ABSTRACT
Renal dysfunction is common in chronic liver diseases. The cause of renal dysfunction is either multi-organ involvement in acute conditions or secondary to advanced liver diseases. The present study was undertaken to assess the renal function test in chronic liver diseases and find out the association of alteration of renal function with gradation of liver diseases (assessed by child –pugh criteria) and find out the association of alteration of renal functions among the case of chronic liver disease of different aetiology. Methods: This prospective cross sectional study was conducted in the Department of Medicine, Shri. B. M. Patil Medical College, Hospital & Research Centre, Vijayapur during November 2016 to August 2018 with 65 case of chronic liver diseases after considering the exclusion criteria. The patient were interviewed with predesigned and pre tested schedule examined clinically followed by some laboratory investigation relevant to diagnose the aetiology of chronic liver diseases, and to assess the severity of renal dysfunction. Statistical analysis was done by appropriate statistical software including but not restricted to MS Excel, SPSS ver.20 Results: Majority of the patients were male(90.8%) and the mean age of the patients was 45.78 ±13.19 years. 72.2% patients suffered from Alcoholic liver diseases while 13.9% and 10.8% patients had chronic hepatitis B and chronic hepatitis C respectively. Two patients had Nonalcoholic steatohepatitis. It was observed that 36.9% patients had renal dysfunction and most. Conclusion: This study emphasizes the fact that we should be more vigilant when treating Chronic Liver Disease (CLD) patients, regarding their renal function, as proper screening, prevention and treatment of renal dysfunction can decrease morbidity and mortality.
ABSTRACT
Background: 1.Effect of atropinization with different methods.2.Outcomes in terms of duration of hospital stay and patients recovery. Methodology: An open-label randomized clinical trial was conducted in, Shri B M Patil Medical College Hospital and Reasearchcentre, Vijyapura, Karnataka in 108 individuals with OPC poisoning .We compared two groups that used a titrated dosing protocol based on a structured monitoring sheet for atropineinfusion with another group using an ‘ad hoc’ regime. The aim was to compare the efficacy andsafety of conventional bolus doses with individualized incremental doses of atropine for atropinization followed by continuous atropine infusion for management of OPC poisoning. Results: Out of 108 patients ,54 patients received conventional bolus dose atropine (group A) and 54 patient received rapidly incremental doses of atropine followed by infusion (group B).36 subjects analysed in group A and 32 in group B for moderate to severe poisoning.The mortality in group A was 11.1%(4/36) and in group B was 6.3%(2/32).The mean duration of atropinization in group A was 5.8hrs (348)in minutes compared to time 26.9minutes for group B. Conclusion: Administration of atropine using a fixed algorithm is easy and effective in providing the atropine requirement in management of early phase of acute OPC poisoning.Rapid incremental dose atropinization followed by atropine infusion reduces mortality and morbidity from OPC poisoning and shortens the length of hospital stay and early recovery .Incremental atropine and infusion should become the treatment of choice for OPC poisoning.