This study investigated hypocalcemia in patients with acute gastroenteritis at Liaquat University Hospital in Hyderabad, Pakistan. The study included 66 patients with acute gastroenteritis and 66 healthy control subjects. The mean serum calcium level was significantly lower in patients with acute gastroenteritis (6.8455 ± 1.8266 mg/dL) compared to the control group (9.2167 ± 0.5534 mg/dL). Hypocalcemia was observed in 62 (94%) of gastroenteritis patients but only 13 (20%) of controls. The results indicate that low serum calcium is common in patients with acute gastroenteritis.
Fluid balance is a determining factor of mortality in patients with sepsis and septic shock. A prospective study of 42 critically ill patients with severe sepsis or septic shock found that those who did not survive (nonsurvivors) had higher accumulated positive fluid balances at 48, 72, and 96 hours compared to survivors. The risk of mortality was significantly higher for patients with over 2.5L of accumulated fluid balance at 72 hours. While initial fluid resuscitation is important, the results suggest that excessive positive fluid balances later in treatment are associated with worse outcomes for patients with severe sepsis or septic shock.
Vitamin D supplementation in type 2 diabetes patients with pulmonary tuberculosis may lead to earlier sputum smear conversion. In a study of 30 patients with both conditions and vitamin D deficiency, those receiving weekly vitamin D and daily calcium (group 1) showed smear conversion after 6 weeks on average, versus 8 weeks for the non-supplemented group. While the difference was not statistically significant, vitamin D appeared to provide a trend toward faster clinical improvement when added to standard antituberculosis treatment. Larger studies are needed to validate if vitamin D deficiency screening and supplementation could benefit similar patients.
This document provides guidelines for the diagnosis, treatment and prevention of Clostridium difficile infections (CDI). It summarizes key recommendations with evidence grading. For diagnosis, it recommends nucleic acid amplification tests over toxin enzyme immunoassays, and only testing diarrheal stool samples. It stratifies treatment based on disease severity into mild-moderate (treat with metronidazole), severe (vancomycin with/without metronidazole), and complicated (vancomycin orally and rectally with intravenous metronidazole). It also covers recurrent CDI treatment, managing CDI in patients with comorbidities, and infection control practices like contact precautions and environmental disinfection. The guidelines
Immunological and clinical assessment of adult hivMonaYuliari
This document summarizes a study of HIV patients in Nigeria who switched from first-line to second-line antiretroviral treatment. The study analyzed data from 4,206 patients treated at a hospital HIV clinic between 2006-2014. It found that after several years on first-line drugs, patients generally had improved CD4 counts and clinical conditions. However, about 25% were lost to follow up, and some showed immunological failure requiring a switch to second-line protease inhibitor-based regimens. Characteristics of patients at initiation, during treatment, and at the switch point were analyzed to evaluate treatment responses and needs for improved retention in care.
Antihyperglycemic effects of short term resveratrol supplementation in type 2...zanet1
1) The study examined the effects of short term resveratrol supplementation in patients with type 2 diabetes who were receiving standard antidiabetic treatment. 66 patients were randomly assigned to receive either 1 g per day of resveratrol or a placebo for 45 days.
2) Resveratrol treatment significantly decreased systolic blood pressure, fasting blood glucose, HbA1c, insulin, and insulin resistance compared to baseline. HDL was also significantly increased.
3) In contrast, the placebo group had slightly increased fasting glucose and LDL compared to baseline. Liver and kidney function markers were unchanged with resveratrol treatment.
DOI: 10.21276/ijlssr.2016.2.3.10
ABSTRACT- Introduction: Paediatric Diabetic Ketoacidosis (DKA) studies are limited in Asia and none have
investigated markers of disease severity or prolonged hospital Length Of Stay (LOS). We investigate predictors of disease
severity and prolonged hospital LOS by analysing the demographics and signs and symptoms of patients with DKA.
Methods: We conducted a retrospective study of the medical records of patients who presented to the emergency
department of a tertiary paediatric hospital in Singapore between 2012 and 2013 and were diagnosed with DKA, obtaining
demographics, signs, symptoms, serum pH levels, precipitating causes, and hospital LOS for the 67 eligible patients.
Results: 82.1% of patients were tachycardic, 44.8% tachypneic and 20.9% febrile; none were hypotensive. The most
common symptoms were nausea and vomiting (56.7%), polyuria and polydipsia (50.7%), lethargy (34.3%), and fever
(22.4%).Half had mild DKA (48.5%) while a quarter of patients each had moderate (24.2%) and severe DKA (27.3%). A
higher proportion of those with severe DKA presented with tachypnea (p=.007). Prolonged LOS patients were younger at
presentation (p = .010), and a higher proportion had no prior history of DM (p=.061), presented with polyuria or
polydipsia (p=.062) and had a lower pH on presentation (p=.056).
Conclusions: Paediatric patients with DKA present with non-specific symptoms. Patients with tachypnea were more
likely to have a worse disease severity. Younger patients, those without a history of DM, or had lower serum pH, and
polyuria and polydipsia were more likely to have a prolonged hospital LOS.
Key-words- Diabetic Ketoacidosis,Child;Emergency Medicine, Length of Stay, Severity of Illness Index
Laproscopic management of huge ovarian cystArsla Memon
This document summarizes a study on the laparoscopic management of huge ovarian cysts. Five patients with ovarian cysts ranging from 18 to 42 cm in diameter were treated laparoscopically. The cysts were drained of 1-12 liters of fluid under laparoscopic guidance before performing laparoscopic oophorectomy or cystectomy. There were no complications and the cysts were found to be benign. The study concludes that with proper patient selection and surgical expertise, it is possible to remove large ovarian cysts laparoscopically.
This study investigated calcium and vitamin D intake in healthy children. 184 children with intake below recommendations were randomly assigned to receive dietary counseling plus calcium/vitamin D supplements (Group 1) or counseling alone (Group 2). After 4 months, Group 1 showed improved intake of both nutrients and optimal vitamin D levels, while Group 2 only improved calcium intake and had lower vitamin D levels. The study concludes that counseling alone is not sufficient to achieve adequate vitamin D intake.
Fluid balance is a determining factor of mortality in patients with sepsis and septic shock. A prospective study of 42 critically ill patients with severe sepsis or septic shock found that those who did not survive (nonsurvivors) had higher accumulated positive fluid balances at 48, 72, and 96 hours compared to survivors. The risk of mortality was significantly higher for patients with over 2.5L of accumulated fluid balance at 72 hours. While initial fluid resuscitation is important, the results suggest that excessive positive fluid balances later in treatment are associated with worse outcomes for patients with severe sepsis or septic shock.
Vitamin D supplementation in type 2 diabetes patients with pulmonary tuberculosis may lead to earlier sputum smear conversion. In a study of 30 patients with both conditions and vitamin D deficiency, those receiving weekly vitamin D and daily calcium (group 1) showed smear conversion after 6 weeks on average, versus 8 weeks for the non-supplemented group. While the difference was not statistically significant, vitamin D appeared to provide a trend toward faster clinical improvement when added to standard antituberculosis treatment. Larger studies are needed to validate if vitamin D deficiency screening and supplementation could benefit similar patients.
This document provides guidelines for the diagnosis, treatment and prevention of Clostridium difficile infections (CDI). It summarizes key recommendations with evidence grading. For diagnosis, it recommends nucleic acid amplification tests over toxin enzyme immunoassays, and only testing diarrheal stool samples. It stratifies treatment based on disease severity into mild-moderate (treat with metronidazole), severe (vancomycin with/without metronidazole), and complicated (vancomycin orally and rectally with intravenous metronidazole). It also covers recurrent CDI treatment, managing CDI in patients with comorbidities, and infection control practices like contact precautions and environmental disinfection. The guidelines
Immunological and clinical assessment of adult hivMonaYuliari
This document summarizes a study of HIV patients in Nigeria who switched from first-line to second-line antiretroviral treatment. The study analyzed data from 4,206 patients treated at a hospital HIV clinic between 2006-2014. It found that after several years on first-line drugs, patients generally had improved CD4 counts and clinical conditions. However, about 25% were lost to follow up, and some showed immunological failure requiring a switch to second-line protease inhibitor-based regimens. Characteristics of patients at initiation, during treatment, and at the switch point were analyzed to evaluate treatment responses and needs for improved retention in care.
