Urea Values Research Articles

To evaluate the reliability of Urea and Creatinine values in vaginal wash fluid for the diagnosis of PROM

Background & Methods: The aim of the study is to evaluate the reliability of urea and creatinine values in vaginal wash fluid for the diagnosis of PROM. Study performed on pregnant women in the third trimester between 28 and 37 weeks of gestation with history of possible leakage of amniotic fluid at tending in the department of Obstetrics and Gynaecology. Results: Total 50 subjects were recruited. Group 1 is PROM confirmed 25 subjects . Group 2 were controls and in each group 25 subjects were allotted. The comparison of co-morbidity between study groups in vaginal wash fluid to diagnosis the high rupture of membrane. Around 24% of subjects had co-morbidity in PROM confirmed category. Conclusion: In PROM confirmed subject urea level was 9.99 ± 4.16 and in controls it was around 4.12 ± 2.65. This shows that both PROM confirmed and suspected subjects had increased urea level than the control group. Thus urea and creatinine levels in vaginal wash fluid serves as an excellent diagnostic marker in diagnosing premature rupture of membrane. In conclusion, our study demonstrated that the measurement of vaginal fluid urea and creatinine is a simple and reliable test for diagnosis of PROM.

A Cross Sectional Study of the Prevalence of Retinopathy in Patients with Chronic Kidney Disease on Hemodialysis in a Tertiary Care Centre in Chengalpattu District, South India

Context: Many studies have reported varying proportions of retinopathy among cases with chronic kidney disease (CKD). Cases with severe grades of CKD were more likely to develop ocular complications, especially diseases which occurs due to small vessel pathology. Aim: To estimate the prevalence of various types of retinopathies in patients with CKD undergoing hemodialysis in a tertiary care centre in South India. Settings and Design: The outpatient Department of Ophthalmology and Hemodialysis unit of Nephrology, Karpaga Vinayaga Institute of Medical Sciences from January 2022 to June 2023 A cross-sectional hospital-based observational study in a low resource setting. Methods and Material: The study consists of 28 patients who were known cases of CKD on hemodialysis. Patients underwent complete ocular evaluation and findings were noted. The pre hemodialysis values of blood urea and serum creatine, hemoglobin, liver function tests and vital parameters were also noted. Data analysis was done utilising version 20 of Statistical Packages for the Social Sciences (SPSS). Results: 56 eyes of 28 patients on hemodialysis were studied. The mean age was 53 years + 10.9 with a male preponderance. 31.6% had retinopathy of which 26.3% had hypertensive retinopathy and 5.3% had diabetic retinopathy. This is contrary to the previous studies that have reported a higher incidence of diabetic retinopathy in patients with end stage CKD. Hypertension resulted in CKD earlier than diabetes. Conclusion: The results emphasize the importance of frequent eye examination in patients with CKD to identify retinopathy earlier, thus potentially averting permanent vision impairment.

Growth performance, serum metabolites, plasma protein fraction, meat lipid profile and antioxidant activities of breast meat of broiler chicken fed diets containing Cinnamomum ceylon powder, Zingiber officinale powder and Moringa oleifera leafmeal supplem

An experiment was conducted to determine growth performance, serum metabolites, plasma protein fraction, meat lipid profile and antioxidant activities of meat of broilers as affected by Cinnamomium ceylon, Zingiber officinale and Moringa oleifera supplementation. A total of 112 day old chicks were allotted into four treatments replicated four times with seven birds per replicate in a completely randomized design (CRD). Basal diets were formulated for broiler starters (0-28days) and finisher phase (29-56) days. The basal diets were divided into 4 diets : diet 1- control diet without supplementation; diet 2- contained 0.2% Cinnamomum ceylon supplementation (CCS); diet 3- contained 0.2% Zingiber officinale supplementation (ZOS), diet 4-contained 0.2% Moringa oleifera leafmeal (MOLM) supplementation. The experiment lasted for 56 days. Results showed an improvement in final liveweight, weight gain, feed intake and feed conversion ratio of birds on 0.2% MOLM. Birds on phytogenic feed additives have lower values of urea, cholesterol, glucose, high density lipoprotein and low density lipoprotein. Birds administered phytogenic supplements exhibited much greater plasma albumin levels. Low levels of meat cholesterol, triglycerides and low density lipoprotein were found in birds fed phytogenic feed additives while high levels of high density lipoprotein were recorded for birds on phytogenic feed additives. The supplementation of broilers diets with phytogenic feed additives increased the glutathione peroxidase and superoxide dismutase and decreased lipid peroxidation. It was concluded that supplementation of broiler diets with Moringa oleifera leaf meal enhanced body weight gain, antioxidant activities also reduced cholesterol level in both serum metabolites and meat.

