9 research outputs found
Frequency of in hospital mortality of cirrhotic patients due to sepsis
No full textIntroduction: Infection is a common complication of liver cirrhosis, as 30–50% of patients with cirrhosis either present with infection during admission, or develop infection during hospitalization. The severity of the underlying liver disease makes patients with cirrhosis more susceptible to the development of sepsis, compared to the general population. Patients with cirrhosis have a high risk of developing sepsis. According to the Global Burden of Disease study, liver cirrhosis caused 1.2% of global disability adjusted life years and 2% of all deaths worldwide in 2010. Objective: To determine the frequency of in hospital mortality of cirrhotic patients due to sepsis. Materials and Methods: It is Descriptive Study conducted at Department of Gastroenterology, Asian Institute of Medical Science (AIMS), Hyderabad, Pakistan from January 31, 2020 to July 30, 2020. All patients who fulfilled the inclusion criteria and visited to AIMS; Hyderabad were included in the study. Child-Turcotte-Pugh (CTP) score was calculated by clinical parameters, i.e. encephalopathy and ascites, and laboratory results, i.e. bilirubin and albumin concentrations, and prothrombin time and MELD score were calculated by it using laboratory parameters bilirubin, serum creatinine and international normalization ratio (INR).
Short-Term Mortality and Survival among Patients with Acute-On- Chronic Liver Failure: A Prospective Cohort Study
No full textObjective: To evaluate the frequency of short-term mortality (30 days) and survival among patients with acute-on-chronic liver failure (ACLF). Methods: A descriptive cross-sectional was carried out at gastroenterology department of the Asian Institute of Medical Sciences Sindh, Pakistan Patients with acute-on-chronic liver failure (ACLF) aged more than 30 years of either gender were included. The patients were monitored for one month to assess the mortality or survival.Results: Overall average age of 40.9 years. 73.5% were male and 26.5% were female.Organ failure stratification indicated that 51.3% had fewer than three organ failures, while 48.7% had three or more. In terms of 30-day mortality, 61.5% of participants expired, while 38.5% survived. Analyzing mortality by age, gender and etiology was not statistically significant (p = >0.05). Although organ category analysis indicated that mortality was significantly higher in category 2 (p = 0.043).Conclusion: Among patients with ACLF, the short-term mortality was observed to highly frequent and significantly associated to patients with multiple organ failures. The findings underscore the importance of organ failure stratification as a key predictor of outcomes in ACLF, suggesting that early identification and management of organ dysfunction may be critical in improving survival rates.Key words: ACLF, mortality, etiology, predictors
Assessment of the Predictors and Mortality in Patients of Acute on Chronic Liver Failure; A Prospective Study
No full textObjective: To evaluate the predictors of short-term mortality in patients with acute-on-chronic liver failure (ACLF).
Methodology: This prospective study was conducted at the gastroenterology department of the Asian Institute of Medical Sciences Sindh, Pakistan from January 2018 to December 2018. All the patients with acute-on-chronic liver failure (ACLF) aged more than 25 years and of either gender were included. A complete history was obtained including demographic profile and specifics on clinical characteristics (jaundice, ascites, gastro-intestinal bleed, grade of encephalopathy, records of vital parameters etc.). Serum electrolytes, viral serology, autoimmune profile, liver function tests, serum creatinine, prothrombin time, and INR were among the laboratory tests performed on each patient.
Results: A total of 99 patients were studied; their average age was 40.90+13.93 years; and there was a male predominance (73.5%). HCV and HBV+HDV were the most common etiological factors. According to the frequency of organ failure, hepatic failure was in 59.8% of the cases, renal failure was in 43.6% of the cases, CNS failure was in 38.5% of the cases, 41.0% of the cases had circulatory failure, coagulation failure was in 55.6% of the cases, and respiratory failure was seen in 17.1% of the cases. Overall, the 30-day mortality rate was 61.5%. Hepatic failure, renal failure, CNS failure, coagulation failure, SBP, and grading of ACLF were significantly associated with short-term survival rate (p= <0.05). While gender, etiology, circulatory failure and respiratory failure were statistically insignificant (p= >0.05). MELD score >28, CTP score >13, organ failure >3 and ACLF grade II and III were also highly significantly linked to short term survival rate (p-0.0001).
