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Prevalence of Uremic Pruritus, Its Risk Factors and Impact on Health Related Quality-Of-Life in Patients on Maintenance Hemodialysis
No full textBackground: Renal pruritus is one of the most debilitating symptom of chronic kidney disease especially affecting patients on maintenance hemodialysis. Subjects and Methods: It was a cross-sectional questionnaire based study. Demographic, dialysis related and biochemical parameters of maintenance hemodialysis patients were recorded, and a pre-defined questionnaire was put to them. Severity was calculated with 12 point pruritus severity scale (PSS), health-related quality of life with SKINDEX-10, and sleep survey with ITCH-MOS. Results: The total of 164 patients (mean age 52 ± 17years, males-57.9%, females-42.1%) completing questionnaire and laboratory analysis were included in the study. Prevalence of pruritus was 53.7% (mild in 31.8%, moderate-45.5%, severe-22.7%). Prevalence was higher in diabetic CKD (p=0.0001), and irregularly dialyzed patients (p=0001). The severity of pruritus correlated with older age (p=0.004), shorter dialysis vintage (p=0.000), irregular dialysis (0.000), higher serum phosphorus (0.003), and parathyroid hormone level (0.000) and higher calcium-phosphorus product (0.001). SKINDEX-10 showed worsening symptoms, emotional and functional quality of life (p=0.000), and poorer sleep quality and quantity as per ITCH-MOS (0.000), with increasing severity of itching. Conclusion: Renal itch is highly prevalent in maintenance hemodialysis patients, most severely affecting diabetics, elderly, irregularly dialyzed patients, with poorly controlled mineral bone parameters. The severity correlates with worsening sleep and overall quality-of-life. 
The Association between Serum Lipid Profile and Retinopathy in Type 2 Diabetes Mellitus Patients
No full textBackground: Blood such as VLDL, intermediate density lipoprotein (IDL), chylomicrons, chylomicron remnants and lipoprotein and therefore provides a more accurate estimate of CV risk than LDL-C alone, as shown in numerous epidemiological and clinical studies. This is particularly true for patients who are already on statin therapy or those with elevated levels of VLDL-C such a patients with obesity, metabolic syndrome and diabetes. Subjects and Methods: A pre-structural proforma was used to collect baseline date detailed clinical history with clinical examination and relevant investigation was done on participating individuals. Results: Significant correlation between HbA1c and various circulating lipid parameters and significant difference of lipid parameters in two groups (</.0% and >7.0%) of glycated haemoglobin indicates that HbA1c can be used as a potential biomarker for predicting dyslipidemia in type 2 diabetic patients. Conclusion: As good control of diabetes is shown to keep the lipid levels in near normal range, it appears important to aim at critical control of DM to prevent or at least postpone the onset of various complications. 
Urinary Interleukin 6: A Prognostic Bio Marker in Lupus Nephritis
No full textBackground: Lupus nephritis is an frequent and potentially serious complication of SLE. It is an inflammatory disease of connective tissue and immune system, where we find organs and cells undergo damage initially mediated by tissue-restricting auto antibodies and immune complexes. Our aim was to evaluate the association of urinary interleukin 6 in lupus nephritis patients and validate its use as a prognostic marker. For this we took the complete demographic profiling of the participant patients along with all biochemical parameter were checked. For IL-6 analysis, we analyzed the whole immunological profile and correlated the level of urinary proteins, serum creatinine and urinary IL-6. The mean values of urinary IL-6 at presentation and after 6 months of treatment were calculated. Any change after 6 months was noted and correlation of Il-6 with disease activity scores was observed. Urinary IL-6 was found to be significantly high in patients of lupus nephritis than controls. Urinary IL-6 was higher in patients of severe form of lupus nephritis such as Class IV than other classes of lupus nephritis. Urinary IL-6 may be used as a prognostic marker of lupus nephritis. The patients who achieved complete remission had near normal levels of urinary IL-6 and patients with partial remission had decreased level of urinary IL-6 than at presentation after 6 months of induction phase treatment. But patients with no remission did not show any significant decrease in urinary IL-6 levels at 6 months. So, urinary Il-6 may be used to monitor the response to therapy. 
Department of Medicine, Faculty of Medical Sciences, Delta University, Abraka, Delta, Nigeria.
No full textBackground: One of the major causes of morbidity and mortality worldwide is acute myocardial infarction (AMI). Various cardiac markers have been used from time to time for assessing the diagnosis and prognosis of the disease. Hence; we planned the present study to evaluation of cardiac markers in patients with myocardial infarction. Subjects and Methods: The present study included assessment of different cardiac markers in patients with myocardial infarction. For the present study, ethical approval was obtained from the ethical committee of the institution, and written consent was obtained after explaining in detail the entire research protocol. A total of 20 AMI patient and 20 healthy controls were included in the present study. Fresh blood samples were taken and mean serum creatine kinase (CK), and cardiac troponin (CT) values were assessed and compared. All the results were analysed by SPSS software. Chi- square test was used for assessment of level of significance. Results: Mean value of CK-MB among the patients of the AMI group and the control group was 28 IU/L and 18 IU/L respectively. Mean value of CT among the patients of the AMI group and the control group was 4.8 ng/L and 0.5ng/L respectively. The cardiac biomarkers were found to be significantly raised among the AMI patients in comparison to the healthy controls. Conclusion: These biomarkers are assessable biological variables which function as indices for health analysis.  
