A study to evaluate the correlation of serum albumin levels with chronic periodontitis.

Context: Periodontitis is a chronic inflammatory disease caused by bacterial infection of the supporting tissues around the teeth. Serum albumin levels might be the practical marker of general health status. Albumin concentration is associated with nutrition and inflammation. Aims: The aim of this study was to evaluate the relationship between periodontal health status and serum albumin levels. Subjects and Methods: A total of 60 subjects of both genders with age range of 40–70 years were included in the study. Patients were divided into two groups viz. Group I; clinically healthy subjects and Group II; patients with chronic periodontitis, that is, loss of attachment ≥5 mm. Serum albumin concentration was estimated by bromocresol green albumin method. Statistical Analysis Used: Student’s unpaired t‑test. Results: The mean value of serum albumin levels for Group I was 4.815 g/dL with standard deviation (SD) of 0.127 and for Group II, the mean value of serum albumin levels was 4.219 g/dL (SD 0.174). The difference between serum albumin levels in Group I and Group II were found to be statistically significant (P ≤ 0.001). Conclusions: The findings of this clinical trial suggest an inverse relationship between the serum albumin concentration and chronic periodontal disease.

Randomized evaluation of fluid resuscitation with crystalloid (saline) and colloid (polymer from degraded gelatin in saline) in pediatric septic shock.

OBJECTIVE: To compare the efficacy of crystalloid (Normal saline) and colloid (polymer from degraded Gelatin in saline Haemaccel) intravenous fluid in restoration of circulating volume in children with septic shock. DESIGN: Prospective, randomized, open-label trial. SETTING: Pediatric Emergency and Intensive Care Unit of a tertiary care referral and teaching hospital. SUBJECTS AND INCLUSION CRITERIA: Sixty patients, between 1 month to 12 years of age, with septic shock, without clinical evidence of organ failure at admission or underlying immunodeficiency. INTERVENTION: Resuscitation with normal saline or polymer from degraded gelatin (Haemaccel) in the boluses rate of 20 mL/kg till hemodynamic stabilization or if central venous pressure (CVP) exceeded 10 mmHg (fluid requirement beyond 40 mL/kg guided by BP and CVP). METHODS: Hemodynamic parameters (heart rate, capillary filling time, pulse volume, and blood pressure) were recorded before and during resuscitation, and then 2 hourly for 12 hours. Central venous pressure line was placed within first hour, soon after starting fluids. Estimation of plasma volume and body water was done at the end of first hour of fluid resuscitation. OUTCOME MEASURES: Hemodynamic stabilization (heart rate, capillary refill time, systolic BP in normal range), plasma volume at the end of fluid resuscitation and incidence of organ dysfunction. RESULTS: 31 patients were randomized to normal saline and 29 to gelatin polymer. Both the groups were similar with respect to age, gender, primary diagnosis, initial hemodynamic parameters and PRISM score. Pneumonia (n = 22; 36%), gut-associated sepsis (n = 13), and dengue hemorrhagic fever (n = 11) were the common primary diagnosis. Initial hemodynamic stabilization was achieved in all. The mean (SD plasma volume (saline--53.4 (2.0 mL/kg, gelatin polymer--53.2 (1.9 mL/kg), extracellular fluid volume, total body water and interstitial fluid volume at the end of first hour of resuscitation were similar. The requirement of inotropes, incidence of organ dysfunction and case fatality rate (Saline--29%, gelatin polymer--31%), were similar in two groups. CONCLUSION: Both normal saline and gelatin polymer solution were equally effective as resuscitation fluid with respect to restoration of plasma volume and hemodynamic stability. Normal saline upto 110 mL/kg, and gelatin polymer solution upto 70 mL/kg may be required in first hour for successful fluid resuscitation of septic shock in children.