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Background: Several scoring systems have been designed for risk stratification and prediction of outcomes in upper GI bleed. Endoscopy plays a major role in the diagnostic and therapeutic management of UGIB patients. However not all patients with UGIB need endoscopy. The objective of the present study was compared the prediction of mortality using different scoring systems in patients with upper GI bleed. A decision tool with a high sensitivity would be able to identify high and low risk patients and for judicious utilization of available resources.Methods: 100 patients were assessed with respect to their clinical parameters, organ dysfunction, pertinent laboratory parameters and five risk assessment scores i.e. clinical Rockall, Glasgow Blatchford, ALBI, PALBI and AIMS65 were calculated.Results: For prediction of outcomes, AIMS65 was superior to the others (AUROC of 0.889), followed by the GBS (AUROC of 0.869), followed by clinical Rockall score (AUROC 0.815), followed by ALBI score (AUROC of 0.765), followed by PALBI score (AUROC of 0.714) all values being statistically significant.Conclusions: The AIMS65 score is best in predicting the mortality in patients with upper GI bleed. The optimum cut off being >2. Though GBS may be better in predicting the need for intervention, it is inferior in predicting the mortality. The newer scores like ALBI and PALBI are inferior to AIMS65 and GBS in predicting mortality.

Introduction:Cardiac dysfunction in patients with cirrhosis occurs in the setting of a circulatory dysfunction characterized by a marked splanchnic arterial vasodilation. Circulatory changes can lead to the cardiac dilatation of the left chambers and the development of functional changes in the heart. The present study is intended to assess cardiac functions in patients of liver cirrhosis.Material and methods: It was a cross sectional study conducted among 74 diagnosed cases of liver cirrhosis, admitted to department of general medicine, KIMS Hospital during the 6 months study duration. Results:Overall LVDD was diagnosed in 59 cases (79.73%). Out of which, 47.29% cases presented with Stage 1 (impaired relaxation) LVDD, Stage 2 LVDD (pseudo normal) among 31.08% and only one patient had severe restrictive type of (Stage 3) LVDD. Conclusion:Left ventricular diastolic dysfunction is commonly associated with advancement of hepatic dysfunction while systolic function is maintained till advanced hepatic failure.

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Background: The objective of this study was to study the multiple clinical parameters in patients with VAP and to compare the 3 scores namely, APACHE II, SOFA and CPIS in predicting the treatment outcome of patients with ventilator associated pneumonia.Methods: It was a cross sectional observational study conducted on forty patients admitted in ICU between June 2018 and July 2019, who developed VAP after admission to ICU. Logistic regression analysis was applied to estimate the predictive ability of the APACHE II, SOFA and CPIS scoring systems in assessing VAP-related mortality. A p value of <0.05 was considered significant. All analyses were performed using SPSS software version 10.Results: The sample size in our study was 40 patients. The mean age of patients was 43.4±15.9. The mean duration of mechanical ventilation before VAP onset was 8±2 days. Klebsiella species was the most common organism isolated from ET aspirate. Of the three scores only APACHE II was independent predictor of the mortality in the logistic regression analysis.Conclusions: APACHE II score is better at predicting mortality in patients with VAP as compared to SOFA and CPIS scores. Age, co-morbidities, duration of ICU stay, time of acquiring VAP, multi organ dysfunction, need for ionotropes and multi drug resistant organisms play an important role in predicting the outcome of patients.