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Journal of Clinical and Experimental Hepatology

Nidhi Prabhakar, Naveen Kalra, Arunanshu Behera, Ashim Das, Anupam Lal, Radha Krishan Dhiman, Niranjan Khandelwal
No abstract text is available yet for this article.
December 2017: Journal of Clinical and Experimental Hepatology
Suvradeep Mitra, Saumya Gupta, Divya Dahiya, Uma N Saikia
Primary sarcomatous hepatocellular carcinoma (PSHCC) is a rare and aggressive variety of hepatocellular carcinoma (HCC). The recent evidence suggests that anticancer therapy promotes the dedifferentiation of the carcinomatous component and is largely responsible for this aggressive variant of HCC. However, in the absence of any anticancer therapy, occurrence of PSHCC is extremely rare. Herein, we present a rare case report of a 65 year old male patient, with a hepatitis B positive status, presenting with PSHCC without any history of anticancer therapy...
December 2017: Journal of Clinical and Experimental Hepatology
Madhusudhanan Jegadeesan, Neerav Goyal, Subash Gupta
Safe performance of donor hepatectomy is crucial for sustainability of a living donor liver transplantation (LDLT) program. Middle hepatic vein (MHV) is always encountered during parenchymal transection irrespective of right or left donor hepatectomies. Here we present a safe and effective technique for tackling MHV bleed during LDLT from a single centre experience.
December 2017: Journal of Clinical and Experimental Hepatology
Vikrant Sood, Bikrant B Lal, Suman Lata, Archana Rastogi, Seema Alam
Cholemic or bile cast nephropathy is an under-reported entity characterized by acute renal dysfunction in patients with hepatic insult. Limited literature is available regarding its clinical presentation, pathogenesis and prognosis. We hereby present a pediatric case who presented with acute on chronic liver failure with renal dysfunction secondary to cholemic nephropathy.
December 2017: Journal of Clinical and Experimental Hepatology
Adnan Naim, Qiuwei Pan, Mirza S Baig
Matrix metalloproteinases (MMPs) are proteinases capable of degrading components of the extracellular matrix and numerous nonmatrix proteins. MMPs along with tissue inhibitors of MMPs, have been implicated in the pathogenesis of liver diseases. Although, the precise mechanism-of-actions of MMPs in various liver related disorders is largely unknown, however, data from diverse experimental models indicate that these proteinases influence cellular activities including proliferation and survival, gene expression, as well as multiple aspects of inflammation...
December 2017: Journal of Clinical and Experimental Hepatology
Narendra S Choudhary, Sanjiv Saigal, Rinkesh K Bansal, Neeraj Saraf, Dheeraj Gautam, Arvinder S Soin
While antibody mediated hyper-acute vasculitic rejection is rare in liver transplant recipients, acute and chronic rejection have clinical significance. The liver allograft behaves differently to other solid organ transplants as acute rejection generally does not impair graft survival and chronic rejection (CR) is uncommon. The incidence of acute and chronic rejection has declined in current era due to improved immunosuppressive regimens. Acute rejection generally improves with steroid boluses and steroid resistant rejection is uncommon...
December 2017: Journal of Clinical and Experimental Hepatology
Anil C Anand
As the cirrhosis progresses, development of complication like ascites, hepatic encephalopathy, variceal bleeding, kidney dysfunction, and hepatocellular carcinoma signify increasing risk of short term mortality. Malnutrition and muscle wasting (sarcopenia) is yet other complications that negatively impact survival, quality of life, and response to stressors, such as infection and surgery in patients with cirrhosis. Conventionally, these are not routinely looked for, because nutritional assessment can be a difficult especially if there is associated fluid retention and/or obesity...
December 2017: Journal of Clinical and Experimental Hepatology
Henry N Luma, Servais A F B Eloumou, Cécile Okalla, Olivier Donfack-Sontsa, Ruth Koumitana, Agnes Malongue, Georges B Nko'Ayissi, Dominique N Noah
Background/Aims: Hepatitis B virus (HBV) and hepatitis D virus (HDV) coinfection is associated with more severe liver disease than HBV alone. More knowledge on the epidemiology and clinical impact of HDV-infected individuals is needed in Cameroon.We aimed at determining the frequency of anti-HDV antibody testing in hepatitis B surface antigen (HBsAg) positive patients, the proportion of anti-HDV positivity, and the characteristics of anti-HDV positive compared to anti-HDV negative patients in a tertiary hospital setting in Cameroon...
December 2017: Journal of Clinical and Experimental Hepatology
Akash Shukla, Amit Gupte, Vedant Karvir, Prashant Dhore, Shobna Bhatia
Aims: The natural history of portal cavernoma cholangiopathy (PCC) in patients with significant biliary obstruction (SBO) who cannot undergo shunt surgery, is not known. We therefore, analyzed data of patients of extra-hepatic portal venous obstruction (EHPVO) with PCC. Methods: Prospectively recorded details of 620 (age 21.2 [11.4] years; 400 [65%] males) patients with primary EHPVO were reviewed. Outcomes (hepatic decompensation/mortality) of patients with PCC and SBO without shuntable veins were noted at follow up of 7 [4-11] years...
