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Journal of Clinical and Experimental Hepatology    [4 followers]  Follow    
  Full-text available via subscription Subscription journal
     ISSN (Print) 0973-6883
     Published by Elsevier Homepage  [2556 journals]
  • Biomimetic Enzyme Nanocomplexes: Use as Antidotes and Preventive Measures
           for Alcohol Intoxication
    • Authors: Radha K. Dhiman
      Pages: 273 - 274
      Abstract: In most living eukaryotic cells enzymes mediating sequential steps of a reaction are usually co-localized within organelles allowing more efficient completion of the reaction without much need for transport of intermediaries between different organelles. Similarly, multiple enzymes with complimentary functions involving multiple consecutive reactions are also spatially co-localized and enhance not only the overall efficiency but also minimize the toxicity of intermediate products generated during the reaction by prompt elimination of intermediate products toxic by the co-localized enzymes. The typical example of such organellar localization is the peroxisome where catalase enzyme detoxifies the hydrogen peroxide produced during enzymatic reactions occurring in the peroxisome.
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-12-01
      DOI: 10.1016/j.jceh.2013.12.004
      Issue No: Vol. 3, No. 4 (2013)
  • Patients with Diabetes Mellitus are Prone to Develop Severe Hepatitis and
           Liver Failure due to Hepatitis Virus Infection
    • Authors: Kumar K. Singh; Subrat K. Panda, Shalimar, Subrat K. Acharya
      Pages: 275 - 280
      Abstract: Background: Acute viral hepatitis (AVH) is usually a self-limiting illness. Diabetics are prone to develop liver diseases and liver regeneration is impaired in them. Natural course of AVH in diabetics has not been assessed and may be severe.Design: Observational prospective study to evaluate natural course of AVH in patients with and without diabetes mellitus. Consecutive patients with AVH were included and categorized in to those with or without diabetes. Etiology, complications, mortality and recovery parameters of AVH were identified and compared between two groups.Results: 131 consecutive AVH between March 2007 and March 2009 were evaluated; 12 diabetics and 83 non-diabetics (n = 95) were included for analysis. Hepatitis E was the commonest cause (n = 55, 57.89%) in the whole cohort. However, Hepatitis B virus (HBV) as the etiology was significantly higher among diabetics than in non-diabetics (58.33% vs. 25.3%, P = 0.02). In contrast, hepatitis E was the etiology in 61.44% of non-diabetics. Frequency of severe hepatitis was significantly higher in diabetics than in non-diabetics (5/12; 41.67% vs. 9/83; 10.64%, P 
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-11-11
      DOI: 10.1016/j.jceh.2013.11.003
      Issue No: Vol. 3, No. 4 (2013)
  • Association of Interleukin-1β and Gene Polymorphisms with Liver
           Pathogenesis in Hepatitis B Virus Infection among Eastern Indian
    • Authors: Avik Biswas; Rajesh Panigrahi, Manisha Pal, Binay K. De, Sekhar Chakrabarti, Mrinmoy K. Ghosh, Bikash C. Chandra Seth, Susanta Roychowdhury, Runu Chakravarty
      Pages: 281 - 287
      Abstract: Background: Interleukin-1β (IL-1β) is an important member of the family of the proinflammatory cytokines that modulate outcome of hepatitis B virus (HBV) infection.Objectives: This study was designed to investigate the relationship between the polymorphic genotypes of the interleukin-1β (IL-1β) promoter region and the interleukin-1 receptor antagonist gene (IL-1RN) and disease outcome in HBV-infected individuals.Methods: DNA was extracted from 395 study subjects including HBV carriers with varying clinical presentations, as well as healthy controls and spontaneously recovered cases (SRC). Polymorphisms in IL-1β (at position −511) and IL-1RN (variable nucleotide tandem repeats, VNTR) were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and PCR based assay respectively.Results: Among the study subjects, different IL-1β (at position −511) (CC, CT and TT) and IL-1RN (1/1, 1/2, 2/2 and 1/3) polymorphic genotypes were found at variable proportions. Logistic regression analysis revealed, no notable difference at the level of IL-1β promoter (P = 0.244; OR = 0.78; 95% CI = 0.52–1.18) or IL-1RN genotype polymorphism (P = 0.840; OR = 1.03; 95% CI = 0.78–1.36) among the HBV carriers and controls or SRC cases. Pairwise proportion testing showed, IL-1β −511 genotype CC was significantly higher among asymptomatic carriers (ASC) in comparison with liver cirrhosis (LC) patients (P value = 0.028) and healthy control group (P-value = 0.036). IL-1RN genotype 2/2 was considerably higher in LC group than SRC as well as control group. Combinations of IL-1β (−511) and IL-1RN polymorphisms were associated with disease progression, such as CC-1/2 with ASC and TT-2/2 with LC.Conclusion: IL-1β polymorphisms are found to be associated with disease severity. Different polymorphic combinations are associated with degree of disease severity. Overall this is the first report from Eastern India, which shows association of IL-1β polymorphisms with HBV-related hepatic complications.
