Publications by authors named "Ruveena Rajaram"
Globally, nearly half of deaths from cirrhosis and chronic liver diseases (CLD) and three-quarters of deaths from hepatocellular carcinoma (HCC) occur in the Asia-Pacific region. Chronic hepatitis B is responsible for the vast majority of liver-related deaths in the region. Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common form of CLD, affecting an estimated 30% of the adult population.
View Article and Find Full Text PDFBackground And Aim: Abnormal liver biochemistry (ALB) is common among patients with COVID-19 infection due to various factors. It is uncertain if it persists after the acute infection. We aimed to investigate this.
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- Acute-on-chronic liver failure (ACLF) is a critical condition stemming from an acute liver insult in patients who already have chronic liver disease (CLD), and there's ongoing debate about its definition and classification.
- The increasing prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD), particularly due to metabolic issues and alcohol consumption, is changing the understanding of CLD causes and necessitating new diagnostic criteria.
- There is a growing concern about the interaction between MAFLD and ACLF, as the presence of metabolic risk factors complicates the clinical management and understanding of disease progression in these patients, highlighting the need for more research in this area.
Article Synopsis
- MAFLD (Metabolic Dysfunction-Associated Fatty Liver Disease) is becoming more common, and it can lead to serious liver problems called MAFLD-ACLF, but what affects patient recovery isn't fully known yet.
- In a study, researchers looked at data from patients with MAFLD-ACLF to understand their health conditions and see who survived after 90 days, finding that about 51% of patients did survive.
- They discovered new scoring systems to better predict survival, which included factors like diabetes and the causes of liver damage, and these new scores worked better than older ones.
Article Synopsis
- Machine learning (ML) models were developed and tested on nearly 1,700 NAFLD/MASLD patients to improve the detection of significant fibrosis (SF) compared to traditional scoring methods like FIB-4.
- The study found that ML models performed 7%-12% better than FIB-4, with an optimized random forest model achieving the highest accuracy in identifying patients with SF.
- Effective use of simple blood tests and ML can significantly enhance patient screening, reducing unnecessary referrals and missed diagnoses in patients with non-alcoholic fatty liver disease.
Background: High body mass index (BMI) is a major risk factor for cancer development, but its impact on the global burden of cancer remains unclear.
Methods: We estimated global and regional temporal trends in the burden of cancer attributable to high BMI, and the contributions of various cancer types using the framework of the Global Burden of Disease Study.
Results: From 2010 to 2019, there was a 35 % increase in deaths and a 34 % increase in disability-adjusted life-years from cancers attributable to high BMI.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the latest term for steatotic liver disease associated with metabolic syndrome. MASLD is the most common cause of chronic liver disease and is the leading cause of liver-related morbidity and mortality. It is important that all stakeholders be involved in tackling the public health threat of obesity and obesity-related diseases, including MASLD.
View Article and Find Full Text PDFBackground: With changes in the epidemiology and treatment of chronic liver disease (CLD), the impact of various etiologies of liver disease on steatosis and advanced fibrosis are uncertain.
Methods: A retrospective study was conducted among liver disease patients of various etiologies undergoing transient elastography (TE) over a 9-year duration.
Results: Data for 2886 patients were analyzed and had the following demographics: The median age was 60 (IQR: 45-69) years, 51% were males, and ethnicity was predominantly Chinese (52.
Background: Histologically assessed liver fibrosis stage has prognostic significance in patients with non-alcoholic fatty liver disease (NAFLD) and is accepted as a surrogate endpoint in clinical trials for non-cirrhotic NAFLD. Our aim was to compare the prognostic performance of non-invasive tests with liver histology in patients with NAFLD.
Methods: This was an individual participant data meta-analysis of the prognostic performance of histologically assessed fibrosis stage (F0-4), liver stiffness measured by vibration-controlled transient elastography (LSM-VCTE), fibrosis-4 index (FIB-4), and NAFLD fibrosis score (NFS) in patients with NAFLD.
Development and validation of the Adult cirrhosiS Knowledge Questionnaire.
Eur J Gastroenterol Hepatol
March 2023
Background: Assessing a patient's knowledge regarding liver cirrhosis is important to improve patient outcomes. This study aimed to develop and validate the Adult cirrhosiS Knowledge Questionnaire (ASK-Q) to assess patients' knowledge regarding liver cirrhosis from multiple aspects.
Methods: A 24-item ASK-Q with four domains: self-understanding (5 items), aetiology (5 items), complications (5 items) and management (9 items) of liver cirrhosis was developed based on literature review and expert panel input.
Background And Aim: The spectrum of gastrointestinal (GI) and liver diseases is recognized to have a geographical variation, which may be due to environmental or genetic differences. We aimed to explore this further in a specialist clinic serving a multi-ethnic Asian urban population.
Methods: A retrospective analysis of outpatient data from this institution's electronic medical records was conducted between January and June 2019.
Chronic liver disease (CLD) is the commonest ailment affecting the hepatobiliary system. Six significant pathologies related to CLD include hepatic osteodystrophy (HO), increased infection susceptibility, sarcopenia, osteonecrosis of the femoral head (OFH), increased risk of periprosthetic complications and fracture. Hepatic osteodystrophy, which comprises osteopenia, osteoporosis, and osteomalacia, refers to alterations in bone mineral metabolism found in patients with CLD.
View Article and Find Full Text PDFObjectives: Obesity and non-alcoholic fatty liver disease (NAFLD) are rampant in South East Asia. There is paucity of data exploring its' impact on donor suitability for living donor liver transplantation (LDLT). We aimed to describe and examine the factors related to non-utilization of potential donors in our LDLT programme.
View Article and Find Full Text PDFHydroxyurea is an antimetabolite drug that is commonly used in many hematological disorders. Ulcer formation in the gastrointestinal tract is a rare phenomenon associated with this drug. We report a case of a 73-year-old woman who was found to have an isolated ileocecal valve ulcer while on hydroxyurea 1 g daily for essential thrombocythemia.
View Article and Find Full Text PDFMesenchymal stem cell (MSC) transplant may offer an alternative to liver transplantation in patients with end-stage liver disease. However, its efficacy remains uncertain. MSC was performed on a 50-year-old male with decompensated (Child-Turcotte-Pugh grade C) alcoholic liver cirrhosis due to an absence of donors for adult-deceased and living-related liver transplantation.
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