CoroDet: A deep learning based classification for COVID-19 detection using chest X-ray images

BACKGROUND AND OBJECTIVE

The Coronavirus 2019, or shortly COVID-19, is a viral disease that causes serious pneumonia and impacts our different body parts from mild to severe depending on patient's immune system. This infection was first reported in Wuhan city of China in December 2019, and afterward, it became a global pandemic spreading rapidly around the world. As the virus spreads through human to human contact, it has affected our lives in a devastating way, including the vigorous pressure on the public health system, the world economy, education sector, workplaces, and shopping malls. Preventing viral spreading requires early detection of positive cases and to treat infected patients as quickly as possible. The need for COVID-19 testing kits has increased, and many of the developing countries in the world are facing a shortage of testing kits as new cases are increasing day by day. In this situation, the recent research using radiology imaging (such as X-ray and CT scan) techniques can be proven helpful to detect COVID-19 as X-ray and CT scan images provide important information about the disease caused by COVID-19 virus. The latest data mining and machine learning techniques such as Convolutional Neural Network (CNN) can be applied along with X-ray and CT scan images of the lungs for the accurate and rapid detection of the disease, assisting in mitigating the problem of scarcity of testing kits.

METHODS

Hence a novel CNN model called CoroDet for automatic detection of COVID-19 by using raw chest X-ray and CT scan images have been proposed in this study. CoroDet is developed to serve as an accurate diagnostics for 2 class classification (COVID and Normal), 3 class classification (COVID, Normal, and non-COVID pneumonia), and 4 class classification (COVID, Normal, non-COVID viral pneumonia, and non-COVID bacterial pneumonia).

RESULTS

The performance of our proposed model was compared with ten existing techniques for COVID detection in terms of accuracy. A classification accuracy of 99.1% for 2 class classification, 94.2% for 3 class classification, and 91.2% for 4 class classification was produced by our proposed model, which is obviously better than the state-of-the-art-methods used for COVID-19 detection to the best of our knowledge. Moreover, the dataset with x-ray images that we prepared for the evaluation of our method is the largest datasets for COVID detection as far as our knowledge goes.

CONCLUSION

The experimental results of our proposed method CoroDet indicate the superiority of CoroDet over the existing state-of-the-art-methods. CoroDet may assist clinicians in making appropriate decisions for COVID-19 detection and may also mitigate the problem of scarcity of testing kits.

Comparison between Efficacy of Combined Use of Hyaluronidise and Triamcinolone versus Hyaluronidise, Triamcinolone Acetonide and Oral Colchicine in the Treatment of Oral Submucous Fibrosis

Oral submucous fibrosis (OSF) is a chronic complex potentially pre-malignant condition caused by chewing areca nut and other irritants. It is an insidious process characterized by Juxta-epithelial deposition of fibrous tissue in the oral cavity and pharynx. OSF is very common in Southeast Asia and also now a days increase in Europe and North America. The aim of this study to compare the effectiveness of intralesional injection of triamcinolone and hyalurunidase versus intralesional injection of triamcinolone plus injection hyalurunidase with oral colchicine. The study included 60 patients of clinically diagnosed case of oral submucous fibrosis. Patients were divided into two Groups A and B. Group A patients received combination intralesionsl injection of triamcinolone acetonide 10mg/ml in 1ml with injection hyalurunidase 1500IU in 2ml with injection 2% lidocaine 7ml. 15 days interval in 3 months and Group B received intralesional injection of triamcinolone acetonide 10mg/ml in 1ml with injection hyalurunidase 1500IU in 2ml with injection 2% lidocaine 7ml in each 15 days interval for 3 months with oral colchicine 0.5mg twice daily for 3 months. Diagnosis based on burning sensation of mouth, blanching of mucosa, ulceration in oral cavity and also reduced mouth opening. Follow up assessment was done at intervals 1st follow up on 21st days after starting of treatment then 2nd follow up after 3 months and last 3rd follow up after 6 months. Before starting of treatment all patients were properly explained about the study and took their written consent. Much more improvement occurred in Group B patients, reducing in burning sensation and also increases in opening of mouth. In both groups blanching mucosae were improved. Treatment regimen of Group B is more effective in increasing mouth opening and improves burning sensation of oral cavity. No side effects were seen in both groups' patients.

