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Hepatocellular carcinoma (HCC) is a major cause of morbidity and mortality in all parts of the world. We analyzed the clinical presentation, etiology, and tumor characteristics of HCC presenting to our hospital. All patients diagnosed to have HCC from September 2007 to August 2010 were prospectively enrolled. HCC was diagnosed according to EASL criteria—USG/CT/MRI of the abdomen and/or serum alpha-fetoprotein and/or histology (where indicated). Detailed clinical and laboratory parameters were noted. Barcelona Clinic Liver Cancer (BCLC) staging was done. One hundred and twenty-eight patients (22 females, mean±SD; age, 49.8 ± 10.2 years) were diagnosed to have HCC. Underlying cirrhosis was present in 99.2 %. Hepatitis C virus infection, alone (21.9 %) or with alcohol (22.9 %) was the most common etiological factor, followed by alcohol alone; 33.6 % of the patients had more than one etiological factor. Most patients (83.5 %) presented with features of decompensated cirrhosis. HCC leading to decompensation of cirrhosis was the first presentation of the liver disease in nearly one third of the cases. Serum alpha-fetoprotein was >200 ng/mL in 67.2 % of the patients, while it was normal in 18.7 % of the patients. The mean±SD size of HCC was 5.3 ± 2.9 cm. HCC was multicentric in 57 %, and portal vein thrombosis was present in 34.4 %. About 66 % of the patients belonged to BCLC stage C or D. Hepatitis C virus infection was the most common cause of HCC in Punjab. One-third of the patients had multiple etiological factors and almost all had underlying cirrhosis and presented at advanced stage.

The role of infliximab in the treatment of acute severe ulcerative colitis is established. However, all the data available in the literature are from western countries. This is the first report on the use of infliximab in patients with severe steroid-refractory ulcerative colitis from India. Retrospective analysis of 28 patients who had received infliximab therapy for induction of remission, with three doses of 5 mg/kg at 0, 2, and 6 weeks, was performed. Twenty-four (85.6 %) patients had shown a clinical response by week 8 and, hence, avoided urgent colectomy. In 2 years of follow up, 9/16 (56 %) patients had not required colectomy. Infliximab averted colectomy in a proportion of patients with severe steroid-refractory ulcerative colitis.

Sustained virological response (SVR) is achieved in a high proportion of patients with chronic hepatitis C infection, particularly those with genotype 2 or 3 HCV infection. However, data on long-term durability of virological response in patients who achieve SVR are limited.To evaluate the long-term durability of virological response in patients who have achieved SVR with interferon-based combination therapy.One hundred patients with chronic HCV infection who had obtained SVR after IFN and ribavirin combination therapy were followed up for up to 8 years with annual HCV RNA testing.During a followed up of 6 months to 8 years, 8 of 100 patients with initial SVR developed late relapse of HCV infection. Relapse was more common in patients who had cirrhosis (5/28 [18%] vs. (3/72 [4%] with no cirrhosis; p=0.037).SVR is durable in most patients, but some patients do have late relapse; long term follow up may be particularly important in a subset of patients with HCV infection who have liver cirrhosis.

Data on transmission of HCV infection from mother to infant in India are limited. Between July 2006 to June 2007, women attending our hospital in the third trimester of pregnancy were screened for anti-HCV. Those testing positive for anti-HCV were tested for HCV RNA. Infants of mothers with HCV infection were followed for up to 24 months. Eight of 488 pregnant women (1.6%) tested positive for anti-HCV; of these, seven had detectable HCV RNA. Two of 7 (29%) children born to HCV-infected mothers had persistently positive HCV RNA, indicating perinatal transmission; one additional child had transient HCV positivity. Passive transfer of HCV antibodies was observed in five babies. HCV infection was detected in 1.4% of pregnant women, and perinatal transmission of HCV to newborns was detected in 29% of such cases.

Interferon therapy for hepatitis C can result in renal complica-tions as interstitial nephritis, minimal change disease andimmune complex glomerulonephritis [1]. We present the caseof a 42-year old man infected with chronic hepatitis C whodeveloped focal and segmental glomerulosclerosis (FSGS)after treatment with pegylated interferon alfa 2a and ribavirin.A 42-year-old man reported with incidental detection ofhepatitis C virus infection (anti-HCV positive) at the time ofdonation. His risk factors included surgery for fracture tibia,bloodtransfusionsandfrequentuseofinjectionspossiblywithreusable needles and syringes for joint pains. His physicalexamination was unremarkable. His baseline laboratoryinvestigationsshowedhemoglobin13g/dL,meancorpuscularvolume (MCV) 87 fl, white blood cell count 4000/cumm,platelet count 3,00,000/mm