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ISSN: 2313-7479
Adv. Biomed. Pharma. 2:4 (2015) 175-180
Advances in Biomedicine and Pharmacy
(An International Journal of Biomedicine, Natural Products and Pharmacy)
Original Paper
Prevalence of hepatic diseases among different patients at crescent
gastroliver and general hospital limited, Dhaka, Bangladesh:
a national survey
Adity Bhowmik1, Mohammad Amjad Hossain2
1
Department of Pharmacy, Atish Dipankar University of Science and Technology
2
Atish Dipankar University of science and Technology.
*Corresponding Author: Adity Bhowmik
Department of Pharmacy, Atish Dipankar University of Science and Technology, House # 83, Road # 4 , Banani, Dhaka-1213
E-mail address: [email protected]
Running Title: Prevalence of hepatic disease
Received: 04 July, 2015; Revised: 01 August, 2015 Accepted: 14 August, 2015
Abstract
As liver disorders are one of the most shared and frequent of all types of diseases in Bangladesh, So, we designed our survey
on liver diseases with main objective to explore the epidemiology of liver disorders in one of the reputed hospital of
Bangladesh, Crescent Gastro liver and General Hospital, Dhaka, Bangladesh which is receiving huge number of patients with
different liver disorders The ultimate outcome of our survey is clear in case of patients data. Survey represents the prevalence
of different forms of hepatic disorders among the patients visiting to this hospital such as obstructive jaundice 51%, Chronic
HBV infection 16%, hepatocellular carcinoma 8%, decompensated liver cirrhosis 8%, liver cirrhosis 5%, liver abscess and
biliary cirrhosis 3%, hepatic encephalopathy 2%, acute viral hepatitis 1%, hepato-renal syndrome 1%, acute hepatitis D on
chronic hepatitis B 1%, hepatic precome and non-alcoholic steatohepatitis (NASH) to cirrhosis were less than 1% of all 452
hepatic patients respectively.
Keywords: Prevalence, liver abscess, hepato-renal syndrome, non-alcoholic steatohepatitis
Introduction
virus, 800,000 people from hepatitis-C virus and nearly 20
million people are suffering from other liver- related
diseases like liver cirrhosis, cancer and fatty liver disease,"
Professor Mobin Khan, President of Bangladesh
Hepatology Society, was quoted as saying by leading
English newspaper The Independent on Thursday [1,2].
The cause of the 43 percent cases admitted to hospitals
with acute hepatitis and jaundice was hepatitis E virus, 22
percent cases by hepatitis B, 8 percent was hepatitis A and
3 percent was hepatitis C, he said. Mobin, a leading
hepatologist in the South Asian country, said hepatitis-B
virus causes about 41 percent of liver cirrhosis and 25
percent of liver cancer in the country [3-5]. Though the
Although skin is considered to be the largest organ of
the human body, liver is known to be the largest
internal organ and the largest gland in the huma n
body. Liver disease can be inherited (genetic) or caused
by a variety of factors that damage the liver, such as
viruses and alcohol use. Obesity is also associated with
liver damage. Over time, damage to the liver results in
scarring (cirrhosis), which can lead to liver failure, a lifethreatening condition. The number of people suffering
from liver disease in Bangladesh is increasing at an
alarming rate as about 35 million people are somehow
suffering from the disease. "About 15 million people are
now suffering from the chronic liver disease hepatitis-B
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Advances in Biomedicine and Pharmacy Vol. 2 (4) 2015
vaccine of hepatitis-B is very effective to prevent the virus,
very few people take the vaccine for lack of awareness, he
said. He further said in 80 percent cases, hepatitis-B is not
curable and prevention is the best way to combat the
disease [6-8]. But hepatitis-C can be cured through early
diagnosis and treatment. Though hepatitis-A and E viruses
are not so malignant, hepatitis-B and C pose serious threats
to human health, he said, stressing the need to be cautious
during blood transfusion and using syringe and needles
[9,10].
Questions for the patients are as follows
Questionnaires on Epidemiology of Hepatic Disorder to
patients:
1. What is your Age?
2. What is your sex?
3. What is your body Weight (kg)?
4. What is your height?
5. Are you suffering from Hepatic Disorder?
6. What Types of Hepatic Disorder you are affected
with?
7. How long you are affected?
8. What about your food habit (majority)?
9. Are you smoker?
10. Do you drink Alcohol?
11. Do you have any Tattoos?
12. Does your job involve exposure to chemicals,
blood or body fluids?
13. Have you ever had a blood transfusion?
14. Have you had liver problems before?
15. Has anyone in your family ever been diagnosed
with liver disease?
16. What types of sign and symptom are observed?
17. Are you suffering from others disease?
18. What types of pathological test, have you done?
19. What types of medications and supplements do
you take?
20. Will you need surgery?
Materials and Methods
Study design
The survey conducted at the Crescent gastroliver &
general hospital limited (CG&GHL) in Dhaka district. At
the CG&GHL the survey sample was drawn from the
target population and the information obtained from the
sample once by questioning them and collected the
information provided by them.
Sample Selection
In Crescent gastroliver & general hospital limited,
questionnaire sheets were provided as a representative of
the survey, a total of 20 questionnaires were processed for
patient survey and total of 1000 questionnaire sheets for
the patient survey were considered. In Crescent gastroliver
& general hospital limited, registered physicians were
interviewed. They are all specialized individual sectors and
they are responsible for patient healthcare service.
Results and Discussion
It was a discern, descriptive and analytical research. .
