scholarly journals Cirrhosis of liver is a risk factor for gallstone disease

2017 ◽  
Vol 5 (5) ◽  
pp. 2053
Author(s):  
Nikhil U. Shirole ◽  
Sudhir J. Gupta ◽  
Dharmesh K. Shah ◽  
Nitin R. Gaikwad ◽  
Tushar H. Sankalecha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Cirrhosis ◽  
General Population ◽  
Gallstone Disease ◽  
Gall Stone ◽  
Gallstone Formation ◽  
Cross Sectional ◽  
Gall Stones ◽  
Cirrhotic Patients ◽  
Common Clinical Finding

Background: Gallstones are common clinical finding in general population. Mean prevalence rate in Indian population is 4-5%. The prevalence of gallstones is found to be high in cirrhotic patients compared to the general population in some western studies. Cause of this increased prevalence however is not known. Aim of the study was to evaluate prevalence of the gall stones in the cirrhotic patients, assess risk factors in cirrhotic patients and clinical presentation.Methods: This is the cross sectional observational study, included cirrhotic patients (compensated or decompensated). Risk factors for gallstone formation (age, gender and diabetes mellitus), characteristics of liver cirrhosis (etiology, Child Turcotte Pugh class, hypersplenism and varices) and clinical presentation were assessed in all cirrhotic patients with gallstones.Results: 336 patients with liver cirrhosis are included in this study; 201 (59.80%) male and 135 (40.2%) female. Mean age of the patients is 44.95±13.1 years. Overall prevalence of gall stones was 12.8% (43/336). Out of 43 patients, 23 (53.5%) are male and 20 (46.5%) are female. As child status progresses from A to B to C, prevalence of gall stone increases, with 60.46% (26/43) of gall stones occurring in the patients with CTP class C. Only 8 (18.6%) patients had gallstone related symptoms while rests were asymptomatic. 5 (11.6%) had concurrent CBD stones. Cholecystectomy was possible in only 2 patients with symptomatic gallstones.Conclusions: The prevalence of gall stones in cirrhotic is higher than general population which increases with the severity of liver cirrhosis. Most cirrhotic patients are asymptomatic for gallstones.

scholarly journals Prevalence of Gall Stones in Liver Cirrhosis

2015 ◽  
Vol 53 (200) ◽  
pp. 275-279
Author(s):  
Sudhamshu K.C. ◽  
Dilip Sharma ◽  
Sandip Khadka ◽  
Niyanta Karki ◽  
Bikash Jaishi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Cirrhosis ◽  
Portal Vein ◽  
Gallstone Disease ◽  
Gallstone Formation ◽  
Female Ratio ◽  
Gall Stones ◽  
Vein Diameter ◽  
Severity Of The Disease ◽  
Male To Female

Introduction: Increased incidence and prevalence of gallstones in liver cirrhosis has already been reported by many studies. This study aimed to investigate the prevalence of gallstone disease in Nepali patients with liver cirrhosis and to identify risk factors for gallstone formation. Methods: Consecutive patients of liver cirrhosis presenting to liver clinic from January, 2010 to December, 2012 were evaluated for GS by ultrasonography at their first visit. Liver cirrhosis was diagnosed on the basis of clinical features, laboratory parameters, ultrasonography, and/or histopathology. Results: Two hundred and twenty four LC patients were studied. Male to female ratio was 2.3:1. Alcohol was the major etiological factor for LC followed by hepatitis B, alone or in conjunction with alcohol. Seventy-four patients (33%) were found to have GS. Incidence of GS was more in advance stage of cirrhosis. There was no significant correlation between formation of GS and etiology of LC, except for the HCV related liver cirrhosis, in which it was present in 39% of the patients. More the advance disease,more was the incidence as 57% of Child-C patients had GS. Portal vein diameter was also associated with GS formation. When portal vein diameter was more than 13 mm, there was more GS formation. Conclusions: One third of the patients of LC showed GS at the presentation. Patients with HCV related cirrhosis are more prone to develop GS than other. Severity of the disease and portal vein diameter was found to be associated with GS formation. Keywords: gallstones; liver cirrhosis; ultrasonography.

