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Journal of Clinical and Experimental Hepatology

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https://www.readbyqxmd.com/read/28970716/autoimmune-hepatitis-diagnostic-dilemma-when-it-is-disguised-as-iron-overload-syndrome
#1
Gyanendra K Acharya, Hung-I Liao, Simona Frunza-Stefan, Ronakkumar Patel, Moe Khaing
Elevated serum ferritin level is a common finding in iron overload syndrome, autoimmune and viral hepatitis, alcoholic and nonalcoholic fatty liver diseases. High transferrin saturation is not a common finding in above diseases except for iron overload syndrome. We encountered a challenging case of 73-year-old female who presented with yellowish discoloration of skin, dark color urine and dull abdominal pain. Initial laboratory tests reported mild anemia; elevated bilirubin, liver enzymes, and transferrin saturation...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970715/norethisterone-related-drug-induced-liver-injury-a-series-of-3-cases
#2
Narendra S Choudhary, Vijay Bodh, Shraddha Chaudhari, Neeraj Saraf, Sanjiv Saigal
Drug induced liver injury (DILI) is uncommon and severe forms are associated with significant morbidity and mortality. Female sex hormones (estrogens and progestogens) related DILI generally occur with estrogen component. Progesterone component related DILI are infrequently reported. Norethisterone is commonly used drug in gynecologic practice to prevent excess per vaginal bleeding. We report 3 cases of Norethisterone related DILI manifesting as significant rise of transaminases. All of these patients took Norethisterone for prolonged periods and improved completely after withdrawal of drug...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970714/toward-a-better-definition-of-acute-on-chronic-liver-failure
#3
REVIEW
Ajay Duseja, Shivaram P Singh
Acute-on-chronic liver failure (ACLF) has been defined differently in the East and West. The definitions given by Asian Pacific association for the study of liver (APASL) and American association for the study of liver (AASLD) and European association for the study of liver (EASL) working group have fundamental deficiencies and contradictions and do not encompass all patients with ACLF seen in the East and West. Although the World Gastroenterology Organisation (WGO) working party attempted to provide an improved definition but this too is not appropriate...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970713/chronic-hepatitis-c-do-generics-work-as-well-as-branded-drugs
#4
REVIEW
Madhumita Premkumar, Gagandeep S Grover, Radha K Dhiman
India has a large share of the hepatitis C virus (HCV) burden of the world. Unsafe medical practices and blood transfusions are the leading modes of transmission of HCV in India. The commonest HCV genotype in India is genotype 3 followed by genotype 1. While directly acting antivirals (DAAs) agents have become available at reasonable rates in India, cost of therapy remains a major barrier for control of HCV in India. Generic DAAs have been proven to be cost-saving in prior studies. We examined data from various studies in India and elsewhere using generic DAAs, and evaluated whether they are equally efficacious as the branded drugs...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970712/liver-transplantation-for-acute-on-chronic-liver-failure
#5
Narendra S Choudhary, Neeraj Saraf, Sanjiv Saigal, Arvinder S Soin
BACKGROUND: Acute-on chronic liver failure (ACLF) is defined as acute insult on previous liver disease that causes sudden worsening of liver functions. METHODS: ACLF is characterized by high incidence of organ failure and prognosis is remarkably worse than patients with cirrhosis. Incidence of organ failures is very high despite best medical care and timely liver transplant before development of multi organ failure is associated with good survival rates. RESULTS: At present, there are no reliable score or ways to correctly identify patients who are going to recover from patients who will need transplantation...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970711/is-portal-venous-pressure-or-porto-systemic-gradient-really-a-harbinger-of-poor-outcomes-after-living-donor-liver-transplantation
#6
Amol Vijay Kanetkar, Dinesh Balakrishnan, Sudhindran Sudhindran, Puneet Dhar, Unnikrishnan Gopalakrishnan, Ramachandran Menon, Othiyil Vayoth Sudheer
BACKGROUND: Portal hyperperfusion as a cause of small for size syndrome (SFSS) after living donor liver transplantation (LDLT) remains controversial. Portal venous pressure (PVP) is often measured indirectly and may be confounded by central venous pressure (CVP). METHODS: In 42 adult cirrhotics undergoing elective LDLT, PVP was measured by direct canulation of portal vein and porto systemic gradient (PSG) was obtained after subtracting CVP from PVP. None underwent portal inflow modulation...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970710/transient-elastography-fibroscan-in-patients-with-non-cirrhotic-portal-fibrosis
#7
Praveen Sharma, Rachit Agarwal, Shashi Dhawan, Naresh Bansal, Vikas Singla, Ashish Kumar, Anil Arora
