scholarly journals Case Report on Cirrhosis of Liver

Author(s):  
Sheetal Sakharkar ◽  
Samrudhi Gujar ◽  
Vaishali Tembhare ◽  
Pranali Wagh ◽  
Jaya Khandar ◽  
...  

Liver is the second largest organ in human body, more than 5,000 separate bodily functions .including helping blood to clot, cleansing the blood of toxins to converting food into nutrients to control hormone levels, fighting infections and illness, regenerating back after injury and metabolizing cholesterol, glucose, iron and controlling their levels. A 56- years old patient was admitted in AVBRH on date 9/12/2020 in ICU with the chief complaint of abdominal distension, breathlessness on exertion, pedal edema, fever since 8 days. After admitted in hospital all investigation was done including blood test, ECG, fluid cytology, peripheral smear, ultrasonography, etc. All investigation conducted and then final diagnosis confirmed as cirrhosis of liver. Patient was not having any history of communicable disease or any hereditary disease but he has history of hypertension and type II Diabetes mellitus for 12 years. Patient was COVID-19 negative and admitted in intensive care unit. Patient had been undergone with various investigations like physical examination, blood test, CSF fluid examination, ascitic fluid examination, fluid cytology, peripheral smear, ultrasonography, RT-PCR etc. Patient was treated with tab. farobact ER 300 mg BD, tab. Lasix 40 mg OD, tab. Udilive 300 mg BD, tab. Rifagut 300 mg BD, tab. Metformin 500 mg OD, tab. Amlo 5mg OD, syp. Duphalac 30ml HS. Monitor vital signs, maintain input output, Monitoring and managing potential complications like, bleeding and haemorrhage, hepatic encephalopathy, fluid volume excess, monitor laboratory tests as indicated, Identify and assess for pedal edema. Conclusion: Cirrhosis of the liver is one of the final stages of liver disease. It is a serious condition, causing scarring and permanent damage to the liver. Life expectancy depends on the stage and type of cirrhosis of liver. Cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function (decompensated cirrhosis). Advanced cirrhosis is life-threatening. If liver cirrhosis is diagnosed early and the cause is treated, further damage can be limited and, rarely, reversed.

1985 ◽  
Vol 54 (03) ◽  
pp. 617-618 ◽  
Author(s):  
J C Kirchheimer ◽  
K Huber ◽  
P Polterauer ◽  
B R Binder

SummaryPlasma urokinase antigen levels were studied in 78 patients suffering from liver diseases. Blood was drawn before any specific medication was initiated. Impairment of liver function was comparable in all patients. In both groups of cirrhotic liver disease (alcoholic and non-alcoholic), normal levels of plasma urokinase antigen were found as compared to age-matched control groups. In both groups of patients with hepatomas (with or without a history of liver cirrhosis), however, significantly increased plasma urokinase antigen levels could be determined. These data indicate that an increase in plasma urokinase antigen might rather relate to malignant growth in liver disease than to impaired liver function.


2019 ◽  
Vol 98 (8) ◽  
pp. 326-327 ◽  

Introduction: The umbilical vein can become recanalised due to portal hypertension in patients with liver cirrhosis but the condition is rarely clinically significant. Although bleeding from this enlarged vein is a known complication, the finding of thrombophlebitis has not been previously described. Case report: We report the case of a 62-year-old male with a history of liver cirrhosis due to alcoholic liver disease presenting to hospital with epigastric pain. A CT scan of the patient’s abdomen revealed a thrombus with surrounding inflammatory changes in a recanalised umbilical vein. The patient was managed conservatively and was discharged home the following day. Conclusion: Thrombophlebitis of a recanalised umbilical vein is a rare cause of abdominal pain in patients with liver cirrhosis.


2014 ◽  
Vol 17 (1) ◽  
pp. 42
Author(s):  
Shi-Min Yuan

Extracardiac manifestations of constrictive pericarditis, such as massive ascites and liver cirrhosis, often cover the true situation and lead to a delayed diagnosis. A young female patient was referred to this hospital due to a 4-year history of refractory ascites as the only presenting symptom. A diagnosis of chronic calcified constrictive pericarditis was eventually established based on echocardiography, ultrasonography, and computed tomography. Cardiac catheterization was not performed. Pericardiectomy led to relief of her ascites. Refractory ascites warrants thorough investigation for constrictive pericarditis.


PEDIATRICS ◽  
1959 ◽  
Vol 24 (2) ◽  
pp. 312-312
Author(s):  
SAUL KRUGMAN

This book is the 4th volume of a series of the official history of the Medical Department, U.S. Army in World War II. It is the first of 3 volumes which will deal with the problems of communicable disease in military practice. This excellent book is written from the viewpoint of preventive medicine by 21 highly qualified authorities in the field of infectious diseases. It is divided into three sections: Part I—an introduction dealing with general considerations of modes of transmission; Part II—discussion of diseases transmitted chiefly through the respiratory tract; and Part III— diseases transmitted chiefly through the alimentary tract. It is an attractive, cleanly printed text, amply and cleanly illustrated with 91 tables and 48 charts.


