Clinical and Haematological Abnormalities in Decompensated Chronic Liver Disease Patients.

The liver is the largest organ of the body weighing 1-1.5 kg, which is 1.5-2.5% of the lean body mass. It plays a major role in protein synthesis, nutrient regulation, metabolism, and the combination of bilirubin and drugs, detoxification, bile production, and immune maintenance. Pathogenesis of hematological changes is multifactorial and included portal hypertension induce sequestration, alteration in bone marrow stimulating factors, viral and toxin-induced bone marrow suppression. Anemia of diverse etiology occurs in about 75% of patients of CLD. Causes of anemia in CLD are iron deficiency, hypersplenism, anemia of chronic disease, autoimmune hemolytic anemia, folic acid deficiency, aplastic anemia, and as an effect of an antiviral drug. Alcohol is a widely used drug with side effects that include hematopoiesis suppression. MATERIAL: To assess the clinical and hematological abnormalities in chronic liver disease patients, a cross sectional study was conducted in Shyam Shah medical college and associated Sanjay Gandhi Memorial Hospital during the period from Jan 2020 to June 2021. About 78 patients will be included in the present study. All the cases included in the study were admitted to the hospital ward evaluated for chronic liver disease and hematological abnormalities. OBSERVATION: In our study, we had 71 male and 7 female patients with an average age of 46.61±12.73 years. About 58.97% of the patients were alcoholics. Abdominal distension (74.36%) and Jaundice (56.41%) were the most common presenting complaints. Pallor was present in 54 (69.23%) cases. Splenomegaly was present in 30 (50.84%) chronic liver patients. All 78 patients had anemia and the most common type of anemia was normocytic normochromic anemia (58.97%). CONCLUSION: In this study, we can conclude that, in chronic liver patients, various hematological changes are very common which need to be identified and corrected early to reduce morbidity and mortality. It is important to typify anemia in cirrhosis with respective etiology, characterizing hematological abnormalities may help in better clinical management and help to improve prognosis.

A Clinical Study of Cirrhosis with Special Reference to Thyroid Function.

It is known that impaired thyroid function affects liver function and similarly liver disorders, also affect thyroid function. In this study, we looked at the clinical profile of cirrhosis and studied the correlation between cirrhosis and thyroid function. MATERIAL: The study was conducted as an observational cross-sectional study on patients with cirrhosis of liver reporting at the Department of Medicine, SSMC Rewa (M.P.) during the study period of 15 months i.e. from 1st April 2020 to 30th June 2021. Detailed history regarding risk factors, duration of liver disease, history pertaining to its etiology was obtained. The severity of liver disease was assessed using the Child-Pugh score. All the patients were then subjected to relevant investigations including Serum T3, T4, TSH. OBSERVATION: A total of 100 cases of liver cirrhosis were enrolled in our study with a mean age of 53.26±12.54 years. We observed a statistically significant association of Child Pugh Score with T3, T4 as well as TSH (p<0.05). We observed a moderate correlation of Child-Pugh score with T3 levels and TSH (r=0.452 and 0.311 respectively; p<0.05), and a weak correlation was observed with T4 (r=0.240; p<0.05). CONCLUSION: In cirrhosis of the liver majority of subjects show impaired thyroid functions. Thyroid hormone levels help assess the severity as well as the course of cirrhosis and among T3, T4, TSH values, Total T3 is considered as a better predictor of severity of cirrhosis.