Evaluation of Serum Levels of Hepatic Enzymes and Plasma Proteins between Different Types of Acute Viral Hepatitis.

This cross-sectional study was carried out in 80 serologically diagnosed cases of acute viral hepatitis to assess and compare the serum hepatic enzymes & plasma proteins between four different types (A,B,C,E), 20 in each group. Hepatitis E, hepatitis B and hepatitis C were more prevalent in males than that in females. The study showed that geometric mean of S.AST of all the four types differed significantly (F= 274.94, p<0.001). Geometric mean of S.ALT, S.AST and S.ALP in cases of HCV were significantly lower than others (p<0.001). Geometric mean of S.ALT & S.AST in cases of HEV were significantly increased than others (p<0.001). But the geometric mean of S.ALP of HBV was significantly higher than others (p<0.001). On the other hand though S.ALP of HAV and HEV was lower than HBV but significantly higher than HCV (p<0.001). The mean±SD of serum albumin of HCV was decreased significantly in contrast to those of HAV and HBV (p<0.001). A:G ratio of HCV was also significantly lower than other three (p<0.001). It was revealed through the study that hepatic enzymes were most affected in cases of HEV but least affected in cases of HCV.

Spot morning urine protein creatinine ratio and 24 hour urinary total protein excretion rate.

Proteinuria helps to establish the diagnosis of most renal diseases and also to predict the outcome of such diseases. Proteinuria is biochemically represented by measuring the protein concentration in timed collection of 24 hour urine. But, 24-hour timed urine collection is time consuming, cumbersome and often unreliable due to collection errors and also results in undue delay on diagnostic process. An alternate approach avoiding arduous and inaccurate timed urine collection can be the measurement of protein creatinine ratio in spot morning urine. This study was aimed to evaluate whether the spot morning urine protein creatinine ratio can be a reliable alternative to 24-hour urinary total protein (UTP) estimation. The study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka on 50 (fifty) non-diabetic Chronic Renal Disease (CRD) patients with an age ranging from 18 -70 years. The study subjects were grouped into mild, moderate and severe CRD on the basis of GFR. Urinary protein and creatinine concentrations were measured in spot morning urine samples and their ratios were calculated. Urinary protein measured in 24-hour timed collected urine samples gave the 24-hour UTP excretion rate. In our study, spot morning urine protein creatinine ratio significantly correlated with 24-hour UTP excretion rate in all CRD patients. Severe CRD patients gave significant positive correlation (p<0.05), whereas mild and moderate CRD patients gave very highly significant positive correlation (p<0.001). Therefore, it may be suggested that protein creatinine ratio in spot morning urine can be accepted as a reliable and alternative to 24-hour UTP excretion rate in non-diabetic chronic renal disease patients. This simple and inexpensive procedure will thus simplify the way of establishing the severity of renal disease along with its prognosis.