European Journal of Molecular & Clinical Medicine

The frequency of cirrhosis is about 20–40 cases per 100,000 populations, and this indicator is steadily increasing. At present, it is one of the six main causes of death at the age of 35–60 years in economically developed countries. Foreign and domestic scientists are working on the development and synthesis of new drugs of chemical and natural origin for the treatment and prevention of liver diseases of various origins, in particular liver cirrhosis. Many studies have shown an important pathogenic role in the occurrence and progression of some liver diseases with changes in the intestinal microbiota. Therefore, antibiotics, prebiotics and probiotics are an effective treatment for liver diseases, which can correct the intestinal microbiota.

Umbilical hernia with dilated paraumbilical collateral vein as its content is rare. Diagnosing this condition is extremely crucial as rupture of the herniated umbilical vein during herniorrhaphy in a patient with ascites can be a fatal complication. Here we are reporting a case of a 37-year-old male who presented with complaints of abdominal distension, hematemesis, umbilical hernia with pulsations felt over the herniated sac. On ultrasonography, features of liver cirrhosis, portal hypertension and umbilical hernia with a herniated dilated vessel showing venous waveform on Doppler were seen. Contrast enhanced computed tomography (CECT) showed signs of liver parenchymal disease and dilated left paraumbilical vein coursing just beneath the anterior abdominal wall towards umbilicus with herniation through the umbilical hernia. Porto-systemic collaterals from this were then seen to be draining into right common femoral vein. Looking at the clinical and radiological features – diagnosis of Cruveilhier Baumgarten syndrome was observed. 

Background: All chronic liver diseases end with cirrhosis. Upper gastrointestinal tract
hemorrhage brought on by the formation of esophageal varices is the most frequent
cause of death in cirrhotic individuals. It will be possible to prevent potential difficulties
during interventional procedures and surgery if portosystemic collaterals are diagnosed
using non-invasive approaches.
Materials and Methods: A cross-sectional study involving 90 patients who were
diagnosed with liver cirrhosis based on symptoms and test results and presented to the
medical gastroenterology department. To best display portal venous architecture,
disease, and venous collaterals, Color Doppler US was first done using the Philips Epiq
7G machine. The transducer and gain settings were changed in each instance. The work
station was used to obtain portography pictures while the 256 Slice Phillips (Brilliance)
was used to do CT. All of the patients underwent endoscopy, and the results were
compared using the Pearson's Coefficient test to those obtained from USG and CT.
Results: Of the 90 patients, 26, 14, 38, and 12 had esophageal varices of Grades I–III
and none at all. Grade I and II varices were not found in USG, however 8/12 Grade III
varices were. All 38 cases of grade II varices and 12 cases of grade III varices were
found using CT. For the diagnosis of paraesophageal, splenorenal, anterior abdominal
wall, peri-umbilical, and peri-cholecystic collaterals, USG and CT showed excellent
agreement (Kappa values >0.7). There was no agreement between USG and CT for the
detection of esophageal, gastric mucosal, perigastric, and retroperitoneal collaterals.
Conclusion: Grade III varices are found by USG, while Grade II and III varices are
found by CT. Compared to USG, CT is more effective at delineating all portosystemic
collaterals. When defining intricate collateral routes, USG is less accurate than MDCT
portal venous phase. In order to identify unanticipated varices that could cause
considerable bleeding during liver transplant procedures, multislice CT can be used to
detect potentially problematic varices by tracing the path of tortuous veins.

