Introduction: Brucellosis is a zoonotic disease which is also known as Mediterranean fever. It is acquired from the handling of infected animals or consuming contaminated milk or milk products. The incubation period varies from 1-3 weeks to several months before clinical disease appearance and it shows multiorgan involvement. This study focuses on the varied presentation of this disease and laboratory findings. Materials and Methods: This is a retrospective study, where the past 15 years data of cases diagnosed with brucellosis was studied in a tertiary care center in South India. Patient demographics, clinical presentation, duration of stay in the hospital, hematological and biochemistry profiles were collected and analyzed in SPSS. Results: More number cases were found among the male gender (70%), mostly in the 20- 40 years age group (40%). 95% of cases reported fever, 40% with arthralgia (29% generalized in nature), and 32% with a headache. A Positive Pearson correlation between CRP and NLR, and CRP and PLR were found, which was statistically significant. Mean laboratory values were documented. 37% of patients were found to have hepatosplenomegaly on ultrasound Conclusion: Most of the patients were admitted as cases with pyrexia of unknown origin. Our study focused on the different clinical presentations and laboratory findings of brucellosis and will help give a better understanding and outline during brucellosis case diagnosis and management in a cost-efficient manner.
Objective: To find an accurate cut-off value for Portal vein diameter as a diagnostic tool for Portal hypertension on comparing with Doppler ultrasound, CT abdomen, or endoscopy of collateral circulation. Materials and methods: This was a cross-sectional study, with a sample size of 100 patients. Inclusion criteria were patients above the age of 15 years who underwent routine USG abdomen for various conditions in the Radiology Department of a tertiary hospital. Distribution of age, gender, chronic liver disease, portal hypertension, and portal vein diameter of all the patients were measured and recorded. Portal hypertension was diagnosed using the presence of collaterals either on upper endoscopy (if done), Doppler USG, or CT multiphase abdomen. Results: Portal vein diameter of 10.5mm was found to have a sensitivity of 61.22%, specificity of 60.78%, a positive predictive value of 60.00%, a negative predictive value of 62.00%, and accuracy of 61.00%. 45 out of 59 (76.3%) and 37 out of 49 (75.5%) patients of the 50-70 years age group had chronic liver disease and portal hypertension respectively. 45 out of 65 (69.2%) males 37 out of 65 (56.9%) males developed CLD and PHTN. Conclusion: Using portal vein diameter as a diagnostic indicator of PHTN has an accuracy of %, so it can be used in routine USG abdomen of CLD patients to prevent the dreaded complications of PHTN and treat it early. Male gender and patients above the fifth decade were increasingly predisposed to both CLD and PHTN.
Background: Non-Alcoholic Steatohepatitis (NASH) is an aggressive form of Non-Alcoholic Fatty Liver disease (NAFLD), with liver inflammation and scarring. Due to a lack of clinical biomarkers and asymptomatic nature, NASH is often under-diagnosed. It is the most common cause of chronic liver disease in the USA. Liver biopsy is the gold standard to diagnose NASH, but it is invasive and life-threatening and histologic evaluation of a liver biopsy sample is imperfect as a reference because of sampling variability due to the irregular distribution of fibrosis. Aim: Validating AST/ALT ratio as a stand-alone scoring system in NASH is scarce and so this study aims to establish a correlation between FibroScan values and AST/ALT ratio. Methodology: All NASH patients, who underwent FibroScan were included. Their demographics, FibroScan, AST, ALT values were recorded in M S Excel and Pearson correlation between FibroScan values and AST/ALT ratios of 150 NASH patients was calculated using SPSS. Results: Out of 150 NASH patients, 72% were males and 57.33% belonged to 40-50 years age group. FibroScan values and AST/ALT ratio showed positive Pearson correlation of 0.245, (p value=0.003). FibroScan values and splenic size also showed a positive Pearson correlation of 0.289 (p value<0.001). Conclusion: Males of 40-50 years age group had higher distribution of NASH, so middle aged males should be screened routinely as they are at a higher risk. FibroScan value with AST/ALT ratio and splenic size showed a positive correlation, thus showing that AST/ALT ratio and splenic size increases with increase in liver stiffness.
