BACKGROUNDAcute ischaemic stroke remains the second most leading cause of death throughout the world and 85% of strokes are due to infarction. Carotid atherosclerosis remains an important contributor to the ischaemic stroke patients. Internal carotid artery is the commonest site of atherosclerosis and occurs predominantly in diabetic, hypertensive, dyslipidaemic patients.The aim of our study is to find the prevalence of carotid artery stenosis in acute ischaemic patients and association with risk factors like diabetes mellitus, hypertension, dyslipidaemia.
BACKGROUND Chronic liver disease in the clinical context is a disease process of the liver that involves a process of progressive destruction and regeneration of the liver parenchyma leading to fibrosis and cirrhosis. Of the various complications in liver cirrhosis including hepatorenal syndrome type 1, still carries the worst prognosis. The aim of this study is to assess the resistivity index of cirrhotics with ascites and cirrhotics without ascites, to correlate with clinical status and serum creatinine levels, to detect persons with increased resistive index in the presence of normal renal parameters and to identify a subset of patients at higher risk of development of HRS to find out the usefulness and applicability of this methodology. MATERIALS AND METHODS A total of 92 patients in which there were 75 cases which included cirrhosis with ascites, cirrhosis without ascites and 17 controls which included fatty liver and healthy individuals formed the study group. Patients were selected for the study who satisfied all the inclusion and exclusion criteria. Study design is a single centre, descriptive, cross-sectional and non-interventional study. Inclusion criteria is patients attending Medical Gastroenterology Clinic and General Medicine Wards with Chronic Liver Disease with or without decompensation. Exclusion criteria is pre-existing renal parenchymal disease, other causes of renal vasoconstriction, druginduced renal failure (e.g. aminoglycosides and NSAIDs), glomerulonephritis, prerenal failure, sepsis and acute tubular necrosis. Detailed clinical history was taken from each patient and a complete review of their case notes performed. A complete clinical examination of the abdomen was done for each patient. Blood investigations were done. USG abdomen was done which detects the liver echoes, ascitic fluid and kidney size. Portal Doppler was done to elicit portal hypertension picture. Renal Doppler was done to measure the resistivity index. The RI of three renal vessels, obtained in three renal areas was measured in each patient by using at least three Doppler spectra and the mean value was calculated. RESULTS In our study in cirrhotics, renal vascular resistance indices evaluated by duplex Doppler ultrasonography are already increased in the early phase of the disease. Development of ascites is associated with a further increase in the resistance indices. Renal vasoconstriction evaluated by these indices is correlated with Child score, which quantitatively measures the hepatic function in cirrhosis. CONCLUSION We conclude that intrarenal RI measurement is a predictor of renal vasoconstriction and serves to detect early renal function impairment in cirrhotic patients. The diagnosis of elevated RI may be taken into account in the clinical management of these patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.