Cirrhoses, Liver

The goal of this clinical trial is to test a low-touch vs high-touch drug-free pain self-management program that may help lower pain and improve quality of life for adults with cirrhosis and pain. Participants are assigned by chance to one of two study groups. The groups receive different levels of support. The main questions it aims to answer are: * Do the programs help lower pain? * Do the programs improve quality of life? * Is one program more effective than the other? Researchers will compare a low-touch self management program to a high-touch self-management program to see if the programs help manage pain. Participants in the low-touch arm will: * Learn new ways to manage pain without medication * Receive access to the self-guided digital self-management platform * Receive general behavioral text message nudges * Receive a free Fitbit to keep Participants in the high-touch arm will: * Learn new ways to manage pain without medication * Receive tailored access to the self-guided digital self-management platform * Received individualized pain coaching and optional group coaching sessions * Participate in a structured walking or meditation curriculum * Receive a free Fitbit to keep

Cirrhosis, a leading cause of global mortality, progresses to life-threatening complications like ascites, hepatic encephalopathy, and hepatorenal syndrome. Oxidative stress and gut-liver axis dysfunction drive disease progression. Allopurinol, a xanthine oxidase inhibitor, has shown potential in reducing complications in cirrhosis, but robust clinical evidence is lacking. This study will evaluate allopurinol's efficacy in preventing complications in decompensated cirrhosis. This study aims to assess whether allopurinol reduces cirrhosis-related complications (ascites, variceal bleeding, hepatic encephalopathy, SBP, HRS-AKI) and improves MELD/CTP scores in Child-Pugh B/C cirrhosis patients. This study will select 54 patients with decompensated cirrhosis (Child-Pugh B/C). Patients aged 18-70 years, with any etiology of cirrhosis (viral, alcoholic, NAFLD). Patients with acute decompensation, allopurinol hypersensitivity, advanced renal impairment (CrCl \<30 mL/min), pregnancy, or concurrent use of interacting drugs. This randomized controlled trial will be conducted in Hepatology department of BMU after IRB clearance. 54 patients aged 18 to 70 years with Child-Pugh class B or C cirrhosis, admitted to or attending the Outpatient Department of Hepatology at Bangladesh Medical University will be enrolled. After thorough clinical and laboratory evaluation and informed consent, patients will be randomized in a either an allopurinol treatment group or a standard care group with placebo ; 27 participants in each group by block randomization. one group will receive oral Allopurinol (titrated from 100 mg to 300 mg daily for six months) along with standard medical therapy. Another Group will receive same dose of Placebo along with standard medical therapy . Patients will be followed at 6 month to see the progression of cirrhosis-related complications. Data collection will include clinical parameters, laboratory tests, imaging, and endoscopy. All data will be analyzed using the statistical package SPSS (version 29.0 IBM Corp: Armonk NY, USA). Demographic and baseline clinical characteristics will be analyzed using the chi-square test for categorical variables. For continuous variables that follow a normal distribution, the Student's t-test will be applied. Time to first complication will be analyzed using the Cox proportional hazards model, and Kaplan-Meier curves will be used to compare event-free survival between groups. The study protocol is approved by the institutional review board. Written informed consent (Bengali version) will be obtained, ensuring confidentiality and voluntary participation. Participants may withdraw anytime. If effective, allopurinol will offer a low-cost, widely accessible therapy to prevent complications and improve survival in decompensated cirrhosis. To the best of my knowledge this is the first study in Bangladesh to evaluate the efficacy of Allopurinol in prevention of cirrhosis associated complications.

The project will establish a research cohort (called STELIR; STEatotisk Liver-risk In Rogaland) based on a biobank with an associated health register. The purpose is to collect, store and analyze biological material and clinical data from people at risk of steatotic liver disease (fatty liver disease). The research cohort will consist of individuals who agree to participate and will be followed over many years with planned examinations/tests at baseline, after 2 years, after 5 years and every 5 years thereafter. The STELIR cohort consists of individuals between 40 and 70 years of age who have one or more of the following risk factors: Obesity, type 2 diabetes or hazardous or harmful alcohol consumption. The biological material and clinical data collected will be stored and used for research on liver-related disease risk, diagnostics and treatment.

