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1.
Rev. bras. ciênc. vet ; 28(2): 111-116, abr./jun. 2021. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1367979

ABSTRACT

Objetivou-se no presente estudo comparar as técnicas de coleta de urina via sondagem uretral e cistocentese guiada por ultrassom, afim de verificar se o método de coleta pode influir nos resultados laboratoriais. Foram utilizados 12 cães machos, sem histórico de enfermidades, dos quais coletou-se cinco mililitros (mL) de urina via sondagem uretral e cinco mL via cistocentese guiada por ultrassom, ambas no mesmo momento. Posteriormente foi realizada a análise física (cor, odor, densidade, turbidez), química (urobilinogênio, glicose, corpos cetônicos, bilirrubina, proteína, nitrito, pH, sangue e leucócitos) e sedimentoscopia (avaliação de 10 campos de luz, objetiva de 40x). Cilindros urinários, cristais, corpúsculos gordurosos, espermatozoides, bactérias e células vesicais foram classificados qualitativamente como: ausentes (0), discretos (1), moderados (2) e intensos (3). Hemácias, leucócitos, e células de descamação foram quantificadas a partir da média dos campos analisados. As análises bioquímicas de microalbuminúria, creatinina e proteína total urinárias foram realizadas a partir do sobrenadante urinário, removido das amostras após centrifugação, e utilizados kits reagentes, conforme recomendação do fabricante, sendo a leitura em espectrofotômetro. Em todos os testes realizados os valores de p encontrados foram superiores 0,05 (p>0,05), excluindo-se a possibilidade de haver diferenças significativas dos resultados laboratoriais obtidos pelas duas formas de coleta.


The objective of this study was to compare two techniques of urine collection, urethral catheterization and ultrasound-guided cystocentesis, in order to verify if the collection method may influence the laboratory results. Twelve male dogs were used, with no history of diseases, of which five milliliters (mL) of urine were collected by urethral catheterization and five mL by both at the same time. Subsequently, the samples underwent physical analysis (color, smell, density andturbidity), chemical analysis (urobilinogen, glucose, ketone bodies, bilirubin, protein, nitrite, pH, blood and leukocytes) and sedimentoscopy (evaluation of 10 light fields, 40x objective). Urinary casts, fatty corpuscles, spermatozoa, bacteria and bladder epithelial cells were classified qualitatively as absent (0), discrete (1), moderate (2) and intense (3). Red blood cells, leukocytes and desquamation cells were quantified from the mean of the analyzed fields. The urine supernatants were obtained after centrifugation and were used for biochemical analyzes of microalbuminuria, urinary protein and creatinine. The reagent kits were used as recommended by the manufacturer and the samples were read by spectrophotometry. All tests presented p values higher than 0,05 (p>0,05), excluding the possibility of significant differences between the laboratory results of both forms of urine collection.


Subject(s)
Animals , Dogs , Urinary Catheterization/veterinary , Urinary Reservoirs, Continent/veterinary , Urinalysis/veterinary , Dogs/urine , Urine Specimen Collection/methods , Biochemical Reactions/analysis
2.
Arch. endocrinol. metab. (Online) ; 64(6): 720-725, Nov.-Dec. 2020. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1142202

ABSTRACT

ABSTRACT Objective: Evaluate ferritin levels in children and adolescents with type 1 diabetes mellitus and its relation to diabetic microvascular complications, and metabolic control. Subjects and methods: This study included 180 children and adolescents with type 1 diabetes mellitus (T1DM) with a mean age of 14.9 ± 3.1 years and 180 apparently normal children matched for age and sex (control group). All children were evaluated with full history taking, thorough clinical examination, laboratory assessment of high-sensitivity C-reactive protein and hemoglobin A1c (HbA1c), and evaluation of the presence of microvascular complications. Serum ferritin levels were measured using electrochemiluminescence immunoassay. The patients were divided into two groups according to the presence or absence of microvascular complications. Results: Serum ferritin levels were significantly higher in patients with T1DM in both groups compared with healthy controls (p < 0.001). Additionally, patients with microvascular complications had higher serum ferritin concentrations than those without microvascular complications (p < 0.001). Patients with microalbuminuria showed higher ferritin levels compared with patients without microalbuminuria (p < 0.05). Stepwise regression analysis revealed that levels of HbA1c and urinary albumin excretion were independently related to ferritin levels (p < 0.001 for both). On receiver operating characteristic (ROC) curve analysis, a ferritin cutoff value of 163.6 ng/mL differentiated patients with microvascular complications from those without microvascular complications with a sensitivity of 92.1% and specificity of 93.4%. Conclusion: Serum ferritin levels are elevated in T1DM, particularly in patients with microvascular complications.