AN EPIDEMIOLOGICAL STUDY TO EVALUATE THE ASSOCIATION OF RISK FACTORS FOR GALLSTONE FORMATION

2021 ◽  
pp. 51-53
Author(s):  
Surajit Lahiri ◽  
Subham Roy Choudhury ◽  
Subhajit Shyam
Keyword(s):  
Risk Factors ◽  
Gallstone Disease ◽  
Strong Association ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Gallstone Formation ◽  
Public Health Issue ◽  
P Value ◽  
Cross Sectional ◽  
Waking Up

Gallstone disease and its complications are a major public health issue, equally affecting both the developed and the developing countries across the globe. The unmodiable risk factors are universally same. The modiable risk factors however, can vary from place to place depending upon social customs, lifestyle, food habits and preferences. This justies the need for regional studies to look for association of risk factors that can precipitate gallstone disease so that preventive programmes can be undertaken to reduce its incidence. The project was an institution-based observational cross-sectional study on 96 subjects to look for the risk factors associated with gallstone formation. The patients were chosen using simple random sampling technique as per the pre-decided inclusion and exclusion criteria. The data was collected through a pre-designed and pre-tested semi-structured questionnaire. For all the tests for the study, a p-value of < 0.05 was considered signicant. All the statistical signicance of the project was evaluated at a condence interval of 95%. Based on the objective of the study, further descriptive and inferential statistics was drawn. Our study showed a strong association between gallstone disease and the time elapsed between waking up in the morning and taking breakfast, with 88 subjects (91.66%) out of the possible 96 taking their breakfast over 2 hours (120 minutes) after waking up. Thus reduction in overnight fasting by advising people to take their breakfast within 2 hours (120 minutes) of waking up, can bring down the incidence of gallstone disease signicantly. Thus we propose awareness programmes to highlight this issue amongst the population at risk.

scholarly journals Gall bladder stones and the associated histopathology– a tertiary care centre study

2017 ◽  
Vol 5 (4) ◽  
pp. 1368
Author(s):  
Vijayakumaran Pillai ◽  
Renjith Sreekantan ◽  
Meer M. Chisthi
Keyword(s):  
Gallstone Disease ◽  
Tertiary Care ◽  
Gall Stone ◽  
Chronic Cholecystitis ◽  
Premalignant Lesions ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Cholesterol Levels ◽  
Gall Stones

Background: Gall stones form one of the main reasons for recurrent upper abdomen pain. Cholecystectomy has turned out to be one of the commonest laparoscopic procedures done all over the world. The objectives of the study were to analyse the histopathological changes in gallstone disease and to study the clinical and biochemical factors that are seen in gall stone disease.Methods: This was a hospital based cross sectional study conducted at a tertiary care centre from January 2013 to December 2014. 108 patients admitted with diagnosis of cholelithiasis and posted for cholecystectomy were studied. Their clinical and biochemical data and post-operative stone analysis results and histopathological reports were collected and analyzed.Results: 63% of the patients were females with a female to male ratio of 1.7:1. Of the group, 64.8% had a BMI between 25 and 29.9. 65.7% patients got operated within one year of the onset of symptoms. Serum cholesterol levels were found elevated in majority of patients. 61% patients had multiple gall stones. 62% had stones composed of cholesterol, bilirubin, calcium carbonate and calcium oxalate. 102 out of the 108 specimens showed histological features of chronic cholecystitis only. One case showed a premalignant change in the form of pyloric metaplasia.Conclusions: Cholelithiasis is seen mostly in females, most of them having elevated cholesterol levels. The commonest histopathological change associated with cholelithiasis is chronic cholecystitis. Premalignant lesions are seen only in a small minority only. Hence early elective cholecystectomy can prevent malignant transformation in asymptomatic gall stones.

scholarly journals AB0407 CARDIOVASCULAR BURDEN IN SYSTEMIC SCLEROSIS: QRISK3 VERSUS FRAMINGHAM FOR RISK ESTIMATION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1232.1-1232
Author(s):  
M. Di Battista ◽  
S. Barsotti ◽  
A. Della Rossa ◽  
M. Mosca
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Systemic Sclerosis ◽  
High Risk ◽  
General Population ◽  
Risk Score ◽  
Predictive Accuracy ◽  
Risk Estimation ◽  
Cross Sectional

