Zeeshan Wani - Academia.edu (original) (raw)

Papers by Zeeshan Wani

Asian journal of medical sciences, Mar 1, 2024

Cureus, May 19, 2023

Sepsis and septic shock are major healthcare problems, affecting millions of people around the wo... more Sepsis and septic shock are major healthcare problems, affecting millions of people around the world each year. The speed and appropriateness of therapy administered in the initial hours of treatment are likely to influence the outcome. We conducted a study to validate the clinical assessment score named 'quick sequential organ failure assessment' (qSOFA) score for use in the early identification of sepsis patients in the emergency department. Our primary objective was to see the sensitivity and specificity of the qSOFA-score for diagnosing sepsis in the emergency department and our secondary objective was to compare the sensitivity of the qSOFA score with the National Early Warning (NEW) score in patients with sepsis.

Journal of Gastroenterology and Hepatology, Apr 28, 2016

The prevalence and clinical significance of hyponatremia in cirrhotics have been well studied; ho... more The prevalence and clinical significance of hyponatremia in cirrhotics have been well studied; however, there are limited data on hyperkalemia in cirrhotics.

Digestive Diseases and Sciences, Oct 15, 2015

Systemic inflammatory response syndrome (SIRS) is associated with an increased risk of hepatic en... more Systemic inflammatory response syndrome (SIRS) is associated with an increased risk of hepatic encephalopathy, renal failure, and poor outcome in patients with cirrhosis; however, there is a paucity of studies on this entity for severe alcoholic hepatitis (SAH). To evaluate SIRS at baseline as a predictor of development of acute kidney injury (AKI) and mortality in patients with SAH. Consecutive in-patients with SAH (discriminant function ≥ 32) without AKI at baseline were followed up for the development and progression of AKI (AKIN criteria). Of the 365 patients (mean age 45.5 ± 9.5, 356 males), SIRS at baseline was present in 236 (64.6 %). AKI developed in 122 (33.4 %), of which 50 (40.9 %) had progression of AKI. SIRS was associated with bacterial infections in 96 (40.6 %) and in 140 (59.3 %) occurred in the absence of proven infection microbiologically. The presence of SIRS predicted both AKI development (p < 0.001, OR 2.9, 95 % CI 1.7-4.8) and AKI progression (p = 0.002, OR 3.27, 95 % CI 1.48-7.21). Resolution of AKI also had a significant inverse association with SIRS (p = 0.001). High MELD score (p = 0.002, HR 1.1, 95 % CI 1.02-1.09), in-hospital progression of AKI (p = 0.04, HR 1.54, 95 % CI 1.003-2.38), and SIRS (p = 0.004, HR 1.98, 95 % CI 1.25-3.1) were significant predictors of 90-day mortality (model 1), while high MELD score (p < 0.001, HR 1.1, 95 % CI 1.04-1.12) and bacterial infections (p = 0.001, HR 1.8, 95 % CI 1.27-2.6) were independent predictors of mortality in the second multivariate model (model 2). SIRS at admission predicts both the development of AKI and 90-day mortality in patients with SAH. This could definitely have a therapeutic and prognostic implication.

Background: Iron deficiency is one of the major morbidities worldwide. The standard treatment is ... more Background: Iron deficiency is one of the major morbidities worldwide. The standard treatment is the oral iron therapy, however, the concerns of slower response makes it a less feasible option in situations where quicker response is desired. The objective of this study was to compare the response, the quickness of the response and tolerability of intravenous iron with that of oral iron. A prospective, observational cohort study was conducted on 300 patients of iron deficiency anemia in District Hospital Srinagar wherein 110 patients received oral iron and 190 patients received intravenous iron. The mean hemoglobin increase at 3 weeks in oral iron group was 1.71 g/dl and in intravenous group it was 2.75 g/dl. Conclusion: Intravenous iron therapy is more effective than oral iron in terms of rapidity of the response

