ABSTRACT
Background: Malaria is one of the most severe public health problems worldwide. India contributes a substantial burden of malaria. It can cause several complications. Aims and Objectives: This study was conducted to determine the association of parasitemia of current malaria with age of patients, hemoglobin level, liver function test (LFT), platelet count, previous history of malaria, and relapse/recrudescence of malaria up to 1 year. Materials and Methods: An observational study conducted in hospital settings included thin and thick smear preparation with Leishman’s staining to determine the parasitemia as per the WHO guidelines from the blood samples of 280 malaria parasite dual antigen (MPDA) kit positive patients and their details were taken during study period of 2 years. Hemoglobin, LFT, and platelet count were tested and they were correlated with parasitemia. The previous history of malaria was taken and follow-up was done up to 1 year for relapse/recrudescence and their association with parasitemia in current disease was evaluated. Statistical tool R was used for data analysis. Results: Age group 20–40 years was most commonly affected with maximum mean percentage parasitemia. Higher parasitemia was associated with higher grade of anemia, LFT derangement, and thrombocytopenia. Disease severity was maximum for mixed infection followed by falciparum and vivax malaria. About 9.28% of patients with the previous history of malaria developed lower parasitemia in current infection. Relapse rate in vivax malaria –2.325% and recrudescence rate in falciparum malaria–12.5%. Conclusion: Malaria parasitemia should be reported routinely as it carries prognostic importance.
ABSTRACT
Important immune-mediated liver illnesses include autoimmunity hepatitis (AIH) and primary biliary cirrhosis. Typically, they are distinguished based on histological, biochemical, serological, and clinical parameters. Diagnostic criteria for many conditions are typically met by patients with autoimmune liver disease. The diagnosis of AIH/primary sclerosing cholangitis overlap is based on a mix of biochemistry, autoantibody profile, cholangiogram, and liver histology; there are no universally accepted criteria for this. The patient can remain asymptomatic or present with pruritis and jaundice. Diagnosis is through liver biopsy showing bile duct destruction and proliferation. The treatment is by high-dose ursodeoxycholic acid.
ABSTRACT
Purpose: Pregnancy?induced hypertension is a multisystem disorder that occurs after 20 weeks of pregnancy usually in primigravidas and is characterised by proteinuria, pedal edema, hypertension, and abnormal liver and kidney function tests. Since there exists a close relationship between retinal, cerebral, and renal vessels, fundoscopy gives the opportunity of observing the changes in the vascular tree. Methods: We conducted a study on 203 pregnant females over a period of 1.5 years in the rural population of North India. We recorded the baseline data from the patient files, including the biochemical investigations, and conducted a fundoscopic examination of all patients included in the study, and correlation of various variables was established. Results: Out of 203 patients (403 eyes), 60% were primigravidas of mean age 25.71 ± 4.46 years with the mean duration of pregnancy being 36 weeks. The mean systolic and diastolic blood pressure were160 and 101 mmHg, respectively. There was no significant correlation was seen of proteinuria with eclampsia and the fundus findings. But there was a significant correlation between proteinuria and pedal edema and between the fundus findings and deranged LFT and KFT values. Relationship between the variables was calculated by using Chi?square and Fisher’s exact test. A P value < 0.05 was taken as significant. Conclusion: Hypertension in pregnancy is the major concern of public health issue worldwide. With proper understanding of the correlating factors such as fundus changes which are directly correlated with whole bo dy vascular changes, which might affect the fetal growth, we can easily predict the outcome and can take appropriate actions as early as possible
ABSTRACT
ABSTRACT Background: A large number of patients admitted to the medical intensive care unit (MICU) have abnormal liver function tests (LFT). This includes patients with critical illness with or without preexisting liver disease and patients with acute primary liver injury. There are very few studies which have investigated the spectrum of liver disease, clinical profile and outcome in patients admitted to the MICU. Objective To evaluate the occurrence, etiology, clinical profile, laboratory profile and outcome of hepatic dysfunction in patients admitted to the MICU. To evaluate the utility of model for end-stage liver disease (MELD) score on admission as a predictor of adverse short term outcome in patients with hepatic dysfunction admitted in MICU. Methods: It was a prospective observational study, conducted from December 2017 to December 2018 in a tertiary care hospital. Two hundred and two patients admitted to the MICU with LFTs as per the inclusion criteria were analyzed and their short-term outcome at 7 days was studied in relation to various parameters. Results: LFT abnormalities were present in 202/1126 (17.9%) of the patients admitted to MICU. Critical illness associated liver dysfunction was found in 172 (85.2%) patients, chronic liver disease in 11 (5.4%) patients and acute viral hepatitis in 19 (9.4%) patients. Most common symptom was fever (68.3%) followed by vomiting (48.0%). Among LFT abnormalities, elevated transaminases, raised international normalized ratio and high MELD score on admission correlated with poor short-term outcome. Requirement for inotropes and mechanical ventilation correlated with poor short-term outcome. Mortality did not differ significantly between patients with chronic liver disease, patients with acute viral hepatitis and patients with critical illness associated hepatic dysfunction. Hepatic dysfunction in MICU was associated with poor outcome and a high short-term mortality of 56.4% (114/202). Conclusion: Liver function abnormality is common in patients who are admitted to the MICU and its presence is an indicator of poor short-term outcome.
