Isolated Proteinuria in Hepatitis A Versus E Virus (HAV vs HEV) Infected Patients: A Hospital Based Observational Study.

Introduction: Viral hepatitis, either acute or chronic, may lead to nephropathies as one of its multiple extrahepatic complications which often remain clinically silent for a long period and are overlooked. Proteinuria can be a useful tool for early detection of the underlying renal impairment. This study was undertaken to detect the presence of proteinuria and to assess and compare the level of proteinuria in HAV and HEV- infected cases; the two most common causes of acute hepatitis in Bangladesh. Method: For this 100 diagnosed patients of HAV & HEV (50 each) hepatitis were screened for isolated proteinuria in a random spot urine sample during their 3rd to 4th post-ecteric follow ups. Result: 43% HAV and 45% HEV patients had high spot urinary protein with maximum incidence (54 %) occurring in 3rd decades of life. The pattern of isolated proteinuria was significantly different in HAV vs HEV cases. The mean ± SD value of spot urinary protein of HEV females was significantly higher than that of HAV where highest rate (64%) of mild proteinuria was observed in HAV and maximum number (46%) of moderate proteinuria in HEV patients. Conclusion: Spot urinary protein concentration should be checked quantitatively in every HEV as well as HAV- hepatitis patient even when clinically improved.

Comparison of Conventionally Measured Serum Bicarbonate Values with Bicarbonate Values Obtained in Arterial and Venous Blood Gas Analysis.

Bicarbonate (HCO3-) measurement in serum or plasma from a sample of venous blood is routinely practiced in hospital patient management. HCO3- status can also be assumed from Blood gas analysis requiring arterial blood as sample which is cumbersome for both patients and doctors. This study was undertaken to evaluate the extent of agreement among biocarbonate values obtained during venous, arterial blood gas analysis and conventionally measured serum bicarbonate levels in a group of intensive care unit (ICU) patients to determine whether conventionally measured serum HCO3- (from peripheral venous blood) and calculated HCO3-values (from arterial blood gas [ABG] analyzers) can be used interchangeably. A total of 51 adult patients with diverse medical conditions, presenting at a tertiary health centre ICU were enrolled in this study when deemed by the treating physician to have an ABG analysis. Arterial and venous samples were taken as close in time as possible for blood gas analysis and routine blood tests. Bland-Altman analyses were used to compare the three methods. The HCO3- levels from ABG, Venous Blood gas (VBG) and tconventionally measured serum HCO3- showed acceptably narrow 95% limits of agreement using the Bland-Altman method. VBG reveals higher level of agreement with the ABG bicarbonate values compared to measured serum HCO3-. Thus, venous blood can be an alternate for arterial blood where ABG analyzer is available. conventionaly serum HCO3- measurements can also be useful and used as substitute for an expensive ABG analyzer in resource constrained health care sectors when required.