International Journal of Medical and Biomedical Studies, 2020

Background: Gastric adenocarcinoma is one of the frequent cancers seen in Kashmir valley. Patient... more Background: Gastric adenocarcinoma is one of the frequent cancers seen in Kashmir valley. Patients often present with advanced disease and Gastric Outlet obstruction (GOO). We studied the profile and management of patients presenting with malignant GOO due to Gastric cancer at our center. Methods: A prospective one and half year study from May 2018 to Dec 2019 was done in the Department of Surgical Gastroenterology, Government Medical College, Srinagar. All adult patients with clinical and endoscopic evidence of malignant gastric outlet obstruction and features of gastric cancer were included. Results: Twenty three patients with GOO due to Gastric malignancies were noted in this period with a M:F ratio of 1.9:1 and age range of 32 to 79 years. Vomiting was the most common symptom present in 83 % patients followed by early satiety which was present in 74% of cases. Though patients gave history suggestive of weight loss but only 17 % patients had a documented weight loss. Palliative g...

Hepatology International, 2021

Background and aims Acute-on-chronic liver failure (ACLF) is considered a main prognostic event i... more Background and aims Acute-on-chronic liver failure (ACLF) is considered a main prognostic event in patients with chronic liver disease (CLD). We analyzed the 28-day and 90-day mortality in ACLF patients with or without underlying cirrhosis enrolled in the ACLF Research Consortium (AARC) database. Methods A total of 1,621 patients were prospectively enrolled and 637 (39.3%) of these patients had cirrhosis. Baseline characteristics, complications and mortality were compared between patients with and without cirrhosis. Results Alcohol consumption was more common in cirrhosis than non-cirrhosis (66.4% vs. 44.2%, p < 0.0001), while non-alcoholic fatty liver disease/cryptogenic CLD (10.9% vs 5.8%, p < 0.0001) and chronic HBV reactivation (18.8% vs 11.8%, p < 0.0001) were more common in non-cirrhosis. Only 0.8% of patients underwent liver transplantation. Overall, 28-day and 90-day mortality rates were 39.3% and 49.9%, respectively. Patients with cirrhosis had a greater chance of ...

Liver international : official journal of the International Association for the Study of the Liver, Oct 10, 2017

There is limited data on predictors of acute kidney injury(AKI) in ACLF. We developed a PIRO mode... more There is limited data on predictors of acute kidney injury(AKI) in ACLF. We developed a PIRO model (Predisposition, Injury, Response, Organ failure) for predicting AKI in a multi-centric cohort of ACLF patients. Data of 2360 patients from APASL-ACLF Research Consortium (AARC) was analysed. Multivariate logistic regression model (PIRO score) was developed from a derivation cohort (n=1363) which was validated in another prospective multicentric cohort of ACLF patients (n=997) RESULTS: Factors significant for P component were serum creatinine[(≥2mg/dl)OR 4.52, 95% CI (3.67-5.30)], bilirubin [(<12 mg/dL,OR 1) versus (12-30 mg/dL,OR 1.45, 95% 1.1-2.63) versus (≥30 mg/dL,OR 2.6, 95% CI 1.3-5.2)], serum potassium [(<3 mmol/LOR-1)versus (3-4.9 mmol/L,OR 2.7, 95% CI 1.05-1.97) versus (≥5 mmol/L,OR 4.34, 95% CI 1.67-11.3)] and blood urea (OR 3.73, 95% CI 2.5-5.5); for I component nephrotoxic medications (OR-9.86, 95% CI 3.2-30.8); for R component,Systemic Inflammatory Response Syndrome,...

