Background and AimAcute kidney injury (AKI) is a common complication of chronic liver disease (CLD). We performed a prospective study to evaluate the risk factors and spectrum of AKI among decompensated cirrhosis (DC) patients and the impact of AKI on survival.MethodsThis study was conducted in consecutive DC patients hospitalized in SCB Medical College between December 2016 and October 2018. AKI was defined as per ICA criteria. Demographic, clinical, and laboratory parameters and outcomes were compared between patients with and without AKI.ResultsA total of 576 DC subjects were enrolled, 315 (54.69%) of whom had AKI; 34% (n = 106) had stage 1A, 28% (n = 90) stage 1B, 21% (n = 65) stage 2, and 17% (n = 54) stage 3 AKI. Alcohol was the predominant cause of CLD (66.7%). In 207 (65.7%) patients, diuretic/lactulose/nonsteroidal anti‐inflammatory drugs use was noted, and infection was present in 190 (60.3%) patients. Compared to those without AKI, patients with AKI had higher leucocyte count, higher serum urea and creatinine, higher Child‐Turcotte‐Pugh, higher Model of End‐Stage Liver Disease (MELD) scores (P < 0.001), longer hospital stay, and lower survival at 28 days and 90 days (P < 0.001). Besides, in patients with stages 1A to 3 AKI, there were differences in overall survival at 28 days (P < 0.001) and 90 days (P < 0.001).ConclusionsOver half of DC patients had AKI, and alcohol was the most common cause of cirrhosis in them. Use of AKI‐precipitating medications was the most common cause of AKI, followed by bacterial infection. AKI patients had increased prevalence of acute‐on‐chronic liver failure and had prolonged hospitalization and lower survival both at 28 days and 90 days.

A Data Warehouse is an integral part of those enterprises which want to have a clear business insights from customer and operational data. It includes collection of technologies aimed at enabling the knowledge worker (executive, manager, analyst) to make better and faster decisions. It is expected to present the right information in the right place at the right time with the right cost in order to support the right decision. Over the years ,the practice of Data warehousing proved that the traditional online Transaction Processing (OLTP) systems are not fully appropriate for decision support. From the survey and evaluation of the literature related to Data Warehouse and with consultation and feedback of the data warehouse practitioners working in renowned IT giants ,it has been observed that the fundamental problems arise in populating a warehouse with quality data. . This paper mainly focuses on the study of the issues that hinder the data quality and performance of the Data warehouse and some of the means that may be opted to realize a better performance with respect to accuracy and quality to meet the challenging and dynamic needs of the corporate world.

Background: The occurrence of acute kidney injury (AKI) in acute-on-chronic liver failure (ACLF) negatively impacts the survival of patients. There are scant data on the impact of serum urea on outcomes in these patients. We performed this study to evaluate the relationship between admission serum urea and the survival in patients with ACLF and AKI. Methods: A prospective study was conducted on patients with ACLF (as per Asian Pacific Association for the Study of the Liver criteria) and AKI (as per Acute Kidney Injury Network criteria) hospitalized in the gastroenterology ward between October 2016 and May 2018. Demographic, clinical and laboratory parameters were recorded, and outcomes were compared in patients with respect to the admission serum urea level. Results: A total of 103 of 143 hospitalized patients with ACLF had AKI and were included as study subjects. The discrimination ability between survivors and the deceased was similar for serum urea levels (area under the receiver operating characteristic curve [AUROC] [95% confidence interval {CI}]: 28 days survival, 0.76 [0.67-0.85]; 90 days survival, 0.81 [0.72-0.91]) and serum creatinine levels (AUROC [95% CI]: 28 days survival, 0.75 [0.66-0.84]; 90 days survival: 0.77 [0.67-0.88]) in patients with ACLF and AKI. However, on multivariate analysis, admission serum urea (not serum creatinine) was an independent predictor of mortality in these patients both at 28 days (p = 0.001, adjusted hazard ratio [

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Detection of basic differentiating characteristics of eye diseases from the images of the retina can be a good approach as a low-cost method for broad-bas ed initial screening. For example early diabetic retinopathy detection enables application of laser therapy treatment in order to prevent or delay loss of vision. The paper has referenced Diabetic retinopathy and Retinitis pigmentosa for analysis. Automated approach for detection of microaneurysms in digital color fundus photographs helps ophthalmologist to detect the emergence of its initial symptoms and determine the next action step for the patient. A similar mechanism for automated early disease detection method with respect to the features of the normal eye is proposed. The detection algorithm features identification of black pigments like minute features, microaneurysm and exudate detection and these features extracted can prove to a greater extent as ready instances for defectiveness. A number of images along with the feedback and consultation from the ophthalmologist in this area of medical science has proved to be a great help towards the observation as derived from this mechanism and discussed in the later end of this paper. The proposed mechanism can be extended up to the limit of supervised learning so as to automate the practical feedbacks as obtained from the practitioners.