The relationship between urodynamic bladder compliance and urinary fibrosis markers in children with neurogenic bladder dysfunction

BackgroundDecreased bladder compliance is an important risk factor for upper urinary tract in children with neurogenic bladder dysfunction (NBD). Urodynamics is the gold standard in determining bladder compliance. ObjectiveTo investigate the relationship between low bladder compliance and urinary fibrosis markers in NBD. Study designSpina bifida patients with NBD, who admitted between March 2021 and July 2021 were included. Patients with low compliant bladders, no renal scar, no recurrent urinary tract infections formed low compliance, LC group. Normal compliance, NC group, was comprised of patients with normocompliant bladders and the same characteristics. Control group (Group C) consisted of patients for outpatient surgery and had no known bladder dysfunction. Compliance was calculated with the formula ΔV/ΔP and a value of under 15 ml/cmH2O was accepted as low. Age, gender, urine density, serum urea, creatinine levels and urodynamic parameters were noted. Urinary type 1, type 3 collagen and its precursor procollagen type 3 and serum type 1 and 3 collagen were determined by ELISA. Results72 patients were included (LC group, n:31, NC group, n:24, C group n:17, mean age 7,39±1,24 years). No significant difference was observed in the comparison of age, gender, urine density and serum urea and creatinine values. No significant difference was observed between the LC and NC groups for urodynamic parameters, except for bladder compliance. Urinary collagen type 1 in LC group (11,71±3,02 ng/ml) was found to be significantly higher than that of the C group (9,45±1,97 ng/ml) (p=0,03). Urinary procollagen type 3 was significantly higher in LC group (103,15±24 ng/ml) when compared to C group (82,42±22,26 ng/ml) (p=0,016). Urinary collagen type 1 level above 9,20 ng/ml was 80,6% sensitive and 70,6% specific and urinary procollagen type 3 level above 78 ng/ml was 87% sensitive and 70,6% specific in predicting low compliance. DiscussionThis study seems to be the first study in the literature to evaluate bladder fibrosis and compliance, biochemically, by measuring urinary collagen levels in NBD. Urinary fibrosis markers are not currently an alternative to urodynamics for bladder compliance, but they may have potential to reduce the need for urodynamics with this indication. ConclusionDetermination of urinary collagen levels may be a marker of bladder wall fibrosis and may indirectly show decreased bladder compliance. It is plausible to say that invasive methods such as urodynamics may be less preferred for defining bladder compliance, instead, urinary biomarkers may have merit for this purpose in the future.

Childhood cerebral malaria: Pattern of biochemical parameters and clinical outcome in a Nigerian tertiary hospital

BackgroundThe outcome of children with cerebral malaria involves an interplay of factors including clinical and biochemical parameters, a deep knowledge of these laboratory biochemical parameters is essential. Thus, this study aimed to assess the pattern of the biochemical parameters in children with cerebral malaria and how it may affect the clinical outcomes. MethodsA prospective observational cohort study among fifty subjects at the children's emergency unit. The participants were children aged 6 months to 12 years admitted with a history of fever and altered sensorium, demonstrable malaria parasite in the blood film and cerebrospinal fluid (CSF) analysis not suggestive of central nervous system (CNS) infections. Detailed history was taken with thorough examinations of each child. Samples were collected for malaria parasites, serum electrolytes, urea, creatinine, and blood glucose values. The clinical outcomes were correlated with the analyte levels. Results60 % of the children survived without any sequelae with the highest proportion (70 %) of survivors being children above five years. Children with hypoglycemia had a 3.5-fold higher risk of poor outcomes and this is statistically significant (RR = 3.65 p = 0.014). Hyperkalaemia was significantly associated with poor outcomes (RR = 2.57, p = 0.009). Subjects with hypochloraemia had three times the risk of poor outcome and mortality with statistically significant association (RR = 3.07, χ2 = 8.519, p = 0.004). There was a significant association between metabolic acidosis and poor clinical outcome. (RR = 1.99, χ2 = 4.089, p = 0.043). The parasite density was significantly associated with the serum bicarbonate (HCO3−) and Chloride, p-value < 0.05. ConclusionHypoglycaemia, hyperkalemia, hypochloremia and metabolic acidosis were significantly associated with poor outcomes, thus, good predictors of clinical outcomes in children diagnosed with cerebral malaria. Periodic evaluation and monitoring of these parameters is essential for prompt intervention to forestall devastating outcomes.

