scholarly journals Comparing the Effectiveness of Carvedilol and Propranolol to Prevent Reoccurrence of Esophageal Variceal Bleeding in Patients with Liver Cirrhosis.

2021 ◽  
Vol 15 (8) ◽  
pp. 2491-2493
Author(s):  
Liaqat Khurshid ◽  
Asadullah Khan ◽  
Salim Hassan ◽  
Adil Naseer Khan
Keyword(s):  
Liver Cirrhosis ◽  
Arterial Pressure ◽  
Portal Vein ◽  
Variceal Bleeding ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Portal Vein Flow ◽  
Group A ◽  
Cirrhotic Patients ◽  
Group B

Objective: To compare the efficacy of carvedilol and propranolol to prevent reoccurrence of esophageal variceal bleeding in patients with liver cirrhosis. Study Design: Place and Duration: Department of Gastroenterology and Hepatology, Ayub Teaching Hospital, Abbottabad, Pakistan for six months duration from 15th November 2020 to 15th May 2021. Methods: Total one hundred and forty patients of ages between 18-65 years were presented in this study. Patients detailed demographics age, sex, body mass index and Child-Turcotte-Pugh (CTP) class were recorded after taking written informed consent. Patients were equally (n=70) divided into two groups. Group A had 70 patients and received carvedilol while group B had 70 patients and received propranolol for 6 months. Reoccurrence ofesophageal variceal bleeding in cirrhotic patients among both groups were observed at 2nd, 4th and 6th months and patients pulse rate, arterial pressure and portal vein flow were recorded at these time points. Complete data was analyzed by SPSS 26.0 version. Results: Mean age of the patients in group A was 40.38 ± 5.87 years with mean BMI 28.09 ± 7.33 kg/m2 and in group B mean age was 39.43 ± 12.69 years with mean BMI 27.53 ± 8.84 kg/m2. In group A 45 (64.3%) patients were males and 25 (35.7%) were female patients while in group B 50 (71.43%) were male patients and 20 (28.7%) patients were females. We found that there was no statistically significant difference observed among both groups regarding these demographic variables. Reoccurrence of bleeding observed in group A was significantly lower (among 20 (28.6%) cases) as compared to group B (among 36 (51.43%) cases). Pulse rate, mean arterial pressure and portal vein flow was found lower in the carvedilol group as compared to propanol group with p value < 0.05 upon follow up at2,4 and 6 months. Conclusion: We found in this study that the drug carvedilol was more effective and safe to prevent reoccurrence of esophageal variceal bleeding in cirrhotic patients as compared to propanol. Keywords: Cirrhotic patients, Carvedilol, Propanol, Portal vein flow, Mean arterial pressure

scholarly journals Comparative Efficacy of Terlipressin and Octreotide along with Endoscopic Band Ligation in the Management of Esophageal Variceal Bleeding

2021 ◽  
Vol 2 (2) ◽  
pp. 41-48
Author(s):  
Sadia Asif ◽  
Ayesha Shehbaz Khan ◽  
Sarmad Zahoor ◽  
Hafiz Mudabbar Mahboob ◽  
Uzma Malik ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Medical Emergency ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Band Ligation ◽  
Female Patients ◽  
Group A ◽  
Cirrhotic Patients ◽  
Endoscopic Band Ligation ◽  
Group B

Esophageal variceal bleeding is a medical emergency that carries a high mortality rate despite appropriate management. Terlipressin and Octreotide are two common agents used as adjuvant agents in the management of variceal bleeding. The objective of this study is to compare the effectiveness of Terlipressin with Octreotide along with endoscopic band ligation in the management of esophageal variceal bleeding in cirrhotic patients. This randomized control study was carried out at the Department of General Medicine, Fatima Memorial Hospital, Lahore, for six months extending from February 2019 to July 2019. A total of 100 cirrhotic patients were selected /based on predetermined inclusion and exclusion criteria. The patients were randomly divided into two groups of equal strength. Hence, 50 patients were included in Group A and 50 patients were included in Group B along with banding. Group A received Terlipressin whereas Group B received Octreotide. The two groups were monitored for variceal bleeding for 72 hours. The mean age of the patients in Group A was 55.9±7.3 years and for the patients in Group B it was 56.8±7.4 years. In Group A, 36 (72.0%) male and 14 (28.0%) female patients were included. In Group B, there were 34 (68.0%) male and 16 (32.0%) female patients. In Group A, the treatment was effective for 46 (92.0%) patients and in Group B, 36 (72.0%) patients had an effective treatment. It is concluded from this study that Terlipressin is statistically more effective than Octerotide in terms of preventing esophageal variceal bleeding.

scholarly journals Comparative Efficacy of Terlipressin and Octreotide along with Endoscopic Band Ligation in the Management of Esophageal Variceal Bleeding

2020 ◽  
Vol 2 (2) ◽  
pp. 41-48
Author(s):  
Sadia Asif ◽  
Ayesha Shehbaz Khan ◽  
Sarmad Zahoor ◽  
Hafiz Mudabbar Mahboob ◽  
Uzma Malik ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Medical Emergency ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Band Ligation ◽  
Female Patients ◽  
Group A ◽  
Cirrhotic Patients ◽  
Endoscopic Band Ligation ◽  
Group B

