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Bone Mineral Density in Patients With Cirrhosis of Liver Awaiting Liver Transplantation
CIRRHOSIS AND COMPLICATIONS
16 SAFETY AND OUTCOME OF PROTOCOL BASED INJECTION OF N-BUTYL-2CYANOACRYLATE (GLUE) FOR OBLITERATION OF GASTRIC VARIX Bhuvan Shetty, Avinash Balekuduru, Lokesh Locheruvapalli, Ravi Kiran, B.S. Satyaprakash M.S. Ramaiah Hospital, Bangalore, India
Cirrhosis and Complications
Background and Aim: In patients with portal hypertension at first endoscopy and of all variceal bleeds, 20% occur from gastric varices but outcome is worse than with esophageal variceal bleeding 1–3. The technique of endoscopic glue injection in gastric varix is not standardized. The aim of the study is to assess the efficacy and outcome of protocol based injection of glue injection at our center. Methods: We retrospectively studied all the subjects who underwent glue injection from March 2014 to February 2016. The age, gender, etiology and severity of liver disease, type of gastric varix, and outcome were systematically recorded. Results: Glue injection was done in 21 subjects during the study period. Their mean age was 41 + 10 years and 15 (71%) were men. Ethanol was the most common etiology in 11 (52%) subjects. Majority (62%) were Child–Turcott–Pugh score of A. The type of gastric varix1 was 16 (76%) of GOV 1, 3(14.2%) of IGV 1 and 2(9.5%) of GOV 1. Complications occurred in four patients which included mortality in 1 and rebleed requiring repeat injection in 3 (14.2%). Conclusion: Glue injection is useful in active bleed from gastric varices and the technique and dose of glue injection needs to be standardized by larger studies. CONFLICTS OF INTEREST The authors have none to declare. Corresponding author: Bhuvan Shetty. E-mail: [email protected] http://dx.doi.org/10.1016/j.jceh.2016.06.083
Pallav Parikh, Sharad Deshmukh, Sarojini Parameswaran, K.R. Palaniswami, N. Murugan, A.T. Mohan, Ubal Dhus, Usha Srinivas, P. Piramnayagam, M. Hariharan, V.P. Seshadri, M. Preethi Apollo Hospital, Chennai, India
Background and Aim: There is association between cirrhosis and low bone mineral density (BMD) and limited data regarding prevalence of low BMD in patients awaiting liver transplantation in India. Aim of this study is to determine the prevalence of low BMD and factors associated with it in Indian patients with cirrhosis awaiting liver transplantation. Methods: Patients with Child–Turcotte–Pugh (CTP) class B or C cirrhosis awaiting liver transplantation who fulfilled the inclusion criteria were included in study. BMD measurement at lumbar spine and femoral neck were obtained by Dual Energy X-ray Absorptiometry (DXA). Prevalence of low BMD (defined as T score below 1) among the study population was determined by using Hologic DXA database (Caucasian reference standards) and newly generated ICMR database. Results: Study group comprised of 100 Indian cirrhotic patients awaiting transplantation (79 males). Mean age was 51.2 + 9.7 years with most common etiology of cirrhosis was alcohol (36%). Cirrhosis was CTP class B in 42% and class C in 58%. By using Hologic DXA database and ICMR database prevalence of low BMD was 82% (osteopenia 42% and osteoporosis 40%) and 62% (osteopenia in 43%; osteoporosis in 19%), respectively. Low BMD prevalence was high at the lumbar spine (82%) compared to femoral neck (54%) (P < 0.05). Conclusion: Present study revealed high prevalence of low BMD in Indian patients with cirrhosis awaiting liver transplantation using both database. To decrease complications, correction of osteopenia and osteoporosis in cirrhotic patients should be considered, for which further studies are required. CONFLICTS OF INTEREST The authors have none to declare.
