Introduction: The gut mucosa in portal hypertension is the seat of microcirculatory changes that compromise its integrity and increase its susceptibility to damage. The mucosal changes in portal hypertension may require pharmacological, directed endoscopic or portal decompressive therapy. The objective of the study is to find out various upper gastrointestinal tract endoscopic findings in patients of portal hypertension.Methods: A prospective, cross-sectional, observational study of sixty patients of portal hypertension was conducted from June to October 2009. The esophagus, stomach and upper duodenum was visualized for any changes, especially by taking the tip of the instrument close to the mucosa.Results: Out of total, 60, 47 (78.3%) cases were cirrhotic and 13 (21.7%) cases were non-cirrhotic portal hypertension. The most frequent upper GI endoscopic finding was esophageal varices 56 (98.3%) followed by gastropathy 49 (81.6%), gastric hyperemia 19 (31.6%), duodenal hyperemia and erosive gastritis 16 (26.6% in each) and gastric varices 12 (20%). Esophageal varices were equally prevalent among cirrhotic and non cirrhotic portal hypertensive patients, 46 out of 47 (97.9%) and 13 out of 13 (100%) respectively. Gastropathy was more prevalent in cirrhotic patients with 87.2% vs. 75% in NCPF followed by 40% in EHO. However, duodenal ulcers were seen only in EHO 12.5%. Erosive gastritis was more prevalent in EHO (75%) followed by NCPF (60%), however, it was less frequent in cirrhotic portal hypertension (14.8%).Conclusions: The most common upper GI endoscopic finding in portal hypertensive patients were found to be esophageal varices followed by gastropathy, peptic ulcer disease (gastric and duodenal hyperemia, chronic gastritis, erosive gastritis, gastric ulcer and duodenal ulcer)._______________________________________________________________________________________Keywords: gastrointestinal tract; portal hypertension; varices.

Introduction: Stroke is broadly classified as cerebral infarction, intracerebral hemorrhage and subarachnoid hemorrhage. Neuroendocrine profile is altered in acute ischemic stroke and there is a link between hypothyroidism and atherosclerosis which in turn may lead to stroke. The objective of this study was to find out the prevalence of alteration of thyroid hormones in patients with ischemic stroke in a tertiary care center. Methods: This descriptive cross-sectional study was conducted from June to December 2019 in a tertiary care center. Ethical approval was taken from Institutional review board of National Academy of Medical Sciences (reference number: IM 175). Patients with a diagnosis of stroke, without evidence of cardioembolic source, history of liver disease, renal failure and thyroid disease and who do not use thyroidal supplementation within 180 days prior the event were included. Convenience sampling was done. Data was entered in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 22. Point estimate at 90% Confidence Interval was calculated along with frequency and percentage for binary data. Results: The prevalence of altered thyroid levels among 73 patients was 13 (17.8%) (90% Confidence Interval= 10.44-25.16). Among them 11 (15.1%) were hypothyroid and 2 (2.7%) were hyperthyroid. Among severity of hypothyroid cases, subclinical hypothyroidism grade IA was seen in 51 (70%), subclinical hypothyroidism grade IB was seen in 22 (30%), Conclusions: The prevalence of altered thyroid levels among patients undergoing ischemic stroke was similar to the findings of other international studies.

Introduction  Stroke is the sudden death of brain cells that occurs due to lack of oxygen, caused by blockage of blood flow or rupture of an artery to the brain leading to permanent disability or death. Diabetes mellitus has been established as a major risk factor for stroke. However, this study was conducted to incorporate glycemic status and its correlation with severity of stroke. Materials and Methods A cross-sectional observational study was conducted in the Department of Internal medicine, Neurosurgery, Emergency and Endocrinology of Bir Hospital. Ethical clearance was granted by Institutional Review board of National academy of medical sciences. A total of 50 patients with stroke presented within 72 hours of symptoms of stroke was included in the study. Data was collected and stored in MS-EXCEL sheet and analyzed using SPSS. Results Among 50 patients with stroke enrolled for the purpose of this study, 54% had ischemic and 46% hemorrhagic stroke. Patient pool was predominantly 51-60 years of age. Majority of the patients were euglycemic, of these 56.67% suffered hemorrhagic stroke, while known diabetics predominantly suffered ischemic stroke. Euglycemic patients had CT lesion measuring 5-10mm compared to larger lesions of  >10mm in known diabetics. Euglycemic patients had better outcome in contrast to newly diagnosed and known diabetics. Conclusion The study found that patients with higher glucose levels had increased severity of stroke. Increased morbidity was documented among known diabetics and newly diagnosed cases of DM in comparison to euglycemics and patients with stress hyperglycemia.