Background:Cardiovascular (CV) diseases, namely myocardial infarction and stroke, are not among the most known and frequent complications of systemic sclerosis (SSc), but there is growing evidence that SSc patients have a higher prevalence of CV diseases than the general population [1].Objectives:To compare two algorithms for CV risk estimation in a cohort of patients with SSc, finding any correlation with clinical characteristics of the disease.Methods:SSc patients without previous myocardial infarction or stroke were enrolled. Traditional CV risk factors, SSc-specific characteristics and ongoing therapies were assessed. Framingham and QRISK3 algorithms were then used to estimate the risk of develop a CV disease over the next 10 years.Results:Fifty-six SSc patients were enrolled. Framingham reported a median risk score of 9.6% (IQR 8.5), classifying 24 (42.9%) subjects at high risk, with a two-fold increase of the mean relative risk in comparison to general population. QRISK3 showed a median risk score of 15.8% (IQR 19.4), with 36 (64.3%) patients considered at high-risk. Both algorithms revealed a significant role of some traditional risk factors and a noteworthy potential protective role of endothelin receptor antagonists (p=0.003). QRISK3 was also significantly influenced by some SSc-specific characteristics, as limited cutaneous subset (p=0.01), interstitial lung disease (p=0.04) and non-ischemic heart involvement (p=0.03), with the first two that maintain statistically significance in the multivariate analysis (p=0.02 for both).Conclusion:QRISK3 classifies more SSc patients at high-risk to develop CV diseases than Framingham, and it seems to be influenced by some SSc-specific characteristics. If its predictive accuracy were prospectively verified, the use of QRISK3 as a tool in the early detection of SSc patients at high CV risk should be recommended.References:[1]Ngian GS, Sahhar J, Proudman SM, Stevens W, Wicks IP, Van Doornum S. Prevalence of coronary heart disease and cardiovascular risk factors in a national cross-sectional cohort study of systemic sclerosis. Ann Rheum Dis. 2012;71:1980-3.Disclosure of Interests:None declared

scholarly journals Oral health inequality in people with severe mental illness: a cross-sectional study using National Health and Nutrition Examination Survey 1999-2016

2021 ◽  
Author(s):  
Jing Kang ◽  
Jianhua Wu ◽  
Vishal Aggarwal ◽  
David Shiers ◽  
Tim Doran ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Oral Health ◽  
General Population ◽  
Health Outcomes ◽  
Severe Mental Illness ◽  
Tooth Loss ◽  
List Type ◽  
Cross Sectional ◽  
Oral Health Outcomes

AbstractOBJECTIVETo explore whether people with severe mental illness (SMI) experience worse oral health compared to the general population, and the risk factors for poor oral health in people with SMI.METHODThis study used cross-sectional data from the National Health and Nutrition Examination Survey (1999-2016) including on self-rated oral health, ache in mouth, tooth loss, periodontitis stage, and number of decayed, missing, and filled teeth. Candidate risk factors for poor oral health included demographic characteristics, lifestyle factors, physical health comorbidities, and dental hygiene behaviours. The authors used ordinal logistic regression and zero-inflated negative binomial models to explore predictors of oral health outcomes.RESULTS53,348 cases were included in the analysis, including 718 people with SMI. In the fully adjusted model, people with SMI were more likely to suffer from tooth loss (OR 1.40, 95% CI: 1.12-1.75). In people with SMI, the risk factors identified for poor oral health outcomes were older age, white ethnicity, lower income, smoking history, and diabetes. Engaging in physical activity and daily use of dental floss were associated with better oral health outcomes.CONCLUSIONSPeople with SMI experience higher rates of tooth loss than the general population, and certain subgroups are particularly at risk. Having a healthy lifestyle such as performing regular physical exercise and flossing may lower the risk of poor oral health. These findings suggest opportunities for targeted prevention and early intervention strategies to mitigate adverse oral health outcomes.Significant outcomes (x3)People with severe mental illness were at 40% higher risk of tooth loss when compared to the general population.Older adults, smokers and people with diabetes were at particularly high risk of poor oral health.Physical exercise and daily use of dental floss were associated with better oral health outcomes.Limitations (x3)The number of cases with data on periodontal disease was limited.The study was cross-sectional so causation could not be inferred.The analysis used prescriptions of antipsychotic and mood stabilising medication as a proxy measure of severe mental illness, as clinical diagnoses were not available in the dataset.Data availability statementThe NHANES 1999-2016 data is available at CDC website: https://www.cdc.gov/nchs/nhanes/index.htm, and is accessible and free to download for everyone.

