Novel Tracer Methods to Evaluate Muscle Protein Metabolism in Cirrhosis

To determine the rate and mechanisms of skeletal muscle protein synthesis and breakdown in cirrhotic patients by using multiple tracers and single muscle biopsies.

Inclusion Criteria: * The diagnosis of cirrhosis based on liver biopsy and/or clinical, biochemical, and imaging criteria. * Patients with Child Pugh score from A5- to B7 * Control group: Subject in control group should have serum ALT and AST within normal range. Exclusion Criteria for both groups (cirrhotic and control) are: * diabetes * cancer * kidney failure * pregnancy * recent surgery (bowel resection or Gastric bypass operation) * Advanced cardiac or pulmonary disease * patient with thyroid disease \& Coagulopathy ( INR \>1.4 and platelet count \