scholarly journals Noninvasive clinical predictors of portal hypertensive gastropathy in patients with liver cirrhosis

2017 ◽  
Vol 5 (3) ◽  
pp. 169-173 ◽  
Author(s):  
Rajesh Mandhwani ◽  
Farina M. Hanif ◽  
Muhammad Manzoor Ul Haque ◽  
Rajesh Kumar Wadhwa ◽  
Nasir Hassan Luck ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Predictive Value ◽  
Abdominal Ultrasound ◽  
Portal Hypertensive Gastropathy ◽  
Clinical Predictors ◽  
Liver Lobe ◽  
Cross Sectional ◽  
Gi Endoscopy

AbstractBackground and ObjectivesPortal hypertensive gastropathy (PHG) is described endoscopically as “mosaic-like appearance” of gastric mucosa with or without the red spots. It can only be diagnosed by upper gastrointestinal (GI) endoscopy. The aim of this study was to determine the diagnostic accuracy of platelet count to spleen diameter ratio (PSR) and right liver lobe diameter to albumin ratio (RLAR) in the detection of PHG using upper GI endoscopy as a gold standard in patients with liver cirrhosis.Material and MethodsThis cross-sectional study was conducted in the Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi. All consecutive patients with ages 18–65 years who were screened using esophagogastroduodenoscopy (EGD) to exclude esophageal varices were enrolled. At the same time, findings related to PHG were noted. After informed consent, all the patients had blood tests including platelet count and albumin and abdominal ultrasound determining spleen diameter and right liver lobe diameter.ResultsOut of 111 patients, 59 (53.15%) were males with a mean age of 44 ± 12.61 years. Rate of PHG was observed in 84.68% (94/111) cases confirmed by EGD. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PSR were 87.23%, 5.88%, 83.67%, 7.69%, and 74.7%, respectively, and those of RLAR were 28.72%, 70.59%, 84.38%, 15.19%, and 35.14%, respectively.ConclusionPSR is better predictor of PHG than RLAR but at the expense of relatively lower specificities and NPV likely because of underlying pathophysiology (portal hypertension) which is similar for esophageal varices, PHG, and ascites.

scholarly journals The magnitude and correlates of esophageal Varices among newly diagnosed cirrhotic patients undergoing screening fibre optic endoscope before incident bleeding in North-Western Tanzania; a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Daniel W. Gunda ◽  
Semvua B. Kilonzo ◽  
Zakhia Mamballah ◽  
Paulina M. Manyiri ◽  
David C. Majinge ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Esophageal Varices ◽  
Clinical Laboratory ◽  
Cross Sectional Study ◽  
Endoscopic Examination ◽  
Clinical Predictors ◽  
Endoscopic Screening ◽  
Cross Sectional ◽  
Northwestern Tanzania ◽  
Cirrhotic Patients

Abstract Background Bleeding esophageal varices is a deadly complication of liver cirrhosis. Guidelines recommend an early diagnosis of esophageal varices before incident bleeding by screening all patients diagnosed with liver cirrhosis. Though it has been reported elsewhere that the presence of esophageal varices varies widely among cirrhotic patients this has not been assessed in Tanzania since endoscopy is not readily available for routine use in our setting. This study was designed to determine the prevalence of esophageal varices and assess the utility of clinical parameters in predicting the presence of varices among cirrhotic patients in northwestern Tanzania. Methods A cross-sectional analysis of adult patients with liver cirrhosis was done at Bugando Medical Centre. Demographic, clinical, laboratory and endoscopic data were collected and analyzed using STATA 13. The presence of esophageal varices was detected using endoscopic examination and associated factors were assessed by logistic regression. The predictive value of clinical predictors was also assessed by calculating sensitivity and specificity. Results A total of 223 patients were enrolled, where 88 (39.5%; 95%CI: 33.0–45.9) had esophageal varices. The varices were independently associated with increased age (OR: 1.02; 95%CI: 1.0–1.04; p = 0.030); increased splenic diameter (OR:1.3; 95%CI:1.2–1.5; p <  0.001), increased portal vein diameter (OR:1.2; 95%CI: 1.07–1.4; p = 0.003), having ascites (OR: 3.0; 95%CI: 1.01–8.7; p = 0.046), and advanced liver disease (OR: 2.9; 95%CI: 1.3–6.7; p = 0.008). PSDR least performed in predicting varices, (AUC: 0.382; 95%CI: 0.304–0.459; cutoff: < 640; Sensitivity: 58.0%; 95%CI: 46.9–68.4; specificity: 57.0%; 95%CI: 48.2–65.5). SPD had better prediction; (AUC: 0.713; 95%CI: 0.646–0.781; cut off: > 15.2 cm; sensitivity: 65.9%; (95% CI: 55–75.7 and specificity:65.2%; 95%CI: 56.5–73.2), followed by PVD, (AUC: 0.6392; 95%CI: 0.566–0.712;cutoff: > 1.45 cm; sensitivity: 62.5%; 95CI: 51.5–72.6; specificity: 61.5%; 95%CI: 52.7–69.7). Conclusion Esophageal varices were prevalent among cirrhotic patients, most of which were at risk of bleeding. The non-invasive prediction of varices was not strong enough to replace endoscopic diagnosis. However, the predictors in this study can potentially assist in the selection of patients at high risk of having varices and prioritize them for endoscopic screening and appropriate management.