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-11-18
      DOI: 10.1016/j.jceh.2013.11.006
      Issue No: Vol. 3, No. 4 (2013)
  • Hepatitis B Virus Infection can Cause Hepatocellular Carcinoma in Less
           Advanced Liver Cirrhosis: A Comparative Study of 142 Patients from North
    • Authors: Anil Arora; Praveen Sharma, Pankaj Tyagi, Vikas Singla, Veronica Arora, Naresh Bansal, Jay Toshniwal, Ashish Kumar
      Pages: 288 - 295
      Abstract: Background and aims: The clinical profile of patients with hepatocellular carcinoma (HCC) may differ depending on the etiology of HCC. There is no study from India comparing the clinical profile of patients of HCC due to hepatitis B virus (HBV) infection with other etiologies.Methods: We retrospectively reviewed the records of patients clinically diagnosed as HCC between Nov 2000 and Dec 2012 admitted under a single unit of Department of Gastroenterology at our hospital. We compared the clinical presentation of patients of Hepatitis B virus etiology (HBV group) with other etiologies (Non-HBV group).Results: One hundred and forty-two patients were included (median age 60 years [range 30–83], 92% males). The etiology was HBV in 56 (39%) and among the non-HBV group (n = 86, 61%) the etiological spectrum was following: alcohol 31 (22%), cryptogenic 26 (18%), HCV 27 (19%), and miscellaneous 2 (1%). The median age of presentation was significantly less for HBV group than in non-HBV (56 [30–77] vs. 62 [42–83] years, P 
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-08-26
      DOI: 10.1016/j.jceh.2013.08.007
      Issue No: Vol. 3, No. 4 (2013)
  • Seroprevalence and Risk Factors of Hepatitis B and Hepatitis C Virus
           Infections in Uttarakhand, India
    • Authors: Garima Mittal; Pratima Gupta, Rohit Gupta, Vivek Ahuja, Manish Mittal, Minakshi Dhar
      Pages: 296 - 300
      Abstract: Background and aims: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are a serious global public health problem affecting billions of people. A population based serological survey was conducted in Uttarakhand, India to determine the prevalence and risk factors of HBV and HCV infections.Methods: A cross-sectional study was conducted to achieve the primary objective of estimating the prevalence of HBsAg and anti-HCV seropositivity and to estimate the potential risk factors.Results: A total of 495 volunteers completed the study questionnaire and underwent blood tests for HBsAg and anti-HCV serology. Of these, 339 (68.5%) were males and 156 (31.5%) were females. The mean age of the volunteers was 31 ± 4 years. The overall infection rate was 4.4% (n = 22) in the studied population. The seroprevalence of HBsAg was found to be 2.8% (n = 14) and of anti-HCV antibodies 1.8% (n = 9), whereas dual infection i.e. HBV and HCV infection was seen in 0.2% (n = 1). The overall analysis of risk factors of our data showed that persons who have received multiple blood transfusions, history of hepatitis among family members, visits to unregistered medical practitioners and uneducated people are at more risk for acquiring hepatitis B and hepatitis C infection.Conclusions: The results indicate an intermediate level of endemicity of HBV and HCV infection in this geographical area of Uttarakhand. Some independent risk factors like blood transfusion, intra familial transmission, and visit to unregistered practitioners were identified.
