scholarly journals Descriptive study of clinical profile and outcome in patients of acute on chronic liver failure, at a tertiary care center in Northern India

2020 ◽  
Vol 7 (11) ◽  
pp. 1687
Author(s):  
Rakesh Kumar ◽  
Vandana Rana ◽  
Varghese Koshy ◽  
Vandana Gangadharan ◽  
George Koshy
Keyword(s):  
Liver Failure ◽  
Care Center ◽  
Tertiary Care ◽  
Descriptive Study ◽  
Chronic Liver ◽  
Clinical Profile ◽  
Chronic Liver Failure ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Common Cause

Background: Acute-on-chronic liver failure (ACLF) is a recently described syndrome that is characterized by abrupt deterioration in patients with chronic liver disease (CLD) and has high short-term mortality. The aim of this study was to describe the clinical profile, causes and outcomes of ACLF at a tertiary care centre in Northern India.Methods: In this descriptive study of 50 consecutive patients, were included, between August 2015 to January 2018, who were admitted and diagnosed as ACLF as defined by APASL. Causes of acute precipitating event and CLD and outcomes were assessed.Occurrence and severity of organ failure was also assessed.Results: 48 (96 %) were males and 2 (4%) were females with male to female ratio was 24:1. The mean age of male and female subjects was similar, 40.7±9.9 years and 39.2±9.4 years respectively. The most common cause of CLD was alcohol in 50% cases and next most common cause was hepato-tropic viruses HBV infection in 20%, HCV in 6% cases and there was unknown cause in 12 % cases. The most common precipitating factor of acute decompensation was alcohol in 50% cases, hepatotropic viruses in 30% cases. Excluded sepsis and GI bleed as precipitating events. The combined mortality at the end of 1-month and 3-months, in our study was 60%. CLIF-SOFA score was found to be the most reliable scoring system to discriminate between survivors and non survivors. Conclusions: Alcohol was the commonest precipitating cause of ACLF. Organ failures (OFs) are independently predictive of mortality.

Clinical profile, natural history, and predictors of mortality in patients with acute-on-chronic liver failure (ACLF)

2015 ◽  
Vol 127 (7-8) ◽  
pp. 283-289 ◽  
Author(s):  
Ivana Mikolasevic ◽  
Sandra Milic ◽  
Mladen Radic ◽  
Lidija Orlic ◽  
Zeljka Bagic ◽  
...  
Keyword(s):  
Natural History ◽  
Liver Failure ◽  
Chronic Liver ◽  
Clinical Profile ◽  
Chronic Liver Failure ◽  
Predictors Of Mortality

scholarly journals TO STUDY THE PREVALENCE AND CLINICAL PROFILE OF CHRONIC ATRIAL FIBRILLATION IN HOSPITALIZED PATIENTS

2014 ◽  
Vol 04 (02) ◽  
pp. 017-020
Author(s):  
Dharma Rao V. ◽  
Rajaneesh Reddy M. ◽  
Srikanth K. ◽  
Raj Kumar Prakash B. ◽  
Satya Prasad A. ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Chronic Atrial Fibrillation ◽  
Hospitalized Patients ◽  
Clinical Profile ◽  
Female Dominance ◽  
Elderly Age ◽  
Female Ratio

Abstract: Objective: To determine the prevalence of chronic atrial fibrillation (AF) in a tertiary care center and to identify the clinical profile of chronic AF in hospitalized patients. Methods: All patients admitted to Mamata General Hospital in medicine/cardiology wards with chronic AF (persistent and permanent) during the period January 2012 to December 2012 were included into the study. The principal exclusion criteria were new onset AF and acute AF. Results: During the study period, 49 patients were admitted with chronic AF with an average of 45.44 years. A slight female dominance was seen with male: female ratio of 1:1.2. Half of the patients (51%) were below the age 50 years. The elderly age group comprised of only 16.3% of cases. The commonest presenting complaint was dyspnea followed by palpitation. Rheumatic valvular heart disease was seen more commonly in people below the age of 50 years whereas hypertension and ischemic heart disease after 50 years. Heart failure was the commonest condition associated with the chronic AF and was the cause of hospitalization in almost fifty percent of cases Conclusion: Chronic AF is still a cause of concern in India in people below the age of 50 years due to high prevalence of rheumatic fever inspite of advances in the medical field.

scholarly journals Surgical Management and Early Outcome of Encephalocele

2021 ◽  
Vol 10 (1) ◽  
pp. 42-45
Author(s):  
Prakash Kafle ◽  
Mohan Raj Sharma ◽  
Sushil Krishna Shilpakar ◽  
Gopal Sedain ◽  
Amit Pradhanang ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Care Center ◽  
Tertiary Care ◽  
Surgical Excision ◽  
Clinical Profile ◽  
Bony Defect ◽  
Female Ratio ◽  
Early Outcome ◽  
Good Outcome ◽  
Occipital Encephalocele

