What Is an Anaesthetist?

Image Anaesthetists are specialist doctors who are responsible for providing anaesthesia to patients for operations and procedures. In addition anaesthetists have a range of practice which extends beyond anaesthesia for surgery to include pain management and intensive care. Anaesthetists form the largest specialty group of doctors in NHS hospitals. They are doctors who have chosen after qualifying to undertake postgraduate specialist training of at least seven years in anaesthesia, intensive care medicine and pain management. Most consultant anaesthetists have developed subspecialist interests in a particular area of surgical practice, or in pain management or critical care. In the Trust there are... Read More

Anesthetist Vs. Anesthesiologist

Image Anesthetists and anesthesiologists are two types of medical professionals who administer anesthesia to patients during medical procedures. They often work together to provide pain relief before, during and after a patient’s surgical, obstetrical or therapeutic procedure. Both positions require an interest in the medical profession and a dedication to the years of training required. To enter either profession, you should be compassionate, patient and willing to work long hours. The jobs are demanding, but you can help provide needed relief to those experiencing pain, making them very worthwhile professions. The primary differences between an anesthesiologist versus an anesthetist are the... Read More

What types of anesthesia do physician anesthesiologists provide?

Image Physician anesthesiologists are usually in charge of providing the following types of anesthesia care: General anesthesia: This type of anesthesia is provided through an anesthesia mask or IV and makes you lose consciousness. It is used for major operations, such as a knee replacement or open-heart surgery. Monitored anesthesia or IV sedation:  IV sedation causes you to feel relaxed and can result in various levels of consciousness. Depending on the procedure, the level of sedation may range from minimal (making you drowsy but able to talk) to deep (meaning you won’t remember the procedure). This type of anesthesia often is... Read More

Role of the Physician Anesthesiologist

Image If you’re preparing for surgery, you’ve probably given a lot of thought to the education, training and experience of the surgeon performing the procedure. But you may not have thought much about the physician anesthesiologist or the importance of his or her medical expertise in your procedure — before, during and after — to keep you safe and comfortable. Physician anesthesiologists meet with you and your surgeon before surgery to assess your health and make decisions to ensure your anesthesia care is as safe and effective as possible. They monitor your vital signs during surgery, including how well your heart... Read More

A Rare Case of Posterior Uterine Wall Rupture Complicated by Massive Transfusion and Disseminated Intravascular Coagulation

Image Uterine rupture is a potentially catastrophic complication of caesarean section. Atypical rupture occurring away from the previous scar site is extremely rare with less than 20 cases reported in the literature. A 38-yearold presented at 37 weeks gestation with maternal collapse. Emergency caesarean section revealed foetal loss and a posterior uterine rupture with an intact lower uterine segment. A subtotal hysterectomy was performed. Disseminated intravascular coagulopathy (DIC) developed rapidly and required massive transfusion. The patient was discharged home twelve days later. Posterior uterine rupture is rare and requires prompt surgical intervention and multi-disciplinary teamwork to prevent serious maternal morbidity. Uterine... Read More

Anesthetic Challenges in Management of Parturient With Congenitally Corrected Transposition of Great Arteries

Image Congenitally corrected transposition of the great arteries is once in a blue moon heart defect in which the heart’s lower two chambers and ventricles, are reversed in their positions. Right ventricle (RV) battles to function as the ventricular pump against the substantial systemic vascular resistance. As the age increases, these parturient tend to develop primitive ventricular dysfunction. CCTGA has a prevalence of 0.4–0.6% of all congenital heart disease cases and complete heart block develops in cases of 30% CCTGA. In these parturients the physiological cardiovascular changes of pregnancy may expedite the rate of ventricular failure. We describe anesthetic challenges in... Read More

Ultrasound Guided Axillary Block for Upper Limb Surgery, Rural Experience

Image Ultrasound-guided axillary block is a standard anesthetic technical for surgery of the lower part of the upper limbs including the arm, elbow, forearm, wrist and fingers. We carried out a prospective and descriptive study over 03 years on patients undergoing upper limb surgery under ultra sound guided axillary block, out in the surgery department of the CHDII saint croix Isoanala south Madagascar, rural area. The purpose of this study is to evaluate the efficiency of ultrasound-guided axillary blocks for upper limb surgery. We included 67 patients with a mean age of 35.53±10.68 years with a predominantly male population. The majority... Read More

Spinal Cord at The Conus Medullaris For Treatment Refractory Pudendal

Image Pudendal neuralgia is a neuropathic pain syndrome consisting of debilitating pain along the pudendal nerve distribution. Current evidence offers a variety of therapeutic options, however many patients demonstrate inadequate pain control. We present a 56 year old woman with an eight year history of left groin, vaginal, and rectal pain consistent with pudendal neuralgia. After failing physical therapy, pharmacologic therapy, and surgical intervention, a spinal cord stimulator was placed at the conus medullaris with subsequent 65% pain relief and improved sitting time. This report demonstrates spinal cord stimulation uniquely targeted to the conus medullari as an effective treatment modality for... Read More

Morphology expands understanding of lesions

Image For many years since renal biopsies entered the armamentarium of the nephrologist, the standard approach to assessment was light microscopy with gradual addition of selected special stains, immunofluorescence, and then electron microscopy. An explosion in understanding of the spectrum of etiologies underlying the limited repertoire of lesions in the kidney, coupled with in-depth mining of morphologic lesions and their implications for prognosis, has ensued over the last decades. An exciting direction for exploration of new information for pathogenesis of glomerular diseases was driven by the seminal observation that mutations in nephrin were causal in congenital nephrotic syndrome of Finnish type.... Read More

Kidney International and the COVID-19 infection

Image The Editorial Team of Kidney International would like to reassure our readership that we will continue to bring you high-quality information throughout the COVID-19 pandemic to help all of us deal with the crisis and provide high-quality care to our patients. We have a mechanism in place to rapidly review and arrive at publication decisions for papers on the COVID-19–related implications for the kidney and release these papers in an open access format within one week after acceptance. We believe the best way nephrologists can contribute to the fight against this disease is by arming ourselves with the best and... Read More

Acute Episode Of Itching And Possible Amniotic Embolism With Circulatory Collapse In A Full Term Pregnant Patient

Image Amniotic fluid embolism (AFE) is a rare but serious obstetric condition. Its presentation includes a variety of signs and symptoms, most commonly hypoxia, hypotension, cardiac arrest, disseminated intravascular coagulopathy (DIC) and severe bleeding. A 28-year-old G1P0 full-term patient was admitted for an acute severe itching episode. After ruling out cholestasis, induction of labor and epidural analgesia was started. No significant progress of labor was seen in the next several hours. Blood was seen soaking the epidural catheter site. This was thought of as possibly an early sign of DIC. The decision was made to perform an urgent cesarean section. The... Read More

Methylene Blue Anaphylaxis Under Anaesthesia, During Sentinel Lymph Node Mapping In A Patient Undergoing Bilateral Mastectomy

Image Methylene blue is a widely used dye for sentinel lymph node mapping for solid tumours especially breast cancer. Anaphylaxis is a life threatening reaction that can occur during Anaesthesia. Methylene blue has been reported to be the safest dye, indeed a recent systematic review and metaanalysis reported no cases of anaphylactic reactions. We report a case of a 37-yr-old female who experienced an anaphylactic reaction to methylene blue resulting in Intensive Care Admission. Methylene blue is a dye used for sentinel lymph node mapping for numerous solid tumor’s particularly breast cancer. Several blue dyes are available however methylene blue is... Read More

Chronic Glomerulonephritides

Image Abstract Immune mediated injuries comprise a major bulk of renal disorders that mostly manifest as acute or chronic glomerulonephritides. Besides initial investigations for renal disorders, diagnosis of immune mediated renal diseases requires a battery of immunological tests and renal histopathology. The laboratory tests include anti-nuclear antibodies (ANA) followed by anti-double stranded deoxyribonucleic acid antibodies (antidsDNA) and/or anti-extractable nuclear antigens (anti-ENA), complement levels (C3, C4, factor H), rheumatoid factor (RF), C reactive proteins (CRP), anti-streptococcal antibodies including anti streptolysin-O titer (ASOT) and anti-deoxyribonuclease B (anti-DNAse B), anti-neutrophilcytoplasmic antibodies (ANCA), anti-glomerular-basement membrane antibodies (anti-GBM), cryoglobulins detection, anti-phospholipid antibodies, nephritic factor, anti-phospholipase A2... Read More

