Biochemical and ultrastructural studies on the protective effect of ginger extract against cisplatin-induced hepatotoxicity in adult male albino rats

Cisplatin is a highly effective antineoplastic drug used for treatment of solid tumors. Hepatotoxicity is the major adverse side effect in cisplatin-based chemotherapy. The objective of this study was to investigate the possible chemoprotective effects of ginger on the liver biochemical and ultrastructural changes induced by cisplatin chemotherapy. Twenty-four adult male albino rats were randomly divided equally into four groups: group 1 [control group]; group 2 [ginger-treated group]; group 3 [cisplatin-treated group]; and group 4 [cis platin + ginger-treated group]. At the end of the treatment, animals were killed and blood samples and liver tissues were collected for the biochemical and ultrastructural investigations. Cisplatin chemotherapy induced severe liver lesions manifested by a significant decrease in serum levels of aspartate aminotransferase and alanine aminotransferase and a significant increase in serum albumin level. Furthermore, dilated and vesiculated rough endoplasmic reticulum, megamitochondria, swollen mitochondria, myelin figure, lipid droplets, and wide discontinuous blood sinusoids with absence of endothelial cells and detachment of Kupffer cells were observed. Oral administration of ginger simultaneously with cisplatin improves the liver dysfunction and lesions induced by cisplatin. The results obtained provide in-vivo evidence, at biochemical and ultrastructural levels, of the chemoprotective effects of ginger against the hepatotoxicity induced by cisplatin chemotherapy

Biochemical evaluation of the protective impact of silymarin against cyclophosphamide- induced hepatotoxicity in rats

This study was designed to investigate the ameliorative effect of silymarin on the hepatotoxicity induced by cyclophosphamide [CP] in female albino rats. The results revealed that cyclophosphamide induced marked increase in relative liver weight and serum levels of ALT, AST and decrease in serum albumin level which were normalized by silymarin administration. Pretreatment with silymarin significantly attenuated cyclophosphamide-induced increases in malondialdehyde [MDA] in the liver homogenate. The results revealed that the activities of lysosomal enzymes acid phosphatase [ACP], beta-N-acetyl glucosaminidase [beta-NAG] and beta- galactosidase [beta-GAL] were increased significantly in CP-treated animals while pretreatment by silymarin caused marked attenuation in the increased activities of the three enzymes. Cyclophosphamide significantly decreased reduced glutathione [GSH], glutathione-s-transferase [GST] and glutathione reductase [GR] levels in the liver homogenate, while pretreatment with silymarin blunted the decreased levels of GSH,GST and GR. Our results revealed the potential hepatoprotective effect of silymarin against cyclophosphamide-induced hepatotoxicity. So, it may be worthy to consider the beneficial use of silymarin as supplement with cyclophosphamide therapy

Mitochondrial modulation as a potential mechanism of Vetiveria zizanioides root extract against liver damage in mice

The relationship between the expression of mitochondrial voltage-dependent anion channels and the protective effects of methanolic extract of Vetiveria zizanioides Linn. Root against carbon tetrachloride-induced liver damage was investigated. Pretreatment of mice with Vetiveria zizanioides Linn. Root extract [300 and 500 mg/kg] significantly blocked the carbon tetrachloride-induced increase in both serum aspartate aminotransferase and serum alanine aminotransferase levels. The mitochondrial membrane potential was dropped from -188.0 +/- 2.5 mV to -156.8 +/- 3.0 mV [P < 0.01] after the mice had been treated with carbon tetrachloride. Pretreatment with methanolic extract of Vetiveria zizanioides Linn. Root [300 and 500 mg/kg] attenuated carbon tetrachloride -induced mitochondrial membrane potential dissipation [P< 0.05]. In addition, pretreatment of Vetiveria zizanioides Linn. Root extract at various concentrations exerted a dose-dependent effect against sensitivity to mitochondrial swelling induced by Calcium. Also, 500 mg/kg dose of extract significantly increased both transcription and translation of voltage-dependent anion channels, which was down-regulated by carbon tetrachloride treatment. The above data suggest that Vetiveria zizanioides Linn. Root extract mitigates the damage to liver mitochondria induced by carbon tetrachloride, possibly through the regulation of mitochondrial voltage-dependent anion channels, one of the most important proteins in the mitochondrial outer membrane

Effects of reduced glutathion and vitamin c on cisplatin-induced hepatotoxicity in rats

