ABSTRACT
BACKGROUND: The role of esophageal laboratory testing in predicting response to balloon dilatation in patients with achalasia cardia has been evaluated in the West; data in Indian patients are scant. AIM: To study the predictors of response to pneumatic balloon dilatation in Indian patients with achalasia cardia. METHODS: Twenty-five patients with achalasia cardia who had earlier undergone esophageal manometry before balloon dilatation (Group A) were recalled for clinical evaluation. Another consecutive 25 patients with newly diagnosed achalasia (Group B) underwent esophageal manometry and isotope transit studies before and after dilatation. RESULTS: The overall symptom response to dilatation in the 50 patients at median (range) follow up of 26 (1-60) months was 64%. Pre-dilatation clinical and laboratory parameters did not predict outcome. All patients with 1-week post-dilatation lower esophageal sphincter (LES) basal pressure less than or equal to 10 mmHg and residual pressure less than 6 mmHg were asymptomatic at follow up. CONCLUSION: Post-dilatation LES basal pressure less than or equal to 10 mmHg and residual pressure less than 6 mmHg are predictors of symptom response to balloon dilatation in patients with achalasia cardia.
Subject(s)
Adolescent , Adult , Aged , /methods , Child , Child, Preschool , Esophageal Achalasia/diagnosis , Esophagoscopy , Female , Follow-Up Studies , Humans , Male , Manometry , Middle Aged , Predictive Value of Tests , Probability , Recurrence , Treatment OutcomeABSTRACT
The phosphomonoesterases catalyse the hydrolysis of primary esters of phosphoric acid which help the bacteria to survive in phosphate stressed environment. Ninety-five bacterial isolates were obtained from domestic sewage and industrial effluents of gelatine and soap factories at Jabalpur on a medium enriched with phosphate and were screened for phosphatase production. The phosphatase producers were tentatively identified as Escherichia coli, Vibrio vulnificus, Aeromonas hydrophila, Staphylococcus aureus, Pseudomonas maltophilia and Micrococcus varians. The in vitro studies on the production of phosphomonoesterases by bacteria was conducted. The maximum alkaline phosphatase production was recorded on 8th day of incubation by E.coli and P.maltophilia, on 10th day of incubation by V.vulnificus while M.varians and P.maltophilia produced higher acid phosphatase on 4th and 10th day of incubation respectively. The detailed investigations were done to find out the effect of various physical and chemical factors on phosphomonoesterases activity and the optimum conditions required for enzyme activity.