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Point-of-care ultrasound (POCUS) has evolved in recent years in clinical practice, helping in early bedside diagnosis of important etiologies. Many medical schools and training programs are integrating POCUS into their curriculum. Especially with the technological advances of newer handheld ultrasound devices, POCUS has now become a component adjunct to clinical examination, in the clinic and bedside in critical care units. The diagnostic utility of POCUS lies both in early identification of critical kidney disease, and also extra-renal pathologies from a focused cardiac ultrasound, lung ultrasound, and integrated fluid assessment. There is a need to incorporate POCUS in training in pediatric nephrology and establish competency standard criteria. This review shall cover how POCUS helps in enhancing patient care in pediatric kidney disorders and critical children, and the recent advances., Author(s): Sidharth Kumar Sethi [sup.1] , Rupesh Raina [sup.2] , Abhilash Koratala [sup.3] , Afagh Hassanzadeh Rad [sup.4] , Ananya Vadhera [sup.5] , Hamidreza Badeli [sup.4] Author Affiliations: (1) grid.429252.a, [...]

Background AKI is an important complication post cardiac surgery in children. An early diagnosis can help in mitigating complications and allow for prognostication. Urinary albumin:creatinine ratio (ACR) as a biomarker can provide a cheaper and more accessible AKI risk assessment and prediction. There is a paucity of paediatric literature regarding its utility. Methods This was a prospective observational study, enrolling all children aged 1 month to 18 years, who underwent cardiac surgery, with use of cardiopulmonary bypass. Cohort was divided into groups 75.8 mg/g) predicted post-operative AKI after adjusting for clinical variables (adjusted RR, 11.71; 1.85-16.59). In the group aged 141.3 mg/g) predicted post-operative AKI in unadjusted analysis but not after adjusting for clinical variables (RR, 2.78; 0.70-6.65). For AKI risk prediction, AUC (95% CI) was highest after combining clinical model and pre-operative ACR for groups aged < 2 years [0.805 (0.713-0.896)] and [greater than or equal to] 2 years [0.872 (0.772-0.973)]. Conclusions This study provides evidence for use of albuminuria as a feasible biomarker in AKI prediction in children post cardiac surgery, especially when added to a clinical model. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information., Author(s): Arushi Nautiyal [sup.1] , Sidharth Kumar Sethi [sup.2] , Rajesh Sharma [sup.3] , Rupesh Raina [sup.4] , Abhishek Tibrewal [sup.4] , Romel Akole [sup.3] , Aditi Gupta [sup.5] , [...]

Background and objectives Dialysis disequilibrium syndrome (DDS) is a rare neurological complication, most commonly affecting patients undergoing new initiation of hemodialysis (HD), but can also be seen in patients receiving chronic dialysis who miss regular treatments, patients having acute kidney injury (AKI), and in those treated with continuous kidney replacement therapy (CKRT) or peritoneal dialysis (PD). Although the pathogenesis is not well understood, DDS is likely a result of multiple physiological abnormalities. In this systematic review, we provide a synopsis of the data available on DDS that allow for a clear picture of its pathogenesis, preventive measures, and focus on effective management strategies. Methods We conducted a literature search on PubMed/Medline and Embase from January 1960 to January 2021. Studies were included if the patient developed DDS irrespective of age and gender. A summary table was used to summarize the data from individual studies and included study type, population group, age group, sample size, patient characteristics, blood and dialysate flow rate, and overall outcome. A descriptive analysis calculating the frequency of population size, symptoms, and various treatments was performed using R software version 3.1.0. Results A total of 49 studies (321 samples) were identified and analyzed. Out of the included 49 studies, a total of 48 studies reported the presence of DSS among patients (1 study reported based on number of dialysis and therefore was not considered for analysis). Among these 48 studies, 74.3% (226/304) patients were reported to have DSS. The most common symptoms were nausea (25.2%), headache (24.8%), vomiting (23.9%), muscle cramps (18.1%), affected level of consciousness (8.8%), confusion (4.4%), and seizure (4.9%) among the 226 DDS patients. Furthermore, 12 studies decided to switch from HD to alternative dialysis modalities including continuous venovenous hemofiltration/hemodiafiltration (CVVH/CVVHDF) or PD which reported no DDS symptoms. Conclusion Early recognition and timely prevention are crucial for DDS patients. We have provided comprehensive clinical practice points for pediatric, adolescent, and young adult populations. However, it is essential to recognize that DDS was reported more frequently in the early dialysis era, as there was a lack of advanced dialysis technology and limited resources., Author(s): Rupesh Raina [sup.1] [sup.2] [sup.3] , Andrew Davenport [sup.4] , Bradley Warady [sup.5] , Prabhav Vasistha [sup.1] , Sidharth Kumar Sethi [sup.6] , Ronith Chakraborty [sup.1] [sup.2] , Prajit [...]

