Background: In many studies it was noticed that following a laparoscopic cholecystectomy (LC), liver function parameters were disturbed. The carbon dioxide pneumoperitoneum causes changes in the splanchnic microcirculation and can affect cardiac, pulmonary, liver and kidney physiology. Alterations in intracranial pressure, blood acid- base control and the immune system have also been seen. This study was done to know the effects of carbon dioxide pneumoperitoneum on liver function tests in LC. Aim of the study was to study the significance of alterations in Liver function tests and procedure’s safetyMethods: Blood samples of 100 patients who underwent laparoscopic cholecystectomy preoperatively once and post operatively after 24 hours were collected. These blood samples were tested for LFT. The pre op and post op levels of these liver function test values were compared.Results: The level of serum AST, ALT, bilirubin (total) and ALP were increased significantly during the first 24 hrs. Postoperatively after laparoscopic cholecystectomy as compared to baseline values and the levels of serum albumin and total proteins were decreased.Conclusions: There may be a transient elevation of hepatic enzymes after LC and the major causative factor seemed to be CO2 pneumoperitoneum.
Background: One of the independent risk factor for erectile dysfunction is diabetes mellitus. The present study planned to determine the prevalence and factors associated with ED in DM.Methods: A one year cross-sectional study on a total of 208 patients with type 1 or 2 diabetes. National Institutes of Health (NIH) approved questionnaire for International Index of Erectile Function (IIEF) was used to interview each patient to assess for ED.Results: In this study 12.98% of patients had ED score between 13 to 18 suggestive of mild to moderate ED and 9.62% with 19 to 24 scores suggestive of mild degree. The prevalence of erectile dysfunction was 32.21%. The mean age in patients with erectile dysfunction was significantly high (58.40±10.96 years) compared to those without erectile dysfunction (51.00±11.16 years) (p<0.001) Of the 119 patients with duration of diabetes between one to five years 42.02% had ED and of the 3 patients with duration of more than five years 66.67% had ED (p<0.001). Prevalence of ED was higher in patients with HbA1c levels between 7.0 to 8.5 (32.76%) and >8.5 (37.07%). Prevalence of erectile dysfunction was higher in patients with history of smoking (63.64%) (p<0.001) and alcohol intake (51.85%) (p<0.001). The prevalence of erectile dysfunction was also significantly high in patients with history of hypertension (59.7%) (p<0.001).Conclusions: The ED in patients with diabetes mellitus was significantly prevalent with age, duration of diabetes, history of hypertension, cardiovascular disease, glycemic control and hypertriglyceridemia.
Background: Diagnostic scores have been found to be very efficient. The present study was taken up to calculate diagnostic efficacy of Fenyo-Lindberg (FL) scoring system in patients of acute appendicitis.Methods: A one-year cross sectional study was done on 100 patients in patients with right lower quadrant pain. Group I had patients with score of -2 and above and group II with score below -2. The groups were compared with histopathological diagnosis. Then, the sensitivity, specificity, positive predictable value (PPV) and negative predictable value (NPV) were calculated.Results: In this study, the males were 52 and females were 48.15 patients, Total leucocyte count (TLC) had more than 14,000 whereas 16 patients had onset of pain in less than 24 hours. 47 patients had vomiting. Tenderness was present in all cases, while rebound tenderness was present in 54% of cases. 98% of patients had progression of pain, whereas migration was seen in 76%. 56% patients had increased pain on coughing. 54 patients had acute appendicitis on histopathology. The study shows that this scoring system has sensitivity of 72% and specificity of 71% in diagnosing acute appendicitis. The PPV was 75% and NPV was 68%.Conclusions: The FL score is an inexpensive clinical tool that may help the diagnosis of acute appendicitis. The results are comparable to previous studies but as the sample size is small, study has to be done in higher sample size to get the data necessary to generalize the findings and the fact that this study was first on this scoring system in India should also be considered.
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