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| Prevalence of Chronic Liver Diseases in Non-hcv and Hbv in our Population: Posted: 15 Apr 2011 12:43 PM PDT Liver Building, Liverpool "The Royal Liver Building is arguably the most famous building in Liverpool. It was designed in 1908 by Walter A. Thomas and was completed in 1911. "At the top of the building, sat on each of the two towers are the mythical Liver Birds, the symbol of Liverpool. They are 18 feet tall, have a total wing span of 24 feet and are made of copper. Local legend has it that if they fly away, Liverpool will cease to exist. The Liver Birds are a cross between an eagle and a cormorant (the bird of good luck to sailors). A German sculptor called Carl Bernard Bartels, who was living in England, designed them. When the Great War broke out, Carl Bernard Bartels was arrested as a German citizen and imprisoned on the Isle of Man. The City of Liverpool removed all reference to his achievements and at the end of the war, despite having a wife in London, he was sent back to Germany. "The clocks, 25 feet in diameter, are bigger than the clocks in London’s Big Ben and are the largest electrically driven clocks in the United Kingdom. They were built to give mariners the most accurate local time and are said to be accurate to within thirty seconds per year." Tangentially, see my photo Surf that reminds some of Walter Crane’s painting, Neptune’s Horses. Crane was born in Liverpool. Prevalence of Chronic Liver Diseases in Non-hcv and Hbv in our Population: PREVALENCE OF CHRONIC LIVER DISEASES IN NON-HCV AND HBV IN OUR POPULATION: Authors:DRghulamrasoolbhurgri,shamim-ur-rehman,bilawal, anisrehman. SUMMARY: Liver diseases are damaged the function of hapetocytes, it may causes hepatocellular necrosis, fibrosis, and regeneration with nodule formation. In our study there was a group of patients who is negative for both viral markers, there were more females that have chronic liver disease. This group need to the investigated further for other well defined but uncommon causes of chronic liver disease. Key words: hepatitis, liver disease, chronic liver disease, hepatitis C virus, hepatitisB virus, cirrohosis. INTRODUCTION:
Chronic liver disease in which liver damage slowly by process and persisting over long time.It means it act as slow poison for healthy human body. It is characterized by replacement of liver tissue by fibrous scar tissue as well as regenerative nodules (lumps that occurs as a result of a process inwhich damage tissue is regenerated.It is already to progressive loss of liver function-cirrhosis is due to alcoholism, but in our population it is prohibited by people due religion, poverty and customs society, Hepatitis C, Hepatitis B virus are main role this dangerous disease in our population.
BASIC STRUCTURE OF LIVER:
“Liver is the largest gland in the body weighing about 1.4 k.g in an adult. It is situated under diaphragm in the upper abdomen cavity and is held in place by several ligaments.It is reddish-brown colour and comprise of four anatomical lobes.When viewed from the front the dominant left and right lobes can be seen which are separated by falciform ligament.Situated in a depression on the posterior surface of the liver in the gall bladder, a pear shaped sac which stores bile synthesis by the liver.The liver performs many metabolic functions. It has ability to store and metabolites useful substances such as nutrients,but it breakdown or detoxifying harmful substances to render then inert and less harmful”(Dr.viva Rolfe 2004)
“Liver weighing roughly 1.2-1.6 k.g performs many of the functions necessary for staying healthy. It is located in the right side of the body under the lower ribs and is divided into four lobes of unequal size. Two large vessels carry blood to the liver, the hepatic artery comes from heart and carries blood rich in nutrients absorbed from the small intestine. These vessels divided into smaller and smaller vessels, ending in capillaries. Each lobule is composed of hepatocytes, add, and remove substance from it. The blood then leaves the liver via the hepatic vein, returned to the heart, and is ready to be pumped to the rest of the blood.
