Background: Intradialytic hypotension (IDH) remains the most common complication of hemodialysis (HD) with potentially devastating consequences despite the technological advances regarding the hemodialysis techniques of the last decades. The increasing number of advanced-age patients, diabetics and patients with cardiovascular comorbidities undergoing hemodialysis emphasizes the need on implementation of new IDH avoidance tactics. Aim of the Work: Our work aimed to evaluate serum albumin (Alb) level and C-reactive protein level in hemodialysis patients and their correlation with dialysis-induced hypotension (DIH). Patients and Methods: This prospective study was conducted based on data collected from HD patients treated at Aswan University Hospital, dialysis unit, in a period from 1/1/2017 to 30/5/2017. It included 40 chronic HD patients with no history of endocrine tumors, diabetes mellitus, liver failure, heart failure, or unstable coronary artery disease. Patients with hemoglobin less than 9 mg/dL, feverish patients, and patients with any source of apparent infection were excluded. The age of the patients ranged from over 18 to less than 75 years. Results: : the mean value of serum albumin level in group (A) was (2.97 ± 0.71) with the highest serum albumin was 4.4 and the lowest serum albumin was 2.1, while in Group (B) the mean value of serum albumin level was (4.53 ± 0.74) with the highest serum albumin was 5.5 and the lowest serum albumin was 2.8. There was a significant decrease in serum albumin level in patients in group (A) who had developed hypotensive episodes during hemodialysis ( P value < 0.001), in group (A) also there were 18 patients had positive C-reactive protein (90 %) and 2 patients had negative C-reactive protein (10 %) with a mean value (15.67 ± 13.27), while in group B : there were 2 patients had positive C-reactive protein level (10 %) and 18 patients had negative C-reactive protein level ( 90 %) with a mean value (2.07 ± 1.48) , So, there was a significant increase in C-reactive protein level in patients in group (A) who had developed hypotensive episodes during dialysis ( P value < 0.001). Conclusion: Serum Alb. levels and high levels of CRP may predict an increased risk of DIH in regular HD patients and this was the main issue for our study, however we also found that there were some other biochemical markers, which can come inbetween with our two main markers, which confirm our results. Recommendations: Further studies on a larger scale of patients are needed to confirm these results.
Background: Gastrointestinal (GI) bleeding is a potentially life threatening abdominal emergency that remains a common cause of hospitalization. Bleeding from the upper gastrointestinal tract is approximately five times more common than from the lower gastrointestinal tract bleeding and seems to be more common in men and the elderly. Aim: Identify various cause and outcomes of upper gastrointestinal tract bleeding patients in Aswan University Hospital by follow-up the patients and their different fates on the numerous lines of treatment. Methodology: This study included 100 patients who were complaining of upper gastrointestinal tract bleeding and selected from patients in Aswan University Hospitals.
Results:The results of the current study showed that the most common causes of upper GIT bleeding are the variceal causes representing 57% of causes of GIT bleeding, followed by non-variceal causes representing 43% of causes of GIT bleeding. The most common cause of the variceal bleeding is the esophageal varices alone representing (40%) of the causes of variceal bleeding followed by combined esophageal and gastric varices representing (12%) and the gastric varices alone representing (5%) of the causes of upper GIT bleeding.
Conclusion:The endoscopic therapy was successful in most cases. The recurrence rate of bleeding was significantly high among patients with variceal bleeding. The patients with variceal bleeding have fewer treatmentrelated complications and better survival rates when they are treated by band ligation,
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