Suhail Ahmed Almani, Abdul Sattar Memon, Amir Iqbal Memon, Iqbal Shah, Qasim Rahpoto, Rahim Solangi.
Cirrhosis of liver: Etiological factors, complications and prognosis.
J Liaquat Uni Med Health Sci Jan ;7(2):61-6.

OBJECTIVE: To determine the etiological factors, complication(s) and prognosis of patients suffering from liver cirrhosis in our setup. DESIGN: Cross-sectional study. SETTING: Medical and surgical departments of Liaquat University Hospital Hyderabad/Jamshoro, Sindh – Pakistan, from April 2005 to April 2007. METHODS: Patients having an evidence of cirrhosis of liver on ultrasound examination of abdomen were enrolled. All those patients who were not confirmed to be cirrhotic, excluded from this study. All cases were studied to determine the etiological factors, complications and prognosis of disease. All data were recorded on a proforma. Patients with acute variceal hemorrhage were referred to surgical department for endoscopic sclerotherapy or variceal band ligation. RESULTS: Total 100 patients were studied, 67(67%) males and 33(33%) females. Their mean age was 53.09 with SD= 8.85814 years. Majority of patients, 52(52%) had HCV infection, 16(16%) had HBV infection, 16(16%) had HBV and HCV co-infection, 08(08%) had alcohol abuse, 01(01%) had primary biliary cirrhosis, 02(02%) had Wilson`s disease and no etiological factors were recorded in 05(05%) patients. Ascites was present in 59(59%) cases, portal hypertension in 42(42%), esophageal varices in 29(29%), spontaneous bacterial peritonitis in 29(29%), acute variceal hemorrhage in 27(27%), hepatic encephalopathy in different grades in 24((24%), hepatorenal syndrome in 09(09%) and hepatocellular carcinoma in 07(07%) patients. All patients with acute variceal episode(s) were adequately and timely treated in surgical department. When cirrhotic patients were grouped into child-Pugh`s classification, 37(37%) were in class `A` category, 37(37%) in class `B` category, and 26(26%) in class `C` category. CONCLUSION: HCV infection is the major risk factor for cirrhosis in our setup. Ascites was the commonest complication. Patients with child-Pugh`s class `A` cirrhosis had significantly longer survival than patients with child-Pugh`s class `B` and `C`. A multidisciplinary approach for prevention and control of ever increasing HCV infection must be adopted and to make the public awareness through the mass media about its drastic complications, and possible modes of its transmission.

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