ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
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.
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Aim and Objectives: This study is determined the vertical distance between lingual frenum and incisal edge of mandibular central incisors in dentulous subject and edentulous denture wearer subjects and their variation in different age groups and sex. Materials and Methods: This study involved 120 dentulous subjects (60 men, 60 women) and 20 complete denture wearers. Depending upon the age, the dentulous subjects were divided into three groups. Each group consisted of 40 subjects (20 men, 20 women). Group I consisted of 20-30 yr age, group II 30-4 0yr age and group III consisted of more than 40 yr age. Mandibular impressions of dentulous and denture wearers were made with irreversible hydrocolloid and cast retrieved. The vertical distance between the anterior attachment of lingual frenum and incisal edges of the mandibular central incisors for both the dentulous and edentulous subjects was measured on the casts with the help of dental surveyor. Data were tabulated and stastically analysed. Results: Overall (irrespective of gender) normative range for vertical distance between the anterior attachment of the lingual frenum and mesioincisal edge of mandibular central incisor among dentulous subjects is 9.52-10.24 mm. If we consider gender it is 10.00-11.13 mm for male and 8.82-9.58 mm for female. Conclusion: This study indicated that the distance between the antero-superior most point on the lingual frenum and the mesio-incisal edges of mandibular central incisors can be used as a reliable landmark when the frenum is recorded during function.
ABSTRACT
Background: Despite availability of adequate sunshine, Indian population has the highest prevalence of low bone mass and Bone Mineral Content (BMC). Risk factors for osteoporosis have been extensively studied in the west but poorly investigated in India. We studied BMD and Bone Turnover Markers (BTMs) among healthy young adults. Methods: Fifty one healthy young adults (28 Males, 23 Females) in the age group of 20-35 years were studied. Morphometric, biochemical parameters and BMD (whole body, spine, hip & wrist) were recorded. Anthropometric measurements included height, weight, BMI and Waist/Hip Ratio (WHR). BTMs studied included - serum Bone-Specific Alkaline Phosphatase (sBAP), serum Collagen cross-linked C-Terminal telopeptide (sCTx), serum Osteocalcin (OC) and human intact parathyroid hormone (hPTH) using standard ELISA kits. Results: Of 51 healthy volunteers 21.57% had normal BMD, 13.73% were frankly osteoporotic and 64.70% were osteopenic. Age, weight and BMI were the best predictors of total BMD and BMC at all sites. sCTX positively correlated with Total Bone Area (TBA), BMD at Hip and Forearm. Using multiple regressions - age, weight, and BMI were significant predictors of BMD in young adults. Percentage body fat had inverse correlation with BMC, BMD and TBA. Weight and height positively correlated with BMD at femoral neck, inter-trochanter and Ward’s triangle. Body weight was best predictor of BMD at femoral neck, Ward’s triangle, forearm UD, forearm MID and forearm1/3. Conclusion: Majority of healthy young Indians have poor bone health as evidenced by bone markers.