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MINI-REVIEW
Jong-Hon Kang, Takeshi Matsui

Changing Etiology in Liver Cirrhosis in Sapporo, Japan

[Year:2018] [Month:January-June] [Volumn:8 ] [Number:1] [Pages:100] [Pages No:77-80][No of Hits : 815]


ABSTRACT

In Japan, preventive measures and antiviral therapy against acute or chronic viral infection had achieved remarkable progress in the 1980s or later. On the contrary, metabolic syndrome complicated with fatty liver has emerged as a public health concern to date.
In the current study, we attempted to clarify etiological changes in liver cirrhosis treated in a single tertiary institute in Sapporo, Japan, from 1998 to 2016.
Medical records of 1,166 patients (787 males, with mean of 64.9 ± 11.7 years), diagnosed as having liver cirrhosis for 19 years, were retrospectively reviewed to analyze etiology and clinical features.
During the past 10 years, annual numbers of cirrhotic patients with chronic infection of hepatitis B virus (HBV) or hepatitis C virus (HCV) decreased from 50 or more to 20 or less, and alcoholic liver disease or cryptogenic liver injury emerged as major cause of liver cirrhosis. Among 100 cirrhotic patients of unknown cause, nonalcoholic fatty liver disease (NAFLD) occupied almost 50% in 19 observational years.
In order to control the rising trend in NAFLD related with metabolic syndrome, preventive measures including education in society would be required in Japan.

Keywords: Etiology, Japan, Liver cirrhosis.

How to cite this article: Kang J-H, Matsui T. Changing Etiology in Liver Cirrhosis in Sapporo, Japan. Euroasian J Hepato-Gastroenterol 2018;8(1):77-80.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Tadashi Ohara, Tatsuo Suzutani

Intake of Bifidobacterium longum and Fructooligosaccharides prevents Colorectal Carcinogenesis

[Year:2018] [Month:January-June] [Volumn:8 ] [Number:1] [Pages:100] [Pages No:11-17][No of Hits : 653]


ABSTRACT

Introduction: We aimed to investigate the effects of intake of yogurt containing Bifidobacterium longum (BB536-y) and fructo-oligosaccharides (FOS) in preventing colorectal carcinogenesis in healthy subjects, and the preventive effects of short-chain fatty acids (SCFA), whose production was enhanced by the intake of BB536-y and FOS, in human colon cancer cell lines.

Materials and methods: The subjects were 27 healthy persons who were divided into a group taking yogurt containing BB536 (BB536-y group; n = 14) and a group taking yogurt containing BB536 and FOS (BB536-y with FOS group; n = 13) once a day for 5 weeks. The feces were sampled before and after the intake to analyze the amount of SCFA in the feces and the profile of intestinal flora, such as putrefactive bacteria and Bacteroides fragilis enterotoxin (ETBF). Subsequently, human colon cancer cell lines (DLD-1 cells, WirDr cells) were cultured in the presence of SCFA (butyric acid, isobutyric acid, acetic acid) in order to evaluate the cell growth-inhibitory activity of SCFA (WST-8 assay) by calculating the IC50 value from the dose-response curve.

Results: Intake of BB536-y increased the total amount of SCFA in the feces and significantly suppressed the detection rate of ETBF and growth of putrefactive bacteria. Intake of BB536-y with FOS was associated with a higher Bifidobacterium detection rate than that of BB536-y alone. The contents of butyric acid, isobutyric acid, and acetic acid, namely, of SCFA, were also decreased. Analysis of the results of culture of DLD-1 cells and WirDr cells in the presence of butyric acid, isobutyric acid, and acetic acid revealed that each of the substances showed significant cell growth-inhibitory activity, with the activity being the highest for butyric acid, followed by that for isobutyric acid and acetic acid.

Conclusion: These findings suggest that intake of both BB536-y and BB536-y with FOS prevents colorectal carcinogenesis.

Keywords: Colorectal carcinoma, Gastroenterology, Intestinal microbiome, Prebiotics, Probiotics, Short-chain fatty acids.

