Coagulation Profile in Liver Diseases: A Study of 300 Cases in a Tertiary Care Hospital in Uttarakhand, India

2017 ◽  
Vol 2 (2) ◽  
pp. 61-64
Author(s):  
Sanjeev Kishore ◽  
Gautam Bhatia ◽  
Sanjay Kaushik ◽  
Rajnish Kumar ◽  
Umesh Bhatia
Keyword(s):  
Platelet Count ◽  
Liver Diseases ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Coagulation Cascade ◽  
Care Hospital ◽  
Coagulation Profile ◽  
Coagulation Abnormalities ◽  
Increased Risk ◽  
Coagulation Tests

ABSTRACT Background The liver is the cornerstone of the coagulation system. The physiology of blood coagulation is closely linked to liver function as the liver synthesizes most of the factors of the coagulation cascade and fibrinolytic proteins. Objective The objective of this study was to evaluate coagulation abnormalities associated with chronic liver diseases and determine the coagulation abnormalities using various coagulation studies [prothrombin time (PT), activated partial thromboplastin time (APTT), bleeding time (BT), clotting time (CT), and platelet count]. Materials and methods This study included 300 patients clinically diagnosed with liver disease and who were divided into three categories – cirrhosis, hepatitis, and other liver diseases. The coagulation tests PT, APTT, BT, CT, and platelet count were performed and the results were evaluated in groups. Results Out of the 300 patients, 156 were diagnosed with cirrhosis, 75 were of viral hepatitis, and 69 were of other liver diseases. About 62% (186/300) had prolonged PT. About 39.3% (118/300) had prolonged APTT. The BT was prolonged in 34% (102/300), while CT was prolonged in 10.6% (32/300). Thrombocytopenia was seen in 46% (138/300) patients. Conclusion We concluded that various abnormalities of coagulation tests vary greatly with different liver disorders, duration of the disorders, and their severity. Prolongation of PT and APTT in advancing liver cirrhosis indicates damage to the liver parenchyma resulting in decreased production of coagulation proteins with increased risk of bleeding tendencies, which can be detected before these ensue. How to cite this article Bhatia G, Kaushik S, Kumar R, Kishore S, Bhatia U. Coagulation Profile in Liver Diseases: A Study of 300 Cases in a Tertiary Care Hospital in Uttarakhand, India. Int J Adv Integ Med Sci 2017;2(2):61-64.

scholarly journals Coagulation profile in liver diseases: A study of 250 cases in a tertiary care hospital

2020 ◽  
Vol 3 (3) ◽  
pp. 185-188
Author(s):  
Dr Shobhana Prajapati ◽  
Dr . ◽  
Manisha M Shah ◽  
Dr. Roopam K Gidwani ◽  
Dr. Falguni Goswami ◽  
...  
Keyword(s):  
Liver Diseases ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Coagulation Profile

scholarly journals Audit of Clinical Profile and Outcomes of Acute Variceal Bleed in a Tertiary Care Hospital

2019 ◽  
Vol 10 (03) ◽  
pp. 166-171
Author(s):  
Anurag Lavekar ◽  
Vijaykumar TR ◽  
Nandeesh HP ◽  
Deepak Suvarna ◽  
Aradya HV ◽  
...  
Keyword(s):  
Platelet Count ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Serum ◽  
Clinical Profile ◽  
Serum Total Bilirubin ◽  
Care Hospital ◽  
Variceal Bleed ◽  
Increased Risk ◽  
Low Platelet Count

Abstract Aims The main purpose of this article is to conduct audit of clinical profile and outcomes of patients presenting with acute variceal bleed in a tertiary care hospital. Methods and Material This was a retrospective study of patients presenting with variceal bleed in a tertiary care center. Data were generated through a computerized electronic record system. Data of patients admitted for acute variceal bleed from August 2018 to December 2018 were collected and considered for analysis. Statistical analysis was done using the software Statistical Package for the Social Sciences (SPSS) 22.0 version. Results Overall, 107 cases were analyzed. In 89.7% (96) cases, cirrhosis of liver was a cause of variceal bleed. Besides, 77.6% (83) patients had large esophageal varices. Five patients (4.7%) required glue injection. Rebleed rate in present study was 0.9%. Mortality due to variceal bleed was 9.3% (10). Acute rebleed (p = 0.002), low mean arterial pressure (MAP; p = 0.001), low platelet count (p = 0.001), high serum creatinine (p = 0.001), high serum total bilirubin (p = 0.001), high international normalized ratio (INR; p = 0.001), and higher model for end stage liver disease (p = 0.001) were associated with increased risk of mortality. Door to endoscopy time (<12 hours or 12–24 hours) did not affect the mortality rate (p = 0.699). Terlipressin given 24 hours after endotherapy is equally effective as terlipressin given 5 days after endotherapy. Conclusion Mortality due to acute variceal bleed can be reduced with timely intervention. Low MAP, low platelet count, higher serum bilirubin and creatinine, and higher INR are predictors of increased mortality due to variceal bleed. Endoscopy done within 12 to 24 hours of presentation did not affect the outcome.