Chronic kidney disease patients

Image Abstract Introduction: Anemia could be a frequent and early complication of Chronic nephropathy (CKD), and its prevalence will increase with the worsening of nephritic perform, involving over five hundredth of patients in predialysis (stage 5) and much nearly one hundred of patients in dialysis [1]. The administration of oral or blood vessel iron and glycoprotein (Epo) could be a key part for the correction of anemia each in patients with CKD and in patients on chronic dialysis. The aim of our work was to verify the effectiveness of oral liposomal iron in a very cluster of our home dialysis patients... Read More

Operation Theatre Procedure Awareness for an Anaesthesiologist

Image It’s been a well-known fact that anaesthetist and surgeon work as a team for the betterment for the patient. There are various situations where anaesthetists have provided the lifesaving suggestions to the surgeon in a crux situation. Airway manipulative procedures are a difficult situation for the anaesthetists and surgeon both as the working field is same; so the time is the limiting factor in these cases because more is the time taken more are the chances for hypoxic episodes. Distally located lower respiratory tract foreign body removal especially in pediatric cases are tricky situations and are the most challenging and... Read More

Meningitis Post-Spinal Anaesthesia

Image Meningitis post-administration of a central neuraxial blockade is although a rare complication but a potentially fatal one. Breach in aseptic precautions leading to introduction of bacteria is considered the most probable cause and haematogenous spread due to microscopic vessel injury in symptomatic or asymptomatic bacteremia is also one of the etiologies. Mostly, a single anaesthesiologist may be seen with such cluster of cases. Sometimes defective drugs or faulty equipment used for the procedure may also lead to this complication. We report two cases where spinal anesthesia was performed by different anaesthesiologist’s in different operation theatres of the same hospital, which... Read More

Unusual Pre-oxygenation Techniques and Transorbital Fibre-optic Intubation

Image Extensive maxillo-facial surgery can create significantly complex airway anatomy. We present the case report of a 31-yrs-old female presenting for elective day case surgery. She had a past medical history of Asperger Syndrome and T4 N0 spindle cell sarcoma of the left maxilla for which she had a left orbital exenteration and maxillectomy and left-sided neck dissection in 2004 with no anaesthetic complications. This was accompanied with post-operative radiotherapy which had left her with severe radiation trismus. Her American Society of Anaesthesiologists (ASA) grade was II and airway assessment found that she had moderate neck flexion and extension with a... Read More

Anaesthetic Management of a Case of Large Retroperitoneal Leiomyosarcoma

Image Leiomyosarcoma is an aggressive soft tissue sarcoma derived from smooth muscle cells typically of uterine, gastrointestinal or soft tissue origin. Leiomyosarcoma of soft tissue is thought to arise from the smooth muscle cells lining small blood vessels. It can also arise directly from the viscera, including the gastrointestinal tract and uterus. We present a case of large retroperitoneal leiomyosarcoma with close proximity to major blood vessels and left renal vessels involvement, for tumour excision and its anaesthetic management. A relatively long surgery with major blood loss along with the left nephrectomy made this procedure challenging for the anaesthesiologist in maintaining... Read More

The gastrointestinal tract bacterial flora

Image COMMENTARY An 83-year-old white male with past medical history of cerebrovascular accident, urinary incontinence with indwelling Foley catheter, atrial fibrillation, hyperlipidemia, systolic cardiomyopathy was brought by family for purple discoloration of Foley tubing and urinary bag for last 2 days (Figure 1). Patient complained of malaise and mild constipation. He had no history of trauma to the catheter. He denied fever, chills or dysuria. Physical examination was unremarkable with no suprapubic tenderness DISCUSSION Change of Foley catheter and treatment of underlying urinary tract infection form the mainstay of treatment of Purple Urine Bag Syndrome (PUBS). It is an interesting but... Read More

Anti-glomerular-basement membrane antibodies (anti-GBM)

Image Abstract Immune mediated injuries comprise a major bulk of renal disorders that mostly manifest as acute or chronic glomerulonephritides. Besides initial investigations for renal disorders, diagnosis of immune mediated renal diseases requires a battery of immunological tests and renal histopathology. The laboratory tests include anti-nuclear antibodies (ANA) followed by anti-double stranded deoxyribonucleic acid antibodies (antidsDNA) and/or anti-extractable nuclear antigens (anti-ENA), complement levels (C3, C4, factor H), rheumatoid factor (RF), C reactive proteins (CRP), anti-streptococcal antibodies including anti streptolysin-O titer (ASOT) and anti-deoxyribonuclease B (anti-DNAse B), anti-neutrophilcytoplasmic antibodies (ANCA), anti-glomerular-basement membrane antibodies (anti-GBM), cryoglobulins detection, anti-phospholipid antibodies, nephritic factor, anti-phospholipase A2... Read More

Undiagnosed ALCAPA presentation at the preoperative anesthesia clinic

Image Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly first described in 1908 and has an incidence of 0.26% of all cases of congenital heart diseases. Nearly 90% of patients die within one year if left untreated; however, a few patients can survive into adulthood. This depends on the inflow of blood to the left coronary artery (LCA) via collaterals from the right coronary artery (RCA). We report a case of a 45-year-old woman referred to the preoperative anesthesia clinic in April 2017 for a laparoscopic hysterectomy under general anesthesia. Anomalous origin... Read More

Use of methylene blue in hepatic arterial infusion pump resulting in serotonin syndrome. A case report

Image We report a case of a 35 year old woman with colon cancer metastatic to liver and lung who presented for exploratory laparotomy and/placement of hepatic arterial infusion pump for chemotherapy. Surgical course was notable for aberrant hepatic artery anatomy requiring extended dissection time, vascular surgery consultation, and use of substantial methylene blue to aid in visualization. Of note, patient’s history was also significant for anxiety and depression, for which she was being treated with the selective serotonin reuptake inhibitor (SSRI) duloxetine (Cymbalta). The patient subsequently developed serotonin syndrome in the postoperative period but fully recovered. Our case highlights the... Read More

Determinants Of Volume Status In Peritoneal Dialysis: A Longitudinal Study

Image ABSTRACT Aim In peritoneal dialysis (PD), fluid overload is frequent and associated with cardiac dysfunction and mortality. As it is considered a modifiable risk factor, we wished to describe clinical determinants of fluid overload in a longitudinal cohort of PD outpatients. Methods We consecutively included PD outpatients treated with CAPD or APD attending for their routine clinical visit at a single tertiary hospital. Extracellular water (ECW) to total body water (TBW) ratio was measured by multifrequency bioelectrical impedance (MFBIA). Peritoneal transport characteristics were measured with a standard peritoneal equilibration test. Patients had a second follow‐up visit with the same measurements.... Read More

Rituximab in maintaining remission in adults with Podocytopathy

Image Introduction Rituximab is currently used after the conventional agents have failed in the management of steroid dependent (SD)/ steroid resistant (SR) podocytopathies and have a safer toxicity profile. We report 53 adults with podocytopathies who were managed effectively with CD19‐targeted rituximab therapy. Methods This was a prospective study carried out at a tertiary care centre in India between January 2014 to June 2019. Adults between 16‐60舁years with SD, frequently relapsing (FR), and SR nephrotic syndrome (NS) due to podocytopathy received rituximab in a CD19‐targeted approach. Primary outcome: Percentage of patients who were in remission at 6 and 12 months. Secondary... Read More

