Background: Gastroesophageal varices due to portal hypertension in patients with liver cirrhosis is an important cause of morbidity and mortality. Gold standard investigation for varices is esophagogastroduodenoscopy and patients are advised to undergo regular follow up based on the risk stratification. But the invasive nature, risk of procedure-related complication and lack of accessibility and affordability makes it important to identify simpler methods to screen patients. Platelet count/spleen diameter (PSD) ratio has been validated as a marker for oesophageal varices (OV) in multiple studies but with varying results. The present study was conducted to evaluate the accuracy of PSD ratio in OV.Methods: A cross-sectional study was conducted in patients diagnosed with liver cirrhosis. Clinical examination, relevant laboratory investigations, abdominal ultrasound and endoscopy were performed and data were recorded. PSD was calculated. Receiver-operator characteristics curves were plotted to determine cut-off values. Sensitivity, specificity, positive and negative predictive values were calculated.Results: Total 100 patients were included in this study, out of which 25% of patients did not have varices on endoscopy. The mean PSD was for patients without varices 1242.82 (253.45) and 883.51 (582.38467) for patients with OV. The area-under-curve was 0.823, 95% CI=0.734-0.912, p value=0.000001. The cut-off value for PSD was calculated from the ROC analysis was 1077. The sensitivity, specificity, positive and negative predictive values were 76%, 88%, 95% and 55% respectively.Conclusions: PSD ratio is not an efficient parameter for detection of varices in patients with liver cirrhosis. The current evidence does not support its role as a screening test for identification of patients with OV.

Background:The prevalence and incidence of thyroid disorders is influenced primarily by sex and age are more common in women and in older adults. Thyroid disorders if left untreated will increase risk of cardiovascular diseases and osteoporosis. Hence, screening for thyroid dysfunction must be done as routine investigation in the women presenting with menopausal symptoms.Methods:This case control study includes 50 pre-menopausal women of age group 34-49 years and 50 post-menopausal women of age group 50-55 years, visiting General medicine department of Victoria hospital and hospital affiliated to Bangalore Medical College and Research Institute. All the subjects were subjected for serum triiodothyronine (T3), tetraiodothyronine or thyroxine (T4), thyroid stimulating hormone (TSH), free T3 and T4 levels.Results:Out of all subjects; 23 were hyperthyroid out of which 14 were post-menopausal women, 37 were hypothyroid out of which 19 were post-menopausal women. Chi-square test showed no significant association. Negative and weak correlation was seen between total T3 and age; total T4 and age; TSH and age; free T3 and age; free T4 and age in pre-menopausal women. Negative and moderate correlation was seen between total T3 and age; total T4 and age; free T3 and age. There was a positive and weak correlation seen between TSH and age; weak positive non-significant correlation seen between free T4 and age. Significant correlation was seen between total T3 and age in post-menopausal women.Conclusions:Post-menopausal women should be monitored for serum T3, T4, TSH levels for reducing risk of thyroid dysfunction.