Etiology, Pathology and presentation of Cirrhosis of live. signs and symptoms and complication of the disease. Its a basic level Presentation on this given topic to have an idea about the Cirrhosis of Liver.
Etiology, Pathology and presentation of Cirrhosis of live. signs and symptoms and complication of the disease. Its a basic level Presentation on this given topic to have an idea about the Cirrhosis of Liver.
Cirrhosis is a diffuse process characterized by liver necrosis & fibrosis and conversion of normal liver architecture into structurally abnormal nodules that lack normal lobular organization
DILI is possible consequence of ingestion of OTC drugs like PCM.
so it require careful clinical knowledge before taking drugs without doctors prescriptions...
In the vedio you can see how the presentation was supposed to be
The link :
http://www.youtube.com/watch?v=MFBdaSF-JqM
To download my Animated presentation vist
https://www.dropbox.com/s/qg6ie3mpcbvp793/Gastric.Ulcer.ToPost.pptx
Thanks for watching
Cirrhosis is a diffuse process characterized by liver necrosis & fibrosis and conversion of normal liver architecture into structurally abnormal nodules that lack normal lobular organization
DILI is possible consequence of ingestion of OTC drugs like PCM.
so it require careful clinical knowledge before taking drugs without doctors prescriptions...
In the vedio you can see how the presentation was supposed to be
The link :
http://www.youtube.com/watch?v=MFBdaSF-JqM
To download my Animated presentation vist
https://www.dropbox.com/s/qg6ie3mpcbvp793/Gastric.Ulcer.ToPost.pptx
Thanks for watching
CASE PRESENTATION ONCIRRHOSIS OF LIVER WITH PORTAL HYPERTENSION, HEPATIC EN...Akhil Joseph
A DETAIL CASE PRESENTATION ON CIRRHOSIS OF LIVER WITH PORTAL HYPERTENSION, HEPATIC ENCEPHALOPATHY AND GRADE II OESOPHAGEAL VARICES WITH CONGESTIVE GASTROPATHY. LIVER CIRRHOSIS AND ALL ITS COMPLICATION IN A PATIENT.
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. ... As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function (decompensated cirrhosis)
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.
Alcoholic liver disease is a term that encompasses the hepatic manifestations of alcohol overconsumption, including fatty liver, alcoholic hepatitis, and chronic hepatitis with hepatic fibrosis or cirrhosis.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Thesis Statement for students diagnonsed withADHD.ppt
19 hepatic cirrhosis
1. Hepatic Cirrhosis Bin Wu, MD & PhD Professor and Head Department of Gastroenterology The Third Affiliated Hospital Sun Yat-Sen University
2. Aim: Master: Clinical Manifestation and Diagnosis of Hepatic cirrhosis Acquaint: Distinguish Diagnosis and Complication as well as Rule of Treatment Know: Causes and Risk Factors , Mechanism. Times: 2 hours
3. Definition Hepatic c irrhosis is a chronic, degenerative disease in which normal liver cells are damaged and are then replaced by scar tissue.
4. Description Hepatic Cirrhosis changes the structure of the liver and the blood vessels that nourish it. The disease reduces the liver's ability to manufacture proteins and process hormones, nutrients, medications, and poisons.
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6. Long-term alcoholism is the primary cause of cirrhosis in the United States. Men and women respond differently to alcohol. Although most men can safely consume two to five drinks a day, one to two drinks a day can cause liver damage in women. Individual tolerance to alcohol varies, but people who drink more and drink more often have a higher risk of developing cirrhosis. In some people, one drink a day can cause liver scarring.
7. Chronic liver infections, such as hepatitis B and particularly hepatitis C, are commonly linked to cirrhosis. People at high risk of contracting hepatitis B include those exposed to the virus through contact with blood and body fluids. This includes healthcare workers and intravenous (IV) drug users. In the past, people have contracted hepatitis C through blood transfusions. As of 2003, cirrhosis resulting from chronic hepatitis has emerged as a leading cause of death among HIV-positive patients; in Europe, about 30% of HIV-positive patients are coinfected with a hepatitis virus.