BACKGROUND: Non-cirrhotic portal hypertension (NCPH) is a common cause of variceal bleed in developing countries. Transient elastography (TE) using Fibroscan is a useful technique for evaluation of fibrosis in patients with liver disease. There is a paucity of studies evaluating TE in patients with Non-cirrhotic portal fibrosis (NCPF) and none in Asian population. Aim of this study was to evaluate role of TE in NCPF. METHODS: Retrospective data of consecutive patients of NCPF as per Asian pacific association for the study of liver (APASL) guidelines were noted...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970709/comparison-of-contrast-enhanced-ultrasound-with-contrast-enhanced-computed-tomography-for-the-diagnosis-of-hepatocellular-carcinoma
#8
Sandeep Moudgil, Naveen Kalra, Nidhi Prabhakar, Radha Krishan Dhiman, Arunanshu Behera, Yogesh Kumar Chawla, Niranjan Khandelwal
BACKGROUND/AIMS: The most common primary malignant tumor of liver is hepatocellular carcinoma (HCC). The highest risk of developing HCC is seen in patients of cirrhosis. Ultrasound is used for surveillance in these patients. This study evaluates the role of contrast enhanced ultrasound (CEUS) in the diagnosis of HCC and compares CEUS to contrast enhanced computed tomography (CECT). MATERIALS AND METHODS: This prospective study included 22 patients with cirrhosis and suspected to have HCC on the basis of gray scale ultrasound or elevated Alpha-fetoprotein...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970708/comparative-study-of-community-acquired-and-nosocomial-spontaneous-bacterial-peritonitis-and-its-variants-in-150-patients
#9
Girisha Balaraju, Mallikarjun Patil, Adarsh C Krishnamurthy, Dheeraj Karanth, Harshad Devarbhavi
BACKGROUND: Nosocomial acquisition of spontaneous bacterial peritonitis (SBP) is debated as having a different microbial etiology and prognosis. Identification of clinical, laboratory predictors of mortality and appropriate empirical antimicrobial selection is necessary to prevent early mortality and morbidity. We aimed to find the clinical and bacteriological profile in nosocomial and community acquired SBP and its variants, and the predictors of mortality. MATERIAL AND METHODS: One hundred and fifty patients with 162 discrete episodes of different types of SBP were analyzed...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970707/role-of-human-wharton-s-jelly-derived-mesenchymal-stem-cells-wj-mscs-for-rescue-of-d-galactosamine-induced-acute-liver-injury-in-mice
#10
Raghu Ramanathan, Secunda Rupert, Sakthivel Selvaraj, Jeswanth Satyanesan, Rosy Vennila, Surendran Rajagopal
BACKGROUND/AIM: Mesenchymal stem cells (MSCs) are multipotent precursor cells having self-renewal ability making them a candidate for use in regenerative medicine. Acute liver injury results in sudden loss of hepatic function leading to organ failure. Liver transplantation is often required to salvage patients with acute liver failure. Due to shortage of organs, identification of alternate method is the need of the hour. In view of this, an attempt has been made to check the regenerative ability of WJ-MSCs (wharton's jelly derived MSC) in mice models for acute liver injury...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970706/brain-microstructural-correlates-of-cognitive-dysfunction-in-clinically-and-biochemically-normal-hepatitis-c-virus-infection
#11
Ajay Kumar, Amar Deep, Rakesh K Gupta, Virendra Atam, Samir Mohindra
BACKGROUND/AIMS: This study examined correlates of the brain's neurocognitive performance among clinically and biochemically normal adult patient with hepatitis C virus (HCV). We hypothesized that anti-HCV positive individuals would demonstrate structural brain abnormalities and neurocognitive dysfunction as well as the changes in cell component and extracellular space in the white matter regions of brain in asymptomatic HCV infection by using diffusion tensor tractrography (DTT) metrics...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970705/characterization-of-cerebral-edema-in-acute-on-chronic-liver-failure
#12
Tarana Gupta, Radha K Dhiman, Chirag K Ahuja, Swastik Agrawal, Madhu Chopra, Naveen Kalra, Ajay Duseja, Sunil Taneja, Niranjan Khandelwal, Yogesh Chawla
BACKGROUND AND AIMS: The nature of cerebral edema in acute-on-chronic liver failure (ACLF) is not well studied. We aimed to characterize cerebral edema in ACLF using magnetization transfer ratio (MTR) and diffusion tensor imaging (DTI). METHODS: Forty-six patients with cirrhosis and acute decompensation were included. Patients were divided into groups A (no cerebral failure, n = 39) and B (cerebral failure, n = 7). Group A was subdivided into no-ACLF (n = 11), grade 1 (n = 10), grade 2 (n = 9) and grade 3 (n = 9) ACLF as per CANONIC study...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970704/hemophagocytic-lymphohistiocytosis-masquerading-as-acute-liver-failure-a-single-center-experience
#13
Nitin Jagtap, Mithun Sharma, Gupta Rajesh, Padaki Nagaraja Rao, Sekaran Anuradha, Manu Tandan, Mohan Ramchandani, Duvvuru Nageshwar Reddy
