Association of serum sodium and 24-hour urinary sodium level with the severity and complications of ascites in cirrhotic patients.

Hyponatremia is an independent predictor of mortality in cirrhotic patients but little is known regarding the relationship between the level of serum sodium and 24-hour urinary sodium with the development of severity and complications of cirrhotic ascites. To observe the association of serum sodium and 24-hour urinary sodium levels with different grades of ascites and its complications in cirrhotic patients. In the department of Gastroenterology in a tertiary care hospital, this cross-sectional study was conducted from April 2019 to September 2020. A total of 96 admitted cirrhotic patients with ascites were enrolled in this study by consecutive sampling. Out of 96 patients with cirrhotic ascites, 48 patients had mild, moderate, and severe ascites and 48 patients had complications of ascites like refractory ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome. The mean serum sodium level was 131.69 ±â€…4.90 and 124.88 ±â€…5.67 mmol/L and the 24-hour urinary sodium level was 76.82 ±â€…45.64 and 35.26 ±â€…22.57 mmol/L in uncomplicated and complicated ascites groups respectively with P value < .001. In grade 1, grade 2, and grade 3 ascites, there was a significant (P = .001), association between mean serum sodium (mmol/L) level (R -0.777) and 24-hour urine sodium (mmol/L) level (R -0.704) but no significant difference was seen when refractory ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome were considered. In our finding, low serum sodium and low 24-hour urinary sodium levels were associated with the development of severe complications of cirrhotic ascites. Hence, Serum sodium and 24-hour urinary sodium levels can be good predictors of grading and complications of cirrhotic ascites.

Removal of Cu(II), Pb(II) and Cr(VI) ions from aqueous solution using amidoximated non-woven polyethylene-g-acrylonitrile fabric.

Pre-irradiation method was applied to graft acrylonitrile (AN) onto non-woven polyethylene film. Graft yield reached 130% at 70 kGy radiation dose, 60% monomer concentration and 4 h reaction time when H2SO4 was used as an additive. The modification of AN grafted films with hydroxyl amine hydrochloride was done for the preparation of amidoxime adsorbent. The constructed adsorbent was characterized using FTIR, DMA and SEM. The amidoxime adsorbent was used for adsorption of Cu(II), Pb(II) and Cr(VI). Adsorption capacity was investigated under different conditions: contact time, pH and initial metal ion concentration. The optimum condition for maximum adsorption was found to be contact time 72 h and initial metal concentration 500 ppm for all the metal ions studied and pH 5.2 for Cu(II), 5.4 for Pb(II), 1.5 for Cr(VI). Kinetic adsorption data was elucidated using pseudo-first-order and pseudo-second-order equations. The equilibrium experimental data of metal adsorption matched Langmuir isotherm model. From the Langmuir equation, the monolayer saturation adsorption capacity (highest adsorption capacity) of the adsorbent was found to be 74.62 mg/g for Cu(II), 107 mg/g for Pb(II) and 156.25 mg/g for Cr(VI). The thermodynamics of metal adsorption was also investigated. Furthermore, desorption and reuse of the adsorbent film was studied. The results suggest that the adsorbent can be effective for adsorption of Cu(II), Pb(II) and Cr(VI).

A study on efficacy of lamivudine therapy in decompensated cirrhosis of liver due to chronic hepatitis B virus infection.

The prognosis of decompensated cirrhosis of liver resulting from chronic Hepatitis B Virus (HBV) infection is poor and liver transplantation is the only established mode of treatment. The benefits of treatment with interferon are outweighed by serious side effects and risks of fatal exacerbation of disease activity. Lamivudine rapidly reduces hepatitis B viral DNA in serum to undetectable levels. The purpose of this study was to evaluate effectiveness and safety of Lamivudine treatment in patients with advanced and end stage liver disease caused by Hepatitis B. This was a prospective observational study in which a total of 45 patients, 39 (87.0%) male and 6 (13.0%) female who had viral activity and child pugh score e" 8 were given Lamivudine 100 mg orally once daily. Among them 30 patients completed at least 6 months of therapy, majority (27 patients) showed improvement in liver function with decrease in serum ALT from mean (+/- SD) 118.8 +/- 106.5 to 50.2 +/- 57.1 U/L (p < 0.001), decrease in serum bilirubin from 73.9 +/- 80.5 to 44.7 +/- 62.9 micromol/l (p = 0.129), increase in serum albumin from 26.2 +/- 4.2 to 33.2 +/- 3.4 g/l (p < 0.05), decrease in prothrombin time from 8.3 +/- 4.0 to 3.9 +/- 2.9 seconds prolonged (p < 0.05) and reduction in child pugh score from 11.0 +/- 1.7 to 7.0 +/- 1.3 (p < 0.001). Seroconversion was found in 5 (11.1%) patients on Intention to treat analysis. Among the seroconverted group, 1 (2.2%) patient also lost HBsAg. Six (13.0%) patient had procore mutant virus, 2 (4.4%) of them showed virological response. Therefore, total 7 (15.5%) patients showed virological response by intention to treat analysis. We conclude that inhibition of viral replication with Lamivudine results in a significant improvement of liver function in patients with decompensated cirrhosis of liver due to HBV infection.