Successful Anesthetic Management Of Parturient With Advanced Abdominal Pregnancy

Image Abdominal pregnancy is a rare form of ectopic pregnancy associated with high mortality and morbidity for both the fetus and the mother. It is often observed in developing nations with poor outcomes as most cases result in fetal demise. We present a 48 year old parturient diagnosed with abdominal pregnancy who elected to continue the pregnancy despite the communicated risks. The patient was admitted to the hospital at 24 weeks of gestational age for antepartum observation with the goal of surgical delivery at 28 weeks of gestation. General anesthesia was provided with multiple large bore intravenous access in anticipation of... Read More

New Protocol For Treatment Of Complex Regional Pain Syndrome

Image Complex regional pain syndrome is a rare condition that causesdebilitating pain and loss of mobility to one or more extremities. While multiple tools have been developed to diagnose this disease, the treatments currently employed are highly variable and the results are unpredictable. In order to address this, we did a review of the literature and created a standardized six week complex regional pain syndrome treatment protocol which included many treatments with proven benefit employed simultaneously. In this article, we present our brief literature review, our standardized protocol, and three case reports of patients who had successful treatment of their disease... Read More

Successful Management of an Emergent Cesarean Delivery in a Patient with History of Ross Procedure: A Case Report

Image Severe aortic valvular disease can be treated with valve replacement using an autologous pulmonary valve, also known as the Ross procedure. In young females who wish to bear children in the future, the Ross procedure may be a preferable option over mechanical or bioprosthetic valve replacement, as it offers long-term durability without the need for life-long anticoagulation. However, it is not without complications. Here in, we present the successful perioperative anesthesia management of a patient with history of Ross procedure and mitral valve bioprosthesis, with subsequent development of severe aortic insufficiency and moderate mitral stenosis, who delivered a preterm infant... Read More

Regional Anesthesia

Image Regional anesthesia is the use of local anesthetics to block sensations of pain from a large area of the body, such as an arm or leg or the abdomen. Regional anesthesia allows a procedure to be done on a region of the body without your being unconscious. Major types of regional anesthesia include: Peripheral nerve blocks: A local anesthetic is injected near a specific nerve or bundle of nerves to block sensations of pain from the area of the body supplied by the nerve. Nerve blocks are most commonly used for surgery on the arms and hands, the legs and... Read More

Efficacy of administration of oral liposomal iron after a period of intravenous iron carboxymaltose in two groups of chronic kidney disease patients: home hemodialysis and conservative therapy

Image Abstract Introduction: Anemia could be a frequent and early complication of Chronic nephropathy (CKD), and its prevalence will increase with the worsening of nephritic perform, involving over five hundredth of patients in predialysis (stage 5) and much nearly one hundred of patients in dialysis [1]. The administration of oral or blood vessel iron and glycoprotein (Epo) could be a key part for the correction of anemia each in patients with CKD and in patients on chronic dialysis. The aim of our work was to verify the effectiveness of oral liposomal iron in a very cluster of our home dialysis patients... Read More

Perioperative management of a caesarean section in a patient with isolated pulmonic stenosis and severe pre-eclampsia

Image The anaesthetic management of a parturient with isolated pulmonic stenosis and severe pre-eclampsia is particularly challenging. Each of this needs to be evaluated as a separate entity and managed in unison. The challenges that we faced were compounded by the urgent nature of Caesarean section in view of equivocal NST with meconium stained liquor. This provided us with little opportunity to evaluate the present cardiac status and the spectrum of manifestations of pre-eclampsia. Central venous and arterial access was promptly established to enable monitoring of fluid and hemodynamic status peri-operatively. Management of preeclampsia was initiated by the use of intra-venous... Read More

A systematic approach in the management of a high output ileostomy resulting in a favorable clinical outcome

Image High output ileostomy is not uncommon and when diagnosed, it should be managed expeditiously and systematically in order to prevent complications such as dehydration, electrolyte disturbance and acute kidney injury. A multi modal regimen consisting of correction of fluid and electrolyte deficit; restriction of oral hypotonic fluids with dietary modifications and use of anti-motility drugs was sequentially and concomitantly introduced to achieve a favourable clinical outcome. Patient education regarding dietary modifications and recognition of dehydration due to high output stoma is paramount. A co-ordinated multi-disciplinary approach involving the patient, family, dietician, community nurses and hospital doctor is vital. High output... Read More

A Quick Site to vascular Disease and Treatment

Image Journal of Vascular Diseases and Treatment is a comprehensive multidisciplinary journal that publishes peer-reviewed articles on an open access platform on the causes, and consequences of vascular diseases by laying a special emphasis on prevention, cure and rehabilitation in the wake of vascular disorder. Journal of Vascular Diseases and Treatment covers a broad spectrum of topics under this category for study by including cardiovascular abnormalities, cerebro-vascular, Reno-vascular and intestinal vascular diseases. The journal also focuses on topics like atrial fibrillation, mitral valve diseases, angina pectoris, myocardial infarction, atherosclerosis, cardiac arrest, pericarditis, cardiomyopathy, cardiac amyloidosis, and Aorta Disease.... Read More

Renal Diet

Image A renal diet is a diet that restricts foods which are high in sodium, potassium and phosphorus. The diet is recommended for people with late stages of chronic kidney disease and end-stage kidney disease. The diet attempts to reduce the build-up of micronutrients in the blood in order to prevent, arrhythmias, bone disorders, fluid overload, vascular calcification and hypertension. The renal diet is restrictive. Foods such as potatoes, orange juice, tomatoes, bananas, dairy products and processed meats should be avoided. Furthermore foods such as orange/ orange juice and avocados also contains a good dose of potassium therefore it’s recommended to... Read More

Heart Disease & Chronic Kidney Disease (CKD)

Image Heart disease can cause kidney disease, but kidney disease can also cause heart disease. Heart disease is the most common cause of death among people on dialysis. When your kidneys are not working well, they cannot support the other parts of your body as they should. This can cause problems with your heart. Heart disease often does not have any symptoms until your heart and blood vessels are badly damaged. The best way to prevent heart disease is to prevent the problems that can lead to it, such as anemia, high blood pressure and problems with calcium and phosphate levels.... Read More

End-of-Life Care

Image End-of-life care (or EoLC) refers to health care for a person with a terminal condition that has become advanced, progressive, and/or incurable. End-of-life care requires a range of decisions, including questions of palliative care, patients' right to self-determination (of treatment, life), medical experimentation, the ethics and efficacy of extraordinary or hazardous medical interventions, and the ethics and efficacy even of continued routine medical interventions. In addition, end-of-life often touches upon rationing and the allocation of resources in hospitals and national medical systems. Such decisions are informed both by technical, medical considerations, economic factors as well as bioethics. In addition, end-of-life... Read More

Dental Anesthesia

Image Dental anesthesia (or dental anaesthesia) is a field of anesthesia that includes local anesthetics, sedation, and general anesthesia. In dentistry, the most commonly used local anesthetic is lidocaine (also called xylocaine or lignocaine), a modern replacement for procaine (also known as novocaine). Its half-life in the body is about 1.5–2 hours. Other local anesthetic agents in current use include articaine (also called septocaine or ubistesin), bupivacaine (a long-acting anesthetic), Prilocaine (also called Citanest), and mepivacaine (also called Carbocaine or Polocaine). Different types of local anaesthetic drugs vary in their potency and duration of action. A combination of these may be... Read More

Purple Urine Bag Syndrome

Image An 83-year-old white male with past medical history of cerebrovascular accident, urinary incontinence with indwelling Foley catheter, atrial fibrillation, hyperlipidemia, systolic cardiomyopathy was brought by family for purple discoloration of Foley tubing and urinary bag for last 2 days (Figure 1). Patient complained of malaise and mild constipation. He had no history of trauma to the catheter. He denied fever, chills or dysuria. Physical examination was unremarkable with no suprapubic tenderness. Change of Foley catheter and treatment of underlying urinary tract infection form the mainstay of treatment of Purple Urine Bag Syndrome (PUBS). It is an interesting but unusual presentation... Read More

