ABSTRACT
Introduction: Cirrhosis liver, is characterized by diffuse destruction and regeneration of hepatic parenchymal cells leading to deposition of connective tissue with resulting disorganization of the lobular and vascular architecture. Despite the remarkable regenerative capacity of the liver, once hepatic parenchymal reserve is exceeded, clinically overt or decompensated cirrhosis ensues. Portal hypertension develops due to resistance to blood flow through the liver resulting increase in portal venous pressure leading to diversion of blood flow through low resistance portosystemic collaterals thereby bypassing the liver. The current study was designed to precisely evaluate the cardiovascular system in a group of patients with hepatic cirrhosis based on clinical examination. Aim of the study: To clinically evaluate patients with hepatic cirrhosis with respect to changes in heart rate, blood pressure, mean arterial pressure, ECG jugular venous pressure and precordial examination. Materials and Methods: 50 patients of cirrhosis liver were selected for the study. These patients were admitted in the general medical wards. All patients were subjected to routine investigations. All patients were subjected to ultrasound scan abdomen to confirm the diagnosis of cirrhosis. Patients with ascites underwent abdominal paracentesis and fluid was analyzed for protein content and cells. All patients were then subjected to electrocardiography, chest X-ray and M-mode 2-Dimensional echocardiography. Results: Out of the 50 patients studied 35 (70%) were males and 15 (30%) were females. The age of the patients ranged from 19 years to 75 years. 5 Patients (10%) were alcoholics, 14 patients (28%) had past history of jaundice or, 8 patients (16%) presented with haemetemesis. Among this 4 patients were P. Elango, G. Indumathi. Cardiac changes in hepatic cirrhosis in Government Dharmapuri Medical College Hospital, Dharmapuri. IAIM, 2017; 4(9): 19-24. Page 20 HbsAG+ (8%) and 2 patients were diabetics 4%. All patients had sonographic evidence of cirrhosis.with portal hypertension. Out of 50 patients, 3 patients had elevated blood pressure. Previous studies show that the systolic blood pressure more than 160 mmHG and diastolic blood pressure more than 95 mmHg are the range for hypertension in cirrhotic patients. The electro cardiac gram showed an average heart rate of 82/ m. The low QRS voltage in chest leads and limb leads were found in 10 patients. T wave inversion was found in chest leads (V1 to V3 / V6) in 4 (8%) patients, in II, III avf in 7 patients (14%). The chest roentgenogram showed Hepatic Hydrothorax in 5 patients (10%). Cardio megaly was evident in chest X – ray in 11 patients (22%). Conclusion: The result of this study clearly showed that a large number of patients with hepatic cirrhosis are asymptomatic (40%) about cardiovascular system, have evidence of cardiac involvement in electrocardiography and echo cardiograph. cardiac decompensation in cirrhosis is rare despite the high output state and its presence as indicated by left ventricular systolic dysfunction.
ABSTRACT
Introduction: In India, OP compounds cause more self-poisoning deaths in southern and central India. In Northern India, aluminum phosphide causes most deaths with a fatality ratio. Poisoning due to occupational exposure, accounted for about one fifth of the incidents, with a fatality ratio of less than 1%. More than 90% of the non-occupational incidents were suicidal, with a fatality rate more than 10% and the majority of the subjects are young males. Accidental exposures accounted for 8- 10% of the incidents and homicidal use (less than 1%) were other forms of poisoning. The reported overall mortality following OP insecticide poisoning varies from 4-30% in different countries and institutions. Aim: To estimate serum Amylase levels in acute organophosphorus compound poisoning and the find out the clinical outcomes. Materials and methods: The study was conducted in Government Dharmapuri Medical College Hospital, Dharmapuri. Study duration was from January 2017 to June 2017. Of a total of 145 patients with organophosphorus compound poisoning admitted to the hospital during the study period, 40 were included in the study. 10 healthy (age matched) individuals were kept as a control. Biochemical evaluation which includes Serum Amylase Blood glucose, urea, creatinine, and Liver function tests were analyzed and matched among the two groups. Results: The biochemical results have not shown much variation from the normal levels in our study. P. Elango, G. Indumathi. A study of serum amylase levels in acute organophosphorous poisoning at Government Dharmapuri Medical College Hospital, Dharmapuri. IAIM, 2017; 4(9): 6-11. Page 7 In the study, the Amylase levels were significantly elevated at the time of admission (185.2 U/L) and have shown a gradual remission with proper treatment. The mean Amylase level in severely poisoned patients was 297.7 U/L which was significantly (P < 0.01) higher than the healthy control group. On comparing the Amylase levels in first 24 hours against control, the variations were considered to be significant (P < 0.01). Conclusion: From the observation we made, it could be suggested that OP pesticide poisoning is a serious condition that needs rapid diagnosis and treatment. The mean Amylase level in first 24 hours of OP poisoning was 154 U/L which is significantly higher than the control groups.
ABSTRACT
Objective: Five commercial brands were analyzed with respect to their physical characters, chemical content, and drug release. Methods: The brands of metformin were randomly selected. All the groups were coded and analyzed. The tablets were examined for their shape, size, weight, and color and the tablets were tested for their friability, disintegration, drug content, and purity using standard procedures. Results and discussion: On physical inspection, Brand C 500 was is the smallest and Brand D 500 SR was the largest in size. Brand C 500 was lesser in weight while Brand E XR 500 weighed more. On purity test, all other brands passed the standard for purity. All the brands had loss in weight less than 1% after the friability test. On chemical content examination, variation was seen between the batches as well as the brands. The brands such as Brand A XL 500 and Brand D 500 SR contained the required content. But the brands like Brand C 500 and Brand E XR 500 had only lesser content and failed in the validity test. Conclusion: The physical properties of the five brands of metformin tablets were analyzed. Sustained release dosage form was mainly designed for maintaining therapeutic blood or tissue levels of the drug for extended period of time. Apart from the color and shape, the weight and size are very important to improve patients’ compliance. It is the duty of the pharmaceutical company to manufacture proper dosage forms to achieve the therapeutic goal.