Cardiac changes in patients with chronic liver disease: A prospective descriptive study

Background: The systemic circulation in patients with cirrhosis is hyperdynamic with an increased cardiac output and heart rate and a reduced systemic vascular resistance as the most pronounced alterations. The concomitant cardiac dysfunction has recently been termed “cirrhotic cardiomyopathy”, which is an entity different from that seen in alcoholic heart muscle disease. Objective: To study cardiac changes in patients with chronic liver disease. Methodology: The present study was a prospective descriptive clinical study consisting of thirty five patients with cirrhosis who were inpatients in the department of Medicine, tertiary care Institute, from Oct 2011 to Oct 2013.The patients were evaluated for presence of cirrhotic cardiomyopathy. Results: In A group there is no patient, while in Child- Pugh Score- B group 14 subjects have cirrhotic cardiomyopathy out of 16 and in C group 18 have cirrhotic cardiomyopathy out of 19. We analyzed that there was no relation between severity of liver disease and cirrhotic cardiomyopathy (p value- 0.446). Conclusion: Indian patients with cirrhosis do have diastolic dysfunction. In the absence of other risk factors for cardiac disease, this dysfunction can be attributed only to cirrhotic cardiomyopathy

Invasive cranial mycosis our experiences

Fungi can cause serious cranial infections in immunocompromised and diabetic patients. Common pathogens mainly include Aspergillus and Mucor. These organisms cause tissue invasion and destruction of adjacent structures (e.g. orbit, ethmoid, sphenoid, maxillary & cavernous sinuses). Mortality and morbidity rate is high despite combined surgical, antifungal and antidiabetic treatment. We present our experience of six cases with such infection