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Rising incidence of acute hepatitis A among adults and clinical characteristics in a tertiary care center of Pakistan

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World Journal of Virology 2025年第1期14卷 73-82页

作者： Yumna Shahid amna subhan butt Iqra Jamali Faisal Wasim Ismail Division of Gastroenterology Department of MedicineAga Khan University HospitalKarachi 74800Pakistan Department of Medicine Aga Khan University HospitalKarachi 74800Pakistan

BACKGROUND For decades,hepatitis A virus(HAV)has been a leading cause of acute hepatitis among children and was less prevalent among ***,recently a paradigm shift has been observed in the epidemiology of HAV,as evident by cases of acute hepatitis due to HAV among *** To estimate frequency of HAV in acute viral hepatitis and compare characteristics in HAV and hepatitis E virus(HEV)*** This was a trend analysis conducted at Aga Khan University Hospital Karachi(Sindh,Pakistan)from February 2024 to May *** aged 18 years and older diagnosed with acute viral hepatitis attributed to hepatotropic viruses in 2024 were *** compare the trend patients admitted with acute hepatitis during 2019-2023 were also *** regarding clinical and laboratory parameters were *** yearly trend of acute hepatitis due to HAV and HEV was analyzed,and comparative analysis was done between HAV and HEV cases among *** A total of 396 patients were found to have acute hepatitis during our study *** was diagnosed in 234 patients(59%)while 157 patients(39.6%)were found to have acute HEV ***,acute hepatitis B virus infection was identified in 3 patients(0.7%),whereas acute hepatitis C virus infection was found in 2(0.5%)cases of acute *** trends showed increasing occurrence of HAV infection among adults over last 5 *** patients with acute HAV were younger than patients with HEV(28 years±8 years vs 30 years±8 years;P<0.01).Higher levels of total bilirubin were seen in HEV infection,while higher levels of alanine transaminase were seen in HAV ***,a higher proportion of acute liver failure(ALF),coagulopathy,and mortality were observed in *** An increase in acute hepatitis A cases among adults shows less severity than hepatitis E,highlighting the need for better sanitation,hygiene,and adult hepatitis A vaccination programs.

关键词： Acute hepatitis Hepatitis A virus Hepatitis E virus Acute liver failure Hepatotropic virus Vaccination

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Metabolic dysfunction-associated fatty liver disease and low muscle strength: A comment

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World Journal of Gastroenterology 2024年第17期30卷 2371-2373页

作者： Masood Muhammad Karim amna subhan butt Department of Gastroenterology The Aga Khan University HospitalKarachi 74800SindhPakistan Department of Medicine Aga Khan University HospitalKarachi 74800Pakistan

The diagnosis of non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease only on the basis of laboratory parameter score such as Hepatic Steatosis Index which includes liver enzymes,gender,basal metabolic index,and presence of diabetic mellitus is not sufficient to exclude other causes of deranged liver enzymes especially medications and autoimmune related liver *** the guideline suggests ultrasound is the preferred first-line diagnostic procedure for imaging of NAFLD,as it provides additional diagnostic information and the combination of biomarkers/scores and transient elastography might confer additional diagnostic accuracy and evident from previous similar studies too.

关键词： Non-alcoholic fatty liver disease Metabolic dysfunction associated fatty liver disease Low muscle strength Hepatic Steatosis Index Letter to the editor

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Redefining non-alcoholic fatty liver disease to metabolic associated fatty liver disease: Is this plausible?

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World Journal of Hepatology 2022年第1期14卷 158-167页

作者： Jalpa Devi Aimun Raees amna subhan butt Department of Gastroenterology Liaquat University of Medical and Health SciencesJamshoro 74800Pakistan Department of Gastroenterology Aga Khan University HospitalKarachi 74800Pakistan

Recently,a single letter change has taken the world by storm.A group of experts have developed a consensus to upgrade the term non-alcoholic fatty liver disease(NAFLD)to metabolic associated fatty liver disease(MAFLD),suggesting that MAFLD would more accurately reflect not only the disease pathogenesis but would also help in patient stratification for management with ***,the difference of opinion exists,which has made the NAFLD vs MAFLD debate the current talk of the *** review will focus on the plausibility and implications of redefining NAFLD as MAFLD.

