Evaluation of Neutrophil-to-Lymphocyte Ratio (NLR) and Its Correlation with Severity of Liver Cirrhosis Based on Child-TurcottePugh Score in a Tertiary Care Hospital, Barpeta, Assam

BACKGROUND Liver cirrhosis (LC) is the final common pathway for all chronic liver diseases. It is a major cause of morbidity and mortality in adults globally. Systemic inflammation has now been proposed to play a crucial role in the natural history of progressive liver damage and is one of the main causes of precipitating compensated liver cirrhosis to decompensated state. Neutrophil to lymphocyte ratio (NLR) has been considered as an important inexpensive biomarker to indicate ongoing inflammation in patients with cirrhosis. The purpose of this study was to find out if there is any significant correlation between neutrophil to lymphocyte ratio and Child Turcotte Pugh score (CTP) among liver cirrhosis patients. METHODS We conducted a cross sectional study involving patients diagnosed with liver cirrhosis in Fakhruddin Ali Ahmed Medical College & Hospital, Barpeta, from November 2019 to January 2021. All patients were diagnosed based on clinical history, examination and ultrasound. The study enrolled 101 cirrhotic patients irrespective of aetiology. Total white blood cell (WBC) count, neutrophil count and lymphocyte count were recorded and neutrophil to lymphocyte count was calculated. Child Turcotte Pugh score was calculated by taking data from medical records of the patients. RESULTS Out of the 101 patients enrolled in our study, majority were males (78). A significant correlation was found between NLR and CTP score in liver cirrhosis patients. The patients with NLR < 3 showed mean CTP score of 6.1 ± 0.55, with NLR in between 3 to 6 showed CTP score of 8.2 ± 1.2 and with NLR > 6 showed mean CTP score of 11 ± 0.76 CONCLUSIONS NLR can be used as a single independent biomarker and a simpler scoring system for assessment of severity of liver cirrhosis but needs further studies and evaluation. KEYWORDS Neutrophil-to-Lymphocyte Ratio, Child-Turcotte-Pugh Score, Cirrhosis

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To Evaluate Auditory Evoked Potentials in Non Alcoholic Liver Cirrhosis Subjects Attending a Tertiary Care Hospital: A Cross Sectional Study

International Journal of Physiology ◽

10.5958/2320-608x.2019.00043.x ◽

2019 ◽

Vol 7 (2) ◽

pp. 55

Author(s):

Gowri Velayutham

Keyword(s):

Liver Cirrhosis ◽

Evoked Potentials ◽

Auditory Evoked Potentials ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Alcoholic Liver Cirrhosis ◽

Sectional Study ◽

Cross Sectional

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CLINICAL AND RADIOLOGICAL STUDY OF PSORIATIC ARTHRITIS IN A TERTIARY CARE HOSPITAL

10.36106/ijsr/3141128 ◽

2021 ◽

pp. 68-70

Author(s):

Kurimilla Narasimha Prasad ◽

P.Vijay Sekhar ◽

Gopinath Mogilicherla ◽

Boppani Praveen Kumar

Keyword(s):

Psoriatic Arthritis ◽

Tertiary Care ◽

Clinical Manifestations ◽

Clinical History ◽

Cross Sectional Study ◽

Care Hospital ◽

Cross Sectional ◽

Female Ratio ◽

Chronic Progressive Disease ◽

Detailed Clinical History

Introduction: Psoriatic Arthritis (PA) is an autoimmune inammatory disease involving ligaments, tendons, fascia and spinal and/or peripheral joints in association with or without psoriasis of the skin and/or nails. This study done to determine the natural course, clinical presentation and radiological ndings of the disease. To ascertain the incidence of Psoriati Objective: c arthritis, analyse the different clinical manifestations of PA and to evaluate the clinical and radiological correlation in patients. This Materials and Methods: was a non-interventional, cross-sectional study comprised of 12 patients of PA. In all patients, detailed clinical history was taken followed by clinical and radiological examination were done depending on the joint involved. Out of the total attendance of 5801 new patients at Results: tended, 224 patients had psoriasis (5.35%), there were 12 cases of PA detected, thus accounting for 0.21%. Out of the 12 patients of PA, there were 8 males and 4 females. The male to female ratio was found to be 2: 1, The mean age was 40 years. The joints involved were Proximal inter-phalangeal joints of hands in 7 patients (58.34%), Distal interphalangeal joints of hands in 3 patients (25%), Knee joint and ankle joint in each one patient respectively (8.33%). Majority of the patients on radiographic lms, revealed bony erosions, narrowing of joint spaces, minimal periosteal reaction. One case revealed osteoporosis and fusion of PIP-joints. Five cases didn't reveal any abnormal radiological features. This Conclusion: study conrms that PA is a chronic, progressive disease in the majority of patients. Despite clinical improvement with current DMARD treatment, PA results in radiological damage.

