Good presentation . No rigid treatment can be suggested for all cases. Best is to go by urine C/S tests with empirical treatment to start with . Presence of DM2 should be eleminated . The neglect of treatment would make Dr Shivraj Agarwal Sir's forewarning about future prognosis ., a reality .
उपयोगी एवं महत्त्वपूर्ण जानकारी हेतु धन्यवाद देता हूं।
VERY MUCH USEFUL AND INFORMATIVE POST ABOUT PYELONEPHRITIS. IT'S CLINICAL PRESENTATION & DIAGNOSIS ALONG WITH TREATMENT IS ELABORATED IN DETAILED. IF NOT DIAGNOSED & TREATED IN TIME,IT MAY LEAD TO KIDNEY FAILURE ,WHICH WILL EVENTUALLY LEAD TO DIALYSIS AND EVEN KIDNEY TRANSPLANT SCENARIO,WHICH CREATES LOT OF FINANCIAL BURDEN AS WELL. EARLY DIAGNOSIS & PROMPT MEDICAL ATTENTION IS THE KEY TO STOP COMPLICATION'S.
Very Nice Sir ji
Good update on Pyelonephritis
Informative knowlegeble post
Pyelonephritis A renal disease easily diagnosed and easily curable if proper and ethical steps are followed so that an important organ of body can be saved and pt may spared from painful steps of renal dialysis or transplant and thence finencial burden Only thing we need to understand the clinical manifestations and reasons responsible for it as every individual has different reasons causing pyelonephritis Indeed females are more commonly facing owing to their private parts association and personal hygiene beside humanly sexual activity Males are no excused to contribute in their fate Treatment is simple but still complicated as inadequate diagnosis and treated irrelevantaly with any antibiotic is responsible as resistance and cross resistance makes the work more difficult hence proper workout and selection of antibiotics is key word to get rid of it Here I will not spare hospitals who are no less responsible to add the horror catheterization is measure cause No due precautions of aseptic procedures are followed and invite unending problem This article has elaborated nicely about treatment complications and organisms found commonly But labs are not far behind in confusing the reports of c&s in one report you get resistance but very next shows sensitivity Well I donot want to blame them it is behaviour of organism which keeps modulating
Very informative and knowledge boosting educational presentation on Pyelonephritis Diagnosis & Treatment. Thanks for sharing useful presentation Sir.
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A 70 yr old male C/O Fever since 5 days Burning micturation Right side flank pain Nausea Skin dry No pedal oedema or Sweeling Pt Urine pass 2-3 time/night 19/10/20 Blood report attach CRP 28.2 Creat 1.5 Mg/Dl 21/10/20 Creat 1.9 mg/Dl Creatnine high : Choice of antibiotic Please suggest the management and diagnosisDr. Nayan Baman2 Likes11 Answers
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Chronic kidney failure, also known as chronic renal failure, chronic renal disease, or chronic kidney disease, is a slow progressive loss of kidney function over a period of several years. The symptoms of worsening kidney function are non-specific, and might include feeling generally unwell and experiencing a reduced appetite. CKD is initially without specific symptoms and is generally only detected as an increase in serum creatinine or protein in the urine. Later on there is- increased urination, especially at night decreased urination blood in the urine (not a common symptom of chronic renal failure) urine that is cloudy or tea-coloured puffy eyes, hands, and feet (called edema) high blood pressure fatigue shortness of breath loss of appetite nausea and vomiting (this is a common symptom) thirst bad taste in the mouth or bad breath weight loss generalized, persistent itchy skin muscle twitching or cramping a yellowish-brown tint to the skin Pathology- A normal kidney contains approximately 1 million nephrons, each of which contributes to the total glomerular filtration rate (GFR). In the face of renal injury (regardless of the etiology), the kidney has an innate ability to maintain GFR, despite progressive destruction of nephrons, as the remaining healthy nephrons manifest hyperfiltration and compensatory hypertrophy. This nephron adaptability allows for continued normal clearance of plasma solutes. The hyperfiltration and hypertrophy of residual nephrons, although beneficial for the reasons noted, has been hypothesized to represent a major cause of progressive renal dysfunction. Causes- Type 1 or type 2 diabetes High blood pressure Glomerulonephritis Interstitial nephritis, an inflammation of the kidney’s tubules and surrounding structures Polycystic kidney disease Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers Recurrent kidney infection, also called pyelonephritis Types- Each patient is classified into one of the following 5 stages of CKD according to the progression of damage. Stage 1: Kidney damage with normal or increased GFR(>90 mL/min/1.73 m2) Stage 2: Mild reductionin GFR (60-89 mL/min/1.73 m2) Stage 3: Moderate reductionin GFR (30-59 mL/min/1.73 m2) Stage 4: Severe reductionin GFR (15-29 mL/min/1.73 m2) Stage 5: Kidney failure(GFR <15 mL/min/1.73 m2 or dialysis) Complications- Anemia – hemoglobin levels drop and not enough oxygen reaches many parts of the body. Central nervous system damage. Dry skin, skin color changes. Fluid retention – this can lead to swollen tissue, heart failure, and fluid build-up in the lungs. Hyperkalemia– blood potassium levels rise; this can result in heart damage. Insomnia – this is a common consequence of kidney failure Lower libido (sex drive) Male erectile dysfunction. Osteomalacia– bones become weak and break easily. Pericarditis – the sac-like membrane that envelops the heart (pericardium) becomes inflamed. Stomach ulcers. Weak immune system– the patient becomes much more susceptible to infection. Complications in children: Erythropoietinproduction drops, resulting in a much lower red blood cell count. Vitamin D – the kidneys will no longer be able to activate vitamin D, resulting in poor calcium absorption and muscle function. Consequently, children with kidney failure may fail to grow properly. Complications during pregnancy: When a woman is pregnant the kidneys have to work especially hard because the amount of fluid in the body increases. Pregnant women with chronic kidney failure may experience worsening hypertension and an increase in waste products in their blood. This can affect both the mother and her baby. Women with chronic kidney failure who are pregnant have a significantly higher risk of developing preeclampsia, compared to other women – blood pressure rises dangerously high. If left untreated the result could be a brain hemorrhage, or hemorrhaging in the liver or kidneys – both potentially fatal for both mother and baby.Dr. Shali5 Likes7 Answers
50y/f c/o dysuria with burning sensation previously blood urea and s.creat was 73 and 4.8 respectively after a week BUrea and Screat is 80 and 4.2 urine pus cell 40-45 pt was on a/b tamsulosin bid and pain killer kindly suggest how to manage.Dr. Mandeep Sharma0 Like6 Answers
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A 35yr female pt c/o-fever with chills 4-5days bodyache, headache, weakness, burning micturation Pathology reports attached below plzz suggest needfulDr. Rohan Banchare5 Likes23 Answers
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A female aged 45 yrs who is a known case of Hypothyroidism and T2DM presented with complaints of High grade Fever a/w chills, Pain lower abdomen since 5-7 days and Altered Sensorium since 2 days....Her urine ketone status was normal and pt was morbid obese...Comment on her reports and how to approach to treat this patientDr. Hardik Ahuja0 Like20 Answers