Online ISSN: 2515-8260

Keywords : Cirrhosis


EVALUATION OF THYROID PROFILE IN CIRRHOTIC PATIENTS AND ITS CORRELATION WITH CHILD PUGH SCORE

Dr Mayuri Singh, Dr Lalit Solanki, Dr Hiram Sanghvi, Dr Dushyant S. Patel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1518-1524

Introduction:Liver plays vital role in metabolism of thyroid hormone. The liver is the most important organ in the peripheral conversion of tetraiodothyronine (T4) to T3 by Type 1 deiodinase1,2. Type I deiodinase is the major enzyme in the liver and accounts for approximately 30%–40% of extrathyroidal production of T3, it can carry out both 5’-and 5-deiodination of T4 to T3. Moreover, the liver is involved in thyroid hormone conjugation and excretion, as well as the synthesis of thyroid binding globulin3. T4 and T3 regulate the basal metabolic rate of all cells, including hepatocytes, and thus modulate hepatic function also. Thyroid diseases affect liver function; liver disease may affect thyroid hormone metabolism; and a variety of systemic diseases affect both the organs. There are clinical and laboratory associations between thyroid and liver diseases. Patients with chronic liver disease may have thyroiditis, hyperthyroidism, or hypothyroidism. Patients with subacute thyroiditis or hyperthyroidism may have liver function abnormalities, which return to normal as the thyroid function improves.4 Available studies suggest that the most frequent change is decreased total T3 and free T3 concentration which is reported to be associated with severity of hepatic dysfunction. Serum T4 levels either remain normal or slightly low. However, serum TSH levels remain normal or slightly raised. These changes in thyroid hormone levels are so well established that these can be used as a sensitive index of liver function.

A study of acute kidney injury in cirrhosis of liver

Dr. Meghna Vaidya, Dr. Nitin Sarate, Dr. Juhi Kawale, Dr. Vinayak Pai

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 26-34

Background: The prevalence of renal dysfunction has been reported to vary from 14-50% in
patients with cirrhosis. The prevalence is estimated to be approximately 50% among patients
with cirrhosis and ascites and 20% of patients with advanced cirrhosis admitted to the hospital
3,4. The wide range in prevalence is likely due to different study populations and varying
definitions of renal dysfunction. Patients with HRS who fail to respond to medical therapy or
those with severe renal failure of other etiology may require renal replacement therapy.
Simultaneous liver kidney transplant (SLK) is needed in many of these patients to improve
their post-transplant outcomes. However, the criteria to select patients who would benefit from
SLK transplantation are based on consensus and lack strong evidence to support them. Heath
care system has evolved over the last decade and newer drugs are available for the management
of complication of cirrhosis. We attempt to study its impact on course and outcome of acute
kidney injury. Also few of the patients could possibly be on the antiviral drugs for hepatitis B
and hepatitis C. If these patients are admitted they will be included in study and we would study
the effect of the effect of this drug on acute kidney injury and vice versa. Hence, the present
study was conducted to study clinical profile of patients with acute kidney injury in liver
cirrhosis.

A retrospective cohort study on laparoscopic cholecystectomy in cirrhosis patients

Dr. Faisal Mumtaz,Dr.Urooj Najami,Dr.Prabodh Bansal,Dr Gopal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2797-2803

Background:The advanced instruments like harmonic shears have made laparoscopic cholecystectomy (LC) a safe option. The present study determined twoyearsexperience of patients after laparoscopic cholecystectomy in cirrhosis patients.
Methods: A total of 50 cirrhotic patients underwent LC from August 2020 to February 2022. The type of surgery performed was laparoscopic cholecystectomy. The parameters recorded were,presence of adhesions,use ofharmonic devices, amount of bleeding during surgery,rate of conversion to open surgery and the reasons thereof, operative time in minutes, plasma and platelet transfusion postoperatively and duration of hospital stay .
Results:Majority of the patients were of Child-Pugh class A. The cause of cirrhosis was hepatitis C virus (HCV) in most of the patients. Biliary colic was found to be the most common presentation. Higher CTP, model for end-stage liver disease (MELD) scores, higher mean international normalization ratio (INR) value, lower mean platelet count, higher operative bleeding, higher blood, and plasma transfusion rates, longer mean operative time and postoperative hospital stays were found to be statistically significantand  correlated well with 30-day morbidities and mortalities.
Conclusion: LC could be a better surgery performed in patients with cirrhosis. However, higher CTP and MELD scores, greater operative bloodloss, largerno of  blood and plasma transfusion in units, longer operative time, lower platelet count, and higher INR values can be considered factors resulting in poor outcome. 

Updated Management and Prediction of Gastroesophageal Varices in Cirrhotic Patients

Mohammed Ibrahim Ali, Aya Magdy Tawfik, Mohamed Mohamed Refaey, Sameh Saber Bayoumi, Ahmed F. Omar

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4323-4338

Background: Cirrhosis is a condition that result from chronic liver disease, and is characterized
by advanced fibrosis, scarring, and formation of regenerative nodules leading to architectural
distortion. Patients with cirrhosis are at increased risk of numerous complications that can
occur secondary to portal hypertension, abnormal liver synthetic function, or combination of
both. Portal hypertension (PH) is an increase in portal pressure beyond the threshold of 10
mmHg (clinically significant portal hypertension, CSPH) increases the risk of gastroesophageal
varices (GEVs). Gastroesophageal varices (GEV) are the most relevant porto-systemic
collaterals resulting from clinically significant portal hypertension, for which the presence of
EV is an independent predictor of mortality. Variceal bleeding is one of the most fatal
complications of portal hypertension which caused by rupture of gastric and mainly OV with a
mortality rate of 17% to 57%. Non-invasive predication of varices in cirrhotic patients is useful
as generalized screening of all cirrhotic patients by endoscopy would increase the work load of
endoscopy units.

