Health literacy is the capacity of an individual to understand information related to a disease in order to make an informed decision. In patients with kidney diseases, studies have reported increasing impact of limited health literacy on health outcomes. Our paper discusses current literature on health literacy in kidney diseases.

Hypertriglyceridemia is the etiology of acute nonbiliary pancreatitis in up to 3% of patients. Along with the supportive treatment of acute pancreatitis, treating the precipitating cause is important as well. There have been reports where heparin and insulin have been used for acute reduction of triglycerides, although there are no established guidelines for efficacy of these modalities. Heparin and insulin decrease triglycerides by stimulating lipoprotein lipase activity, which degrades triglycerides into fatty acids and glycerol. We present a case where a 54-year-old male presented with hypertriglyceridemia-induced acute pancreatitis. The serum triglyceride level was 10,320 mg/dl (normal: 0–15 mg/dl) at the time of admission. We started the patient on intravenous insulin and heparin infusion, and within 24 h of induction of treatment, the levels decreased by 50% to 5407 mg/dl. Thus, heparin and insulin can be considered a safe treatment modality for rapidly reducing triglyceride levels.

Oral health status of HIV positive individuals is in poor condition which may be a sequela of variety of factors. This study was aimed at assessing and comparing the oral health status and oromucosal lesions between HIV positive and negative individuals in India. A total of 126 HIV positive and 532 HIV negative individuals were recruited for the study. Oral health status and oromucosal lesions were recorded using WHO oral health assessment form (1997). Data was analyzed using chi-square and independent sample student's t test. Majority (85.7%) of people suffering from HIV belonged to lower socioeconomic status. The mean for DMFT score was found to be significantly higher in HIV positive individuals (12.83 ± 9.6) as compared to HIV negative individuals (8.34 ± 7.6) (P value < 0.0001). Nearly 75% of HIV positive individuals showed oromucosal lesions with candidiasis (36%) being the most common. Nearly 50% of HIV positive individuals had community periodontal index (CPI) and loss of attachment (LOA) score >2. In conclusion HIV positive individuals have poor oral health status and poor periodontal status compared to control group. Effective policies need to be drafted to take care of the oral health of this high risk group.

BackgroundInterest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents.MethodsThis was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology.Results131 (80.9%) of 162 residents completed the survey. 19 (14.8%) residents indicated interest in a nephrology career, with 8 (6.3%) indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2) and residents who were not (Group 1). The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed), practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed), and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed). More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04), whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02).ConclusionsThe initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents’ interest in nephrology careers. Residents endorsed several negative perceptions of nephrology, which may affect career choice.