Among the most important liver functions are, Removing and excreting body waste and hormones as well as drugs and foreign substances. Synthesizing plasma proteins, including those necessary for blood clotting,12 clotting factors are produced by the liver. Producing immune factors and removing bacteria helping body fight against infection. Producing bile to acid digestion. Excretion of bilurobin Storing certain vitamins, minerals, and sugars.”(Tzanakakis et al 2000)
“Liver is an organ in vertebrates, including humans. It plays a major in metabolism and has a number of functions in the body including detoxification, glucagon storage and plasma proteins sythesis.I t also produces bile, which is important for digestion. It also starts in hepato or hepatic from Greek word for liver, hepar. Hepatocytes play main role in. Liver produces and excretes bile required for food, some of the drain directly into duodenum and some stored in gallbladder. Glyconeogensis (formation of glucose from certain aminoacid lactate or glycerol). Glyucogenolysis (the formation of glycogen from glucose). Breakdown of insulin and other hormones. Lipid metabolism, cholesterol synthesis, production of triglycerides. Liver produces coagulation factor, 1(fibrinogen) 11 (prothrombin) v, vii.ix, xi, as well as protein c and proteins and antithrombin. Liver converts ammonia into urea.”(spiritus2005).
PHYSIOLOGICAL FUNCTIONS OF LIVER:
“Liver functions: HEMOSTASISè glucose, protein, fat, cholesterol, hormones, vitamins, in particular fat soluble vitamins (ADEK)
SYNTHESISè protein including clotting factors, bile acids, heparin, somatomedins, promote growth hormones, cholesterol and acute phase of proteins.
STORAGEè vitamins, glycogen, cholesterol. Iron, copper, fats.
EXCRETIONè cholesterol, bile acids, phopholipds, bilurobin, drugs, poison including heavy metals, hormones.
FILTERINGè poisons, nutrients, Iga, drugs, dead damage cells in circulatory system.
IMMUNEè excretes Iga into digestive tract kupffer cells (macrophages) filter out antigens.” (Liver foundations-2002).
“The liver is vulnerable to a wide of variety of metabolic, toxin, microbial, circulatory and neoplastic insults. The dominant primary diseases of the liver are viral hepatitis, alcoholic liver disease and hepatocellular carcinoma. More often, hepatic damage is secondary, to some of the most common diseases in humans, such as cardiac decompensation, disseminated cancer and extrahepatic function. There are following morphological changes in liver: Degeneration and intracellular accumulation damage from toxin or immunologic insult may cause swelling of hepatocytes. Necrosis and aptosis, any significant insult to the liver can cause hepatocytes necrosis, in aptosis cell death isolated hepatocytes round up to form shrunken, pykinolic, and intensity esinophilic cells containing fragmented nuclie. Inflammation –injury to the liver associated with an influx of acute and chronic inflammatory cells is termed hepatitis. Regeneration hepatocytes have long life spans and they proliferate in response to tissue resection or cell death. Fibrosis –fibrous tissue is formed in response to inflammation or direct to toxic insult to the liver, fibrosis points toward generally irreversible hepatic damage(kumar,abbas,et al 2004) ETIOLOGY OF LIVER DISEASE.
