ABSTRACT
Introduction: Heart failure causes a number of pathophysiological affects which, alone or in combination result in liver cell damage. As a consequence, liver function abnormalities are so common in heart failure. Liver dysfunction in heart failure is usually mild and asymptomatic and often detected incidentally on routine liver biochemical investigations. Aim of The Study: To study the influence of congestive heart failure on liver biochemical profiles. Materials and methods: Among cases admitted with heart failure in the medical wards, government general hospital, sixty patients who had met the inclusion and exclusion criteria were taken up for study. Results: Among the total heart failure cases, 40% were due to rheumatic heart disease. Dilated cardiomyopathies represent about 23% of cases. Heart failure secondary to coronary artery heart disease is seen in about 13% of cases. We have found five cases with acute heart failure and three cases with hypotension. Present study revealed a strong correlation between liver function derangements and the above cases. Conclusion: The study observed 20% of cases with jaundice. Among sixty cases liver enlargement was seen in 63% of cases. Increased liver size is strongly correlated with hyperbilirubinemia. Though the conjugated fraction of bilirubin is also elevated, the levels of unconjugated fraction were higher. Serum aminotransferases were elevated in 78% of cases unlike serum alkaline phosphatase which is increased only in 25% of cases. There found to be a significant correlation between rise in unconjugated bilirubin and elevation of serum aminotransferases.
ABSTRACT
Background: Obstructive sleep apnea (OSA) is associated with several metabolic disorders. The hypoxia due to OSA can alter liver function and increases the risk of nonalcoholic fatty liver disease and hepatic necrosis. Serum aminotransferase levels are predictive factors for liver injury. In this study we aimed to evaluate association between serum aminotransferase levels and severity of OSA. Materials and Methods: Sixty six patients who their OSA disorder was confirmed with PSG entered the study. All patients had Body Mass Index (BMI) above 30. Serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in a group of 33 patients with severe OSA (AHI≥30) were compared to 33 patients with mild OSA (5<AHI<15). We also searched for correlation between factors of hypoxemia such as apnea hypopnea index (AHI), Oxygen Desaturation Index (ODI) and percentage of time spent with SPO2<90% (%T<90) with serum aminotransferase levels. Results: Mean levels of AST were (21.33±8.62) and (21.15±9.39) in severe and mild group respectively. Mean levels of ALT were also measured as (24.24±14.07) and (19.82±9.74) in severe and mild group respectively. The levels of AST and ALT were not significantly different in these two groups (P-value=0.935), (P-value = 0.142). Mean ODI in severe and mild group was (56.33±26.97) (14.00±10.46) (P-value <0.001) and T<90% was (33) 100% and (14) 42.4% (P-value <0.001) respectively which were significantly higher in severe group. Conclusion: The results from this study showed no significant correlation between serum aminotransferase levels and severity of OSA.
ABSTRACT
Introduction: Acute viral hepatitis due to faeco- oral group of hepatitis viruses is endemic in India. Outbreaks of hepatitis E virus infection are more common than the hepatitis A virus. Aim: The present study aimed at determining the seroprevalence of IgM antibodies to hepatitis A and E virus in clinically diagnosed acute viral hepatitis cases. And to determine its usefulness against the disease prevention. Study Design: A cross sectional study was carried out on symptomatic patients referred from paediatric and gastro enterology department of Princess Esra hospital. Place and Duration of Study: Around one hundred and eight subjects were analyzed for anti IgM antibodies to hepatitis A and E virus and liver function test in the department of laboratory medicine for Microbiology and biochemistry at Princess Esra Hospital, Deccan College of Medical Sciences between January 2013 and January 2014. Methodology: Blood samples were collected under strict aseptic precautions and tested for anti-HAV and Anti-HEV IgM antibodies using capture elisa from diasorin. Biochemical analysis included estimation of serum aminotransferases, alkaline phosphatase and bilirubin levels. Results: An overall seropositivity of 54% was observed in the present study. More number of the subjects as 46.29% tested positive for anti HAV IgM than for anti HEV IgM as 7.4%. Co-infections were not noticed. Acute viral hepatitis due to hepatitis A virus is more common in children in the age group 6-10 years followed by 11-15 years and lastly 0-5 years indicating the epidemiological shift. Infection with hepatitis E virus was common in adolescent and adults. Males were more susceptible to both the infections than females. Liver function test results correlated well with viral markers indicating damage to the liver parenchyma. The socioeconomic status of the individuals revealed that 95% of the subjects were below poverty line and didn’t have access to proper drinking water and sanitary facilities. None were vaccinated against Hepatitis A virus. Conclusion: The present data suggest that we need to have a dual pronged approach against prevention of acute viral hepatitis caused by A and E virus. Government authorities should prioritize on bringing a uniform improvement in the living standards of the society and make vaccine available to the high risk group at a subsidized rate.