Association of Low Thyroid Hormone with Migraine Headache

This cross sectional comparative study was done to investigate the association between low thyroid hormone level and migraine headache in adults patients. The study was conducted in Mymensingh Medical College Hospital, a tertiary level hospital of Bangladesh. Study period was from November 2017 to April 2018. The study subjects consisted of 50 patients with migraine headache as case, compared with 50 patients of headache other than migraine as control, seen in Neurology out patient department (OPD). Thyroid function test was performed by new automated immuno-chemiluminometric assay. Mean age was 29.80±9.87 years in migraine group and 34.18±11.82 years in non migraine group. Male female ratio was 1:2.3 and 1:1.7 in two groups. Level of TSH was significantly higher in migraine patients (3.52±2.53 vs. 2.25±2.13) than other headache patients (p=0.008). Thyroid disorder especially subclinical hypothyroidism was significantly higher (28% vs. 08%) in migraineurs than non migraineurs (p=0.032). No significant relationship was found between thyroid hormone level and headache characteristics of migraine patients (p>0.05). Migraine headache is associated with low thyroid hormone and thyroid disorder can be considered as comorbidity of migraine headache.

Level of Serum Vitamin D, To Which People Are at Risk of Developing Acute Myocardial Infarction in Bangladesh

Incidence of Myocardial Infarction is increasing day by day in developing countries. Most of the patients who sustain myocardial infarction have coronary atherosclerosis. There are several risk factors for the development of atherosclerosis. Among all the risk factors, vitamin D deficiency has been proposed to play an important role in the development of atherosclerosis. With this aim, a case-control study was carried out to explore the association of serum vitamin D with acute myocardial infarction. The enrolled study subjects were categorized into Group A which comprised of STEMI, Group B, comprised of NSTEMI and Group C comprised of age and sex matched individuals free from acute myocardial infarction. The mean values of serum vitamin D (in ng/ml) were 20.17, 20.8 and 24.77 respectively in STEMI, NSTEMI and control groups. It differed significantly among groups (p<0.001) and it was significantly low in STEMI and NSTEMI groups compared to control group (p<0.001 and p=0.004). From this study it can be concluded that low serum vitamin D is an independent risk factor for developing acute myocardial infarction. Individuals with serum vitamin D <20ng/ml have higher chance of developing acute myocardial infarction compared to those with serum vitamin D >20ng/ml.

Defect-Rich Dopant-Free ZrO2 Nanoclusters and Their Size-Dependent Ferromagnetism

As an intermediate form of matter between a single atom or molecule and the bulk, nanoclusters (NCs) provide novel properties because of their high surface area-to-volume ratios and distinct physical and electronic structures. These ultrasmall NCs offer a new approach to advance charge-spin manipulation for novel devices, including spintronics and magnetic tunneling junctions. Here, we deposit monosized ZrO₂ NCs over a large area by using gas-phase aggregation followed by in situ size selection by a quadrupole mass filter. These size-specific NCs exhibit sub-oxide photoemission features at binding energies that are dependent on the cluster size (from 3 to 9 nm), which are attributed to different oxygen vacancy defect states. These dopant-free ZrO₂ NCs also show strongly size-dependent ferromagnetism, which provides distinct advantages in solubility and homogeneity of magnetism when compared to traditional dilute magnetic semiconductors. A defect-band hybridization-induced magnetic polaron model is proposed to explain the origin of this size-dependent ferromagnetism. This work demonstrates a new protocol of magnetization manipulation by size control and promises potential applications based on these defect-rich size-selected NCs.

Cartilage Ossiculoplasty from Stapes to Tympanic Membrane in One-Stage Intact Canal Wall Tympanoplasty for Cholesteatoma

This prospective study was conducted at Department of ENT, Mymensingh Medical College Hospital, a tertiary care center in Bangladesh January 2017 to December 2018 to report hearing results and post operative complications of cartilage interposition ossiculoplasty in one-stage intact canal wall (ICW) tympanoplasty for cholesteatoma where ossicular chain is eroded or has to be removed either partially or totally. Total 42 patients underwent Intact canal wall (ICW) tympanoplasty for cholesteatoma with at least intact stapes footplate and in conjunction, cartilage ossiculoplasty was done during the same procedure. Patients were followed up regularly at 1 week, 1 month, 3 month, 6 month and at 1 year as usual follow up protocol to note complications and hearing status in 1 year follow up. In intact stapes suprastructure group, in the preoperative period, the mean air conduction thresholds (AC), bone conduction threshold (BC) and air-bone gap (ABG) were 48.3db, 9.5db and 38.8db respectively. Postoperatively, with a mean follow-up of 12 months, AC, BC and ABG were 27.6db, 9.7db and 17.9db respectively. In missing stapes supra structuregroup, in the preoperative period, the mean air conduction thresholds (AC), Bone conduction threshold (BC) and air-bone gap (ABG) were 57.4db 13.5db and 43.9db respectively. Postoperatively, with a mean follow-up of 12 months, AC, BC and ABG, were 33.9db, 14.2db and 19.7db respectively. For management of cholesteatoma cases, cartilage ossiculoplasty can be done effectively in conjunction with of intact canal wall tympanoplasty in a single setting. Complications are a few and easily manageable. Hearing results are at least as good as with other prosthesis and helps in avoiding subsequent surgery, discomfort and cost to the patients.

