Background: Extra-hepatic portal vein obstruction (EHPVO) due to portal vein thrombosis is an important cause of portal hypertension in several region including India. The cause of thrombosis in these patients remains unclear. Objective of the study was to study the demographic features, etiology, clinical, laboratory findings with special reference to thrombophilic factors like protein C, protein S and antithrombin III deficiency in children with EHPVO.Methods: The prospective analysis of 62 patients of EHPVO (<14 years of age) was done in the Department of Hepatology, SCB medical College, Cuttack. After detailed history, clinical examination, Ultrasound abdomen /color Doppler and Upper GI endoscopy, the subjects were analyzed for any deficiency of thrombophilic factors like protein C, protein S and antithrombin III.Results: A total of 62 patients (37 Male, 25 Female) with mean age of 8.3+3.1 years were studied. Growth retardation was present in the form of wasting (alone) 20.9%, stunting (alone) 25.8% and both wasting and stunting was found in 9.8% cases. History of neonatal, umbilical sepsis and umbilical vein catheterization was found in 15.9% and 10.2% of cases respectively. Haemorrhage from oesophageal varices was prevalent symptoms in 85.9% patients. Splenomegaly was found in 91.9% patients and ascites in 9.4% patients. 47 patients studied for protein C, S and antithromibin III. 14 patients were found to have thrombophilia: protein C deficiency in 9, protein S deficiency in 8, Antithrombin III deficiency in 6.Conclusions: The etiology of EHPVO in the majority of patients remain still unclear. It is commonly associated impaired somatic growth. The risk of EHPVO increases in the presence of thrombophilia, resulting from deficiency of naturally occurring anticoagulant proteins like Protein C, Protein S and Antithrombin III.

No abstract

Background: Acute on chronic liver failure (ACLF) is a recently recognised entity in chronic liver disease patients. Data regarding ACLF in terms of clinical presentation, etiology of underlying cirrhosis, precipitating factors, prognostic factors are lacking from eastern India. The present study was undertaken to evaluate the above factors along with the assessment of short-term mortality (4 weeks) in patients of ACLF.Methods: In this prospective observational study, 120 patients diagnosed as ACLF were included. A comparison of complications, biochemical profiles and prognostic scores was made between the survivor and non-survivor groups.Results: Of the 120 ACLF patients included, the mean age was 44.9±8.6 years and the male to female ratio was 2.5:1. Common clinical presentations were jaundice (100%), ascites (88.3%), hepatic encephalopathy (60%). The most common etiology for underlying CLD was alcohol (51.7%) followed by chronic hepatitis B (20%) and chronic hepatitis C (15%) infection. Alcohol hepatitis (40%) followed by hepatotropic viral infections (20%) and drug-induced liver injury (15%) were common identifiable precipitating agents. After a follow-up period of 4 weeks, 56 (46.6%) out of 120 patients died. The presence of sepsis, hyponatremia, renal failure, and coagulopathy was significantly associated with high mortality. Mortality was higher among patients having high Chronic liver failure consortium- acute on chronic liver failure (CLIF-ACLF) grade and closely related to the number of organ failures.Conclusions: ACLF is a rapidly progressive syndrome in chronic liver disease patients, having high short-term mortality.

Background: Non-communicable diseases (NCDs) are ragging reality of today’s world and have moved up the priority list of most countries worldwide including India. Objectives were to find out prevalence of different types of strokes among the patients admitted in neurology department of SCB medical college, to study socio-clinical profiles of admitted stroke patients and to find out associated risk factors with different types of strokes.Methods: Cross-sectional hospital-based study in neurology ward of SCB MCH, Cuttack, Odisha in 2019-20.Results: The mean age 60.93±12.8, males are more affected, 60-69 years were more affected, 76% were ischemic strokes, 85% cases weakness of limbs reported, hypertension, diabetes, alcoholism, smoking, dyslipidemia were major risk factors. Hypertension and smoking found to be highly significant in case of young stroke patients.Conclusions: Major modifiable risk factors were hypertension (63.3%) followed by alcohol intake 53.9%.

Introduction: Wilson’s Disease is an autosomal recessive disease. It is characterized by degenerative changes in the brain, liver and Kayser-Fleischer Rings in the Cornea. It is observed with the prevalence of approximately 1:3000 among all ethnic groups. Aims & Objectives: To study the clinical profile and therapeutic aspects of Wilson’s Disease. Material and Methods: It was a prospective observational study conducted in the department of Hepatology of SCB Medical College & Hospital, in Cuttack city of Odisha. Patients were followed up after 6 month and response to treatment was observed. Results: Most patients were in age group 11-15 years (43%), male, female ratio being 2:1. 64% patients had hepatic presentations, 11% patients had neurological presentations and 25% of patients had both hepatic & neurological presentations. The hepatic presentations were jaundice in 79% of cases followed by Ascites and pedal edema in 75% of cases each, 29% patients were having UGI bleeding. Among the 28 patients 68% presented with KF Rings, 16% patients had child A, 28% had Child B and 56% patients had Child C cirrhosis. Conclusion: The commonest presentation of Wilson’s disease was Chronic Liver Disease.