{"title":"Liver Cirrhosis & Hepatocellular Carcinoma in Chronic Hepatitis B: Role of Hepatic Vena Cava Syndrome in the Pathogenesis","authors":"S. Shrestha","doi":"10.30654/mjgh.10019","DOIUrl":"https://doi.org/10.30654/mjgh.10019","url":null,"abstract":"Background: Chronic hepatitis B (CHB) is highly prevalent in some Afro-Asian countries and is associated with high incidence of liver cirrhosis (LC) and hepatocellular carcinoma (HCC), whereas in the West with low prevalence it has a benign course. Pathogenesis of LC in CHB is not well-defined. Materials & Method: Hepatic vena cava syndrome (HVCS), a disease of hepatic venous outflow obstruction is a comorbid condition of CHB patients in Nepal. Presence of HVCS is ascertained by ultrasonography and color Doppler (US/CD) examination of inferior vena cava and liver. This is a retrospective study of a 1542 CHB patients followed for a long period to assess its clinical course. Of these, 988 patients were categorized into two groups based on assay of HBeAg: HBeAg-positive 19% into replicative phase, HBeAg-negative 81% in non-replicative phase. Results: Eighty per cent of the patients were asymptomatic at the time of diagnosis. Acute exacerbations (AE) developed precipitated by bacterial infection with elevation of serum aminotransferases in 80%, and in 11.6 % it was followed by ascites with US/CD evidence of HVOO. About 14% developed mild splenomegaly with hematological features of hypersplenism. These features were consistent with natural history of HVCS. LC developed in 21.3% and HCC in 4.7 % of patient. The incidences of LC and HCC in replicative and non-replicative phases of CHB were similar. But patients with LC and HCC had high incidence of AEs, ascites and hypersplenism. Conclusion: HVCS contributed to the symptomatic clinical course and development of LC and HCC in CHB.","PeriodicalId":209275,"journal":{"name":"Mathews Journal of Gastroenterology and Hepatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125684000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Factors Influencing the Severity of Irritable Bowel Syndrome in the HGE Department of the Center Hospitalier Universitaire de Cocody Abidjan CI","authors":"S. D., A. M, Al Vera Vdm, O. A., Lah Bi R","doi":"10.30654/mjgh.10020","DOIUrl":"https://doi.org/10.30654/mjgh.10020","url":null,"abstract":"Email: drambake@yahoo.fr ABSTRACT Aim: To determine the factors influencing the severity of IBS. Methods: This was a monocentric prospective cross-sectional study with an analytical aim, conducted in outpatient Hepato-Gastroenterology consultations. All patients meeting the ROME III criteria were included. Results: 107 patients were collected out of 1343, i.e. a prevalence of 7.96%. There was a female predominance with a sex ratio of 0.52%. The average age of our patients was 40 years. The 30-50 age group was the most represented with 60.82%. The 2 main personal histories were abdominal surgery (28.04%) and atopic terrain (16.82%). More than half of the patients, 52.34%, had a family history of IBS. The main digestive signs of IBS found were bloating (77.57%), constipation (39.25%) and abdominal pain (32.71%). The constipation-predominant IBS subtype accounted for 39.25%, followed by the alternating diarrhea/constipation (24.30%) and unclassified (24.30%) subtypes. Nearly half of our patients (44.86%) had a sign frequency of at least 3 days/week. The 3 other digestive symptoms found were rumbling (63.55%), flatulence (57.94%) and dyspepsia (48.60%). The 3 main extra-digestive signs found were low back pain (55.14%), sleep disorders (28.04%) and asthenia (23.36%). The mode of progressive installation predominated with 56.60% and the duration of evolution was long in 76.64% of patients. 51.40% of our patients reported having severe transit disorders, 42.99% moderate bloating and moderate abdominal pain in 42.99%. 54.21% of patients declared the financial cost and 35.51% absenteeism as the main impact on quality of life. The 2 main psychological factors found were stress (58.88%) and anxiety (39.25%). The practice of regular physical activity was found in 39.35% of patients. The main dietary habits were milk (61.68%), taking meals at irregular times (48.60%) and insufficient fluid intake (35.51%). In univariate analysis, there was a statistically significant association between the type of IBS and sex (p<0.005); between the practice of physical activity and the severity of bloating, transit disorders (P<0.05); between the severity of the symptoms and the sex in case of transit disorder (P<0.05) finally between the stress and the severity of the abdominal pain (p<0.05). There was no statistically significant link between the type of IBS and the frequency of signs (P>0.05); between *Corresponding Author Factors Influencing the Severity of Irritable Bowel Syndrome in the HGE Department of the Center Hospitalier Universitaire de Cocody Abidjan CI","PeriodicalId":209275,"journal":{"name":"Mathews Journal of Gastroenterology and Hepatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122572929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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