3.
Article | IMSEAR | ID: sea-211024

ABSTRACT

Background: Recent advancements in diagnostic modalities for microalbuminuria have shown that urinaryexcretion of albumin is more in hypertensive patients as compared to subjects with normal blood pressure.Microalbuminuria is known to be associated with certain complications like dyslipidemia, cardiac complications,atherosclerosis and kidney disease. Purpose: To analyze the prevalence of microalbuminuria and its clinicalcorrelation with essential hypertension. Material and Methods: The study was of cross-sectional design,which was carried out in outpatient and inpatient departments of Medicine in DY Patil Medical School andHospital, Nerul, Navi Mumbai. Results: Out of total 190 study participants 96 were normotensive controls,while 94 were hypertensive patients. Mean age in control group was 48 ± 9.4 years, while that in hypertensivegroup, it was 49.2 ± 10.2 years. The 24 hours mean urinary excretion of albumin in hypertensive patients withmicroalbuminuria was found to be 80.21, while it was 12.91 and 7.89 in hypertensive patients withoutmicroalbuminuria and control groups, respectively. Conclusion: Early screening to detect microalbuminuriain early stages will help to initiate appropriate treatment regimen and prevent the risk of complications and thusimprovement in prognosis.

4.
Article | IMSEAR | ID: sea-204671

ABSTRACT

Background: Sickle cell disease prevalence is more in central part of India. This study tries to find extent of renal involvement, risk factors and screening tests in sickle cell disease.Methods: Study was Cross sectional observational study. Demographic and clinical findings were recorded. Renal function tests like serum creatinine, blood urea nitrogen, eGFR were studied. Presence of microalbuminuria was checkeed. Ultrasonography abdomen was done to see the texture and corticomedullary differentiation of kidney.Results: Total 143 patients were studied. Out of which, 117 homozygous (SS type), 26 heterozygous (AS type). Majority belonged to school going age group (i.e. 5 to 10 year age group) with male preponderance in homozygous state. Microalbuminuria was more common in crisis state (61.84% in SS pattern and 83.33% in AS pattern) as compared to steady state in both SS and AS pattern patients. Dipstic method detected more proteinuria than heat coagulation suggesting dipstick method superior to heat coagulation test. Low eGFR was common in patients with SS pattern as compared to patients with AS pattern and was significantly associated with microalbuminuria in both steady state and crisis state. Abnormal USG was seen 3.44% in patients with SS pattern. Renal involvement started below 5 years of age and then increases with age, homozygous childrens in crisis state are affected more.Conclusions: Renal involvement is common in sickle cell anemia i.e it is seen in 50% of the patients. Increasing age, male sex and homozygous state were risk factors. Simple test like dipstic method and heat coagulation test can be used as screening test to detect microalbumiburia, with dipstic method being superior. Presence of microalbuminuria can detect early renal involvement in sickle cell disease. This will help in early diagnosis and management of such patients which avoids further renal complications and thus prevents mortality and morbidity.

