International Journal of Research and Review

Number 9, 2022

1-8
The Difference of Urinary Neutrophil Gelatinase-Associated Lipocalin Level between Liver Cirrhosis Patients With and Without Hepatorenal Syndrome

Authors: Fakhrurrazi Nasution, Gontar Alamsyah Siregar, Ilhamd, Dharma Lindarto

Abstract

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Objective: To determine differences of urinary Neutrophil Gelatinase-Associated Lipocalin level in liver cirrhosis patients with or without Hepatorenal Syndrome (HRS). Methods: This study was conducted on 46 liver cirrhosis patients (20 patients without hepatorenal syndrome, 26 patients with hepatorenal syndrome). Diagnosis of HRS was based on International Ascites Club criteria. Urinary NGAL was examined using ELISA method. Data analysis was performed with p<0,05 stated as statistically significant. Result: This study showed more HRS cases was found in male than female, with an average age of 53,95 years old for hepatic cirrhosis without HRS, and 57,35 with HRS. The most common cause of this study is Hepatitis B virus, and the highest grade of severity is in Child Pugh-C. The average urinary NGAL level in liver cirrhosis with HRS is 59,39 ± 58,98 ng/ml and 130,78 ± 45,14 ng/ml in liver cirrhosis without HRS. Conclusion: There was a significant higher urinary NGAL level in liver cirrhosis with HRS (p = 0.000), with the cut-off of urinary NGAL to differentiate cirrhosis patients with and without HRS was 95,115 ng/ml.

9-16
Post-operative Complications of Complicated Paediatric Appendicitis in a Tertiary Teaching Hospital

Authors: Aravind C S, Sam Varkey, Binu M K, Shinaz Sadiq, Maneesha U R

Abstract

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Background: Acute appendicitis is a common surgical problem, with complicated appendicitis having significant post operative complications, which contribute significantly to cost of medical care. Methodology: A hospital based retrospective study was conducted in department of paediatric surgery, Thiruvananthapuram. Study population consisted of children treated with complicated appendicitis from January 2016 to June 2021. Results: The study had 30.4% surgical site soft tissue infection (SSI). There was 13.48% incidence of major complication, with laparoscopic and open appendicectomies having similar incidence even though not statistically significant. SSI was more common with appendicular abscess and post ileal appendix. Post operative intra-abdominal abscess is more common with open appendicectomy, generalised peritonitis, post ileal appendix and base/proximal perforation of appendix. Post operative adhesive intestinal obstruction was more common with laparoscopic appendicectomy, appendicular abscess and base/proximal perforation of appendix. Total hospital stay correlates significantly with duration of symptoms on presentation with mean hospital stay of 7.72 days. Conclusion: Complicated appendicitis have high incidence of post operative complications, 30.4% SSI and 13.48% serious complications like intra-abdominal collection and adhesive intestinal obstruction.

17-27
Diffusion Weighted and Dynamic Contrast Enhanced Magnetic Resonance Imaging in Carcinoma of Cervix: Role of Apparent Diffusion Coefficient Value and Time Intensity Curve Pattern in Chemoradiotherapeutic Response Evaluation

Authors: Raghavendra H K, Alpana Manchanda, Anju Garg, Kishore Singh, Gauri Gandhi

Abstract

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Introduction: Magnetic resonance imaging (MRI) is a widely used imaging modality in the imaging evaluation of carcinoma of cervix. The aim of our study was to evaluate the response in carcinoma cervix patients following chemoradiotherapy by Diffusion weighted (DW-MRI) and Dynamic contrast enhanced-MRI (DCE-MRI). Methods: 21 inoperable biopsy proven patients (mean age 48.43 years) of carcinoma cervix were included in the study. All patients underwent MRI (conventional, DW and DCE) of the pelvis thrice. Baseline MRI, Post chemotherapy MRI after neoadjuvant chemotherapy and Post chemoradiotherapy MRI after completion of concurrent chemoradiotherapy. Post treatment apparent diffusion coefficient(ADC) values and Time intensity curve(TIC) pattern were compared with baseline values. Results: Baseline meanADC value of all patients was 0.82 x10-3 mm2/s. After completion of treatment, 18 patients showed complete resolution of tumor and showed 0.50 x10-3 mm2/s increase in meanADC value from baseline MRI which was significantly higher than remaining 3 patients with residual tumor (0.50 x10-3 mm2/s v/s 0.17 x10-3 mm2/s). ADC threshold value of 1.15 x10-3 mm2/s was defined, differentiating the residual tumor from the healthy cervical tissue after chemoradiation. On post treatment MRI, 17 out of 18 patients with complete resolution of tumor showed increasing trend of enhancement on TIC and only one patient showed plateau pattern. 2 of the 3 patients with residual tumor showed washout pattern and one patient showed plateau pattern. Conclusion: ADC values and TIC pattern differ in patients with complete response to chemoradiotherapy from patients with residual tumor, so helps in differentiating residual tumor from cancer free cervix.

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A Comparative Study of Efficacy of Miniature Punch Grafting and Platelet Rich Plasma Therapy in Treatment of Focal Stable Vitiligo in 50 Cases

Authors: Vijay Soyal, Deval N Vora, Jinali Makwana

Abstract

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Introduction: Vitiligo, a depigmented skin disorder is characterized by selective loss of melanocytes, which in turn leads to pigment dilution in the affected areas of the skin. The characteristic lesion is a totally amelanotic, non scaly, chalky white macule with distinct margins. If the disease is not progressing for the past one year it is described as stable vitiligo. There are various treatment options available for the treatment of focal stable vitiligo. It can be safely treated with miniature punch grafting as well as platelet rich plasma therapy. Aims and Objectives: Aim of this study is to compare efficacy of miniature punch grafting and platelet rich plasma therapy and to evaluate the outcome of treatment of focal stable vitiligo. Materials and Methods: Total 50 patients were selected and divided into two groups. One group was treated with miniature punch grafting while the other group underwent platelet rich plasma therapy. Pre-treatment and post treatment assessment was done by VASI (Vitiligo area scoring index) score. Result: A total of 25 patients were selected for grafting. Perigraft pigmentation was evident from 3rd week of grafting steadily increasing up to the end point of record i.e 6months. 17 patients showed good response, 4 patients showed average response while 4 patients showed poor or no response at all. Out of the 25 patients taken for platelet rich plasma therapy, 7 patients showed good response, 7 patients showed average response while 11 patients showed poor or no response at all. Conclusion: Miniature punch grafting showed better response as compared to platelet rich plasma therapy but both the therapies have their pros and shortcomings.

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A Comparative Study of Efficacy of Fractional CO2 Laser vs Microdermabrasion in Treatment of Acne Scars (Total 100 Patients)

Authors: Jinali Makwana, Deval Vora, Vijay Soyal

Abstract

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Introduction: Acne vulgaris is a common disease affecting pilosebaceous unit that can lead to significant scarring. Fractional CO2 Laser and microdermabrasion are effective non-surgical treatment modalities for acne scars. Aims and objectives: To study and compare the efficacy of fractional CO2 Laser and microdermabrasion therapy in acne scars. Material and methods: Total 100 patients were selected in our study. 50 patients were allotted into each group. Scar grading assessment was done by Goodman and Baron qualitative scar grading system. Result: 50 patients were taken in each group. There was a significant improvement in grading of acne scars at the end of 6months of treatment. On comparison of fractional CO2 Laser with microdermabrasion, p-value was <0.05 that is significant. Conclusion: Fractional CO2 Laser showed better improvement in grading of acne scars then microdermabrasion, though none of these treatments are 100% effective in treating acne scars.