scholarly journals Platelet Count/Spleen Diameter Ratio as a Predictor of Esophageal Varices in Patients with Liver Cirrhosis

2017 ◽  
Vol 15 (2) ◽  
pp. 37-40
Author(s):  
Dipendra Khadka ◽  
Sudhamshu KC ◽  
Sandip Khadka ◽  
Kiran Regmi ◽  
Pooja KC
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Complete Blood Count ◽  
Liver Function Tests ◽  
Cross Sectional Study ◽  
Diameter Ratio ◽  
Cross Sectional ◽  
Predictive Values ◽  
Non Invasive

Introduction: Upper gastro-intestinal endoscopy still remains the gold standard for screening of patients suspected to have esophageal varices but not without limitations. So, this study was conducted to access the diagnostic validity and correlation between non-invasive parameters like platelet count, spleen diameter and their ratio with esophageal varices (EV) in patients with liver cirrhosis. Methods: A hospital based descriptive cross-sectional study was carried out in Liver unit of National Academy of Medical Sciences, Bir Hospital, from October 2016 to September 2017. Complete blood count, liver function tests, liver ultrasound and UGI endoscopy were done for all patients included in the study to detect esophageal varices and the platelet count/spleen diameter (PC/SD) ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices or not. Results: Total patients of liver cirrhosis studied after exclusion were 191 EV was present in 125 patients (65.4%). The platelet count/spleen diameter ratio using a cutoff value of ≤ 909 to detect EV independent of the grade had 93% sensitivity and 100% specificity and positive and negative predictive values of 100% and 91% respectively. Conclusions: PC/SD ratio now can be used as a predictor of presence of esophageal varices in liver cirrhosis.

scholarly journals Platelet Count/Splenic Diameter Ratio to Predict Oesophageal Varices in Portal Hypertension

2019 ◽  
Vol 2 (2) ◽  
pp. 192-196
Author(s):  
Buddhi Sagar Lamichhane ◽  
Manoj Koirala ◽  
Bishwo Raj Baral
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Portal Hypertension ◽  
Esophageal Varices ◽  
Rural Areas ◽  
Predictive Value ◽  
Tertiary Hospital ◽  
Diameter Ratio ◽  
Oesophageal Varices ◽  
Cirrhosis Of Liver

