Acute pancreatitis occurs only in 4-8% of patients with gallstone disease and 50% acute pancreatitis recur within 1-6 months. As in other parts of country, the incidence of gallstone disease has been increasing in our region. This study has been carried out in our hospital to find out the disease pattern. MATERIALS AND METHODSAll the patients admitted with acute gallstone pancreatitis during the period were included. Various biochemical parameters and radiological investigations like x-ray, Ultrasonography (USG), Computerized Tomography (CT) of abdomen were done in all patients. The treatment plan was focused on adequate initial resuscitation, supportive care and early detection of complications. Duration of stay in the hospital, complications and followup were recorded. RESULTSThirty two patients were included in the study; 41-60 years was the most common age group. Male:Female ratio was 1:2.2. Meitei was most commonly affected ethnic group. Epigatric pain and tenderness were the most common clinical features. Most (75%) of the patient's serum amylase was above three times the upper normal limit. Ultrasonography diagnosed 75% of cases, whereas computerized tomography diagnosed 100%. Average hospital stay was 8 days. Complications included pleural effusion and pseudocyst. CONCLUSIONGenetic basis of occurrence of gallstone pancreatitis among the various ethnic groups of Manipur needs to be addressed. Serum amylase and ultrasonography were useful initial diagnostic modality. The acceptance of index cholecystectomy in our local population is very low and the awareness of treatment modalities has to be increased.
OBJECTIVE:To Study clinical profile of HIV and AIDS patients and find its correlation with CD4 + and CD8 + T lymphocyte levels. MATERIALS AND METHODS: 104 HIV infected or AIDS cases were enrolled. Demographic and clinical data were recorded. General and systemic examinations with particular attention to presence of opportunistic infections was done. The diagnosis of HIV/AIDS was done bases on the criteria provided by National AIDS Control Organization (NACO). CD4 + count was estimated by Fluorescent Activated Cell Sorter (FACS). Opportunistic infection (OI) was diagnosed based on clinical signs, symptoms supported by laboratory investigation findings. Serum total protein, serum SGPT were estimated using kit method. RESULTS: The data collected was analyzed statistically using SPSS version II. Out of 104 HIV/AIDS cases, most cases were in the age group (30 -40) years. Tuberculosis was the commonest OI 40(38%) including 72(69%) extra pulmonary tuberculosis 16(15%) followed by oral candidiasis 22 (21%), cyptococcal meningitis 15 (14%) and others. Most patients had CD4 + T lymphocyte count between ( 100 -200) cells/µl and CD8 + T lymphocyte in range (400 -600) cell/µl. Hepatitis C and Hepatitis B co infections occurred in 24 (23%) and 11 (11%) of cases respectively. All had CD4 count below 400 cell/ µl. A significant level of correlation was observed between CD4 and serum total protein with Karl Pearson's correlation coefficient r=0.270, at 0.01 level of significance. CONCLUSION: IDU was the commonest route of infection. Tuberculosis including extra pulmonary tuberculosis being the most common OI. Co infections with Hepatitis -C and Hepatitis B occurred in many patients which could be attributed for the rise in SGPT levels. Most of the OIs occurred in patients having CD4 count <100 cells/µl. Out of 104 cases, 68 cases were under antiretroviral drugs and 14 such cases developed OIS. Hence there is possibility of treatment failure on first line drug treatment and in these cases further study is required.
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