RESUMEN
Background: Upper gastrointestinal bleeding (UGIB) is a life-threatening emergency with an overall mortality rate of around 10%. Complete Rockall score is designed to identify patients who are at greater risk of adverse outcome. The aim of this study was to assess the Rockall score as a predictor of adverse outcome in elderly population presenting with UGIB. Methods: Cross-sectional observational study to be carried out in indoor patients presenting with upper GI bleed and to study the correlation between Rockall score and outcome of patients at GSVM Medical College, Kanpur during 2020-2022. Results: Patients were grouped according to Rockall score with number of patients having score less than 3-13, 3-6-63, more than 6-18. Out of 120 cases, 56 (46.66%) had re-bleeding during hospital stay has an average score of 5.05 and rest 64 (53.33%) did not had re-bleeding and has a score of 4.11. Number of cases requiring having average score <3 has 8.1, score 3-6 has 8.38 and >6 has 9.67 has average hospital of stay (days). Number of cases requiring intensive care were 27 (22.5%) has 5.19 average Rockall score. Out of 120 studied cases, 101 (84.16%) were discharged has 4.29 and 19 (15.83%) were expired has 5.95 average Rockall score. Conclusions: Acute UGIB is a medical emergency and Rockall score is ideal to stratify elderly patients to anticipate outcome and prognosis.
RESUMEN
Background: Skeletal manifestation in liver diseases represents the minimally scrutinized part of the disease spectrum. Vitamin D has a central role in developing hepatic deficiency of osteodystrophy in patients with chronic liver disease. This study aimed to investigate vitamin D levels and their and their relationship with disease advancement in these patients according to child Pugh-score. Aims and Objectives were study of vitamin D level in patients with different aetiology of chronic liver disease and its correlation with child Pugh score. Methods: This was a cross sectional study conducted over 200 patients after applying inclusion and exclusion criteria in patients with different etiology of chronic liver disease. Results: In our study total (N=200), 152 patients of alcoholic liver disease 41 patients having deficient vitamin D, 79 having insufficient vitamin D level and 32 patients having normal vitamin D level. Patients of chronic liver disease also have negative correlation on vitamin D level with Child Pugh score. In our study it was found that patients having higher Child Pugh score there is more chance of having vitamin D deficiency and insufficiency than the patient’s low Child Pugh score. Conclusions: The prevalence of vitamin d deficiency in patients with CLD was found to be having a significant correlation with increasing CTP score with p value <0.001.
RESUMEN
Background: Upper gastrointestinal bleeding (UGIB) is a life-threatening emergency with an overall mortality rate of around 10%. Complete Rockall score is designed to identify patients who are at greater risk of adverse outcome. The aim of this study was to assess the Rockall score as a predictor of adverse outcome in elderly population presenting with UGIB. Methods: Cross-sectional observational study to be carried out in indoor patients presenting with upper GI bleed and to study the correlation between Rockall score and outcome of patients at GSVM Medical College, Kanpur during 2020-2022. Results: Patients were grouped according to Rockall score with number of patients having score less than 3-13, 3-6-63, more than 6-18. Out of 120 cases, 56 (46.66%) had re-bleeding during hospital stay has an average score of 5.05 and rest 64 (53.33%) did not had re-bleeding and has a score of 4.11. Number of cases requiring having average score <3 has 8.1, score 3-6 has 8.38 and >6 has 9.67 has average hospital of stay (days). Number of cases requiring intensive care were 27 (22.5%) has 5.19 average Rockall score. Out of 120 studied cases, 101 (84.16%) were discharged has 4.29 and 19 (15.83%) were expired has 5.95 average Rockall score. Conclusions: Acute UGIB is a medical emergency and Rockall score is ideal to stratify elderly patients to anticipate outcome and prognosis.
RESUMEN
Background: Skeletal manifestation in liver diseases represents the minimally scrutinized part of the disease spectrum. Vitamin D has a central role in developing hepatic deficiency of osteodystrophy in patients with chronic liver disease. This study aimed to investigate vitamin D levels and their and their relationship with disease advancement in these patients according to child Pugh-score. Aims and Objectives were study of vitamin D level in patients with different aetiology of chronic liver disease and its correlation with child Pugh score. Methods: This was a cross sectional study conducted over 200 patients after applying inclusion and exclusion criteria in patients with different etiology of chronic liver disease. Results: In our study total (N=200), 152 patients of alcoholic liver disease 41 patients having deficient vitamin D, 79 having insufficient vitamin D level and 32 patients having normal vitamin D level. Patients of chronic liver disease also have negative correlation on vitamin D level with Child Pugh score. In our study it was found that patients having higher Child Pugh score there is more chance of having vitamin D deficiency and insufficiency than the patient’s low Child Pugh score. Conclusions: The prevalence of vitamin d deficiency in patients with CLD was found to be having a significant correlation with increasing CTP score with p value <0.001.
