A study of clinical profile and factors affecting mortality in patients with acute on chronic liver failure in a tertiary hospital in north east India

Background: Data regarding Acute on Chronic Liver Failure (ACLF) patients from North East India is scarce and presentation to hospital is often late. We aim to study their clinical profile, aetiology of underlying chronic liver disease, precipitating factors, predictors of mortality and their short term outcome (3 months).Methods: Among 1000 consecutive patients of any form of acute decompensation, 245 patients diagnosed as ACLF were prospectively studied. Comparison was done between survivors versus non survivors of ACLF and between ACLF and Non ACLF patients.Results: Mean age of ACLF patients was 44.2±10.3 years and male:female ratio was 13.4:1. Common causes of underlying cirrhosis in ACLF was alcoholic liver disease, 210 (85.7%), Hepatitis B virus related cirrhosis, 20 (8.2%), Hepatitis C virus related cirrhosis, 6 (2.4%) and cryptogenic in 8 (3.3%). Precipitating causes were alcoholic hepatitis in 98 (46.6%) among alcoholic cirrhosis, acute flare of Hepatitis B infection in 12 patients (60%) among Hepatitis B related cirrhosis, recent use of drugs in 110 (44.8%), sepsis in 71 (28.9%), spontaneous bacterial peritonitis (SBP) in 36 (14.7%), urinary tract infection in 36 (14.7%), acute hepatitis A in 5 (2%) and acute hepatitis E in 3 (1.2%). hepatic encephalopathy, low sodium, high International Normalised Ratio (INR) were found to be significantly associated with high mortality. Increasing number of organ failures is associated with increasing risk of death.Conclusions: ACLF is characterized by rapid deterioration especially when multiorgan failure sets in due to certain precipitating factors in a previously diagnosed or undiagnosed chronic liver disease.

Indications, outcomes and complications of therapeutic endoscopic retrograde cholangiopancreatography procedures in a tertiary care centre in North East India

Background: Therapeutic endoscopic retrograde cholangiopancreatography (ERCP) is one of the most complex endoscopic procedures in the management of several pancreatobiliary diseases. There is no comprehensive data available till date about ERCP procedures from North East India. The aim of this study was to review the indications, outcomes and complications of endoscopic retrograde cholangiopancreatography (ERCP) procedures in a tertiary care centre of North East India.Methods: We retrospectively analysed the clinical records of all patients undergoing ERCP between July 2011 and November 2019. ERCP was performed under sedation (Midazolam + Pentazocine). Patient’s demographic characters, ERCP indications, outcome and post-ERCP complications were reviewed. Potential important patient and procedure related risk factors for overall post-ERCP complications were investigated.Results: A total 1038 patients were included in the study. Cannulation of the desired duct was successful in 89.2% of ERCPs. Among them male patients were 392 and females were 646. Mean age was 45 years and the age range were 7 to 92 years. Commonest indication was choledocholithiasis followed by malignancy. Overall Success rate was 82.66% with 84.64% in CBD stone and 75.65% in stenting of malignancy. Post ERCP complications developed in 96 patients (9.2%) and pancreatitis was the most common post-ERCP complication. Sedation related complications occurred only in few cases.Conclusions: Despite its associated morbidity and risk of mortality, ERCP is an important method for managing the pancreatic-biliary diseases. Indications, outcomes, and complications of therapeutic ERCPs in our centre are comparable to those reported from other centres

Abstracts of National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020

This book presents the abstracts of the papers presented to the Online National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020 (RDMPMC-2020) held on 26th and 27th August 2020 organized by the Department of Metallurgical and Materials Science in Association with the Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jharkhand, India. Conference Title: National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020Conference Acronym: RDMPMC-2020Conference Date: 26–27 August 2020Conference Location: Online (Virtual Mode)Conference Organizer: Department of Metallurgical and Materials Engineering, National Institute of Technology JamshedpurCo-organizer: Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jharkhand, IndiaConference Sponsor: TEQIP-

Constraining the magnitude of the Chiral Magnetic Effect with Event Shape Engineering in Pb-Pb collisions at sNN\sqrt{s_{\rm NN}} = 2.76$ TeV

In ultrarelativistic heavy-ion collisions, the event-by-event variation of the elliptic flow $v_2$ reflects fluctuations in the shape of the initial state of the system. This allows to select events with the same centrality but different initial geometry. This selection technique, Event Shape Engineering, has been used in the analysis of charge-dependent two- and three-particle correlations in Pb-Pb collisions at $\sqrt{s_{_{\rm NN}}} =2.76$ TeV. The two-particle correlator $\langle \cos(\varphi_\alpha - \varphi_\beta) \rangle$, calculated for different combinations of charges $\alpha$ and $\beta$, is almost independent of $v_2$ (for a given centrality), while the three-particle correlator $\langle \cos(\varphi_\alpha + \varphi_\beta - 2\Psi_2) \rangle$ scales almost linearly both with the event $v_2$ and charged-particle pseudorapidity density. The charge dependence of the three-particle correlator is often interpreted as evidence for the Chiral Magnetic Effect (CME), a parity violating effect of the strong interaction. However, its measured dependence on $v_2$ points to a large non-CME contribution to the correlator. Comparing the results with Monte Carlo calculations including a magnetic field due to the spectators, the upper limit of the CME signal contribution to the three-particle correlator in the 10-50% centrality interval is found to be 26-33% at 95% confidence level

Constraining the magnitude of the chiral magnetic effect with event shape engineering in Pb–Pb collisions at √sNN=2.76 TeV

In ultrarelativistic heavy-ion collisions, the event-by-event variation of the elliptic flow v2 reflects fluctuations in the shape of the initial state of the system. This allows to select events with the same centrality but different initial geometry. This selection technique, Event Shape Engineering, has been used in the analysis of charge-dependent two- and three-particle correlations in Pb–Pb collisions at √sNN=2.76 TeV. The two-particle correlator 〈cos⁡(φα−φβ)〉, calculated for different combinations of charges α and β, is almost independent of v2 (for a given centrality), while the three-particle correlator 〈cos⁡(φα+φβ−2Ψ2)〉 scales almost linearly both with the event v2 and charged-particle pseudorapidity density. The charge dependence of the three-particle correlator is often interpreted as evidence for the Chiral Magnetic Effect (CME), a parity violating effect of the strong interaction. However, its measured dependence on v2 points to a large non-CME contribution to the correlator. Comparing the results with Monte Carlo calculations including a magnetic field due to the spectators, the upper limit of the CME signal contribution to the three-particle correlator in the 10–50% centrality interval is found to be 26–33% at 95% confidence level