5.
Article | IMSEAR | ID: sea-212169

ABSTRACT

Background: Metabolic syndrome includes a constellation of various metabolic abnormalities that have been associated with cardiovascular disease, stroke and all-cause mortality in the general population. It has now been established that it is also associated with renal dysfunction. This study was done to assess renal function in metabolic syndrome in Indian population as well as its correlation with different parameters of the metabolic syndrome.Methods: A cross-sectional study was conducted in a university hospital from 2014 - 2015. Renal functions were studied in 100 obese individuals, 50 with and 50 without metabolic syndrome after informed consent and the results were analysed.Results: 100 obese individuals, 50 with and 50 without metabolic syndrome were compared. All underwent a physical examination and relevant investigations. All parameters of renal function showed significant derangement in cases as compared to controls. 38 patients (76%) among the cases (N=50) of metabolic syndrome had altered renal functions versus 9 patients (18%) among controls (n=50). Individually, there was a significant correlation of altered renal function (reduced estimated glomerular filtration rate eGFR and presence of microalbuminuria) with fasting blood glucose and systolic blood pressure (p=0.001), diastolic pressure (p=0.003) and triglyceride levels (p=0.036). High density lipoprotein-cholesterol levels did not show a significant correlation.Conclusions: Obese individuals with metabolic syndrome have significant derangement of renal functions as compared to those without metabolic syndrome. Most parameters of the syndrome are also independently associated with alteration of renal functions.

6.
Article | IMSEAR | ID: sea-202864

ABSTRACT

Introduction: Microalbuminuria has relationship on thedevelopment of coronary heart disease and it may identify asa new risk factor of this disease. The MA happens more oftenin diabetic patients with AMI but it has been reported evenin non –diabetic patients with AMI. The aim of the presentstudy was to assess the prevalence of microalbuminuria innon diabetic and non hypertensive patients suffering fromAMI. To evaluate the relationship between MA and AMI innon- diabetic and non hypertensive patients admitted in ICCUcardiology department at Rajshree Medical Research InstituteBareilly (UP).Matereial and methods: The study was carried out in thedepartment of Biochemistry and ICCU in RMRI, Bareilly(UP) to establish the correlation between MA with 50non diabetic, non hypertensive patients of AMI and in50 healthy age matched controls. MA was determined byimmunoturbidimetric method and plasma glucose weremeasured by enzymatic method.Result: There was a significant increase in the level of MA inpatients with AMI who were non diabetic, non hypertensive ascompare to those in the healthy control.Conclusion: MA may have an association with AMI inabsence of traditional risk factors like diabetes and HTN. SoMA can be used as an adjunct biochemical parameter in nondiabetic, non hypertensive AMI patients.

7.
Article | IMSEAR | ID: sea-200780

ABSTRACT

This study was aimed at investigating the nutrient and bioactive components of Annona muricataand Fagara zanthxoyloidefrom south-southern Nigeria. The roots and leaves of these plants were collected from communities within this region and an analysis of the phytochemical, mineral and vitamin components of these plant parts were carried out using standard methods. The results of the investigation revealed the a high presence of alkaloids (27.34 ± 0.15 and 12.98 ± 0.98), flavonoids (19.66 ± 0.04 and 3.71 ± 0.46) and phenols (15.10 ± 0.11 and 0.07 ± 0.42) in the leaves and roots of Annona muricatawhile alkaloids (35.55 ± 0.95 and 50.90 ± 0.83), tannins (28.70 ± 0.19 and 55.37 ± 0.47) and terpenoids (18.23 ± 0.08 and 41.21 ± 0.16) were observed in leaves and roots of Fagara zanthoxyloide. Mineral analysis revealed the presence of iron (20.23 ± 0.01 and 5.21 ± 0.02), calcium (3.67 ± 0.06 and 1.59 ± 0.01), copper (2.17 ± 0.011 and 0.16 ± 0.01) and magnesium (3.04 ± 0.01 and 2.18 ± 0.005) in leaves and roots of Annona muricataand iron, copper (2.53 ± 0.011and 7.38 ± 0.017) and zinc (5.16 ± 0.02 and 5.32 ± 0.011) in leaves and roots of Fagara zanthoxyloide.The leaves and roots of both plants also showed the presence of folate (26.82±0.48 and 23.47±0.03 for A. muricata and 15.82±0.18 and 20.63±0.91 for F. zanthoxyloide) and ascorbate (31.97±0.03and 26.89±0.19 for A. muricataand13.86±0.13 and 30.21±0.01for F. zanthoxyloide) in appreciable quantities while vitamins D, E and K were also observed in minute concentrations in both plant samples. These results may thus suggest that these plants from this region as a result of their rich nutrients and bioactive compositions may play a large role in alleviating the salient nutritional, physiological and medical challenges observed among people within this region.

