Previous History Of Jaundice Research Articles

Seroprevalence of Hepatitis C Virus in High School Students of Bangladesh - A Single Centre Study

Introduction: Hepatitis C virus is an important pathogen due to its high prevalence and ability to cause serious complications like chronic hepatitis, cirrhosis, end stage liver disease and eventually liver cancer. Aim of this study was to Hepatitis C virus seroprevalence in the high school going children in Bangladesh.
 Materials and Method: It was a cross sectional study carried out in Ghior D.N. High School, Manikganj over 600 high school students within the period from April 2007 to April 2008. Two hundred students each from class VIII to X were selected. Informed written consent was taken from each students and their demographic and socioeconomic attributes, various potential parenteral exposures to blood and blood products were noted down in pre designed structured questionnaire. Venous blood of 3.0 ml was collected and was tested for anti HCV by commercial kit according to standard operating procedure. All positive cases were confirmed by ELISA method. Statistical data analysis was performed using SPSS 20.0 software. Students T test and chi-square test was done to test the significance of the factors of study in relation with the seroprevalence of anti-HCV antibodies. P< 0.05 was considered as significant.
 Results: The mean age of the participants was 14.6±2.26 years. Of the 600 students, 289 (48%) were male and 311(52%) were female. It was not statistically significant (P=0.089). Among the 600 students, none tested positive for hepatitis C. Of them, 60 (10.0%) belonged to upper class, 222 (37.0%) to middle class and 318 (53.0%) to lower class. Total 34 students had previous history of jaundice and 288 had previous surgeries. Both the comparison between previous jaundice with no jaundice and previous surgeries with no surgery was not statistically significant (P=0.18, 0.089).
 Conclusion: Prevalence of Hepatitis C is 0% in high school students in this study. Further extensive nationwide study should be carried out to determine the real scenario.
 Sir Salimullah Med Coll J 2022; 30: 51-54

Effects of Body Massage on Response to Phototherapy in Neonatal Hyperbilirubinemia: A Randomized Clinical Trial

Background: Massage therapy has been commonly practiced as a traditional complementary therapy in neonates. This study was designed to evaluate the effects of massage on decreasing bilirubin levels in infants undergoing phototherapy. Materials and Methods A total of 60 term icteric infants without known risk factors who were admitted to the neonatal intensive care unit of Ghaem Hospital, Mashhad, Iran from 2016 to 2018 were involved in this preliminary clinical trial. The infant participants were randomly divided into the massage + phototherapy (intervention group, n=30) who received massage therapy (with field technique) thrice daily (every 8 hours) for 30 minutes each, and phototherapy alone (control group, n=30) who received phototherapy and routine care. Serum bilirubin samples were obtained at different time points in both groups. Results: The mean feeding time in the intervention and control groups were 22.5 and 21.4 min, respectively. The mean birth weights in the intervention and control groups were 3052 and 3187 gr, respectively. No significant differences were found between the two groups in age, sex, Apgar score, maternal profile, and previous history of jaundice (P>0.05). Rates of bilirubin loss were 0.81±0.19 mg/dl/h and 0.59±0.18 mg/dl/h in the intervention and control groups, respectively (P=0.043), in the first 8 hours of admission which dropped to 0.46±0.16 and 0.37±0.22, respectively (P=0.958), in the first 30 hours of admission. Conclusion Based on the results, massage is suggested as a complementary method for phototherapy, especially in the first eight hours of treatment during toxic high bilirubin levels and at the peak risk of kernicterus.