2018 ◽  
Vol 63 (1) ◽  
pp. 24-43 ◽  
Author(s):  
Susan Heydon

This article explores the introduction of smallpox vaccination into Nepal in 1816 at the request of the Nepalese government; the king, however, was not vaccinated, contracted the disease and died. British hopes that vaccination would be extended throughout the country did not eventuate. The article examines the significance of this early appearance of vaccination in Nepal for both Nepalese and British, and relates it to the longer history of smallpox control and eventual eradication. When the Nepalese requested World Health Organization (WHO) assistance with communicable disease control in the mid-twentieth century little had changed for most Nepalese. We know about the events in 1816 through the letters of the newly imposed British Resident after Nepal’s military defeat in the Anglo-Nepal War (1814–16). By also drawing on other sources and foregrounding Nepal, it becomes possible to build up a more extensive picture of smallpox in Nepal that shows not only boundaries and limits to colonial authority and influence but also how governments may adopt and use technologies on their own terms and for their own purposes. Linking 1816 to the ultimately successful global eradication programme 150 years later reminds us of the need to think longer term as to why policies and programmes may or may not work as planned.


2020 ◽  
Vol 3 (2) ◽  
pp. 9-14
Author(s):  
Margaret A ◽  
Manjubala Dash

Background: Hypertensive disorders of pregnancy are a major health problem to the world and is found to be the major cause of maternal morbidity and mortality accounting for nearly 10-15% 0f maternal deaths. Objective:To assess the determinants of Pregnancy induced hypertension. Methods: A case control study was conducted among pregnant women at Rajiv Gandhi Women and Children Hospital, Puducherry. 63 women with PIH were selected as cases and 63 normotensive pregnant women were taken as controls. The cases were selected by purposive sampling and the controls by simple random sampling. The tool consists of a self structured questionnaire which consists of the socio demographic factors and various other determinants assumed as a risk factor for PIH and some required information was also obtained from the case records. Statistics: The odds ratio and Chi-square test was used to determine the risk and association between PIH and the determinants respectively.Results: Primigravida (OR=2.826), multiple pregnancy (OR=2.629), presence of pedal edema (OR=54.836), family history of diabetes (OR=2.969), family history of hypertension (OR=5.5) Overweight (OR=2.12) and obesity (OR=6.52) were found to be significant risk factors of PIH. There was statistically significant association with history of abortion, parity, presence of pedal edema, use of contraceptives, family history of diabetes, family history of hypertension, prepregnancy Body mass index and PIH.


Author(s):  
Sharad Deshmukh ◽  
Suchita Deshmukh ◽  
Sarojni A Parameswran ◽  
P Pirmanayagam ◽  
N Murgan ◽  
...  

Background: Abnormalities in the bone metabolism observed in chronic liver disease are referred to as hepatic osteodystrophy. Osteoporosis and osteopenia are each part of this condition. Both conditions have a significant impact on morbidity, causing fractures that may result in chronic pain, long-lasting immobility, and deformity. Prevalence of fracture in patients with liver transplantation ranges from 15% - 65%. A high rate of fracturing is seen within the initial 1–2 years after transplantation. Aim: To determine the prevalence of low bone mineral density (osteopenia and osteoporosis) in Indian patients with cirrhosis of liver awaiting liver transplantation as per currently used Hologic DXA database Methods: This was a prospective observational study done at the department of gastroenterology and hepatology, Apollo Hospitals, Chennai from April 2011 to March 2013. All patients who fulfilled the inclusion criteria underwent detailed history taking, physical examination and relevant laboratory investigations. One hundred patients were selected for the scope of the study. Results: Sixty-eight per cent of patients were in the age group of 45 to 65 years. The mean age ± SD of the study subjects was 51.2 ± 9.7 years. The mean age for male patients was 50.5 ± 10.1 years, and for females was 54 ± 7.3 years. Cirrhosis was due to alcohol in 36% of the patients, viral hepatitis in 28% (HBV in 10% and HCV in 18%) patients. 42% were in Child’s class B, and the remaining 58% were in Child’s class C. MELD score was less than 20 in 62% patients. One third was diabetic; one third gave the history of backache. History of smoking was present in one fifth (20%) patients, and a history of fracture (most of them were traumatic) was present in 13% of patients. By using Hologic DXA database at the lumbar spine, osteopenia and osteoporosis were diagnosed in 44% and 38 % patients respectively. At the femoral neck, osteopenia and osteoporosis were diagnosed in 45% and 9% of patients. By using ICMR database at the lumbar spine, osteopenia and osteoporosis were diagnosed in 38% and 17% patients respectively. Similarly, at the femoral neck, osteopenia and osteoporosis were diagnosed in 34% and 5%. By using the Hologic DXA database, osteopenia and osteoporosis were diagnosed in 42% and 40 % patients. By using ICMR database, osteopenia and osteoporosis were diagnosed in 43% and 19% patients respectively. Conclusion: In light of the above results, the present study revealed a high prevalence of low bone mineral density (osteopenia and osteoporosis) in Indian patients with cirrhosis of liver awaiting liver transplantation. The lumbar spine was the most frequently and severely affected site in hepatic osteodystrophy. Keywords: Osteopenia, Osteoporosis, Low Bone Mineral Density, Liver Cirrhosis


1969 ◽  
Vol 5 (1) ◽  
pp. 644-647
Author(s):  
SARA GUL ◽  
ATIF HUSSAIN ◽  
KASHIF UR REHMAN KHALIL ◽  
IMRANULLAH ◽  
MUHAMMAD ISHTIAQ ◽  
...  

