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Watch Shuddh Desi Romance Hindi Movie online full video, trailers, first look photos. The movie will be released in theatres in.Introduction {#sec1-1}
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In patients with end stage renal disease, the accumulation of urea and other nitrogen waste products in the body leads to metabolic acidosis, hence end stage renal failure (ESRF). Ammonia is metabolized within the liver to urea, therefore, to maintain acid-base balance, the kidneys excrete about 60% of the body’s circulating ammonia. So, patients with ESRF require regular dialysis, the aim of which is to remove urea and other nitrogen waste products, thereby, improving acid-base balance. Ammonia is a toxin which can be directly toxic to the body or can be converted into other nitrogen waste products. Ammonia is freely filtered in the glomeruli and all other reabsorbed in the renal tubules. Therefore, the modalities which can help in decreasing the amount of ammonia in the body are; 1) its low protein diet, 2) removal of toxins with haemodialysis, 3) low salt diet, 4) reduced protein and purine intake.
Case Report {#sec1-2}
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A 61-year-old male, farmer by occupation, presented to our hospital with swelling on dorsum of right hand for 1 month, pain, numbness of index finger of right hand and weakness of right hand for 2 weeks, pain in lower abdomen for last 3 days, no visual disturbances and pain on auscultation of right side of abdomen. There was no history of paresthesia, change in bowel habit, nausea, vomiting, or alteration in the rate of micturition. The past history and family history was not significant. On examination, the patient was dyspnoeic and had decreased hearing in the right ear. Systolic murmur was heard over lower chest. Rest of the systemic and local examinations were normal. The patient had a pulse rate of 80/min, blood pressure of 110/70 mmHg, afebrile, normal white blood cell count, ESR of 80 mm/hour, C-reactive protein (CRP) of 8.84
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