ABSTRACT
Background and Objectives: Omicron, a variant of SARS COV2, is looming large as a cause of global concern. Its high transmissibility can pose challenges in healthcare allocation in a highly populous country like India. Studying the behaviour of the virus among the Indian population will definitely help in planning for the impending omicron surge, so we conducted a preliminary analysis of the clinical and epidemiological characteristics of the suspected omicron cases in the early part of the surge. Methodology: The study was conducted in the Rajiv Gandhi Government General Hospital, from 17th December 2021 to 11th January 2022. A total number of 159 consecutive patients ≥18 years of age with the S gene target failure were enrolled and clinically followed up during hospitalisation. Results: Nearly half (n = 79, 49.7%) were aged between 18 and 30 years and the mean (SD) age of the patients was 35.1 (14.9); 52.8% (n = 84) were males and 54.7% (n = 87) were healthcare workers. The NLR ratio and CRP were raised in unvaccinated individuals. Out of 159 patients, only 4 patients required oxygen and all the others showed a mild course of illness and there was no mortality. Conclusion: The clinical course of suspected omicron patients was mild in those who were vaccinated. Unvaccinated individuals with comorbid illness need to be closely monitored for prompt referral for acute care. Further studies are needed in the high-risk group with omicron.
ABSTRACT
INTRODUCTION: Extrahepatic biliary atresia is a progressive disorder characterised by fibroinflammatory obliteration or stenosis of the extrahepatic biliary tree leading to obstruction of bile flow and cholestatic jaundice. It is the most common cause for cholestasis in newborn. Histopathological criteria for diagnosing biliary atresia from liver biopsy have not been clearly defined. AIM: This study was undertaken to analyse the significance of the various histopathological features in diagnosis and prognosis of extrahepatic biliary atresia from liver biopsy specimens. MATERIALS AND METHODS: This was a retrospective study of 43 cases of extra-hepatic biliary atresia diagnosed and treated at a tertiary care hospital between January 2010 to December 2014. Formalin fixed paraffin embedded liver biopsy tissues were processed by standard technique and the slides were stained with haematoxylin and eosin. All the slides were reviewed and graded by a semi-quantitative scoring system. Features such as increased age at kasai's portoenterostomy, portal fibrosis, bile duct proliferation, cholestasis, portal inflammation and duct plate malformation were studied. Statistical analysis was worked out using SPSS 17.0 (statistical package for the social science software). Chi-square test was used to find association between various parameters with respect to mortality and Kaplan-Meier estimator was used for survival analysis of the population under study. RESULTS: In this study comprising of 43 cases, only 6 cases (13.95%) were alive at the end of 6 months follow-up. Twenty patients who died and the 17 cases with poor survival had greater degrees of fibrosis, bile duct proliferation and cholestasis. Majority of the cases with duct plate malformation expired inspite of earlier surgical intervention. Thus proving the association of fibrosis, bile duct proliferation, cholestasis and duct plate malformation with the survival and prognosis of biliary atresia cases. Age at surgery did not show any correlation with prognosis as cases operated even at <60 days had poor survival. CONCLUSION: From this study it can be concluded that in extrahepatic biliary atresia patients, presence of duct plate malformation, greater degrees of fibrosis, bile duct proliferation and cholestasis were strongly associated with poor prognosis.