<b><i>Background:</i></b> The association between viral infections and glomerular diseases, commonly known as “viral glomerulopathies,” has been described in various clinical scenarios for decades. Despite advancements in diagnostic tools, it remains challenging to establish a causative link fully. <b><i>Summary:</i></b> Data from mouse models have substantiated clinical observations and implicate direct viral infection in the pathogenesis of viral glomerulopathy, particularly in human immunodeficiency virus-associated nephropathy. In addition to the traditional concept of direct viral effects on kidneys, other factors such as <i>APOL1</i> risk alleles can further modify the clinical outcomes or presentations of different viral glomerulopathies. Newly developed antiviral drugs are now applicable to a wider range of patients with lower kidney function and fewer side effects. <b><i>Key Message:</i></b> Efforts focusing on vaccines and antiviral treatments have significantly reduced the incidence of viral glomerulopathies. However, the most recent pandemic caused by severe acute respiratory syndrome coronavirus 2 infection complicated by COVID-associated nephropathy illustrates our susceptibility to novel viruses. Ongoing research is pivotal to deciphering the mechanisms behind viral glomerulopathies and discovering therapeutics in a collaborative approach.
Background: Any kind of stress, physical or emotional leads to increased production of ACTH, thus leading to increased glucocorticoid release and hence, hyperglycemia. Various studies suggest that the treatment of Stress Hyperglycemia has tremendous potential to reduce the morbidity and mortality among hospitalized patients with Stress Hyperglycemia. Aims: To study the prevalence and prognostic value of stress hyperglycemia in determining the cardiovascular outcome in non-diabetic acute coronary syndrome patients. Material and Methods: This study was conducted in 100 patients with no previous history of diabetes with Acute Coronary Syndrome over a period of 18 months. Stress Hyperglycemia in the acute phase of Acute Coronary Syndrome was defined as random blood glucose levels greater than or equal to 140 mg/dl. Patients were divided into two groups A and B on the basis of random blood sugar as normoglycemics and those with Stress Hyperglycemia, respectively. These groups were compared to demonstrate the correlation between stress hyperglycemia and cardiovascular outcome of heart failure, arrhythmias, cardiogenic shock or death. The data was collected and statistically analysed. Results: Out of 100 patients of acute coronary syndrome with no previous history of diabetes, 38 % were found to be having stress hyperglycemia. Heart failure, arrhythmia, shock and death occurred in 57.89%,13.16 % 13.16 %, 21.05% of Stress Hyperglycemic patients as compared to only 16.12%,4.83%, 8.06 %, 6.45 % in normoglycemic patients, respectively. Summary and Conclusion: There is high prevalence (38%) of Stress Hyperglycemia in Acute coronary syndrome patients and is associated with adverse outcomes such as heart failure, arrhythmia, cardiogenic shock and death.
Background:In cirrhotic patients, in addition to hepatocyte and Kuppfer cells dysfunction, portopulmonary shunt, intrapulmonary arteriovenous shunt and VA/Q inequality can induce a decrease in PaO2 and SaO2 as well as acid base disturbances. The present study was done to analyse arterial blood gas changes, prevalence of hypoxemia and acid base disturbances as well as to correlate grading of hypoxemia with different aetiologies and Child-Pugh score in patients with liver cirrhosis and ascites. Methods: The present correlative cross sectional study was conducted on 100 patients with cirrhosis and ascites for a period of 24 months. Arterial blood gas samples obtained by percutaneous radial puncture were analysed for various acid base abnormalities and arterial blood gas oxygenation. Results: Acid base disturbances observed were: respiratory alkalosis in 39 cases (39%), metabolic alkalosis in 20 cases (20%), metabolic acidosis in 11 cases (11%), metabolic acidosis with respiratory alkalosis in 10 cases (10%) and no acid base disturbance in 20 cases (20%). Mean values of PaO2 was 75.85±7.8 mmHg, PaCO2 was 35.27±5.13 mmHg, pH was 7.44±.115 and HCO 3was 23.65±3.85 mmol/l. Alcoholic cirrhotics had hypoxemia in 42% cases in contrast to hypoxemia in other aetiologies ( Hepatitis C 18%, Hepatitis B 5%).Conclusion: Metabolic abnormalities, hypoxemia and hypocapnia are commonly found in cirrhotics. Hypoxemia is more common in alcoholic cirrhotics but has no correlation with Child-Pugh score.
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