Co-abuse of amphetamine and alcohol harms kidney and liver.

The prevalence of alcohol use disorder was found 75% higher among amphetamine dependent patients. Alcohol and amphetamine alone have nephrotoxicity and hepatoxicity. But, the degree of risk with coabuse of alcohol and amphetamine is unknown. The objective of this study was to assess toxic effects of amphetamine-alcohol co-abuse on the liver and kidney. he present study was a cross-sectional study conducted et al. Amal Hospital for Mental Health, Qassim region, KSA and include one hundred participants. Seventy-five participants were patients hospitalized for the treatment of abuse, and twenty-five participants, were healthy voluntaries, have no history of abuse. An experienced psychiatrist conducted patient interviews and assessed the patients using the DSM-5 criteria. The data from healthy participants were considered as a control. The abuse group was paired with the control group by age and lifestyle. Participants were split into: Group I: Control group (n = 25); Group II: Amphetamine (AMP) abuser group (n = 25); Group III: Alcohol abuser group (n = 25) and Group IV: Combined drug abuser group (AMP and alcohol) (n = 25). The socio-demographic data was collected. Complete medical examination, Body Mass Index and samples of blood and urine were collected from all participants for analytical tests; determination of alcohol and AMP levels, kidney functions and liver functions. The mean BMI values in groups II, III, and IV showed no significant change from the control group. The serum level of albumin and alkaline phosphatase showed significant decrease in all abuser groups. While, alanine transaminase (ALT), Aspartate transaminase (AST) and osteopontin levels showed significant increase in all abuser groups. Fasting blood sugar values showed significant increase in alcohol abusers. On the other hand, it revealed no significant change in AMP and combined groups. The mean values of urea showed no significant change in AMP and alcohol abusers and significant increase in combined drug abuser group. The serum creatinine and all abuser groups showed significant increase in Cystatin C. The alteration in the most of studied biochemical parameters were more than two folds in combined group compared with that of AMP or alcohol groups. Study reveals synergistic liver and kidney toxicity. Amphetamine-alcohol co-abuse significantly heightens kidney and liver toxicity.

B-009 Verification of Result Interchangeability Between Two Analyzers in the Determination of Uric Acid and Urea

Abstract Background Uric acid and urea are two parameters widely used in the diagnosis and management of renal pathology. In our laboratory, they are determined using Atellica Solution® analyzers (Siemens Healthineers). After validating a new Siemens equipment, Atellica CI®, it is essential to ensure result interchangeability in our laboratory accredited by ISO 15189:2012. Objectives evaluate the interchangeability of results for uric acid and urea measured by Atellica Solution® and CI® analyzers. Methods A total of 40 serum samples from patients with uric acid values between 1.3 and 15.2 mg/dL, and another 40 serum samples from patients with urea values between 7 and 142 mg/dL were processed in parallel. Statistical analysis of the results was performed using Passing-Bablok regression and Bland Altman mean difference analysis with Method Validator Version 1.19. Results are expressed with their 95% confidence interval. Results Uric Acid: After analyzing Bland-Altman differences, a statistically significant slight systematic error was found, as the 95% CI does not include 0, with slightly higher results in CI 1900®. Regarding Passing-Bablok regression analysis, there were no systematic errors of constant type (since the 95% CI of the intercept includes 0) but a discreet significant proportional systematic error was observed (the confidence interval of the slope does not include 1).Urea: In Bland-Altman analysis, a discreet systematic error was observed as the 95% CI of the mean difference does not include the null value. Regarding Passing-Bablok regression analysis, there were no systematic errors of constant type (since the 95% CI of the intercept includes 0) or proportional type (since the 95% CI of the slope includes 1), indicating interchangeability between both analyzers. Conclusions The results obtained by both Atellica Solution® and CI® analyzers for uric acid and urea assays are interchangeable since the statistically significant differences observed can be considered analytically and clinically insignificant.

