Kariithi, F.N. Kel (2009) Cortisol Levels and Short Term Outcome in HIV Infected Patients with Sepsis in Kenyatta Hospital. Masters thesis, University of Nairobi.
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Abstract
Introduction Adrenal insufficient occurs in Human immunodeficiency virus (HIV)/ Acquired Immunodeficiency) Syndrome (AIDS) and causes morbidity and mortality} in HIV patients. Objective To determine cortisol levels and short term out come at 2 weeks in HIV infected and HIV uninfected patients admitted with sepsis in Kenyatta National hospital. Design This was a Cross Sectional Comparative study. Settings Medical wards, Intensive Care Unit. Renal Units Kenyatta National Hospital. Subjects Patients admitted with sepsis. Method Consecutive HIV infected admitted with sepsis as defined by a tool adopted from the consensus conference held 2008 wore recruited. Male or female HIV infected patient s aged more than 13 years and their age and sex matched comparative HIV negative patients were included. A baseline cortisol test was done. Synthetic cosyntrophin was given intravenous!} To stimulate the adrenal glands and serum cortisol levels at 30 and 60 minutes done following the stimulation. Patients wore then followed until 2 weeks after admission to establish their outcome. Expected outcomes were either discharge from the hospital or death. P values of 0.005 were considered significant at confidence intervals of 95%. Adrenal insufficiency was defined as baseline cortisol levels < I30nmol,'l and or failure to achieve cortisol levels of > 414nmol/l post stimulation. Results A total of 94 HIV infected and HIV uninfected patients wore recruited in the study 47 patients in each group. The mean age was 36=12.2 in the HIV infected group and 37= 13.4 HIV uninfected group. There was no statistically significant difference in the proportions of patients with adrenal insufficiency} in the two groups. The prevalence of primary adrenal insufficiency in the stud and comparative groups was 19% and 25.5% respectively. There were more deaths in the comparative group 31.9% compared to the study group at 24%. Conclusion There was no significant difference of adrenal insufficiency in the study group and comparative group in the comparative group.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Africana |
| Depositing User: | Geoffrey Obatsa |
| Date Deposited: | 20 Dec 2016 08:16 |
| Last Modified: | 20 Dec 2016 08:16 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/1135 |
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