Background: One of the major causes of morbidity and mortality in Nepal is portal hypertension due to liver cirrhosis. In rural areas where a lot of cases of cirrhosis of liver are prevalent and endoscopic expertise and facilities are not available, predicting the presence of esophageal varices through non-invasive means may reduce a large number of unnecessary endoscopies. This study is to identify the relationship of platelet count /splenic bipolar diameter ratio with the presence of esophageal varices in portal hypertension. Materials and methods: Eighty patients were included in this study between Jestha 2072 to Baisakh 2073 with the diagnosis of portal hypertension admitted in Bir hospital, Kathmandu which is a tertiary hospital of government of Nepal, which were mostly due to liver cirrhosis. The patients fulfilling the inclusion criteria underwent lab investigations, ultra sonogram and UGI endoscopy. The data were assessed for descriptive studies and means were compared using t-test. The cut off value of platelet count to spleen diameter ratio of 1150 was used to predict the presence or absence of oesophageal varices. Statistical analysis was done using SPSS 20 software Results: Platelet count to splenic diameter ratio with a cut off value of 1150 has sensitivity of 89.7%, specificity of 83.3%, positive predictive value of 96.8% and negative predictive value of 58.8% (p= 0.002, CI=95%) with 89.5 % accuracy. Conclusion: Platelet count to splenic bipolar diameter ratio can be a good predictor of presence of esophageal varices in patients with portal hypertension in the resource poor settings.

scholarly journals Significance of Non-Invasive Markers as Predictor of Esophageal Varices in Liver Cirrhosis

2017 ◽  
Vol 56 (208) ◽  
pp. 412-6 ◽  
Author(s):  
Dipendra Khadka ◽  
Sushil Prajapati ◽  
Sudhamshu KC ◽  
Jeetendra Kaji Shrestha ◽  
Niyanta Karki ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Complete Blood Count ◽  
Clinical Expertise ◽  
Spleen Size ◽  
Cross Sectional ◽  
Cutoff Value ◽  
Non Invasive ◽  
Pugh Class

Introduction: Upper gastro-intestinal endoscopy remains the gold standard for screening for esophageal varices but it has its own limitations. It is an invasive, expensive and uncomfortable procedure and needs clinical expertise. Accordingly, this study was conducted to establish the role of non-invasive markers for prediction of esophageal varices in liver cirrhosis. Methods: A hospital based descriptive cross-sectional study was carried out in Liver unit of National Academy of Medical Sciences, Bir Hospital, from October 2016 to September 2017. Complete blood count, liver function test, liver ultrasound and upper gastro-intestinal endoscopy were done for all patients to detect esophageal varices and to correlate with different non-invasive markers. Results: Total 191 patients of liver cirrhosis were studied after exclusion. Platelet count of 92082.00±43435.83/mm3 and spleen size of 144.21±10.71 mm was found to be good predictors of presence of EV (P≤0.001). Significant association between Child-Turcotte-Pugh class and presence of varices was observed (P≤0.001). AST/ALT ratio with cutoff value of 1.415 showed sensitivity of 82.4% and specificity of 36.4%. APRI at a cutoff value of 1.3 showed a sensitivity of 83.2% and specificity of 50%. Conclusions: Platelet count, spleen size and Child-Turcotte-Pugh class are good predictors of presence of esophageal varices in patients with liver cirrhosis. AST/ALT ratio and APRI score are not good substitutes for upper gastro-intestinal endoscopy.   Keywords:  esophageal varices; liver cirrhosis; non-invasive markers; portal hypertension; upper gastro-intestinal.

scholarly journals Prediction of Aspartate Aminotransferase to Platelet Ratio Index with Size of Esophageal Varices in Liver Cirrhosis

2019 ◽  
Vol 17 (01) ◽  
pp. 38-41
Author(s):  
Amrendra K Mandal ◽  
Prashant Subedi ◽  
Mukesh Sharma Paudel ◽  
Suman Thapa ◽  
Paritosh Kafle ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Variceal Bleeding ◽  
Predictive Value ◽  
Aspartate Aminotransferase ◽  
Count Ratio ◽  
Institutional Review ◽  
Ethical Approval ◽  
Small Varices

