Literally speaking all humanbeings are badbreathres. Oral cavity contains millions of anaerobic bacteria like fusobacterium and actinomyces which acts on the protein of food materials and putrifies them. This process results in the formation of offenssive gases like hydrogen sulphide,methyl mescaptan,cadaverin,skatol,putrescine ect causing bad odor. If oral hygiene is not maintained properly all will suffer from bad breath. Most of us control this by regular brushing,tongue cleaning and gargling. Even after maintining cleanliness in the mouth some individuals suffer from offenssive smell due to various causes which has to be diagnosed and treated properly.

Some common causes of bad breath.

1) Poor oral hygiene:

If oral hygiene is not maintained properly the mouth becomes the seat for millions of bacteria which produce offenssive gases by degrading the food debris. Bad breath is severe in those who do not brush their teeth regularly and clean their mouth after every food. Snacks taken inbetween meals can also produce bad breath because of improper cleaning.
Badbreath is common in almost all people in the morning on waking. During sleep there is less production of saliva .Saliva has got some antibacterial properties which help to keep the mouth clean. Saliva conains oxygen molecules which is needed to make oral cavity aerobic. So the reduction in it’s quantity during sleep makes a favourable condition for anaerobic bacteria.

2) Food habits:

The main cause of bad smell is due to degradation of protein by the bacteria and hence all food products rich in protein favours bad breath. Meat,fish,milk products, eggs,cakes,nuts,pear and ect can cause bad breath. Some food articles can produce particular type of smell which may be unpleasent. Raw onion can produce typical bad smell. It is said that an apple a day keeps the doctor away,a raw onion a day keeps everybody away. Eating groundnuts can also produce bad smell. However if proper cleaning is done smell can be reduced irrespective of the nature of food. Irregularity in timing of food can also produce bad breath. Small food articles taken in between the meals can also produce bad smell.

3) Biofilm:

There is formation of a thin sticky coating called biofilm on the tongue and oral mucosa. This coating is thick on the posterior aspect of the tongue where millions of gram negative bacteriae are seen .The thick coating on the tongue is always associated with badbreath. Even a thin biofilm can make anaerobic condition favourable for bacterial proliferation.

4) Dental caries:

This is a destructive process causing decalcification with distruction of enamel and dentine resulting in cavitisation of the tooth. These are produced mainly by the lactobacilli . Food particles are deposited inside these cavities and are putrified by the anaerobic bacteria producing bad smell. Normal brushing will not remove the food debris easily and hence they are putrified completely. Caries are common in schoolgoing children and in those who donot maintain proper oral hygiene .Calcium and vitamin deficiency can also predispose caries.

5) Gingivitis:

Gum is a mucus membrane with supporting connective tissue covering the tooth bearing borders of the jaw .The main function of gum is protection .Gingivitis is the inflammation of the gum .Due to various causes gum tissue get infected resulting in swelling,pain and discharge. If the condition become worse the infection spread towards peridontal area leading to continuous discharge called pyorrhoea. Some times the infection goes deep producing alveolar abscess with discharge of pus. Infection can even reach the bone causing osteomyelitis.All these conditions can produce offenssive smell.

6) Gum retraction:

When the gums retract from the teeth a gap is developed which will lodge food particles and cause bad breath.

7) Dental plaques and tartar deposits; Plaques and tartar is deposited mainly in the gaps between the teeth and gum. This will provide shelter for the food debris and bacteria causing bad breath.

Ulcerative lesions& coatings:

Almost all ulcerative lesions of the mouth are associated with bad breath. These lesions may be caused by bacteria,viruses,food allergies or due to autoimmune disorders. Apthous ulcer is the commonest amoung ulcerative lesions. Others are herpes,fungal infections,vincents angina,infectious mononucleosis,scarlet fever,diphtheria,drug reactions and ect. Cancerous ulcers produce severe bad breath. All fungal infections produce white coating(candidiasis). Leucoplakia is a white thick patch on the mucus membrane of the mouth & tongue. It is considered as a precancerous condition. Offenssive breath is associated with these conditions.