Conclusion: According to the study's findings, hepatic failure, renal failure, CNS failure, coagulation failure, and ACLF grading, CTP score > 13, MELD score > 28, and the presence of hepato-renal syndrome were found to be significant predictors of short-term mortality in patients with Acute On-Chronic Liver Failure (ACLF)
1037 Safety and Efficacy of Sofosbuvir Plus Ribavirin and Sofosbuvir Plus Daclatasvir With or Without Ribavirin Combinations in Children and Adolescents With Chronic Hepatitis C
No full textBoron deficiency in rainfed wheat in pakistan: Incidence, spatial variability and management strategies
No full textBoron (B) deficiency is potentially an important nutrient constraint in calcareous soils. We determined B deficiency incidence and spatial distribution in rainfed wheat (Triticum aestivum L.) in 1.82 Mha Pothohar plateau in Pakistan, its relationship with soil types, crop responses to B, and internal B requirement and B fertilizer use efficiency of wheat. Plant and soil analyses indicated deficiency in 64percent of the 61 sampled fields; geostatistics-aided contour maps delineated B deficient areas. In rainfed field experiments, B use increased wheat yields up to 11percent. Fertilizer requirement was 1.2 kg B ha-1; critical B concentration (mg kg-1) ranges were: young whole shoots, 4-6; flag leaves, 5-7. Boron uptake by wheat was 0.14-0.58percent of applied dosage, leaving substantial residual impact. Highly cost-effective B use or B-efficient genotype adoption can enhance wheat productivity and grower-income. Such effective nutrient assessment and management approaches can be beneficially adopted elsewhere as well. © Taylor and Francis Group, LLC.Alloway B. J., 2008, MICRONUTRIENT DEFICI; Berger KC, 1944, SOIL SCI, V57, P25, DOI 10.1097-00010694-194401000-00003; Bergmann W, 1992, NUTR DISORDERS PLANT; BHATTI AU, 1991, REMOTE SENS ENVIRON, V37, P181, DOI 10.1016-0034-4257(91)90080-P; Bingham F. T., 1982, Methods of soil analysis. Part 2. Chemical and microbiological properties, P431; GAINES TP, 1979, COMMUN SOIL SCI PLAN, V10, P1099, DOI 10.1080-00103627909366965; Goldberg S., 1993, Boron and its role in crop production., P3; Gupta U. C., 1993, BORON ITS ROLE CROP; Havlin J.L., 2005, SOIL FERTILITY FERTI; HOLLOWAY RE, 1992, AUST J AGR RES, V43, P987, DOI 10.1071-AR9920987; Jones J R, 1991, PLANT ANAL HDB; Keren R., 1985, ADV SOIL SCI, V1, P229; Li B, 1978, J NE AGR COLL, V3, P1; Munson R. D., 1990, Soil testing and plant analysis., P359; Rashid A, 2008, MICRONUTRIENT DEFICI, P149, DOI 10.1007-978-1-4020-6860-7_6; Rashid A, 1997, COMMUN SOIL SCI PLAN, V28, P441, DOI 10.1080-00103629709369802; Rashid A., 2006, P IFA INT WORKSH MIC; Rashid A, 1997, COMMUN SOIL SCI PLAN, V28, P149, DOI 10.1080-00103629709369779; RERKASEM B, 1994, AGRON J, V86, P887; Rerkasem B, 1997, EUPHYTICA, V96, P257, DOI 10.1023-A:1003093532561; Rerkasem B, 2004, FIELD CROP RES, V89, P173, DOI 10.1016-j.fcr.2004.01.022; Reuter DJ, 1997, PLANT ANAL INTERPRET, P81; Reuter J., 1997, PLANT ANAL INTERPRET, P3; Shorrocks VM, 1997, PLANT SOIL, V193, P121, DOI 10.1023-A:1004216126069; Shorrocks V.M., 1992, P INT S ROL SULPH MA, P39; Soylu S, 2004, J PLANT NUTR, V27, P1077, DOI 10.1081-PLN-120037537; Subedi KD, 1997, EUPHYTICA, V95, P21, DOI 10.1023-A:1002926117203; TIWARI R J, 1988, Journal of the Indian Society of Soil Science, V36, P180; WEBB RA, 1972, J HORTIC SCI BIOTECH, V47, P309; WEIR RG, 1983, 1183 NEW S WAL DEP A; Yau SK, 2008, CROP SCI, V48, P854, DOI 10.2135-cropsci2007.10.053923
Frequency of hepatocellular carcinoma in patients with hepatitis C received treatment with directly antiviral agents