RESUMO Contexto: Um grande número de pacientes internados na unidade de terapia intensiva (UTI) tem testes de função hepática anormais (TFH). Isso inclui pacientes com doença crítica com ou sem doença hepática pré-existente e pacientes com lesão hepática primária aguda. Há poucos estudos que têm investigado o espectro da doença hepática, perfil clínico e desfecho em pacientes admitidos em UTI. Objetivo Avaliar a ocorrência, etiologia, perfil clínico, perfil laboratorial e desfecho de disfunção hepática em pacientes internados na UTI médica. Avaliar a utilidade do modelo para doença hepática em estágio terminal (MELD). Escore na admissão como preditor de desfecho adverso a curto prazo em pacientes com disfunção hepática admitida em UTI. Métodos: Foi realizado um estudo observacional prospectivo, de dezembro de 2017 a dezembro de 2018 em um hospital de atenção terciária. Foram analisados 202 pacientes internados na UTI com TFH conforme os critérios de inclusão e seu desfecho a curto prazo de 7 dias foi estudado em relação a diversos parâmetros. Resultados: Anormalidades dos testes estiveram presentes em 202/1126 (17,9%) dos pacientes internados na UTI. Doença crítica associada à disfunção hepática foi encontrada em 172 (85,2%) pacientes, doença hepática crônica em 11 (5,4%) pacientes e hepatite viral aguda em 19 (9,4%) pacientes. O sintoma mais comum foi a febre (68,3%), seguido de vômito (48,0%) casos. Entre as anormalidades do TFH, transaminases elevadas, INR e escore MELD elevados na admissão correlacionaram-se com desfecho ruim de curto prazo. Exigência de inotrópicos e ventilação mecânica correlacionaram-se com desfecho de curto prazo ruim. A mortalidade não diferiu significativamente entre pacientes com doença hepática crônica, pacientes com hepatite viral aguda e pacientes com doença crítica associada à disfunção hepática. A disfunção hepática em UTI esteve associada a um desfecho ruim e à uma alta mortalidade a curto prazo de 114/202 (56,4%). Conclusão: A anormalidade da função hepática é comum em pacientes que são admitidos nas unidades de tratamento intensivo e sua presença é um indicador de desfecho de curto prazo ruim.
ABSTRACT
Background: The present study was conducted with the objective to assess the spectrum of liver disease in pregnancy, and its course and effect on maternal and fetal outcomes.Methods: The present study was conducted as a prospective follow up study in the department of Obstetrics and Gynaecology, J. K. Hospital for a period of 1 year. The pregnant women between the ages of 18-35 years presenting with symptoms suggestive of underlying liver disease were selected. Socio demographic details and clinical history was obtained from all the participants and they were subjected to liver function test (LFT). All patients were followed till 2 weeks post-partum period. The maternal and fetal outcomes were noted.Results: The following results were obtained: pregnancy-induced hypertension (PIH) was the most common cause of abnormal LFT (46.66%), about 57.5% patients delivered at term, 63.3% patients delivered vaginally, mostly cases delivered a term healthy neonate between 2.5-3.0 kg weight with Apgar score >7 at 5 minutes after birth and maternal complications were seen in 10.82% cases.Conclusions: Our study shows that though liver disease is uncommon in Indian pregnant women, but it is associated with high maternal and perinatal morbidity. A high index of suspicion of liver disease, early diagnosis, prompt referral to a higher centre when required, appropriate supportive management, and a proactive policy of early delivery when indicated may improve the maternal and fetal outcomes in pregnant women with liver disease. Thus LFT should be conducted as a routine investigation in all pregnant females during first and second trimester.