How to cite this article: Ohara T, Suzutani T. Intake of Bifidobacterium longum and Fructooligosaccharides prevents Colorectal Carcinogenesis. Euroasian J Hepato-Gastroenterol 2018;8(1):11-17.

Source of support: Nil

Conflict of interest: None


 
MINI-REVIEW
Patharapan Lersritwimanmaen, Supot Nimanong

Hepatocellular Carcinoma Surveillance: Benefit of Serum Alfa-fetoprotein in Real-world Practice

[Year:2018] [Month:January-June] [Volumn:8 ] [Number:1] [Pages:100] [Pages No:83-87][No of Hits : 618]


ABSTRACT

Introduction: Better treatment outcome of early-stage hepatocellular carcinoma (HCC) warrants employment of screening programs, in which ultrasonography (US) and serum alfa-fetoprotein (AFP) have been recommended. Considering cost-effectiveness, serum AFP has recently been withdrawn from several guidelines for HCC surveillance. However, there were limited studies on benefits of AFP for HCC surveillance in Thailand.

Materials and methods: This is a retrospective study of a proportion of HCC cases in which a diagnostic study was triggered by high serum AFP levels, but US failed to detect the lesion. Patients who received diagnostic imaging for HCC at Siriraj Hospital between January 1, 2012 and December 31, 2014 were included. All the patients must fulfill criteria for HCC surveillance according to American Association for the Study of Liver Diseases (AASLD) practice guidelines on the management of HCC 2010 or European Association for the Study of the Liver-European Organisation for Research and Treatment of Cancer (EASL-EORTC) Clinical Practice Guidelines: Management of HCC 2012. Previous diagnosis of any liver malignancy was excluded. Demographic data, underlying liver diseases, screening of AFP and US results, and definite diagnosis of HCC were recorded.

Results: Of the 452 cases who fulfilled inclusion and exclusion criteria, chronic hepatitis B, C, and alcoholic cirrhosis were accountable for 53.8, 25.9, and 7.3% respectively. Totally, 150 cases were diagnosed with HCC. Additional HCC detection rate by high serum AFP but failed US of 15.3% was demonstrated. Subgroup analysis revealed significant benefit of AFP in cirrhotic patients with chronic hepatitis B and C (p-value 0.004 and 0.002). No significant benefit was observed in cirrhosis of other causes and in noncirrhotic chronic hepatitis B.

Conclusion: We reported a 15.3% additional benefit of serum AFP for HCC surveillance in conjunction with US of liver. Chronic hepatitis B and C with cirrhosis significantly derived the benefit from serum AFP screening.

Keywords: Alfa-fetoprotein, Hepatocellular carcinoma, Surveillance.

How to cite this article: Lersritwimanmaen P, Nimanong S. Hepatocellular Carcinoma Surveillance: Benefit of Serum Alfa-fetoprotein in Real-world Practice. Euroasian J Hepato-Gastroenterol 2018;8(1):83-87.

Source of support: Nil

Conflict of interest: None


 
MINI-REVIEW
Ruksana Raihan, Amirah Azzeri, Fatiha H Shabaruddin, Rosmawati Mohamed

Hepatocellular Carcinoma in Malaysia and Its Changing Trend

[Year:2018] [Month:January-June] [Volumn:8 ] [Number:1] [Pages:100] [Pages No:54-56][No of Hits : 603]


ABSTRACT

Hepatocellular carcinoma (HCC) is one of the leading causes of death globally. In Malaysia liver cancer is the eighth most common cause of cancer for both gender and fifth most common cause of cancer for males. Liver cancer is a cause of premature death in Malaysia: The trend from 1990 to 2010 was observed upward. Since 1990, the annual years of life lost (YLLs) from liver cancer have increased by 31.5%. Older persons are at higher risk and there is male predominance observed. Curative surgical resection, liver transplantation, and supportive symptomatic care, including percutaneous ethanol injection and radiofrequency ablation (RFA), and noncurative transarterial chemoembolization (TACE) are among available treatment facilities. Yet the survival rate is very poor as majority of patients present at very advanced stage. Hepatitis B virus (HBV) remained the leading cause of HCC in Malaysia. Several studies showed cryptogenic causes, which are mainly nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) among the predominant causes of HCC in Malaysia than hepatitis C virus (HCV), alcohol, or any other reason. This mainly correlates with the increasing incidence of diabetes and obesity in Malaysia.