Background: There are limited studies pertaining to management of encephalocele in Nepal. So the present study seems justifiable to bridge the gap in the literature on encephalocele from Nepal on its clinical profile and early outcome. This study aims to characterize the clinical profile, management and outcome of largest series of encephalocele at tertiary care center in Nepal. Materials and Methods: A retrospective analysis of encephalocele, managed surgically at two tertiary care centers between 2015 and 2020, was performed. Results: Total of 25 cases was surgically managed in the present study. The median age of study population was 2.5 months. There were 11 male and 14 female with male to female ratio of 1:1.26. Occipital encephalocele was the most common variant. Lump in the head (n=11) was the commonest clinical presentation followed by hyperteliorism (n=10). One patient presented with cleft lip and one had CSF discharge in a case of occipital encephalocele. Bony defect was the common radiological findings. Excision and repair was the most common mode of surgery leading to good outcome. Mortality rate was 4% with morbidity of 20%. Conclusion: Early surgical excision and tight dural closure with repair of bony defect is the standard treatment with relatively good outcome.

scholarly journals Changing trends in idiopathic retinal vasculitis in a tertiary eye care centre of Nepal over a ten-year period

2012 ◽  
Vol 4 (2) ◽  
pp. 256-262 ◽  
Author(s):  
R Sitaula Kharel ◽  
S Aryal ◽  
S N Joshi ◽  
J K Shrestha
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Retinal Vasculitis ◽  
Visual Outcome ◽  
Common Finding ◽  
Ocular Involvement ◽  
Care Centre ◽  
Eye Care ◽  
Tertiary Care Centre ◽  
Female Ratio

Objectives: To study the demographic profile, clinical presentations, management and visual outcome of retinal vasculitis in a tertiary eye care center of Nepal Materials and methods: A retrospective, record based study of retinal vasculitis cases in the retina clinic of a tertiary care centre in Nepal from January 2009 to January 2011 was carried out. Results of the study were compared to those from the study conducted in a similar set- up between 1998 and 2000. Results: Sixty-nine eyes of 51affected patients were evaluated in the study. The male/female ratio was 2.64:1 vs 19:1 a decade ago (p=0.0027). The mean age of the patients was 33.53 ± 12.29 years in the present study. Bilateral ocular involvement was present in 18 cases (35.3%) vs 56.14% in the past decade (p=0044).The common symptoms were dimness of vision (29.4%), floaters (25.5 %) and flashes of light (3.92%). Seventy-one eyes (69.6%) had the best corrected visual acuity of 6/18 or better. Four eyes (3.92 %) had no light perception. Vascular sheathing was the most common finding (32.35%), followed by vitritis (30.39%). Corticosteroids were primarily used to manage retinal vasculitis (39.21%). No association of retinal vasculitis with tuberculosis was found.Conclusion: The demographic pattern and clinical presentation of idiopathic retinal vasculitis has changed over a decade period in Nepal.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6541 Nepal J Ophthalmol 2012; 4 (2): 256-262  

scholarly journals Clinical profile of cases of dysphagia presenting in ENT department: a study from rural tertiary care center

2017 ◽  
Vol 3 (3) ◽  
pp. 639
Author(s):  
Ginni Datta ◽  
Manish Gupta ◽  
Naiya Rao
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Clinical Problem ◽  
Needle Aspiration ◽  
Clinical Profile ◽  
Barium Swallow ◽  
Tertiary Care Centre ◽  
Predominant Symptom ◽  
Alarm Symptom ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Swallowing is a complex motor reflex requiring coordination among the neurologic system and muscles of the oropharynx and oesophagus. Disorders both benign and malignant may interfere with the process and cause dysphagia. We hereby undertake a study in a rural tertiary care centre to study the clinical profile of cases of dysphagia and to find the relative incidence of various etiologies of dysphagia.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted upon both out and indoor patients coming to Department of Otorhinolaryngology from January 2016 to January 2017 with predominant symptom of difficulty in swallowing for both solids, liquids or either. Detailed history &amp; examination was done. Further endoscopy, barium swallow, fine needle aspiration cytology (FNAC) &amp; biopsies were done as required. A total of 140 cases were taken into consideration.  </p><p class="abstract"><strong>Results:</strong> The mean age was 52.5 years with 60% patients males and 40% females. The commonest etiology of dysphagia was Gastroesophageal reflux disease (GERD) occupying 28.57%of cases. Among them 65% werefemales majority in the age group of 45-55 years. The 2<sup>nd</sup> common cause of dysphagia was growth pharynx 18.5% of cases. Among them 19 cases were diagnosed as growth oropharynx and 7 cases as growth supraglottis extending to hypopharynx. 88.46% were males and all were smokers. The 3<sup>rd</sup> common etiology of dysphagia was obstructive oesophageal causes which included oesophageal malignancies, oesophageal webs, strictures and diverticula in the frequency of 16%, 3%, 3% and 6% respectively. Oesophageal malignancies were mainly adenocarcinoma, all males who were chronic smokers.</p><p><strong>Conclusions:</strong> Dysphagia is a commonly encountered clinical problem &amp; limited studies exist regarding the prevalence of dysphagia etiologies. It is an alarm symptom, malignancy should be ruled out, and warrants early intervention. </p>

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