scholarly journals COMPARATIVE STUDY OF AST: ALT RATIO IN LIVER DISEASES IN A TERTIARY CARE HOSPITAL IN BAREILLY

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Ajaya Kumar Anand ◽  
Dr. Govind Singh
Keyword(s):  
Chronic Hepatitis ◽  
Obstructive Jaundice ◽  
Viral Hepatitis ◽  
Liver Diseases ◽  
Alcoholic Hepatitis ◽  
Tertiary Care ◽  
Serum Levels ◽  
Control Group ◽  
Care Hospital ◽  
Significant Difference

Background: Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT), the enzymes predominantly found in the hepatocytes, exhibit specific elevations in serum levels in different liver diseases. The ratios of their serum levels (AST: ALT ratio or De Ritis ratio) also exhibit specific patterns providing important diagnostic clues. The objective of the study is to establish the diagnostic utility of the AST: ALT ratio in liver diseases. Material and methods: The present study was conducted to measure the serum levels of these enzymes from the blood samples collected from a total of 60 patients with diagnosis of Alcoholic Hepatitis (AH, n= 18), Viral Hepatitis (VH, n= 18), Obstructive Jaundice (OJ, n= 06) and Chronic Hepatitis (CH, n= 18) to calculate their ratio as Mean ± SD, separately in each disease group. 24 normal healthy individuals were studied as control group. The data was analyzed using SPSS (Version 17.0) software and ‘p’ values were elicited using student-‘t’ test. Results: An AST: ALT ratio of 2.005±0.833, 0.648±0.228, 0.865±0.147 and 1.314±0.305 was observed in AH, VH, OJ and CH respectively. Control group showed a mean AST: ALT ratio of 1.001±0.158. A significant difference (p<0.05) was observed when each case group was compared with control except OJ vs Control where the ‘p’ value was observed >0.05.  A significant difference (p<0.05) was observed when comparison was done between any two of the disease groups. Conclusion: AST: ALT ratio can be useful in differentiating the liver diseases. Key words: AST:ALT ratio, De Ritis ratio, Alcoholic Hepatitis, Viral Hepatitis, Obstructive Jaundice and  Chronic Hepatitis.

A Randomised Double-Blind Trial of Pentoxifylline Alone versus Pentoxifylline Plus N Acetyl Cysteine in the Treatment of Severe Alcoholic Hepatitis in a Tertiary Care Hospital in Mysore, Karnataka

2021 ◽  
Vol 8 (8) ◽  
pp. 399-404
Author(s):  
Anurag Lavekar ◽  
Deepak Suvarna ◽  
Aradya V ◽  
Nandeesh P ◽  
Vijayakumar R ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Alcoholic Hepatitis ◽  
Tertiary Care ◽  
Study Groups ◽  
Care Hospital ◽  
Double Blind ◽  
Term Survival ◽  
Significant Difference ◽  
Severe Alcoholic Hepatitis ◽  
Acetyl Cysteine

BACKGROUND Proven therapeutic options for treating severe alcoholic hepatitis are limited. The study was conducted to compare pentoxifylline alone versus combination of Pentoxifylline plus N acetylcysteine in severe alcoholic hepatitis patients. METHODS A randomised, parallel, double blind, active controlled trial was conducted in which, 240 cases were considered for analysis and were divided into two study groups i.e. tablet pentoxifylline alone versus tablet pentoxifylline plus tablet N acetylcysteine. The pentoxifylline group received 400 mg thrice daily for one month and the other group received tablet pentoxifylline 400 mg thrice daily with tablet N–acetyl cysteine 600 mg twice daily for one month. Enrolled patients were called for follow up at one and three months. The parameters were compared between the two study groups statistically and the results were obtained. RESULTS Forty-nine (20.4 %) patients expired in 3 months, out of which 35 (14.5 %) expired at the end of 1st month. There was no significant difference in survival between two groups at the end of one and three months (P = 0.58 and 0.10 respectively). Although liver function test (LFT), PT-INR (prothrombin timeinternational normalised ratio) improved significantly from baseline in both the groups (P < 0.0001), no significant difference was observed between the two groups. Prevalence of hepatic encephalopathy was significantly low in pentoxifylline plus N-acetylcysteine group at one and three months (P = 0.04 and 0.02 respectively). CONCLUSIONS Addition of N acetyl cysteine to pentoxifylline helps in reducing hepatic encephalopathy in patients with severe alcoholic hepatitis; however, it does not improve the short-term survival. KEYWORDS Pentoxifylline, N-acetylcysteine, Alcoholic Hepatitis, Liver Disorder

scholarly journals Biomarkers to Assess Liver Function in Various Types of Liver Diseases