Keywords: Cryptogenic, Hepatocellular carcinoma, Malaysia, Nonalcoholic fatty liver disease, Nonalcoholic steatohepatitis.

How to cite this article: Raihan R, Azzeri A, Shabaruddin FH, Mohamed R. Hepatocellular Carcinoma in Malaysia and Its Changing Trend. Euroasian J Hepato-Gastroenterol 2018;8(1):54-56.

Source of support: Nil

Conflict of interest: None


 
MINI-REVIEW
Preetam Nath, Shivaram P Singh

Nonalcoholic Fatty Liver Disease: Time to Take the Bull by the Horns.

[Year:2018] [Month:January-June] [Volumn:8 ] [Number:1] [Pages:100] [Pages No:47-51][No of Hits : 599]


ABSTRACT

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world affecting almost one-fourth of the population. It may progress to nonalcoholic steatohepatitis (NASH), cirrhosis, end-stage liver disease, and liver cancer in the long run. Besides, it may make the natural history in other chronic liver diseases worse too. Furthermore, patients of NAFLD more often suffer from metabolic syndrome, ischemic heart disease, and extrahepatic malignancies than others, leading to a lower overall survival than the general population. Obesity and sedentary lifestyle are among the most important risk factors for NAFLD apart from increasing age, male sex, and certain genetic factors. Due to the rising incidence, possible adverse consequences, and the futile available treatment options, prevention is the key to tackle this health menace. Spreading awareness, adopting a healthy lifestyle with appropriate dietary modifications, regular physical activity are the cornerstones for challenging this unfolding monster.

Keywords: Awareness, Lifestyle change, Nonalcoholic fatty liver disease, Prevention.

How to cite this article: Nath P, Singh SP. Nonalcoholic Fatty Liver Disease: Time to Take the Bull by the Horns. Euroasian J Hepato-Gastroenterol 2018;8(1):47-51.

Source of support: Nil

Conflicts of interest: None


 
ORIGINAL ARTICLE
Renuka Malipatel, Mallikarjun Patil, Pritilata Rout, Marjorie Correa, Harshad Devarbhavi

Primary Gastric Lymphoma: Clinicopathological Profile

[Year:2018] [Month:January-June] [Volumn:8 ] [Number:1] [Pages:100] [Pages No:6-10][No of Hits : 566]


ABSTRACT

Introduction: Gastrointestinal tract (GIT) is the most common site of involvement of extranodal non- Hodgkin’s lymphoma (NHL). There is regional variation in anatomical distribution of extranodal NHL, stomach being the most common site followed by small intestine. Primary gastric lymphoma (PGL) predominantly involves the antrum and corpus of the stomach. It arises from mucosa-associated lymphoid tissue (MALT) and is of B-cell lineage and often associated with Helicobacter pylori infection. Primary gastric lymphoma often presents with nonspecific symptoms. The present study was undertaken to ascertain the clinicopathological characteristics of PGL at a tertiary care center in South India.

Materials and methods: It is a retrospective study from 2006 to 2016. Patient’s data were obtained from institutional medical records. The histopathology slides were reviewed. The relevant immunohistochemistry (IHC) markers done were leukocyte common antigen (LCA), CD3, CD20, CD79a, CD10, Bcl-2, Bcl-6, CD5, Cyclin D1, CD138, and Ki-67. Correlating with the immunoprofile, further subtyping was done.

