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Research Us in CRF

Research Us in CRF

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Published by kamal_ismaeel2028

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Published by: kamal_ismaeel2028 on Jul 19, 2009
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02/05/2013

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CHAPTER ONE 
1
 
Synopsis.
(Proposal of renal ultrasound in chronic renal failure)
Introduction
Ultrasound is recognized as an important adjunct to clinical examination in care of  patients with many common illnesses.The WHO “goal of health for all” recommended that many of the U/S examinations will be performed at the first referral level ; it is now a routine examination in Obstetrics &Gynaecology.As there is no ionizing radiation, it should be the preferred method of imaging whenever it can aid to reach a diagnosis.Although C/T Scanning has superceded U/S in many aspects of diagnosis, still U/S remains avery useful, easy, safe, quick, non-invasive, available, and relatively inexpensive technique.Chronic renal failure is a common disease nowadays everywhere and appears in U/Swith strict criteria ; so it is easily diagnosed by U/S ; and the True Cut Needle Biopsy of thekidney is performed under sonographic guidance.Skill, proper training and experience is mandatory to making an accurate diagnosis from U/Simages.
The Problem of the study
The kidney is affected in a vast variety of diseases e.g. congenital anomalies, calculi,hydronephrosis, solid renal masses, cystic renal diseases, and medical renal diseases such as pyelonephritis, glomerulonephritis, nephrotic syndrome, acute and chronic renal failure.My thesis will be dealing with renal U/S in chronic renal failure.
Objectives
1. To find the incidence of CRF in patients coming with different renal complaints inSudanese population i.e. to sort out CRF patients from one hundred selected differentrenal disease patients and to show the role of ultrasound in their diagnosis2. To find out how many of them are already on dialysis ? how many of them needdialysis ? how many need transplantation ?
2
 
Hypothesis
It is expected that U/S is a good tool in diagnosing CRF which will help in early management..
Methodology
It is a field work practical study. I will select one hundred patients with different renal problemsand find out how many of them are suffering from CRF and show the classical sonographicappearances of CRF in the selected cases.Different US equipments with varying facilities will be used namely Aloka SSD 500, ToshibaCEE / ECC, Shimadzu SDU-350, Medison 1500 etc…
Data Collection
Will be done by evaluating one hundred patients, in my full-time private clinic in Sinnar city and in sinnar teaching hospital renal unit and in Gezira renal teaching hospital, who suffer from renal disease especially CRF, and who differ in sex, age, occupation, social status, andeconomic status. The sources of data collection will be the patients data sheets which will beespecially for thesis needs (questionnaire) . In addition to request forms which will include the patient’s complaints and the physician’s clinical findings. The variables of data collection are thekidneys, ureters, and urinary bladder.Scanning technique of the kidney requires : a full bladder, Liberal amount of coupling jellon the upper abdomen, A 3.5 MHz transducer for adults and a 5.0 MHz for children and thinadults, Using the liver as an acoustic window, the right kidney is best seen in supine position indeep inspiration. Scan over right upper abdomen in a longitudinal axis then rotate the patient tothe left lateral decubitus position then angle the beam as necessary and adjust the gain to obtainthe best image of the renal parenchyma in this coronal view. The left kidney is scanned in asimilar sequence using the spleen as an acoustic window.The methods for data analysis will be by computer, summarizing, classifying, and thenanalyzing the collected data sheets. Complex tables will be used and carried out in the study.The relationship between different variables, and the important statistical indicaters will bedrawn from the study.The area for the study will be in the different diagnostic U/S centers at Wadmedani –Universityof Gezira-Renal Unit, and at the renal unit in Sinnar hospital, and in my full time private clinic
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