NUTRITIONAL APPROACHES TOWARDS PREVENTION AND TREATMENT OF DCLD

Decompensated chronic liver disease (DCLD) is also known as decompensating cirrhosis. Cirrhosis is a chronic liver disease that is commonly resulting of hepatitis or alcohol use disorder. It is the severe scarring of liver seen at the terminal stages of chronic liver disease. The diet of patients with chronic liver disease is based on a standard diet with supplements addition as necessary. Restrictions may be harmful and should be individualized. In this study we detailed a patient having decompensated chronic liver disease and observed all require parameter in dietary management. The patient undertook a dietary counselling for 16 days and dietary modification was done according to the patient condition. The HB level was 9.1g/dl, so beetroot juice in the mid-morning and soybean and 2 egg whites were suggested to increase the protein level. Later it was seen that Hb level was increased to 9.9g/dl and protein level was increased to 6g/dl. Also, the potassium level was below normal, so coconut water suggested. what to avoid and what to include and a sample menu and a diet chat was given to the patient at the time of discharge. Malnutrition is a potentially reversible condition that, when identified and treated appropriately, can lead to improvement of the outcomes of patients with DCLD.

A RETROSPECTIVE STUDY OF CLINICAL AND ETIOLOGICAL PROFILES OF PATIENTS PRESENTING WITH PANCYTOPENIA

Early diagnosis and treatment are crucial in the management of pancytopenia. A retrospective cross-sectional study was undertaken at ZMCH,DAHOD. All eligible participants more than 13 years of age were included. A thorough history taking along with clinical examination and laboratory investigations were performed among the study population. Data was analyzed using SPSS version 13. The most common nding suggestive of etiology was megaloblastic anemia at 38.4%, which was more common among females. Aplastic anemia was the second most common nding at 24.6%. Other diagnoses included hypersplenism, myelodysplastic syndrome and acute leukemia. Fever and pallor were the most common presenting symptoms. Blood examinations demonstrated anisopoikilocytosis, hypersegmented neutrophils, erythroblasts, macrocytes and reticulocytes, which were found in differing proportions in the various etiological diagnoses.It is noteworthy that megaloblastic anemia, a reversible condition, is common in India compared to the higher occurrence of aplastic anemia and myelodysplastic syndrome in developed nations

518 - AUTOIMMUNE DEMENTIA – WHEN TO SUSPECT?

Background:Autoimune dementias are underrecognized clinical entities, frequently misdiagnosed as neurodegenerative or prion disorders. However, the prognosis is vastly different since immunotherapy can treat these conditions and restore functionality.Research objective:To reflect on autoimmune dementias, briefly presenting the autoimmune syndromes, how to diagnose them and some clinical cues to be attentive of.Methods:Literature search on Pubmed and Google Scholar.Results:The incidence and prevalence of autoimmune dementias are unknown, but autoimmune and inflammatory causes account for 20% of dementia in patients younger than 45 years of age.Autoimmune dementias are classified according to syndromic presentation, specific serologic markers, or histopathologic findings.Patients with autoimmune dementias usually present with an acute or subacute disorder of memory, thinking, or behaviour. Clinical clues that can help clinicians identify autoimmune dementias include six of the following: (i) rapidly progressive or fluctuating course; (ii) multifocal and diverse clinical presentations; (iii) personal or family history of autoimmunity; (iv) detection of inflammatory markers in the cerebrospinal fluid; (v) presence of a neural-specific autoantibody and (vi) favourable response to a trial of immunotherapy. Also, unsuspected cancer, new or recurrent, may manifest neurologically as autoimmune dementia.In evaluating patients with dementia and autoimmune disease, clinicians should be aware of the possible coexistence of these disorders.Conclusions:Recognition of clinical and serologic clues to autoimmune dementia allows early and sustained treatment. Misdiagnosis of a potentially reversible condition as a progressive neurodegenerative disorder can have devastating consequences for the patient and family.

Cardiogenic shock with complete heart block secondary to dengue myocarditis requiring temporary pacing

This case illustrates acute myocarditis with complete heart block in a 13-year-old teenager as a rare complication of acute dengue illness. He required urgent temporary pacing with inotropic support and antifailure medications. Complete heart block in dengue myocarditis is an acute but reversible condition. A similar presentation in a dengue-endemic country or with a history of travelling to tropical countries warrants a suspicion of dengue infection.