RESUMEN
Background: Liver Cirrhosis is the end-stage for chronic liver disease. Repeated course of endoscopy is recommended, as this intervention is expensive and often poorly accepted by patients, there is a need for non-invasive methods to predicts the progression of portal hypertension as well as the presence and size of esophageal varices. This study was aimed to assess the APRI and Transient Elastography for predicting esophageal variceal bleed in cirrhotic patients. Objectives of the study were to study Diagnostic accuracy of APRI for Prediction of esophageal variceal bleed in liver cirrhosis, diagnostic accuracy of Transient Elastography for Prediction of esophageal variceal bleed in liver cirrhosis, comparison of diagnostic accuracy of APRI and Transient Elastography for Prediction of esophageal variceal bleed in liver cirrhosis. Methods: It was a Single centre, observational study in 35 patients of chronic liver disease. Patients were included in the study after fulfilling inclusion and exclusion criteria. CBC, LFT, KFT, SE, viral marker, USG whole abdomen, UGIE, Transient Elastography was done. APRI was calculated for every patient. Results: The APRI and Transient Elastography showed moderate diagnostic accuracy in predicting the presence of esophageal variceal bleed. Transient Elastography performed better for prediction of esophageal variceal bleed. Conclusions: The APRI and Transient Elastography showed moderate diagnostic accuracy in predicting the presence of esophageal variceal bleed. They help in starting prophylactic therapy earlier to prevent the bleeding and other complications of varices. These non-invasive parameters can also play an effective role in conjunction with endoscopy in predicting the presence of esophageal varices.
RESUMEN
Background: Cardiovascular diseases are the most important causes of morbidity and mortality in CKD mainly due to accelerated atherosclerosis. Mg2+ possesses an anti-atherosclerotic effect, because of its anti-inflammatory and antioxidant properties. Mg2+ deficiency promotes hydroxyapatite formation and calcification of VSMC thus leading to accelerated plaque formation. To evaluate relationship between serum Mg2+ level and atherosclerotic changes in CKD patients who are hemodialysis dependent versus who have not undergone hemodialysis. Methods: This hospital based observational cross-sectional study has been carried out in Department of K.P.S Institute of Medicine, GSVM Medical College, Kanpur.58 subjects (29 being dialysis dependent and other 29 who have not undergone dialysis sessions yet. All the subjects underwent routine tests and intima media thickness (IMT) of carotid artery was measured via Doppler study. Results: In our study the mean value of Mg was 2.25 mg/dl + 0.81 with 17 patients had hypomagnesemia. IMT of carotid artery with a mean value of 0.91mm + 0.24, was found to be increased in 16 patients, these were the patients who were on hemodialysis and had lower magnesium levels. Serum Mg2+ was negatively correlated (Pearson correlation coefficient was -0.677 and -0.704) with CIMT with statistical significance as (P<0.001) , only in patients who have underwent series of hemodialysis sessions. Conclusions: We concluded that serum Mg might be considered as a modifiable risk factor of atherosclerosis (and thus, cardiovascular mortality) in Hemodialysis dependent CKD patients.
RESUMEN
Background: Patients with type 2 diabetes mellitus are more prone to thyroid disorders. Hypothyroidism in them leads to an aggravation of microvascular complications. Screening for thyroid dysfunction in diabetic patients will allow early treatment of hypothyroidism. The aim of this study was to assess the prevalence of hypothyroidism in patients with type 2 diabetes mellitus and its correlation with age, HbA1c, BMI and duration of diabetes. Methods: This was a cross sectional study that was conducted at department of medicine GSVM medical college, Kanpur. 200 female patients with type 2 diabetes mellitus attending the outpatient department without any prior history of thyroid disease, chronic liver disease or acute illness were recruited for the study. Results: Our study describes 14% prevalence of hypothyroidism (subclinical hypothyroidism 13.5%) among 200 diabetic subjects. Hypothyroidism was more common in older age group maximum seen in age group 70-79 years (66.7%). Hypothyroidism was more common in subjects having diabetes for a longer duration; maximum seen in 25-30 years group (40%). No correlation was found between BMI and hypothyroidism. Conclusions: The prevalence of hypothyroidism was 14% among female patients with type 2 diabetes mellitus in this study. Overt hypothyroidism was 0.5 % and subclinical hypothyroidism was more common (13.5%) among the study subjects. Hypothyroidism was more common in older age group. and in subjects having diabetes for longer duration. No corelation was found between prevalence of hypothyroidism and body mass index (BMI).