8.
Article | IMSEAR | ID: sea-194636

ABSTRACT

Background: Microalbuminuria is a marker of endothelial dysfunction and an important risk factor for cardiovascular diseases. Microalbuminuria may be seen due to hypoxemia in patients with chronic obstructive pulmonary disease (COPD). The objectives were to study the presence of microalbuminuria in patients with chronic obstructive pulmonary disease and to determine the relationship of microalbuminuria with severity of COPD using GOLD staging.Methods: The study was done on 68 patients of COPD. Urine spot albumin measurement, pulmonary function tests, spirometry and GOLD staging were done. Severity of COPD was assessed by GOLD staging. Pearson Co-relation test and ANOVA test were used for statistical analysis.Results: Statistical analysis showed that strong and statistically significant positive correlation of Microalbuminuria with GOLD staging(r =0.749, p = 0.001).Conclusions: Microalbuminuria(MAB) was found to increase in patients with increasing severity of COPD. Hence its potential role as a marker of severity of disease and in predicting risk of cardiovascular disease can be explored.

9.
Article | IMSEAR | ID: sea-211971

ABSTRACT

Background: Urinary albumin excretion has been purported to be strongly linked to cardiovascular events in hypertensive patients. The prevalence of microalbuminuria in patients with essential hypertension and its relationship with target organ damage was evaluated with the present study, as the correlation of microalbuminuria and target organ damage except cardiovascular events has not been deliberated upon much in the past.Methods: One hundred and twenty cases of essential hypertension were enrolled sequentially. Prevalence of urinary albumin excretion and its correlation with target organ damage (left ventricular hypertrophy, retinopathy and stroke) was analyzed. Urinary albumin excretion was assessed by turbidimetry method, while microalbuminuria was calculated by urine albumin to creatinine ratio.Results: Microalbuminuria was observed in 57.7% cases of essential hypertension. Target organ damage was observed in 62.5% (75) patients, out of which 78.66% patients had associated microalbuminuria (p<0.05). Higher prevalence was observed in patients with longer duration and greater severity of hypertension, increased body mass index and dyslipidemia.Conclusions: The assessment of microalbuminuria in hypertensive patients is a great value addition for the evaluation of target organ damage. Prompt control of hypertension and lipid levels along with weight management may lead to decreased risk of microalbuminuria.

10.
Bol. méd. postgrado ; 35(2): 30-34, Jul.-Dec. 2019. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1120204

ABSTRACT

Se realizó una investigación cuantitativa de tipo correlacional con el objeto de evaluar la asociación entre microalbuminuria (MA), proteína C reactiva ultrasensible (PCR-us) y riesgo cardiovascular (RCV) de acuerdo a la escala de Framingham en pacientes con síndrome metabólico (SM) que asistieron a la consulta del Servicio de Medicina Interna del Hospital Universitario Dr. Luis Gómez López durante el período junio 2017-junio 2018. La muestra la conformaron 30 pacientes con una edad promedio de 49,53 ± 13,35 años y predominio del sexo femenino. El 53,3% de los pacientes no tenía tratamiento. El 73,3% de los pacientes presentaron RCV muy alto y alto de acuerdo a la escala de Framingham. La mayor parte de los pacientes con RCV muy alto presentaron valores elevados de PCR-us. Se observó una correlación positiva entre los valores de PCR-us y el RCV (R=0,533, p < 0.05). Es importante la identificación temprana del SM como factor de riesgo para el desarrollo de enfermedades cardiovasculares(AU)


