Abstract : Background;Malaria is of immense importance among tropical diseases in India. Pathophysiology of complicated malaria is multifactorial in origin involving tissue hypoxia, liver dysfunction, and impaired renal handling of bicarbonate. Acidosis is an important contributor to death from severe falciparum malaria. Metabolic acidosis results from abnormal microcirculatory perfusion and anaerobic glycolysis as a result of sequestration of parasitized erythrocytes and, also, cellular dysfunction consequent on release of host and parasite-derived toxic mediators.Material and methods:The study was conducted at Victoria and Bowring & lady Curzon hospitals, attached to Bangalore medical college & research institute, Bangalore. A total of 40 patients with complicated malaria with respect to serum lactate levels measured serially every 24hours were studied.Results:During our study, 24 out of 40 patients had lactate levels >19.8mg/dl. Out of these 24 patients,10 were given blood transfusion,3 were given platelet transfusion,9 were given inotropic support and 2 were dialysed as compared to patients with normal lactate levels who were 4,1,2 and 0 respectively; implying the fact that the incidence of complications are high in patients with hyperlactatemia. Also, 3 patients died during the study; all of them were from increasing levels of lactate levels on day 3 when compared to levels at the time of admission.
Archive for June, 2015
Background: The metabolic syndrome consists of constellation of central obesity, hyperglycemia, hypertension, hypertriglyceridemia and low HDL cholesterol. Elevated serum Complement C3 levels independently predicted incident type 2 diabetes and increased cardiovascular risk in prospective studies in apparently healthy men and women.
ABSTRACT Background: Diabetic nephropathy is the single most frequent cause of end stage renal disease. GFR is the best index of renal function in health and disease. Its direct measurement with inulin or EDTA requires specialized technical personnel. Properties of an ideal endogenous blood substance to estimate GFR should include release into blood stream at constant rate and free filtration by glomerulus. Serum Creatinine is the most commonly used filtration marker in clinical practice but its accuracy is significantly hampered by the confounding influence of diet, age, gender and muscle mass. Microalbuminuria is first detectable functional abnormality, but there is 40% day to day variability. Several factors can increase urinary albumin like exercise, UTI, CCF. Cystatin C is s 13kDa protein expressed in all nucleated cells and produced at constant rate. It is freely filtered by glomerulus. It does not return to blood stream and is not secreted by renal tubules. It has been suggested to be “ideal” endogenous marker.