Browsing by Author "Khan, M. F."

Now showing 1 - 7 of 7
  • No Thumbnail Available
    Item
    Clinical and biochemical profile of hyponatremia and the role of vaptans in comparison to other standard modalities of therapy
    (Medip Academy, 2023-10) Ahmed, J.; Khan, M. F.; Umakanth, S.; Shetty, S.
    Background: This study, conducted from August 2014 to August 2015, investigated hyponatremia in 228 in-hospital patients, aiming to discern its clinical and biochemical features and compare the efficacy of vaptans against standard treatments. The null hypothesis assumed no significant disparity in outcomes, while the alternate hypothesis posited otherwise. Methods: Using an open-label, non-blinded, observational, prospective comparative design, we assessed 228 hyponatremia patients. We scrutinized their clinical and biochemical profiles and made comparisons between moderate and profound hyponatremia cases, along with different treatment approaches. Results: Our findings revealed that patients aged 61-80, primarily females, dominated the cohort. Moderate hyponatremia occurred in 56.6% of cases, with severe hyponatremia in 43.4%. Common symptoms included drowsiness, nausea, and vomiting. Euvolemic hyponatremia was predominantly due to SIADH, while heart failure led to most hypervolemic cases. Various treatments were employed, with fluid restriction and normal saline being common. Tolvaptan and 1.6% hypertonic saline significantly increased serum sodium levels at 24 and 48 hours. Hospital stay duration didn’t significantly differ, and no osmotic demyelination cases emerged. Mortality stood at 10.5%, notably higher in profound hyponatremia cases. Conclusions: This study provides insights into hyponatremia’s clinical and biochemical aspects and compares vaptans to standard treatments. Tolvaptan and hypertonic saline displayed promise in raising serum sodium levels. Nevertheless, further research is warranted to validate these findings and explore additional factors impacting hyponatremia treatment outcomes.
  • No Thumbnail Available
    Item
    Comparison of clinical outcomes of conventional hemodialysis and online hemodiafiltration
    (Medip Academy, 2023-08) Malik, M. S.; Khan, M. F.; Babu, K.; Siddini, V.; Ballal, S.
    Background: Several studies have suggested that online hemodiafiltration (OL-HDF) may reduce the risk of mortality and improve quality of life of these patients compared with standard hemodialysis. Methods: Forty stable out patients on dialysis (20 patients on hemodialysis and 20 patients on online hemodiafiltration) above age of 18 years and dialysis vintage of more than 3 months were followed up for 18 months. Clinical, biochemical parameters of these patients along with the SF-36 score at baseline and after 18 months of follow up were assessed. Results: At 18 months, statistically significant difference was found between hemodialysis (HD) and OL- HDF groups in erythropoietin dose (p=0.047), urea reduction ratio (p=0.016), Kt/V (p=0.005), hemoglobin (p=0.043), serum albumin (p=0.002), phosphorus (p=0.024), parathyroid hormone (p=0.007), potassium (p=0.007), ?2 microglobulin (p=0.002), high sensitive c-reactive protein (p=0.037), and serum bicarbonate levels (p=0.022). We found statistically significant difference in intradialytic complications namely intradialytic hypotension, muscle cramps, simultaneous hypotension and muscle cramps and stoppage of dialysis. In terms of mortality, the difference was not statistically significant (p=0.052). Conclusions: Patients on OL- HDF were having better quality of life than patients on HD. Better solute clearance, anemia control, improved nutritional and Mineral bone disorder parameters were seen in OL-HDF. Less complications during dialysis were seen with OL-HDF. The difference in mortality rate between the HD group and OL- HDF group was not statistically significant.
  • No Thumbnail Available
    Item
    Extensive ileocaval and renal vein thrombosis mimicking acute pyelonephritis
    (Medip Academy, 2023-12) Khiste, S. D.; Avinash, I.; Khan, M. F.
    Renal vein thrombosis (RVT) is a rare clinical diagnosis which is the presence of thrombus in the major renal veins or its tributaries. Major causes include nephrotic syndrome, trauma, malignancy, hypercoagulable states. Presentation could be unilateral or bilateral flank pain and/or haematuria. Symptoms could be confused with nephrolithiasis. A normal ultrasonography (USG) in the initial stage could delay the diagnosis and hence propensity for dreaded complications such as loss of renal function and pulmonary embolism. Anticoagulation is the mainstay of therapy for RVT. Review of the literature reveals that thrombolytic therapy can also be used in patients with the most severe disease. Here we present a case of a young male, who initially suspected to have acute pyelonephritis, turned out to have extensive Iliocaval and unilateral RVT secondary to factor V leiden mutation who underwent catheter directed thrombolysis and mechanical thrombectomy.
  • No Thumbnail Available
    Item
    Not an innocent bystander: case series of tranexamic acid induced cortical necrosis
    (Medip Academy, 2024-03) Hande, M.; Khan, M. F.; Babu, K.; Siddini, V.; Rampure, S.
