Drug Induced Gynecomastia
The prevalence of chronic liver disease in non-HCV and HBV in our population:
The prevalence of IN NO chronic liver and HBV-HCV in our population:
Authors: DRghulamrasoolbhurgri, Shamim-ur-Rehman, Bilawal, anisrehman.
SUMMARY:
damaged liver function hapetocytes can cause hepatocellular necrosis, fibrosis and regeneration with the formation nodule.
In our study, there was a group of patients who are negative for both viral markers, there were more women who have liver disease chronic. This need for additional research group for other causes well defined but rare chronic liver disease.
Keywords: hepatitis, liver disease, chronic liver disease, hepatitis C, hepatitis B, cirrhosis.
INTRODUCTION:
Chronic liver disease in which liver damage by a slow and persistent and time.It means acting as a slow poison to the health of human body. It is characterized by replacement of liver tissue by fibrous scar tissue and regenerative nodules (lumps that occur as a result of a structure in which the process regenerated.It damage is progressive loss of liver function, cirrhosis due to alcoholism, but in our population, it is forbidden by the religion of the people due to poverty and social customs, hepatitis C, hepatitis B is the primary mission of this dangerous disease in our population.
Basic structure of the liver:
"The liver is the largest gland in the body weighs about 1.4 kg in an adult. It lies below the diaphragm in the upper abdominal cavity and is held in place by several brown ligaments.It reddish and consists of four anatomically lobes.When the dominant left front and right lobes can be considered, which are separated by the falx ligament.Situated in a depression on the posterior surface of the liver in the gallbladder bladder, a pear-shaped sac that stores bile from the liver performs synthesis liver.The many metabolic functions. He has the ability to store and metabolites useful substances such as nutrients, but the failure or the detoxification of harmful substances to do so inert and less harmful "(Dr.viva Rolfe 2004)
"Liver weight of approximately 1.2 to 1.6 kg performs many functions necessary to stay healthy. It is located on the right side body under the lower ribs and is divided into four lobes of unequal size. Two large vessels that carry blood to the liver, hepatic artery from the heart and carries blood rich in nutrients absorbed by the small intestine. These boats divided into load on smaller and smaller, ending in capillaries. Each lobe is composed of hepatocytes, add and remove the substance of them. Then, the blood leaves the liver through the hepatic vein, which returns to the heart, and is ready to be pumped to the rest of the blood.
Among the most important functions of the liver,
- Withdrawal and excrete body wastes and hormones and drugs and foreign substances.
- Synthesis of plasma proteins, including those for blood clotting, 12 clotting factors are produced by the liver.
- Produces immunity factors and elimination of bacteria help fight infections.
- Produce bile acid for digestion.
- Excretion bilurobin
- Storage of certain vitamins, minerals and sugars. "(Tzanakaki et al 2000)
"The liver is an organ in vertebrates, including humans. Plays an important role in metabolism and has a number of functions in the body, including detoxification, storage of glucagon and plasma proteins also produces bile sythesis.I t, which is important for digestion. It is also from liver or liver from the Greek word for liver, Hep. Hepatocytes play the lead role in.
- Liver produces and excretes bile required for food, some leakage directly into the duodenum and some stored in the gallbladder.
- Glyconeogensis (training of glucose from lactate or amino acids of some of the glycerin).
- Glyucogenolysis (The formation of glycogen from glucose).
- Distribution of insulin and other hormones.
- lipid metabolism, cholesterol synthesis, production of triglycerides.
- Liver produces clotting factor, 1 (fibrinogen) 11 (PT) vii.ix V, XI and protein C and protein antithrombin.
- Liver converts ammonia urea. "(Spiritus2005).
Physiological functions of the liver:
"The functions of the liver: Hemostasis glucose, protein, fat, cholesterol, hormones, vitamins, especially fat-soluble vitamins (ADEK)
Synthesize proteins including coagulation factors, bile acids, heparin, somatomedins, promote growth hormones, cholesterol and acute phase proteins.
STORAGEè vitamins, glycogen, cholesterol. Iron, copper, fat.
EXCRETIONè cholesterol bile acids phopholipds, bilurobin, drugs, poisons, including heavy metals, hormones.
FILTRATION poisons, nutrients, Iga, drugs, damage the cells died in the circulatory system.
Iga IMMUNEè excreted from the digestive tract of Kupffer cells (macrophages) Filter antigens. (Liver Foundation, 2002).