Assessment of Prevalence of Iron Deficiency Anemia among Known Population
No full textBackground: The most significant and common cause of anemia is iron deficiency. Hence, we planned the present study to assess the prevalence of iron deficiency anemia among known population. Subjects and Methods: A total of 350 subjects who reported to the department of internal medicine for routine checkup were included in the present study.Blood samples were obtained from all the subjects and were sent to central laboratory for the assessment of blood hemoglobin levels. Criteria described in the past literature were used for categorizing patients with iron deficiency anemia. Females with mean hemoglobin concentration less than 11.5 g/dL, and males with mean hemoglobin concentrations less than14 g/dL were categorized as anemic.6 All the results were analyzed by SPSS software. Results: Overall prevalence of iron deficiency anemia in the present study was 15.28 percent. The overall prevalence of iron deficiency anemia was found to be higher among subjects with more than 60 years of age. Also, significantly higher prevalence of iron deficiency anemia was found among females. Conclusion: Prevalence of iron deficiency anemia was found to be higher among females and illiterates. Therefore health education programs are recommended in future for increasing the awareness of adverse events associated with iron deficiency anemia among general population.  
Evaluation of Patients with Dengue Infection for Their Clinical and Hematological Profile, Management and Outcomes at Mount Zion Medical College Hospital in Kerala
No full textBackground: Dengue Fever which is also known as break bone fever is a benign syndrome begin by many arthropod– borne viruses, which is specify by myalgia, high grade fever, or arthralgia, rash, leukopenia and lymphadenopathy. Our study was carried out with an aim to describe the different clinical spectrums of dengue with its hematological profile. Subjects and Methods: A total of 130 cases were anticipated with age of all groups, and those who were serologically positive for Dengue tested by ELISA/Card (NS1, IgG, IgM) method were included in this study. Patients found to be serologically dengue negative and positive patients who were also found to be positive for other coexisting infections, viz. malaria, typhoid, etc and not done the clinical test were excluded, so this study included all patients diagnosed with dengue. The examination based on WHO criteria and the case definition was based on compatible clinical history and, confirmed by positive serology for dengue applying the ELISA IgM method. All patients with bleeding manifestations, thrombocytopenia with platelet count < 30,000 cu/mm were admitted and pregnant patients and infants with decrees platelet counts were admitted. Results: Out of a total of 130 cases enrolled in the study a total of 75 (58%) did not have bleeding manifestations and comprised the Group I of study where as remaining 55(42%)patients presented with bleeding manifestations and were placed in Group II of study. Among these 130 patients with confirmed diagnosis, 75were Group I while the rest were Group II giving a Group I to Group II. Their ages ranged from 4 years to 80 years. Conclusion: In the current study the clinical profile of patients having bleeding manifestations which is the extreme form of dengue fever was marked by raised portion of hepatomegaly and decreased platelet count. The clinical course of disease is marked by a rationalization of platelet count by day 5 of illness. Dengue fever does not have specific medical therapy hence clinical recovery monitoring is largely dependent on haematological parameters. This study concludes that parameter like platelet count, haematocrit, leukocyte count and coagulation studies aid greatly in clinical monitoring of patient.  
Comparative Study of Adenosine Deaminase Levels in Pleural Effusion of Tuberculous and Non Tuberculous Etiology; A Cross Sectional Study
No full textBackground: Tuberculous pleural effusion (TPE) is very common in developing countries in comparison of developed countries; further TPE is one of the common characteristic of extra pulmonary tuberculosis. Adenosine deaminase (ADA) is an important enzyme which is found highly active in the diseases which induce cellular immunity. Therefore, the present study was designed to evaluate the accuracy of ADA level in the diagnosis of pleural effusion caused by tubercular etiology. Subjects and Methods: This was a cross-sectional type of study conducted at tertiary care institute. Total one hundred thirty five patients of pleural effusion were recruited for the study among them eighty nine pleural effusion patients were suffering with tuberculosis and forty six pleural effusion patients were without tuberculosis. A p-value < 0.05 was considered statistically significant. IBM SPSS Statistics 21 manufactured by IBM USA was used for entire calculations. Results: Findings of the present study have shown there was significant difference between ADA level of tubercular effusion patients (69.3±27.22) in comparison of non-tubercular pleural effusion patients (20.46±7.34). Further there was a significance difference between Lactate dehydrogenase (LDH) levels of the tubercular effusion patients (172.72±25.7) in comparison of non-tubercular pleural effusion patients (81.91±6356). However there was no significance difference between total protein (p>0.05), glucose level (p>0.05) and total cells (p>0.05) level of both groups. Conclusion: Finding of the present study showed that The ADA level was significantly high in pleural effusion patients with tubercular etiology in comparison of non-tubercular pleural effusion.  
