232 research outputs found
Treatment of Decompensated Alcoholic Liver Disease
No full textAlcoholic liver disease (ALD) is a spectrum ranging from simple hepatic steatosis to alcoholic hepatitis and cirrhosis. Patients with severe alcoholic hepatitis can have clinical presentation almost similar to those with decompensated cirrhosis. Scoring with models like Maddrey discriminant function, a model for end-stage liver disease, Glasgow alcoholic hepatitis score, and Lille model are helpful in prognosticating patients with ALD. One of the first therapeutic goals in ALD is to induce alcohol withdrawal with psychotherapy or drugs. Most studies have shown that nutritional therapy improves liver function and histology in patients with ALD. The rationale for using glucocorticoids is to block cytotoxic and inflammatory pathways in patients with severe alcoholic hepatitis. Pentoxifylline, a tumor necrosis factor alpha (TNFα) suppressor, and infliximab, an anti-TNFα mouse/human chimeric antibody, has been extensively studied in patients with alcoholic hepatitis. Liver transplantation remains the definitive therapy for decompensated cirrhosis/alcoholic hepatitis despite the issues of recidivism, poor compliance with postoperative care, and being a self-inflicted disease
Fatty liver - Current and future treatment: A narrative review
No full textA holistic approach is required for managing patients with nonalcoholic fatty liver disease (NAFLD). Lifestyle interventions and medical management of metabolic risk factors currently form the cornerstone of NAFLD management. A target weight loss of approximately 7%–10% in overweight/obese patients is recommended with the help of dietary calorie restriction and exercise. None the less, attaining and sustaining the target weight loss is a major challenge with lifestyle interventions. Exercise alone has also been shown to be beneficial even in the absence of weight loss and may be the modality of choice in patients with lean NAFLD. Currently, pioglitazone and Vitamin E are recommended by most of the scientific societies in patients with biopsy proven, noncirrhotic nonalcoholic steatohepatitis (NASH). Recently, saroglitazar has been approved by the drug controller general of India for management of NAFLD with comorbidities or NASH with F1-F3 fibrosis. Although not recommended as a primary modality to treat NAFLD per se, bariatric surgery is an alluring option in otherwise eligible obese patients without cirrhosis. A lot of research is being carried out in the field of NASH pharmacotherapy and many new drugs are in the pipeline
Early and current socio-economic position and cardiometabolic risk factors in the Indian Migration Study.
No full textAIMS: The aim of this study is to estimate the associations of early and current socio-economic position (SEP) on adult cardiometabolic risk factors in the Indian Migration Study (N = 7,067). METHODS AND RESULTS: Linear mixed models were used to estimate associations between early and current SEP and cardiometabolic risk factors: systolic blood pressure (SBP), body fat and Homeostasis Model Assessment (HOMA) score. In males, high current SEP was associated with higher SBP. In both genders, high early and current SEP were associated with higher body fat, current SEP dominating the associations. High early SEP was associated with higher HOMA score in males only, and the effect size halved after adjustment for current SEP. High current SEP was associated with higher HOMA score more strongly in males than in females. CONCLUSION: Higher SEP, more importantly in adulthood than childhood, was associated with cardiometabolic risk factors in an Indian population. The relationship between SEP over the life course and urbanization should be considered in the Indian context when public health interventions to prevent cardiovascular disease are planned
Development and validation of composite risk score to assess risks of major noncommunicable diseases in Northern Indian populations: A research protocol
No full textRole of stereotactic body radiation therapy in liver metastasis: A pilot study from tertiary cancer institute in India
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