9) Diseases of the salivary glands:

Saliva is very useful to supply oxygen to all parts of the oral cavity. Even a thin film of coating called biofilm can provide an anaerobic condition in the mouth. Saliva can wet these layers and make an aerobic condition which is unfavourable for the bacteria .Any condition which reduces the production of saliva can increase bacterial activity. Some times the salivary duct is obstructed by stones or tumors.Cancer of the salivary gland is associated with offenssive odor. In suppurative parotitis purulant dischrge in to the mouth causes bad breath.

10) Tonsillitis:

Tonsils are a pair of lymphoid tissue situated in the lateral wall of oropharynx. Inflammation of the tonsil is called tonsillitis. Bad breath is seen in both acute and chronic tonsillitis. Quinsy or peritonsillar abscess can also produce bad breath.

11) Tonsillar plaques & tonsillar fluid:

If bad breath persists even after maintaining proper oral hygeine there is possibility of this condition. Serous fluid secreated from the folds of tonsil is very offenssive. Some patients complain that they hawk some cheesy materials from the throat;which are very offenssive in nature. These are formed inside the tonsillar crypts which contain thousands of bacteriae. In such conditions tonsillectomy gives noticiable relief from bad breath.

12) Pharyngitis& pharyngial abscess:

Pharynx is a fibromuscular tube which forms the upper part of the digestive & respiratory tract. Inflmmation of the pharynx is called pharyngitis, caused mainly by bacteria and viruses. Bad breath is present in pharyngitis along with other signs like cough and throat irritation. Abscesses in the wall of pharynx can also produce offenssive discharge of pus in to the throat.

13) Dentures:

Denture users may complain about bad smell due to lodgement of small food debris in between. Proper brushing may not be possible in denture users especially fixed dentures.

14) Tobacco:

Tobacco chewing is associated with bad breath. The smell of tobacco itself is unpleasent for others. Tobacco can irritate the mucus membrane and cause ulcers and coatings. Gingivitis and pyorrhoea are common in tobacco chewers. Tartar is deposited on the teeth mainly near the gums. Tobacco chewers get gastric acidity with eructations. All these causes offenssive smell.

15) Smoking:

Smokers always have bad smell. It can also produce lesions in the mouth & lungs causing bad breath.Smoking increases carbon dioxide in the oral cavity & reduces oxygen level,causing a favourable condition for bacteria. Smoking reduses appetite & thirst hence acid peptic disease is common in chain smokers.

16) Lesions in the nose & ear:

Bad breath is occasionally seen in sinusitis(infection of para nasal sinuses). In case of post nasal dripping bad breath is common due to the presence of protein in the discharges. These proteins are degraded by the bacteria. Infection in the middle ear with discharge of pus in to the throat through the eustachian tube(passage from middle ear to the throat)can also cause offenssive odor. Chronic rhinitis(infection of mucus membrane of nose) and forign bodies in the nose can also produce bad smell in the expired air.

17) Diabetes mellitus:

Mostly all diabetic patients suffer from bad breath. Coated tongue,ulcers &coatings in the mouth ,increased sugar level in tissues ect are responsible for bad breath.Bacterial growth in diabetic patient is very faster than non diabetic individuals.

18) Fevers:

Bad breath is common in almost all fevers. Even an acute fever can produce bad breath. Severe bad breath is seen in typhoid .Other infectious diseases like Tuberculosis , AIDS ect produce bad smell.

19) Fasting & dehydration:

Dry mouth favours bacterial activity. So any condition which produce dryness in the mouth makes the breath offenssive. Eventhough the food particles are known to produce bad breath, fasting can also produce the same. Production of saliva is also reduced during fasting. Chewing and swallowing also helps to keep the mouth clean.

20) Bedridden patients:

Bedridden patients suffer from offenssive breath due to thick coating on the tongue. water intake is also limited in these patients. Regurgitation of food aggravates the condition. Since they talk less aeration in the oral cavity is reduced which favours anaerobic bacteria to become active.

21) Diseases of stomach & esophagus:

Eructation of gas and food produce unpleasent smell. Abnormality in the function of lower sphincter can allow the food to regurgitate upwards causing bad breath. Bad breath is also common in gastritis,gastric ulcer and cancer of stomach.

