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INTRODUCTION: Acid Base Disorders (ABDs) are commonly encountered in critically ill Chronic Kidney Disease (CKD) patients. Timely and correct analysis of Arterial Blood Gases (ABG) is critical for the diagnosis, treatment and prediction of outcome of the patients. AIM: The aim was to explore type and prevalence of ABDs in 31 critically ill CKD patients from a tertiary care hospital in Maharashtra, to compare two methods of analysis- bedside and systematic approaches and to clinically correlate the nature of ABDs in these patients. MATERIALS AND METHODS: The initial ABG reports of 31 consecutive CKD patients were analysed by two methods. Medica Easy stat analyser was the equipment for analysis with Principle of potentiometry and ion selective electrode for pH and pCO2 and amperometry for pO2. Serum albumin was also measured by Bromocresol green dye binding method using liquixx albumin kit in Erba XL 300 autoanalyser. STATISTICAL ANALYSIS: Chi-square test was used for statistical analysis using Epi Info version 3.5.4 and SPSS 14.0 softwares. RESULTS: The systematic method showed a significantly higher prevalence of mixed disorders (50%) compared to bedside method (12.9%). Most prevalent disorder by bedside method was metabolic acidosis in 15 cases (48.39%). By the systematic method, 3 reports were invalid. As a single category, most prevalent type was both simple respiratory alkalosis and mixed metabolic acidosis with respiratory alkalosis- 6 of 31 cases in each type (19.36% each). As a whole, metabolic acidosis (including both High Anion Gap Metabolic Acidosis or HAGMA and Non Anion Gap Metabolic Acidosis or NAGMA with 4 in each type) was most prevalent- 8 of 31(25.8%). CONCLUSION: Systematic approach was more effective in diagnosing mixed acid base disorders. By systematic method the findings of analysis in most cases could be correlated with the clinical condition and provisional diagnosis. Thus interpretation of ABDs by using stepwise approach could be useful to the clinicians in early diagnosis and management of the patients.
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BACKGROUND: Recent studies indicate that the risk of coronary artery disease (CAD) in women is no less than that in men and menopausal women are equally vulnerable as men. Studies of recent risk factors like hyperhomocysteinemia and elevation in lipoprotein (a) reveal controversial role of the same. This study hence is an attempt to study the prevalence of these factors in women and their correlation with lipid profile. MATERIALS AND METHODS: Two hundred women were enrolled in the study- 100 premenopausal women (21-45y) and 100 menopausal (50-55y). All the subjects were screened for homocysteine by ELISA and lipoprotein (a) and lipid profile by automation. RESULTS: Prevalence of hyperhomocysteinemia was 52% and 62% in premenopausal and menopausal women respectively. A significant positive correlation was seen for total cholesterol and triacylglycerol with serum Homocysteine in premenopausal women while pronounced positive correlation for serum cholesterol with serum Homocysteine in menopausal women. The prevalence of elevated lipoprotein (a) was 42% and 45% in premenopausal and menopausal women respectively. There was no correlation between lipoprotein (a) and lipid profile in both groups. CONCLUSION: The findings of the study conclude that premenopausal and menopausal women constitute a subpopulation where recent risk factors like hyperhomocysteinemia and elevated lipoprotein(a) could be assessed along with lipid profile as screening tests to identify the risk of CAD. This would help in proper counselling of the concerned women and minimize the risk.
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Mucopolysaccharidosis are a group of rare metabolic disorders of the lysosomal storage disease family caused by the absence or malfunctioning of lysosomal enzymes responsible for their breakdown. It encompasses disorders in which undegraded or partly degraded glycosaminoglycans accumulate in the lysosomes of many tissues owing to a deficiency of specific lysosomal enzymes. Here we report a case of a 7 years old child displaying the symptoms of Morquio's disease (Mucopolysaccharidosis type IV). Urine screening tests were performed which gave contrasting results.
