Aim: The aim of the study is to determine the etiology of seizures in the elderly and types of seizure in elderly populations. Materials and Methods: This was a cross-sectional study carried out on patients of age more than 60 years with seizures and who satisfied inclusion and exclusion criteria, admitted in Bangalore Medical College and Research Institute (BMCRI) attached hospitals, Bengaluru, between November 2016 and October 2018. After obtaining ethical clearance and approval from the institutional ethics committee of BMCRI, written informed consent was taken from the patients. Detailed history was taken from all patients, and all patients underwent thorough clinical examination and investigations. The diagnostic probability was based on the clinical data obtained from the patient charts and the results of electroencephalography (EEG) and computed tomography (CT) scans. The etiology of seizures was determined on the basis of medical history, neurologic examination, EEG, and CT scans. Results: A total of 58 patients of new-onset seizure included in the study out of which 30 were male and 28 were female. Majority of the patients were aged between 60 and 70 years. Male-to-female ration was almost equal. GTCS was the major type of seizure. Cerebrovascular infarct was the most common etiology. Diabetes and hypertension (HTN) were the most common comorbid conditions. Conclusion: Seizure was the dominant manifestation of various underlying disorders in the elderly, of which cerebrovascular disease was the most common cause, followed by metabolic cause. Comorbidities such as diabetes and HTN also had an important role in seizure activity. GTCS was the most common type of seizure in the elderly.
Background: Alcoholic liver Disease (ALD) encompasses a spectrum of Injury, ranging from simple steatosis to frank cirrhosis which is evaluated by many scoring systems. Aims and Objective: Our study aims at evaluating the discriminative abilities of Child-Pugh, model for end-stage liver disease (MELD), and albumin-bilirubin (ALBI) scores in predicting the inhospital mortality in cirrhotic patients complicated with acute upper gastrointestinal bleeding. Materials and Methods: Data of Patients with Liver cirrhosis secondary to ethanol presented with Upper GI bleed were retrospectively reviewed. Child Pugh, MELD and ALBI scores were calculated for the patients and results from ROC curves were analysed. Results: In our study conducted on 112 patients, the age distribution was between 18-74 yrs with mean age ofpatients being 46.47+/-10.9 years, sex ratio Male: Female: 105:7 with mortality rate of 33.4%.the Area under curves of ROC of ALBI, Child Pugh and MELD are 0.743, 0.864 and 0.763. Conclusion: The prognostic performance of all 3 scores was comparable but Child Pugh score was found to have better prognostic significance than ALBI and MELD score.
Background: Liver cirrhosis is the end result of chronic liver injury. Cirrhosis of liver may progressively deteriorate from a well-compensated state to decompensated conditions. Aims and Objective: Our study aims at evaluating the AST to Platelet Ratio Index (APRI) for predicting the in-hospital mortality and also comparing APRI, MELD and albumin for predicting in hospital mortality in chronic liver disease. Materials and Methods: Data of Patients with Chronic liver disease were retrospectively reviewed. MELD and APRI scores were calculated for the patients and results from ROC curves were analysed. Results: In our study conducted on 299 patients, the age distribution was between 18-64 years with mean age of patients being 46.47+/-10.9 years, sex ratio Male: Female: 266:37 with mortality rate of 17.7%. The area under curves of ROC of APRI, MELD and Albumin are 0.63, 0.76 and 0.55. Conclusion: APRI is an independent predictor of mortality. The prognostic performance of all 3 was comparable but MELD has better prognostic significance than APRI score.
Background: Several scoring systems have been designed for risk stratification and prediction of outcomes in upper GI bleed. Endoscopy plays a major role in the diagnostic and therapeutic management of UGIB patients. However not all patients with UGIB need endoscopy. The objective of the present study was compared the prediction of mortality using different scoring systems in patients with upper GI bleed. A decision tool with a high sensitivity would be able to identify high and low risk patients and for judicious utilization of available resources.Methods: 100 patients were assessed with respect to their clinical parameters, organ dysfunction, pertinent laboratory parameters and five risk assessment scores i.e. clinical Rockall, Glasgow Blatchford, ALBI, PALBI and AIMS65 were calculated.Results: For prediction of outcomes, AIMS65 was superior to the others (AUROC of 0.889), followed by the GBS (AUROC of 0.869), followed by clinical Rockall score (AUROC 0.815), followed by ALBI score (AUROC of 0.765), followed by PALBI score (AUROC of 0.714) all values being statistically significant.Conclusions: The AIMS65 score is best in predicting the mortality in patients with upper GI bleed. The optimum cut off being >2. Though GBS may be better in predicting the need for intervention, it is inferior in predicting the mortality. The newer scores like ALBI and PALBI are inferior to AIMS65 and GBS in predicting mortality.
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