2019 ◽  
pp. 28-31
Author(s):  
Pradeep G ◽  
Vikram B ◽  
Sharma DVHS
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Obstructive Jaundice ◽  
Viral Hepatitis ◽  
Liver Function Test ◽  
Alcoholic Liver Disease ◽  
Liver Diseases ◽  
Serum Levels ◽  
Function Test ◽  
Glutamyl Transferase

Background: It is estimated that liver diseases are among the top ten killer diseases in India, causing deaths every year. Besides, there are those who suffered from chronic liver problems needing recurrent hospitalization and prolonged medical attention, which leaves them physically, mentally, emotionally and financially devastated. Methodology: The study included (n=80) various liver disease patients admitted to the General Medicine department and controls (n=20) subjects were having normal health within the age group of 30-55 years. Serum levels of bilirubin, Aspartate Transaminase, Alanine Amino Transferase, Alkaline Phosphatase and Gamma Glutamyl Transferase parameters were studied among the subjects suffering from cirrhosis, alcoholic liver disease, viral hepatitis, obstructive jaundice type of liver diseases. Result: The results of this study showed that the increase in serum levels of Bilirubin, AST, ALT, ALP and GGT in various types of liver diseases i.e Obstructive jaundice, Cirrhosis of the liver, Viral hepatitis, Alcoholic Liver disease when compared with controls. Conclusion: Biochemistry laboratory investigations i.e. Liver Function Test (LFT) are a simple, easy measure of tools which can early diagnose the various types of liver diseases. Keywords: Liver diseases; Liver Bio-markers;  Liver Function Test.

scholarly journals The effect of ladder approach on development of preterm low birth weight infants with HIE-2

2020 ◽  
Vol 7 (3) ◽  
pp. 520
Author(s):  
Tushar R. Jadhav ◽  
Shailaja S. Jaywant
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Premature Infants ◽  
Tertiary Care ◽  
Control Group ◽  
Care Hospital ◽  
Post Intervention ◽  
Low Birth Weight Infants ◽  
Significant Difference

Background: Premature infants with Peri-natal asphyxia leading to a hypoxic-ischemic encephalopathy (HIE) are at greater risk for cerebral palsy. HIE grade II infants have long term neurological complications due to maladaptive brain wiring during NICU stay. Ladder approach, with graded stimulation program is administered by Occupational therapist, plays a vital role to minimize the maladaptive responses to environment. Objective of this study was to effect of Ladder Approach on preterm low birth weight Infants with HIE-2 as compared to conventional treatment. Design of this study was to Prospective Block Randomized Convenient Sampling Control Trial, Experimental design study. The study was carried out in the NICU and PU ward of Tertiary care hospital in metropolitan city from April 2015 to October 2016. The study subjects included a convenient sample of 30 preterm Low birth weight HIE-2 infants randomly selected into study or control groups. Neonatal behavioural Assessment scale (NBAS), Infant Neurological International Battery (INFANIB).Methods: The preterm infants from study group who received Ladder Approach and control group who received routine conventional care only. Outcome measures NBAS was at baseline and first follow up. INFANIB was administered at second follow up to assess neurodevelopment.Results: Showed that the premature infants of the study had significant difference in neuro behavioral status with mean for all subcomponents from to post intervention mean 39.6 in experimental group and from baseline mean of 24.3 to post intervention mean score of 33.2 in control group on neurobehavioral scale. Further neurodevelopmental status showed similar results on INFANIB in experimental group.Conclusions: The premature Infants with HIE grade 2, receiving ladder approach have shown more mature responses resulting into well-organized Neurobehavioral status, and resulted in improved brain wiring as evident in INFANIB.

