Diagnosis for Covid-19

Diagnosis for Covid-19

When a kidney disease patient develops symptoms of the coronavirus disease 2019 (COVID – 19) or one is exposed to the COVID 19 virus, one must contact the nephrologist immediately. Also if a patient comes in close contact with someone who has been diagnosed  with the virus, then also needs to contact the nephrologist immediately. In haemodialysis centres chances of infection in patients and dialysis staff is very high. In india especially in delhi ncr most of the dialysis centres are having adequate space. Main dialysis unit hall, staff’s rooms, dialysis patients waiting hall, cafeteria, restrooms etc don’t have adequate space to maintain social distancing. Morbidity and mortality are also very high in patients with kidney diseases, post kidney transplant and dialysis patients.

COVID-19 diagnostic testing

  • Molecular test. 

It is also known as PCR test. This test detects the genetic material of the COVID 19 virus using a technique of the lab called polymerase chain reaction (PCR) A testing executive collects fluid from the nose, throat swab or less often from saliva.

  • Antigen test. 

Antigen tests can produce results very fast using a throat swab or nasal swab to get sample fluid. This test is faster and cheaper than the molecular tests. A positive Antigen test is considered very accurate but there is an increased chance of false- negative results. So these tests are not as sensitive as the molecular tests.

For a COVID 19 test one needs to provide sample mucus from nose or throat or may be sample of saliva. The sample needed for testing may be collected at the home, hospital or a drive-up testing centre.

  • Nose or throat swab. 

For this process a healthcare professional inserts a thin flexible stick with a cotton attached at the tip into the nose or at the back of the throat, brushes the swab to collect a sample of mucus. This might be somewhat uneasy. For the nasal sample there might be swabbing into both the nostrils to collect mucus samples for the tests. The swab gets rotated in place before being pulled out, then the sample gets sealed inside a tube and is sent to the lab for further analysis.

  • Saliva sample. 

Though not considered the best way to get a good sample.

COVID-19 antibody testing is also known as serology testing. It is a blood test which is done to find out if one has a past infection with SARS- COV– 2 , the virus that causes the COVID 19 disease.

How much time to develop COVID19 antibodies?

After one is infected with COVID 19 virus, it may take two to three weeks to develop enough antibodies which are detected in an antibody test. So it’s important that one is not tested too soon.

For how long COVID19 antibodies will last?

Antibodies may be detected in ones blood for several weeks after one recovers from 

COVID-19 These antibodies may provide some kind of immunity to the COVID 19 virus but currently there is not enough evidence present to know how long these antibodies or past infection protects one from getting another infection.

Why COVID19 antibodies done?

Antibody testing for the virus may be done if – 

  • One had symptoms of the virus in the past but testing was not done
  • If one have to do a medical procedure in a hospital or clinic
  • One had a positive infection in the past and wants to donate plasma, a part of one’s blood that contains antibodies that can help treat others who have severe cases of COVID 19 

To conduct the antibody test a healthcare professional typically takes a blood sample usually by a finger prick or by drawing blood from a vein in one’s arm.

Kidney stones in children

What are kidney stones?   

Kidneys stones are dense accumulations of salt plus minerals often made up of calcium or uric acid. They develop inside the kidney as well as they can move to different portions of the urinary tract.

Stones diverge in size. Some are very tiny and some are a little bit in inches. Some kidney stones can convert so big they take up the whole kidney.

A kidney stone develops when lots of certain minerals in the body collect in the urine. When you are not properly hydrated, the urine becomes more intense with immense levels of certain minerals. When mineral levels are more eminent, it’s more possible that a kidney stone will develop.

More petite kidney stones that reside in the kidney usually don’t create any symptoms. Might be you not remark anything is awry until the stone passes into the ureter, the tube that urine travels via to get from the kidney to the bladder.

Kidney stones are frequently extremely painful. Most stones will move on their own without medication. But, you may require a method to break up or eliminate stones that don’t move.

What are the indications of kidney stones? The indications can include:

  • Pain in the abdomen or back
  • Color changes in urine because of blood
  • Pain when the child urinates
  • The requirement to urinate in a hurry
  • Nausea and vomiting 

Few children with kidney stones do not feel or observe any complaints. In these children, doctors usually discover kidney stones incidentally. This can occur if a child has an imaging test, like an X-ray, for different reasons.

Should the child see a nephrologist or urologist? Yes. If the child has the complaints mentioned above, take the children to the nephrologist or urologist as soon as possible. Kidney stones can prevent urine flow as well as create infections.

Will the child require tests? Yes. The nephrologist or urologist will take an exam plus prescribe the tests on a sample of the child’s urine. The child will also require an imaging test, like a CT scan, ultrasound, or X-ray and related tests. Imaging tests found photographs of the inside of the body of the child. They can determine if a kidney stone is creating the signs. If the child has a stone, imaging tests can further prove its size as well as where it is placed.

How are kidney stones treated? Each child has required different Treatment for kidney stones. The appropriate treatment depends on:

 

  • The size, variety, and position of the stone
  • the level of pain the child has
  • If the child is vomiting, and how much the child vomits
  • If the child can take large quantities of fluids

If the stone is small as well as produces only mild signs, the child might be ready to stay home plus wait for it to move in the urine on its own. If they stay at home the child will probably require having a high quantity of fluids. Can take pain killers after consulting a nephrologist like diclofenac, ibuprofen etc. Before taking painkillers kidney function (creatinine) should be normal.

The kidney specialist might require you to have the child urinate via a strainer so you can grab the stone when it comes out. The kidney doctor can explain to you how to perform this.

A child might necessitate treatment in the hospital if:

  • The stone is blocks flow of urine
  • The child has hard pain or is ejecting
  • The child cannot take large quantities of fluid

Hospital treatment can include:

  • Pain medication, either in pills or intravenous;
    if he or she is vomiting too much to keep pills down. 
  • Medication to aid pass the stone
  • Fluids delivered within a vein 
  • Treatment to eliminate the stone, or break it inside tinier pieces so it can

Pass more easily. Doctors can do this with:

  • A device that utilizes sound waves to separate up stones within smaller portions, shock wave lithotripsy.
  • A thin tube that goes inside the body where the urine comes out – The

the tube’s distal end has unique devices to split up stones or get them out.

Will the child have different kidney stones?

Maybe if the child receives a kidney stone, they have a tremendous chance of getting a different one later. To aid keep this from occurring, make sure the child takes lots of water.

The kidney doctor will perform tests to discover what made the first stone. Depending on the outcomes, you might require to switch what the child consumes.

If so, the kidney doctor can advise you which feed the child should not have. The child might also order new medications to prevent the child from having extra kidney stones.

Dialysis of COVID-19

Dialysis of COVID-19

As COVID-19 has engulfed the whole world, a pandemic situation has come into existence. Here is a set of questions to intimate you about the dialysis process of COVID-19 patients.

How dialysis of COVID-19 takes place?

The Government has taken initiatives to set up different dialysis centers, especially for COVID-19 patients throughout the country. All the dialysis technicians have to abide by the guidelines formulated by the higher authorities. Each center has three separate units for the tests. They are the outside area, the screening area, and the internal Dialysis Unit.

What are the duties of the Administration for dialysis units?

According to the Government’s general guidelines, the administration authorities of every dialysis center should follow these rules;-

  • The hospital should specify at least one hemodialysis facility with an adequate number of dialysis machines and trained staff
  • District Administration should ensure that dialysis consumables are delivered to both hospitals.

When should a patient visit a Dialysis center for COVID-19?

Before visiting the dialysis unit, the patient should recognize the symptoms first. The usual signs of COVID-19 are fever, sore throat, cough, shortness of breath, body ache, fatigue, etc. There should be appropriate arrangements for all the arrivals in the screening area. The patients stable on maintenance hemodialysis can come to the unit alone without the support of any attendant.

Can dialysis patients recover post COVID-19 infection?

According to the recent reports, around 80% of the COVID patients undergoing dialysis have mild or moderate symptoms. However, 15-20% of the cases show that the patients are suffering from severe conditions. As per experts, after proper dialysis, the COVID-19 patients can fully recover within six weeks on an average. But, the duration can extend to a few months in some severe cases.