22) Intestinal diseases:

Bad breath is common in patients suffering from ulcerative lesions of intestine like ulcerative collitis..Other diseases are malabsorption syndrome intestinal tuberculosis, peritonitis ect.

23) Diseases of lungs:

Lung diseases like pneumonia, lung abscess,chronic bronchitis,bronchiectasis,tuberculosis, lung cancer ect can produce bad odor during expiration.

24) Liver disorders:

Liver diseases like hepatitis, cirrhosis,can cause bad breath.Gall bladder diseases with vomiting also causes unpleasent odor.

25) Psychiatric patients:

Bad breath is common in psychotic patients due to poor hygiene,irregular food habits,less water intake and ect.

26) Somatisation disorder:

This is a psychiatric disorder charecterised by the presence of a physical symptom that suggest a medical illness .These patients come with physical complaints like pain,nausea difficult respiration, bad smell ect. This condition is diagnosed after detailed examination of the patient with all investigations.Since this is a psychiatric disorder it has to be managed with a psychological approach.

[ THE POINTS MENTIONED IN THIS ARTICLE IS FOR GENERAL INFORMATION. ANY PERSON HAVING BAD BREATH SHOULD CONSULT A QUALIFIED DOCTOR ]

No tags

A woman is beautiful as she is! Welcome to the power of women, the power that makes them just as capable, as smart, as funny, and as compassionate as men. More than that, it empowers them to take up her distinctive position in society, at the same time being a daughter, a wife, a mother, homemaker, and all the other roles her considerable responsibilities call upon her seemingly infinite energy. Along with this emotional fluency, skill required to make a family survive and the language of power, the quintessential woman needs to be physically fit as well.

Very few physical disorders are unique to women, or are more prevalent or serious in women. Medical wellness consultants will inform you that the earliest to appear are precocious puberty, anorexia and bulimia. Reproductive health concerns are a major focus of women’s health. Cancer is the leading cause of death in middle-aged women. Smoking contributes to numerous causes of death and disability among women.

Lung Cancer: Cancer accounts for maximum deaths among women aged between 35 to 54 years. For years, breast cancer was the leading cancer killer among women, but now lung cancer takes the lead with more and more women taking to cigarette smoking. What makes this change frightening and dramatic is that lung cancer is a preventable disease, yet today it kills more women than breast cancer.

Breast Cancer: There is, however, good news from women health specialists regarding breast cancer treatment. Modification in surgical procedures, research indicating that estrogen receptors respond well to a drug called tamoxifen and experimenting with a new drug called RU-486, along with women taking a more active part in their health care are considerable contributions to the treatment of breast cancer.

Gallstones occur four times more frequently in women than men. Attributed to multiple pregnancies, obesity, and rapid weight loss, the real cause of this disorder is still unknown. Stones are formed in the gall bladder due to a saturation of cholesterol and bile salts that crystallize and collect over time. A number of experimental drugs are being used as an alternative to a surgical approach called cholecystectomy.

Menopause and Osteoporosis: Post-menopausal women often suffer a disorder called Osteoporosis. Lack of estrogen after menopause causes loss of bone mass, resulting in weak bones that are susceptible to easy injury in case of a fall or mishap. There are no symptoms, and that is why Osteoporosis is known as the “silent disease”. Certain steps can be taken to prevent osteoporosis from ever occurring. Women over the age of 50 have the greatest risk of developing osteoporosis and Caucasian and Asian women are more likely to develop this condition. Heredity and less body weight are an important risk factors. Exercise, calcium, vitamin D, and post-menopausal estrogen replacement play an important role in preventing this disorder.

Thyroid abnormalities are four to five times more common among women than among men. While, there is effective treatment, the cause again is unknown. Arthritis and diabetes are other disorders that are more common in women. Lupus erythematosus is a disease in which 90 percent of the victims are women.

Hence, there are quite a few disorders that are more frequent in women than in men or that differentially affect women. While considerable progress has been made to combat most of these, there remains much to be learned about others.

It is every woman’s prerogative to form clear questions about her physical health, find clear answers, gain a sense of empowerment through knowledge, and inevitably achieve peace of mind through total wellness. Here is information shared, openly and candidly, associated with women health and wellness. We women need to arm ourselves. We need this knowledge to manage our own care.