scholarly journals Trends and causes of maternal mortality in a tertiary care hospital over five years: 2013-2017

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Sonia Rafiq ◽  
Wajeeha Syed ◽  
Simi Fayaz Ghaffar
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Creative Commons ◽  
Increased Risk ◽  
Mortality Ratio ◽  
Public Health Challenge

Background and Objective: Maternal death measurement is essential to a country’s wellbeing and development status. In emerging countries like Pakistan, it remains an intimidating and failed public health challenge. Objectives of our audit were to estimate trends and causes of maternal demise in Lady Reading Hospital, Peshawar, Pakistan. Methods: Between January 2013 to December 2017, a retrospective study was carried out at Medical Teaching Institute, Lady Reading Hospital, Peshawar. A structured proforma was used to collect data from the medical records. To detect trends in mother demise maternal mortality ratio was calculated for each year and for all five years, Spss version 23 was used for data analysis. Results: In the five-year periods 134 deaths were recorded. The maternal mortality during the study period was 431/100,000 live births. An unstable trend in mortality with two crowning periods in 2013 and 2017 was observed. Hemorrhage persisted as the foremost cause of maternal death over the five years period, accounting for 47.76% deaths followed by hypertension, accounting for 25.37% deaths. An increased risk of 35.08% was observed among women aged 25-29 years, followed by 26.11% in 20-24 years and 23.88% in >30 years. Conclusion: There is a decreasing trend of maternal death from 2013 to 2016 but a slight increase was noted in 2017. Hemorrhage was the top cause responsible for the maternal death. doi: https://doi.org/10.12669/pjms.35.4.1091 How to cite this:Rafiq S, Syed W, Ghaffar SF. Trends and causes of maternal mortality in a tertiary care hospital over five years: 2013-2017. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.1091 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals A Retrospective Drug Utilization Study on Psychiatric Illness in a Tertiary Care Teaching Hospital

2021 ◽  
pp. 148-153
Author(s):  
I. Jerlin Michelle ◽  
E. Dhanushri ◽  
V. Nidhish RAJ ◽  
Muhammad Aslam Syed ◽  
A. Priyadharshini ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Psychotropic Drugs ◽  
Psychiatric Illness ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Increased Risk ◽  
Drug Utilization Studies ◽  
Standard Value

Psychiatric disorders are now widely recognized as a major contributor to the global burden of disease. It has been described that there is an increased risk of adverse effects when more than one psychotropic drug is prescribed. Knowledge of the pattern of utilization of drugs in the general population can be achieved through the conduct of drug utilization studies. The present study has therefore been conducted to observe the pattern of drug use in psychiatry patients in a tertiary care hospital. Aim and Objective: To assess the epidemiology of various psychiatric illnesses among the study population To assess the Prescribing Pattern of drugs in Psychiatric Illness. To assess the drug-drug interactions in the prescription using MICROMEDEX. Methodology: A retrospective descriptive observational study was performed in a tertiary care hospital. A total of 100 prescriptions were collected from MRD.  Results: The study reported that 66% of patients were males and 34% were females. The average number of drugs and psychotropic drugs per prescription is six and four respectively. Around 61.98% of drugs in the prescription are psychotropic drugs, among that 40.17% of benzodiazepines are majorly used, followed by 34.27% of antipsychotics. Almost 95 prescriptions had a minimum of one drug-drug interaction.  The average number of psychotropics per prescription was higher than in studies. The average number of drugs per prescription was 5.84, which lead to polypharmacy. Conclusion: Using WHO indicators prescription analysis was done and it showed some deviation from the standard value which can be improved. Polypharmacy was noted in this study. Most of the drug is prescribed in the brand name which should be avoided.

scholarly journals Interactive effects of asparagine and aspartate homeostasis with sex and age for the risk of type 2 diabetes risk

2020 ◽  
Author(s):  
Hui-Huan Luo ◽  
Xiao-Fei Feng ◽  
Xi-Lin Yang ◽  
Rui-Qin Hou ◽  
zhongze fang
Keyword(s):  
Type 2 Diabetes ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Female Gender ◽  
Elevated Risk ◽  
Interactive Effects ◽  
Care Hospital ◽  
Secondary Interaction ◽  
Increased Risk

Abstract Background Asparagine and aspartate homeostasis link with type 2 diabetes (T2D). This study aimed to explore whether asparagine and aspartate metabolism interacted with sex and age to increase the risk of T2D.Methods From 27 May 2015 to 3 August 2016, we consecutively retrieved 1032 T2D patients and 1522 subjects without T2D from a tertiary care hospital in Liaoning, China. Restricted cubic spline nested in the logistic regression was used to draw odds ratio curves of plasma asparagine to aspartate ratio for T2D by sex and age. Cutoff point was select where curves went apart, indicating possible interaction. Addictive interactions of asparagine to aspartate ratio with sex or age and secondary interaction with copresence of unfavorable sex and age were further estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S). Results Ratio of asparagine to aspartate >1.5 was associated with elevated risk of T2D (OR: 7.99, 95%CI: 5.50 to 11.6), which was enhanced by female gender to 13.6, (95%CI: 8.10-22.9) and by >50 years of age to 28.7 (14.6-56.3), with significant additive interactions. There was a significant secondary-interaction of copresence of female sex and > 50 years of age with high asparagine to aspartate ratio for increased T2D risk with the OR being further increased to 34.4 (20.5 - 57.5). Conclusions High asparagine to aspartate ratio was associated with markedly increased risk of T2D, which was further amplified by either female gender or >50 years of age, and especially both.