After a successful recovery from ventilation, the patients can go through a post-traumatic stress disorder. But, those who lack desirable response in ventilation can suffer from an acute lung disorder. This can also be fatal.

What is the dialysis process for patients with acute kidney injury?

The symptoms are generally mild but AKI patients requiring renal replacement therapy can develop serious complications. For such patients with AKI, bed-side dialysis will be more preferable than shifting to the central dialysis unit.

COVID-19 Impact on Kidney Patients

COVID-19 Impact on Kidney Patients

High rates of kidney damage are prominent in several COVID-19 patients. The symptoms can be mild, as well as severe. Here are some important points one can consider in this aspect. 

What are the precautions for kidney patients to be taken considering COVID-19?

The patients suffering from COVID-19 have the highest chances of getting acute kidney problems. As a precautionary measure, the patients at high risk should do the following;-

  • Wash your hands frequently with soap or hand wash
  • Do not touch your face, eyes, and nose
  • Use alcohol-based sanitizers to keep your hands germ-free
  • Avoid going to crowded places like shopping centers, cinema hall, etc
  • Wear masks whenever you are in the public
  • Keep safe distance with others, especially those who are sick
  • Contact the medical helplines as soon as you notice any symptoms like cough, high fever, breathing problems
  • Keep a stock of emergency supplies like food, medicines, etc. 

Can I get diagnosed on an emergency basis?

If you find the signs of any symptoms of COVID-19, call the nearest dialysis center. You can also contact your nephrologist or the helpline numbers for COVID-19. Schedule an appointment with your kidney specialist or get a suitable time to visit any other dialysis center if there are not enough beds.

Is there more chance of getting attacked by Coronavirus if I have kidney disorders?

The following group of people has the highest chances of occurrences of COVID-19;-

  • Elderly people
  • People suffering from acute health issues including cardiovascular diseases, asthma, weak immune system, HIV, diabetes, chronic kidney disease
  • Pregnant woman

In case you had kidney transplantation or are taking a high dosage of medicines, you may be at a higher risk than others. Hence, strictly follow all the necessary precautions to avoid COVID-19 attacks. 

What are the kidney-friendly foods to stock in this pandemic?

In this pandemic situation of COVID-19, food delivery from outside is not at all recommended. Please try to cook at home only and avoid all the restaurant foods. There are a lot of apps today for the delivery of groceries at your doorstep. Contact with them and maintain a safe distance while taking the delivery. 

Visit the website  to learn about the emergency food articles that you can stock in your freezer or refrigerator to avoid going to markets frequently. 

What to do if I am suffering from depression?

If you are undergoing the dialysis of COVID-19 and suffering from depression, please consult with your nephrologist immediately. The support of your counselor is highly needed at such crucial periods. Mental health counseling is a must during the dialysis as the high-dosage of medications can affect you both physically and mentally. Some tips for anxiety and depression are as follows;-

  • Breathing exercises
  • Meditation
  • Physical exercises
  • Mindful thinking
  • Practice having sufficient hours of sound sleep
  • Journaling

Can I miss by dialytic treatments for COVID-19?

You should never miss your treatments when you are undergoing dialysis for COVID-19. In case of any sickness or other concerns, please consult your dialysis center immediately. Always maintain proper hygiene around you and avoid going out. No medicines should be skipped. For a speedy recovery, listen to all the instructions of the healthcare team. 

What are the effects on patients with Acute Kidney Injury(AKI) and Chronic Kidney Disease(CKD)?

COVID-19 is likely to attack patients suffering from Acute Kidney Injury or Chronic Kidney Disease. The primary symptoms of detecting kidney disease in the patient are swelling, nausea, vomiting, weakness, fatigue and many non specific. On investigations in blood test high creatinine levels or the presence of a high level of proteins in urine. Unfortunately, the mortality rates are higher for people with severe kidney issues. Hence, they should be extra cautious and try to prevent the occurrence of COVID-19. These patients are supposed to regularly consult a kidney specialist and do as per the nephrologist’s instruction. Regular monitoring of those patients is required who has high creatinine in blood and protein in the urine. They are at high risk of getting chronic kidney disease that can be progressed to  end-stage kidney disease also. Immediate treatment and medications can reduce the severity of the case. But, the recovery rates are not very high for such kidney-affected patients. 

Can Coronavirus cause kidney damage?

According to recent cases, it is evident that Coronavirus is targeting the lungs and the kidneys more. Thus, for COVID-19 patients can lead to Acute Kidney Injury(AKI). Such damage in the kidney is not very chronic. But, there are high possibilities that the subsequent stages can be severe for the patient. Proper treatment can cause the recovery of these patients. However, after discharge also, these patients can suffer from low kidney function. 

Early reports from the USA and China show that around 30% of the COVID-19 hospitalized patients have symptoms of mild or moderate kidney damages. Many patients even have high blood pressure or diabetes. Even those who did not have any kind of kidney problems are also suffering from kidney issues after the COVID19 infection. The coexistence of multiple health issues can be dangerous for COVID-19 patients and also requiring dialysis in severe AKI. Hence, the dialysis procedure should be more stringent. Every dialysis center should ensure that there are enough medicines, and they are never out of stock. Abnormal blood through urine should be immediately reported to the physicians for prompt treatment. 

What are the possibilities for kidney damage in the case of COVID-19?

Till now, the exact impact of Coronavirus on the kidneys is not entirely clear. However, the experts suggest a few of the instances in which you can suffer from kidney damage. 

  • Coronavirus can infect the kidney cells and cause potential damage to them. The receptors present in these cells attract the deadly virus and allow them to produce replicas of themselves. Such receptors are also present in the heart and lungs. Hence, new Coronavirus can be found in those cells, too, and the effects of which can be severe. 
  • Malfunctioning of kidneys can cause due to lack of a sufficient amount of oxygen in the organs. The COVID-19 patients show symptoms of breathlessness and lack of oxygen in the blood. Hence, the virus can attack the kidney and even cause pneumonia.
  • The newly born Coronavirus is highly powerful, and the reaction can take your life too. The response can go to an extreme level and give rise to cytokine storms within the patient’s body. This case involves the rapid movement of cytokines inside the body. Actually, these are small proteins that play a leading role in enabling communication between the cells when the immunity system fights against any infection. However, a sudden generation of cytokine storm can cause an inflammatory situation. During the process of destroying the virus, it can severely hamper the kidney functioning. 
  • Due to COVID-19, there can be tiny clots in the blood. These may result in clogging of the blood vessels present in kidneys. In turn, the filtration process of the kidneys may get hampered, thus impairing the functions of it within the body. 

Due to all these symptoms, the nephrologists are always cautious about the impact of COVID-19 on kidneys as the after-effects can lead to severe kidney injury.

Low-potassium diet-kidney-Patients

Patient education: Low-potassium diet (The Basics)

What is potassium?

Potassium is a mineral that is found in almost all foods. Everybody needs potassium to work normally and energetically. It maintains the heart beating and keeps the nerves and muscles working properly. But people need only a limited amount of potassium. Too much or little potassium in the body can create problems.

The presence of too much potassium in the blood is called “hyperkalemia.” This can create problems with heart rhythm and muscle weakness.

When is potassium too low or too high?

 

  • Low potassium

 

Potassium comes from the foods which we have in meals or courses. Healthy kidneys eliminate excess potassium in the urine to aid control of normal blood levels.

Because most fruits contain high potassium, low potassium is difficult in people who have a healthy diet.

Some of the outcomes of low potassium involve muscle weakness, cramping, as well as fatigue.

 

  • High potassium

 

When kidneys lose they can no longer eliminate excess potassium, so the level grows up in the body. High potassium in the blood is identified as hyperkalemia, which may happen in people including advanced degrees of chronic kidney disease. Usually high potassium is silent with no symptoms. Few impacts of high potassium are nausea, weakness, anesthesia, and slow pulse rate.

For people with advanced CKD, dialysis is required to aid control potassium in emergency cases. With dialysis treatment potassium decreases suddenly, but potassium levels increase, so nephrologists have to find out factors of high potassium like high-potassium foods must be restrained.

Who might require being on a low-potassium diet?

In chronic kidney disease patients mostly want to be on a low-potassium diet to prevent hyperkalemia.