Synthesis of Well-Defined Polyolefin Grafted SiO2 Nanoparticles with Molecular Weight and Graft Density Control

Recent advances in surface-initiated polymerization have given rise to a range of brush nanocomposites and hybrid functional materials. However, the synthesis of pure polyolefin-grafted nanocomposites by surface-initiated ring-opening metathesis polymerization (SI-ROMP) is a significant challenge due to the particle aggregation and irreversible particle coupling. This study presents a synthetic approach toward well-defined poly(cyclooctene)- and polyethylene-grafted nanoparticles by tethering Grubbs third generation catalyst on the particle surface and initiating the polymerization in a rapid manner. This work also serves as a template to prepare other hairy nanoparticles and functions as a basis toward understanding their thermomechanical behaviors.

SHadow Under the Lamp (SHUL): Smoking behavior of the health professionals

Background

Smoking cessation is the best option a health professional can offer to the patients for averting the preventable causes of mortality and morbidity.

Purpose

To determine smoking behavior, preferred cessation methods, and attitudes towards smoking cessation amongst health professionals.

Methods

The cross-sectional study, conducted in six countries, included doctors and nurses working at different hospital settings. Participants responded anonymously to an online questionnaire.

Results

Among 1109 participants, 36% were from Saudi Arabia, 14% from Nepal, 14% from Indonesia, 12% from Australia, 12% from Jordan, and 12% from Pakistan. Mean age was 33 years, 61% were females and 58% were nurses. One in eight (12%) was daily smoker. Among current smokers, 42% smoked 2-9 cigarettes/day, and 26% had their first cigarette within 5-30 minutes after waking up. Half of the smokers perceived it as 'very important' to quit smoking, 30% had tried to quit in the last six months, and 31% preferred to have a group quit program with the same health professionals. Only 17% had formal training on smoking cessation, but 57% were interested to receive one. Half of the participants said they (53%) 'always' asked patients if they smoked, but 89% said they advised to quit, 76% said they assessed intention to quit, 28% said they assisted by providing materials on cessation, and 33% said they arranged follow up for cessation. Compared to current smokers, never smokers were more likely to 'always' ask patients if they smoked (78% vs. 22%, p = 0.044, ORs 1.39, 95%CIs 1.01-1.91), assist smokers by setting quit dates (74% vs. 26%, p = 0.039, ORs 1.54, 95%CIs 1.03-2.29), arrange follow up (77% vs. 23%, p = 0.044, ORs 1.40, 95%CIs 1.01-1.94).

Conclusions

Health professionals reported moderately good behavior around advice to smokers, but it is much worse among current smokers. Health professionals who smoke should be both encouraged to quit and to better support their patients to do so.

Key messages

Smoking cessation support for patients was not good among health professionals, who were smokers. Health professionals need to quit smoking in order to provide better cessation support for patients.

COVID 19: Importance of Physical Rehabilitation Medicine Capacity Building

No Abstract.

Oral Mucosal Graft Augmented Anastomotic Urethroplasty for Post Traumatic Urethral Stricture and Distraction Defect: Outcome in 100 Patients