This study aims to equip health professionals with essential directions for their practice and
research in fatty liver disease. In fatty liver disease, excess fat is accumulated in the liver
cells, and it mainly has two types: Alcoholic Fatty Liver Disease (AFLD) and Non-Alcoholic
Fatty Liver Disease (NAFLD). AFLD is widely accepted to be associated with excessive
alcohol consumption. However, in NAFLD's case, although the name acknowledges that it is
not associated with excessive alcohol consumption, the exact cause of NAFLD remains
ambiguous. Furthermore, for almost four decades, without specialised treatments and
prevention strategies, NAFLD has constantly increased, affecting more than a quarter of the
world's population. Meanwhile, although the current dietary recommendations for NAFLD
patients orbit around the conventional High-Carbohydrate Low-Fat diets, mounting evidence
advocates the broader benefits of Low-Carbohydrate High-Fat (LCHF) diets in this regard.
Therefore, focusing on the databases such as PubMed, Cochrane Library, and Google
Scholar, the authors have carried out an advanced literature search reporting on the efficacy
of LCHF diets on NAFLD. After a comprehensive search—using appropriate "keywords and
Boolean operators" and "inclusion & exclusion criteria"—the authors selected a potentially
relevant set of existing peer-reviewed articles for this narrative review. After critically
investigating the LCHF-NAFLD theme, the authors found that LCHF diets may significantly
decrease liver fat and may even reverse the disease by targeting the key causes of hepatic fat
storage, i.e., high insulin levels, excessive calorie consumption (mainly from carbohydrates),
and excessive consumption of refined carbohydrates. Additionally, LCHF diets may provide
a comprehensive health benefit beyond liver health. The authors conclude that the LCHFNAFLD
theme represents a rich vein of research opportunities. The authors encourage and
call researchers, doctors, nutritionists, dieticians, and related-health professionals to engage
more with the LCHF-NAFLD theme.

Background: Liver cirrhosis (LC) is an irreversible condition which results from necrosis
of hepatocytes with loss of reticular network and nodular regeneration of residual liver
tissue. This study was undertaken to assess the relation between serum prolactin levels and
the severity of the liver cirrhosis.Materials & methods: This cross-sectional observational
study was conducted during one calendar year at a tertiary care center in Western India
among 50 cases of established liver cirrhosis. Serum Prolactin was estimated using ADVIA
Centaur® CP Immunoassay System (Siemens®) by Chemiluminescent technique. The
modified Child Pugh score was calculated for each study participant. The patients were
categorized into Classes A, B or C based on the score obtained. Hepatic encephalopathy
was diagnosed and graded as per West Haven classification system. The grade I-II were
taken as mild and grade III-IV as advanced hepatic encephalopathy for calculation of the
modified Child-Pugh score. Ascites was graded as mild, moderate and severe. All the data
were stored in excel sheet using Microsoft® Office 2007. Results: The mean serum
prolactin, serum albumin, serum Bilirubin and INR were 48.1±26.8 ng/ml, 2.8±0.6 g/dl,
4.8±4.9 mg/dl and 2.2±1.0 respectively. (Table No. 1) The mean serum prolactin level in
alcoholic cirrhosis (49.2±25.1 ng/ml) does not statistically differ from non-alcoholic
cirrhosis (46.6±29.4 ng/ml) cases (p > 0.05). The mean serum prolactin level was
statistically significantly higher among cases in Modified Child Pugh Class-C (68.91 ±
17.80 ng/ml) compared to Class B (33.26 ± 7.41 ng/ml) and Class A (10.03 ± 4.01ng/ml)
cases. The mean serum prolactin level was 81.36 ± 19.85 ng/ml in cases with severe ascites,
60.09 ± 18.05 ng/ml in moderate ascites cases, 36.1583 ± 15..06 ng/ml in mild ascites cases
and 19.79 ± 12.29 ng/ml in cirrhosis cases without ascites. The difference in mean serum
prolactin level was significant among different severity of ascites. The serum prolactin
level was 81.08 ± 18.04 ng/ml in cases with advanced hepatic encephalopathy, 56.89 ±
15.05 ng/ml in cases with mild hepatic encephalopathy and 26.16 ± 13.99 ng/ml in
cirrhosis cases without encephalopathy. Conclusion: Serum Prolactin levels showed
positive correlation with Modified Child Pugh Score and Fibroscan in predicting the
severity of disease.