RESUMO
Background: Liver cirrhosis is an irreversible liver damage and can result into various complications due to hepatocellular damage and fibrosis. Ascites and then superadded sub acute bacterial peritonitis [SBP] is not uncommon
Objective:To determine the frequency of spontaneous bacterial peritonitis in cases with liver cirrhosis
Methodology: This was a cross sectional study that was conducted at Department of Medicine, Sheikh Zayed Hospital, Rahim Yar Khan from 1stMarch to 30thSeptember 2016, in which 150 cases of liver cirrhosis were selected according to clinical and laboratory investigation. SBP was labeled according to standard international criteria. Data analyses was done by SPSS version 21
Results: In this study, there were total 150 patients of liver cirrhosis out of which, 93 [62%] were males and 57 [38%] females. The mean age of the patients was 52.43+/-5.12 years. There were 84 [56%] cases in child class Pugh C and 66 [44%] in class B. SBP was seen in 45 [30%] of the cases. SBP was observed more in those with child Pugh class C where it was seen in 31 [36.90%] cases as compared to 14 [21.21%] cases in child class b with p= 0.04. SBP was also more common in those that had liver cirrhosis for more than 3 years where it was seen in 36 [37.11%] cases as compared to 9 [16.98%] that had cirrhosis for less than 3 years, with p= 0.01
Conclusion: Spontaneous bacterial peritonitis is a common complication in the liver cirrhosis and it is significantly high in cases that had child pugh class C and those with duration of liver cirrhosis more than 3 years
RESUMO
Background: Chronic liver disease [CLD] leads to extensive health care burden due to various complications including hepatic encephalopathy
Objective: To determine the efficacy of Rifaxamin in hepatic encephalopathy
Methodology: This was a descriptive cases series study, which was conducted at Department of Medicine, Sheikh Zayed Hospital, Rahim Yar Khan from 1[st] January to 31[st] July 2016. The cases with age 20-60 years and of either sex having chronic liver disease of both Child Pugh Class B and C presenting with acute hepatic encephalopathy of grade II or more within 1 week diagnosed according to west haven criteria were included in this study. Rifaxamin was administered at a dose of 550 mg three times a day for 1 week. Efficacy was labeled as yes when there was complete resolution of symptoms of hepatic encephalopathy with 7 days of administration of the drug. The data was analyzed by using SPSS version 21
Results: In study there were 80 cases out of which 57 [71.25%] were males and 23 [28.75%] females. The mean age was 53.23 +/- 4.81 years. There were 58 [72.50%] cases in child pugh class C and 22 [27.50%] in class Bay 37 [46.25%] has grade IV encephalopathy. Efficacy of Rifaxamin was seen in 34 [42.50%] of cases. It was significantly high in child class B where it was observed in 12 [54.55 %] cases as compared to 22 [37.93%] cases in Class C. [P= 0.01]. Efficacy was better in those with grade II hepatic encephalopathy where it was seen in 5 [62.50%] out of 8 cases followed by 16 [45.71%] out of 35 cases in grade III and 13 [35.14 %] out of 37 cases having grade IV encephalopathy. [P= 0.001]
Conclusion: Rifaxamin is being used for the treatment of hepatic encephalopathy and it has shown significant better results in Child pugh class B and grade II encephalopathy