No tags

Rhubarb is a sweet, round-leaved pie plant, which is said to have some digestive qualities with a laxative effect.  It is said to improve the tone of the bowel once it reaches the intestines, which aids in health of the digestive tract.  It is said to help those who suffer from constipation, diarrhea and other digestive problems.It has also been known to control gastrointestinal hemorrhage.  It tends to aid in forming blood platelets, and this helps in treating jaundice, a condition when the person’s skin and whites of the eyes become a discolored yellow due to bile pigments that have increased in number.  Jaundice is a result of liver disease.  Rhubarb root helps with diarrhea because the galloytannin is isolated from the root and counteracts with the toxin secreted by the bacteria that tends to cause cholera.There are some side effects that are associated with ingesting rhubarb root.  These can include severe cramping in the abdomen, and lessening the amount of root taken in can alleviate it.  If too much rhubarb root is taken, symptoms can occur.  These include vertigo, nausea and vomiting.  Long-term use also isn’t always a good idea, because it can lead to hypokalemia and liver cirrhosis. People who have or are susceptible to gall or kidney stones are advised not to take rhubarb root.Rhubarb root should not be taken with cardiac medications, steroids, diuretics and laxatives because of a potential loss of potassium.  The loss of potassium can be decreased by also taking licorice root with the rhubarb root.

No tags

Bad breath is a common health problem which greatly affects the day to day activities of so many people. The offensive odor from the mouth is unpleasant to those who come in close contact with bad breathers.

The problem will be doubled by psychological trauma leading to depression. The sufferers from this problem will be isolated from the society. This can even lead to marital disharmony.

Literally speaking all human beings are bad breathers. Oral cavity contains millions of anaerobic bacteria like fusobacterium and actinomyces which acts on the protein of food materials and putrefies them. This process results in the formation of offensive gases like hydrogen sulphide, methyl mescaptan, cadaverin, skatol causing bad odor. Most of us control this by regular brushing, tongue cleaning and gargling. Even after maintaining cleanliness in the mouth some individuals suffer from offensive smell due to various causes which has to be diagnosed and treated properly.

Here are the most common causes of bad breath.

1) Poor oral hygiene:

If oral hygiene is not maintained properly the mouth becomes the seat for millions of bacteria which produce offensive gases by degrading the food debris. Bad breath is severe in those who do not brush their teeth regularly and clean their mouth after every food. Snacks taken in-between meals can also produce bad breath because of improper cleaning.

Bad breath is common in almost all people in the morning on waking. During sleep there is less production of saliva .Saliva has got some antibacterial properties which help to keep the mouth clean. Saliva contains oxygen molecules which are needed to make oral cavity aerobic. So the reduction in it’s quantity during sleep makes a favorable condition for anaerobic bacteria.

2) Food habits:

The main cause of bad smell is due to degradation of protein by the bacteria and hence all food products rich in protein favor bad breath. Meat, fish, milk products, eggs, cakes, nuts, pear can cause bad breath. Some food articles can produce particular type of smell which may be unpleasant. Raw onion can produce typical bad smell. It is said that an apple a day keeps the doctor away, a raw onion a day keeps everybody away. Eating groundnuts can also produce bad smell. However if proper cleaning is done smell can be reduced irrespective of the nature of food. Irregularity in timing of food can also produce bad breath. Small food articles taken in between the meals can also produce bad smell.

3) Biofilm:

There is formation of a thin sticky coating called biofilm on the tongue and oral mucosa. This coating is thick on the posterior aspect of the tongue where millions of gram negative bacteria are seen .The thick coating on the tongue is always associated with bad breath. Even a thin biofilm can make anaerobic condition favorable for bacterial proliferation.

4) Dental caries:

This is a destructive process causing decalcification with destruction of enamel and dentine resulting in cavitisation of the tooth. These are produced mainly by the lactobacilli. Food particles are deposited inside these cavities and are putrefied by the anaerobic bacteria producing bad smell. Normal brushing will not remove the food debris easily and hence they are putrefied completely. Caries are common in schoolgoing children and in those who do not maintain proper oral hygiene .Calcium and vitamin deficiency can also predispose caries.