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 Cardiovascular Risk Factors in Patients with Acute MI in a Secondary Hospital in Bangladesh

2020 ◽  
Vol 12 (2) ◽  
pp. 96-101
Author(s):  
Mohammad Ullah ◽  
Suman Kumar Saha ◽  
Md Toufiqur Rahman ◽  
Md Abdul Karim ◽  
Rashid Ahmed
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Family History ◽  
Cardiovascular Diseases ◽  
General Population ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Secondary Hospital

Background: Incidence of noncommunicable disease, specially cardiovascular diseases, is increasing in Bangladesh. Prevalence of risk factors in ischaemic heart disease (IHD) has been studied in different tertiary hospitals and institutes. This study was done in a secondary hospital with a patient population mainly of low socioeconomic condition and was compared with other patient groups of the country and Indian subcontinent. Methods: this cross sectional study was conducted in Manikganj Sadar Hospital from July 2019 to December 2019. All the patients admitted with the diagnosis of myocardial infarction (MI) were included. Cardiovascular risk factors, like smoking, diabetes mellitus (DM), hypertension (HTN), family history of premature cardiovascular diseases, dyslipidaemia and obesity, were evaluated among the patients. Results: This cross-sectional study showed most of the patients were in the age group of 50-59 years. 66% of the male patients and 2% of the female patients were smoker. 66% of the patients were hypertensive, 44% patients were diabetic, 28.5% patients were overweight, 60.4% patients had total cholesterol > 200mg/dl, 73.6% patients had LDL>130 mg/dl, 110 76.3% patients had HDL < 40 mg/ dl, 72.2% had triglyceride >150 mg/dl and 39% patients had family history of premature cardiovascular disease. Ninety (62.5%) patients had anterior MI, 50 (34.7%) patients had inferior MI and 4 (2.7%) patients had NSTEMI. 65 patients had no major risk factor and 57 % had three or more risk factors. Conclusion: The study population was more aged in comparison to other studies conducted in different parts of Bangladesh. Prevalence of smoking habit was lower but the prevalence of HTN, DM and dyslipidaemia were higher than the general population and other cohorts of MI patients. The prevalence of major risk factors was much higher than the general population of Bangladesh. Cardiovasc. j. 2020; 12(2): 96-101

scholarly journals Ultrasonographic Study of Gallbladder Wall Thickness and Emptying in Cirrhotic Patients without Gallstones

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Massimiliano Loreno ◽  
Salvatore Travali ◽  
Anna Maria Bucceri ◽  
Giuseppe Scalisi ◽  
Carla Virgilio ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Wall Thickness ◽  
Gallstone Formation ◽  
Normal Subjects ◽  
Gallbladder Wall ◽  
Wall Thickening ◽  
Gallbladder Emptying ◽  
Portal Vein Flow ◽  
Gallbladder Wall Thickening ◽  
Cirrhotic Patients

Background and Aim. Gallbladder wall thickening and impaired contractility are currently reported in cirrhotic patients and often related to portal hypertension and hepatic failure. The purpose of this work was to evaluate, by ultrasonographic method, gallbladder wall thickness and gallbladder emptying after a standard meal in normal subjects and in patients with compensated liver cirrhosis without gallstones.Methods. Twenty-three patients with Child-Pugh class A liver cirrhosis and twenty healthy controls were studied. Gallbladder wall thickness (GWT), gallbladder fasting volume (FV), residual volume (RV), and maximum percentage of emptying (%E) were calculated. Measurements of mean portal velocity, portal vein flow, and serum albumin were performed too. Statistical analysis was assessed by Student's “ttest” for unpaired data.Results. GWT was  cm in cirrhotic patients and  cm in controls (). FV and RV were, respectively,   and   in cirrhotic patients,   and   in healthy volunteers (). %E was smaller in cirrhotics () as compared to controls (; ).Conclusions. In patients with compensated liver cirrhosis without gallstones gallbladder wall thickness is increased whereas its contractility is reduced. These early structural and functional alterations could play a role in gallstone formation in more advanced stages of the disease.

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