Antihyperglycemic effects of short term resveratrol supplementation in type 2...zanet1
1) The study examined the effects of short term resveratrol supplementation in patients with type 2 diabetes who were receiving standard antidiabetic treatment. 66 patients were randomly assigned to receive either 1 g per day of resveratrol or a placebo for 45 days.
2) Resveratrol treatment significantly decreased systolic blood pressure, fasting blood glucose, HbA1c, insulin, and insulin resistance compared to baseline. HDL was also significantly increased.
3) In contrast, the placebo group had slightly increased fasting glucose and LDL compared to baseline. Liver and kidney function markers were unchanged with resveratrol treatment.
DOI: 10.21276/ijlssr.2016.2.3.10
ABSTRACT- Introduction: Paediatric Diabetic Ketoacidosis (DKA) studies are limited in Asia and none have
investigated markers of disease severity or prolonged hospital Length Of Stay (LOS). We investigate predictors of disease
severity and prolonged hospital LOS by analysing the demographics and signs and symptoms of patients with DKA.
Methods: We conducted a retrospective study of the medical records of patients who presented to the emergency
department of a tertiary paediatric hospital in Singapore between 2012 and 2013 and were diagnosed with DKA, obtaining
demographics, signs, symptoms, serum pH levels, precipitating causes, and hospital LOS for the 67 eligible patients.
Results: 82.1% of patients were tachycardic, 44.8% tachypneic and 20.9% febrile; none were hypotensive. The most
common symptoms were nausea and vomiting (56.7%), polyuria and polydipsia (50.7%), lethargy (34.3%), and fever
(22.4%).Half had mild DKA (48.5%) while a quarter of patients each had moderate (24.2%) and severe DKA (27.3%). A
higher proportion of those with severe DKA presented with tachypnea (p=.007). Prolonged LOS patients were younger at
presentation (p = .010), and a higher proportion had no prior history of DM (p=.061), presented with polyuria or
polydipsia (p=.062) and had a lower pH on presentation (p=.056).
Conclusions: Paediatric patients with DKA present with non-specific symptoms. Patients with tachypnea were more
likely to have a worse disease severity. Younger patients, those without a history of DM, or had lower serum pH, and
polyuria and polydipsia were more likely to have a prolonged hospital LOS.
Key-words- Diabetic Ketoacidosis,Child;Emergency Medicine, Length of Stay, Severity of Illness Index
Laproscopic management of huge ovarian cystArsla Memon
This document summarizes a study on the laparoscopic management of huge ovarian cysts. Five patients with ovarian cysts ranging from 18 to 42 cm in diameter were treated laparoscopically. The cysts were drained of 1-12 liters of fluid under laparoscopic guidance before performing laparoscopic oophorectomy or cystectomy. There were no complications and the cysts were found to be benign. The study concludes that with proper patient selection and surgical expertise, it is possible to remove large ovarian cysts laparoscopically.
This study investigated calcium and vitamin D intake in healthy children. 184 children with intake below recommendations were randomly assigned to receive dietary counseling plus calcium/vitamin D supplements (Group 1) or counseling alone (Group 2). After 4 months, Group 1 showed improved intake of both nutrients and optimal vitamin D levels, while Group 2 only improved calcium intake and had lower vitamin D levels. The study concludes that counseling alone is not sufficient to achieve adequate vitamin D intake.
This systematic review and meta-analysis evaluated the efficacy of oral corticosteroids for acute wheezing episodes in asthmatic preschoolers. The analysis included 11 randomized controlled trials involving oral corticosteroid treatment compared to placebo. The results showed no significant differences overall between corticosteroids and placebo for hospital admissions, need for additional corticosteroid treatment, or unscheduled visits. However, corticosteroids may reduce hospital admissions and additional corticosteroid need for more severe cases presenting to the emergency department or requiring hospitalization. The evidence was deemed inadequate to form clinical recommendations due to limitations in the studies.
This document provides guidelines from the European Association for the Study of the Liver (EASL) on nutrition in chronic liver disease. It finds that malnutrition is frequently a problem for patients with liver cirrhosis and is associated with worse outcomes. All patients with advanced chronic liver disease, especially those with decompensated cirrhosis, should undergo nutritional screening. Those at risk of malnutrition based on the screening should receive a detailed nutritional assessment. The guidelines recommend assessing muscle mass, using global assessment tools, and performing a dietary intake evaluation for those found to be malnourished or at risk. They provide recommendations on nutritional management and screening in specific situations like hepatic encephalopathy or before and after liver transplantation.
Prevalence and risk factors of fatty liverfarzaneh N
The study aimed to investigate the prevalence and risk factors of fatty liver disease (FLD) in Chengdu, Southwest China. The researchers found that:
1) The overall prevalence of FLD was 12.5%, with males having a much higher prevalence of 18.9% compared to 5.7% in females.
2) Multiple logistic regression analysis identified 10 factors associated with FLD, including male sex, age, BMI, fasting plasma glucose, hypertension, triglycerides, total cholesterol, HDL-C, LDL-C, and ALT abnormalities.
3) The prevalence of FLD was found to be closely related to sex, age, BMI, and other metabolic syndrome features.
Anaemia in Chronic Renal Failure Patients Undergoing Haemodialysis: A across ...Neeleshkumar Maurya
ABSTRACT Chronic renal failure disease is frequently associated with anaemia and the level of anaemia correlates with the stage of chronic kidney disease (CKD). A cross-sectional study was conducted in 44 chronic kidney disease patients in the department of medicine, M.L.B. Medical College, Jhansi during the period January to June, 2018. The study was evaluating the profile of anaemia and to find the association between the severity of anaemia and ckd-5 patients time period of taking on haemodialysis. Haemoglobin, blood urea, serum albumin, serum creatinine levels were examined using standard techniques. There was a significant difference in the haemoglobin of CKD patients taking 30 days regular interval 3 times values (P <0.05). All 44 patients (100%) were anaemic there was no significant correlation between the severity of anaemia and serum creatinine levels (P > 0.82) the most frequent anaemia in chronic kidney disease patients was a malnourished type of a moderate degree anaemic (7 10mg/dl). A significant correlation was not found between the severity of anomie and serum creatinine levels 30 day interval of CKD of patients on haemodialysis. Keywords: - haemodialysis, anomie, serum creatinine, haemoglobin, malnutrition.
The document provides guidelines for the management of sepsis and septic shock in adults from the Surviving Sepsis Campaign. It recommends that hospitals use a performance improvement program including sepsis screening and standard operating procedures. It recommends against using qSOFA alone as a screening tool due to low sensitivity. It suggests measuring blood lactate in adults suspected of sepsis to help identify those at higher risk of poor outcomes.
Abstract— Non Alcoholic Fatty Liver Disease is also becoming public health impotance nowadays. So this study was aimed to determine the association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. This study includes a total of 222 subjects were enrolled as per the inclusion/exclusion criteria, out of which 110 cases who had NAFLD with hepatic steatosis on ultrasonography and 112 subjects who did not have NAFLD were considered control. These cases and controls were interrogated and investigated further. Observations were recorded and association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. Statistical methods used were unpaired student’s t-test for continuous variables, Fischer’s and chi-sq test for categorical variables using bivariate analysis by Graph Pad Instat Version 3.10. Risk was assessed in terms of Odd's Ratio. The patients with MS and NAFLD had a higher proportion of CVD compared with those who did not have NAFLD (29.1 vs 18.1 %). This study concludes that NAFLD is significantly associated with MS; most significant with WC, followed by TG and FBS and thus can be considered as hepatic component of MS. This needs more research with large multi-centric prospective studies to evaluate NAFLD as an independent risk factor for CVD.
This meta-analysis reviewed 5 randomized controlled trials involving 4,303 patients to determine if early goal-directed therapy (EGDT) according to Surviving Sepsis Campaign guidelines improves mortality outcomes in patients with severe sepsis or septic shock. The studies showed no statistically significant difference in 28-day, 60-day, or 90-day mortality between patients who received EGDT and those who received usual care. Secondary outcomes like hospital length of stay and need for organ support also did not differ significantly between the two groups. While EGDT decreased mortality, the effect was not statistically significant.
