RESUMO
Objective: To determine the frequency of hepatic hydrothorax and its association with Child Pugh Class in patients with liver cirrhosis
Study Design: Descriptive, analytical study
Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-Ill, [Ward- 7], from June 2012 to May 2013
Methodology: All patients with established diagnosis of decompensated chronic liver disease were included. Detailed history, thorough physical examination, routine laboratory investigations, chest X-ray and abdominal ultrasound were carried out in all patients to find out the presence of pleural effusion and ascites, respectively. Fifty milliliters of pleural fluid was aspirated in all patients with pleural effusion using the transthoracic approach, taking ultrasound guidance, wherever required. Fluid was sent for microscopic, biochemical, and microbial analysis. SBEM defined if pleural fluid with polymorphonuclear [PMN] cell count > 500 cells/mm[3] or positive culture with PMN cell count > 250 cells/mm[3] with exclusion of a parapneumonic effusion
Results: Two hundred and six patients met the inclusion criteria, with mean age of 41.25 +/- 13.59 years. Among them, 149 [72.3%] were males and 57 [27.7%] females. Twenty-three [11.2%] had hydrothorax; right sided involvement was in 18 [78.3%] subjects, 3 [13%] had left sided while bilateral pleural effusion was found in 2 [8.7%] cases. SBEM was found in 07 [30.43%] cases. Mean serum albumin 3.125 +/- 0.71 gram/dl. There was association between serum albumin levels and hydrothorax. A significant association of hydrothorax with Child Pugh scoring system [p=0.018], but not with serum albumin [p=0.15]
Conclusion: The frequency of hepatic hydrothorax has a significant association with hepatic function as assessed by Child Pugh scoring system, but not with serum albumin
RESUMO
Interferon Alfa has been widely used to treat chronic hepatitis C virus infection. In this report, we present a case series of two patients referred to Sarwar Zuberi Liver Centre, Civil Hospital Karachi, who suffered from chronic hepatitis C. After getting detailed clinical examination and baseline work up prior to starting treatment, these patients were offered therapy with usual recommended dose of 3 million units of alpha-interferon subcutaneously thrice weekly. Both these patients developed clubbing of fingers during the course of treatment, one developing it during the 2[nd] month while the other during the 4[th] month. It was of grade II in one patient and of grade III in another and was bilateral in both the cases. Clubbing was not presented prior to start of treatment and no other secondary cause of clubbing was found in any of the case. These patients were not on any other drug that is known to interfere with interferon or can be associated with clubbing. No national or international data regarding such unusual side effect is available. Whether this effect is idiosyncratic or dose related and whether it is reversible or not after completion of treatment is yet to be established