scholarly journals LIVER CIRRHOSIS

2015 ◽  
Vol 22 (04) ◽  
pp. 420-425
Author(s):  
Ali Akbar ◽  
Mukhtiar Hussain Jaffery ◽  
Mushtaq Ali Memon ◽  
Suneel Arwani ◽  
Hamid Nawaz Ali Memonq ◽  
...  

Liver cirrhosis results from prolonged, widespread but patchy hepato-cellularnecrosis due to various reasons. Objectives: To determine the frequency and severity ofhyponatremia in patients with liver cirrhosis. Study Design: Descriptive case series study.Period: Six months. Setting: Liaquat University Hospital Hyderabad. Methods: The cirrhoticsubjects were assessed for hyponatremia and its severity. The data was analyzed in SPSS 16and the frequency and percentage was calculated for hyponatremia and statistically p -value≤0.05 was considered as significant. Result: Sixty five percent males and thirty five percentfemales of liver cirrhosis were studied. The mean age ± SD of overall cirrhotic subjects was40.79±7.83. The hyponatremia was identified in 72% (51 males and 21 females) patients. Themean ±SD for Na+ level in overall population was 129.73±83.51 while it was 119.92±3.61 inhyponatraemic cirrhotic subjects. The sodium level in male and female hyponatraemic cirrhoticpatients was 121.73±8.63 and 118.92±3.31. Conclusions: Dilutional hyponatremia is frequentin patients with liver cirrhosis.

2015 ◽  
Vol 22 (04) ◽  
pp. 426-431
Author(s):  
Sadia Niaz Siddiqui ◽  
Mushtaq Ali Memon ◽  
Ghulam Hussain Baloch ◽  
Hamid Nawaz Ali Memon ◽  
Suneel Arwani ◽  
...  

Objectives: To determine the frequency and severity of thrombocytopenia inpatients with liver cirrhosis. Study Deisgn: Cross sectional study. Period: 01-03-2013 to 31-08-2013. Setting: Liaquat University Hospital, Hyderabad. Methods: The cirrhotic patients wereassessed for thrombocytopenia and its severity. The data was analyzed in SPSS version 11.00and frequency and percentage was computed. The chi-square test was applied and p -value≤0.05 was considered as statistically significant. Results: Total one hundred patients wereevaluated for thrombocytopenia, 70% males and 30% females. The mean ± SD for age incirrhotic subjects was 41.16±14.24 whereas the mean ±SD for age in male and female cirrhoticpatients was 42.81±10.96 and 40.63±9.85. The thrombocytopenia was detected in 68%, ofwhich 43(63.2%) were males and 25(36.8%) were females. Mean±SD for platelet in all subjectswas 130.85±8.33 whereas it was 68.82±6.52 in thrombocytopenic cirrhotic patients. Mean±SDplatelet count in male and female thrombocytopenic patients was 70.94±7.42 and 64.72±5.84.Out of sixty eight thrombocytopenic cirrhotic subjects 23 had mild thrombocytopenia, 25had moderate thrombocytopenia and 20 had severe thrombocytopenia while in relation toChild-Pugh class B (p<0.01) predominant. Regarding the duration of the liver cirrhosis, thethrombocytopenia was predominant in patients between 6-12 months. The common presentingfeature observed in relation to gender were malaise 21%, fatigue 17, nausea / vomiting 14%and combine feature in 21 cirrhotic patients (p=0.04). Conclusions: The thrombocytopeniawas detected in patients with liver cirrhosis, therefore frequent platelet assessment is one of themost important step to monitor platelet count and reduce severe and life threatening episodesof bleeding.


2015 ◽  
Vol 22 (03) ◽  
pp. 293-298
Author(s):  
Shuaib Ansari ◽  
Irfan Murtaza Shahwani ◽  
Zeeshan Ali ◽  
Syed Zulfiquar Ali Shah ◽  
Faisal Shahab