This guideline presents recommendations for the management of acute pancreatitis (AP). Key recommendations include: assessing hemodynamic status upon presentation and providing resuscitation as needed; admitting patients with organ failure to intensive care; providing aggressive intravenous hydration within the first 12-24 hours; using ERCP within 24 hours for patients with AP and cholangitis; not routinely using prophylactic antibiotics for severe AP or sterile necrosis; considering infected necrosis in patients not improving after 7-10 days and using antibiotics known to penetrate pancreatic necrosis; and providing enteral nutrition for severe AP to prevent infectious complications while avoiding parenteral nutrition.
This randomized controlled trial compared the efficacy of pentoxifylline and prednisolone in treating severe alcoholic hepatitis. 68 patients were divided into two groups - one received pentoxifylline and the other received prednisolone for 4 weeks, followed by a tapering dose of prednisolone over 7 weeks. More patients died in the prednisolone group (12 patients) compared to the pentoxifylline group (5 patients) by 3 months. Patients receiving prednisolone also had more life-threatening complications like hepatorenal syndrome and gastrointestinal bleeding. The study suggests pentoxifylline is superior to prednisolone for treating severe alcoholic hepatitis due to its reduced mortality and renopro
Risk factors of chronic liver disease amongst patients receiving care in a Ga...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This guideline discusses the appropriate use of endoscopy in evaluating patients with dyspepsia. It recommends that patients over 50 years old or those with alarm features should undergo endoscopy due to their higher risk of structural diseases like cancer or peptic ulcers. Younger patients without alarm features may initially receive noninvasive testing for H. pylori infection and be treated if positive, or try acid suppression therapy. If these approaches do not resolve symptoms, endoscopy is recommended to check for structural causes. The guideline aims to help clinicians determine which dyspepsia patients most need endoscopy versus other initial treatment strategies.
This study analyzed 107 cases of acute pancreatitis treated at a hospital in Islamabad, Pakistan over one year. Gallstones were found to be the most common cause, accounting for 36.5% of cases. Alcohol was a factor in 11.2% of cases. In 46.7% of cases, no clear cause was identified. Based on the Ranson score, 35.5% of cases were considered severe. The average hospital stay was 8.9 days and mortality rate was 8.4%, with all deaths occurring in severe cases. The authors conclude that while the causes and severity of acute pancreatitis in Pakistan are generally similar to other countries, gallstones are a relatively more common cause than alcohol compared to Western
efficacy and safety of Sulfad tablets in the management of NASH
patients: A randomized ,prospective, open label, multi-center,
controlled, phase III clinical trial.
Goal directed resuscitation for patientsDrJawad Butt
In this randomized controlled trial conducted across 51 centers, 792 patients with early septic shock who were randomized to receive early goal-directed therapy (EGDT) were compared to 796 patients receiving usual care. The primary outcome of all-cause mortality at 90 days was 18.6% in the EGDT group and 18.8% in the usual care group, showing no significant difference between the groups. Secondary and tertiary outcomes also showed no differences. The findings suggest that EGDT does not offer a survival advantage over usual care for patients presenting with early septic shock.
This study analyzed clinical outcomes of treated and untreated patients with hepatitis C virus (HCV) infection in two cohorts. It found that HCV patients who did not respond to interferon-alpha based treatment had a significantly increased risk of developing cirrhosis compared to untreated patients, even after adjusting for factors like fibrosis stage and psychosocial risks. Specifically, treatment nonresponders had a 2.35 times higher hazard of cirrhosis in the Veterans Affairs cohort and a 5.9 times higher hazard in the University Hospital cohort compared to untreated patients. However, the overall survival of nonresponders was not significantly different than untreated patients. This suggests that while interferon-alpha treatment failure may accelerate liver fibrosis, it does not necessarily impact overall
1) The study evaluated a 12-week treatment with daclatasvir, asunaprevir, and beclabuvir with or without ribavirin for patients with hepatitis C virus genotype 1 infection and compensated cirrhosis who were either treatment-naive or treatment-experienced.
2) Sustained virologic response at posttreatment week 12 was achieved by 98% of treatment-naive patients and 93% of treatment-experienced patients when ribavirin was included, and by 93% and 87% respectively when only the fixed-dose combination was used.
3) The treatment was generally well-tolerated though there were 4 treatment discontinuations due to adverse events
This document summarizes a study of 233 cases of abdominal tuberculosis treated at a hospital in Pakistan from 2003-2008. Some key findings include:
- The average age was 28 years and most patients were from poor families.
- The most common presentation was acute abdomen (67%), requiring emergency surgery. Common surgical findings included intestinal strictures (69%).
- Most cases involved the ileocecal region and presented as intestinal obstructions.
- The majority of cases were considered primary abdominal tuberculosis, though some had a history of pulmonary TB.
- Most patients required hospitalization, with an average stay of 19.5 days. The in-hospital mortality rate was 2.1%.
Frequency of prediabetes and influence of various riskSamiullah Shaikh
This study aimed to determine the frequency of prediabetes and observe the influence of various risk factors on the development of prediabetes. The study found that 29.4% of subjects had prediabetes. Several risk factors were strongly correlated with prediabetes, including high BMI, family history of diabetes, history of gestational diabetes, history of delivering a high birth weight baby, low HDL cholesterol, and high triglycerides. The results suggest screening those with risk factors can help identify individuals at high risk of developing diabetes.
This study investigated hypocalcemia in patients with acute gastroenteritis at Liaquat University Hospital in Hyderabad, Pakistan. The study included 66 patients with acute gastroenteritis and 66 healthy control subjects. The mean serum calcium level was significantly lower in patients with acute gastroenteritis (6.8455 ± 1.8266 mg/dL) compared to the control group (9.2167 ± 0.4534 mg/dL). Hypocalcemia was observed in 62 (94%) of gastroenteritis patients but only 13 (20%) of controls. The results demonstrate that low serum calcium is common in patients with acute gastroenteritis.
Hurricane Gustav caused damage across Cuba in late August 2008, destroying homes and infrastructure but causing no reported deaths. In the capital of Isla de la Juventud, a ferry was overturned by Gustav's winds. Residents returned to find flooded homes and washed out roads after Gustav passed through western Cuba. People were seen making repairs to roofs and cleaning up debris left behind by the powerful storm.
Validation of three non invasive markers in assessing the severity of liver f...Samiullah Shaikh
This study aimed to compare three non-invasive markers (APRI, AST/ALT ratio, FIB-4) to liver biopsy for assessing liver fibrosis severity in hepatitis C patients. The study analyzed data from 158 hepatitis C patients who underwent liver biopsy and had their APRI, AST/ALT ratio, and FIB-4 calculated based on routine blood tests. Results found that APRI and FIB-4 were better than AST/ALT ratio at excluding or predicting advanced liver fibrosis, with APRI <1 excluding advanced fibrosis in 70% of patients and FIB-4 <1.45 in 74% of patients. APRI >1 predicted advanced fibrosis in 87% of patients and FIB-4 >1.
This systematic review and meta-analysis evaluated the efficacy of oral corticosteroids for acute wheezing episodes in asthmatic preschoolers. The analysis included 11 randomized controlled trials involving oral corticosteroid treatment compared to placebo. The results showed no significant differences overall between corticosteroids and placebo for hospital admissions, need for additional corticosteroid treatment, or unscheduled visits. However, corticosteroids may reduce hospital admissions and additional corticosteroid need for more severe cases presenting to the emergency department or requiring hospitalization. The evidence was deemed inadequate to form clinical recommendations due to limitations in the studies.
This document provides guidelines from the European Association for the Study of the Liver (EASL) on nutrition in chronic liver disease. It finds that malnutrition is frequently a problem for patients with liver cirrhosis and is associated with worse outcomes. All patients with advanced chronic liver disease, especially those with decompensated cirrhosis, should undergo nutritional screening. Those at risk of malnutrition based on the screening should receive a detailed nutritional assessment. The guidelines recommend assessing muscle mass, using global assessment tools, and performing a dietary intake evaluation for those found to be malnourished or at risk. They provide recommendations on nutritional management and screening in specific situations like hepatic encephalopathy or before and after liver transplantation.
Prevalence and risk factors of fatty liverfarzaneh N
The study aimed to investigate the prevalence and risk factors of fatty liver disease (FLD) in Chengdu, Southwest China. The researchers found that:
1) The overall prevalence of FLD was 12.5%, with males having a much higher prevalence of 18.9% compared to 5.7% in females.
2) Multiple logistic regression analysis identified 10 factors associated with FLD, including male sex, age, BMI, fasting plasma glucose, hypertension, triglycerides, total cholesterol, HDL-C, LDL-C, and ALT abnormalities.
