Pattern of liver enzymes and maternal outcome in eclamptic patients admitted to the Intensive Care Unit, University College Hospital, Nigeria

Introduction: Eclampsia, a hypertensive disorder, is one of the leading causes of maternal mortality in developing countries like Nigeria. We evaluated the relationship between the pattern of liver enzymes and maternal mortality in eclamptic women. Method: A retrospective study of 55 eclamptic women admitted to the Intensive Care Unit (ICU), University College Hospital, Nigeria, was conducted. Data were obtained on their demographic, obstetric, and clinical characteristics, liver enzyme patterns, and maternal outcome. Analysis was by descriptive statistics, univariate analysis, and non-parametric tests with level of significance set at p<0.05. Results: Maternal deaths occurred in 27.3% and elevation of liver enzymes was observed more among the dead patients compared with those who survived. Alanine aminotransferase (ALT) was the most commonly elevated liver enzyme, occurring in almost all (90.9%) the patients. Maternal mortality was significantly associated with age (p=0.001), saturated oxygen levels (p=0.007), elevated alkaline phosphatase (p=0.008), alanine aminotransferase (p=0.013), aspartate aminotransferase (p=0.016), and total bilirubin (p<0.001). Conclusion: Maternal mortality due to eclampsia was clinically associated with age, elevated liver enzymes and a lower serum level of total bilirubin. Liver transaminases are therefore important prognostic indicators associated with eclampsia.

Cadmium and Mercury Exposure: Oxidative, Neurobehavioural and Histological Alterations to the Cerebellum of Wistar Rats

Background: The unprecedented increase in metal exposure has been aided by modern industrialization and anthropogenic activities. Cadmium and mercury are recognized as two of the most common heavy metals with destructive impacts on most organ systems. The present study was designed to investigate and improve existing literature on the possible deleterious effects of cadmium and mercury exposure. Methods: Adult Wistar rats were treated with cadmium chloride (5 mg/kg/day) and mercury chloride (4 mg/kg/day) for 14 days. Body, brain and cerebellar weights, motor deficits, antioxidant and lipid peroxidation activities as well as histological alterations to the cerebellum were evaluated at the end of the experiment. Results: Findings showed a significant reduction in body and brain weights, dysregulation of antioxidant enzymes activity and impaired locomotion and exploratory activity in treated rats. Also, an increase in lipid peroxidation and degeneration of Purkinje cells of the cerebellum was observed in treated rats. Conclusion: Overall, these results corroborate previous findings that cadmium and mercury induce deleterious effects on the cerebellum and central nervous system. In addition, this study helps to provide an anatomical perspective and information on the exact cerebellar changes induced by cadmium and mercury in Wistar rats.

Relationship between Elevated Liver enzymes and Metabolic syndrome among Egyptian adults

Background and study aim: Liver enzymes are important markers for hepatocyte damage. Metabolic syndrome (MS) is a combination of metabolic abnormalities including high blood glucose, obesity, hypertension and dyslipidemia. The incidence of MS is believed to be increasing in Egypt. The purpose of this study is to examine the relationship between elevated liver enzymes and MS among Egyptian adults. Patients and Methods: A total 138 apparently healthy subjects were randomly included (99 females and 39 males). Demographic, clinical (blood pressure, body mass index and waist circumference) and biochemical (measurements of alanine aminotransferase (ALT), aspartate amino-transferase (AST), alkaline phosphatase (ALP), lipid profile, blood glucose and viral markers) were collected from every subject. Metabolic syndrome was defined according to a well-known criteria and subjects in the final analysis were divided into group I; metabolic syndrome and group II; non-metabolic syndrome subjects. Results: In this study, 92 persons fulfilled three of the five criteria of metabolic syndrome (group I) with prevalence of 66.7% while group II (non-metabolic syndrome) represented 33.3%. Patients with MS were older and less physically active in comparison with group II. There were an association between elevations in liver enzymes (ALT, AST, ALP) and MS. ALT, AST and ALP were elevated in 42.4%, 17.2% and 20.7% of patients with MS respectively. ALT and AST showed positive correlation with elevated blood glucose and triglycerides levels while AST/ALT ratio showed negative correlation with diastolic blood pressure, triglycerides level and waist circumference. The more items of MS the patient have the higher the level of liver enzymes. Conclusion: Among Egyptian adults elevated levels of liver enzymes were associated with MS and a correlation was noticed with its components