scholarly journals A Structured Maternity Case Record to Improve Quality of Documentation in a Tertiary Care Hospital, Delhi

2021 ◽  
Author(s):  
AG Radhika ◽  
Chetna Dengri ◽  
Abhishek Kumar ◽  
Shalini Singh
Keyword(s):  
Tertiary Care ◽  
Intervention Group ◽  
Control Group ◽  
Care Hospital ◽  
Case Record ◽  
Hospital Case ◽  
Sequence Of Events ◽  
Significant Difference ◽  
Time Of Admission

Introduction: India contributes to about 18% of global maternal deaths and 22.6% of still births. Efforts to improve the quality of care are challenged by the lack of reliable documentation of data. Hence, a concise, structured maternity case sheet (PrasavRecord) was designed with the aim to bring about an improvement in documentation of treatment and events related to woman in labour from the time of admission till her discharge from the hospital. Aim: To study the improvement in quality of documentation from the time of admission till discharge of a woman in labour with the help of structured format i.e., PrasavRecord. Materials and Methods: The study was conducted in February 2017. A quasi experimental study design was used, and the completeness of data recorded by the resident doctors in the existing hospital case sheet (control group) with those recorded in PrasavRecord (intervention group) were assessed in a total of 65 deliveries in each arm. Details of the patient from admission to the labour room followed by the entire sequence of events during labour as well as hospital stay in postpartum period were recorded over 130 parameters under different sections in PrasavRecord. Statistical analysis was done by using SPSS version 21.0. Results: Completeness of the documentation in terms of history, investigations and findings at examination including those at labour, nearly, 92% of the doctors rated PrasavRecord as “good and very good” for appearance, recommended its routine use, and 75% agreed that the format will be useful for conversion to electronic medical record. There was highly significant difference between the average percentage of completeness in PrasavRecord 75.8 {95% CI (74.2-77.4)} and hospital case sheets 42.2 {95% CI (40.9-43.6)} i.e., z=5.38 p-value <0.001. Conclusion: PrasavRecord is a simple, acceptable and user-friendly data entry format which improves the quality of documentation of the processes and practices during childbirth. Larger trials are required to finetune it to facilitate its widespread use thereby, ensuring a uniform documentation process of labour and postpartum.

Evaluation of Mirror Therapy for Upper Limb Rehabilitation in Stroke

2013 ◽  
Vol 24 (3) ◽  
pp. 63-69 ◽  
Author(s):  
Laisram Nonica ◽  
Muzaffar Tufail ◽  
RK Wadhwa ◽  
Borah Diganta ◽  
SY Kothari
Keyword(s):  
Upper Extremity ◽  
Tertiary Care ◽  
Self Care ◽  
Motor Recovery ◽  
Control Group ◽  
Care Hospital ◽  
Mirror Therapy ◽  
Treatment Protocols ◽  
Upper Limb Rehabilitation ◽  
Significant Difference

Abstract Trials have shown modest clinical improvement in disabilities after stroke with the use of different techniques; however most of the treatment protocols for the paretic upper extremity are either expensive or labour intensive, which makes the provision of intensive treatment for many patients difficult. It has been suggested that mirror therapy is a simple, inexpensive and, most importantly patient-directed treatment that may improve upper extremity function. A prospective randomised case control study was done on 60 patients of both the sexes in the age group of 19 to 82 years having stroke for the first time. This study was conducted in the Department of Physical Medicine and Rehabilitation of a tertiary care hospital. All the patients who fulfilled the criteria were enrolled for study; patients were randomly allotted to the study or control group. Study group was given mirror therapy in addition to the conventional stroke rehabilitation programme. Patients were assessed in terms of motor recovery (Brunnstrom stages), spasticity (modified Ashworth Scale), and the self-care items of the Barthel index. These indices were measured at 0 month (pretreatment), 1 month (post-treatment), and 6 months (follow-up). There was a statistically significant difference in spasticity improvement between the study and control groups; however no significant difference was seen in motor recovery and self care items between the groups. The patients had significant improvements within the groups after the therapy for one month. Mirror therapy can be a useful intervention supplement in rehabilitation of patients; it provides a simple and cost effective therapy for recovery of hand function.

