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Blue-green crystals:A telltale sign of poorer outcome?

Journal of Acute Disease 2022年第6期11卷 254-255页

作者： Rajeev Ranjan soumya jagannath mahapatra Tushar Sehgal Department of Laboratory Medicine All India Institute of Medical SciencesNew Delhi110029India Department of Gastroenterology All India Institute of Medical SciencesNew Delhi110029India

Dear editors,Here we present the case of a 27-year-old male who came to the emergency with a high spiking fever,worsening upper abdominal pain,and shortness of breath for the last 3 *** consent had been taken from the *** patient had complaints of multiple episodes of vomiting and *** examination,the patient was febrile(101ºF)with a pulse rate of 130 per minute(normal:60-100 per minute)and blood pressure of 108/68 mmHg(normal:120/80 mmHg).

关键词： vomiting febrile fever

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Effect of thrombocytopenia and platelet transfusion on outcomes of acute variceal bleeding in patients with chronic liver disease

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World Journal of Hepatology 2022年第7期14卷 1421-1437页

作者： Sagnik Biswas Manas Vaishnav Piyush Pathak Deepak Gunjan soumya jagannath mahapatra Saurabh Kedia Gyanranjan Rout Bhaskar Thakur Baibaswata Nayak Ramesh Kumar Shalimar Department of Gastroenterology and Human Nutrition All India Institute of Medical SciencesNew Delhi 110029DelhiIndia Division of Biostatistics UT Southwestern Medical CenterDallasTexas 75390United States Department of Gastroenterology All India Institute of Medical SciencesPatna 800014BiharIndia

BACKGROUND Platelet transfusion in acute variceal bleeding(AVB)is recommended by few guidelines and is common in routine clinical practice,even though the effect of thrombocytopenia and platelet transfusion on the outcomes of AVB is *** To determine how platelet counts,platelets transfusions,and fresh frozen plasma transfusions affect the outcomes of AVB in cirrhosis patients in terms of bleeding control,rebleeding,and *** Prospectively maintained database was used to analyze the outcomes of cirrhosis patients who presented with *** outcomes were assessed as the risk of rebleeding at days 5 and 42,and risk of death at day 42,considering the platelet counts and platelet *** score matching(PSM)was used to compare the outcomes in those who received platelet *** comparisons were done using Kaplan-Meier curves with log-rank tests and Coxproportional hazard model for rebleeding and for 42-d *** The study included 913 patients,with 83.5%men,median age 45 years,and Model for End-stage Liver Disease score *** count50×10^(9)/L were found in 23(2.5%),168(18.4%),and 722(79.1%)patients,*** rates were similar between the three platelet groups on days 5 and 42(13%,6.5%,and 4.7%,respectively,on days 5,P=0.150;and 21.7%,17.3%,and 14.4%,respectively,on days 42,P=0.433).At day 42,the mortality rates for the three platelet groups were also similar(13.0%,23.2%,and 17.2%,respectively,P=0.153).On PSM analysis patients receiving platelets transfusions(n=89)had significantly higher rebleeding rates on day 5(14.6%vs 4.5%;P=0.039)and day 42(32.6%vs 15.7%;P=0.014),compared to those who didn'*** mortality rates were also higher among patients receiving platelets(25.8%vs 23.6%;P=0.862),although the difference was not *** multivariate analysis,platelet transfusion and not platelet count,was independently associated with 42-d *** e

关键词： Gastrointestinal Hemorrhage Platelet transfusion Thrombocytopenia Fresh frozen plasma Portal hypertension Mortality

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Management of pancreatic fluid collections in patients with acute pancreatitis

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Journal of Pancreatology 2019年第3期2卷 82-90页

作者： mahapatra soumya J. Garg Pramod K. Department of Gastroenterology All India Institute of Medical SciencesNew DelhiIndia

Acute pancreatitis is associated with development of pancreatic fluid collections(PFCs).Acute PFCs that develop in interstitial edematous pancreatitis mostly resolve but some may persist and evolve into *** necrotic collections occurring in acute necrotizing pancreatitis generally persist and evolve into walled-off necrosis(WON)after 3 to 4 *** acute fluid collections do not require drainage unless they are large and cause compression of adjacent organs,contribute to increase in intraabdominal pressure or become *** infected collections can be managed with antibiotics and percutaneous drainage but may require necrosectomy either by minimally invasive surgical or endoscopic methods such as video-assisted retroperitoneal debridement and percutaneous endoscopic *** sterile collections,that is,pseudocyst and WON with a defined wall are best treated by internal transmural drainage which can be achieved either by per-oral endoscopic or surgical,preferably laparoscopic,*** late,infected PFCs are increasingly being treated with an endoscopic step-up approach that has been shown to be better than minimally invasive surgical step-up approach in terms of lesser *** of lumen apposing metal stents during endoscopic drainage has emerged as an attractive option that facilitates necrosectomy in infected WON.

关键词： Acute pancreatitis Infected pancreatic necrosis Necrosectomy Pancreatic fluid collections Walled-off necrosis

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