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Nephron Sparing Surgery in Renal Tumors : A Case Report A 69 yrs old male presented to our OPD with h/o left sided varicocele. A known case of Diabetes, hypertension and bilateral medical renal disease, he underwent MRI abdomen which revealed a large lower pole lesion in left kidney with no renal vein or IVC thrombus. DTPA Scan revealed a 61% function in the affected kidney. Due to his bilateral medical renal disease and poorly functioning contra lateral kidney, he was planned for Nephron Sparing Surgery / partial nephrectomy (L) and DJ Stenting under cold ischaemia. Post op patient initially showed a rise in creatinine levels which gradually settled down to pre operative levels. Before we go into the discussion of partial nephrectomy or nephron sparing surgery (NSS) in RCC, I would like to emphasize on the presenting complaint. Varicocele in the left side is one of the presentation of Left sided kidney mass, which occurs due to the drainage of the gonadal vein into the renal vein on the left side and generally indicates tumor thrombus in the venous system renal/ IVC, however in this case it was because of compression of left gonadal vein by the renal mass. Renal tumors comprise approximately 3.8% of all new cancers with median age at diagnosis of 64 yrs. It is the third most common urological malignancy. The rate of RCC has increased by 1.6% per year for last 10 yrs, the reason of which is unknown. Majority of them are renal cell carcinomas and 80% of them are clear cell variety. Smoking and obesity are high risk factors of RCC. Some genetic diseases are also associated with RCC, like Von Hippel Lindau (VHL) disease. At presentation 25% are locally advanced. More often patient presents with metastatic disease (20%) . Only a few patients present with Virchows Triad - the 'too late triad' ( of hematuria, abdominal pain and flank mass). A CT Scan or MRI of the whole abdomen including pelvis clinches the diagnosis. A NEEDLE BIOPSY IS NOT NE

The program has led to significant improvements in patient self-management, greater adherence to key evidence-based practices, and improved outcomes, including reduced symptoms for asthma patients, reduced readmissions for heart failure patients, and lower hemoglobin A1c for diabetes patients.

A resource largely for patients and non-professional consumers of medicine and health care, created by the Mayo Clinic as an educational tool to help facilitate delivery of better, more efficient medicine to informed, participatory clients.

There are more and more patients with IgA Nephropathy in the world. According to the research of recent years, it shows that 80 percent of patients with IgA Nephropathy are female. The amazing result indicates that a lot of families may be confused about whether IgA Nephropathy affects fertility or not. This article may help you solve your problem.

Prevention of sudden cardiac death with omega-3 fatty acids in patients with coronary heart disease: A meta-analysis of randomized controlled trials.\nZhao YT, Chen Q, Sun YX, Li XB, Zhang P, Xu Y, Guo JH.\nAnn Med. 2009 Jan 16:1-10. [Epub ahead of print]\nPMID: 19148838

Association of vitamin D deficiency with heart failure and sudden cardiac death in a large cross-sectional study of patients referred for coronary angiography.\nPilz S, März W, Wellnitz B, Seelhorst U, Fahrleitner-Pammer A, Dimai HP, Boehm BO, Dobnig H.\nJ Clin Endocrinol Metab. 2008 Oct;93(10):3927-35. Epub 2008 Aug 5.\nPMID: 18682515

Not enough vitamin D: health consequences for Canadians. Schwalfenberg G. Can Fam Physician. 2007 May;53(5):841-54. Review PMID: 17872747 Conclusion Low levels of VTD are considered a major public health problem in Canada, especially during the winter. Those with risk factors should be screened for low 25(OH)D levels and repletion therapy instituted if needed. Researchers have estimated that the oral dose of vitamin D3 to attain and maintain 25(OH)D levels >80 nmol/L is 2200 IU/d if baseline levels are 20 to 40 nmol/L, 1800 IU/d if levels are 40 to 60 nmol/L, and 1160 IU/d if levels are between 60 and 80 nmol/L.64 We need to ensure that patients have healthy blood levels of 25(OH)D to prevent levels of parathyroid hormone from rising and to maximize absorption of calcium, magnesium, and phosphate. Positive effects on bone are marginal at best unless patients consume at least 800 IU/d of VTD. The emerging and exciting role of the VTD receptor and the actions of VTD in maintaining health in other cell types have become more apparent during the last decade.