scholarly journals A quality of life assessment and the correlation between generic and disease-specific questionnaires scores in outpatients with chronic liver disease-pilot study

2017 ◽  
Vol 55 (3) ◽  
pp. 129-137 ◽  
Author(s):  
Milica Obradovic ◽  
Zoran Gluvic ◽  
Nina Petrovic ◽  
Milan Obradovic ◽  
Ratko Tomasevic ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Liver Disease ◽  
Pilot Study ◽  
Liver Diseases ◽  
Alcoholic Hepatitis ◽  
Chronic Liver ◽  
Control Group ◽  
Chronic Liver Diseases ◽  
Healthy Control

Abstract Introduction. Chronic liver diseases (CLD) are an important cause of morbidity and mortality in general population. The aim of this study was to analyze potential differences between patients with CLD and healthy control group, and to estimate the severity of CLD by using simple questionnaires: general health questionnaire (GHQ-12) and chronic liver disease questionnaire (CLDQ). Methods. A cross-sectional pilot study was performed in Zemun Clinical Hospital during years 2014 and 2015. Sixty participants were divided into 4 groups (15 per group): chronic alcoholic hepatitis, other chronic hepatitis, liver cirrhosis, and healthy control group. Entire study population chose one of four offered answers of structured questionnaires GHQ-12 and CLDQ, based on which mean model of end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) scores were calculated. Results. Mean GHQ12 and CLDQ scores were 10.5 and 5.21 ± 1.11 respectively. Regarding certain CLDQ domain scores, a significant difference between alcoholic and non-alcoholic hepatitis groups in the worry domain was observed. Mean MELD score was 7.42 ± 2.89 and did not differ between chronic hepatitis groups, while mean CTP score was 5.73 ± 0.88. A statistically significant correlation was observed between GHQ12 and CLDQ scores (ρ = -0.404, p < 0.01), but not between subjective and objective scores. Conclusions. Mean GHQ12 and CLDQ scores pointed out to general psychological no-distress condition of the studied participants, as well as scarcely expressed CLD-specific complaints. Mean MELD and CTP scores indicated stable chronic liver diseases, with low three-month mortality rates in the cases of chronic hepatitis, as well as determination to Child A group in the case of liver cirrhosis.

scholarly journals Staphylococcus spp Resistance to Chlorhexidine: Is There Any Impact Related to the Routine Use for Hand Hygiene?

2020 ◽  
Vol 41 (S1) ◽  
pp. s390-s391
Author(s):  
Icaro Boszczowski ◽  
William Kazumassa Minami ◽  
Marcia Baraldi ◽  
Ana Paula Marchi ◽  
nia Alves dos Santos ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Efflux Pump ◽  
Tertiary Care ◽  
Intervention Group ◽  
Sodium Thiosulfate ◽  
Brain Heart Infusion ◽  
Control Group ◽  
Care Hospital ◽  
Significant Difference ◽  
The Impact

