regular dietary assessment is required

Silent brain infarcts in chronic kidney disease patients with nonspecific neurological symptoms

Introduction: Silent brain infarcts (SBI) are parenchymal lesions of previous infarcts, classified as type III cerebrovascular disorder. A study was undertaken to find the relation between SBIs and nonspecific neurological complaints, an association of high sensitivity C-reactive protein (hsCRP) with silent brain infarcts. Methodology: It was a cross-sectional study conducted in the department of Nephrology, GSL Medical College, from January to December 2020. Individuals aged > 18 years with nonspecific neurological complaints were included. MRI brain, hsCRP and electrocardiogram were also carried as per the standard protocol. Fischer exact test was used to find the statistical significance; P < 0.05 was considered statistically significant. Results: A total of 51 members have included the male-female ratio was 1.04. SBI was presented in 27.4% (14). Age-wise, among the cortical SBI patients, maximum (75%) were in the> 61 years group. High density lipoprotein levels were > 40 mg/dL in 39.2%, normal triglycerides (TGL) were observed in 71% and raised hsCRP in 62.7% (32). Statistically, there was no significant difference in TGL levels. hsCRP levels were raised in 3 (75%) members with cortical SBI; statistically, there was no significant difference. Conclusion: The traditional risk factors associated with stroke were present in the patients with SBI. hsCRP was raised in chronic kidney disease patients having NSCL and having SBI

A study to find the utility of MRI in the evaluation of painful hip joints

Introduction: Magnetic resonance (MR) imaging is a valuable tool in the evaluation of hip disorders. With these, a study was conducted to assess the role of MRI in the early evaluation of painful hip joints. Materials and Methods: It was a cross-sectional study conducted in the department of Radiodiagnosis, GSL Medical College, Rajahmundry. The study protocol was approved by the Institutional Ethical Committee. Patients presenting with acute or chronic hip pain pathology of all age groups, both gender who referred for MRI were included in the study. Imaging has been done with 1.5 Tesla Philips Achieva machines using abdominal surface coils and spine coils. Results: Out of the 30 participants, avascular necrosis was diagnosed in 46.6% (14) participants, joint effusion in 10% (3) cases, osteoarthritis (OA) in 4 (13.3%) cases, tuberculosis (TB) in 10% (3), 6.6% (2) each was diagnosed to be Perthe’s, developmental dysplasia of the hip (DDH) and metastasis, respectively. All the pathological findings were diagnosed using MRI also. Conclusion: MRI helps in the evaluation of the involvement of articular cartilage in the form of T2W hyperintensity. It also helps in the evaluation of soft tissue involvement along with the detection of bone marrow edema

A study on nephropathy in type2 diabetes individuals in coastal Andhra Pradesh, India

Introduction: Diabetes nephropathy (DN) is an important, life-threatening microvascular complication of diabetes mellitus (DM). With this, a study was conducted to find the association between type 2 DM and DN. Materials and Methods: The study was conducted in the department of general medicine, GSL Medical College. Type 2 diabetic subjects who attended the outpatient and inpatient wards, aged > 30 years were included in the study, known renal disease/ were not considered. Albumin creatinine ratio was measured by immune turbidometry using a microalbuminuria test kit provided by ERBA MANHEIM GERMANY. Serum creatinine was done by creatininase enzymatic method, eGFR was calculated using the CKD-EPI equation. P<0.05 was considered statistically significant. Results: A total of 150 DM participants were included in the study; mean serum creatinine was 1.59 + 1.25 with a range from 0.4 to 8.7 mg/dl and mean eGFR of the study participants was 73.65 + 40.428 ml/min/m2 with a range from 7 to 162 ml/min/m2. DN was detected in 45% (67) participants. Conclusions: The present study reveals that there was significant evidence to support that microalbuminuria or proteinuria in patients with diabetes is a potential risk factor not only for kidney function impairment but also as a marker for high risk of cardiovascular complications

Role of Computed Tomography (CT) in traumatic head injury evaluation – a cross-sectional study

Introduction: CT is the single primary modality in the evaluation of patients with acute head injuries. With these, a study was taken to find various clinico radiological patterns of head injuries and to correlate the CT features with clinical operative findings. Materials and Methods: This was a cross-sectional study carried in patients of head injury. The patients with a head injury, craniofacial trauma who underwent CT scanning were included in the study. Patients on the ventilator and with Glasgow coma scale <6 were excluded. Patients were scanned using dual Slice CT, Siemens somatom Emotion duo. A P-value of less than 0.05 was considered statistically significant. Results: Total 223 patients were included, 76.2% were males and 73.5% were abnormal scans. Among all intracranial traumatic lesions (ITL) the incidence of multiple ITLs were the most common (35%) and the death rate was 12.6%. Temporal bone fractures (15.2%) were the highest. Conclusion: It was concluded that 21 – 40 years is the typical age group for head injuries, common among male and the incidence of mortality rate is more > 61 years. MICTLs are the most frequent type of hematomas

Hypothyroidism in type 2 diabetics – a hospital-based prevalence study

Introduction: Thyroid hormones and insulin are the antagonists and both are involved in cellular metabolism. With this, the study was planned to find the prevalence of thyroid dysfunction in type 2 diabetes mellitus (DM). Materials and Methods: Study was conducted in the department of General Medicine, GSL Medical College. The study protocol was approved by the institutional ethical committee. All type 2 diabetics aged >30yrs, irrespective of treatment were included in the study. Individuals on metformin therapy, smokers, thyroid hormone users, who underwent thyroid surgery, individuals on radioiodine therapy, pregnant women and individuals on steroids were excluded. Venous blood samples were taken from for fasting blood glucose and 2-hour post glucose blood sugar, glycosylated hemoglobin, lipid profile, and thyroid function estimated measured by using the autoanalyzer. Chi-square test was used to compare differences in categorical variables and p<0.05 was considered statistically significant. Results: Among 104 participants, 82.7% were euthyroid, 12.5% had subclinical and 4.8% had clinical hypothyroidism; statistically the difference not significant when age/gender was correlated. But there was a significant association with dyslipidemia. Conclusion: Hypothyroidism is very common among type 2 DM individuals and both complement others' metabolism

Incidence of contrast induced nephropathy among patients undergoing coronary interventions

Background: Contrast media (CM) used during diagnostic and therapeutic percutaneous procedures is eliminated by the kidneys. A study has been planned to find the adverse effects of contrast agents on renal system. Methods: This was a hospital based cross sectional study, conducted in the department of general medicine, GSL Medical College. Individuals >25 age, both gender with heamoglobin concentration of > 10mg/dl were included. Exclusion criteria was also followed. Iodixanol or iohexol was used, administered at the rate of 80 – 100 ml per participants. Blood samples were collected standard techniques before the procedure and 48 hours after the procedure for serum creatinine levels. Renal function was assessed by estimating creatinine clearance using the Cockcroft-gault formulae. As per national kidney foundation participants were divided in to 4 categories normal, mildly impaired, moderately impaired and severely impaired renal function; p<0.05 was considered as statistically significant. Results: Out of 80 study subjects, CIN was increased with age, identified in 37.9% diabetics, 48.3% smokers, 41.4% alcoholics; statistically there was no significant difference. In the normal category 34.5%, 41.4% in mild category, 24.1% in moderate renal dysfunction category developed CIN, association was statistically significant. Conclusions: With these findings we conclude that overall increase in the incidence of CIN with age and no influence of gender as well as conditions like diabetes and hypertension

Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

10.1016/s0140-6736(21)01169-7The Lancet397102922337-236