Author(s): Sidharth Kumar Sethi [sup.1] , Maninder Dhaliwal [sup.2] , Veena Raghunathan [sup.2] , Hritik Raaj [sup.3] , Samit Kumar Mahato [sup.3] , Ananya Vadhera [sup.3] , Marie-Agnes Dragon-Durey [sup.4] [...]

Author(s): Sidharth Kumar Sethi [sup.1] , Shalini Goel [sup.2] , Ananya Vadhera [sup.3] , Hritik Raaj [sup.3] , Samit Kumar Mahato [sup.3] , Pranaw Kumar Jha [sup.4] , Shyam Bihari [...]

Author(s): Sidharth Kumar Sethi [sup.1] , Abhyuday Rana [sup.2] , Shyam Bihari Bansal [sup.2] , Alka Rana [sup.3] , Dinesh Kumar Yadav [sup.2] , Kritika Soni [sup.2] , Marie-Agnès Dragon-Durey [...]

Author(s): Sidharth Kumar Sethi [sup.1] , Maninder Dhaliwal [sup.2] , Veena Raghunathan [sup.2] , Hritik Raaj [sup.3] , Samit Kumar Mahato [sup.3] , Ananya Vadhera [sup.3] , Marie-Agnes Dragon-Durey [sup.4] [...]

Author(s): Sidharth Kumar Sethi [sup.1] , Shalini Goel [sup.2] , Ananya Vadhera [sup.3] , Hritik Raaj [sup.3] , Samit Kumar Mahato [sup.3] , Pranaw Jha [sup.4] , Shyam Bansal [sup.4] [...]

Wide ranges of age and weight in pediatric patients makes renal replacement therapy (RRT) in acute kidney injury (AKI) challenging, particularly in the pediatric intensive care unit (PICU), wherein children are often hemodynamically unstable. Standard hemodialysis (HD) is difficult in this group of children and continuous veno-venous hemofiltration/dialysis (CVVH/D) has been the accepted modality in the developed world. Unfortunately, due to cost constraints, CVVH/D is often not available and peritoneal dialysis (PD) remains the common mode of RRT in resource-poor facilities. Acute PD has its drawbacks, and intermittent HD (IHD) done slowly over a prolonged period has been explored as an alternative. Various modes of slow sustained IHD have been described in the literature with the recently introduced term prolonged intermittent RRT (PIRRT) serving as an umbrella terminology for all of these modes. PIRRT has been widely accepted in adults with studies showing it to be as effective as CVVH/D but with an added advantage of being more cost-effective. Pediatric data, though scanty, has been promising. In this current review, we elaborate on the practical aspects of undertaking PIRRT in children as well as summarize its current status., Author(s): Rajiv Sinha [sup.1] , Sidharth Kumar Sethi [sup.2] , Timothy Bunchman [sup.3] , Valentine Lobo [sup.4] , Rupesh Raina [sup.5] Author Affiliations: (1) 0000 0004 1801 0469, grid.414710.7, Institute [...]