2205 Bupivacaine-Induced Liver Injury: A Diagnostic Dilemma

INTRODUCTION: Bupivacaine is local anesthetic (1). Very few cases of bupivacaine induced liver injury have been noted in the literature; we report a case of this very rare side effect (2). CASE DESCRIPTION/METHODS: A 69-year-old male patient underwent a right inguinal herniorrhaphy. One week after the surgery, patient began to have nausea, vomiting, fever, and dark brown urine. Stools were normal and there was no pruritis. There was no previous history of jaundice, chronic liver disease or malignancy. New medication use, alcohol, illicit drug use, risky sexual behavior was negative. On examination, vitals were all within normal limits. Icterus was present but otherwise his skin was only remarkable for the left lower quadrant scar, which was healing well without surrounding erythema or purulent discharge. Liver function tests were notable for a total bilirubin of 17.4 mg/dL, direct bilirubin was 10.8 mg /dL,. AST was 355 U/L, ALT was 570 U/L, alkaline phosphatase was 944 U/L, LDH was 315 U/L. Viral, autoimmune and structural causes of acute hepatitis were excluded. Given the negative evaluation, a retrospective review of medications received during and after surgery was performed, and the patient was found to have received bupivacaine via PCA post-operatively. As all the other options were excluded, the patient was diagnosed with liver injury from bupivacaine. The patient was managed conservatively and recovered fully in about four weeks. DISCUSSION: Bupivacaine is a local anesthetic which can be given through elastomer pumps for pain control (1). There are case reports in the literature that suggested bupivacaine can cause liver injury when given for more than one week (2,3). DILI is a diagnosis of exclusion (2,4). The common causes of liver injury such as drugs, alcohol, viruses, autoimmune diseases and biliary tract abnormalities need to be excluded (4). The diagnosis can be established with the help of Naranjo criteria (5) (Table 1). Most of these liver injuries respond to conservative management. There have been no reports of any acute or chronic liver failure in such cases. If the patient is at high risk of liver injury then they should receive local anesthetic agent other than bupivacaine (3).

Detection of Neonatal Jaundice among the Newborn Using Kramer?s Criteria

Introduction: Jaundice is one of the most common conditions which need medical attention in newborn babies. In most babies with jaundice there is no underlying disease, and this early jaundice is termed as physiological jaundice.Objectives: To determine the incidence of Neonatal jaundice by Kramer’s criteria among Newborns in the Postnatal ward. To assess the risk factors that leads to Neonatal Jaundice.Methodology: The research approach was Quantitative approach and Non experimental research design was adopted for this study. The sample size was 80 Newborns and purposive sampling technique was used. The data was collected by using Kramer’s criteria. Results were analyzed by using descriptive and inferential statistics.Results and findings: Out of 80 babies, 20 babies had Neonatal jaundice, total incidence rate was 25%. 43(53.8%) babies were in female sex group and 37(46.2%) babies were in male sex group According to the risk factors Majority 14(17.5%) of neonates had not given colostrums given at birth, 15(8.8%) of neonates had not initiated breastfeed within 24 hours of birth, 1(1.2%) of neonates had previous history of jaundice in siblings. According to mothers risk factors 7(8.8%) of mothers had Gestational hypertension, 7(8.8%) of mothers had Gestational diabetes mellitus, 2(2.5%) of mothers had hypothyroidism during pregnancy. There was significant association observed with the post test scores with their selected demographic variables like colostrum intake by the Newborn.Conclusion: “Visual inspection of Neonatal jaundice by using Kramer’s criteria” is a suitable low-cost and a feasible alternative modality for early detection of neonatal jaundice in a poor resource setting.

High Prevalence of Wilson's Diseases with Low Prevalence of Kayser-Fleischer Rings among Patients with Cryptogenic Chronic Liver Diseases in Bangladesh.

ABSTRACTBackgroundChronic liver disease (CLD) is common in Bangladesh; however, a major bulk remains as cryptogenic CLD as they remain devoid of known pathological agents leading to have a check of Kayser–Fleischer (K–F) rings for possible Wilson's disease (WD) and many of these patients develop complications such as cirrhosis of liver and hepatocellular carcinoma. However, there remains considerable proportions of CLD patients with undefined etiology (cryptogenic CLD) and these patients cannot be provided effective therapy based on etiological factors. Here, the proportion of WD among cryptogenic CLD patients in Bangladesh has been evaluated to improve the management of CLD and reduce complications.Materials and methodsA total of 941 patients with cryptogenic CLD [negative for hepatitis viruses, alcohol, nonalcoholic fatty liver disease (NAFLD), drug, and autoimmunity] were enrolled in the study. To assess if they have been suffering from WD, the levels of copper in 24-hour urine were evaluated. Definitive WD was diagnosed when 24-hour urinary copper output was >100 μg and strongly indicative WD patients excreted >40 μg of copper in 24 hours.ResultsOut of 941 patients with cryptogenic CLD, 212 patients were diagnosed as definitive WD and 239 patients as strongly indicative WD on the basis of 24-hours copper excretion. The age distribution ranging of the patients varied from 1 year to 90 years. There was a male predominance. Considerable numbers of WD patients had previous history of jaundice. Kayser–Fleischer rings were mostly uncommon and detected in five patients with WD only.DiscussionWilson's disease is not a rare entity in Bangladesh; rather, it seems to be fairly common among CLD patients. A country-wide epidemiological survey should be conducted for diagnosis of WD in Bangladesh to provide a proper management strategy for these huge numbers of WD patients. In fact, most of the WD patients are unaware of their diagnosis and the general physicians are equally unaware of diagnosis and management of WD.How to cite this articleChoudhury N, Quraishi SB, Atiqullah AKM, et al. High Prevalence of Wilson's Diseases with Low Prevalence of Kayser–Fleischer Rings among Patients with Cryptogenic Chronic Liver Diseases in Bangladesh. Euroasian J Hepato-Gastroenterol 2019;9(2):67–70.

