Discriminatory value of blood urea:creatinine ratio in upper gastrointestinal bleeding with and without cirrhosis of liver.

AIM: To evaluate the discriminatory ability of blood urea:creatinine ratio in upper gastro-intestinal bleeding (UGIB) with and without cirrhosis of liver. METHODS: Blood urea:creatinine (BU/CR) ratio in 160 adult patients of UGIB were studied after excluding clinically overt cirrhosis of liver, renal failure and hematochezia. All were subjected to ultrasonography of abdomen. Only those showing cirrhosis and portal hypertension (n=76) were taken up for liver biopsy to confirm the diagnosis. BU/CR ratio was compared to UGIB cases without cirrhosis of liver (n=84). RESULTS: The mean (+/- SD) blood urea creatinine ratio was significantly lower in the group with cirrhosis than without cirrhosis of liver (22.49 +/- 6.13 vs. 38.07 +/- 8.08, Z value 13.91). CONCLUSION: In absence of renal failure, the blood urea/creatinine ratio may differentiate UGIB with associated cirrhosis of liver from those without. Being simple, cheap and readily available, it can be of some value in those patients with cirrhosis of liver clinically not associated with gross findings of cirrhosis. In our study it was also noted that, an arbitrary cut-off value of 30 showed considerable overlap between the two groups; hence this ratio may not always differentiate between the cirrhotics and non-cirrhotics. Therefore, reproducibility of these results needs further studies, taking into account other factors which can modify the BU level in our population.

Status of haemostasis in patients with peptic ulcers having haemorrhagic complication [In Anamnesis]

Peptic ulcer is one of the common diseases in the world. Most frequent and sometimes dramatic complication of peptic ulcer is haemorrhage. According to different authors, 20-60% of the patients with peptic ulcer present with gastroduodenal haemorrhage. Pathogenesis of haemorrhage was attributed to disturbances of haemostatic system. However, the data regarding this is small and controversial, Earlier studies were mostly devoted to the study of plasma factors but recently interest has grown in the cellular mechanisms of haemostasis i,e, adhesive and aggregative properties of thrombocytes and erythrocytes. In this paper an effort is made to summarize all published data regarding haemostatic status of peptic ulcer patients with particular attention to those with a history of haemorrhage in anamnesis

Niveles de pepsinógeno I sérico en el ulceroso duodenal sangrante / Serum pepsinogen I levels in bleeding duodenal ulcerous

Se compararon los niveles de Pepsinógeno I (PG I) séricos de 25 ulcerosos duodenales con antecedentes de sangramiento (UDS), 25 ulcerosos duodenales no sangrantes (UDNS) y un grupo control, igualmente distribuídos por edad y sexo. El valor más elevado que en los UDNS, esta diferencia sin embargo, no fue estadísticamente significativa. No obstante, el 88%de los UDS presentaron valores de PG I elevados comparados con el 72%de los uDNS. Dichos grupos si tuvieron diferencia significativa (p<0.001) con el grupo control. Concluímos que la medición del PG I sérico, es un sensible método diagnóstico complementario en el ulceroso duodenal. Su capacidad discriminatoria como índice de severidad, por el antecedente de hemorragia, sin embargo, no pudo ser demostrado. La hemorragia sigue siendo unreto en la historia natural del ulceroso duodenal