Serum calcium and phosphorous balance in diabetic nephropathy and its correlation with glycated hemoglobin

Background: Timely control of hemoglobin A1c (HbA1c) level is very important in patients with diabetic kidney disease. Diabetic nephropathy brings changes in mineral metabolism. The changes in calcium and phosphorous level is a reason for increased morbidity or decreased quality of life in these patients. Conflicting reports are available on serum calcium level and decline in kidney function. This study is to analyse the changes in calcium and phosphorous level in different stages of diabetic nephropathy and its correlation with glycated haemoglobin.Methods: A cross sectional study with 60 diabetic nephropathy patients admitted in MES Medical College for a period of 1.5 years. Patients with cardiac, liver, thyroid dysfunction, under dialysis were excluded from the study. Fasting blood sugar, HbA1c, calcium, phosphorous, creatinine were assessed by VITROS 5600 integrated system. The study population is divided into groups by two different means, according to HbA1c and estimated glomerular filtration rate (eGFR) value. Statistical analysis was performed by statistical package for the social sciences (SPSS) software. Level of significance calculated at 95%.Results: eGFR value showed a highly significant correlation with age (p=0.016), creatinine (p≤0.00001), calcium (p≤0.00001), phosphorous (p≤0.00001) and HbA1c (p=0.00001). There was no significant difference in creatinine and eGFR between male and female subjects. Only eGFR (p=0.0396) showed a significant difference between poor and good glycaemic control groups.Conclusions: This study shows highly significant correlation between the decreased eGFR hypocalcaemia, hyperphosphatemia, increased serum creatinine level and HbA1c. Strict glycemic control is crucial in maintenance of mineral homeostasis and prevention of blood calcium, phosphorous abnormalities.

Is serum phosphorous level an early indicator of post-operative hypocalcemia after total thyroidectomy? A prospective analysis

Background: Total thyroidectomy is a commonly performed surgery. Postoperative hypocalcemia is a worrisome complication which can be treated if recognized early. We analysed serum phosphorous as a potential marker of postoperative hypocalcemia.Methods: The study was a cross-sectional study done in our tertiary care hospital. We analysed the serum phosphorous levels of 50 patients who underwent total thyroidectomy at our institution. The incidence of hypocalcemia was documented and analysed with respect to serum phosphorous.Results: In the study, 18 (36%) had hypocalcaemia on third postoperative day and 32 (64%) had no hypocalcaemia. There was no relation between post thyroidectomy day one serum phosphorus value and post-thyroidectomy day three serum calcium value (p=0.709).Conclusions: The study did not find any statistically significant association between serum phosphorous and post-thyroidectomy serum calcium levels.

Impact of Functional Food Mixes on Serum Calcium and Phosphorous Level – An Interventional Study

Agriculture is the main occupation of the people. Further cultivation, public occupied themselves in weaving, tanning and metallurgy. Among the various occupations weaving is one of the second major occupations in India next to agriculture. A long tradition of excellence in its craftsmanship, Indian Handloom is said to have dated back to the ancient ages. 15th August 1947, noticeable turnings face for the country's handloom weavers. Weavers are the main population in India who suffer from major health problems such as respiratory problems, musculoskeletal disorders and chronic diseases like hypertension as well as disabilities such as everlasting ears hot failure due to revelation to sound. For the interventional study interview schedule was used and screened 90 subjects based on the health problems, subjects divided into 3 groups such as EM – 30, EMS-30 and CM-30. Functional food mixes prepared and formulated soya based health mixes and assessed the nutrient content of health mixes, and supplemented to the experimental groups. There is no supplementation for the control group. Then the impact was evaluated by using biochemical parameters. After the supplementation revealed, the soya based health mixes are reduced the risk of osteoporosis.

