ABSTRACT
Background: Cirrhosis is defined anatomically as a diffuse process with fibrosis and nodule formation. It is the result of the fibrogenesis that occurs with chronic liver injury. For reduced liver biosynthesis capacity, low level of serum cholesterol, low density lipoprotein (LDL) and high density lipoprotein (HDL) is usually observed in the chronic liver disease. Due to the high prevalence of chronic liver disease in our country we have conducted this study to determine role of lipid profile in a patient with cirrhosis and to assess its relationship to the severity of cirrhosis.Methods: In this cross-sectional study, patients classified in 3 groups as per CTP classification for severity of cirrhosis. Serum lipid profile was observed in these patients. The primary aim was to assess changes in various parameters of lipid profile and its relationship with severity of liver cirrhosis.Results: About 74 cirrhotic patients were enrolled, 20 in class A, 25 in class B and 29 in class C. serum lipid profile was observed in these patients. Serum cholesterol and HDL cholesterol were decreased with increasing severity of cirrhosis. Serum triglyceride level increases with progression of cirrhosis and very low density lipoprotein (VLDL) level has no correlation with severity of cirrhosis.Conclusions: Serum cholesterol and HDL level decreases with progression of cirrhosis. In future serum lipid profile can be used in classification criteria for assessing severity of liver cirrhosis.
ABSTRACT
Background: Serum phosphate level correlate with atherosclerosis in both animal models and humans with advanced chronic kidney disease and coronary calcification is a known impact of higher serum phosphate, but whether this relationship exists among individuals with Non-CKD is unknown. we conducted this study to observe role of higher serum phosphate level in cardiovascular comorbidities like MI and CHF in Non-CKD patients.Methods: In this observational study, 300 patients were enrolled, half of the patients having Clinical features or positive biochemical markers (Troponin-I for MI and serum BNP for CHF) suggestive of myocardial infarction and heart failure were taken as case group and half of the subjects were taken as control group with similar baseline characteristics. All participants in this study were consenting and more than 18 years of age.Results: The mean value of serum phosphate level in case group was 4.41±1.40 while in control group was 3.19±1.07 showing statistically significant difference (p-value <0.001). In case group 65% patients were having MI with higher serum phosphate level (4.22±1.40).Conclusion: Higher serum phosphate level is related to increased cardiovascular morbidities even in non-CKD patients.
ABSTRACT
Background: Citicoline has emerged as a potential neuroprotectant in experimental models in stroke patients. Citicoline has shown some beneficial effects in human ischaemic stroke and with an excellent safety profile while in haemorrhagic stroke data is limited. Authors conducted this study to test role of citicoline in stroke patients in terms of cognition, memory and post stroke disability.Methods: In this prospective study, patients had to be previously independent, aged >18 years of age, presented within 24 hours of onset of symptoms of stroke diagnosed by neuroimaging (CT or MRI). Patients received either a placebo or 500 mg/12 h citicoline for 12 weeks (orally or intravenously). The primary aim was to evaluate improvement in cognition, memory and post stroke disability after 12 weeks. The efficacy endpoint was the percentage of subjects with MMSE and DRS at 12 weeks.Results: Total 75 stroke patients were enrolled, 40 in control group and 35 in citicoline group were allotted randomly. Patients in citicoline group were given intravenous citicoline 500 mg/12 hour during hospital stay and orally 500 mg/12 hour after discharge for up to 12 weeks. Control Group was given Placebo. cognition, memory and post stroke disability show positive improvement in citicoline group.Conclusions: Citicoline shows beneficial effects in stroke in terms of cognition, memory and post stroke disability.
ABSTRACT
Background: The study was conducted to evaluate and compare the protective effects of spironolactone (alone) and its effects along with ACE inhibitor (ramipril) on diabetics (30-70year) in relation to proteinuria and state of diabetic nephropathy.Methods: A comparative, prospective, non-randomized, non-blinded experimental study was conducted on 56 patients (30-70year) of diagnosed type 2 diabetes mellitus showing proteinuria. Total duration of study was about one year from October 2017 to October 2018. Patients were divided in two groups, group A (n=28, spironolactone 25mg and ramipril 5mg) and group B (n=27, spironolactone 25mg). Subjects were followed over 12weeks and baseline and 12-week urine ACR being compared.Results: Both the group after receiving respective drug were followed for 3month duration and response were assessed by measuring urine ACR value at end of 3months. Mean values of baseline and follow up urine ACR for group A and group B were 471.5±465.62, 244.66±237.54 and 474.88±438.94, 268.42±268.16 respectively, P value found to be >0.05 at 95%C.I. It was observed that percentage reduction of urine ACR were 48% and 43.47% in group A and group B respectively.Conclusions: In the study, it was concluded that spironolactone had significant effect over proteinuria reduction over follow up period in patient with diabetic nephropathy though there was no additional statistically significant advantage of addition of spironolactone and ACE inhibitor over proteinuria reduction. Significant reduction of proteinuria occurred in both group A and group B over 12weeks follow up period, 48 % reduction in group A and 43.47% in group B. This difference proved statistically not significant after applying independent t-test.