Evaluation of Platelet Count as a Predictor of Severe Pancreatitis

Introduction: Acute pancreatitis is a life threateninginflammatory disease with high morbidity and mortality.Multiple markers are used to predict severity of pancreatitis.An effective marker would help greatly in early diagnosis ofdisease severity and thus help in timely treatment.The presentstudy attempted to evaluate blood platelet levels as a markerfor assessing the severity of acute pancreatitis.Material and methods:37 patients with acute pancreatitisadmitted in Department of Surgery IGMC Shimla wereincluded in the study after taking informed consent. Patientswere evaluated and diagnosed with acute pancreatits usingblood investigation (serum amylase) as well as imagingmodalilities(ultrasound and contrast enhanced CT scan).Patients blood platelets level were compared on day 1 and day5 of admission in mild and severe pancreatitis patients.Resultswere then analysed statistically.Results: On statistical analysis a platelet count of ≤ 150 m/mm3 was found to be statistically significant on both day 1(p=0.008)) and day 5 (p=0.001) of admission between patientswith mild and severe pancreatitis.Conclusion: Platelets level can function as a cost effectivegood prognostic marker for assessing severity of pancreatitis

Association Between Nutrition Status and Cognitive Impairment Among COPD Patients and age Matched Healthy Controls

Background:Nutritional abnormalities & Cognitive decline are frequent systemic manifestations associated with COPD. The study aimed to investigate and compare the cognitive & nutritive parameters in COPD with age matched healthy controls, and to find association between cognitive impairment & nutrition parameters. Methods: 100 subjects were recruited, and divided into two groups. Group I consisted of fifty consecutive physician diagnosed COPD patients & Group II included fifty healthy volunteers respectively. The spirometric parameters recorded were FEV1 (Liters), FVC (liters), FEV1/FVC ratio(% predicted),FEF 25%75%(liters/sec). Anthropometric measurements included Body Weight, Height and BMI measurements. Nutritional status was assessed using mini nutritional questionnaire (MNA). Body composition was assessed by four-frequency bioelectric impedance analysis (BODY STAT, QUADSCAN, USA). The following parameters were calculated: FFM, FFMI & FMI. The exercise capacity was assessed by the six minute walking distance test (6MWD). MMSE (mini mental state examination) and MOCA (montreal cognitive assessment) were used for cognitive function. All the recordings were compared within and between groups and correlation was also computed between MMSE, MOCA and MNA score. Results were analyzed using SPSS,version 16 & Pearson correlation coefficient. Results: We found out that COPD patients showed decline in all the parameters as compared to healthy controls. And, great strength of association was found between MNA & MOCA in COPD patients. Conclusion: Thus our study indicates that COPD patients have age independent loss of muscle mass as well as cognition, and loss of cognition is associated with decline in nutritional parameters or vice versa.

Six-minute walk work in patients with chronic obstructive pulmonary disease.

Background: Six Minute Walk Test (6MWT) has demonstrated good reliability and validity as an assessment for exercise tolerance for moderate to severe COPD. 6MWD is a known to be a preferred outcome for this test; however, it does not account for differences in body weight that are known to influence exercise capacity. Aim of current study was to correlate of distance product (6MWWORK) with various variables in study group of patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: Sixty patients of diagnosed COPD underwent pulmonary function test and 6MWT. Correlation coefficients were calculated for the 6-Min Walk Distance (6MWD) and 6MWORK with variables of pulmonary function and 6MWT. Results: The mean of 6MWD was 312.0 ± 21.2 meters and mean 6MWWORK was 31246 ± 2414 kg.m in the study population. 6MWD significantly correlated with age (r = 0.25), height (r = 0.42), body mass index (r = -0.32) and body weight (r = 0.48). 6MWORK yielded higher correlation coefficients than did 6MWD when correlated with FEV (r = 0.66 vs. 0.35), FEV1/FVC ratio (-0.46 vs. -0.24). The ROC curve demonstrated that 6MWORK had a significantly larger calculated area under the curve (P <0.05) than 6MWD with FEV1. Conclusion: 6MWWORK is an improved outcome of 6MWT to monitor functional capacity in patients of chronic obstructive pulmonary disease.