Cisplatin [CDDP] is a widely used anticancer drug, however it can produce undesirable side effects such as hepatotoxicity when used at high doses. The aim of the present work to evaluate the protective effect of reduced glutathione [GSH] and vitamin C on CDDP-induced hepatotoxicity. Eighty male Sprague-Dawley rats were divided into eight groups, 10 rats each. Group I, control group. Group II received Cisplatin [7.5 mg /kg, i.p] for 5 consecutive days. Group III received GSH [600 mg/kg /day, i.p]. Group IV received vitamin C [250 mg/kg/day, orally]. Group V received GSH for 15 days then CDDP for 5 days. Group VI administered vitamin C for 15 days then CDDP for 5 days. Group VII administered both GSH and CDDP for 5 days. The last Group [VIII] administered both vitamin C and CDDP for 5 days. Serum alanine aminotransferase [ALT] and aspartate aminotransferase [AST] activities [markers of hepatotoxicity], antioxidants [superoxide dismutase [SOD], glutathione peroxidase [GSHPx], catalase [CAT], glutathione reductase [GSHR] activities and gene expression, glutathione [GSH] content] and lipid peroxidation products [malondialdehyde, MDA] in rat liver tissue were measured. CDDP hepatotoxicity was manifested by an increase in serum ALT and AST, elevation of MDA as well as a decrease in GSH and the activities and gene expression of antioxidant enzymes [SOD, GSHPx, CAT, GSHR] in liver tissues. Serum ALT, AST and hepatic MDA decreased in the combination groups in comparison with the CDDP group. The activities and gene expression of SOD, GSHPx, CAT and GSHR and the GSH concentration increased in the combination groups as compared to the CDDP group. Reduced glutathione and vitamin C either taken before or concomitant with cisplatin attenuated the CDDP hepatotoxicity

Serum prohepcidin, iron and hepatic iron status in chronic hepatitis C in Egyptian patients

Patients with chronic hepatitis C [CHC] often have increased liver iron. Hepcidin has recently emerged as a key regulator for iron homeostasis. Therefore, we aimed to study the relationship between serum prohepcidin, serum iron indices, hepatic necro-inflammation, fibrosis and hepatic iron density and to determine the predictors of advanced fibrosis in these patients. Fifty CHC treatment naive patients and 20 healthy controls were enrolled in this study. Complete blood count, liver function tests, serum iron indices and serum prohepcidin were assayed. Liver biopsy was performed for all patients for assessment of necro-inflammatory activity, fibrosis and liver iron density. Thirty-four patients [68%] had mild fibrosis [stage 0, 1,2] and sixteen [32%] had advanced fibrosis [stage 3, 4]. All cases were positive for liver iron stain [68% mild, 32% advanced]. Mean serum prohepcidin level was significantly lower in CHC patients than healthy controls. In univariate analysis, prohepcidin was significantly associated with necro-inflammatory activity [P<0.05] and advanced fibrosis [P<0.05]. Multivariate analysis revealed that necro-inflammatory activity and liver iron density arc independently associated with stage of fibrosis. No significant correlations were found between prohepcidin and serum iron indices or liver iron score. Scrum prohcpcidin is reduced in CHC which may be one -not the only- factor leading to iron overload in these patients. Histological grading and hepatic iron density are independent predictors of advanced fibrosis. Further studies are needed to clarify the role of viral and host genetic factors in hepatic iron deposition

Effect of exposure to electromagnetic field on some aspects of hepatic function in rats

Exposure to electromagnetic fields [EMF] may pose health risks and cell damage in various tissues, among the most susceptible tissues to EMF exposure being the liver. It was, thus, intriguing to investigate the possible effect of whole body exposure to EMF of mobile phones on some parameters reflecting the liver function. This study was performed on 111 albino rats of both sexes. Rats were divided into 2 main groups: 4 weeks exposure group [group I] and 8 weeks exposure group [group II]. Rats in each group were further subdivided into 4 subgroups, namely; rats not exposed to EMF of mobile phone [control groups, Ic and IIc], rats exposed to EMF of mobile phone for 1 hour/day [groups I[1] and II[1]], for 2 hours/day [groups I[2] and II[2]] and for 3 hours/day [groups I[3] and II[3]]. Exposure to EMF did not result in any significant change in plasma activities of both alanine aminotransferase [ALT] and aspartate aminotransferase [AST] in all exposed rats compared with their matched control. However, there was significant prolongation of both prothrombin time [PT] and activated partial thromboplastin time [PTT] accompained by significant elevation of hepatic malondialdehyde [MDA] content and reduction of nitric oxide [NO] content in hepatic tissue, the changes being more marked with increase in the duration of exposure. Microscopic examination of the liver tissue showed hepatocytic vacuolizations, irregular diameters of sinusoidal lumens, inflammatory cellular infiltrations and reduced glycogen content, the changes becoming intense with prolongation of the EMF exposure period. Exposure to EMF of mobile phones poses a risk factor for liver dysfunction, and, therefore, long term or excessive use of mobile phones better be avoided