A correlation-type quantitative investigation was carried out with the aim to evaluate the association between microalbuminuria (MA), high-sensitive C-reactive protein (hs-CRP) and cardiovascular risk (CVR) determined by the Framingham scale in patients with Metabolic Syndrome (MS) who attended the Internal Medicine Service of the Hospital Universitario Dr. Luis Gómez López during the period June 2017-June 2018. Thirty patients were included with an average age of 49.53 ± 13.35 years and female sex predominance. According to the Framingham scale, 73.3% of patients had very high and high CVR. Most patients with very high CVR had elevated levels of hs-CRP. There was a positive and significant correlation between hs-CRP levels and CVR (R=0.533, p <0.05). An early diagnosis of MS is important as a risk factor for the development of cardiovascular disease(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , C-Reactive Protein , Cardiovascular Diseases/physiopathology , Technetium Tc 99m Aggregated Albumin , Metabolic Syndrome/pathology , Body Mass Index , Public Health , Diabetes Mellitus, Type 2 , Abdominal Circumference , Internal Medicine
11.
Article | IMSEAR | ID: sea-200421

ABSTRACT

Background: Microalbuminuria has been shown to predict cardiovascular disease (CVD) in patients with hypertension. Recently the FDC of losartan and hydrochlorothiazide (HCTZ) has been reported to be effective for achieving a target BP level and also improvement in cardiovascular prognosis. The present study was conducted to compare effect of losartan plus hydrochlorothiazide combination therapy and high dose amlodipine monotherapy on blood pressure and microalbuminuria.Methods: Total 184 patients with hypertension were randomly allocated to two groups. The patients in group 1 received Amlodipine 5 mg orally for first 4 weeks. The patients from group 2 received losartan 50 mg orally for first 4 weeks. Patients in group 1 were titrated to amlodipine 10 mg orally for next 4 weeks. The patients in group 2 were titrated to FDC of losartan (50 mg) plus HCTZ (12.5 mg) for next 4 weeks. Follow杣p visits were scheduled at 4 weeks and 8 weeks. Pulse rate, sSBP and sDBP were estimated at each follow杣p. Microalbuminuria was estimated at 8 weeks.Results: There was no significant difference in mean change in sSBP, sDBP and pulse rate between two treatment groups (p>0.05). There was greater reduction in microalbuminuria in group 2 patients (p<0.0001). The adverse effects such as flushing and lower extremity oedema were significantly more in amlodipine group (p<0.05).Conclusions: Losartan plus HCTZ has similar effect on BP, better safety profile and superior effect on microalbuminuria level reduction.

12.
Article | IMSEAR | ID: sea-211708

ABSTRACT

Background: Diabetic kidney disease is the leading cause of premature death in young diabetic patients. Detection of diabetic kidney disease as early as possible in the disease process currently offers the best chance of delaying or possibly preventing progression to end-stage renal disease. The present study was aimed to evaluate utility of serum cystatin C based eGFR for early diagnosis of diabetic kidney disease.Methods: Diagnosed patients of type 2 diabetes mellitus having frank proteinuria were excluded. Patients without proteinuria were tested for microalbuminuria.  50 patients having microalbuminuria were tested for 24 hour urine creatinine, serum creatinine and serum cystatin C. Both cystatin C based eGFR and eGFR by Cockcroft and Gault equation were compared with standard GFR by 24 hour urine Creatinine clearance respectively.Results: There was statistically significant positive correlation between cystatin C based eGFR and standard GFR by 24 hr Creatinine clearance (r=0.87). For eGFR by Cockcroft-Gault equation, it was 0.36 (r=0.36).Conclusions: The results of this study suggest that serum cystatin C based eGFR  measurement is a useful, practical tool for the evaluation of renal involvement in the course of diabetes. As serum creatinine values are affected by many factors like age, sex, muscle mass and diet, serum cystatin C based eGFR estimation offers a hope that diabetic kidney disease can be well prevented with appropriate interventions.

