Pathogenesis of Hepatic Encephalopathy and Hyperdynamic Syndrome in Cirrhosis

Aims: This study aimed at assessing the risk factors for hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) in patients with hepatocellular carcinoma (HCC) and portal hypertension. Method: Consecutive patients (n=279) with primary HCC who underwent TIPS between January 1997 and March 2012 at a single institution were retrospectively reviewed. Patients were followed up for 2 years. Pre-TIPS, peri-TIPS and post-TIPS clinical variables were reviewed using univariate and multivariate analyses to identify risk factors for HE after TIPS. Results: The overall incidence of HE was 41% (114/279). Multivariate analysis showed an increased odds for HE in patients with: >3 treatments with transcatheter arterial chemoembolization (TACE) and/or trans-arterial embolization (TAE) (odds ratio [OR], 4.078; 95% confidence interval [95%CI], 1.748-9.515); hepatopetal portal flow (OR, 2.362; 95%CI, 1.032-5.404); high portosystemic pressure gradient (OR, 1.198; 95%CI, 1.073-1.336) and high pre-TIPS MELD score (OR, 1.693; 95%CI, 1.390-2.062). Odds for HE were increased 1.693 fold for each 1-point increase in the MELD score, and 1.198 fold for each 1-mmHg decrease in the post-TIPS portosystemic pressure gradient. Conclusion: The identification of clinical variables associated with increased odds of HE may be useful for the selection of appropriate candidates for TIPS. Results suggest that an inappropriate decrease in the portosystemic pressure gradient might be associated with HE after TIPS. In addition, >3 treatments with TACE/TAE, hepatopetal portal flow, and high MELD score were also associated with increased odds of HE after TIPS. Key words: – – – .

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Hepatic Encephalopathy and Liver Failure in Pediatric Patient with hepatitis A

International Journal of Drug Delivery Technology ◽

10.25258/ijddt.v9i3.16 ◽

2019 ◽

Vol 9 (o3) ◽

Author(s):

Shaima’a Dakhel AbdulHassa

Keyword(s):

Hepatic Encephalopathy ◽

Liver Failure ◽

Hepatitis A ◽

Gene Sequence ◽

Stool Examination ◽

Age Group ◽

Significant Difference ◽

Medical City ◽

Sequence Method ◽

Stool Samples

Gairdia lamblia is one of parasites that cause intestinal problems within the human body, particularly private travelers and children. In this study a total of (100) diarrheal patients, 20 patients with Giardiasis were identified by fecal antigen. 9 out of 20(20%) of them were infected by fecal antigen, while 9(9%) of them were infected by using the screening general stool examination (GSE). The stool samples were collected from patient how vested the Medical City/ Baghdad and Tikrit teaching Hospital during the period from 1 st may 2018 to 1 February 2019. The results revealing a significant difference (p andlt; 0.05) between the two methods of detection for G. lamblia (Fecal antigen method and GSE). IT has been shown that out of 20 infected individuals 12(12%) were males and 8(8%) were females, indicating regarding no significant deference in the distribution of Giardiasis among genders. In regard the age, our results showed that highest infection rate 8(3.2%) was recorded in the age group (10-19) years, followed by the age group (20-2) years which was 692.4%). In this study five mutations were recorded at position (926, 1094, 1202and 1304), by using tpiA gene sequence method, and tpiB gene was on point mutation change (G254A), in the position (85) of triose phosphate isomease.

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