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Article
EVALUATION OF CYTOMORPHOLOGICAL CHANGES IN URINE SAMPLES OF UREMIC PATIENTS UNDERGOING REGULAR HEMODIALYSIS

Author: Arif S. Malik عارف سامي مالك
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2011 Volume: 9 Issue: 1 Pages: 18-23
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: Dialysis is one of the common strategies of renal replacement therapy for patients with chronic renal failure; however it harbors significant cellular changes in various body fluids.Objective: To evaluate the cellular changes in urine samples of patients undergoing dialysis.Methods: Seventy-two fresh midstream, spontaneously voided urine samples, they were included in the study. Early morning samples were excluded, Duration of dialysis was taken into consideration (short term and long term dialysis). Samples were centrifuged at 3000 round per minute for 15 minutes, the supernatants were decanted and the sediments were examined cytomorphologically.Results: The gross appearance of all urine samples was neither purulent nor hemorrhagic. Microscopically there was an excessive shedding of urothelial cells in urine samples of patients undergoing dialysis compared with samples of the control group which showed evidence of normal shedding. There were no significant cytological atypia or malignancy in all urine samples. The excessive exfoliation in the absence of significant inflammation, hemorrhagic, or cytological atypia was compared with control group.Conclusions: The study revealed that some cytological changes do occur in the urothilial cells in patients undergoing dialysis; these changes need further attention to disclose their real causes.Key words: chronic renal failure, hemodialysis, cytomorphology, epithelial exfoliation


Article
EVALUATION OF THYROID FUNCTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Author: Arif S. Malik عارف سامي مالك
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2011 Volume: 9 Issue: 2 Pages: 162-169
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Thyroid function has been extensively evaluated in patients with chronic kidney disease, however the results are variable.Objective:The study was designed to investigate the thyroid dysfunction in uremic patients clinically and biochemically.Methods:The study was conducted in the department of medicine and dialysis unit in AL-Kadhimiya Teaching Hospital in Baghdad. Three groups were taken sixteen patients with end stage renal disease undergoing regular hemodialysis, 22 patients with chronic renal failure treated conservatively and 21 healthy volunteers with no previous history of thyroid disease and their renal function were normal(control group), serum TT3, TT4 and TSH were estimated in all patients and control group by RIA Kits. The results were tabulated and statistically analyzed using Chisequare and t-test.Results:Fifty nine persons included in this study divided into three groups (regular hemodialysis 16, conservative treatment 22 and the control group were 21). Goiter was demonstrated in 12.5% in hemodialysis group, 4.54% of the conservatively treated group. Uremic patients kept on conservative treatment or on regular hemodialysis showed significant reduction of TT3 and TT4 in comparison to the control group, however the level of TSH didn’t show significant alterations, and there were no significant deference in TT3 andTT4 between the patients on conservative management and those maintained on regular hemodialysis.Conclusions:Low TT3 and TT4 are often observed in clinically euthyroid patients with chronic renal failure. These abnormalities do not appear to change significantly after the institution of regular dialysis, on other hand TSH values in clinically euothyroid patients with chronic renal failure were within the normal range, this normal TSH may indicate functional euthyroid status.Key words:Hemodialysis, Chronic renal disease, Triiodothyronin (T3), Thyroxin (T4), Thyroid stimulating hormone (TSH)


Article
SEROCONVERSION RATE OF HEPATITIS C VIRUS INFECTION AMONG HAEMODIALYSIS PATIENTS IN AL-KADHIMIYA TEACHING HOSPITAL (DIALYSIS UNIT)

Authors: Arif S Malik عارف سامي مالك --- Hasanain MH AL-Rubaie حسنين الربيعي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2011 Volume: 9 Issue: 4 Pages: 343-349
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

BackgroundHepatitis C virus (HCV) infection is a serious public health problem throughout the world. Chronic haemodialysis patients are at higher risk for acquiring hepatitis C virus (HCV) infection.ObjectiveTo assess the rate of seroconversion of hepatitis C virus (HCV) infection every month for one year duration, to evaluate the possible associated risk factors and the relationship of hepatitis C virus infection with blood transfusion and duration of hemodialysis.MethodsFifty seven patients, 37 males (65%) and 20 females (35%), who were on regular haemodialysis in Al-Kadhimiya Teaching Hospital was studied during the period between January 2009 and December 2009. Patients were analyzed monthly with anti –HCV antibodies using a commercial enzyme-linked immuno-sorbant assay BioKit (bioelisa HCV 4.0) and serum Alanin aminotransferase measurements.ResultsTwenty three patients (40.3%) were HCV positive of whom, 13 were males (56.5%) and 10 were females (43.5%). History of blood transfusion, number of blood transfusion and duration of haemodialysis, had significant correlation in acquiring HCV infection.ConclusionSeroconversion of HCV infection was of high rate incidence (40.3%). Duration of HD, history of blood transfusion and number of blood transfusion(s) are factors affect the rate of seroconversion of HCV infection in patients on regular HD. The higher rate of seroconversion of HCV infection needs further research to identify the causes and to establish a well organized prophylactic program by using more sophisticated and accurate investigation.Key wordsHepatitis C virus infection, Hemodialysis, Chronic renal failure