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Study of electrolytes in patients of Dengue in a tertiary care hospital in India

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20192114 ◽

2019 ◽

Vol 6 (3) ◽

pp. 763

Author(s):

Prakash Ram Relwani ◽

Neelam N. Redkar ◽

Deepanshu Garg

Keyword(s):

Demographic Data ◽

Dengue Infection ◽

Tertiary Care ◽

Clinical History ◽

Cross Sectional Study ◽

Care Hospital ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Electrolyte Disturbances ◽

Low Platelet Count

Background: Dengue is a mosquito borne viral infection. It is the most common arboviral disease globally. In the year 2017, India had 1,53,635 cases of dengue with 226 deaths. Electrolyte disturbances reported in dengue infection are hyponatremia, hypokalaemia and hyperchloremia. Considering the serious nature of effects of dyselectrolytemias and high incidence of dengue in India, it is necessary to have a thorough understanding about electrolyte disturbances in Dengue, so as to predict, diagnose and treat them accordingly.Methods: This study was performed in a tertiary care centre in Mumbai, India. The study was a prospective observational cross-sectional study. 150 Patients diagnosed with Dengue were enrolled for the study. Patients’ demographic data, clinical history, examination findings and investigations including electrolyte values were recorded and analysed.Results: A higher incidence of dengue was seen in young age group among admitted patients (74%). Hyponatremia (45.33%) and Hypokalaemia (10.60%) were more commonly observed than hypernatremia (3.33%) and hyperkalaemia (3.33%). Hypochloraemia (6.66%) was seen slightly more than hyperchloraemia (6.00%). Fever was Present in 98.66%, retro orbital headache in 86.66%, vomiting in 56.00%, joint pain in 69.00%, lethargy in 70.66%, breathlessness in 36.00%, bleeding in 8.66%, abdominal pain /tenderness in 18.00%. 85.00% had low platelet count, 30.66% had low hemoglobin and 36.66% had leucopenia. Haematocrit was found to be less in 27.33% and high in 1.33%.Conclusions: From the above results we concluded that, there is a need to have a degree of suspicion about dyselectrolytemias while managing patients with Dengue. Also, patients need to be subjected to necessary lab investigations early during management so that if abnormalities are found, they can be promptly and appropriately managed as some of these abnormalities may lead to increased severity as well as mortality.

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HEPATOMA;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.05.3471 ◽

2019 ◽

Vol 26 (05) ◽

Author(s):

Abdul Latif ◽

Riaz Hussain Awan ◽

Seema Nayab ◽

Khadim Hussain Awan ◽

Faqir Muhammad Awan

Keyword(s):

Hepatitis B ◽

Tertiary Care ◽

Age Groups ◽

Clinical History ◽

Cross Sectional Study ◽

Chronic Viral Hepatitis ◽

Care Hospital ◽

Cross Sectional ◽

Ultrasound Of Liver ◽

Study Setting

Objectives: To determine the frequency of hepatoma in patients with cirrhosis attending tertiary care hospital Karachi. Study Period: Six months July to December 2017. Study Design: Descriptive cross sectional study. Setting: Department of Gastroenterology, Liaquat National postgraduate Medical centre Karachi. Patients and Methods: The clinical history was taken from patients and ultrasound of liver was done to and mass if any and its size was noted. Noninvasive criteria for diagnosing hepatoma were utilized and all information was noted and entered in the proforma and analyzed in statistical software. Results: A total of 213 cases, 15.02% individual hepatitis B and 21.13% subject hepatitis C. Frequency of hepatoma in cirrhotic population detected as 10.33% (22/213). Rate of hepatoma was not significant among different age groups (p=0.202). Rate of hepatoma was also not significant between male and female (p=0.59). Conclusion: Persistent chronic viral hepatitis B and C infection with cirrhosis responsible for acquiring hepatoma.