Effectiveness of laboratory tests in tracking severely COVID-19 infections

AIM: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a virus that causes COVID-19 (Coronavirus Disease 2019), and poses serious difficulties in terms of healthcare systems and global public health. With the large number of publications on COVID-19, clinicians need a synthesis of evidence to provide guidance when dealing with patients with COVID-19. Emerging studies reveal the existence of numerous demographic, clinical, immunological, biochemical and radiographic data that may be useful for clinicians to predict the severity and mortality of COVID-19. The aim is of this study; To determine laboratory parameters that can predict the course and severity of COVID-19 disease in patients with diagnosed solely SARS-CoV 2 PCR test positivity results and independently of the clinic status of selected patients and based on laboratory findings. MATERIALS AND METHODS: This study is a retrospective cross-sectional study conducted at Karacabey State Hospital between January and April 2022. Among the patients who applied to the COVID-19 outpatient clinic, 469 patients (261 females, 208 males) over the age of 18 and positive for SARS-CoV-2 RT-PCR were included in the study. The patients were divided into groups as outpatients, inpatients and patients in need of intensive care (intensive care unit, ICU). Demographic data (age, gender), COVID-19 RT-PCR results, and simultaneous laboratory parameters of the patients were scanned retrospectively. RESULTS: When CRP, urea, ferritin, LEU, NEU, MONO, RBC, HGB, HCT, MCV, NLR, PLR, CRP-NR, and SII index values were taken into consideration, a statistically significant difference was found between the groups. Creatinine, ALT, AST, LDH, troponin I, mass CK-MB, D dimer, LYM, EOS, PLT, ELR, and PNR values were not significantly different between the groups. CONCLUSIONS: Advantages of this study; Comparing the changes in the patient's other laboratory findings based on a single positive PCR test result and finding meaningful rates in terms of serious covid risk. The disadvantage of this study is that it is a study independent of the patient's clinic and disease stage. CRP, urea, ferritin, and indexes such as NLR, PLR, CRP-NR, and SII index values can be used to predict the severity of the disease.

Synergistic modulation of endoplasmic reticulum stress pathway, oxidative DNA damage and apoptosis by β-amyrin and metformin in mitigating hyperglycemia-induced renal damage using adult zebrafish model

Diabetic nephropathy (DN) can be prevented with early therapeutic intervention in diabetic patients. Recent investigations suggest that β-amyrin, a pentacyclic triterpenoid, could offer significant benefits with its potential antihyperglycemic and nephroprotective effects. We investigated the protective effects of β-amyrin alone and combined it with metformin, the cornerstone therapy for diabetes, using a hyperglycemic adult Zebrafish (ZF) model. The ZF were subjected to hyperglycemia by immersing them in 111 mM glucose solutions. Treatment efficacy was assessed by measuring serum glucose and insulin levels and antioxidant, ER stress, apoptosis, and proinflammatory markers. ZF kidneys were also studied for immunohistochemistry and histopathology. Results revealed that the combined treatment of β-amyrin and metformin resulted in a significant decrease (p ≤ 0.05) in blood glucose levels to 104.54 ± 1.63 mg/dL, in comparison to 388.75 ± 4.32 mg/dL in the untreated diseased control group. The reduction in hyperglycemia was more pronounced than treatment with either compound alone. Moreover, treatment with the combination restored renal function in diseased ZF, leading to significantly lower (p ≤ 0.05) serum urea (SU: 19.57 ± 1.61 mg/dL) and serum creatinine (SC: 0.56 ± 0.02 mg/dL) values compared to treatment with β-amyrin (SU:27.02 ± 0.96 mg/dL; SC: 0.7 ± 0.01 mg/dL) or metformin (SU: 24.53 ± 1.29 mg/dL; SC: 0.6 ± 0.02 mg/dL) alone. The treatment also reduced oxidative stress markers, apoptosis and ER stress markers, and proinflammatory cytokines. Histopathological analysis showed improved renal architecture with significantly lower (p ≤ 0.05) renal tubular injury scores with the combination than with individual treatment. This study provides novel insights into the combined therapeutic effects of β-amyrin and metformin in mitigating hyperglycemia-induced renal damage through key molecular pathways, highlighting a potentially effective therapeutic strategy for diabetic nephropathy. The findings hold promising translational relevance for developing combination therapies aimed at improving clinical outcomes in diabetic nephropathy patients.