Background: Liver cirrhosis is one of the major causes of morbidity and mortality. The threatening complication of Liver cirrhosis is variceal bleeding. Early diagnosis and initiation of therapy can reduce mortality associated with variceal bleeding. This study is designed to predict the esophageal varices by non-invasive method using aspartate aminotransferase to platelet count ratio index (APRI).Methods: A total of 100 patients were studied between March 2016 and February 2017 with the diagnosis of Liver cirrhosis admitted at Bir Hospital fulfilling the inclusion and exclusion criteria. Ethical approval was obtained from Institutional review board of National Academy of Medical Sciences.Results: Out of one hundred patients, 80 were males and 20 females. On endoscopy, small varices were present in 28 (28%) patients and large varices in 51(51%) patients. APRI with a cutoff value of 0.908 has sensitivity of 87.3% and specificity of 71.4%, positive predictive value of 92% and negative predictive value of 60% (p=0.001) for the detection of varices.Conclusions: Aspartate aminotransferase to platelet count ratio index can be a useful tool to indirectly predict esophageal varices in a patient with Liver Cirrhosis.Keywords: Aminotransferase; aminotransferase to platelet ratio index APRI; esophageal varices; liver cirrhosis; platelet count.

scholarly journals Clinical Profile and Upper Gastrointestinal Endoscopic Findings of Patients Presenting with Liver Cirrhosis with Portal Hypertension

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Shatdal Chaudhary ◽  
Niraj Kumar Jaiswal ◽  
Aakash Shahi ◽  
Pradip Chhetri
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Esophageal Varices ◽  
Clinical Profile ◽  
Upper Gastrointestinal Endoscopy ◽  
Portal Hypertensive Gastropathy ◽  
Cross Sectional ◽  
Female Ratio ◽  
Endoscopic Findings ◽  
Upper Gastrointestinal

Introduction: Liver cirrhosis is a common problem faced by physicians worldwide and is also responsible for 11th most common cause of death globally. Data regarding prevalence of esophageal varices and other upper gastrointestinal changes in patients with liver cirrhosis is scare in Nepal. So this study was carried out to find clinical profile and upper gastrointestinal endoscopic findings of patients presenting with liver cirrhosis with portal hypertension. Methods: This was a cross-sectional observational hospital based study conducted in the department of internal medicine and endoscopy unit of the Universal College of Medical Sciences, Bhairahawa, Nepal. The study was done from 21 February 2019 to 20 November 2019 in the patients presented with liver cirrhosis with portal hypertension. Sample size of 80±10 was calculated based on the statistics of previous data. The upper gastrointestinal endoscopy was done in all the patients. The data was collected using the predesigned pro-forma. Results: Total 89 patients with liver cirrhosis were enrolled with mean age of 51.84±12.26 years and male: female ratio of 3.68:1. As per Child Pugh classification (CTP) 45 patients (51%) were in Class C, 33 patients (37%) were in Class B and 11 patients (12%) were in Class A. Esophageal varices were present in 51 (57.3%) patients. According to Westaby classification grade I esophageal varices were seen in 17 (19.1%), grade II esophageal varices were seen in 26 (29.2%), grade III esophageal varices were seen in 8 (8.9%) patients. Portal hypertensive gastropathy (PHG) was seen in 64 (71%) patients. The association between esophageal varices and PHG grade was found statistically significant (P= <0.001). Conclusions: Liver cirrhosis was more commonly seen in middle age males. Esophageal varices and portal hypertensive gastropathy were common endoscopic findings present in patients with liver cirrhosis. There was statistically significant association between esophageal varices and PHG.

scholarly journals PLATELET COUNT SQUARED/SPLEEN DIAMETER-ASPARTATE AMINOTRANSFERASE RATIO: NON-INVASIVE METHOD TO PREDICT ESOPHAGEAL VARICES

2017 ◽  
Vol 54 (3) ◽  
pp. 222-224 ◽  
Author(s):  
Ângelo Zambam de MATTOS ◽  
Larissa Faraco DAROS ◽  
Angelo Alves de MATTOS
Keyword(s):  
Logistic Regression ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Predictive Value ◽  
Aspartate Aminotransferase ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Predictive Values ◽  
Non Invasive

