ABSTRACT
Background: Fever is the most common complaint with bringing children for hospital consultation. Dengue is a cause of public health concern with case fatality rate of 1%. Ferritin is an acute-phase reactant which is produced in response to infection and inflammation. Liver enzymes are also considered as markers of febrile illness. Aim of this study was to assess serum ferritin levels, aspartate-aminotransferase (AST) and alanine-aminotransferase (ALT) levels in pediatric inpatients with febrile illness, to correlate it with patient’s Dengue profile and to analyse these parameters with sub-group analysis of dengue and OFI.Methods: Among 120 children admitted for fever of more than 3 days duration were included in the study. 58 were Dengue-NS1 positive and the remaining 62 were considered to be OFI. Serum ferritin levels, AST and ALT were the investigative parameters measured at the time of admission for the study and treated as per WHO Dengue Guidelines. Data was coded and entered in Microsoft Excel 2013. Data was analysed using SPSS v16. p value of <0.05 was considered statistically significant.Results: Ferritin levels were higher in Dengue-IgM positive subgroup than in OFI subgroup (U= 173, Z score -6.09, p<0.00001). AST levels are higher in Dengue-NS1 positive subgroup than in OFI subgroup (U= 103, Z score -8.08, p<0.00001). AST levels were also higher in Dengue-IgM positive subgroup than in OFI subgroup (U= 377.5, Z score -4.86, p<0.00001). ALT levels are higher in Dengue-NS1 positive subgroup than in OFI subgroup (U=76, Z score -8.95, p<0.00001) as well as in Dengue-IgM positive subgroup than in OFI subgroup (U= 417, Z score -4.4, p<0.00001).Conclusions: Hyperferritinemia and elevation of hepatic-transaminases is seen in dengue. Although elevated in other febrile illnesses, it is elevated more so in dengue. This can be a predictor of severity of dengue fever, but needs to be confirmed in larger studies.
ABSTRACT
Asiaticoside is a triterpenoid present in Centella asiatica extract, responsible for the therapeutic activity of this plant in chronic liver disease. The hepatocyte is the cell responsible for the endocrine and exocrine functions of the liver, in addition to the conversion of harmful substances into non-toxic compounds that are excreted in the bile. That is why the liver is sensitive to the action of some drugs, such as paracetamol. Hence, paracetamol was used as an experimental model of liver damage, with the aim of assessing the effectiveness of asiaticoside, in a standard therapeutic dose, as a hepatoprotector in Wistar rats. In this experiment, 40 animals were used and divided into two groups: those treated with asiaticoside and the untreated control group. Animals from the first group were subjected to pretreatment with the active ingredient (1mg/kg/dia P.O.) for eight days and exposed to a toxic dose of paracetamol (3 g/kg P.O.) on the eighth day. After 24 h and 72 h, these rats were sacrificed for the collection of blood samples and liver fragments. To assess hepatoprotective activity, serum enzymes (AST, ALT and alkaline phosphatase) indicative of liver damage were measured and histological and morphological analyses of liver tissue were performed. The results obtained showed that asiaticoside exerted hepatoprotective action, since it promoted a reduction in histological lesions and a decrease in serum levels of AST and ALT. From these results, we conclude that asiaticoside, in the dose most commonly used in herbal medicine, protects the liver against acute hepatitis induced by paracetamol...
O asiaticosídeo é um triterpenóide presente no extrato da Centella asiatica, sendo responsável pela atividade terapêutica desta planta em doenças hepáticas crônicas. O hepatócito é a célula responsável pelas funções endócrinas e exócrinas do fígado, além de converter substâncias nocivas em materiais não tóxicos excretados pela bile. Por esse motivo, o fígado é sensível à ação de alguns fármacos, como, por exemplo, o paracetamol. Assim, utilizando o paracetamol como modelo experimental de lesão hepática, o objetivo deste estudo foi avaliar a ação hepatoprotetora do asiaticosídeo, na dose estabelecida como terapêutica, em ratos Wistar. Dois grupos compostos por vinte animais cada, tratados com asiaticosídeo (1mg/kg/dia v.o.) por oito dias e não tratados foram submetidos à intoxicação com elevada dose de paracetamol (3 g/kg v.o) no oitavo dia. Em seguida, os animais foram eutanasiados após 24 h ou 72 h para coleta de amostras de sangue e fragmentos de fígado. Para avaliação da atividade hepatoprotetora, foi realizada a dosagem sérica de enzimas indicativas de lesão hepática (AST, ALT e Fosfatase Alcalina) e a análise histológica e morfométrica do tecido hepático. Os resultados obtidos permitiram evidenciar que na dose utilizada, o asiaticosídeo apresenta atividade hepatoprotetora, uma vez que o grupo submetido ao tratamento prévio apresentou menos lesões histológicas e menores níveis séricos de AST e ALT quando comparado ao grupo controle. Estes resultados permitem concluir que o asiaticosídeo, na dose mais usualmente empregada na fitoterapia, apresentou atividade hepatoprotetora na hepatite aguda causada por elevada dose de paracetamol...