The most frequent etiology of hyperkalemia is:

  1. 1. Certain medicines– Some medicines contain certain ones for high blood pressure and heart problems which may increase the level of potassium in the body. Examples: Angiotensin-converting enzyme (ACE) inhibitors, aldosterone receptor blockers, Angiotensin II receptor blockers (ARBs).
  2. Kidney disease: the kidneys filter the blood and erase much salt and water through urination. They maintain the level of potassium in the blood normal. When the kidneys don’t work properly or stop working, they can’t get rid of the potassium in the urine. Then, too much potassium is made up in the blood.

Many people who get a treatment called “dialysis” for kidney disease need to be on a low-potassium diet. Dialysis is a treatment that takes over the job of the kidneys.

What does consuming a low-potassium diet include?

Almost all foods contain potassium. So the key is to:

  1. Select foods with low levels of potassium
  2. Leave or eat only small amounts of foods with high levels of potassium

Your nephrologist will perhaps suggest that you work with a dietitian (food expert) to help in making a strategy for your meals. He or she will tell you how much potassium you should eat every day. 

To figure out how much potassium you are eating, you will need to look at the food’s nutrition label. You will need to look at them:

 

1.” Potassium” amount – It says you how much potassium is in 1 course of the food. If you eat 1 meal, then you are eating this quantity of potassium.

2.”Serving size” – It tells you how much a portion is. If you eat 2 courses, then you are having 2 times the quantity of potassium listed.

What are other ways to cut down on potassium?

 

  • Here are some different ways to cut down on potassium:

 

  1. Evacuate the liquid from canned fruits, vegetables, or meats before eating.
  2. If you eat foods that have a lot of potassium, eat only little portions only if your potassium is low or normal. if already high then not to take high potassium food items.
  3. Lessen the amount of potassium in the vegetables you eat. You can do this with both of them i.e. frozen and raw vegetables. (If all the vegetables are fresh and raw, then peel and cut them up first.) To reduce the amount of potassium, soak the vegetables in hot unsalted water for at least 2 hours. Then drain the water and rinse the vegetables in hot water. If you make the vegetables, prepare it without salted water.

Some foods that is low in potassium:

  • Fruits: apple juice, apples, blackberries, blueberries, cherries, cranberries, peaches, pears, pineapples, plums, strawberries, and watermelon. But if high potassium levels then better to avoid most.
  • vegetables: asparagus, cabbage, carrots, cauliflower, celery, corn, cucumber, eggplant, green beans, green peas, green peppers (capsicum), kale, lettuce, okra (ladies’ fingers), onions, radish, water chestnuts, wax beans, yellow squash, zucchini, and spinach. 
  • Proteins: almonds, cashews, chicken, eggs, flaxseed, peanuts, pumpkin seeds, sunflower seeds, turkey and walnuts. 

 Some foods that is high in potassium: 

  • fruits: avocado, bananas, coconut, cantaloupe, and honeydew melons, dates, dried fruits, figs, kiwi, mango, oranges and orange juice, and raisins. 
  • Vegetables: arctic, baked beans, beets, broccoli, Brussels sprouts, cabbage, carrots, olives, potatoes, pickles, pumpkins, and tomatoes and tomato juice. 
  • proteins: black beans, clams, ground beef, kidney beans, lobster, navy beans, salmon, steak and white fish 
  • other: chocolate, dairy products, granola, milk, peanut butter, soups that are salt-free or low sodium, soy milk, sports drink, yogurt, whole grain bread, and tomato sauce. 

 

Medicines for chronic kidney disease

What kind of medicines are utilized to treat chronic kidney disease? 

Individuals with chronic kidney disease are treated with: 
  • Blood pressure medicines – If you have chronic kidney disease, you have a higher possibility of having high blood pressure. Blood pressure medicines can help forestall heart disease and hinder kidney disease. 
  • Other medicines – These will rely upon the kind of kidney disease you have, and if you have other medical issues. 

Normally, the kidneys filter the blood and evacuate waste and overabundance salt and water. In individuals with chronic kidney disease, the kidneys quit working just as they should. They can’t filter medicines just as they normally would, which can cause unsafe levels of medicines in your body. Along these lines, your doctor may guide you to take a lower portion or change to an alternate medicine. Toward the finish of this article there is a list of things you can do to be careful when taking medicines. 

A few medicines can likewise hurt your kidneys. These incorporate “NSAIDs, for example, ibuprofen or naproxen. Before you go for any kind of new medicines, comprising medicines and over-the-counter supplements, ask your nephrologist how they can influence your kidneys. 

Listed underneath are the medicines used to treat chronic kidney disease. 

Medicines that treat high blood pressure and slow kidney disease 

You may require more than 1 kind of blood pressure medicine to support your kidneys: 

  • Diuretics (water pills) – Diuretics lower blood pressure by helping the body dispose of additional salt and liquid. Examples are furosemide (lasix), torsemide (dytor) and others. They cause individuals to urinate a ton, particularly from the start. In the event that this makes it hard for you to take these medicines, work with your kidney doctor to locate a decent time to take them. Usually need to take a morning if once daily dosing. If I need to take twice daily then the second dose to be taken by afternoon only. Diuretics work better in the event that you limit the measure of salt (sodium) you eat. 

A case of a usually utilized diuretic is furosemide (brand name: Lasix). 

  • ACE inhibitors and ARBs – Angiotensin-changing over compound inhibitors (called “Pro inhibitors”) and angiotensin receptor blockers (called “ARBs”) work in comparable ways. These medicines bring down the blood pressure by loosening up the blood vessels. They additionally bring down the pressure inside the kidneys so the kidneys can filter better and delay kidney disease progression.

Instances of ACE inhibitors incorporate ramipril (cardace), Benazepril (Lotensin), Captopril, Enalapril (envas), Fosinopril, Lisinopril (Prinivil, Zestril), Moexipril, Perindopril. Instances of ARBs incorporate candesartan and valsartan. 

  • Other blood pressure medicines – Depending on your blood pressure and the kind of kidney disease you have, your kidney specialist may prescribe different kinds of blood pressure medicines, for example, calcium channel blockers (amlodipine, cilnidipine, benidipine, efonidipine nicardipine, nifedipine, verapamil, diltiazem etc. 

Different medicines 

Your nephrologist may prescribe different medicines, contingent upon the kinds of issues brought about by your kidney disease. These might include: 

  • Vitamin D — Having chronic kidney disease can prompt having low degrees of calcium in the blood. This can mess bone up. To help avoid bone issues, a nephrologist once in a while prescribes vitamin D (cholecalciferol or calcitriol).
  • Phosphate binders — Phosphate is a mineral found in numerous nourishments. Having chronic kidney disease can expand the measure of phosphate in the body. This can be unsafe. To overthrow the evaluation of phosphate in the human body, doctors can prescribe medicines called “phosphate binders.” To work, these medicines must be taken with snacks and meals. Your doctor may likewise prescribe you eat nourishments that have low measures of phosphate. Examples sevelamer and calcium acetate.
  • Sodium bicarbonate — When you have chronic kidney disease, the degrees of acids in your body can get abnormal. This can prompt issues like weak muscles and bones. Your doctor may prescribe a sodium bicarbonate pill to help with this issue. 

Individuals who take sodium bicarbonate need to abstain from eating a lot of salt. That is on the grounds that sodium bicarbonate likewise has salt in it. Having an excess of salt in your body raises your blood pressure and can exacerbate your kidney disease. 

  • Medicines to treat anemia — Anemia is the medical term for when an individual has too hardly any red blood cells. This condition can make you feel tired or weak. It is normal in individuals with chronic kidney disease. 

Kidney doctors treat anemia by giving you additional iron. They can likewise make use of medicines called erythropoiesis-stimulating agents (called “ESAs” or erythropoietins).

Medicines for your other medical conditions 

Medicines that your doctor prescribes for high diabetes (blood sugar) or high cholesterol are additionally important in treating your kidney disease. 

What would I be able to do to be safe? 

To be careful, it’s important to take your medicines precisely as your doctor lets you know, so you get the correct measure of each medicine. Making use of pill boxes and updates can help. 

Your nephrologist needs to know the entirety of the medicines you take. This incorporates any over-the-counter medicines, herbs and vitamins. So it’s a smart thought to keep a list of the names and dosages and carry it with you every single time you go to any doctor. 