ABSTRACT BACKGROUND - Variceal bleeding has a high mortality among cirrhotics, and screening with endoscopy is indicated at the diagnosis of cirrhosis. Screening with endoscopy implies discomfort, risks and considerable costs. OBJECTIVE - To evaluate platelet count squared/spleen diameter-aspartate aminotransferase ratio (PS/SA), as a non-invasive predictor of esophageal varices in cirrhotics. METHODS - This cross-sectional study evaluated cirrhotics for PS/SA and presence of esophageal varices. Outpatient records of cirrhotic patients were reviewed for the abovementioned data. Sensitivity, specificity, negative and positive predictive values of PS/SA were calculated. After the univariate analysis, variables with P<0.10 were submitted to a logistic regression. RESULTS - The study included 164 cirrhotics, 59.70% male, with a mean age of 56.7 years. Hepatitis C was the most frequent cause of cirrhosis, being present in 90 patients. Patients were classified as Child-Pugh A in 52.44% and as Child-Pugh B or C in 47.56%. Esophageal varices were present in 72.56% of the patients at endoscopy. PS/SA, with a cutoff of 3x108, had a sensitivity of 95.80% (confidence interval of 95% - 95%CI=0.92-0.99), a specificity of 22.70% (95%CI=0.10-0.35), a positive predictive value of 77.20% (95%CI=0.70-0.84) and a negative predictive value of 66.70% (95%CI=0.42-0.91). In the logistic regression, only platelet count and Child-Pugh score were associated to esophageal varices (P<0.05). CONCLUSION - PS/SA has an excellent sensitivity to predict esophageal varices, allowing almost one fourth of patients without esophageal varices to spare endoscopy. Nevertheless, PS/SA is not independently associated to esophageal varices.

scholarly journals To determine the correlation between mean platelet count and frequency of grading of esophageal varices in patients of liver cirrhosis.

2021 ◽  
Vol 28 (06) ◽  
pp. 833-841
Author(s):  
Masood Javed ◽  
Dilshad Mohammad ◽  
Zain Masood ◽  
Ghulam Abbas Sheikh ◽  
Muzammal Iftikhar ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Oesophageal Varices ◽  
P Value ◽  
Pathology Laboratory ◽  
Cross Sectional ◽  
Grade Ii ◽  
The Mean ◽  
Grade Iii

Objectives: To determine the correlation between mean platelet count and grading of esophageal varices in patients of liver cirrhosis. Study Design: Cross Sectional study. Settings: Department of Medicine, DHQ Hospital (FMU) &AFM&DC Faisalabad. Period: 17th August 2019 to 16th February 2020. Material & Methods: A total of 105 patients liver cirrhosis with esophageal varices were included in the study according to the inclusion and exclusion criteria. For assessment of platelet count 2ml blood sample was sent to hospital pathology laboratory and it was reported by the pathologist. Upper GI endoscopy was performed by gastroenterologist for confirmation and grading of oesophageal varices. Results: In our study, it was observed that 04 (3.81%) patients had grade- I EV, 34 (32.38%) Grade-II, 39 (37.14%) Grade III, 15 (14.29%) Grade IV and 13 (12.38%) patients had Grade V esophageal varices. While correlating the mean platelet count and grading of esophageal varices in patients of liver cirrhosis, it was observed that the mean platelet count of the patients with Grade-I EV was 149000± 26000, platelet count in patients with Grade-II EV was 122000 ± 26000, platelet count in patients with Grade-III EV was 100000 ± 23000, platelet count in patients with Grade-IV EV was 98000 ± 26000 and platelet count in patients with Grade-V EV was 94000 ± 22000 with correlation r value of 0.370 and p-value of 0.0001 which is statistically significant. Conclusion: This study concluded that there is inverse correlation between mean platelet count and grades of esophageal varices in patients of liver cirrhosis.

scholarly journals Assessment of Spleen Stiffness for Prediction of Varices in Patients with Hepatitis C Related Cirrhosis Using Transient Elastography

2020 ◽  
pp. 9-18
Author(s):  
Naglaa El-Toukhy Ramadan El-Toukhy ◽  
Sharaf Elsayed Ali Hassanien ◽  
Ramy A. Metwaly ◽  
Medhat A. Khalil ◽  
Badawy A. Abdulaziz
Keyword(s):  
Liver Cirrhosis ◽  
Hepatitis C ◽  
Esophageal Varices ◽  
Predictive Value ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Diagnostic Value ◽  
Group I ◽  
Spleen Stiffness ◽  
Cirrhotic Patients

