ABSTRACT
Background: Higher cardiovascular morbidity found to be more in early stages of chronic kidney disease patients. Present study was done to study the prevalence of cardiac valvular calcification correlated with serum phosphate levels in chronic kidney disease.Methods: A total of 153 (78 chronic kidney disease patients, 75 controls with age and sex matched) coming to ESIC Hospital, Chennai were utilized to conduct the present study. Patients of stages 3 to 5 with matched controls of age and sex were considered for this study. Cases were classified in to different stages of chronic kidney disease based on estimated Glomerular Filtration Rate which was calculated using Cockcroft-Gault equation using age, body weight, and serum creatinine. The blood samples of patients belonging to both the groups were tested for serum creatinine and serum phosphate. The Echocardiogram was done for the patient with chronic kidney disease to assess cardiac valvular calcification.Results: 51% of the subjects in the study group were detected as having chronic kidney disease in ultrasonogram. 20% of the patients in the study group were having coronary artery disease compared to 4% in the control group. Mean serum phosphate levels between subjects with Valvular calcification in chronic kidney disease and without calcification was statistically significant among the study group was noted in the present study.Conclusions: Elevated levels of serum phosphate correlated with cardiac valvular calcification showed significant role in chronic kidney disease.
ABSTRACT
BACKGROUND: Surgery is the mainstay of treatment of patients with peptic duodenal perforation. With the advent of minimal access techniques, laparoscopy is being used for the treatment of this condition. METHODS: Retrospective analysis of 120 consecutive patients (mean age 44.5 years; 111 men) with duodenal ulcer perforation who had undergone laparoscopic surgery. RESULTS: 87 patients had history of tobacco consumption, 12 were chronic NSAID users, 72 had Helicobacter pylori infection and 36 had a co-morbid condition. The mean time to surgery from onset of symptoms was 28.4 hours. The median operating time was 46 minutes. All patients underwent laparoscopic closure of the perforation with Graham's patch omentopexy; 12 patients underwent additional definitive ulcer surgery. The morbidity rate was 7.5%; no patient needed conversion to open surgery or died. The mean postoperative hospital stay was 5.8 days. CONCLUSION: Results of laparoscopic management of perforated peptic ulcer are encouraging, with no conversion to open surgery, low morbidity and no mortality.