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Correlating Abdominal Ultrasound and Upper GI Endoscopic Findings of Schistosomiasis
( Aeden Bernice G. Timbol ),( Angela V. Djajakusuma ),( Vanessa Charlene O. Co ),( Melissa A. Llanto ),( Edhel S. Tripon ),( Ma. Lourdes O. Daez ),( Janus P. Ong ),( Nonette A. Cupino ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: This study aims to correlate the ultrasound and endoscopic findings of portal hypertension in patients with schistosomiasis and to determine which among these findings showed the best predictive values for the presence of endoscopic signs of portal hypertension. This study also aims to determine the correlation of Hepatitis B and/or Hepatitis C co-infection with the endoscopic and sonographic characteristics of patients with schistosomiasis. Methods: This is a prospective, cross-sectional study of 82 adult patients diagnosed with schistosomiasis. Each patient underwent screening upper endoscopies to assess the presence of varices and portal hypertensive gastropathy and holoabdominal ultrasound with doppler studies to assess the extent of hepatosplenic involvement. One-way ANOVA, Chi-square, Fischer’s exact test were performed to determine which ultrasound findings showed the best predictive values for the presence of endoscopic signs of portal hypertension. Results: Of the 82 patients, almost half (47.6%) had esophageal varices (54% small vs 46% large), 8.5% had gastric varices, and 46.3% had portal hypertensive gastropathy (PHG) on screening upper endoscopy. A significant correlation was found between the presence of esophageal varices, gastric varices, and PHG with the following ultrasonographic findings: grade of liver appearance, surface irregularity, spleen length, and size of right lobe. Seventeen percent tested positive for HbsAg while none tested positive for anti-HCV. Among the patients with hepatitis B/schistosomiasis co-infection, grade III (severely coarsened) echopattern, irregular liver surface, and the presence of short gastric vein collateral had a significant correlation with findings of portal hypertension on endoscopy. Conclusions: Among patients with schistosomiasis, the grade of liver appearance, surface irregularity, spleen length, and size of right lobe on abdominal ultrasound strongly predicts the presence of endoscopic signs of portal hypertension.
( Aubrey Q. Taguba ),( Mariel Dianne S. Velasco ),( Mara Teresa T. Panlilio ),( Maria Joanne M. Rubio ),( Margaret Elaine J. Villamayor ),( Janus P. Ong ),( Ma. Lourdes O. Daez ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: Low vitamin D levels result in higher incidence of liver fibrosis and cirrhosis, poor treatment response, and increased morbidity and mortality in patients with chronic liver disease (CLD). This study assessed whether CLD patients in the Philippines, despite adequate sunlight exposure, have vitamin D deficiency and whether this is associated with poor outcomes. Methods: Consecutive CLD patients at the outpatient clinics of PGH were included. Clinical data such as age, gender, body mass index, etiology of CLD, presence of cirrhosis and ascites, and number of hours of sun exposure daily were recorded. Standard biochemical liver tests within 3 months of enrolment into the study, such as alanine and aspartate aminotransferases, prothrombin time, total bilirubin, and albumin were documented. Child Pugh scores for cirrhotic patients were computed. Serum vitamin D was determined using the ARCHITECT chemiluminescent microparticle assay. STATA SE version12 for Windows was used for statistical analyses. Univariate analysis and simple logistic regression were used to determine independent predictors of vitamin D deficiency. A p-value of<0.05 was considered as statistically significant. Results: A total of 72 patients were included. The prevalence of vitamin D deficiency (<20ng/mL) was 6.9%; insufficiency (20.1 to 29ng.mL) 52.8%; and sufficiency (>30ng/mL) 40.3%. Both univariate analysis and logistic regression showed no statistical difference among vitamin D deficient, insufficient, and sufficient subjects in terms of etiology and factors affecting the severity of CLD. Conclusions: Vitamin D deficiency and insufficiency are prevalent in Filipino CLD subjects. Guidance on adequate sunlight exposure and dietary intake should be part of health maintenance intervention for these patients.