Background and aims Acute-on-chronic liver failure (ACLF) is associated with a high mortality rate in the absence of liver transplantation. There is limited data on predictors of survival in ACLF in children. Therefore, we prospectively studied the predictors of outcome of ACLF in children. Methods A prospective evaluation of 31 children in the age group of 1-16 years who fulfilled the criteria for ACLF according to Asian Pacific Association for the Study of the Liver (APASL) 2008 consensus was done. All consecutive children were evaluated for etiology, diagnosis and severity of ACLF. For grading of organ dysfunction, the sequential organ failure assessment (SOFA) score was calculated. SOFA constitutes the parameters of respiration, coagulation, cardiovascular system, central nervous system, and renal and liver functions. We evaluated possible correlation between outcomes and different variables. Results Of the 31 children who fulfilled the criteria for ACLF, the common underlying chronic liver diseases (CLD) were autoimmune hepatitis (AIH) in 41.9% and Wilson disease in 41.9% of the patients. Superinfection with hepatitis A virus (HAV) (41.9%) was the most common etiology of acute deterioration. To find the best predictor for outcome, linear regression analysis was performed. Multivariate analysis revealed that the SOFA score and the International Normalized Ratio (INR) were predictors of survival. Six (19.4%) patients died. Causes of death were multiorgan failure in four and liver failure in two patients. Conclusion The mortality in ACLF is 19.4% and the causes of death were multiorgan failure and liver failure. The SOFA score and INR were predictors of outcome of ACLF in children.
An anomaly map of the Z component has been produced for the region of the Indian sub-continent for the first time by the Survey of India using MAC;SAT data. Data of thousands of kilometres of satellite tracks of varying altitude have been reduced to a common elevation of 400 km by removing the external field and linear trend. The entire data was plotted on a map of 1 : 6 M and mean values of 2 ° × 2 ° blocks then accepted for contouring. A prominent magnetic low is reflected over the Himalayas and a prominent high over the Indian peninsula. The dividing line of positive and negative anomalies between the Himalayas and Deccan Traps falls along the Narmada lineament.
The magnetic measurements of declination (D), horizontal (H) and vertical (Z) components of earth's magnetic field, collected from ground surveys between 1962 and 1966, are used to develop an analytical model of geomagnetic field variations over Indian region for the epoch 1965. In order to reflect spatial features with wavelengths of approximately 1000 kin, sixth degree polynomial as a function of differential latitude and longitude is calculated by the method of least squares. The root mean square fit of the model to the input data is better than that accounted by the International Geomagnetic Reference Field for 1965.0. lsomagnetic charts drawn for D, H, Z and total force (F) reflect more details than that shown on world magnetic charts. Further, the values of the field at common repeat stations recorded between 1962 and 1974, after eliminating the field values for the epoch 1965.0, are used to get the secular variation as well as its spatial dependence again by means of polynomial which now includes coefficients which are functions of time and of geographical locations. The accuracy of coefficients is tested against the behaviour of secular variation at permanent magnetic observatories. The merits and limitations of the model are discussed.
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