Results: A total of 405 patients of NHL were seen during the study period, out of which 43 patients were PGL. There were 32 males and 11 females, with M:F of 2.9:1. The mean age at diagnosis was 58 years. Abdominal pain and new-onset dyspepsia were the commonly observed presenting symptoms. The common site of involvement was antrum (20). Diffuse large B-cell lymphoma (DLBCL) was the most common histological subtype. Helicobacter pylori infection was seen in 18 (41%) patients. Majority of the patients were in stages II and III.

Conclusion: In our study, the initial presentation of PGL was with nonspecific symptoms like abdominal pain and new-onset dyspepsia. High degree of suspicion of such symptoms and biopsy of all suspicious lesions is essential for early detection. Diffuse large B-cell lymphoma was the most common histological subtype seen in our study.

Keywords: Diffuse large B-cell lymphoma, Dyspepsia, Non-Hodgkin’s lymphoma, Primary gastric lymphoma.

How to cite this article: Malipatel R, Patil M, Rout P, Correa M, Devarbhavi H. Primary Gastric Lymphoma: Clinicopathological Profile. Euroasian J Hepato-Gastroenterol 2018;8(1):6-10.

Source of support: Nil

Conflict of interest: None


 
MINI-REVIEW
Mark Muthiah, Chern H Chong, Seng G Lim

Liver Disease in Singapore

[Year:2018] [Month:January-June] [Volumn:8 ] [Number:1] [Pages:100] [Pages No:66-68][No of Hits : 558]


ABSTRACT

Liver disease is a significant health issue in Singapore. In the Singapore Burden of Disease Survey, liver cancer and liver cirrhosis contributed 3.2 and 0.9% of years of life lost (YLL) out of 182,753 YLL respectively. Liver cancer was ranked 8th and liver cirrhosis was ranked 20th in YLL. Liver cancer is the 5th most common cancer in males, and has an age-adjusted rate of 17.6 per 100,000 population. The underlying etiology of liver cirrhosis is chronic hepatitis B (CHB) in 63.3%, alcohol in 11.2%, cryptogenic in 9%, and chronic hepatitis C (CHC) in 6.9%. The overall seroprevalence rate of CHB is 3.6%, while CHC is approximately 0.1%. The trend in prevalence of liver cancer is gradually reducing as is CHB. However, less is known about alcoholic liver disease and fatty liver disease and there is some evidence that the latter is increasing. Singapore has a multilayered health care system designed to provide basic health care needs to the population. There are various schemes available that provide subsidized and assisted health care for treatment of hepatitis B and C as well as liver transplantation. Health policy with regard to a national action plan has not yet been developed and there is room for health care specialists, government and nongovernment agencies to work together to tackle liver disease in Singapore.

Keywords: Alcoholic liver disease, Burden of disease, Chronic hepatitis B, Chronic hepatitis C, Cirrhosis, Hepatocellular carcinoma, Liver cancer, Nonalcoholic fatty liver disease.

How to cite this article: Muthiah M, Chong CH, Lim SG. Liver Disease in Singapore. Euroasian J Hepato-Gastroenterol 2018;8(1):66-68.

Source of support: Abbott, Merck Sharpe and Dohme, Gilead Sciences

Conflict of interest: Seng Gee Lim is on the advisory board of Abbott, Gilead Sciences, Merck Sharpe and Dohme, Bristol Myer Squibb, Abbvie, Abbott. Speakers Bureau: Abbott, Bristol Myers Squibb, Roche


 
MINI-REVIEW
Oidov Baatarkhuu, Tsagaantsooj Gerelchimeg, Dashchirev Munkh-Orshikh, Badamnachin Batsukh, Ganbold Sarangua, Jazag Amarsanaa

Epidemiology, Genotype Distribution, Prognosis, Control, and Management of Viral Hepatitis B, C, D, and Hepatocellular Carcinoma in Mongolia

[Year:2018] [Month:January-June] [Volumn:8 ] [Number:1] [Pages:100] [Pages No:57-62][No of Hits : 539]


