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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]

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]