Prevalence of dysmagnesemia among CKD patients in North India
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Magnesium is the second-most common intracellular cation after calcium with 99% of total body magnesium distributed intracellularly in bones, muscles, and soft tissues. Only 1% of total body magnesium is present extracellularly that contributes to the normal serum magnesium concentration of 1.8–2.6 mg/dL. Recently, many studies have focused on the role of magnesium homeostasis and human health. Diabetes and hypertension are the leading causes of chronic kidney disease (CKD), and the significance of magnesium in CKD has been astonishing in medical practice. In this study, we investigated the serum levels of magnesium and its prevalence at different stages of CKD. This cross-sectional descriptive study was conducted over a period of 2 months. Serum magnesium levels were analysed in 224 patients with CKD and were grouped into five stages of CKD according to the guidelines of the Kidney Disease: Improving Global Outcomes (KDIGO) based on glomerular filtration rate. Laboratory data of patients was analysed using the IBM SPSS V23 software (Chicago, USA) for statistical relationship between serum magnesium levels and stages of CKD in patients with CKD. Mean serum magnesium level of the study population was 2.21 ± 0.75 mg/dL; 50.9% of the patients were normomagnesemic (normal level of magnesium ions in the blood), followed by 30.4% hypomagnesemic and 20.5%, hypermagnesemic. CKD was more common in males (63.4%), compared to females (36.6%). Mean age of patients in G5 stage was significantly higher than in G3a, G3b, and G4 stages (P = 0.001). A progressive decline in renal function and retention of uraemic solutes was observed with progression of CKD. Multiple factors, both inherited or acquired, such as diuretics and alcohol, are implicated in controlling serum magnesium levels. Magnesium deficiency leads to 2.12-fold higher risk of progression to end-stage renal disease (ESRD).Cite
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Seperti pada dewasa, teknik regional anestesi pada pediatrik kini makin popular digunakan oleh ahli anestesikarena keuntungannya. Namun demikian selalu ada risiko dan kemungkinan timbulnya komplikasi dari setiap tindakan yang dilakukan, termasuk tindakan anestesi regional pada pediatrik. Insidensi komplikasi anestesi regional pada pediatrik tidak banyak, dan kalaupun terjadi komplikasi adalah minor. Komplikasi bisa diakibatkan dari identifikasi ruang saraf, alat, obat, teknis tindakan anestesi regionalnya dan komplikasi lainnya.Walaupun tidak banyak kejadian komplikasi regional anestesi yang dilaporkan pada pediatrik, dan bukanlah komplikasi yang fatal, teknik regional anestesi pada pediatrik harus dilakukan dengan lebih hatihati, pertimbangan risiko dan keuntungannya untuk menghindari terjadinya komplikasi, terlebih karena kebanyakan komplikasi dapat dihindari dengan mempelajari teknik yang benar, menggunakan peralatan yang sesuai, dan sangat menerapkan prinsip keamanan pada pasien dengan baik.
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Genentech is partnering with the German cancer company Affimed to develop immunotherapies for multiple kinds of solid and blood cancers. Affimed is developing therapies that engage natural killer cells of the innate immune system to help direct them to attack cancer cells. Genentech will pay Affimed $96 million up front and up to $5 billion more in potential payments.
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ABSTRACT Airway management is particularly difficult in children with severe congenital anomalies. Such patients are extre- mely sensitive to the respiratory depressant effects of anaesthetic agents. We describe the successful and safe app- lication of caudal anaesthesia for inguinal hernia repair in three cases with severe congenital anomalies (Joubert syndrome, I-cell syndrome). The three patients concerned had congenital anomalies including serious facial defor- mity, respiratory failure and cardiovascular defects. They were administered a single dose of caudal epidural anaest- hesia for inguinal hernia surgery in order to avoid complications associated with general anaesthesia. Caudal block was performed and 1 mL/kg levobupivacaine 0.25% administered. We conclude that caudal epidural anaesthesia can be an effective, suitable and safe anaesthetic technique for inguinal herniotomy without the need for general anaesthesia or endotracheal intubation in children with severe congenital anomalies. Key Words: Caudal anaesthesia, children, congenital anomaly OZET Havayolu yonetimi, ciddi konjenital anomalileri olan cocuklarda ozellikle zordur. Bu tur hastalar anestezik ilaclarin solunum depresan etkilerine karsi asiri derecede duyarlidir. Kaudal anestezinin inguinal herni onarimindaki basarili ve guvenli uygulamasi konjenital anomalileri (Joubert sendromu, I-cell hastaligi) olan uc olguda gosterilmistir. Ilgili uc cocuk hastada, ciddi yuz deformitesi, solunum yetmezligi ve kardiyovaskuler bozukluk dahil konjenital bozuk- luklar vardi. Genel anesteziyle iliskili komplikasyonlari onlemek icin inguinal herni cerrahisinde tek doz kaudal epi- dural anestezi uygulandi. Kaudal anestezide %0.25 levobupivakain 1 mL/kg kullanildi. Kaudal epidural anestezinin, ciddi konjenital bozukluklari olan cocuklarda inguinal herni onarimi acisindan genel anesteziye veya endotrakeal entubasyona gerek duyulmadan etkili, uygun ve guvenli bir alternatif anestezi teknigi olabilecegi sonucuna varildi. A na h ta r Sozcukler: Kaudal anestezi, cocuk, konjenital bozukluk
Levobupivacaine
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Budd–Chiari syndrome
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The nationally-recognized Susquehanna
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