5) Gingivitis:

Gum is a mucus membrane with supporting connective tissue covering the tooth bearing borders of the jaw .The main function of gum is protection .Gingivitis is the inflammation of the gum .Due to various causes gum tissue get infected resulting in swelling, pain and discharge. If the condition becomes worse the infection spread towards periodontal area leading to continuous discharge called pyorrhea. Some times the infection goes deep producing alveolar abscess with discharge of pus. Infection can even reach the bone causing osteomyelitis. All these conditions can produce offensive smell.

6) Gum retraction:

When the gums retract from the teeth a gap is developed which will lodge food particles and cause bad breath.

7) Dental plaques and tartar deposits; Plaques and tartar is deposited mainly in the gaps between the teeth and gum. This will provide shelter for the food debris and bacteria causing bad breath.

Ulcerative lesions and coatings:

Almost all ulcerative lesions of the mouth are associated with bad breath. These lesions may be caused by bacteria, viruses, food allergies or due to autoimmune disorders. Apthous ulcer is the commonest among ulcerative lesions. Others are herpes, fungal infections, vincents angina, infectious mononucleosis, scarlet fever, diphtheria, drug reactions. Cancerous ulcers produce severe bad breath. All fungal infections produce white coating (candidiasis). Leucoplakia is a white thick patch on the mucus membrane of the mouth and tongue. It is considered as a precancerous condition. Offensive breath is associated with these conditions.

9) Diseases of the salivary glands:

Saliva is very useful to supply oxygen to all parts of the oral cavity. Even a thin film of coating called biofilm can provide an anaerobic condition in the mouth. Saliva can wet these layers and make an aerobic condition which is unfavorable for the bacteria .Any condition which reduces the production of saliva can increase bacterial activity. Some times the salivary duct is obstructed by stones or tumors. Cancer of the salivary gland is associated with offensive odor. In suppurative parotitis purulant discharge into the mouth causes bad breath.

10) Tonsillitis:

Tonsils are a pair of lymphoid tissue situated in the lateral wall of oropharynx. Inflammation of the tonsil is called tonsillitis. Bad breath is seen in both acute and chronic tonsillitis. Quinsy or peritonsillar abscess can also produce bad breath.

11) Tonsillar plaques and tonsillar fluid:

If bad breath persists even after maintaining proper oral hygiene there is possibility of this condition. Serous fluid secreted from the folds of tonsil is very offensive. Some patients complain that they hawk some cheesy materials from the throat, which are very offensive in nature. These are formed inside the tonsillar crypts which contain thousands of bacteria. In such conditions tonsillectomy gives noticeable relief from bad breath.

12) Pharyngitis and pharyngeal abscess:

Pharynx is a fibro muscular tube which forms the upper part of the digestive and respiratory tract. Inflammation of the pharynx is called pharyngitis, caused mainly by bacteria and viruses. Bad breath is present in pharyngitis along with other signs like cough and throat irritation. Abscesses in the wall of pharynx can also produce offensive discharge of pus in to the throat.

13) Dentures:

Denture users may complain about bad smell due to lodgment of small food debris in between. Proper brushing may not be possible in denture users especially fixed dentures.

14) Tobacco:

Tobacco chewing is associated with bad breath. The smell of tobacco itself is unpleasant for others. Tobacco can irritate the mucus membrane and cause ulcers and coatings. Gingivitis and pyorrhea are common in tobacco chewers. Tartar is deposited on the teeth mainly near the gums. Tobacco chewers get gastric acidity with eructations. All these cause offensive smell.

15) Smoking:

Smokers always have bad smell. It can also produce lesions in the mouth and lungs causing bad breath. Smoking increases carbon dioxide in the oral cavity and reduces oxygen level, causing a favorable condition for bacteria. Smoking reduces appetite and thirst hence acid peptic disease is common in chain smokers.

16) Lesions in the nose and ear:

Bad breath is occasionally seen in sinusitis (infection of para nasal sinuses). In case of post nasal dripping bad breath is common due to the presence of protein in the discharges. These proteins are degraded by the bacteria. Infection in the middle ear with discharge of pus in to the throat through the Eustachian tube (passage from middle ear to the throat) can also cause offensive odor. Chronic rhinitis (infection of mucus membrane of nose) and foreign bodies in the nose can also produce bad smell in the expired air.