Solvent-free mechanosynthesis of Schiff bases derived from thiadiazole with potential application in sensing ionic species and NLO applications

In this work, we report the solvent-free mechanosynthesis of three Schiff bases (SBs) derived from 1,3,4-thiadiazole covalently bonded to indole (Th-In), quinoline (Th-Qn) and triphenylamine (Th-TPA) groups. This green chemistry method showed a drastic reduction in reaction time and avoidance of solvents for obtaining SBs, with good reaction yields. The molecular structures of SBs were investigated by computational chemistry calculations, with global reactivity parameters indicative of electron acceptor behavior, estimation of frontier molecular orbitals, and their theoretical band gaps of 3.49 and 3.4 eV for Th-In and Th-Qn, respectively, and the lowest of 299 eV for Th-TPA. To evaluate the possible NLO response, the hyperpolarizabilities (β) were also estimated, which are several orders of magnitude higher than the urea value used as a reference. The absorption and emission spectra were calculated using TD-DFT. These results showed a larger redshift for Th-TPA, with possible charge transfer processes more intense than those obtained for Th-In and Th-Qn. The photophysical properties of the Schiff bases were determined, with band gap values for Th-In, Th-Qn, and Th-TPA of 2.53, 2.66, and 2.39 eV in solution and 2.77, 2.26, and 2.21 eV in film, respectively. When the SBs were evaluated as potential naked-eye colorimetric chemosensors, colorimetric changes were observed in Fe2+, Fe3+, Pb2+, Cu2+, and Ag+ ions, with Ag+ being the most promising. Z-scan was used to evaluate the nonlinear response of the SBs and showed saturable absorber behavior with self-focusing processes. Cyclic voltammetry was used to determine the electrochemical band gaps, which were 2.70, 2.71, and 1.98 eV for Th-In, Th-Qn, and Th-TPA, respectively. Th-TPA exhibits superior optical and electrical properties among the three SBs investigated. In addition, it exhibits photochromism, which can be used in conjunction with its other properties in NLO and sensor applications.

Synthesis, crystal structure, spectroscopic, electronic and vibrational properties of N′-[(E)-3-pyridinylmethylene]nicotinohydrazide trihydrate: Experimental and computational study

N′-[(E)-3-pyridinylmethylene]nicotinohydrazide trihydrate (C12H10N4O·3(H2O)) was synthesized and its structure was determined by single crystal X-ray diffraction method. X-ray analysis showed that the compound crystalized in the triclinic system P-1 with a = 7.1134 (3) Å, b = 10.0208 (4) Å, c = 10.3601 (4) Å, α = 96.386 (3)°, β = 96.995 (3)°, γ = 101.219 (4)°, V = 712.05 (5) Å3 and Z = 2 and exhibits that the title compound (I) consists of N′-[(E)-3-pyridinylmethylene]nicotinohydrazide (II) (C12H10N4O), and three water molecules of crystallization. The two water molecules are attached to the third water molecule through intermolecular two OH…O hydrogen bonds. At the same time, this water molecule is linked to the NH amide group of the hydrazone by an intermolecular NH…O hydrogen bond. Hirshfeld surface (HS) analyses were carried out are to visualise the intermolecular interactions in the crystals of Compound I. The geometric optimization of the titled compound has been carried out by different computational methods such as by Hatree Fock (HF) and Density Functional Theory (DFT) methods with the 6–311++G (d,p) basis set. The vibrational frequency, dipole moment (μ), polarizability (α), hyperpolarizability (β), and electronic properties including the highest occupied molecular orbital-lowest unoccupied molecular orbital (HOMO–LUMO) of the compound have been calculated at the level of both theories. In the results of crystal analysis and geometry calculations of the compound I, it was observed that intermolecular hydrogen bonds, N2H2A…O3, O3H31…O2 and O3H32…O4, were formed. The energy band gap (Eg = ELUMO-EHOMO) values were also obtained by using ELUMO and EHOMO at the level of both theories. The value of equilibrium (ground state) dipole moment of the studied molecule was calculated to be 8.31 Debye in B3LYP and 7.55 Debye in HF. The calculated hyperpolarizability values at the B3LYP/6–311++G(d,p) of the compound are 2.53 × 10−30 esu and this value corresponds to 6.79 times the hyperpolarizability value of urea.

Determination of haptoglobin, serum amyloid A, some other acute phase proteins, and biochemical parameters in cattle with hydatid cysts

The aim in this study is to determine some acute phase proteins and biochemical parameter levels in cattle infected with the hydatid cysts. In the study, a total of 30, Brown Swiss cattle including 15 infected with the hydatid cysts in the study group and 15 in the control group were used. Haptoglobin, serum amyloid A (SAA), ceruloplasmin, interleukin (IL)-6, total protein, albumin, aspartate amino transferase (AST), gamma glutamyl transferase (GGT) and alkaline phosphatase (ALP) activity, urea, creatinine, iron (Fe) levels were determined colorimetrically. When the animals infected with hydatid cysts and control group were compared, it was determined that haptoglobin, SAA, IL-6, AST, ALP, GGT activity, urea, creatinine levels and acute phase protein index values increased, while albumin levels decreased. In addition, it was determined that the ceruloplasmin and total protein levels increased, globulin, albumin/globulin and Fe levels decreased, but they were statistically insignificant. In conclusion, it was determined that there were significant changes in the biochemical parameters and increased haptoglobin and SAA synthesis in the animals infected with the hydatid cysts, and it is thought that these parameters may contribute to the pathogenesis and diagnosis of the disease.

