Dr Manasa thesis

DISSERTATION PLAN ACTIVITY

TITLE:

Factors influencing clinical decision making around therapeutic interventions for critically ill renal failure patients in a rural medical college 


PROBLEM STATEMENT:  Most of the renal failure patients present with sob pedal adema Tachypnea due to which they are requiring early dialysis 


Aim:

To study various events related to and influencing treatment decisions around patients with critically ill renal failure 


Objectives :

1) Document the events and symptoms leading to the patient presenting with renal failure 


2) Study the associations between the events and certain symptoms influencing the therapeutic decision taken 


3) Document the patient outcomes resulting from the therapeutic decisions over two years of follow up 


Methodology:

Qualitative observational study 

Inclusion criteria 

a) All patients of renal failure defined by biochemical azotemia and radiological indicators 


b) All patients with substantial diagnostic and therapeutic dilemma in the initial presentation defined by lack of etiologic diagnosis and lack of strong indicators toward dialysis. 


Exclusion criteria:

Renal failure patients with diagnosis clear at presentation such as pre renal or obstructive uropathy


 PLACE OF STUDY: General Medicine department kamineni Institute of Medical Sciences Narketpalle Nalgonda

STUDY PERIOD: October 2020 to october 2022:

SAMPLING SIZE: 50


PROFORMA:

IP No:

Age:

Sex:

Occupation

Complaints:

    Dsypnea 

    Pedal odema  

     Facial odema

     Chest pain

     Palpitations

  PAST HISTORY: HTN

                               DM

                               NSAID USE

EXAMINATION: Pallor:

              Pedal odema :             TEMP:

             JVP :                               CVS:

              PR  :                                CNS:

              RR   :                                R/S:

              BP   :                               ABDOMEN:

                                                     FUNDOSCOPY:

                            

Investigations for the assessment of renal function

Blood urea:

Serum creatinine:

Urine albumin:

Urine sugar:

Pus cells:

RBC cast:

RBS:

LFT:

USG abdomen:

eGFR using cockcroftgault formula:

stage of CKD:

INVESTIGATIONS FOR ASSESSMENT OF CARDIAC ABNORMALITY:

1) ECG

2) 2D ECHO

3) FLP

4) sr. Electrolytes

5) Chest xray

RISK FACTORS 

1) Anaemia

2) Hypertension 

3) Age

4) Smoking

5)Alcohol


1)http://sairaghuver.blogspot.com/2020/10/18-year-old-female-with-lupus-nephritis.html

2)https://bhargavichiruvella.blogspot.com/2020/10/this-is-online-e-log-book-to-discuss.html



https://in.docworkspace.com/d/sIP_ao6FfitrXhAY


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