Study the association between platelets count and grades of oesophageal varies in patients of cirrhosis of liver with portal hypertension

Background: cirrhosis of liver is a diffuse process of fibrosis that converts the liver architecture into structurally abnormal nodules Portal hypertension leads to dilatation of portal vein, splenomegaly, and formation of portal systemic collaterals at different sites. Screening endoscopy is recommended for early detection of esophageal varices (EVs) in cirrhotic patients with portal hypertension. However, this approach is limited by its invasiveness and cost. The aim of the study was to determine if platelet count can predict the presence of EVs, especially large (grade III, IV) EVs in need of prophylactic therapy.Methods: Statistically 100 patients previously or newly diagnosed with cirrhosis of liver with portal hypertension without history of hepatic encephalopathy, variceal bleeding, EVL, use of beta blockers, were selected for the study. Ultrasonography was performed in all cases to note the spleen size. Routine blood testing including platelet count was done and UGI-Endoscopy was done to detect presence of varices with grades. Statistical Analysis: Statistical analysis was done using Statistical Package for Social Survey (SPSS) for Windows version 17.0. The data obtained was analysed using mean, SD, Student’s t-test and chi square correlation coefficient, p value <0.05 was considered significant.Results: Among 100 patients studied ,90% patients were found to have esophageal varices. Based on endoscopic grading, incidence of grade 2 and grade 3 esophageal varices predominated, accounting to 48% and 23 % respectively. On correlation of platelet count with grades of esophageal varices it was evident that 44 patients had their platelet count less than 1 lac out of which 24 patients had grade 2 varices followed by 14 patients with grade 3 varices, p value <0.001 and was highly significant.Conclusions: The study depicts that with decrease in platelets count the chances of formation of higher grades of oesophageal varices increases and also a positive association exists.

To Study the Association between Splenic Size and Grades of Oesophageal Varices in Patients of Cirrhosis of Liver with Portal Hypertension.

Chronic liver disease develops when the functional capacity of the liver is deranged, and it is not able to maintain normal physiological conditions. This study was carried to find out the association of portal vein size with gastro-oesophageal varices in diagnosed cases of cirrhosis of liver, so that this parameters can be used in predicting propensity to oesophageal varices non-invasively, and thus help in starting prophylactic therapy earlier to prevent bleeding and other complications of varices.METHODS100 patients previously or newly diagnosed with cirrhosis of liver with portal hypertension without history of hepatic encephalopathy, variceal bleeding, EVL, use of beta blockers, were included for the study. Ultrasonography was done in all cases to find out the spleen size. Routine blood testing including platelet count was done and UGI-Endoscopy was performed to see the presence of oesophageal varices of different grades. The data obtained was analysed using mean, SD, Student’s t-test and chi square correlation coefficient. p Value of <0.05 was considered for significant.RESULTSAmong 100 patients studied, 90% patients were found to have oesophageal varices. Based on endoscopic grading, incidence of grade 2 and grade 3 oesophageal varices predominated, accounting to 48% and 23 % respectively. On correlation of splenic diameter with grades of oesophageal varices, it was found that patients with splenic diameter >13 cm had higher grades of oesophageal varices i.e. 32 patients were grade 2 and 18 patients were grade 3, with p<0.001 and was found highly significant.CONCLUSIONSIn this study, we found that with increasing spleen size there are chances of formation of higher grades of oesophageal varices and both are also having positive association.

Study the usefulness of ascitic fluid cholesterol level in diagnosis of malignant related ascites

