Online ISSN: 2515-8260

Keywords : Ascites


A Study On Clinical Profile Of Patients With Ascites Admitted To Tertiary Care Center

Dr. Bhargava Rama Karantha, Dr. Anil Kumar, Dr. Spoorthi AS .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 2673-2677

Ascites is the accumulation of free fluid in the peritoneal cavity. Ascites is one of the most common complaint amongst the various clinical problems confronting a physician, and ascitic fluid analysis is the most effective way of etiological diagnosis. Traditional classification into ‘exudative’ and ‘transudative’ depending on the Serum Ascites Albumin Gradient (SAAG) is unable to correctly identify the conditions. Hence a more reliable method to classify the same is required. Early diagnosis of Tuberculosis Peritonitis is often difficult to make as symptoms of Tuberculosis Peritonitis is generally non-specific. The study was conducted on patients with ascites admitted to the Medicine and Gastroenterology Department,. Totally 124 patients were included in the study of which, 98 patients had Cirrhotic Ascites, 12 patients had Tubercular Ascites, 14 patients had Malignant Ascites. Clinical evaluation, abdominal ultrasonography, and laboratory investigations were conducted as follows: Serum lipid profile, Ascitic Lipid Profile and SALG of total cholesterol, triglyceride, HDL cholesterol, and LDL cholesterol. On analysis, it was found that the SALG values are significantly higher in cirrhosis than tuberculosis or malignancy. A close relationship between the levels of SALG and type of Ascites was found which was significant for differential diagnosis.

A CLINICAL STUDY OF CIRRHOSIS WITH SPECIAL REFERENCE TO THYROID FUNCTION”

Dr. M.H. Usmani, Dr. Karan Saran Kapur, Dr. Sabendra Singh Sikarwar, Dr Anuj Jain

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 151-161

Background-It is known that impaired thyroid function affect the liver function and similarly liver disorders Also affect thyroid function. In this study we looked  at the clinical profile of cirrohosis and studied the correlation between cirrhosis  and thyroid function.
Methodology- The study was conducted as an observational cross sectional Study on patients with cirrhosis of liver reporting at Department of Medicine, SSMC Rewa (M.P.) during the study period of 15 months i.e. from 1st April 2020 to 30th June 2021. Detailed history regarding risk factors, duration of liver disease, history pertaining to its etiology was obtained. Severity of liver disease was assessed using Child Pugh score. All the patients were then subjected to relevant investigations including Serum T3, T4, TSH.
Results-A total of 100 cases of liver cirrhosis were enrolled in our study with mean age of 53.26±12.54 years. We observed a statistically significant association of Child Pugh Score with T3, T4 as well as TSH (p<0.05). We observed a moderate correlation of Child Pugh score with T3 levels and TSH (r=0.452 and
0.311 respectively; p<0.05), and weak correlation was observed with T4 (r=0.240; p<0.05).
Conclusion- In cirrhosis of liver majority of subjects show impaired thyroid functions. Thyroid hormone levels are helpful in assessing the severity as well as course of cirrhosis and among T3,T4,TSH value,TotalT3 faired as better predictor of severity of cirrhosis.

A Hospital Based Prospective Study to Compare the Serum Ascitic Fluid Albumin Gradient (SAAG) with Ascitic Fluid Total Protein (AFTP) in Hepatic and Non-Hepatic Causes of Ascites at Tertiary Care Center

Mukesh Kumar Khinchi, Shiv Kumar Goyal, Mukesh Sonkaria, Aashish Kumar Bagarhia

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 375-381

Background: The traditional way of classification of ascites by AFTP offers little insight to the pathophysiology of ascites formation and it has further drawbacks. In order to overcome it the classification of ascites based on SAAG has emerged. Even SAAG also has some draw backs like non correlation with ascites due to nonalcoholic cirrhosis and difficulty in identifying the ascites due to mixed etiology. So, the study is conducted to compare the serum ascetic fluid albumin gradient (SAAG) with ascetic fluid total protein (AFTP) in hepatic and non-hepatic causes of ascites at tertiary care center.
Materials& Methods: A hospital based prospective study done on 80 patientswho were admitted in the medical ward under Department of General Medicine, General surgery and radiation oncology in SMS Medical College, Jaipur, Rajasthan. They are classified on the basis of SAAG into High SAAG and low SAAG and on the basis of AFTP into Transudate and Exudate. After the etiology of ascites evaluated by various diagnostic procedures the sensitivity, specificity and diagnostic accuracy of SAAG and AFTP in identifying the pathophysiology of ascites calculated separately. The diagnostic accuracies of SAAG and AFTP compared statistically.
Results: Our study showed that the mean age was 50.23 years. Male to female ratio was 2.33:1. The cirrhosis occupies the maximum with 60%, liver metastasis, Antenatal with Hypertensionoccupiestheleastwith1.25%each. The diagnostic accuracy of SAAG and AFTP for individual aetiologies of ascites were found and compared. SAAG was found to be superior to AFTP with a P value of <0.01 which was statistically significant.
Conclusion: We concluded that the diagnostic accuracy of SAAG and AFTP was compared and SAAG was found to be superior to AFTP and it was proved statistically significant.