Role of immunology laboratory in diagnosing renal diseases

Image Immune mediated injuries comprise a major bulk of renal disorders that mostly manifest as acute or chronic glomerulonephritides. Besides initial investigations for renal disorders, diagnosis of immune mediated renal diseases requires a battery of immunological tests and renal histopathology. The laboratory tests include anti-nuclear antibodies (ANA) followed by anti-double stranded deoxyribonucleic acid antibodies (antidsDNA) and/or anti-extractable nuclear antigens (anti-ENA), complement levels (C3, C4, factor H), rheumatoid factor (RF), C reactive proteins (CRP), anti-streptococcal antibodies including anti streptolysin-O titer (ASOT) and anti-deoxyribonuclease B (anti-DNAse B), anti-neutrophilcytoplasmic antibodies (ANCA), anti-glomerular-basement membrane antibodies (anti-GBM), cryoglobulins detection, anti-phospholipid antibodies, nephritic factor, anti-phospholipase A2... Read More

Pain

Image Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain's widely used definition defines pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage". In medical diagnosis, pain is regarded as a symptom of an underlying condition. Pain motivates the individual to withdraw from damaging situations, to protect a damaged body part while it heals, and to avoid similar experiences in the future. Most pain resolves once the noxious stimulus is removed and the body has healed, but... Read More

Cesarean section

Image Caesarean section, also known as C-section, or caesarean delivery, is the use of surgery to deliver babies. A caesarean section is often necessary when a vaginal delivery would put the baby or mother at risk. Reasons for this may include obstructed labor, twin pregnancy, high blood pressure in the mother, breech birth, or problems with the placenta or umbilical cord. A caesarean delivery may be performed based upon the shape of the mother's pelvis or history of a previous C-section.  A trial of vaginal birth after C-section may be possible. The World Health Organization recommends that caesarean section be performed... Read More

Metabolic Syndrome and Chronic Kidney Disease

Image Metabolic syndrome and chronic kidney disease (CKD) have become global public health problems due to their increasing prevalence and their close associations with cardiovascular events. First recognised by Reavenin 1988, metabolic syndrome (previously known as syndrome X) is a complex pathophysiological issue and essentially considered as an assembly of cardiovascular and metabolic risk factors, which include abdominal obesity, dyslipidaemia, hypertension and insulin resistance/ hyperglycaemia components. Over the years, there have been several definitions of metabolic syndrome. In most of the epidemiological studies NCEP-ATP (National Cholesterol Education Program-Adult Treatment Panel III) criteria were used. Lastly, Harmonized (Consensus) Definition incorporating IDF (International... Read More

Emerging the Field of Clinical Nephrology

Image   Clinical Nephrology and Research is a multidisciplinary, open access, peer reviewed, scholarly journal that publishes original scientific manuscripts based on recent research innovations pertaining to the diagnosis and management of kidney diseases. The Editorial Board of the journal is over whelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in submissions of the scientific work in the mode of manuscripts. During this year we look forward to taking some initiatives that would encourage and reward our prospective audience which include clinicians, research... Read More

Anesthesia for Eye Surgery

Image Ocular surgery may be performed under topical, local or general anesthesia. Local anaesthesia is more preferred because it is economical, easy to perform and the risk involved is less. Local anaesthesia has a rapid onset of action and provides a dilated pupil with low intraocular pressure. History: Susruta Samhita has evidences of use of anaesthesia for ocular surgeries. Inhalational anaesthesia was used for this purpose. Egyptian surgeons used carotid compression to produce transient ischemia during eye surgery to reduce the perception of pain. In 1884, Karl Koller used cocaine for ocular surgery. The same year, Herman Knapp used cocaine for... Read More

Save time and Discover Emerging Anesthesia

Image On behalf of our esteemed journal Anesthesiology Case Reports (Pulsus group) we are here to announce that our journal is a monthly, peer-reviewed, open access journal, which is devoted to showcase all the relevant research information on anesthesia and its related case studies. The Editorial Board of the journal is over whelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in submissions of the scientific work in the mode of manuscripts. During this year we look forward to taking some initiatives that would... Read More

Glomerular Filtration Rate

Image Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal (kidney) glomerular capillaries into the Bowman's capsule per unit time. Central to the physiologic maintenance of GFR is the differential basal tone of the afferent and efferent arterioles (see diagram). In other words, the filtration rate is dependent on the difference between the higher blood pressure created by vasoconstriction of the input or afferent arteriole versus the lower blood pressure created by lesser vasoconstriction of the output or efferent arteriole. GFR is equal to the Clearance Rate when any solute is freely filtered and is neither reabsorbed... Read More

Renal function

Image Renal function is an indication of the kidney's condition and its role in renal physiology. Glomerular filtration rate (GFR) describes the flow rate of filtered fluid through the kidney. Creatinine clearance rate (CCr or CrCl) is the volume of blood plasma that is cleared of creatinine per unit time and is a useful measure for approximating the GFR. Creatinine clearance exceeds GFR due to creatinine secretion, which can be blocked by cimetidine. Both GFR and CCr may be accurately calculated by comparative measurements of substances in the blood and urine, or estimated by formulas using just a blood test result... Read More

Pain Management in Children

Image Pain management in children is the assessment and treatment of pain in infants and children. Pain management, pain medicine, pain control or algiatry, is a branch of medicine employing an interdisciplinary approach for easing the suffering and improving the quality of life of those living with chronic pain. The typical pain management team includes medical practitioners, pharmacists, clinical psychologists, physiotherapists, occupational therapists, physician assistants, nurses. The team may also include other mental health specialists and massage therapists. Types Acute: Usually, acute pain has an obvious cause and is expected to last for a few days or weeks. It is usually managed with... Read More

Trauma

Image Trauma surgery is a surgical specialty that utilizes both operative and non-operative management to treat traumatic injuries, typically in an acute setting. Trauma surgeons generally complete residency training in General Surgery and often fellowship training in trauma or surgical critical care. The trauma surgeon is responsible for initially resuscitating and stabilizing and later evaluating and managing the patient. The attending trauma surgeon also leads the trauma team, which typically includes nurses and support staff as well as resident physicians in teaching hospitals. Training: Most United States trauma surgeons practice in larger centres and complete a 1-2 year trauma surgery fellowship,... Read More

Dialysis

Image In medicine, dialysis (from Greek διάλυσις, Dialysis, "dissolution"; from διά, dia, "through", and λύσις, lysis, "loosening or splitting") is the process of removing excess water, solutes, and toxins from the blood in people whose kidneys can no longer perform these functions naturally. This is referred to as renal replacement therapy. Dialysis is used in patients with rapidly developing loss of kidney function, called acute kidney injury (previously called acute renal failure), or slowly worsening kidney function, called Stage 5 chronic kidney disease, (previously called chronic kidney failure, end-stage renal disease, and end-stage kidney disease). Dialysis is used as a temporary... Read More

Renal Cell Carcinoma

Image Renal cell carcinoma (RCC) is a kidney cancer that originates in the lining of the proximal convoluted tubule, a part of the very small tubes in the kidney that transport primary urine. RCC is the most common type of kidney cancer in adults, responsible for approximately 90–95% of cases. Initial treatment is most commonly either partial or complete removal of the affected kidney(s).Where the cancer has not metastasised (spread to other organs) or burrowed deeper into the tissues of the kidney, the five-year survival rate is 65–90%,but this is lowered considerably when the cancer has spread. The body is remarkably... Read More

Airway Management

Image Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. This ensures an open pathway for gas exchange between a patient's lungs and the atmosphere.This is accomplished by either clearing a previously obstructed airway; or by preventing airway obstruction in cases such as anaphylaxis, the obtunded patient, or medical sedation. Airway obstruction can be caused by the tongue, foreign objects, the tissues of the airway itself, and bodily fluids such as blood and gastric contents. Airway management is commonly divided into two categories: Basic and Advanced. Basic techniques are generally non-invasive and do... Read More