Frequency of Hepatitis C in admitted patients of Department of Obstetrics & Gynaecology, Ghurki Trust Teaching Hospital, Lahore

Objective: To assess the frequency of hepatitis C in admitted patients of department of obstetrics and gynaecology Ghurki trust teaching hospital, Lahore. Design: Descriptive study Place and duration of study: This study was conducted on patients admitted in obstetrics and gynaecology ward Ghurki trust teaching hospital, Lahore from 1st January 2005 to 31st December 2005. Patients and methods: A total of 1569 patients of age between 20 to 70 years were admitted in obstetrics and gynaecology ward Ghurki trust teaching hospital, Lahore and were screened for anti-HCV antibodies by 3rd generation ELISA. All positive patients were asked about previous history of jaundice, surgery, blood transfusion, multiple injections and dental procedures. Results: Out of 1569 patients 107 were found to be anti-HCV positive. Mean age of patients was 34.5 years. Frequency of anti-HCV was maximum (38.3%) in 31-40 years age group and in gynaecology patients (12.5%). Previous history of multiple injections and dai handling were the most commonly associated factors. Co-existent hepatitis B and C was found in only 2 (1.8%) patients. Conclusion: Hepatitis C is becoming an alarmingly common problem in the area of Ghurki Trust Teaching Hospital, Lahore. Its modes of transmission need to be properly evaluated for its control and prevention.

HAV Immunity in Iranian Medical Students

Background:Hepatitis A, a fecal-oral transmitted disease, which has been considered endemic in developing countries, seems to change its pattern in developing countries because of their improved socioeconomic status.Objectives:In the present study, we aimed to determine the need of vaccination in 270 students at AJA University of Medical Sciences.Materials and Methods:The serum level of anti-HAV antibody was checked in 270 students of AJA University of medical students, and effect of different factors, including age, gender, pre-university entrance exam region, familial education, familial income, clean water availability, and previous history of jaundice were tested.Results:Of total 270 students, 30 were female. Their age ranged between 18 and 30 years old with the mean age of 20.58 years and just 34% of students had positive level of anti-HAV antibody. Age and sex had no role in positive serum level of anti-HAV antibody. According to analyzed data, lack of clean water availability, pre-university entrance exam region, lower family education, and poor health status estimation increased statistically the risk of HAV infection.Conclusions:Because 66% of students were anti-HAV antibody negative and they will work as health care workers in future, our study suggest vaccinating all students accepted at AJA University of Medical Sciences.

Routine haemoglobin electrophoresis screening in day case herniotomy in Nigerian children: Is it evidence-based?