17) Diabetes mellitus:

Mostly all diabetic patients suffer from bad breath. Coated tongue, ulcers and coatings in the mouth, increased sugar level in tissues are responsible for halitosis. Bacterial growth in diabetic patient is very faster than non diabetic individuals.

18) Fevers:

Bad breath is common in almost all fevers. Even an acute fever can produce bad breath. Severe bad breath is seen in typhoid .Other infectious diseases like Tuberculosis, AIDS produce bad smell.

19) Fasting and dehydration:

Dry mouth favors bacterial activity. So any condition which produces dryness in the mouth makes the breath offensive. Even though the food particles are known to produce bad breath, fasting can also produce the same. Production of saliva is also reduced during fasting. Chewing and swallowing also helps to keep the mouth clean.

20) Bedridden patients:

Bedridden patients suffer from offensive breath due to thick coating on the tongue. Water intake is also limited in these patients. Regurgitation of food aggravates the condition. Since they talk less aeration in the oral cavity is reduced which favors anaerobic bacteria to become active.

21) Diseases of stomach and esophagus:

Eructation of gas and food produce unpleasant smell. Abnormality in the function of lower sphincter can allow the food to regurgitate upwards causing bad breath. Bad breath is also common in gastritis, gastric ulcer and cancer of stomach.

22) Intestinal diseases:

Bad breath is common in patients suffering from ulcerative lesions of intestine like ulcerative colitis. Other diseases are malabsorption syndrome intestinal tuberculosis, peritonitis.

23) Diseases of lungs:

Lung diseases like pneumonia, lung abscess, chronic bronchitis, bronchiectasis, tuberculosis, lung cancer can produce bad odor during expiration.

24) Liver disorders:

Liver diseases like hepatitis, cirrhosis, can cause halitosis. Gall bladder diseases with vomiting also causes unpleasant odor.

25) Psychiatric patients:

Bad breath is common in psychotic patients due to poor hygiene, irregular food habits, less water intake and.

26) Somatisation disorder:

This is a psychiatric disorder characterized by the presence of a physical symptom that suggest a medical illness .These patients come with physical complaints like pain, nausea difficult respiration, bad smell. This condition is diagnosed after detailed examination of the patient with all investigations. Since this is a psychiatric disorder it has to be managed with a psychological approach.

No tags

PREVALENCE OF CHRONIC LIVER DISEASES IN NON-HCV AND HBV IN OUR POPULATION:Authors:DRghulamrasoolbhurgri,shamim-ur-rehman,bilawal, anisrehman.SUMMARY:Liver diseases are damaged the function of hapetocytes, it may causes hepatocellular necrosis, fibrosis, and regeneration with nodule formation.In our study there was a group of patients who is negative for both viral markers, there were more females that have chronic liver disease. This group need to the investigated further for other well defined but uncommon causes of chronic liver disease.Key words: hepatitis, liver disease, chronic liver disease, hepatitis C virus, hepatitisB virus, cirrohosis.

PREVALENCE OF CHRONIC LIVER DISEASES IN NON-HCV AND HBV IN OUR POPULATION:

Authors:DRghulamrasoolbhurgri,shamim-ur-rehman,bilawal, anisrehman.

SUMMARY:

Liver diseases are damaged the function of hapetocytes, it may causes hepatocellular necrosis, fibrosis, and regeneration with nodule formation.

In our study there was a group of patients who is negative for both viral markers, there were more females that have chronic liver disease. This group need to the investigated further for other well defined but uncommon causes of chronic liver disease.

Key words: hepatitis, liver disease, chronic liver disease, hepatitis C virus, hepatitisB virus, cirrohosis.

INTRODUCTION:

INTRODUCTION:

Chronic liver disease in which liver damage slowly by process and persisting over long time.It means it act as slow poison for healthy human body. It is characterized by replacement of liver tissue by fibrous scar tissue as well as regenerative nodules (lumps that occurs as a result of a process inwhich damage tissue is regenerated.It is already to progressive loss of liver function-cirrhosis is due to alcoholism, but in our population it is prohibited by people due religion, poverty and customs society, Hepatitis C, Hepatitis B virus are main role this dangerous disease in our population.

