000			03375cam a2200349 a 4500
003			EG-GiCUC
005			20250223032837.0
008			211030s2021 ua dh f m 000 0 eng d
040			_aEG-GiCUC _beng _cEG-GiCUC
041	0		_aeng
049			_aDeposite
097			_aM.Sc
099			_aCai01.11.18.M.Sc.2021.Wa.E
100	0		_aWalid Mohamed Hassan Abdelrehim
245	1	0	_aEvaluation of international normalized ratio (INR) as a risk factor for bleeding esophageal varices in cirrhotic patients / _cWalid Mohamed Hassan Abdelrehim ; Supervised Ayman Mohamed Fouad , Moustafa Saeed Mohamed Ahmed , Laila Ahmed Rashed
246	1	5	_aتقييم النسبة المعيارية الدولية كعامل خطر لنزيف دوالى المرئ فى مرضى التليف الكبدى
260			_aCairo : _bWalid Mohamed Hassan Abdelrehim , _c2021
300			_a182 P. : _bcharts , facsimiles ; _c25cm
502			_aThesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Internal Medicine
520			_aBackground and study aims: Upper gastrointestinal bleeding due to ruptured esophageal varicesis still remaining serious and life-threatening complication in patients with liver cirrhosis. The mortality from bleeding esophageal varicesreaches about 15-20% (Carbonell et al; 2004).There are many risk factors of bleeding from esophageal varicesincluding alcohol use, large varix size, and presence of risky signs on the varix (e.g. cherry red spots) (Jalan and Hayes, 2000). It wasdetected that increased portal vein diameter and low platelet countwere associated with presence of large esophageal varices and; as aresult, high risk of bleeding (Sudha-Rani et al; 2015).Correction of coagulopathy state in patients with liver cirrhosis isa common clinical concept especially in case of variceal bleeding. TheAmerican Association for the Study of Liver Diseases (AASLD)considered fresh frozen plasma and platelets transfusion to controlbleeding esophageal varices in patients with significant coagulopathyand/or thrombocytopenia (Garcia-Tsao et al; 2007). International normalized ratio (INR) is derived from prothrombin time(PT).It is calculated as a ratio of the patient{u2019}s PT in seconds to a control PT.The reference values for INR take into account in PT measurement in devicerelated variations and type of reagents used. INR has been initially used toreflect anticoagulation effect of warfarin (Pourafkari et al; 2019).INR elevation in chronic liver disease has been considered by cliniciansas an evidence of coagulopathy which should be corrected in case ofvariceal bleeding. However, pathophysiology of coagulopathy in cirrhoticpatients have more complexity; so that, INR may not be valid or accurate to express the coagulopathy status in these patients. Also,correction of theINR may not be beneficial in the management of bleeding esophagealvarices (Caldwell et al; 2006)
530			_aIssued also as CD
653		4	_aBleeding esophageal varices
653		4	_aCirrhotic patients
653		4	_aInternational normalized ratio (INR)
700	0		_aAyman Mohamed Fouad , _eSupervisor
700	0		_aLaila Ahmed Rashed , _eSupervisor
700	0		_aMoustafa Saeed Mohamed Ahmed , _eSupervisor
856			_uhttp://172.23.153.220/th.pdf
905			_aNazla _eRevisor
905			_aShimaa _eCataloger
942			_2ddc _cTH
999			_c82851 _d82851