Study of evaluation and correlation of calcium and phosphorus in chronic kidney disease with reference to parathyroid hormone

Background: Recent guidelines for bone metabolism and disease in CKD recommend that, the target levels for calcium (Ca), phosphorus (P), calcium x phosphorus product(Ca × P) and parathyroid hormone (PTH) levels should be maintained at 8.8-10.2 mg/dl, 2.1-5.6 mg/dl, < 57.1mg2/dl2 and 8.7-79.6 pg/ml, respectively in patients of CKD.Methods: This was an observational study done in 70 patients, presenting in outpatient and inpatient department of tertiary care multi-specialty teaching hospital. Study was carried out at Dhiraj Hospital, Vadodara, Gujarat, in interval of one and half year.The study was investigation based, in the age group of 18 years and above who presented with chronic kidney disease. Serum Ca and serum P levels were measured by Fully Automated Colorimetry and Parathyroid hormone was measured by FLIA-fluoroscence linked immunoassay.Results: Among the 70 patients of chronic kidney disease, 55.7% showed abnormal calcium levels, 41.4% showed abnormal phosphorus levels,72.9% showed abnormal PTH levels,11.4% showed abnormal Ca x P levels.Conclusions: The correlation between the phosphorus and PTH was linear and statistically significant. But the correlation between calcium and PTH was statistically insignificant and between Ca x P and PTH was very weak and statistically insignificant in CKD patients.

The Rubber Stopper: A Simple and Inexpensive Technique to Prevent Pin Tract Infection following Kirschner Wiring of Supracondylar Fractures of Humerus in Children

Percutaneous pinning after closed reduction is commonly used to treat supracondylar fractures of the humerus in children. Minor pin tract infections frequently occur. The aim of this study was to prevent pin tract infections using a rubber stopper to reduce irritation of the skin against the Kirschner (K) wire following percutaneous pinning. Between July 2011 and June 2012, seventeen children with closed supracondylar fracture of the humerus of Gartland types 2 and 3 were treated with this technique. All patients were treated with closed reduction and percutaneous pinning and followed up prospectively. Only one patient, who was a hyperactive child, developed pin tract infection due to softening of the plaster slab. We found using the rubber stopper to be a simple and inexpensive method to reduce pin tract infections following percutaneous pinning.

Factors of hearing impairment among Saudi children: a comparative epidemiological study

To determine and compare the various risk factors for hearing impairment in the four major regions of Saudi Arabia. Materials and Nine thousand five hundred forty children below the age of 15 were surveyed from the four major provinces of Saudi Arabia. A questionnaire was filled and an ENT examination with audiological assessement were carried out for each child. The various risk factors were studied. Nine thousand, five hundred and forty children were screened. Out of these 13% were hearing impaired and 8% were at risk of hearing impairment. Consanguinous marriages, failure to attend antenatal clinics, abnormal pregnancy and labour, prematurity, lack of immunization, xenthematous diseases and jaundice were the risk factors for hearing impairment, The Western and Southern regions of Saudi Arabia were found to have the highest rate of some of these risk factors. Conclusions: Consanguinous marriages should be discouraged. Attendance of antenatal clinics and immunization should be encouraged through proper health education and counseling programmes

Triple-drug therapy of Helicobacter pylori infection in duodenal ulcer disease.

OBJECTIVE: To evaluate the efficacy of triple-drug therapy for Helicobacter pylori infection and the effect of its eradication on relapse of ulcer in patients with duodenal ulcer (DU) disease. METHODS: Patients with uncomplicated DU who were H. pylori-positive on urease test or histology were given triple-drug therapy (metronidazole, tetracycline, colloidal bismuth subcitrate). Ulcer healing and H. pylori status were assessed one month after completion of therapy. Those with healed ulcers were followed up endoscopically for ulcer recurrence at 3-month intervals for one year or more. RESULTS: Fifty seven of 60 consecutive DU patients (95%) who were H. pylori-positive were taken up for the study; 46 patients (36 men; median age 40 years, range 13-70) completed the study. Thirty one of them (67%) eradicated H. pylori and had healed ulcers at one month post therapy; of 15 patients with persistent H. pylori infection, ulcers healed in 12 (p = ns). After an average follow up of 11 months, 8 of 12 H. pylori-positive patients had relapse of DU compared to 5 of 31 (16%) H. pylori-negative patients (p < 0.01). CONCLUSIONS: Triple-drug therapy was effective and safe for H. pylori infection, the lower rate of eradication observed compared to results elsewhere probably being related to bacterial resistance. Eradication of H. pylori was associated with healing of ulcers, resolution of antral gastritis and a significant fall in the rate of ulcer relapse.

use of sand bags under the shoulders in adenotonsillectomy

Two hundred and seventy three patients were investigated to find out the benefits of using sand bags under the shoulders of patients undergoing adenoidectomy, tonsillectomy or both. One hundred and fifty two patients were operated without the use of sand bags under their shoulders while in 121 patients sand bags were used. The use of sand bags added no benefit, nor was there any complications or technical difficulty connected to the position of the head and neck

Ossiculoplasty: comparison of four different methods

The use of plastipore PORP and TORP prostheses in ossiculoplasty is still a controversial issue. This study assesses their value in gearing improvement as compared to autograft and homograft ossicles. Eighty-eight patients aged 3-47 years with chronic suppurative etitis media were included in this study. Fifty-seven patients had non- cholesteatomatous otitis media and 31 had cholesteatoma. Reconstruction of the gap between the drum and stapes [type II tympanoplasty] was performed with autograft sculptured incudes in 30 patients and with PORPs in 25 patients. In drum to stapedial footplate reassembly [type III typanoplaty] homograft incuded was used in 18 patients and TORPs in 15 patients. All patients were followed up for at least one year postoperatively when the hearing was assessed. Surgery was considered successful if the patient obtained a 20 dB or less difference between pre-operative bone and post-operative air conduction in the speech frequencies. Sixty three% of patients who had undergone incus interposition [type II tympanoplasty] fulfilled this criterion. Similar success was obtained in 29% of patients with homograft incus. In type III tympanoplasty, homograft incus gave 39% success rate while TORP gave 40% success rate. In type II tympanoplasty incus interposition has given statistically better results than PORP [p 0,04] as regards hearing gain. However, in type III tympanoplasy, the difference between the results of homograft incudes and TORP was insignificant. Whenever possible incus interposition in type II tympanoplasty should be the methods of choice. In drum to footplate re-construction, TORP, however still has a place in ossiculoplasty

Effect of calcium channel blockers on experimentally induced seizures in rats.

Chemically different classes of calcium channel blockers were examined in rats for their effects on behavior, tolerability and protection against maximal electroshock seizures (MES) and pentylenetetrazol (PTZ) induced seizures. In MES test at doses (mg/kg, ip) that were devoid of side effects, felodipine, 50, afforded 100% protection, while nimodipine, 5; pimozide, 10; and thioridazine, 25, showed 50 to 66% protection. Nifedipine, 10, and diltiazem, 50, showed 30 and 66% protection respectively, but were associated with side effects. Verapamil and loperamide were ineffective against MES and PTZ induced seizures. Nimodipine, 1 mg/kg, ip, was the most potent agent and produced 100% protection against PTZ. Equieffective doses were pimozide, 25, felodipine, 50, and thioridazine, 50. The rest of the calcium channel blockers showed marginal to moderate activity against chemoshock. The data obtained suggest that some calcium channel blockers possess anticonvulsant activity and may be considered as adjuvant therapeutic agents in epileptics refractory to conventional antiepileptic medication.