ABSTRACT
Background: Intrahepatic cholestasis of pregnancy is a multifactorial condition of pregnancy diagnosed when otherwise unexplained pruritus with abnormal liver function test and neither of which has an alternative cause. The most appropriate gestational age for the delivery of women with ICP is yet to be determined. The present study is designed to determine whether with active intervention, pregnancy with ICP can be carried to a later gestation.Methods: Fifty Women with diagnosed a case of ICP were recruited into the study. The diagnosis of ICP was based on the symptoms, clinical examination and lab investigations. Group I: 25 women planned for delivery at POG 37 - 37+6 weeks of pregnancy. Group II: 25 women Planned for delivery at POG ≥38 weeks of pregnancy.Results: In group, one woman had preterm delivery at POG 36+2 weeks and rest of 24 women were delivered at POG 37-37+6 weeks. In group II, out of 25 women one woman had emergency LSCS at POG 35+3 weeks for MSL and induction of labour was done in 2nd for abnormal fetal well-being tests at POG 37 weeks. One woman had pre-term delivery at POG 36+1 weeks. Remaining 22 women in group II were delivered at POG ≥38 weeks. In the present study there was no significant difference in the gestational age at delivery between the two groups.Conclusions: It can be concluded that pregnancies with obstetric cholestasis can be carried to later gestation of ≥38 weeks under surveillance with UDCA treatment.
ABSTRACT
Background: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) infections are major global health problems with common modes of transmission. Objective: To determine the prevalence, demographic characteristics, risk factors and liver dysfunction among antenatal women with HIV and HBV co-infection. Methodology: A crosssectional study of 586 pregnant women. Socio-demographic data were collected and blood samples were collected and tested for HBsAg and HIV infection. The liver function test was conducted on those who tested positive to HBV alone and have HIV/HBV co-infection. Data were analyzed using SPSS version 18 statistical program. Result: The prevalence of patients with HIV and HBV co-infection was 0.3%. They are single and in the age group of 21-24. The mean value of total bilirubin and unconjugated bilirubin of the patients with HBV/HIV co-infection were significantly higher (p=0.037) than in those with hepatitis B virus infection alone. Conclusion: The study showed low HIV/HBV co-infection amongst antenatal women and confirmed the assertion that co-infection leads to significant impaired liver function. This should be kept very low or eradicated to reduce devastating complications of HIV/HBV co-infection.
ABSTRACT
The liver is fundamental in metabolizing thyroid hormones,and hepatocytes are often affected in thyroid disease. Thyroiddisorders often accompany abnormal serum enzyme levelsand disturbances in liver functions. These thyroid-liverassociations may cause diagnostic confusions. Neglect of thesefacts may result in over or under diagnosis of associated liveror thyroid diseases and thereby cause errors in patient care.Aim of the present study was to determine the biochemicalmarkers of liver function test Aspartate transaminase (AST),Alanine transaminase (ALT) and Alkaline phosphatase (ALP)in patients with hypothyroidism and to find their possiblecorrelation with thyroid profile.Material and Methods: The study included 50 patients withsubclinical hypothyroidism (TSH 6.0-9.9miu/l), 50 patientswith overt hypothyroidism (TSH ≥10.0 miu/l) and 50 agematched normal euthyroid controls. In all study groups FT3,FT4, TSH, AST ALT and ALP were estimated. Thyroid profileand LFT were estimated using fully autoanalyser. p value<0.05 considered as significant.Results: Subjects with both subclinical hypothyroidism andovert hypothyroidism had significantly raised serum AST,ALT and ALP (p<0.0001) compared to controls. Further, TSHshowed significant positive correlation with AST, ALT andALP (P<0.001) in both subclinical and overt hypothyroidism,Conclusion: Hypothyroid patients should be regularlychecked for biochemical parameters of LFT. As early detectionand treatment can prevent the further complications relatedto the disorder and will be helpful during the management ofhypothyroid patients.
