ABSTRACT
Objective: To determine 3rd generation cephalosporin resistance in patients with community-acquired spontaneous bacterial peritonitis [SBP] using early response assessment
Methods: This prospective quasi-experimental study was carried out at Doctors Hospital and Medical Center from January 2016 to September 2018. Patients with cirrhosis and SBP were included. Third generation cephalosporins i.e. cefotaxime/ceftriaxone were used for treatment of SBP. Response after 48 hours was assessed and decline in ascitic fluid neutrophil count of < 25% of baseline was labelled as cephalosporin resistant. Carbapenem were used as second line treatment. Recovery and discharge or death of patients were primary end points
Results: Male to female ratio in 31 patients of SBP was 1.2/1 [17/14]. Hepato-renal syndrome was diagnosed in 11[37.9%] patients. Cefotaxime was used for 16[51.6%] patients whereas ceftriaxone for 15[48.3%] patients. Early response of SBP was noted in 26[83.8%] patients while 5 [16.2%] were non-responders to cephalosporins. SBP resolved in all non-responding patients with i/v carbapenem. In-hospital mortality was 12.9% and had no association with cephalosporin resistance. High bilirubin [p 0.04], deranged INR [p 0.008], low albumin [p 0.04], high Child Pugh [CTP] score [p 0.03] and MELD scores [p 0.009] were associated with in-hospital mortality
Conclusion: Cephalosporin resistance was present in 16.2% of study patients with community-acquired SBP. Mortality in SBP patients is associated with advanced stage of liver disease
ABSTRACT
Background: Heavy alcohol consumption is an inevitable cause of alcoholic liver disease with a high chance to progress to Alcoholic Liver Cirrhosis. Alcohol could damage the function of body organs and could cause cancer. Liver damage due to excessive alcohol consumption is usually presented as fatty liver [build-up of fats in the liver], steatohepatitis, fibrosis, alcoholic cirrhosis, and hepatocellular carcinoma. When liver fibrosis progresses, it will ultimately end up as alcoholic cirrhosis
Objective of the Study: This article was intended to explore and investigate the possible optimal diagnosis and management of Alcoholic liver cirrhosis
Methods: We searched the medical literatures to retrieve studies for the review till 30 November 2017. Electronic search in the scientific database from 1965 to 2017- [Medline, Embase. The Cochrane Library websites were searched for English Publications [both reprint requests and by searching the database]. Data extracted included authors, country, year of publication, characteristics of patients, pathophysiology, risk factors, clinical manifestations, different diagnostic approaches and treatment modalities
Conclusion: Absolute abstinence remains the foundation for any treatment of any acute or chronic Alcoholic Liver Disease. It's also important to understand that no treatment will cure cirrhosis or repair scarring in the liver that has already occurred and the only resort would be liver transplantation which is also debatable provided the complications it carries along. Nevertheless, timely diagnosis of alcoholic cirrhosis in people with alcoholic liver disease is the cornerstone for evaluation of prognosis or choosing treatment strategies such as nutritional and medical support and lifestyle change
ABSTRACT
Background: Heavy alcohol consumption is an inevitable cause of alcoholic liver disease with a high chance to progress to Alcoholic Liver Cirrhosis. Alcohol could damage the function of body organs and could cause cancer. Liver damage due to excessive alcohol consumption is usually presented as fatty liver [build-up of fats in the liver], steatohepatitis, fibrosis, alcoholic cirrhosis, and hepatocellular carcinoma. When liver fibrosis progresses, it will ultimately end up as alcoholic cirrhosis
Objective of the Study: This article was intended to explore and investigate the possible optimal diagnosis and management of Alcoholic liver cirrhosis
Methods: We searched the medical literatures to retrieve studies for the review till 30 November 2017. Electronic search in the scientific database from 1965 to 2017- [Medline, Embase. The Cochrane Library websites were searched for English Publications [both reprint requests and by searching the database] .Data extracted included authors, country, year of publication, characteristics of patients, pathophysiology, risk factors, clinical manifestations, different diagnostic approaches and treatment modalities
Conclusion: Absolute abstinence remains the foundation for any treatment of any acute or chronic Alcoholic Liver Disease. It's also important to understand that no treatment will cure cirrhosis or repair scarring in the liver that has already occurred and the only resort would be liver transplantation which is also debatable provided the complications it carries along. Nevertheless, timely diagnosis of alcoholic cirrhosis in people with alcoholic liver disease is the cornerstone for evaluation of prognosis or choosing treatment strategies such as nutritional and medical support and lifestyle change