3) The prevalence of FLD was found to be closely related to sex, age, BMI, and other metabolic syndrome features.
Anaemia in Chronic Renal Failure Patients Undergoing Haemodialysis: A across ...Neeleshkumar Maurya
ABSTRACT Chronic renal failure disease is frequently associated with anaemia and the level of anaemia correlates with the stage of chronic kidney disease (CKD). A cross-sectional study was conducted in 44 chronic kidney disease patients in the department of medicine, M.L.B. Medical College, Jhansi during the period January to June, 2018. The study was evaluating the profile of anaemia and to find the association between the severity of anaemia and ckd-5 patients time period of taking on haemodialysis. Haemoglobin, blood urea, serum albumin, serum creatinine levels were examined using standard techniques. There was a significant difference in the haemoglobin of CKD patients taking 30 days regular interval 3 times values (P <0.05). All 44 patients (100%) were anaemic there was no significant correlation between the severity of anaemia and serum creatinine levels (P > 0.82) the most frequent anaemia in chronic kidney disease patients was a malnourished type of a moderate degree anaemic (7 10mg/dl). A significant correlation was not found between the severity of anomie and serum creatinine levels 30 day interval of CKD of patients on haemodialysis. Keywords: - haemodialysis, anomie, serum creatinine, haemoglobin, malnutrition.
The document provides guidelines for the management of sepsis and septic shock in adults from the Surviving Sepsis Campaign. It recommends that hospitals use a performance improvement program including sepsis screening and standard operating procedures. It recommends against using qSOFA alone as a screening tool due to low sensitivity. It suggests measuring blood lactate in adults suspected of sepsis to help identify those at higher risk of poor outcomes.
Abstract— Non Alcoholic Fatty Liver Disease is also becoming public health impotance nowadays. So this study was aimed to determine the association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. This study includes a total of 222 subjects were enrolled as per the inclusion/exclusion criteria, out of which 110 cases who had NAFLD with hepatic steatosis on ultrasonography and 112 subjects who did not have NAFLD were considered control. These cases and controls were interrogated and investigated further. Observations were recorded and association of Non Alcoholic Fatty Liver Disease with metabolic syndrome and Cardio-Vascular disease along with assessment of degree of severity of NAFLD with respect to number of components of metabolic syndrome. Statistical methods used were unpaired student’s t-test for continuous variables, Fischer’s and chi-sq test for categorical variables using bivariate analysis by Graph Pad Instat Version 3.10. Risk was assessed in terms of Odd's Ratio. The patients with MS and NAFLD had a higher proportion of CVD compared with those who did not have NAFLD (29.1 vs 18.1 %). This study concludes that NAFLD is significantly associated with MS; most significant with WC, followed by TG and FBS and thus can be considered as hepatic component of MS. This needs more research with large multi-centric prospective studies to evaluate NAFLD as an independent risk factor for CVD.
This meta-analysis reviewed 5 randomized controlled trials involving 4,303 patients to determine if early goal-directed therapy (EGDT) according to Surviving Sepsis Campaign guidelines improves mortality outcomes in patients with severe sepsis or septic shock. The studies showed no statistically significant difference in 28-day, 60-day, or 90-day mortality between patients who received EGDT and those who received usual care. Secondary outcomes like hospital length of stay and need for organ support also did not differ significantly between the two groups. While EGDT decreased mortality, the effect was not statistically significant.
This guideline presents recommendations for the management of acute pancreatitis (AP). Key recommendations include: assessing hemodynamic status upon presentation and providing resuscitation as needed; admitting patients with organ failure to intensive care; providing aggressive intravenous hydration within the first 12-24 hours; using ERCP within 24 hours for patients with AP and cholangitis; not routinely using prophylactic antibiotics for severe AP or sterile necrosis; considering infected necrosis in patients not improving after 7-10 days and using antibiotics known to penetrate pancreatic necrosis; and providing enteral nutrition for severe AP to prevent infectious complications while avoiding parenteral nutrition.
This randomized controlled trial compared the efficacy of pentoxifylline and prednisolone in treating severe alcoholic hepatitis. 68 patients were divided into two groups - one received pentoxifylline and the other received prednisolone for 4 weeks, followed by a tapering dose of prednisolone over 7 weeks. More patients died in the prednisolone group (12 patients) compared to the pentoxifylline group (5 patients) by 3 months. Patients receiving prednisolone also had more life-threatening complications like hepatorenal syndrome and gastrointestinal bleeding. The study suggests pentoxifylline is superior to prednisolone for treating severe alcoholic hepatitis due to its reduced mortality and renopro
Risk factors of chronic liver disease amongst patients receiving care in a Ga...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This guideline discusses the appropriate use of endoscopy in evaluating patients with dyspepsia. It recommends that patients over 50 years old or those with alarm features should undergo endoscopy due to their higher risk of structural diseases like cancer or peptic ulcers. Younger patients without alarm features may initially receive noninvasive testing for H. pylori infection and be treated if positive, or try acid suppression therapy. If these approaches do not resolve symptoms, endoscopy is recommended to check for structural causes. The guideline aims to help clinicians determine which dyspepsia patients most need endoscopy versus other initial treatment strategies.
This study analyzed 107 cases of acute pancreatitis treated at a hospital in Islamabad, Pakistan over one year. Gallstones were found to be the most common cause, accounting for 36.5% of cases. Alcohol was a factor in 11.2% of cases. In 46.7% of cases, no clear cause was identified. Based on the Ranson score, 35.5% of cases were considered severe. The average hospital stay was 8.9 days and mortality rate was 8.4%, with all deaths occurring in severe cases. The authors conclude that while the causes and severity of acute pancreatitis in Pakistan are generally similar to other countries, gallstones are a relatively more common cause than alcohol compared to Western
efficacy and safety of Sulfad tablets in the management of NASH
patients: A randomized ,prospective, open label, multi-center,
controlled, phase III clinical trial.
Goal directed resuscitation for patientsDrJawad Butt
In this randomized controlled trial conducted across 51 centers, 792 patients with early septic shock who were randomized to receive early goal-directed therapy (EGDT) were compared to 796 patients receiving usual care. The primary outcome of all-cause mortality at 90 days was 18.6% in the EGDT group and 18.8% in the usual care group, showing no significant difference between the groups. Secondary and tertiary outcomes also showed no differences. The findings suggest that EGDT does not offer a survival advantage over usual care for patients presenting with early septic shock.
This study analyzed clinical outcomes of treated and untreated patients with hepatitis C virus (HCV) infection in two cohorts. It found that HCV patients who did not respond to interferon-alpha based treatment had a significantly increased risk of developing cirrhosis compared to untreated patients, even after adjusting for factors like fibrosis stage and psychosocial risks. Specifically, treatment nonresponders had a 2.35 times higher hazard of cirrhosis in the Veterans Affairs cohort and a 5.9 times higher hazard in the University Hospital cohort compared to untreated patients. However, the overall survival of nonresponders was not significantly different than untreated patients. This suggests that while interferon-alpha treatment failure may accelerate liver fibrosis, it does not necessarily impact overall
1) The study evaluated a 12-week treatment with daclatasvir, asunaprevir, and beclabuvir with or without ribavirin for patients with hepatitis C virus genotype 1 infection and compensated cirrhosis who were either treatment-naive or treatment-experienced.
2) Sustained virologic response at posttreatment week 12 was achieved by 98% of treatment-naive patients and 93% of treatment-experienced patients when ribavirin was included, and by 93% and 87% respectively when only the fixed-dose combination was used.
3) The treatment was generally well-tolerated though there were 4 treatment discontinuations due to adverse events
This document summarizes a study of 233 cases of abdominal tuberculosis treated at a hospital in Pakistan from 2003-2008. Some key findings include:
- The average age was 28 years and most patients were from poor families.
- The most common presentation was acute abdomen (67%), requiring emergency surgery. Common surgical findings included intestinal strictures (69%).
- Most cases involved the ileocecal region and presented as intestinal obstructions.
- The majority of cases were considered primary abdominal tuberculosis, though some had a history of pulmonary TB.
- Most patients required hospitalization, with an average stay of 19.5 days. The in-hospital mortality rate was 2.1%.
