Publications by authors named "Shasthry Sm"

Article Synopsis
  • - The study aimed to evaluate the safety, effectiveness, and tolerability of Naltrexone in treating alcohol use disorder in patients with alcohol-related cirrhosis.
  • - After 4 weeks of treatment, there were notable reductions in liver enzyme levels, self-reported craving, AUDIT scores, and the number of drinking days, indicating potential benefits.
  • - The findings suggest that Naltrexone is safe and effective for managing alcohol use disorder in patients with liver complications, supporting its clinical use in these cases.
View Article and Find Full Text PDF

Alcohol-associated liver disease (AALD) is a global health problem with increasing incidence with associated high morbidity and mortality. Patients with AALD have varied clinical presentation encompassing a spectrum ranging from alcoholic steatosis, alcoholic steatohepatitis to alcohol-associated fibrosis/cirrhosis, which can be either compensated or decompensated. We need uniformity in defining each of the stages of AALD, which will help in both research and patient care.

View Article and Find Full Text PDF

Introduction: Severe alcohol-associated hepatitis (SAH) carries high 1-month mortality. Corticosteroids provide a modest 28-day but not 90-day survival benefit, due to development of infections and organ failures. Granulocyte colony-stimulating factor (GCSF) has shown promise in patients with SAH by its immunomodulatory and regenerative capabilities.

View Article and Find Full Text PDF
Article Synopsis
  • The study focuses on the COVID-19 clinical outcomes in patients with liver disease compared to those without, analyzing data from India.
  • Out of 232 liver disease patients, a significant 59.1% tested positive for COVID-19, with those having additional health conditions at a greater risk for severe outcomes and mortality.
  • The research also uncovered differences in genetic mutations between the COVID-19 strains affecting liver disease patients and those without, suggesting an important distinction in how the virus manifests in these two groups.
View Article and Find Full Text PDF

Background: Serum immunoglobulin G (IgG) level is elevated in autoimmune liver diseases (AILDs), especially autoimmune hepatitis (AIH). However, its utility is limited in current practice as different criteria propose different cut-off values leading to considerable ambiguity.

Materials And Methods: A cross-sectional study was conducted among patients with AILD who underwent a liver biopsy over a ten-year period.

View Article and Find Full Text PDF

Aims: Autoimmune liver diseases (AILD) represent a spectrum of related yet distinct immune-mediated disorders. The literature on the prevalence of these AILDs in Indian population is scarce. This study aims to assess the prevalence and clinicopathological spectrum of various AILDs especially the overlap syndrome.

View Article and Find Full Text PDF

Background And Aims: Portosinusoidal vascular disease (PSVD) is a broad term encompassing varied histological patterns with changes in portal tracts and sinusoids without cirrhosis. We aimed to assess whether there is any clinical and pathological difference among the various histological categories of PSVD.

Patients And Methods: This study included liver biopsy cases classified as PSVD (2020-2022).

View Article and Find Full Text PDF
Article Synopsis
  • Direct intrahepatic portosystemic shunt (DIPS) stent placement is a treatment for Budd-Chiari syndrome, but it can become occluded due to thrombosis, leading to complications.
  • A study compared a new technique called balloon-occluded thrombolysis (BOT) with the traditional catheter-directed thrombolysis (CDT) for treating occluded DIPS stents, focusing on successful recanalization, hospital stay length, and medication dosage.
  • Results showed that BOT led to a higher recanalization rate, shorter hospital stays, and lower doses of thrombolytic agents than CDT, suggesting that BOT is a more efficient and safer option for DIPS stent revision.
View Article and Find Full Text PDF

Background: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is an uncommon form of primary liver carcinoma. It is heterogenous in terms of morphology, immunohistochemistry, radiology, and clinical features; making it a challenging entity for diagnosis.

Aims: The purpose of the present study was to evaluate clinicopathological characteristics of patients with cHCC-CCA.

View Article and Find Full Text PDF
Article Synopsis
  • A study evaluated the effectiveness of pegylated interferon (PEG-IFN) alpha 2b in patients with HBeAg-negative chronic hepatitis B (CHB) who experienced clinical relapse after stopping long-term nucleotide analogues (NAs).
  • Out of 118 patients, 69.5% had a relapse; 44 were treated with PEG-IFN for 48 weeks, while the remaining 38 were given tenofovir alafenamide fumarate (TAF) based on when their relapses occurred.
  • Ultimately, 15.9% of those treated with PEG-IFN achieved hepatitis B surface antigen (HBsAg) loss, indicating some effectiveness, while no patients receiving TAF achieved
View Article and Find Full Text PDF
Article Synopsis
  • Severe alcohol-associated hepatitis (SAH) is linked to high mortality due to severe liver inflammation, leading to acute-on-chronic liver failure (ACLF) and complications like infections and organ failure.
  • A study of 819 SAH patients revealed that a higher hepatic venous pressure gradient (HVPG) negatively correlated with patient outcomes, indicating that those with HVPG ≥20 mmHg experienced more complications and higher mortality rates.
  • Prednisolone treatment showed a favorable response in many patients, but independent predictors of 90-day mortality included high MELD scores, elevated HVPG, and hepatic encephalopathy, while improvements in HVPG and MELD were noted in follow-up assessments.
View Article and Find Full Text PDF

Alcoholic hepatitis is a clinical syndrome with or without pre-existing chronic liver disease (CLD), and the majority of patients present with acute-on-chronic liver failure (ACLF) having a high 28-day mortality. The treatment of alcoholic hepatitis is suboptimal with corticosteroid having one 1month survival benefit but not translated to a survival benefit beyond six months. Survival benefit has been observed in only about 50-60% of treated patients.

