The role of parathyroid hormone and cardiac output in pulmonary hypertension in hemodialysis patients

Introduction: High prevalence of pulmonary hypertension has been reported in patients with chronic renal failure, especially those undergoing hemodialysis. Objectives: Considering the high prevalence of pulmonary hypertension in hemodialysis patients and uncertainty about the causes, the present study planned to investigate the role of parathyroid hormone (PTH) and cardiac ejection fraction (EF %) in development of pulmonary hypertension. Patients and Methods: By simple census sampling, all patients on hemodialysis in the hemodialysis center of Birjand University of Medical Sciences were enrolled. After obtaining written consent, the EF% and systolic pulmonary artery pressure (sPAP) were determined using echocardiography (MEDISON V10 model, Korea). The cut-point of less than 35 mm Hg was considered for normal sPAP. The blood sample was prepared to assay PTH using COBAS411 and ROCH kit. Independent t test or Man-Whitney test were used to compare means. P value <0.05 was considered significant. Results: A totsl of 114 patients were enrolled in the study. Finally 89 patients, including 49 (55.1%) male and 40 (44.9%) female completed the study. The mean age and mean sPAP of the studied patients were 55.14 ± 15.68 years and 30.65 ± 12.10 mm Hg respectively. Among the studied patients, normal and high sPAP were reported in 60 (67.4%) and 29 (32.6%) cases respectively. Cardiac EF% in patients with normal and high sPAP was 59.08 ± 2.83 versus 56.37 ± 4.79 respectively (P = 0.01). PTH was determined 275.12 ± 218.44 versus 395.67 ± 332.05(pg/mL) (P = 0.03), in patients with normal and high sPAP respectively. Conclusion: The prevalence of pulmonary hypertension in the studied patients was 32.6%. Patients in the pulmonary hypertension group had higher levels of PTH and lower cardiac EF%.

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Prevalence of Self-Medication and Its Factors among University Students in Bandar Abbas City

International Electronic Journal of Medicine ◽

10.31661/iejm671 ◽

2018 ◽

Vol 7 ◽

Author(s):

Atefeh Mohammadi

Keyword(s):

Herbal Medicines ◽

Target Population ◽

Easy Access ◽

Medical Sciences ◽

Self Medication ◽

Delay In Diagnosis ◽

Consumption Culture ◽

High Prevalence ◽

The Mean ◽

Bandar Abbas

Background: Self-medication can lead to the latency of the real severity of disease, delay in diagnosis, a complication of treatment, threatening side effects, and unexpected intoxication. The present research aimed to explore the prevalence of self-medication and its factors among students affiliated to Bandar Abbas universities in 2016. Materials and Methods: This Descriptive Analytic study was performed on 600 students affiliated to the universities in Bandar Abbas; Islamic Azad University, Payam-e-Noor University, and University of Medical Sciences. The sample was selected through a stratified sampling method, and the data were collected by a questionnaire comprised of two parts, demographic information (6 items), and risk factors of self-medication and self-medicated drugs (26 items). SPSS version 19 was used to analyze the data through the required tests. Result: The mean age of the students was 24.11±5.85 years. One hundred and ninety-one subjects (31.8%) were male, and 409 (68.2%) were female. The results revealed the prevalence of self-medication in the target population was 80.2%., the main reasons for self-medication were reported underestimating the disease 461(77.0%), previous experience of the disease 457(76.4%), repeated prescription 441(73.6%), and easy access to drug 423(70.6%). The most prevalent drugs self-medicated by students were acetaminophen, herbal medicines, antibiotics, other drugs, sedatives, and anti-acids, respectively. Conclusion: Considering the high prevalence of self-medication (80.2%) revealed in this research, there is a need for more attentive care for consistent education and drug consumption culture promotion. Specific approaches can help the provision of easy access to medical services in universities.