13.
Article | IMSEAR | ID: sea-194484

ABSTRACT

Background: Type 2 Diabetes (T2D) with microalbuminuria have increased risk of progression to overt proteinuria, and after some time, renal failure. It is the leading cause of end-stage renal disease as a sequalae of Diabetic Nephropathy (DN) and an independent risk factor for Cardio-Vascular Diseases (CVD). Initial finding for microalbuminuria can prevent long-term complications. The objective of the present investigation was to study the relation between microalbuminuria and with other biochemical parameters related to complications of T2D.Methods: This observational study was conducted among 150 T2D patients attending to the OPD, Department of General Medicine during the time period March 2018 to April 2019. The patients were interviewed for socio-demographic details, history and clinical examination and subjected to blood investigations and Electrocardiogram (ECG).Results: Microalbuminuria was present in 47(31.3%) of the diabetics. The age group 48-63 years 18(38.3%), male gender 33(70.2%) duration of diabetes >5 years 11(23.4%). The smokers, Diabetic Retinopathy, Peripheral Neuropathy, Ischemic Heart Disease, SBP 160-170 mmHg, DBP 95-100 mmHg and 100-105 mmHg, BMI 30-35 Kg/m2, TG >250 mg/dl, LDL >110 mg/ dl and HbA1c 7.5-9 % showed a greater odds ratio and significant association (p<0.001) with microalbuminuria.Conclusions: There was an increased prevalence of microalbuminuria among patients with T2D. It also showed a significant association of major microvascular and macrovascular complications of T2D and microalbuminuria

14.
Article | IMSEAR | ID: sea-189050

ABSTRACT

Diabetic Nephropathy is a microvascular complication leading to impairment of renal function which occurs in the patient with long standing diabetes mellitus. Diabetic nephropathy is the leading cause of chronic kidney disease (CKD), end stage renal disease (ESRD) and CKD requiring renal replacement therapy. Furthermore, the prognosis of diabetic patients on dialysis is poor, with survival comparable to many forms of cancer. Fortunately, in the recent years, apart from better metabolic control of diabetes, specific nephro-protective interventions have become available. The true prevalence of diabetic nephropathy is underestimated because proteinuric patients are usually asymptomatic. The aim of this research is to find out the prevalence of microalbuminuria, overt proteinuria and ESRD in diabetic patients. Methods: The study was conducted in the Department of General Medicine, Civil Hospital, Aizawl. Type II Diabetes Mellitus patients admitted in the General Medicine ward were included in the study. 117 cases of type 2 diabetes were subjected to detailed clinical examination and investigations. Blood glucose estimation, urinary albumin excretion rate, 24 hours urinary protein excretion and renal function tests were performed. Based on the results of these tests, patients were classified into four groups: Normoalbuminuria-54 cases, Microalbuminuria-38 cases, Macroalbuminuria-15 cases & ESRD-10 cases. Results: The prevalence of microalbuminuria was 32.5% and prevalence of macroalbuminuria was 21.4%. 8.5% patients had ESRD. 40% of macroalbuminuria patients had end stage renal disease. Conclusion: Age of the patients who had microalbuminuria, macroalbuminuria and ESRD were significantly higher when compared to normoalbuminuric patients. The glycemic control was poorer in patients having microalbuminuria, macroalbuminuria and ESRD group as compared to patients having normoalbuminuria.

15.
Article | IMSEAR | ID: sea-205281

ABSTRACT

Background: Diabetic nephropathy (DN) is the most common cause of end stage renal disease (ESRD). Early detection of the disease and treatment of this chronic complication which would reduce the medical and economic burden. Early detection of kidney injury by evaluating gene expressions of Il-6, Il-10, LDLr, and CD36 in T2DM with pre-ESRD microalbuminuria minimizes the risk of DN. Methods: Present research work conducted at the Department of Biochemistry, School of Medicine, Navi Mumbai. This study includes 241 subjects (118 male, 123 women, and age ranges 30-70 years) were included after screening for T2DM by measurement of blood glucose in fasting, post-prandial, glycosylated haemoglobin. Microalbumin in urine and e-GFR is measured to eliminate patients of ESRD. Subjects were recruited after written consent and enrolled as per inclusion/exclusion criteria. Categorization of subjects in three study groups; group I (30-45 years), group II (46-70 years) were done on the basis of T2DM duration 3-6 years, glycosylated haemoglobin level (HbA1c) ≥ 7.0% with fasting blood glucose ≥126 mg/dl) and microalbuminuria (30-300 mg/dl) in study group, equal numbers of healthy volunteers enrolled in control group. Blood samples were processed for other renal parameters and RT-PCR to check expressions of novel genes Results: In study groups all renal, lipids parameters are within normal range except albumin/creatinine ratio (p <0.012), e-GFR (p <0.00) and cholesterol (p <.00). Descriptive analysis showed high significance (p <.00) of delta CT gene expressions, parameters in pre-ESRD microalbuminuria subjects. Conclusion: Screening biochemical renal parameters are not enough to prevent DN even in microalbuminuria. Early detection of gene expressions of novel biomarkers predicts risk of kidney injury. Early intervention may prevent morbidity and mortality of kidney due to diabetic nephropathy.

