Background: Chronic Kidney Disease (CKD) with its high prevalence, morbidity and mortality, has become an important public health problem. The incidence and prevalence of CKD is increasing worldwide, including India. CKD is associated with a variety of hematological abnormalities, include anaemia, infections and bleeding diathesis. Anaemia is the most consistent hematological abnormality and is associated with poor quality of life and poor cardiovascular outcomes.Methods: A hospital based cross-sectional observational study was done to detect the prevalence of haematological abnormalities, correlation of anaemia with CKD stage and evaluation of iron deficiency. Newly diagnosed CKD (stages 3 to 5) patients were included in this study. Presence of anaemia (Hb%, haematocrit, MCV, peripheral smear), iron deficiency (TSAT, serum ferritin), thrombocytopenia, leucocyte count and coagulation abnormalities (PT, APTT) in different stages of CKD were studied.Results: All the subjects in study group had anaemia which was normocytic and normochromic and of moderate degree in most patients. The severity of anaemia progressed with stage of the disease. Iron deficiency was significantly prevalent (52% in the study population, with transferrin saturation (TSAT) <20%). WBC count was not significantly altered. There was mild thrombocytopenia in a few patients. Bleeding time or other in vitro tests of platelet function were not measured. The coagulation parameters, PT and APTT, were not significantly altered.Conclusions: All CKD patients should be screened for iron deficiency anaemia for its early treatment and to decrease morbidity.
BACKGROUND NAFLD (Non-Alcoholic Fatty Liver Disease) is now one of the commonest causes of abnormal liver function and has a higher incidence among obese and diabetic patients. It is considered to be the hepatic consequence of metabolic syndrome or a cluster of metabolic disorders. The association of NAFLD with each of these individual components is well known. However, it is unknown whether the risk for this disease is increased in patients with the metabolic syndrome. METHODS We studied the clinical profile of patients of NAFLD, varying degrees of severity as diagnosed by ultrasonography and evaluated the cross-sectional relationship between NAFLD and the metabolic syndrome along with its individual components. RESULTS It was found that most patients with NAFLD were asymptomatic. 55% of the study population which comprised of patients with NAFLD on ultrasonography, had features of metabolic syndrome. In addition, the individual components of metabolic syndrome were highly prevalent. Impaired fasting glucose was seen in half of the study population and elevated systolic BP in more than half (60%). Increased waist circumference, low HDL and high triglyceride levels were seen in majority of the patients (85-87%). There was a greater association of metabolic syndrome with increasing severity of the fatty liver disease. CONCLUSIONS Many patients of NAFLD remain undiagnosed as they tend to be asymptomatic, therefore recognizing those at risk is the first step. All patients with metabolic syndrome should be screened for NAFLD for early detection.
Introduction: Sepsis is a life-threatening condition of human body. It is caused by improper response of host immune system to various infective conditions. Procalcitonin (PCT) has been a promising biomarker for aiding early diagnosis, risk stratification and treatment in patients with sepsis and septic shock. Aim: To study correlation of serial serum procalcitonin (day1, 3 and 7) with severity of sepsis and patient outcomes (in-hospital stay or mortality). Materials and Methods: The study was a descriptive, observational study conducted at Krishna Institute of Medical Sciences, Secunderabad, Telangana, India, on 100 patients admitted to Medical Intensive Care Unit (MICU), both males and females of age more than 18 years, with sepsis or septic shock, from August 2019 to January 2021. Serum procalcitonin was measured by BRAHMS PCT-Q immunochromatographic assay using a commercially available test kit. Blood, urine and wound cultures were performed to confirm specific infection. The Chisquare test, Fischer’s-exact test and Pearson correlation tests were used to calculate association and correlations amongst qualitative data. Results: Total 100 patients (mean age was 49.9±17.0 years; 62 males and 36 females) were included in the study. A total of 74 patients were observed to be have sepsis and 26 patients Ihad septic shock. Mortality was 36%. There was a positive correlation with Sequential Organ Failure Assessment (SOFA) score on day 1 and 3, but not day 7. PCT was high in 85% of patients on admission (day 1). Higher levels of PCT was observed both in patients with sepsis (82.4%) and septic shock (92.3%), suggesting that it is a good diagnostic marker in these patients. Mean PCT was higher in death patients compared to discharged patients on day 1,3 and 7 (p-value<0.05). Majority of patients (71.8%) with higher PCT on admission stayed in ICU for less than 5 days, whereas over half (53.3%) with normal PCT had a short ICU stay (p-value=0.18). Conclusion: Procalcitonin is a useful marker for early diagnosis of sepsis and septic shock and also severity of infection on admission to ICU. High procalcitonin also predicts mortality and can be a useful tool for rational use of antibiotics in patients admitted to ICU.
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