Esophageal Varices and Associated Factors in Cirrhotic Patients With Hepatitis C

Abstract

Background: Infection with hepatitis C virus is reported to have infected almost 71 million people worldwide. This study was done to assess the frequency and associated factors leading to oesophageal varices in patients presenting with hepatitis C related liver cirrhosis. Methods: A cross-sectional study was conducted at Patel Hospital, Karachi, Pakistan from 9th May to 5th October 2019. Patients of either gender having age >20 years presenting with HCV related liver cirrhosis, and Child Pugh class A, B and C were consecutively enrolled in the study. Data on variables like: age, gender, Childs Pugh Score (A/B/C), smoking status, laboratory characteristics like hemoglobulin (Hb), TLC, platelets, serum albumin level, cholesterol, alkaline phosphate (ALK), alkaline transaminase (ALT), ascites and presence of oesophageal varices was recorded and analysed using SPSS-21.0. Results: Out of 167 patients, mean age was 44.86±14.74 years. Eight-nine (53.3%) of the patients were males. The mean duration of cirrhosis was 5.78±1.10 months. Thrombocytopenia was observed in majority (n=130, 77.8%) of the patients. There were 33 (19.8%) patients with Child Pugh score A while Child-Pugh score B and C was found in 67 (40.1%) each. The frequency of oesophageal varices was 141 (84.4%). A significantly higher proportion of oesophageal varices were found among thrombocytopenic patients (p<0.001), ascites (p-0.024), and having “C” Child-Pugh score (p 0.012). Conclusion: Oesophageal varices were found in a considerable proportion. Thrombocytopenia, ascites and Child-Pugh class C were found as leading contributing factors to oesophageal varices.

Prevalence of stunting among under-five children in refugee and internally displaced communities: a systematic review and meta-analysis

“…The baseline characteristics of each article were analyzed and summarized (participants, study design, country of origin of refugees, and outcome) in Table 3 . Of the 30 studies, 29 were cross-sectional ( 14 – 16 , 29 – 54 ), while one record-based study was found ( 13 ). The study period ranged from 2005 to 2022, with 22 studies conducted among the refugee population and eight studies conducted among internally displaced population.…”

“…The study period ranged from 2005 to 2022, with 22 studies conducted among the refugee population and eight studies conducted among internally displaced population. In terms of geographical distribution, the majority (12 out of 30) of the refugees originated from the African region ( 15 , 32 , 34 – 37 , 39 , 45 , 47 , 49 , 50 ), followed by the Eastern Mediterranean Region (eight out of 30) ( 16 , 29 – 31 , 33 , 52 – 54 ) and South-East Asian region of WHO member states (nine out of 30) ( 14 , 38 , 40 – 44 , 48 , 51 ). One study was multicountry research ( 13 ), where the refugee population included were from Africa, South, East and Central Asia, and the Pacific African countries.…”

“…One study was multicountry research ( 13 ), where the refugee population included were from Africa, South, East and Central Asia, and the Pacific African countries. In eight studies, participants were internally displaced, out of which four studies had population groups from the African region (Nigeria, Uganda, Burkina Faso, and Cameroon) ( 15 , 32 , 34 , 50 ), and four studies had population groups from South-East Asian (Srilanka, Pakistan, Bangladesh, and Myanmar) ( 14 , 40 , 42 , 44 ). Overall, 30 studies, including 31,565 under-five refugee and internally displaced children, were found eligible for the meta-analysis.…”

Triplex PCR Amplification of Different Melting Profile Amplicons for Simultaneous Detection of HCV, HBV, and HIV-1 Genomes in a Single Tube

“…The false negative may result due to the inability to detect low viral load into samples [3] or due to body defects to produce antibodies in immune suppressed patients and those with current HIV infection [4]. On the other hand, the false positive may result due to some interfering medications received by the patient such as immunoglobulin therapy [5], patients with rheumatoid arthritis [6], patients who recovered from a previous infection [7], or due to antibody cross reactivity of similar viral antigens [4]. Therefore, antibody-targeted serological tests cannot differentiate between active or past-infected patients.…”

“…Despite the cost, the diagnostic methods based on the detection of viral genomes into the samples are more effective and accurate than serological methods [7]. In particular, reverse transcription polymerase chain reaction (RT-PCR) methodologies are easy to be established into laboratories with high sensitivity, automation facility, and low risk of contamination whether during reactions preparation or post-operation chemical disposal [9].…”