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Evaluation of Transient Elastography in Prediction Of De novo Recurrence of Hepatocellular Carcinoma after Radiofrequency Ablation

QJM ◽

10.1093/qjmed/hcab107.013 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Nadia abdelaty Abdelkader ◽

Moustafa Hamed Abdelaleem ◽

Mohammed El-Gharib Abo El- maaty ◽

Heba Ismail Aly ◽

Sayed Ahmed Sayed

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Transient Elastography ◽

P Value ◽

Hepatic Decompensation ◽

Non Invasive ◽

Prediction Of Mortality ◽

The Mean ◽

One Year

Abstract Background Hepatocellular carcinoma (HCC) is the sixth most common malignancy worldwide and it is also a common cause of death in patients with chronic liver disease. The curative treatment options for HCC that are currently available are surgical resection, liver transplantation and radiofrequency ablation .Despite progressive improvements in the efficacy of RFA, the survival of patients with HCC who undergo RFA remains disappointing, mainly due to frequent intrahepatic recurrence of HCC after RFA. Aim of the work To evaluate the role of transient elastography (as an indirect indicator to degree of liver fibrosis) in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation in hepatitis C related hepatocellular carcinoma .And to compare between transient elastography and other non invasive fibrosis indices in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation hepatitis C related hepatocellular carcinoma Patients and methods This prospective cohrt study was conducted on hepatocellular carcinoma patient, who underwent radiofrequency ablation in Tropical Medicine Department in Eldemerdash and Ain Shams Specialized Hospital, HCC clinic Ain Shams University Hospitals, Cairo, Egypt between march, 2017 and May, 2019. Data of the patient, who underwent radiofrequency ablation during the study period, were reviewed and the patients who fulfilled the inclusion criteria were enrolled into this study. The patients who fulfilled the inclusion criteria and underwent radiofrequency ablation were followed up for 12 months. Results TE revealed 28 patients with F4 and only 2 patients with F3, the mean measurement of liver stiffness was (22.45 ± 10.36) KPa. There was a significant negative correlation between LS and denovo recurrence of HCC (mean of LS in patients with complete response was 17.19 ± 3.32 and the mean of LS in patient with denovo recurrence was 36,94 ± 5.93,with the The best cut off value ≥24.65 (p value < 0.001)). There was no significant correlation between CDC, FIB4, API scores and denovo recurrence of HCC. Also it was found that the LS was significantly associated with prediction of manifestation of hepatic decompensation after RFA (means of LS in patient without manifestation decompensation after RFA (p value <0.001) .Regarding prediction of mortality, LS at cut off value > 42 .75 (p value = 0,031) was significantly associated with prediction of mortality after one year of RFA. As regard serum non invasive fibrosis indices our results showed correlation between FIB4 score and hepatic decompensation after one year of intervention (the mean of FIB4 score in patients ascites and jaundice was 6.05 ± 4.71 (p value = 0.05) ).Therewas no statistically significant correlation between CDS and API with hepatic decompensation after RFA .As regard role of serum non invasive fibrosis indices in prediction of mortality after RFA, FIB4 score, CDS and API were statistically non significant. Conclusion Our data suggest that LS measurement is a useful predictor of HCC de novorecurrence overall survival and possibility of hepatic decompensation after RFA

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Role of Chemical Biomarkers in Prediction of Intra-Amniotic Infection in Cases with Preterm Premature Rupture of Membrane, Observational Study

Journal of Gynecology & Reproductive Medicine ◽

10.33140/jgrm.03.02.08 ◽

2019 ◽

Vol 3 (2) ◽

Keyword(s):

