A study of impact of cost-effective nutritional supplement in patients on maintenance hemodialysis

Nutritional status in patients on hemodialysis is always of concern as malnutrition predisposes to excess morbidity and mortality. Most of the nutritional supplements available in the market are expensive. We explored the possibility of improving nutrition of the patients on maintenance hemodialysis by supplementation of calories and proteins that can be given in the form of a palatable and economical gruel in this prospectively designed, open labeled study. Patients who were on maintenance hemodialysis (twice a week) for a period of at least 6 months were divided into two groups. The study group was given the gruel supplement and the control group was not given the gruel supplement. Nutritional status was assessed in the study group and controls at 0 and 3 months by the following parameters: percentage body fat, mid arm muscle circumference and serum albumin. Analysis of results revealed that there was a significant decline in the protein intake at the end of the 3^rd month in the control group (P = 0.01). Other parameters did not show significant change at the end of the study period in both groups. The nutritional supplement can be assumed to have helped at least in the maintenance of protein intake over this short period and could possibly in the long run contribute to improvement of nutritional parameters.

Native valve Escherichia coli endocarditis following urosepsis

Gram-negative organisms are a rare cause of infective endocarditis. Escherichia coli, the most common cause of urinary tract infection and gram-negative septicemia involves endocardium rarely. In this case report, we describe infection of native mitral valve by E. coli following septicemia of urinary tract origin in a diabetic male; subsequently, he required prosthetic tissue valve replacement indicated by persistent sepsis and congestive cardiac failure.

Collagenofibrotic glomerulopathy - Case report with review of literature

Collagenofibrotic glomerulopathy is a rare, idiopathic glomerular disease characterized by abnormal accumulation of type III collagen fibrils within the mesangial matrix and subendothelial space and a marked increase in serum type III procollagen peptide levels. Proteinuria (commonest feature), edema, hypertension, and occasional progression to end-stage renal disease are the various features of this disease. The etiology and pathogenesis remain elusive. There have been reports of the disease running in the family, suggesting the possibility of genetic transmission. We report two cases of this rare entity.

Cancer care in the rural areas of India: a firsthand experience of a clinical oncologist and review of literatures

Over 8,00,000 new cases are diagnosed and 5,50,000 deaths occur annually due to cancer in India. The dramatic increase in morbidity and mortality due to cancer is a matter of concern for the society. Though the burden of cancer involves the entire nation, but the rural and underprivileged population represents majority of patients. Despite an already overwhelming burden of health problems, it is high time we must address the cancer pandemic and its alarming share of morbidity and mortality. Many large scale and innovative initiatives have been launched to counter the deadly disease. This includes efforts to expand the resources for health education and increase awareness of cancer prevention to the people and health care providers. These initiatives call for an unprecedented level of cooperation among international agencies, government and nongovernmental organizations, international foundations, healthcare system and local institutions. This review signifies the need for special attention to cancer prevention and early diagnosis with emphasis to rural and remote places of India.

Squamous cell carcinoma over a nevus: a rare case

Malignant melanoma and basal cell carcinoma are more common over a preexisting nevus. But squamous cell carcinoma over a nevus is a rare phenomenon. A 55-year-old male presented with a slow growing noduloulcerative lesion on a preexisting nevus over scalp. For that he had undergone excisional biopsy. Biopsy came out to be a squamous cell carcinoma with lateral margin positive for tumor. So postoperative radiotherapy given by means of HDR brachytherapy. Now he is on follow-up.