Cardiothoracic Anesthesiology

Image Cardiothoracic anesthesiology is a sub speciality of the medical practice of anesthesiology, devoted to the preoperative, intraoperative, and postoperative care of adult and Pediatric patients undergoing cardiothoracic surgery and related invasive procedures. It deals with the anesthesia aspects of care related to surgical cases such as open heart surgery, lung surgery, and other operations of the human chest. These aspects include perioperative care with expert manipulation of patient cardiopulmonary physiology through precise and advanced application of pharmacology, resuscitative techniques, critical care medicine, and invasive procedures. This also includes management of the cardiopulmonary bypass (heart-lung) machine, which most cardiac procedures require... Read More

Good pasture’s Syndrome

Image Good pasture syndrome (GPS), also known as anti-glomerular basement membrane disease, is a rare autoimmune disease in which antibodies attack the basement membrane in lungs and kidneys, leading to bleeding from the lungs and kidney failure. It is thought to attack the alpha-3 subunit of type IV collagen, which has therefore been referred to as Good pasture’s antigen. Good pasture syndrome may quickly result in permanent lung and kidney damage, often leading to death. It is treated with medications that suppress the immune system such as corticosteroids and cyclophosphamide, and with plasmapheresis, in which the antibodies are removed from the... Read More

Pyelonephritis

Image Pyelonephritis is inflammation of the kidney, typically due to a bacterial infection. Symptoms most often include fever and flank tenderness. Other symptoms may include nausea, burning with urination, and frequent urination. Complications may include pus around the kidney, sepsis, or kidney failure. It is typically due to a bacterial infection, most commonly Escherichia coli. Risk factors include sexual intercourse, prior urinary tract infections, diabetes, structural problems of the urinary tract, and spermicide use. The mechanism of infection is usually spread up the urinary tract.  Less often infection occurs through the bloodstream. Diagnosis is typically based on symptoms and supported by... Read More

What do anesthesiologists do?

Image An anesthesiologist is a doctor who gives a patient medication so they do not feel pain when they are undergoing surgery. However, these specialist physicians play a much wider role than just putting people to sleep for surgery. They are also involved in a range of other medical procedures, including carrying out assessments in critical care units, dealing with emergency situations, and giving advice about pain management. The anesthesiologist provides pain relief before, during and after surgery, but they also fulfill a number of other important roles. Pain relief in surgery Before an operation, a patient will meet... Read More

Palliative care

Image Palliative care (derived from the Latin root palliare, or “to cloak”) refers to an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex illness. Within the published literature, many definitions of palliative care exist; most notably, the World Health Organization describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.” Palliative... Read More

Hematuria

Image Hematuria (American English) or haematuria (British English) is a clinical sign. It is defined by the presence of blood or red blood cells in the urine. An anatomical framework is helpful in developing a comprehensive differential diagnosis. Blood or red blood cells can enter and mix with urine at multiple anatomical sites. These include the urinary system, female reproductive system, and integumentary system. Urinary causes occur anywhere between the kidney glomerulus and the urethral meatus. These can be divided into glomerular and non-glomerular causes. Non-glomerular causes can be further subdivided into upper urinary tract and lower urinary tract causes. After... Read More

When You Should See a Nephrologist?

Image Nephrologists are physicians who specialize in the diagnosis and treatment of kidney disease. What conditions are treated by a kidney doctor, and when is a referral to one of these specialists needed? If you haven't heard about nephrology (the study of kidney disease) before, it's not surprising. Chronic kidney disease (CKD) is often referred to as the "silent killer," as many people have mild symptoms or no symptoms at all when they are diagnosed. There are many different terms which can be used to describe kidney disease which can add to the confusion. As noted above, Nephrologists are doctors who... Read More

Geriatric Anesthesia

Image Geriatric anesthesia (or geriatric anaesthesia) is the branch of medicine that studies anesthesia approach in elderly. The perioperative care of elderly patients differs from that of younger patients for a number of reasons. Some of these can be attributed to the changes that occur in the process of aging, but many are also caused by diseases that accompany seniority. The distinction between so-called normal aging and pathological changes is critical to the care of elderly people. Anesthesia and surgery has become more common as the population survives longer. Perioperative management of the geriatric patients requires knowledge’s about changes associated with... Read More

Local anesthesia

Image Local anesthesia is any technique to induce the absence of sensation in a specific part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It allows patients to undergo surgical and dental procedures with reduced pain and distress. In many situations, such as cesarean section, it is safer and therefore superior to general anesthesia. It is also used for relief of non-surgical pain and to enable diagnosis of the cause of some chronic pain conditions. Anesthetists sometimes combine both general and local anesthesia... Read More

Kidney failure

Image Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys are functioning at less than 15% of normal. Kidney failure is classified as either acute kidney failure, which develops rapidly and may resolve; or chronic kidney failure, which develops slowly. Symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications of acute and chronic failure include uremia, high blood potassium, and volume overload. Complications of chronic failure also include heart disease, high blood pressure, and anemia. Causes of acute kidney failure include low blood pressure, blockage of the urinary tract,... Read More

Kidney Transplantation

Image Kidney transplantation or renal transplantation is the organ transplant of a kidney into a patient with end-stage kidney disease. Kidney transplantation is typically classified as deceased-donor (formerly known as cadaveric) or living-donor transplantation depending on the source of the donor organ. Living-donor kidney transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient. Exchanges and chains are a novel approach to expand the living donor pool. In February 2012, this novel approach to expand the living donor pool resulted in the largest chain in the world,... Read More

Pain Management

Image Pain management, pain medicine, pain control or algiatry, is a branch of medicine employing an interdisciplinary approach for easing the suffering and improving the quality of life of those living with chronic pain. The typical pain management team includes medical practitioners, pharmacists, clinical psychologists, physiotherapists, occupational therapists, physician assistants, nurses. The team may also include other mental health specialists and massage therapists. Pain sometimes resolves promptly once the underlying trauma or pathology has healed, and is treated by one practitioner, with drugs such as analgesics and (occasionally) anxiolytics. Effective management of chronic (long-term) pain, however, frequently requires the coordinated efforts... Read More

Anesthesia and Its Role in Clinical Sciences

Image Anesthesia or anaesthesia (from Greek "without sensation") is a state of controlled, temporary loss of sensation or awareness that is induced for medical purposes. It may include analgesia (relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss of memory), or unconsciousness. A patient under the effects of anesthetic drugs is referred to as being anesthetized. Anesthesia enables the painless performance of medical procedure that would otherwise cause severe or intolerable pain to an unanesthetized patient, or would otherwise be technically unfeasible. Three broad categories of anesthesia exist: General anesthesia suppresses central nervous system activity and results in... Read More

Glomerulonephritis

Image Glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis) is inflammation of the tiny filters in your kidneys (glomeruli). Glomeruli remove excess fluid, electrolytes and waste from your bloodstream and pass them into your urine. Glomerulonephritis can come on suddenly (acute) or gradually (chronic).  Glomerulonephritis occurs on its own or as part of another disease, such as lupus or diabetes. Severe or prolonged inflammation associated with glomerulonephritis can damage your kidneys. Treatment depends on the type of glomerulonephritis you have. Symptoms Signs and symptoms of glomerulonephritis depend on whether you have the acute or chronic form and the cause. Your first indication that something is wrong might... Read More

Urinary Tract Infection (UTI)

Image A urinary tract infection (UTI) is an infection in any part of your urinary system — your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra. Women are at greater risk of developing a UTI than are men. Infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a UTI spreads to your kidneys.Doctors typically treat urinary tract infections with antibiotics. But you can take steps to reduce your chances of getting a UTI in the first place. Symptoms: Urinary tract infections don't always cause... Read More

Perioperative care of cannabis users

Image The perioperative management of patients using cannabis, either for recreational or medical purposes, remains a challenge for the anesthesiologist due to its multi-organ side effects. However, the interactions between cannabinoids and general anesthetic agents, as well as the impact on intraoperative patient care are not yet fully understood. Discussing cannabis pharmacology and perioperative considerations for naïve and chronic users. The Endocannabinoid System: The Endocannabinoid System (ECS) is a biological system consisting of specific ligands, G protein-coupled cannabinoid receptors (CB-R), neurotransmitters and enzymes mediating the endocannabinoids synthesis and metabolism . N-arachidonoyl-ethanolamine (AEA; anandamide) and 2-arachidonoylglycerol (2-AG) are endocannabinoids (ECBs) synthetized from phospholipids of the... Read More

