ABSTRACT
Introduction: Esophageal varices are generally the mostcommon clinical manifestation of portal hypertension inPatients of liver cirrhosis. Most common causes of deathin liver cirrhosis are hemorrhage from esophageal varices.The present study has been carried out to identify clinical,biochemical and ultrasonographic parameters which mightnon‑invasively predict the existence and the risk of varicealbleed.Material and Methods: The present prospective observationalstudy was conducted in 2 years among 100 patients sufferingfrom liver cirrhosis above 18 years of age. Detailed history,clinical examination, investigations to fulfill the inclusionand exclusion criteria of all patients was taken. Different nonendoscopic parameters were taken Plateletcount, Coagulationprofile, Ultrasonography whole abdomen, Child-PughTorcotte (CPT) Score, AST to platelet ratio index (APRI) forthe detection of esophageal varices and its grading in livercirrhosis patients which was confirmed by endoscopy.Results: There was significant association of presence ofesophageal varices in liver cirrhosis patients with presence oficterus, presence of ascites,presence of splenomegaly, gradeof Child Pugh Score, AST to Platelet rationdex (APRI score)Prothrombin Time and International Normalized Ratio(PT/INR), mean TB (mg/dl), mean spleen size.Conclusions: The result of present study concluded thatsome parameters are strongly associated with grades ofvarices and could be useful for early detection and subsequentmanagement of varices.
ABSTRACT
Hepatitis B virus infection continues to be a major global health problem with an estimated 350 million carriers. The response to available treatment modalities is not impressive. The advent of RNA Interference--a phenomenon of sequence-specific degradation of RNAs mediated by double-stranded RNA--holds promise as a potential therapy for chronic hepatitis B virus infection. Synthetic preparations of short RNA (21-23 bp long) can be used to mediate this process of gene silencing with a lower immune response. The duration of suppression can be further increased by using a vector delivery system. Small interfering RNA (siRNA) has several advantages over conventional therapy, which include fewer side-effects, a lower chance of developing escape mutants and non-requirement of viral replication for its action. A potent knockdown of the gene of interest with high sequence specificity makes RNA interference a powerful tool that has shown antiviral effect against hepatitis B virus. However, the 'off-target effect', i.e. suppression of genes other than the intended target, poor siRNA stability, inefficient cellular uptake, widespread biodistribution and non-specific effects need to be overcome. The problem of long-term toxicity of siRNA should be addressed and an ideal vector delivery system needs to be designed before it can be put to clinical use.