Interleukin 6 ◽

Mean Value ◽

Maternal Serum ◽

P Value ◽

Subclinical Infection ◽

Premature Rupture ◽

Cutoff Value ◽

The Mean ◽

Sensitivity Specificity

Introduction: Early recognition of subclinical intra-amniotic infection before development of clinical Chorioamnionitis dramatically improve neonatal outcome before affection of fetal neurological function. Objective: this study was conducted to evaluate the role of procalcitonin and interleukin-6 in early prediction of intrauterine infection in pregnant women with premature rupture of membranes. Methods: This observational prospective cohort study was conducted on 100 pregnant women with preterm premature rupture of membrane (PPROM), Patients were divided into 2 groups: Group I: with normal CRP and WBCs level. Group2: with subclinical infection which was detected by elevated WBCs count >15,000 c/mm3 and / or positive CRP. This group was divided into two groups (Group (II) and Group (III) according to development of Chorioamnionitis. follow up of these patients was done to detect the cutoff value of procalcitonin and interleukin-6 as a predictive indicator of clinical intra-amniotic infection in patients with premature rupture of membrane. Results: This study showed that the mean value of maternal serum PCT concentration was higher in patients with clinical infection than its concentration in patients without infection or with subclinical infection with P-value 0.0001 which is highly significant between the studied cases and with cutoff value was >0.67ng/ml, sensitivity, specificity, PPV, NPV was 88.7%, 42.9%, 79.7% and 60% respectively and the mean value of maternal serum IL-6 concentration was also higher in patients with clinical infection than its concentration in patients without infection or with subclinical infection with P-value 0.001which is highly significant between the studied cases and with cutoff value was >11.1pg/ ml, sensitivity, specificity, PPV, NPV was 67.9%, 61.9%, 81.8% and 43.3% respectively. Conclusion: maternal serum procalcitonin is a good predictor of clinical intra-amniotic infection with good sensitivity, specificity, PPV, NPV which is nearly good as CRP which is better than serum interleukin-6 regarding sensitivity

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Correlation between quality of life and adherence to treatment in hemodialysis patients

Journal of Renal Injury Prevention ◽

10.15171/jrip.2019.05 ◽

2018 ◽

Vol 8 (1) ◽

pp. 22-27 ◽

Cited By ~ 1

Author(s):

Mahin Naderifar ◽

Mansoureh Zagheri Tafreshi ◽

Mahnaz Ilkhani ◽

Magid Reza Akbarizadeh ◽

Fereshteh Ghaljaei

Keyword(s):

Quality Of Life ◽

Healthcare Providers ◽

Life Quality ◽

Well Being ◽

Sample Volume ◽

Hemodialysis Patients ◽

Adherence To Treatment ◽

Medical Sciences ◽

The Mean

Introduction: Institutionalizing adherence to treatment in hemodialysis patients is one of the important nursing goals for improving quality of life in these patients. Adherence to treatment approach in these patients can play a pivotal role in improving the health level and feeling of well-being. Objectives: This study aimed at determining the quality of life in hemodialysis patients presenting to hemodialysis centers affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran, on the basis of adherence to treatment. Patients and Methods: This is a correlational descriptive-analytic study. The study population consisted of hemodialysis patients in five hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran, in 2017. The data were collected during 8 months from October 2016 to May 2017 in Tehran. A sample volume of 200 patients was determined in this study. Demographic information questionnaire, KDQOL-SF, and ESRD-AQ were applied in data collection. Availability sampling method was used to select the samples on the basis of inclusion criteria. The data were analyzed with SPSS version 18 using descriptive and inferential statistics. Results: Our findings showed that 50% of the patients were male. Most of the respondents of the study (23%) were 51-60 years old. The results indicated that the mean score of quality of life of patients was 50.42±22.81. The mean total score of adherence to treatment was 901.13±85.30. Also, the correlation coefficient in this study revealed a significant correlation between total score of quality of life and adherence to treatment (r=0.218, P<0.01). Conclusion: Considering the significant correlation between adherence to treatment and life quality of patients, healthcare providers can promote the life quality of these patients via focusing on planning programs for emphasizing the role of education and interventions that improve adherence to treatment in these patients.

