Abstract
REASON ANALYSIS FOR ASCITES AMONG ADULT POPULATION ADMITTING IN THE EMERGENCY AND MEDICAL WARDS IN TERTIARY CARE HOSPITALS IN PRAKASAM DISTRICT: A REVIEW ON PROGNOSIS AND OUTCOME

A. Sandhya, T. Murali Krishna Reddy*, K. Manoj Kumar and B. T. Rao

ABSTRACT

Back Ground: Ascites is a late complication of cirrhosis that not only reduces the patient‟s quality of life but also is associated with a mean survival of the patients. Abdominal ultrasound examination plays a significant role in patients with ascites for assessing the size and the causes of ascitic fluid in the abdomen. Methodology: A cross sectional study was conducted on the ascites patients attended the emergency wards, male medical and female medical inpatient wards of Government General Hospital Ongole, Prakasam District mainly and also nearby existing private hospitals. Specific structured face to face interviews were conducted by using pre-tested questionnaire which was administered to a patient to obtain the information. With the Laboratory evidence, possible cause of ascites were identified and based upon the response to treatment, predictors of the prognosis also evaluated for ascites. Results: Out of 40 patients with ascites 50% were males and 62.5% were illiterate. All the patients have been suffering with pallor and oedema, thirty one (77.5%) patients developed jaundice, eighteen patients (45%) have abdominal scar and distended veins were noticed in six (15%) cases. Hepatomegaly was noticed in all the forty patients. Ascitic fluid analysis revealed that in twenty two (55%) cases the cell count was less than 250. Protein value of more than 3.2gm/dl was noticed in five (12.5%) cases. chronic liver disease with cirrhosis is the main cause for ascites (82%) followed by congestive heart failure which contributed 5%. One sample t statistics of ESR, Hemoglobin, Bilurubin SAAG, protein and ADA levels in ascitic Fluid shown significant association with ascites (P<0.05). Limitations: All the patients were admitted on emergency basis in the hospitals and anthropometric measurements were not done for most of the patients. Conclusions: Ascites cases attending to the hospitals mainly due to Chronic Liver Disease followed by cirrhosis which was because of many causes. There is a need to evaluate most common reason for chronic liver disease, the reason being insignificant association has found between alcoholism and chronic liver disease in this study. Further studies are required to find out the reasons for cirrhosis especially in females.

Keywords: Cirrhosis, Serum-ascites albumin gradient, Hepatomegaly, Ultrasound Examination.


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