Author(s): Ardhendu Kumar Sen1, Rima Moni Doley2, Ogin Jerang3, Dharamsingh Timung4
Alcohol is the most commonly abused drug worldwide causing liver injury with respect to dose, duration, type of alcohol consumption and drinking patterns and gender with diverse ethnicity and social customs. There is high prevalence of alcohol use in the society without much social taboo in the North Eastern States of India and also there is a high prevalence of different ethnic tribes with the custom of taking country made alcohol casually as a part of their tradition.
The aim of this study is to study the clinical profile of patients with alcoholic liver disease in upper Assam of north east India.
MATERIALS AND METHODS
The study was a hospital-based observational study in which patients of 18 years and older and diagnosed to have alcoholic liver disease were included. Cases excluded were patients of NASH, viral hepatitis, drug-induced hepatitis, haemochromatosis, alcoholic liver disease with diabetes and kidney disease. Informed written consent was taken from the patients or their attendants. Ethical clearance was taken from the Institutional Ethical Committee. A total of 138 cases were selected for the study. A detailed evaluation of clinical history, examination and investigations and the results were recorded in a predesigned proforma.
Out of 138 patients, 113 were males and 25 were females with male:female ratio of 4.5:1. Majority of cases (34.78%) were in the age group of (41-50) years. It was observed that 98 patients (71.01%) belonged to the lower socioeconomic status group. The average duration of alcohol intake was 18.39 ± 6.24 years for males and 16.76 ± 6.59 years for females. The overall average duration of alcohol intake was 18.09 ± 6.29 years. The majority of the patients (104 cases, 75.36%) took both foreign and country-made liquors. The most common clinical presentation was abdominal distension and swelling of feet (71 cases, 51.45%) followed by jaundice (68 cases, 49.28%) and anorexia (56 cases, 40.58%). The mean haemoglobin level was 8.6 ± 2.02 gm%. The mean AST was 155.61 ± 85.24 U/L and mean ALT was 81.65 ± 37.59 U/L. In ultrasonography of abdomen, cirrhosis of liver was seen in 60.14% cases, fatty liver in 20.29% cases and hepatomegaly with hepatitis in 19.57% cases. The most common findings in UGI endoscopy was oesophageal varices (56.19% cases). The average duration of alcohol intake in fatty liver, hepatitis and cirrhosis cases were 12.77 ± 3.70, 14.56 ± 6.83 and 20.53 ± 6.08 years, respectively. The most common ECG findings were sinus tachycardia (31.88%). Atrial fibrillation was seen in 8.69% cases.