FEATURES OF HEMOGRAM INDICATORS FOR CIRROSIS OF THE LIVER

I.I. Bakhriev .; SH.Yu., Beknazarov; S.J. Khojanazarova; E.A. Eshbayev

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2473-2482

Abstract: It is known that, against the background of the progression of chronic hepatitis,
significant changes in blood elements are occurring. The number of red blood cells, the
level of hemoglobin, the color index, the content of reticulocytes, platelets and leukocytes
in patients with chronic diffuse diseases of the liver are significantly lower than in people
without diseases of the hepatobiliary system, and blood counts decrease as the activity of
inflammation in the liver and the transformation of chronic hepatitis B increase cirrhosis
of the liver. The purpose of this work is to identify the features of the hemogram in patients
with cirrhosis of the liver.

Hepatitis C Seroprevalence Among A Tertiary Hospital Based General Population In Northern India

Heena Sharma; Vasim Mahdi Zaidi; Dr.Gomty Mahajan; Suman Kumari

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 4088-4094

Hepatitis C is a disease caused by enveloped, RNA virus belongs to Flaviviridae family. It causes inflammation of the liver that lead to liver cirrhosis and finally hepatocellular carcinoma. Its genome consists of open reading frame (ORF) codes for structural and non-structural proteins. The ORF have 5´ and 3´ UTR regions. Hepatitis C virus is cause of post transfusion hepatitis. Symptoms of HCV include fatigue, dark urine, belly pain, joint pain, itchy skin, sore muscles and jaundice. It is a blood-borne transmitted agent. Use of unsafe therapeutic injections also leads to HCV infection. Diagnosis of HCV infection can be done by various methods like Enzyme Immunoassay (EIA) and Recombinant Immunoblot Assay (RIBA). The aim of this study is to estimate seroprevalence of Hepatitis-C in both sexes and different age groups in hospital based general population. And to study the trends of HCV infections in a tertiary hospital located at Northern India.
A prospective study was conducted for four months (January-April) at Tertiary Hospital in Northern India. Total numbers of 1643 blood samples were screened for the presence of anti-HCV antibodies in patient’s serum. Samples were tested by HCV TRI-DOT rapid test. Positive samples were retested by SD BIOLINE HCV rapid test and confirmed by ELISA.Out of 1643, 102 (6.2%) samples were HCV positive. Among seropositive samples, 48 were males (2.9%) and 54 were females (3.2%). HCV seropositivity was shown by 40 IPD patients (2.4%), 52 OPD patients (3.1%) and 10 ICU patients (0.6%). Among departments, patients from Recovery showed (0.6%), General ward (1.0%), Private room (0.2%), Neurology lab (0.1%) and Emergency (0.3%) showed HCV seropositivity. On analyzing age-wise seropositivity, it was found that maximum seropositivity was seen in 30-40 years (2.9%) followed by >55 years (1.4%), 40-55 years (1.2%) and<30 years (0.5%). Analysis of patients on the basis of risk factors showed that 17 had history of surgical operation (1.0%), 18 had history of blood transfusion (1.0%), 6 had history of dental procedure (0.3%), 25 showed history of injecting drug use (1.5%), 21 used contaminated syringes (1.2%) and 15 patients was under haemodialysis (0.9%). Professional health worker should protect themselves while handling infected blood. Counselling and testing should be done for those who are at risk for infection.

Electrolytes System Disorder And Liver Enzyme Alteration In Adult Men With Hepatocellular Injury

Alzahraa Ibrahim Abdulmajeed; Wafaa Sh. Al – Zuhairi; Ekhlas Abdallah Hassan

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 6, Pages 805-812

Objective: The current study aimed to estimate the magnitude of liver hepatocellular damage in adult men suffering from advanced stages of liver infection considering various important variables (age, BMI, TSB, DSB, GOT, GPT, Na+, K+, Cl-). Background: The main cause of hepatocellular injury is viral hepatitis C. Development of this disease leads to transformation of normal liver tissue into fibroses and nodules (cirrhosis), and it is associated with numerous complications, including gastrointestinal bleeding, ascites, renal function disorder and electrolyte disturbance. Method: The sera of all participants, including 25 patients with VHC and 15 cirrhotic patients, were collected for comparison with 23 control donors (healthy men). The present study was conducted in Baaqubah General Hospital/Diyala. Serum electrolyte concentrations were measured by spectrophotometry assay. Results: significantly decreasing sodium concentration in cirrhotic patients and statistically increasing chloride concentration in patients with liver disease compared with the control (P value < 0. 05). Furthermore, a number of disorders that effect of the liver enzymes levels, Conclusion: The essential decrease in sodium (Na+) concentration was observed in cirrhotic men caused by reduction in renal perfusion. This result is in contrast to that of serum chloride, which increased in patients with liver diseases.