ABSTRACT
Introduction: Acute gastrointestinal (GI) bleeding is a lifethreatening emergency that remains a common cause ofhospitalization worldwide. The aetiology of acute uppergastrointestinal bleed (UGIB) varies with each geographicalregion. Study aimed to analyse clinical profile, endoscopicprofile and in-hospital mortality in patients with acute uppergastrointestinal bleeding.Material and methods: This was a retrospective analysisconducted in a Tertiary care centre in Bangalore. In this studywe analysed the records of consecutive patients admitted withUpper Gastro-Intestinal bleeding over period of three yearsfrom January 2016 till January 2019.Results: We analysed two thirty consecutive patientsdiagnosed with acute upper gastrointestinal bleeding, 77.4%patients were males and 22.6% were females, mean age ofpresentation was 49.10 years. Most of the patients, oneseventy-three (75%) were between the age group of 31-70 years. Melena was the most common symptom 80.4%followed by hematemesis 47%. History of chronic alcoholintake was noted in ninety three (40.4%) and smoking in sixtyfive (28.3%), medication history depicted that sixteen (6.92%)patients were on NSAIDS; fifteen (6.49%) patients were onanti-platelet drugs, five (2.1%) patients were on steroids, one(0.4%) patient was on Newer Oral Anti Coagulants.Conclusion: The present study reported peptic ulcer diseaseas the most common cause of upper GI bleeding, followedby portal hypertension related bleeding. The most commonendoscopic lesions reported were esophageal varices,followed by duodenal ulcer. Upper G.I endoscopy is animportant modality in both diagnosis and therapy in upperG.I bleed, concomitant medical and Endoscopic therapy mayreduce mortality, morbidity and also the need for surgery/interventional radiology assisted haemostasis.
ABSTRACT
Background: Stroke is defined as an abrupt onset of a neurologic deficit that is attributable to a focal vascular cause. Acute ischemic stroke is the fourth leading cause of death and most common cause of long-term disability worldwide. Hyponatremia is the commonest electrolyte disturbance encountered in the neurological intensive care units. This study investigated to evaluate hyponatremia in acute ischemic stroke patients as a reliable prognostic marker on admission to ICU.Methods: A total of 150 patients admitted to M S Ramaiah Hospitals during the period of October 2014 to September 2016 who fulfilled the inclusion criteria were considered in the study. All patients were evaluated by neurologist/ physician and the diagnosis of Acute ischemic stroke was made by Clinical examination and confirmed by Computed Tomography (CT) and/ Magnetic resonance imaging (MRI) brain. Hyponatremia was defined as serum sodium level <135 mmol/L and recorded on admission. Outcome was assessed by National Institute of Health Stroke Scale (NIHSS) score at admission, day 5 and at discharge, duration of ICU stay, duration of hospital stay and in-patient mortality.Results: Among the 150 patients admitted with acute ischemic stroke, mean age was 60 years, 68% were males and 36% patients had hyponatremia. Baseline characteristics were similar between groups except for gender distribution (p=0.037). Hyponatremic patients had higher NIHSS score on admission, on day 5 and at discharge (p=<0.001). Hyponatremic patients had a longer duration of ICU stay (p=<0.001) and in hospital stay (p=<0.001). Hyponatremia was associated with higher mortality in hospital (p=0.026).Conclusions: Study demonstrates that hyponatremia at admission in acute ischemic stroke patients is associated with acute mortality, worse NIHSS score at admission and at discharge, and longer duration of ICU and hospital stay.