Background: Uremic pruritus is a common and troublesome symptom of chronic kidney disease. It is one of the dominant dermatological manifestations of chronic kidney disease which affects the quality of life of patients. Objective: To assess the prevalence and severity of uremic pruritus in chronic kidney disease patients undergoing maintenance hemodialysis. Methodology: A prospective cross-sectional study was done over three months among chronic kidney patients undergoing maintenance hemodialysis to show the association of mineral bone disorders with uremic pruritus. Patients complaining of pruritus were taken as cases and then pruritus was quantifi ed using a Visual Analogue Scale. Results: 144 patients participated in this study, out of which 41 (28.47%) were females. Mean age was 54.97±9.75 years and 68.06% patients were on dialysis. Uremic pruritus was seen in 80 patients (55.56%), amongst them 23 patients (28.75 %) had severe pruritus as measured by Visual Analogue Scale.Uremic pruritus was more frequent and more severe in patients having higher serum phosphorus levels (p =0.004). Conclusion: This study further substantiates the need of adequate control of phosphorus levels in hemodialysis patients to reduce complications like uremic pruritus.

Objective: To know the efficacy of Bronchoalveolar Lavage (BAL) in establishing diagnosis and its impact on overall health status of the patients. Methods: A single center, longitudinal study involving 40 patients aged > 18 years old with septic shock with similar baseline characteristics was conducted. Two study arms, 20 patients in intervention arm - patient with utilization of Bronchoscopy and BAL in aiding diagnosis and 20-patients in conservative- arm without Bronchoscopy were compared in terms of establishing diagnosis primarily and secondarily in terms of length of stay and 30-day mortality. We were able to identify following organisms in BAL sample: Mycobacterium tuberculosis- 4, Acinetobacter baumanii- 3, Pseudomonasaeruginosa- 2, Klebsiella oxytica- 2, E. coli- 2, Streptococcus pneumoniae- 2, Staphyloccus aureus- Results: We were able to identify various infectious agents as mentioned above 16/20 in BAL group compared to 8/20 in conventional arm; neoplasm in 4 out of 20 subjects in BAL group. In 80% of cases, BAL helped in identifying the organisms compared to only 40% in tracheal aspirate group. In addition, six cases in Intervention arm vs. nine cases in conventional arm had more than > 14 days hospital stay with the p-value 0 .492091. Interventional arm had lesser mortality 5 cases vs. 7 cases in Conventional arm with the p-value of 0.490153 which was not statistically significant. Conclusion: We conclude that the diagnostic bronchoscope and related procedures among critically ill patients are helpful in identifying the pathogens and in detecting malignancy.

Varicella pneumonia is uncommon among adults and can present as potentially life-threatening complications of varicella. Here we report a case of a 43-year-old man with no known history of chronic disease and no allergic history who presented to our hospital emergency department with widespread skin eruptions over the entire body and hemoptysis. Varicella pneumonia was diagnosed based on the patient being in contact with his 6-year-old son who had contracted chickenpox 10 days back, typical cutaneous lesions, pulmonary symptoms and radiographic findings. The patient was treated with oral acyclovir and was admitted to the intensive care unit for monitoring. The patient recovered completely after 10 days of treatment.