P1551FAMILY SUPPORT IS CRUCIAL FOR DIALYSIS PATIENTS TREATMENT ADHERENCE AND QUALITY OF LIFE

Background and Aims Non-compliant dialysis patients are at increased risk of mortality. Compliance depends on patient demographics, educational level and income. Family support and marital status might also influence the patients compliance, as well as the quality of life. Missed/shortened dialysis sessions, adherence to prescribed medications, excessive phosphate serum values and interdialytic weigh gain, smoking and adherence to medical investigations provide indicators of non-compliance. Aim: To assess the impact of family support on different compliance indicators in the dialysis patients. Method In this observational study 134 dialysis patients were scored for different indicators of compliance from 0-2 and summary scores of compliance were assessed. Clinical and laboratory data were obtained from the previous two years. Patients with mean IDWGs >4.5% of body weight (BW) and/or phosphorous level above 1.6 mmol/L were scored with 1, patients with IDWG/BW more than 5.7% and/or 2.0 for mean phosphorous level were scored with 2. Summary scores of non-compliance were also assessed. Patients were scored for quality of life with SF-36 questionnaire. Patients non-adherence was analysed for predictors in multivariate analysis. Results Estimated rates of noncompliance varied: Medical investigations 63%, phosphorous 33, IDWG 22, therapy 14%, HD treatment 9%. When the complete dietary fluid, medications and treatment regimen were studied noncompliance rate was 73%, and when adherence to medical investigations was added the rate rose up to 87%. Patients with family support above median level (≥25) were significantly more often men (0.049), with diabetes (p=0.014), lower socioeconomic status (0.001) and married (0.003). The quality of life scores were significantly worse in the low family supported patients (56.73±26.15 vs 39.23±24.05, p=0.0001). They also scored worse in overall non-compliance scores 2.04±1.71 vs 2.97±2.06, p= 0.007). In the multivariate analysis the non-compliance was predicted most powerfully in patients with younger age, low social status and lower family support (β=-0.202, p=0.023, β=0.220, p=0.036, β=-0.175, p=0.019, respectively). Conclusion Family support is crucial for dialysis patients adherence to treatment and Quality of life. Efforts should be done to recognize the patients real needs and adequately help those confronting dialysis burden and improve their quality of life.

Changes in serum phosphorous level during inpatient treatment of children with severe acute malnutrition

Background: SAM children have increased requirements for phosphorus during recovery. If requirements are not met, they may develop refeeding hypophosphatemia leading to increased morbidity and mortality. However, no much studies known about the effect of current therapeutic diets (F-75 and F-100) on serum phosphate in SAM children.Methods: Prospective observational study, in which measuring serum phosphate at admission, at end of stabilization phase and at discharge in SAM children between 6-59 months.Results: Among 35 children enrolled, mean serum phosphate was 4.3 ±0.6 mg/dl at admission, 4.1± 0.8mg/dl at end of stabilization phase and 4.4±0.7mg/dl at discharge. 17% of children had hypophosphatemia at admission, 31% at end of stabilization phase and 17% at discharge. mean weight gain in hypophosphatemia and normophosphatemia groups are 1.3±1.46mg/kg/day and 2.51±2.63mg/kg/day (p=0.1) respectively. Mean duration of stay in hypophosphatemia and normophosphatemia groups are 11.6±1.26 and 10.26±1.54 days respectively (p=0.016).Conclusions: Hypophosphatemia was common among children with SAM at admission and increased at end of stabilization phase. Serum phosphate remains subnormal in about 1/5th of the children at discharge. This could be problematic for further recovery as phosphorus is needed for catch-up growth and bioavailability of phosphorus is low in local diets. Hence, authors suggest phosphorus supplementation in SAM children.

