ABSTRACT
Background: The major cause of morbidity and mortality in patients with portal hypertension is due to oesophageal varices. Upper gastrointestinal endoscopy is considered best to detect varices earlier. It’s an invasive tool which is expensive and increased financial burden among patients. Hence this study is undertaken to find non-invasive indicators of oesophageal varices in cirrhosis patients with portal hypertension and to establish the role of portal vein diameter determined by ultrasonography in predicting the oesophageal varices. Aim and objectives: To detect non-invasive indicators of oesophageal varices in chronic liver disease, to determine the relation between oesophageal varices on upper gastrointestinal endoscopy and portal vein diameter, to determine other non-invasive parameters to identify oesophageal varices. Materials and methods: A cross sectional study on 45 patients, who were diagnosed to have chronic liver disease and are being presented to outpatient department and were admitted in Malla Reddy Institute of Medical Sciences, Suraram over a period of one year under department of general medicine. All the patients with chronic liver disease who underwent upper gastrointestinal endoscopy are included in the study. Results: 45 patients with cirrhosis of liver were included in the study, among which 32 were males and 13 were females with a mean age group of 46 years. On upper gastrointestinal endoscopy 87% of patients had oesophageal varices while other 13% of patients were normal. Mean portal vein diameterwas 13.8 mm and has a positive linear correlation with p<0.01 and positive predictive value of 95.25%. Majority of patients belonged to the platelet count group of 50,000 to 1lakh and its inversely co related to the severity of varices. Majority of patients with oesophageal varices had moderate splenomegaly. Conclusion: Ultrasonography of portal vein diameter and spleen size along with thrombocytopenia are reliable, inexpensive and easily reproducible non-invasive tool in predicting the presence of oesophageal varices and hence can identify the patients who require endoscopy on a prophylactic basis.
ABSTRACT
The main objective of the present study was to prepare and evaluate the colon-specific pectin alginate microspheres of 5-fluorouracil (5-FU) for the treatment of colon cancer. Calcium alginate beads were prepared by extruding 5-FU loaded alginate solution to calcium chloride solution and gelled spheres were formed instantaneously by ionotropic gelation reaction using different ratios of 5- FU and alginate, alginate and calcium chloride, stirring speeds (500-1500 rpm) and reaction time. The core beads were coated with ethyl cellulose to prevent drug release in the stomach and provide controlled dissolution of enteric coat in the small intestine and maximum drug release in the colon. Morphology and surface characteristics of the formulation were determined by scanning electron microscopy. In vitro drug release studies were performed in conditions simulating stomach to colon transit in the presence and absence of pectinase enzyme. No significant release was observed at acidic pH, however, when it reached the intestinal pH where ethyl cellulose starts to dissolve, drug release was observed. Also, release of drug was found to be higher in presence of pectinase enzyme. The DSC and FT-IR studies were also indicates there were no interactions between the drug and the polymers used.