Study of Electrocardiographic and 2d Echocardiographic Changes & Its Correlation with Fibroscan in Chronic Alcoholics

Objective: Alcohol is a widely used psychoactive substance with dependence producing properties. Excess alcohol consumption over a long period can be associated with variety of cardiovascular disorders. Thus, the study was undertaken to evaluate the Electrocardiographic and Echocardiographic abnormalities in chronic alcoholics and also to evaluate UGI Endoscopy and Fibro scan findings in asymptomatic alcoholic patients. Materials and Methods :50 chronic alcoholics and 50 age and sex matched controls attending the outpatient in N.S.C.B. Medical College and Hospital, Jabalpur were selected for the study. It was a prospective case-control study designed in age group 20-60 years, having history of chronic alcoholism. Patients with known diabetic, hypertension and cardiovascular disorders were excluded from the study.Results: The Prevalence of Cardiovascular disorders in patients of chronic alcoholism was 42% in our study. Most common ECG changes are Sinus Tachycardia (12%) followed by Non-specific ST-T wave changes (10%). Most common 2D Echo changes are increased posterior wall thickness (16%) followed by increased interventricular thickness (10%) and diastolic dysfunction (10%). The prevalence of cardiovascular abnormalities is found to be increased with increased duration of alcohol consumption. The most common UGI endoscopy findings in chronic alcoholics were Antral Gastritis (6%), Duodenitis (6%) and Moderate PHG (4%). The Mean LSM of chronic alcoholics in Fibro scan is ≤5.8.Conclusions:This study concludes that cardiovascular changes occur in chronic alcoholics prior to development of symptomatic cardiac disorders; which are early changes and are reversible and can be easily detected with noninvasive investigations like ECG and 2D Echo

Study of liver Disorders during pregnancy and fetomaternal outcome in a tertiary care hospital

Background: Liver disease in pregnancy encompasses a spectrum of diseases which causes abnormal liver function tests. The liver disorders are associated with significant maternal and foetal morbidity and mortality. The present study was done with objective to study incidence, clinicopathological correlation of liver disorder during pregnancy and its impact on maternal and foetal outcome.Methods: This prospective observational study was conducted in Department of Obstetrics and Gynaecology, NSCB Medical College Jabalpur. Eighty-five antenatal cases, on the basis of inclusion criteria were studied prospectively. Those subjected to detailed history and examination, clinical symptoms suggestive of liver disorders followed by all available LFTs including LDH along with some more definitive tests to aid identification of underlying cause and followed up till delivery in terms of maternal and foetal outcome. Results: The incidence of the liver disorders in pregnancy was 0.86%. In study group, 76.5% cases were between 20-30 years of age,72.9% cases were primigravida and 90.59% cases presented in third trimester of pregnancy. In this study, 76.4% presented with pregnancy specific liver disorder, of these 32.9% had pre-eclampsia, 11.7% had eclampsia, 11.7% had HELLP syndrome. 16.4% with ICP, AFLP 2.3%and Hyperemesis gravidarum in 1.1% cases. Maternal mortality was 10.58% and morbidity was 34.12%. Live birth 61%, still birth 38.82%, preterm 21.1% and IUGR 24.7%. NICU admission required in 28.57% cases. Conclusions: Regular antenatal check-up, screening and diagnosing liver disorder at an earliest, proper treatment and timely referral to higher centres can save the lives of many mothers and foetuses