Abstract: We describe a young man of 37 years with a transient but marked Oligoasthenoteratozoospermia (OAT) syndrome due to severe covid infection with the perfect recovery of semen parameters along with recovery of general health. Setting district general hospital: Intervention none.We review the role of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2 virus), the role of Angiotensin-Converting Enzyme 2 (ACE-2), Angiotensin 1-7 (Ang 1-7) and propose that it is potentially involved in a cause and effect mechanism of injury. PubDate: 23 Mar, 2022
Abstract: Background: Chronic hemodialysis patients have higher cardiovascular morbidity compared to the general population. A number of studies have suggested that patients undergoing hemodialysis with polymethylmethacrylate (PMMA) membranes have a better outcome compared to other membranes. Methods: We performed a retrospective, multicenter study to evaluate the impact of PMMA membranes compared to other types of membranes on clinical parameters considered important risk factors for the development of cardiovascular disease in chronic kidney disease patients. Results: The study included 104 patients (52 patients on PMMA and 52 patients on other membranes) from ten dialysis centers, monitored for 24 months. HDL cholesterol (mg/dL) increased significantly in the PMMA group (41.4 ± 10.8 to 44.1 ± 13.5, p = 0.0467), but not in the control group (41.8 ± 13.8 to 39.4 ± 9.6, p = 0.8628). At 24 months total cholesterol and triglycerides (mg/dl) were significantly lower in the PMMA group than in the control group (142.4 ± 43.8 vs. 166.1 ± 43.4, p = 0.0321 and 106 (76.5-176) vs. 170 (118-254), p = 0.014), respectively. Serum creatinine (mg/dL) increased significantly from baseline to 24months in the PMMA group (9.20 ± 2.5 to 9.47 ± 2.3, p = 0.0291), but not in the patients treated with other membranes (8.39 ± 2.6 to 8.37 ± 2.3, p = 0.2743). In addition creatinine was significantly higher in the PMMA group compared to the other group (9.47 ± 2.3 vs. 8.37 ± 2.3, p = 0.0493).WBCs (109/L) increased significantly in the control group (6151 ± 1846 to 6672 ± 1872, p = 0.0457) but not in the PMMA group (6326 ± 2113 to 6152 ± 1832, p = 0.8981). At 24 months platelets (109/L) and CRP (ng/dL) were significantly lower in the PMMA group compared to the control group (185 (144-222) vs. 210 (173-259), p = 0.0498 and 0.70 (0.30-1.59) vs. 3.76 (0.46-10.2), p = 0.023, respectively). Iron and transferrin (μ g/dL) decreased signifi cantly in the patients treated with other membrane (62.5 ± 30.4 to 52.6 ±19.0, p = 0.0113 and 178 (157-218) to 170 (124-203), p = 0.0019, respectively), but not in the PMMA group.Conclusion: This retrospective study of data from 104 patients shows a favorable effect of PMMA on clinical variables considered relevant for the development of atherosclerosis in hemodialysis patients. PubDate: 04 Jan, 2022
Abstract: Background: Chronic Renal Failure (CRF) is a general health problem having a genuine effect on the quality of life of the patients experiencing hemodialysis.Objectives: The aim and objectives of this cross-sectional study was to evaluate the effect of dialysis on the quality of life of patients with End Stage Renal Failure (ESRF).Methodology: Sample of 103 Patients Undergoing hemodialysis were included in study from two hospitals (public sector) of Quetta Pakistan. Information was gathered by the fruition of a self-utilized survey a part of KDQOL-SF fusing the instrument of the SF-36 survey of health and an extra poll so as to incorporate demographics. Writing survey depended on studies, audits and articles got from global information bases concerning the quality of life of individuals with end stage renal failure.Result: A total of 103 responses were collected out of which 54 (53.4%) were males and 49 (47.6%) were females with the mean age between 30 and 45 (38.8%) years old. Majority of the patients were in a Moderate state of health 56 (54.4 %) and 33(32%) were those who had Bad health state, while 14 (13.6%) patients with Good quality of health. Majority of the patients were not at all bothered by dryness of skin (27.2%), itchy skin (39.8%), lack of appetite (32%), washed out or exhausted (39%), soreness of muscles (35%), pain in their joints (32%), easy brouising (45.6%), sleepiness at the day time (42.7%), cramps during dialysis (60.2%) and after dialysis (36.9%), stiffness of joints (33%), back pain (31.1%), numbness in hands or feet (37.9%), bone aches (30.1%), muscle pain (41.7%), headache (26.2%), stomach problem or nausea (31.1%), shortness of breath (43.7%), faintness or dizziness (64.1%), hot or cold spells (36.9%), trouble concentration (52.4%), trouble in getting