Prevalence of chlamydia trachomatis infection in infertile women attending fertility clinics in Benin city, Nigeria: a public health concern

This study was carried out to deduce the prevalence of Chlamydia infection amongst infertile women attending fertility clinics in Benin City, Nigeria. Fifty infertile women with either primary or secondary infertility and with their ages ranging from 24 to 51 years were enrolled for this study. The serum of each patient was screened for Chlamydia antibodies with the enzyme-linked immune-sorbent assay (ELISA) and immunoglobulin G (IgG) index of 0.90 or less was reported as seronegative for IgG antibody, while IgG index of 1.00 or greater were positive for IgG antibody. Findings in the present study revealed that 24 % to 52 % of the patients that attend the fertility clinics in Benin City, Nigeria were most likely to be infected with Chlamydia; with the primary infertile patients accounting for 32 % of the cases and secondary infertile patients for 68 % of the cases. Prevalence of Chlamydia infection was also found to be quite high amongst women aged between 36 and 40 years old. Since lack of symptoms often makes the clinical diagnosis of Chlamydia infection somewhat difficult, thus increasing the prevalence of this disease; routine screening is recommended to enable early therapeutic interventions of positive cases

Copro-antigen versus classical microscopy as diagnostic tool for giardia lamblia infection in Egyptian patients

Background: Giardia lamblia, a flagellate protozoa, is a one of the most common causes of non-viral (parasitic) diarrheal illness in humans. Laboratory diagnosis mainly consists of direct microscopic examination of stool specimen for trophozoites and cysts. However, due to intermittent fecal excretion of the parasite, the patient may be misdiagnosed, continue excreting the parasite and infecting others. Therefore, other methods of diagnosis should be looked for, which overcome the drawbacks of microscopy when used alone for diagnosis. The present study aimed to evaluate the efficacy of coproantigen detection by ELISA test in comparison to direct microscopy in the diagnosis of G. lamblia in stool specimens from patients with diarrhea and other gastrointestinal symptoms. Patients and methods: stool samples were collected form 250 child included in the present study (150 symptomatic and 100 apparently healthy as a control group) aged between 1-10 years old, and subjected for direct microscopic examination and ELISA test for copro-antigen detection. Results: out of 250 stool samples, 53 specimens (21.2%) were positive for Giardia by direct microscopy, while 68 specimens (27.2%) were positive by ELISA test. Conclusion: ELISA test for copro-antigen detection in stool samples is a rapid and effective method with high sensitivity and specificity for diagnosis of giardiasis in stool specimens even when the parasitic count is low, thus reducing the chances of missing even in the asymptomatic cases

Increased Levels of Pancreatic Enzymes in Sickle Cell Anemia and the Effect of Proteinuria

Background/Objective: Sickle cell disease (SCD) is the most common hemoglobinopathy in Nigeria; and the condition can affect any part of the body including the pancreas. The study seeks to evaluate the levels of pancreatic enzymes in blood and urine of SCD patients in steady clinical state; and the effect of proteinuria on the enzyme levels as proteinuria was previously reported in SCD subjects. Materials and Methods: Urine and plasma amylase; serum lipase; and proteinuria were determined in 150 subjects comprising 100 SCD patients and 50 age/sex matched apparently healthy subjects with normal hemoglobin using commercially available reagent test kits. Results: Urine amylase (P = 0.029); serum amylase (P 0.001); lipase (P

