Alcoholic Liver Diseases: General Diagnostic Approach

Introduction: Alcohol is consumed all over the world. Itis toxic to liver. It causes different liver problems, like fattyliver, alcoholic hepatitis and cirrhosis. The disorders causedby alcohol use are main causes of mortality and morbidity.Excessive consumption of alcohol is one of the top 5 riskfactors for death and disability globally. The present studywas conducted to diagnose alcoholic liver diseases so thatby proper approach patient can be brought to normal life.Material and methods: This prospective observational studycomprising of 50 patients was conducted at SHKM Govt.Medical College, Nalhar, Haryana from April 2018 to March2019. The detail history, Audit scoring, physical examinations,lab investigations and ultrasound studies were done. Properethical norms were maintained and statistical analysis wascarried out.Results: Out of total of 50 patients, 12% patients wereasymptomatic, 68% patients had fatty liver on the basis ofultrasonography and AST and ALT levels. 12% patients hadalcoholic hepatitis and 8% patients had cirrhosis. AST andALT were raised in most patients. AUDIT score was morethan 8 in all patients of alcoholic hepatitis and cirrhosis.Discussion: Alcoholic liver disease affects only smallpercentage of regular drinkers. Since alcoholic liver diseasein most of the patients is potentially reversible, hence afterproper diagnosis and with a sober approach, regular efforts,psychological counselling and use of pharmacological agentswe can treat the patients of alcoholic liver disease and bringthem to the normal life, which is the aim of this study.

A Cross-Sectional Study of Premenstrual Dysphoric Disorder (PMDD) in Nursing Staff of Tertiary Care Center in One of the Aspirational District of North India and its Relationship with Quality of Life and Self-Esteem

Introduction: Menstruation is a physiological process. Premenstrual dysphoric disorder (PMDD) is a hormone-based mooddisorder causing a severe and debilitating form of premenstrual syndrome. The diagnosis of PMDD is considered as per theDiagnostic and Statistical Manual of Mental Disorder – fourth edition (DSM-IV).Aims and Objectives: The aim of the study was to study premenopausal dysphoric disorder in nursing staff of tertiary carecenter in one of the aspirational district of North India and its relationship with quality of life (QOL) and self-esteem.Materials and Methods: A cross-sectional study was done among 150 female nursing staff (of menstrual age) working inthe medical college and hospital. Premenstrual symptoms screening tool, Rosenberg self-esteem scale, the women’s QOLquestionnaire were used. A proper performance was given to each subject. The questioner was based on DSM-IV criteria. Thesubject had to answer “yes” or “no.” The subjects were classified according to the presence of symptoms. The presence orabsence of depressive symptoms was assessed using Hamilton Depression Rating Scale.Results: As per DSM-IV criteria for the diagnosis of PMDD, in our study out of a total of 150 subjects, 13 suffered from PMDD.Our prevalence rate came out to be 8.67%.Conclusion: The study of PMDD is highly useful because it makes us realize that the suffering of women having PMDD isgenuine and we cannot ignore these symptoms. We have to be very considerate to them, and all modalities of treatment shouldbe given to relieve the women of their sufferings and to reduce the physical and psychological distress. The need of the houris that both gynecologist and psychiatrist work in cooperation to reduce the problems caused by PMDD.

Study of Medicolegal Aspects of Unknown Cases in P.M.C.H., Patna

Introduction: When people die and their bodies are found withno identifying documentation, it is very difficult for the police toestablish their identities. These bodies are labelled as‘unknown/unidentified dead bodies’ (UIDB). The body ispreserved in the mortuary for 72 hours, from the time it isreceived in the mortuary. If no one claims the body after 72hours the police are legally authorized to dispose of the body.The aim of study is to find incidence of unnatural deaths inrelation to the age, sex, pattern of injuries and other parameterof the unknown victims and to ascertain the root cause of alltypes of deaths.Materials and Methods: This prospective study wasconducted in the Department of Forensic Medicine andToxicology, Patna Medical College, Patna, Bihar, Indiabetween August 2012 to September 2014. All the medico legalautopsies of unknown/unidentified bodies during this periodwere included in the study. Information regarding unclaimedbodies with regard to age, sex, cause of death and manner ofdeath was sourced from the autopsy reports and the inquestpapers of the investigating officers.Results: Out of total of 5103 autopsies done 401(7.85%) wereunknown/unidentified dead persons. 342 cases (85.28%) wereof male. Incidence of unknown/unidentified death was mainly inmiddle age group (30-50yrs) (42.64%). 225 (56.10%) deathswere due to accident/injury. Major cause of death due toinjuries were polytrauma. Highest cases were seen in winterseason and lowest in Autumn. 279 cases were untreated and122 hospitalized or treated cases in total unknown cases.Conclusion: Most of the literature available were on theindividual body identification or identification of victims of massdisasters. Unknown bodies comprised 7.85% of the totalautopsy load of the department. The age group 21-40 yearswas responsible for 44.85% of total cases. Accident is animportant cause of morbidity and mortality in the study area.Males are the most affected population; the common agegroup affected is 21–40 years. However, more studies arerecommended to find the actual cause of accidents andprevalence of homelessness and its health-related effects onmorbidity and mortality, which will help in providing health carefacilities to the needy.