Evaluation of the hepatoprotective effect of butanol extract of clytostoma binatum against thioacetamide-induced hepatic damage in rats

The plant phenolic compounds such as flavonoids have an important role in the treatment of many diseases and some of them have a potent hepatoprotective effect. This study was aimed to evaluate the anti oxidant and hepatoprotective activity of butanolic extract of Clytostoma binatum on thioacetamide induced hepatic damage in rats. Male Sprague -Dawley rats [200-250 gm] were divided into 5 groups. The first group was designated as a control group [group 1]. The second group [group2] was received Clytostoma binatum extract at a dose of 0.2 gm/kg body weight, given orally daily for one month. The third group [group3] was intraperitoneal injected with thioacetamide at a dose of 200 mg/kg body weight twice in week for one month to induce liver fibrosis. The fourth group [group 4]; was administrated orally with the butanol extract of Clytostoma binatum at a dose of 0.2 gm/kg body weight, given pre-treatment with thioacetamide for one month. The fifth group [group] received Clytostoma binatum extract [0.2 gm/kg body weight] post- treatment with thioacetamide for one month. The antioxidant activity was determined by measuring the levels of reduced glutathione, catalase, lipid peroxidation, total antioxidant capacity and nitric oxide. The degree of hepatoprotection was assessed by estimating levels of biochemical markers including AST and ALT activities as well as the activity of glucose-6-phosphatase and hydroxy proline content. The treatment with extract [Clytostoma binatum] exhibited improvement in liver enzymes and antioxidant enzymes [reduced glutathion and catalase] as well as glucose-6-phosphatase and reduce lipid peroxidation, nitric oxide, hydroxyproline and collagen. Data on the biochemical parameters and histopathological examination of rat liver sections revealed hepatoprotective potential of Clytostoma binatum pre- and post-treatment with thioacetamide which induced hepatic damage in rats. Our results suggested that butanolic extract of Clytostoma binatum possesses hepatoprotective activity against thioacetamide induced hepatic damage. The protective effect of this extract can be due to the presence of flavonoids and iridoids compounds and their antioxidant effect

Assessment of exposure of Egyptian infants to aflatoxin M1 through breast milk

Mothers are exposed to many toxins that can reach their infants through breast milk. One of these toxins is aflatoxins, produced by Aspergillus fungus. Aspergillus colonizes grains, especially in tropical regions where there is high temperature and humidity. Aflatoxins are highly toxic, mutagenic, teratogenic, and carcinogenic. One of these is aflatoxin B1 that is excreted in breast milk as aflatoxin M1 [AFM1]. This is a cross-sectional study in which 150 mother-infant dyads were included. All the infants were exclusively breastfed. Infant weights' standard deviation scores were documented at birth and at 6 months. At 6 months, before starting weaning, AFM1 was measured in breast milk by enzyme-linked immunosorbent assay and by liver enzymes; alanine aminotransferase [ALT] and aspartate aminotransferase [AST] for all mothers and infants. Ninety-eight mothers [65.3%] had AFM1-positive breast milk samples [AFM1 > 0.05 microg/ according to the European Community and Codex Alimentarius]. AFM1 levels ranged between 0.2 and 19.0micro g/l [mean: 7.1 +/- 5.0micro g/l]. In cases considered negative, AFM1 levels ranged between 0.01 and 0.05 microg/l [mean: 0.04 +/- 0.01 microg/1]. Infants of AFM1-positive mothers had lower weight standard deviation scores at birth and at 6 months [P=0.04 and 0.0001]. ALT and aspartate aminotransferase of mothers and ALT of infants were significantly higher in dyads having AFM1-positive breast milk [P=0.0001, 0.0001, and 0.03, respectively]. Aflatoxins represent a real threat in Egypt. The higher liver enzymes in AFM 1-positive cases might represent an alarm toward future development of hepatocellular carcinoma. Cooperation of ministries is recommended to combat this problem. The public should be educated about proper food storage and about the hazards of aflatoxin ingestion