Systemic inflammatory response syndrome (SIRS) is a generalized disorder,immune response to infection which results in disturbed microcirculation, visceral perfusion andultimately visceral failure. Objectives: To determine the frequency of systemic inflammatoryresponse syndrome in patients with liver cirrhosis. Design: Cross sectional descriptive.Period: Six months study. Setting: At Liaquat University Hospital Hyderabad. Patients andmethods: All the patients with liver cirrhosis for 06 months duration admitted in the ward werefurther evaluated for systemic inflammatory response syndrome. The data was analyzed inSPSS 16 and the frequency and percentage was calculated. Results: During six months studyperiod, total 100 cirrhotic subjects were studied for SIRS. The mean ± SD for age in all (100)cirrhotic patients was 45.74 ± 7.537. The mean temperatures was 40.42±0.32 where as it was39.72±0.43 and 38.92±0.11 in male and female population respectively. The mean heart beatwas 128.42±6.74 where as it was 115.83±8.93 and 120.62±5.53 in male and female populationrespectively. The mean respiratory rate was 25.31±3.52 where as it was 23.52±2.31 and26.63±3.21 in male and female population respectively. The mean white blood cell count was28.81±4.51 where as it was 23.74±4.73 and 30.83±5.73 respectively. The SIRS was observedin 70% subjects of which 47(67.1%) were males and 23(32.9%) were females (p=0.04). Majorityof SIRS subjects were 30-39 years of age and male population was predominant (p=0.03). Thegender distribution in relation to severity of liver disease was statistically significant (p=0.05)while the SIRS in relation statical analysis. Conclusions: The systemic inflammatory responsesyndrome occurs in patients with liver cirrhosis.


2016 ◽  
Vol 23 (09) ◽  
pp. 1052-1056
Author(s):  
Samar Raza ◽  
Tariq Zaffar Shaikh ◽  
Ghulam Hussain Baloch ◽  
Zaheer Ahmed ◽  
Syed Zulfiquar Ali Shah

Objectives: To determine the frequency of raised serum CRP level in patientswith community acquired pneumonia. Study Design: Cross sectional descriptive study.Period: Six months. Setting: Liaquat University Hospital Hyderabad. Patients and Methods:All the patients with 20 -75 years of age, either gender diagnosed as community acquiredpneumonia were further evaluated for C-reactive protein while the data was analyzed in SPSSversion 16. Results: During six month study period, total 135 patients with community acquiredpneumonia were evaluated for C-reactive protein. The mean ±SD for age of patients with CAPwas 48.93±8.41 whereas it was 53.53±6.73 and 50.54±5.81 in male and female subjectsrespectively. The mean age ±SD of patient with raised CRP was 46.94±8.43. The mean ±SDof CRP in overall population was 08.8±1.52 while it was 07.94±1.32 and 10.83±1.64 in maleand female individuals respectively. Of 135 subjects 84(62.2%) were males and 51(37.8%) werefemales while the CRP was elevated in 91(67.4%) patients. The age in relation to gender andCRP was statistically significant (p= 0.02 and 0.05) while the gender in relation to CRP was alsostatistically significant (p=0.03). Conclusion: The present study found that the CRP was raisedin 91(67.4%) predominantly male individuals with community acquired pneumonia


Author(s):  
Manoochehr Ghorbanpour ◽  
Mohammad Ali Seyfrabie ◽  
Babak Yousefi

Objective. Patients undergoing Soave surgery for Hirschsprung's disease are at risk for some complications. The aim of this study was to investigate such short-term and long-term complications and evaluate the outcome of the operation in these patients. Methods. A case series study was carried out during the last 12 years, during 2007 to 2018 in Besat hospital of Hamadan. Data collection conducted using a checklist includes questions about demographic information, clinical features, and short-term and long-term complications, and consequences of post-operative surgery. The findings of the study were analyzed using SPSS software version 20 and appropriate statistical tests. P-value less than 0.05 was considered statistically significant. Results. A total of 55 children underwent Soave surgery during the last 12 years in Besat Hospital Hamadan, Iran. The mean age of the patients was 38±10 days during surgery, of which 56.4% were female. The mean hospital stay was 7.3 days. Also, the mean weight of children at birth was 2970±447 gr. Most of the patients were born as NVD (52.7%) and term (74.5%). The most common comorbidity was congenital heart disease. The most common short-term complication was intestinal obstruction in 14 patients (25.5%) and the most frequent long-term complication was intestinal obstruction and constipation (27.3% each cases). The mortality rate of patients in this study was 14.5% in total. Conclusions. One stage surgical procedure in Hirschsprung's disease is a safe and effective method, but care should be taken in choosing patients and patients should be monitored for possible complications, so that they can be considered and implemented for proper treatment.


2021 ◽  
Vol 15 (10) ◽  
pp. 2779-2782
Author(s):  
Saira Khalid ◽  
Nasir Shah ◽  
Yasir Abbas Zaidi ◽  
Muhammad Saleem Hasan ◽  
Saqib Jahangir ◽  
...  