Article
EFFECT OF BLOOD FLOW RATE ON DIALYSIS ADEQUACY IN AL-KADHIMIYA TEACHING HOSPITAL

Authors: Arif S Malik عارف سامي مالك --- Ehab J Ghali ايهاب جمعة غالب
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2012 Volume: 10 Issue: 3 Pages: 260-264
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Adequacy of dialysis is one of determinants of morbidity and mortality. The Blood flow rate is one of important factors of adequacy of dialysis in patients with Hemodialysis.Objectives:To assess the effect of blood flow rate on adequacy of dialysis.Methods:Seventy patients maintained on regular Hemodialysis in the dialysis unit, Al-Kadhimiya Teaching Hospital. Their body weight and blood urea level before and after hemodialysis sessions were recorded, volume of ultra-filtration, duration of dialysis and blood flow rate were documented in a checklist. Both (kt/v) and (URR) were determined at three different pump speed (150-200), (201-250) and (251-300) ml/min. During hemodialysis, the hemodynamic status and vital signs of patients were monitored and controlled.Results:Efficiency of dialysis was calculated using the standard formulas. Paired t-test showed no significant difference in dialysis efficiency between the three groups. Conclusion:Higher rate of inadequacy of hemodialysis, and no significant correlation was observed between BFR groups.Key words:Hemodialysis, Blood flow rate, Adequacy of dialysis


Article
EFFECT OF DIALYSATE TEMPERATURE ON HEMODYNAMIC STABILITY AMONG HEMODIALYSIS PATIENTS

Authors: Tarik A. Hussein طارق حسين --- Arif S. Malik عارف سامي مالك
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2014 Volume: 12 Issue: 2 Pages: 173-179
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Hypotension is one of the complications of hemodialysis treatment. It increases morbidity and mortality and can compromise the dialysis efficacy. Cooling the dialysate below 36.5°C is an important factor that contributes to hemodynamic stability in patients during hemodialysis.Objective:To assess the effect of dialysate temperature on hemodynamic stability during hemodialysis sessions, post dialysis fatigue and the adequacy of dialysis.Methods:A total of 40 patients were assessed during six dialysis sessions; in three sessions, the dialysate temperature was (37 °C) and in three other sessions, the dialysate temperature was (35 °C). Specific scale questionnaires were used in each dialysis session, to evaluate the symptoms during the dialysis procedure as well as post-dialysis fatigue, and respective scores were noted. Blood pressure, heart rate, temperature were recorded. Also dialysis efficacy using Kt/v, urea reduction ratio were measured.Results:The results showed that usage of low dialysate temperature was associated with the following : higher post dialysis systolic blood pressure (P < 0.05) and lower post dialysis heart rate (P < 0.05), better intra-dialysis symptoms score and post-dialysis fatigue scores (P < 0.05 and P < 0.05, respectively), shorter post-dialysis fatigue period (P < 0.05) as well as Similar urea removal and Kt/V .Conclusion:Cool dialysis is an important factor in hemodynamic stability during hemodialysis. Also it improves symptoms during and after hemodialysis. Cool dialysis has no effect on adequacy of dialysis.Key words:Hemodialysis, Cool dialysate, Hypotension, Hemodynamic


Article
ERECTILE DYSFUNCTION IN HAEMODIALYSIS PATIENTS IN AL-IMAMAIN AL-KADHIMIAN MEDICAL CITY AND AL-KINDY TEACHING HOSPITALS

Authors: Furat H. Karim فرات حسن كريم --- Arif S. Malik عارف سامي مالك
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2014 Volume: 12 Issue: 3 Pages: 222-229
Publisher: Al-Nahrain University جامعة النهرين

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Background:Erectile dysfunction is the inability to attain or maintain an erection sufficient for satisfactory sexual performance. There is a very high prevalence among dialysis patients. Many factors play a role including the disease itself and dialysis.Objective:To identify the rate of erectile dysfunction in uremic patient undergoing haemodialysis and to find the association between the erectile dysfunction and many confounding factors.Methods:All male patients of end stage renal disease were kept on maintenance haemodialysis therapy. Patients were divided into two groups according to the International index of erectile function-5, first group with erectile dysfunction with score of 21 and less, the second group without erectile dysfunction with score of 22 and more.Results:The percentage of erectile dysfunction in the study sample was (84.9%). Factors responsible for erectile dysfunction are diabetes mellitus (73.3%), increasing age (75.5%) of patients, high predialysis urea level (82.2%), smoking, hepatitis B and C virus infection, systolic blood pressure, albumin, creatinine, haemoglobin and the duration of dialysis are not related.Conclusion:Majority of the patients with end stage renal disease on maintenance haemodialysis have higher rate of erectile dysfunction. Major factors responsible for erectile dysfunction are diabetes mellitus, increasing age and high predialysis urea.Keywords:Haemodialysis, erectile dysfunction, International index of erectile function-5.

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