Indian Journal of Gastroenterology最新文献

Background and objectives: The occurrence of hepatitis E virus (HEV) infection in pregnant women is a significant concern for maternal and neonatal health. Detection of HEV can be done through anti-HEV antibodies (immunoglobulin G [IgG] and immunoglobulin M [IgM]) or RNA-based tests. Robust estimates of exposure of hepatitis E among pregnant women in northern India are limited. So, this study was done to evaluate the seroprevalence of hepatitis E in pregnant females.

Methods: The prospective cohort study was conducted at the department of obstetrics and gynecology for one year. The study was approved by the Institutional Ethical Committee (ECR/262/Inst/UP/2013RR-19 Ref code XV-PGTSC-IIA/P24). A 5-mL blood sample was collected from each participant's median cubital vein, centrifuged and serum/plasma separated early to prevent hemolysis of red blood cells and stored at - 20 °C for further analysis. The study used the Wantai HEV IgG ELISA diagnostic kit manufactured in Beijing, a commercially available enzyme-linked immunosorbent assay for qualitative detection of IgG antibodies to hepatitis E virus in human serum or plasma. Results were calculated by relating each specimen absorbance value to the cut-off value (C.O). All specimens fulfilled quality control criteria and the index was defined as A/C.O.

Results: Of 602 pregnant patients tested, 287 patients (47.7%) were IgG HEV positive and 326 patients (52.3%) were IgG HEV negative. Seropositivity increases with an increase in age. Total 51.3% of rural area females were seropositive than 45.3% in urban population. Low body mass index (BMI) was associated with high seropositivity.

Discussion: Seroprevalence of hepatitis E in the north Indian population in the present study was quite high. The result of the present study can be used in formulating the guidelines for hepatitis E vaccination in pregnant females.

Background: Splenomegaly commonly occurs in portal hypertension due to cirrhosis, potentially causing leukopenia, thrombocytopenia and portal hypertension. Partial splenic artery embolization (PSE) serves as a substitute for splenectomy, given the significant risks associated with surgery in cirrhotic patients. In addition to improving hematologic indices, PSE may indirectly benefit liver-related outcomes and reduce portal hypertension complications.

Methods: The objective of this study was to assess the short-term (One-month) and long-term (24-month) impact on hematological parameters and liver function post-PSE, to compare the hematological parameters and liver function in patients with different volumes of spleen embolization (group A-< 50% and group B-> 50%) and to evaluate the changes in the status of esophageal varices and Child-Turcotte-Pugh (CTP) score after PSE. A review of medical records of 47 patients who underwent PSE between March 2011 and March 2023 was conducted from the hospital database. PSE was primarily indicated for hypersplenism-related complications in cirrhotic patients and to improve blood counts for safer anti-viral therapy in hepatitis C virus (HCV) infection. Information regarding patient demographics, underlying liver disease, indication for PSE and baseline laboratory values was noted at short-term (One month) and long-term duration (24 months).

Results: Short-term follow-up revealed an 80 ± 11.8% increase in total leukocyte count (TLC) and a 143 ± 39% rise in platelet count, while long-term follow-up showed a 56 ± 8.6% increase in TLC and an 83.7 ± 21% increase in platelet count. Albumin levels rose from 3.0 ± 0.6 g/dL before PSE to 3.3 ± 0.58 g/dL (10.4 ± 1.4% increase) in the long term. Cumulative variceal bleeding episodes decreased from 2.1 to 0.72, alongside an improved CTP score from baseline.

Conclusion: PSE leads to sustained hematologic improvement and favorable changes in liver-related parameters. Embolization limited to < 50% achieves comparable long-term benefits with fewer complications, supporting its role as a safer therapeutic strategy in cirrhotic patients with hypersplenism.