Clinical Profile and Upper Gastrointestinal Endoscopy Findings of Patients Presenting with Liver Cirrhosis with Portal Hypertension

ABSTRACT Introduction: Liver cirrhosis of is a common problem faced by physicians in worldwide and is also responsible for 11th most common cause of death globally. Data regarding prevalence of esophageal varices and other upper gastrointestinal changed in patients with liver cirrhosis is scare in Nepal. So this study was done to find out clinical profile and upper gastrointestinal endoscopy findings of patients presenting with liver cirrhosis with portal hypertension. Methods: This was a cross-sectional observational hospital based study conducted in the department of internal medicine and endoscopy unit of the Universal College of Medical Sciences, Bhairahawa, Nepal. The study was done from 21 February 2019 to 20 November 2019 in the patients presented with liver cirrhosis with portal hypertension. The upper gastrointestinal endoscopy was done in all cases. The data was collected using the predesigned pro-forma. Results: Total 89 patients with liver cirrhosis were enrolled with mean age of 51.84±12.26 years and male : female ratio of 3.68 : 1. As per Child Pugh classification (CTP) 45 patients (51%) were in Class C, 33 patients (37%) were in Class B and 11 patients (12%) were in Class A. Esophageal Varies were present in 51 (57.3%) patients. According to Westaby classification grade I esophageal varices were seen in 17 (19,1%), grade II esophageal varices were seen in 26 (29.2%), grade III esophageal varices were in 8 (8.9%) patients. Portal hypertensive gastropathy (PHG) were seen in 64 (71%) patients. Conclusions: The prevalence of esophageal varices in cirrhotics was 57% whereas PHG was seen in 71 % patients

Study of Serum Uric Acid Level in Acute Coronary Syndrome in Nepalese Subjects

At present, cardiovascular diseases are global health problems responsible for 17.3 million deaths per year and adding extra burden in developing countries like Nepal. Studies show that serum uric acid (SUA) can result in endothelial dysfunction which can lead to vascular disease like stroke. In this study, we determined serum uric acid levels in patients with acute coronary syndrome (ACS) and assess its risk factors. A cross sectional study was conducted in 82 patients with ACS who fulfilled the inclusion criteria included in the study and their serum uric acid level were investigated. It was found that 51 (62.2%) were males and 31 (37.8%) were females. Mean age in study population was 60.26 ± 11.34 years. Majority of the population belongs to 56-65 years age group. The mean uric acid level of our study population was 6.03 ± 1.50 mg/dl (male = 5.92 ± 1.72, female = 6.64 ± 1.53). SUA ? 7 mg/dl was maximum in 56-65 years age group and there was no association between age and SUA (P value = 0.146). Over half of the study population were hypertensive i.e. 42 (51.21%) and smoker i.e. 43 (52.43%). It showed association between SUA and ACS (P value = 0.003). Among those having diabetes, maximum have SUA ? 7 mg/dl i.e. 17 (47.22%). Among those having high cholesterol level, male have higher incidence than female with no association between T. Cholesterol and gender (P value = 0.49). The mean value of T. Cholesterol was 189.83 ± 46.81 mg/dl (male = 198.78 ± 55.19 mg/dl, female = 202.30 ± 54.92 mg/dl) with (P value = 0.52). In conclusion, the mean age of ACS patients was 60.26 years, with the peak incidence at the age of 56-65 years. The ACS had male predominance. The potential risk factors of ACS were: Age >56 years (65.83%), male sex (62.2%), dyslipidemia (35.36%, hypertension (51.2%), diabetes mellitus (43.9%), smoking (52.4%) and alcohol consumption (39%). Among these SUA significantly associated with risk factors were- Sex, Diabetes Mellitus, T. Cholesterol. There was association between serum uric acid level and ACS patients. Hypertension and smoking constitutes one of the major risk factor for ACS in study population