This cross-sectional study was performed in the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University. The purpose of this study was to assess the diagnostic value of serum Glypican-3 in detecting hepatocellular carcinoma. It was conducted during January 2015 to December 2016. Through convenience sampling technique, 30 diagnosed patients of hepatocellular carcinoma were enrolled in this study. Mean age was 50.26 ± 14.7 years. Males were the predominant gender in the study, which was 86.7%. Among the 30 respondents, 76.7% had HBsAg positive, 10% had anti HCV antibodies present. Mean serum glypican 3 level was 378.00 ± 168.42 ng/ml. Significant association of Alfa-fetoprotein and serum Glypican 3 in hepatocellular carcinoma patients was found. Serum Alfa-fetoprotein and serum Glypican 3 both were significantly detected in hepatocellular carcinoma but Glypican 3 was more sensitive and specific to detect hepatocellular carcinoma.
Women in gastroenterology are underrepresented all over the world and in South Asia, the numbers are even fewer. Women doctors in South Asia have their unique set of problems that they have to deal with. They are trained well and are keen to publish but are not considered good enough. They do not get the same opportunities as their male colleagues. There is more expectation from women doctors to look after their families and children. We can correct this discrepancy by giving more opportunities, arranging flexible training, deserving promotions, leadership roles, equal pay, and research mentors for women doctors in gastroenterology in South Asia, and educating our society to treat women doctors, at par with men.Kedia D, Kamani L, Begum MR, et al. Journey of Women in Gastroenterology in South Asian Countries: From Training to Leadership. Euroasian J Hepato-Gastroenterol 2023;13(1):41-43.
Background and Objective: Caspase-cleaved cytokeratin 18 (CK18 M30) is a potential clinically useful biomarker in liver disease as it is released from hepatocytes during apoptosis. Chronic hepatitis B virus (HBV) infection affects more than 400 million people worldwide. For treatment of chronic hepatitis B, it is very essential to know the necro inflammatory status of liver. Cytokeratin (CK) 18 is an intermediary filament protein, expressed in hepatocytes, which is proteolytically cleaved during liver damage. In this study, we aimed to investigate whether serum CK-18 fragment M30 level significantly related with the hepatic necroinflammatoryactivity in patients with HBV related compensated chronic liver disease (CLD)..Methods: This was a prospective observational study. All patients who met the inclusion and exclusion criteria were assessed for liver biopsy. The total sample was 40 patients. This study was conducted in Department of Hepatology, Bangabandhu Sheikh Mujib Medical University. Per cutaneous transthoracic liver biopsy was done. Specimens were sent to department of pathology, BSMMU for METAVIR scoring. Result: Among 40 CHB patients, the highest frequency was found at 21-30 age groups, male 31(77.5%) and female 9(22.5%), the mean HBV DNA PCR was found 5.3±1.7 (IU/ml). The mean AST and ALT were found 40.2±20.2 (U/L) and 66.4±68.2 (U/L) respectively. 16 patients were HBeAg positive and 24 patients were HBeAg negative. CK-18 M30 level in both HBeAg negative CHB patients and HBeAg positive patients were almost similar(128.8±32.91 and 123.9±28.1), Activity METAVIR score of hepatic necro inflammationreveals, A0 was 0 (0.0%), A1 was 7(17.5%), A2 was 21(52.5%), A3 was 12(30.0%),Correlation between factors and activity METAVIR score on spearman correlation test reveals, Correlation co-efficient (r value)-age was 0.204, GGT was 0.287 , ALT was 0.333, AST was 0.360, Serum CK 18 fragment M30 level was negatively correlated with activity score of hepatic necro inflammation (r= -0.073; p=0.357). The correlation between ALT and AST with activity score were statistically significant (p<0.05). The area under the receiver-operator characteristic (ROC) curves for prediction of serum CK-18 fragment M30 level reveals - area under curve(AUC)0.307, which gave a cut off value of 100 U/L with 78.8% sensitivity and 14.3% specificity for prediction of significant necro inflammation (A2 and A3). Conclusion: This study indicates there was no correlation between serum CK-18 fragment M30 level and hepatic necroinflammatory activity in patients with HBV related compensated chronic liver disease (CLD). As a result, CK 18 M30 cannot be used as an accurate non-invasive predictor of significant inflammatory activities in patients with CHB.
Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a dreaded complication. But the frequency of this complication varies widely (1%–40%) among the literature and across geographical regions. With uncertainty in the estimation of occurrence and having no accepted, safe, effective method to prevent it, identification of its frequency and predictable risk factors is very crucial in a local or regional setting. The aim of this study was to identify the frequency of PEP and its risk factors from 4 tertiary care referral centers from a country in the South East Asia Region. This cross-sectional study was done on 1042 consecutive ERCP in adult patients (age >18 years) with baseline serum amylase levels less than 3 times the upper level of standard value. On the basis of clinical features and the amylase level at 24 hours (the next morning), the procedure was evaluated to confirm PEP. The frequency of PEP was calculated and procedure, patient, or operator-related independent risk factors for occurring PEP were analyzed using univariate and multivariate analyses. The study found 204 (19.6%) cases of PEP. In multivariate regression analysis, young age, suspected Sphincter of Oddi Dysfunction, recurrent pancreatitis, needle papillotomy, and pancreatic sphincterotomy were significant risk factors. The univariate analysis also found difficult cannulation and pancreatic duct injection with contrast as significant risk factors. Both patient-related and procedure-related risk factors acted independently for the development of PEP, which occurred in 19.6% of cases. This multicenter assessment of the frequency and risk factors for PEP in our patients would be extremely beneficial for future prevention of this complication.