During the research period, we exhaustively screened all
patients fulfilling our inclusion criteria. In case of age
factor, majority was above 50 years (43%), 31-40 years
(24%), 41-50 years (17%), below 30 years (16%) of all
patients respectively. Female patients were 37% and male
patients were 63%. The feature of hepatic patient described
as 45% and other diseased patient were55% [Figure:
1].Hospital survey represents the prevalence of different
forms of hepatic disorders in this hospital is high (45%)
including, obstructive jaundice 51%, Chronic HBV
infection
16%,
hepatocellular
carcinoma
8%,
decompensated liver cirrhosis 8%, liver cirrhosis 5%, liver
abscess and biliary cirrhosis 3%, hepatic encephalopathy
2%, acute viral hepatitis 1%, hepato-renal syndrome 1%,
acute hepatitis D on chronic hepatitis B 1%, hepatic
precome and non-alcoholic steatohepatitis (NASH) to
cirrhosis were less than 1% of all 452 hepatic patients
respectively [Figure: 2]. 56% were smoker and 12% were
alcoholic [Figure: 3].
Field work
The survey data were collected from the Crescent
gastroliver & general hospital limited, from 1 st September
2014 to 30th December 2014, which were used for the
development of study tools, collection of data and analysis.
Data collection and Analysis
This paper and pencil field survey consisted of open, close
ended and multiple choice questions. An English language
survey was developed based on information drawn from
relevant literatures pertaining to use of Prescription drugs
used during liver disorders in Bangladesh. Separate
questionnaires were prepared for patient survey.
Questionnaires for all the patients related to Hepatic
disorder, age, height, patient history and list of drugs
included.
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Prevalence of hepatic disease
Advances in Biomedicine and Pharmacy Vol. 2 (4) 2015
There were 8% of all patients who had tattoos [Figure: 3].
15% were of all patient’s job involved exposure to
chemicals, blood or, body fluids [Figure: 3]. 38% were of
all patients had blood transfusion [Figure: 3]. Although
not the majority but there were patients who faced
chemicals, blood or, body fluids (15%) and blood
transfusion (38%). These two might be their reason for
disease.30% had family history and 70% was out of it. The
most common symptom was Skin and eyes that appear
yellowish (Jaundice) (70%). From 452 patients, 30% had
family history (12% spouse, 17% parents, 1% grandparents) and 70% were out of it. The most common
symptom
was
Skin
and
eyes
that
appear
yellowish(Jaundice) (70%), then itchy skin (65%),
followed by nausea or vomiting (62%), pale stool colour
(41%), abdominal pain and swelling (38%),loss of appetite
(28%), dark coloured urine (24%), swelling legs and
ankles (7%), Chronic fatigue (1%) [Figure: 4]. During the
survey, pathological tests were also be noted of all hepatic
patients like HBsAg, Anti-HCV, Anti-HAVIgM,
Anti-HEVIgM (100%) ; Serum creatinine, Alkaline
phosphate (87%); Serum Bilirubin (72%); Complete blood
count(CBC),alpha-fetoprotein (AFP),CA19.9 (Cancer
antigen test) (69%); Prothrombin time (64%);
Serum
total
protein,
Serum
albumin,
Electrolytes
(62%);
Serum
glutamate-pyruvate
transaminase (61%);Ultrasound,
CT and ERCP or MRCP (MRI of biliary tract and
pancreas) (55%); Urine specific gravity(USG) (3%)
respectively [Figure: 5]. Different hepatic diseased
patients were treated by some medicines in which some of
the medicines were similar and some were dissimilar. Used
medicines were Lactulose (96%), Ceftriaxon and Cefixime
(71%), Ondensatron (70%), Rifampin (68%), Trimonium
methyl sulphate (65%), Antihistamines hydroxyzine,
diphenhydramine (55%), Ursodeoxycholic Acid (39%),
Phytomenadione (Vit-K) (30%), Ketorolac Tromethamine
(29%), Meropenam (28%), Ribavirin (16%),Lamivudine
(2%) respectively [Figure: 6]. Among those hepatic
patients 64% needed surgery and 36% were treated by
drugs only.
Figure 1: The number of patient suffering from hepatic disease
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Advances in Biomedicine and Pharmacy Vol. 2 (4) 2015
Figure 2: Types of hepatic disorders.
Figure 3: Life style related information (smoking, alcoholic, having tattoos, chemical exposure, blood transfusion) of patients
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Advances in Biomedicine and Pharmacy Vol. 2 (4) 2015
Figure 4: Patient’s signs and symptoms of liver problems
Figure 5: Patient’s pathological test of liver problems
Figure 6: Patient’s medication and supplements of liver problems
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Advances in Biomedicine and Pharmacy Vol. 2 (4) 2015
as soon as possible and at the same time Government
should take necessary steps regarding these issues.
Conclusion
Four months survey among the in-door patients in all
departments of Crescent Gastro liver and General Hospital,
we found patients visiting to this hospital were suffering
with diverse hepatic disorders including mainly
obstructive
jaundice,
chronic
HBV
infection,
hepatocellular carcinoma, decompensated liver cirrhosis,
liver cirrhosis, liver abscess and biliary cirrhosis. We
found that diet habits and epidemiology plays an important
role, however the exact mechanism of the prevalence of
these disorders needs to be further investigated and cured
Acknowledgements
We want to thanks all the staff and members in the hospital
for their countless contribution and the patients for their
nice co-operation.
Conflict of interest
The authors declare that there is no conflict of interest to
reveal.
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