Background and Study Aims: Portal hypertension is one of the most important complications of liver cirrhosis. The prevalence of varices among cirrhotic patients is variable. Therefore, endoscopic screening of all patients with liver cirrhosis would result in a large number of unnecessary additional burdens to endoscopic units. Our aim was to assess the diagnostic accuracy of spleen stiffness measured by transient elastography (Fibroscan) for prediction of the presence of varices in patients with hepatitis C related cirrhosis. Patients and Methods: The study was carried out on 100 patients with HCV-induced cirrhosis and were divided into 2 groups according to presence or absence of varices by Esophago-gastro-duodenoscopy: Group I: patients with HCV-induced cirrhosis with varices; Group II: patients with HCV-induced cirrhosis without varices. Clinical and laboratory parameters, andominal ultrasonography, Upper gastrointestinal endoscopy and transient elastography to assess the liver and spleen stiffness were carried out to all studied persons. Results: Spleen stiffness had significant diagnostic value to differentiate between cirrhotic patients with varices and cirrhotic patients without varices , it had significant diagnostic value in presence of esophageal varices at cut-off (≥46.4 K Pascal) the sensitivity for detection of esophageal varices was 93%, specificity 100%, positive predictive value (PPV) was 80%, negative predictive value (NPV) was 100%; accuracy was 95% and area under the curve was 0.98 denoting that spleen stiffness is a good predictor of esophageal varices. Conclusion: Spleen stiffness was considered as an excellent predictor of esophageal varices and better than liver stiffness in prediction of esophageal varices presence and had significant diagnostic value to differentiate between the patients with varices and patients without varices at cut off (≥46.4 K Pascal) and it may have a role in variceal grading.

scholarly journals Platelet count can predict the grade of esophageal varices in cirrhotic patients: a cross-sectional study

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 101
Author(s):  
Anum Afsar ◽  
Muhammad Nadeem ◽  
Syed Asim Ali Shah ◽  
Huma Hussain ◽  
Aysha Rani ◽  
...  
Keyword(s):  
Platelet Count ◽  
Negative Correlation ◽  
Esophageal Varices ◽  
Significant Negative Correlation ◽  
Cross Sectional Study ◽  
Variceal Hemorrhage ◽  
Sectional Study ◽  
Cross Sectional ◽  
Grade Ii ◽  
Cirrhotic Patients

Background: Bleeding from esophageal varices is a life-threatening complication in cirrhosis. Screening endoscopy is recommended in cirrhotic patients to identify patients at risk of variceal hemorrhage, but this is an invasive procedure and has limitations. Therefore, thrombocytopenia has been proposed to predict the existence and grade of esophageal varices. The aim of the current study was to determine a correlation between platelet count and grades of esophageal varices in patients with liver cirrhosis. Methods: This cross-sectional study was conducted at the POF Hospital, Wah Cantt from 1st October, 2017 to 30th May, 2018. Newly diagnosed cases of cirrhosis having varices of any grade on endoscopy were included. Endoscopic findings of patients were standardized using Paquet grading system. On the basis of platelet count, patients were divided into four subgroups. Platelet count groups were correlated with grading of esophageal varices using Spearman rank correlations. Chi Square test was used to see association between the platelet count and grade of esophageal varices. Results: 110 patients were included in the study, 55.5% (n=61) were male. Mean age of the patients was 59.89±9.01 years. Platelet count was <50,000/uL in 35.5% patients, 50,000-99,000/uL in 26.4%, 100,000-150000 in 12.7%, and >150,000/uL in 25.5% patients. Grade I esophageal varices were found in 23.6% of patients, whereas grade II, III and IV were found in 24.5%, 33.6% and 18.2% of patients, respectively. Mean platelet count was 213884.62/mm3 in patients with grade I varices, whereas it was 119518.52/mm3, 58386.49/mm3 and 21600.00/mm3 in patients with grade II, III and IV varices, respectively (p=<0.0001). A significant negative correlation between platelet count and grades of esophageal varices was found (p<0.001). Conclusion: Platelet count can predict the grade of esophageal varices in cirrhotic patients. There is significant negative correlation between platelet count and grades of esophageal varices.

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