ABSTRACT
Background: Chronic kidney disease is a major public health problem worldwide. As kidney function declines, it leads to several metabolic abnormalities including dysregulation of mineral metabolism. It is also reported that hyperphosphatemia in patients with advanced kidney disease is associated with an increased risk of mortality and cardiovascular events, and is higher in dialysis-dependent chronic kidney disease (CKD) patients compared to non-dialysis CKD. However, data in the Indian context is limited. Objectives were to evaluate and compare serum phosphorus levels and associated factors in non-dialysis and dialysis CKD patients. Also, the impact of dietary phosphate restriction and the use of phosphate binders on serum phosphorus is analysed. Methods: A cross-sectional study was conducted at a tertiary care hospital in Kolkata, India, with 100 CKD patients: 50 non-dialysis CKD patients and 50 dialysis-dependent CKD patients. Relevant demographic, clinical and laboratory parameters including serum phosphorus, calcium, parathyroid hormone (PTH), alkaline phosphatase, albumin and estimated glomerular filtration rate (eGFR) were collected. Data was analyzed using appropriate statistical tests. Results: Mean serum phosphorus was significantly higher in the dialysis CKD group (6.12±0.34 mg/dl) compared to the non-dialysis CKD group (4.56±0.80 mg/dl). Serum calcium and PTH were also higher while eGFR and albumin were lower in the dialysis CKD group. Serum phosphorus levels increased with advancing CKD stages in the non-dialysis group. Phosphate binder helped phosphorus control in dialysis CKD patients. Conclusions: Our study is in confluence with other reports and dietary phosphate restriction and the use of phosphate binders help optimize phosphorus levels in CKD patients.
ABSTRACT
Introduction: The ideal bone graft substitute should provide osteogenetic cells to facilitate bone regeneration, osteoinductive factors to induce bone formation and an osteoconductive matrix to directly stimulate bone deposition. The present study was conducted to radiologically assess the regenerative potential of hydroxyapatite with collagen and to evaluate the clinical usefulness of these materials to enhance bone healing. Materials and methods: Orthopentomogram (OPG) were taken after extraction in the control group and after extraction but before graft placement in study group and post operatively after 8 weeks. Each image was analyzed for bone density of the post-extraction sockets through ‘densitometric analysis’ software in the OPG program. Chi-square test was applied to find the correlation. Results: Post-operative mean measurement for study group was 108.72±22.54 after extraction and was 136.59±23.20 after 8 weeks with significant p value (0.00). The value for control group was 119.69±18.41 after extraction and was 121.39±14.21 after 8 weeks with insignificant p value (1.96). Conclusion: Grafting of the surgical site results in faster regeneration of tissue and computer assisted image analysis software is an important aid in assessing the bone density changes at the surgical site.
ABSTRACT
Of 613 children evaluated in a village in Haryana 94 (15.3%) were observed to have chronic suppurative otitis media (CSOM). Fifty eight (61.7%) children had hearing impairment. CSOM contributed to 71.6% of the hearing impaired (58/81). On analysis of association of CSOM with literacy and socio-economic status of mothers, and age, sex, and upper respiratory tract infections (URI) in children positive correlation was observed only with URIs (P < 0.001). Literacy and socio-economic status of the mothers did not correlate significantly with knowledge about treatment seeking, and ear cleaning practices, probably due to the narrow range of incomes and literacy levels. An intervention program consisting of play, demonstrations, health charts and slogans, and aural cleaning and antibiotic drops was introduced.