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A Successful Application of the Intraoperative Parathyroid Hormone Assay in Tertiary Hyperparathyroidism

The American Surgeon ◽

10.1177/000313480707300318 ◽

2007 ◽

Vol 73 (3) ◽

pp. 281-283 ◽

Cited By ~ 5

Author(s):

Leila Thanasoulis ◽

Juliane Bingener ◽

Kenneth Sirinek ◽

Melanie Richards

Keyword(s):

Parathyroid Hormone ◽

Success Rates ◽

Tertiary Hyperparathyroidism ◽

Equivalent Rate ◽

Parathyroid Hormone Assay ◽

The Mean ◽

Intraoperative Parathyroid Hormone ◽

Intraoperative Parathyroid Hormone Assay

The role of the intraoperative parathyroid hormone (IOPTH) assay in patients with tertiary hyperparathyroidism (3HPT) is not well defined. To evaluate the utility of the IOPTH in 3HPT, we compared its use in 72 patients with primary hyperparathyroidism (1HPT) and 3HPT undergoing parathyroidectomy. Sixty-three patients with 1HPT and nine patients with 3HPT were identified. There were 30 men and 42 women (mean age, 58 years). The mean serum calcium and preoperative intact PTH levels in 1HPT were 11.1 mg/dL and 214 pg/mL compared with 11.2 mg/dL and 849 pg/mL in 3HPT (Ca, non significant; PTH, P < 0.05). Intraoperatively, a solitary abnormal gland was found in 62 of 72 (86%) patients. Seven patients with 3HPT had three- or four-gland hyperplasia. The two groups were compared to determine if a 10-minute postexcision IOPTH decline >50 per cent would have similar success rates. Seventy-one of 72 (98.6%) patients had a >50 per cent decline from the baseline IOPTH at the end of the operation. The average reduction from baseline was 85.3 per cent in 1HPT and 88.6 per cent in 3HPT (not significant). Average follow-up was 9.8 months for 1HPT and 11.1 months in 3HPT. Three of 63 patients (4.8%) with 1HPT and five of nine patients (55.6%) with 3HPT had inappropriate elevations in PTH ( P < 0.05). All patients with 3HPT were normocalcemic compared with 62 of 64 (97%) patients with 1HPT (not significant). The IOPTH assay can be used in 3HPT in an identical fashion with an equivalent rate of normocalcemia compared with its applications in 1HPT.

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Comparison between use of combination of mifepristone and misoprostol versus misoprostol alone in the management of intrauterine fetal death

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182880 ◽

2018 ◽

Vol 7 (7) ◽

pp. 2778

Author(s):

Sreeveena Talasani ◽

Pran Hitha Venkamolla ◽

Kalpana Betha

Keyword(s):

Side Effects ◽

Fetal Death ◽

Intrauterine Fetal Death ◽

P Value ◽

Ultrasound Scan ◽

Efficacy And Safety ◽

Medical Sciences ◽

The Mean ◽

Group 2 ◽

Group 1

Background: Intrauterine fetal death (IUFD) is estimated to occur in 1% of all pregnancies. The advent of prostaglandins has revolutionized the management of IUFD. There are limited studies using a combined regimen of mifepristone and misoprost for induction of labor in IUFD. Hence this study was undertaken to assess the efficacy and safety of combined regimen with misoprostol alone, in the management of IUFD.Methods: This hospital based prospective study included 60 pregnant women with IUFD admitted at Mediciti Institute of Medical Sciences, during the period January 2015 to July 2016. An ultrasound scan was performed to confirm IUFD and localize the placenta. Women were divided alternatively into 2 groups with 30 in each group (group 1- women received 200 mg mifepristone orally followed by misoprostol after 24 hours & in group 2, 100 µg misoprostol every 6 hourly for a maximum of 4 doses between gestational age 24-26 weeks, 25-50 µg 4 hourly for a maximum of 6 doses beyond 26 weeks).Results: The mean induction to delivery interval was 10 hours in group 1 and 16.3 hours in group 2 (p value 0.007). Mean dose of misoprostol required in group 1 was 1.87 and 2.67 in group 2 (p value 0.008). With respect to side effects, the two groups did not differ significantly.Conclusions: The combined regimen was more effective than misoprostol for the induction of labour in IUFD, in terms of higher rate of successful delivery and shorter induction to delivery interval.

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Lifestyle of students at Tehran University of Medical Sciences during Corona Epidemic: A cross-sectional study

Iranian Journal Of Health Sciences ◽

10.18502/jhs.v9i3.7308 ◽

2021 ◽

Author(s):

Fatemeh Rahimi ◽

Elahe Alamdar ◽

Hengame Sadat Seyed Mirnasab ◽

Somaieh Borjalilu ◽

Mahnaz Pouresmaeil ◽

...