Background:To determine the prevalence of haemoglobinopathies in children who require day case herniotomy in our centre and ascertain if routine screening is necessary in all patients who require herniotomy.Materials and Methods:A 12-month retrospective analysis of patients requiring herniotomy in our centre. Data including age, sex, diagnosis, haemoglobin electrophoresis status, surgical outcome and hospital stay were analysed.Results:Ninety-five patients had complete records. There were 84 boys and 11 girls. M:F ratio: 7.6:1. The mean age was 3.2 ± 0.6 years. Fifty-five point eight per cent of the patients had right inguinal hernias while 35.8% had left inguinal hernias. Eight patients (8.4%) had bilateral inguinal hernias. Twenty-six patients (27.4%) had haemoglobinopathies while 69 patients (72.6%) had homozygous Haemoglobin A. The Sickle Cell trait (HbAS) was found in 22 patients (23.2%) while the HbAC was found in three patients (3.2%). One patient (1.1%) had Sickle Cell disease (Haemoglobin SS). He had had blood transfusion and previous history of jaundice. All patients survived and all patients were discharged on the day of surgery (mean hospital stay: 4hrs (range: 2.5 hrs–12 hrs)) except the patient with Sickle Cell disease who was admitted a day before surgery and discharged a day after the operation.Conclusion:One in four children coming for day case herniotomy in our centre had the Sickle Cell trait while only 1% had the Sickle Cell disease. These findings are in keeping with the prevalence in the Nigerian population. Routine screening may not be necessary for all patients coming for herniotomy in our centre. Clear indication(s) should be outlined for screening.

Xanthogranulomatous cholecystitis mimicking gallbladder cancer and causing obstructive cholestasis

Xanthogranulomatous cholecystitis (XGC) is a destructive inflammatory disease of the gallbladder that can mimic gallbladder carcinoma. We present the case of a 35-year-old Hispanic male complaining of right upper quadrant pain and jaundice for 2 months prior to admission. He denied a history of fever, nausea/vomiting, and weight loss. The past medical history was relevant only for diabetes. He had no previous history of jaundice or previous operations. CA19-9 was slightly elevated (52 U/mL). Abdominal ultrasonography showed an irregular thickening of the gallbladder wall and no gallstones were detected. CT scan also revealed an irregular thickening of the wall of the gallbladder body suggestive of malignancy. At laparotomy, the mass was adherent to the duodenum and colon, and although the frozen section biopsy was negative, the intraoperative findings were suggestive of malignancy, and the patient underwent left liver trisegmentectomy, resection of the common bile duct and Roux-en-Y hepaticojejunostomy. Pathological examination unexpectedly revealed XGC without malignancy. Preoperative and intraoperative differential diagnosis of XGC from gallbladder carcinoma remains a challenge when it is associated with inflammatory involvement of surrounding tissues. Since gallbladder carcinoma and XGC may coexist, radical resection is justified when malignancy cannot be completely ruled out.

CC-008 Please see this man with abnormal liver function tests

<h3>Introduction</h3> A 45-year-old man presented with a 2-day history of jaundice and severe epigastric pain radiating through to his back. He also complained of nausea and vomiting. He noted his urine to be dark and his stools pale but denied having pruritis. He drank 30 units of alcohol a week and had returned from mainland Spain 5 days prior to his illness. There was no previous history of jaundice or additional risk factors for chronic liver disease. He was on no regular medications. His only significant past medical history was a laparoscopic cholecystectomy performed 8 months previously due to an attack of cholecystitis. <h3>Methods</h3> Initial blood tests demonstrated a mildly raised bilirubin and amylase but a marked transaminitis (ALT 2073 iu/l, normal range 0–35 iu/l). Twenty-four hours after admission he deterioratd with sepsis, renal failure, thrombocytopaenia and a microangiopathic anaemia. Imaging demonstrated common bile duct stones causing biliary obstruction and pancreatic inflammation. He was treated for his microangiopathic anaemia and as part the management of pancreatitis underwent an early therapeutic ERCP to provide biliary drainage. <h3>Results</h3> The prevalence of common bile duct stones (CBDS) in patients with symptomatic gallstones is quoted to lie between 10 and 20%.1 In patients who are not jaundiced and have a normal trans-abdominal ultrasound the prevalence is said to be &lt;5%.2 The natural history of CBDS is not well understood but if they do become symptomatic the consequences are often serious. He was assessed as low risk for CBDS and as suggested by current BSG guidelines did not have any additional biliary imaging.3 This patient had an atypical presentation of a relatively common condition and subsequently developed a very rare complication. He required a prolonged critical care admission to support the management of multi-organ failure, which involved the expertise of a closely coordinated multidisciplinary team. <h3>Conclusion</h3> The traditional teaching that an ALT &gt;1000 iu/is due to drugs, viral hepatitis or ischaemia is a good rule of thumb. However, it is not a “golden rule” and when the clinical picture does not fit, the differential diagnosis needs to be widened. This case highlights the difficulties, complexity and spectrum of clinical conditions which present with abnormal liver function tests.