BACKGROUND: Hypertension is one of the common non communicable disease and is reported to beprevalent in 20% to 50% of the adult population, hypertension is one of the major contributor ofmortality and morbidity in developing and developed countries. The cross-sectional descriptive studywas formulated to find the prevalence and to assess different etiological factors of hypertension.MATERIAL & METHODS: This cross-sectional study among 400 adults of age 25-75 years wasconducted in months of June to December 2014 in Phase 5, Hayatabad Peshawar. A detailed structuredproforma having important questions was used to collect important data regarding various variables.RESULTS: Our study results showed that 22.75% of the study people were hypertensive i.e. 10.25% ofmales and 12.5% of females; and the prevalence of hypertension showed positive association withadvancing age. Out of all respondents; 60.25% were males while 39.75% were females; 28.5% weresmokers; 5.25% consume predominantly meat; 32.5% were obese & overweight; 36.75% checked theirB.P regularly; and 19.75% had positive history of hypertension in family.CONCLUSION: We conclude that hypertension prevalence was high among our study population andwas associated with various modifiable and non modifiable risk factors thus population based preventivestrategies are needed to control and prevent hypertension.KEY WORDS: Hypertension, Age, Diet, Smokers, Hayatabad, Peshawar.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S M Kraus ◽  
P Samuels ◽  
N Laing ◽  
M Ntsekhe ◽  
A Chin ◽  
...  

Abstract Background Cardiomyopathies pose a great challenge because of poor prognosis and high prevalence in LMIC with limited access to specialised care. Little is known about the clinical profile of cardiomyopathy in Africa. Purpose Delineation of clinical presentation and cardiovascular magnetic resonance (CMR) phenotypes of cardiomyopathy. Method The African Cardiomyopathy and Myocarditis Registry Program (IMHOTEP) is a prospective multi-centre, hospital-based study and aims to investigate the clinical characteristics, aetiology, genetics, management and outcomes of cardiomyopathies in Africans. Results Assessment of the first 99 adult cases showed that dilated cardiomyopathy (DCM; n=67) was commonest, followed by hypertrophic (HCM; n=13), left ventricular noncompaction (LVNC; n=11), restrictive (RCM; n=4) and arrhythmogenic (ARVC; n=4) cardiomyopathies. Idiopathic DCM (22%) and peripartum cardiomyopathy (16%) accounted for the majority (Figure). A family history of cardiomyopathy or SCD was reported in 20% of cases. Mean age of presentation was 37±12 years. Most patients (96%) were symptomatic at presentation. NYHA class III/IV was more frequently seen in DCM (61%), RCM (50%) and LVNC (64%), whereas syncope was more common in ARVC (50%) and HCM (23%). VT and aborted cardiac arrest were reported in 7% and 3%, respectively. Onset of symptoms in the peripartum period was observed in 47% of women. Beta-blockers and ACE-inhibitors were prescribed in 77% and 78%, respectively, however optimal dosing was achieved in ≤14% of patients at a median time of 5.4 months after symptom onset. CMR was performed in 67 (68%) cases (Table) and contributed diagnostically in a third of cases. Late gadolinium enhancement (LGE) was observed in 92%. In DCM, linear mid-wall and subendocardial patterns of LGE were seen in 95% and 8% of patients respectively – a much higher percentage than previously reported in the literature. CMR volumetric and functional assessment DCM, n=38 HCM, n=11 ARVC, n=3 RCM, n=4 LVNC, n=11 LVEF (%) 27±15 78±7 55±5 52±7 32±17 LVEDV/BSA (ml/m2) 150±40 80±17 98±12 59±13 155±52 LV mass/BSA (g/m2) 82±23 102±35 74±3 71±14 88±31 RVEF (%) 34±15 68±10 22±15 49±18 33±15 RVEDV/BSA (ml/m2) 104±37 68±15 189±27 56±8 106±51 All continuous variables presented as mean ± standard deviation. Cardiomyopathy diagnosis (n=99) Conclusion IMHOTEP is the first multi-centre registry for cardiomyopathy in Africa. Preliminary data suggests an earlier age of onset with female predominance compared to other cohorts, and DCM is the predominant form of cardiomyopathy in Africa. Acknowledgement/Funding NEWTON FUND NON-COMMUNICABLE DISEASE - South African Medical Research Council (SAMRC/GSK)


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