Shashank shetty, Sujatha siddappa*
Background: An estimated 229 per million population ,are afflicted with end stage renal disease in our country. Chronic kidney disease poses a health threat and financial burden on patients from developing country like ours, where 70 % of the population are from rural areas which make them economically vulnerable group. The number of these patients who opt for renal transplant as an option to renal replacement therapy is uncommon by virtue of this very fact.
Methods: A Study in tertiary care government hospital in South India .Our hospital has an outpatient department of 35,616 patients annually. The inpatient statistics are 2564 .Our hospital is the only one of its kind in the country. It is also a tertiary care where renal transplants are done as a renal replacement therapy. The aim is to study the incidence of chronic kidney disease, and the number of them who have opted for renal transplant as a renal replacement therapy from among the patients who are undergoing dialysis at our institution for end stage renal disease..
Results: On an average the total number of cases of CKD 1254 cases per year which includes both dialysis and non dialysis patients. Out of which 426 are cases of end stage renal disease on dialysis. The later patients are then systematically screened for economics of transplant with aid from the government of Karnataka and compliance quotient. In the end the total percentage of patients from the group of end stage renal disease undergoing transplant is about 7 %.
Conclusion: The incidence of chronic kidney disease is ever growing however the number of patients who opt for renal transplant is a small number especially in developing countries like ours. The constraints are many beginning with economics the dynamics of transplant and patient compatibility amongst others to name a few
Kafil Akhtar*, Mohd Talha, Shivani Gupta, Ashok Kumar
Genitourinary tuberculosis contributes to 10-14% of extrapulmonary tuberculosis and is a major health problem in India. Prostate tuberculosis is uncommon and is usually found incidentally following transurethral resection. The most common mode of involvement is haematogenous, though descending infection and direct intracanalicular extension is known. Predisposing factors include prior tubercular infection, immunocompromised status, previous BCG therapy. Apart from histopathological examination which is confirmatory to diagnosis, urine PCR with good sensitivity and specificity, may be quite helpful in the diagnosis. Imaging techniques like CT/MRI also allow good visualization of the lesion and its extension. We report a case of a 35 year old male who presented with complaints of difficulty in micturition. On digital rectal examination prostate was found to be enlarged with nodularity. TRUS biopsy showed diffuse caseating epithelioid granulomas. Treatment was given in the form of chemotherapy regimen of 4 anti-tubercular drugs. This case has emphasised the importance of considering prostatic tuberculosis in the differential diagnosis of carcinoma prostate, both of which may have the same clinical presentation. With a high index of suspicion, it may be possible to diagnose a larger number of cases of prostatic tuberculosis, especially in our country where tuberculosis is almost endemic.
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