Selective operative cholangiography in the performance of laparoscopic cholecystectomy

The objective of this prospective study was to evaluate the role of intraoperative cholangiography (IOC) for patients undergoing laparoscopic cholecystectomy (LC) to determine whether it could be safely omitted for all patients who fit standard criteria, namely normal liver function tests, no history of gallstone pancreatitis, common bile duct (CBD) diameter less than 10 mm or previous history of jaundice. Data were collected prospectively from 194 consecutive patients who had LC for symptomatic gall bladder disease. IOC was not performed in any patient. The conversion rate was 6.1% and one CBD injury occurred. Our experience demonstrates that LC performed without routine IOC does not result in an increased incidence of retained stones in selected patients who have no history of pancreatitis, normal liver function tests and CBD less than 10 mm diameter.

Hepatitis E Virus Infection with Nonimmune Hemolytic Anemia

Hepatitis E Virus Infection with Nonimmune Hemolytic Anemia

ACUTE HEPATITIS IN OKINAWA, JAPAN-ANALYSIS OF 277 CASES

Purpose: To eastablish the clinical and laboratory features of acute hepatitis diagnosed and treated at 500-bed teaching hospital in Okinawa, Japan. Methods: “Acute hepatitis” was defined as a case with the following. (1) A case without previous history of jaundice, abdominal girth, variceal bleeding or PSE. (2) A case without previous laboratory, serological or pathological diagnosis of chronic hepatitis or cirrhosis. (3) A case of acute or subacute presentation of symptoms as jaundice, general fatigue or darkened urine. (4) A case with elevated ALT, AST or Alkaline phosphatase above twice normal. 277 patients with acute hepatitis during phase I(1989–1993) and phase II(1999–2003) were examined retrospectively. Results: 150 patients were in the phase I (75 males and 80 females) and 122 patients were in the phase II(55 males and 67 females). Among phase I there were 13(8.7%), 5(3.3%), 29(19.3%), 36(24%) and 39(26%) patients with acute hepatitis B, C, drug induced liver damage, liver damage with other medical problems and unknown etiology, respectively. Among phase II there were 5(4.1%),16(13.1%),9(7.3%),21(17.2%),29(23.8%) and 16(13.1%) patients with hepatitis A, acute hepatitis B, autoimmune hepatitis, drug induced liver damage, liver damage with other medical problems and unknown etiology, respectively. “Other medical problems” including, sepsis (21 cases-35.6%), shock(8-13.6%), malignancy(6-10.1%) pneumonia(5-8.5%) and ischemic heart disease(4-6.8%). Among hepatitis A, acute hepatitis B and etiology unknown acute liver damage (EUALD), maximal ALT was significantly higher in hepatitis A and acute hepatitis B than EUALD(hepatitis A vs Hepatitis B vs EUALD = 3664.3 vs 2290.8 vs 704.4, p <0.05) and maximal T-bili was significantly higher in hepatitis B than hepatitis A and EUALD (hepatitis A vs Hepatitis B vs EUALD = 6.5 vs 13.9 vs 3.8, p <0.05). Conclusions: Acute hepatitis experienced by us revealed features as; Total number of cases in phase II was less than in phase I. There were significant cases of drug induced liver damage and liver damage with other medical problems both in phase I and II. Acute hepatitis with unknown etiology seems to be milder elevation of T-bili and ALT than hepatitis A or acute hepatitis B.

Simvastatin-induced myositis occurring in a patient with viral hepatitis A

A 60 year old female was admitted with jaundice, malaise &amp; loss of appetite. Two weeks before admission she had complained of diarrhoea with abdominal pain. There was no previous history of jaundice, blood transfusion or foreign travel. She denied pruritus, and stools were of normal colour, although her urine was dark. She was non-smoker &amp; did not drink alcohol regularly. She was known to have ischaemic heart disease &amp; hypercholestolaemia and had been taking ramipril 5mg , clopidogrel 75mg, simvastatin 20mg &amp; omeprazole 20mg daily for the previous two years.