17 BONE MINERAL DENSITY IN PATIENTS WITH CIRRHOSIS OF LIVER AWAITING LIVER TRANSPLANTATION
S42
Corresponding author: Pallav Parikh. E-mail: [email protected] http://dx.doi.org/10.1016/j.jceh.2016.06.084
© 2016, INASL
16 SAFETY AND OUTCOME OF PROTOCOL BASED INJECTION OF N-BUTYL-2CYANOACRYLATE (GLUE) FOR OBLITERATION OF GASTRIC VARIX Bhuvan Shetty, Avinash Balekuduru, Lokesh Locheruvapalli, Ravi Kiran, B.S. Satyaprakash M.S. Ramaiah Hospital, Bangalore, India
Cirrhosis and Complications
Background and Aim: In patients with portal hypertension at first endoscopy and of all variceal bleeds, 20% occur from gastric varices but outcome is worse than with esophageal variceal bleeding 1–3. The technique of endoscopic glue injection in gastric varix is not standardized. The aim of the study is to assess the efficacy and outcome of protocol based injection of glue injection at our center. Methods: We retrospectively studied all the subjects who underwent glue injection from March 2014 to February 2016. The age, gender, etiology and severity of liver disease, type of gastric varix, and outcome were systematically recorded. Results: Glue injection was done in 21 subjects during the study period. Their mean age was 41 + 10 years and 15 (71%) were men. Ethanol was the most common etiology in 11 (52%) subjects. Majority (62%) were Child–Turcott–Pugh score of A. The type of gastric varix1 was 16 (76%) of GOV 1, 3(14.2%) of IGV 1 and 2(9.5%) of GOV 1. Complications occurred in four patients which included mortality in 1 and rebleed requiring repeat injection in 3 (14.2%). Conclusion: Glue injection is useful in active bleed from gastric varices and the technique and dose of glue injection needs to be standardized by larger studies. CONFLICTS OF INTEREST The authors have none to declare. Corresponding author: Bhuvan Shetty. E-mail: [email protected] http://dx.doi.org/10.1016/j.jceh.2016.06.083
Pallav Parikh, Sharad Deshmukh, Sarojini Parameswaran, K.R. Palaniswami, N. Murugan, A.T. Mohan, Ubal Dhus, Usha Srinivas, P. Piramnayagam, M. Hariharan, V.P. Seshadri, M. Preethi Apollo Hospital, Chennai, India
Background and Aim: There is association between cirrhosis and low bone mineral density (BMD) and limited data regarding prevalence of low BMD in patients awaiting liver transplantation in India. Aim of this study is to determine the prevalence of low BMD and factors associated with it in Indian patients with cirrhosis awaiting liver transplantation. Methods: Patients with Child–Turcotte–Pugh (CTP) class B or C cirrhosis awaiting liver transplantation who fulfilled the inclusion criteria were included in study. BMD measurement at lumbar spine and femoral neck were obtained by Dual Energy X-ray Absorptiometry (DXA). Prevalence of low BMD (defined as T score below 1) among the study population was determined by using Hologic DXA database (Caucasian reference standards) and newly generated ICMR database. Results: Study group comprised of 100 Indian cirrhotic patients awaiting transplantation (79 males). Mean age was 51.2 + 9.7 years with most common etiology of cirrhosis was alcohol (36%). Cirrhosis was CTP class B in 42% and class C in 58%. By using Hologic DXA database and ICMR database prevalence of low BMD was 82% (osteopenia 42% and osteoporosis 40%) and 62% (osteopenia in 43%; osteoporosis in 19%), respectively. Low BMD prevalence was high at the lumbar spine (82%) compared to femoral neck (54%) (P < 0.05). Conclusion: Present study revealed high prevalence of low BMD in Indian patients with cirrhosis awaiting liver transplantation using both database. To decrease complications, correction of osteopenia and osteoporosis in cirrhotic patients should be considered, for which further studies are required. CONFLICTS OF INTEREST The authors have none to declare.
17 BONE MINERAL DENSITY IN PATIENTS WITH CIRRHOSIS OF LIVER AWAITING LIVER TRANSPLANTATION
S42
Corresponding author: Pallav Parikh. E-mail: [email protected] http://dx.doi.org/10.1016/j.jceh.2016.06.084
© 2016, INASL