Keyword(s):

Spiritual Growth ◽

Cross Sectional Study ◽

Demographic Variables ◽

P Value ◽

Sectional Study ◽

Medical Sciences ◽

Cross Sectional ◽

Health Promoting ◽

The Mean ◽

Health Promoting Lifestyle

Background and purpose: There is concern that students may have an unhealthy lifestyle as a result of changes that occurred during corona conditions, so this study aimed to determine the status of the lifestyle and its relationship with the demographic characteristics of postgraduate students during the corona span. Material and Methods: This cross-sectional study was conducted at Tehran University of Medical Sciences in 2020. The link to the online Health-Promoting Lifestyle Questionnaire Profile2 was sent to conduct the research. To examine the relationships between the mean scores of health-promoting lifestyle and different variables, an independent samples t-test was applied in the case of dichotomous demographic variables (gender, education level, and income-generating activity), while one-way analysis of variance test was used to evaluate the multilevel demographic variables (marital status, place of residence, and faculty). The Pearson correlation coefficient was also used for testing age. Results: The sample 240, (75.4%) were female and 145 of them, (60.4%) were single. The mean age of them was 32.21±7.45.45 years old. The lifestyle total score was 138.28± 21.18 at the average level. The highest score was related to spiritual growth (26.93±5.01), whereas the lowest score was reported on physical activity (16.92±5.17). The difference between the mean of health-promoting lifestyle was not significant in terms of demographic variables.According to the results, a statistically significant difference was observed between male and female students in the field of nutrition. Also, students were significantly different in the nutrition domain regarding students’ residence (p-value <0.05). Spiritual growth was significantly different among students in terms of marital status (p-value <0.05). Conclusion: Although the mean score of health-promoting lifestyle was not different from other studies, further studies are proposed to plan health interventions in accordance with epidemic conditions for students.

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PBL session conducted for second year undergraduate students of medicine and dentistry at Universal College of Medical Sciences Nepal: Perception of the participants

Janaki Medical College Journal of Medical Science ◽

10.3126/jmcjms.v9i1.38338 ◽

2021 ◽

Vol 9 (1) ◽

pp. 55-60

Author(s):

PiryaniRano Mal ◽

Piryani Suneel ◽

Gautam Narayan

Keyword(s):

Undergraduate Students ◽

Medical Sciences ◽

Cross Sectional ◽

Student Centered ◽

Validated Questionnaire ◽

Perceptions Of Students ◽

The Mean ◽

Second Year ◽

Strongly Agree

Background and Objectives: Problem-based-learning (PBL) is generally recognized as a student centered instructional approach. Universal College of Medical Sciences Nepal introduced PBL to second year MBBS and BDS students in July 2019.This study assessed the perceptions of students of second year MBBS and BDS who participated in PBL session. Material and Methods: This was a cross-sectional questionnaire-based study assessing perceptions of the participant students. The validated questionnaire was used for the collection of data at the end of PBL session. The questionnaire comprised of two parts; Part I- Students’ perceptions and attitude towards PBL (9 statements) and Part II Students’ perceptions about the role of tutor in PBL(11 statements).Data were analyzed using SPSS version 21. The frequency, mean and standard deviation were computed and t test was used for the comparison of responses on statements of MBBS and BDS groups. Results: The mean scores on7 out of 9 statements on students’ perceptions and attitude towards PBL was higher than fourat Likert scale 1-5 (5=strongly agree, 4=agree, 3=to some extent agree, 2=disagree, 1=strongly disagree) and on 2 statements was higher than 3.5. The mean scores on all the statements with regard to students’ perception about the role of tutor in PBL were higher than four. The mean scores of both MBBS and BDS groups of students on all statements were compared; the significant differences were obtained only on 2 statements out of 20. Conclusion: The perceptions and attitude of students towards PBL and perceptions about the role of tutor were positive.

