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5/ 🏆 PACIFY = LGALS3BP + Procalcitonin + CLIF-C OF + Lactate ✅ AUC: 0.96 ✅ Reduces unnecessary antibiotic use ✅ Improves infection diagnosis in ACLF. Game-changer? We think so. #PrecisionMedicine pratibha28.shinyapps.io/final_equation…

Thrilled to share our 🔥 work on proteomics-based infection diagnosis in cirrhosis! This study results from immense hard work, collaboration, and invaluable guidance from my mentor and colleagues. Grateful to be part of this journey towards biomarker-driven precision medicine

🔥🔥🔥 News in Hepatology: Non-Acute Decompensation (NAD) of Cirrhosis is a possibly a distinct Entity! 🔬🩸 A new study in Journal of Hepatology characterizes NAD as a unique stage in cirrhosis with important clinical & biological implications. 🧵 Let’s dive together Prof Rajiv Jalan

1️⃣ What is Non-Acute Decompensation (NAD)? Unlike acute decompensation (AD), NAD is a gradual progression of cirrhosis with worsening ascites, mild hepatic encephalopathy (HE), or jaundice—but without much systemic inflammation. 🤔 Why does it matter? ⏩

2️⃣ Why Should We Care? NAD has a worse survival (81.7%) than compensated cirrhosis (100%) but fares better than AD (31.2%). 🛑 More than HALF of NAD patients progress to AD within 12 months! What puts them at risk? 👇

3️⃣ Who Progresses from NAD to AD? 🚨Patients with NAD who develop AD have lower survival (68.2%) than those who remain stable (95.3%). Key predictors of progression: 🔴 Severe ascites 🟡 High bilirubin, CTP, MELD scores 🟢 Elevated Gasdermin-D & RIPK3 (cell death markers!)

4️⃣ Cell Death—The Missing Link? 🧬💥 Surprisingly, NAD patients have increased cell death (necroptosis/pyroptosis) but NOT much of systemic inflammation! 🔥 Could cell death be the silent driver of disease progression in cirrhosis?

5️⃣ Biomarkers That Predict Worsening Disease 📉 Low IGF-1 predicts poor prognosis! 🧪 Key cell death markers: 📊 Gasdermin-D > 5.22 ng/mL ⏩ Higher risk of AD 📊 RIPK3 > 2.21 ng/mL ⏩ Increased risk of progression

6️⃣ Risk Stratification = Personalized Medicine? 🩺 This study identifies high-risk NAD patients who need early interventions! 🟢 Low risk: Stable with only portal hypertension 🔴 High risk: Severe ascites, jaundice, high GasD/RIPK3

7️⃣ How Does NAD Compare to AD? 🚫 AD is characterized by massive inflammation & high cell death ✅ NAD has cell death but no systemic inflammation 🧐 Is NAD a “pre-injury” state that progresses to AD with the right trigger?

9️⃣ Key Takeaways for Hepatologists & Researchers 🔬 NAD is a distinct clinical entity in cirrhosis 📉 Cell death > Inflammation in early disease progression ⚠️ Early biomarkers can identify high-risk patients for intervention

🔟 Where Do We Go From Here? 🤝 Collaboration needed! This opens doors for: ✅ Early detection using biomarkers ✅ Personalized treatments targeting cell death ✅ Clinical trials for new therapies

What do you think? 🤔 Should we rethink cirrhosis progression based on cell death & inflammation? In AD we have clarity now👍 In NAD? gut.bmj.com/content/early/… Gut Journal Let’s discuss! 🔄💬 #Hepatology #LiverTwitter Elliot Tapper Jasmohan Bajaj Shalimar Rakhi Maiwall BASL education feed

📢 Excited to share our latest work in Journal of Hepatology 🚨Characterisation of Non-acute Decompensation (NAD) in Cirrhosis! Kudos to Dr Nipun Verma Dr Rajiv Ranjan for their outstanding hard work. Grateful to the Hepatology PGI Ajay Duseja Sunil Taneja Pratibha Garg

Thanks to Dr Nipun Verma for always bringing out the best in me, and for continuous help and support. 🙏 Big thanks to Ajay Duseja and Sunil Taneja for your exceptional guidance Hepatology PGI 👏 And a special shout-out to my colleague Pratibha Garg, for constant support! 🌟"

A matter of great pride and honour for the department of Hepatology Hepatology PGI for bagging three awards at the 11th Annual Research Day of the Institute. Sincere thanks to PGI dpgimerchd, colleagues, collaborators, students and our patients for helping us achieve this.

Best Poster Presentation Awards proudly celebrate the most outstanding and innovative research contributions showcased during the poster sessions, highlighting excellence, scientific rigour, and emerging talent in hepatology - Congratulations to all of our poster awardees at

Honored to receive the Best Poster Presentation award in the 'Cirrhosis & Complications - Clinical' at #EASL2025. Grateful for the support of my mentors at Hepatology PGI and a special thanks to Dr Nipun Verma for invaluable mentorship. Ajay Duseja Sunil Taneja Arka De

Global Fatty Liver Day!! “Fatty Liver is Preventable! Control Diabetes, Hypertension, Obesity, and Dyslipidemia.” Healthy Diet and Regular Exercise can do wonders !!! INASL Ajay Duseja M PREMKUMAR Arka De Dr Nipun Verma Sahaj Rathi MD, DM, MRCP Rohit Mehtani Akash Roy EASLnews