Sandesh Jadhav, (2023) A Study on Clinical, Microbiological, Radiological, Abnormalities in Acute Pyelonephritis. Masters thesis, Stanley Medical College, Chennai.
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Abstract
BACKGROUND Acute pyelonephritis (APN) is a severe infection caused by microbes like E coli, Klebsiella. Major risk includes DM, immunocompromised state, renal stone(s), prior surgery or instrumentation of urinary tract. Patients present symptoms like fever, dysuria, loin pain, altered sensorium. A prospective observational study was done to analyse clinical,laboratory profile, and outcome of patients admitted in medical, nephrology and urology wards, Government Stanley Medical College Hospital, Chennai , over a period between April 2021 to September 2021. METHOD A sample size of 80, of APN patients admitted to medical, nephrology and urology wards. The patients were interviewed for demographic and other details like age, sex, past medical history of comorbidity, along with presenting complaints were noted. Further these patients were subjected to physical examination for clinical signs and these were recorded separately in a separate proforma. Lab parameters were analysed for arriving at the statistical significance and correlation. RESULTS In this study the sample populations mean age was arrived as 56.74±9.36 (SD), with the lowest recorded age being 38years and highest being 74. There were 13 male patients admitted for APN diagnosis and 67 women included during the entire study period. The sample populations duration of diabetes was 12.65±7.42 with lowest duration of 4 years in a patient with highest recorded duration being 27 years. Blood sugar level in the overall sample population average was arrived as 339.19±75.54mg/dL. There was a strong correlation between the sample population’s diabetic profile analysis with respect to age; duration of diabetics, blood sugar level and HbA1C. When the blood samples were profiled serum creatinine (Sr C) population’s mean was 5.22±2.44mg/dL. The least recorded SrC was 2mg/dL and the highest being 9.1mg/dL. When contrasting the male and female samples, the average was 4.64±2.3mg/dL and 5.22±2.44mg/dL, with the least and maximal values being 2 and 9.1mg/dL among women and while it was 2.3 and 7.7mg/dL amidst men. Altered sensorium was noted among 9 subjects, shock was reported in 10 subjects with 4 men and 5 women had altered sensorium; 4 men and 6 women presented shock during admission. CONCLUSION Fever, loin pain and dysuria were the predominant symptoms prevailed in significant number of patients. E coli was the predominant causative organism isolated from the culture, but multi-organ dysfunction was more common in K pneumonia. Elevated serum creatinine levels, high WBC count, thrombocytopenia, poor glycaemic control; associated with poor outcome, and required timely aggressive management. Timely CT assisted drainage and nephrectomy can be performed for cases with advanced pyelonephritis patients to prevent mortality.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.200120101025 |
| Uncontrolled Keywords: | Clinical, Microbiological, Radiological, Abnormalities, Acute Pyelonephritis. |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 02 May 2021 13:47 |
| Last Modified: | 20 Mar 2024 06:20 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/15579 |
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