Hepatic encephalopathy in chronic liver disease produced by chronic viral hepatitis

Background: Hepatic encephalopathy [HE] involves neuropsychiatric dysfunction as a result of metabolic disturbance. The objective of the study was to determine and compare grades of hepatic encephalopathy in patients of viral hepatitis B, C, and co-infection

Methods: A cross-sectional study was designed which included seventy five patients of chronic HBV, HCV, and co-infection of either sex, aged 35 years or above. The patients were equally divided into 3 groups. Hepatic encephalopathy was classified into four grades based on the West Haven classification

Results: Out of the 75 subjects, 51 [68.0%] were males and 24 [32.0%] were females. The Mean age was 44.69+/-7.423 years. Grade I hepatic encephalopathy was a significant feature of both chronic HCV and co-infection groups. The development of grade II encephalopathy was more marked in chronic HBV group, while grade III encephalopathy was more frequent in chronic HCV group. However, frequency distribution of grade IV encephalopathy remained same in all groups

Conclusion: The study concluded that progression of encephalopathy was not more marked in co-infection group. In fact, hepatic encephalopathy equally developed in study groups

Comparison of clinical features of chronic liver disease produced by chronic viral hepatitis

Background: Chronic infection with either Hepatitis B virus [HBV] or Hepatitis C virus [HCV] represents one of the major causes of chronic liver disease [CLD] globally. The objective of this study was to compare clinical features of CLD produced by chronic viral hepatitis B, C, and co-infection

Methods: A cross-sectional study was designed which included 75 patients of chronic HBV, HCV, and co-infection, aged 35 years or above, of either sex. The patients were equally divided into 3 groups

Results: Out of the 75 subjects, 51 [68%] were males and 24 [32%] were females. The mean age was 44.69+/-7.423 years. The relevant clinical features like fever, anorexia, and vomiting were more marked in chronic HBV group. However, splenomegaly as well as easily and poorly controlled ascites was distributed with same frequency in chronic HCV and co-infection groups. Breathlessness was equally frequent in chronic HBV and HCV groups, while hematemesis and melena were frequent in chronic HBV and co-infection groups. The frequency distribution of jaundice was more marked in co-infection group only

Conclusion: The clinical features were not more prevalent in co-infection group. The distribution of some features like breathlessness was same in two groups

Serum homocysteine as a risk factor for coronary heart disease

Homocysteine [Hcy] is an intermediate formed during the catabolism of sulphur containing essential amino acid, methionine and Less than one percent of tHcy is found as the free form. Development of atherosclerotic changes and thrombo-embolism are common features in patients with homocysteinuria. This study was conducted to assess the relationship of Hcy and coronary heart disease [CHD] in our population. The cross-sectional analytical study was carried out at the Department of Biochemistry, Hazara University Mansehra and Ayub Medical College, Abbottabad. A total of 80 subjects were included in this study and were divided into 2 groups. Cases Group consisted of 40 patients who had confirmed Myocardial Infarction [MI] coming for routine follow-up [first re-visit] after the acute attack. Control Group consisted of 40 matching healthy individuals. Demographic data including age, gender, dietary habits, height and weight as documented in preformed proforma. Blood pressure was taken in sitting posture. Serum total Hcy were measured. Data was entered into computer using SPSS 16.0 for analysis. The mean age of the cases was 59.68 +/- 8.06 [30-70] years and that of the controls was 58.93 +/- 6.93 [48-76] years. The average BMI of cases was 27.70 +/- 3.61 Kg/m[2] and of the controls was 25.66 +/- 2.98 Kg/m[2]. This increase of BMI from controls to cases was statistically significant [p<0.050]. The mean systolic BP of the cases was 153.88 +/- 11.90 mmHg in comparison with 142.62 +/- 11.65 mmHg for the controls. This difference was statistically significant [p<0.001]. Mean tHcy level of the cases was 17.15 +/- 4.45 micromol/l while that of controls was 12.20 +/- 2.53 micromol/l. There is a statistically significant difference between cases and controls with respect to Hcy levels [p<0.001]. Plasma tHcy level has a powerful predictor value of CHD and routine screening for elevated Hcy concentrations is advisable especially for individuals who manifest atherothrombotic disease without their traditional risk factors.

Assessment of iron deficiency in pregnant women by determining iron status

Background: Pregnant women constitute a high risk group for iron deficiency. Maternal iron deficiency and particularly iron deficiency anaemia may be associated with detrimental effects on maternal and infant function and particularly with a higher risk of preterm delivery and delivery of low birth weight neonates. Objective of this study was to assess and compare the iron status of normal healthy non-pregnant women with that of pregnant women of Hazara Division. Methods: This study was conducted at Faculty of Health Sciences, Hazara University, and Ayub Medical College, Abbottabad from 1st March to 31st August 2006. Altogether 120 women, 90 pregnant at various stages of pregnancy and 30 non-pregnant women as control group were included in this study by convenience sampling. Their iron status was assessed by determination of haemoglobin [Hb], Serum ferritin, Serum-iron, Total Iron Binding Capacity [TIBC], Unsaturated Iron Binding Capacity [UIBC], and Percentage saturation of transferrin. Data generated on these variables were subjected to ANOVA and correlation analysis. Results: The salient finding of this study is a significant decrease in Hb, Serum ferritin, Serum iron, percentage saturation of transferrin and a significant increase in values of TIBC and a pronounced increase in UIBC in 2nd and 3rd trimester compared to 1st trimester in iron deficient pregnant women. The mean values of Hb, SF, and Fe/TIBC% were significantly lower in the cases than in the control and significantly higher values of TIBC and UIBC were observed in the cases compared to controls. Significant correlations were observed for TIBC, UIBC and Fe/TIBC% against serum iron in different trimesters of pregnancy. Conclusion: A high percentage of the pregnant women are iron deficient due to factors such as high parity, poor dietary habits and socioeconomic status