Lipid Profile as an Indicator of Severity in Cirrhosis of Liver: Hospital based Cross-sectional Study

Background: Various scoring systems are available to assess the severity of cirrhosis, that is, the Child-Pugh score and Model for End-Stage Liver Disease (MELD) score. Since the liver is the major site for converting excess carbohydrates into various lipids, the deranged lipid profile can act as a prognostic biomarker of cirrhosis. We assessed the lipid profile abnormalities among patients with cirrhosis of the liver and correlated them with the severity of cirrhosis. Materials and methods: This is an analytical cross-sectional study on lipid profile as an indicator of severity in cirrhosis of the liver among patients admitted to the medical ward of a tertiary care teaching hospital in Tamil Nadu. Following detailed investigation and confirmation of cirrhosis, a fasting serum lipid profile was measured in all eligible patients with cirrhosis. Total serum cholesterol, triglyceride (TGL), and high-density lipoprotein (HDL) were measured by direct method and serum low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL) were calculated by using the Friedwald formula. Results: A total of 120 patients were studied. Of them, 76 (63%) were male. Of them, alcohol (84, 75.0%), hepatitis B (8, 7.1%), and nonalcoholic steatohepatitis (NASH) (6, 5.4%) were the most common cause of cirrhosis. A clear dose-response relationship (decreasing trend) is seen in the levels of lipids for increasing severity based on the Child-Pugh score and MELD score (except for a score of ?10). Further, the cholesterol, LDL, and HDL were significantly lower among patients with ascites or with spontaneous bacterial peritonitis compared to their respective groups. However, none of the lipid profiles significantly differed based on the presence of upper gastrointestinal (UGI) bleeding. Conclusion: This study observed that there is a significant reduction in levels of lipid profile parameters like serum total cholesterol, LDL, VLDL, TGL, and HDL in patients with cirrhosis as the severity increases. Further formulation of the scoring system in association with a preexisting scoring system may provide a better assessment of patients’ prognosis in view of morbidity and mortality. We recommend it is necessary to assess the fasting lipid profile in all patients with cirrhosis and prognosticate their disease progression.

Assessment of perioperative transfusion therapy and complications in sickle cell disease patients undergoing surgery

Perioperative blood transfusion is usually given to sickle cell disease patients to reduce or prevent perioperative morbidity. Assessment of such a practice was the subject of our study. A retrospective one year survey of sickle cell disease patients undergoing surgery at Salmaniya Medical Complex, Bahrain was conducted. The medical records were reviewed to characterize the surgical procedure, transfusion management and perioperative complications. 85 sickle cell disease patients who underwent surgery were studied. Preoperatively, 21.2% had exchange transfusion [ETX], 24.7% had simple transfusions [STX] and 54.1% had no transfusion [NTX]. 14.1% of all patients had postoperative complications, and 50% of those, had complications from the laparoscopic cholecystectomy group. The incidence of sickle cell crisis postoperatively was 22.2% in ETX group, 9.5% in STX group and 4.34% in the NTX group. The incidence of acute chest syndrome postoperatively was found to be 5.55% in the ETX group, 4.76% in the STX group and 4.34% in the NTX group. No intraoperative complications were recorded in all groups. All patients who had postoperative complications had a preoperative HBSS > 40%.Exchange transfusion does not prevent perioperative complications of sickle cell disease patients. HBSS > 40% carries a higher risk of postoperative complications

Spectroscopic studies of some new azino compounds

The electronic absorption spectra of some new azino compounds derived from hydrazine and different aldehyde and ketones are investigated in organic solvents of varying polarities. The important bands in the IR spectra and the main 1H NMR signals are assigned and discussed in relation to molecular structure. Although work on the absorption spectra of azino compounds has been reported in the literature [1-3], a series of new azino compounds derived from hydrazine and different aldehyde and ketones was prepared and in order to throw more light on their structures, these compounds were subjected to elemental analysis, spectroscopic studies and Uv-visible spectral behavior in organic solvents of varied polarity. The study included also the assignment of IR bands and 1H NMR signals by considering the effect of molecular structure on the spectral behavior

hospital based case-control study of hepatocellular carcinoma

A hospital based case-control study was conducted to define the role of some of the factors predisposing to hepatocellular carcinoma [HCC]. It included 62 HCC cases and 62 age, sex and occupation matching control. Selected past history like schistosomal infection, jaundice, blood transfusion, contraceptive pills use, alcohol consumption and family history of cancer were examined. The history of schistosomiasis and that of jaundice show statistical significant differences