No full textBackground and Aims: Hepatitis C infection is one of leading causes of liver cirrhosis and a considerable proportion of hepatocellular carcinoma worldwide. Despite the very high efficacy of Directly Acting Viral Agents (DAAs) on clearance of hepatitis C their role remains controversial on development of Hepatocellular Carcinoma. The Aim of this study is to analyze hepatocellular occurrence in hepatitis C patients after achieving Sustained virologic response on directly acting viral agent. Methods and Material: It is prospective study conducted on outpatients in the Hepato-gastroenterology department of Asian Institute of Medical Science Hospital Hyderabad from 21-10-2018 to 20-04-2019. All patients who fulfilled the criteria were enrolled, their baseline demographic characteristics, Child Pugh Class, MELD score, alpha-fetoprotein level and Ultrasound liver before and after treatment collected. Duration of DAAs treatment and type of DAAs used also noted. Hepatocellular carcinoma labelled when Triphasic CT scan liver shows typical characters of hepatocellular carcinoma i.e. arterial phase hyperenhancement and delayed washout on portal and venous phase or ultrasound liver shows focal liver lesion with alpha-fetoprotein level more than 300ng/ml. Results: One hundred fifty-seven patients of chronic hepatitis C enrolled in the study after exclusion criteria. 
Stylistic Analysis of Ahmed Ali’s Short Story Our Lane
No full textThe undertaken study is based on stylistic analysis of Ahmed Ali’s short story Our Lane. The study analyzes how the author has used linguistic features like noun, adjective, conjunction, sentence complexity to portray the social, political, economic, religious, psychological and cultural conditions of the colonized natives of the Indian subcontinent in the wake of the British colonial rule. The story portrays how the colonial rule has deteriorated the people socially, economically, politically and psychologically. Ahmed Ali’s use of adjective is in consonant with the established norm of using 7 to 8% of the total text (Hofland & Johansson, 1987:6). Whereas, the median of 343 sentences is 13, which is shorter than the length of an average modern sentence, which according to Ellegard is 17.8 words. While rebutting colonial narrative, he deviates from the standards of English language: excessive use of coordinating conjunction ‘and’ is evidence to it. Most adjectives of positive characteristics qualify to the past, whereas the adjectives referring to present are either of negative or of neutral characteristics, and thus the writer recognizes the glory of the past and condemns the disintegrating present and uncertain future in the colonized land
Stylistic Analysis of Ahmed Ali’s Short Story Our Lane
No full textThe undertaken study is based on stylistic analysis of Ahmed Ali’s short story Our Lane. The study analyzes how the author has used linguistic features like noun, adjective, conjunction, sentence complexity to portray the social, political, economic, religious, psychological and cultural conditions of the colonized natives of the Indian subcontinent in the wake of the British colonial rule. The story portrays how the colonial rule has deteriorated the people socially, economically, politically and psychologically. Ahmed Ali’s use of adjective is in consonant with the established norm of using 7 to 8% of the total text (Hofland & Johansson, 1987:6). Whereas, the median of 343 sentences is 13, which is shorter than the length of an average modern sentence, which according to Ellegard is 17.8 words. While rebutting colonial narrative, he deviates from the standards of English language: excessive use of coordinating conjunction ‘and’ is evidence to it. Most adjectives of positive characteristics qualify to the past, whereas the adjectives referring to present are either of negative or of neutral characteristics, and thus the writer recognizes the glory of the past and condemns the disintegrating present and uncertain future in the colonized land
Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial
No full textBackgroundTranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding.MethodsWe did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124.FindingsBetween July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98).InterpretationWe found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial.</div