If your medicines cause difficult side effects, or if you can’t afford your medicines, converse with your kidney doctor. There are frequently approaches to manage these issues. The initial step is to tell your nephrologist.

Planning for kidney transplant

Planning for kidney transplant

Kidney transplant is the surgical process of replacing the diseased kidney with the healthy one. The need for kidney transplant arises when your kidney is not able to function normally. This is the end stage of the renal disease when it is necessary to replace the kidney. If both kidney’s are not function properly then you just need to replace only one kidney. A person can live normally on his one kidney and live his life normally.

Evaluation before kidney transplant

Before going for kidney transplant, you must have to get full health evaluation by taking proper tests and examinations. It will help you in decision making for the kidney transplant. After deciding for the kidney transplant you have to go through the following steps.

  • Find out the best match with your kidney. The donor can be a family member or an outsider whose blood group is matching with yours.
  • The evaluation will take one day or the several days. On the day of evaluation, you and your family will meet the transplantation team.
  • Several health tests and examinations will take place at the transplantation centre and decide that you have need surgery or not.
  • Tests you need to do are: blood and tissue type tests, HIV and hepatitis test, prostate exam for men, mammogram and pap smear for women, heart and lung examination, kidney and liver test, colon exam etc.
  • You have to ready yourself for the kidney transplant physically as well as mentally. If you are not ready for the surgery then it make your transplantation process dangerous.
  • Before surgery, you have to follow the instructions by the doctors about caring yourself as well as your kidney.
  • Clear all the doubts about your surgery, by asking the questions about financial support system, insurance policy that will help you to plan and prepare the best care of yourself.

After the evaluation, if you are ready for the transplantation then you need a kidney donor. If you do not have living donor then the team of transplantation will added your name in the waiting list of kidney donor. If living donor is available then your transplantation process can be start earlier.

Post kidney transplantation planning

Once your transplantation process has done then you have to stay in the hospital till doctor’s measure your good health condition.  Your stay in the hospital will be depend on some factors like type of transplant procedure, body acceptance of new organ and your overall health condition. Doctors and nurses will take care of you until you will feel comfortable and confident to go home. You need to follow some instruction before going home that is given below.

  • Without any assistance you have to follow your medicine schedule correctly.
  • Keep thermometer and blood pressure cuff with you to take care of your temperature and blood pressure.
  • If any medication problem arise then report immediately to transplant coordinator.
  • Keep a record of fluid intake and urine output regularly.
  • Regularly follow appointments with transplantation team and tell them your health condition. So that they can give you proper medication.
  • After going home keep a record of your weight, blood pressure and temperature daily.
  • You need to avoid being around infected people (with colds and flu) at least three months because in this case the danger of infection is more.

After following the above instructions you will recover from the surgery successfully. It will also help the doctors to identify that your body is accepting the new kidney or not. If not then the prescribed medication treatment by doctors will help you to control the rejection.

About Chronic Kidney Disease

About CKD

What is chronic kidney disease?

What are symptoms of kidney failure?

There are less or no symptoms in mild to moderate kidney failure. Thus, early or even late kidney failure is usually detected on a preventive health check-up.
Swelling over body sometimes it is first noticed over feet (around ankles) or over face (around eyes).
Nausea, vomiting, hiccoughs.
Breathlessness on exertion or physical activity.
Low sugar levels (hypoglycaemia) in case of diabetic related kidney failure.
Generalized weakness, easy fatigability.

Life threatening presentation

a. Convulsions
b. Abnormal heart rate (due to high potassium)
c. Chest pain (pericarditis)
d. Altered sensorium (uremic encephalopathy)
e. Severe metabolic acidosis

How to delay chronic kidney disease progression?

Detection of kidney disease at an early stage.
Control of blood pressure (less than 135/85 mmHg, less than 130/80 mmHg in proteinuria cases)
Control of blood sugar (HbA1c less than 7%)
Avoid nephrotoxic agents (common painkillers, some antibiotics and indigenous agents) and many others
Proper treatment of infections.
Proper treatment of urine outflow obstruction.
Avoid tobacco consumption and smoking
Healthy lifestyle
Very high protein intake
Proper treatment of stones
Some kidney harmful or nephrotoxic medications

Diabetic kidney disease

Kidney disease is very common in diabetic patients. In present scenario life style related diseases like obesity, diabetes, and coronary heart disease related kidney disease are very common. Swelling over feet or face is generally a common symptom in diabetic kidney disease.
Blood sugar level should be:
• Between 70 and 130 before eating ;
• Less than 183 about 2 hours After eating ;
• Between 90 and 150 at bedtime.

How to monitor kidney related complications in a diabetic patients?

• Following to be monitored at least 3 to 6 monthly.
• Urine for proteinuria-urine for micro albuminuria, urine for albumin(dipstick)
• Serum creatinine level.

Whether my both kidneys are affected?

Even a single kidney is enough to perform all functions of kidney (remove all toxins, and other functions) from our body. If serum creatinine level is high then either both kidneys (if both kidneys are working) are affected or if there is a single functioning kidney and that only is affected.
Kidney disease run in family

There are few kidney diseases common in family members. Following kidney diseases are:

1 Diabetes related kidney disease.
2 Polycystic kidney disease (PKD) – autosomal dominant PKD or ADPKD is passed from parent to child by an autosomal dominant type of inheritance. Thus if one parent has the disease, each child has a 50-50 chance of developing the disease.
3 Fabry disease- it involves major organs.
4 Kidney stones
5 High Blood Pressure
6 Alport Syndrome- leading to CKD (hereditary nephritis), deafness and eye abnormalities.
7 Unknown family related kidney disease.

How to manage chronic kidney disease?

How to know how much my kidneys are working?

Glomerular-filtration Rate: It is a rate at which blood is filtered through glomeruli in a minute. It tells us that how much the kidneys are functioning. It can be measured or estimated. There are various formulas for measuring GFR:
1. Cockcroft gault formula (CGF)
2. The Modification of Diet in Renal Disease (MDRD) equation
3. Creatinine clearance (Urine)
4. Others
How to estimate GFR:
1. Inulin
2. DTPA
Most commonly used are CGF and DTPA
Using this GFR we can differentiate chronic kidney disease (CKD) into different stages
Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 5 ND (not on dialysis) Stage 5 D (on dialysis) Stage 5 T (post-transplant) Patient can himself calculate GFR easily by computed formulas which are easily available on mobile applications and internet.

How to prevent kidney diseases?

Kidney diseases are common in:-
A. Diabetic patients
B. Hypertensive patients
C. Coronary heart diseases patient
D. Cerebrovascular disease patient
E. Over weight and Obese patient
F. Persons who are on long term kidney harmful medicines like painkillers (NSAIDS, lithium), some anti-biotic, some indigenous medication.
G. Smokers and chronic tobacco users.
H. Patients having recurrent urine infections.
I. Patients having multiple kidney stones
J. Persons in whom family member is suffering from kidney disease
K. Some genetic related kidney disease.
L. Urine outflow obstructive diseases.
M. Hyperuricemia and gout.
N. Connective tissue diseases like sjogrens, rheumatoid, sarcoidosis and others.
O. Others

If there are above risk factors than routinely kidney function test (creatinine) and urine routine examination to be done.
If any modifiable risk factor is present than we need to modify them.

Medicines for chronic kidney disease (CKD)

In managing CKD there are lots of medicines are required. There is a major issue of pill burden (number of pills per day). Following medicines are used in treating CKD.
• Hypertension-anti-hypertension medicines.
• Anemia-oral or intravenous iron, injection erythropoietin, darbepoetin, mircera.
• Antacids, proton pump inhibitors
• Calcium Supplements.
• Phosphate binders
• Vitamin-D active or Cholecalciferol.
• Vaccination- To prevent hepatitis B, Pneumonia, flu.
• Multivitamins.
• To control acidosis.
• Medicine related to primary disease.
• And others.

How to know how much my kidneys are working?

How to know how much my kidneys are working?

