Assessment of Risk Factors and Clinical Presentations in a Liver Cirrhotic State-Pakistan

6 Abstract: Background: Liver cirrhosis is one among most common causes of death throughout the world. Pakistan is known as cirrhotic state with high number of cirrhosis anywhere in the world. Aims: The objectives of this study were to assess risk factors, clinical features and complications of liver cirrhosis. Method: This study was done at medical wards of Khyber Teaching Hospital and Lady Reading Hospital Peshawar. Data was collected from 74 patients with cirrhosis through structured questionnaire. Results revealed that in our results showed that Prevalence of liver cirrhosis is high in age group > 45 years(68.9%) and in male patients(79.7%), low in intermediate age group (29.7%) and infrequent in young age group (1.4%). Out of 74 cases 38 were attributed to HCV only, 12 to HBV and HCV co-infection, 7 to HBV only, 6 to HBV and Alcohol and HCV and Alcohol each, 3 to HBV, HCV and Alcohol acting conjointly and 1 to Fatty liver disease. For 1 patient the cause was unknown. More than 75% hepatitis (B and C) was associated with clinical mal-practices. Most frequent signs and symptoms in decreasing order were anorexia and weight loss (100%), jaundice (90.5 %), abdominal disturbances and spleenomegaly (75%), bleeding tendencies, decreasing mental function, itching and palmer erythema (<20%). Complications were ascites (97.3%), peripheral oedema(73%), recurrent infections (43.2), hepatic encephalopathy (28%), GIT bleeding (4.1%) and hepatocellular carcinoma (1.4%). Serum ALT and total Bilirubin were raised in 80 % and 90.7% patients respectively. Conclusion: Hepatitis C is the most frequent cause of liver cirrhosis mostly acquired through prick by contaminated syringes or blades or through blood transfusion.