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Background: Histologically, cirrhosis is characterised by distorted hepatocellular regeneration, aberrant fibrosis, and bridging fibrous septa that result in strange hepatocellular architecture. Clinically, this manifests in a variety of ways like lethargy, pruritus and jaundice etc. However, in end stage liver disease, a phase called decompensated liver cirrhosis appears which is manifested in the form of ascites, portal hypertension, splenomegaly, gastro-esophageal varices and in the worst cases, hepatic encephalopathy. Objective: To determine the frequency of oxygen desaturation in patients with decompensated cirrhosis by using pulse oximetry at rest and after 6 minutes walk on a flat surface. Methodology: This descriptive study of 139 patients were carried out at Medicine Department of Medicine, Khyber Teaching Hospital Peshawar, Pakistan from October 2019 to April 2020. To meet the diagnostic requirements of decompensated liver cirrhosis, including smaller liver, dilated portal vein, splenomegaly, and ascites, a liver ultrasound was conducted. All patients had their oxygen saturation checked using a Santa Medical Generation 2 pulse oximeter both at rest and after a 6-minute walk. All information was entered into a proforma that was created specifically for this use. To control variables and research bias, strict exclusion criteria was followed. Results: In the current study, 139 patients were included, of whom 29% were between the ages of 30 and 50 and 71% between the ages of 51 and 70. The SD was ±10.85, and the mean age was 58. Among the study cases 34% were female and 66% were male. Only 25 patients (18%) among the study cases had oxygen desaturation throughout the six-minute walking test. Conclusion: Frequency of oxygen desaturation (after 6 minutes walk on a flat surface) was 18% in patients presenting with decompensated liver cirrhosis. [ABSTRACT FROM AUTHOR]

Objectives: To measure the changes in oxygen saturation using pulse oximetry during flexible upper gastrointestinal endoscopy in unsedated patients. Methodology: This is an observational study conducted on 356 patients undergoing unsedated upper gastrointestinal Endoscopy, during April 2009 to January 2010. Complete demographic data, systemic history, smoking history, laboratory evaluation and American Society of Anesthesiologists Physical Status (ASA-PS) were recorded in all patients. Patients with severe systemic disease (ASA-PS III-VI), those who needed emergency endoscopy and with anemia of hemoglobin <8gm/dl were excluded from the study. Results: Out of 356 patients 186 (52.2%) were male and 170 (47%.8) were female. All the patients tolerated the procedure well at the start and at the end and had no oxygen desaturation. At mid of the procedure 21 (5.9%) patients showed mild oxygen desaturation and 4 (1.1%) showed moderate oxygen desaturation while 331 (93%) showed no oxygen desaturation. No patient at any stage showed severe oxygen desaturation. Relationship of smoking, co-morbidity and clinical signs with mid procedure oxygen saturation is insignificant in both genders. Conclusion: It is concluded that mild to moderate hypoxia is some what common during therapeutic endoscopic procedure and of no serious consequence. However, severe hypoxia is not recorded in our study. The unsedated gastrointestinal endoscopy is a safe procedure for the diagnostic purpose, as it does not produce hypoxia during this; therefore pulse oximetry is not a precondition in patients undergoing unsedated diagnostic endoscopy without severe systemic disease. We recommend monitoring through pulse oximetry in patients with age greater than 45 years and procedure longer than 8 minutes. [ABSTRACT FROM AUTHOR]