This document discusses renal function tests and their clinical implications. It begins by outlining the general anatomy and functions of the kidney. It then classifies renal function tests into urine analysis, blood tests, and tests of glomerular and tubular function. Specific tests are described, including creatinine clearance for glomerular function and urine concentration tests for tubular function. The document discusses how renal function tests can help in assessing and monitoring kidney damage and adjusting drug dosages. Clinical conditions that can be indicated by renal function tests include diabetic nephropathy, acute kidney injury, glomerular diseases, and chronic kidney disease.
rft is described in detail . function of kidney, objectives of doing the test. the various test available for assessing the renal function with clinical interpretation is available.
rft is described in detail . function of kidney, objectives of doing the test. the various test available for assessing the renal function with clinical interpretation is available.
Renal function tests are very useful for effective clinical evaluation of renal failure for effective management. So it is useful for medical and allied professional students and clinical practitioners.
Test for pancreatic and intestinal functions are very important for clinical evaluation gastro intestinal disorders . So it will e useful for medical and allied professional students and practitioners.
Creatinine clearance may be used as indicator for GFR because:
Creatinine is endogenously produced.
Creatinine is released into body fluid at constant rate.
Its plasma level maintained within narrow limits.
Its plasma level not affected by dietary factors
A test in which blood or urine samples are checked for the amounts of certain substances released by the kidneys. A higher- or lower-than-normal amount of a substance can be a sign that the kidneys are not working the way they should. Also called kidney function test.
The slides show the gastric and pancreatic function test along with the significance of these tests and the conditions in which the values of which increase.
Renal function tests are very useful for effective clinical evaluation of renal failure for effective management. So it is useful for medical and allied professional students and clinical practitioners.
Test for pancreatic and intestinal functions are very important for clinical evaluation gastro intestinal disorders . So it will e useful for medical and allied professional students and practitioners.
Creatinine clearance may be used as indicator for GFR because:
Creatinine is endogenously produced.
Creatinine is released into body fluid at constant rate.
Its plasma level maintained within narrow limits.
Its plasma level not affected by dietary factors
A test in which blood or urine samples are checked for the amounts of certain substances released by the kidneys. A higher- or lower-than-normal amount of a substance can be a sign that the kidneys are not working the way they should. Also called kidney function test.
The slides show the gastric and pancreatic function test along with the significance of these tests and the conditions in which the values of which increase.
The main function of the kidney is excretion of water soluble waste products from our body.
Derangement of any of these function would result in either decreased excretion of waste products and hence their accumulation in the body or loss of some vital nutrient from the body.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Colonic and anorectal physiology with surgical implications
Renal function test
1. Renal Function Test
Dr. Apeksha Niraula
Assistant Professor
Department of Biochemistry
BPKIHS
2. Objectives
General Anatomy
Functions of Renal System
Classification of renal function tests (Urine analysis,
blood, Glomerular function and Tubular function)
Clinical Implications
3. Overview of General Anatomy
Two bean shaped
Both side of vertebrae
Weight: 150 gm
About 10 to 13 cm (4 to 5 inches) long
Approximately 5 to 7.5 cm (2 to 3
inches) wide
About 2 to 2.5 cm (1 inch) thick
Size of fist
Site: T11-L3
5. Formation of
urine as the
waste product
Excretion of
NPN
substances
Regulation of
salt & water
balance
Regulation of
acid-base
balance
Production of
Hormones
Functions of
KIDNEY
7. Urine Analysis
Normal color: Urochrome pigment : pale to amber
Blue green: Riboflavin, pseudomonas infection etc
Pink-orange-red: Hb, myoglobin, porphyrins
Red-brown black: Hb, myoglobin, RBC, Homogentisic acid etc
Specific gravity/osmolarity:
Sp. Gr. :1.005-1.030
Osmolarity (24hrs): 500-800 mOsm/kg of water
Turbidity: Due to infection or fat particles
8. Reagent impregnated cellulose strips
Protein
Albumin
Hemoglobin
Glucose
pH
Reagent Strip Dipstick Test
9. Microscopic Examination
Centrifugation of fresh sample
Sediment observation under
microscope
Erythrocyte
Leukocyte
Epithelial cells
Casts ( composed of Tamm Horsfall
glycoprotein)
Fat or pigmented particles
Parasites or bacteria
Crystals
10. Classification of Renal Function Tests
Tests based on Glomerular filtration:
i. Urea clearance test.
ii. Endogenous creatinine clearance test.
iii. Inulin clearance.
iv. Cr51- EDTA clearance test.