Background: Although guidelines recommend the use of chlorhexidine gluconate (CHG) for hand hygiene (HH), the impact of its routine use on antimicrobial resistance is not clear. Objective: To analyze the impact on the CHG susceptibility among isolates obtained from hands of HCW during its routine use for HH. Methods: We conducted a crossover study at 4 medical-surgical wards of a tertiary-care hospital in São Paulo, Brazil. In 2 units (intervention group), we established routine use of CHG for HH. For the other 2 units (control group), regular soap was provided. The availability of alcohol formulation for HH was not changed during the study. Every 4 months we swapped the units, ie, those using CHG changed for regular soap and vice versa. At baseline, we cultured the hands of HCWs. Only nursing staff hands were investigated. For hand culturing, HCWs placed their hands inside a sterile bag containing a solution of phosphate-buffered saline, Tween 80, and sodium thiosulfate. After the solution incubated overnight, it was inoculated onto brain-heart infusion. Next, it was plated on McConkey and Mannitol agar. MALDI-TOF was used for identification. Agar dilution was performed for Staphylococcus spp. We selected all Staphylococcus spp with MIC ≥ 8 and performed inhibition of efflux pump test. For isolates that showed a decrease of 2 dilutions, we searched the gene qacA/B by polymerase chain reaction. Results: We obtained 262 samples from HCW hands yielding 428 isolates. The most frequent genera were Staphylococcus spp (58%), Acinetobacter spp (8%), Enterobacter spp (8%), Stenotrophomonas spp (5%), Klebsiella spp (4%), Pseudomonas spp (3%), and others (14%). Staphylococcus spp were less frequent in the intervention compared to control group (43% vs 61%; OR, 0.48; 95% CI, 0.29–0.69; P = .005). Among all Staphylococcus spp, the proportion of chlorhexidine resistance (RCHG; MIC ≥ 8) was 12%. All resistant isolates recovered susceptibility after inoculation with pump-efflux inhibitor. For pump-inhibited isolates, 53% had the gene qacA/B amplified by PCR. We did not investigate RCHG among gram-negative isolates. There was a nonsignificant increase in Staphylococcus spp RCHG in the intervention group (4% to 6%; P = .90). Healthcare-acquired infection rates did not change significantly during the intervention. The consumption of CHG increased from 7.3 to 13.9 mL per patient day. Conclusions: We did not detect a significant difference in RCHG during the routine use of CHG for HH, although we observed increasing resistance. Further investigation is needed to clarify other reasons for increasing MIC to CHG.Funding: NoneDisclosures: None

scholarly journals A STUDY TO ASSESS EFFECTIVENESS OF FOOT REFLEXOLOGY ON ANXIETY OF PATIENTS UNDERGOING HEMODIALYSIS IN TERTIARY CARE HOSPITAL, KARAD.

2017 ◽  
Vol 10 (7) ◽  
pp. 345 ◽  
Author(s):  
Samir K Choudhari ◽  
Nutan Potdar ◽  
Prabhuswami Hiremath ◽  
Dhanraj Kharat
Keyword(s):  
Tertiary Care ◽  
Control Group ◽  
Research Approach ◽  
Care Hospital ◽  
Control Groups ◽  
Dialysis Unit ◽  
Study Results ◽  
Significant Difference ◽  
And Control ◽  
Experimental Group

Objectives: (1) To assess the level of anxiety among experimental and control groups of patients undergoing hemodialysis. (2) To determine the effectiveness of foot reflexology on anxiety among experimental group of patients undergoing hemodialysis. (3) To find the association between level of anxiety and selected sociodemographical variables among experimental and control groups of patients undergoing hemodialysis.Methods: The research approach adopted for this study was an evaluative approach, where the research design was a quasi-experimental design. The study was conducted in the dialysis unit in Krishna Hospital, Karad. The sample consists of 40 patients undergoing hemodialysis and further assigned to 20 in the experimental group and 20 in the control group. A convenient sampling technique was used to select the sample. The experimental group received foot reflexology twice in a week for 3 consecutive weeks and each session lasted for 20 minutes where a control group followed hospital routine management. The data were collected by structured questionnaire. The data were analyzed using descriptive and inferential statistics.Results: The mean post-test anxiety score in the experimental group was 16.6, and in the control group, it was 22.55, which was significantly greater. The t-test value was 3.50 and was found significant at p<0.001 level. The values revealed that there was a statistically significant difference in a level of anxiety between the experimental and control groups in the post-test.Conclusion: The study results show that the foot reflexology was effective to reduce the level of anxiety.

scholarly journals Verification of two Alternative Do-it-yourself Equipment Respirators Seal as COVID-19 Protection (VADERS-CoV): a quality assessment pilot study

2020 ◽  
Author(s):  
Marco Pettinger ◽  
Mona Momeni ◽  
Clemence Michaud ◽  
Michel Van Dyck ◽  
David Kahn ◽  
...  
Keyword(s):  
Pilot Study ◽  
Quality Assessment ◽  
Occupational Safety ◽  
Tertiary Care ◽  
Face Mask ◽  
Control Group ◽  
Care Hospital ◽  
Health Administration ◽  
Significant Difference ◽  
Do It Yourself

