To evaluate resistive index in various stages of liver cirrhosis and to determine its significance in developing hepatorenal syndrome. METHODS: Study included 60 cirrhotic patients divided into 4 groups (15 patients each): compensated liver cirrhosis (group A), diuretic responsive ascites (group B), refractory ascites (group C), hepatorenal syndrome (group D) and ten healthy persons as control group (E). All patients subjected to detailed history taking and clinical examination. Laboratory investigations included simple urine analysis, complete blood picture, liver function tests, blood urea and serum creatinine, serum sodium and serum potassium, and protein concentration. Ultrasonographic examination and renal duplex Doppler were under taken to assess the Resistive index. RESULTS: The RI of interlobar and arcuate arteries were significantly higher in all patient groups than in control group (p <0.05), the RI was significantly higher in patients with refractory ascites than in patients with diuretic responsive ascites, and also in patient of diuretic responsible ascites than in patients with compensated cirrhosis (p < 0.05), in patient with hepatorenal syndrome than in patient with diuretic responsive ascites and patients with compensated cirrhosis (p<0.05). Also Creatinine levels & blood urea levels in patients with the hepatorenal syndrome was significantly higher than that of other different groups (p<0.05) but there was no significant change in creatinine levels between patients with compensated cirrhosis and control group. While creatinine levels in patient with diuretic responsive ascites was significantly higher than that in patient with compensated cirrhosis (p<0.05) there was no significant change between patient with diuretic responsive ascites and patient with refractory ascites. CONCLUSION: Resistive index increases with degree of hepatic decompensation. Renal duplex ultrasound is a noninvasive, simple and easy method to study intrarenal hemodynamics in patients with liver cirrhosis may predict patients at risk of hepatorenal impairment.
Background: A cancer diagnosis can have a significant impact on mental health and wellbeing. Cancer is the second most common cause of death after heart diseases and it accounted for 9.6 million deaths worldwide in 2018. Various individual psychosocial and contextual factors potentially contribute to the development of anxiety and depression among people with cancer. In comparison with general people, the prevalence of anxiety and depression is frequently found to be higher among cancer patient, but estimates vary due to various factors, such as the type of cancer, treatment setting, and prognosis of disease. The present study was conducted to find out the estimate of depression in cancer patients undergoing chemotherapy and determine the various factors associated with depression.Methods: A cross-sectional study was conducted amongst cancer patients undergoing chemotherapy at Department of Oncology, Government Bundelkhand Medical College and Hospital, Sagar from January to April 2019. 150 participants were interviewed using predesigned questionnaire based on the Beck’s depression inventory.Results: Out of 150 cancer patients, 83 (55.3%) were found to be depressed. Depression was comparatively higher in patients’ ≥50 years; in males. Among the study patients, 83 (55.33%) had depression of which 21 (25.3%) had borderline clinical depression, 54 (65.06%) had moderate depression and 08 (9.6%) had severe depression.Conclusions: The study revealed depression in majority of patients receiving chemotherapy. Treatment of cancer patients need to be complemented by psychological support. Research is urgently needed into the possible impacts of long term effects of cancer treatment on mental health.
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