ABSTRACT
Background: Chronic liver disease (CLD) is a major cause of morbidity. In CLD high plasma glucose and HbA1c level are independently associated with severe disease and poor prognosis. The Child Pugh scoring is still the corner stone in prognostic evaluation of CLD patients. Aims & Objectives: The aim of this study was to evaluate plasma glucose (FBS, PPBS) & glycosylated haemoglobin (HbA1c) in patients with CLD and calculate the Child-Pugh score for each patient and correlate with each other. Methods: It was a cross sectional,observational hospital based study consisted of 100 patients with CLD whose FBS,PPBS and HbA1C were measured & it was correlated with Child-Pugh score. Results: There was significant association between impaired FBS & impaired OGTT &PPBS with the severity of CLD (p - 0.0487& 0.0476). However HbA1c & its correlation with Child Pugh score showed no significance (p- 0.142) but incidence of death with raised plasma glucose & with raised HbA1c were significant ( p - 0.043 & 0.042). Conclusion: Incidence of impaired FBS, OGTT & PPBS were more in-patient with CLD, which may be considered as prognostic marker for the severity of CLD. Impaired blood gucose may also adversely affect outcome of CLD& therefore, blood glucose should be determined in every CLD patients. Early detection & management can improve the overall outcome of CLD patients.
ABSTRACT
Retroperitoneal fibrosis is one of the rare fibrotic processes mainly involving caudal aspect of the retroperitoneum. In up to 70% of patients no causative factor for retroperitoneal fibrosis can be identified, where it resembles auto-immune reaction. A 30-year-old lady presented with progressive oedema of the lower extremities, jaundice and abdominal swelling. Clinical examination revealed doughy abdominal feel and diffuse tenderness. Ultrasonography showed dilated intrahepatic bilary radicles and mild ascites. Contrast CT-scan showed enhancing sheath of soft tissue extending from porta down to aortic bifurcation encasing common bile duct, aorta, inferior vena cava and the ureters. CT-guided fine needle aspiration cytology revealed metastatic adenocarcinoma. Ascitic fluid did not show any malignant cell. No abdominal mass could be detected. The patient died during the course of palliative chemotherapy.