Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension

These guidelines on transjugular intrahepatic portosystemic stent-shunt (TIPSS) in the management of portal hypertension have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the Liver Section of the BSG. The guidelines are new and have been produced in collaboration with the British Society of Interventional Radiology (BSIR) and British Association of the Study of the Liver (BASL). The guidelines development group comprises elected members of the BSG Liver Section, representation from BASL, a nursing representative and two patient representatives. The quality of evidence and grading of recommendations was appraised using the GRADE system. These guidelines are aimed at healthcare professionals considering referring a patient for a TIPSS. They comprise the following subheadings: indications; patient selection; procedural details; complications; and research agenda. They are not designed to address: the management of the underlying liver disease; the role of TIPSS in children; or complex technical and procedural aspects of TIPSS.

British Society of Gastroenterology and UK-PSC guidelines for the diagnosis and management of primary sclerosing cholangitis

These guidelines on the management of primary sclerosing cholangitis (PSC) were commissioned by the British Society of Gastroenterology liver section. The guideline writing committee included medical representatives from hepatology and gastroenterology groups as well as patient representatives from PSC Support. The guidelines aim to support general physicians, gastroenterologists and surgeons in managing adults with PSC or those presenting with similar cholangiopathies which may mimic PSC, such as IgG4 sclerosing cholangitis. It also acts as a reference for patients with PSC to help them understand their own management. Quality of evidence is presented using the AGREE II format. Guidance is meant to be used as a reference rather than for rigid protocol-based care as we understand that management of patients often requires individual patient-centred considerations.

Guidelines on the management of abnormal liver blood tests

These updated guidelines on the management of abnormal liver blood tests have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines, which this document supersedes, were written in 2000 and have undergone extensive revision by members of the Guidelines Development Group (GDG). The GDG comprises representatives from patient/carer groups (British Liver Trust, Liver4life, PBC Foundation and PSC Support), elected members of the BSG liver section (including representatives from Scotland and Wales), British Association for the Study of the Liver (BASL), Specialist Advisory Committee in Clinical Biochemistry/Royal College of Pathology and Association for Clinical Biochemistry, British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN), Public Health England (implementation and screening), Royal College of General Practice, British Society of Gastrointestinal and Abdominal Radiologists (BSGAR) and Society of Acute Medicine. The quality of evidence and grading of recommendations was appraised using the AGREE II tool. These guidelines deal specifically with the management of abnormal liver blood tests in children and adults in both primary and secondary care under the following subheadings: (1) What constitutes an abnormal liver blood test? (2) What constitutes a standard liver blood test panel? (3) When should liver blood tests be checked? (4) Does the extent and duration of abnormal liver blood tests determine subsequent investigation? (5) Response to abnormal liver blood tests. They are not designed to deal with the management of the underlying liver disease.

Toxopathological and immunotoxical effects of thiamethoxam in white mice

In order to investigate toxopathological and immunotoxic, effects of thiamethoxam in mice. Forty eight white mice, both sexes were divided into four groups equally, 1st group was immunized twicely with Brucella melitensis Rev1.with two weeks intervals. 2nd group was immunized as in the 1st group and at same time administrated orally with 83.73mg\kg B.W of thiamethoxam daily for 6 weeks.3rd group was administrated with thiamethoxam as in the 2nd group while the 4th group was served as control negative group. Immunological examination DTH and humoral immunity revealed that the thiamethoxam induced depressed in both arms of immune response as comparing with vaccinated non-treatment animals. The pathological examination revealed that the thiamethoxam induced, necrosis, hypertrophy of hepatocytes with multiple granulomatous lesion scatter in liver parenchyma and these lesions were progressive with period time particularly at 6 weeks post-treatment that showed marked proliferation of hepatocytes. The electron microscope examination to liver section showed lipid droplet, proliferation of mitochondria enlargement in addition to distraction of nuclear membrane and presence facular space, also there was severe hemorrhage in the renal interstitial tissue with inflammatory cells infiltration together with fibrosis of the glomeruli wall. Congestion with inflammatory cells infiltration in the red pulp of spleen, in addition to gliosis in the brain parenchyma was seen .The immunized animals showed mild pathological changes characterized by aggregation of mononuclear cells, The electron microscope to liver section showed normal organelles cell. with lymphoid hyperplasia in the spleen and in subepithelial layer of intestinal mucosa. We concluded that thiamethoxam induced toxopathological changes in the internal organs of mice and stimulated the immune response diminished its toxic effects.

Hepatoprotective Activity of Dried- and Fermented-Processed Virgin Coconut Oil

The present study aims to determine the hepatoprotective effect of MARDI-produced virgin coconut oils, prepared by dried- or fermented-processed methods, using the paracetamol-induced liver damage in rats. Liver injury induced by 3 g/kg paracetamol increased the liver weight per 100 g bodyweight indicating liver damage. Histological observation also confirms liver damage indicated by the presence of inflammations and necrosis on the respective liver section. Interestingly, pretreatment of the rats with 10, but not 1 and 5, mL/kg of both VCOs significantly (P<.05) reduced the liver damage caused by the administration of paracetamol, which is further confirmed by the histological findings. In conclusion, VCO possessed hepatoprotective effect that requires further in-depth study.