Tests to measure Renal Plasma Flow (RPF):
i. Para-amino hippurate test (PAH).
ii. Filtration fraction
Tests based on tubular function:
i. Concentration and dilution tests.
11. Glomerular Function Measurement
Plasma Urea
Plasma Creatinine and clearance
Calculated creatinine clearance (eGFR)
Inulin clearance
Isotopic technique for measuring GFR
Cystatin C
Plasma β2-microglobulin
12. Clearance Test
Clearance is that volume of blood or plasma from which a measured amount of
substance can be completely eliminated into the urine per unit of time.
C= UV / P
C= clearance
U= concentration of substance in urine ( in mg / 100 ml )
V= volume of urine in ml / min
P = concentration of substance in plasma/ blood
Clearance tests are
Endogenous - Urea, Creatinine,
Exogenous - Inulin , 51Cr-EDTA
13.
14. Creatinine clearance
At normal level of creatinine, this metabolite is filtered at the glomerulus but neither
secreted nor reabsorbed by the tubules. Hence, its clearance gives the GFR
Convenient method for estimation of GFR since:
Normal metabolite in the body
Does not require the intravenous administration of any test material
Estimation of creatinine is simple
Procedure of test:
An accurate 24 hr urine specimen is collected
Collect a blood sample for serum creatinine determination
Estimate the serum and urinary creatinine concentration
Normal range: 95- 105 ml/ min
15. Serum Urea
Plasma urea is widely ordered along with creatinine for measuring renal
function but has many disadvantages:
Plasma concentration is dependent in part on its rate of formation
Significant passive reabsorption from tubules
Method of estimation
Direct chemical : DAM in hot acidic medium
Indirect Enzymatic method: Urease, Glutamate Dehydrogenase method
16. Cystatin-C
Low mol. Wt. protein: 13.4 kDa, non glycated basic protein
Cysteine protease inhibitor, found in surface of all nucleated cell
Its plasma concentration appears to be far less dependent than that of
creatinine on weight, height, muscle mass, age or sex
More sensitive index of mild renal impairment that is it increase in creatinine
blind range (GFR of 70-90mL/min/1.73m2)
GFR estimation is far less variable
Immunoassay technique available but expensive
17. Plasma β2-Microglobulin
Mol wt. of 11.8 KDa is shed into plasma at constant rate
Passes freely through the glomeruli
Normally <2 mg/L in plasma
Impaired renal function: upto 40 mg/L
Direct relationship between plasma β2-microglobulin and GFR but its
measurement has not been widely adopted as an index of GFR for
methodological reasons
18. Exogenous Substances for GFR
Inulin:
Plant polysaccharide (fructose monomer)
satisfies all criteria for estimation of GFR (Gold standard for estimation of GFR)
Disadvantages:
Time consuming
Poor specificity of analysis
Chromium-EDTA
Isotopic (simple)
Time consuming
19. Test of Tubular Function
Proximal tubular function
Phosphate reabsorption test
Detection of urinary amino acid
Detection of glycosuria
Distal tubular function
Urinary concentration and dilution
Urinary acidification
20. Urine concentration tests
Restrict water intake for 14- 16 hours
Collect three urine samples at 1-, 2- and 4 hours
Measure specific gravity
Normal tubular function - >1.025
Decreased renal function = 1.020
Severe renal impairment approaches < 1.010
Normal finding does not rule out active kidney diseases
“Fluid deprivation may be contraindicated in heart diseases and early renal
failure”
21. Quantitative Assessment of Proteinuria
Total protein measurement
Albumin
Bence Jones Proteinuria
Myoglobinuria
22.