Idiopathic Atrial Flutter Associated with Dilated Cardiomyopathy in a Preterm Newborn: A Case Report

<b><i>Background:</i></b> Arrhythmias in neonates are uncommon and usually affect newborns with a normal heart or associated with structural heart disease. Meanwhile, one uncommon type of supraventricular arrhythmias is atrial flutter (AF), which is reentry mechanisms in the atrium. The AF may result in heart failure or even death, but the majority of its cases have revealed favorable prognosis in the event of early prenatal diagnosis and immediate treatment [J Am Coll Cardiol. 2006;48:1040–6, Semin Fetal Neonatal Med. 2006;11:182–90, and Arch Argent Pediatr. 2007;105:427–35]. A persistent tachyarrhythmia can progress to a state of cardiac dysfunction known as tachycardia-induced cardiomyopathy. While this may be a rare cause of dilated cardiomyopathy and heart failure in children, the condition is usually reversible and should be considered in newborn and infants [Europace. 2011;14(4):466–473]. <b><i>Case Report:</i></b> A preterm 33+1-week male newborn with birth weight 2,790 g was delivered through cesarean section. The baby presented with tachycardia after birth associated with respiratory distress. The physical examination showed heart rate &#x3e;220/min, and ECG showed “saw tooth pattern” after intravenous adenosine boluses confirming diagnosis of AF (2-3:1). The heart rate reverted to sinus rhythm after synchronized cardioversion. Due to poor LV myocardial performance with dilated chambers, the baby received intravenous milrinone, followed by oral captopril. The baby was discharged on oral medications in perfect clinical condition, and follow-up showed no recurrence AF with improved cardiac function. <b><i>Conclusion:</i></b> Despite the rare occurrence, AF should be considered in differential diagnosis of newborn arrhythmia and diagnosed after intravenous adenosine injection. In few cases, AF can be associated with dilated cardiomyopathy which is a reversible condition.

Colombian-Spanish Migrants in London since the Great Recession

This article discusses the (dis)integration processes of Colombian-Spanish migrants arriving in London since the 2008 economic crisis, as the background to understand their political attitudes and participation. It is based on data from qualitative quantitative fieldwork, complemented with statistical and bibliographical sources. From a transnational perspective that takes into account the home country and more than one destination, the results indicate that the context of the Great Recession in Spain and Brexit in the United Kingdom have had diverse impacts in migrants’ integration processes, which are appreciable in their remigration trajectories, work and social experiences, but also in their political interests, participation and ideologies. From this data, we confirm the need to interpret migrants’ complex mobilities and their political participation based on a broader conception of integration processes, which includes their multidimensional character and reversible condition, and reflects the growing diversity of (im)mobile political experiences in contexts of crises.

The Risk Of Developing Anemia In Patients With Chronic Heart Failure And Its Prognostic Value

Analysis of modern views on the problem of anemia in chronic heart failure (CHF), on the main pathogenetic mechanisms of its formation and the possibility of drug correction. The CHF problem has a number of interdisciplinary aspects. One of the pathologies often encountered in CHF is anemia, which aggravates hemodynamic disturbances and worsens the prognosis in patients. Understanding the mechanisms of the development of anemia in CHF is of great importance for the choice of treatment tactics. The review discusses the views on the pathogenetic mechanisms of the formation of anemic syndrome in patients with CHF. The approaches to its treatment from the point of view of pathogenesis are considered. Anemia in CHF is associated with an increased risk of death, worsening of the course of concomitant diseases and an increase in the functional class of heart failure, but it is a potentially reversible condition.

Hypotestosterone in Male with Obesity

Obesity can be defined as the excess of body fat. The prevalence of obesity worldwide increases in the last decades andcauses a higher risk of cardiovascular diseases. Male subjects tend to develop visceral (abdominal) obesity, which producespro-inflammatory adipokines. Obesity in males is associated with low testosterone levels. Several mechanisms have beenproposed to explain the link between male obesity and hypotestosterone, including increased aromatization oftestosterone to form estradiol, suppressing the Hypothalamus-Pituitary (HPT) axis due to pro-inflammatory adipokines, anddecrease of Sex Hormone Binding Globulin (SHBG) production. Because hypotestosterone in males with obesity is afunctional but reversible condition, it is essential to screen testosterone levels in obese males for early intervention andtreatment.

A community-based prediabetes knowledge assessment among Saudi adults in Al-Ahsa region, 2018

Background: Prediabetes has been considered to be a reversible condition; a modification of lifestyle and other intervention can be successfully applied during the prediabetes period to prevent the development of type 2 diabetes. The purpose of the present study was to assess knowledge of prediabetes and its risk factors for the community in the Al-Ahsa region.Design and method: A cross-sectional community-based study was conducted in the Al-Ahsa region from mid-to-late December 2018. A sample size of 812 was determined using a single-proportion formula.Results: Of the 812 respondents who gave consent to participate in the interview; the male to female ratio was 1.1:1. 13.2% of the respondents reported that they had diabetes. Among the respondents, 87.1% had a high level of knowledge of prediabetes, while 12.9% had low-to-moderate knowledge. 84% of males 40 years of age or older, 88.7% (384) of people with university or higher education, and 95.1% (78) of people who worked as health practitioners had high knowledge of prediabetes.Overall, there was a statistically significant association between age and prediabetes knowledge (𝑥2 =5.006, p=0.025). Occupation also showed a significant statistical association with prediabetes knowledge (𝑥2 =9.85, p=0.02). Conclusion: Knowledge is considered an important factor in the prevention of prediabetes and diabetes. People in Al-Ahsa demonstrated a high level of knowledge regarding some risk factors for prediabetes. However, there were a number of deficiencies in the knowledge of prediabetes risk factors and preventive measures as well as in general knowledge of prediabetes, which may lead to a high prevalence of prediabetes and diabetes.