scholarly journals Assessment of Malnutrition in Chronic Liver Disease Patients with the Child Pugh Classification at a Large Tertiary Care Center in Karachi, Pakistan

2021 ◽  
Vol 15 (1) ◽  
pp. 1-5
Author(s):  
Aamna Qazi ◽  
◽  
Saqib Basar ◽  
Keyword(s):  
Liver Disease ◽  
Hepatitis B ◽  
Chronic Liver Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Chronic Liver ◽  
Cross Sectional ◽  
Large Tertiary Care ◽  
Class B

Background: Child Pugh classification is an easy-to-use method that allows Physicians to assess malnutrition in patients suffering from CLD. Objective: To determine the frequency of malnutrition at different stages of chronic liver disease in accordance with Child Pugh classification. Study Design: The type of study is a cross-sectional study. Settings: Medical Unit III Civil Hospital, Karachi Pakistan. Duration: Six months from 31st May 2016 to 30th November 2016. Methodology: All the patients between the age 30 to 60 years who are known cases of CLD secondary to hepatitis B, C or both, with active signs of CLD were included. All the patients having debilitating co-morbidities likes malignancy, TB, psychiatric, etc. were excluded. Anthropometric evaluation and lab investigation at the time of admission were performed for all the patients. Results: The average age was 48.12±8.521 years and duration of disease was 5.48±3.792 months. There were 61.54% male and 38.46% females. Hepatitis-B was observed in 19.91% (n=44) cases, Hepatitis-C was 62.44% (n=62.44) and both hepatitis B and C was observed in 17.65% (n=39) cases. According to Child Pugh score, 9.5% cases were in class A, 32.58% were in class B and 57.92% were in class C. Frequency of malnutrition in chronic liver disease patients was 62.44% (138/221). Rate of malnutrition was significantly high in class B and C (p=0.002). Rate of malnutrition was also observed to be significantly high in those cases who were positive for both hepatitis like B and C (p=0.001). Effect of duration of cirrhosis was also not statistically significant with malnutrition. Conclusion: Malnutrition was significantly common among chronic liver disease patients regardless of viral etiology. Child Pugh B & C patients were found to have more significant malnourished states.

scholarly journals Hyponatremia in Chronic Liver Disease among Patients Presenting to a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (244) ◽  
pp. 1225-1228
Author(s):  
Abashesh Bhandari ◽  
Ashlesha Chaudhary
Keyword(s):  
Liver Disease ◽  
Confidence Interval ◽  
Chronic Liver Disease ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Chronic Liver ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Hyponatremia is a frequent problem in chronic liver disease. To the best of our knowledge, no study of hyponatremia in chronic liver disease has been conducted in our setting. The aim of this study is to study the prevalence of hyponatremia in patients with chronic liver disease attending the outpatient department of a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted in 114 patients with chronic liver disease attending the out-patient department of a tertiary care hospital in Kathmandu, Nepal between November 2020 and July 2021. Ethical approval was taken from the Institutional Review Committee of Nepal Medical College and Teaching Hospital (Reference number: 028-077/078). Convenience sampling was done. The collected data was entered and analyzed in Microsoft Excel. Calculation of point estimate at 95% confidence interval was done along with frequency and proportion for binary data. Results: Among 114 patients with chronic liver disease studied, 47 (41.22%) (32.18-50.25 at 95% Confidence Interval) patients had hyponatremia (≤130mmol/L) with mean age of 53.44±7.57 years. Thirty (63.8%) patients out of these were males and 17 (36.2%) patients were females. Conclusions: The prevalence of hyponatremia among patients with chronic liver disease was found to be higher when compared to other similar studies.

scholarly journals ANALISIS FERITIN DAN AST TO PLATELET RATIO INDEX SEBAGAI PETANDA DERAJAT FIBROSIS PENYAKIT HATI KRONIS (Analysis Ferritin and AST to Platelet Ratio Index as a Marker Degree of Fibrosis Chronic Liver Disease)

2018 ◽  
Vol 22 (1) ◽  
pp. 72
Author(s):  
Yulianti Yasin ◽  
Uleng Bahrun ◽  
Ibrahim Abdul Samad
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Cell Damage ◽  
Clinical Chemistry ◽  
Cross Sectional Study ◽  
Chronic Liver ◽  
Impedance Method ◽  
Iron Deposit ◽  
Cross Sectional ◽  
Modified Method

Chronic liver disease is an endemic disease in Indonesia which is still a global health problem and detected when it’s developinginto fibrosis. The determination of fibrosis is important for the treatment and prognosis of chronic liver disease. AST to Platelet RatioIndex (APRI) score is the most common used to assess the degree of liver fibrosis. Ferritin is an iron deposit that found in the liver andthe levels depend on the degree of the cell damage. The aim of this study was to analyze ferritin levels as a marker of the fibrosis degreein the chronic liver disease. This cross-sectional study of 47 patients with chronic liver disease performed at Dr. Wahidin SudirohusodoGeneral Hospital between May–June 2012. The subjects are grouped into cirrhotic and noncirrhotic, based on the theory that in cirrhoticliver fibrosis was considered as an irreversible condition. AST to platelet ratio index score based on the Wai CT formulation, includingthe examination of AST by optimizing UV-test according to International Federation of Clinical Chemistry (IFCC) modified method onthe ABX Pentra 400, examination of platelet by impedance method on Sysmex XT 2000i and ferritin levels were measured by ECLIAmethod using Elecsys 2010 Analyzer. The Spearman correlation tests showed no association between ferritin levels and APRI in cirrhoticand non cirrhotic patients (p=0.704 and r=–0.057). In conclusion, ferritin can not be used as the marker in determining the degreeof fibrosis patients suffering chronic liver disease. Further studies are expected using a more valid method for determining the degree offibrosis such as liver biopsy or fibro scan.

