Introduction: Cirrhosis and its associated complication of portal hypertensive gastropathy (PHG), among others, remain a significant cause of death in resource-poor countries with limited capacity for liver transplantation. This research aimed to assess the association of Helicobacter pylori (H. pylori) with portal hypertensive gastropathy and its severity in patients with and without cirrhosis.Methodology: The study was conducted at a tertiary care hospital in Pakistan from April 2021 to May 2022. Liver cirrhosis was diagnosed by clinical manifestations, ultrasonography, and laboratory investigations. The severity of liver cirrhosis was assessed using the Child-Pugh scoring system. The association of H. pylori with portal hypertensive gastropathy in patients with and without cirrhosis was assessed using the chisquare test.Results: A total of 120 patients participated in the study, of which 40 were without liver cirrhosis, while 80 were with cirrhosis. Among patients with cirrhosis, 24 were in Child-Pugh class A, 26 in class B, and 30 in class C. Of patients with liver cirrhosis who were H. pylori-negative, 37.5% (15/40) had portal hypertensive gastropathy. Of these, 12.5% (5/40) had severe PHG, while 25% (10/40) had mild PHG. Of patients with liver cirrhosis who were H. pylori-positive, 62.5% (25/40) had PHG. Of these, 2.5% (1/40) had severe PHG, while 60% (24/40) had mild PHG. Helicobacter pylori contributed nonsignificantly (p=0.080), showing no association with portal hypertensive gastropathy. Conclusion:Helicobacter pylori does not appear to have any significant association to cause or worsen portal hypertensive gastropathy in patients with liver cirrhosis.
Background: Liver cirrhosis is reduced liver function caused by the growth of scar tissue known as fibrosis. The injury to hepatic tissues leads to the creation of scar tissue, which, over time, can replace normally functioning tissues. Objectives: The study evaluated the correlation of endoscopic findings with MELD and NIEC scores in patients with liver cirrhosis in Lahore. Methods: MELD scores were assessed based on the results of the biochemical laboratory tests using the equation. 9.57 x log(creatinine) + 3.7 x log(bilirubin) + 11.2 x log(INR) +6.43, while the endoscopy in assessing variceal characteristics was demonstrated according to the NIEC scoring system. Results: The etiological factors underlying the cirrhosis were hepatitis B (35.03%), hepatitis C (23.78%), Wilson disease (19.94%), autoimmune disorders (10.48%) and 3.58% with idiopathic etiology. The major clinical manifestations were jaundice (73.91%), followed by ascites (69.30%), gastrointestinal bleeding (34.27%), etc. The patients were classified as per the MELD scoring index into Group A (<18) and Group B (>18). The patients of Group A were significantly high 67.01% (262/391), (p<0.05) than Group B 32.99% (129/391) out of which 39 patients died. Endoscopic findings were also studied according to scoring at the NIEC index and the patients were classified into different risk assessment classes. Conclusion: Being a potentially life-threatening illness, cirrhosis necessitated prompt evaluation and action to minimize the death rate. In individuals with liver cirrhosis, NIEC and MELD scores appeared to be reliable predictors of esophageal varices. Keywords: Ascites; Endoscopy; Gastrointestinal bleeding; Icterus; Risk assessment.
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