RESUMEN
Background: Liver Cirrhosis is the end-stage for chronic liver disease. Repeated course of endoscopy is recommended, as this intervention is expensive and often poorly accepted by patients, there is a need for non-invasive methods to predicts the progression of portal hypertension as well as the presence and size of esophageal varices. This study was aimed to assess the APRI and Transient Elastography for predicting esophageal variceal bleed in cirrhotic patients. Objectives of the study were to study Diagnostic accuracy of APRI for Prediction of esophageal variceal bleed in liver cirrhosis, diagnostic accuracy of Transient Elastography for Prediction of esophageal variceal bleed in liver cirrhosis, comparison of diagnostic accuracy of APRI and Transient Elastography for Prediction of esophageal variceal bleed in liver cirrhosis. Methods: It was a Single centre, observational study in 35 patients of chronic liver disease. Patients were included in the study after fulfilling inclusion and exclusion criteria. CBC, LFT, KFT, SE, viral marker, USG whole abdomen, UGIE, Transient Elastography was done. APRI was calculated for every patient. Results: The APRI and Transient Elastography showed moderate diagnostic accuracy in predicting the presence of esophageal variceal bleed. Transient Elastography performed better for prediction of esophageal variceal bleed. Conclusions: The APRI and Transient Elastography showed moderate diagnostic accuracy in predicting the presence of esophageal variceal bleed. They help in starting prophylactic therapy earlier to prevent the bleeding and other complications of varices. These non-invasive parameters can also play an effective role in conjunction with endoscopy in predicting the presence of esophageal varices.
RESUMEN
Background: Cardiovascular diseases are the most important causes of morbidity and mortality in CKD mainly due to accelerated atherosclerosis. Mg2+ possesses an anti-atherosclerotic effect, because of its anti-inflammatory and antioxidant properties. Mg2+ deficiency promotes hydroxyapatite formation and calcification of VSMC thus leading to accelerated plaque formation. To evaluate relationship between serum Mg2+ level and atherosclerotic changes in CKD patients who are hemodialysis dependent versus who have not undergone hemodialysis. Methods: This hospital based observational cross-sectional study has been carried out in Department of K.P.S Institute of Medicine, GSVM Medical College, Kanpur.58 subjects (29 being dialysis dependent and other 29 who have not undergone dialysis sessions yet. All the subjects underwent routine tests and intima media thickness (IMT) of carotid artery was measured via Doppler study. Results: In our study the mean value of Mg was 2.25 mg/dl + 0.81 with 17 patients had hypomagnesemia. IMT of carotid artery with a mean value of 0.91mm + 0.24, was found to be increased in 16 patients, these were the patients who were on hemodialysis and had lower magnesium levels. Serum Mg2+ was negatively correlated (Pearson correlation coefficient was -0.677 and -0.704) with CIMT with statistical significance as (P<0.001) , only in patients who have underwent series of hemodialysis sessions. Conclusions: We concluded that serum Mg might be considered as a modifiable risk factor of atherosclerosis (and thus, cardiovascular mortality) in Hemodialysis dependent CKD patients.
RESUMEN
Background: Patients with type 2 diabetes mellitus are more prone to thyroid disorders. Hypothyroidism in them leads to an aggravation of microvascular complications. Screening for thyroid dysfunction in diabetic patients will allow early treatment of hypothyroidism. The aim of this study was to assess the prevalence of hypothyroidism in patients with type 2 diabetes mellitus and its correlation with age, HbA1c, BMI and duration of diabetes. Methods: This was a cross sectional study that was conducted at department of medicine GSVM medical college, Kanpur. 200 female patients with type 2 diabetes mellitus attending the outpatient department without any prior history of thyroid disease, chronic liver disease or acute illness were recruited for the study. Results: Our study describes 14% prevalence of hypothyroidism (subclinical hypothyroidism 13.5%) among 200 diabetic subjects. Hypothyroidism was more common in older age group maximum seen in age group 70-79 years (66.7%). Hypothyroidism was more common in subjects having diabetes for a longer duration; maximum seen in 25-30 years group (40%). No correlation was found between BMI and hypothyroidism. Conclusions: The prevalence of hypothyroidism was 14% among female patients with type 2 diabetes mellitus in this study. Overt hypothyroidism was 0.5 % and subclinical hypothyroidism was more common (13.5%) among the study subjects. Hypothyroidism was more common in older age group. and in subjects having diabetes for longer duration. No corelation was found between prevalence of hypothyroidism and body mass index (BMI).