“There are following main causes of liver diseases,Hepatitis virus A,B,C,D,E. Epstein-Barvirus,cytomegalovirus,yellowfever virus.Non-viral infection:leptospira, toxoplasma gendi,q fever,Poison-aflatoxin, carbantetrachloride, mushrooms, Drugs- paracetamol ,halothane, alcohal, pergnancy,shock, wilson disease. CLINICAL MANIFESTATIONS:
SYMPTOMS:anorexia, malaise,fever,jaundice, right abdomenal pain,hepatomegaly, gynicomastacia, pruritus,hematamesis, confusions,
SIGNS: jaundice, hepatomegaly, pale stool, dark colored urine, palmer erythrema, clubbing, jaundice, spleenomegaly testicular atrophy, gynecomastia, with other complications- colateralveins peripheral edema, ascites.”(Davidson-2004) COMMON LABS:TESTS FOR LIVER DISEASES:
“The diagnosis of liver diseases depends upon a combination of history, physical examination,labortary testing and sometime radiological studies and biopsy. Alanine aminotranferase: ALT is enzyme produced In hepatocytes, the major cell type in the liver. All types of hepatitis (viral, alcoholic, drug induced etc) cause hepatocyte damage that can lead to elevation in the serum ALT activity. Aspartate aminotransferase: AST similar to ALT but less specific for liver disease as it is also produced in muscle and can be elevated in other condition (heart attack). Alcoholic hepatitis and viral hepatitis may it. Alkaline phosphatase: It is an enzyme, produced in bileducts, intestine, kidneys, placenta and bone.It is elevated in case chronic liver diseases. Gamma glutamyl tranferase: It is an enzyme produced in bile duct, in alcohalism and biliary disease it is elevated. Bilurobin: Bilurobin is the major breakdown that results from the destruction of old blood cells.It is removed from the body by the liver, chemically modified by process call conjugation, secreted into bile passed into intestine and some extent reabsorbed by intestine.In chronic liver disease, acquired liver diseases, the serum biliurobin is elevated. Albumin:Many factors necessary for blood clotting are made in liver. When liver function is impaired, their synthesis and secretion into blood is decreased.In chronic liver disease, it highly elevated. Platelets count: These are smallest blood cells in liver disease, spleen becomes large, blood flow through liver is impaired platlets are fallen from normal. Serum protein electrophoresis: In cirrohosis, the albumin may decreased and the gamma- globulin can be significantly elevated.”(Howard,J.Worman 1998).
METHOD;
One hundred patient diagnosed as chronic liver disease,from which 35 patients were enrolled in this study protocol,after consent,after screening, duration of study was between 2005-2006, admitted in NonHCV,HBV, liver cirrhotic disease ward, in Muammad Medical College Hospital, AIM AND OBJECTIVE OTHIS STUDY:
To evaluated the causes of liver diseases without virus,because liver was deterioate in its function due to HCV,and HBV,it was common concept in our community.No doubt it was still a big danger for our population. RESULTS:
These results were analytic by help of spss from which frequecies of each group were describer as follw:
Mean of reseach found in graphs
Summary of study and corelation of each group were analised very well. BIOSTATISTICS ANALYSIS:
Frequencies:
Correlation Descriptive Statistics Mean
Std. Deviation
N
Total number of patients
41.1100
12.10467
100
Total number of liver cirrhotic patients
40.6000
11.50499
35
Total male patients
29.8000
5.62139
15
Total female patients
48.7000
7.24097
20
Correlation
Total number of patients
Total number of liver cirrhotic patients
Total male patients
Total female patients
Total number of patients
Pearson Correlation
1
1.000(**)
.998(**)
.526(*)
Sig. (2-tailed)
.
.000
.000
.017
N
100
35
15
20
Total number of liver cirrhotic patients
Pearson Correlation
1.000(**)
1
1.000(**)
.525(*)
Sig. (2-tailed)
.000
.
.
.018
N
35
35
15
20
Total male patients
Pearson Correlation
.998(**)
1.000(**)
1
.883(**)
Sig. (2-tailed)
.000
.
.
.000
N
15
15
15
15
Total female patients
Pearson Correlation
.526(*)
.525(*)
.883(**)
1
Sig. (2-tailed)
.017
.018
.000
.
N
20
20
15
20
** Correlation is significant at the 0.01 level (2-tailed).
* Correlation is significant at the 0.05 level (2-tailed). DISCUSSION:
In this prospective study, there were certain points for consideration that what causes of females affected more by liver disease as compared male.This study showed females were more,interpreted by graphs and charts.
Chronic liver disease is marked by gradual destruction of liver tissue overtime.It is seventh leading cause of death in United States, according to National Institute of Diabetes and Digestive and Kidneys disease becaudse of chronic damage to the liver, scar tissue slowly replaces normal functioning liver tissue, as the normal liver is lost, nutrients, hormones, drugs, and poisons,are not processed effectively by the liver. In addition, protein production and other substances produced by the liver are inhibited.
