3,909 research outputs found

    Acute-on-chronic Liver Failure: MELD Score 30-day Mortality Predictability and Etiology in a Pakistani Population

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    Background: Cirrhosis is a pathological condition that ultimately leads to liver failure. Acute on chronic liver failure (ACLF) has a high short term mortality rate. Viral hepatitis is the most common cause of liver failure in our local population. We carried out this study to identity the 30-day mortality and etiology of patients presenting with ACLF using Model for End-Stage Liver Disease (MELD) score predictability. Methodology: This was a descriptive case series, conducted at Sheikh Zayed Hospital, Lahore, Pakistan from January 31, 2018 to July 30, 2018. One hundred and eighty five patients who met the inclusion criteria were enrolled using 95% confidence level and 4% margin of error. Data was entered and analyzed with SPSS version 23.0. Numerical variables including age was presented by Mean ± S.D. Categorical variables i.e. gender, etiology of acute-on-chronic liver failure and 30-day mortality were presented by frequency and percentage. Data was stratified for age, gender, duration of chronic liver disease and MELD grade to address the effect modifiers. Post-stratification chi-square test was calculated using 95% significance (p≤0.05). Results: Majority of the enrolled patients were male (74.6%) while only 25.4% of the patients were female. One hundred and thirty patients (70.3%) had underlying viral hepatitis while twelve patients (6.5%) and forty three patients (23.2%) presented with alcoholic liver disease and drug-induced ACLF, respectively. Eighty patients (43.2%) died within 30 days of admission.The 30-day mortality with respect to MELD grade was statistically significant (p<0.001) with the highest mortality noted in grade-IV and thirty five patients (43.8%) dying within 30 days of admission (p<0.001). Grade-II and III MELD scores also contributed to the 30-day mortality with twenty three patients (28.8%) and nineteen patients (23.8%) dying within 30 days of admission (p<0.001). Conclusion: MELD scores are able to accurately predict the short-term mortality in patients with ACLF and viral hepatitis was the most common etiology in our population. Early detection and use of appropriate prognostic models may alleviate mortality and morbidity in paitents with ACLF

    Bandgap narrowing in Mn doped GaAs probed by room-temperature photoluminescence

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    The electronic band structure of the (Ga,Mn)As system has been one of the most intriguing problems in solid state physics over the past two decades. Determination of the band structure evolution with increasing Mn concentration is a key issue to understand the origin of ferromagnetism. Here we present room temperature photoluminescence and ellipsometry measurements of Ga_{100%-x}Mn_{x}As alloy. The up-shift of the valence-band is proven by the red shift of the room temperature near band gap emission from the Ga_{100%-x}Mn_{x}As alloy with increasing Mn content. It is shown that even a doping by 0.02 at.% of Mn affects the valence-band edge and it merges with the impurity band for a Mn concentration as low as 0.6 at.%. Both X-ray diffraction pattern and high resolution cross-sectional TEM images confirmed full recrystallization of the implanted layer and GaMnAs alloy formation.Comment: 24 pages, 7 figures, accepted at Phys. Rev. B 201

    Gestational diabetes in a developing country, experience of screening at the Aga Khan University Medical Centre, Karachi

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    In order to determine the prevalence of glucose intolerance in pregnancy, 1267 consecutive women attending the antenatal clinic of the Aga Khan University Medical Centre were subjected to a 75 g glucose challenge followed 2 hr later by plasma glucose determination irrespective of gestation on the first antenatal visit. The test was repeated at 28-32 weeks of gestation if the patients had an abnormal initial screen at less than 28 weeks gestation and a normal glucose tolerance test on diagnostic follow-up and for those who had a risk factor for gestational diabetes and a normal initial screen at less than 28 weeks gestation. The glucose challenge test was abnormal (2 hr plasma glucose greater than 140 mg%) in 8.6% of the screened population. Follow-up oral glucose tolerance test on these patients revealed a prevalence of 3.2% of gestational diabetes and 1.9% of impaired glucose tolerance test based on the modified O\u27Sullivan criteria. Improvement in cost effectiveness of screening programmes was adjudged possible by avoiding glucose tolerance tests in patients with 2 hr plasma glucose value of greater than 170 mg% after a 75 g oral glucose challenge for screening

    Ionizing Radiation Leakage in Radio-Diagnostic Centers at Gaza Strip Hospitals, Palestine

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    The fact of using radiation in medicine has led to major improvements in the diagnostic and treatment of human diseases. However, it carries some risks of health problems. In Gaza governorates hospitals, there is tremendous development has taken place in the radio-diagnostic field and there is no clear radiation protection program, lack of clear information about radiation protection measures and guidelines. The objective of this study was an assessment whether yearly equivalent radiation dose received by the radio-diagnostic workers and public in governmental Gaza governorates hospitals are within the dose limits recommended by ICRP or not. The study was carried out in nine governmental hospitals. The hospitals were selected because of their large and diverse of their radio-diagnostic services. The radiation survey meter (OD-01) was used to measure radiation leakage. Data sheet was also used to elicit information about the radio-diagnostic rooms and machines specifications. The results indicate that the fluoroscopy and CT scan rooms were not efficiently lead lined and the radiation protection is not well organized. The measured values of radiation dose rate at different locations in basic X-ray and mammography rooms are found within a permissible limits for occupational stuff and public. However, the recommended distance between the X-ray machine and control panel have not been achieved in some rooms. Therefore, there is a desperate need for rules, regulations and radiation protection act in the field of radiation in medical field
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