Liver Enzymes and Trace Elements in the Acute Phase of Sickle Cell Anaemia

BACKGROUND: Trace elements are required for the performance of numerous functions of immune cells. It is not clear whether levels of trace elements are elevated and whether there is a relationship between the levels of liver enzymes and trace elements in patients with sickle cell anaemia in crisis. OBJECTIVE: To compare the plasma levels of liver enzymes and trace elements in non sickle cell anaemia (NSCA); sickle cell anaemia subjects in the steady state (SCASS) and sickle cell anaemia patients in crisis (SCAC). METHODS: Haematological parameters; liver enzymes and trace elements were determined in 20 NSCA subjects; 20 SCASS subjects and 18 SCAC subjects. Variables studied included aspartate aminotransferase (AST) alanine aminotransaminase (ALT); alkaline phosphatase (ALP); and the trace elements copper; zinc; and manganese. RESULTS: Levels of liver enzymes were higher in the SCAC subjects than in the NSCA or SCASS subjects (p

Pharmacotherapy for Chronic Heart Failure

Background : Heart failure is a chronic and progressive disorder which results due to inability of the heart to pump adequate blood to meet up the metabolic demands of the body. Detecting patients with heart failure could be simple but rather complex of clinical decisions as presentation could be classical or non-specific with minimal symptoms and or signs. Management is aimed at relieving symptoms; improving quality of life; preventing hospitalisation and arresting disease progression thus prolonging survival. In addition to pharmacologic measures; non-pharmacologic ones are also employed. Method : Relevant literature was reviewed using medical journals and also via internet. The key words employed were: Heart failure; Chronic heart failure; Diuretics; Vasodilators; Angiotensin receptor blockers (ARBS) and Angiotensin converting enzyme inhibitors (ACEI). The National Heart; Lung and Blood Institute; Canadian Cardiovascular Society; American College of Cardiology websites were also used in the course of this review. Results: This review was able to support the use of beta- blockers; ACEI; ARBS; digitalis; diuretics; vasodilators and aldosterone antagonists in the management of chronic heart failure. Conclusion : The objectives of drug therapy in heart failure includes the short-term goals of stabilising the patient; improving haemodynamic function and conferring symptomatic improvement; as well as the long-term goal of limiting disease progression; decreasing hospital re-admission rates and improving survival. The cause needs to be established and aggravating factors identified (and where possible treated). Most of the drugs; if not all; are used in combination with one another to achieve maximal therapeutic goal. Use of some drugs could be entertained as an add-on therapy depending on any co-existing medical condition.1

Evaluation de l'activite des enzymes hepatiques au cours du diabete sucre

La presente etude avait pour objectif d'evaluer les consequences du diabete sucre sur l'activite des enzymes du foie Les activites ont ete determinees par la methode cinetique classique chez des diabetiques. Cette etude transversale effectuee sur 85 sujets diabetiques a ete realisee au laboratoire de Biochimie Medicale de l'UFR des Sciences Medicales d'Abidjan en collaboration avec le service d'Endocrinologie Diabetologie du CHU de Yopougon. L'etude a ete realisee de septembre 2004 a fevrier 2005; soit une duree de 5 mois. Nos resultats obtenus sont les suivants : AU PLAN EPIDEMIO- CLINIQUES : une predominance du diabete de type 2 (90;6pour cent); un sexe ratio de 0;93 ; une duree moyenne d'evolution du diabete est de 3;96 ans; une proportion du desequilibre glycemique dans 45;5pour cent des cas. AU PLAN BIOLOGIQUE: l'activite serique moyenne de l'Aspartate amino transferase (ASAT) est de 40;77 U.I/l; l'activite serique moyenne de l'Alanine amino transferase (ALAT) est de 36;79 U.I/l; l'activite serique moyenne de la Phosphatase alcaline (PAL) est de 119;28 U.I/l ; l'activite serique moyenne de la gamina glutamyl transferase (yGT) est de 3;35 U.I/l. L'ensemble des activites enzymatiques moyen traduit une tendance legere d'une cytolyse. Ces resultats amenent a suggerer un controle et un suivi des enzymes hepatiques pour une meilleure prise en charge; et un suivi regulier des diabetiques en Cote d'Ivoire