December 2017: Journal of Clinical and Experimental Hepatology
Mahek Shah, Soumya Patnaik, Obiora Maludum, Shantanu Patil, Toni Anne De Venecia, Vincent M Figueredo
Background: Patients with cirrhosis who develop Spontaneous Bacterial Peritonitis (SBP) suffer from cirrhotic cardiomyopathy which is characterized by impaired contractility in response to stress despite a relatively normal resting cardiac output. We hypothesized that electrocardiographic and echocardiographic information would help prognosticate patients developing SBP in addition to existing scoring systems. Methods: Cirrhotic patients admitted to Einstein Medical Center from 01/01/2005 to 6/30/2012 for SBP, and did not receive a transplant within one year, were included...
December 2017: Journal of Clinical and Experimental Hepatology
Anna Wang, Dorothy Yu, Yuewen Gong, Jessie Garber, Gerald Y Minuk
Background/Aims: Primary sclerosing cholangitis (PSC) is a chronic, progressive hepatobiliary disorder characterized by extensive fibrosis and stricturing of the intra- and/or extra-hepatic bile ducts: Previous studies have documented low phosphatylcholine (PC) concentrations in PSC bile. The aim of this study was to determine whether low PC levels in bile facilitate toxic bile acid induced injury of biliary tract epithelial cells resulting in enhanced transforming growth factor-beta (TGF-β) expression and increased collagen synthesis by myofibroblasts...
December 2017: Journal of Clinical and Experimental Hepatology
Ayaskanta Singh, Sasmita Parida, Jimmy Narayan, Preetam Nath, Pradeep K Padhi, Girish K Pati, Prasanta K Parida, Chudamani Meher, Omprakash Agrawal, Shivaram P Singh
Background and aims: With the rising prevalence of obesity and metabolic syndrome, nonalcoholic fatty liver disease (NAFLD) has become the most common liver disorder in both developed and developing nations. Several studies on NAFLD have described waist circumference, a surrogate marker of visceral fat accumulation and waist height ratio as a better screening tool for NAFLD and metabolic syndrome than body mass index (BMI). We conducted this study to assess simple abdominal obesity indices as a predictor of NAFLD and determine the appropriate cut-off levels with reference to NAFLD...
December 2017: Journal of Clinical and Experimental Hepatology
Mayank Jain, Joy Varghese, Tom Michael, Chandan Kumar Kedarishetty, Balajee G, Subramanian Swaminathan, Jayanthi Venkataraman
Background: End stage liver disease leads to immune dysfunction which predisposes to infection. There has been a rise in antibiotic resistant infections in these patients. There is scanty data f from India or idea regarding the same. Aim of the study: The present study was undertaken to determine the type of infection acquired and the prevalence of antibiotic resistant infections in cirrhotic patients at a tertiary referral center in South India. Materials and methods: In this retrospective study, all consecutive cirrhotic patients hospitalized between 2011 and 2013 with a microbiologically-documented infection were enrolled...
December 2017: Journal of Clinical and Experimental Hepatology
Narendra S Choudhary, Sanjay Saran Baijal, Sanjiv Saigal, Amit Agarwal, Neeraj Saraf, Rohit Khandelwal, Vaibhav Jain, Anubhav Harish Khandelwal, Abhay Kapoor, Deepak Jain, Smurti R Misra, Rajesh Puri, Randhir Sud, Arvinder S Soin
Background: Large portosystemic shunts (PSSs) may lead to recurrent encephalopathy in patients with cirrhosis and embolization of these shunts may improve encephalopathy. Material and methods: Five patients underwent balloon-occluded retrograde transvenous obliteration (BRTO) or plug-assisted retrograde transvenous obliteration (PARTO) of a large PSS at our center in last 2 years for recurrent hepatic encephalopathy (HE) at a tertiary care center at north India...
December 2017: Journal of Clinical and Experimental Hepatology
Anantha Nuthalapati, Nicholas Schluterman, Anuj Khanna, Deborah Greenberg, Paul J Thuluvath
Background/aims: The mortality of hospitalized patients for complications of cirrhosis is very high. We examined the independent predictors of mortality, particularly the impact of increments in creatinine, in 339 consecutive patients (636 admissions) who were admitted for complications of cirrhosis. Methods: Clinical characteristics, biochemical parameters including serum creatinine levels at various time intervals, and mortality data were recorded for all admissions...
December 2017: Journal of Clinical and Experimental Hepatology
Vaibhav Somani, Deepak Amarapurkar, Apurva Shah
Background and aims: Conventional coagulation tests (CCTs) in patients with cirrhosis only assess procoagulant factors and are poor predictors of bleeding risk. In spite of this knowledge, they are routinely used prior to invasive procedures, and attempts are made to correct these abnormalities before invasive procedures. These practices are not supported by the evidence and are harmful to the patients. Methods: This prospective study included 150 patients of cirrhosis undergoing invasive procedures...
December 2017: Journal of Clinical and Experimental Hepatology
Ashish Kumar, Praveen Sharma, Shrihari A Anikhindi, Ritesh Prajapati, Rachit Agarwal, Bhupendra Sharma, Naresh Bansal, Vikas Singla, Anil Arora
Background: Non-selective beta-blockers (NSBBs) are recommended for prophylaxis of first variceal bleeding in patients of cirrhosis with large esophageal varices. However, the data is conflicting whether NSBBs can also prevent growth of small esophageal varices to large size. Aim: To perform a meta-analysis of the randomized clinical trials comparing NSBBs with placebo for prevention of development of large esophageal varices in patients of cirrhosis with small esophageal varices...
December 2017: Journal of Clinical and Experimental Hepatology
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
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
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
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