Clinical Spectrum of Alcoholic Liver Disease in Subjects Attending Outpatient Department at a Tertiary Care Hospital
Komathi Subramaniam *
Department of Pharmacy Practice, Bhaskar Pharmacy College, Jawaharlal Nehru Technical University, Hyderabad 500075,Telangana, India.
Penugonda Praval Reddy
Department of Pharmacy Practice, Bhaskar Pharmacy College, Jawaharlal Nehru Technical University, Hyderabad 500075,Telangana, India.
Pulluri Saikiran
Department of Pharmacy Practice, Bhaskar Pharmacy College, Jawaharlal Nehru Technical University, Hyderabad 500075,Telangana, India.
P. Nageshwara Rao
Department of Hepatology, Asian Institute of Gastroenterology Hospitals, Gachibowli, Hyderabad, Telangana, India.
A. V. Kishore Babu
Department of Pharmacy Practice, Bhaskar Pharmacy College, Jawaharlal Nehru Technical University, Hyderabad 500075,Telangana, India.
A. Srinivasa Rao
Department of Pharmacy Practice, Bhaskar Pharmacy College, Jawaharlal Nehru Technical University, Hyderabad 500075,Telangana, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Alcoholic liver disease is one of the primary medical complication of chronic ethanol abuse. It encloses a wide spectrum of diseases comprising of fatty liver, alcoholic hepatitis, alcoholic cirrhosis and hepatocellular carcinoma.
Methodology: A prospective, observational study was done at AIG hospitals in the department of hepatology for a period of 6 months. A total of 200 patient’s diagnosed clinically and biochemically with various spectrum of ALD were recruited for the study.Non-invasive prognostic scores were calculated at the time of admission and correlated with severity of disease.
Results: Among 200 study participants, 34.8% belongs to age group of 36-45 years. All were male patients with age group ranged from 25 to 73 years. We observed the high levels of alkaline phosphatese, aspartate aminotransferase/alanine aminotransferase ratio, mean corpuscular volume, total bilirubin and international normalized ratio in Severe Alcoholic hepatitis patients. Non-invasive prognostic markers like child-turcotte-pugh score,model for end stage liver disease-sodium and maddrey’s discriminant factor were assessed for all patients.Prevalence of different stages of ethanol mediated liver disease were-12% of alcoholic fatty liver,17.5% of alcoholic hepatitis,6% of acute on chronic liver failure,32.5% of chronic liver disease,24% of decompensated chronic liver disease,6% of past decompensated chronic liver disease with current living donor liver transplant and 2% cases of hepatocellular carcinoma.
Conclusion: Hazardous ethanol abuse is more typical in adult males especially among productive age group. The subjects were cautioned on their personal basis regarding fallout of alcoholic liver disease, and guided for latency of alcohol not immediately but definitely.
Keywords: Spectrum, alcoholic liver disease, child-turcotte-pugh score, model for end stage liver disease - sodium, maddrey’s discriminant factor