ABSTRACT
Eleusine coracana is considered one of the most nutritious cereals. It has different names in local languages. It is known as Ragi in Telugu and Kannada/aariyam in Tamil, and Madua in Hindi and in Nigeria, it is known as Okababa in Yoruba, Dawa in Hausa, etc. This study sought to investigate the protective ability of ethanolic extracts of Eleusine coracana in Arsenic trioxide induced hepatotoxicity using rat models. Animals were grouped into four (4). Group A received only distilled water, in group B,C and D hepatotoxicity was induced using 5 mg/dl Arsenic Trioxide solution for 14 days, followed by treatment in group C and D daily with 200 mg and 500 mg per kg body weight respectively for 14 days, and changes in body weight and Liver Function parameters were determined. Eleusine coracana contains Tannins, phlobatannins,Falavonoids and Terpenoids but not Steriods and Saponins, Eleusine treated groups had a significant decrease in the organ-body weight index. The mean weight and Total Protein was significantly reduced in the intoxicated-untreated group (group B). The AST, direct and total Bilirubin level was significantly higher in group B compared to control and other treated groups. Eleusine cocarna as a plant and source of food contains certain phytochemicals which are capable of managing hepatic cell injury, this serve as a point for pharmacological intervention.
ABSTRACT
Epilepsy is the fourth most common neurological disease and affects people of all ages. There are 150,000 new cases of epilepsy every year.The highest incidence of epilepsy in children coupled with the need of long-term antiepileptic treatment could lead to alterations in haemato-biochemical parameters at an early age. Phenytoin and valproic acid are commonly used antiepileptic drugs in children. This study was aimed to assess the serum lipid profile and liver function tests in children with epilepsy on phenytoin or valproic acid monotherapy for 6 months and their control counterparts. Methods: This case control study recruited children from the pediatric outpatient department of Esic Hospital, Okhla. All consecutive children diagnosed with epilepsy as per International League against Epilepsy definition on phenytoin or valproic acid monotherapy for 6 months were enrolled along with the percentage distribution of type of seizures they were suffering. After baseline clinical and anthropometric evaluation (including body mass index [BMI]), the fasting blood samples were analyzed for serum lipid profile and liver function changes. Results: Total of 133 children were enrolled. There were 42 and 36 patients in phenytoin and valproic acid groups respectively and 55 in normal healthy control group. We observed statistically significant high mean total cholesterol and alkaline phosphatase levels in group receiving phenytoin when compared with valproic acid or control group. Conclusion: The lipid and liver enzyme abnormalities may be observed in children on phenytoin or valproic acid therapy, which warrants careful screening and monitoring as young children have immature detoxification mechanisms and a greater variability in dosing owing to a wider range of body size and weight. New epilepsy research should be integrated in areas i.e. Genomics, neuroimaging, neuropsychology and neuropathology for better understanding of the disease and to improve the global health outcomes.
ABSTRACT
Background: It is estimated that liver diseases are among the top ten killer diseases in India, causing deaths every year. Besides, there are those who suffered from chronic liver problems needing recurrent hospitalization and pro-longed medical attention, which leaves them physically, mentally, emotionally and financially devastated. Methodolo-gy:The study included (n=80) various liver disease patients admitted to the General Medicine department and controls (n=20) subjects were having normal health within the age group of 30-55 years. Serum levels of bilirubin, Aspartate Transaminase, Alanine Amino Transferase, Alkaline Phosphatase and Gamma Glutamyl Transferase parameters were studied among the subjects suffering from cirrhosis, alcoholic liver disease, viral hepatitis, obstructive jaundice type of liver diseases. Result:The results of this study showed that the increase in serum levels of Bilirubin, AST, ALT, ALP and GGT in various types of liver diseases i.e Obstructive jaundice, Cirrhosis of the liver, Viral hepatitis, Alcoholic Liver disease when compared with controls. Conclusion:Biochemistry laboratory investigations i.e. Liver Function Test (LFT) are a simple, easy measure of tools which can early diagnose the various types of liver diseases.
ABSTRACT
Background: Cirrhosis is a condition in which the liver slowly deteriorates and is unable to function normally due to chronic long lasting injury. Liver biopsy is considered as a gold standard for the diagnosis of cirrhosis and has many problems like bleeding, infective peritonitis which limit use of liver biopsies in all patients.Methods: A comparative study was done (90 cases and 90 controls) who fulfilled the inclusion criteria in a tertiary center.Results: The present study was conducted using a total of 180 participants, 90 USG diagnosed cases of liver cirrhosis was compared with 90 healthy controls. The mean AST level in the cirrhosis was 66.50±27.06 as compared to 21.26±6.52 in controls which was statistically significant. In this study the sensitivity and specificity of APRI was found to be 100.0% and 84.44% respectively, and the positive and negative predictive values were 86.54% and 100% respectively with significantly Area under the curve (AUC) (0.999, P>0.01).Conclusions: A simple index like Aspartate platelet ratio index, consisting of 2 readily available laboratory results (AST level and platelet count), can predict cirrhosis with a high degree of accuracy.
