Utility of MELD Score as Prognostic Indicator in Patients of Liver Cirrhosis and its Correlation with Child-Pugh Score

Introduction: The model for end-stage liver disease (MELD)score is a useful tool to assess prognosis in critically illcirrhotic patients. Therefore present study’s aim is to evaluateprognostic value of MELD score in patients with cirrhosis andto find out the correlation of MELD score with Child-PughScore.Material and Methods: Present study was carried out ina large public hospital in Mumbai from October 2003 toNovember 2004 on liver cirrhosis patients. Seventy sixpatients of cirrhosis of liver who had attended gastroenterologyoutpatient department of the hospital were included in thestudy. Thirty age and sex matched healthy controls wereincluded in the study. MELD score was calculated at Mayoclinic calculator site.Results: Mean age of cases of cirrhosis was 46.97 + 12.96years with range of 15-74 years. There was no significantdifference in the age or sex distribution of cases in the survivalor expired category (p>0.05). Our study showed significantdifference in mortality between the three Child Pugh grades(p<0.05). Present study showed significant correlationbetween MELD score and Child-Pugh Score. Mean MELDscore was significantly more in expired cases (22.0+7.74)than in survived cases (14.87+6.42) during six monthlyfollow up period (p<0.05).Cases with MELD scores ≥30 hadsignificantly high mortality rate.Conclusion: Therefore MELD score can be used as significantshort term prognostic factor in patients with cirrhosis.

Profile of chronic small-bowel diarrhea in adults in Western India: a hospital-based study.

BACKGROUND: Small-bowel diarrhea is reported to account for 10% of all cases of chronic diarrhea. Data on the etiology and clinical presentation of chronic small-bowel diarrhea in adult Indians is scarce. METHODS: 50 patients (mean age 32.8 years; 26 men) with chronic small bowel diarrhea were evaluated clinically, and investigated to determine etiology. The diagnosis of small-bowel diarrhea was based on history, stool volume and associated symptoms. RESULTS: Abdominal pain (n=22, 44%) and weight loss (n=37, 74%) were the most common symptoms, apart from diarrhea. Anemia (70%) and hypoalbuminemia (48%) were other important biochemical abnormalities. Intestinal tuberculosis (26%) and celiac disease (26%) were the most common causes of chronic small-bowel diarrhea. CONCLUSION: Tuberculosis of intestine and celiac disease are common causes of small-bowel diarrhea in our population. Tropical sprue seems to be a rare cause.

Intestinal amyloidosis presenting as malabsorption syndrome.

Intestinal amyloidosis presenting with small bowel diarrhoea with malabsorption is an infrequent clinical entity. The present case report includes such a case and discusses the diagnostic approach in such a case.

Hepatic granuloma in chronic hepatitis C.

We report the findings in a 54-year-old male with chronic hepatitis C with granulomas liver biopsy. Unfortunately, this patient died before treatment could be started.

Type 1 diabetes mellitus and extrahepatic portal vein obstruction: a causal association?

So far, no association has been described between multifactiorial disorders such as insulin- dependent diabetes mellitus and extrahepatic portal vein obstruction (EHPVO), which is the most common cause of extra-hepatic portal hypertension in children. We describe 3 cases of EHPVO who developed type 1 diabetes mellitus.