The surgical procedures of post traumatic posterior urethral stricture and distraction defects range from the extremely simple to the extremely radical. In oral Mucosal Graft Augmented Anastomotic Urethroplasty (OMG AAU) the stricture segment is excised followed by partially re-anastomosis of the dorsal or ventral urethral wall then the reconstruction is completed by placement of oral mucosal graft into the remaining urethral defect. The aim of this study is to determine the impact and assess the effectiveness of this technique, discuss the procedure and outcome and to refine them where found lacking. A prospectively collected review of records was done from September 2010 to April 2019. A total 100 patients with post traumatic urethral stricture and distraction defect were treated by dorsal onlay oral mucosal graft augmented anastomotic urethroplasty by same surgeon in a single centre. All were followed up every 3 and 6 monthly for 1-2 years with uroflowmetry. Retrograde urethrogram/Micturating cysto-urethrogram (RGU/MCU) and cystoscopy were reserved for those who had complained of obstructive symptoms and uroflowmetry evidence of outflow obstruction. The etiology of trauma was road traffic accident (RTA) (69%), falling astride (28%) and traumatic catheterization (3%). Mean excised stricture length was 1.5cm (Range 1.0-2.2). The mean length of dorsal onlay considering excised stricture length and 1cm spatulations was 4.25cm (range 2.0-6.5). The successful recovery was observed in 94% cases. On conclusion the technique of OMG AAU is very easy to do, reliable and has high success rates. This is also the procedure of choice for long segment obliterative strictures. For post traumatic obliterative strictures and distraction defects we strongly recommend the procedure for successful and patient satisfactory outcome.

P0298EMPHYSEMATOUS PYELONEPHRITIS: SEVEN YEAR EXPERIENCE OF MANAGING CONSECUTIVE 22 PATIENTS IN A SINGLE CENTER OF BANGLADESH

Background and Aims

Emphysematous pyelonephritis (EPN) is an uncommon, severe, necrotizing infection of the renoureteral unit and is recognized by accumulation of gas within the collecting system, renal parenchyma and/or perinephric tissue. Common risk factors for EPN are diabetes mellitus, renal stone, obstructive uropathy and immunosuppression. Principles of treatment include resuscitative measures, antibiotics, strict glycaemic control and interventions in selected cases. This study aimed to describe clinical, laboratory and imaging characteristics of EPN patients with special emphasis on in-hospital outcome.

Method

This cross-sectional study included consecutive 22 EPN patients, managed in the Department of Internal Medicine and the Department of Nephrology of a tertiary care hospital in Dhaka, Bangladesh from January 2013 to December 2019. Patients’ selected socio-demographic, clinical and laboratory parameters and in-hospital treatment-outcome were recorded in case record forms at the time of discharge or death, if were any.

Results

Total patients were 22 (mean age 46.8±12.5, range 34.0–55.0 years) including 16 (72.7%) females. All (22, 100%) were diabetic [one (4.5%) patient was newly detected as diabetic during EPN diagnosis]. Three (13.6%) patients had renal stones (bilateral in one), two (9.1%) had obstructive uropathy, six (27.3%) had chronic kidney disease, 12 (54.5%) had hyponatreamia and 16 (72.7%) were complicated by acute kidney injury (AKI). Patients presented with fever (22, 100%), loin pain/renal angle tenderness (19, 86.4%), vomiting (19, 86.4%) and dehydration (8, 36.4%). One (4.5%) patient had pneumaturia. One (4.5%) patient presented with uraemic encephalopathy and none had shock. One (4.5%) patient had tender ectopic (pelvic) right kidney. Patients had leukocytosis (mean total white cells 19917±7549, range 10250–37630/cmm of blood) and four (18.2%) patients had thrombocytopaenia. All patients had high erythrocyte sedimentation rate (mean 65.7±20.8, range 35–120 mm in 1st h) and C-reactive protein (mean 68.9±60.3, range 18–209 mg/L). Glycaemic status was poor [mean random blood glucose at admission 17.4±6.0, range 10.6–35.5 mmol/L and mean glycated haemoglobin (HbA1c) 9.8±2.1, range 6.9–15.5%]. Diagnosis of EPN was confirmed by abdominal ultrasonography and computed tomography scan. One patient had EPN in ectopic right kidney, one patient had EPN along with air in ureter, two patients had associated emphysematous cystitis and one had psoas abscess. Ten (45.5%) patients had EPN in right kidney (including pelvic kidney), 11 (50%) had EPN in left kidney, one (4.5%) had bilateral EPN and three (13.6%) patients had concomitant contralateral pyelonephritis. According to Huang and Tseng classification, one (4.5%) patient had class 4 EPN, three (13.6%) patients had class 3B, five (22.7%) patients had class 3A and thirteen (59.1%) patients had class 2 EPN. Escherichia coli was the most common (13, 59.1%) organism identified on urine culture [including four (4/13, 30.8%) cases with extended-spectrum beta-lactamase positive E. coli] and four (18.2%) patients were complicated by bacteraemia. Five (22.7%) patients required surgical interventions [nephrectomy in three (13.6%) and open drainage in two (9.1%)]. All patients were treated with intravenous antibiotics and other supportive measures. One patient required three sessions of haemodialysis. Mean hospital stay was 16.1±6.4 (range 7–31) days. AKI resolved in 3 (3/16, 18.8%) patients and in others renal function was improving at the time of discharge and there was no death.

