الفهرس 
Vascular And Architectural Alterations In CirrhosisOnly 14 pages are availabe for public view
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Abstract
This study is about patients with esophageal varices that may occur as a result of cirrhosisThe sample was chosen randomly from different hospitals in Cairo, and the most specific samples were from a Om Al-Masryeen Hospital in Egypt, which consisted of 75 patients, was divided into (54) males and (21) females, and their ages.Ranging from 37 to 78 years old, data were taken from each case that included a personal data formAnd a questionnaire for assessing the economic and social situation, a form for dietary habits, and a form for health history Body measurements questionnaire, food consumption pattern form, medical and laboratory examination formAnd a 24-hour retrieval form and a form for collecting the meals that were eaten. (BMI) The weight and height of the study participants were determined and the body mass index was calculatedAs well as measuring the height and weight of all patients under study through personal interviews, then he didParticipants edited the questionnaire, which contained the aforementioned forms, and they were registeredAnd follow-up medical analyzes of existing patients from the reality of their medical files, as well as frequent patientsfrom the periodic follow-up to them in the outpatient clinic, in order to analyze hemoglobin, red blood cells, white blood cells, bilirubin, liver enzymes, blood fluidity rate, and ureaCreatinine and uric acid, as well as an analysis of fasting and fasting glucose. The number of patients with cirrhosis was (75), the number of people with diabetes was (20), and those with hepatitis C were (69). The results showed that (15) of the patients were infected. with schistosomiasis.
The resulting arrived at revealed the following:
1- It was found that 65% of the respondents were married, 30% were widows, there were no singles, and 4% were divorced.
2- It was found that 72% of the sample were males and 28% were females.
3- The percentage of those with university education was 21% of the sample, the percentage of those with intermediate education was 38%, the percentage of those who could read and write was 30%, and the percentage of illiterate people was 11% of the patients under study.
4- Most of the participants in the study were from middle-income families, and their percentage was 81% of the sample. Also, the income of limited families amounted to 17% of the sample, while the percentage of high-income families was 1% of the patients.
5- It was found that the average height of these patients was 6.180, and most of them were men, and the average weight was 493. The body mass index was .8 33, which indicates that many cases were obese, and the average age of these patients was 2558, as the incidence increases with age
6- The results showed that there are diseases associated with esophageal varices, 20% of patients suffer from schistosomiasis, and 92% of patients are infected with hepatitis C virus. It was found that 22% suffer from kidney disease and 8% suffer from heart disease, while bone diseases were 100% of all patients.
7- The patients who were taking supplements and vitamin B for the type of drug, Becozyme Forte, were 10%, while 54% of the patients did not take supplements, and the percentage of those taking Bikvit was 18%, while those who were taking Milga were 16%, and those who were taking Hepafort 9%, Hebalopin 5%, and a drug Hepaton 25%, while those taking Seamun 16%, Arsotoin 4%, Warsoplus 8%, Bional 6%, Arsofalk 8%, Levatek 4%, Hepamax 6%, Silymarin 1% and Levanox 5% of patients.
8- For patients who take calcium supplements, 10% of patients take calcitron, while 76% of patients do not take calcium supplements, 1% of patients take Matrix Calcium, 8% of patients take Steokere, and 4% of patients take Maxical.
9- It was found that 98% of the patients had anemia and 97% had jaundice (yellowness). It was also found that 80% of the patients had dark urine, 8% had brown, and the yellow color represented 12% of the patients under study. It was also found that 97% Of the patients have a tumor in the leg as a result of liver cirrhosis and fluid accumulation.
10- It was found that 100% of all patients with esophageal varices were suffering from flatulence, and 37% of patients had signs of abdominal surgery.
11- The study showed that among the clinical symptoms that appeared on the patients, the change in the color of the stool, the black color represented 85% as a result of bleeding in the stool resulting from varicose veins bleeding, while the dark brown color represented 14% of the patients. It was also found that 70% of the patients were infected. Constipation as a result of lack of fiber intake and 42% had diarrhea.
12- It was also found from laboratory analyzes that hemoglobin in most patients was low, which indicates that they suffer from anemia due to bleeding resulting from esophageal varices.
13- The study showed that the average hemoglobin was 10.53,gm/dl red blood cells 3.41,(cell/µl) platelet count averaged 37.28(microliter) while white blood cells represented 5.10, (microliter) PTT-PC rate 52.57,(Per-sec) and the average rate of P.P sugar in patients 170.97(mmol/L) while fasting sugar was 121.9(mmol/L).
