Correlation of Arterial and Venous pH and Bicarbonate in Patients With Renal Failure.

Background and objective Blood gas analysis plays a pivotal role in the management of various respiratory and metabolic disorders. Both arterial and venous samples can be used for blood gas analysis. Arterial blood sampling is technically difficult and is associated with more complications as compared to venous sampling. Many studies have shown the correlation of arterial and venous pH and bicarbonate levels in sepsis, diabetic ketoacidosis (DKA), chronic obstructive pulmonary disease (COPD), and circulatory failure. But, there is a paucity of data, pertaining specifically to the correlation of arterial blood gas (ABG) analysis and venous blood gas (VBG) analysis in patients with renal failure. The objective of this study was to look for any possible correlation between arterial and venous pH and bicarbonate values in patients with renal failure. Methods This cross-sectional study was carried out at a large tertiary care hospital in Rawalpindi, Pakistan. Over a period of eight months, 101 patients with renal failure were enrolled after obtaining informed consent. Arterial and venous samples from the patients were obtained, analyzed, and compared. Results Out of the total 101 patients, 53 (52.5%) were male while 48 (47.5%) were female. The mean age of the patients was 46.23 ±15.54 years. Mean arterial pH and venous pH were 7.35 and 7.28 respectively. The Pearson correlation coefficient between arterial and venous pH was found to be 0.857 (p<0.001). The mean arterial and venous bicarbonate values were 14.47 mEq/L and 15.51 mEq/L respectively. And the Pearson correlation coefficient between arterial and venous bicarbonate was found to be 0.842 (p<0.001).  Conclusion Venous pH and bicarbonate levels correlate strongly with arterial pH and bicarbonate levels, respectively, in patients with renal failure.

Assessment of Severity of Dengue Fever by Deranged Alanine Aminotransferase Levels.

Introduction Dengue fever (DF) is the most common arbovirus-related infection worldwide. Most of the dengue infections are asymptomatic. The clinical presentation of DF varies from mild febrile illness to dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Both DHF and DSS are severe forms of illness and carry higher rates of mortality. Various clinical parameters are associated with severe DF. The objective of this study was to determine any relation between elevated alanine aminotransferase (ALT) levels at presentation and development of severe DF. Methods This cross-sectional study was carried out at a large tertiary care hospital in Rawalpindi, Pakistan. Over a period of six months, 65 dengue patients were enrolled and their ALT levels were recorded at presentation. All the patients were managed as per guidelines in a similar way, and clinical course was followed for the development of severe forms of DF, such as DHF and DSS. Results Out of total 65 patients, 45 (69.2%) were males and 20 (30.8%) were females. Classical DF was present in 18 (27.7%) patients, whereas 47 (72.3%) patients developed DHF or DSS. Patients with DF had a mean ALT level of 131.67 (±244.48) U/L at presentation, whereas patients with DHF and DSS had a mean ALT level of 228.15 (±467.88) U/L at presentation. The Mann-Whitney U test was applied to compare differences between ALT levels of both groups, and p value was found to be 0.018 (<0.05). Thus, it was concluded that there was a statistical difference between ALT levels of patients with simple DF and patients with DHF or DSS.  Conclusion Higher serum levels of ALT at presentation can give a clue about possibility of progression to severe forms of DF (DHF and DSS). Therefore, patients with higher ALT at presentation should be prioritized and monitored more rigorously.

A study on the potential reprotoxic effects of thimerosal in male albino rats.

Thimerosal is ethyl mercury based compound which is being used as a preservative in vaccines since decades. Pharmaceutical products and vaccines that contain thimerosal are among the potential source of mercury exposure. Current research was intended to ascertain the reprotoxic effects of thimerosal on rat testes. Twenty-four adult male albino rats were sorted into four groups (n = 6). The first group was a control group. Rats of experimental Group 2, 3 and 4 were treated with various dosages of thimerosal (0.5, 10, 50 mg/kg) respectively. Rats were decapitated after thirty days of trial and different parameters were analyzed. Thimerosal exposure resulted in a significant decrease in antioxidant enzyme activities including catalase (CAT), peroxidase (POD), superoxide dismutase (SOD), glutathione reductase (GSR) and increased levels of thiobarbituric acid reactive substances (TBARS). Different doses of thimerosal significantly decreased (p < 0.05) the concentration of plasma testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH). Additionally, Daily sperm production (DSP) and efficiency of daily sperm production were significantly reduced followed by thimerosal exposure. Moreover, thimerosal significantly (p < 0.05) decreased the primary spermatocytes, secondary spermatocytes, number of spermatogonia along with spermatids. Thimerosal induced adverse histopathological and morphological changes in testicular tissues such as decreased Leydig cells, diameter of seminiferous tubules, tunica albuginea height and epithelial height. On the other hand, the increase in tubular lumen and interstitial spaces was observed due to thimerosal. These outcomes indicated that thimerosal has potential reprotoxic effects in male albino rats.