Frequency of prediabetes and influence of various riskSamiullah Shaikh
This study aimed to determine the frequency of prediabetes and observe the influence of various risk factors on the development of prediabetes. The study found that 29.4% of subjects had prediabetes. Several risk factors were strongly correlated with prediabetes, including high BMI, family history of diabetes, history of gestational diabetes, history of delivering a high birth weight baby, low HDL cholesterol, and high triglycerides. The results suggest screening those with risk factors can help identify individuals at high risk of developing diabetes.
This study investigated hypocalcemia in patients with acute gastroenteritis at Liaquat University Hospital in Hyderabad, Pakistan. The study included 66 patients with acute gastroenteritis and 66 healthy control subjects. The mean serum calcium level was significantly lower in patients with acute gastroenteritis (6.8455 ± 1.8266 mg/dL) compared to the control group (9.2167 ± 0.4534 mg/dL). Hypocalcemia was observed in 62 (94%) of gastroenteritis patients but only 13 (20%) of controls. The results demonstrate that low serum calcium is common in patients with acute gastroenteritis.
Hurricane Gustav caused damage across Cuba in late August 2008, destroying homes and infrastructure but causing no reported deaths. In the capital of Isla de la Juventud, a ferry was overturned by Gustav's winds. Residents returned to find flooded homes and washed out roads after Gustav passed through western Cuba. People were seen making repairs to roofs and cleaning up debris left behind by the powerful storm.
Validation of three non invasive markers in assessing the severity of liver f...Samiullah Shaikh
This study aimed to compare three non-invasive markers (APRI, AST/ALT ratio, FIB-4) to liver biopsy for assessing liver fibrosis severity in hepatitis C patients. The study analyzed data from 158 hepatitis C patients who underwent liver biopsy and had their APRI, AST/ALT ratio, and FIB-4 calculated based on routine blood tests. Results found that APRI and FIB-4 were better than AST/ALT ratio at excluding or predicting advanced liver fibrosis, with APRI <1 excluding advanced fibrosis in 70% of patients and FIB-4 <1.45 in 74% of patients. APRI >1 predicted advanced fibrosis in 87% of patients and FIB-4 >1.
This study examined 158 hepatitis C patients to determine the frequency of liver fat (steatosis) and its relationship to fibrosis severity. The results showed:
1) Steatosis was present in 45% of patients and ranged from mild to severe.
2) A strong correlation was found between increasing steatosis severity and worsening fibrosis stage.
3) No significant relationships were found between steatosis and either patient age or BMI. This suggests steatosis may play a role in accelerating liver disease progression in hepatitis C.
This study aimed to compare clinical diagnoses of stroke localization to CT scan findings in 110 patients. Clinically, 80.9% were diagnosed with cerebral infarction and 19.1% with cerebral hemorrhage. CT scans confirmed infarction in 83% and hemorrhage in 47.6%. Left parietal/temporo parietal infarction was the most common clinical diagnosis (43 patients) and CT scans confirmed in 41 patients. Middle cerebral artery territory involvement was most frequent. The study concluded that clinical localization of stroke is not always accurate but CT scans help provide confident diagnoses and inform prognosis and treatment.
The document discusses several audience theories for analyzing TV drama, including the hypodermic needle theory which suggests media have direct effects on passive audiences, the two-step flow theory which proposes opinion leaders influence others, and uses and gratifications theory which posits audiences actively use media to fulfill various needs and that individuals consume media differently. It also explores critiques of uses and gratifications theory and provides learning outcomes around developing knowledge of audience theories and skills in analyzing TV drama through applying such theories.
Sound is used in horror movies to create atmosphere, highlight important moments, convey emotions and power, and enhance the viewing experience. Some common scary sounds include unexplained noises meant to startle and unsettle viewers. Hearing unknown sounds can be scarier than seeing something, as it allows the imagination to run wild. The document then presents five movie titles and asks the reader to guess their famous soundtracks, including Jaws, The Exorcist, Psycho, The Shining, and Halloween.
This document discusses representations in media and introduces some key concepts:
- Representation refers to how people, ideas, events, places are portrayed or depicted.
- The media relies on audiences understanding and accepting the representations it presents.
- Representations can be of people of different genders, religions, values, nationalities, ages, and more.
- When analyzing representations, it's important to consider what is being represented, how, to whom, and whose interests it reflects.
- Representations in Asian films can differ significantly from their Hollywood remakes.
Diabetes is a rapidly and serious health problem in Pakistan. This chronic condition is associated with serious long-term complications, including higher risk of heart disease and stroke. Aggressive treatment of hypertension and hyperlipideamia can result in a substantial reduction in cardiovascular events in patients with diabetes 1. Consequently pharmacist-led diabetes cardiovascular risk (DCVR) clinics have been established in both primary and secondary care sites in NHS Lothian during the past five years. An audit of the pharmaceutical care delivery at the clinics was conducted in order to evaluate practice and to standardize the pharmacists’ documentation of outcomes. Pharmaceutical care issues (PCI) and patient details were collected both prospectively and retrospectively from three DCVR clinics. The PCI`s were categorized according to a triangularised system consisting of multiple categories. These were ‘checks’, ‘changes’ (‘change in drug therapy process’ and ‘change in drug therapy’), ‘drug therapy problems’ and ‘quality assurance descriptors’ (‘timer perspective’ and ‘degree of change’). A verified medication assessment tool (MAT) for patients with chronic cardiovascular disease was applied to the patients from one of the clinics. The tool was used to quantify PCI`s and pharmacist actions that were centered on implementing or enforcing clinical guideline standards. A database was developed to be used as an assessment tool and to standardize the documentation of achievement of outcomes. Feedback on the audit of the pharmaceutical care delivery and the database was received from the DCVR clinic pharmacist at a focus group meeting.
Prevalence of Anamiea and Its Predictors in Pregnant Women Attending Antenata...iosrjce
Background: Anemia impairs cognitive development, reduces physical work capacity and in severe cases
increases risk of mortality particularly during prenatal period. In India, 16% of maternal deaths are attributed
to anemia. However, high prevalence of anemia among pregnant women persists in India despite the
availability of effective, low-cost interventions for prevention and treatment. Aknowledge of them
sociodemographic factors associated with anemia will help to formulate multipronged strategies to attack this
important public health problem in pregnancy.
Objective: To assess the prevalence of anaemia and its predicting factors among pregnant women attending
antenatal clinic at Tertiary care center.
Study Design: Descriptive cross-sectional study
Methods: A hospital based cross-sectional study design was conducted from January 2014 – September 2014
among 5788 pregnant womens who had been attending antenatal clinic. Red blood cell morphology and Hgb
level determination were assessed following the standard procedures. Socio-demographic data was collected by
using a structured questionnaire. The data entered and analyzed by using the SPSS version 16.0 statistical
software. P<0.05 was considered as statistically significant.
Result: Overall prevalence of anemia among the pregnant women was found to be 86.37%. Factors such as
diet, level of education of women and their husbands and socioeconomic status were found to be significantly
associated with the prevalence of anemia in pregnancy.
Conclusion: The present study showed high prevalence of anemia and the majority of them were of the
moderate type (hemoglobin: 10-10.9 g/dl). Low socioeconomic class, illiteracy, Multiparous were significantly
associated with high prevalence of anemia during pregnancy in Indian women.
Serum interleukin - 6 level among sudanese patients with chronic kidney disease
Authors:Safaa I.A Nasr , Rbab A.M Adam , Hala M.M Ibrahim , Afra S.A Abdelgadir , Ibrahim Alkider , Solomon M. Gamde , Simon P. Abriba
Int J Biol Med Res. 2023; 14(4): 7652-7654 | Abstract | PDF File
Evaluation of Oxidative status of gout patients in a Cameroonian urban hospit...J-réné Nkeck
This study evaluated the oxidative status of patients experiencing acute gout attacks compared to healthy controls in Cameroon. The study found higher levels of malondialdehyde, a marker of oxidative stress, in patients with gout attacks. However, levels of antioxidant enzymes like superoxide dismutase, glutathione peroxidase and catalase were similar between patients and controls. Thus, patients with gout attacks have evidence of elevated oxidative stress based on higher malondialdehyde levels, but their overall antioxidant defenses appear to be similar to healthy individuals.
This study analyzed 100 cases of acute kidney injury (AKI) at a tertiary care hospital in India to determine the incidence and epidemiology of AKI. The main findings were:
1) The incidence of AKI was 5.57% of total hospital admissions.
2) The most common cause of AKI was sepsis following trauma. Other common causes included pneumonia, urinary tract infections, and meningitis.
