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Objective: To observe baseline characteristics, ACLF (Acute on Chronic Liver Failure) grading and mortality in ACLF patients using EASL CLIF CRITERIA. Study Design: Prospective, Observational study. Setting: Medical unit III, ward 7, Jinnah Postgraduate Medical Centre, Karachi. Period: January 2022 to June 2022. Material & Methods: We prospectively analysed data of hospitalised liver cirrhosis patients at a tertiary care hospital in Karachi, Pakistan. The data was analysed in SPSS version 25. Results: There were a total of 43 ACLF patients, with the median age of IQR of 56(47-62) years, out of which 20 (46.5%) patients were male and 23 (53.5%) were females. The most common etiology of liver cirrhosis was hepatitis C 26(60.5%) followed by other etiologies nine (20.9%) and hepatitis B eight (18.6%). The most common precipitating factor was infection 19(44.2%) and the most frequent organ failure (OF) was renal failure (60.5%), followed by cerebral failure (46.5%) and other OFs. There were 24 patients in ACLF grade one, 13 in grade two and six in grade three ACLF. All six patients of ACLF grade three belonged to CTP C (Child-Turcotte-Pugh score) (100%) with 100% mortality. ACLF grade two had nine (69.2%) and ACLF grade one had eight (33.33%) CTP C patients. The in hospital mortality of ACLF was 23%. The median MELD Na of these patients was 28 (23-31), CLIF Consortium Organ Failure score was 9(8-10) and CLIF C ACLF Score was 45 (38-55). Conclusion: Highest mortality was observed in Child Pugh C and ACLF grade three in our patients. Such patients must be closely monitored and referred early for medical management and liver transplantation. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate salicylidene salicylhydrazide (SCS) for any possible toxicological effects on male reproductive system in Albino male BALB/c mice. Study Design: Experimental study. Study Setting: Department of Histopathology, Khyber Medical College Peshawar and Department of Pharmacy, University of Peshawar, Peshawar were utilized for conducting this study. Period: July, 2020 to December, 2020. Material & Methods: Male BALB/c mice were daily administered with SCS at 5, 25, and 50 mg/kg for 7 and 14 days. The body and testes weights were measured and the testes were subjected to histological tissue processing techniques. Results: The extent of testicular toxicity was evaluated by using modified Johnsen scoring system for assessing the level of spermatogenesis, and morphometric analysis by measuring the diameter of the seminiferous tubules, thickness of germinal epithelium, and area of interstitial cells of Leydig. The body and testes weights showed that the various doses of SCS have no substantial effects after 7 and 14 days. The tested doses of SCS did not produce any distinguishable change in the normal histological features of seminiferous tubules and interstitium after 7 days. However, after 14 days, the 50 mg/kg dose of SCS was associated with vacuolization and loosening of germinal epithelium. These mild-to-moderate histopathological aberrations was confirmed from morphometric analysis in this dose group in which a decrease in the seminiferous tubules' diameter and reduction in the thickness of germinal epithelium along with an increase in the interstitial area were observed. Conclusion: These findings concluded that SCS is considered to be relatively safe. [ABSTRACT FROM AUTHOR]

Objectives: To determine the frequency of sexual dysfunction in the patients suffering from chronic liver disease. Period: 1 year from June 2013 to May 2014. Study Design: An observational study. Setting: Asian Institute of Medical Sciences. Methodology: 150 cases of chronic liver disease including patients of both genders at Asian Institute of medical sciences who had suggestive history and signs /symptoms of sexual dysfunction. Results: Study found 51.3% of total patients were suffering with sexual dysfunction. Out of all participating females, 52.2% were affected and among the total male patients 51% males were suffering from sexual dysfunction. Hepatitis C virus (HCV) and Hepatitis B virus (HBV) were positive in 76.7% and 11.3%, respectively. Conclusion: Sexual dysfunction is a common complication in the patients suffering from chronic liver disease. [ABSTRACT FROM AUTHOR]

Objectives: To find out the frequency of hypoglycemia in patients with diabetic nephropathy. Study Design: Cross sectional study. Setting: Emergency department and department of medicine Liaquat university Hospital Hyd/ Jamshoro. Study Period: One year from 01-03-2009 to 28-02-2010. Methodology: Two hundred cases of diabetic nephropathy on the basis of symptoms and signs of hypoglycemia were selected in this study. Results: Out of 200 patients, 102(51%) were males and 98(49%) were females, 10.5% had type-1 diabetes and 89.5% had type-2 diabetes. Most of the patients belonged to 60 to 75 years of age. The average duration of diabetes was 12.20 ± 6.14 years. Out of 23 hypoglycemic patients, 5 (21.7%) had type-1 diabetes in which 4 were male and one was female while 18 (78.3%) had type-2 diabetes in which 10 were male and 8 were female patients. Conclusion: It was observed that hypoglycemia was common in diabetic patients, who developed renal failure due to diabetic nephropathy. [ABSTRACT FROM AUTHOR]