THE EFFECTIVENESS OF STEM CELL THERAPY IN MYOCARDIAL INFARCTION REVIEWED FROM UREUM, CREATININE AND KIDNEY HISTOPATHOLOGY LEVELS

This study aims to study the effectiveness of single placental stem cell therapy or cardiomyocyte combination in pigs experiencing myocardial infarction in terms of urea, creatinine and kidney organ histopathology values. A total of 9 pigs were divided int o three groups: without therapy (K1), single placental stem cell therapy (K2), and cardiomyocyte coculture combination therapy (K3). All pigs underwent circumflex artery ligation of the proximal coronary artery branch to stimulate cardiac ischemia and therapy was given after myocardial infarction and ST-elevation were formed. The pigs were then treated for eight weeks, euthanized and necropsied for kidney organ removal. The re sults showed a significant decrease in urea and creatinine values (P0.05) in K2 and K3 as compared to K1. Histopathology results showed a decrease in glomerular atrophy values (K2: 10.26±0.93 and K3: 12.44±1.21), tubular necrosis (K2: 13.67±3.76 and K3: 17.23±0.55), and tubular dilation (K2: 16.36±1.26 and K3: 18.03±1.76) and these values were significantly different than those observed in K1. It was concluded that the administration of placental stem cell therapy or combined with cardiomyocyte coculture could reduce urea, creatinine values, and improve kidney tissue histopathologically.

Biomarkers of COVID-19 short-term worsening: a multiparameter analysis within the prospective multicenter COVIDeF cohort.

During a pandemic like COVID-19, hospital resources are constrained and accurate severity triage of the patients is required. The objective of this study is to estimate the predictive performances of candidate biomarkers for short-term worsening (STW) of COVID-19. Prospective, multicenter (20 hospitals in Paris) cohort study of consecutive COVID-19 patients with systematic biobanking at admission, during the first waves of COVID-19 in France in 2020 (COVIDeF cohort). Consecutive COVID-19 patients were screened for inclusion. They were excluded in presence of severity criteria defined by either an ICU admission, mechanical ventilation (including noninvasive ventilation), acute respiratory distress, or in-hospital death before sampling. Routine blood tests measured during usual care and centralized systematic measurement of creatine kinase, C-reactive protein (CRP), procalcitonin, soluble urokinase plasminogen activator receptor (suPAR), high-sensitive troponin T (TnT-hs), N terminal pro-B natriuretic peptide (NT-proBNP), calprotectin, platelet factor 4, mid-regional pro-adrenomedullin (MR-proADM), and proendothelin were performed. The primary outcome was STW, defined by a severity criteria within 7 days. A backward stepwise logistic regression model and a 'best subset' approach were used to identify independent association, and the area under the receiving operator characteristics (AUROC) was computed. Five hundred and eleven patients were analyzed, of whom 60 (11.7%) experienced STW. Median time to occurrence of a severity criteria was 3 days. At admission, lower values of eosinophils, lymphocytes, platelets, alanine aminotransferase, and higher values of neutrophils, creatinine, urea, CRP, TnT-hs, suPAR, NT-proBNP, calprotectin, procalcitonin, MR-proADM, and proendothelin were predictive of worsening. Stepwise logistic regression identified three biomarkers significantly associated with worsening: CRP [adjusted odds ratio (aOR): 1.10, 95% confidence interval (95% CI): 1.06-1.15 for a 10-unit increase, AUROC: 0.73 (0.66-0.79)], procalcitonin [aOR: 0.42, 95% CI: 0.22-0.81, AUROC: 0.69 (0.64-0.88)], and MR-proADM [aOR: 2.85, 95% CI: 1.74-4.69, AUROC: 0.75 (0.69-0.81)]. These biomarkers outperformed clinical variables except diabetes and cancer comorbidities. In this multicenter prospective study that assessed a large panel of biomarkers for COVID-19 patients, CRP, procalcitonin, and MR-proADM were independently associated with the risk of STW. ClinicalTrials.gov NCT04352348.