3) Risk factors for AKI included diabetes, hypertension, hypotension, HIV, cancer, and hepatitis.
4) The majority of AKI cases were stage II. Males on average developed AKI at a younger age than females.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
This document provides guidelines for the management of acute pancreatitis (AP). It summarizes key recommendations regarding the diagnosis, etiology, risk stratification, and management of AP. The diagnosis of AP is usually established by abdominal pain and elevated serum amylase and/or lipase levels. Contrast-enhanced CT or MRI is only recommended if the diagnosis is unclear or the patient fails to improve. Patients should be stratified based on the presence of organ failure or systemic inflammatory response syndrome and those with organ failure admitted to intensive care. Aggressive intravenous hydration within the first 24 hours and assessment of fluid status is important. Guidelines are also provided for managing gallstone pancreatitis, infectious complications, and interventions.
This document discusses issues in liver health and disease for non-hepatologists. It provides an overview of the changing epidemiology of viral hepatitis and new hepatitis B vaccines. It also addresses non-alcoholic fatty liver disease (NAFLD) and how increased recognition of this condition has led to new screening and potential therapy approaches. The document uses audience response questions to highlight clinical cases involving liver disease in HIV patients and discusses topics like viral hepatitis coinfections, hepatitis B vaccine strengths and limitations, and the natural history and risk factors associated with NAFLD.
C11 egyptian standards for diabetes mellitus 2009Diabetes for all
The document provides guidelines for diabetes care in Egypt created by a committee of Egyptian diabetes experts. It outlines recommendations for screening, diagnosing, classifying, preventing, and managing both type 1 and type 2 diabetes. The goals are to establish standards for clinical practice, treatment goals, and quality evaluation tools adapted for the Egyptian healthcare system and culture. An initial patient evaluation is recommended to assess family history, medical history, examine for complications, and create a personalized diabetes management plan. Lifestyle interventions including diet, exercise and weight loss are emphasized for prevention and treatment.
C11 egyptian standards for diabetes mellitus 2009Diabetes for all
This document provides an executive summary of the 2009 Egyptian Clinical Practice Recommendations for Diabetes Mellitus. It lists the coordinating and editing committee members who drafted the recommendations as well as other project participants. The recommendations are intended to provide clinicians, patients, and others involved in diabetes care with treatment goals and evaluation tools adapted for the Egyptian context. The recommendations are based on a review of international guidelines as well as primary literature sources, with adaptations made to suit Egypt's culture and resources. Classification, diagnostic criteria, and key points regarding diabetes diagnosis and prediabetes conditions are also summarized.
This study evaluated the efficacy and safety of direct-acting antivirals (DAAs) in patients with hepatitis C infection on hemodialysis. Fifty-four patients receiving hemodialysis with HCV were treated with either sofosbuvir and velpatasvir or sofosbuvir and daclatasvir. Among those treated with sofosbuvir and velpatasvir, all achieved sustained virological response at 12 weeks. Two patients treated with sofosbuvir and daclatasvir did not achieve response. The study demonstrated high efficacy of 95.6% and safety of DAAs in treating hepatitis C in patients on hemodialysis.
International Journal of Engineering Research and Applications (IJERA) is an open access online peer reviewed international journal that publishes research and review articles in the fields of Computer Science, Neural Networks, Electrical Engineering, Software Engineering, Information Technology, Mechanical Engineering, Chemical Engineering, Plastic Engineering, Food Technology, Textile Engineering, Nano Technology & science, Power Electronics, Electronics & Communication Engineering, Computational mathematics, Image processing, Civil Engineering, Structural Engineering, Environmental Engineering, VLSI Testing & Low Power VLSI Design etc.
This document summarizes the results of a randomized, prospective, open-label clinical trial evaluating the efficacy and safety of Sulfad tablets for the management of non-alcoholic steatohepatitis (NASH) patients. The trial involved 100 patients taking Sulfad tablets for 3 months. Significant improvements were seen in liver enzymes and lipid profiles after 1, 2, and 3 months of treatment. No major safety issues were reported. The study concluded that Sulfad tablets were well-tolerated and effective for the management of NASH patients.
This study estimated the prevalence of chronic kidney disease (CKD) among 132 patients attending a diabetes clinic in Jamaica. Approximately 86% of patients had CKD based on estimated glomerular filtration rate (eGFR) below 60 or albuminuria of 30 mg/g or higher. Over 20% had moderate albuminuria and 62% had severe albuminuria. Based on risk categories from the KDIGO guidelines, 51% were at high risk and 17% at very high risk of adverse outcomes like mortality, cardiovascular disease, and kidney failure. The high prevalence of CKD and risk of adverse outcomes shows the need for further studies on preventing CKD in diabetes patients in developing countries.
The document describes a conference on biotechnology, bioinformatics, biomedical sciences and stem cell applications taking place from November 11-12, 2016 in Singapore. It provides the conference schedule, list of speakers, and abstracts of papers being presented on topics related to diabetes, hypertension, cardiovascular disease, cognitive functions and thrombogenesis. The conference will bring together researchers from various universities and institutions in Asia to present and discuss their work in healthcare, life sciences and stem cell applications.
Role of the Biochemistry Labs in Promoting the Health Care Services for the I...IJERA Editor
The health care in the State of Kuwait depends to a greater extent on the biochemical and clinical labs attached
at each hospital. The data obtained from these laboratories will facilitate the process of diagnosing the disease
accurately. This will have a positive impact on the selection of appropriate treatment for the patients in general
and for diabetics specifically.
The main objective of this research was to build a profile for lab analysis and a database for building a
comprehensive system of integrated activities to raise health care for diabetic patients in Kuwait. The study
revealed the burden of admitted diabetic cases on the blood chemistry laboratory in Sabah Hospital (in relation
to length of stay and total numbers of lab requests). The aim was fulfilled by designing a model of the
biochemical tests for diabetics; filling in forms from the reality of patient data, completing and analyzing the
results electronically.
The study showed the importance of biochemical and clinical labs since they act as the link of patient's
information at the secondary health care level.
My STSH Scholary Article about TREATMENT of PRE-DIABETES with SSDDDr. Sutanu Patra
I had done research on "Scope of Individualistic treatment with Serially Succussed and Diluted Drugs in treating Pre-diabetic condition: an Open-label Exploratory trial – in search of Prevention of Diabetes" and this was got awarded in Short Term Studentship in Homeopathy (STSH) 2014 by Central Council for Research in Homeopathy (CCRH), Ministry of AYUSH, Govt. of India.
Role of Serum Zinc and Copper in Children with Gastroenteritisiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Proton Pump Inhibitors and Risk of Acute and Chronic Kidney Disease: A Retros...KhalafAlGhamdi
This document summarizes a study presented at a nephrology journal club that examined the association between proton pump inhibitor (PPI) use and the risk of acute kidney injury (AKI) and chronic kidney disease (CKD) using a large health insurance database. The study found that PPI use was associated with a 4-fold higher risk of AKI and a 20% higher risk of CKD compared to non-users. While the results strengthen evidence of this association, limitations include potential residual confounding and inability to account for over-the-counter medication use. The conclusion calls for provider education and deprescribing initiatives to reduce PPI overuse and potential kidney risks.
This study examined 162 patients with cirrhosis who underwent endoscopic variceal band ligation to treat esophageal varices. The study aimed to determine the frequency and risk factors associated with the development of secondary gastric varices after eradicating esophageal varices. The results found that secondary gastric varices developed in 38 patients (23.5%) after eradicating their esophageal varices. Factors associated with an increased risk of developing secondary gastric varices included having more advanced liver disease (based on Child-Pugh class), larger esophageal varices at initial presentation, requiring more sessions of band ligation to eradicate the esophageal varices, and already having gastric varices present at initial presentation.
Frequency of metabolic syndrome and its’ variousSamiullah Shaikh
This study examined the frequency of metabolic syndrome and its components in 357 patients with ischemic stroke in Pakistan. The researchers found that metabolic syndrome was present in 46.2% of patients, with the three most common components being high waist circumference (34.5%), high fasting blood sugar (35.3%), and low HDL cholesterol (26.5-73.5%). Female patients accounted for 75.2% of those with metabolic syndrome. The results suggest metabolic syndrome is a frequent occurrence in patients with ischemic stroke and its components are strongly associated with increased risk of the condition.
