First Page-1

Manuscript Type : Single Case Study
SUCCESSFUL MANAGEMENT OF DIALYSIS DEPENDENT

Title :
CHRONIC KIDNEY DISEASE WITHOUT SURGICAL
MEASURES - A CASE STUDY
Author Name : Dr Kaushal Patel,

PG Scholar 2nd year, PG department of Panchkarma, J S Ayurveda Mahavidyalaya.
ORCID : 0009-0004-0703-1384
Address : Ramjimandir Falia, Ramnath, Po Delol, Ta Kalol, Panchmahals, Gujarat, 389310
Email : Patelkaushal6372@gmail.com
Author Name : Prof Dr Kalapi Patel,

Principal and superintendent, H.O.D, PG department of Panchkarma, J S Ayurveda
Mahavidyalaya and P D Patel Ayurveda Hospital
ORCID : 0000-0001-9563-7423
Address : “Indraprasth” Meditimba,Po.Nanavada,Ta-Malpur,Dist.Sabarkantha-383345
Email : drkalapi@rediffmail.com
Author Name : Dr Chintan Bhatt,

Assistant professor, PG department of Panchkarma, J S Ayurveda Mahavidyalaya.
ORCID :
Address : A-22 sanidhya bunglows, opposite saishav school, gotri sevasi road, Gotri, Vadodara -
390021
Email : chintanbhatt25091991@gmail.com
Acknowledgements
We would like to express our gratitude to all those who contributed to the completion of this case
report. First and foremost, we extend our heartfelt thanks to the patient who generously allowed
us to share their medical journey for the benefit of others.
We would like to acknowledge the healthcare professionals involved in the patient's care, whose
expertise and dedication played a crucial role in the successful management of this case. Their
collaborative efforts and commitment to patient well-being have been invaluable.
Furthermore, we appreciate the support and guidance provided by our colleagues and mentors,
whose insights and feedback greatly enriched the content of this report.
Lastly, we extend our thanks to the medical community for fostering an environment of
continuous learning and knowledge sharing. It is through these collaborative efforts that we can
enhance our understanding of medical conditions and improve patient care.
This case report would not have been possible without the collective contributions of all those
mentioned above. We are truly grateful for their involvement and support.
Presentation(s) or Awards at a meeting : The findings presented in this case report have not
been previously shared at any other meeting or conference. This represents the first presentation
of the material, and the authors are pleased to contribute novel insights to the field.
Source(s) of Support and Funding : The authors declare that there was no external source of
support or funding for the research, development, or publication of this case report. This work
was conducted without financial assistance or sponsorship from any organization, and the
authors have not received any grants, honoraria, or other forms of support related to this study.
Conflict of Interest statement : The authors declare that there is no conflict of interest
regarding the publication of this case report. We affirm that we have no financial, personal, or
professional interests that could influence the objectivity, integrity, or impartiality of the content
presented in this manuscript.
Consent to Participate : The patient featured in this case report has provided written informed
consent for their participation. The consent encompasses the use of their medical information,
diagnostic images, and any other relevant details necessary for the understanding and publication
of this case report. The patient is aware that their identity will be kept confidential, and all efforts
will be made to anonymize any potentially identifiable information.
Patients’ consent form :
Name of Investigators: Dr. Kaushal D. Patel, Prof. Dr. Kalapi B. Patel, Dr Chintan Bhatt
Name of the Institution: J. S. Ayurveda Mahavidyalaya & P. D. Patel Ayurved Hospital,
Nadiad.
Name and address of the sponsoring (funding) agency: N. A.
Documentation of the informed consent form
Name of the participant: __________________________________________________
I, ___________________________________________________declare that the Informed

Consent Booklet has been given to me. After reading, all the remaining questions have been
answered. I am well informed about the following topics regarding the study:
 Purpose of the study
 Number of patients that are going to be enrolled
 Emerging treatment period and number of assessments
 Procedures of the treatment and assessments and my responsibilities
 Experimental aspects and involvement of research
 Risks and inconveniences
 Expected benefits
 Alternatives
 Compensation for study related injury
 Voluntary participation with every time possibility of withdrawal
 Direct access to records
 Confidentiality
 Getting new information timely
 Reasons for termination
 Duration
 After completion of study
 Instruction about diet
 Contact person
An impartial witness read the Informed Consent Booklet and attended the informed consent
process.
I fully agree to enroll into the study.
Name and signature/thumb impression of the participant (or legal representative if participant
incompetent):
(Name) _______________________________ (Signature) __________________________
Date: __________ Time: ________
Name and signature of impartial witness (required for illiterate patients):
(Name) _______________________________ (Signature) __________________________
Date: __________ Time: ________
Name and signature of the Investigator or his representative obtaining consent:
(Name) _______________________________ (Signature) __________________________
Date: __________ Time: ________
Investigator Certificate
I certify that all the elements including the nature, purpose and possible risks of the
above study as described in this consent document have been fully explained to the subject
(in Hindi / Gujarati language, if patient don’t understand English). In my judgment, the
participant possesses the legal capacity to give informed consent to participate in this research
and is voluntarily and knowingly giving informed consent to participate.
Signature of the Investigator:
________________________________________Date:_____________
Name of the Investigator:
____________________________________________________________
Ethical Approval and/or Institutional Review Board (IRB) Approval are to be submitted within this
file document.

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Manuscript Type : Single Case Study

SUCCESSFUL MANAGEMENT OF DIALYSIS DEPENDENT

Author Name : Dr Kaushal Patel,

Author Name : Prof Dr Kalapi Patel,

Author Name : Dr Chintan Bhatt,

Name of the participant: __________________________________________________

I, ___________________________________________________declare that the Informed

 Purpose of the study

 Number of patients that are going to be enrolled

 Emerging treatment period and number of assessments

 Procedures of the treatment and assessments and my responsibilities

 Experimental aspects and involvement of research

 Risks and inconveniences

 Compensation for study related injury

 Voluntary participation with every time possibility of withdrawal

 Direct access to records

 Getting new information timely

 Reasons for termination

 After completion of study

 Instruction about diet

I fully agree to enroll into the study.

(Name) _______________________________ (Signature) __________________________

Date: __________ Time: ________

Name and signature of impartial witness (required for illiterate patients):

(Name) _______________________________ (Signature) __________________________

Date: __________ Time: ________

Name and signature of the Investigator or his representative obtaining consent:

(Name) _______________________________ (Signature) __________________________

Date: __________ Time: ________

Signature of the Investigator:

Name of the Investigator:

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