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-11-11
      Issue No: Vol. 3, No. 4 (2013)
  • Acute Exacerbation of Chronic Hepatitis B: The Dilemma of Differentiation
           from Acute Viral Hepatitis B
    • Authors: Pankaj Puri
      Pages: 301 - 312
      Abstract: Exacerbations of chronic hepatitis B are common in endemic countries. Acute exacerbation of chronic hepatitis B virus (CHB-AE) causing derangement of liver functions may be seen in a flare of HBV in immune clearance phase or as a reactivation of HBV in patients with inactive or resolved HBV infection. While reactivation of HBV is usually seen in HBsAg positive patients, it is being increasingly recognized in patients with apparently resolved HBV infection who do not have HBsAg in serum but have IgG antibody to core antigen (anti-HBc) in the serum, especially so in patients on chemotherapy, immunosuppressive therapy or undergoing hematopoietic stem cell transplantation. In an icteric patient who is HBsAg positive, it may be difficult to differentiate CHB-AE from acute viral hepatitis B (AVH-B). Both may have similar clinical presentation and even IgM anti-HBc, the traditional diagnostic marker of AVH-B, may also appear at the time of exacerbation of CHB. The differentiation between CHB-AE and AVH-B is important not only for prognostication but also because management strategies are different. Most cases of AVH-B will resolve on their own, HBsAg clearance is achieved spontaneously in 90–95% of adults and treatment is rarely indicated except in the few with severe/fulminant disease. In contrast, in CHB-AE, the onset of jaundice may lead to decompensation of liver disease and treatment is warranted. The mechanisms of acute exacerbation and the differentiating features between AVH-B and CHB-AE are reviewed.
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-09-05
      DOI: 10.1016/j.jceh.2013.08.014
      Issue No: Vol. 3, No. 4 (2013)
  • Neonatal Hemochromatosis
    • Authors: Amy G. Feldman; Peter F. Whitington
      Pages: 313 - 320
      Abstract: Neonatal hemochromatosis is a clinical condition in which severe liver disease in the newborn is accompanied by extrahepatic siderosis. Gestational alloimmune liver disease (GALD) has been established as the cause of fetal liver injury resulting in nearly all cases of NH. In GALD, a women is exposed to a fetal antigen that she does not recognize as “self” and subsequently begins to produce IgG antibodies that are directed against fetal hepatocytes. These antibodies bind to fetal liver antigen and activate the terminal complement cascade resulting in hepatocyte injury and death. GALD can cause congenital cirrhosis or acute liver failure with and without iron overload and siderosis. Practitioners should consider GALD in cases of fetal demise, stillbirth, and neonatal acute liver failure. Identification of infants with GALD is important as treatment is available and effective for subsequent pregnancies.