Glomerular-filtration Rate: It is a rate at which blood is filtered through glomeruli in a minute. It tells us that how much the kidneys are functioning. It can be measured or estimated. There are various formulas for measuring GFR:

  • Cockcroft Gault formula (CGF)
  • Modified diet MDRD
  • Creatinine clearance (Urine)
  • Others

How to estimate GFR:

  • Inulin
  • DTPA

Most commonly used are CGF and DTPA
Using this GFR we can differentiate chronic kidney disease(CKD) into different

Stages

  • Stage 1
  • Stage 2
  • Stage 3
  • Stage 4
  • Stage 5
  • Stage 5 ND (not on dialysis)
  • Stage 5 D (on dialysis)
  • Stage 5 T (post transplant)

The patient can himself calculate GFR easily by computed formulas which are easily available on mobile applications and internet. Consult with Nephrologist (DR RAJESH GOEL) Sr Nephrologist in delhi NCR.

Nephritic Syndrome

NEPHRITIC SYNDROME:

When there is a mild to moderate protein leaking in urine, microscopic hematuria (cola coloured urine), abnormal renal function (increased serum creatinine), and swelling over body and high blood pressure is known as nephritic syndrome.

Childhood nephritic syndrome is usually self-resolving and requires no specific treatment.

In adults, kidney biopsy and specific treatment is usually required.

NEPHROTIC SYNDROME (NS)

When there is excessive protein leaking through urine which causes swelling of the body low albumin level in the blood than this is known as nephrotic syndrome.

CLINICAL FEATURES

  • Swelling all over the body (early morning facial puffiness and swelling around the ankle late evening are the initial symptom )
  • Frothy urine
  • Breathing difficulty
  • Increased body weight

INVESTIGATIONS

  • Urine routine and examination
  • 24 hours urine for protein and creatinine
  • Serum albumin level
  • Lipid profile
  • Other special investigations

Like kidney biopsy, vasculitic markers like ANA, complement levels, ASO titres

TREATMENT

Conservative, BP control, steroids and immunosuppressive drugs.

CHILDHOOD NEPHROTIC SYNDROME

NS is very common during childhood. Kidney biopsy is usually is not required in childhood ns. It is easily managed by steroids. Rarely kidney biopsy and other immunosuppressive drugs are required. Childhood nephrotic syndrome can be a single episode, infrequent relapsing, frequent relapsing, and steroid dependent and steroid resistant.

Parental guidance :

Parents need to monitor the treatment response at home by decreasing swelling and daily monitoring of protein leaking by using urine albumin sticks.

Renal Biopsy

Renal Biopsy/Kidney Biopsy Specialist in Delhi

Kidney Biopsy Specialist Delhi: A Renal Biopsy/kidney biopsy is a procedure in which small pieces of (6-8 mm) kidney tissue is taken out and subsequently, that kidney biopsy sample is processed to evaluate the microscopic picture, immunofluorescence, and electron microscopy is done. It is a simple bedside procedure done under local anesthesia. Ultrasound guidance is required for locating kidneys. It is done for diagnosing kidney disease, its prognosis, and any special treatment required. It is done on a prone position from the back for native kidney biopsy and from the front for transplanted kidney (graft) biopsy. The patient requires 24hrs of hospitalization for observation.

Why I should get a kidney biopsy

  • To know the type of kidney disease AKI, CKD, RPGN
  • To know the cause of kidney disease Nephrotic syndrome, SLE, IGA, ANCA, Anti-GBM, myeloma
  • To know the prognosis and outcome of kidney disease.
  • To know the cause of graft dysfunction
  • To know the graft status ( protocol biopsy)

Dr. Rajesh Goel is one of the best Nephrologists  In India with 18+ years of experience. He did his DNB Nephrology from Pushpawati Singhania Research Institute. He did  Fellowship in Kidney Transplant from Medanta The Medicity. He started serving as Senior Consultant Nephrology in P.S.R.I at Sheikh Sarai, Delhi, and as well as Senior Nephrologist in his clinic Kidney Care Centre.  

Online Consultation

Whatsapp consultation-Email consultation-

Phone consultation-Video consultation

Charges: 800 RUPEES/- For Two Times

Payment through any IMPS or NEFT or PAYTM

But it cannot replace consultation after doing the clinical examination.

# It is not applicable for medico medical-legal cases

Kidney Transplant in Delhi

Why is Kidney Transplant better than Dialysis?

A kidney is a bean-shaped fist-sized organ which is responsible for excreting the waste particles and other harmful substance out from the blood by producing urine. Kidney Transplant in Delhi has become quite common. A Kidney transplant might require for many reasons which mostly includes any chronic kidney disease or kidney failure. Kidney transplant helps in restoring the fatal condition of the kidney by surgery or replacing a kidney with a new one. A kidney transplant is a last-minute solution for all the patients suffering from chronic kidney disease.

What is a Kidney Transplant?

In simpler words, a kidney transplant in Delhi is a surgery or a surgical process that involves the replacement of an old and damaged kidney with a new one given by a donor. Thus, the normal functioning of the kidney is affected when it is negatively impacted by any chronic disease.

The need for a Kidney transplant : There are certain malfunctions of kidneys that can be treated by dialysis. Dialysis is a treatment procedure under which a machine undertakes the responsibility of the kidney when they become incapable of doing their duties. Dialysis can be troublesome whereas consulting kidney transplant doctors in Delhi could be a wise idea.

The proper functioning of the kidney is measured with the GFR or glomerular filtration rate. If the measurement resulted in 20ml/min or less, then it is considered to be a chronic kidney disease or the last stage of renal disease. Following are the reasons why one should prefer a kidney transplant over dialysis:

  •    A successful kidney transplant can give lifelong freedom from visiting the medical center on a regular basis and improve the quality of your life.
  •    Dialysis helps in improving the function of kidneys; however, the fatality might reoccur. Having a kidney transplant will eventually reduce the risk of uncertain death.
  •    Under Dialysis, the subject might need to maintain a strict diet that might not involve in case of a kidney transplant.
  •    Kidney transplant incurs onetime payment whereas Dialysis may incur regular expenses.

When will you not be eligible for a Kidney Transplant? : As discussed earlier, the benefits of having a kidney transplant are mentioned through the comparison with dialysis. However, there is a certain time when you might not be eligible for having a kidney transplant even after being diagnosed with chronic kidney diseases. Following are the condition where a kidney transplant hospital in Delhi considers before undertaking the transplant process:

  • The first thing that would be a matter is age, which is far more important than kidney transplant costs in Delhi.
  • A person above the age of 70-75 might be at a higher risk.
  • Any other underlying chronic diseases that might not get better even after having a transplant. This includes cancerous disease and infections that cannot be cured.
  • Any health condition caused due to high drug dosage or alcohol consumption is non-curable.

People who are at the last stage of renal disease can avail of extra years of life after a successful kidney transplant. However, it’s always better to take safety measures to stay away from the medical as well as fatal diseases.

Coronavirus

The Overview Of Coronavirus(COVID-19) And The Basic Patient Education 

 

2020 has brought a global crisis affecting the lives of billions. People are dealing with one of the deadliest viruses that have emerged on the Earth. The most common term on every lip today is COVID-19 that refers to the coronavirus. But, observing some precautions can save you from being the victim of this virus. Therefore, patient education is important. Please go through the article to get an overview of the do’s and don’ts in the scenario of the corona.

What is COVID-19? : COVID-19 is the medical term for coronavirus, which is a deadly infectious disease. The recent discovery of this brand-new virus has left the entire world into a pandemic situation. The actual name of this virus is SARS CoV-2. The virus generally spreads through saliva or nose discharge of an infected person as he/she sneezes or coughs. Hence, you have to take appropriate protection to save yourself from getting infected.

This virus came into existence in Wuhan, China during December 2019. There are a lot of controversies regarding its origin. But, nothing is conclusive. Eventually, it spread throughout the globe at lightning speed, engulfing lakhs of innocent lives. As per the recent reports till may 2020, more than 6 million people across 213 countries have been affected by the coronavirus. The death number is increasing day by day. However, more than 2.6 million people have already recovered from this deadly disease.

Symptoms of Coronavirus: If you want to have full protection, then you must be aware of the symptoms of coronavirus. The most common symptom is fever. But, older people or those who are having several health issues can get fever in the later stage of the disease. The other symptoms that tell that a person is being infected by Covid-19 are as follows;-

  • fatigue
  • shortness of breath
  • cough
  • pain in joints and muscles
  • nausea
  • vomiting
  • diarrhea
  • sputum production
  • Loss Of taste
  • Loss of Smell

The symptoms are not the same in every person. Some even have sneezing, running nose, etc. that seem to be quite normal in the beginning. But, after the test, they are found to be COVID positive. The initial cases also showed chest tightness as well as palpitations.

