Jaundice in adult patients above 50 years of age: a comparative study of liver function tests

Background: Diagnosis of jaundice involves a range of tests. The liver function tests are done in all to arrive at a diagnosis and then manage the case appropriately. With advancing age, the incidence of liver disease increases. Understanding these changes is important for the management of liver diseases in the elderly. We conducted this study to find the difference in mean levels of Liver enzymes in younger and older age group of patients suffering with jaundice.Methods: It was a prospective observational study. All patients admitted with jaundice in the medicine ward satisfying inclusion/exclusion criteria were enrolled. The results of liver function tests in younger age and older age participants were then compared.Results: Total 100 participants were enrolled during the study period. 53 were enrolled in group one and the rest in group two. Anorexia (90%) was the most common symptom followed by abdominal distension (54%). The total bilirubin (8.8±4.7) as well as conjugated bilirubin (3.4±2.8) were higher in group one though they were not significant statistically (p=0.10 and 0.25 respectively). Mean AST and ALT levels were much higher in group 1 and statistically significant (p values <0.004 and 0.002 respectively). Conversely the mean PT values were higher in group two (p=0.02).Conclusions: Although the symptom severity may be more in elderly, the LFTs are not deranged proportionately. So there is a need to devise separate cut offs and these have to be lower for the older age group patients with jaundice. More studies with larger sample size are required to confirm the results.

Clinical and biochemical profile of patients hospitalized with jaundice: Experience from a teaching hospital in north India

Background: Jaundice is a common problem in both medical and surgical practice. For best line of management, it is very essential to differentiate all types of jaundice. The cause can often be correctly anticipated clinically but usually biochemical and radiological imaging investigations are required for confirmation. Here we present a study on clinical and biochemical profile of jaundice patients admitted in a tertiary care hospital.Methods: It was an observational study and all patients admitted with jaundice in the department of medicine meeting inclusion/exclusion criteria were enrolled. Data was collected on a self-designed, pretested and structured format.Results: Out of 100 patients, 77 were males, and median age of 47.5 years. Apart from jaundice, anorexia was the most common presenting complaint (90%), while ascites was the most common finding. Cirrhosis (60%) was the most common cause of jaundice. The mean total bilirubin was 7.9 mg%. Mean Hemoglobin in patients with cirrhosis was 9.7gm/dL. 78% patients of cirrhosis revealed esophageal varices. Majority (80%) showed hypoproteinemia. PT was prolonged >3sec in 87% of cases. On USG shrunken liver was noted in all patients with cirrhosis, enlarged liver was found in two patients of liver abscess while altered echotexture was seen in 66% cases. 90 patients improved, 9 died and only one was referred.Conclusions: Alcoholic liver disease was the leading cause of cirrhosis (92%). Jaundice in general and alcoholic cirrhosis in particular affects mostly the productive age group of the male population and has a high economic burden on our society.

Palatogingival Groove - Cause of Root - Canal Failure - A Case Report.

Morphological defects occurring in dental structure can be sometimes predisposing factors for the onset of inflammatory processes in the periodontal and/or pulpal tissues. Palatogingival groove is one such defect, most frequently found on the lingual surface of maxillary laterals. They are easily overlooked as aetiologic factors, as these grooves are covered by periodontal tissues. This case report discusses successful management of a root-canal treated maxillary lateral incisor with an associated radicular lingual groove having persisting inflammatory condition. The management included a combination of endodontic therapy and periodontal regenerative techniques.

Prosthetic Rehabilitation of A Patient With Acquired Acricular Defect Using Silicone Biomaterial - A Case Report.

Auricular defects may be congenital or acquired and are the second most common craniofacial malformation. There are two main treatments: surgical reconstruction or prosthetic rehabilitation. The former is as great a challenge to surgeons because of the complex shape and size of the human ear. On the other hand, rehabilitation with a prosthetic ear matched to the contra lateral ear provides a better morphologic result. Presented in this article is a case report of a patient with an acquired auricular defect managed with a prosthesis made of elastic silicone material.

NDM-1 Resistance: Fleming’s predictions become true.

Bacteria, beside other microorganisms are mainly responsible for human sufferings beside their beneficial effects. After discovery of Penicillin bacterial diseases were controlled to a much extent. The name ‘antibiotic’ makes us feel that we, humans are superior at least from microorganisms. Serious infections caused by bacteria that have become resistant to commonly used antibiotics have become a major global healthcare problem in the 21st century. Resistance to antibiotics shows that they can fight back and challenge our knowledge and intellect. Discovery of New Delhi metallo-1 make us feel that this is the result of our own ignorance. Indiscriminate, irrational and illogical use of antibiotics is helping bacteria to fight against us. What objections are being raised at the Govt. level, and how research community defends us, keeping that apart, the question is to realize and resolve the threat rather than to overlook it. Our outlook need to be changed and health policies and guidelines need to be reevaluated and overhauled timely.