Objective: To determine the frequency of ethnicity and other etiological factors of hepatocellular carcinoma. Methodology: This cross-sectional study was conducted at the Liaquat University Hospital Hyderabad, Department of gastroenterology. The study occurred from March 2018 to February 2019 for a total period of one year. All the patients diagnosed as the cases of hepatocellular carcinoma; age more than 20 years of both genders were included. All the patients were assessed regarding their ethnicity and risk factors of hepatocellular carcinoma. A self-made study proforma was used for the data collection and data was analyzed by using the SPSS version 26. Results: A total of 80 patients of hepatocellular carcinoma were studied, their average age was 53.12+9.69 years, average CLD known duration was 05.40+3.90 years and the average known duration of HCC was 01.17+0.79 years. Males were in majority 76.3% and 40.0% of the cases had advanced disease. According to the ethnicity of the cases, Sindhi patients were 70.0%, followed by 6.3% were Punjabi, 1.3% were Pathan, 7.5% were Baloch and 15.0% were others. HCV was the most common cause 83.8%, 7.5% cases had HBV, followed by 2 cases had HBV+HDV and one case had HCV and HBV co-infection, while four cases were NBNC HCC patients. Tumor stage was statistically insignificant according to ethnicity (p-0.495). Conclusion: Sindhi and Punjabi population was observed to be mostly affected and HCV was concluded the most common causative factor of hepatocellular carcinoma. Keywords: Ethnicity, causes, HCC

Introduction: Bacterial infections are known reason for morbidity and mortality in hospitalized patients with cirrhosis among which Spontaneous bacterial peritonitis (SBP) is most common, accounts for around 20% to 30% mortality rate. Objective: To evaluate the frequency of in-hospital mortality in SBP patients. Study Design: Descriptive case series. Setting: Asian Institute of Medical Sciences Hospital Hyderabad. Duration: From 1st January 2019 to 30th June 2019. Material and Methods: Adult patients diagnosed to have spontaneous bacterial peritonitis and followed for outcome. Results: 223 patients of spontaneous bacterial peritonitis I,e 165 (74%) male and 58 (26%) female fulfilling the inclusion criteria were enrolled in study. Mean age obtained was 47.56 ± 13.069 years and Hepatitis C with most common etiology for CLD was 128 (57.4%) followed by Hepatitis B 26 (11.7%), Hepatitis B + D 30 (13.5 %) and Alcohol 8 (3.6 %). Hepatocellular carcinoma in 70 (31.4 %) only. CTP (Child-Turcot-Pugh) score and MELD (Model for End-stage Liver Disease) score used to access stage of cirrhosis. 38 (17 %) patients with CTP class B and 185 (83 %) with CTP class C. The mean MELD score of all patients found to be 23.09 ± 15.686. Among 223 patients, in-hospital mortality was observed in 61 (27.4%), 115 (51.6%) were discharged with improvement and rest 47 (21.1%) discharged with no improvement. Practical Implication: This study's findings underscore the need for early detection and aggressive management of Spontaneous Bacterial Peritonitis in patients with advanced liver disease, especially those with CTP Class C and high MELD scores, to reduce the high in-hospital mortality rate. Conclusion: Significantly high in-hospital mortality was found to be associated with SBP, with CTP Class C, High MELD Score, increased creatinine, bilirubin, PT, INR and decreased albumin especially in females. Keywords: Cirrhosis; In-hospital mortality; Spontaneous bacterial peritonitis

Objective: To determine the liver function assessment in the patients presented with hepatocellular carcinoma. Methodology: This cross-sectional study was done at the gastroenterology departments of Liaquat University Hospital Hyderabad and Indus Medical College TM Khan. Patients with an age range of 20 to 70 years, both genders, and having hepatocellular carcinoma were included in the study. A 5 mL blood sample was taken from each participant and sent to the hospital diagnostic laboratory to assess the serum bilirubin level and albumin level. The albumin-bilirubin (ALBI) score was used for hepatic function. Data was collected using a self-made research proforma, and it was analyzed using SPSS 26. Results: A total of 58 cases having HCC were assessed regarding hepatic function. The mean age of the patients was 55.39+12.39 years. Males were in the majority 75.9%, and females were 24.1%. The majority of the patients (72.4%) had child Pugh class C, 12.1% had child Pugh class B, and 15.5% of the cases had child Pugh class A. Elevated bilirubin levels of albumin levels and Alpha-fetoprotein levels were significantly associated to the child Pugh class C (p= <0.05). Most of the cases, 67.3%, had an ALBI score > − 1.39, 10.3% cases had ALBI score − 2.59 to − 1.39, and 22.4% of patients had an   ALBI score ≤ − 2.60. Conclusion: Severe hepatic dysfunction was observed to be frequently high among patients having hepatocellular carcinoma, as most of the cases had Pugh class C and ALBI stage 3. Due to the extremely small sample size used in this study, the results are not trustworthy. Keywords: HCC, Hepatic function, Bilirubin, Albumin, ALBI