April 2018

Monthly Archive

Notification and counselling of hepatitis positive blood donors, their immediate emotional response, contact-testing and their follow-up: Study from a…

Posted by on 25 Apr 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Notification and counselling of hepatitis positive blood donors, their immediate emotional response, contact-testing and their follow-up: Study from a tertiary care hospital! Transfus Apher Sci. 2018 Apr 13;: Authors: Tiwari AK, Bhardwaj G, Dara RC, Arora D, Aggarwal G, Bhargava R, Madan K Abstract INTRODUCTION: Post-donation counselling informs donors of unusual test results. Timely notification and counselling regarding their Transfusion Transmitted Infection (TTI) status is necessary for early clinical intervention in the donor and reducing risk of transmission. We share our experience with respect to Hepatitis B (HBV) and Hepatitis C (HCV) positive donors who were counselled and followed-up for clinical outcome. MATERIALS AND METHODS: It was prospective 2-year study in TTI positive blood donors. Confirmed positive HBV/ HCV donors were notified to attend the donor-clinic or to visit local hepatologist for further management. At donor clinic, donor’s immediate emotional response was observed; donors were offered contact-testing, associated risk factors were noted, counselled, referred to hepatologist, treated and followed-up for clinical outcome. RESULTS: Of 481 donors (0.91%) confirmed positives, 351 were contacted telephonically; 280 promised to attend donor clinic and 71 were referred to their local hepatologist. 145 donors attended the donor clinic, eventually. Most common immediate emotional response noted were ‘feeling of fear’ (55.2%) and ‘disbelief’ (35.2%). Most common associated risk factor was history of medical treatment/ injections without knowledge of sterilisation. Five donors availed contact testing and four (spouses in all four cases) came out positive. Of 98 donors contacted post-counselling; 89 went to hepatologist. No medication was advised to seven donors (low viral load), 59 donors completed treatment course and 23 donors were undergoing treatment at time of follow-up. Nine donors opted for alternative treatment or “no treatment”. CONCLUSION: Donor-clinic proved beneficial to substantial number of donors and their families. PMID: 29685393 [PubMed – as supplied by publisher]

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Notification and counselling of hepatitis positive blood donors, their immediate emotional response, contact-testing and their follow-up: Study from a…

SYSTEMATIC REVIEW: Drug induced liver injury: Alternative causes in case series as confounding variables.

Posted by on 03 Apr 2018 | Tagged as: Hepatitis B Alternative Medicine

SYSTEMATIC REVIEW: Drug induced liver injury: Alternative causes in case series as confounding variables. Br J Clin Pharmacol. 2018 Apr 01;: Authors: Teschke R, Danan G Abstract AIMS: Drug-induced liver injury (DILI) is rare as compared to the worldwide frequent acute or chronic liver diseases. Therefore, patients included in series of suspected DILI are at high risk of not having DILI, whereby alternative causes may confound the DILI diagnosis. The aim of this review is to evaluate published case series of DILI for alternative causes. METHODS: Pertinent studies were identified using a computerized search of the Medline database for publications from 1993 through 30 October 2017. We used the following terms: drug hepatotoxicity, drug induced liver injury, hepatotoxic drugs combined with diagnosis, causality assessment, and alternative causes. RESULTS: Alternative causes as variables confounding the DILI diagnosis emerged in 22 published DILI case series, ranging from 4% to 47%. Among 13,335 cases of suspected DILI, alternative causes were found more likely in 4,555 patients (34.2%), suggesting that DILI was probably not DILI. Biliary diseases such as biliary obstruction, cholangitis, choledocholithiasis, primary biliary cholangitis, and primary sclerosing cholangitis were among the most missed diagnoses. Alternative causes included hepatitis B, C, and E, CMV, EBV, ischemic hepatitis, cardiac hepatopathy, autoimmune hepatitis, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, and alcoholic liver disease. CONCLUSIONS: In more than one third of published global DILI case series, alternative causes as published in these reports confounded the DILI diagnosis. In the future, published DILI case series should include only patients with secured DILI diagnosis, preferentially established by prospective use of scored items provided by robust diagnostic algorithms such as the updated RUCAM (Roussel Uclaf Causality Assessment Method). PMID: 29607530 [PubMed – as supplied by publisher]

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SYSTEMATIC REVIEW: Drug induced liver injury: Alternative causes in case series as confounding variables.