Determine the Frequency of Portal Vein Thrombosis in Patients with Liver Cirrhosis

Objective: The aim of this study is to determine the frequency of portal vein thrombosis in patients with liver cirrhosis. Study Design: Retrospective/Case-control Place and Duration: Medicine and Gastroenterology department of Peshawar Institute of Medical Sciences, Peshawar and DHQ Teaching Hospital, Charsadda for six months duration from August 2020 to January 2021. Methods: Total 100 patients of both genders were presented in this study. Patients detailed demographics age, sex and body mass index were recorded after taking written consent, Patients were aged between 20-75 years. Patients who had liver cirrhosis were included in this study. Complete patients were undergone for Doppler ultrasonography for observation of portal vein thrombosis. Complete data was analyzed by SPSS 24.0 version. Results: Out of 100 patients, 60 (60%) were males and 40 (40%) patients were females. Mean age of the patients were 47.08±7.42 years with mean BMI 28.22±9.61kg/m2. We found that 60 (60%) patients had hepatitis C, 29 (29%) patients had hepatitis B, 7 (7%) had chronic liver disease, 3 (3%) patients had autoimmune hepatitis and 1 (1%) patient had other disease (Wilson’s). Among hundred patients frequency of portal vein thrombosis (PVT) was 15 (15%) and majority of them were males 12 (80%). Conclusion: We concluded that the frequency of portal vein thrombosis was high among patients of liver cirrhosis and mostly patients of hepatitis C were affected. Keywords: Liver cirrhosis, Portal vein, Thrombosis

ETIOLOGY OF LIVER CIRRHOSIS IN DISTRICT BUNER, KHYBER PAKHTUNKHWA

Objective: The aim of our study was to determine the most common cause of liver cirrhosis in district Buner. Methodology: This was retrospective cross-sectional study. Data was collected from patient’s record register from January 2016 till December 2018. A total of 203 patients were included in this study. Data was collected and entered and analyzed in IBM SPSS 23. Results: Out of 203 cases, 135(66.5%) were males and 68 (33.5%) were females. The main cause of cirrhosis was HCV (n=163, 80.3%) and HBV (n=27, 13.3%). Cryptogenic cirrhosis occurred in 9 cases (4.4%) while others were only 1% (n=2). HCV was more positive in males (n=108, 66.25%) than in females (n=55, 33.7%), this was statistically significant with a p value .022. Conclusion: We conclude with our study that HCV is major cause of Liver Cirrhosis in our patients. HCV is more common in males than in females. Cirrhosis occurs most commonly in 4th, 5th and 6th decades of life after being infected with HBV and HCV. Keywords: Liver cirrhosis, Hepatitis C virus, Hepatitis B virus, Pakistan.

Association between osteoporosis and hepatitis B cirrhosis: a case-control study

Background and aims: Hepatitis B virus (HBV)-related cirrhosis is associated with decreased bone mineral density (BMD); however, the mechanism is yet unknown. To assess the incidence of osteoporosis in patients with HBV-associated cirrhosis and relevant mechanisms. Methods: A total of 80 hospitalized patients with HBV-associated cirrhosis and 80 healthy controls were enrolled. The levels of serum osteocalcin, total procollagen type 1 amino-terminal propeptide, β-C-terminal telopeptide of type I collagen (β-CTX), and 25-hydroxy vitamin D3 (25(OH)D3) was evaluated in the cirrhosis group. Results: The BMDs of the lumbar spine (P<0.001) and hip joints (P=0.015) in the cirrhosis group were significantly lower than those in the controls. The incidence of osteoporosis in the cirrhosis group was significantly higher than that in the con- trol group (P<0.001). Compared to the patients of the Child-Pugh grade A and B, the BMD of lumbar spine and 25(OH)D3 was significantly decreased in patients of grade C, while β-CTX was elevated. Patients in the cirrhosis group faced a higher risk of osteoporosis as compared to the controls(P<0.001). Conclusion: Enhanced bone resorption accounted for increased risk of osteoporosis in severe cirrhosis. Thus, HBV-asso- ciated cirrhosis was a risk factor for osteoporosis. Keywords: Liver cirrhosis; bone density; osteoporosis; osteopenia; hepatitis B, chronic.

Quality of Life in Patients With Liver Cirrhosis: A Systematic Review

Background: Quality of life (QOL) is a powerful phrase that reflects maintaining health and well-being in different societies and cultures, reflecting the positive and negative aspects of people’s lives. Patients with liver cirrhosis (LC) have an undesirable QOL, and this has become one of the most important causes of mortality in the world. Objective: This review article aimed to summarize the results of previous studies on health-related QOL in patients with LC to determine their problems and needs. Methods: This review was conducted using Cochran’s seven-step model. This paper is the result of research on QOL in patients with LC through searches conducted in Google Scholar, PubMed, and Science Direct using the keywords liver cirrhosis, chronic liver disease, quality of life, health-related quality of life, and self-care for articles published between 2012-2018. Ultimately, 11 articles were obtained and analyzed. Results: The results of this review showed that the QOL in patients with LC is poor and is lower than in other populations. Many factors, such as age, gender, and education, influence QOL and should be addressed in order to solve the challenges and problems faced by these patients. Increasing awareness and education are the most important issues for LC patients. Conclusion: QOL in patients with LC is affected by many factors. The lack of awareness about the disease and its complications is considered the biggest problem for these patients. To improve the QOL and care of these patients, nursing care guidelines, awareness raising, and education about the disease and its complications, treatment, and new treatments are needed.