ABSTRACT
Heart failure is characterized by the inability of systemic perfusion to meet the body's metabolic demands and is usually caused by cardiac pump dysfunction and may occasionally present with symptoms of a noncardiac disorder such as hepatic dysfunction. Aim: To study the association of Liver function tests in patients with heart failure. Methods: Prospective cross-sectional study was conducted in Tertiary Medical College Hospital in heart failure patients. Complete biochemical investigations like plasma glucose, blood urea, serum creatinine, serum electrolytes, complete hemogram, liver function tests, urine analysis, x-ray chest, ultrasonography abdomen, ECG and echocardiography. Results: 50 heart failure patients were included in this study. In patients with ejection fraction, less than or equal to 40% or greater than 40%, bilirubin value shown statistical significance differences, other parameters are shown statistical insignificance. Conclusion: Increased bilirubin was independently associated with decreased ejection fraction in patients with heart failure.
ABSTRACT
Physicians of all specialties are required to assess abnormal results of liver function tests. Many patients with abnormal results in liver function tests do not have primary liver disease; most of the frequently requested tests are influenced by myriad non-hepatic factors. The most common tests are those for serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and bilirubin. Hepatocellular injury is indicated by abnormally elevated AST and ALT levels compared to the ALP level. Cholestatic injury is indicated by an abnormally elevated ALP level compared to AST and ALT levels. The majority of bilirubin circulates as unconjugated bilirubin, and an elevated conjugated bilirubin level is a marker of hepatocellular or cholestatic injury. Obtaining a detailed medical history, a clinical examination, and optimal interpretation of abnormal results of liver tests can enable the determination of the cause of liver diseases, facilitating their diagnosis and therapy.
Subject(s)
Humans , Alanine Transaminase , Alkaline Phosphatase , Aspartate Aminotransferases , Bilirubin , Diagnosis , Diagnosis, Differential , Hepatitis , Liver Diseases , Liver Function Tests , LiverABSTRACT
Background: Abnormal liver enzymes and liver function in congestive cardiac failure has long been recognized and occurs quite frequently in acute and chronic failure. Heart failure (HF) is characterized by the inability of systemic perfusion to meet the body's metabolic demands and is usually caused by cardiac pump dysfunction and may occasionally present with symptoms of a non-cardiac disorder such as hepatic dysfunction. The primary pathophysiology involved in hepatic dysfunction from HF is either passive congestion from increased filling pressures or low cardiac output and the consequences of impaired perfusion. Aim of the study: The present study was undertaken to identify alterations in the liver biochemical profiles in relation to congestive heart failure and also to show their significance with respect to the duration of heart failure. Materials and methods: Totally Sixty cases with heart failure of various etiologies and twenty healthy controls who got admitted at medicine ward of Sri Rajah Mutaiah Medical College and Hospital in the year 2019 March-August were included in the study. The higher number of cases was found within the age group of 40 to 50 years followed by the age group of 50 to 60 years. Laboratory tests measured only a limited number of these functions. No one test enabled the clinician to accurately assess the liver's total functional capacity. To increase both the sensitivity and specificity of laboratory tests in the detection of liver disease, it is best to use them as a battery. Results: Present study has found a strong relationship between liver function derangements and heart failure cases. 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 was also elevated, the levels of unconjugated fraction were higher. Mathew Jeraud. Clinical evaluation of liver function in congestive heart failure in Cuddalore District . IAIM, 2019; 6(9): 43- 48. Page 44 Serum aminotransferases were elevated in 78% of cases, unlike serum alkaline phosphatase which was increased only in 25% of cases. There found to be a significant correlation between rise in unconjugated bilirubin and elevation of serum aminotransferases. Conclusion: Study revealed marked alterations in liver function with acute heart failure and during hypotension when compared to chronic heart failure. Low serum proteins and serum albumin levels are seen in many of the cases. Various factors play in causing these changes which have already been discussed. Serum prothrombin time, though prolonged in 88% of cases, the changes were only mild.