ABSTRACT

Mongolia is located between Russia and China. The total population of Mongolia as of December 2017 is estimated to be 3.2 million people. According to our previous study results, the prevalence of HBV was 11.8%, and anti-HDV was detected in 4.8% among the HBsAg-positive subjects. Interestingly, most HCV infection is caused by genotype 1b. Among all HBV DNA-positive samples, 98.5% were classified into genotype D, and regarding HDV genotypes, all HDV RNA-positive samples, 100%, were classified into genotype I.
The second study is the baseline survey of a Nationwide Cancer Cohort Study. Prevalence of HBsAg was 10.6%. Additionally, HCV infection was observed in 9.9%, and 0.8% were coinfected with HBV and HCV among the general population aged from 10 to 64 years.
The third study investigated the population-based prevalence of hepatitis B and C virus in apparently healthy population of Ulaanbaatar city, Mongolia. The anti-HCV prevalence was 9.0%. In addition, the prevalence of HBV was 8.0%.
The fourth study is on the prevalence of HCV and coinfections among nurses in a tertiary hospital in Mongolia. The prevalence of HCV was 18.9%. Additionally, HBV infection was observed in 23.1%, and 1.2% were coinfected with HCV and HBV.
Mongolia has the highest HCC incidence in the world (78.1/100,000, 3.5× higher than China). As a result, the Mongolia government has launched The National Viral Hepatitis Program, which is a comprehensive program that involves all aspects from prevention to care and disease control to meet a reduction goal for morbidity and mortality due to HBV, HCV, and HDV. Consequently, access to antiviral therapies is now improving in Mongolia.

Keywords: Genotype, Hepatitis B virus, Hepatitis C virus, Hepatitis D virus, Hepatocellular carcinoma, Mongolia, National program.

How to cite this article: Baatarkhuu O, Gerelchimeg T, Munkh-Orshikh D, Batsukh B, Sarangua G, Amarsanaa J. Epidemiology, Genotype Distribution, Prognosis, Control, and Management of Viral Hepatitis B, C, D, and Hepatocellular Carcinoma in Mongolia. Euroasian J Hepato-Gastroenterol 2018;8(1):57-62.

Source of support: Nil

Conflict of interest: None

ABSTRACT

Mongolia is located between Russia and China. The total population of Mongolia as of December 2017 is estimated to be 3.2 million people. According to our previous study results, the prevalence of HBV was 11.8%, and anti-HDV was detected in 4.8% among the HBsAg-positive subjects. Interestingly, most HCV infection is caused by genotype 1b. Among all HBV DNA-positive samples, 98.5% were classified into genotype D, and regarding HDV genotypes, all HDV RNA-positive samples, 100%, were classified into genotype I.
The second study is the baseline survey of a Nationwide Cancer Cohort Study. Prevalence of HBsAg was 10.6%. Additionally, HCV infection was observed in 9.9%, and 0.8% were coinfected with HBV and HCV among the general population aged from 10 to 64 years.
The third study investigated the population-based prevalence of hepatitis B and C virus in apparently healthy population of Ulaanbaatar city, Mongolia. The anti-HCV prevalence was 9.0%. In addition, the prevalence of HBV was 8.0%.
The fourth study is on the prevalence of HCV and coinfections among nurses in a tertiary hospital in Mongolia. The prevalence of HCV was 18.9%. Additionally, HBV infection was observed in 23.1%, and 1.2% were coinfected with HCV and HBV.
Mongolia has the highest HCC incidence in the world (78.1/100,000, 3.5× higher than China). As a result, the Mongolia government has launched The National Viral Hepatitis Program, which is a comprehensive program that involves all aspects from prevention to care and disease control to meet a reduction goal for morbidity and mortality due to HBV, HCV, and HDV. Consequently, access to antiviral therapies is now improving in Mongolia.

Keywords: Genotype, Hepatitis B virus, Hepatitis C virus, Hepatitis D virus, Hepatocellular carcinoma, Mongolia, National program.