TOXICITY TEST OF KELAKAI LEAF EXTRACT (Stenochlaena palustris) TOWARD WISTAR RAT KIDNEY (Rattus norvegicus)

Background: Excessive free radicals cause oxidative stress which is dangerous for the body. The number of free radicals in the body can be controlled with the presence of antioxidants. Kelakai leaves (Stenochlaena palustris.) are known to have activity as an antioxidant which has the potential to become an ingredient in herbal medicine. Purpose: To prove whether there is a toxic effect of administering kelakai leaf extract on the kidneys of Wistar rats based on analysis of blood urea and creatinine levels. Method: A pure experimental study with a posttest-only with control group design method, there were 4 groups consisting of 1 negative control group and 3 treatment groups who were given kelakai leaf extract orally for 28 days and then analyzed the blood urea and creatinine levels of the Wistar rats. Results: The average values of urea and creatinine levels in the three treatment groups were still within the normal range. There was a significant difference in the urea levels of all groups (p&lt;0.05), and there was no significant difference in the creatinine levels of treatment groups 2 and 3 (p&gt;0.05). Conclusion: Kelakai leaf extract given orally for 28 days did not cause toxic effects on the kidneys of Wistar rats based on analysis of blood urea and creatinine levels.

Course and complications of influenza A in seniors over 65 years of age.

Influenza A and B viruses cause epidemics every year, with approximately 3-5 million serious cases and about 290,000 to 650,000 deaths worldwide. Most patients die from bacterial complications of influenza. The aim of our study was to describe the clinical pictures of influenza and the development of the complications in seniors over 65 years of age, who were treated in University Hospital Pilsen. The course of the disease and changes in laboratory parameters were evaluated with regard to the method of treatment performed. A descriptive retrospective study was performed. Clinical and laboratory data of seniors with the diagnosis of influenza were extracted from electronic medical records and later analysed. The data were processed with Excel 2016 and Statistica. A collection of 261 seniors, of whom 218 were hospitalized and 43 treated in an outpatient setting, has been studied. Patients who later developed complications had elevated values of CRP, procalcitonin, urea, and creatinine. The antiviral drug oseltamivir was administered to 226 of 261 seniors. Forty-seven seniors (18.0%) died from influenza and its complications (severe pneumonia with acute respiratory insufficiency or heart failure). The course of influenza in seniors was usually more severe and required hospitalization along with antiviral treatment. The mortality rate in the monitored group exceeded 18%. Annual timely vaccination, but also other preventive measures, and maybe considering other risk groups are methods to prevent severe or even fatal cases of influenza.

Estimation of urea, uric acid and creatinine levels in patients of primary hypothyroidism - A cross-sectional study.

The thyroid gland is one of the largest endocrine glands in the body, secreting thyroxine (T4) and triiodothyronine (T3). Mild hypothyroidism can have negative consequences for a variety of tissues, even though clinically the patients are euthyroid. Many research studies were conducted to evaluate the serum creatinine levels of people with hypothyroidism; however, relatively little research was conducted to evaluate serum urea and serum creatinine levels in subclinical hypothyroidism. As a result, the current study was carried out to investigate urea, uric acid, and creatinine levels in hypothyroidism. Our study aimed to determine and correlate the levels of urea, uric acid and creatinine in newly diagnosed primary hypothyroidism cases. In this cross-sectional study, 96 newly diagnosed cases of primary hypothyroidism were included. The findings were correlated with 20-60-year-old and sex-matched cases. Serum urea was determined by the kinetic method (Glutamate Dehydrogenase Method), serum uric acid by the uricase method and serum creatinine by Jaffe's method in Erba's Mannheim fully automated analyser. This study showed a positive correlation between uric acid and thyroid stimulating hormone (TSH) and a negative correlation between urea and creatinine. There was no statistical significance in the mean values of urea, uric acid and creatinine but an increased level of urea, uric acid and creatinine was seen in the age group 20-30 years when compared with the other age groups. The study concludes that serum urea showed a positive correlation with TSH, whereas uric acid and creatinine showed a negative correlation with TSH, and there was no statistical significance in the mean values of urea, uric acid and creatinine in hypothyroid patients.

Evaluation of Oxidative Stress, Thyroid Hormones, Trace Elements and Some Biochemical Markers in Goats Naturally Infected with Theileria ovis.