“obesity is not associated with nonalcohlic fatty liver disease but it also adversely affects the progression of other liver disease.Specific directly interventions should focus on decreasing intake of low-nutrient and high sodium food, as wellas high fat sources of meat/ protein”(kimech et al 2008)
“our study match with the study of the klad chareon et al(2004) in which they aimed to determine the prevalences on non alcohalic steatohepatitis in thai patients with non HBV,HCV,chronic hepatitis. Forty six patients with negative markers of viral hepatitis B and viral hepatitis C and non alcohalic consumption were enrolled.just in our study we enrolled 100liver cirrhotic patients from which we selected non alcohalic and non HBV,HCV.They informed consent for liver biopsy and blood collecting to identify the etiological of chronic hepatitis was performed.Thai patients wth non alcolic,non HBV,HCV,chronic hepatitis with obesity,diabetes mellitus and dyslipidemia”(kladchareonN,et al 2004)
“This study match with the study of the Omagrik et al 1996 ,They discovered of hepatitis c virus (HCV) has enabled the diagnosis of type c chronic liver disease, which had the past been diagnosed as part of non-A,non-B,chronic liver disease. Although most cases with chronic liver were by hepatitis B,C there are stillcases of non B,C,chronic liver disease.Forty two patients with chronic liver disease who were seronegative hepatitis B,Cwere followed in the study for treatment.The yearly incidence hepatocellular carcinoma 9.3% with liver cirrohosis and 3.9% of chronic hepatitis.This suggested that their population sample contained a number of patients with type B,typeC or other etiological agents.Our study suggested that more detialed and accurate tests of detecting HBV andHCV should be considered before maing diagnosis o non B,nonC chronic liver disease that there was need to revial unknown etiological agents.
REFERENCES: Omagarik,komatsuk,katoy,1996 “clinical manifestation of non HBV,HCV chronic liver disease” Internal medicine 1996,vol35,600-604. Kladchareon N, Treepraserkstut,Mahachai 2004,prevalences of nonalcolic steatohepatitis in Thai patients with non HBV,HCV chronic hepatitis”Jmed Assoc Thai2004 sep87 suppl 2:s29-34. Kimch, kallman, Baiec et al 2008 “nutritional assessments of patients with non alcolic fatty liver disease” obes, surg jun 17. Liver foundation trust 2002-liver is a vital organ of body,www.liver foundation.org.html. Kumar,abbas, fausto”the liver”basis pathology of disease 7th edition 2004. Howard. J.Warman 1998 'common labortary test in liver disease. Dr vivaRolf 2004 “anatomy of liver” school of nursing and accademic division of midwifery university of Nottingham. Tzankakis et al “liver assist-device” annual review medical engineering 2000-607-632. Spiritus 2005 function of liver;spiritus-temporis.com. Haslett,chilver, collenge hunter Davidson's “princal and practic of medicine'the liver” 2004 19th edition churchil living stone,edinberg. working>as>assitant>professor>inmmc>mirpurkhas>sindh
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| treatment for liver cancer and get the facts about it Posted: 15 Apr 2011 12:43 AM PDT well, it beats liver cancer treatment for liver cancer and get the facts about it Liver cancer: My issues and answers The liver is a big organ on the proper aspect of the abdomen and is secured by the chest box. The liver has numerous functions. Plays a function in converting meals into power. It also filters and stores the blood. 2. What is liver cancer? Liver cancer is a disorder in which liver cells become abnormal, develop out of control and type a cancerous tumor. This form of cancer is termed principal liver cancer. Principal liver cancer is also named hepatocellular carcinoma or malignant hepatoma. Really youthful kids may possibly produce one more kind of liver cancer termed hepatoblastoma. Cancer that spreads to the liver from one more component of the entire body (metastatic cancer) is not the identical as primary liver cancer. This simple fact sheet specials with main liver cancer in adults. For data on hepatoblastoma or cancer that has spread to the liver from one more site, get in touch with the Data Service on Cancer (CIS) Nationwide Cancer Institute (NCI), the phone amount listed under. 3. What are the danger variables for liver cancer? Researchers have identified that people with some other liver ailments have a greater probability than common of building key liver cancer. For instance, from 5 to ten percent of folks with liver cirrhosis (a progressive condition that leads to scarring of the liver) ultimately develop liver cancer. New study suggests that way of life elements this kind of as alcohol consumption and malnutrition, lead to equally cirrhosis and liver cancer. Aflatoxins a group of chemicals developed by a fungus that can contaminate selected meals like peanuts, corn, grain and seeds are carcinogenic (cancer leading to agents) of liver cancer. 