ABSTRACT
Neutrophil to Lymphocyte Ratio (NLR) has been considered an inexpensive biomarker to reflect inflammation in patients with cirrhosis. Raised NLR has been associated with poor clinical outcome and mortality in these patients. We conducted this study to correlate the association of Neutrophil to Lymphocyte Ratio with complications of cirrhosis and assess the short-term outcome during hospital admission. MethodsWe conducted a prospective observational study in 120 patients with cirrhosis from January 2017 to June 2018. All patients were diagnosed based on clinical history, examination and ultrasound. Complications were diagnosed by clinical and laboratory evaluation. Total white blood cell count, lymphocyte count, and neutrophil count were recorded, and neutrophil to lymphocyte ratio was calculated. Statistical analysis by means of test of association and binary logistic regression analysis was carried out. ResultsOut of the 120 patients enrolled in our study, majority were male (90%), and in the age group 51 - 60 years (38.3%). Majority (39.2%) of the patients had portal hypertension with oesophageal variceal bleeding as complication. Mean NLR for the patients was 5.824. A total of 91% patients with NLR>12 were admitted with decompensated liver disease and 66.7% of those patients presented with more than 2 complications that is hepatic encephalopathy and spontaneous bacterial peritonitis. 41.7% patients with NLR >12 had mortality as the outcome. Chi square test of association of NLR with complications (p=0.003) and mortality (p=0.03) were significant. However, NLR could not predict complications in our study population. ConclusionsRaised Neutrophil to Lymphocyte Ratio is associated with complication and mortality in patients with cirrhosis. However, it could not effectively predict the complications in patients with cirrhosis.
ABSTRACT
Introduction: Hypertension is one of the most common cardiovascular risk factors but the medication\r\nadherence rate among hypertensive patients is low. Objectives: To develop, validate and test the reliability of Medication Adherence Questionnaire (MAQ) in hypertensive patients. Materials and methods: A\r\ncross-sectional study was conducted among hypertensive patients in Department of General Medicine\r\nfor eight months. The MAQ was prepared by referring to the previously validated questionnaires and\r\nother related medication adherence studies. It was validated by the expert committee and tested for\r\ntest-retest reliability. The medication adherence data It was validated collected from patients who have\r\nbeen receiving at least one antihypertensive medication in the past three months. Results: The mean\r\nmedication adherence score for the test and re-test are 66.25 ± 19.49 were 67.50 ± 19.19 respectively,\r\nand the test-retest reliability of MAQ was 0.979. Out of 299 patients, 180 (60.20%) were males, and\r\n118 (39.46%) were females. In our study population, most of the patients were found to have medium\r\nmedication adherence (53.84%) followed by low medication adherence (39.13%) and high medication\r\nadherence (7.02%). Conclusion: The self-reported 8-item MAQ It was validated developed and tested\r\nfor reliability in South Indian hypertensive patients.The mean medication adherence of the study population was 71.77 ± 13.94, which indicates low medication adherence to antihypertensive treatment
Introducción: La hipertensión es uno de los factores de riesgo cardiovascular más frecuentes y el índice\r\nde adhesión al tratamiento entre los pacientes hipertensos es bajo. Objetivos: Elaborar, validad y evaluar\r\nla fiabilidad del Medication Adherence Questionnaire (MAQ) en pacientes hipertensos. Materiales y métodos: Se llevó a cabo un estudio transversal durante ocho meses en pacientes hipertensos atendidos en\r\nel Departamento de Medicina General. El MAQ fue elaborado con referencia a cuestionarios validados\r\ncon anterioridad y de acuerdo con lo hallado en otros estudios relacionados con la adhesión al tratamiento farmacológico. La validación del MAQ fue realizada por el comité de expertos y analizada en\r\ntérminos de fiabilidad prueba-repetición de la prueba. La información sobre la adhesión al tratamiento\r\nfarmacológico fue recabada mediante la evaluación de los pacientes que habían recibido al menos una\r\ndroga antihipertensiva durante los últimos tres meses. Resultados: El puntaje medio correspondiente a la\r\nadhesión al tratamiento ante la prueba y la reiteración de la prueba fue 66.25 ± 19.49 y 67.5 ± 19.19,\r\nrespectivamente, y la fiabilidad del MAQ fue 0.979. De los 299 pacientes, 180 (60.2%) fueron de sexo\r\nmasculino y 118 (39.46%) fueron de sexo femenino. En nuestra población en estudio, la mayoría de los\r\npacientes presentaron un nivel intermedio de adhesión al tratamiento farmacológico (53.84%), seguido\r\npor el nivel bajo (39.13%) y elevado de adhesión al tratamiento farmacológico (7.02%). Conclusión: El\r\ncuestionario autoadministrado MAQ de ocho ítems fue creado y evaluado en términos de fiabilidad en\r\npacientes hipertensos residentes en el sur de la India. El puntaje medio correspondiente a la adhesión al\r\ntratamiento farmacológico en la población en estudio fue 71.77 ± 13.94, lo cual indica un nivel bajo de\r\nadhesión al tratamiento con drogas antihipertensivas