关键词： Non-alcoholic fatty liver disease Metabolic associated fatty liver disease Fatty liver disease Non-alcoholic fatty liver Review

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Impact of direct acting antivirals on occurrence and recurrence of hepatocellular carcinoma: Biologically plausible or an epiphenomenon?

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World Journal of Hepatology 2018年第2期10卷 267-276页

作者： amna subhan butt Fatima Sharif Shahab Abid Section of Gastroenterology Department of Medicine Aga Khan University Hospital

Hepatocellular carcinoma(HCC) is a major cause of morbidity and mortality worldwide. Chronic hepatitis C virus infection(HCV) is the most common cause of HCC in many European countries, Japan and Pakistan. Introduction of the new direct acting antivirals(DAAs) has revolutionized the management of HCV worldwide, with high rates of sustained virologic response in patients who could not have tolerated the previous interferon based treatments. However, recently there have been reports raising caution about the long term effects of DAAs, particularly a possible increased risk of HCC. Therefore this review explores the current molecular studies as well as clinical data that investigate the impact of DAAs on occurrence and recurrence of HCC.

关键词： Hepatocellular carcinoma Direct acting antivirals Hepatitis C

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Is transarterial embolization a valuable treatment option for spontaneous rupture of hepatocellular carcinoma: experience from a tertiary care hospital of South-Asia

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Hepatoma Research 2016年第1期2卷 279-286页

作者： amna subhan butt Saeed Hamid Nazish butt Fatima Sharif Tanveer Ul Haq Wasim Jafri Section of Gastroenterology Department of MedicineThe Aga Khan UniversityKarachi 74800Pakistan The Aga Khan University Karachi 74800Pakistan Department of Radiology The Aga Khan UniversityKarachi 74800Pakistan

Aim:Transarterial embolization(TAE)has been found beneficial in treatment of ruptured Hepatocellular carcinoma(HCC)in earlier *** far no data is available from *** aim of this study was to evaluate clinicopathological characteristics,outcomes of patients presented with spontaneously ruptured,unresectable HCC treated with or without TAE and to evaluate the factors associated with 30-day ***:This was a cross sectional ***≥18 years old,presented with spontaneous rupture of unresectable HCC,were *** outcome measures were control of bleeding,in-hospital mortality,30-day mortality and factors associated with 30-days ***:Out of 850 patients,24 patients were diagnosed with spontaneously ruptured *** age was 58.29±15.26 years.A total of 11(45.8%)patients were treated conservatively and 13(54.2%)underwent *** of bleeding due to ruptured HCC was significantly higher for those treated via TAE as compared to those who were treated conservatively(92.3%vs.36.4%,P=0.008).Overall median duration for which the patients remained alive after HCC rupture was longer for TAE group(39 days vs.5 days,P=0.03).In-hospital mortality(30.8% vs.72.7%,P=0.04)and 30-day mortality was also lower in TAE group(38.5%vs.90.9%,P=0.01).Those who underwent TAE had lower risk of mortality then conservative group odds ratio(OR)0.25,95% confidence interval(CI0.07-0.90,P=0.03).Failure to control bleeding was associated with higher 30-day mortality(OR 2.14,95% CI 1.24-3.68,P=0.009).Conclusion:Ruptured HCC is a life threatening complication requiring early diagnosis and *** is an effective and well-tolerated treatment in the management of ruptured HCC.

关键词： Ruptured hepatocellular carcinoma transarterial embolization Pakistan

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National guidelines for the diagnosis and treatment of hilar cholangiocarcinoma

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World Journal of Gastroenterology 2024年第9期30卷 1018-1042页