Theileriosis is a tick-borne disease caused by protozoon species in the Theileria genus of the Theileriidae family. The biochemical changes induced by infection are considered to be an important understanding of the pathophysiology of caprine theileriosis. In this study, it was aimed to determine oxidative stress, thyroid hormones, trace elements, and biochemical parameters in theileriosis infection. A sample of 14 goat was used for this purpose, of which 7 were healthy and 7 were infected with Theileria ovis. Theileria infection was diagnosed from the polymerase chain reaction (PCR). Sera from blood samples was tested for total antioxidant capacity (TAC), total oxidant capacity (TOC), oxidative stress index (OSI), alanine aminotransferase (ALT), aspartate transaminase (AST), gamma glutamyl transferase (GGT), total protein, albumin, triglyceride, cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), urea, blood urea nitrogen (BUN), creatinine, triiodothyronine (T3), thyroxine (T4), copper (Cu), zinc (Zn), cobalt (Co), manganese (Mn), selenium (Se), iron (Fe). TOC, OSI, AST, ALT and GGT values were higher in the patient group than in the healthy group (P < 0.05). On the other hand, there were decreases in TAC, T3, T4, total protein, albumin, creatinine, Cu, Zn, Se, and Co values (P < 0.05). However, there was not found to be a statistical difference between the healthy and patient groups in terms of triglyceride, cholesterol, HDL, LDL, urea, BUN, Mn, and Fe values (P > 0.05). It can be stated that oxidative stress is a complication of caprine theileriosis and it may be accompanied with hypothyroidism and deficits in trace minerals.

Bilirubin not just a routine parameter plays an important role in chronic kidney disease

Background: Chronic kidney disease (CKD) is a major health burden in India as well as throughout the world. Imbalance between antioxidant defense and oxidative stress plays a major role in this multifactorial disorder. Recent studies have shown that serum total bilirubin plays an important role in the progression of CKD. Aims and Objectives: The aim of the study is to estimate serum total bilirubin, estimated glomerular filtration rate (eGFR), urea, creatinine and to find out whether there is correlation between serum total bilirubin, eGFR, and different stages of CKD. Materials and Methods: The study is conducted in the department of biochemistry after getting ethical clearance. Two hundred and sixty-nine samples of controls and cases of CKD collected. Serum total bilirubin, urea, and creatinine were calculated in autoanalyzer using standard protocol. eGFR is calculated using a standard formula. Results: There is a significant positive correlation (spearman’s correlation r=0.196, P=0.001) between serum total bilirubin and eGFR value. There is also a significant negative correlation (r=−0.239, P&lt;0.0001) between serum total bilirubin and stages of CKD. Median value of serum urea is also high in cases compared to control. Conclusion: The serum bilirubin may be an important biomarker in the pathogenesis of CKD.

Investigation of the thyroid function in end-stage renal failure disease in a Baquba teaching hospital/Diyala governorate - Iraq

Renal failure is the inability of the kidneys to excrete nitrogenous waste products, resulting in their retention in the bloodstream. Several correlations exist between renal and thyroid functions; however, end-stage renal failure is unlikely to be influenced by thyroid hormone function and is connected to a higher prevalence of hypothyroidism. The purpose of this study is to ascertain how thyroid status and renal function relate to renal failure patients. Serum creatinine and urea levels were tested in 50 healthy persons and 100 patients with renal failure illness. The acquired data showed that, in comparison to the control group, the average levels of creatinine and urea were significantly higher. The sick group recorded (122.98 mg/dL and 6.55 mg/dL) and (28.38 mg/dL and 0.75 mg/dL) in comparison to the control group, which has urea and creatinine values within the virtually normal range, respectively. In contrast, TSH levels showed no significant differences and have values within the normal range of TSH values, with 2.33 mIU/L for the experimental group and 2.0 mIU/L for the control group. In contrast, T4 values of the experimental group showed significantly lower levels than the control group, with 83.42 ng/dL compared to 103.77 ng/dL. T3 values, however, showed no significant changes and remained within the normal range of 1.75 to 1.64 nmol/L. In addition, the results demonstrated significant differences in the mean levels of anti-TPO, anti-Tg, and anti-TSHR antibodies. The anti-Tg showed a significant decrease in mean values, which were 28.89 IU/ml and 79.49 IU/ml compared to the control group ranges of 34.41 and 86.68 IU/mL. Finally, anti-TSHR showed a significant increase in the mean, which was 1.24 IU/L compared to 1.18 IU/L in the control group.