It has also been seen in around 89% cases, the patients are having fevers after being hospitalized. Even the infected persons also go through tastelessness and loss of smell. In medical terms, there is a time-gap known as the incubation period. This is between the time of getting infected and the time of development of the symptoms. The usual range of this period may be from 2 to 14 days. Hence, whenever you are observing any of the symptoms mentioned above, see a doctor immediately and get yourself tested. Some people can also have complications such as multi-organ failure, blood clots, heart inflammation, pneumonia, Acute Respiratory Distress Syndrome, and many others. It becomes quite challenging for doctors to treat such patients.

What are the preventive measures in Coronavirus?

No medicine has been discovered to prevent infectious disease. The only remedy is taking proper precautionary measures to reduce the chances of getting affected. If all of us join hands and do the needful, we will definitely succeed in defeating this dangerous virus. Let us see what the necessary steps are that you should take in order to fight Corona.

  • Wash your hands frequently with soap or alcohol-based hand sanitizer. This will kill the germs and will lessen the chances of spreading the virus.
  • Do not touch the face, mouth, or eyes. Hand-touch can transmit the disease quickly. It is more important when you are coming from outside as there are high chances of getting contaminated when you are outdoors. As a result, the germs can infect your body instantly.
  • Following social distancing is very important. Try to have at least 1 meter, that is, 3-feet distance when you are communicating with someone. This is because, when someone sneezes, coughs, or simply talks, the saliva droplets or other liquids can come on your face. So, if the person, by any chance, has got the infection, it will infect you too.
  • Avoid any crowded place in this terrible scenario. The reason is that there are more chances of getting in touch with an infected person amidst crowds.
  • You must ensure that you and all the people living in your house, apartment, or locality are maintaining complete hygiene. If you see any diversion, take necessary action immediately or try to make them understand the risk of a non-hygienic living. Always wear masks and gloves when you are going out or while talking with someone. Also, make sure the others are following the rules as well. Tell them about the instructions given by the government and to abide by them. You can avoid several diseases like flu, influenza, Covid-19, etc. if you follow good respiratory hygiene.
  • You should avoid traveling and remain in the homes. Home quarantine is the most effective way to break the chain of transmission of this deadly virus. In this way, you can protect yourselves as well as society at large. In case you have a cough and cold, then it is always better to go for self-isolation. If you can maintain these small points, you can easily get rid of the virus.
  • Whenever you are having fever, cough, and cold or trouble breathing, do not waste time. Immediate medical attention should be sought and follow all the instructions given by the physician. Calling in advance will allow you to get the correct treatment on time. The national and local authorities have all the information related to corona patients in a particular area. Therefore, through a small step, you can carry out the duty of protecting society from further spread of the virus.
  • You should always be updated about the current position and scenario from the reports as per trusted sources. Do not rely on any kind of rumors. WHO and the local authorities are the best source from where you can get the correct information. Follow the rules and regulations formed by the government in this respect. Thus, act as a responsible citizen of the nation.
  • Please wash your shoes and clothes regularly, after coming from outside. Also, don’t forget to wash or sanitize all tangible objects like money, bags, etc. This will wipe off all the germs that can contaminate your body.

The Spread Of The Virus : Coronavirus can spread in various ways. The most common source is the droplets of saliva or fluid from the running nose of an infected person. There are two major ways through which a person can come in contact with these things;-

Direct Contact: A person has the maximum risk of getting the infection from a Corona positive person from coming into close contact if he is having the face uncovered or not maintaining the 1-meter distance.

Indirect Contact: The droplets containing the virus can remain as it is on the clothes or shoes for several days. So, you should not touch any of such articles or come across the ground having the virus. Otherwise, you have all the possibilities to get infected by the disease.

So, now the precautions and the way in which the disease transmits are clear to you. Therefore, you should avoid these activities that can increase the chance of infection. Rather, you should also take appropriate actions if the people near you are not following these rules. Remember, only our joint efforts can beat this tough circumstance. Hence, we should forget all the quarrels and other disturbances and focus on the betterment of our society.

People Facing The Highest Risk : We are going to mention over here the persons who are most likely to get affected by COVID-19.

The highest chances of infection lie with the family members or the persons coming in close contact with the COVID-19 patients. The older people, aged more than 60 years, should avoid going to crowded places or hospitals. They are more prone to the disease than the younger generation. Also, the same thing holds true for people suffering from high blood pressure, heart syndromes, respiratory problems like asthma, cancer, or diabetes.

It has observed that children and pets are less likely to get the disease. However, some recent reports also show that if the owner is COVID positive, then his/her pet can be infected. This holds good for the children as well. So, everyone should maintain hygiene in every step to fight against coronavirus.

What You Should Do After Getting The Symptoms: The symptoms of COVID-19 are quite similar to the usual cough and cold and respiratory issues that anybody can have due to the season change. It is true that every person showing such signs is not infected with Corona. But, verification of the same is essential. Without proper tests, you cannot be sanguine that the person is not a victim of the deadly disease. As a precaution, the suspected persons should follow these instructions. This is the measure of protection for themselves as well as society.

The most effective step for preventing the coronavirus from spreading is through home quarantine. The persons who must be at home for the 14 days are as follows;

  • Persons developing the symptoms
  • Those who have a traveling history in COVID affected places
  • People coming in close contact with the suspected or the infected COVID-19 persons

If these people see that these symptoms are prominent, they should immediately take medical help without any delay. Proper treatment and care are vital for curing the unfortunate victims.

Test For Corona: Although there is no vaccine yet for the coronavirus, the doctors have arranged for proper medical tests to detect the disease. If the doctor suspects that you have Corona, then you have to go through a series of tests. The first step involves taking a swab from the nose, and then the sample will be sent for the clinical lab. The doctors, as well as the nurses, should wear the requisite PPE kit while dealing with the COVID positive patients. Moreover, all the healthcare staff should abide by the necessary instructions for extra protection. However, all medical organizations are not conducting corona tests or admitting the patients. There are separate laboratories where these tests are being carried out. The people working in these labs should follow the testing instructions so that no one can get affected by the infected person. Let us take a look at the different kinds of tests that are applicable to the Corona suspected patients.

As mentioned earlier, the swab test is the first one to test the sample taken from the nose or throat. The primary residing place of coronavirus is the saliva. So, without conducting a swab test, nothing can be known with certainty.

The next step is the nasal aspirate. This test involves injecting a saline solution into the nose. After that, the sample will be taken with some amount of suction.

The tracheal aspirate is another technique of testing whether you are Corona positive or not. Here, the doctor will use a bronchoscope to reach the lungs by inserting it through the mouth. The doctors will collect the samples from the lungs only.

A thick mucus known as sputum comes in contact with the lungs and comes out as the person coughs. This process is called a sputum test, where the patient has to cough up the sputum. The fluid is collected in a special cup, or a swab test is taken for that.

Last but not least, a blood test is essential by taking a blood sample from the arm’s vein.

Apart from all these tests, another rapid test is also there. This is to test the different samples taken from the throat, nose, and lungs. Thus, this test is common in most of the CDC-approved clinics and hospitals that ensure a speedy recovery and accurate diagnosis of the disease.

Most importantly, while conducting all these tests, the health professional will instruct the patient to wear proper masks and follow other precautions too.

Instructions For Home Quarantine : Every country is going through a very tough time, both in terms of physical as well as financial conditions. The order of lockdown is prevailing in almost all countries. By now, people are well-acquainted about the positive and negative effects of lockdown. But, there was no other way to prevent the virus and its transmission. During your quarantined period at home, you should do the following activities and lead a hygienic life.

  • Staying in a separate room is highly needed. Please avoid a distance of more than 1 meter with others.
  • Ensure that there is only one caretaker
  • It is always advisable to wear a mask(preferably N-95). In the absence of the same, you can also use a cotton cloth and tie it around your neck. It is very important to cover your nose and mouth completely to prevent transmission of the virus.
  • The infected person must have separate towels, dishes, and similar other things. All the articles should be washed and cleaned very well.
  • The floors, cupboards, and other furniture should be cleaned at least once during the entire day.

