ABSTRACT
Objectives: The study aimed to determine the frequency and risk factors for Extra Hepatic Manifestations among patients with Hepatitis B and C related Chronic Liver Diseases
Study Design: Cross Sectional Study
Place and Duration of Study: This Study is conducted at the Department of Medicine [Both indoor and outdoor patients] of Civil Hospital, Karachi from 2012 to 2016
Materials and Methods: In this study of 548 patients, who were positive for HBV or HCV, fulfill the selection criteria and were suffering from Chronic Hepatitis, Cirrhosis or HCC were examined for Extra Hepatic Manifestations clinically and if required appropriate tests were done to confirm the diagnosis and finding. Frequency and risk factors were determined for extra hepatic manifestations. Test of statistical significance were applied where p value of <0.05 was considered to be statistically significant cut-off
Results: Majority of patients 432 [78.8%] were HCV Positive and 116 [21.2%] were found to be HBV positive. Overall frequency of extra hepatic manifestations was found to be 54.7 %. Patients with chronic hepatitis C and B. The Extra Hepatic Manifestations of 60.6 % in HCV and 32.8% in HBV respectively. Diabetes Mellitus [DM] is the most common extra hepatic manifestation found in both, chronic HCV [19.0%] and chronic HBV patients [5.2%] whereas hypertension is the second commonest extra hepatic manifestation among HBV patients [12.1%]. Disease duration > 5 years, age> 45 years, Viral PCR, Raised ALT and Hepatocellular Carcinoma associated with chronic HCV and HBV were found to be significant risk factors for extra hepatic manifestations
Conclusion: Extra Hepatic Manifestations are more common in HCV associated liver diseases than HBV. Diabetes and hypertension are the main extra hepatic manifestation among HBV and HCV positive patient. Disease duration > 5 years, age> 45 years, Viral PCR, Raised ALT and HCC associated with chronic HCV and HBV were found to be significant risk factors for Extra Hepatic Manifestation
ABSTRACT
Review and describe the clinical characteristics and outcomes of Diabetic Ketoacidosis [DKA] in type land type 2 Diabetic patients. We reviewed the medical records of all patients with a diagnosis of DKA in known diabetics and followed their clinical course and outcome. We classified patients as "type 1" and "type 2" diabetes mellitus based on their treatment history. DKA with recent onset of diabetes excluded because of uncertainty of type of diabetes. We compared the groups for precipitating factors, clinical characteristics and outcomes. Sixty-seven patients fulfilled criteria for inclusion in the study. Of 67 patients 44 [65.7%] were male. Twenty [30%] patients had type 2 diabetes. Mean age of type 1 diabetics was 21.6 +/- 6.lyears while type 2 Diabetics were older and had 48.7 +/- 9 years mean age. Body Mass Index [BMI] and duration of diabetes were greater in type 2 Diabetes. A history of prior DKA was noted in 28 patients and all of them were type 1 Diabetics. Infections were the most common precipitating factor in total [41.8%] but in type 2 Diabetes noncompliance was the main precipitating factor. There were 8 deaths in total and mortality rate was apparently higher in type 2 Diabetes. DKA could frequently complicate type 2 Diabetes contrary to belief and carries relatively high mortality