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Limited data suggest that children often have mild and asymptomatic disease, but some do require hospitalization. In a report from China, of the total infections, 2.4% were children. Although most children infected with SARS-CoV-2 have either asymptomatic (4%), mild illness (51%), or moderate illness (39%), severe illness has been reported in 6% of pediatric cases. The incubation period is similar to that of adults. This article briefly outlines SARS CoV-2 Infection in Children.

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Chronic kidney disease (CKD) is an irreversible progressive health problem often associated with cardiovascular complication, bone mineral metabolism disorder, uremic toxin deposition, and immune dysregulation. The gut microbiome is an important modulator of immune function and performs a plethora of functions inside the host body. Several factors such as diet, antibiotic use, environmental pollutant modulates the composition of Gut microbiota. An intervention with dietary substances may be a therapeutic strategy to modulate the healthy Gut microbiota composition and slowing the progression of CKD.

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Malnutrition refers to abnormalities induced by an inadequate diet, whereas wasting refers to abnormalities that cannot be corrected solely by increasing the diet.^[6] Although these entities are different in their etiopathogenesis somewhat, both share some common features such as low serum albumin, prealbumin, and body mass index. Although these entities are different in their etiopathogenesis somewhat, both share some common features such as low serum albumin, prealbumin, and body mass index. Hence, subjective and objective assessment of PEW and intervention for correctible factors must be carried out routinely.

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Objective: The objective is to assess the prevalence of malnutrition and its associated factors in adult patients on hemodialysis (HD). Patients and Methods: A total of 271 participants (149 males and 122 females) from four major dialysis units were included in this descriptive cross-sectional study conducted from October 2020 to March 2021. Nutritional status was measured using a subjective global assessment tool. The anthropometric indices, body mass index (BMI), and biochemical parameters, including albumin and electrolytes, were also measured in all patients. Results: The overall prevalence of estimated nutritional status was as follows: 50.2% were well-nourished, 42.4% were mildly/moderately malnourished, and 7.4% were severely malnourished. The primary etiology of kidney disease was mostly due to hypertension (38.7%) and diabetes (32.8%). No significant association was detected with regard to age, sex, residence, marital status, occupation, and cause of kidney disease (P > 0.05). Higher educational level, lower BMI, and serum albumin were significantly associated with malnutrition (P < 0.02, <0.005, and <0.02, respectively). Conclusion: Approximately 50% of the adults on HD had variable degrees of malnutrition. BMI and serum albumin levels were significantly associated with the state of malnutrition. Comprehensive clinical nutrition services and counseling should be incorporated into the structure of HD units under the care of a dedicated nutritionist.

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Background: Chronic kidney disease (CKD) is a growing health problem worldwide. Uremic toxin buildup caused by protein bacterial metabolites such as indoleamines, urea, and indoxyl sulfate contribute to dysbiosis in the gut microbiome in hemodialysis patients, which contributes to a pro-infiammatory environment. Aims: This systematic review of the literature considers the confiicting evidence on probiotic supplementation and infiammatory status in CKD patients receiving hemodialysis. Methods: PubMed, EBSCO, and Google Scholar were all used to search for control/clinical trials demonstrating the effects of probiotic supplementation on these protein bacterial metabolites and C-reactive protein (CRP) levels. Results: Four of the five studies observed no significant findings in the reduction of infiammatory status in this population. One study demonstrated a significant reduction in CRP levels after 3 months of probiotic supplementation. Many articles varied between using single and multiple strains of bacteria which contributed to limitations to the studies. There was limited supporting evidence to suggest that probiotic supplementation could reduce infiammatory status in hemodialysis patients. Conclusions: Based on the findings, more research is needed before any conclusive recommendations can be made on whether probiotic supplementation would be beneficial for patients receiving hemodialysis treatments.

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Chronic kidney disease (CKD) has evolved into a major noncommunicable disease in India due to both increased incidence and diagnosis. It is believed to affect <10% of adult population who are at excess risk of cardiovascular (CV) and renal morbidity and mortality. The incidence of end-stage renal disease is about 152 per million which is driven by diabetes, hypertension, and chronic glomerulonephritis. In later stages of CKD, phosphate (P) retention is the rule with its myriad pathological links to vascular calcification and CV mortality. This article focuses on protein intake and P restriction in CKD.

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The rapid spread of coronavirus disease 2019 (COVID-19) to pandemic proportions since March 2020 has placed enormous pressure on health-care workers worldwide. India was placed on a nationwide lockdown from March to May 2020 and is gradually opening up with regard to travel and businesses. India is the third worst-hit country in the world after the United States and Brazil with 2.1 million documented cases. Coronavirus 2 infection is commonly associated with acute kidney injury in severe cases. The rapid spread of coronavirus has strained and stretched our health-care system, in particular, nephrology service to previously unknown dimensions. This has affected the normal routine of clinical training and necessitated a change in the approach to medical education. Apart from the training perspective, the stress on account of changes in clinical rotation, fear of contracting COVID-19, and uncertainty about the future course of disease and job prospects affects mental health of residents. This brief review explores the impact of such curtailed clinical activities and teaching and the possible approaches to nephrology teaching during the pandemic.

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Malnutrition is prevalent in patients on hemodialysis. About 18%–75% of patients with chronic kidney disease, undergoing maintenance dialysis, show evidence of wasting. The genesis of malnutrition in hemodialysis patients is multifactorial and comprises reduced dietary nutrient intake, metabolic derangements associated with uremia, and the adverse effects of hemodialysis and other concurrent morbid conditions. In spite of much progress done in recent years in recognizing the pathomechanistic link between malnutrition and mortality, consensus regarding the therapeutic strategies to deal with nutrition-related clinical problems is lacking. Protein–energy wasting (PEW) is the most influential risk factor for adverse outcomes and death. Nutritional supplementation (orally or parenterally) is useful in the management of PEW.

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