Pattern of liver cysts with their surgical management

Background: Liver cysts are seen in up to 5% of the population. 15-16% of such cysts are symptomatic. Symptomatic cysts are found more commonly in women who are over 50 years of age.Simple hepatic cysts are believed to be congenital in origin.Methods: The observational study was conducted in the department of hepatobiliary department of surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Total of 80 cases were randomly selected for the study. Clinical examination and evaluation were done from July 2013 to June 2014. Proper consent was taken from the respective concern. Statistical analysis of the results was obtained by using window-based computer software statistical packages for social sciences (SPSS-22).Results: Most of the respondents were female (65%). The male-female ratio was 1:1.9. The mean age was 46.4 (±SD 10.191) years, ranging from 13-76 years. There were 69 non-parasitic diseases and 11 parasitic diseases. Among them 30 patients were diagnosed as liver cyst incidentally and they required no treatment. Liver function was abnormal in 70% patients. It was found from ultrasonography (USG) and computed tomography (CT) scan of abdomen that right lobe involvement (65% and 28% respectively) is more common than left lobe (21.3% and 12% respectively). The most common complication following surgical interventions was haemorrhage (32.4%).Conclusions: Females are affected most and M:F=1:1.9, usual affected age groups are of 5th decade and common in rural area. Imaging is the best modality for diagnosis of cystic lesions but serological investigations are also helpful

Clinical characteristics, risk factors, and thyroid profile of patients admitted with acute left ventricular heart failure from a tertiary hospital in Northeast India: A single-center retrospective cohort study

Introduction: Heart failure (HF) is a progressive chronic clinical syndrome. Thyroid dysfunction in HF patients has been reported in the literature. We aimed to explore the prevalence of thyroid dysfunction among acute left ventricular failure (LVF) patients admitted to our hospital. Materials and Methods: A retrospective study involving 78 patients diagnosed with acute LVF was conducted. Baseline information that included demographics, risk factors, clinical presentations, and biochemical data was recorded. A comparison of acute LVF patients with thyroid dysfunction to those with normal thyroid function was analyzed and documented. Results: About 29.5% (n = 23; 63.8 ± 11.4 years) of patients had normal thyroid function and 70.5% (n = 55; 65.3 ± 6 years) had thyroid dysfunction (P = 0.0003). The mean age of the cohort was 64.7 ± 12.4 years and 68% (n = 53) were men. Hypertension was the most common risk factor among both groups (56.5%, n = 13 vs. 67.3%, n = 37; P = 0.0006). Around 13% (n = 3) of patients with normal thyroid function and 20% (n = 11) of patients with thyroid dysfunction expired (P = 0.0325). The most common symptom seen in both groups was shortness of breath (28%, n = 16 vs. 72%, n = 41; P = 0009). There was a high prevalence of HF with reduced ejection fraction (60.8%, n = 14 vs. 65.5%, n = 36; P = 0.0018). Electrocardiography abnormalities were noted in 70.5% (n = 55) of patients of the cohort (65.2%, n = 15 vs. 72.7%, n = 40; P = 0.007). Irregularities in two-dimensional echocardiography and Doppler were seen in 76.5% (n = 59) of patients (69.6%, n = 16 vs. 78.2%, n = 43; P = 0.0004). Conclusions: Thyroid dysfunction can cause significant adverse effects on the heart. Early diagnosis and treatment of thyroid abnormalities can reduce and/or prevent the development of serious cardiac problems including HF

A single-center retrospective study of Vitamin D status and acute left ventricular heart failure from a super specialty tertiary care hospital in Northeast India

