Study of Plasma Glucose and HbA1c in Patients with Chronic Liver Disease

Background: Chronic liver disease (CLD) is a major cause of morbidity. In CLD high plasma glucose and HbA1c level are independently associated with severe disease and poor prognosis. The Child Pugh scoring is still the corner stone in prognostic evaluation of CLD patients. Aims & Objectives: The aim of this study was to evaluate plasma glucose (FBS, PPBS) & glycosylated haemoglobin (HbA1c) in patients with CLD and calculate the Child-Pugh score for each patient and correlate with each other. Methods: It was a cross sectional,observational hospital based study consisted of 100 patients with CLD whose FBS,PPBS and HbA1C were measured & it was correlated with Child-Pugh score. Results: There was significant association between impaired FBS & impaired OGTT &PPBS with the severity of CLD (p - 0.0487& 0.0476). However HbA1c & its correlation with Child Pugh score showed no significance (p- 0.142) but incidence of death with raised plasma glucose & with raised HbA1c were significant ( p - 0.043 & 0.042). Conclusion: Incidence of impaired FBS, OGTT & PPBS were more in-patient with CLD, which may be considered as prognostic marker for the severity of CLD. Impaired blood gucose may also adversely affect outcome of CLD& therefore, blood glucose should be determined in every CLD patients. Early detection & management can improve the overall outcome of CLD patients.

Assessment of Left Ventricular Diastolic Function Morbidity in Chronic Obstructive Lung Disease in Population of West Bengal.

Introduction: Right ventricular dysfunction is a well known complication or association of Chronic obstructive pulmonary disease (COPD). Only recently the association of Left ventricular dysfunction with COPD has gained importance. Whether this is an independent co-morbidity or a consequence of the COPD is yet to be clearly ascertained but more and more studies are showing Left ventricular dysfunction to be present in patients with COPD. Materials and Methods: We conducted a pilot study in our institutes with 50 patients in our institution. This was an observational Cross sectional study where patients were diagnosed and classified according to GOLD criteria. Results: We found Left Ventricle (LV) dysfunction in about 84% of these patients. Systolic and diastolic dysfunctions were present in 2% cases. Patient’s presenting age, duration and stage of the disease has significant positive correlation with left ventricular diastolic dysfunction. Conclusion: Treatment of this Left ventricular dysfunction was absolutely necessary in the holistic treatment of the patient as left ventricular dysfunction has an independent detrimental effect in COPD patients. As such, we recommend that all COPD patients should have an Echocardiography on first presentation.