8. Liver injury, reactions to prescription medications, certain autoimmune disorders, exposure to toxic substances, and repeated episodes of heart failure with liver congestion can cause cirrhosis. A family history of diseases can genetically predispose a person to develop cirrhosis.
9. Cirrhosis is the seventh leading cause of disease related death in the United States . It is twice as common in men as in women. The disease occurs in more than half of all chronic alcoholics and kills about 25,000 peoples a year. It is the third most common cause of death in adults between the ages of 45 and 65.
10. Hepatitis is the first leading cause of disease related death in the China . So far, HBsAg + peoples are about 1200 million (1, 200, 000, 000), and peoples who are infected HCV are about 38 million (38, 000, 000).
11. Types of cirrhosis Portal or nutritional cirrhosis is the form of the disease most common in the United States. About 30–50% of all cases of cirrhosis are this type. Nine out of every 10 people who have nutritional cirrhosis have a history of alcoholism . Biliary cirrhosis is caused by intrahepatic bile-duct diseases that impede bile flow. Bile is formed in the liver and is carried by ducts to the intestines. Bile then helps digest fats in the intestines. Biliary cirrhosis can scar or block these ducts. It represents 15–20% of all cirrhosis. Various types of chronic hepatitis, especially hepatitis B and hepatitis C , can cause post-necrotic cirrhosis. This form of the disease affects up to 40% of all patients who have cirrhosis.
12. Chronic hepatitis B and C Alcoholic liver disease Drugs or toxins Cardiac cirrhosis (heart failure ) Certain parasitic infections (such as schistosomiasis) Primary biliary cirrhosis Autoimmune hepatitis Primary sclerosing cholangitis Other: such as Wilson's disease , Hereditary Hemochromatosis , Alpha 1-antitrypsin deficiency , Galactosemia , Cystic fibrosis In China, the chronic hepatitis is common cause, but not the alcoholic liver disease. Risk factors of Hepatic cirrhosis
13. Worldwide Prevalence of HBV and Incidence of HCC World prevalence of HBV carriers HBsAg carriers-prevalence <2% 2–7% >8% Poorly documented Annual incidence of primary HCC Cases/100,000 population 1–3 3–10 10–150 Poorly documented WHO 2003
14. Hepatitis B Related Death in China * >85% related to HBV infection He et al. NEJM 2006 Per 100,000 person/yr 10 1.3 16.0 113 Women 8 1.7 26.7 193 Men 8 1.5 21.3 306 Total Chronic liver diseases* Rank order Percentage of total death Mortality No. of Deaths Cause of death
21. This liver is slightly enlarged and has a pale yellow appearance, seen both on the capsule and cut surface. This uniform change is consistent with fatty metamorphosis (fatty change). Here are seen the lipid vacuoles within hepatocytes. The lipid accumulates when lipoprotein transport is disrupted and/or when fatty acids accumulate. Alcohol, the most common cause, is a hepatotoxin that interferes with mitochondrial and microsomal function in hepatocytes, leading to an accumulation of lipid. Fatty Liver H&E Fatty Liver lipid vacuoles Healthy
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23. Normal liver Cirrhosis after hepatitis Cirrhosis after fatty liver R egenerative nodules F ibrotic scar tissue Hepatic lobule Centre vein Fatty granule H epatic cord
26. Ongoing liver damage with liver cell necrosis followed by fibrosis and hepatocyte regeneration results in cirrhosis. This produces a nodular, firm liver. The nodules seen here are larger than 3 mm and, hence, this is an example of macronodular cirrhosis. This is an example of a micronodular cirrhosis. The regenerative nodules are quite small, averaging less than 3 mm in size. The most common cause for this is chronic alcoholism. The process of cirrhosis develops over many years. M acronodular cirrhosis M icronodular cirrhosis >3.0mm <3.0mm Mix is including maro- and micronodular cirrhosis Pathology
27. Clinical Manifestation Compensation Stage: The signs and symptoms of cirrhosis are nonspecific and frequently related to the complications. anemia bleeding gums constipation decreased interest in sex diarrhea dull abdominal pain dry skin and itching fatigue fever fluid in the lungs hallucinations indigestion lethargy lightheadedness loss of appetite muscle weakness musty breath nausea neuritis vomiting weakness weight loss
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30. Jaundice is a condition in which a person's skin and the whites of the eyes are discolored yellow due to an increased level of bile pigments in the blood resulting from liver disease. Jaundice is sometimes called icterus, from a Greek word for the condition.