Effects of Yoga on Blood Pressure and MDA in Mild Hypertensive Patients.
No full textBackground: Cardiovascular diseases (CVD) have emerges as the leading cause of mortality throughout the world. Essential hypertension is one of the important risk factor for CVD in modern society despite advanced and effective management. Malondialdehyde (MDA) is a well known marker of oxidative stress, which is produced by oxidation of poly unsaturated fatty acid. Nadishodhan pranayam leads to decrease stress as well as blood pressure. Subjects and Methods: It was an interventional type of study. Ninety seven mild hypertensive patients (53 males and 44 females) of group I completed the yoga program. While, fifty normotensive subjects were include as control in group II. Blood pressure and MDA was measured of every participants before and after three months of yoga program. Results: Total ninety seven mild hypertensive patients of age 33.6± 8.66 years of group I completed three months yoga program. However, fifty subjects (34.7± 7.73 years)of group II had not done any yogic exercise during three months. Results of the present study showed that there was a significant difference in SBP (p<0.001), DBP (p<0.001), HR (p<0.001), PP (p<0.001) and MAP (p<0.001) group I mild hypertensive patients after following three months yoga program. There was a significant difference between before and after yoga program MDA level of group I mild hypertensive patients. However, there was an insignificant difference between before and after three months level of MDA in group II control subjects. Conclusion: In this study, it has been observed that daily practice of yoga improves the blood pressure of mild hypertensive patients. Moreover, it substantially decreases the oxidative stress. Yoga can be an effective alternative to reduce the blood pressure in mild hypertensive patients either with medication or without medication.  
Complications in Pregnancy and Foetal Outcomes in Gestational Diabetes – An Observational Study in a Tertiary Hospital in Nigeria
No full textBackground: A retrospective cohort study to compare the pregnancy complications and foetal outcomes in pregnancies complicated by diabetes mellitus. Subjects and Methods: One hundred and eighty five diabetic pregnant patients who delivered at the Department of Obstetric & Gynecology, University of Nigeria, Nsukka. during the 3-year-period formed the subjects of this study. There were 27(14.6%) (type 1) - insulin dependent diabetics, group 1, 19 (10.2%)(type 2), non insulin dependent diabetic patients who constituted group 2 and 139(75.2 %) gestational diabetic patients who made up group 3. Data extracted from the case files included maternal age, gravidity, parity , number of abortions, gestational age at booking, time of diagnosis of diabetes mellitus, complications during pregnancy, birth weight, placental weight. Results: There were no statistically significant differences in the three groups regarding the mean gravidity, parity, birth weight and placental weight (p>0.05). However, statistically significant differences were found with respect to the mean maternal age, gestation at booking, fasting blood sugar, and gestation at delivery (p<0.05). Out of 139 gestational diabetics, 23(16.5 %) were diagnosed by the 14" week of pregnancy while 24(17.2 %) were diagnosed between the 15- 27 weeks of gestation. The control of blood sugar was adjudged to be poor in 32% of gestational diabetics, 50% of type 2 diabetics and 69 % of type I diabetics, with statistically significant difference between the groups, (p<0.05). Although there was statistically significant difference between the groups regarding one of the pregnancy compli- cations( polyhydramnios) (p<0.05), none were found in other complications (p>0.05). The overall caesarean section rate was 48%. The overall perinatal mortality was 5.7%, all the deaths occurred in babies born to patients with gestational diabetes. Conclusion: Gestational diabetes accounted for all the fetal losses in this study, while polyhydramnios was the most common antenatal complication which was significantly higher in type 1 diabetics.  
Assessment of Cases of Stroke in Emergency Department
No full textBackground: One of the leading causes of death and adult disability among general population is stroke. The efficacy of acute stroke treatment is very time dependant. This includes both pharmacological and mechanical thrombolysis. Hence; we planned the present study to assess the cases of stroke which reported to the emergency department of the institution. Subjects and Methods: The present study included assessment of cases of stroke which reported to the emergency department of the medical institution. A total of 50 cases of stroke were included in the present study. Complete demographic details of all the patients were obtained. All the results were compiled in Microsoft excel sheet and were analysed by SPSS software. Results: Dyslipidaemia was found to be present in 80 percent of the patients. Disturbances in speck and visual disturbances were found to be present in 78 percent and 80 percent of the patients. Motor and sensory symptoms were found to be present in 72 percent and 64 percent of the patients. Headache and dizziness was present in 84 percent and 78 percent of the patients. Conclusion: Stoke represent a significant health problem with high mortality and morbidity. It is more common in elderly subjects with positive history of smoking and dyslipidaemia.