Study Objectives: To determine the frequency of cirrhotic cardiomyopathy in patients with liver cirrhosis and to compare it across varying grades of cirrhosis on Child Turcotte Pugh classification. Study Design and Settings: It was a descriptive cross-sectional study carried at Department of Medicine, Lahore General Hospital Lahore over 1 year from Jan 2018 to Dec 2018. Patients and Methods: The present research involved 100 male and female patients aged between 16-70 years having liver cirrhosis diagnosed at least 6 months ago. These patients underwent echocardiographic screening of cardiomyopathy which was diagnosed by the presence of diastolic dysfunction (i.e. increased E/A ratio>1). An informed written consent was obtained from every patient. Results of the Study: There was a male predominance (M:F, 1.6:1) among cirrhotic patients with a mean age of 51.9±9.8 years. The mean BMI was 26.5±3.7 Kg/m2 while the mean duration of cirrhosis was 22.0±10.9 months. Majority (49.0%) of the patients belonged to CTP Class C followed by Class-B (39.0%) and Class-A (12.0%). Cirrhotic cardiomyopathy was observed in 41.0% patients with cirrhosis. There was statistically insignificant difference in the observed frequency of cirrhotic cardiomyopathy among various subgroups of cirrhotic patients depending upon patient’s age (p-value=0.928), gender (p-value=0.997), BMI (p-value=0.983) and duration of disease (p-value=0.782). However, it increased considerably with worsening of disease on CTP Classification; Class-A vs. Class-B vs. Class-C (8.3% vs. 35.9% vs. 53.1%; p-value=0.013). Conclusion: Cirrhotic cardiomyopathy was observed in a substantial proportion of cirrhotic patients and was more frequent in patients with more severe disease which warrants routine echocardiographic screening of cirrhotic patients so that timely recognition and anticipated treatment of this complication may improve the case outcome in future medical practice. Keywords: Cirrhosis, Cardiomyopathy, Child Turcotte Pugh Class


2020 ◽  
Vol 129 (8) ◽  
pp. 795-800 ◽  
Author(s):  
Zhengcai Lou

Objective: We evaluated the graft take rate and hearing gain of endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap for repairing an anterior tympanic membrane perforation. Study design: A retrospective case series Setting: Tertiary university hospital Materials and Methods: The study population consisted of patients with an anterior perforation undergoing endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap. The primary outcome was the graft take rate at 6 months. The secondary outcomes were the air–bone gap (ABG) gain at 3 months and complications. Results: A total of 51 patients with a unilateral anterior marginal perforation were included in this study. The mean operation time was 62.2 ± 8.3 minutes. The graft success rate was 92.2% (47/51) at 6 months. The mean preoperative ABG was 28.07 ± 5.13 dB, while the mean postoperative ABG was 12.24 ± 4.89 dB ( P < .05). No patients reported sensorineural hearing loss, altered taste, facial nerve palsy, vertigo, or tinnitus. Two patients with a middle perforation developed postoperative purulent otorrhea that resulted in residual perforations. The cartilage graft was extruded into the anterior annulus in two patients with large perforations that resulted in graft lateralization in one patient and residual perforation in the other. Conclusions: Endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap is a useful procedure with a low reperforation rate for repairing anterior perforation.


2021 ◽  
Vol 28 (11) ◽  
pp. 1552-1556
Author(s):  
Samara Siddique ◽  
Yasir Imran ◽  
Asma Rizwan ◽  
Sahira Aaraj

Objectives: To evaluate the role of Diacerein among patients with OA. Study Design: Retrospective Case Series. Setting: Mayo Hospital, Lahore. Period: April 2020 to September 2020. Material & Methods: The study was conducted among forty patients with OA (grade II to IV according to ACR criteria) at Department of Rheumatology (EMW), Mayo Hospital, Lahore. Baseline WOMAC (Western Ontario and McMaster Universities Arthritis Index) and VAS (Visual Analogue Scale) was noted. Diacerine, 100mg in bd (twice a day) dose was given for 6 months. After 6 months, WOMAC and VAS were noted and %age improvement was calculated. Results: The mean WOMAC at presentation was 48.78+6.42 and after treatment was 36.20+20 (p<0.05). The mean VAS before and after treatment was 5.88+1.20 and 3.58+3.22, respectively (p<0.05). A 20% improvement was seen among 40% patients. The efficacy of the drug was labeled as yes in 40% patients. One (2.5%) patients suffered from diarrhea, and one (2.5%) patient had raised LFTs after treatment. Conclusion: Diacerine significantly improves the mean WOMAC and VAS score after 6 months of therapy. The efficacy is also high. So, it can be considered as an alternative drug among symptomatic patients with OA in whom the symptoms do not improve after conventional analgesics.