Effect of splenectomy on liver regeneration and function following partial hepatectomy: experimental study

The presence of enough remaining functioning liver parenchyma to avoid life-threatening postoperative liver failure is a major prerequisite for hepatic resection in patients with hepato biliary carcinoma. There are clinical reports which confirm the beneficial clinical effects of splenectomy on integrity of the residual liver following liver resection for hepatocellular carcinoma in cirrhotic patients with hypersplenism and portal hypertension. This experimental study was designed on hamsters to evaluate the proliferative capacity and function of the remaining liver lobes; in which splenectomy was done simultaneously with partial hepatectomy compared with those in which splenectomy was not done. Forty hamsters were divided into two groups: GI; in which partial hepatectomy was performed without splenectomy and the GIl; in which animals were subjected to partial hepatectomy with prior splenectomy. Animals from each group were subjected to liver biopsy from the remaining lobes 48, 72 hours and one week after surgery. Also, serum alanine aminotransferase [ALT] and total bilirubin were tested before, 48, 72 hours and one week after hepatectomy. Hepatic regeneration in the remaining lobes was assessed through histo-pathological study, DNA ploidy of the hepatic nuclei using computerized image analysis system and determining of the labeling index of the nuclear factor NF Kappa B [P105], a novel monoclonal antibody specific for P105 protein by immunohistochemistry. In GIl: induction of NK kappa B [PI05] labeling index showed maximum expression depending on the regenerative capacity of the remaining liver lobes. In contrast, in GI; liver regeneration was slow. Also, changes in liver function of Gil indicated that splenectomy prior hepatecotomy may minimize dysfunction in the remaining hypertrophied liver lobes

Screening for metabolic liver diseases crucial to increase SVR to patients with CHC

Liver diseases and its complications is common health problem worldwide. The emergence of metabolic disorders as a cause after exclusion of viral hepatitis nowadays is important. This is retrospective study on 200 patient's age range from 6 months to 18 years old [50 females and 150 males]. The patients divided into 2 groups according to age < 5 years and >5 years and all investigations done was collected and statistically processed. Abdominal enlargement was observed in 166/200 of all patients, 48/166 [67.6%] in patients <5 years old and 118/166 [91.5%] in patients >5years old with statistical significant, jaundice was present in 34/200 of patients, 23/34 [32.4%] in patients <5 years old and 11/34 [8.5%] in patients >5 years old, with statistical significant difference, CBC was normal in 58/200 of all age groups. 10/58 [14.1%] in patients <5 years old, 48/58 [73.2%] in patients <5 years old, with statistical significant difference and abnormal CBC in 142/200 [61/142, 62.8%] in age group > 5 years old, 81/142 [85.9%] in age group <5 years. Metabolic disorders was normal in 124/200 of all age groups, 23/124 [32.4%] in patients <5 years old. Metabolic disorders was abnormal in 76/200 of all, 48/76 [67.6%] in patients >5 years old and 28/76 [21.7%] in patients < 5 years old, with statistical significant difference and for both age groups. The sensitivity of modalities used in the diagnosis of liver disease was as follow for US, study of metabolic profile, abnormal liver functions and abnormal CBC, 83.1%, 65.2%, 61.6% and 66.1% consequently

Study of natural killer and natural killer T cells in chronic hepatitis C infection

Natural killer [NK] and natural killer T [NKT] cells are components of the innate immune system, and participate in the inflammatory processes during hepatic diseases. Impaired activity of these cells is suggested to contribute to viral persistence and chronic infection in hepatitis C virus [HCV] infection. However, the exact mechanisms are not yet fully understood. To investigate the frequency of peripheral NK and NKT cells in patients with chronic HCV infection, as compared with healthy controls. Thirty patients with chronic hepatitis due to HCV infection were included. Patients with liver cirrhosis, HCV and hepatitis B virus co-infection, diabetes mellitus, or who received interferon therapy were excluded. In addition, 20 normal healthy individuals were included as controls. Assessment of the frequency of peripheral NK and NKT cells by flow cytometry was carried out for all individuals. Compared with controls, patients with HCV had significantly lower percentages of NK and NKT cells in peripheral blood. Among patients with HCV, NK and NKT cell percentages did not correlate significantly with serum transaminase levels. Defective innate immunity, as evidenced by reduced peripheral NK and NKT cell frequency, is observed in patients with chronic hepatitis C infection

