<strong>Introduction:</strong> Percutaneous nephrolithotomy (PCNL) is a standard minimally invasive urological procedure for the treatment of large renal calculi. It is also associated with complications a...<strong>Introduction:</strong> Percutaneous nephrolithotomy (PCNL) is a standard minimally invasive urological procedure for the treatment of large renal calculi. It is also associated with complications arising from absorption of irrigation fluid and intravenous fluid injection. We evaluated the changes occurring in vital and blood parameters during PCNL using 0.9% normal saline (NS) as an irrigation fluid. <strong>Materials and Methods:</strong> We prospectively studied 71 patients who underwent PCNL in our hospital between 2016 and 2018. NS (0.9%) was used as irrigation fluid in all patients. Changes in hemodynamics, hemogram, renal function tests and serum electrolytes were noted and assessed for significance using paired t-test. These changes were correlated with ASA grade, BMI, total operating time, total irrigation fluid used and total intravenous fluid used using Pearson’s correlation test. <strong>Results:</strong> A significant fall in serum creatinine was present (1.30 ± 0.96 vs. 1.24 ± 0.93) along with a rise in eGFR (85.39 ± 24.10 vs. 90.18 ± 22.58). A significant rise in serum potassium (4.34 ± 0.45 vs. 4.5 ± 0.56) and chloride levels (104.79 ± 3.51 vs. 106.69 ± 3.14) post-operatively was noted. A significant rise in pulse rate (80.84 ± 10.13 vs. 87.76 ± 13.12) and systolic blood pressure (127.67 ± 15.90 vs. 136.88 ± 19.56) post-operatively was noted. There was no significant change noted in hemoglobin, PCV, platelets and serum sodium levels. Total operating time and irrigation fluid volume showed a positive correlation with changes in eGFR, serum chloride, post-operative pulse rate and blood pressure values. Intravenous fluids volume correlated positively with changes in serum potassium, chloride, post-operative pulse rate and blood pressure values. <strong>Conclusion:</strong> High amount of irrigation fluid absorption can cause early post-operative changes in patients’ hemodynamics and blood indices. Overzealous hydration during PCNL with potassium containing fluids can also lead to hyperkalemia and hyperchloremic acidosis. Thus, early post-operative monitoring of serum electrolytes should be done in all patients after PCNL to prevent complications arising from dyselectrolytemia.展开更多
Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency and sickle cell disease are common genetic defects of red blood cells that lead to hemolytic anemia. The prevalence of G6PD deficiency in sickle cell pat...Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency and sickle cell disease are common genetic defects of red blood cells that lead to hemolytic anemia. The prevalence of G6PD deficiency in sickle cell patients is unknown in Benin. Objective: This study aimed to determine the prevalence of G6PD deficiency in sickle cell patients at the CNHU-HKM of Cotonou. Methods: This prospective study was conducted from April to November 2022 at the blood-related diseases teaching clinic and included sickle cell patients in the stationary phase. G6PD determination was performed using the enzymatic method on a Mindray BS 200 machine following the Herz method. Hematological parameters were determined using the XT 4000i analyzer and supplemented by a blood smear stained with May Grunwald Giemsa. Data were analyzed using Epi Info 3.5.4 software. Results: One hundred and sixty-four sickle cell patients (80 SS homozygotes and 84 SC heterozygotes) in the intercritical phase, with a mean age of 26.30 ± 10.76 years, were included. The prevalence of G6PD deficiency was 9.1% (15 cases found in 7 SS patients and 8 SC patients). In G6PD-deficient patients, the mean concentration of the enzyme was lower in Hb SC heterozygotes than in Hb SS homozygotes: 3.56 IU/g Hb versus 4.98 IU/g Hb. The mean reticulocyte count was 231.43 G/L in the deficient group, compared to 216.32 G/L in the non-deficient group. Conclusion: The preliminary results of our study reveal a high prevalence of G6PD deficiency in sickle cell patients. The impact of this association on hematologic and biological parameters should be evaluated for better management of sickle cell disease.展开更多
文摘<strong>Introduction:</strong> Percutaneous nephrolithotomy (PCNL) is a standard minimally invasive urological procedure for the treatment of large renal calculi. It is also associated with complications arising from absorption of irrigation fluid and intravenous fluid injection. We evaluated the changes occurring in vital and blood parameters during PCNL using 0.9% normal saline (NS) as an irrigation fluid. <strong>Materials and Methods:</strong> We prospectively studied 71 patients who underwent PCNL in our hospital between 2016 and 2018. NS (0.9%) was used as irrigation fluid in all patients. Changes in hemodynamics, hemogram, renal function tests and serum electrolytes were noted and assessed for significance using paired t-test. These changes were correlated with ASA grade, BMI, total operating time, total irrigation fluid used and total intravenous fluid used using Pearson’s correlation test. <strong>Results:</strong> A significant fall in serum creatinine was present (1.30 ± 0.96 vs. 1.24 ± 0.93) along with a rise in eGFR (85.39 ± 24.10 vs. 90.18 ± 22.58). A significant rise in serum potassium (4.34 ± 0.45 vs. 4.5 ± 0.56) and chloride levels (104.79 ± 3.51 vs. 106.69 ± 3.14) post-operatively was noted. A significant rise in pulse rate (80.84 ± 10.13 vs. 87.76 ± 13.12) and systolic blood pressure (127.67 ± 15.90 vs. 136.88 ± 19.56) post-operatively was noted. There was no significant change noted in hemoglobin, PCV, platelets and serum sodium levels. Total operating time and irrigation fluid volume showed a positive correlation with changes in eGFR, serum chloride, post-operative pulse rate and blood pressure values. Intravenous fluids volume correlated positively with changes in serum potassium, chloride, post-operative pulse rate and blood pressure values. <strong>Conclusion:</strong> High amount of irrigation fluid absorption can cause early post-operative changes in patients’ hemodynamics and blood indices. Overzealous hydration during PCNL with potassium containing fluids can also lead to hyperkalemia and hyperchloremic acidosis. Thus, early post-operative monitoring of serum electrolytes should be done in all patients after PCNL to prevent complications arising from dyselectrolytemia.
文摘Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency and sickle cell disease are common genetic defects of red blood cells that lead to hemolytic anemia. The prevalence of G6PD deficiency in sickle cell patients is unknown in Benin. Objective: This study aimed to determine the prevalence of G6PD deficiency in sickle cell patients at the CNHU-HKM of Cotonou. Methods: This prospective study was conducted from April to November 2022 at the blood-related diseases teaching clinic and included sickle cell patients in the stationary phase. G6PD determination was performed using the enzymatic method on a Mindray BS 200 machine following the Herz method. Hematological parameters were determined using the XT 4000i analyzer and supplemented by a blood smear stained with May Grunwald Giemsa. Data were analyzed using Epi Info 3.5.4 software. Results: One hundred and sixty-four sickle cell patients (80 SS homozygotes and 84 SC heterozygotes) in the intercritical phase, with a mean age of 26.30 ± 10.76 years, were included. The prevalence of G6PD deficiency was 9.1% (15 cases found in 7 SS patients and 8 SC patients). In G6PD-deficient patients, the mean concentration of the enzyme was lower in Hb SC heterozygotes than in Hb SS homozygotes: 3.56 IU/g Hb versus 4.98 IU/g Hb. The mean reticulocyte count was 231.43 G/L in the deficient group, compared to 216.32 G/L in the non-deficient group. Conclusion: The preliminary results of our study reveal a high prevalence of G6PD deficiency in sickle cell patients. The impact of this association on hematologic and biological parameters should be evaluated for better management of sickle cell disease.