How to cite this article: Baatarkhuu O, Gerelchimeg T, Munkh-Orshikh D, Batsukh B, Sarangua G, Amarsanaa J. Epidemiology, Genotype Distribution, Prognosis, Control, and Management of Viral Hepatitis B, C, D, and Hepatocellular Carcinoma in Mongolia. Euroasian J Hepato-Gastroenterol 2018;8(1):57-62.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Sheikh MF Akbar, Mamun Al-Mahtab, Sakirul I Khan

Nature of Host Immunity during Hepatitis B Virus Infection and designing Immune Therapy

[Year:2018] [Month:January-June] [Volumn:8 ] [Number:1] [Pages:100] [Pages No:42-46][No of Hits : 523]


ABSTRACT

Hepatitis B virus (HBV) infections represent one of the major public health problems in global context. More than 2 billion people in the world have been infected with this virus at some point of time in their life and millions are chronically infected, indicating that chronic HBV-infected subjects remain as a living source of HBV transmission. The public health impact of this is tremendous. Considerable numbers of chronic HBV-infected individuals would eventually develop progressive liver diseases and their complications like hepatic failure, liver cirrhosis (LC), and hepatocellular carcinoma (HCC). Epidemiological studies have suggested that about 0.6 to 1.2 million people die annually from HBVrelated liver diseases. These figures about death due to HBV and sufferings from HBV-related diseases indicate a notion of medical emergencies about HBV. In addition to these, the impact of HBV on health care delivery system moves beyond these numbers of HBV-related patients and HB-related deaths. This is because significant insights have already been developed about epidemiology, virology, and pathogenesis of HBV. Also, an effective and widely used preventive vaccine is available against HBV. In addition to these, antiviral drugs against HBV have been developed from early 1980s and several such drugs are now available commercially in the open market around the worldwide. Unfortunately, the ongoing therapeutic regimens could not stand the test of time and new insights about HBV pathogenesis are required for the development of new, novel, and evidence-based therapies for chronic HBV infections.

Keywords: Chronic hepatitis B, Immune therapy, Pathogenic immunity, Protective immunity, Therapeutic immunity.

How to cite this article: Akbar SMF, Al-Mahtab M, Khan SI. Nature of Host Immunity during Hepatitis B Virus Infection and designing Immune Therapy. Euroasian J Hepato-Gastroenterol 2018;8(1):42-46.

Source of support: The study has been supported by Japan Agency for Medical Research and Development (AMED), Japan.

Conflict of interest: None


 
MINI-REVIEW
David H Muljono, Teguh Wijayadi, Rizalinda Sjahril

Hepatitis B Virus Infection among Health Care Workers in Indonesia

[Year:2018] [Month:January-June] [Volumn:8 ] [Number:1] [Pages:100] [Pages No:88-92][No of Hits : 511]


ABSTRACT

Hepatitis B virus (HBV) infection is a global health problem with an estimated 257 million chronically infected people. Indonesia is a moderately hepatitis B-endemic country with 7.1% prevalence of hepatitis surface antigen (HBsAg). This infection is considered as an important occupational hazard among health care workers (HCWs), who may become further transmitters of this infection. The extent of hepatitis B among HCWs and specific control strategy are not available in Indonesia. A study was done on 644 HCWs, who were categorized into administration, nonintervention, and intervention groups. The prevalence of HBsAg, antibody to HBV core antigen (anti-HBc), and antibody to HBsAg (anti-HBs) was 4.7, 18.5, and 36.7% respectively, while 57.3% were negative for all seromarkers, indicating susceptibility to this infection. Increasing trend with age was observed in the exposure to infection (anti-HBc) (p < 0.001) and the marker of resolved infection (HBsAg-, anti-HBc+, anti-HBs+) (p = 0.004), suggesting accumulated exposure to HBV infection by increasing age. Rising trend of exposure rate was also observed across the administration, nonintervention, and intervention groups (p < 0.001). By length of service period, significant escalation of exposure (p = 0.010) and resolved infection (p < 0.001) were also observed, suggesting increasing occupational risk to HBV infection. There is an urgent need to safeguard the HCWs with hepatitis B vaccination and provide continuing education at various health care setups. The establishment of a national policy and a roadmap for effective and efficient intervention is required for the prevention, diagnosis, postexposure management, and treatment of HBV infection in this special population.