"The liver is vulnerable to a wide variety of metabolic disorders, toxins, insults microbial, cardiovascular and neoplastic diseases. The major prevalent diseases of the liver are viral hepatitis, alcoholic liver disease and hepatocellular carcinoma. In most cases, liver injury is secondary to some of the most common diseases in humans, such as congestive heart failure, cancer and the role of extrahepatic spread. It is the result of the morphological changes in the liver:
- Degeneration and accumulation damage intracellular toxin or immune insult can cause swelling of the hepatocytes.
- Necrosis and Aptos, significant insult to the liver can cause necrosis of hepatocytes, cell death in isolated hepatocytes suitable cells are combined to form shrunken, pykinolic, which contains the intensity Nucl esinophilic fragmented.
- The inflammation related to liver injury in an influx of acute and chronic inflammatory cells known as hepatitis.
- regenerating hepatocytes have a long lifespan and proliferate in response to the removal of tissue or cell death.
- fibrosis fibrous tissue forms in response inflammation or direct toxic insult to the liver, liver fibrosis points usually irreversible (Kumar, Abbas, et al 2004)
ETIOLOGY liver disease.
"A then the main causes of liver disease, hepatitis viruses A, B, C, D, E. Epstein-Barvirus, cytomegalovirus, a viral-yellowfever virus.Non: Leptospira, Toxoplasma Gendi, Q fever, poison, aflatoxin, carbantetrachloride, fungi, drugs, Paracetamol, halothane, alcohol, pergnancy, shock disease Wilson.
CLINICAL:
Symptoms: anorexia, malaise, fever, jaundice, abdomenal pain, hepatomegaly, gynicomastacia, pruritus, hematamesis, confusion,
SIGNS: jaundice, hepatomegaly, pale stools, dark urine, erythrema Palmer, clubbing, jaundice, splenomegaly, testicular atrophy, gynecomastia, with other complications, colateralveins peripheral edema, ascites. "(Davidson, 2004)
LABS COMMON: liver disease:
"The diagnosis of liver disease depends on a combination of history, physical examination, and radiological studies and biopsy labortary times.
- alanine aminotransferase: ALT enzyme is produced in hepatocytes, the cell type major liver. All types of hepatitis (viral, alcohol, drugs, etc.) cause hepatocyte damage that can lead to an increase in serum ALT activity.
- aspartate aminotransferase: ALT AST similar to but less specific for liver disease, also occurs in the muscles and can be raised in a state of others (heart attack). Alcoholic hepatitis and viral hepatitis, it can be.
- Alkaline phosphatase is an enzyme produced in bileducts, intestine, kidney, placenta bone.It and rises in chronic cases of liver.
- gamma glutamyl transferase: This is an enzyme produced in the bile duct in alcohalism and biliary tract disease is high.
- Bilurobin: Bilurobin is the great failure resulting from destruction cells.It of old blood is removed from the body by the liver, chemically modified by conjugation of the appeals process, went into the bile secreted in the gut and to some extent reabsorbed by intestine.In chronic liver disease, acquired liver diseases, high serum biliurobin.
- Albumin: There are many factors necessary for blood clotting are produced in the liver. When liver function deteriorates, their synthesis and secretion in the blood is decreased.In chronic liver disease, is very high.
- Platelet count: What are the smaller cells blood in liver, the spleen becomes the blood flow through large platlets liver deprived of normal.
- Serum protein electrophoresis: In cirrhosis, albumin and globulin may decrease may increase significantly. "(Howard J. Worman 1998).
METHODS;
One percent of patients diagnosed with chronic liver disease, of which 35 patients were included in the study protocol, after approval, after examination, the study period was from 2005-2006, has admitted NonHCV, HBV, liver cirrhosis Ward disease Muammar Medical College Hospital,
STUDY GOAL AND OBJECTIVE Othis:
To assess the causes of liver disease, the virus, since the liver has been deterioate in their function due to HCV and HBV, it was common question our community.No concept that he was still a great danger to our population.
RESULTS:
These results were analytically by using SPSS frequencies of each group that descriptor that follw:
Average Research that found in graphics
Summary Corelli study and analyze each group were very good.
Biostatistics Analysis:
Frequency
Correlation
Descriptive Statistics
Average
Std Detour
N
Total number of patients
41.1100
12.10467
100
Total number of patients with liver cirrhosis
40.6000
11.50499
35
Total male patients
29.8000
5.62139
15
Total women
48.7000
7.24097
20
Correlation
Total number of patients
Total number of liver cirrhosis patients
Total male patients
Total female patients
Number Total patients
Pearson Correlation
1
1,000 (**)
0998 (**)
0526 (*)
Sig (2-tailed)
.