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-11-04
      Issue No: Vol. 3, No. 4 (2013)
  • A Review and Current Perspective on Wilson Disease
    • Authors: Mallikarjun Patil; Keyur A. Sheth, Adarsh C. Krishnamurthy, Harshad Devarbhavi
      Pages: 321 - 336
      Abstract: Wilson disease is a rare, inherited autosomal recessive disease of copper metabolism and may be more common where consanguinity is prevalent. Much has been known about the disease after it was first described by Kinnier Wilson as ‘progressive lenticular degeneration in 1912. Over 500 mutations of the ATP7B gene has been identified with no clear genotype to phenotype correlation. Loss of ATP7B function leads various grades of reduced biliary excretion of copper and reduced incorporation of copper into ceruloplasmin; accumulation and toxicity of copper in the liver, brain and other tissues results in liver toxicity and other myriad manifestations of the disease. The clinical features may vary from asymptomatic state to chronic liver disease, acute liver failure, neuropsychiatric manifestations and hemolytic anemia. Diagnosis is based on the combination of clinical sign's, biochemical features, histologic findings and mutation analysis of ATP7B gene. Subtle geographical differences exist with a disproportionate proportion of children presenting with acute liver failure. A high index of suspicion is needed for an early diagnosis. Ratios of biochemical indices for early diagnosis need validation across geographical regions and may not be particularly applicable in children. Better biomarkers or the need for tests for early detection of ALF persists. Drugs used in the treatment of Wilson disease include copper chelating agents such as d-Penicillamine, trientine and zinc salt. Untreated Wilson disease uniformly leads to death from liver disease or severe neurological disability. Early recognition and treatment has excellent prognosis. Liver transplantation is indicated in acute liver failure and end stage liver disease. Family screening in order to detect the disorder in the first-degree relatives is warranted. This review provides an overview of different aspects of Wilson disease including geographical differences in presentations and clinical management and the limitations of currently available tests.
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-06-21
      DOI: 10.1016/j.jceh.2013.06.002
      Issue No: Vol. 3, No. 4 (2013)
  • Changing Pattern of Donor Selection Criteria in Deceased Donor Liver
           Transplant: A Review of Literature
    • Authors: Dronacharya Routh; Sudeep Naidu, Sanjay Sharma, Priya Ranjan, Rajesh Godara
      Pages: 337 - 346
      Abstract: During the last couple of decades, with standardization and progress in surgical techniques, immunosuppression and post liver transplantation patient care, the outcome of liver transplantation has been optimized. However, the principal limitation of transplantation remains access to an allograft. The number of patients who could derive benefit from liver transplantation markedly exceeds the number of available deceased donors. The large gap between the growing list of patients waiting for liver transplantation and the scarcity of donor organs has fueled efforts to maximize existing donor pool and identify new avenues. This article reviews the changing pattern of donor for liver transplantation using grafts from extended criteria donors (elderly donors, steatotic donors, donors with malignancies, donors with viral hepatitis), donation after cardiac death, use of partial grafts (split liver grafts) and other suboptimal donors (hypernatremia, infections, hypotension and inotropic support).
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-11-25
      DOI: 10.1016/j.jceh.2013.11.007
      Issue No: Vol. 3, No. 4 (2013)
  • Peritoneovenous Shunt Scintigraphy to Assess Shunt Patency in Patients
           with Refractory Ascites
    • Authors: Raja Senthil; Sumati Sundaraiya, Rajasekhar Perumalla, Mohamed Rela
      Pages: 347 - 350
      Abstract: Peritoneovenous shunt scintigraphy is an infrequently performed study to non-invasively assess shunt patency in patients with recurrent or refractory ascites in cirrhotic patients. We describe two patients of chronic liver disease in whom 99mTc-macroaggregated albumin scintigraphy was performed to assess the patency of peritoneovenous shunt. Visualization of lung activity was interpreted as indicative of shunt patency. While both lungs were visualized almost immediately in the first patient, they were visualized by 30 min in the second patient. Visualization of radiolabeled peritoneal fluid in the entire length of the shunt tubing may be variable, and was seen in only one patient. Scintigraphy also helped in excluding communication between the ascites and right groin collection in the second patient.
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-06-10
      DOI: 10.1016/j.jceh.2013.05.012
      Issue No: Vol. 3, No. 4 (2013)
  • Splenosis Mimicking Hepatic Adenoma
    • Authors: Marcin Krawczyk; Günther Schneider, Georgios Farmakis, Vincent Zimmer, Frank Lammert
      Pages: 351 - 352
      Abstract: Hepatocellular adenomas are rare benign liver tumors that, if not smaller than 5 cm and asymptomatic, do, in general, not require surgical intervention. However, larger tumors should be resected since there is a risk of hemorrhage or malignant transformation. We present here a case of abdominal and hepatic splenosis mimicking hepatocellular adenoma.
