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Objective:To determine the association of thrombocytopenia as a predictor of mortality in septic patients. Material and Methods: The study was done from November 2018 to January 2019 in all the ICU departments at Liaquat National Hospital. All patients in the ICU who had been diagnosed with sepsis at time of admission were part of the study. A daily platelet count was recorded for every patient since the time of admission until discharge or mortality occurred. Any drop of platelet count >50% compared with admission counts was also noted down. Results:A sample of 168 patients were part of the study. Out of the total, 47 patients presented with sepsis and thrombocytopenia at the time of admission and discharge. Out of them, 21 patients (45%) expired. Expired patients were 14 (67%) male and 7(33%) females with a mean age of 60.14±13.14 years (range 34-81 years). The mean length of hospital stay per patient was 8.43±6.37 days (range 1-25 days). Moreover, 9(42.90 %) of the expired patients were hypertensive and 10(47.60%) were diabetic. Conclusion: The study concludes that observing sequential platelet count in septic patients could assist health care workers in making timely intervention in high risk patients and consequently decreasing the risk of mortality associated with septic patients. [ABSTRACT FROM AUTHOR]

Introduction and Rationale: Lateral internal sphincterotomy is an eff ective treatment for chronic anal fissures; however, the risk of "incontinence" has generated interest in pharmacologic approaches that are far less eff ective and may be poorly tolerated. This study was done to objectively define the risk of incontinence with sphincterotomy using the fecal incontinence severity index and assess the implications for quality of life using the fecal incontinence quality of life scale. This study was undertaken to obtain local data as there is litt le available local data. This would help in bett er counselling of patients and would serve as an impetus for further research on subject. Objective: To assess the frequency of fecal incontinence and flatus incontinence in patients undergoing sphincterotomy. Material and Methods: This study was designed to assess the long-term outcomes and quality of life of patients who have under-gone lateral sphincterotomy for chronic anal fissure. The medical records of patients who under-went this operation between 2015-2016 were reviewed. A questionnaire was filled by contacting patients on phone to assess their current status, along with the fecal incontinence and stool incontinence. Study design: Retrospective cohort study. Settings: Department of general Surgery, Liaquat National Hospital and Medical College Duration of study: From January 2015 to December 2016, Sample Size: After checking with the records a total of 60 patients were operated during the study period. Out of which 39 patients responded and gave consent for being part of the study. Data collection: The inpatient and OPD record were reviewed of all the patients from January 2015 to December 2016 and were interviewed. The complete data of individual patients was collected and computed. Results: A total of 60 patients were recruited After fullfilling the inclusion criteria. After initial information a total of 39 patients agreed to the research proposal and were interviewed, 27 males and 12 females. The largest group of patients were from 35-40 years age group with minimum 19 and maximum 60 years old. A total of 30% of patients reported as having occasional flatulence incontinence. 32% of patients reported occasional stool incontinence. None of the respondents reported total incontinence. None of the respondents reported total loss of anal function. There were no recurrences. Conclusion: Flatulence and fecal incontinence After lateral sphincterotomy is a serious issue. Quality of life issues need to be addressed in further studies. [ABSTRACT FROM AUTHOR]

The Meyers' ortho-alkylation is a well established methodology for the formation of new carbon-carbon bonds. The asymmetric approach to this has only been able to give moderate to good disastereoselectives. [...]

Alcohol consumption is a major risk factor for various diseases worldwide and is one of the most common causes of chronic liver disease. Alcohol use has risen over the past 30 years and is forecast to continue to rise. Concurrently, there has been an increased incidence of alcohol-associated liver disease (ALD). Alcohol use, regardless of the amount, leads to years of health loss across populations when considering the strong association between alcohol consumption and overall disease burden. Given the rising incidence of ALD and associated mortality, it is imperative to study the underlying factors driving these trends. This article summarizes the diagnosis and management of ALD, with a focus on various screening and prognostic tools and treatments for alcohol-associated hepatitis., Competing Interests: The authors have no relevant conflicts of interest to disclose., (Copyright © 2020, Gastro-Hep Communications, Inc.)