Cardiovascular and Thoracic Anesthesia

Image Lung-protective ventilation during cardiac surgery: Lung-protective ventilation strategies use low tidal volume (TV), low driving pressure, and positive end-expiratory pressure (PEEP). In a retrospective study of nearly 4700 patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), lung-protective ventilation was associated with fewer postoperative pulmonary complications (pneumonia, prolonged postoperative mechanical ventilation, need for reintubation, and/or poor oxygenation with arterial oxygen tension [PaO2]/fraction of inspired oxygen [FiO2] ratio <100 mmHg) compared with other ventilation strategies. A sensitivity analysis revealed that use of driving pressure <16 mmHg alone, but not PEEP or low TV, was also independently associated with fewer pulmonary complications. Although... Read More

Kidney stone disease

Image Kidney stone disease, also known as urolithiasis, is when a solid piece of material (kidney stone) develops in the urinary tract. Kidney stones typically form in the kidney and leave the body in the urine stream. A small stone may pass without causing symptoms. If a stone grows to more than 5 millimeters (0.2 in), it can cause blockage of the ureter, resulting in severe pain in the lower back or abdomen. A stone may also result in blood in the urine, vomiting, or painful urination. About half of people who have had a kidney stone will have another within... Read More

Clinical Nephrology and Research: Explore your Research Work-New Edition

Image Clinical Nephrology and Research [PULCNR] is a peer-reviewed journal that offers researchers and scholars in-depth useful reviews and research trials and surveys of new and novel approaches in the field of Clinical Nephrology and Clinical Sciences. Like the Anesthesia research, topics are diverse. Recent topics have included focussing on Clinical Nephrology Research: Clinical Nephrology Diabetic nephropathy Pediatric nephrology Renal replacement therapy Dialysis Renal transplantation Immunosuppressant management Each peer-reviewed issue assesses practice issues; practice settings; therapeutics issues; disease management; the latest research; as well as issues arising from today’s emerging health-care research. Journal Aim PULCNR... Read More

Post-obstruction pulmonary edema complicated by transient cardiac dysfunction in a young woman

Image A 17-year-old woman who had been healthy since birth developed postobstruction pulmonary edema (POPE) after maxillofacial surgery. She was extubated in a semi-conscious state after general anesthesia, and developed severe airway obstruction due to glossoptosis, and blood and secretions in the oral cavity. When the obstruction was released approximately 10 min later, the chest radiograph showed an increased cardiothoracic ratio, and cardiac ultrasonography showed a reduction in the left ventricular ejection fraction when compared to the normal values for the same age. A diagnosis of type-I POPE with associated left ventricular dysfunction was made, and oxygen and diuretic administration were... Read More

Anesthesiology Case Reports: Explore your Research Work-New Edition

Image Anesthesiology Case Reports [PULACR]  is a peer-reviewed journal that offers researchers and scholars in-depth useful reviews and research trials and surveys of new and novel approaches in the field of  Anesthesiology and Clinical Sciences. Like the Anesthesia research, topics are diverse. Recent topics have included focussing on Anesthesia Research: Anesthesiology Anesthetic drug administration Anesthetic practice Pharmacokinetics of anesthetic drugs Pre and postoperative disease complication Anesthetic drug industries Anesthestics Analgesia Critical care Emergency care Postoperative considerations Each peer-reviewed issue assesses practice issues; practice settings; therapeutics issues; disease management; the latest research; as well as issues... Read More

Facts of Immune Disorder and Therapy

Image The Journal of Immune Disorder and Therapy  is a peer-reviewed, open access Journal aims to publish the latest developments in Autoimmune diseases, Rheumatology, Dermatology, Endocrinology, Molecular genetics, Cell biology etc. Immune system has long been recognized as the authoritative reference for the most current, clinically relevant and highest quality research in the field of immunology. The immune system is made up of a network of cells, tissues, and organs that work together to protect the body against infection and maintain overall health. Vaccines like work by stimulating the immune system to produce antibodies against... Read More

Nephritic Syndrome

Image Nephritic syndrome is a collection of symptoms due to kidney damage. This includes protein in the urine, low blood albumin levels, high blood lipids, and significant swelling. Other symptoms may include weight gain, feeling tired, and foamy urine. Complications may include blood clots, infections, and high blood pressure. Causes include a number of kidney diseases such as focal segmental glomerulosclerosis, membranous nephropathy, and minimal change disease. It may also occur as a complication of diabetes or lupus. The underlying mechanism typically involves damage to the glomeruli of the kidney. Diagnosis is typically based on urine testing and sometimes a kidney... Read More

Polycystic Kidney Disease

Image Polycystic kidney disease (PKD or PCKD, also known as polycystic kidney syndrome) is a genetic disorder in which the renal tubules become structurally abnormal, resulting in the development and growth of multiple cysts within the kidney. These cysts may begin to develop in utero, in infancy, in childhood, or in adulthood. Cysts are non-functioning tubules filled with fluid pumped into them, which range in size from microscopic to enormous, crushing adjacent normal tubules and eventually rendering them non-functional as well. PKD is caused by abnormal genes which produce a specific abnormal protein; this protein has an adverse effect on tubule... Read More

Local Anesthesia and its evolution in Anesthesiology

Image Local anesthesia is any technique to induce the absence of sensation in a specific part of the body generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It allows patients to undergo surgical and dental procedures with reduced pain and distress. In many situations, such as cesarean section, it is safer and therefore superior to general anesthesia. It is also used for relief of non-surgical pain and to enable diagnosis of the cause of some chronic pain conditions. Anesthetists sometimes combine both general and local anesthesia... Read More

Trends in Anesthesiology

Image The core element of the specialty is the study and use of Anesthesia and Anesthetics to safely support a patient's vital functions through the perioperative period. Since the 19th century, anesthesiology has developed from an experimental area with non-specialist practitioners using novel, untested drugs and techniques into what is now a highly refined, safe and effective field of medicine. In some countries anesthesiologists comprise the largest single cohort of doctors in hospitals. Trends for the future of anesthesiology: Lower income(as adjusted for inflation): There will be multiple causes for this: a) An aging population, with the significantly... Read More

When Should You See a Urologist?

Image Urology is a branch of medicine that specializes in the medical and surgical aspects of the female and male urinary tract as well as the male reproductive system. Urologists usually focus on any of these 7 subspecialties: Calculi for stones in the urinary tract Female urology for pelvic outlet relaxation disorders and urinary incontinence Male infertility Neuro urology for erectile dysfunction and voiding disorders Pediatric urology Renal transplantation Urologic oncology, which deals with cancer Common Concerns That Need the Attention of a Urologist: 1)Recurrent Urinary Tract Infection: UTI or urinary tract infection, as its name suggests, is the... Read More

Cranberry Juice Superior at Preventing a Urinary Tract Infection

Image Researchers reveal that cranberry juice is much better at preventing biofilm formation, the precursor of a urinary tract infection, than cranberry extracts. Having scientific research now proving the age old wisdom that cranberries are able to prevent a urinary tract infection, experts questioned if there’s a component of the berry that, when extracted plus condensed, probably in pill form, could be as beneficial as drinking cranberry juice or eating the sauce in preventing a urinary tract infection. Researchers examined proanthocyanidins or PACs, a group of flavonoids present in cranberries. Since they were considered to be the ingredient which provides the... Read More

Advancements of Acute Pain Management in Anesthesia

Image Incorporation of acute pain modalities within anesthesia practices has greatly expanded over the years, and this has brought positive changes in patient care and physician payment. However, where new techniques become "standard of care," adjustments. As the preeminent provider of outsourced anesthesia billing and management services in America, we are always interested in how anesthesia providers are modifying their practices to take advantage of new pain management modalities and changing patient expectations. Anesthesia is not just focused on the operating room and the delivery suite. It is increasingly concerned with the entire perioperative episode. That includes the diagnosis and treatment... Read More

