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Background & Aims Pretransplant renal failure is commonly reported to be a poor prognostic indicator affecting survival after liver transplantation ( LT). However, whether the impact of renal failure on patient outcome varies according to the aetiology of the underlying liver disease is largely unknown. Methods We investigated the association between renal failure at the time of LT and patient outcome in patients with alcoholic liver disease ( ALD) ( n = 6920), non-alcoholic steatohepatitis ( NASH) ( n = 2956) and hepatitis C ( HCV) ( n = 14 922) using the United Network for Organ Sharing ( UNOS) database between February 2002 and December 2013. A total of 24 798 transplant recipients were included. Results The presence of renal failure was more frequently seen in patients with ALD (23.95%) and NASH (23.27%) compared to patients with HCV (19.38%) ( P < 0.001). In multivariate analysis, renal failure was an independent predictor of poor survival. Renal failure showed detrimental effect on patient survival in the overall series ( HR = 1.466, P < 0.0001). Importantly, the impact of renal failure was less marked in patients with ALD ( HR = 1.31, P < 0.0001) than in patients with NASH ( HR = 1.73, P < 0.0001) or HCV ( HR = 1.52, P < 0.0001). Despite a higher model for end-stage liver disease ( MELD) score at the time of LT, ALD patients with renal failure had better long-term prognosis than non- ALD patients. Conclusions Renal failure at the time of LT conferred a lower patient and graft survival post- LT. However, renal failure has less impact on the outcome of patients with ALD than that of patients with non-alcoholic liver disease after LT. [ABSTRACT FROM AUTHOR]

Introduction: Substance use refers to the use of any psychoactive substance or drug, including licit and illicit drugs, other than when medically indicated. Psychoactive substance use poses a threat to the health, social and economic fabric of families, communities and nations. Chandigarh has more than 0.2 million students from across the country pursuing their courses in higher education institutions. There is a very little information about pattern of drug dependence among the college students of Chandigarh. Objectives: To study the prevalence and pattern of substance use among college students of Chandigarh and to study the psycho-social behaviour of youth and perceived reasons for using substances. Material and Methods: A Cross - sectional community based study. A stratified multi-stage random sample design was adopted in study. The study instrument was a questionnaire which was developed by reviewing relevant literature and previously used standardized instruments and protocols including the WHO questionnaire. On the basis of 60% prevalence anticipated on the basis of pilot study, 90% confidence coefficient and 10% permissible error - sample size came out to be 256. Results: Prevalence of substance use was seen in 52.7% students belonging to age group 19 to 21 years. More prevalence of substance use was found among law students (76.2%) followed by the students from Art stream (62.5%). Among the users alcohol was most commonly used (53.5%), followed by smokers (27.3%), tobacco chewers (8.2%), cannabis (6.8%).49% of the users were using substances on daily basis, followed by 23% who using weekly.29.3% of users had father using any substance. Relief from psychological stress (66.0%) followed by easy availability (46.9%) were the most common reasons of substance abuse. that substances use is common among college going male students irrespective of their social demographic characteristics like age [OR 0.76, 95%CI (.443-1.317)] religion [OR.859 95%CI (.461-1.598)], parental education, occupation and socio-economic status. Therefore, interventions in terms of health education/counselling for reducing substance use among them should be adopted, irrespective of their socio-demographic characteristics. Suggestions: This study suggested some life style related interventions in order to reduce the problem of substance use. There is an utmost need to educate and counsel young students regarding harmful effects of substance use. Health education may be imparted in the school curriculum. Parents should also be educated on discouragement of substance use and on taking proper care of their children. [ABSTRACT FROM AUTHOR]