Association of gallstone disease risk with serum level of alkaline phosphatase

To see the relationship between personal history and blood chemistry of preoperative gallstone patients with gallstone disease. A Cross sectional study. Liaquat University Hospital Jamshoro for a period of three years. Gallstone patients admitted for the treatment during January 1999 to December 2001 were studied with the help of a predesigned proforma for recording the personal history and blood chemistry results of the individual patients. A total of 172 patients was studied. Majority [85.33%] of the gallstone patients was females. Females under 45 years age [65.38%] and females having more than three children [70.55%] were more prone to develop gallstones than the respective female group of over 45 years age [34.62%] and having upto three children [29.45%]. Past history of the gallstone patients revealed that 53.5%, 23.2%, and 9.3% of the cases had jaundice, diabetes mellitus and renal stones respectively. Blood chemistry of the patients showed that 18.2%, 2.8%, 3.44% and 4.1% had respectively hyperbilirubinemia, hyperuremia, hyperglycemia and hypoglycemia. Alkaline phosphatase and alanine aminotransferase levels in plasma and total leuckocyte count in blood were raised in 17%, 39.7% and 9% cases respectively. However, low plasma alkaline phosphatase levels were also found in 31.1% gallstone patients. The levels of plasma alkaline phosphatase were significantly high [p<0.01] in females than in males, and in females over 45 years age than under 45. Risk of gallstone disease in females is associated with serum alkaline phosphatase level

Surgical incidence of cholelithiasis in Hyderabad and adjoining areas [Pakistan]

To determine the surgical incidence of cholelithiasis in Hyderabad and adjoining areas. Design: Cross sectional study. Settings: Surgical Units of Liaquat University of Medical and Health Sciences, Jamshoro; Memon Charitable Hospital; Wali Bhai Rajputana Hospital; Naseem Medical Center; and Isra University Hospital, Hyderabad. Patients: 483 male and 1583 female patients of 10 to 80 years age surgically treated for gallstones during the years 1999 to 2001. Measurements: The surgical incidence of cholelithiasis for the period January 1999 to December 2001 was studied with the help of a questionnaire designed to know the dietary habits, age, sex and month of presentation of gallstone cases. Of the gallstone patients treated, the surgical incidence in mates was found to be 4.0% [95% CI, 3.6 - 4.5] and in females 14.2% [CI, 14.1 - 15.7], constituting male to female ratio 1:3.3. May and November were the peak months for the presentation of gallstone cases. The age range for male gallstone patients was 10 to 78 years and for females 11 to 80. The peak age group for the occurrence of gallstones in males was 45-59 years and in females 30-44. Females between the ages 30 - 44 years were seen to be more prone to develop gallstones than the females of any other age group. Conclusions: Overall surgical incidence for chotelithiasis was found to be 9.03% [95% CI, 8.6 - 9.4], with females being 3.3 times more prone to develop gallstones than the males

Cholelithiasis in southern Sindh, Pakistan: incidence and composition of gallstones

To determine the surgical incidence and composition of gallstones at the Liaquat Medical College Hospital, Jamshoro [Hyderabad]. Design; A 3-year retrospective study of cholelithiasis and analysis of 77 gallstones by infrared spectroscopy. Setting: Surgical Units, Liaquat Medical College Hospital and Department of Biochemistry, University of Si. Subjects: Three hundred fifty seven consecutive cholelithiasis patients treated in the Surgical Units of Liaquat Medical College Hospital, Jamshoro. Main outcome measures: Surgical incidence of cholelithiasis with regard to epidemiological risk factors, composition of gallstones by age and sex of patients. The surgical incidence for cholelithiasis was found to be 3.07% [1.9% among males and 10.7% among females]. The highest female to male ratio [7:1] was seen in 20-29 year age group and the maximum prevalence of the disease in both sexes occurred between 30-39 years age. August to November were the peak months for the presentation of cholelithiasis patients. IR analysis of 77 gallstones disclosed that 60 [77.92%] including 41 [53.25%] pure cholesterol stones, contained cholesterol as a major constituent. The remainder 17 [22.08%] gallstones were mainly composed of bilirubin and calcium salts. Both cholesterol and pigment stones were preponderantly seen in patients between 40-59 years age. Pure cholesterol stones predominantly occurred in females than in males, while reverse was true for pure pigment stones. The present results reflect a better understanding of epidemiology and composition of gallstones of this area and further to decide whether to treat gallstone patients therapeutically or surgically

Is hypocitraturia associated with phosphaturia-a potential cause of calcium urolithiasis in first-time stone formers

The serum and 24 hour urinary excretion levels of various lithogenic and inhibitory substances were assessed in 24 male patients with calcium stone and no previous history of urolithiasis and in 19 age-matched controls. Two groups did not differ significantly [P<0.01] except in the excretions of sodium, citric acid [being higher in normals] and inorganic phosphate [being higher in patients]. Fifty percent patients had hyperphosphaturia, 29.2% hypocitraturia, 20.8% hyperoxaluria and 16.7% hypercalciuria. The present data suggests that hypocitraturia in association with phosphaturia might be one of the main risk factors responsible for calcium urolithiasis in this area