Background and Aim: Viral infections, drugs, metabolic disorders, and autoimmune processes can cause hepatitis, which is a diffuse inflammatory condition of the liver. Hepatitis E (HEV) and hepatitis A (HAV) viruses are the most common causes of acute viral hepatitis (AVH). AVH and chronic liver failure (ACLF) patients were studied to determine whether they were infected with various hepatotropic and non-hepatotropic viruses. Patients and Methods: This prospective study was conducted on 186 adult patients with ACLF and AVH in the Department of Gastroenterology, DHQ Teaching Hospital and Mufti Mahmood Memorial Hospital, Dera Ismail Khan from September 2020 to August 2022. Our study included consecutive patients with acute viral hepatitis who had a definite viral etiology, a fever or jaundice that developed after 3 weeks, and an ALT that was 2x the upper limit of normal. There were three serological tests performed for all the patients: hepatitis (A, B, C, D, and E), Epstein-Barr virus (EBV), and non-hepatitis (CMV). Data analysis was carried out in SPSS version 26. Results: Of the total 186 samples investigated, the incidence of ACLF and AVH was 60 (32.3%) and 126 (67.7%) respectively. The prevalence of confirmed etiology such as HEV, HAV, HBV, and HCV was 98 (52.7%), 29 (15.6%), 20 (10.8%), and 2 (1.1%) respectively. The mixed viral etiology and Epstein-Barr virus was present in 18 (9.7%) and 19 (10.2%) respectively. The most prevalent cause of infection was HEV found in 76 (60.3%) AVH and 42 (70%) ACLF cases. The mortality rate among AVH patients was significantly lower 2.4% (n=3) than ACLF 23.3% (n=14). As compared to ACLF patients, AVH patients had significantly higher infections caused by non-hepatotropic viruses (24 vs. 3, p=0.001). There were significantly more mixed infections in AVH as opposed to ACLF (28 vs. 4, p<0.001). Conclusion: The present study concluded that both AVH and ACLF patients were susceptible to HEV-associated hepatitis. There were significant numbers of patients with AVH being infected with non-hepatotropic viruses including CMV and EBV. These viruses are much less common in patients with ACLF. Keywords: Epidemiology, Non-hepatotropic virus, Acute viral hepatitis, Acute chronic liver failure
Background and Aim: Thrombosis of the portal vein or obstruction of the hepatic venous outflow tract is the cause of portal vein thrombosis (PVT) and Budd-Chiari syndrome (BCS). Patients with PVT may experience a shorter survival rate compared to those without. The present study aimed to determine the portal vein thrombosis occurrence in Budd-Chiari syndrome patients. Patients and Methods: This cross-sectional study was conducted on 46 Budd-Chiari syndrome patients in Gastroenterology department of DHQ Teaching Hospital and Mufti Mahmood Memorial Hospital, Dera Ismail Khan from November 2021 to October 2022. Written informed consent was taken from each individual. Doppler ultrasonography (colored-pulsed) was used to confirm the PVT and BCS cases. Clinical data, laboratory findings, and radiological data were recorded. SPSS version 26 was used for data analysis. Results: The overall mean age of the BCS patients was 28.34±4.6 years. The prevalence of portal vein thrombosis in BCS patients was 12.8% (n=6). Of the total cases, the incidence of chronic and acute BCS presentation was 42 (91.3%) and 4 (8.7%) respectively. The most prevalent symptoms of BCS were abdominal pain and abdominal enlargement in 38 (82.6%) and 41 (89.1%) respectively. Hepatomegaly and ascites were most prevalent clinical signs found in 36 (78.3%) and 37 (80.4%) respectively. The incidence of esophageal varices, gastric extension, and fundal varices were 32 (69.6%), 4 (8.7%), and 2 (4.3%) respectively. About 21 (45.7%) cases had Portal hypertensive gastropathy (PHG). Conclusion: A higher incidence of PVT was observed in the present study than previously reported. Sociodemographic data and underlying etiology of BCS were not significantly different between patients with and without PVT. Those with PVT were more likely to experience hepatic tenderness, increased white blood cells, and increased direct bilirubin. PVT and other patients had similar Doppler ultrasound findings. Keywords: Portal vein thrombosis, Prevalence, Budd-Chiari syndrome
Background and Aim: Polyps of the gastrointestinal tract (GI) are apparent protrusions from the mucosal surface. The majority of polyps is asymptomatic and goes unnoticed; however in symptomatic situations, the most common clinical manifestations include abdominal discomfort, and rectal prolapse, intestinal blockage, and GI bleeding. The present study intended to assess the colorectal polyps characteristics based on clinical, pathological, and endoscopy in children and adolescents. Patients and Methods: This retrospective study was conducted on 78 children and adolescents (<18 years) with colorectal polyps in Gastroenterology Department of DHQ Teaching Hospital and Mufti Mahmood Memorial Hospital, Dera Ismail Khan from January 2020 to September 2022. Participants were assessed for various clinical variables such as age, gender, colonoscopy-related signs and symptoms, polyp identification, symptom’s onset age, duration between colonic polyp’s endoscopic diagnosis and symptoms onset, and intestinal polyps family history. Polyp’s characteristics involved: frequency, histology, morphological type, and distribution. SPSS version 26 was used for data analysis. Results: The overall mean age was 8.6±2.4 years with an age range 3 to 18 years. Of the total 78 colonic polyps, there were 48 (61.5%) male and 30 (38.5%) females. The most prevalent symptom was rectal bleeding present in 94.6% (n=74) cases with 13.8±16 months. Juvenile was the prevalent polyps found in 76.9% (n=60), out of which 96.7% (n=58) were in left colon. The prevalence of Solitary polyps, multiple polyps, familial adenomatous polyposis, and Peutz-Jeghers syndrome (PJS) was 10.3% (n=8), 6.4% (n=5), 3.8% (n=3), and 2.6% (n=2) respectively. Polyposis syndrome cases were more likely to have old age, diarrhea, anemia, and abdominal pain. Peutz-Jeghers syndrome majority patients experienced intestinal partial blockage with acute episodes, abdominal pain, and emergency laparotomy, resulting in increased morbidity. Conclusion: The present study found that clinical signs of polyposis syndrome include anemia, diarrhea, abdominal pain, polypectomy history, and older age at presentation. Despite the fact that the most commonly diagnosed kind of polyp was juvenile colonic polyps, the current investigation recognized a substantial number of polyposis syndromes children, which are related with individual’s higher rate of morbidity. Keywords: Colonic polyps, Clinical features, Endoscopic characteristics, Colonoscopy
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