Evaluation of plasma serotonin concentration in acute appendicitis.

BACKGROUND: Due to lack of reliable biochemical/radiological markers, the diagnosis of acute appendicitis is based only on clinical features. METHODS: We estimated plasma serotonin levels in 48 patients with acute appendicitis (histologically proven), 27 patients with abdominal pain of other etiologies, and 20 healthy controls. RESULTS: The plasma serotonin levels were (mean +/- SD) 36.6 +/- 12.5 nmol/L, 12.5 +/- 3.6 nmol/L and 10.4 +/- 3.5 nmol/L in the three groups, respectively. The levels in patients with acute appendicitis were significantly higher (p < 0.001) than in the other groups, giving 93.8% sensitivity and 95.7% specificity to the test. CONCLUSION: Plasma serotonin level is a reliable marker of acute appendicitis, especially in the first 48 hours.

Comparative evaluation of gastric secretory response to banana and porridge.

Unripe Banana (Plantain) is used in South India as a bland diet for peptic ulcer patients. Flour made of plantain is quite often prescribed in dyspepsia in this part of the country. This has led to the belief that ripe banana may also be a bland fruit. However, it was observed by the Senior Author that ripe banana does produce symptoms of hyperacidity. Hence a study was undertaken to assess whether ripe banana is a bland food or not. A total of 115 patients entered the study. 89 individuals had no GIT symptoms, 15 patients had proved peptic ulcer while 11 patients had non-ulcer acid dyspepsia. The gastric residue was emptied by a nasogastric tube after a night fast. Patients were then given 80 gms. of banana or porridge on two different days. Then consecutive 15 minute samples of gastric juice were collected and submitted for estimation of acid output in mEq/l. It was observed that gastric acid values were higher following banana as compared to porridge and the difference was statistically significant (p < 0.001). It was was thus concluded that ripe banana is not a bland food. It should not be recommended as a part of bland diet for patients of acid peptic disease.

Ultrasonography versus roentgenography in suspected cases of cholecystolithiasis.

The present study was carried out to evaluate the relative merits of ultrasonography and roentgenography in 50 cases of suspected cholecystolithiasis. The accuracy rate with roentgenography (plain X-ray abd, OCG and IVC) in the diagnosis of cholecystolithiasis was 92.5% where as it was 95% with ultrasonography. Oral cholecystography should be done in patients with normal ultrasound examination if the symptoms are strongly suggestive of cholecystolithiasis.

Mechanism of hypercalciuria in experimental metabolic acidosis.

To study the mechanism of hypercalciuria in metabolic acidosis, ammonium chloride loading (long) test was performed in 68 stone formers and 50 controls. Administration of ammonium chloride in both stone formers and controls produced a significant increase in urinary volume, ammonium and calcium excretions, no change in plasma calcium and creatinine clearance and significant decrease in plasma bicarbonate. However, on the third day of ammonium chloride loading test, urinary ammonium excretion and plasma bicarbonate levels were significantly lower while urinary calcium excretion was significantly greater in stone formers than in controls. Thus calciuresis could be correlated with the degree of metabolic acidosis but not with the rate of urinary ammonium excretion.