ABSTRACT
Background: depression is an important health problem due to its prevalence and associated consequences. The life time prevalence of depression ranges between 10 to 21 % in population. According to the precipitation of the WHO, depression is estimated to become the second leading cause of dysfunction by the year 2020. Among medical students, academic stressors include the volume of material to be learned, academic performance and evaluation [examinations and continuous assessments]
Method: a cross-sectional study was conducted and the total of 300 Medical students from 18 to 25 years to age participated in this study. Students in this study were undergraduate students. Duke health profile were given to the students. Data analysis was done by using Chi square test
Results: 300 students from fourth year and final year were recruited for the study. Mean anxiety score was 35.4 SD + 19.9 with minimum score of 0 and maximum score of 99.6. Mean depression score was 35.9 SD + 21.8 with minimum score of 0 and maximum score of 100. Mean anxiety depression score was 28.8 SD + 33.8 with minimum score of 0 and maximum score of 100. Mental score was compared among medical students, 47.4% of fourth years and 34.2% of had severe mental stress [Score 75 - 100], Anxiety score was compared among medical students, 2.6% of fourth years and 3.4% of had severe anxiety [Score 75 - 100], Depression score was compared among medical students, 3.9% of fourth years and 5.5% of had severe depression [Score 75 - 100], 14.9% of fourth years and 18.5% of had moderate depression [Score 50 - 75]
Conclusion: anxiety score showed a little female predominance. Depression among medical students of fourth year was little more as compared to the final year students. Depression was more among male students than female students
ABSTRACT
Introduction: Over the last two decades the use of personal music player [PMP] with headphones/earphones has increased tremendously. Those people using headphones/ earphones on regular basis belongs from all age groups. They become accustomed to use headphones/earphones at high volumes and over long periods of time which may be implicated in ongoing permanent hearing loss in these individuals. Both the intensity and duration of noise exposure determines the potential for damage of the hair cells of the inner ear. The study population was the university students using such devices, however audiogram performed only in participants using these devices for more than 1 hour a day, at moderate to high volumes
Objective: To identify association of sensorineural hearing loss and noise exposure from a personal music player with head phones/earphones among the young university students
Material and methods: This prospective study conducted at Dow International Medical College, DUHS from January 2015 to April 2015. All Final year students were invited for the survey. Informed consent was taken from each participant. Data was collected regarding the duration and hours of use of personal music players. To detect degree of the change in hearing threshold, Audiograms assessment done on 56 participants from high risk group. The data was analyzed using SPSS16
Result: The majority of earphone users are young adults. The audiogram showed mild hearing loss in frequencies over 0.5- 8 kHz
Conclusion: There is mild hearing loss in the high risk group, therefore adequate counseling, for these individuals, regarding change of their listening habits is necessary if further hearing loss is to be prevented
ABSTRACT
The objectives of the study were to: 1. List the different complications of Grand multipara. 2. Compare the complications of Grand multipara with women of low parity. 3. Compare the fetal outcomes of Grand multipara with women of low parity. Study Design: Cross sectional Setting: Post natal Wards of Gynae unit I, II and III of Abbasi Shaheed Hospital and Sobhraj Maternity Hospital Duration of study: April to Aug 2008 Sample size: 100 Complications in grand multipara had been found in 80% of cases as compared to 20% of women with low parity. Abortion rate was found to be higher in grand multipara [3%] as compared with women of low parity [0%]. Twelve% of newborns were born by breech presentation in grand multipara as compare to just 4% in women of low parity. Regarding the fetal outcome, 5% of grand multipara gave birth to dead newborns as compared to only 1% of women of low parity. Grand multipara had more maternal and fetal complications as compared to women of low parity