Background: Dengue fever is currently the most important arthropod borne viral disease. Since occurrence of dengue infections has been an epidemic in many parts of India and complications like DHF and DSS are increasing, while at the same time the diagnosis is challenging, particularly the laboratory diagnosis is confusing, this study was conducted to evaluate the different laboratory test methods and to compare their respective efficacy, timing, advantages and disadvantages.Methods: This study was done in the Department of Microbiology in collaboration with the Department of Medicine and Pediatrics in two tertiary care medical colleges and hospitals in eastern India. Blood samples from 319 patients with clinical features suggestive of Dengue fever were included in this study. Laboratory investigations were done which included immunological assays that were performed using commercially available kits - SD dengue duo NS1Ag + Ab combo rapid test, NS1 Ag capture ELISA, IgM capture ELISA, IgG capture ELISA test for dengue and other routine tests -full blood cell count, coagulation tests, routine biochemical and lipid profile were also done. Ethical considerations were taken care of and statistical evaluations were done.Results: An increased detection of IgM antibody (46.15%) was seen in the early febrile period (1-5 days) as compared to the mid-febrile period (6-10 days), and late febrile period (6-10 days) when it is 6.89%. IgG antibody is much less in early febrile period (4.16%). Compared to mid-febrile period (24.13%), and late febrile period (62.5%). IgM antibodies were detected in 44.5% of the samples, IgG antibodies were detected in 43.5% of the samples, Rapid test was positive in 36.9% and NS1AG ELISA was detected in 43.5% of the samples in the study.Conclusions: It can be inferred from our study that for detection of dengue in the early febrile period (1-5 days), estimation of dengue-specific serum IgM is the most sensitive antibody detection method.

A study on substance abuse among male undergraduate students of medical college, Kanpur.

Introduction: According to the 2009 Global Health Risks report, substance abuse is one of the top 20 factors for death and disability worldwide. Globally, there is an increasing trend for people to use multiple substances, either together or at different times, which is likely to further increase the risks. This study was undertaken to know out the prevalence of substance abuse among male undergraduate students and to find out any influencing factor. Material & Methods: The cross-sectional study was conducted among male undergraduate students of G.S.V.M Medical College, Kanpur, Uttar Pradesh in 2015. Data was recorded in a pre-designed and pretested questionnaire and analyzed using standard statistical tools Results: Nearly 40.5% of students accepted substance abuse. Peer pressure (41.97%) and anxiety or stress (37.03%) were the commonest reasons for initiation. Substance abuse by parents was found to be significantly associated with substance abuse by students (P<.001). Conclusion: Substance abuse is prevalent among male medical undergraduates. Peer pressure followed by anxiety or stress were the commonest reasons for initiation. Substance abuse by parents increases the likelihood of substance abuse by students.

A study on newborn care practices among the mothers residing in slums of Kanpur Nagar.

Introduction: Despite efforts by government and other agencies, neonatal mortality is still high in our country. Among all other reasons, lack of proper newborn care practices is one of the major contributors for such high rates of mortality. This study was undertaken to assess newborn care practices among mothers residing in slum areas. Material & Methods: A cross sectional study was carried out among 360 mothers of infants in slums of Kanpur. A pre designed and pre tested questionnaire was used. Percentages, chi-square & Fischer’s exact test was used to analyse data using SPSS. Results: Nearly 23.05% deliveries were conducted at home, mostly by untrained dais. Bathing the baby after birth was practiced in 44.45% of home deliveries. In case of home deliveries, eyes were cleaned in 69.95% cases , weight was taken in 29.02% newborns and cord was cut with unsterile blade in 19.2% cases. Turmeric powder with oil or ghee was applied on cord in 94% of home deliveries and in 17.3% of hospital deliveries after the child was brought home. A significant difference was seen in cord care practices in home and hospital deliveries. Early initiation of breast feeding and colostrum was given by 35.5% and prelacteal feed was given by 63.9%. Conclusion: Awareness regarding newborn care practices was good among mothers who delivered their babies in institutions, as depicted by various healthy practices followed by them which were significantly associated with institutional deliveries.

Caroli’s syndrome with ureterovesical calculi in a young child.

An 18-month-old boy was admitted with fever, abdominal pain, and hepatomegaly. CT scan revealed dilatation of intrahepatic biliary radicals with central dot sign, bilateral nephrocalcinosis, multiple ureteric and urinary bladder stones and right-sided obstructive hydroureteronephrosis due to a ureterovesical calculus of about 1.5 cm. Liver biopsy showed early hepatic fibrosis.