AbstractBackgroundDuring the ongoing COVID-19 pandemic, healthcare workers are facing shortage in personal protective equipment, especially adequate respirators. Alternative do-it-yourself respirators (ADR) emerge, without any proof of protection.ObjectiveVerify seal potential of two ADR compared to a common FFP2 respirator.DesignQuality assessment pilot study.SettingTertiary Care Hospital.ParticipantsTen anaesthesiology residents.InterventionsParticipants performed quantitative face-fit tests (QNFT) with three respirators to evaluate seal. A common FFP2 respirator was used as baseline (control group). ADR tested in this study are an Anaesthesia Face Mask (AFM) and a full-face Modified Snorkelling Mask (MSM) with a 3D-printed connector, both in conjunction with a breathing system filter.Main outcome measuresNon-inferior seal performance of ADR over FFP2, assessed by calculated QNFT based on measured individual fit factors, as defined by the Occupational Safety and Health Administration.ResultsFor each respirator a total of 90 individual fit factor measurements were taken. Within the control group, seal failed in 37 (41%) measurements but only in 10 (11%) within the AFM group and in 6 (7%) within the MSM group (P < 0.001 respectively). However, when calculating the final, mean QNFT results, no statistically significant difference was found between respirators. Successful QNFT were determined for 5 out of 10 participants in the control group, for 8 in the AFM group (P = 0.25) and for 7 in the MSM group (P = 0.69).ConclusionBoth ADR do have the potential to provide non inferior seal compared to a common FFP2 respirator. While AFM respirators are easily assembled, snorkelling masks must undergo significant but feasible modifications. Our results suggest that those ADR masks might be further investigated as they seem to be viable alternatives for situations when certified respirators are not available.Trial registrationClinicaltrials.gov identifier: NCT04375774

scholarly journals Efficacy of Topiramate as Prophylactic Treatment of Severe Migraine in Children attending OPD of a Tertiary Care Hospital in Bangladesh- a Randomized Control Trial

2021 ◽  
Vol 44 (3) ◽  
pp. 153-156
Author(s):  
Banita Mistry ◽  
Shameem Ara Begum ◽  
Narayan Saha ◽  
Shyamal Sarker ◽  
Mahua Chandra ◽  
...  
Keyword(s):  
Treatment Group ◽  
Prophylactic Treatment ◽  
Tertiary Care ◽  
Post Treatment ◽  
Control Group ◽  
Care Hospital ◽  
Treatment Frequency ◽  
Significant Difference ◽  
Severe Intensity ◽  
Severe Migraine

Background: Migraine is the most common cause of severe recurrent headache in children. Flunarizine (FNZ) is safe and effective drug for prevention of migraine in children. Topiramate (TPM) is also successful as a preventive drug for migraine in children on randomized, double-blind, placebo-controlled trials. Objective: This study was done to observe the efficacy of Topiramate and also perform a comparison TPM and FNZ in patients with migraine of severe intensity in our situation. Materials & Methods: This was a randomized controlled trial done from January to July, 2018. This study was carried out in the OPD of Paediatric Neurology department, National Institute of Neurosciences, (NINS) Dhaka. Forty Children, 5-15 years old diagnosed as migraine with/without aura with severe intensity were randomized either as in study group (TPM treatment group) and control group (FNZ treatment group). Primary end point of the study was to find out the efficacy and safety of both TPM and FNZ after 4 months of treatment. Result: Post-treatment frequency of headache/month was significantly decreased in both groups (within group, p <0.001). There was no significant difference considering pre and post-treatment frequency of headache/month between two treatment groups. (pre-treatment p- 0.333 and post-treatment p- 0.401). Adverse events were not significantly different between the groups p<0.387. Conclusion: Topiramate is equally efficacious as Flunarizine in prophylactic treatment of severe migraine in children. Bangladesh J Child Health 2020; VOL 44 (3) :153-156

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