16.
Article | IMSEAR | ID: sea-194397

ABSTRACT

Background: Microalbuminuria is a sign of glomerular dysfunction in general and sign of tubulointerstitial disease to a lesser extent. Hypoxia induces endothelial cell to release a number of different vasoactive agents including endotheline-1, platelet derived growth factor (PDGF), nitric oxide; that causes endothelial injury and lead to microalbuminuria. This study was aimed to assess the prevalence of microalbuminuria in COPD patients and assess the Relationship of microalbuminuria with the disease severity in the forms of FEV1, PaO2, PaCO2, and BODE INDEX in COPD patients.Methods: Total 130 COPD patients were included in our cross sectional study. Total patients were divided into two groups, 1st group was COPD with microalbuminuria while 2nd group was COPD without microalbuminuria. Lung function test, 6 min walk distance, arterial blood pressure (BP), BODE index, arterial blood gases, fasting and post prandial plasma glucose and kidney function tests were measured. Screening for microalbuminuria was done by measuring urinary microalbumin in a random spot urine collection.Results: The prevalence of microalbuminuria was 29.23% in patients of COPD. As compared with COPD without microalbuminuria group, COPD with microalbuminuria group were more hypoxic (12% vs 74%, P=0.0001 ), more hypercapnic (22% vs 84%, p=0.00001) and most of the patients with grade III (16% vs 34%, p=0.00001) or grade IV (19% vs 47%, p=0.00001) severity (according to GOLD criteria).Conclusions: Patients with severe COPD with hypoxemia or hypercapnia were significantly associated with microalbuminuria.

17.
Article | IMSEAR | ID: sea-194388

ABSTRACT

Background: The specific question of whether PCI or surgical treatment offers any advantage over MT in patients with stable angina and multivessel disease remains unanswered. Objective of our research was to study various risk factors which interferes the outcome of various therapeutic procedures in coronary artery disease.Methods: This was prospective observational study carried out in a tertiary care center from July 2014 to July 2016. A total of 98 subjects undergoing different therapeutic strategies were followed up. Risk factors which interferes the outcome of various therapeutic procedures in coronary artery disease (CAD) were studied.Results: There was a significant difference in mean SYNTAX score (P = 0.003), urine micro albumin levels (P=0.006), and body mass index (0.046) between those who had MACE and who did not have MACE.Conclusions: The urine micro albumin >30 mg/l and highest SYNTAX score were significantly associated with MACE at 1 year in subject with severe CAD.

