Online ISSN: 2515-8260

Keywords : Chronic liver disease

Role of Pegylated Interferon and Ribavarin in Chronic Hepatitis C in childhood cancer survivors less than 12 years

Dr. Gitika Pant, Dr Nishant Verma, Dr Shreshtha Ghosh

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 4, Pages 1229-1234

Chronic hepatitis C (CHC) may be seen in cancer survivors due to frequent blood component therapy and parenteral exposures during treatment. Considering the long term adverse effects of CHC, the study was carried to evaluate the response of combination therapy (Pegylated Interferon and Ribavirin) in cancer survivors affected with CHC as direct acting antivirals have still not been approved for children below 12 years age.
Methods: This was a retrospective study carried in cancer survivors below 12 years, who had CHC. They were treated with combination of Pegylated interferon alpha2b 60mcg/m2/week and ribavirin 15mg/kg/day for 24 or 48 weeks for Genotypes 3 and 1 respectively. Rapid viral response (RVR) and sustained viral response (SVR) were evaluated by PCR at 4 weeks of starting therapy and after 24 weeks of completing therapy. Data on coinfection with Hepatitis B was also evaluated.
Results: Of the 32 patients, 21 were leukemia/lymphoma survivors and 11 were survivors of solid tumours. Genotype 1 was seen in 22/32(69%) and Genotype 3 in 10/32(31%). Hepatitis B co-infection was present in 6 (18.7%) patients. RVR (100% vs 45.5%) and SVR (100% vs 62%) were significantly higher for Genotype 3 as compared to Genotype 1. SVR for HCV was not significantly different in those with HBV coinfection as compared to those without.
Conclusion: Pegylated IFN and ribavirin combination therapy is a successful modality for treating CHC in age group <12 years in childhood cancer survivors where long term morbidities due to Hepatotropic viruses affect the quality of life.

A Study on Correlation of serum sodium levels with severity of the chronic liver disease

Dr. Sajal Goyal , Dr. Ajit Sawhney, Prof. Dr. W. P. Singh

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 4856-4865

A progressive decline in liver function lasting longer than six months, including the production of clotting factors and other proteins, the detoxification of hazardous metabolic waste products, and the excretion of bile, is known as chronic liver disease (CLD). The  normal range of serum sodium  is about 135-145 mEq/L. Its homeostasis is essential for cell function. Abnormal sodium levels can result from an imbalance in the body's overall water balance management. Patients having chronic liver disease often experience the complication of hyponatremia. Although hyponatremia is often described as having sodium level in those patients less than 135 mEq/L, in people with hepatic disease, the threshold is 130 mEq/L.

Analysis of Renal Dysfunction in Patients with Liver Cirrhosis: An Institutional Based Study

Jainish Kamlesh Kumar Modi, Alpesh Vadher

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 337-342

Introduction: Liver disease is a common disorder affecting multiple system. It accounts for approximately 2 million deaths every year worldwide and 1 million due to complications of cirrhosis. Current epidemiological trends show that common liver diseases in Asia–Pacific countries are alcohol-related liver diseases, non-alcoholic fatty liver disease (NAFLD), hepatitis B and C, etc. Most of them lead to cirrhosis of liver. Renal dysfunction is one of the most common complications of cirrhosis with high morbidity and mortality.
Materials and Methodology: This study was adopted to be conducted as hospital-based study was carried on 133 cirrhotic patients admitted in the Tertiary care centre. Patients details that includes their demographic data, clinical examination findings and results of laboratory investigations were collected. CTP (Child Pugh) score and MELD (Model for End Stage Liver disease) Score of patients were also briefed. End results for continuous variables were expressed as means and standard deviation. Categorical variables were described as percentages. Significant factors that were associated with the presence of renal dysfunction was analysed using binary logistic regression analysis Bivariate analysis was carried out using pearsons coefficient of correlation. Odds Ratio (OR) was enabled to ascertain the strength of relationship between two variables.
Results: A total of 133 patients were included in this study. Male patients were in majority constituting 85.3% (n=113) of the total population, the rest were females (14.7%). Mean age of patients in the study group was 51.32 years (+ 13.72). The most common aetiology of cirrhosis was found to be alcohol, comprising of about 74.5%. 22 patients had more than 1 aetiology for cirrhosis, the most common of which has combined alcohol and NASH (Non-Alcoholic Steato Hepatitis) related, observed in 9 patients.
Conclusion: The present study has found significant correlation between the severity of liver dysfunction and some parameters of renal dysfunction. However, there is no such significant association was observed between the distribution of various renal parameters among different aetiologies of chronic liver disease.

To evaluate cardiac dysfunctions in patients with chronic liver disease

Suhas Mule, Achyut Kannawar, Ramesh Kawade, Dany John, Abhijeet Shelke

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 4693-4697

Aim: To evaluate cardiac dysfunctions in patients with chronic liver disease.
Material and Methods: The research comprised 100 hospitalised individuals with chronic liver disease. All CLD patients were interviewed and their demographic data, symptoms, and presentation were obtained using a pre-designed structured proforma. Patients who declined to participate in the experiment, on the other hand, were not included. The height, weight, BMI, and belly circumference of each patient were all measured. At the start, vital indicators such as pulse, blood pressure, breathing rate, and SPO2 were collected and recorded. The patients were then subjected to a battery of tests, including a CBC, LFT, RFT, lipid profile, RBS, ascitic fluid analysis, ECG, and 2D ECHO.
Results: Patients without cardiac dysfunction had an average age of 41.69 years, while patients with cardiac dysfunction have an average age of 47.96 years. Cardiac dysfunctions were most common in CLD patients between the ages of 45 -55, with 90% of cases involving males and 10% involving women. When diastolic function was assessed, 75% of patients satisfied two of the three problematic criteria given above, 45% had an enlarged LVMI, and 52% had a larger LA size. All of the measures had a statistically significant link with the severity of CLD (P=0.021). Alcohol was the most common cause of chronic liver disease in both groups of study participants with and without cardiac dysfunction (70%), followed by hepatitis B (10%).
Conclusion: Diastolic dysfunction is the most prevalent aberrant cardiac presentation in chronic liver disease patients. There is no link between the onset of cardiac failure and the cause of chronic liver disease. There is a link between the severity of chronic liver disease and the development of heart dysfunction.