作者： Faisal Saud Dar Zaigham Abbas Irfan Ahmed Muhammad Atique Usman Iqbal Aujla Muhammad Azeemuddin Zeba Aziz Abu Bakar Hafeez Bhatti Tariq Ali Bangash amna subhan butt Osama Tariq butt Abdul Wahab Dogar Javed Iqbal Farooqi Faisal Hanif Jahanzaib Haider Siraj Haider Syed Mujahid Hassan Adnan Abdul Jabbar Aman Nawaz Khan Muhammad Shoaib Khan Muhammad Yasir Khan Amer Latif Nasir Hassan Luck Ahmad Karim Malik Kamran Rashid Sohail Rashid Mohammad Salih Abdullah Saeed Amjad Salamat Ghias-un-Nabi Tayyab Aasim Yusuf Haseeb Haider Zia Ammara Naveed Department of Hepatopancreatic Biliary Surgery&Liver Transplant Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan Department of Hepatogastroenterology and Liver Transplantation Dr.Ziauddin University HospitalKarachi 75600SindhPakistan University of Aberdeen Aberdeen B243FXUnited Kingdom Department of Pathology Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan Department of Gastroenterology&Hepatology Pakistan Kidney and Liver Institute&Research CentreLahore 54000Pakistan Department of Radiology Aga Khan UniversityKarachi 74800Pakistan Department of Oncology Hameed Latif HospitalLahore 54000Pakistan Division of Hepatopancreatic Biliary Surgery&Liver Transplantation Shifa International HospitalIslamabad 44000Pakistan Department of Hepatopancreatic Biliary Surgery&Liver Transplant Shaikh Zayed Hospital and Post Graduate Medical InstituteLahore 54000Pakistan Department of Medicine Aga Khan University HospitalKarachi 74800Pakistan Department of Liver Transplant Pir Abdul Qadir Shah Jeelani Institute of Medical SciencesGambat 66020Pakistan Department of Medicine&Gastroenterology Lifecare Hospital and Research CentrePeshawar 25000Khyber PakhtunkhwaPakistan Department of Hepatopancreatobiliary&Liver Transplant Bahria International HospitalLahore 54000Pakistan Department of Surgery Hepatopancreatobiliary&Liver TransplantDow University of Health SciencesKarachi 74800Pakistan Department of Gastroenterology Hepatology&NutritionPir Abdul Qadir Shah Jeelani Institute of Medical SciencesGambat 66020Pakistan Department of Oncology Dr.Ziauddin HospitalKarachi 74800Pakistan Department of Radiology Rehman Medical InstitutePeshawar 25000Pakistan Army Liver Transplant Unit Pak Emirates Military HospitalRawalpindi 46000Pakistan Department of Gastroenterology Sindh Institute of Urology and TransplantationKarachi 75500Pakistan Rashid Nursing Home and Cancer Clinic Rashid Nursing Home and Cancer ClinicRawalpindi 46000Pakistan Department of Gastroentero

A consensus meeting of national experts from all major national hepatobiliary centres in the country was held on May 26,2023,at the Pakistan Kidney and Liver Institute&Research Centre(PKLI&RC)after initial consultations with the *** Pakistan Society for the Study of Liver Diseases(PSSLD)and PKLI&RC jointly organised this *** effort was based on a comprehensive literature review to establish national practice guidelines for hilar cholangiocarcinoma(hCCA).The consensus was that hCCA is a complex disease and requires a multidisciplinary team approach to best manage these *** coordinated effort can minimise delays and give patients a chance for curative treatment and effective *** diagnostic and staging workup includes high-quality computed tomography,magnetic resonance imaging,and magnetic resonance *** cytology or biopsy utilizing endoscopic retrograde cholangiopancreatography is a mainstay for ***,histopathologic confirmation is not always required before *** ultrasound with fine needle aspiration of regional lymph nodes and positron emission tomography scan are valuable adjuncts for *** only curative treatment is the surgical resection of the biliary tree based on the Bismuth-Corlette *** patients with unresectable hCCA can be considered for liver *** chemotherapy should be offered to patients with a high risk of *** use of preoperative biliary drainage and the need for portal vein embolisation should be based on local multidisciplinary *** with acute cholangitis can be drained with endoscopic or percutaneous biliary *** chemotherapy with cisplatin and gemcitabine has shown improved survival in patients with irresectable and recurrent hCCA.

关键词： Hilar cholangiocarcinoma Bismuth-Corlette classification Memorial Sloan Kettering Cancer Centre Staging Preoperative biliary drainage Portal vein embolisation Surgical resection Hepatectomy

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