ABSTRACT
Introduction: Etiology of Pancreatitis continues to stir up controversy. The incidence of acute pancreatitis has been reported to vary around the world in different studies. The etiological profile of pancreatitis may be different in different parts of the world and it is therefore important that experiences from different parts of the country be recorded. Alcohol was once thought to be most common etiology. Recent studies in western countries show that non-alcoholic causes include more than 50% of causes of pancreatitis. Aim: The aim this study was to know the etiological factors of pancreatitis and to compare the serum amylase, lipase levels in alcoholic and non- alcoholic patients. Materials and methods: This was a prospective observational study conducted in Gandhi Medical College and Hospital, Secunderabad from December 2012 to November 2014 with duration of 2 years. 75 patients were included in this study according to inclusion and exclusion criteria. Detailed history along with physical examination and laboratory investigations for confirmation of diagnosis and etiology were done. Results: In the present study, out of 75 cases, 40 had significant history of alcohol consumption, while 35 were found to be non-alcoholics. The age group of patients in our study was from 18yrs to 62 years. 20 out of 45 alcoholics were less than 40 years old while 21 out of 35 non alcoholics were less than 40 years old. Out of the 75 cases, 51 were males while 24 were females. In our study alcohol causes pancreatitis in 60% of the cases while non-alcoholic causes of pancreatitis included 40% of cases. Mean amylase, mean lipase and amylase: lipase ratio values were raised more in alcoholics than non-alcoholics. Recurrent pancreatitis was also observed in alcoholics than non-alcoholics. N L Varunmai, Mudumala Issac Abhilash, M Uma Devi, P Shravan Kumar. Incidence and etiology of pancreatitis among alcoholic and non-alcoholic patients. IAIM, 2017; 4(5): 117-121. Page 118 Conclusion: Within limitations of this study, concluded that alcohol remains to be most common cause of pancreatitis in south India (Telangana), incidence of recurrent pancreatitis was significantly high in alcoholics and Serum lipase: amylase ratio more in alcoholics than non-alcoholics.
ABSTRACT
Introduction: Studies of renal perfusion when kidney function tests are still normal could be useful in understanding the pathophysiology of functional kidney impairment in cirrhosis. Kidney functional failure in cirrhosis is considered as a consequence of active renal vasoconstriction. The same have been studied by invasive and non-invasive methods. The present study is aimed at non-invasive assessment of renal artery resistance in patients of cirrhosis of liver. Materials and methods: The present study included 30 cases, patients with different stages of cirrhosis, who were clinically stable, while those with major complications like hepatic encephalopathy, major bleeding etc were excluded. All patients were evaluated clinically and a series of laboratory investigations were done. The resistance in the renal artery was calculates as Resistivity index, by using a color Doppler ultrasonography. Results: In our study, we found the main resistivity index was higher in cases with MELD >20. There was further increase in resistivity index as a severity of the cirrhosis increases. Similarly the MDRD EGFR was decreasing as the severity of cirrhosis was increased. Conclusion: Within limitations of the present study, we conclude that the estimation of the resistivity index in the kidney appears to be a sensitive and easy method for studying the early renal hemodynamic alterations in cirrhotic patients and thus by better understanding the Pathophysiology of hepatorenal syndrome.
