ABSTRACT
Porto-systemic encephalopathy [PSE] is a common medical emergency at our settings due to increased prevalence of chronic liver disease. To determine frequency of common precipitating factors in patients having porto-systemic encephalopathy [PSE] at tertiary care settings in Hyderabad. Descriptive case series study. Setting: Department of Medicine Isra University Hospital Hyderabad. Period: 1st April 2011 to 31st December 2011. A total 100 patients manifesting clinical features of PSE were included in this study by non-probability convenience sampling. The data was evaluated in statistical program SPSS version 16. As 100 patients with PSE were enrolled in the current study, out of these 96 patients have precipitating factors involved while only 4 patients have no such factors. Out of these 96 patients, 36 patients have only single risk factor found while in 64 cases multiple factors were implicated. Constipation, infections [except SBP] and renal impairment were noted in 36%, 24% and 22% respectively. Constipation, infections [except SBP] and renal impairment were the most common precipitating factors of porto-systemic encephalopathy in our study. Hence priority should be given to them in terms of hospital funds, medicines and human efforts
ABSTRACT
Introduction: Approximately 30 to 40% of patients with Chronic Hepatitis "C" [CHC] have persistently normal serum alanine aminotransferase [ALT] levels. Historically, these patients have been classified as healthy or asymptomatic and have not received any treatment for CHC infection. However, definition and clinical significance of persistently normal ALT in CHC have been recently revised as new information on liver disease which is now getting available
Aims: To evaluate the histological feature of liver of patients suffering from CHC with persistently normal ALT levels
Methods: In this prospective observational study we recruited consecutive patients infected with CHC with persistently normal ALT since last six months, visited our hepatology clinic from September 2004 to April 2005. The METAVIR scoring system was used for liver histology grading [degree of inflammation] and staging [degree of fibrosis]
Results: A total of 55 patients were recruited from outpatient clinic with normal ALT during a follow up of six months. Mean age of these patients was 36.7+/- 9.78 years; out of these 39 [70.9%] were male. All these patients were diagnosed to have hepatitis C by HCV RNA PCR method. There were 24 [43.6%] patients with stage [fibrosis] equal or greater than 2 and 33 [60%] had biopsy grade equal or greater than 2. Eighteen [32.7%] patients had steatosis on liver biopsy. Twelve patients with stage > 2 had steatosis while 6 patients with stage < 2 had steatosis [p< 0.01]
Conclusion: There was no correlation found between the transaminase level and biopsy scores. Approximately 44 % of the patients have fibrosis equal to or greater than stage 2. The extent of steatosis is directly related to the biopsy score of the patients