Aims: The clinical features, treatment and outcome of fungal peritonitis (FP) in continuous ambulatory peritoneal dialysis (CAPD) patients were examined. Methods: Dialysis records of all 303 end-stage renal disease (ESRD) patients initiated on CAPD treatment between January 1998 and February 2008 were reviewed retrospectively. Results: In the 303 patients dialysed between January 1998 and February 2008, a total of 137 bacterial peritonitis and 43 FP episodes were recorded. The incidence rate of FP was 0.67/100 patient months or 1/148.67 months. It accounted for 23.88% of all peritonitis episodes. Three factors appeared to predict mortality: the presence of non-Candida species, the catheter being left in situ and a serum albumin level <3 g/dl. Multivariate analysis yielded only the latter 2 as predictors of mortality. The use of intraperitoneal antibiotics in the 3 months before infection and low serum albumin have been identified as risk factors for contracting FP. Conclusion: Risk factors for contracting FP and for mortality due to FP have been identified.

Background: Coronary artery bypass grafting (CABG) can be performed with or without pump. Off-pump coronary bypass surgery has become a widely used technique during recent years. Cardiac operations, with the use of CPB, have been linked to a systemic inflammatory response and also reperfusion myocardial injury. These may play a role in undesirable patient outcome.Aim: The purpose of this study was to investigate the inflammatory changes after off-pump and on-pump coronary artery bypass surgery.Setting: Department of Cardiovascular Thoracic surgery and Biochemistry, Lokamanya Tilak Municipal Medical College and General Hospital, Mumbai. Materials and Methods: 70 patients [40 for off pump and 30 for on pump] undergoing coronary artery bypass grafting were enrolled in this study. Arterial blood was collected through an intra-arterial catheter immediately after induction of anesthesia, as well as 1, 6, 24, 48 and 72 hours after surgery. The parameters of inflammatory response; Interleukin IL-6, Interleukin IL-8, and Complement C3a were evaluated. Results: The groups were similar in terms of age, weight, gender ratio, and number of grafts per patient. The levels of inflammatory mediators, including interleukin (IL)-6, IL-8, and C3a, considerably increased and reached their peak levels 6 hours after termination of CPB except IL-6. IL-6 showed significantly elevation (p<0.001) over the time as compared to preoperative, with the values peaking at 24 hours. IL-6, IL-8 and C3a levels were significantly high (p<0.001) in the on-pump group in comparison with the off-pump group. Conclusions: Off-pump coronary artery bypass surgery shows a significant reduction in inflammatory response when compared with On-pump coronary artery bypass surgery. This may contribute to improved myocardial function and faster postoperative recovery. (Ind J Thorac Cardiovas Surg 2006; 22: 10-14)

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