International Journal of Health & Allied Sciences, 2016

Background: Carvedilol is a nonselective beta-blocker with an additional alpha 1 adrenoceptor blo... more Background: Carvedilol is a nonselective beta-blocker with an additional alpha 1 adrenoceptor blocking action, causing a much greater decrease in portal pressure as compared to propranolol. Materials and Methods: One hundred two consecutive patients of cirrhosis of the liver with significant portal hypertension were included, and hepatic venous pressure gradient (HVPG) was measured at the baseline and after 90 min of administration of 12.5 mg carvedilol. Results: A total of 102 patients with mean age of 58.3 ± 6.6 years were included. A total of 42.2%, 31.9%, and 26.6% patients had child Class A, child Class B, and Child Class C cirrhosis, respectively. Mean baseline HVPG was 16.75 ± 2.12 mmHg that dropped to 13.07 ± 2.32 mmHg, after 90 min of administration of 12.5 mg of carvedilol. The mean drop of HVPG was 4.5 ± 2.2 mmHg and 2.4 ± 1.9 mmHg between responders and nonresponders, respectively. Overall, 52 patients (51%) showed acute response while 50 (49%) were nonresponders. Baseline low cardiac output (CO) and high mean arterial pressure (MAP) were significant predictors of acute response on univariate analysis. On multivariate analysis, low baseline CO was found as an independent predictor. Conclusion: Carvedilol is a drug of choice among beta-blockers for primary prophylaxis of variceal bleed. Hemodynamic parameters like baseline low CO high MAP are significantly predicting acute response while as etiology, child class, and variceal size are not significantly associated with acute response to a safe dose of carvedilol.

Journal of Research in Medical Sciences, 2015

There are three types of classification commonly used for GV. 1. Sarin's classification 2. Hashiz... more There are three types of classification commonly used for GV. 1. Sarin's classification 2. Hashizome classification 3. Arakawa's classification. Most commonly used classification is Sarin's classification of GV. SARIN'S CLASSIFICATION Gastric varices are categorized into four types based on the relationship with esophageal varices, as well as by their location in the stomach [Figure 1]. [7] a. Gastroesophageal varix (GOV) type 1: Extension of esophageal varices along lesser b. Gastroesophageal varix type 2: Extension of esophageal varices along great curve c. Isolated gastric varix (IGV) type 1 and d. Isolated gastric varix type 2: Varices in stomach or duodenum as shown in figure. Gastroesophageal varix type 1 is the most common type, accounting for 74% of all GV. However, the incidence of bleeding is highest with IGV type 1, followed by GOV type 2. Overall, the most important predictor of hemorrhage is the size of varices, with the highest risk of first hemorrhage (15%/year) occurring in patients Gastric varices (GV) are responsible for 10-30% of all variceal hemorrhage. However, they tend to bleed more severely with higher mortality. Around 35-90% rebleed after spontaneous hemostasis. Approximately 50% of patients with cirrhosis of liver harbor gastroesophageal varices. In this review, new treatment modalities in the form of endoscopic treatment options and interventional radiological procedures have been discussed besides discussion on classification and pathophysiology of GV.

Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association, Jan 8, 2015

Literature regarding safe doses of carvedilol is limited, and safe doses across different Child c... more Literature regarding safe doses of carvedilol is limited, and safe doses across different Child classes of chronic liver disease are not clear. A total of 102 consecutive cirrhotic patients with significant portal hypertension were included in this study. Hepatic venous pressure gradient was measured at baseline and 3 months after dose optimization. A total of 102 patients (63 males, 39 females) with a mean age of 58.3 ± 6.6 years were included. Among these patients, 42.2% had Child Class A, 31.9% had Class B, and 26.6% had Child Class C liver disease. The mean baseline hepatic venous pressure gradient was 16.75 ± 2.12 mmHg, and after dose optimization and reassessment of hepatic venous pressure gradient at 3 months, the mean reduction in the hepatic venous pressure gradient was 5.5 ± 1.7 mmHg and 2.8 ± 1.6 mmHg among responders and nonresponders respectively. The mean dose of carvedilol was higher in nonresponders (19.2 ± 5.7 mg) than responders (18.75 ± 5.1 mg). However, this diff...

