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( Bickram Pradhan ),( Antoine Hadengue ),( Shatdal Chaudhary ),( Francois Chappuis ),( Dharanidhar Baral ),( Pascal Gache ),( Prahlad Karki ),( Suman Rijal ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Though the type of alcohol consumed is not thought to be associated with Alcoholic Liver Disease (ALD), some studies have shown a beverage specifi c effect. The prevalence of alcohol use disorders (AUD) is very high in Nepal due to easy availability of cheap locally brewed alcoholic beverages. In the present study we aim to detect the prevalence of ALD in patients with AUD and to study the effects of the different types of alcoholic beverages on the liver. Methods: This cross-sectional study was conducted in the internal Medicine department of a tertiary care center in Nepal. All patients classifi ed as having either alcohol abuse or alcohol dependence by DSM IV were evaluated for presence of ALD. Results: A total 1332 patients were screened of which 447 patients (292 males and 155 females) had AUD. Chronic liver disease (CLD) was detected in 144 patients (10.8%). Most of the patients consumed home made locally brewed alcohol like chhang (62%), rakshi (77%) and tongba(16.3%). On multivariate analysis the following variables were found to be signifi cantly associated with CLD: Male sex (OR 1.81, 95% CI [1.12-2.94] p value 0.02): rakshi consumption = 30 units (OR 2.53, 95% CI [1.07-6.01] p value 0.04): togba consumption (OR 3.02, 95% CI [1.22-7.50] p value 0.02 Conclusions: There was a signifi cant increase in the risk of developing ALD with the consumption of rakshi and tongba after adjusting for total unit consumed. The absence of striking differences between our patients with CLD and non-CLD patients as regards the amount of alcohol consumed demonstrates that, although alcohol consumption is a pre-requisite for the development of ALD, other factors like type of alcoholic beverage consumed may be involved.