Métastase sternale révélatrice d'un hépatocarcinome

Introduction. – Bone metastasis from hepatocarcinoma are rare, their elective seats are the ribs, the vertebra and rarely the sternum. We report a case of a sternal metastasis which makes discovery of a hepatocarcinoma. Exegesis. – A 64 year-old man, alcoholic with a previous history of jaundice who developed since 1999 an anterior chest tumor with excellent clinical condition. Laboratory examination showed cytolysis, cholestasis, positive antihepatitis C virus antibodies and elevated serum alphafetoprotein level. Standard radiography and computed tomography of the chest showed an osteolytic lesion of the sternum spread to the adjacent soft tissues and voluminous right hepatic lesion. Pathologic examination of the sternal tumor concluded to a differential adenocarcinoma. Etiologic investigations to find the primitive tumor were negative. Operative procedure was not possible in consideration of the infiltration of the tumor and its situation near the main blood vessels. Radiotherapy gives rise to partial regression of the tumor. A second reading of the tumor biopsy established the diagnosis of metastasis from a hepatocellular carcinoma. The patient died 22 months after the appearance of the sternal metastasis. Conclusion. – Hepatocarcinoma is rarely disclosed by a sternal metastasis, our case-report is particular by its prolonged survival and the good clinical condition during its follow up.

α 1-Acid glycoprotein is increased and associated with rapid nucleation in gallbladder bile with multiple cholesterol gallstone but not with solitary cholesterol or pigment gallstones

• ~-ACID GLYCOPROTEIN IS INCREASED AND ASSOCIATED WITH RAPID NUCLEATION IN GALLBLADDER BILE WITH MULTIPLE CHOLESTEROL GALLSTONES BUT NOT WITH SOLITARY CHOLESTEROL OR PIGMENT GALLSTONES. Masato Abel, Naomi Tanaka, Shinji Tomita, Junichi Shoda, Takashi Yamaguchi*, ~ t s u z a k i , Toshiaki Osuga. Dept. of Gastroenterology, Institute of Chical Medicine, University of Tsukuba, and *Dept. of Gastroenterology, National Mito Hospital, Ibaraki, JAPAN. We have reported that the biliary a,-acid glycoprotein(AAG) promotes cholesterol(eho)-crystallization in vitro(Gastroenterology 106:231,1994) and that its level is elevated in gallbladder bile(GBE) with multiple(m) cho-gallstone (GS)(Hepatology 16:154A,1992). It is not known whether biliary AAG level is altered in GBB with other types of GS. AIM: To determine the precise role of biliary AAG in GS pathogenesis, AAG levels in GBB with different types of GS and their association with rapid NT were studied in comparison with control biles. METHODS: GBB was obtained during operation from 20 controls without GS and from 48 GS patients. GS were classified into 33 choI-GS(13 solitary(s), 20 m) and 15 pig-GS(10 s, 5 m) based on visual inspection and chemical analysis. AAG in GBB was measured by specific ELISA. RESULTS: As shown in the Table, CSI was higher and NT was shorter in GBB with cho-GS than in GBB with pig-GS or control biles. NT of m-cho-GS was shorter than that of s-cho-GS, but CSI was not different in both groups. Both AAG and AAG/total protein were significantly higher in GBB with m-cho-GS than in GBB with s-cho-GS, pig-GS or in control biles. Both AAG and AAG/total protein were significantly correlated with NT(r=-0.49; P 100 Ixg/ml, all of which were associated with very rapid NT, whereas only 1 of 13 m-choI-GS, none of 15 pig-GS, 1 of 20 controls showed AAG>100 pg/ml(p 100 p.g/ml for m-chol GS were 0.50, and 0.96, respectively. Table *p <january 1989), previous history of jaundice, asoites, encephalopathy and serum sodium. Only date of transplantation and serum sodium were kept in the final multivariate model. Our study shows that besides improvement of technical skill and peroperative management, only sodium influence 30 days mortality after liver transplantation.

National survey on laparoscopic cholecystectomy in Spain. Results of a multiinstitutional study conducted by the Committee for Endoscopic Surgery (Associación Española de Cirujanos).