Saudi Journal of Gastroenterology, 2015

Noncirrhotic portal hypertension (NCPH), as it generally is termed, is a heterogeneous group of d... more Noncirrhotic portal hypertension (NCPH), as it generally is termed, is a heterogeneous group of diseases that is due to intrahepatic or extrahepatic etiologies. In general, the lesions in NCPH are vascular in nature and can be classified based on the site of resistance to blood flow as "prehepatic," "hepatic," and "posthepatic." The "hepatic" causes of NCPH can be subdivided into "presinusoidal," "sinusoidal," and "postsinusoidal [Table 1]." Portal vein thrombosis was first seen by Stewart and Balfour in the late 1860s in a patient with splenomegaly, ascites, and variceal dilatation. Kobrich coined the term cavernoma to describe spongy appearance of portal vein (PV). [1] Generally a hypercoagulable state, intra-abdominal infection/peritonitis, and PV anomaly (PV stenosis and atresia) are considered important predisposing factors of EHPVO; however, vast majority of cases are due to primary thrombosis of the PV and often with more than one cause. Accurate epidemiological data on PVT is difficult to obtain. Prevalence of autopsy research in the United States and Japan ranges from 0.05% to 0.5% population prevalence of portal vein thrombosis (PVT) studied by Ogran et al. seen on autopsy series is 1%. [2] Thus PVT is responsible for 5%-10% of all cases of portal hypertension in western countries. Of all cases of portal hypertension (PHT) in developing countries, 40% are attributed to PVT. In children, EHPVO accounts for 80% cases of PHT. [3] Incidence of PVT among liver cirrhotics ranges from 0.6% to 64.1%. [4] After cirrhosis, EHPVO is the most common cause of portal hypertension globally. In the Indian subcontinent, 20%-30% of all variceal bleeds are due to EHPVO. In Japan, 10%-20% of variceal bleeds and in the west, 2%-5% of variceal bleeds are due to EHPVO. Clinical presentation of PVT is different in acute and chronic thrombosis. This depends on development and extent of collateral circulation. Intestinal congestion and ischemia with abdominal pain, fever, diarrhea, rectal bleeding, distension, sepsis, and lactic acidosis with or without splenomegaly are common features of acute PVT.

Renal Failure, 2015

The clinical course and outcome of children with thrombotic thrombocytopenic purpura and posterio... more The clinical course and outcome of children with thrombotic thrombocytopenic purpura and posterior reversible encephalopathy has not been observed and studied till date. The aim of the present study was to know the clinical course and outcome of children with thrombotic thrombocytopenic purpura and posterior reversible encephalopathy. Results from our observation invite potential insight for further research on this subject. From January 2005 to February 2013, seven children diagnosed with thrombotic thrombocytopenic purpura and posterior reversible encephalopathy syndromes were admitted in a tertiary care hospital in Srinagar, Kashmir. The demographic parameters, clinical characteristics and laboratory data were noted. The outcome was defined in the form of complete recovery or death. Thrombotic thrombocytopenic purpura was diagnosed on clinical grounds, laboratory parameters and renal biopsy. The diagnosis was established after an expert opinion from a hematologist. Posterior reversible encephalopathy syndrome was defined on neuroimaging. The common clinical parameters which were shared by all the patients were hypertension and altered sensorium. Four (57.1%) patients showed clinical deterioration and died within one week of admission even after intensive management. Three (42.8%) patients improved clinically and recovered fully and were discharged in stable clinical condition. Repeat imaging on discharge was normal. This series of seven pediatric patients is the first series on this subject. The presence of posterior reversible encephalopathy syndrome in pediatric patients with thrombotic thrombocytopenic purpura complicates the clinical course and worsens the prognosis.