Esophageal variceal bleeding is a medical emergency that carries a high mortality rate despite appropriate management. Terlipressin and Octreotide are two common agents used as adjuvant agents in the management of variceal bleeding. The objective of this study is to compare the effectiveness of Terlipressin with Octreotide along with endoscopic band ligation in the management of esophageal variceal bleeding in cirrhotic patients. This randomized control study was carried out at the Department of General Medicine, Fatima Memorial Hospital, Lahore, for six months extending from February 2019 to July 2019. A total of 100 cirrhotic patients were selected /based on predetermined inclusion and exclusion criteria. The patients were randomly divided into two groups of equal strength. Hence, 50 patients were included in Group A and 50 patients were included in Group B along with banding. Group A received Terlipressin whereas Group B received Octreotide. The two groups were monitored for variceal bleeding for 72 hours. The mean age of the patients in Group A was 55.9±7.3 years and for the patients in Group B it was 56.8±7.4 years. In Group A, 36 (72.0%) male and 14 (28.0%) female patients were included. In Group B, there were 34 (68.0%) male and 16 (32.0%) female patients. In Group A, the treatment was effective for 46 (92.0%) patients and in Group B, 36 (72.0%) patients had an effective treatment. It is concluded from this study that Terlipressin is statistically more effective than Octerotide in terms of preventing esophageal variceal bleeding.

scholarly journals The model for the end-stage liver disease and Child-Pugh score in predicting prognosis in patients with liver cirrhosis and esophageal variceal bleeding

2009 ◽  
Vol 66 (9) ◽  
pp. 724-728 ◽  
Author(s):  
Daniela Benedeto-Stojanov ◽  
Aleksandar Nagorni ◽  
Goran Bjelakovic ◽  
Dragan Stojanov ◽  
Bojan Mladenovic ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Survival Rate ◽  
Variceal Bleeding ◽  
Meld Score ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
End Stage

Background/Aim. Esophageal variceal bleeding is one of the most frequent and gravest complications of liver cirrhosis, directly life-threatening. By monitoring certain clinical and laboratory hepatocellular insufficiency parameters (Child-Pugh score), it is possible to determine prognosis in patients who are bleeding and evaluate further therapy. Recently, the Model for the End-Stage Liver Disease (MELD) has been proposed as a tool to predict mortality risk in cirrhotic patients. The aim of the study was to evaluate survival prognosis of cirrhotic patients by the MELD and Child-Pugh scores and to analyze the MELD score prognostic value in patients with both liver cirrhosis and variceal bleeding. Methods. We retrospectively evaluated the survival rate of a group of 100 cirrhotic patients of a median age of 57 years. The Child-Pugh score was calculated and the MELD score was computed according to the original formula for each patient. We also analyzed clinical and laboratory hepatocellular insufficiency parameters in order to examine their connection with a 15-month survival. The MELD values were correlated with the Child-Pugh scores. The Student's t-test was used for statistical analysis. Results. Twenty-two patients died within 15-months follow-up. Age and gender did not affect survival rate. The Child- Pugh and MELD scores, as well as ascites and encephalopathy significantly differed between the patients who survived and those who died (p < 0.0001). The International Normalized Ratio (INR) values, serum creatinine and bilirubin were significantly higher, and albumin significantly lower in the patients who died (p < 0.0001). The MELD score was significantly higher in the group of patients who died due to esophageal variceal bleeding (p < 0.0001). Conclusion. In cirrhotic patients the MELD score is an excellent survival predictor at least as well as the Child-Pugh score. Increase in the MELD score is associated with decrease in residual liver function. In the group of patients with liver cirrhosis and esophageal variceal bleeding, the MELD score identifies those with a higher intrahospital mortality risk.

scholarly journals The effect of bacterial infections in cirrhotic patients with esophageal variceal bleeding

2014 ◽  
Vol 13 (3) ◽  
pp. 364-369 ◽  
Author(s):  
Zuo-Hua Gan ◽  
Chen-Chi Tsai ◽  
Kuo-Chih Tseng ◽  
Chih-Chun Tsai ◽  
Yu-Hsi Hsieh ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Bacterial Infections ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Cirrhotic Patients

scholarly journals Esophageal Variceal Bleeding as the First Manifestation of COVID-19 Infection: A Case Report

2022 ◽  
Vol 7 (01) ◽  
pp. 41-45
Author(s):  
Christos Sotiropoulos, MD, MSc ◽  
Eftichia Sakka, MD ◽  
Georgios Theocharis, MD, PhD ◽  
Konstantinos Thomopoulos, MD, PhD
Keyword(s):  
Liver Cirrhosis ◽  
Case Report ◽  
Variceal Bleeding ◽  
Clinical Manifestations ◽  
Polymerase Chain Reaction Test ◽  
Variceal Hemorrhage ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Wide Range ◽  
Upper Gastrointestinal

Liver cirrhosis is a defined liver disease with a wide range of clinical manifestations. Variceal bleeding is the main source of gastrointestinal hemorrhage among cirrhotic patients induced by several factors, such as alcohol consumption or infections. This is a report of a cirrhotic patient presenting with esophageal variceal bleeding in the context of COVID-19 infection. We report the case of a 53-year-old patient with liver cirrhosis and multifocal hepatocellular carcinoma presenting with upper gastrointestinal bleeding as the first manifestation of COVID-19 infection. Upon admission, the patient had no symptoms suggestive of a respiratory tract infection or any contact with positive SARS-CoV-2 individual and upper gastrointestinal endoscopy revealed variceal hemorrhage. After a few hours the patient manifested with fever, cough and dyspnea and a SARS-CoV-2 polymerase chain reaction test obtained was positive. The patient was initially treated with endoscopic band ligation and transferred in the COVID-19 infection clinic, where after a few days of hospitalization he passed away. The devastating pandemic of coronavirus disease 2019 had altered the pathophysiology and clinical presentation of several chronic diseases. This case report suggests that coronavirus disease as a potential triggering factor of variceal bleeding.

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