ABSTRACT
BACKGROUND: Ulcerative colitis (UC) is characterized by chronic relapsing-remitting inï¬ammation of the gastrointestinal tract. The chronic inï¬ammatory process may predispose to atherosclerosis. The aim of the study was to assess the carotid intima-media thickness (CIMT) and its relation to subclinical atherosclerosis and to follow up cardiovascular complications in patients with UC. METHODS: 83 patients with proven UC in remission were enrolled in the study. 42 age- and sex-matched healthy controls were taken. Patients with known risk factors for atherosclerosis were excluded from the study. Baseline blood investigations along with C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and fasting lipid profile were done. CIMT was measured using B-mode Doppler imaging study. RESULTS: The mean age of the UC patients was 37.06 ± 14.87 years. Left-sided colitis (45.8%) was the commonest type of presentation according to the extent of the disease. Mean CIMT (0.55 ± 0.17) was significantly higher in UC patients when compared to mean CIMT (0.46 ± 0.13) in the control group (p = 0.002). In Pearson correlation analysis, age, ESR, and CRP were positive and significantly correlated with CIMT. Multiple linear regression analysis (R2 = 0.18, p = 0.0026) revealed that age and CRP were significant independent predictors of mean CIMT. On following up for 6 months, 4 patients with UC had complications in the form of venous thrombosis. CONCLUSION: CIMT is a simple, noninvasive, reliable and objective auxiliary vascular parameter of structural alteration in UC patients.
ABSTRACT
BACKGROUND: The aim of the study was to determine the utility of handgrip dynamometry (HGD) in predicting short term mortality and complications in alcoholic liver disease. METHODS: Patients with alcoholic liver disease were included and nutritional assessment was done using the Subjective Global Assessment (SGA), HGD and other conventional parameters. Mortality rates and complications were compared to nutritional status. RESULTS: 80 patients were included in the study. Mean age of patients was 43.06±10.03 years. 69 patients survived and 11 patients died within the 3 month study duration. Handgrip strength (HGS) was higher in SGA A (28.76±5.48 kg) than SGA B (22.43±4.95 kg) and SGA C (16.78±3.83 kg) (P=<0.001). Number of complications including spontaneous bacterial Peritonitis, gastrointestinal bleeding and encephalopathy in SGA C group were 66.66%, in SGA B 20.75% and SGA A 10%. Mean HGS was significantly higher in the survivors (24.23±5.86) compared to non-survivors (18.04±4.82) (P=0.0011). There was a strong negative correlation between the HGS and Child-Pugh score (P=<0.0012). Multivariate logistic regression analysis to assess the risk factors for death showed handgrip to be in the suggestive significance range (P=0.072). The sensitivity of HGS was 88.41% in predicting short term mortality. CONCLUSIONS: HGS correlates with Child-Pugh score in predicting short term mortality. HGD is a simple, inexpensive and sensitive tool for assessing the nutritional status in alcoholic liver disease and can reliably predict its complications and survival.
