American Journal of Clinical Medicine Research

Background: Acute kidney injury is common in hospitalized patients, and is associated with high rates of morbidity and mortality. Only in a small part of cases it is secondary to obstructive etiologies. Ultrasonography of the urinary tract is todaya routine part of the evaluation of patients with acute kidney injury, and is debated regardingits value in the evaluation of all patients with acute kidney injury. Methods: A retrospective analysis of data of patients who presented to the emergency department of a tertiary medical center with acute kidney injury and who underwent ultrasound studies of the urinary tract. Aims: to evaluate the effectiveness of ultrasonography as a routine part in the evaluation of acute kidney injury in the emergent setting and to identify factors that may identify patients who will benefit of the study and patients who will not. Results: Substantial obstructive pathology was detected in more than 10% of the studies performed. The known history of nephrolithiasis and the use of anti-hypertensive medicines of the ARB/ACE groups and of diuretics were factors shown to have effect on the outcome of the studies performed. Conclusions: Ultrasonography is an important part of the routine evaluation of AKI in the emergency room. Use of certain medicines and history of urinary tract stonesare factors predictive of the findings on imaging studies.

American Journal of Clinical Medicine Research. 2014, 2(5), 103-105. DOI: 10.12691/ajcmr-2-5-3
Pub. Date: November 13, 2014

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Prevalence of Liver Disease in Russia’s Largest City: A Population-based Study

by Komova A., Maevskaya M. and Ivashkin V.

Original Research

Background and aim: Difficulties in accessing data from individual countries, especially Russia, hinder global evaluation of liver disease in Europe. The aim of this study is to estimate the prevalence of liver disease in Moscow, Russia’s capital and most densely populated urban area. Methods: We recruited 5,000 random Moscow residents over the age of 18 in a population-based cross-sectional study. Participants were screened for liver disease between October 2012 and November 2012. Socio-demographic, health and lifestyle information was obtained via questionnaire; alcohol screening was done using CAGE and AUDIT tools; BMI was measured by physical exam; liver tests (ALT, AST, GGTP, bilirubin, ALP, ALT/AST), anti-HCV, HBsAg, and γ-globulins were checked by laboratory analysis; an abdominal ultrasound was performed for all patients. Provisional diagnoses were formed for all participants according to our established algorithm. Results: In total, 4,768 participants completed screening. Socio-demographic data: male 1,671 (33.42%), female 3,329 (66.58%), average age 45 years, average BMI 26.2 kg/m². Average BMI >25 kg/m² was observed among the following occupational groups: retired, disabled, military and businessmen. Health care workers and students were the “slimmest” occupational groups, with only 24.7% and 21.8% having BMI >25 kg/m² respectively. The CAGE and AUDIT questionnaires revealed that a huge number of participants (74.64% of all participants) should reduce the quantity of alcohol they consume, and that 9.8% abuse alcohol or are alcohol dependent. Overall, 1,459 subjects (30.6%, m:f=2:1) had at least one abnormality in liver function tests. We found the following prevalence of liver diseases in Russia’s largest city: NAFLD 7.4% (n=352), ALD 6.9% (n=329), hepatitis C 6.7% (n=322), hepatitis B 1.9% (n=91), DILI 0.82% (n=39), cholestasis 0.69% (n=33), AIH 0.78% (n=37), other forms of liver disease 5.4% (n=258). Conclusions: According to our study, more than one quarter of Moscow residents have abnormal liver tests that may indicate liver disease. NAFLD, ALD and hepatitis C were the main causes of abnormal tests. The primary risk factors for abnormal liver tests as determined by multivariable analysis were: young age (30-59 years, p<0.001), alcohol abuse (AUDIT score >16, p<0.04), and hypercholesterolemia (p=0.016). 80.3% of patients with abnormal liver tests required etiotropic treatment.

American Journal of Clinical Medicine Research. 2014, 2(5), 99-102. DOI: 10.12691/ajcmr-2-5-2
Pub. Date: October 23, 2014

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Estimation of Stress Induces By Malaria Parasite Infection and Effect of Anti-malaria Drugs on Stress Index, Lipid Profile in Uncomplicated Acute Malaria Infected Adult Individuals

by ESAN AYODELE. J and TITILAYO OYEDELE. E

Original Research

Malaria infection is accompanied by increased production of reactive oxygen species which indicates the environment for oxidative stress. Oxidative stress in malaria may originate from several sources including intracellular parasitized erythrocytes and extra-erythrocytes as a result of haemolysis and host response. The aim of this study is to estimate level of stress induces by malaria parasite infection and effect of anti malaria drugs on stress index in uncomplicated acute malaria infected adult individuals. 202 confirmed malaria infected patients were recruited for the study between the ages of 15 – 64 years of both sexes at the general outpatient clinic of the Federal Medical Centre, Ido-Ekiti, Nigeria. 129(63.9%) were males and 73(36.1%) were females. Mean± SD of cortisol, MDA, glucose and HDL in pre anti-malaria drug treatment of age group A were higher compared to other age groups; there is significant difference (p < 0.05) observed in cortisol and glucose. Plasmodium falciparum malaria infection is accompanied by increased production of reactive oxygen species which indicates the environment for oxidative stress. The level of stress induced by malaria parasite is corresponded to the severity of infection and age differences; this could be due to the number of exposure to mosquito bites which increases with age and also increase the level of immunity against malaria infection.

American Journal of Clinical Medicine Research. 2014, 2(5), 87-98. DOI: 10.12691/ajcmr-2-5-1
Pub. Date: October 14, 2014

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