ABSTRACT
Background: Sepsis is an important healthcare concern in India as well as globally. This study shows how the level of microalbuminuria predict mortality of patients diagnosed with sepsis and those without sepsis. Methods: In this study total 150 patients of which 75 patients belonging to each sepsis and non-sepsis group, with age >15 years admitted in Medical Intensive Care Unit (ICU) were enroled Microalbuminuria levels were analyzed at admission and after 24 hours after admission. Results: Microalbuminuria levels were significantly high in patients with sepsis as compared to non sepsis. Microalbuminuria has highest sensitivity of 90 % and specificity of 98 % to differentiate between sepsis and non sepsis in comparison to APACHE II and SOFA scores. Conclusion: Serial monitoring of bedside urine albumin-creatinine measurement might help in the early identification of patients with sepsis that requires early targeted therapy. The 24-hour ACR assessment predicts ICU survival and may have the potential to monitor the efficacy of therapeutic interventions delivered, such as fluid resuscitation, appropriate antibiotics, vasopressors, and ionotropes that affect the endothelium.
ABSTRACT
Background: Osteoporosis is commonly associated with chronic liver disease. Pathologic fracture in osteoporotic patients affects quality of life as well as decrease life expectancy. Around 40% of patients with chronic liver disease may experience osteoporotic fracture. The present study was undertaken to observe the relation of bone mineral density (BMD) with severity of liver cirrhosis along with effects of smoking and alcohol.Methods: A total of 187 liver cirrhosis patients who were admitted in SMS Hospital were taken for study and were classified into class A, B, C as per Child Turcot Pugh’s classification, after applying inclusion and exclusion criteria. All patients underwent standard laboratory testing and bone densitometric studies of the lumbar spine using dual X-ray absorptiometry (DEXA) scan. Statistical analysis done.Results: The bone mineral density was significantly low in Class C. Class C have 41 patients of osteoporosis out of 62 whereas only 16 patients have osteoporosis in Class B and only 1 case of osteoporosis in class A. Hypocalcemia and hypophosphatemia were more in class C as in comparison to class A and B. Also, chronic smoking and alcohol intake were strongly associated with the severity of cirrhosis.Conclusions: The prevalence of osteopenia and osteoporosis is higher in cirrhotic patients and significantly increases with severity. Hypocalcemia and hypophosphatemia are also associated with the cirrhosis. Thus, patients should undergo routine bone densitometry assessment and, if necessary, to be treated for osteoporosis
ABSTRACT
Background: The primary objective of the study was to assess serum free testosterone and high sensitivity c-reactive protein concentrations and their correlation with hematocrit in patients of diabetes mellitus type 2. Hypogonadotropic hypogonadism is a common defect in type 2 diabetes, irrespective of the glycemic control, duration of disease, and the presence of complications of diabetes or obesity. It has been demonstrated that about one third of male patients with diabetes mellitus type 2 have low serum free Testosterone level. Methods: We have included 50 patients of diabetes mellitus type 2 presenting to the department of medicine SMS Hospital Jaipur. Both indoor and out door patients were selected who were free of microalbuminuria and diabetic nephropathy. Primary or secondary hypogonadism, other than diabetes mellitus and anemia of other causes were ruled out. Results: Diabetes mellitus type 2 patients with low serum free testosterone levels have significantly low hematocrit values ( n= 29) (p-value <0.001) and mild anemia compared to eugonadal men ( n= 21). Their correlation was highly significant. Patients with DM type 2 who have low serum free testosterone, also have high hs-CRP concentration. Though hematocrit values were low in patients with high hs-CRP concentration but it was not statistically significant. Conclusion: At the end of the study we concluded that both a low serum free testosterone level and high hs-CRP concentration may play an important role in the pathogenesis of mild anemia and low hematocrit values in DM type 2 patients.