Changes in serum phosphorous level during inpatient treatment of children with severe acute malnutrition

Background: SAM children have increased requirements for phosphorus during recovery. If requirements are not met, they may develop refeeding hypophosphatemia leading to increased morbidity and mortality. However, no much studies known about the effect of current therapeutic diets (F-75 and F-100) on serum phosphate in SAM children.Methods: Prospective observational study, in which measuring serum phosphate at admission, at end of stabilization phase and at discharge in SAM children between 6-59 months.Results: Among 35 children enrolled, mean serum phosphate was 4.3 ±0.6 mg/dl at admission, 4.1± 0.8mg/dl at end of stabilization phase and 4.4±0.7mg/dl at discharge. 17% of children had hypophosphatemia at admission, 31% at end of stabilization phase and 17% at discharge. mean weight gain in hypophosphatemia and normophosphatemia groups are 1.3±1.46mg/kg/day and 2.51±2.63mg/kg/day (p=0.1) respectively. Mean duration of stay in hypophosphatemia and normophosphatemia groups are 11.6±1.26 and 10.26±1.54 days respectively (p=0.016).Conclusions: Hypophosphatemia was common among children with SAM at admission and increased at end of stabilization phase. Serum phosphate remains subnormal in about 1/5th of the children at discharge. This could be problematic for further recovery as phosphorus is needed for catch-up growth and bioavailability of phosphorus is low in local diets. Hence, authors suggest phosphorus supplementation in SAM children.

Growth and Yield Response of BRRI dhan28 to Phosphorous Rates in Batiaghata Upazila of Southwestern Bangladesh

The experiment was carried out during the period from January to May, 2018 at Professor Purnendu Gain Field Laboratory of Agrotechnology Discipline, Khulna University to evaluate the effect of phosphorous (P) on yield and yield attributes of BRRI dhan28. The experiment was consisted of seven P doses viz. T0 = without phosphorus (P), T1 = 9 kg P ha-1, T2 = 12 kg P ha-1, T3 = 15 kg P ha-1, T4 = 18 kg P ha-1, T5 = 21 kg P ha-1 and T6 = 24 kg P ha-1 as treatments. The experiment was laid out in a randomized complete block design (RCBD) with three replications. Only the grain yield and biological yield showed significant variations due to the effect of different rates of phosphorous. Others growth and yield attributes varied insignificantly. The result of this experiment showed that the highest grain yield (3.82 t ha-1) and biological yield (10.87 t ha-1) was obtained from 21 kg P ha-1 (T5). There was an increasing trend of grain yield with the increase of phosphorous level up to 21 kg P ha-1 and then it declined. From the result of this experiment it could be revealed that 21 kg P ha-1 gives better result regarding grain yield of HYV rice variety BRRI dhan28 at Batiaghta upazila of southwestern Bangladesh. South Asian J. Agric., 7(1&2): 30-33

Phytoremediation of Phosphorous and Ammonia with Eichhornia crassipes and Azolla pinnata in Waste Waters from Estero de San Miguel Mendiola Manila Philippines

Wastewater treatment and removal of pollutants by phytoremediation, remain a major concern of the 21th century. This study is focused on the phytoremediation study in Philippine setting, specifically in one of the tributaries of Pasig river-the Estero de San Miguel. It determined the pH, Ammonia and Phosphorous before, 7th and 14th day of phytoremediation with the use of A. pinnata and E. crassipes. Twelve improvised water ponds/troughs, 3 ponds per treatment were used for 14 days. T- control (only wastewater), T1 for A. pinnata + wastewater, T2 for E. crassipes + wastewater and T3 for A. pinnata E. crassipes + wastewater. Potential hydrogen, Ammonia-N mg/L, phosphorous mg/L were analyzed before, on the 7th and 14th day of the study. Data gathered was analyzed using ANOVA and Fisher Least Significant Difference test as post hoc test. Result revealed that T1 (A. pinnata) lowered the pH and ammonia-N (mg/L) of wastewaters from Estero de San Miguel. T3 (combination of A. pinnata + E. crassipes) has significantly lowered the Phosphorous level of the wastewaters. Thus both aquatic macrophytes can be used as phytoremediation agents in the said Estero.