Social and Psychological Variables Associated With Sexual Deviations Among Secondary School Adolescents in Rivers State
CHAPTER ONE
Objective of study
The aim of this study was to determine the concentration of electrolyte, Urea and creatine in the blood cell of pregnant women.
CHAPTER TWO
LITERATURE REVIEW
Anatomy
The bean-shaped kidneys lie in a retroperitoneal position in the superior lumbar region. Extending approximately from T12 to L3, The right kidney is crowded by the liver and lies slightly lower than the left. An adult‟s kidney has a mass of about 150 g (5 ounces) and its average dimensions are 12 cm long, 6 cm wide, and 3 cm thick. Each kidney comprises an outer cortex and an inner medulla.The lateral surface is convex. The medial surface is concave and has a vertical cleft called the renal hilum that leads into an internal space within the kidney called the renal sinus. The ureter, renal blood vessels, lymphatics, and nerves all join each kidney at the hilum and occupy the sinus. The kidney is supplied with oxygenated blood via the renal artery and drained of deoxygenated blood by the renal vein. In addition, urine produced by the kidney as part of its excretory function, drains out via narrow “tubules” called ureters, which in turn connected to the bladder.Atop each kidney is an adrenal (or suprarenal) gland, an endocrine gland that is functionally unrelated to the kidney.(snell 2012 ).
Blood pressure regulation:
Although the kidney cannot directly sense blood, long-term regulation of blood pressure predominantly depends upon the kidney. This primarily occurs through maintenance of the extracellular fluid compartment, the size of which depends on the plasma sodium concentration. Renin is the first in a series of important chemical messengers that make up the renin-angiotensin system. Changes in renin ultimately alter the output of this system, principally the hormones angiotensin II and aldosterone. Each hormone acts via multiple mechanisms, but both increase the kidney’s absorption of sodium chloride, thereby expanding the extracellular fluid compartment and raising blood pressure. When renin levels are elevated, the concentrations of angiotensin II and aldosterone increase, leading to increased sodium chloride reabsorption, expansion of the extracellular fluid compartment, and an increase in blood pressure. Conversely, when renin levels are low, angiotensin II and aldosterone levels decrease, contracting the extracellular fluid compartment, and decreasing blood pressure.(Elaine N. 2004 )
CHAPTER THREE
MATERIALS AND Methods
Study Design/Study Site
This hospital-based case-control study was carried out between October, 2015, and April, 2016, at the Koforidua Polyclinic. A total of 100 patients (50 with gestational malaria as cases and 50 healthy pregnant women as controls) were recruited for this study.
Inclusion Criteria
Pregnant women with singleton pregnancies receiving antenatal care at the study center were eligible to participate in this study.
Exclusion Criteria
Exclusion criteria were participants with preexisting renal diseases, chronic kidney disease, hypertension and diabetes mellitus, human immunodeficiency virus, and acquired immune deficiency.
Ethical Considerations
Ethical clearance for the study was obtained from the University of Cape Coast Institutional Review Board (UCC/IRB) and from the authorities of Koforidua Polyclinic. Consent was sought from participants having explained to them the purpose of the research and its relevance. Participants were made to willingly opt out anytime they felt uncomfortable or had a change of mind.
Collection of Obstetric Data
With the aid of a questionnaire a resident or an intern nurse obtained sociodemographic characteristics and obstetric history (parity, gravidity) of consented participants.
CHAPTER FIVE
DISCUSSION OF FINDINGS AND CONCLUSION
DISCUSSION
The physiological state of pregnancy brings about a lot of with metabolism and excretion of biochemical markers of changes which affect the metabolism of various biochemical renal impairment. Furthermore, during pregnancy cardiac parameters. These changes are largely thought to provide output and renal blood flow are increased together with conducive environment for the growing fetus but may affect
The results of this study indicates lower reference interval for urea, creatinine and electrolytes as compared to the reference interval currently being used at the Awka Hospital physiological increase in GFR resulting increased clearance of creatinine [6], hence pregnant patients with serum creatinine level closer to the upper limit of reference interval for the “normal’’ population, should be examined further for possible renal impairment.
CONCLUSION
Normal pregnancy is associated with progressive decrease in urea and creatinine levels from the first trimester to the third trimester while electrolytes decreases in first half of pregnancy followed by increases from the second trimester to the third trimester. The upsurge in electrolytes concentration from the second to the third trimester of pregnancy may be attributable to the dramatic increase in tubular re-absorption and fetal production.
The absence of reliable data on reference intervals for urea, creatinine and electrolytes among pregnant women in Nigeria call for the establishment of these reference ranges using larger sample size and should cover all the ten regions of the country. This is because the physiological and anatomical changes that come with pregnancy especially those related to the kidney means that the laboratory reference intervals of non-pregnant women are not suitable for pregnant women.
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