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Study of Missing Clinical Details in Computed Tomography Radiology Request Forms: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.4674 ◽

2020 ◽

Vol 58 (222) ◽

Author(s):

Muna Badu

Keyword(s):

Computed Tomography ◽

Binary Data ◽

Tertiary Care ◽

Clinical History ◽

Cross Sectional Study ◽

Radiology Department ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Detailed Clinical History

Introduction: Detailed clinical history through a properly filled requisition form can help a radiologist in making a diagnosis. The objective of this study was to observe the missing clinical details of Computed Tomography requisition forms at radiology department in tertiary care hospital. Methods: This descriptive cross-sectional study was done in 196 Computed Tomography requisition forms in the department of radiology from September 2019 to October 2019. Ethical clearance from the Institutional Review Committee – Reference No. 120720194 was obtained. An informed consent from the participants was taken prior to the procedure. Convenient sampling was done. The data obtained were computed and analyzed using Statistical Package for Social Sciences to tabulate the results. The results were displayed in frequency and proportion of binary data. Results: All the request forms had name filled, however date was filled in 183 (93.4%), age was filled in 195 (99.5%), sex was filled in 193 (98.5%) and address was only in 30 (15.3%) of the forms. Clinical history and provisional diagnosis were written in 179 (91.3%) forms. Signature was found in more than half of forms 135 (68.9%) whereas the department referring the patient was filled in 92 (46.9%) of forms and the name of doctor referring the patient was not filled mostly. The handwriting was clear in 191 (97.4%) of cases and standard words were used. Use of non-standard abbreviation was found in only 2 (1%) forms. Conclusions: Clinical details were filled in most of the requisition forms however other parameters were still incompletely and inadequately filled.

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A Cross-Sectional Study of Thyroid Dysfunction in Patients Suffering from Liver Cirrhosis in a Tertiary Care Hospital in Bengaluru, India

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/358 ◽

2021 ◽

Vol 09 (23) ◽

pp. 1904-1908

Author(s):

Vishal M. Kalmani ◽

Madhuvan H.S ◽

Ravishankar S.N. ◽

Thimmareddy S.R ◽

Kavana M

Keyword(s):

Liver Cirrhosis ◽

Thyroid Hormone ◽

Thyroid Dysfunction ◽

Tertiary Care ◽

Cross Sectional Study ◽

Thyroid Stimulating Hormone ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Thyroid Abnormalities

BACKGROUND Thyroid abnormalities are seen in most of the patients suffering from liver cirrhosis. Cirrhosis of the liver is the major cause of morbidity and mortality worldwide. Cirrhosis plays a vital role in the thyroid hormone metabolism and thyroid hormone circulation by producing thyroid binding globulin. Hence, it is seen that the thyroid dysfunction is associated with the severity of liver disease. We wanted to study the changes in the levels of thyroid hormones in patients suffering from alcoholic liver cirrhosis. METHODS In this cross-sectional study, 50 patients who were admitted to the IP department and ICU of General Medicine Department of Akash Hospital, Devanahalli, for symptoms of cirrhosis of liver were evaluated for their thyroid profile along with other relevant investigations. RESULTS Among the 50 patients studied, 43 were male and 7 were female. 17 patients had an increase in their thyroid stimulating hormone (TSH). These patients also had a significant association with various LFT parameters such as indirect bilirubin, AST, ALT, APS, and GGT. These 17 patients who had increase in TSH also had associated hepatic complications such as - jaundice (41 %), hepatic encephalopathy (35.29 %), bleeding varices (29.4 %), and portal hypertension (82.35 %). CONCLUSIONS Thyroid abnormalities are not uncommon in patients with cirrhosis. Hypothyroidism is the most common abnormality that was detected. Rate of complications is also high in patients with elevated levels of TSH. A fair amount of suspicion is required for detecting thyroid abnormalities in patients suffering from cirrhosis. KEYWORDS Cirrhosis, Thyroid Hormone, Hypothyroidism, Hyperthyroidism, Thyroiditis

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