Keywords: Health care workers, Hepatitis B, Hepatitis B virus, Occupational hazard, Occupational risk.

How to cite this article: Muljono DH, Wijayadi T, Sjahril R. Hepatitis B Virus Infection among Health Care Workers in Indonesia. Euroasian J Hepato-Gastroenterol 2018;8(1):88-92.

Source of support: Research grant from the Ministry for Research and Technology, and Higher Education, Republic of Indonesia

Conflict of interest: Nil


 
ORIGINAL ARTICLE
Enayet Hossain, Ferdaus Ahammed, Satyajit K Saha, Syed A Foez, Mohammad A Rahim, Sheikh M Noor-e-Alam, Abu S Abdullah

Screening of Esophageal Varices by Noninvasive Means in Chronic Liver Disease

[Year:2018] [Month:January-June] [Volumn:8 ] [Number:1] [Pages:100] [Pages No:18-22][No of Hits : 502]


ABSTRACT

Introduction: Noninvasive assessment of esophageal varices (EV) decreases the medical and financial burden related to screening and helps in the management of patients with chronic liver diseases (CLDs). In this study, our aim was to assess the utility of the platelet count/spleen diameter index for the noninvasive evaluation of EV.

Materials and methods: In this cross-sectional observational study, a total of 100 CLD patients underwent screening endoscopy for EV in Medicine and Gastroenterology Department, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh. Platelet count/spleen diameter ratio was assessed in all patients and its diagnostic implication was calculated.

Results: Upper gastrointestinal endoscopy revealed that 45 (45.0%) patients had medium EV followed by 27 (27.0%) that had small EV and 19 (19.0%) patients had large EV. Receiver operator characteristic (ROC) curve was constructed using platelet count/spleen index, which gave a cut-off value of ≥905. The validity of platelet count/spleen index evaluation of CLD was: Sensitivity 92.3%, specificity 66.7%, accuracy 90.0%, positive predictive value (PPV) and negative predictive value (NPV) were 96.6 and 46.2% respectively. True positive was 84 cases, false positive 3 cases, false negative 7 cases, and true negative 6 cases. If we consider cut-off value as 909 in the evaluation of EV in CLD, then true positive was 85 cases, false positive 3 cases, false negative 6 cases, and true negative 6 cases. From this, by calculation, sensitivity was 93.4%, specificity 66.7%, accuracy 91%, PPV 96.6%, and NPV 50%.

Conclusion: The platelet count/spleen index may be proposed to be a safe and reliable mean of screening of EV in CLD patients; however, case.control study would be required to validate this.

Keywords: Chronic liver disease, Esophageal varices, Prognosis, Screening.

How to cite this article: Hossain E, Ahammed F, Saha SK, Foez SA, Rahim MA, Noor-e-Alam SM, Abdullah AS. Screening of Esophageal Varices by Noninvasive Means in Chronic Liver Disease. Euroasian J Hepato-Gastroenterol 2018;8(1):18-22.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Gokben Ozbey, Alfizah Hanafiah

Epidemiology, Diagnosis, and Risk Factors of Helicobacter pylori Infection in Children

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:34-39][No of Hits : 1614]


ABSTRACT

H. pylori infection is a global public health problem associated with some gastrointestinal diseases in children, especially in developing countries, since prevalence of H. pylori is low in the developed world. Both noninvasive (stool antigen test, urea breath test, and blood test) and invasive (histology, rapid urease test, and microbiological culture) tests have been utilized to detect H. pylori infection. However, a single test is not reliable enough and does not provide accurate enough data to determine H. pylori infection among children. Risk factors of H. pylori infection in children were related to ethnicities, household properties, geographic location, living conditions, water sources, type of housing, presence/absence of sewage systems, and garbage collection within the living environment. These risk factors were usually associated with the socioeconomic status of the family. This review article aims to determine the gaps in the knowledge of the epidemiology, risk factors, and diagnostic tests of H. pylori infection among children.

