Hematological, Biochemical and Etiological factors of Chronic Liver Disease in a tertiary care Hospital of Lahore

Chronic Liver Disease (CLD) progresses from hepatocyte inflammation to fibrosis, regeneration, cirrhosis and in some cases to Hepatocellular Carcinoma (HCC). In general, the main etiologies of Liver Cirrhosis (LC) are viral infections (hepatitis C and B viruses), chronic alcohol abuse and Non-Alcoholic Fatty Liver Disease (NAFLD), including Non-Alcoholic SteatoHepatitis (NASH). Major complications of CLD are ascites, upper gastrointestinal bleeding, jaundice (acute or chronic) and hepatic encephalopathy. Objectives: This study assesses the etiological factors and complications of CLDin a tertiary care hospital of Lahore, Pakistan. Study Design: Cross-sectional. Methods: Study was carried out in indoor and Accident & Emergency Departments of Mayo Hospital Lahore. 100 clinically diagnosed CLD cases were chosen through “Convenient Sampling” technique during 3 months. Observations: Most common complications of CLD were upper GI variceal Bleeding (48%) & hepatic encephalopathy (34%) and acute or chronic hepatitis (AVH) (33%). Other less common complications observed were hepatorenal syndrome (10%), Spontaneous bacterial peritonitis (15%), Ascites (5%) and HCC (10%). Conclusions: Hepatitis C was found as main etiological factor of CLD. Bleeding andhepatic encephalopathy are the common complications. Awareness programmes regarding CLD and its complications are mandatory in our society to improve human health.

Bhabha and Spivak: Agency, Resistance and the Role of the Post-Colonial English Writer.

Bhabha and Spivak: Agency, Resistance and the Role of the Post-Colonial English Writer. Bhabha and Spivak approach the Post-Colonial question from different standpoints but their theoretical framework is grounded in Post-Structuralism. Bhabha holds that colonial discourse is ambivalent and it’s inherent ‘gaps’ create its own sites of resistance. On the other hand, Spivak is somewhat skeptical about the issue of agency and resistance of the native and does not see any site from where the colonized subject can make his or her voice heard. This research is designed to analyze the agency of the colonized subject and by extension of the Post-Colonial English writer in the light of these two opposing viewpoints. For this purpose, Bhabha’s concept of ambivalence is analyzed in detail and how this has a bearing on his view of literary representation. Secondly, Spivak’s notion of Colonial master discourses is discussed and how these make representation a very problematic and political issue. Both these theorists agree that representation is also a form of repression and it should never be taken at its face value. Post-Structuralism denies agency to the individual and rejects the notion that ‘individual consciousness’ is the source of meaning and truth while Post-Colonial politics grants this agency to the colonized subject. The theories of Bhabha and Spivak are an attempt to reconcile Post-Structuralism with Post-Colonialism. It is claimed that the Post-Colonial English writings are attempts to challenge the colonial ideology and represent the native population. The point to consider is that the Post-Colonial English writer is the product of colonial discursive practices and is it possible for him or her to resist the colonial structures. The research is an attempt to answer this question in the light of the theories developed by Bhabha and Spivak. The central problem of the study is the nature of agency of the colonized subject and whether the Post-Colonial writer can exercise this agency and resist the colonial power structures. The study is a critique in nature and attempts to analyze the role of the writer theoretically.