BACKGROUND/AIM: Hemophagocytic lymphohistiocytosis (HLH) is a potentially life-threatening disorder of extreme inflammation and unregulated immune response which require prompt recognition and early introduction of definitive therapy. HLH can present with wide range of hepatic dysfunction ranging from mild elevation of transaminases to liver failure. This study is carried out to describe the clinical and laboratory presentation of HLH. METHODS: Patients who were diagnosed with HLH between January 2013 and December 2015 were retrospectively included in this study...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970703/in-situ-splitting-of-the-cadaver-liver-for-two-adult-recipients-by-ldlt-technique
#14
Nilesh S Patil, Neerav Goyal, Shishir Pareek, Mohammed Nayeem, Subhash Gupta
BACKGROUND: To expand the donor pool, split liver transplantation is conventionally performed for one adult and one pediatric recipient. Application of this technique for two adult recipients can produce remarkable impact on the waiting list. Proper donor and recipient selection is crucial for the favorable outcome following full-right and full-left liver split. Right lobe adult to adult living donor liver transplantation (LDLT) is essentially a full right and full left split. However, LDLT techniques have not been used for full right and left split...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970702/generic-direct-acting-antivirals-in-treatment-of-chronic-hepatitis-c-infection-in-patients-of-thalassemia-major
#15
Aabha Nagral, Smita Sawant, Nishtha Nagral, Pathik Parikh, Priya Malde, Rashid Merchant
BACKGROUND: There is no published data of treating hepatitis C in thalassemia major patients with any sofosbuvir based direct acting antivirals (DAAs). This study was performed to determine the efficacy and safety of these regimes using generic drugs in the thalassemia major population. METHODS: In this observational study, 902 patients of thalassemia major from five transfusion centres in Mumbai were screened for HCV antibody. Of the 120 positive patients, HCV RNA was detected in 50%...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28970701/sofosbuvir-and-ribavirin-for-24-weeks-is-an-effective-treatment-option-for-recurrent-hepatitis-c-infection-after-living-donor-liver-transplantation
#16
Anil C Anand, Shaleen K Agarwal, Hitendra K Garg, Sudeep Khanna, Subhash Gupta
BACKGROUND: Recurrent hepatitis C virus (HCV) has been a serious problem after liver transplantation (LT). We report our experience of 24-week therapy with sofosbuvir (SOF) and ribavirin (RBV) in post-LT recurrent HCV in living donor liver transplantation (LDLT) setting in South Asia. METHODS: Data from all patients treated for post-transplantation HCV recurrence in a single center were analyzed. Treatment regimen was 24 weeks of SOF 400 mg daily and RBV (starting at 800 mg daily, increased as tolerated)...
September 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28663684/what-is-the-risk-of-graft-reinfection-in-case-of-liver-transplantation-for-patients-with-acute-hev-or-hav-infection
#17
Anil C Anand, Neerav Goyal, Hitendra K Garg, Shaleen K Agarwal, Sudeep Khanna, Subhash Gupta
No abstract text is available yet for this article.
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28663683/epigastric-pain-in-a-patient-with-cirrhosis
#18
Ying C Lee, Yi C Yeh, Yi Y Chiou, Chieu A Liu, Nai C Chiu
•Classic images of Schistosomiasis.•Pathology proved case.•Impressive educational case.
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28663682/hepatitis-e-virus-induced-acute-liver-failure-with-scrub-typhus-coinfection-in-a-pregnant-woman
#19
Nipun Verma, Megha Sharma, Manisha Biswal, Sunil Taneja, Nitya Batra, Abhay Kumar, Radha K Dhiman
Coinfections contribute significantly to diagnostic challenges of acute febrile illnesses, especially in endemic areas. The confusion caused by overlapping clinical features impedes timely management. Herein, we report an unusual, previously unreported case of a pregnant woman suffering from a coinfection of scrub typhus and hepatitis E virus. A 25-year-old, 31-week pregnant woman presented with jaundice for 5 days and altered sensorium for 2 days. She had features of both viral acute liver failure (ALF) and tropical infections mimicking ALF, including hyperbilirubinemia, coagulopathy, anemia, thrombocytopenia, intravascular hemolysis, and hepatosplenomegaly...
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28663681/living-donor-liver-transplantation-for-acute-liver-failure-with-fixed-pupils-are-we-fixed
#20
Shweta A Singh, Anshuman Singh, Viniyendra Pamecha, Chandra Kant Pandey, Shiv Kumar Sarin
Living donor liver transplantation (LDLT) is fraught with the social and ethical dilemma of excising a part of the liver from a healthy first-degree relative. When LDLT is to be done for an acute liver failure (ALF), identification of a suitable donor is a race against time. Herein, we describe a unique challenge faced by the transplant team of whether to proceed with donor hepatectomy from a son, when the recipient (HBV-related ALF) developed non-reactive fully dilated pupils on the table, prior to beginning the surgery...
June 2017: Journal of Clinical and Experimental Hepatology
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