Keywords: Children, Diagnostic tests, Epidemiology, Helicobacter pylori.

How to cite this article: Ozbey G, Hanafiah A. Epidemiology, Diagnosis, and Risk Factors of Helicobacter pylori Infection in Children. Euroasian J Hepato-Gastroenterol 2017;7(1):34-39.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Dina Zerem, Omar Zerem, Enver Zerem

Role of Clinical, Biochemical, and Imaging Parameters in predicting the Severity of Acute Pancreatitis

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:1-5][No of Hits : 1320]


ABSTRACT

Aim: The assessment of the severity of acute pancreatitis (AP) is important for proper management of the disease and for its prognosis. The aim was to correlate clinical, biochemical, and imaging diagnostic parameters and evaluate their prognostic values in the early assessment of severity of AP.

Materials and methods: We prospectively studied 128 consecutive patients with AP. The predictors were clinical, biochemical, and imaging diagnostic parameters. The outcome measure was the occurrence of complications. Abdominal sonogram, contrast-enhanced computer tomography, and pancreatitisspecific clinical and laboratory findings were done.

Results: According to the Atlanta classification, 84 patients (65.6%) had mild and 44 (34.4%) had severe AP. The severity markers were significantly different between the mild and the severe groups (p < 0.001). Leukocyte count, serum albumin level, C-reactive protein (CRP), Ranson, acute physiology and chronic health evaluation II (APACHE II), and Glasgow score were the factors associated with radiological severity grade. Leukocyte count, CRP, Ranson score, APACHE II, and Glasgow score were the factors associated with the number and appearance of acute fluid collections (AFCs). A significant association was found between the number of AFCs and the occurrence of complications [odds ratio 4.4; 95% confidence interval 2.5-7.6]. Hospital stay was significantly longer in the group with severe disease as compared with the group with mild disease (p < 0.001).

Conclusion: Clinical, biochemical, and imaging diagnostic parameters are related to the clinical course of AP and they can predict its severity. This allows us to determine the severity of the disease and to target the patients with high scores for close monitoring and more aggressive intervention.

Keywords: Acute pancreatitis, Clinical outcome, Complications, Computed tomography, Conventional transabdominal ultrasound, C-reactive protein.

How to cite this article: Zerem D, Zerem O, Zerem E. Role of Clinical, Biochemical, and Imaging Parameters in predicting the Severity of Acute Pancreatitis. Euroasian J Hepato-Gastroenterol 2017;7(1):1-5.

Source of support: Nil

Conflict of interest: None


 
MINI REVIEW
Hasitha S Wijewantha

Liver Disease in Sri Lanka

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:78-81][No of Hits : 1264]


ABSTRACT

Liver disease in Sri Lanka is mainly due to alcoholic liver disease and nonalcoholic fatty liver disease. In contrast to other South Asian countries, the prevalence of hepatitis B and C is low in Sri Lanka and prevalence of hepatitis A is intermediate. The few reported cases of hepatitis E in Sri Lanka are mainly in people who have traveled to neighboring South Asian countries. Wilson’s disease, autoimmune hepatitis, hemochromatosis, drug-induced liver disease, and primary biliary cirrhosis are recognized causes of liver disease in Sri Lanka. Pyogenic and amebic liver abscesses and dengue infection are the other causes of liver disease. Some of the commonly used plants as traditional herbal medicine in Sri Lanka have been shown to have deleterious effects on the liver in animal studies. Considering the high popularity of traditional herbal medicine in the country, it is likely that herbal medicine is an etiological factor for liver disease in Sri Lanka, but no published data are available.

Keywords: Causes of cirrhosis, Liver disease, Nonalcoholic fatty liver disease, Viral hepatitis.

Address reprint requests to: Wijewantha HS. Liver Disease in Sri Lanka. Euroasian J Hepato- Gastroenterol 2017;7(1):78-81.

Source of support: Nil

Conflict of interest: None