Background/Aims:Acute liver failure (ALF) in pregnancy is often associated with a poor prognosis. In this single-center observational study we aim to study the incidence, causes, and factors affecting mortality in pregnant women with ALF.Patients and Methods:Sixty-eight pregnant women reporting with clinical features of liver dysfunction were enrolled as cases. Their clinical course was followed and laboratory studies were performed. The presence of ALF was defined as the appearance of encephalopathy. The results were compared with a control group of 16 nonpregnant women presenting with similar complaints. The cases were further subdivided into two groups of survivors and nonsurvivors and were compared to find out the factors that contribute to mortality.Results:ALF was seen in significantly more number of pregnant women than the controls (P = 0.0019). The mortality rate was also significantly higher (P = 0.0287). Hepatitis E virus (HEV) caused jaundice in a higher number of pregnant women (P < 0.001). It also caused ALF in majority (70.3%) of pregnant women, but HEV infection was comparable between the survivors and nonsurvivors (P = 0.0668), hence could not be correlated with mortality.Conclusions:Pregnant women appear to be more susceptible for HEV infection and development of ALF. The mortality of jaundiced pregnant women increased significantly with appearance of ALF, higher bilirubin, lower platelet count, higher international normalized ratio, and spontaneous delivery.

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Introduction: Various studies have demonstrated superiority of SAAG (serum ascites albumin gradient) in classifying ascites compared to transudate-exudate concept but with conflicting observations. Ascitic fluid total protein (AFTP) level in ascitic fluid is a much cheaper alternative to the serum ascites albumin gradient ratio. Hence in the study, we have compared the diagnostic accuracy of the old cheaper traditional method against the new method. Methods: Total 102 patients of Ascites were included in the study from J.A. group of hospital, G.R.Medical College (M.P.) in year 2013-15. All medical causes of ascites were included in our study and Non medical causes were excluded. The collected data was analyzed by using Pearson Chi-square statistical analysis to determine correlation between variables. Result: For prediction of liver disease it was found that SAAG was significantly (p value 0.0341) more predictive of Liver disease compared to AFTP. SAAG (p value<0.0009) and AFTP (p value 0.49) were both significant for differentiating cause of ascites when comparison was done between liver and non-liver disease. Conclusion: AFTP is a good surrogate marker for detection of liver disease in ascites. AFTP is an excellent diagnostic test for detection of certain extra hepatic diseases leading to ascites like tubercular peritonitis sub-acute bacterial peritonitis and anaemia-hypo-proteinemia.

Background: Since covid has emerged as the most dreadful global health crisis and data on diagnostic profile and morbidity mortality indicators in it is still limited, we propose to study the correlation of morbidity and mortality with values of Inflammatory markers in these patients. To STUDY variations in INFLAMMATORY MARKERS IN Aim: COVID19 PATIENTS and correlating it with severity of disease. using CLIA technique, four Materials and Methods: inflammatory markers ( TROPONIN -I , ferritin, procalcitonin, IL -6) were studied among 400 patients. This was correlated with severity of the disease outcome among the patients. Among the inflammatory markers we studied Results: IL-6 ,Ferritin,Troponin -I ,Procalcitonin. Raised values of IL-6 and raised ferritin levels were associated with severity. Troponin I (91%) ,Ferritin( 70.8%) ,Calcitonin ( 78.5%) were increased but showed no association with mortality. However only IL-6 seems to be associated with increased mortality among Covid patients. On the basi Conclusion: s of findings in this study Inflammatory markers particularly IL -6 and ferritin can be concluded as important predictors of disease severity and outcome.These parameters can be used to identify high-risk patients at resource-limited settings

Background: Incidence of gallbladder carcinoma (GBC) is high among the north Indian population. It may be due to environmental, dietary and reproductive factors. Evaluation of GBC epidemiology will provide important insights into determining causes and risk factors for gallbladder cancer. The aims and objectives were to study the epidemiology, clinical presentation and etiological factors of GBC.Methods: Fifty-one cases of GBC were studied retrospectively at Cancer Hospital and Research Institute (CHRI) Gwalior, Madhya Pradesh, India from January to December 1998. All the patients underwent a detailed history taking and physical examination followed by routine laboratory tests and other investigations including ultrasonographic and computed tomography scan of whole abdomen. Histopathological evaluation of gallbladder specimen was also performed after surgical resection of the GB mass.Results: Incidence of GBC at this centre was 1.49%. GBC was more prevalent among old women (mean age 52.62±12.14 years) belonging to low socio-economic status (SES) (52.94%). Most common presenting symptom of GBC was pain in right hypochondrium (70.4%) followed by anorexia (42.8%), pruritus (35.7%), weight loss (31.2), nausea and vomiting (30.4%). Histopathological examination revealed majority of the case to have adenocarcinoma (84.31%). Gallstones were present in 35.29% patients.Conclusions: GBC is more prevalent in older women belonging to low SES. Gallstones remain the chief risk factor for this malignancy. Histopathological examination of all cholecystectomy specimens for early pre cursor lesion could serve as an important means of early detection of this carcinoma.