14- As indicated by the medical analyzes of patients for kidney function, the percentage of urea was an average of 61.9(mg/dL) and uric acid,5.16(mg/dL) While creatinine was .99(mg/dL), liver function and the ratio of ALT-AST 41.00-54.67(IU/L) liver enzymes are within normal limits among most patients, and this confirms that these enzymes are not necessarily elevated with the occurrence of liver cirrhosis or the occurrence of esophageal varices, and the total bilirubin ratios are lower than normal, with an average of 2.94(mg/dL) among patients. .
15- It was also noted that the albumin ratio for patients was 2.04(g/dL) less than the normal limit, which indicates the existence of a problem with the liver, as the occurrence of liver cirrhosis reduces the percentage of albumin in the blood.
16- The results indicated that there is an increase in the intake of animal protein 88.6 and vegetable protein with an average value of 77.23, as the increase in protein is stored in the liver and this clearly affects the efficiency of the liver and the high percentage of urea and uric acid in the blood. Animal fats 97.20 and vegetable fats 73.27, which affects the efficiency of the heart arteries, as well as an increase in the intake of carbohydrates, with an average value of 545.45 for all patients. As for ash, the values were 1.47, and the lack of intake of fiber with an average value of 1.11, which leads to constipation in these patients. Vegetable and animal proteins, as well as vegetable and animal fats and carbohydrates, which leads to an increase in the total calories consumed daily, and thus weight gain.
17- Less intake of calcium in most patients than the normal limit, which represents a danger to the health of bones and teeth, while the percentage of phosphorous was more than the normal limits, and this represents a danger to the bones and teeth and leads to calcification.
18- The iron intake was lower than the DRI recommendations, Low iron intake leads to a lack of hemoglobin and thus anemia with the presence of cirrhosis of the liver that leads to esophageal varices, whose complications develop and lead to bleeding, in which the patient loses a large amount of iron. blood lead to anemia.
19- These results showed that sodium intake was much higher than the normal limit, as sodium leads to high blood pressure, which leads to many problems that pose a threat to the health of the kidneys and liver, especially for patients with cirrhosis of the liver and esophageal varices, as sodium causes water to be retained inside. The body due to its high osmotic pressure, and this is not required with these patients.
20- It was also found that the intake of potassium in meals exceeded 4.7 mg/d of the permissible daily recommendations, with an average value of 297.06, which affects the heart muscle. It was also found that there was a deficiency of zinc above the permissible recommendations of 10 mg/d. Also, it was found that the percentage of manganese was higher than the permissible recommendations. It has 400 mg/d.
21- It was noted that there was an increase in the intake of vitamin A by 800 mg above the normal limits, and this represents a danger to the liver because this vitamin is stored directly in the liver. An increase in the intake of vitamin C was found above the normal level (N = 90 mg / d). The increase of this vitamin does not represent a danger. It is high because it is considered one of the vitamins soluble in water, and therefore the excess is excreted in the urine, but if it rises very significantly, many problems arise. It was also noted that the intake of vitamin B1 was low (1.2), It was also found that the intake of vitamin B2 was less than the normal limits.
22- When the evaluation of the upper part of the stomach was done laparoscopically, it was found that 64% of the patients were of the third degree and 36% of the patients were of the fourth degree, and injections of varicose veins were performed in 66% of patients with esophageal varices, and ligation of the varicose veins was also performed In 48% of the patients three times, while in 24% of the patients they were ligated 4 times, 3.1% of the patients were ligated 5 times, 4% of the patients were ligated 6 times, and 3.1% of the patients were ligated They were ligated 7 times, 3.1% were ligated 8 times, 3.1% were ligated 9 times, and 18.7% of patients did not have their varicose veins ligated, but injections were used instead of ligation.
23- It was noted that 24% of patients had varicose veins injected once, while 3.17% of patients had varicose veins injected twice, 16% of patients had varicose veins injected three times, and 9% of patients had varicose veins injected 4 times. While 3.33% of patients did not receive injections for varicose veins, it was also discovered that 53% of patients had bleeding from varicose veins after the ligation procedure, and 46% of patients did not have bleeding, and the patient’s ability to perform injections and the degree of varicose veins if they were in an advanced stage or not. No, as it was found that in 64% of patients an esophageal ulcer occurred after ligation, while 36% of patients did not develop an esophageal ulcer after ligation of varices.
24- It was observed from the endoscopy results that in 64% of the patients, the third degree was evaluated for ligation of the esophageal varices, and 36% were of the fourth degree.
25- It was noted that in 48% of the patients, portal hypertension (PHG) was of a simple degree, 37% of the patients had a moderate degree, and 12% had a severe degree, while 2% of the patients had gastroesophageal reflux after endoscopy.