Assessment of Nutritional Status of Patients with Chronic Hepatitis C and HCV-Related Cirrhosis in the Compensated Stage
Hoda M. Amin,
Rasha M. Abdel Samie,
Fardous S. Hamed,
Ebtehal M. Abo Zaid,
El Sayed M. Hammad
Issue:
Volume 4, Issue 2, March 2016
Pages:
24-35
Received:
15 February 2016
Accepted:
23 February 2016
Published:
8 March 2016
Abstract: Background and Aim: Malnutrition is prevalent among patients with chronic liver disease. We aimed to assess the nutritional status of HCV-related compensated cirrhosis and chronic HCV-infected patients compared to healthy control subjects and to compare the different methods used for nutritional assessment namely the anthropometric measures and the Subjective Global Assessment (SGA). Patients and Methods: A total of 120 subjects were recruited. 40 patients with hepatitis C- related compensated liver cirrhosis in Group I, 40 patients with chronic hepatitis C in Group II and 40 age - and sex- matched healthy Egyptian volunteers in Group III. Thorough history taking, physical examination and detailed nutritional assessment were performed including a 24- hour dietary recall. Evaluation of nutritional status was done using different anthropometric measures and the Subjective Global Assessment (SGA). Results: Chronic HCV patients were found to have lower mean daily caloric intake (1858.70±630.2 Kcal/day) as compared to patients with compensated cirrhosis (1923.75±595.8 Kcal/day). The diagnosis of severely malnourished was detected with an increased frequency in the cirrhotic patients by the triceps skin fold thickness (TST) method (52.5%) as compared to mid-arm muscle circumference (MAMC) (30%) and the sub-scapular skin fold thickness (15%). In the chronic HCV patients, an increased frequency of diagnosis of malnutrition was detected by the MAMC% (57.5%) as compared to the other anthropometric indices. Based on the SGA rating, moderate degree of malnutrition was detected in 37.5% of cirrhotic patients and only 27.5% of chronic HCV patients, however, severe degree of malnutrition was not diagnosed in any of the subjects. The majority of the patients with compensated HCV related cirrhosis and chronic HCV group as well as controls were found to be overweight 67.5%, 62.5% and 62.5% respectively. There was a highly significant positive correlation between the BMI and the TST, MAC, MAMC, and sub-scapular skin fold thickness in the three studied groups. Conclusion: Overweight was prevalent among patients with chronic HCV and compensated cirrhosis. SGA underestimated the degree and prevalence of malnutrition as compared to TST, MAMC and sub-scapular skin fold thickness in the liver cirrhosis, chronic hepatitis C and healthy control groups.
Abstract: Background and Aim: Malnutrition is prevalent among patients with chronic liver disease. We aimed to assess the nutritional status of HCV-related compensated cirrhosis and chronic HCV-infected patients compared to healthy control subjects and to compare the different methods used for nutritional assessment namely the anthropometric measures and the...
Show More
Aplastic Anemia in Egypt: Current Situation and Future Prospective
Issue:
Volume 4, Issue 2, March 2016
Pages:
36-42
Received:
6 April 2016
Accepted:
20 April 2016
Published:
11 May 2016
Abstract: Aplastic anemia (AA) is a hypoproliferative anemia that led to a significant morbidity and mortality. Recently, dramatic improvement in prognosis of AA was achieved; this was in part due to advances in immunosuppressive therapy and HSCT. Nevertheless, AA is still one of the most challenging hematological disorders that could face a hematologist. This study was conducted at Assiut University Hospital (AUH), Assiut, Egypt to evaluate current situation and future prospective of AA. 63 patients with AA were prospectively enrolled in the study; they were admitted at the Hematology unit, AUH in the period 1stJan2011 to Feb2012, a 38 patients with iron deficiency anemia (IDA) were included for comparison. Patients' demographic and clinical data were collected through medical history and clinical examination. Both direct and indirect health care costs of anemia were assessed Direct parameters included doctors' and hospital fees, costs of laboratory investigations, medication fees and costs of HSCT or any procedure. Indirect costs included travelling expenses and earning losses. Social burden of anemia was estimated by anemia related morbidity and mortality. Data were analyzed with SPSSV.17, results showed that AA affected young age group with mean age 30.89±13.39 years, without sex predilection, acquired AA was more common than idiopathic (55.6% vs. 44.4%), however mortality was higher in idiopathic AA (46.2%). Causes of aplasia were exposure to chemicals, drugs and hepatitis in order. Only 63.5% of AA were admitted once and 47.6% in general ward, the mean hospital days for patients with AA was 17.73±11.10, compared to 8.32±6.69 in IDA, P=0.000, also higher socio-economic burden of AA was found compared with IDA. These results denoted that management of AA is still ineffective, and that there is a definite need for a strict plan to prevent incidence of AA, particularly in developing countries where effective management of AA is too expensive and relatively unavailable.
Abstract: Aplastic anemia (AA) is a hypoproliferative anemia that led to a significant morbidity and mortality. Recently, dramatic improvement in prognosis of AA was achieved; this was in part due to advances in immunosuppressive therapy and HSCT. Nevertheless, AA is still one of the most challenging hematological disorders that could face a hematologist. Th...
Show More