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Background: Hyperuricemia and micro albuminuria are known to occur independently in diabetes and hypertension. Of late the cardiovascular implication of Hyperuricemia and microalbuminuria in the non-diabetic, non-hypertensive patients has received focus. Hyperuricemia and microalbuminuria are independent risk indicators of ischemic heart disease, also indicates severity of the disease and has been considered as important prognostic indicator. Objectives: To measure and compare serum uric acid levels and microalbuminuria in either of patient and control groups and to identify the association of hyperuricemia and microalbuminuria in acute myocardial infarction in non-diabetic and non-hypertensive patients in a tertiary hospital. Materials and methods: A prospective study was conducted for a period of 8 months from February 2011-September 2011. We included 32 MI patients (diagnosed based on the clinical history and ECG changes) along with 32 age and sex matched healthy controls. A p-value of <0.05 was considered to be statistically significant. Serum uric acid and micro albuminuria were measured in these patients by colorimetric and immunoturbidimetric methods respectively. Results: The study group consisted of 50 patients, among them 32 participants were selected for our study. Our results showed significant change in serum uric acid levels and microalbuminuria when compared to healthy volunteers. In addition to that we observed positive association between serum uric acid and microalbuminuria; serum uric acid and body mass index in AMI patients. Combination NL Varun Mai, Mudumala Issac Abhilash, Chandra Shekhar. Association of hyperuricemia and microalbuminuria in acute myocardial infarction in non-diabetic and non-hypertensive patients. IAIM, 2017; 4(10): 40-51. Page 41 of Killip class and serum uric acid level after acute myocardial infarction was a good predictor of mortality after AMI. Conclusion: These results indicate that assessment of these novel markers should be undertaken so that effective treatment and appropriate life-style changes can be implemented early to prevent morbidity and mortality.
ABSTRACT
Background: Raised serum uric acid has been reported to be associated with an increased risk of coronary heart disease and is commonly encountered with essential hypertension, even untreated hypertension, and type 2 diabetes, which are in turn associated with coronary heart disease. Aim: To estimate the levels of uric acid in patients with essential hypertension. To correlate the levels of uric acid with the severity of hypertension in newly detected hypertensive patients. To compare the levels of uric acid in hypertensives with that in non hypertensives so as to assess the role of uric acid as a risk factor for hypertension. Materials and Methods: This study was an age and sex matched prospective case control study. Matching for other confounding factors such as diet, alcohol and smoking was also done. The study was conducted during the period from September 2010 to September 2012 after obtaining the clearance from the Institutional Ethics Committee. Inclusion Criteria: Patients of age > 18 years, newly detected patients of essential hypertension and patients with essential hypertension on treatment. Exclusion Criteria: Patients with renal failure. Patients on treatment with drugs altering uric acid levels such as thiazides, loop diuretics, pyrazinamide and allopurinol. Lymphoproliferative or myeloproliferative disorders. Secondary hypertension and pregnancy induced hypertension. The study included a total of 142 patients of which 80 were cases (hypertensives) and 62 were controls (non hypertensives). Results: The range of the serum uric acid in cases was 1.40 to 11.30 mg/dl. In hypertensive males it was found to be from 1.40 to 11.30 mg/dl and in hypertensive females it was found to be from 2.70 to 11.10 mg/dl. The range of the serum uric acid in controls was 1.50 to 6.50 mg/dl. In hypertensive Mudumala Issac Abhilash, NL Varun Mai, K.B.R. Sastry. Raised serum uric acid levels as an independent risk factor for the development of hypertension. IAIM, 2017; 4(11): 37-46. Page 38 males it was found to be from 1.50 to 6.50 mg/dl and in hypertensive females it was found to be from 1.60 to 6.20 mg/dl. Serum uric acid is significantly elevated in hypertensives as compared to normotensive individuals. Serum uric acid can be used probably as an early biochemical marker to determine the severity of hypertension as stage 2 hypertensives had more elevation in serum uric acid levels as compared to other hypertensives. The uric acid levels did not differ significantly between hypertensives with and without treatment. There is a considerable difference in the mean serum uric acid levels between stages 1, 2 and isolated systolic hypertension in the newly detected hypertensives but it is not of a linear correlation The total number of newly detected hypertensives were 39 out of which 13 were diagnosed as stage 1 hypertension, 22 as stage 2 hypertension and 4 as isolated systolic hypertension. The mean of the serum uric acid was 4.20 (1.37) mg/dl, 6.56 (1.40) mg/dl and 4.40 (1.40) in stage 1 hypertension, stage 2 hypertension and isolated systolic hypertension respectively, in newly diagnosed hypertensives. Conclusion: Thus serum uric acid estimation can be used for aiding in the diagnosis of essential hypertension as well as in assessment of the severity.