This article has no abstract. The first 100 words appear below:
A 9-year-old girl of non-consanguineous parents presented at the outpatient department with the history of jaundice and abdominal distension for 20 days and respiratory distress for 7 days. She also complained of bloody vomiting without any melena. The mother gave the history of abdominal pain for 2 days which was diffuse in nature. Her menarche had not started yet. Her younger sister is healthy. She had no history of fever, constipation, family history of liver disease, sib death, contact with known tuberculosis patient, blood transfusion or parenteral medication. On examination, she was afebrile, moderately pale, dyspnea and leukonychia. Bilateral pedal edema was present.
Introduction: Chronic liver disease is an important cause of morbidity and mortality in Bangladeshi children. Development of esophageal varices and bleeding is one of the major complications of CLD. The mortality from each episode of variceal bleeding is 30-50% depending on the clinical status of the patient. The upper GI endoscopy is currently the best reliable method available to diagnose the presence of esophageal varices. Objective: To Assess the correlation between blood ammonia level and grading of esophageal varices in CLD patients. Methods: This cross sectional observational study was conducted at the Department of Paediatric Gastroenterology and Nutrition, BSMMU, Dhaka from January 2018 to December 2019. A total of 63 cases of CLD were selected. Study sample were selected according to the inclusion and exclusion criteria. Along with proper clinical history, examination & initial investigation, fasting venous blood ammonia level and upper GI endoscopy were done in all patients. Receiver-Operator Characteristic (ROC) curve was analysis to set up a cut-off value of blood ammonia for prediction of esophageal varices. Sensivity, specificity, positive predictive value, negative predictive value and accuracy were determined to see the performance of blood ammonia value as a diagnostic test for esophageal varices. Results: Among the 63 patients, (74.6%) had esophageal varices. Wilson disease was the most common etiology of CLD (43; 68.3%) among the studied patients. Among the studied patient, the mean ± SD blood ammonia level was 40.5± 18.0 µmol/L in absent esophageal varices group, 50.5± 14.3 µmol/L in grade I varices group, 50.7± 9.9 µmol/L in grade II esophageal varices group, 53.1± 26.9 µmol/L in grade III varices group and 71.9± 19.0 µmol/L in grade IV esophageal varices group. Here p value is 0.002, which is statistically significant. It was observed that the mean ± SD blood ammonia level was 56.2± 17.9 µmol/L in esophageal varices present group (n = 47) ....
This article has no abstract. The first 100 words appear below:
A 10-year old boy, the only issue of his deceased parents, was admitted to the department for the management of recurrent episodes of diarrhea and severe wasting for 2.5 months, low grade, irregular fever with evening rise of temperature, anorexia and repeated attack of skin blister for the last 1 year. The patient complained of chronic, painless, non-bloody, profuse watery diarrhea with a weight loss of 10 kg (decrease to 18 kg from 28 kg prior to illness). He also complained of cough for the last seven days. His father was a driver and died at his 1 year of age due to an unknown disease.
This article has no abstract. The first 100 words appear below:
A 6-month-old boy of non-consanguineous parents admitted to the Department of Pediatric Gastroenterology with the complaints of progressive jaundice, dark urine and generalized pruritus for one month. The boy was well up to five months of age. Then he developed jaundice which was progressive in nature with intermittent pale colored stool along with dark urine. His mother also complaints for generalized pruritus which was severe in intensity (disturbing sleep and daily activities) without any diurnal variations. There was no history of sib death or family history of a similar type of illness.
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