Amyloidosis is a disorder of protein metabolism characterized by extracellular deposition of abnormal protein fibrils. It may either be localized to any organ or systematically distributed throughout the body. The biochemical nature of proteins varies but the physical and tinctorial properties are shared by all the amyloidogenic proteins. In the West, it is mainly composed of amyloid light (AL) type immunoglobulin (Ig) light chains. Amyloidosis of the genitourinary tract is rare except for the kidney and isolated primary amyloidosis of the urinary bladder is even rarer. It mainly presents as intermittent painless gross hematuria. It mimics transitional cell carcinoma on imaging and endoscopic examination. We herein present a case of fifty six-years-old male with history of painless hematuria for three months. Cystoscopy revealed a 1 cm hyperemic area on the posterior wall of urinary bladder. The biopsy showed features of amyloidosis and amyloid A (AA) immunostaining was negative. Extensive workup was done to exclude other sites of involvement and a final diagnosis of primary localized amyloidosis of the urinary bladder was made. The patient is on regular follow-up.
Increased CD44 antigen activity has been reported in recurrent cases of UBC. To date, no reliable biomarker is available with high significance and specificity for non-invasive detection of UBC. This study aimed to identify a CD44-linked microRNAs (miRNAs) (miR-9, miR-34a, miR-203) for non-invasive diagnosis of bladder cancer from other urinary tract malignancies. The expression of CD44-linked miRNAs was examined in serum, urine, and tissue specimens of Indian UBC patients ( N = 25). For this purpose, healthy subjects ( N = 25) and benign prostatic hyperplasia (BPH) ( N = 10) patients were taken as controls. The relative expression of miRNAs was analyzed in serum, urine, and tissue samples using real-time quantitative reverse transcription PCR (qRT-PCR). The diagnostic potential of these miRNAs was accessed by plotting ROC curve. Increased miR-9 expression was observed in serum of UBC patients than healthy and BPH controls. In UBC patients, miR-34a expression was lower than healthy controls but non-significant as compared to BPH. miR-203 expression was considerably higher in serum of UBC patients but non-significant as compared to BPH controls. miR-203 was found to be considerably higher in urine samples from UBC patients as compared to BPH and healthy controls. The diagnostic potential of these miRNAs was evaluated using the ROC curve. Higher miR-203 levels in the urine of Indian UBC patients demonstrate its non-invasive diagnostic ability out of the three miRNAs studied. Our results characterize the non-invasive diagnostic potential of CD44-linked miR-203 in the urine of Indian UBC patients, which could be utilized in clinical settings in future after validation in larger patient cohort.
Objective: The purpose of this study is to determine whether or not oral medication is more effective than intravenous medication in the treatment of peritonitis caused by bacteria. Study Design:Comparative study Place and Duration: Department of Internal Medicine Gangaram hospital Lahore and Medical ward, THQ Hospital Dargai, from October, 2021 to March, 2022. Methods: There were 102 cases of both genders having spontaneous bacterial peritonitis because of cirrhosis were included. Included patients were aged between 18-60 years.After taking informed written consent, detailed demographics of enrolled cases were recorded. Patients were equally divided in two groups. Group I received intravenous antibiotic in 51 patients and group II received oral antibiotics in 51 patients. Post-treatment outcomes were compared among both groups. SPSS 22.0 was used to analyze all data. Results: We found that effectiveness in group I was higher 47 (92.2%) as compared to group II44 (86.3%) but not a significant difference observed. Frequency of mortality in group II was 4 (7.8%) and in group I 3 (5.9%). Diarrhea, nausea, vomiting, rashes and gastrointestinal distress were the most common adverse effects in both groups. Conclusion: We concluded in this study that the use of antibiotics orally and intravenously for SBP treatment was affective equally. There was no any significant difference observed in both procedures. Keywords: Cirrhosis, Oral Antibiotics, Intravenous Antibiotics, SBP, Efficacy
Objective: To determine the frequency of hepatorenal syndrome in patients presented with chronic liver disease, also examine one month mortality in patients diagnosed with hepatorenal syndrome. Study Design: Prospective/Observation Study Place and Duration: Medical Ward, THQ Hospital Dargai Malakand and Ziauddin University Karachi, From November, 2021 to April, 2022. Methodology: One hundred and five patients of either gender presented with chronic liver disease having ages 18 to 65 years were enrolled. Detailed demographics including age, sex, BMI, duration of disease and etiology of liver cirrhosis were recorded after taking informed written consent. Patients with hepatic encephalopathy being treated with nephrotoxic drugs, acute infection, hypovolemia, sepsis, and fulminant and sub-fulminant hepatic failure were excluded. Serum creatinine was analyzed in all the patients to examine renal failure. Outcomes in term of one month mortality was also examined in HRS patients. Data was analyzed by SPSS 24.0. Results: There were 63 (60%) males while 42 (40%) patients were females with mean age 47.18±11.64 years. Mean BMI was 24.66±3.84 kg/m2. Among 105 patients 15 (14.29%) patients were diagnosed to have hepatorenal syndrome. Out of 15 HRS patients, 4 (26.67%) were died. Conclusion: It is concluded that frequency of hepatorenal syndrome in liver cirrhosis patients was high. And HRS was associated with high rate of mortality. Keywords: Chronic Liver Disease, HBV, HCV, Hepatorenal Syndrome, Mortality
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