British Journal of Medicine and Medical Research, 2015

Journal of Clinical and Experimental Hepatology, 2014

Nigerian Journal of Cardiology, 2014

Background: The reported prevalence of concomitant coronary and carotid atherosclerotic disease h... more Background: The reported prevalence of concomitant coronary and carotid atherosclerotic disease has varied among studies due to differences in study populations and methodologies used. Objectives: The purpose of the study was to know the prevalence of carotid atherosclerotic disease and to evaluate the relationship between coronary and carotid atherosclerotic disease. Materials and Methods: We performed a prospective study from December 2010 to November 2012 to determine the association of carotid artery stenosis (CAS) with documented coronary artery disease on Angiography in Kashmiri population. Continuous variables were expressed as mean ± SD. Two-sided unpaired "t"- test was performed for continuous variables and x 2 test for discrete variables. Multivariate stepwise logistic regression analysis was performed to detect independent predictors of CAS using factors that had significant relation in univariate analysis. A value of P ≤ 0.05 was considered statistically significant. Results: The study included 100 patients among whom 19.0% had significant carotid atherosclerotic stenosis (stenosis > 50%). The severity of carotid atherosclerotic stenosis and the carotid artery disease were significantly correlated (P = 0.001). The percentage of patients with three vessel involvements (42.1%) and significant carotid stenosis were more as compared with two vessels (31.6%) and one vessel involvement (21.1%). Independent predictors of significant CAS were the presence of left main descending carotid artery disease (31.3%), triple vessel carotid artery disease (17.8%), increasing age, a history of stroke or myocardial infarction (21.05%), smoking status (78.9%), diabetes mellitus (78.94%), and hypertension (78.94%). We did not find any significant correlation between carotid atherosclerotic stenosis and gender or degree of dyslipidemia. Conclusions: The degree of carotid atherosclerotic disease is related to the extent of coronary artery disease and important risk factors.

Hepatology International, 2008

The first consensus report of the working party of the Asian Pacific Association for the Study of... more The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. With international groups volunteering to join, the "APASL ACLF Research Consortium (AARC)" was formed in 2012, which continued to collect prospective ACLF patient data. Based on the prospective data analysis of nearly 1400 patients, the AARC consensus was published in 2014. In the past nearly four-and-a-half years, the AARC database has been enriched to about 5200 cases by major hepatology centers across Asia. The data published during the interim period were carefully analyzed and areas of contention and new developments in the field of ACLF were prioritized in a systematic manner. The AARC database was also approached for answering some of the issues where published data were limited, such as liver failure grading, its impact on the 'Golden Therapeutic Window', extrahepatic organ dysfunction and failure, development of sepsis, distinctive features of acute decompensation from ACLF and pediatric ACLF and the issues were analyzed. These initiatives concluded in a two-day meeting in October 2018 at New Delhi with finalization of the new AARC consensus. Only those statements, which were based on evidence using the Grade System and were unanimously recommended, were accepted. Finalized statements were again circulated to all the experts and subsequently presented at the AARC investigators meeting at the AASLD in November 2018. The suggestions from the experts were used to revise and finalize the consensus. After detailed deliberations and data analysis, the original definition of ACLF was found to withstand the test of time and be able to identify a homogenous group of patients presenting with liver failure. New management options including the algorithms for the management of coagulation disorders, renal replacement Extended author information available on the last page of the article

Journal of Hepatology, 2014

Serum ferritin is a known marker of hepatic necro-inflammation and has been studied to predict 1 ... more Serum ferritin is a known marker of hepatic necro-inflammation and has been studied to predict 1 year mortality and post-transplant survival in decompensated cirrhotics. However, there are no studies evaluating ferritin as a predictor of early mortality. We investigated whether serum ferritin levels could predict 15 day and 30 day mortality in patients with decompensated cirrhosis. 318 patients with decompensated cirrhosis were included. Patients of decompensated cirrhosis [257 males, mean age of 51 [±13]years, were followed for a median of 31 days. Serum ferritin levels were significantly different between survivors and non-survivors [p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001] and showed significant correlation with MELD score [p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001], CTP score [p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001], leucocyte counts [TLC] [p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001], serum sodium…

Histopathology, 2013

To correlate cirrhosis histology and Laennec fibrosis scoring with portal pressure, as determined... more To correlate cirrhosis histology and Laennec fibrosis scoring with portal pressure, as determined by hepatic venous pressure gradient (HVPG). One hundred and four patients with biopsy-proven cirrhosis and known HVPG were included in the study. Semiquantitative scoring of 12 histological parameters and quantitative assessment by morphometry for septal thickness and nodule diameter and image analysis for fibrosis were performed. Laennec histological subgrading and clinical staging of cirrhosis were also performed. There were significant positive correlations between HVPG and Laennec histological grade of cirrhosis (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), micronodularity (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), the presence of thick fibrous septa (P = 0.015), the amount of collagen in the space of Disse (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and the extent of fibrosis by image analysis (P = 0.003).…