A Study of alcoholic liver disease with special reference to NLR ratio in a tertiary care centre

Nikitha Janga Reddy, Ahmed Siddique, Vikrannth V, Jagadeesan Mohanan, Prasanna Karthik Suthakaran, Kannan Rajendran

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 316-322

Background: Alcohol consumption produces a wide spectrum of hepatic diseases, including fatty liver, alcoholic hepatitis, and chronic hepatitis with liver fibrosis or cirrhosis. Neutrophil lymphocyte ratio (NLR) is an easily measurable laboratory marker that is used to evaluate systemic inflammation and is used as a marker to assess the severity of the disease.
Methods: The study involved subjects aged > 40 years of age who were admitted to a tertiary care center. This study was conducted on 100 patients who were consuming alcohol and were divided into two groups based on the duration and amount of alcohol consumed.
Results: The mean age was 50 ± 9.54 years. Raised NLR was seen in patients who consumed heavy amounts of alcohol and in patients who had consumed alcohol for a longer period of time, irrespective of their complications. A significantly raised NLR is seen in patients consuming moderate and heavy amounts of alcohol and in patients consuming alcohol for a longer period with complications.
Conclusion: NLR can be used as a useful marker of disease progression that correlates well with complications like hepatic encephalopathy (HE), ascites, and gastrointestinal bleeding (GI bleed).

Radiological profile of dengue among infants at a tertiary care hospital with special reference to increased resistive index of middle cerebral artery: A cross sectional study

Dr Santosh Karpur Dr Anupam Bahe Dr Deepali Vagdalker Dr Mahesh Chander D

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1594-1604

Background: Ultrasonography is readily available and is non-invasive which gives quick results. It tells about severity of dengue among infants. It is a promising tool. It can help in management and assessing severity of dengue.
Objective: To study radiological profile of dengue among infants with special reference to increased resistive index of middle cerebral artery
Methods: Retrospective study on subjects admitted with infant dengue was done for two years. Data of 98 infants admitted with Dengue were collected from medical records department. Data of infant dengue with congenital heart disease, comorbidities like sepsis and known case primary immunodeficiency were excluded. Radiological findings of ultrasound abdomen & thorax of the subjects were recorded. 

A HOSPITAL BASED OBSERVATIONAL STUDY TO CORRELATE THE CYTOLOGICAL FEATURES OF THE ASCITIC FLUID WITH CLINICAL DATA AT NEWLY ESTABLISHED TERTIARY CARE CENTER: A CLINICO-PATHOLOGICAL STUDY

Anil Kumar Sethiya, Madan Kumar Solanki, Hanuman Ram Choudhary

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1696-1705

Background: The proper evaluation of ascitic fluid helps in narrowing the diagnostic dilemma faced by the physicians and helps in better management of the patients. Early and accurate diagnosis often depends on appropriate ascitic fluid analysis. The aim of this study to correlate the cytological features of the ascitic fluid with clinical data at newly established tertiary care center.
Materials & Methods: A prospective study was conducted in the Department of Pathology, in a tertiary health care centre over a period of one year. Cytological examination was performed to reveal important information regarding the causes of ascites and classified as benign (with or without infection/ spontaneous bacterial peritonitis), suspicious or malignant conditions. Cytomorphology of the cells was studied and documented paying attention to cellular arrangement, cytoplasmic features and nuclear characteristics. Clinical information of the patient and cytomorphological features of the smears were studied and the samples were categorized into benign (with or without infection/ SBP), suspicious of malignancy or malignant.
Results: Our study showed that the mean age was 55.67 years. Out of 30 cases, 14 were males and 16 were females, with male to female ratio being 7:8. Out of 30 samples, 26 (86.66%) were benign, 2 (6.66%) were suspicious of malignancy, and 2 (6.66%) were positive for malignancy. The most frequent clinical diagnosis was Alcoholic Liver disease comprising of 8 (26.66%) cases. The predominant cell type was Lymphocyte in 14 (46.66%) of cases, Neutrophil in 9 (30%) of cases, Reactive mesothelial cell in 5 (16.66%) of cases and atypical/malignant cells in 2 (6.66%) of cases. Histiocytic cells were also seen.
Conclusion: We concluded that non neoplastic and neoplastic conditions causing ascites can be diagnosed on ascitic fluid cytology. Increased neutrophil count is strongly suggestive of spontaneous bacterial peritonitis (SBP). The careful cytomorphological examination of ascitic fluid is a valuable, simple, rapid, inexpensive and reliable technique in the differential diagnosis of ascites, particularly in resource limited settings.