Medicine
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Item Correction to: Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update(Springer, 2019) Sarin, S.K.; Choudhury, A.; Sharma, M.K.; Maiwall, R.; Al Mahtab, M.; Rahman, S.; Saigal, S.; Saraf, N.; Soin, A.S.; Devarbhavi, H.; Kim, D.J.; Dhiman, R.K.; Duseja, A.; Taneja, S.; Eapen, C.E.; Goel, A.; Ning, Q.; Chen, T.; Ma, K.; Duan, Z.; Yu, C.; Treeprasertsuk, S.; Hamid, S.S.; Butt, A.S.; Jafri, W.; Shukla, A.; Saraswat, V.; Tan, S.S.; Sood, A.; Midha, V.; Goyal, O.; Ghazinyan, H.; Arora, A.; Hu, J.; Sahu, M.; Rao, P.N.; Lee, G.H.; Lim, S.G.; Lesmana, L.A.; Lesmana, C.R.; Shah, S.; Prasad, V.G.M.; Payawal, D.A.; Abbas, Z.; Dokmeci, A.K.; Sollano, J.D.; Carpio, G.; Shresta, A.; Lau, G.K.; Karim, M.F.; Shiha, G.; Gani, R.; Kalista, K.F.; Yuen, M.F.; Alam, S.; Khanna, R.; Sood, V.; Lal, B.B.; Pamecha, V.; Jindal, A.; Rajan, V.; Arora, V.; Yokosuka, O.; Niriella, M.A.; Li, H.; Qi, X.; Tanaka, A.; Mochida, S.; Chaudhuri, D.R.; Gane, E.; Win, K.M.; Chen, W.T.; Rela, M.; Kapoor, D.; Rastogi, A.; Kale, P.; Rastogi, A.; Sharma, C.B.; Bajpai, M.; Singh, V.; Premkumar, M.; Maharashi, S.; Olithselvan, A.; Philips, C.A.; Srivastava, A.; Yachha, S.K.; Wani, Z.A.; Thapa, B.R.; Saraya, A.; Shalimar; Kumar, A.; Wadhawan, M.; Gupta, S.; Madan, K.; Sakhuja, P.; Vij, V.; Sharma, B.C.; Garg, H.; Garg, V.; Kalal, C.; Anand, L.; Vyas, T.; Mathur, R.P.; Kumar, G.; Jain, P.; Pasupuleti, S.S.R.; Chawla, Y.K.; Chowdhury, A.; Alam, S.; Song, D.S.; Yang, J.M.; Yoon, E.L.; APASL ACLF Research Consortium (AARC) for APASL ACLF working PartyThe article Acute-on-chronic liver failure: consensus recommendations of the Asian Pacifc association for the study of the liver (APASL): an update, written by [Shiv Sarin], was originally published electronically on the publisher’s internet portal (currently SpringerLink) on June 06, 2019 without open access. This corrects the article "Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update" in Hepatol Int, volume 13 on page 353. Hepatology International. 2019 ;13(4):353-390.Item Predicting acute liver failure in dengue infection(Sri Lanka Medical Association, 2012) Ranawaka, C.K.; Kumarasena, R.S.; Niriella, M.A.; Miththinda, J.K.N.D.; Pathmeswaran, A.; Dassanayake, A.S.; de Silva, A.P.; de Silva, H.J.INTRODUCTION: Dengue infections (Dl) have a diverse clinical spectrum ranging from asymptomatic illness to severe dengue. Unusual manifestations such as encephalitis, myocarditis, and acute liver failure (ALF) are increasingly recognised. AIMS: To describe the spectrum of liver dysfunction and identify possible predictors of ALF in DI Methods: Serologically confirmed patients with Dl admitted to university medical unit, Ragama from January 2009 to March 2010 were included. Data were obtained from patient records. Results: Out of 240 patients (maleifemale 57.7%:42.5%; mean age 35.6 years[SD 15.4 years]], 49(20.4%) had severe dengue, 164(68.3%) had dengue with warning signs and 27(11.2%) had dengue without warning signs. Abdominal pain, persistent nausea and vomiting (PNV), skin or mucosal bleeding, hepatomegaly and ascites was present in 52.1%J 38.3%, 16.2%, 50% and 11.7% cases respectively. Deranged AST or ALT(ASTALT), serum bilirubin(SB), alkaline phosphatase(ALP), gamma glutamyl transpeptide(GGT), and 1NR were observed in 86.7%, 8.3%, 7.5%, 25% and 10% of patients respectively. Of the 240 patients 41(17.1%) had ASTALT>1000 IU and 199(82.9%) had ASTALT<1000 1U. Only 16/41 patients with ASTALT>1000 IU developed ALF while none from the ASTALT<1000 IU group developed ALF. Presence of 2 or more of elevated SB, elevated ALP or PNV predicted the development of ALF with 93.8% sensitivity, 98.7% specificity, 83.3% positive predictive value and 99% negative predictive value withp<0.001. CONCLUSIONS: ASTALT<1000 IU excluded patients at risk of ALF. Presence of 2 or more of PNV, elevated SB or ALP in patients with Dl may indicate impending ALF. This needs further validation in a larger population.