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-11-11
      DOI: 10.1016/j.jceh.2013.11.004
      Issue No: Vol. 3, No. 4 (2013)
  • Combination Therapy in Severe Alcoholic Hepatitis—Doesn't Really
    • Authors: Ajay Duseja
      Pages: 353 - 354
      Abstract: Mathurin P, Louvet A, Duhamel A, Nahon P, Carbonell N, Boursier J, Anty R, Diaz E, Thabut D, Moirand R, Lebrec D, Moreno C, Talbodec N, Paupard T, Naveau S, Silvain C, Pageaux GP, Sobesky R, Canva-Delcambre V, Dharancy S, Salleron J, Dao T. Prednisolone with vs without pentoxifylline and survival of patients with severe alcoholic hepatitis: a randomized clinical trial. JAMA. 2013;310:1033–1041.
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-11-18
      DOI: 10.1016/j.jceh.2013.11.005
      Issue No: Vol. 3, No. 4 (2013)
  • Hepatobiliary Quiz—8 (2013)
    • Authors: Swastik Agrawal; Radha K. Dhiman
      Pages: 355 - 356
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-11-11
      DOI: 10.1016/j.jceh.2013.11.001
      Issue No: Vol. 3, No. 4 (2013)
  • Hepatobiliary Quiz—8 (2013)
    • Authors: Swastik Agrawal; Radha K. Dhiman
      Pages: 357 - 361
      Abstract: There are four major mammalian genotypes (1–4) and one avian hepatitis E virus (HEV). The genotype 1 and 2 strains of HEV infect only humans, and are restricted to areas where.
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-11-11
      DOI: 10.1016/j.jceh.2013.11.002
      Issue No: Vol. 3, No. 4 (2013)
  • Hepatitis C Virus Heterogeneity: Lipoprotein and Immunoglobulin Binding
           and Clinical Status
    • Authors: Nikki Rae Adler; Marian Biddle, Lauren Beswick, Christopher Hair, Benjamin Allen, Stephen Graves, Aminul Islam, Jonathan P. Watson
      Pages: 362 - 363
      Abstract: Hepatitis C Virus (HCV) infection is a major cause of liver disease globally. More than 350,000 people die from hepatitis C-related liver diseases each year. Persistent HCV infection can progress to liver cirrhosis and hepatocellular carcinoma. Thus, HCV infection is a major cause of morbidity and mortality worldwide. The range of liver disease severity in individual patients with HCV infection is broad. The spectrum of liver disease in patients infected with HCV ranges from asymptomatic carriers, patients with chronic hepatitis of variable severity to end-stage liver cirrhosis. The rate of progression to the cirrhotic stage also varies widely amongst HCV-infected individuals.
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-08-30
      DOI: 10.1016/j.jceh.2013.08.010
      Issue No: Vol. 3, No. 4 (2013)
  • Prevalence of Hepatitis B and C in Puducherry
    • Authors: Arikichenin Olithselvan; Mohamed Rela
      Pages: 364 - 365
      Abstract: Puducherry (Formerly Pondicherry) is a union territory in South India. On the occasion of world hepatitis day 2013 we had conducted a free Hepatitis B and C screening camp for the general public of Puducherry. The purpose of the camp was to create awareness and diagnose hepatitis B and C among the general public. Prevalence data of Hepatitis B and C from Puducherry is not available. The screening camp was a daylong event starting at 10 am and finishing at 10 pm on the 28th of July 2013 on world hepatitis day. This was conducted in 4 locations (Beach road, Muthialpet, Villianour and Ouruvaiyar) across Puducherry. Newspaper adverts, televisions scrolling in local channels and pamphlets distribution were done prior to the screening camp to inform public regarding the event.
      Citation: Journal of Clinical & Experimental Hepatology 3, 4 (2013)
      PubDate: 2013-11-01
      Issue No: Vol. 3, No. 4 (2013)
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