Duties Of A Frontline Worker: Many people have come on the frontline to help the poor and distressed people. They want to help those who are going through a miserable condition due to this lockdown. However, they are very much exposed to the risk of getting the infection. Hence, these frontline workers should follow some simple steps and also guide others to prevent the spread of the virus.

As a responsible citizen, you should follow all the necessary instructions like maintaining social distancing, washing the hands frequently, carrying sanitizers or soap always with you, and similar others. If, as a frontline worker, you need to visit an affected person in any medical facility, you must cover your nose and mouth with a proper mask or cotton cloth. It will be difficult to maintain social distance in a crowded place or slum areas. However, you have to spread awareness about the transmission of the disease to the residents of those areas.

You must not conduct any community meetings or other outreach sessions involving more than 10-12 people. In this way, you can prevent social gatherings and play a vital role in the prevention of coronavirus.

You have to self-monitor for the probable signs of Corona. In case you observe anything similar, you must report to the medical officer without any delay. Also, give special attention to the marginalized. You should remember that older people have the highest risk. Hence, it is crucial to pay frequent visits to old-age homes and ensure that they are not out of the supply of any emergency medicines or food.

The Correct Way To Wear Masks: From the above discussion, you must have noticed that masks are inevitable in this dangerous pandemic situation. But, it is very unfortunate that most of the people do not know how to wear the masks properly. So, here we will give some instructions so that you can utilize these masks in the best possible way and stay protected.

  • Before wearing the masks, always keep your hands clean and sanitized.
  • Always ensure that the mask is not loose.
  • The mask should entirely cover the nose and mouth.
  • Avoid touching the masks from the front. Always use the sides to hold them.
  • It is better to change the masks every 6 to 8 hours. Even you should change it when it is moist.
  • Cotton masks should be cleaned daily.
  • In case of disposable masks, always use a separate bin to throw them. Avoid throwing them here and there as that can increase the chances of virus transmission.

Next Step For Corona Positive : The tests for Corona are carried out in separate steps. When your reports are positive, you should follow all the instructions given by the healthcare professional. These can give you some relief from the symptoms gradually. These steps include;-

  • Drinking a lot of water, juices, etc.
  • Take plenty of rest
  • Take over-the-counter medicines
  • Stay isolated in a separate room where no one can enter

If there are any signs of pneumonia, you should call for medical attention immediately. Along with the coronavirus, you can also have some other health complications. The only way to get cured is to listen actively to everything your doctor says without any questions.

If your reports are negative, then you should enquire whether any further tests are required. In order to prevent any further infection, please maintain hygiene and follow all the necessary precautions. Some people think that the transmission of coronavirus can occur through mosquitoes and flies. However, this is not at all true. The virus spread through clothes, shoes, bags, and their articles. So, try to sanitize everything to have maximum protection.

Precautions For Pregnant Women: The whole world is going through a tremendous critical situation due to the coronavirus pandemic. Pregnant women are in a very challenging situation where they have to take extra care of their health. We will discuss over here, some of the measures that you should definitely take during pregnancy. During this crucial period, a would-be mom is more susceptible to the infection of COVID-19. In fact, they can have a severe infection and other related complications in the delivery. Moreover, if they do not follow all the necessary steps, there are high chances that the child can take birth with the virus too. Hence, she should take all the provisions to protect herself as well as her unborn child.

  • Do not touch the eyes, nose, and mouth without washing the hands properly.
  • Do not come into close contact with any outsider.
  • There is no need to go to work.
  • You should avoid all kinds of non-essential travels

If the person follows all the rules, then it can surely reduce the risks of infection to a great extent.

 

The Deadly Disease Coronavirus (COVID-19)

The Deadly Disease Coronavirus (COVID-19): Few Questions And Answers

Deadly Disease Coronavirus: 2019, December marked the beginning of a black period in the history of mankind. A new name became the subject-matter of the headlines-Coronavirus (COVID-19). Wuhan of China became the first place of its attack. Gradually, the virus spread across the globe like wildfire. The eminent scientists of all countries are putting their heart and soul in the research of a vaccine that can prevent this deadly virus. However, no definite solution is found yet. The countries are going through continuous lockdown. Thus, this virus has adversely affected the health, business, and economic conditions. There is a scarcity of food, personal protection equipment, and people are out of money. Hundreds are facing unemployment issues. To help the public at large at this difficult stage, we will provide some questions and answers.

What is COVID-19 or Novel Coronavirus? How did it get the name? : Coronavirus Disease 2019(COVID-19) is absolutely a new type of virus that has emerged on the Earth’s surface. This is a disease that has no similarity with any of the previously identified diseases that circulate among humans. Hence, the procedure for diagnosis is also different. The diagnosis will not match the processes involved in coronavirus 229E, HKU1, and similar diseases. So, special types of care and treatment will have to be arranged for the COVID-19 affected people.

The novel coronavirus was first identified in Wuhan, China. In the earlier stage, there was no proper name for the disease. After that, when the disease started spreading in other countries also, the World Health Organization (WHO) announced an official name for the same on 11th February 2020. Previously, the experts used to refer to the disease as “2019 novel coronavirus” or “2019-nCoV” as it emerged in December 2019. However, the new name of the disease is Coronavirus Disease 2019, the abbreviation of which is COVID-19. There are various coronaviruses that cause mild respiratory problems. However, as the virus causing COVID-19 is new for humankind, the word novel is attached to the same.

How is the virus transmitted from one person to another? : The rapid transmission of COVID-19 mainly occurs from infected persons to others. The carrier of the virus is the respiratory droplets from the coughs and sneezes of the infected person. If you are taking appropriate protection, these droplets can fall on the nose or mouth or can enter the lungs also during inhalation. The chances of transmission are more when the person comes in close contact with the affected person, say within the distance of six feet. At present, the world is witnessing a ‘community spread’ in several corners as this virus is transmitting at a random speed. The term ‘community spread’ means people of a particular geographical area are getting affected by the disease. Among them, some are not sure how they got the infection.

As the infected persons can spread the disease quickly among a hundred more, it has been recommended that the patients developing the symptoms for the disease should stay in isolation. So, as a responsible citizen, everybody should stay at home quarantine and break the chain of infection. Quarantine means separating a person with a contagious disease with the rest of the world. For COVID-19, the minimum isolation period is 14 days. Therefore, somebody leading a quarantined life is not a risk for society.

Why are we observing a rise in the cases? : The cases of coronavirus are increasing rapidly, mainly due to the carelessness of the locals. Besides, sometimes the government also does not generate accurate records on a timely basis. Laboratory testing requires a lot of time. As a result, the day count varies depending on the scenario. So, in the absence of the correct reports showing the exact number of people affected, an increase in the number of cases is quite evident. Even some people who did not show any symptoms also got positive reports for COVID-19. For how long a person should be kept in the hospital varies on different factors as per the facts and circumstances of each case. Also, the doctors take the decision after consulting with the state and local health officials.

What are the precautionary measures to prevent coronavirus? : The precautionary measures that everybody should take to prevent the spread of coronavirus are as follows;-

  • Wash Your Hands: After coming from a public place, or sneezing or blowing your nose, you must wash your hands thoroughly with soap for at least 20 seconds. In case of unavailability of soap and water, you can use an alcohol-based hand sanitizer. Please avoid touching your mouth, nose, and eyes with unwashed hands.
  • Avoid Close Contact: Please do not come in close contact with any person suffering from any kind of disease. Sick people have the highest risk of being infected. Hence, maintain a safe distance, even at home. Always try to maintain a minimum distance of six feet with others. Avoid any kind of gatherings or crowded places like the mall, cinema halls, etc.
  • Cover The Mouth: It is very important that you wear proper masks to cover your nose and mouth whenever going out or communicating with others. In case you do not have a mask, you can use a cotton cloth and tie it around your face. But, you must keep in mind that wearing masks is mandatory to protect yourself and the others from the infection. However, you cannot avoid social distancing even if you are using a mask.
  • Protection during Coughs and Sneezes: Even if you are in a private place, never cough or sneeze in the open air. You must cover the face with a tissue or hanky and throw the same in the bin. After that, you must wash your hands thoroughly or use a hand sanitizer.
  • Maintain Hygiene and Cleanliness: Clean all the touchable objects, floors, or other surfaces daily that you come across frequently, such as tables, doorknobs, toilets, desks, and others. You can disinfect the non-washable goods like phones, laptops, etc.