RESUMEN
Background: Chronic liver disease (CLD) is a continuous process of inflammation, destruction, and regeneration of liver parenchyma, which leads to fibrosis and cirrhosis. Liver plays an essential physiological role in thyroid hormone activation and inactivation, transport, and metabolism, as well as the synthesis of thyroid binding globulin. A complex relationship exists between thyroid and liver in health and disease. Methods: 103 patients of CLD were included in this study from December 2020 to September 2022. They were classified as per child Pugh scoring after clinical assessment and investigations. Thyroid function profile was measured for all the patients. Results: Among 103 patients, 8 (7.76%) patients were having overt hypothyroidism and 28 (27.18%) patients had subclinical hypothyroidism, while 67 (65.04%) patients had normal thyroid profile levels. There was significant correlation between CTP class and hypothyroidism status of patient (p value <0.001) with 25 (56.81%) patients of CTP class C having subclinical hypothyroidism, while 3 (7.5%) patients of CTP class B had subclinical hypothyroidism and none patient of CTP class A had subclinical hypothyroidism. Conclusions: Our study found that there was increased prevalence of subclinical hypothyroidism in CLD patients which increased with severity of CLD as assessed with CTP class.
RESUMEN
Background: Breast cancer is the most common and remains a major health problem all over the world, affecting both developing and developed countries. The strategy to detect early breast cancer is important which includes breast self-examination (BSE), clinical breast examination, and mammography. The studies have found that women who reported that they had been BSE performers had their breast cancer detected at a smaller size and earlier clinicopathological stage. There is a paucity of data on the knowledge and practice of BSE in Nepal among the female population of eastern Nepal. Therefore, this study is conducted to know the knowledge and practice of BSE among the female population attending the general outpatient department. Methods: A cross-sectional study was conducted over one and half years among 262 females attending general outpatients, using a semi-structured questionnaire. Results: The majority of the participants (29.4%) were in 3rd decade of life followed by 2nd decade (26%). Forty-one (41%) of the respondents had ever heard of BSE and the main source of information was social media (51%). Only 14.5% had adequate knowledge of BSE. Out of all, only 10.7 % were practicing BSE and the frequency of practice among them was rarely (53.5%). Seventy-two (72%) responded that they don’t know how to perform when asked why they did not perform BSE. Conclusions: This study revealed that most of the participants had low knowledge and practice of BSE. Therefore, developing a health education program to raise awareness about BSE is important.
RESUMEN
Background and Objectives: The South East Asian Region has one of the highest incidences of gender based violence in the world which deprives women from the use of their right and liberty. This study was under taken to explore the causes and consequences of domestic violence against women in Meghanath Gorhanna VDC in Mahottari district of Nepal.Material and Methods: : An explorative quantitative and qualitative research design based study was conducted from September to December 2014 in married female of ward, No. 1, 2 and 4 of Meghanath Gorhanna VDC which is located in Mahottari district of Nepal suffering from domestic violence. Sample size consisted of 20 in each ward and sum of total was 60. In-depth interviews, focused group discussion and observation were tools used for data collection.Results: The result of this study reveals that 40% of victims were between age group 20 to 29 years. Domestic violence was higher among illiterate 20(33%). 12(20%) of the women were victimized due to alcoholism of their husband followed by male honor and patriarchal social values. Similarly, majority of the respondents 47(78.3%) suffered from psychological abuse followed by physical assault. 20(33.3%) women were suffered from physical violence. 10% women were suffered from sexual abuse and harassment. The findings also suggest 23(35%) had mental health problem and 14(23 %) women were suffered from reproductive health problem.Conclusion: The study highlights that various factors such as excessive intake of alcohol, patriarchal system of the society, polygamy, sexual dissatisfaction and dowry contributes for the domestic violence in women. The adverse effects of the violence on women are physical health problem, mental health problem, reproductive health problem, chronic conditions and negative health behavior.
RESUMEN
Fatty acid profiles of strains grown under standardized conditions have been used for identification and classification of many bacteria. In this present study, fatty acid analysis of five rhizobial isolates of leguminous tree Pithecellobium dulce at five different localities were carried by gas chromotagraphy, in which totally fifteen fatty acids were identified. But all the fatty acids were not observed in a single isolate though they are isolated from a single species.