2015 ◽  
Vol 22 (02) ◽  
pp. 256-262
Author(s):  
Ahmed Hussain ◽  
Shahnawaz Abro ◽  
Ashfaque Ahmed Bhurgiri ◽  
Raheel Imtiaz Memon ◽  
Syed Zulfiquar Ali Shah

Acute appendicitis is the most common abdominal surgical emergency despiteadvances in radiographic imaging and diagnostic laboratory investigations; the diagnosis ofacute appendicitis remains challenge. Objectives: To evaluate the C-reactive protein in patientswith acute appendicitis. Patients and methods: This cross sectional descriptive study of sixmonths study was conducted at Liaquat University Hospital Hyderabad. All the patients withacute appendicitis were admitted in the ward and were further evaluated for C-reactive protein.The data was analyzed in SPSS 16 and the frequency and percentage was calculated. Results:One hundred subjects with acute appendicitis were recruited and studies. The mean age ±SD ofthe patients was 27.83±07.52 in overall population while it was 29.73±06.64 and 25.84±04.92in male and female subjects with acute appendicitis. The CRP was raised in 60% patients. Thedistribution of age in relation to gender and CRP was statisitically significant (p= 0.01 and<0.01) whereas the CRP was also observed as statistically significant in context to genderand histopathology (p= 0.02 and 0.03) respectively. The mean ±SD of CRP was 7.53±1.52in overall population while it was 6.84±1.64 and 8.65±1.53 in male and female patients withraised CRP. Conclusions: The CRP was elevated in patients with acute appendicitis.


2019 ◽  
Vol 61 (1) ◽  
Author(s):  
Ingrid Mayerly Gómez Viracachá ◽  
Margarita Del Pilar Pedraza Galvis ◽  
Olga Patricia Panqueva Centanaro ◽  
Diana Carolina Estrada Cano ◽  
Ángela María Soler Ramírez ◽  
...  

Aim: To characterize a group of pediatric patients diagnosed with post-infectious bronchiolitis obliterans (PBO) at a university hospital in Bogotá. Methods: A total of 2,635 PBO-compatible clinical histories were reviewed. Pre-defined inclusion and exclusion criteria were applied, and 19 cases were retrieved and used to develop an observational, descriptive, and retrospective study. Results: The mean age for developing acute lower respiratory tract infection (ALRTI) was 18 months. The average hospitalization was 14.5 days. Approximately 21.5% of patients required attention at a pediatric intensive care unit (PICU), and mechanical ventilation was applied for 10% of these cases. A total of 30% of the patients had microbiological isolation, 10.5% corresponded to a respiratory syncytial virus (RSV), and 5% corresponded to a mixed isolation (adenovirus and RSV). All patients had chest high-resolution computed tomography (HRCT) scans, which revealed a mosaic pattern of attenuation in 89.4% of all cases. Conclusions: The sample showed clinical and radiological characteristics similar to those described in other case series worldwide.


2017 ◽  
Vol 157 (4) ◽  
pp. 683-689 ◽  
Author(s):  
Cameron C. Wick ◽  
Demetri Arnaoutakis ◽  
Vivian F. Kaul ◽  
Brandon Isaacson

Objective To describe a novel technique for lateral graft tympanoplasty. Study Design Case series with chart review. Setting Tertiary care university hospital. Subjects and Methods Pediatric and adult patients with tympanic membrane perforations deemed unfavorable for a medial graft technique due to the perforation characteristics or myringitis. Results Between 2014 and 2016, 34 ears from 31 patients underwent a transcanal endoscopic lateral cartilage graft tympanoplasty. The mean age was 24.4 years (range, 6-71 years), and 22 patients (65%) were younger than 18 years. All patients had tympanic membrane perforations. Eighteen patients (53%) had total or near-total perforations, leaving a minimal anterior remnant, and 16 patients (47%) had extensive myringitis. A bisected tragal cartilage-perichondrium shield graft was used in 33 patients (97%). The mean (SD) follow-up length was 9.8 (5.7) months. Initial perforation closure rate was 88.2% (30/34). Three of the persistent perforations underwent a revision endoscopic medial graft tympanoplasty with successful closure, leaving a final closure rate of 97.1% (33/34). Five patients (15%) required topical therapy for postoperative myringitis. Mean (SD) pure-tone average and air-bone gap significantly improved by 11.5 (10.7) dB ( P < .001) and 11.4 (10.6) dB ( P < .001), respectively. Twenty-seven patients (79%) closed their air-bone gap within 20 dB. Conclusion Transcanal endoscopic lateral cartilage graft tympanoplasty is feasible, and initial data support favorable outcomes. Further data are necessary for evaluation of long-term results and efficacy comparisons.


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