18.
Article | IMSEAR | ID: sea-209387

ABSTRACT

Background: Sepsis following surgery or trauma remains one of the leading causes of morbidity and mortality in hospitalpopulations, especially in populations in intensive care units (ICUs). The key to successful control of sepsis-associated infectionsis early prediction and rapid treatment of the disease. Standard clinical and laboratory parameter testing estimate the levels ofexpression of interleukin-1 β (IL-1 β), IL-6, IL-8, and IL-10, tumor necrosis factor-α, FasL (Fas ligand is a type-II transmembraneprotein), and CCL2 (C-C Motif Chemokines Ligand 2) mRNA and growth differentiation factor-15. These are a few measuredby real- time reverse transcriptase polymerase chain reaction.Aim of the Study: In this study, evaluation of the urinary albumin/creatinine ratio (ACR) was used as a prognostic predictorin critically ill sepsis patients.Materials and Methods: In a prospective observational study, 365 adult critically septic patients were included. After clinicalevaluation, urine spot samples were collected on admission and 24 h later for ACR1 and ACR2. Admission Acute Physiologyand Chronic Health Evaluation (APACHE) IV score and the highest recorded Sepsis-related Organ Failure Assessment (SOFA)score of their daily estimation were considered. The need for mechanical ventilation was assessed in addition to inotropic and/or vasoactive support, renal replacement therapy (RRT), and in-hospital mortality.Observations and Results: A total of 365 patients who were critically ill with sepsis were initially recruited to this study. Thepatients included in this study were aged between 28 and 87 with a mean age of 62.37 ± 9.15 years. There were 235 (64.38%)males and 130 females (35.61%). The highest SOFA score was 7.4 (4.0–14.0) ranging from 1 to 17 and APACHE IV scorerecorded within the first 24 h of ICU admission was 76.8 (58.8–98.0) ranging from 46 to 118. Of 365 patients, 191 (52.32%)required ventilator support, 201 (55.06%) needed inotropic and/or vasoactive support to maintain hemodynamics, and 71(19.45%) needed RRT. The mean length of hospital stay in the present study was 17.65 ± 8.60 days.Conclusions: Evaluating the urinary ACR values regularly in all critically ill sepsis patients was a simple, rapid, non-invasive,inexpensive, easy to perform, and interpret test for early prognosis and prediction of mortality

19.
Article | IMSEAR | ID: sea-194282

ABSTRACT

Background: Microalbuminuria among obesity cases reflects specific glomerular damage or is the marker of generalized endothelial cell dysfunction is still debatable. Thus, this study aimed to assess the presence of microalbuminuria among obese persons and non-obese individuals, who were euglycemic and normotensive.Methods: A case control study was conducted among patients attending outpatient department of general medicine in Govt Thiruvarur Medical College, Thiruvarur, for their illnesses from June 2017 to December 2017. A total of hundred participants with fifty obese cases and fifty non obese controls were included in this study. Detailed history and examination were done by the principal investigator and the same was documented in a proforma. Data entry was done using Microsoft excel and the statistical analysis includes odds ratio were calculated using Statistical Package for Social Sciences (SPSS) software version 17.Results: Among the study participants, 32% and 4% had microalbuminuria in obese and non-obese group, respectively. Also, obese participants were 11.29 times at higher chances of having microalbuminuria when compared to the non-obese patients with significant p value (p=0.002).Conclusions: Microalbuminuria can be used to predict the risk of complications in obese subjects in order to bring down the overall morbidity and mortality related to renal function.

20.
Article | IMSEAR | ID: sea-194273

ABSTRACT

Background: Diabetes mellitus has emerged as one of the most common health hazard all over the world. Diabetic nephropathy is the most challenging long term complication of Type 2 Diabetes mellitus and microalbuminuria is the earliest marker of diabetic nephropathy. In diabetes, chronic hyperglycemia and deranged lipid profile lead to excess generation of free radicals. The increased oxidative stress plays a major role in pathogenesis of diabetic complications, including diabetic nephropathy. There are many naturally occurring antioxidant enzymes in our body. Diabetes has multiple effects on protein levels and activity of these antioxidant enzymes. This further augments the oxidative stress. There are many non-enzymatic antioxidants in our body which include vitamins A, C, E and trace minerals like copper, zinc, manganese and selenium.Methods: The study was done on a total of 150 subjects. Group A comprised of 60 Type 2 diabetic patients with diabetic nephropathy, Group B comprised of 60 Type 2 diabetic patients without diabetic nephropathy and Group C comprised 30 healthy controls. Total antioxidant status, microalbuminuria and glycosylated haemoglobin were measured.Results: In present study, authors found that total antioxidant status is drastically reduced in all diabetic patients, and it was found to be further low in patients with diabetic nephropathy. This decrease was found to be directly proportional to the degree of diabetic nephropathy, as measured by the levels of microalbuminuria.Conclusions: Timely institution of antioxidant supplementation therapy may emerge as a promising measure in delaying the onset and progression of diabetic complications, especially diabetic nephropathy.

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