What are the symptoms of coronavirus? : People who are having coronavirus can develop different types of symptoms. Sometimes, these are even seen much after the reports are generated, showing positive corona results. The most common symptoms include high fever, dry cough, and troubled breathing. Besides, there are a few less common signs, too, that indicate that you might have been infected by the virus. These are sore throat, diarrhea, aches and pains, headache, skin rashes, and many more. However, you will understand that the health condition is taking a serious turn when you are suffering from acute chest pain, shortness of breath, or loss of speech or unsteady movements. So, if you have any of these, an immediate call for medical help. Always remember that you cannot compromise with your health as well as that of your family. Hence, without any delay, take the initiative to go through the tests. Once you are assured of the reports, whether you are having COVID-19 or not, you can think of the next steps.

 

What should you do after developing any of the symptoms? : Coronavirus has already taken millions of lives across the globe. The way it is spreading, getting paranoid is very natural. However, if you are always afraid about what is going to happen in the next moment, it will not do any good. The proper solution will be to take appropriate precautions and to follow all the instructions of the government in this regard. By taking some small steps, we can protect ourselves as well as the whole society.

If you or any of your family members are showing any kind of symptoms of the corona, it is essential that you maintain home quarantine strictly and do not move out of the house except for extreme emergencies. Before going to any medical facility, it is better to explain all your symptoms to your doctor over the phone. In case the symptoms are mild, the doctor will only advise you to drink a lot of liquids, stay at home, take sufficient rest, and keep a watch on the symptoms. If you observe any betterment, you should communicate that too. However, in case of the development of some more symptoms, do not hesitate to share that with your physician. Your health is very crucial. So, always wear a mask and avoid crowded places or public transport.

Who has the highest chances of getting affected by the virus? : The virus causing COVID-19 can infect anyone irrespective of their age. However, medical history suggests that majorly two groups of people have the highest risk of getting affected by the disease. One section includes the older people who are aged 60 years or above; the other group consists of sick people. Sick means those who are suffering from some acute health problems like cancer, cardiovascular disease, diabetes, or any other chronic disease. The risk will start increasing for the people above 40 years of age. Hence, adults should behave in a more responsible way to protect themselves as well as others from the harmful hands of this virus. Special circulars and advice are there from the WHO for these two groups of people. These are steps to ensure that they get full protection from the infection of COVID-19. Such people who are not staying in isolation are exposed to vulnerabilities for getting the infection. Hence, there should be a special arrangement of treatment and social care for these people.

What are the different types of tests associated with Disease Coronavirus? There are different kinds of tests associated with coronavirus to identify whether a person is having COVID-19 or not. These areas under;

Swab test: This is the first and primary test where the samples of fluid are taken from the throat or nose. It is quite painful for the patient while the samples are collected.

Sputum test: Sputum is a kind of thick mucus. This is collected when you cough and kept in a separate cup.

Blood test: A blood sample is also taken to check whether your blood contains the virus.

Rapid test: This is the most popular test that involves the collection of fluid samples from the lungs, nose, or throat. It is prevalent in most of the CDC-approved health organizations and ensures an accurate diagnosis more quickly.

There are many other tests, but during all the tests, you can feel a bit uncomfortable. However, these effects are temporary in nature. After the test is over, the respective places will heal slowly.

When should a person get admitted to the hospital in Disease Coronavirus? : When a person severely develops any of the symptoms, he or she should go to the medical help immediately. The hospital authorities can decide to admit a suspected patient immediately and put the person in an isolation ward. There are no separate hospitals as per the WHO recommendations for COVID-19 patients. However, some countries can choose to build separate cells to keep the affected persons separate from the general crowd. Moreover, every patient should abide by the WHO infection prevention suggestions so that they can protect the other patients, medical staff, and visitors.

Does any protected immunity develop after treating the corona infection? Is there any chance of recurrence of the Disease Coronavirus? : There is no conclusive evidence until now that persons recovering from the coronavirus infection have developed any antibodies. Hence, you cannot say with certainty there can be no chances of recurrence of this deadly disease. Immunity develops a pathogen through natural infection. It is a multi-step process, and so it is not easy to develop the protected resistance power to prevent the further occurrence of COVID-19. Some think that antibiotics have the potential to treat or prevent the disease. However, this is not true.

What is the recommended PPE for healthcare professionals dealing with corona patients? : All healthcare professionals dealing with corona patients should take extra protection for themselves. Personal protection equipment or PPE is a must for people working in healthcare units. FFP2 and FFP3 respirators are the best to provide respiratory protection. Besides, the ideal PPE kit should also contain goggles or face shields to protect eyes, long-sleeved water-resistant gown, and medicated gloves for hand protection.

 

Covid-19-Hemodialysis

Covid-19-Hemodialysis-Unit-Preparedness-Checklist

 

This checklist contains the guidelines given by the government. This is specifically for various dialysis units across the place. If patients arrive at hospitals with Cocid-19 symptoms, this needs to be followed.

Before The Arrival Of The Patient                                                                Done(Y/N)  Remarks

Things to Assess:

The dialysis staff needs to be educated about:

  • Epidemiology, Testing and Triage of Covi-19.
  • Wearing the PPEs.
  • Etiquettes to be observed while coughing and sneezing.
  • Hand wash and sanitization.

Details related to Stocks:

  • Dialysate, dialysers, tubes, catheters, fistula, needles and heparin.
  • Disinfectants and medication.
  • Stick of PPEs and sanitization materials.

Details related to staff rosters and shifts:

  • Presence of adequate staff members.
  • Detection of Exposure rate of staff members.

Signboards in all languages in the Dialysis unit

Signage asking patients and relatives to report Covid-19 symptoms

Instructions related to reporting of SAR Covid 19 before embarking into the Dialysis area

The Screening Area

Things to Assess:

Presence of an entry and exit for staff members and patients

Presence of a specific area for screening patients before dialysis begins

Adequate space for social distancing in the wards

Availability of Masks

Screening Guidelines in the Screening area:

  • Covid -19 symptoms
  • Thermal screening
  • Contact History
  • Recent Travel History Outside India

 

Presence of adequate and relevant signage on Covid -19.

Sanitizing norms in the wards – hand wash with at least 60% alcohol for hand

wash with liquids disinfectant soaps for 20 seconds

Signing of consent documents with respect to Covid-19

 

The Dialysis Area

Elements To be Assessed

Teaching of Cough Etiquettes to patients

Maintenance of Eating guidelines

Presence of alcohol-based hand sanitizer

Presence of Trash cans

Presence and usage of 3-layer surgical masks

Following of hand hygiene rules

Presence of Questionnaire on Respiratory symptoms of dialysis staff

Social distancing norms maintenance in the unit

Availability and Usage of:

  • Stethoscopes
  • Thermometers
  • Oxygen saturation probes
  • BP cuffs

 

Guidelines for Suspected Patients

Dialysis arrangements for Covid -19 patients:

Needs isolation

Staff division between positive and negative patients

 

Dialysis norms of patients detected for Covid -19 in the last few hours.

Distance of 2 meters maintained between two patients

Usage of PPE for staff caring for Covid-19 infected patients

  • Shoe covers
  • Gown
  • Googles
  • Cap
  • Mask N95 or Triple layer
  • Surgical gloves

Maintenance of usage guidelines of PPEs and disposal

Notification about Covid-19 positive patients to District medical teams

 

Cleaning and Disinfection Process

Cleaning details of dialysis machines and trash cans after each shift

Change of upholstery and bed linen after each shift

Maintenance of gowns and kits and disinfection with 2% hypochlorite solution

Disinfection of furniture – beds, tables, trays, counters, toilets, faucets, taps, bathroom WC.

Presence of dedicated cleaners for wheelchairs and weighing machine

Usage and maintenance of 2 % hypochlorite, 60 % alcohol and other disinfectants

Proper usage and disposal of gloves

RO disinfection procedure maintenance