BASIC STRUCTURE OF LIVER:

“Liver is the largest gland in the body weighing about 1.4 k.g in an adult. It is situated under diaphragm in the upper abdomen cavity and is held in place by several ligaments.It is reddish-brown colour and comprise of four anatomical lobes.When viewed from the front the dominant left and right lobes can be seen which are separated by falciform ligament.Situated in a depression on the posterior surface of the liver in the gall bladder, a pear shaped sac which stores bile synthesis by the liver.The liver performs many metabolic functions. It has ability to store and metabolites useful substances such as nutrients,but it breakdown or detoxifying harmful substances to render then inert and less harmful”(Dr.viva Rolfe 2004)

“Liver weighing roughly 1.2-1.6 k.g performs many of the functions necessary for staying healthy. It is located in the right side of the body under the lower ribs and is divided into four lobes of unequal size. Two large vessels carry blood to the liver, the hepatic artery comes from heart and carries blood rich in nutrients absorbed from the small intestine. These vessels divided into smaller and smaller vessels, ending in capillaries. Each lobule is composed of hepatocytes, add, and remove substance from it. The blood then leaves the liver via the hepatic vein, returned to the heart, and is ready to be pumped to the rest of the blood.

Among the most important liver functions are,

“Liver is an organ in vertebrates, including humans. It plays a major in metabolism and has a number of functions in the body including detoxification, glucagon storage and plasma proteins sythesis.I t also produces bile, which is important for digestion. It also starts in hepato or hepatic from Greek word for liver, hepar. Hepatocytes play main role in.

PHYSIOLOGICAL FUNCTIONS OF LIVER:

“Liver functions: HEMOSTASISè glucose, protein, fat, cholesterol, hormones, vitamins, in particular fat soluble vitamins (ADEK)

SYNTHESISè protein including clotting factors, bile acids, heparin, somatomedins, promote growth hormones, cholesterol and acute phase of proteins.

STORAGEè vitamins, glycogen, cholesterol. Iron, copper, fats.

EXCRETIONè cholesterol, bile acids, phopholipds, bilurobin, drugs, poison including heavy metals, hormones.

FILTERINGè poisons, nutrients, Iga, drugs, dead damage cells in circulatory system.

IMMUNEè excretes Iga into digestive tract kupffer cells (macrophages) filter out antigens.” (Liver foundations-2002).

“The liver is vulnerable to a wide of variety of metabolic, toxin, microbial, circulatory and neoplastic insults. The dominant primary diseases of the liver are viral hepatitis, alcoholic liver disease and hepatocellular carcinoma. More often, hepatic damage is secondary, to some of the most common diseases in humans, such as cardiac decompensation, disseminated cancer and extrahepatic function. There are following morphological changes in liver:

ETIOLOGY OF LIVER DISEASE.

“There are following main causes of liver diseases,Hepatitis virus A,B,C,D,E. Epstein-Barvirus,cytomegalovirus,yellowfever virus.Non-viral infection:leptospira, toxoplasma gendi,q fever,Poison-aflatoxin, carbantetrachloride, mushrooms, Drugs- paracetamol ,halothane, alcohal, pergnancy,shock, wilson disease.

CLINICAL MANIFESTATIONS:

SYMPTOMS:anorexia, malaise,fever,jaundice, right abdomenal pain,hepatomegaly, gynicomastacia, pruritus,hematamesis, confusions,

SIGNS: jaundice, hepatomegaly, pale stool, dark colored urine, palmer erythrema, clubbing, jaundice, spleenomegaly testicular atrophy, gynecomastia, with other complications- colateralveins peripheral edema, ascites.”(Davidson-2004)

COMMON LABS:TESTS FOR LIVER DISEASES:

“The diagnosis of liver diseases depends upon a combination of history, physical examination,labortary testing and sometime radiological studies and biopsy.