Conclusion

Most EPN patients were successfully managed by conservative approach in this study, two-thirds had AKI, one-fourth required surgical interventions and there was no death. Though conservative approaches for managing EPN is becoming popular, we emphasize interventions should not be delayed, as and when indicated, and may appear life-saving.

Distribution of Microorganisms in Neonatal Sepsis and Possible Outbreak of Enterobacter spp. in Neonatal Intensive Care Unit

Background: Neonatal sepsis is one of the leading causes of neonatal mortality and morbidity globally, more in developing countries. Frequent monitoring of changing pattern of pathogens causing neonatal sepsis is mandatory for effective treatment. Objectives: This study was done to isolate and identify different organisms of sepsis and to compare different types of organisms between early-onset neonatal sepsis (EONS) and late-onset neonatal sepsis (LONS). Materials and Methods: This cross sectional descriptive study was conducted in Department of Microbiology in collaboration with Department of Neonatology, (DMCH) Dhaka. Blood sample was collected from 106 clinically suspected septicemic neonates and isolation and identification of organism was done by automated blood culture and standard microbiological protocol. Data was collected from attendants by filling a predesigned questionnaire. Results: Among 106 samples, 76 (71.69%) were bloodculture positive. Prevalence of (LONS) was higher 42 (55.26%) in comparison to (EONS) 34 (44.74%). Male neonates were affected more 42 (55.26%) than female 34 (44.74%). Among the isolated organisms, Enterobacter spp. was the predominant organism 20 (26.31%) followed by Klebsiella pneumoniae 18 (23.68%) and Candida spp. 12 (15.79%). Conclusion: Gram-negative organisms play the leading role for causing neonatal sepsis and Enterobacter outbreak should be concerned. Therefore, regular surveillance of organism profile causing neonatal sepsis is of utmost necessity. KYAMC Journal Vol. 11, No.-1, April 2020, Page 14-20

Facial Amphiphilicity-Induced Polymer Nanostructures for Antimicrobial Applications

New antimicrobial agents are needed to address ever-increasing antimicrobial resistance and a growing epidemic of infections caused by multidrug resistant pathogens. We design nanostructured antimicrobial copolymers containing multicyclic natural products that bear facial amphiphilicity. Bile acid based macromolecular architectures of these nanostructures can interact preferentially with bacterial membranes. Incorporation of polyethylene glycol into the copolymers not only improved the colloidal stability of nanostructures but also increased the biocompatibility. This study investigated the effects of facial amphiphilicity, polymer architectures, and self-assembled nanostructures on antimicrobial activity. Advanced nanostructures such as spheres, vesicles, and rod-shaped aggregates are formed in water from the facial amphiphilic cationic copolymers via supramolecular interactions. These aggregates were particularly interactive toward Gram-positive and Gram-negative bacterial cell membranes and showed low hemolysis against mammalian cells.

Comparison between Outcomes of Endoscopic Sinus Surgery and Surgical Excision in Case of Rhinosporiodiosis

Rhinosporiodiosis is a chronic granulomatous infection of the mucus membranes caused by Rhino sporidium seeberi that manifest as vascular friable polyps and arise in the nasal mucosa. The mode of infection is probably trans-epithelial penetration. Rhinosporiodiosis is endemic in India, Pakistan and Srilanka. It occurs sporadically in the United States of America. The aim of this study was to compare betweenthe outcomes of endoscopic sinus surgery andsurgical excision in rhinosporiodiosis. The cross sectional comparative study was conducted among 40 patients with rhinosporiodiosis from January 2018 to April 2019 in the department of Otolaryngology and Head-neck surgery of Mymensingh Medical College Hospital, Bangladesh. All the patients were following up to 6 month after surgery. Most of them are male 24(60.0%) and female are 16(40.0%). Age of the patients in this study was (Mean±SD) 34.8±13.5 years. More than half of the patients had rhinosporiodiosis in the inferior turbinate (25, 62.5%) followed by 8(20.0%) in nasal septum and 7(17.5%) in the nasal floor. Endoscopic Sinus Surgery was done purposively among 20 patients and surgical excision was done purposively among another 20 patients. At the time of operation no complication occurs in case of endoscopic sinus surgery but in case of surgical excision small of amount bleeding was present. All the patients were followed up to 6 month after surgery. No recurrence was found in patients with endoscopic sinus surgery but 7(35.0%) patients who underwent surgical excision had recurrence of rhinosporiodiosis at follow up after six months of surgery. Chi-square test showed that the incidence of recurrence after 6 months of surgery was significantly lower in endoscopic sinus surgery (p=0.004). The study results concluded that endoscopic sinus surgery is better option for rhinosporiodiosis.