Frequency of cirrhotic cardiomyopathy in patientsSamiullah Shaikh
This study aimed to determine the frequency of cirrhotic cardiomyopathy in patients with liver cirrhosis. The study included 74 patients with liver cirrhosis. Various tests were performed including ECG, echocardiogram, and proBNP levels. Cirrhotic cardiomyopathy was diagnosed if abnormalities were found on tests. The results found cirrhotic cardiomyopathy present in 44.6% of patients. A strong relationship was seen between cardiomyopathy and severity of cirrhosis, prolonged QT interval, reduced ejection fraction, and elevated proBNP levels. The study concluded that cirrhotic cardiomyopathy was present in a sizable proportion of patients, and increased with later stages of cirrhosis.
Frequency of hyponatraemia and its influence on liver cirrhosis related compl...Samiullah Shaikh
This study evaluated the frequency and impact of hyponatremia (sodium levels below 130 mEq/L) in 217 patients with liver cirrhosis and ascites. Hyponatremia was found in 26.7% of patients and was associated with more severe liver disease and ascites. Patients with hyponatremia also experienced more frequent hepatic encephalopathy and cirrhosis complications like hepatorenal syndrome and spontaneous bacterial peritonitis during their hospital stay compared to patients with normal sodium levels. The study concluded that hyponatremia is common in cirrhotic patients and negatively influences the development of cirrhosis complications.
This study compared serum copper and zinc levels in 100 patients with chronic hepatitis C and 50 healthy controls. Serum zinc levels were significantly lower in patients (mean 3.2357 μmol/L) than controls (mean 4.246 μmol/L). Serum copper levels were significantly higher in patients (mean 2.210 μmol/L) than controls (mean 2.073 μmol/L). The authors conclude that increased copper and decreased zinc in patients may contribute to hepatic injury caused by chronic hepatitis C.
This study evaluated 222 patients with decompensated cirrhosis of the liver to compare the accuracy of the original Child-Pugh score and a creatinine-modified Child-Pugh score in predicting short-term outcomes. The creatinine-modified score added points based on serum creatinine levels to the original score. The creatinine-modified score more accurately predicted the development of complications like encephalopathy and ascites. It also better predicted in-hospital mortality and length of stay compared to the original Child-Pugh score. The creatinine-modified score showed marginally better prognostic accuracy than the original score, suggesting inclusion of serum creatinine can improve the predictive ability of the Child-P
This study examined 24 patients with Wilson's disease who presented with hepatic and/or neurological manifestations. The average age was 11.8 years. Most common presentations were jaundice (29.2%) and movement disorders like Parkinsonism (29.3%). Laboratory findings found low serum ceruloplasmin in 79.2% and high urinary copper in 62.5%. Based on criteria involving Kayser-Fleischer rings and ceruloplasmin levels, 70.8% were diagnosed with Wilson's disease. The study concludes that Wilson's disease causes diverse clinical presentations and requires a high index of suspicion for diagnosis.
Validation of three non invasive markers in assessing the severity of liver f...Samiullah Shaikh
This study aimed to compare three non-invasive markers (APRI, AST/ALT ratio, FIB-4) to liver biopsy for assessing liver fibrosis severity in hepatitis C patients. The study analyzed data from 158 hepatitis C patients who underwent liver biopsy and had their APRI, AST/ALT ratio, and FIB-4 calculated based on routine blood tests. Results found that APRI and FIB-4 were better than AST/ALT ratio at excluding or predicting advanced liver fibrosis, with APRI <1 excluding advanced fibrosis in 70% of patients and FIB-4 <1.45 in 74% of patients. APRI >1 predicted advanced fibrosis in 87% of patients and FIB-4 >1.
This study examined 158 hepatitis C patients to determine the frequency of liver fat (steatosis) and its relationship to fibrosis severity. The results showed:
1) Steatosis was present in 45% of patients and ranged from mild to severe.
2) A strong correlation was found between increasing steatosis severity and worsening fibrosis stage.
3) No significant relationships were found between steatosis and either patient age or BMI. This suggests steatosis may play a role in accelerating liver disease progression in hepatitis C.
This study evaluated 222 patients with decompensated cirrhosis of the liver to compare the accuracy of the original Child-Pugh score and a creatinine-modified Child-Pugh score in predicting short-term outcomes. The creatinine-modified score added points based on serum creatinine levels to the original score. The creatinine-modified score more accurately predicted the development of complications like hepatic encephalopathy and ascites. It also better predicted in-hospital mortality and length of stay compared to the original Child-Pugh score. The creatinine-modified score showed marginally better prognostic accuracy than the original score, suggesting inclusion of serum creatinine can improve the predictive ability of the Child-
Frequency of hyponatraemia and its influence on liver cirrhosis related compl...Samiullah Shaikh
This study evaluated the frequency and impact of hyponatremia (sodium levels below 130 mEq/L) in 217 patients with liver cirrhosis and ascites. Hyponatremia was found in 26.7% of patients and was associated with more severe liver disease and ascites. Patients with hyponatremia also experienced more complications like hepatic encephalopathy. Even mild hyponatremia with sodium levels between 131-135 mEq/L increased the risk of cirrhosis complications compared to patients with normal sodium levels. The study concludes that hyponatremia is common in cirrhotic patients and negatively influences the development of cirrhosis complications.
This study analyzed the causes of stroke in 50 young patients aged 15-35 years at a tertiary hospital in Pakistan. The most common cause of stroke was infective meningitis (34%), primarily tuberculosis meningitis. The second most common cause was cardioembolism (20%), mainly due to valvular heart disease. Other major causes included hypertension (14%), pregnancy-related conditions (12%), and systemic lupus erythematosus (4%). Overall, infectious diseases were the leading cause of stroke in this young patient population.
This study aimed to compare serum zinc and copper levels in patients with chronic hepatitis C and healthy individuals. The researchers found:
1) Serum zinc levels were significantly lower in patients with chronic hepatitis C compared to healthy controls.
2) Serum copper levels were significantly higher in patients with chronic hepatitis C compared to healthy controls.
3) The increased copper levels in chronic hepatitis C patients may contribute to hepatic injury, while lower zinc levels indicate zinc deficiency which can impact liver function.
This study examined 24 patients with Wilson's disease who presented with hepatic and/or neurological manifestations. The average age was 11.8 years. Most common presentations were jaundice (29.2%) and movement disorders like Parkinsonism (29.3%). Laboratory findings found low serum ceruloplasmin (<20 g/l) in 79.2% of patients and high urinary copper excretion (>100 ug/24hrs) in 62.5% of patients. Based on clinical and laboratory criteria, the diagnosis of Wilson's disease was made in 70.8% of patients. The study concludes that Wilson's disease can present with diverse symptoms involving the liver or nervous system and requires a high index of suspicion for
Validation Of Three Non Invasive Markers In Assessing The Severity Of Liver F...Samiullah Shaikh
The document evaluated three non-invasive markers - APRI (AST to platelet ratio index), AST/ALT ratio, and FIB-4 - for assessing the severity of liver fibrosis in patients with hepatitis C and compared them to liver biopsy results. The study found that APRI and FIB-4 were able to exclude minimal fibrosis in 70% and 74% of patients respectively, and predict advanced fibrosis in 87% and 98% of patients respectively. Both markers performed better than AST/ALT ratio. The study concluded that APRI and FIB-4 can reliably predict the stage of liver fibrosis in most hepatitis C patients and could help reduce the need for liver biopsies.
This study aimed to compare clinical diagnoses of stroke localization to CT scan findings in 110 patients. Clinically, 80.9% were diagnosed with cerebral infarction and 19.1% with cerebral hemorrhage. CT scans confirmed infarction in 83% and hemorrhage in 47.6%. Left parietal/temporo parietal infarction was the most common clinical diagnosis (43 patients) and CT scans confirmed this in 41 patients. Middle cerebral artery territory involvement was most frequent. The study concluded that clinical localization of stroke is not always accurate but CT scans help provide confident diagnoses and inform prognosis and treatment.
This study aimed to determine the frequency of steatosis in 158 hepatitis C patients and examine its relationship to fibrosis. The key findings were:
1) Steatosis was present in 45% of liver biopsies. A strong correlation was observed between increasing steatosis and worsening fibrosis.
2) No significant relationship was found between steatosis and either BMI or age.
3) The results suggest steatosis may play a role in accelerating liver disease progression in hepatitis C by fueling free radical production, amplifying the virus's cytopathic effect. Efforts to control steatosis may help slow disease progression.
