ABSTRACT
Background: To assess the extent of Ultrasound (USS) abdomen findings in acute viral hepatitis and further assess the role of USS as a prognostic marker.Methods: From May 2013 to September 2016, a total of 220 patients of acute Enterogenic viral hepatitis were studied by routine USS within first seven days of onset of symptoms, followed by routine USS between 10 to 15 days and follow up scan after 12 weeks. Only patients with acute Enterogenic viral hepatitis (Hepatitis A and Hepatitis E) were included. All patients with chronic liver disease and other form of acute hepatitis i.e. Hepatitis B, C and D were excluded from the study.Results: Among 220 patients of acute viral hepatitis routine USS findings including hepatomegaly, bright liver and thickened GB wall and periportal adenopathy were in isolation or in combination up to varying degrees. The commonest routine USS finding in acute phase was thickened GB wall (80%). 14 patients exhibited triad of enlarged Portal Vein (PV), Splenomegaly and Ascites. These 14 patients had prolonged stay in hospital and 11 patients had deranged liver function tests at 12 wks. interval and three patients developed hepatic encephalopathy including one patient who went into fulminant hepatic failure. Out of the patients who did not exhibit this triad 72 patients still had deranged LFT at 12 weeks and maximum of these patients had a combination of USS markers at presentation.Conclusions: USS has very little if any role in the diagnosis of acute viral hepatitis. It can however play an important role as a prognostic marker during the acute phase where it can detect enlarged portal vein, splenomegaly and ascites. This triad of USS findings is suggestive of transient portal hypertension likely due to hepatic congestion. Also, other USS markers if seen in combination at presentation can reliably predict a poorer prognosis
ABSTRACT
Background: The study was planned to detect an association of HIV infection and sub-clinical atherosclerosis in the form of increased carotid intima-media thickness (IMT) Methods: 50 HIVpatients and 50 matched healthy controls were studied. The HIVpatients were further sub classified into those on ARTor not on ART. All of them underwent carotid doppler to identify subclinical atherosclerosis in the form of presence of either pathological intima-media thickness (IMT) or atherosclerotic plaque. Mean IMTwas calculated in various groups and the statistical analysis done. Results: The mean IMT in the test group (HIV), ART, Non ART, control groups was 0.746 mm (SD 0.181), 0.817 mm (SD 0.167), 0.58 mm (SD 0.068) ,0.572 mm (SD 0.101) respectively. There is significant difference in the mean IMT of HIV Vs control groups, ART Vs Non ART sub groups. There is no significant difference in mean IMTof Non ARTVs Control group. Conclusion: HIV patients have higher prevalence of subclinical atherosclerosis and significantly higher mean IMT as compared to Healthy controls. The prevalence of subclinical atherosclerosis is even higher in ARTtreated HIVpatients.