breath (52.4%), blurred vision (42.7%), chest pain (52.4%), swelled ankles (34%), loss of tast 3 (35.9%), clotting or other access site problems (62.1%) and majority of the patients were extremely bothered by lack of strength (36.9%), weakness and fatigue (51.5%), excessive thirst (41.7%), dryness of mouth (34%), trouble in sleeping (37.9%), head ach (26.2%). Majority of the patients were somewhat bothered by high blood pressure (19.4%) and low blood pressure (13.6%).Conclusion: Specific variables, such as age, gender, social support, income, the quality of life of the patients is effected either negatively or positively by education physical functioning health and disease symptoms. Particular factors, for example, age, gender, social support, income, education, physical working wellbeing and ailment side effects can influence either decidedly or adversely the quality of patients life. PubDate: 31 Dec, 2021
Abstract: From the establishment of nearly universal health coverage for end stage renal disease in 1972 to 2021, the primary treatment modality has been in-center hemodialysis despite significant advances in home therapies such as peritoneal dialysis and home hemodialysis. PubDate: 28 Sep, 2021
Abstract: Background: End-Stage Kidney Disease (ESKD) and associated complications are related with increased prevalence of psychological disorders. There is a growing trend of elderly and high comorbid individuals beginning chronic Hemodialysis Programs (HD) while there is limited knowledge about the influence of functional impairment and comorbidity burden in the prevalence of mental health disorders and life satisfaction on HD population. The purposes of this study were to report the local prevalence of psychological disorders, life satisfaction and self-reported health status as well to describe differences in functional status and comorbidity burden scores between patients with moderate/severe psychological disorders and those none/mild alterations of a Latin American chronic HD cohort.Methods: Transversal uni-center study in 139 Ecuadorian chronic and stable HD patients. Once patients were eligible to participate six tests were applied to explore functional status (Barthel Index and PPS score), depression, anxiety and stress prevalence (DASS-21 scale) comorbidity burden (Charlson Index), self-rated health state (EQ-5D/VAS) and satisfaction with life (SWLS score) Exclusion criteria were: Time in HD less than 6 months, recent hospitalization (less than 3 months) and severe cognitive impairment. Continuous symmetric variables were described as mean ± standard deviation or median and interquartile range if asymmetric. T-test was used for symmetric continuous variables, U-Mann-Whitney if asymmetric and chi-square for qualitative variables.Results: A total of 79 (55%) patients were male. Mean time in HD was 73 ± 47 months, with mean age 56 ± 15,7 years. Prevalence of moderate/severe mental health disorders were: depression (28%), anxiety (37%) and stress (34%). Moderate/severe depressed patients scored significatively lower in Barthel Index (p=0.048) and those with moderate/severe stress scored significatively lower in Barthel Index (p=0.025) and PPS score (p=0.030). Time in HD> 92 months was significatively related with moderate severe/anxiety (0.044). Unsatisfaction with life was found in 20% of patients and it was significatively related with lower functional Barthel Index (p=0.017) and PPS score (p=0.041) when compared with those satisfied with life. Patients with self-rated health status <70% on EQ-5D VAS scored significatively lower in Barthel Index (p=0.022) and PPS score (0.003) vs those with ≥70% score. No differences were found with age, CKD etiology, civil and laboral status. Conclusions: Prevalence of mental health disorders is similar to other series reported. Patients with moderate/severe depression, stress, unsatisfaction with life, and low self-reported health state had worst functional status than those with none/mild alterations. Time in HD over 7.6 years was associated with higher intensity of anxiety. PubDate: 28 Aug, 2021
Abstract: We report a case of a 63-year-old female presenting with abdominal pain, who suffered a dramatic deterioration in her condition following a diagnosis of bilateral renal infarcts on imaging. Within days she had developed widespread aneurysmal dilatation, dissection and thrombosis of the intra-abdominal arterial tree, requiring emergency transfer to a tertiary vascular centre for treatment of polyarteritis nodosa. She responded well to intravenous cyclophosphamide and is now receiving treatment on an outpatient basis. PubDate: 27 Jan, 2021
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