Indian Journal Of Clinical Practice
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Role of Beta-Blockers in Prevention of Hepatopulmonary Syndrome in Chronic Liver Disease: An Observation
Get PDFAim: Study was initiated to study the presence of hepatopulmonary syndrome (HPS) in chronic liver disease patients, and role of beta-blockers in its occurrence. Methods: Patients admitted in Dept. of Medicine and patients attending the Medicine OPD were examined and investigated for presence of HPS irrespective of its typical clinical features as explained in the literature. Patients having ascites or pleural effusion were managed by means of paracentesis and pleural tap first and then included in the study. Patients having any other primary pulmonary disease like bronchial asthma or chronic obstructive pulmonary disease were excluded from the study. Arterial blood gas analysis and contrast-enhanced echocardiography was done to confirm presence of arterial hypoxemia and pulmonary shunt, the diagnostic criteria. Results: During 1 year study, total 125 patients were enrolled in the study after appropriate selection criteria. Twenty-eight out of 125 patients were not taking propranolol. Propranolol is contraindicated in these patients for one or two reasons. Four out of these 28 patients developed HPS. One out of 97 patients who were on propranolol developed HPS. Total 5 patients were confirmed having HPS. The Fisher’s exact test statistic value is 0.008887. The result is significant at p < 0.01. Conclusion: Patients of cirrhosis with portal hypertension on treatment with propranolol were having significantly lower chances of development of HPS then those without propranolol. Propranolol may have preventive role for development of HPS
64th Annual Conference of the Indian Society of Gastroenterology (ISGCON 2023)
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From Evidence to Practice: Denosumab in Osteoporosis and Joint Health
Get PDFOsteoporosis and osteopenia are prevalent conditions in India, particularly among postmenopausal women and the elderly, leading to increased fracture risks and morbidity. Denosumab, a monoclonal antibody, demonstrates superior efficacy over other treatments in reducing fracture risk and enhancing bone mineral density (BMD). Clinical trials highlight its effectiveness in preventing periprosthetic bone loss, improving implant stability, and mitigating femoral head collapse in various conditions; combination therapies involving denosumab further amplify BMD gains and reduce fracture risk. The article reviews the efficacy and safety of denosumab in managing osteoporosis, joint replacement therapy, and avascular necrosis based on a review of clinical evidence and studies. Denosumab emerges as a cornerstone therapy for osteoporosis management, offering multifaceted benefits in fracture prevention, joint replacement therapy, and avascular necrosis