We present a joint study conducted by the Committee for Endoscopic Surgery in Spain. Sixty-nine surgeons reported 2,342 laparoscopic cholecystectomies (LCs) performed until November 1992. The conversion rate was 5.1%. The overall morbidity was 7.1%. The biliary morbidity was 0.45%: Seven severe bile duct injuries were recognized at laparoscopy (0.28%) and four lesions were postoperatively diagnosed (0.16%). Bile leak unrelated to bile duct lesion occurred in 14 patients (0.7%), leading to five reoperations. The mortality was 0.12% and was unrelated to the laparoscopic approach in two cases. The risk factors for biliary complications were obesity, previous history of jaundice, and previous hospital admissions. Surgeon experience was defined by 50 LCs performed and the overall complication rate presented a statistically significant relation to surgeon experience (P < 0.001).

Prevalence survey for hepatitis B in high-risk university hospital employees

A 1974 prevalence survey of laboratory and dialysis employees identified 8.7% (4 of 46) with evidence of past hepatitis B infection. Since then increasing numbers of asymptomatic carriers have been admitted to University Hospital. Reports of exposures by employees have also increased. With the availability of a hepatitis B vaccine and the changes in patient population, a second prevalence survey was conducted to target employees at greatest risk for hepatitis B virus. Sixty-two percent (422 of 687) of high-risk employees who completed both blood work and questionnaires were study participants; 10.66% (45 of 422) had positive markers for hepatitis B virus. Laboratory personnel had the highest prevalence rate, 15% (25 of 164), whereas obstetric personnel had the lowest, 0% (0 of 52). Prevalence increased with age ( χ 2 for linear trend, p = 0.000005), years of blood handling (p = 0.00003), work in a laboratory setting (p = 0.02), increasing numbers of puncture wounds from needles of patients with hepatitis B virus infection (p = 0.02), previous history of jaundice (p = 0.0003), and history of hepatitis (p = 0.000002).

Jaundice and Hepatitis B Surface Antigen and Antibody in Greek Haemophiliacs

The incidence of hepatitis B surface antigen (HBsAg) and antibody (HBsAb) in 101 Greek multitransfused haemophiliacs with or without a previous history of jaundice was studied. Using the haemagglutination inhibition assay, HbsAg was detected in 9.9%, HBsAb in 61.3% and HBsAg plus Ab in 11.8% of the cases. The incidence of jaundice was 14.8%. Liver function was tested by means of Normotest, SGOT, SGPT and serum protein electrophoresis. Abnormal values of liver function tests were found in 47% of the patients. The abnormal findings were related to the presence of HBsAg or Ab and to the history of jaundice. There was no significant difference between the various groups of patients.

The Seroprevalence of Hepatitis B Virus Among Children Attending Urban and Rural Hospitals

Objectives: This study was conducted to a) find out and compare the period prevalence of HBsAg in children attending outdoor and indoor of an urban and a rural hospital b) determine the risk factors for Hepatitis B surface antigen positivity. Materials and Methods: Three hundred and twenty three children were included in this study. Among them 162 attended an urban hospital and 161 attended a rural hospital. Collected sera were examined for HBsAg by ELISA method in a standard laboratory. Results: Among the 162 urban children 17 (10.5%) were found to be HBsAg positive and among the 161 rural children 6 (3.7%) were found to be HBsAg positive. This difference is statistically significant (P value &lt; 0.05). In urban area, 12 (16.2%) school aged, 3 (6%) pre-school children and 2 (5.5%) infants were found to be HBsAg positive. In rural area, more pre-school (6%) than school children (2.8%) were found to be HBsAg positive. In urban area, 11.5% male children and 9.5% female children were found to be HBsAg positive and in rural area, 5.2% male and 2.8% female children were to be HBsAg positive. Among 17 HBsAg positive cases who attended urban hospital, 11 (19.6%) had past history of jaundice and 6 (5.6%) had no past history of Jaundice (P value &lt; 0.05). Among those 17 HBsAg positive cases, 13 (14.6%) had past history of inoculation within last 6 months and 4 (5.5%) had no such history. This difference is also statistically significant (P value &lt; 0.005). Conclusion: Prevalence of positive HBsAg marker is fairly high in urban children (10.5%). Prevalence of HBsAg has no age and sex prediction. More sero-positive children in urban area have previous history of jaundice and history of inoculation in last 6 months, but no one in rural area had history of jaundice or inoculation within last 6 months. Key word: Serosurvilance; Hepatitis B virus. N.B. This publication is based on a dissertation DOI: 10.3329/bjch.v30i1.6178 Bangladesh J Child Health 2006; VOL 30 (1/2/3): 17-21