Cirrhosis of liver is a risk factor for gallstone disease

Abstract

INTRODUCTIONGallstones are a common clinical finding in the general population. Various ultrasound survey studies have shown prevalence rate of 10-15% in adult European, and of 3-5% in African and Asian populations.1 Study by Unisa S et al in northern India showed gall stones prevalence of 4.15% in healthy adults >30years of age (5.59% in female and 1.99% in males).2 More than 80% of gallstone carriers are asymptomatic, but about 1-2% per year will develop complications and needs surgery. [3][4][5] The prevalence of gallstones is found to be high in cirrhotic patients as compared with the general population in various studies mostly in western countries. 6Cause of this high prevalence of gallstones in cirrhotic patients is not known. Whether cirrhosis per se or presence of portal hypertension influences this increased frequency is unknown. ABSTRACTBackground: Gallstones are common clinical finding in general population. Mean prevalence rate in Indian population is 4-5%. The prevalence of gallstones is found to be high in cirrhotic patients compared to the general population in some western studies. Cause of this increased prevalence however is not known. Aim of the study was to evaluate prevalence of the gall stones in the cirrhotic patients, assess risk factors in cirrhotic patients and clinical presentation. Methods: This is the cross sectional observational study, included cirrhotic patients (compensated or decompensated). Risk factors for gallstone formation (age, gender and diabetes mellitus), characteristics of liver cirrhosis (etiology, Child Turcotte Pugh class, hypersplenism and varices) and clinical presentation were assessed in all cirrhotic patients with gallstones. Results: 336 patients with liver cirrhosis are included in this study; 201 (59.80%) male and 135 (40.2%) female. Mean age of the patients is 44.95±13.1 years. Overall prevalence of gall stones was 12.8% (43/336). Out of 43 patients, 23 (53.5%) are male and 20 (46.5%) are female. As child status progresses from A to B to C, prevalence of gall stone increases, with 60.46% (26/43) of gall stones occurring in the patients with CTP class C. Only 8 (18.6%) patients had gallstone related symptoms while rests were asymptomatic. 5 (11.6%) had concurrent CBD stones. Cholecystectomy was possible in only 2 patients with symptomatic gallstones. Conclusions: The prevalence of gall stones in cirrhotic is higher than general population which increases with the severity of liver cirrhosis. Most cirrhotic patients are asymptomatic for gallstones.

Emerging green synthetic routes for thiazole and its derivatives: Current perspectives

“…[40] This approach promotes sustainable and efficient chemical processes, optimizing resource utilization and supporting environmentally friendly practices in chemistry. Shirole et al [41] designed the neat synthetic protocol for 2-[3-(4aryl)-1-phenyl-1H-pyrazol-4-yl]benzo [d]thiazole and its derivatives via Vielsmeier Haack formylation of substituted 1,3-diaryl pyrazole aldehydes and 2-amino benzene thiol in the presence of ionic liquid 1-butyl-3-methylimidazolium tetrafluoroborate ([bmim]BF 4 ) as a catalyst through the conventional method and green methods such as microwave irradiation and ultrasound. Among all methods, microwave conditions gave an excellent yield of 82%-94% at 210 W in 3-5 min.…”

“…T A B L E 1 Outline for microwave-assisted synthesis of thiazole derivatives. --3-5 min 82-94 [41] -PEG-400 and water 80 28-34 min 84-89 [42] -Water 130 15 min 52-89 [43] ---0.5-2.91 min 70-80 [44] Chitosan-MgO nanocomposite Dioxane -30-40 min 80-96 [45] SiO 2 /active carbon Diethyl ether -5 min 73-98 [46] -Water 90 6-9 min 80-89 [47] -Water 110 7-10 min 89-92 [48] -Water 110 7 min 89 [49] -Dry toluene 110 12 min 16-64 [50] Silica gel --3-5 min 70-88 [51] -Ethanol 60-120 2-10 min 64-76 [52] -DMF 40 2 h 55-92 [53] --150 4-8 min 22-86 [54] Acetic acid --3 min 92 [55] -Toluene -6-8 min 64-82 [56] Zeolite 5A --0.5-1 min 89-96 [57] Montmorillonite K-10 clay -130 2-5 min 89-96 [58] Montmorillonite K-10 clay --3 min 85-92 [58] Montmorillonite K-10 clay --2.5-6 min 60-75 [59] Montmorillonite K-10 clay --3-5 min 54-74 [59] -Ethanol -3.5 min 82 [60] --200 10 min 98 [61] K 2 CO 3 DMF 130 10 min 61-90 [62] GAA Ethanol 120 2-4 min 88-95 [63] AcOH Ethanol 87 4-6 min 82-92 [64] -PEG-400 -5 min 96-97 [65] Abbreviations: AcOH, acetic acid; DMF, dimethylformamide; GAA, glacial acetic acid; PEG-400, polyethylene glycol-400.…”

Comparative Study Gallbladder Contractility Index Using Ultrasound in Patients with and without Liver Cirrhosis

“…10 The formation of gallstones in patients with liver cirrhosis is due to several factors; one of them is due to bile stasis caused by the decrease in gallbladder contractility index. 11 The decrease in the gallbladder contractility index is due to the humoral, hypoalbuminemia, and also neurological disorders. Neurological disorders in patients with liver cirrhosis are in the form of neuropathy.…”

“…It is contrary to research conducted by Kul et al, 12 suggesting that there was an increase in gallbladder contractility index in patients with liver cirrhosis compared with healthy control. Shirole et al 11 suggest that patients with liver cirrhosis have a higher prevalence of the occurrence of gallstones than in a healthy population. One of the causes is a decrease in the gallbladder contractility index.…”