The impact of ZnO configuration as an external layer on the sensitivity of a bi-layer coated polymer optical fiber probe

Salinity magnitude changes are a critical factor for determining the chemistry of natural water bodies and biological processes. Label-free refractive index sensors are promising devices for detecting these changes. A polymer optical fiber (POF) sensor modified with cladding treatment and a bi-layer zinc oxide/silver (ZnO/Ag) nanostructure coating to determine sodium chloride concentration changes through refractive index variations in water is experimentally demonstrated. The use of three ZnO nanostructure shapes, nanoparticles and horizontally and vertically oriented nanorods, as an external layer and a broad spectrum light source from the visible (Vis) to the near infrared (NIR) region are investigated to achieve optimum sensitivity. The rms roughness, optical band-gap and zeta potential (ZP) value for the vertically oriented sample are 148 nm, 3.19 eV and 5.96 mV, respectively. In the NIR region the wavelength–intensity sensitivity values of probes coated with ZnO nanoparticles and horizontally and vertically oriented nanorods are 104 nm RIU⁻¹–12 dB RIU⁻¹, 63 nm RIU⁻¹–10 dB RIU⁻¹ and 146 nm RIU⁻¹–22 dB RIU⁻¹, respectively, and in the Vis area the values are 65 nm RIU⁻¹–14 dB RIU⁻¹, 58 nm RIU⁻¹–11 dB RIU⁻¹ and 89 nm RIU⁻¹–23 dB RIU⁻¹, respectively. The maximum amplitude sensitivity is obtained for the probe coated with vertically aligned ZnO nanorods in the NIR area due to the deeper penetration of evanescent waves, a higher surface-volume ratio, better crystallinity, more adhesive interactions with salt molecules, larger surface roughness and higher-order dispersion compared to the other coated ZnO nanostructures.

Detecting the salinity magnitude changes as a predominant factor for determining the chemistry of natural water bodies and biological process via label-free refractive index modified optical fiber sensors.

Polymerization-Induced Self-Assembly of Metallo-Polyelectrolyte Block Copolymers

Cobaltocenium-containing polyelectrolyte block copolymer nanoparticles were prepared via polymerization-induced self-assembly (PISA) using aqueous dispersion RAFT polymerization. The cationic steric stabilizer was a macromolecular chain-transfer agent (macro-CTA) based on poly (2-cobaltocenium amidoethyl methacrylate chloride) (PCoAEMACl), and the core-forming block was poly(2-hydroxypropyl methacrylate) (PHPMA). Stable cationic spherical nanoparticles were formed in aqueous solution with low dispersity without adding any salts. The chain extension of macro-CTA with HPMA was efficient and fast. The effects of block copolymer compositions, solid content, charge density, and addition of salts were studied. It was found that the degree of polymerization of both the stabilizer PCoAEMACl and the core-forming PHPMA had a strong influence on the size of nanoparticles.

Comparison of Serum Amylase and Lipase Levels between Predialysis and Maintenance Haemodialysis CKD Patients

This cross sectional study was done to compare serum levels of amylase and lipase between predialysis and maintenance haemodialysis chronic kidney disease (CKD) patients and also to find out their relationship between degrees of renal impairment in Mymensingh Medical College Hospital and National Institute of Kidney Diseases and Urology, Dhaka, Bangladesh from May 2016 to April 2017. A total of 80 patients were included purposively as study subjects and made into two groups namely predialysis CKD group comprising 50 patients and other as maintenance haemodialysis group comprising of 30 patients. Among the predialysis group majority of the CKD was caused by glomerulonephritis (48%) followed by diabetes (26%), HTN (2%) and large portion undiagnosed (24%) whereas in the haemodialysis group ESRD was caused by diabetes (46%) followed by glomerulonephritis (16%), HTN (13%) and undiagnosed (23%). This study showed that mean serum amylase (158±718U/L vs. 111±41U/L) did not significantly differ between study groups except being above reference level but serum lipase (739±888U/L vs. 434±214U/L) was significantly higher in the predialysis group. There was a correlation between rising serum creatinine with serum amylase and lipase.