Obstetric Anesthesia: A Special Challenge for Anesthesiology Practices

Image Obstetric anesthesia is either a make-or-break service for anesthesia practices. Its unique aspects, including (a) the use of epidurals that don't require continuous attention, (b) the ability to manage multiple cases simultaneously, and (c) complex, diverse and inconsistent billing rules, make it a subject for special consideration. From a billing perspective, all anesthesia charges fall into three categories: time-based surgical anesthesia, obstetric (OB) analgesia and non-time-based charges, such as those for invasive monitoring, nerve blocks, and ultrasonic guidance and visit codes. Health plans tend to have policies that pay a contracted rate per unit for surgical anesthesia,... Read More

Call from Clinical Nephrology and Research: Open-Access (Volume 4: Issue: 1)

Image   Nephrology is a specialty practice addressing the protection, promotion, and optimization of health abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities and populations affected by kidney disease. Nephrology encompasses the primary, secondary, and tertiary care of individuals with potential and progressive chronic kidney disease (CKD), end-stage renal disease (ESRD), acute kidney injury (AKI), and other healthcare conditions requiring nephrologic intervention. Nephrology nursing practice spans the... Read More

Scope of Clinical Nephrology and Research in Medical Sciences

Image Our Journal Clinical Nephrology and Research (Pulsus Group) is a monthly, Peer reviewed and Open Access Journal which focuses on recent improvements and scientific advancements in the field of Clinical Nephrology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Clinical Nephrology. The Editorial Board of our journal over whelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in submissions of the scientific work in the mode of manuscripts. During this year we look forward to... Read More

Call from Anesthesiology Case Reports: Open-Access (Volume 3: Issue 1)

Image Anesthesiology is a recognized medical specialty. Anesthesiologists often work as perioperative physicians with responsibilities during the preoperative, intraoperative and postoperative periods to keep the patient comfortable and safe. Other recognized functions within the practice of anesthesiology include management of patients with acute and chronic pain, assisting in the management of cardiopulmonary resuscitation and advanced cardiac life support and the management of critically ill patients in intensive care units.  In today's medical environment with the increasing use of the Care Team Model to provide patient care services, anesthesiologists also provide onsite, immediately available medical direction of non-physician providers... Read More

Scope of Anesthesia in Clinical Sciences for a Better Medicine

Image Our Journal Anesthesiology Case Reports is a monthly, esteemed Open Access and Peer reviewed journal which focuses on recent improvements, advance scientific contributions in the field of anesthesiology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Anesthesiology and Anesthetics. Our Editorial Board members are over whelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in submissions of the scientific work in the mode of manuscripts. During this year we look forward to taking some initiatives... Read More

Call from Clinical Nephrology and Research to Join as Editorial Board Members

Image Our Journal Clinical Nephrology and Research (Pulsus Group) is a monthly, Peer reviewed and Open Access Journal which focuses on recent improvements and scientific advancements in the field of Clinical Nephrology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Clinical Nephrology. The Editorial Board of our journal over whelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in submissions of the scientific work in the mode of manuscripts. During this year we look forward to... Read More

Expertise your Scientific work in Clinical Nephrology and Research

Image Our Journal Clinical Nephrology and Research (Pulsus Group) is a monthly, Peer reviewed and Open Access Journal which focuses on recent improvements and scientific advancements in the field of Clinical Nephrology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Clinical Nephrology. The Editorial Board of our journal over whelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in submissions of the scientific work in the mode of manuscripts. During this year we look forward to... Read More

Call from Anesthesiology Case Reports to Join as Editorial Board Members

Image Anesthesiology Case Reports is a monthly, esteemed Open Access and Peer reviewed journal which focuses on recent improvements, advance scientific contributions in the field of anesthesiology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Anesthesiology and Anesthetics. Our Editorial Board members are over whelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in submissions of the scientific work in the mode of manuscripts. During this year we look forward to taking some initiatives that would... Read More

Call for all the Esteemed Authors to Expertise their Research in Field of Anesthesiology

Image Our Journal Anesthesiology Case Reports is a monthly, esteemed Open Access and Peer reviewed journal which focuses on recent improvements, advance scientific contributions in the field of anesthesiology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Anesthesiology and Anesthetics. Our Editorial Board members are over whelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in submissions of the scientific work in the mode of manuscripts. During this year we look forward to taking some initiatives... Read More

Clinical Trends in Clinical Nephrology and Research

Image Our Journal Clinical Nephrology and Research (Pulsus Group) is a monthly, Peer reviewed and Open Access Journal which focuses on recent improvements and scientific advancements in the field of Clinical Nephrology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Clinical Nephrology. Recent News: Clinico- Pathological Features and predictors of End-stage Renal Disease (ESRD) in C3 glomerulopathy: The term C3 glomerulopathy (C3G) describes renal disorders characterized by the presence of glomerular deposits composed of C3 in the absence of significant amounts of immunoglobulin (Ig). Histologic changes and predictors of renal... Read More

Recent Trends in Clinical Nephrology for Better World

Image Our Journal Clinical Nephrology and Research(Pulsus Group) is a monthly, Peer reviewed and Open Access Journal which focuses on recent improvements and scientific advancements in the field of Clinical Nephrology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Clinical Nephrology. Nephrology, branch of medicine concerned with the study of kidney functions and the treatment of kidney diseases. The first scientific observations of the kidney were made by Lorenzo Bellini and Marcello Malpighi in the middle of the 17th century, but true physiological understanding of the kidney began with Carl Ludwig’s 1844 hypothesis that blood pressure forces waste fluids out of the renal capillaries into... Read More

Recent Trends in Anesthesiology for Better Clinical World

Image Anesthesiology Case Reports is a monthly, esteemed Open Access and Peer reviewed journal which focuses on recent improvements, advance scientific contributions in the field of anesthesiology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Anesthesiology and Anesthetics. Recent News: Post-Partum Subdural Hematoma Revealed by Persistent Headache The subdural hematoma is an exceptional complication of the epidural analgesia following a dural breach causing by the leakage of cerebrospinal fluid (CSF). Its incidence after spinal anesthesia remains un determined. A case of subdural hematoma in a 36-year-old woman, G4P2A1, with a... Read More

Explore Your Ideas and Scientific Work in Anesthesia for Better Science

Image Anesthesiology Case Reports is a monthly, esteemed Open Access and Peer reviewed journal which focuses on recent improvements, advance scientific contributions in the field of anesthesiology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Anesthesiology and Anesthetics. In some countries anesthesiologists comprise the largest single cohort of doctors in hospitals, and their role can extend far beyond the traditional role of anesthesia care in the operating room, including fields such as providing pre-hospital emergency medicine, running intensive care units, transporting critically ill patients between facilities, and rehabilitation programs to optimize patients for surgery. Our esteemed... Read More

Clinical Nephrology and Research in Daily Life

Image Nephrology also studies systemic conditions that affect the kidneys, as diabetes and autoimmune disease; and systemic diseases that occur as a result of kidney disease, such as renal osteodystrophy and hypertension. A physician who has undertaken additional training and become certified in nephrology is called a nephrologist. The term "nephrology" was first used in about 1960. Before then, the specialty was usually referred to as "kidney medicine’’ Nephrology concerns the diagnosis and treatment of kidney diseases, including electrolyte disturbances and hypertension, and the care of those requiring renal replacement therapy, including dialysis and renal transplant patients. Our Journal Clinical Nephrology and Research(Pulsus Group) is a monthly, Peer reviewed and Open Access Journal which focuses... Read More

Clinical Nephrology and Research Marks its Journey by Announcing Discounts on Article Processing charges