Frequency Of Hyponatraemia And Its Influence On Liver Cirrhosis Related Compl...Samiullah Shaikh
This study evaluated the frequency and impact of hyponatremia (sodium levels below 130 mEq/L) in 217 patients with liver cirrhosis and ascites. Hyponatremia was found in 26.7% of patients and was associated with more severe liver disease and ascites. Patients with hyponatremia also experienced more frequent hepatic encephalopathy and cirrhosis complications like hepatorenal syndrome and spontaneous bacterial peritonitis during their hospital stay compared to patients with normal sodium levels. The study concluded that hyponatremia is common in cirrhotic patients and negatively influences the development of cirrhosis complications.
This study analyzed the causes of stroke in 50 young patients aged 15-35 years at a tertiary hospital in Pakistan. The most common cause of stroke was infective meningitis (34%), predominantly tuberculosis meningitis. The second most common cause was cardioembolism (20%), mainly due to valvular heart disease. Other major causes included hypertension (14%), pregnancy-related conditions (12%), and systemic lupus erythematosus (4%). Infective meningitis, particularly tuberculosis, was found to be the leading cause of stroke in young patients in this study.
This study evaluated the predictive ability of the original Child-Pugh score and a creatinine-modified Child-Pugh score for patients with decompensated cirrhosis. The creatinine-modified score showed marginally better prediction of encephalopathy and similar prediction of other complications compared to the original score. Both scores showed similar accuracy in predicting in-hospital mortality and length of stay, with the creatinine-modified score performing slightly better. The creatinine-modified Child-Pugh score may help better stratify patients, especially those in class B of the original score.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
2. World Appl. Sci. J., 7 (6): 777-780, 2009
the Hyderabad city of Pakistan, the second biggest patients with malignancy e.g. Osteoblastic metastases
city of province Sindh and fifth biggest city of country; (e.g. breast cancer, prostate cancer) and tumor lysis
the unhygienic drinking water causes various water- syndrome may cause hypocalcemia. (v) The patients had
related health disorders in Hyderabad, Sindh, Pakistan hypoparathyroidism and pseudohypoparathroidism and
and It has been reported that majority of citizens have (vi) The patients with Vitamin D deficiency or resistance.
suffered from acute gastroenteritis due to use of the While the non cooperative patients who refused to give
hazardous drinking water. written consent or didn’t have interest to participate in
The objective of the present study was to study were in the exclusion criteria in both groups
investigate the disturbance in serum calcium level in (i.e. cases as well as control). The subjects of both groups
patients presented with acute gastroenteritis; our consist of 66 individuals i.e. 66 patients with acute
intention was also to provide data for gastroenteritis (cases group) and 66 healthy individuals
recommendations concerning routine testing (control group). The data was collected through a pre-
panels in these patients to guide clinicians and health formed proforma by taking consent from the subjects and
care worker in the complete assessment and all such maneuvers were under medical ethics. The detail
evaluation protocol for the patients with acute history of all such patients was taken; complete clinical
gastroenteritis. The findings of this study will lead to relevant examination and routine investigation were
better interpretation of current information and will be performed. After that all the subjects of both groups
used to inform policy on public health, leading to creation (cases and control) were then evaluated for serum calcium
of appropriate planning in the management of patients level by taking 3cc venous blood sample and send to
with acute gastroenteritis. laboratory for analysis. The normal range of serum
calcium is: 9-10.5 mg/ dL [11] and the value <9mg/dL
MATERIALS AND METHODS was considered as hypocalcemia / low while the
reading >10.5mg/dL was taken as raised / high. The
This case control study was conducted in the collected data of both groups were analyzed in SPSS
department of Medicine at Liaquat University Hospital version 11.0. The frequency and percentage of
(a tertiary care 1500 bedded teaching hospital) Hyderabad hypcalcemia in patients with acute gastroenteritis (cases)
from February 2009 to July 2009. The study population and healthy individual (control) was calculated. Mean ±
was divided in two groups (1) The patients of acute SD of age was computed between the numerical
gastroenteritis (cases) (2) Normal / healthy individuals parameters. The ANOVA and independent samples T-test
(control). The acute gastroenteritis group contains the was applied at 95% confidence interval among the
patients presented with nausea, vomiting and diarrhea categorical variables. The p-value =0.05 was considered
(loose motion) while control group consists of healthy as statistically significant.
population. The inclusion criteria for cases were (a) the
subjects above 12 years of age, (b) of either gender, were RESULTS
came through outpatient department (OPD), inpatients
and casualty outdoor department (COD) with history of Sixty six (66) subjects in each group were studies, of
acute gastroenteritis i.e. nausea, vomiting and diarrhea which 72(55%) were males and 60 (45%) were females, the
(loose motions) were admitted, evaluated and enrolled in mean age was 36.76±13.40 and their age distribution is
the study while the inclusion criteria for control group mentioned in Table 1. The mean serum calcium in both
was (i) the subjects above 12 years of age, (ii) of either groups is shown in Table 2. The hypocalcemia was
gender. The exclusion criteria for the cases group were, observed in 75(57%) patients while the serum calcium was
(i) The patients had Hypoalbuminemia due to any cause normal in 57(43%) patients. In gastroenteritis (cases)
e.g. cirrhosis, nephrosis, malnutrition, burns, chronic group the hypocalcemia was observed in 62(94%) patients
illness and sepsis. (ii) The patients with hypomagnesemia while 04(6%) patients had normal serum calcium level. In
due to any cause e.g. pancreatitis, aminoglycoside control group, the serum calcium was normal in 53(80%)
treatment, amphotericin B, loop diuretics, alcoholism and subjects while 13(%) subjects had hypocalcemia / low
malnutrition. (iii) The patients with Hyperphosphatemia, serum calcium level. Majority of subjects 92(70%)
high calcitonin level and had Rhabdomyolysis. (iv) The belonged to urban areas.
778
3. World Appl. Sci. J., 7 (6): 777-780, 2009
Table 1: Age Distribution of Participants Although it has not been determined whether calcium
Cases Control from other food sources or from supplements would
----------------------------------- --------------------------------- provide the same benefit, individuals with milk allergy or
AGE (years) Male Female Male Female lactose intolerance might consider alternative sources
12 - 20 00 08 00 08 for calcium. Foods high in calcium include calcium-
21- 30 12 06 12 06 fortified soy products; nuts; green, leafy vegetables (kale,
31 - 40 08 08 08 08 collard greens, mustard greens); and seaweed. The
41 - 50 10 06 10 06 Calcium is best-known as a supplement to support bone
> 50 06 02 06 02 health, but it also has a long history of use to control
P = 1.000 (non significant) diarrhea and also has identified role in protease inhibitor-
related diarrhea, in people with HIV [15]. There are
Table2: Mean Serum Calcium Level of Both Groups different former studies conducted on children that
Serum Calcium (n = 132) Mean ± SD (mg/dL) P-value identified hypocalemia during diarrheal illness [16-17]
Cases (66) 6.8455 ± 1.8266 <0.001* but there are limited studies that focused on hypcalcemia
Control (66) 9.2167 ± 0.5534 in adult subjects with acute gastroenteritis. The
present study will fill such vacant space of limited data
*P value is statistically significant
and open a new forum of discussion because beside the
various advance books, printed and electronic media there
DISCUSSION
is yet shortage of exact, related and specific data on
present theme. The study should need an advance
Acute gastroenteritis is a common cause of morbidity
continuous and extended phase during different time
and mortality worldwide. Conservative estimates put
periods and episodes at various health care centers,
diarrhea in the top 5 causes of deaths worldwide and
clinics and hospitals. Such strategy will lead to
diarrheal diseases are a significant cause for morbidity
providence of updated data which will be helpful in the
across all age groups in industrialized countries. Beside
management protocol of adult subjects with acute
dehydration, there are also various biochemical markers
gastroenteritis.
that disturbed during acute gastroenteritis and by
concentrating on such theme, the current study focused
ACKNOWLEDGEMENT
on disturbance in serum calcium level during acute
gastroenteritis. At the end of study we identified
The valuable and unforgettable help from
hypocalcemia in 62(94%) gastroenteritis patients and SEARLE pharmaceutical during study period is gratefully
it is similar to the study published in the Journal of acknowledged.
Gastroenterology during 2003. [12] However our
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