31. Many of these outward-bound chemicals are excreted into the bile. One particular substance, bilirubin, is yellow. Bilirubin is a product of the breakdown of hemoglobin, which is the protein inside red blood cells. If bilirubin cannot leave the body, it accumulates and discolors other tissues. The normal total level of bilirubin in blood serum is between 0.2 mg/dL and 1.2 mg/dL. When it rises to 3 mg/dL or higher, the person's skin and the whites of the eyes become noticeably yellow.
32. J aundice , a yellow discoloration of all tissues and organs, including the eye and the skin.
33. After liver is damaged, the hepatocytes are not able to treat estrogen , resulting in Spider nevi and Palmar erythema.
36. As the liver becomes fibrotic , there is obstruction of the blood flow through the liver. This results in portal hypertension , an increase in blood pressure within the portal vein and its tributaries. The obstructed hepatic blood flow also causes congestion of the spleen , leading to a markedly enlarged spleen ( splenomegaly ). Also, most people with cirrhosis eventually develop fluid in their abdomen (ascites) and are at an increased risk of developing a spontaneous intraabdominal infection.
40. Portal hypertension results from the abnormal blood flow pattern in liver created by cirrhosis. The increased pressure is transmitted to collateral venous channels. Sometimes these venous collaterals are dilated. Seen here is "caput medusae" which consists of dilated veins seen on the abdomen of a patient with cirrhosis of the liver. A bdomen varices Esophageal varices A much more serious problem produced by portal hypertension results when submucosal veins in the esophagus become dilated. These are known as esophageal varices. Varices are seen here in the lower esophagus as linear blue dilated veins. There is hemorrhage around one of them. Such varices are easily eroded, leading to massive gastrointestinal hemorrhage
44. Image of portal hypertensive gastropathy seen on endoscopy of the stomach. The normally smooth mucosa of the stomach has developed a mosaic like appearance, that resembles snake -skin
52. Lab findings Aminotransferases - AST and ALT are moderately elevated, with AST > ALT. However, normal aminotransferases do not preclude cirrhosis. Alkaline phosphatase – ( AKP )usually slightly elevated. GGT -- correlates with AP levels. Typically much higher in chronic liver disease from alcohol. Bilirubin - may elevate as cirrhosis progresses. Albumin - levels fall as the synthetic function of the liver declines with worsening cirrhosis since albumin is exclusively synthesized in the liver Prothrombin time - increases since the liver synthesizes clotting factors. Globulins - increased due to shunting of bacterial antigens away from the liver to lymphoid tissue. Serum sodium - hyponatremia due to inability to excrete free water resulting from high levels of ADH and aldosterone . Thrombocytopenia - due to both congestive splenomegaly as well as decreased thrombopoietin from the liver. However this rarely results in platelet count < 50,000/mL. Leukopenia and neutropenia - due to splenomegaly with splenic margination. Coagulation defects - the liver produces most of the coagulation factors and thus coagulopathy correlates with worsening liver disease.
53. Other laboratory studies performed in newly diagnosed cirrhosis may include: Serology for hepatitis viruses, autoantibodies ( ANA , anti-smooth muscle, anti-mitochondria , anti-LKM) Ferritin and transferrin saturation (markers of iron overload), copper and ceruloplasmin (markers of copper overload) Immunoglobulin levels (IgG, IgM, IgA) - these are non-specific but may assist in distinguishing various causes Cholesterol and glucose Alpha 1-antitrypsin
54. Imaging Ultrasound , CT and MRI are routinely used in the evaluation of cirrhosis, where it may show a small and nodular liver in advanced cirrhosis along with increased echogenicity with irregular appearing areas. Ultrasound may also screen for hepatocellular carcinoma, portal hypertension and Budd-Chiari syndrome (by assessing flow in the hepatic vein).