    Acute cortical necrosis accounts for <2% of all acute kidney injuries. Pregnancy complications, viperine snake bites, haemolytic uremic syndrome, shock, and severe pancreatitis are all linked to it. There are relatively few case reports of acute cortical necrosis secondary to tranexamic acid, which is utilised in the treatment of acute bleeding because of its antifibrinolytic actions. Acute cortical necrosis is very infrequently brought on by medicines. Here, we present a group of three instances, each of which experienced the onset of oligo-anuria soon after receiving tranexamic acid. Cortical necrosis was demonstrated by contrast computed tomography (CT) and renal biopsy. While the third patient had patchy cortical necrosis and had partially recovered renal functions, the other two patients both had total acute cortical necrosis and are still reliant on dialysis. This case series demonstrates the need for clinicians to be cautious while using tranexamic acid and to be aware of the possibility of abrupt renal cortical necrosis following its administration.
  • No Thumbnail Available
    Item
    Study to assess the patterns of hypertension and factors influencing hypertension in chronic kidney disease
    (Medip Academy, 2023-07) Subramanya, A. M.; Khan, M. F.; Ravindra, A.
    Background: A large proportion of CKD patients have inadequate BP control, and the proportions vary from studies to studies. Clinic BP is considered insufficient to diagnose HTN and monitor overall BP control because it does not correlate well with ambulatory blood pressure monitoring (ABPM), which encompasses white-coat or masked HTN. CKD is associated not only with an abnormal dipping pattern but also with white-coat or masked HTN. Objective of this study was to evaluate the factors influencing the blood pressure in chronic kidney disease patients. Methods: A cross sectional study was conducted at a tertiary hospital in South India from 1st of January 2016 to 31st of July 2017. A total of 124 cases were included in the study. Results: Among subjects with controlled HTN, 31.4% were overweight and 5.7% were Obese. Among Stage 3 CKD subjects, 53.7% had controlled HTN, 12.2% had masked HTN, 12.2% had persistent HTN. We reported that among those with proteinuria 2+, 38.5% had controlled HTN, 11.5% had masked HTN, 19.2% had persistent HTN and 30.8% had white coat HTN. In the study among diabetics, 17.5% had controlled HTN, 36.8% had masked HTN, 43.9% had persistent HTN and 1.8% had white coat HTN. Conclusions: Stage of CKD, diabetes mellitus and proteinuria are determinants of hypertension in CKD patients. ABPM is the best method to monitor BP and hence in the proper management of HTN and in prevention of target organ damage in CKD patients.
  • No Thumbnail Available
    Item
    Two birds one stone-two rare cases of adenine phosphoribosyl transferase deficiency
    (Medip Academy, 2023-02) Khan, M. F.; Siddini, V.; Vankalakunti, M.; Ballal, S.
    Complete adenine phosphoribosyl transferase (APRT) deficiency is a rare inherited metabolic disorder that leads to the formation and hyperexcretion of 2,8-dihydroxyadenine (DHA) into urine. We had a 52-year-old male with Hypertension for 18 months, presented for routine evaluation and was found to have creatinine of 4.29 mg/dl. His urine analysis was done which showed no proteinuria or urinary sediments. His USG done demonstrated normal sized kidneys with mildly increased echogenicities. He underwent a renal Biopsy for etiology determination. Similarly, we had another case of a 54-year-old female with no comorbidities who was identified to have chronic kidney disease in 2018 with a baseline creatinine of 2 mg/dl came with uremic symptoms and history of NSAID intake in June 2019. Her creatinine peaked to 7.9 mg/dl. Urine analysis displayed 1+ proteinuria with no active sediments. Her USG of the kidneys showed normal kidneys with increased echogenicities. She underwent renal biopsy for etiology determination. Biopsy of case 1 showed chronic interstitial nephritis and case 2 showed acute interstitial nephritis. Both biopsies showed deposition of 2,8-dihydroxyadenine crystals. Genetic analysis of both cases showed an exon mutation in chromosome 16.
  • No Thumbnail Available
    Item
    When you least expect it: nephrotic syndrome following dengue fever
    (Medip Academy, 2023-12) Thomas, J.; Khan, M. F.; Siddini, V.; Vankalakunti, M.; Ballal, H. S.
    This case report highlights a rare occurrence of nephrotic syndrome in a previously healthy 20-year-old gentleman. The patient exhibited bilateral lower limb swelling, facial puffiness, and abdominal distension. Notably, he had been hospitalized two weeks prior with dengue fever, characterized by a transient reduction in platelet counts. Routine examinations revealed proteinuria, with creatinine at 0.97 and albumin at 2.2. A renal biopsy confirmed focal segmental glomerulosclerosis (FSGS)- NOS type. This case underscores the significance of considering renal complications in individuals with recent dengue fever, especially when presented with atypical symptoms. The scarcity of reported cases depicting nephrotic syndrome as a sequelae to dengue fever further emphasizes the uniqueness of this scenario.