scholarly journals A cross-sectional study of chronic liver disease patients complicating to hepatic osteodystrophy

2020 ◽  
Vol 7 (6) ◽  
pp. 1013
Author(s):  
Mohammed Jaleel P. ◽  
S. Bhagyabati Devi ◽  
Ningthoukhongjam Reema ◽  
Thangjam Gautam Singh ◽  
Dhileeban Maharajan P.
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Cross Sectional Study ◽  
Bone Diseases ◽  
Chronic Liver ◽  
Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
Metabolic Bone Diseases ◽  
Hepatic Osteodystrophy

Background: Hepatic osteodystrophy encompasses the spectrum of metabolic bone diseases in chronic liver disease (CLD) patients. CLD causing changes in BMD is well known. Although BMD evaluation in CLD cirrhosis are recommended by societies of British and American gastroenterology ,very less number of literature exist from India and none from the North-eastern region of India. Aim of the study to determine the association and severity of bone mineral density changes in patients with CLD and to correlate it with different aetiologies and severity of CLD.Methods: This cross-sectional study which included 79 patients with CLD was conducted in RIMS, Manipur from September 2017 to August 2019. All CLD patients of age 18-60 years were included. DEXA scan and other related blood investigations were performed.Results: Chronic alcohol intake (56.9%), viral infection (20.3%) and mixed (17.7%) were the main aetiology of CLD in our study. Seventy three (92.4%) of the total 79 patients had low BMD (Osteopenia in 29 (36.7%) and osteoporosis in 44 (55.7%) patients). Osteoporosis was detected in 53.4% of alcohol related Cirrhosis, 25%of viral liver disease. Majority of the severe CLD patients (Child class C) had osteoporosis (70.6%) as compared to less severe groups (23.5% and 36.4% in class B and A respectively).Conclusions: CLD patients have high prevalence of osteoporosis. Severity of liver disease, alcoholic liver disease, serum calcium and vitamin D deficiency predisposes to osteoporosis in these patients. Hence early screening of BMD is necessary in CLD patients.

scholarly journals Correlation of lipid profile in patients with severity of liver disease: a cross sectional study in a tertiary care hospital

2016 ◽  
Vol 5 (1) ◽  
pp. 326
Author(s):  
Hashik P. Muhammed ◽  
Kezhakkut Jayaraj
Keyword(s):  
Liver Disease ◽  
Lipid Profile ◽  
Chronic Liver Disease ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Chronic Liver ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lipid Parameters

Background: Many previous studies concluded variation in the lipid parameters such as total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) with severity of liver disease. Hence, this study was conducted to find out the correlation of lipid profile in patients with severe liver disease.Methods: A cross sectional study which included 170 patients admitted with chronic liver disease. Severity of liver disease according to Child Pugh Turcotte Score. The patients were subjected to routine investigation and fasting lipid profile test. Correlation was studied using the Pearson correlation coefficient and the comparison of lipid parameters was also done.Results: Total of 170 consecutive chronic liver disease patients were analysed over a period of one year. Majority of the patients were of the age 51 to 60 years (39.8%). Among the total, 24 patients were in Child Pugh Turcotte Score class A, 47 patients were in class B and 52 were patients in class C. We could observe a significant (p<0.001) negative correlation of all the lipid profile parameters with the severity of liver disease.Conclusions: Serum TC, LDL TG and HDL were decreased in patients with cirrhosis and they are inversely correlated to severity of disease.

scholarly journals Catastrophic Health Expenditure, Distress Financing and Impoverishment due to Out-of-Pocket Expenses for Healthcare among Patients with Chronic Liver Disease: A Cross-sectional Study among Hospitalized Patients in Bangladesh

2021 ◽  
Author(s):  
Mohammad Farhadul Haque ◽  
ANM Shamsul Islam ◽  
Samina Pervin ◽  
Emily Akter ◽  
Mahmudul Hasan
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Health Expenditure ◽  
Cross Sectional Study ◽  
Catastrophic Health Expenditure ◽  
Hospitalized Patients ◽  
Chronic Liver ◽  
Sectional Study ◽  
Cross Sectional ◽  
Distress Financing

Out-of-pocket (OOP) expenses for hospitalized patients with chronic liver disease (CLD) poses an economic challenge on affected household in the form of catastrophic health expenditure (CHE), distress financing and impoverishment. OOP Expenses data for hospitalized CLD patients from Bangladesh is scarce. This study aimed to estimate the OOP expenses and resulting CHE, distress financing and impoverishment among hospitalized patients with CLD. This cross-sectional study was conducted among conveniently selected 107 diagnosed CLD patients admitted at Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) aged 18 years and above. Data were collected from the respondents using a semi-structured questionnaire through face to face interview during discharge from hospital. Out of pocket expenditure for chronic liver disease in selected hospitals was Bangladeshi Taka (BDT) 19,262. Direct medical, direct non-medical and indirect cost was BDT 16,240; 2,165 and 1,510, respectively. Investigation cost and medicine cost contributed to 48.48% and 31.81% of the total OOP expenses, respectively. At 10% threshold level, 29% of the respondents were affected by CHE. 64.5% of the respondents were facing distress financing due to OOP expenses. Among the respondents, 1.9% slipped below the international poverty line of $1.90 (BDT 161.10, in 2019).There was statistically significant (p &lt; 0.05) difference among the mean OOP expenses for different etiological types of chronic liver disease. The study concluded that it requires establishing a more accessible and affordable decentralized health care system for CLD treatment along with the implementation of financial risk protection.

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