ABSTRACT
Background: T2DM is a metabolic disease associated with a group of abnormalities including hyperglycemia, dyslipidemia, hypertension, elevated levels of biochemical and inflammatory markers in circulation. This condition predisposes an individual to a number of adverse consequences which include atherosclerotic cardiovascular disease, neuropathy, nephropathy, and retinopathy. Aim of the study: To compare the various biochemical parameters in T2DM patients and healthy age-matched controls. Materials and methods: The Study included 22 type of II diabetic patients as cases and 22 normal individuals as controls. Fasting blood sugar (FBS) and Postprandial blood sugar (PPBS complete hematological profile, lipid profile, total protein, c-reactive protein and calcium levels were measured in plasma of T2DM and compare with healthy controls. Fasting blood samples were collected into labeled centrifuge tubes, after an 8–12 h overnight fast, from the subjects by venepuncture. The blood samples were centrifuged at 2000rpm for 10 min using a desktop centrifuge and the serum separated and kept in labeled sample bottles at −70°C until further analysis. Results: The results showed higher concentrations of RBC, hemoglobin, HCT, and lymphocytes in healthy controls when compared with T2DM patients and lower concentrations of WBC, platelets, MCV, MCH, neutrophils, monocytes and eosinophils in healthy controls when compared with T2DM patients. Serum lipid profiles in plasma of control and T2DM patients. The results showed high levels of serum lipid profiles including cholesterol, HDL-C, LDL-C and total cholesterol ratio in healthy age-matched controls when compared with T2DM patients. In contrast, the levels of triglycerides were found to be lower in healthy controls when compared with T2DM patients. The results showed that levels of plasma glucose, C-reactive protein, HbA1c were significantly (p<0.05) higher in T2DM Jaiprabu Jayaraj, Pandiamunian Jayabal. Analysis of various biochemical parameters of T2DM patients and healthy controls. IAIM, 2019; 6(7): 1-6. Page 2 patients when compared with those without T2DM (healthy controls). There were also significantly (p<0.01) low levels of total bilirubin, ALT, total protein, albumin, total calcium in plasma of TDM patients when compared with plasma from healthy age-matched controls. Conclusion: The findings in this study support the hypothesis that low-grade systemic inflammation is an underlying factor in the pathogenesis of T2DM and also a common antecedent for both T2DM and CVD. The data from this particular study also provide further evidence that inflammatory markers might provide a method for early detection of CVD risk. These data might have many significant implications for the prevention and treatment of T2DM. Modification of lifestyle habits and management of systemic inflammation should be the major targets for the prevention and treatment of CVD in T2DM patients
ABSTRACT
In the recent American clinical guidelines dealing with laboratory tests for evaluation of liver disease, the American College of Gastroenterology (ACG) recommends ALT upper reference limits of 33 U/L for males and 25 U/L for females respectively, and that individuals with ALT above these"normal"cutoffs should be further investigated. Considering the differences between laboratory assays measuring ALT in our country, the standardization of methods and the consistency of results can not be completely ensured. The uniform "normal"range of ALT recommended by the ACG guidelines is largely based on findings from foreign studies and may not be suitable to Chinese population. On the other hand, reference upper/lower limits should not simply be equated with clinical decision thresholds. However, due to improper application of the related concepts of the above medical laboratory issues, simply recommending the uniform reference range of the ALT may lead to overdiagnosis and unnecessary follow-up examinations.
ABSTRACT
Objective To evaluate the impact of intraoperative administration of S-adenosy-methionine on early remnant liver function and regeneration after left lobe resection.Methods 60 cases undergoing left lobe resection were randomly divided into two groups (30 cases in each group).While postop therapies were the same.Patients in the experimental group received intraoperatively intravenous injection of S-adenosy-methionine 1 000 mg.Postoperatively the two groups were injected with S-adenosy-methionine 1 000 mg/d daily for successive 5 days.Results Liver function injury was markedly alleviated in experimental group after hepatectomy,Level of ALT,AST,TBiL,IBiL index were lower than the control group,the difference was statistically significant (P ＜ 0.05);the LRR and the expression of IL-22 was significantly higher than the control group and the difference was statistically significant (P ＜ 0.05),which indicated improved liver regeneration.Conclusion The intraoperative pretreatment of S-adenosy-methionine can reduce the damage of remnant liver function,promote the restoration of remnant liver function and liver regeneration.
