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Home > Prevalence of Significant Liver Fibrosis in Patients With Hiv Monoinfection Compared to Those With Hiv-Hepatitis B Coinfection As Assessed by Shear Wave Elastography

Prevalence of Significant Liver Fibrosis in Patients With Hiv Monoinfection Compared to Those With Hiv-Hepatitis B Coinfection As Assessed by Shear Wave Elastography

Thesis Info

Author

Nguku, Samuel

Department

Imaging and Diagnostic Radiology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2014

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728062549

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Background: Liver disease is an emerging management problem in human immunodeficiency virus (HIV) infected patients. The incidence of chronic Hepatitis B infection, which accelerates the progression of chronic liver disease and development of liver fibrosis, is ten times higher in patients with HIV than the general population. Staging of liver fibrosis provides essential information in management of these patients. Objective: To determine the prevalence of significant liver fibrosis in patients with HIV mono-infection versus those with HIV-HBV co-infection as assessed with shear wave elastography (SWE). Methods: This was a cross-sectional study whereby HIV infected patients attending the HIV clinic at AKUH, N were consecutively recruited into the study. A total of 105 patients, 70 with HIV mono-infection and 35 with HIV-HBV co-infection, had liver elastography obtained using SWE to assess for presence of significant fibrosis the cut-off of which was 5.6 kPa. The prevalence of significant liver fibrosis was compared between the two groups. Assessment of APRI score (a non-invasive serum biomarker of liver fibrosis) in these patients was also done. Results: The prevalence of advanced liver fibrosis was significantly higher (p <0.0001) in patients with HIV-HBV co-infection, 25.7%, compared to those with HIV mono-infection, 7.1%. APRI score was higher in patients with HIV-HBV co-infection than those with HIV mono-infection. Discussion: The prevalence of significant liver fibrosis observed in the two proportions in the current study is comparable to those reported in other studies. HIV co-infection with HBV accelerates progression to significant liver fibrosis. Association of low CD 4 count with advanced fibrosis supports earlier starting of antiretroviral therapy to prevent rapid progression of liver disease in HIV positive patients. Higher APRI scores in the HIV-HBV co-infected group was as a result of higher AST levels. Conclusion/recommendations: In view of the high prevalence of liver fibrosis in patients with HIV-HBV co-infection, regular monitoring of the disease progression is recommended. A study involving follow up of HIV-HBV co-infected patients to assess for effects of therapy is also recommended.
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’’حقانی رباعیات‘‘ میری نظر میں

’’حقانی رباعیات‘‘ میری نظر میں

شاعری ایک خوبصورت اور من موہنی صنف رْباعی ہے۔ رْباعی کا لفظ رْبع سے نکلا ہے۔عربی زبان میں اربعہ کے معنی ’’چار‘‘ کے ہیں۔اس وجہ سے ایسی صنف شاعری کو رْباعی کہا جائے گا جس کے چار مصرعے ہوں۔

شاعری کی اصطلاح میں رْباعی اس صنف کا نام ہے جس میں مخصوص وزن کے چار مصرعوں میں ایک مضمون یا خیال بیان کیا جاتا ہے۔یعنی رْباعی وہ شعری صنف ہے جس میں عروض کے ماہرین کے مقرر کیے ہوئے خاص وزن،خیال کی وحدت اور بیان کے تسلسل کی پابندی بہت ضروری ہے۔

رْباعی میں بیان کے تسلسل اور خیال کی آہستہ آہستہ بڑھوتری کے اظہار کے لیے ضروری ہے کہ رباعی کے چار وں مصرعے زنجیر کی گھریوں کی طرح ایک دوسرے سے جڑے ہوئے ہوں،الفاظ کا چناؤ موضوع اور خیال کے مطابق ہو پہلے مصرعے میں مناسب الفاظ کے ذریعے خیال کے بارے میں معلومات دی جائیں۔دوسرے اور تیسرے مصرعے میں خیال مکمل طور پر پورے زور و شعور کے ساتھ ڈرامائی انداز میں پیش کیا جائے کیوں کہ چوتھا مصرعہ ہی رباعی کے مجموعی تاثر اور خلاصے کو بیان کرتا ہے۔اس میں ہی رباعی کا اصل خیال یا مضمون کو بیان کیا جاتا ہے جس کی خاطر رباعی لکھی گئی ہے۔

جہاں تک رباعی کے مضامین اور موضوعات کا تعلق ہے۔اس صنف کاآغازمذہبی مضامین کے بیان سے ہوا۔شروع شروع میں حمد،نعت اور توحید کا ذکر ہی رباعی میں کیا جاتا تھا۔پھر آہستہ آہستہ صوفیانہ خیالات ،معرفت کے مضامین رباعی کے موضوعات بن گئے۔صوفیاء کرام کا دین کی تبلیغ کا کام کرنا،لوگوں کو اخلاق کا درس دینا اور معاشرے کی اصلاح یہ سبھی مضامین صوفی شعراء نے رباعی میں بیان کیے۔اگر فارسی رباعی پر نظر ڈالی جائے تو...

السياق القرآني, أهميته, ومدى مراعاته عند الشرح والتفسير

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