1.The number of patients diagnosed with non-alcoholic fatty liver disease is on the increase. Review the key symptoms of the condition and discuss the role of the biomedical scientist in the diagnosis and management of the condition.
2.Discuss the role of host and viral factors in the immunopathogenesis of Hepatitis C infection.
The symptoms of non-alcoholic fatty liver disease
Most people suffering from non-alcoholic fatty liver disease are asymptomatic, and the condition is most times, discovered accidentally, during laboratory examinations testing other conditions or diseases. These tests reveal that that there are increased liver enzyme levels (Raman & Allard, 2006). This implies that many of the patients suffering from the condition will show few or show none of the symptoms associated with the disease. The condition is the most widely known trigger of unexplainable increases in the persistent elevation of liver enzymes, after the number one trigger of the change, hepatitis (Arredondo, Amores &Guerrero, 2010) The key symptoms that lead to the discovery of non-alcoholic fatty liver disease include fatigue, malaise, and diffuse abdominal or right-upper quadrant discomfort (Tolman & Dalpiaz, 2007).
Upon conducting laboratory tests, hepatomegaly is commonly attributed to the condition. In the cases that cirrhosis is detected, the stigmata that results from chronic liver conditions, including ascites, spider angiomata, hard liver body, splenomegally, asterixis or palmar arythema are likely to be identified as well (Tolman & Dalpiaz, 2007). The patients suffering from non-alcoholic fatty liver disease are likely to complain of pruritus or jaundice. In other cases, the patients suffering from these conditions are likely to suffer from a complication of portal hypertension, which may include vericeal bleeding, ascites, or encephalopathy (Arredondo, Amores &Guerrero, 2010). Many of the patients suffering from the condition have developed an association between attributes of the metabolic syndrome, including diabetes mellitus, obesity and variable cases of hypertension and hyperlipidemia (Raman & Allard, 2006).
The role of the biomedical scientist in the diagnosis of non-alcoholic fatty liver disease
There is no single and simple test that can be run to confirm the presence or the absence of non-alcoholic fatty liver disease. For example, the blood tests run during the diagnoses, commonly called LFTs (Liver function tests) evaluate the blood levels of some chemical enzymes that are produced by the liver cells (Arredondo, Amores &Guerrero, 2010). In the case that the tests depict an abnormal pattern of LFTs, it may indicate that the patient is suffering from non-alcoholic fatty liver disease. However, the problem associated with this testing process or phase is that many other conditions of the liver can depict abnormal LFTs. Therefore, in the case that the patient being diagnosed depicts LFTs, the medical professional will need to run other tests, to determine whether they are due to other liver conditions and not due to NAFLD (Chalasani et al., 2012). For example, other tests can be run, to detect different viruses or germs and other that will test the presence of other chemicals found at the liver.
The role of the biomedical scientist during the diagnosis of non-alcoholic fatty liver disease is done on the basis of three main elements: laboratory, physical and imaging testing (Ratziu et al., 2010). However, the final/ authoritative diagnosis of the condition is done, only using liver biopsy testing, which verifies that there are fat levels beyond the normal fat levels present in a healthy liver. The liver biopsy test has remained the standard diagnoses model of checking whether a patient is suffering from the condition (Arredondo, Amores &Guerrero, 2010). Through physical examinations, the biomedical scientist may establish that the condition is not there, or may recognize the presence of extra fat levels, depending on the developmental stage of the condition. The widely common conditions discovered during the testing include splenomegaly, painless hepatomegaly, or chronic liver-disease stigmata (Arredondo, Amores &Guerrero, 2010).
The tests that the doctor can be used to check the condition of the liver include “prothrombin time, complete blood count and hepatitis surface antigen B among others” (Arredondo, Amores &Guerrero, 2010). When conducting these different tests, it is possible that the medical specialist will trace transamine levels; “coagulation altered and elevated alkaline phosphatase levels” (Tolman & Dalpiaz, 2007). Sixty-five percent of the patients undergoing the testing process will show increased amounts of transferring saturation and ferritin.
Many doctors agree that ultrasound imaging of the liver is the best and the most reliable diagnosis imaging model, when they are suspecting that a patient is suffering from non-alcoholic fatty liver disease (NAFLD). Further, considering that the method is relatively cheap, standardized and affordable, it is the most common diagnosis process used by healthcare personnel. When using computerized tomography testing, the doctor can detect intrahepatic fat levels of a threshold level of 30 percent (Arredondo, Amores &Guerrero, 2010). On the other hand, when using magnetic resonance testing for the diagnosis, the medical professional can detect moderate to harsh changes in liver fat levels.
The role of the biomedical scientist in the management of non-alcoholic fatty liver disease
In managing non-alcoholic fatty liver disease, the biomedical scientist seeks to control the risk of developing cardiovascular conditions. Medical studies have shown that patients suffering from NAFLD are more likely to die from heart attack than from liver-related problems. Therefore, the management of the condition will entail the change or the reduction of lifestyle risk factors that increase the risk of cardiovascular problems (Targher, Day & Bonora, 2010). Some of the management recommendations required from the patient include stopping smoking, checking weight gain or the need to lose weight, eating healthy balanced foods and engaging in regular physical exercise.
In managing NAFLD, the doctor may also direct the patient to treatment for high cholesterol levels and high blood pressure, because treating these conditions is believed to reduce the worsening of the NAFLD. Further, for a diabetic patient, the doctor may require the patient to use medication or other control strategies that help in the reduction of blood sugar levels, which helps control the condition (Bhatia et al., 2012). Irrespective of the fact that the condition is not caused by the intake of alcohol, the intake of alcohol is not recommended, because increased intake increases the risk of worsening the condition. Alternatively, or in a complementary manner, the doctor may subject the patient to medication, which is targeted at the liver itself (Chalasani et al., 2012). For example, some of these medications are targeted at reducing or reversing NASH inflammation levels.
Hepatitis C virus (HCV) infection leads to the injury of the liver, after an individual is affected, and it is the leading cause for liver transplantation. The HCV virus is communicated over blood to blood exchange or contact, which is closely related to the sharing of injection devises like, needles (Lloyd et al., 2007). The primary infection by the virus is mainly asymptomatic, and in many cases, it will cause persistent infection. Chronic infection leads to progressive hepatic fibrosis which increases the risk of cirrhosis, hepatocellular carcinoma and liver failure (Lloyd et al., 2007). The clearance of the HCV virus from the body does not eliminate the possibility of infection. The host’s immunity-guided response to HCV engages adaptive and in native actions by the immunity system. The evidence collected in the area shows that difference in the characteristics of the HCV-specific response influences the outcomes of the infection……………………………………………………..
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