Objectives: To determine the serum lipid profile in patients with chronic HCV infection and correlation between serum lipid levels and liver histology. Material and methods: Descriptive study was carried out in Medical Unit I of Liaquat University Hospital Jamshoro Hyderabad, from September 2007 to August 2009. Convenience sampling was used and 30 patients were selected. Positive PCR test for HCV, non diabetic patients and non cirrhotic patients were included in this study. All the patients were selected from the medical OPD. Clinical examination performed and then blood tests were done. Serum lipid profile were determined in all participants after an overnight fast of 12 h. TC, TG, and HDL-C was measured enzymatically with commercial kits (Olympus System Reagent, Hamburg, Germany) by the use of an automated analyzer. The body mass index (BMI) was calculated in accordance with the formula of weight (kg) divided by height2 (m2). Selected patients were called in the ward and biopsy was done via Trucut needle and the specimen was fixed in formalin. The biopsies were used to calculate the degree of steatosis (0-3) and fibrosis by METAVIR score. Results: A total of 30 patients were selected for this study. Out of these 19 were males and 11 females. The patients were divided in three groups. Patients with chronic HCV infection were found to have significantly lower levels of serum TC, HDL-C and LDL-C than normal adults values. Steatosis was present in significant number of patients (36.67%). However, steatosis was not correlating with fibrosis (p>0.005). Conclusions: Hypolipoproteinemia and steatosis are important factors which are associated with chronic hepatitis C. [ABSTRACT FROM AUTHOR]

Aims and Objectives: We evaluated whether HBV +ve and HCV +ve patients are at high risk for developing drug induced hepatitis than control subjects during treatment for tuberculosis with standard short course regimens. Study design: Observational cohort study. Place and duration: This study was conducted at Department of Medicine, Liaquat University of Medical and Health Sciences Jamshoro from May 2008 to May 2011. Material and Methods: All newly diagnosed active tuberculosis patients were included in the study population and they were further screened for hepatitis B surface antigen and HCV antibodies. All patients were divided into three groups. One having no co-infection with hepatitis B and Hepatitis C and was taken as control group, second group was co-infected with hepatitis B and third was co-infected with hepatitis C. short course anti tuberculous regimen was started and patients were followed for six months. Results: One hundred and twenty eight tuberculous patients were divided into three groups. 92 in control groups without any co-infection with hepatitis B and C, 10 were HBV +ve and 26 were HCV +ve. During follow up 24 developed drug induced hepatitis, 8(38.33%, n = 24) in control group, 2(8.33%, n = 24) in hepatitis B group and 14(58.33%, n = 24) in hepatitis C group. Conclusions: These findings suggest that treatment for tuberculosis in HCV seropositive patients is a risk factor for the development of hepatitis exacerbation and HBV seropositive patients shows no any increased risk of hepatitis exacerbation. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of upper GI bleeding and its predicting factors and esophageal varices in the patients with liver cirrhosis disease admitted at medicine ward of Isra university hospital. Design: Prospective and observational study. Setting: Isra university hospital. Period: March 2012 to August 2012 (six months). Methods: Containing 100 patients, mean age was 45.8, and all the patients with cirrhosis disease were included in this study with liver cirrhosis disease. All patients were under went endoscopy and Frequency of upper GI bleeding and varices presentation and classification according to grade were noted. Results: All the 100 patients were selected on the basis of presenting liver cirrhosis disease. Male were more found than the female with the mean age 45.8. Mostly cirrhotic patients were found with HCV positive and upper GI bleeding were noted in (40%) of the cases. With the endoscopic finding mostly patients were noted in ll-lll grad of esophageal varices and according to child pug classification majority of patients was noted in class "C" In addition, thrombocytopenia and red wale markings along with the presence of large sized varices were associated with the presence of esophageal varices. Conclusions: In the conclusion of this study we found majority of the cirrhotic patients with HCV, Esophageal varices and thrombocytopenia are the important factors of upper GI bleeding. Knowledge and etiology of this manuscript may helpful in the prevention of oesophageal varices and upper GI bleeding. [ABSTRACT FROM AUTHOR]