ABSTRACT
Objective To compare the differences of liver function indexes in patients with acute left heart failure and congestive heart failure , and to provide the basis for the diagnosis of heart failure .Methods 142 cases of heart failure from March 2014 to December 2015 in our hospital were selected and divided into 68 cases of acute left heart failure group and 74 cases of congestive heart failure group.The differences in liver function tests were compared between the two groups by comparing the differences in the indexes of heart failure, liver blood biochemistry, general biochemical indexes and late follow-up data.Results Compared with the indexes of heart failure, there were no significant differences in ejection fraction, NT-proBNP, history of heart failure>one years, and the number of patients with right heart failure, the difference was statistically significant (P<0.05).Comparison of liver blood biochemistry: patients with acute left heart failure were alanine aminotransferase, aspartate amino transferase, albumin increased, the difference was statistically significant (P<0.05), and glutamyl aminotransferase, total bilirubin, direct bilirubin, indirect bilirubin decreased, the difference was statistically significant (P<0.05).There was no significant difference between the two groups of patients with alkaline phosphatase and total protein.Compared with the general biochemical indexes, increased triglyceride levels in patients with congestive heart failure group, the difference was statistically significant (P<0.05), there was no significant difference in other indexes.Conclusion AHF patients with ALT, AST increased, CHF with GGT, TBIL, DBIL, IBIL increased, ALB decreased mainly.
ABSTRACT
Abstract Objective This study aims to investigate the role of metabolic syndrome (MetS) and the hypertriglyceridemic-waist (HW) phenotype in determining cardiometabolic risk factors and elevated liver enzymes in a national sample of Iranian pediatric population. Method This nationwide study was conducted in the framework of the third survey of a surveillance program. Students, aged 10-18 years, were recruited from 27 provinces in Iran. The prevalence of cardiometabolic risk factors was compared in students with and without HW and MetS. The association of HW with different cardiometabolic risk factors was determined. Results The mean age of studied population was 14.73 ± 2.41 years. Prevalence of HW and MetS was 3.3% and 4%, respectively. Sixty-nine (71.1%) participants with HW had MetS. The prevalence of obesity, elevated systolic blood pressure, hypercholesterolemia, and elevated alanine aminotransaminase (ALT) was significantly higher in subjects with HW phenotype and MetS than in their peers (p < 0.05). A significant association was observed between HW and elevated levels of cholesterol and ALT, as well as between obesity and low HDL-C (p < 0.05). Conclusions The current findings serve as complementary evidence to previous studies, which have been mainly conducted among adults, suggesting that the HW phenotype is associated with cardiometabolic risk factors, especially with elevated cholesterol and ALT. The authors propose that, in primary care settings and in large epidemiological studies, the measurement of all MetS components can be replaced by studying HW as a screening tool for identifying children at high risk for cardiometabolic disorders.
Resumo Objetivo Investigar o desempenho da síndrome metabólica (SM) e do fenótipo de cintura hipertrigliceridêmica (CH) na determinação de fatores de risco cardiometabólico e enzimas hepáticas elevadas em uma amostra nacional da população pediátrica iraniana. Método Estudo nacional feito na estrutura da terceira pesquisa de um programa de vigilância. Foram recrutados alunos de 10-18 anos de 27 províncias do Irã. A prevalência de fatores de risco cardiometabólico foi comparada em alunos com e sem CH e SM. Foi determinada a associação da CH com diferentes fatores de risco cardiometabólico. Resultados A média de idade da população estudada foi de 14,73 ± 2,41 anos. A prevalência de CH e SM foi de 3,3% e 4%, respectivamente; 69 (71,1%) dos participantes com CH apresentaram SM. A prevalência de obesidade, pressão arterial sistólica elevada, hipercolesterolemia e alanina aminotransferase (ALT) elevada foi significativamente maior em meninos e meninas com fenótipo CH e SM do que em seus outros pares (p < 0,05). A associação de CH foi significativa com elevados níveis de colesterol e ALT, bem como obesidade e HDL-C baixo (p < 0,05). Conclusões Os achados atuais servem de evidência complementar de estudos anteriores, conduzidos principalmente com adultos, e sugerem que o fenótipo CH está associado a fatores de risco cardiometabólico, principalmente com colesterol e ALT altos. Propomos que, em ambientes de cuidados básicos e em grandes estudos epidemiológicas, a medição de todos os componentes de SM possa ser substituída pelo estudo da CH como ferramenta de triagem para identificar crianças com alto risco de apresentarem distúrbios cardiometabólicos.