METHOD;

One hundred patient diagnosed as chronic liver disease,from which 35 patients were enrolled in this study protocol,after consent,after screening, duration of study was between 2005-2006, admitted in NonHCV,HBV, liver cirrhotic disease ward, in Muammad Medical College Hospital,

AIM AND OBJECTIVE OTHIS STUDY:

To evaluated the causes of liver diseases without virus,because liver was deterioate in its function due to HCV,and HBV,it was common concept in our community.No doubt it was still a big danger for our population.

RESULTS:

These results were analytic by help of spss from which frequecies of each group were describer as follw:

Mean of reseach found in graphs

Summary of study and corelation of each group were analised very well.

BIOSTATISTICS ANALYSIS:

Frequencies:

Frequencies:

Correlation

Correlation

Descriptive Statistics

Descriptive Statistics

Mean

Std. Deviation

N

Total number of patients

41.1100

12.10467

100

Total number of liver cirrhotic patients

40.6000

11.50499

35

Total male patients

29.8000

5.62139

15

Total female patients

48.7000

7.24097

20

Correlation

Correlation

Total number of patients

Total number of liver cirrhotic patients

Total male patients

Total female patients

Total number of patients

Pearson Correlation

1

1.000(**)

.998(**)

.526(*)

Sig. (2-tailed)

.

.000

.000

.017

N

100

35

15

20

Total number of liver cirrhotic patients

Pearson Correlation

1.000(**)

1

1.000(**)

.525(*)

Sig. (2-tailed)

.000

.

.

.018

N

35

35

15

20

Total male patients

Pearson Correlation

.998(**)

1.000(**)

1

.883(**)

Sig. (2-tailed)

.000

.

.

.000

N

15

15

15

15

Total female patients

Pearson Correlation

.526(*)

.525(*)

.883(**)

1

Sig. (2-tailed)

.017

.018

.000

.

N

20

20

15

20

** Correlation is significant at the 0.01 level (2-tailed).

* Correlation is significant at the 0.05 level (2-tailed).

DISCUSSION:

In this prospective study, there were certain points for consideration that what causes of females affected more by liver disease as compared male.This study showed females were more,interpreted by graphs and charts.

Chronic liver disease is marked by gradual destruction of liver tissue overtime.It is seventh leading cause of death in United States, according to National Institute of Diabetes and Digestive and Kidneys disease becaudse of chronic damage to the liver, scar tissue slowly replaces normal functioning liver tissue, as the normal liver is lost, nutrients, hormones, drugs, and poisons,are not processed effectively by the liver. In addition, protein production and other substances produced by the liver are inhibited.

“obesity is not associated with nonalcohlic fatty liver disease but it also adversely affects the progression of other liver disease.Specific directly interventions should focus on decreasing intake of low-nutrient and high sodium food, as wellas high fat sources of meat/ protein”(kimech et al 2008)

“our study match with the study of the klad chareon et al(2004) in which they aimed to determine the prevalences on non alcohalic steatohepatitis in thai patients with non HBV,HCV,chronic hepatitis. Forty six patients with negative markers of viral hepatitis B and viral hepatitis C and non alcohalic consumption were enrolled.just in our study we enrolled 100liver cirrhotic patients from which we selected non alcohalic and non HBV,HCV.They informed consent for liver biopsy and blood collecting to identify the etiological of chronic hepatitis was performed.Thai patients wth non alcolic,non HBV,HCV,chronic hepatitis with obesity,diabetes mellitus and dyslipidemia”(kladchareonN,et al 2004)

“This study match with the study of the Omagrik et al 1996 ,They discovered of hepatitis c virus (HCV) has enabled the diagnosis of type c chronic liver disease, which had the past been diagnosed as part of non-A,non-B,chronic liver disease. Although most cases with chronic liver were by hepatitis B,C there are stillcases of non B,C,chronic liver disease.Forty two patients with chronic liver disease who were seronegative hepatitis B,Cwere followed in the study for treatment.The yearly incidence hepatocellular carcinoma 9.3% with liver cirrohosis and 3.9% of chronic hepatitis.This suggested that their population sample contained a number of patients with type B,typeC or other etiological agents.Our study suggested that more detialed and accurate tests of detecting HBV andHCV should be considered before maing diagnosis o non B,nonC chronic liver disease that there was need to revial unknown etiological agents.

REFERENCES:

No tags