Isentress is a new HIV treatment in development. Recent studies have shown Isentress-based therapy maintains activity at 96 weeks in treatment-naïve HIV patients, comparable to efavirenz, which is a current favourite for this patient pool. The benefits of Isentress-based therapy, however, are improved side effect and lipid profiles.

"Dr. Jodie Burton is the acting principal investigator (PI) of the dose-escalation trial of oral vitamin D3 with calcium supplementation in patients with multiple sclerosis with Dr. O'Connor. She started the trial as his fellow, while doing an additional 2 years of training in MS specifically after she received her neurology certification. She completed her fellowship training in 2007. Now she is staff doing clinical research and continuing with the vitamin D trial. As of August 2009, she will be Assistant Professor in Neurology in the Department of Clinical Neuroscience in Calgary and at the University of Calgary. She will be part of the MS team there with Dr. Luanne Metz and the MS group. Please scroll down for an abstract of the trial: A Phase I/II dose-escalation trial of oral vitamin D3 with calcium supplementation in patients with multiple sclerosis." Conclusions: High-dose VD3 (~10 000 IU/day, possibly higher) in MS is safe and tolerable, with evidence of clinical improvement.

Glaucoma (chronic open angle) is a disease that can be difficult to detect until a significant amount of vision is lost because most glaucoma patients have no symptoms. Many patients feel no pain at all, and most have 20/20 vision if they look straight ahead. Left untreated, however, glaucoma can slowly steal your peripheral vision until you have the impression you are seeing things through a tunnel (at best) or until you go blind (at worst).

Embryo transfer is a simple, non-surgical process. Unlike egg recovery, embryo transfer does not require sedation and the patient can be discharged from the hospital between 2 to 5 hours after embryo transfer. Both frozen and fresh embryos can be used in this assisted reproduction procedure. The transfer is performed using image guidance from an ultrasound. The doctor uses a thin catheter to move the embryos into the uterus through the vagina. Once the transfer is complete, the patient is shifted directly in the recovery room for 30 to 60 minutes. The above-mentioned steps are the embryo transfer steps.

trium healthcare provides remote patient monitoring and health care services accessible from anywhere at any time. Click here to learn more about our services.

Prevalence of vitamin d insufficiency in patients with Parkinson disease and Alzheimer disease.\nEvatt ML, Delong MR, Khazai N, Rosen A, Triche S, Tangpricha V.\nArch Neurol. 2008 Oct;65(10):1348-52.\nPMID: 18852350

Low vitamin d levels predict stroke in patients referred to coronary angiography.\nPilz S, Dobnig H, Fischer JE, Wellnitz B, Seelhorst U, Boehm BO, März W.\nStroke. 2008 Sep;39(9):2611-3. Epub 2008 Jul 17.\nPMID: 18635847 \ndoi: 10.1161/STROKEAHA.107.513655

Aviram M, Rosenblat M, Gaitini D, Nitecki S, Hoffman A, Dornfeld L, Volkova N, Presser D, Attias J, Liker H, Hayek T. Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood p

Safety of vitamin D3 in adults with multiple sclerosis. Kimball SM, Ursell MR, O'Connor P, Vieth R. Am J Clin Nutr. 2007 Sep;86(3):645-51. PMID: 17823429 Conclusions: Patients' serum 25(OH)D concentrations reached twice the top of the physiologic range without eliciting hypercalcemia or hypercalciuria. The data support the feasibility of pharmacologic doses of vitamin D3 for clinical research, and they provide objective evidence that vitamin D intake beyond the current upper limit is safe by a large margin.

We know smoking is injurious to health. It causes severe injury to lungs and increases its vulnerability to different types of infections. One such smoking induced disorder is the major damage in air sacs in lungs, which makes patients suffer from abruptly shortage of breath. This problem is called emphysema and it is one of the diseases counted in Chronic Obstructive Pulmonary Disease group, shortly known as COPD.

We know smoking is injurious to health. It causes severe injury to lungs and increases its vulnerability to different types of infections. One such smoking induced disorder is the major damage in air sacs in lungs, which makes patients suffer from abruptly shortage of breath. This problem is called emphysema and it is one of the diseases counted in Chronic Obstructive Pulmonary Disease group, shortly known as COPD.