4. What are the signs and symptoms of liver cancer? Primary liver cancer is tough to detect at an early stage since its early signs or symptoms are typically vague. As with other cancers, this disease can cause a basic feeling of poor well being. Liver cancer can lead to loss of appetite, excess weight loss, fever, fatigue and weakness. As the cancer grows, pain might be existing in the upper abdomen on the appropriate aspect and may possibly extend to the back again and shoulder. Some individuals may possibly really feel a mass in the upper abdomen. Liver cancer can also lead to irritation of the abdomen and a feeling of fullness or bloating. Some people have episodes of fever and nausea or produce jaundice, a condition in which the skin and whites of the eyes turn out to be yellow and the urine becomes dark. It is essential to note that these signs might be triggered by major or metastatic cancer in the liver, a benign (not cancerous) in the liver or other much less really serious conditions. Only a physician can inform for positive. five. How is the diagnosis of liver cancer? To make a diagnosis of liver cancer, the physician says the medical historical past, a bodily examination and purchase some cautious evaluation. Blood assessments are utilised to see how nicely the liver. Can also be utilized to verify the existence of tumor markers, which are substances that are often discovered in abnormal amounts in sufferers with liver cancer. The tumor marker alpha-fetoprotein (AFP) may well be helpful to assist in the diagnosis of liver cancer. About 50 to 70 percent of individuals with main liver cancer have elevated levels of AFP. Even so, other cancers this kind of as germ cell cancer and in some situations, cancer of the abdomen and pancreas also result in elevated AFP. Radiographs of the chest and abdomen, the angiograms (x-rays of blood vessels), the CT scans (films set in purchase by personal computer) and magnetic resonance pictures (pictures designed utilizing a magnetic area) can all they become part of the diagnostic method. The liver scans employing radioactive materials can aid recognize irregular spots in the liver. The presence of liver cancer is confirmed with a biopsy. Is eliminated (by means of a needle or throughout surgical procedure) from liver tissue (biopsy sample) and examined beneath a microscope to see if cancer cells are current. The medical doctor could also search at the liver with an instrument named a laparoscope, which is a smaller instrument into a tube with a light on one particular end. For this process, an incision in the abdomen to insert the laparoscope. The medical doctor may well take away a small piece of tissue in the course of laparoscopy. A pathologist then examines the tissue under a microscope to see if cancer cells are current. six. What is the remedy for liver cancer? Liver cancer is hard to control unless the cancer is found when quite tiny. Nonetheless, remedy can alleviate signs and symptoms and enhance high quality of lifestyle of sufferers. Therapy is dependent on the stage (extent) of the condition, the liver issue and the age and basic overall health of the affected person. Your doctor may well advocate surgical procedure, chemotherapy (treatment method with anticancer medication), radiotherapy (remedy with substantial-vitality rays), biological treatment (remedy that makes use of substances that assist the system fight the cancer) or a mixture thereof remedy. 7. Is there therapy research (clinical trials) obtainable Remedy research (clinical research) are investigation studies intended to find much more efficient treatment options and far better approaches to use present remedies. Participation in therapy research is an alternative for many sufferers with liver cancer. In some research, all patients obtain the new therapy. In others, medical professionals review unique therapies by giving the new treatment method to a individual group and common treatment to one more group. In this way, physicians can examine distinct therapies. In research of treatment method for liver cancer, health professionals are learning new anticancer medicines and drug combinations. They are also learning new techniques to deliver chemotherapy, like as putting the medicines right into the liver. Other investigation approaches consist of cryotherapy (surgical treatment that employs severe cold to destroy cancer cells) and different combinations of typical treatment options. It is really important to start a treatment for liver cancer as soon as you get the diagnosis I am a 23 years old boy who is studing biology in harvard university and miss the sunny days
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