Introduction: Heart failure (HF) is a progressive clinical condition and is a major cause of mortality and morbidity. Various studies have shown the association of Vitamin D deficiency with HF. The present study aimed to investigate the Vitamin D status among acute left ventricular failure (LVF) patients admitted to our hospital. Materials and Methods: Medical records of 55 acute LVF patients were retrospectively assessed. Patients were categorized according to their Vitamin D status. Demographics, risk factors, clinical presentations, and biochemical data of the patients were analyzed and documented. Results: Patients were grouped based on their Vitamin D status as deficient (40%; n = 22), insufficient (32.7%; n = 18), optimal (23.6%; n = 13), and toxic (3.6%; n = 2). The overall cohort included 67.3% (n = 37) of males with a male/female ratio of 2.1:1. Ages ranged from 22 to 86 years with a mean age of 64.8 years ± 2.3. Rural/Urban was 1:0.9. Hypertension (63.6%; n = 35) was the predominant risk factor across all groups. Mortality was the highest in the Vitamin D deficient group (36.4%; n = 8). The most common symptom observed was dyspnea (76.4%; n = 42). A high incidence of HF with reduced ejection fraction (58.1%; n = 32) was seen in the entire cohort with the highest prevalence in the Vitamin D-deficient group (27.3%; n = 15). Conclusions: Our study revealed a high occurrence of Vitamin D deficiency and insufficiency among HF patients. Routine screening of Vitamin D levels should be done in patients with unexplained cardiac problems. Serious adverse events, including HF, can be prevented and/or reduced on early diagnosis and treatment of Vitamin D deficiency/insufficiency

Association of serum uric acid with left ventricular ejection fraction: A retrospective insight from a tertiary care hospital of North East India

Context: Cardiometabolic risk factors play crucial roles in left ventricular dysfunctions (left ventricular failure): a defining feature of heart failure (HF) with preserved ejection fractions (HFpEF). Among the many, serum uric acid (SUA) is a controversial risk factor that needs to be investigated globally. Aim: We aim to elucidate a correlation of SUA with ejection fraction percentage (EF%) in patients with chronic HF supporting the probable notion of hyperuricemia being a prognostic biomarker. Settings and Design: This retrospective, cohort study was performed on patients who visited from January 2022 to June 2022 in the Department of Cardiology at a tertiary care hospital in Northeastern India. Methods: A series of 81 selected patients with known congestive HF were documented with various baseline, clinical, and biochemical parameters. Patients were divided into three groups based on EF% and their relation with SUA, along with other parameters was analyzed. Statistical Analysis: Data were presented as mean ± standard deviation and frequencies for continuous variables and categorical variables, respectively. ANOVA one-way tests were conducted for continuous variables and Chi-square tests for categorical variables. P < 0.05 was considered as statistically significant. Results: A significant correlation was established between levels of SUA and EF (P = 0.021). Hence, hyperuricemia is directly related to an increased risk of lower EF. Conclusion: Even when asymptomatic, SUA can be used as a prognostic biomarker in the assessment of HF diseases

Study to Probe Subsistence of Host-Guest Inclusion Complexes of α and β-Cyclodextrins with Biologically Potent Drugs for Safety Regulatory Dischargement

Abstract Host-guest interaction of two significant drugs, phenylephrine hydrochloride and synephrine with α and β-cyclodextrins were studied systematically. Initially two simple but reliable physicochemical techniques namely conductance and surface tension were employed to find out saturation concentration for the inclusion and its stoichiometry. The obtained 1:1 stoichiometry was further confirmed by two spectrometric methods, UV-Vis study and spectrofluorimetry. Significant shifts in IR stretching frequency also support the inclusion process. Relative stabilities of the inclusion complexes were established by the association constants obtained from UV-Vis spectroscopic measurements, program based mathematical calculation of conductivity data. Calculations of the thermodynamic parameters dictates thermodynamic feasibility of the inclusion process. Spectrofluorometric measurement scaffolds the UV-Vis spectroscopic measurement validating stability of the ICs once again. Mass spectroscopic measurement gives the molecular ion peaks corresponding to the inclusion complex of 1:1 molar ratio of host and guest molecules. The mechanism of inclusion was drawn by 1H-NMR and 2D ROESY spectroscopic analysis. Surface texture of the inclusion complexes was studied by SEM. Finally, the cytotoxic activities of the inclusion complexes were analyzed and found, Cell viability also balances for non-toxic behavior of the ICs. Moreover, all the studies reveal the formation of inclusion complexes of two ephedra free, alternatively emerging drugs (after their banned product having ephedra) SNP, PEH with α and β-CD which enriches the drug delivery system with their regulatory release without any chemical modification