Author(s): Sidharth Kumar Sethi [sup.1] , Arushi Nautiyal [sup.1] , Alka Rana [sup.2] , Rajan Duggal [sup.3] , Ashish Nandwani [sup.1] , Dinesh Yadav [sup.1] , Amit Mahapatra [sup.1] , [...]

Author(s): Sidharth Kumar Sethi [sup.1] , Norma Maxvold [sup.2] , Timothy Bunchman [sup.2] , Pranaw Jha [sup.1] , Vijay Kher [sup.1] , Rupesh Raina [sup.3] Author Affiliations: (1) grid.429252.a, 0000000417644857, [...]

Author(s): Sidharth Kumar Sethi [sup.1] , Abhyuday Rana [sup.2] , Shyam Bihari Bansal [sup.2] , Alka Rana [sup.3] , Dinesh Kumar Yadav [sup.2] , Kritika Soni [sup.2] , Marie-Agnès Dragon-Durey [...]

Author(s): Sidharth Kumar Sethi [sup.1] , Nikita Wadhwani [sup.1] , Pranaw Jha [sup.1] , Rajan Duggal [sup.2] , Reetesh Sharma [sup.1] , Shyam Bansal [sup.1] , Vijay Kher [sup.1] Author [...]

Author(s): Rupesh Raina [sup.1] [sup.2] , Sidharth Kumar Sethi [sup.3] , Timothy Bunchman [sup.4] Author Affiliations: (1) grid.413473.6, 0000 0000 9013 1194, Department of Nephrology, Akron Children's Hospital, , Akron, [...]

Author(s): Vivek Sharma [sup.1] , Sidharth Kumar Sethi [sup.2] , Rupesh Raina [sup.3] , Shyam Bansal [sup.2] , S. S. Baijal [sup.1] , Vijay Kher [sup.2] Author Affiliations: (1) grid.429252.a, [...]

Author(s): Vivek Sharma [sup.1] , Sidharth Kumar Sethi [sup.2] , Rupesh Raina [sup.3] , Shyam Bansal [sup.2] , S. S. Baijal [sup.1] , Vijay Kher [sup.2] Author Affiliations: (1) grid.429252.a, [...]

Author(s): Sidharth Kumar Sethi[sup.1] , Edgar A. Otto[sup.2] , Sara Ma[sup.2] , Rajan Duggal[sup.3] , Virginia Vega-Warner[sup.2] , Vijay Kher[sup.4] Author Affiliations: (1) Pediatric Nephrology, Medanta Kidney and Urology Institute, [...]

Author(s): Sidharth Kumar Sethi [sup.1] , Arushi Nautiyal [sup.1] , Alka Rana [sup.2] , Rajan Duggal [sup.3] , Ashish Nandwani [sup.1] , Dinesh Yadav [sup.1] , Amit Mahapatra [sup.1] , [...]

Author(s): Sidharth Kumar Sethi [sup.1] , Nikita Wadhwani [sup.1] , Pranaw Jha [sup.1] , Rajan Duggal [sup.2] , Reetesh Sharma [sup.1] , Shyam Bansal [sup.1] , Vijay Kher [sup.1] Author [...]

Author(s): Sidharth Kumar Sethi[sup.1] , Edgar A. Otto[sup.2] , Sara Ma[sup.2] , Rajan Duggal[sup.3] , Virginia Vega-Warner[sup.2] , Vijay Kher[sup.4] Author Affiliations: (1) Pediatric Nephrology, Medanta Kidney and Urology Institute, [...]

Sirs, With the availability of the newer web tools in Web 3.0, such as Blogs, Wikis, Twitter and Podcasts, physicians are able to interact and disseminate vital information to fellow [...]

Sirs, With the recent Haiti earthquake causing significant morbidity and mortality [1], it is now time to look back and analyse our readiness for disaster management. Contrary to our expectations [...]

Sirs, Web 3.0 has brought physicians together in a more dynamic, interactive space, with a new spirit of open sharing and collaboration. The new generation of Internet services and devices [...]