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Serum Neutrophil Gelatinase-Associated Lipocalin Levels In Early Detection Of Contrast-Induced Nephropathy

Clinical & Investigative Medicine ◽

10.25011/cim.v39i3.26797 ◽

2016 ◽

Vol 39 (3) ◽

pp. 88 ◽

Cited By ~ 1

Author(s):

Murat Muratoglu ◽

Cemil Kavalci ◽

Elif Kilicli ◽

Meliha Findik ◽

Afşin Emre Kayipmaz ◽

...

Keyword(s):

Early Detection ◽

P Value ◽

Ngal Level ◽

Contrast Induced Nephropathy ◽

Sodium Potassium ◽

Neutrophil Gelatinase Associated Lipocalin ◽

The Mean ◽

Neutrophil Gelatinase ◽

Over Time

Purpose: The purpose of this study was to investigate the role of serum neutrophil gelatinase-associated lipocalin (NGAL) levels in the early detection of contrast-induced nephropathy (CIN). Methods: This prospective study enrolled 74 patients undergoing abdominal tomography with contrast (1 November 2014 - 28 February 2015). Demographic properties (age and sex), symptoms and CT examination results were analysed. Sodium, potassium, urea, creatinine and NGAL levels were measured at 0th, 6th, and 72nd hours. P value < 0.05 was considered statistically significant. Results: CIN developed in 16.2% of the study patients. The mean age was significantly higher in the patients who developed CIN (p0.05). Urea levels did not differ significantly between the groups at 0th and 6th hours (p>0.05) but was significantly higher in the patients with CIN at 72nd hour (p0.05). Creatinine level was not significantly different between the groups (p>0.05) but increased significantly over time (p>0.05). There were no significant differences between the groups with respect to NGAL levels at 0th and 72nd hours (p>0.05) whereas the group with CIN had a significantly higher NGAL level at 6th hour (p

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Prevalence of sickle cell trait and its association to renal dysfunction among blood donors at university of medical sciences teaching hospital, Ondo, Nigeria

African Health Sciences ◽

10.4314/ahs.v21i3.33 ◽

2021 ◽

Vol 21 (3) ◽

pp. 1237-1242

Author(s):

Akinwumi Ayodeji Akinbodewa ◽

Adeyemi Ogunleye ◽

Oluseyi Ademola Adejumo

Keyword(s):

Renal Function ◽

Sickle Cell ◽

Blood Donors ◽

Sickle Cell Trait ◽

P Value ◽

Healthy Donors ◽

Significant Difference ◽

High Prevalence ◽

The Mean ◽

Estimated Glomerular Filtration Rates

Introduction: Prospective blood donors are routinely screened for blood borne infections but medical illnesses and haemo- globin genotype are overlooked despite a high prevalence of haemoglobin AS among Nigerian donors. Objective: To determine the prevalence of haemoglobin AS and its association to renal function, if any. Method: Apparently healthy donors were studied between February and December 2018. Their haemoglobin genotype and, estimated glomerular filtration rates were determined. Results: There were 96 males (94.1%) and 6 (5.9%) females with mean age of 26.7±4.5 years (range 19-44 years) and mean eGFR of 103.97±19.00ml/min/1.73m2. Eighty one (79.4%) and 21 (20.6%) subjects had haemoglobin AA and AS geno- types respectively. The mean eGFR for subjects with haemoglobin AA and AS were 105.2±18.6ml/min/1.73m2 and 99.9 ± 21.2ml/min/1.73m2 respectively (p value = 0.270). Eighty one (79.4%), 20 (19.6%) and 1 (1.0%) subjects had renal function at >90ml/min/1.73m2, 60-89ml/min/1.73m2 and 30-59ml/min/m2 respectively. There was no significant difference in the mean eGFR between subjects with haemoglobin AA and AS (mean difference 5.3, p = 0.265, 95%CI = -4.07 to 14.60). Conclusion: The prevalence of sickle cell trait among Nigerian blood donors is high. There is no significant difference in the renal function status of blood donors with SCT and normal haemoglobin genotype. Keywords: Haemoglobin genotype; sickle cell trait; renal function; blood donor; Nigeria.

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