The aim of the study is to build up a bio-collection of biological samples from patients with cirrhosis. Further work using this bio-collection will permit to describe the influence of different exposome factors (nutrition, physical activity, socio-demographic conditions, tobacco, alcohol, pollutants) on the occurrence of the main type of liver cancer (called HCC). Indeed, in the vast majority of cases, HCC develops within cirrhosis, and the factors that precipitate the progression of cirrhotic patients to HCC remain largely unknown.

The goal of this clinical trial is to learn if the medicine vonoprazan can help prevent ulcers that may develop after endoscopic variceal band ligation (EVBL) in adults with liver cirrhosis. These ulcers sometimes cause pain or delayed bleeding after the procedure. The study will also look at how well vonoprazan is tolerated and if it improves comfort after the procedure. The main questions this study will answer are: Does vonoprazan lower the number and severity of ulcers found on endoscopy after EVBL? Does vonoprazan reduce swallowing pain or chest discomfort compared with placebo? Is vonoprazan safe and well tolerated in people with liver cirrhosis? Researchers will compare vonoprazan 20 mg once daily with a placebo (a look-alike tablet that contains no active medicine) to see if vonoprazan works better to prevent these ulcers. Participants will: Take vonoprazan or placebo by mouth once daily for 14 days after EVBL. Return for a follow-up endoscopy about two weeks later to check for ulcers. Report any symptoms such as pain, nausea, or swallowing difficulty during the study. Adults aged 18 to 75 years with liver cirrhosis who undergo EVBL will be invited to join. Participants will be randomly assigned to one of two groups, and neither they nor the study doctors will know which treatment they receive (double-blind design). The study will take place at Mayo Hospital, Lahore, Pakistan, over about six months. By comparing vonoprazan to placebo, researchers hope to find a better way to protect the esophagus and stomach after EVBL, reduce post-procedure pain, and support faster recovery in people with liver cirrhosis.

In this study,the researchers compared the changes in immune function-related indicators in patients with liver cirrhosis following laparoscopic partial splenectomy,to determine whether this surgical intervention can enhance postoperative immune function and thereby improve patient outcomes.

The objective of this observational study is to compare the differences in proteomics and gut microbiome between the liver cirrhosis group without hepatic encephalopathy and the hepatic encephalopathy group through proteomics and microbiome analysis, screen out the characteristic proteomics and microbiome of patients with hepatic encephalopathy, guide clinical diagnosis and treatment, and conduct in-depth research on the pathogenesis of hepatic encephalopathy. The main questions it aims to answer are: Are there any differences in serum proteomes between patients with liver cirrhosis without hepatic encephalopathy and those with hepatic encephalopathy? If so, what are the main protein differences? There are differences in the fecal microbiome between patients with liver cirrhosis without hepatic encephalopathy and those with hepatic encephalopathy? If so, what are the main microbial differences? This study will screen for the differences in proteomes and gut microbiomes between patients with liver cirrhosis without hepatic encephalopathy and those with hepatic encephalopathy, and identify the characteristic proteomes and microbiomes of patients with hepatic encephalopathy to guide clinical diagnosis and treatment.

The goal of this observational study is to explore whether a Raman-based, deep learning-assisted approach can be used to develop an effective method for early pan-cancer screening. The study includes healthy individuals, patients at risk of cancer, and patients with diagnosed cancers. The main questions it aims to answer are: * Evaluating the deep-learning model's accuracy and specificity in identifying cancer-specific features in Raman spectral data and determining whether this method can accurately classify patients based on risk. * Identifying which model is more adaptable to the Raman spectrum * Providing an interpretable analysis of the model-generated diagnosis Participants are already being diagnosed and follow-up to determine the type of cancer.