0000
0000
0017
N
100
35
15
20
Total number of patients with liver cirrhosis
Pearson Correlation
1,000 (**)
1
1,000 (**)
0.525 (*)
Sig (2-tailed)
0000
.
.
0018
N
35
35
15
20
Total male patients
Pearson Correlation
0998 (**)
1,000 (**)
1
0883 (**)
Sig (2-tailed)
0000
.
.
0000
N
15
15
15
15
Total women
Pearson Correlation
0526 (*)
0525 (*)
0883 (**)
1
Sig (2-tailed)
0017
0018
0000
.
N
20
20
15
20
** Correlation is significant at 0.01 (two tailed).
* Correlation is significant at 0.05 (two tailed).
DISCUSSION:
In this prospective study, there were some points consideration that what makes women most affected by liver disease from the study showed that women male.This Moreover, the interpretation graphs and charts.
Chronic liver disease is characterized by progressive destruction of liver tissue is overtime.It seventh leading cause of death in the United States, according to the National Institute of Diabetes and tissues of digestive and liver diseases becaudse chronic renal damage, injury, gradually replace normal functioning liver tissue such as normal liver is lost, nutrients, hormones, drugs and poisons, are not dealt with effectively by the liver. Moreover, the production of proteins and other substances produced by the liver are inhibited.
"Obesity is not associated with disease nonalcohlic fatty liver but also detrimental to the progression of liver disease.Specific other direct interventions should focus on reducing consumption low sodium nutritional value and high-powered DTH sources of high-fat meat or protein (kimech et al 2008)
"Our study The study coincides with the chareon klåda et al (2004), which were to determine the prevalence of NASH in patients with non-Thai alcohalic with HBV, HCV, chronic hepatitis. Forty-six patients with negative markers of hepatitis B virus and hepatitis C virus and enrolled.just alcohalic consumption in our study, cirrhotic patients registered 100liver of which we have chosen not alcohalic and HBV, HCV.They informed consent for liver biopsy and blood sampling to identify the causative factors of patients with chronic hepatitis was performed.Thai alcolic wth no, HBV, HCV, chronic hepatitis to obesity, diabetes and dyslipidemia (kladchareonN, et al, 2004)
"The party with the study of study Omagrik et al 1996, discovered the hepatitis C virus (HCV) has led to the diagnosis of liver disease chronic type C, which had been diagnosed in the context of non-A non-B chronic liver disease. Although most cases of chronic liver disease hepatitis B, C does not stillcases disease.Forty B, C chronic liver in two patients with chronic liver disease who were seronegative for hepatitis B, followed in the study Cwere annual incidence of hepatocellular carcinoma treatment was 9.3% and 3.9% of chronic liver cirrhosis hepatitis.This suggests that their population sample contains a series of patients with type B, or Typeco another study suggested that etiological detialed agents.Our more precise tests to detect HBV andHCV should be considered before diagnosis Maing not or B, a chronic liver disease was necessary REVIAL nOnC etiologic agents unknown.
REFERENCES:
- Omagarik, Komatsuki, katoy, 1996 "The clinical manifestation of non-HBV, chronic HCV disease of the liver of Internal Medicine 1996, vol35, 600-604.
- Treepraserkstut Kladchareon N, Mahachai, 2004, the prevalence of NASH patients with non-Thai nonalcolic HBV, chronic hepatitis C "Jmed Assoc Suppl Thai2004 sep87 2: S29-34.
- Kimchi Kallman, et al 2008 Baiec "nutritional assessment of patients with fatty liver alcolic" OBE, surg June 17
- Liver Foundation Trust 2002-Liver is a vital organ of the body www.live foundation.org.html.
- Kumar, Abbas, Fausto "liver" disease of the underlying disease 7th edition, 2004.
- Howard. J. Warman 1998 "labortary common test for liver disease.
- Dr. vivaRolf 2004 "the anatomy of the liver School of Nursing and Midwifery Nottingham University accademic Division.
- Tzankakis et al "assistive device for the liver" genius 2000-607-632 medical examination year.
- 2005 Spiritus liver function; spiritus-temporis.com.
- Haslett, Chilver, collenge hunter Davidson princal medicine'the liver and Practice "19th edition 2004 Churchill living stone, edinberg.
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