23. Diabetic Nephropathy
Diabetic nephropathy has been classically defined by the presence of
proteinuria>0.5 g/24 h or
Clinically important indicator of deteriorating renal function in diabetic subjects so
regular screening of albumin loss a valuable in monitoring type 1 and type 2 DM
ACR measures more accurately than random or timed albumin excretion
measurement
24. Acute renal failure / Acute Kidney Injury
ARF is essentially characterized by a sudden decline in renal function, leading to
retention of nitrogenous and other waste products, disordered hydrogen ion
homoeostasis and disturbances of extracellular fluid volume and composition
Potentially life threatening condition and, developing as it often does in patients
who are already severely ill
In many cases of acute renal failure there is oliguria (urine flow rate: <15mL/hr)
25. Glomerular Diseases
Suggested clinically by finding blood and protein in urine on urine reagent strip
testing
Primary Glomerular Disease: IgA nephropathy, membranous nephropathy
Nephrotic Syndrome: Heavy proteinuria (>3g/d), reduced serum albumin and
edema
Acute nephritic syndrome: rapid onset of hematuria, proteinuria, reduced
GFR, sodium and water retention followed by hypertension and localized
peripheral edema
Cause: group A alpha-hemolytic streptococcal infection of pharynx
26. Several disease that results in:
Injury and increase permeability of glomerular basement
membrane
Abnormal findings
Massive proteinuria (>3.5 gm/day)
Hypoalbuminemia
Generalized edema
Other hallmarks. Hyperlipidemia and lipiduria
Nephrotic syndrome
27. Tubular Disease
Renal Tubular Acidosis
Inherited and acquired disorders affecting proximal and distal tubule
Characterized by hyperchloremic, normal anion gap metabolic acidosis and urinary
bicarbonate or hydrogen ion excretion abnormality
Distal RTA (type I): inability to secrete hydrogen ions in DCT in acidosis
Proximal RTA ( type II): failure in bicarbonate reabsorption from PCT
Selective Aldosterone Deficiency (type IV): Aldosterone deficiency or
resistance
28.
29. Chronic Kidney Disease
The National Kidney Foundation-Kidney Disease Outcomes Quality
Initiative (NKF-KDOQI) defines CKD is as abnormalities of kidney
structure or function, present for >3 months, with implications for
health
30.
31. Assessment of the
extent of renal
damage
Monitoring the
progression of
renal damage
Monitoring and
adjusting the dose
of renal toxic
drugs
Renal Function Tests –required for……
32. What to examine???
Renal function tests are divided into the following:
Urine analysis
Blood examination
Glomerular Function Test
Tubular Function Test
33. Teitz textbook of Clinical Chemistry and Molecular Diagnostics; 5th
Edition
Clinical Biochemistry Metabolic and Clinical Aspects; William J
Marshall, 3rd Edition
Textbook of Biochemistry 8th edition; DM Vasudevan
Clinical Chemistry 6th edition; Marshal
References
Nephrotic syndrome may occur when the filtering units of the kidney are damaged. This damage allows protein normally kept in the plasma to leak into the urine in large amounts, which reduces the amount of protein in your blood. Nephrotic syndrome is not a specific kidney disease. It can occur in any kidney disease that damages the filtering units in a certain way that allows them to leak protein into the urine. Some of the diseases that cause nephrotic syndrome, such as nephritis, affect only the kidney. Other diseases that cause nephrotic syndrome, such as diabetes and lupus, affect other parts of the body as well.
Lipiduria makes oval fat bodies in the urine
Renal tubular cell also engulf these fats and shed off.
Primary cause are directly associated with glomerular disease status.
NEPHRITIC syndrome??????
Previuosly renal failure was divided into ARF and CRF. Terms tells the rate at which damage occurs rather than the mechanism at which it occurs.
(NKF-KDOQIevaluate , classify and stratified CKD. + NICE( national institute of health and clinical significance)
Renal has been replaced by Kidney more understand by patients and non specialist.
Most individual with CKD stage 3 donot progress to ESRD, with prevalence stage of CKD stage 3 of 10-20 times greater than Stage 4 and 5. on the basis of epidemiologic and prognostic significance.
ESRD is US federal government defined term – indicates needs for long term treatment by dialysis or transplantation.
Kidney failure is deficned as a GFR < 15 ml/min/1.73m2.
These are the severaltests performed in the laboratoty to assess the kidney function.
Its is said that 2/3 rd of kidney damage only these test shows results.