scholarly journals Prevalence of Valvular and Non-valvular Atrial Fibrillation and the Application of Antithrombotic Treatment in a Tertiary Care Hospital

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Sahadeb Prasad Dhungana ◽  
Rinku Ghimire
Keyword(s):  
Atrial Fibrillation ◽  
Risk Stratification ◽  
Tertiary Care Hospital ◽  
Oral Anticoagulants ◽  
Tertiary Care ◽  
International Normalized Ratio ◽  
Care Hospital ◽  
Clinical Practices ◽  
Antithrombotic Treatment ◽  
Increased Risk

Introduction: Atrial fibrillation is a common atrial tachyarrhythmia with an increased risk of thromboembolism. This study aims to provide information about the application of antithrombotic treatment based on risk stratification schemes for stroke in real-life clinical practices. Methods: This was a descriptive cross-sectional study in 260 patients admitted at the tertiary care hospital with a diagnosis of atrial fibrillation from January 2019 to February 2020 after approval from the Institutional Review Committee (ref. no. 207/2018). Convenient sampling was used. Predisposing conditions for atrial fibrillation, risk factors for stroke, and the use of antithrombotics were obtained based on the pre-structured questionnaires. Data were analyzed by Statistical Package for the Social Sciences version 20. Results: The prevalence of valvular and non-valvular atrial fibrillation was 125 (48.0%), and 135 (51.9%) respectively. Among patients with a non-valvular variant, 102 (75.5%) had a CHA2DS2VASC score of ≥ 2 who were eligible for oral anticoagulants, 13 (9.6 %) patients received it with a majority having sub-therapeutic international normalized ratio. Among patients with valvular type, only 47 (37.6%) patients were receiving oral anticoagulants and 20 (42.5%) patients achieved therapeutic international normalized ratio. Two hundred forty three (93.4%) patients had dilated left atrium (≥40mm), 119 (45.9%) had hypertension and 27 (10.3%) had diabetes mellitus. Conclusions: Antithrombotics were markedly underused in patients with atrial fibrillation. There is a need for proper application of risk stratification schemes for stroke and appropriate use of antithrombotics to prevent thromboembolism.

THALASSEMIA SYNDROME AND OTHER HEMOGLOBINOPATHIES: A SINGLE THALASSEMIA CENTRE EXPERIENCE FROM TERTIARY CARE HOSPITAL OF PURULIA

2021 ◽  
pp. 23-25
Author(s):  
Sudipta Bera ◽  
Tapobrata Biswas ◽  
Anuradha Sinha ◽  
Anindya Adhikari
Keyword(s):  
High Performance ◽  
Tertiary Care Hospital ◽  
Sickle Cell Trait ◽  
Tertiary Care ◽  
Clinical History ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Care Hospital ◽  
Increased Risk ◽  
Thalassemia Trait

Background: Hemoglobinopathies are one of the major health burden globally including India and Southeast Asian region. This study was carried out to nd out the prevalence of β-thalassemia, HbS, HbD, HbE as well as identication of asymptomatic carriers who have an increased risk of having a child with thalassemia in the western part of West Bengal. Materials and methods: In this retrospective cohort study, the data was collected from all newly registered patients with anemia, referred from different outdoor patients in a tertiary care hospital, attending thalassemia clinic over a period of 3 years from January2018 to December2020. Detailed clinical history was taken and blood samples collected are tested with Sysmex automated blood cell counter for red cell indices. Diagnosis of hemoglobinopathy was done by G8 HPLC (high performance liquid chromatography) Analyzer by TOSOH Bioscience. Results: A total 2297 cases were studied during the study period. The age of the patients ranged between 6 months to 60 years. Higher percentage of the study sample was at age of more than 10 years (93.8%). Among 2297 cases, 477 cases showed abnormal Hb fractions on HPLC. The following Hb abnormalities detected were following: β (beta) thalassemia trait 13.2%, β thalassemia major 2.3% followed by sickle cell trait 2.17%, HbE trait 1.8%, HbS disease 0.21%, Hb E disease 0.13%, hereditary persistence of fetal hemoglobin (HPFH) traits 0.17% and Hb D trait 0.08% along with HbE-β-thalassemia 0.30% and HbS-β-thalassemia 0.26%. Conclusion: Among the hemoglobinopathies, β-thalassemia trait (12.9%) is prevalent in western part of Bengal.

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