Image Nephrology is a specialty of medicine and Pediatric medicine that concerns itself with the kidneys: the study of normal kidney function and kidney disease, the preservation of kidney health, and the treatment of kidney disease, from diet and medication to renal replacement therapy (dialysis and kidney transplantation). Our Journal Clinical Nephrology and Research (Pulsus Group) is a monthly, Peer reviewed and Open Access Journal which focuses on recent improvements and scientific advancements in the field of Clinical Nephrology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Clinical Nephrology. The Editorial Board of our journal over whelmed by the response and eagerness... Read More

Anesthesiology Case Reports- The Place to Expertise Inestimable Scientific Work

Image The core element of the specialty is the study and use of anesthesia and Anesthetics to safely support a patient's vital functions through the perioperative period. Since the 19th century, anesthesiology has developed from an experimental area with non-specialist practitioners using novel, untested drugs and techniques into what is now a highly refined, safe and effective field of medicine. Anesthesiology Case Reports is a monthly, esteemed Open Access and Peer reviewed journal which focuses on recent improvements, advance scientific contributions in the field of anesthesiology. Our Journal promulgates all the recent clinical practices that have taken part in the... Read More

Anesthesiological Practices in Daily Life Sciences

Image Anesthesiology, anaesthesiology, anaesthesia or anaesthetics is the medical speciality concerned with the total perioperative care of patients before, during and after surgery.                                                           It encompasses anesthesia, intensive care medicine, critical emergency medicine, and pain medicine. A physician specialised in this field of medicine is called anaesthesiologist. Anesthesiology Case Reports is a monthly, esteemed Open Access and Peer reviewed journal which focuses on recent improvements, advance scientific contributions in the field of anesthesiology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Anesthesiology and Anesthetics. Our Editorial Board members are over whelmed by the response and eagerness of the academic and research contributors to publish with... Read More

Immunology and public health

Image On behalf of the Journal of Immune Disorders & Therapy, as Editor-in-Chief, it is my distinct honour and privilege to inform you that, it’s been second years we have started the Journal, presently we are celebrating the 30th Anniversary and we are privileged to welcome Analytical Society to our journal. Success of the Journal and we are special to invite Analytical Society to our Journal. As Editor-In-Chief it is my great pleasure and honour to welcome you to the Journal of Immune Disorders & Therapy. The Journal of Immune Disorders & Therapy act... Read More

Clinical Practices in Nephrology To Build A Better Health For Tomorrow

Image Our Journal Clinical Nephrology and Research(Pulsus Group) is a monthly, Peer reviewed and Open Access Journal which focuses on recent improvements and scientific advancements in the field of Clinical Nephrology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Clinical Nephrology. The Editorial Board of our journal over whelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in submissions of the scientific work in the mode of manuscripts. During this year we look forward to taking... Read More

Recent Clinical Nephrology Practices for A Better World

Image Clinical Nephrology and Research is a multidisciplinary, open access, peer reviewed, scholarly journal that publishes original scientific manuscripts based on recent research innovations pertaining to the diagnosis and management of kidney diseases. The Editorial Board of the journal is over whelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in submissions of the scientific work in the mode of manuscripts. During this year we look forward to taking some initiatives that would encourage and reward our prospective audience which include clinicians, research scientists,... Read More

Clinical Anesthesia Practices To Improve World Of Clinical Sciences For Better Future

Image Anesthesiology Case Reports is a monthly, esteemed Open Access and Peer reviewed journal which focuses on recent improvements, advance scientific contributions in the field of anesthesiology. Our Journal promulgates all the recent clinical practices that have taken part in the field of Anesthesiology and Anesthetics. Our Editorial Board members are over whelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in submissions of the scientific work in the mode of manuscripts. During this year we look forward to taking some initiatives that would... Read More

Anesthesiology Clinical Practice for a Better Tomorrow

Image On behalf of our esteemed journal Anesthesiology Case Reports (Pulsus group) we are here to announce that our journal is a monthly, peer-reviewed, open access journal, which is devoted to showcase all the relevant research information on anesthesia and its related case studies. The Editorial Board of the journal is over whelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in submissions of the scientific work in the mode of manuscripts. During this year we look forward to taking some initiatives that would... Read More

International Journal of Clinical Rheumatology

Image International Journal of Clinical Rheumatology is committed to distribute most elevated quality studies identified with clinical determination and administration of rheumatic ailments through facilitated parts of clinical consideration and clinical examination concentrated on propelling treatment and personal satisfaction for individuals with joint pain, immune system infections, bone issue, and related conditions. We feel contended to announce that our journal is successfully running in its Volume 14. We have successfully released special issues in our journal entitled Regenerative Medicine in Osteoarthritis and Epidemiology of Osteoporosis. Below are some most viewed articles in our journal. A novel treatment of knee degenerative... Read More

Surgery: Case Report Marks its Decade Long Journey by Announcing Hefty Discounts on Article Processing

Image The editorial team of  Surgery: Case Report are overwhelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in the year-long celebrations. During this year we look forward to taking some initiates that would encourage and reward our prospective customers. It gives us great pleasure in announcing the call for paper on the 4th Anniversary of the Journal at special and hefty discount of up to 20-30 percent on one-time article processing charge based on type of article. ... Read More

Journal of Clinical Genetics and Genomics accelerating scientific discovery in Genetics & Genomics

Image Journal of Clinical Genetics and Genomics is an open access publication aimed at understanding how genetic mutations in specific genes affect the phenotype, and how this information might be harnessed to develop new approaches to therapy. By means of the studies published, this journal aims to bridge the gap between the lab and the  healthcare centers. The Journal of Clinical Genetics and Genomics places... Read More

Imaging in Medicine celebrates 10 successful years and rewards researchers with hefty discounts on APC

Image To commemorate its 10th Anniversary, Imaging in Medicine (Pulsus Ltd), an Open access journal has announced 30 percent of discount on article processing charge. Open access publishers generally accept payments for article processing, web-hosting and online archiving.   The editorial team of “Imaging in Medicine” is overwhelmed by the response and eagerness of the academic and research contributors to publish with the journal and take part in the year-long celebrations. During this year we look forward to taking some initiates that would encourage and reward our prospective customers. It gives us great pleasure in announcing the... Read More

Journal of Reproductive Biology and Endocrinology Would Like To Celebrate the Occasion of Coining Its Fourth Volume

Image The “Journal of Reproductive Biology and Endocrinology” has successfully completed its three volumes and successfully entering into the fourth by 2020. On this occasion, we heart fully invite research scholars, academicians, students and scientists to publish their research findings with this journal and get best in class services. The journal has taken a strong resolution to serve its readers and authors by including the best in class advertising strategies to enhance the author’s scholarly visibility and readability. Having established in the year 2016, “Journal of Reproductive Biology and Endocrinology” achieved good readership and honor from the... Read More

Journal of Blood Disorders and Treatment celebrates its 2nd Anniversary by offering Massive Discounts in Article Processing Charges.

Image Journal of Blood Disorders and Treatment is peer-reviewed, open access, scholarly journal. It mainly aims at publishing the latest advancements in the field, enriching our understanding of blood disorders such as: Clotting Disorders, Anemias, Hematologic Malignancies, Coagulopathies, Thrombotic Disorders, Hemoglobinopathies, Lymphoproliferative Disorders, Plasma Cell Disorders,and Immunologic and Genetic Disorders of the blood. The journal offers a platform for dissemination of information on all aspects of blood-related disorders such as prevention, diagnosis, and management of these disorders. Open access publishers generally accept payments for article processing, web-hosting and online archiving. Journal of... Read More

INTERNATIONAL JOURNAL OF ANATOMICAL VARIATIONS CELEBRATES MORE THAN 10 YEARS OF MEDICAL RESEARCH PUBLICATION

Image International Journal of Anatomical Variations celebrates more than 10 years of its existence in the field of medical publishing and research and extends a very warm welcome to all the authors, researchers, editors, doctors, medical professionals, scientists and student to contribute their latest research findings as full length articles to this International Journal of Anatomical variation. The journal is committed to serve its readers authors by adding the state of the art facilities to enhance the author’s scholarly visibility. International Journal of Anatomical variation is established in the year 2008, one of the most reputed journals of PULSUS... Read More