Study on the presentations of Chronic Liver Disease in correlation to their etiologies.

Venkatraman, G (2006) Study on the presentations of Chronic Liver Disease in correlation to their etiologies. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION : Chronic Liver Disease (CLD) and its sequelae form a major part of gastroenterological workload in any large hospital. As well known, it is a disease with very high degree of morbidity and mortality. In the past, CLD was broadly divided into alcoholic and post hepatitis varieties. Over the years, with the advent of newer techniques for identification of viruses, biochemical markers, and newer histopathological methods, it is now possible to enlarge the classification and attach more informative labels to such cases. Even among virus related CLD, a large group so far labeled as Non A, Non B, identification of Hepatitis C has become an established practice. Transfusion associated NANB hepatitis has a new perspective now. Despite these transformations, a small proportion of patients fail to demonstrate any known viral marker raising further questions. There are now well documented studies on the beneficial effects of antiviral agents in the management of chronic hepatitis B and C. Hence it becomes almost mandatory to determine if a given case of CLD is virus related or not, so that a decision regarding the use of such antiviral agents can be made. Another problem, which is assuming importance, is co-existence of more than one hepatotropic virus. While the co-infection or superinfection of HBV and Hepatitis D Virus (HDV) is well studied, the significance of the presence of viral makers of HBV and HCV in the same patient is not yet clear. Which agent is responsible for the observed liver damage and how the presence of one virus alters the biological behavior of other, are questions which have already caught the attention of hepatologists worldwide. AIM : To study about the various clinical, biochemical and pathological presentations of chronic liver disease and to estimate their relative frequencies. 1. To estimate the contribution of hepatitis virus B & C in causing chronic liver disease in an urban setup 2. To find out the relative prevalence of NASH in patients diagnosed to have chronic liver disease (CLD) OBJECTIVES : The study was conducted with following specific objectives in mind. 1. What is the relative frequency of clinical, biochemical, pathological abnormalities found in chronic liver disease of various etiologies 2. What is the prevalence rate of HBV and HCV in patients with CLD 3. Should NASH be considered to be an emerging risk for CLD in urban population? PATIENTS & METHODOLOGY : The study was conducted in Government General Hospital, Chennai, during the period September 2003 to August 2004. 100 consecutive adult patients admitted to the male and female wards of Medical Gastroenterology ward diagnosed to have CLD (by criteria given below) were included in the study. CONCLUSIONS : 1. Chronic liver disease is a major health problem in this area. 2. 60 out of 100 patients with CLD were related to Ethanol and HBV either singly or in combination. 3. The incidence of HCV infection is very low in this part of the world (4%). 4. A sizeable proportion (28%) belongs to the group of cryptogenic cirrhosis which calls for a lot of research in this sphere to detect new viruses or environmental factors responsible. 5. The prevalence of NASH in patients with CLD is 3% 6. Obesity, Hypertriglyceredemia and Diabetes were present in patients with NASH either singly or in combination. 7. Coexistence of HBV and Alcoholic liver disease does not alter the histopathology or clinical severity of the illness . 8. In view of the too small number of HCV cases, we could not document the histopathological characteristics claimed to be distinctive of HCV infection.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Chronic Liver Disease ; Correlation ; Etiologies.
Subjects: MEDICAL > Gastroenterology
Depositing User: Kambaraman B
Date Deposited: 13 Jul 2017 04:03
Last Modified: 13 Jul 2017 04:03

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