58. Laparoscope can observe hepatic regenerative nodular , and get liver biopsy sample. Cirrhosis of Liver Spleen enlarges
59. Endoscopy Gastroscopy (endoscopic examination of the esophagus, stomach and duodenum) is performed in patients with established cirrhosis to exclude the possibility of esophageal varices. If these are found, prophylactic local therapy may be applied (sclerotherapy or banding) and beta blocker treatment may be commenced.
62. Liver biopsy: The gold standard for diagnosis of cirrhosis is a liver biops y , through a percutaneous, transjugular, laparoscopic, or fine-needle approach. However, a biopsy is not necessary if the clinical, laboratory, and radiologic data suggests cirrhosis. Furthermore, there is a small but significant risk to liver biopsy, and cirrhosis itself predisposes for complications due to liver biopsy .
63. A patient's medical history can reveal illnesses or lifestyles likely to lead to cirrhosis. Liver changes can be seen during a physical examination. A doctor who suspects cirrhosis may order blood and urine tests to measure liver function. Because only a small number of healthy cells are needed to carry out essential liver functions, test results may be normal even when cirrhosis is present. Diagnosis
64. In about 10 out of every 100 patients, the cause of cirrhosis cannot be determined. Many people who have cirrhosis do not have any symptoms (often called compensated cirrhosis). Their disease is detected during a routine physical or when tests for an unrelated medical problem are performed. This type of cirrhosis can also be detected when complications occur (decompensated cirrhosis).
65. Computed tomography scans (CT), ultrasound, and other imaging techniques can be used during diagnosis. They can help determine the size of the liver, indicate healthy and scarred areas of the organ, and detect gallstones. Cirrhosis is sometimes diagnosed during surgery or by examining the liver with a laparoscope. This viewing device is inserted into the patient's body through a tiny incision in the abdomen.
66. Liver biopsy is usually needed to confirm a diagnosis of cirrhosis. In this procedure, a tissue sample is removed from the liver and examined under a microscope in order to learn more about the organ's condition and to properly diagnose it.
67. A newer and less invasive test involves the measurement of hyaluronic acid (HA) in the patient's blood serum. As of 2003, however, the serum HA test is most useful in monitoring the progress of liver disease; it is unlikely to completely replace liver biopsy in the diagnosis of cirrhosis.
68. Prevention Eliminating alcohol abuse could prevent 75–80% of all cases of cirrhosis. Other preventive measures include: M aintaining a healthy diet that includes whole foods and grains, vegetable, and fruits O btaining counseling or other treatment for alcoholism T aking precautions ( practicing safe sex, avoiding dirty needles ) to prevent hepatitis G etting immunizations against hepatitis if a person is in a high-risk group receiving appropriate medical treatment quickly when diagnosed with hepatitis B or hepatitis C H aving blood drawn at regular intervals to rid the body of excess iron from hemochromatosis U sing medicines (chelating agents) to rid the body of excess copper from Wilson's disease W earing protective clothing and following product directions when using toxic chemicals at work, at home, or in the garden
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71. The therapy of cirrhosis is aimed primarily at preventing or reducing the complications. Bleeding esophageal varices (collateral venous channels) are a frequent serious complication of cirrhosis. Various techniques are used to control the bleeding. In some individuals with severe portal hypertension , vascular shunts are made to reduce the pressure in the portal vein by bypassing the liver. Most frequently the portal vein is surgically connected to the inferior vena cava so that some of the blood in the portal vein does not pass through the liver. Treatment
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74. Ref: De Franchis R. Digestive and liver disease 2004;36(S1):S93 Endoscopic sclerotherapy (EST) is an established method for controlling and preventing bleeding from oesophageal varices