View Article and Find Full Text PDF

Background And Aims: Twenty per cent albumin (1.5 g/kg at diagnosis and 1 g/kg on day three, infused over six-hour duration) is recommended particularly in high-risk spontaneous bacterial peritonitis (SBP). Whether reduced dose albumin infusion is as effective as the standard dose albumin infusion is not clear.

View Article and Find Full Text PDF

Dilated and dysfunctional gut lymphatic vessels (LVs) have been reported in experimental cirrhosis. Here, we studied LVs in duodenal (D2)-biopsies of liver cirrhosis patients and investigated the prognostic role of a LV marker, podoplanin (PDPN), in predicting the mortality of patients with cirrhosis. A prospective, single-center cohort study was performed in liver cirrhosis patients ( = 31) and matched healthy controls ( = 9).

View Article and Find Full Text PDF

Background: Severe alcoholic hepatitis (SAH) has high 90-day mortality. Prednisolone therapy has shown modest survival benefits over placebo at 28 but not 90 days. Fecal microbial transplantation (FMT) has shown promise in these patients.

View Article and Find Full Text PDF

Background: Erectile dysfunction (ED) is common in men with cirrhosis. The aim of this study was to assess the prevalence of ED and the factors associated with ED in men with cirrhosis.

Methods: 400 men with cirrhosis [Child-Turcotte-Pugh (CTP) class A, 44.

View Article and Find Full Text PDF

Background And Aims: Cirrhosis patients exhibit cytopenia, and, at times refractory neutropenia to granulocyte colony-stimulating factor (G-CSF), which acts through the CSF3-receptor (CSF3R), and changes in CSF3R can affect the response. We conducted this study to assess the CSF3R status and its relevance in cirrhotic patients.

Methods: Cirrhotic patients (=127) and controls (=26) with clinically indicated bone marrow (BM) examination were studied.

View Article and Find Full Text PDF

Aim: To evaluate the response of locoregional therapy (LRT) on combined hepatocellular-cholangiocarcinoma (cHCC-CC) and intrahepatic cholangiocarcinoma (IHC) and compare their outcomes with propensity matched hepatocellular carcinoma (HCC) patients.

Materials And Methods: From January 2011 to July 2020, 13 patients with cHCC-CC (11 men, two women, median age 56 years) and 15 IHC patients (10 men, five women, median age 60 years) were compared with 101 HCC patients (79 men, 22 women, median age 60 years) after LRT. All tumours were proven histologically.

View Article and Find Full Text PDF
Article Synopsis
  • This study investigated the effectiveness and safety of tadalafil for treating erectile dysfunction (ED) in male patients with cirrhosis.
  • A total of 140 men with ED were assigned to either tadalafil or a placebo for 12 weeks, with erectile function measured using an established questionnaire.
  • Results showed that a significantly higher percentage of patients in the tadalafil group had notable improvements in erectile function and mental health compared to those on placebo.
View Article and Find Full Text PDF

Background & Aims: Sleep-wake abnormalities [poor nighttime sleep and excessive daytime sleepiness (EDS)] are common in patients with cirrhosis. The aim of this study was to assess the prevalence of sleep-wake abnormalities and clinical factors associated with these abnormalities in a group of patients with cirrhosis.

Methods: 1098 patients with cirrhosis [Child Turcotte Pugh (CTP) class A, 22.

View Article and Find Full Text PDF
Article Synopsis
  • This study investigates the immune response in severe alcoholic hepatitis patients, focusing on peripheral blood mononuclear cells (PBMCs) during corticosteroid therapy.
  • At baseline, PBMCs from steroid-non-responders (NR) showed higher activity in gene modules linked to T and B cell activation compared to steroid-responders (R).
  • After 7 days of treatment, NR showed no change in these gene module activities, while R displayed reduced activity in immune-related modules, highlighting differences in immune response based on treatment outcomes.
View Article and Find Full Text PDF

Background: The management practices of liver abscess (LA) have evolved over time. The precise diagnosis of etiology and complications is pivotal for appropriate management.

Methods: Descriptive analyses of consecutive patients treated for LA using electronic medical records at a liver unit between years 2010 and 2020 and investigate relationships between clinical, imaging, laboratory and microbiological findings, treatment strategies and mortality.

View Article and Find Full Text PDF

Idiosyncratic drug-induced liver injury mimics acute and chronic liver disease. It is under recognized and underrecognised because of the lack of pathognomonic diagnostic serological markers. Its consequences may vary from being asymptomatic to self-limiting illness to severe liver injury leading to acute liver failure.

View Article and Find Full Text PDF
Article Synopsis
  • The SARS-CoV-2 pandemic significantly affected public health, especially for liver transplant recipients on immunosuppressants, leading to more severe disease outcomes.
  • Treatment and management of these patients are complicated, involving adjustments to immunosuppression based on the severity of COVID-19 symptoms.
  • In a study of six liver transplant patients, varying degrees of COVID-19 severity were observed, with recovery facilitated by using antiviral drugs, convalescent plasma, prophylactic anticoagulation, and careful monitoring.
View Article and Find Full Text PDF

Background/aims: Liver cirrhosis is an important cause of morbidity and mortality globally. Every episode of decompensation and hospitalization reduces survival. We studied the clinical profile and long-term outcomes comparing alcohol-related cirrhosis (ALC) and non-ALC.

View Article and Find Full Text PDF