Effects of ceftriaxone on reproductive and biochemical aspects of male rats

The present work was a trial to study the effect of ceftriaxone on the reproductive system in male Albino rats. Moreover, some biochemical parameters were also investigated. Fourty-five mature male albino rats weighing from 120 -160 g each of 4-5 month old were used in this study. The animals were divided into 3 equal groups, each of 15 rats. The first and second groups were injected I/M for 5 consecutive days with ceftriaxone at the dose level of 75 mg/kg B.wt. and 300 mg/kg B.wt. respectively. The third group was kept as control and injected I/M with 0.3 ml saline/ rat for 5 consecutive days. The obtained results showed that administration of ceftriaxone induced a variety of side effects. These are represented by reduction of testes, epididymis and accessory sex organ weight, changes in sperm characters [decrease of sperm count and motility] and increase of sperm abnormalities. Moreover, the liver functions were significantly affected. Therefore, caution is required when using large doses of ceftriaxone due to its toxicity to reproductive organs as well as its increasing effect on liver enzymes

Obstructive cholestasis and extra hepatic biliary tract surgery in dogs: clinical and pathological evaluation

The present study aimed to evaluate some surgical techniques as cholecystectomy, cholecystoduodenostomy and cholecystogastrostomy as well as liver functions via biochemical and pathological evaluation following experimental extra hepatic cholestasis. 12 apparently clinically healthy mongrel dogs were used. Extra hepatic cholestasis was induced surgically by obstruction of and common bile duct. Clinically, the animals showed several signs including partial anorexia which continued for 3 days and progressed to complete anorexia for another 2 days, then ali dogs was ate normally by the day 6[th] post operation. Visible jaundice, pale to slightly yellow mucous membrane of conjunctiva and gum, duliness, dehydration and sever emaciation was noticed. Cholecystectomy, Cholecystoduodenostomy and cholecystogastrostomy showed depression with anorexia in the first week and gradually increased until reaching its normal level. Intermittent diarrhea and vomiting were noticed at the first 3 days especially in cholecystogastrostomy. Macroscopically severe distention of gallbladders, cystic ducts and common bile ducts were clearly noticed in cholestatic dogs. Adhesions between liver surface and surrounding peritoneum were found. Serum levels of total and direct bilirubin in choestasis were significantly increased throughout the period of the experiment. GGT, AST, ALT and ALP levels showed marked increase beginning at the second day after complete billiary duct obstruction. Serum cholesterol and glucose levels showed a significant increase. Serum total protein, albumin and globulin levels showed a significant decrease followed by increase throughout the experiment. Biliary bypass proved as easy technique especially cholecystoduodenostomy.it is therefore suggested that; clinical signs, biochemical and pathological changes are useful diagnostic primary tools in mongri dogs affected with extra hepatic obstructive cholestatic lesions. The cholecystoduodenstomy proved as useful surgical procedure to bypass sites of obstruction affecting the extra hepatic billiary tree than cholecystectomy and cholecystodgastrotomy

Evaluation of clinical and laboratory variables as diagnostic indicators of phenylbutazone toxicity in Egyptian draft horses

To the best of the author's knowledge, this is the first report describing the diagnostic significance of clinical as well as various biochemical variables to predict the clinical outcome of phenylbutazone [PBZ] toxicity in Egyptian draft horses. Horses with PBZ toxicity were tentatively diagnosed based on component case history and physical examination findings as well and post-mortem findings in non-survived cases. According to the clinical outcome, diseased horses were categorized into survivors [n=21] and non-survivors [n=17]. Clinically, there was a significant association between non-survivors and anorexia [p<0.01], stasis of intestinal motility [p<0.01], melena / [p<0.01], and diarrhea [p<0.001]. Biochemically, malondialdehyde [MDA/ ], nitric oxide [NO], aspartate amino transferase [AST], gamma glutamyl transferase [GGT], sorbitol dehydrogenase [SD], total bilirubin, urea and creatinine showed a significant increase [p<0.05] in non-survivors compared to survivors; meanwhile, superoxide dismutase activities [SOD], total plasma protein and albumin levels were significantly decreased [p<0.05]. To predict the clinical outcome of PBZ toxicity in examined horses, receiver operating characteristic curve [ROC] was applied for all tested biochemical variables. Analysis of ROC curve showed high sensitivity and specificity of total leucocytic count [TLC], neutrophils, band cell as well as blood urea, creatinine, total plasma protein, AST, MDA, NO, SOD and vitamin C [Vit. C] levels. It could be concluded that clinical and biochemical investigations could provide valuable diagnostic information about the adverse effects of PBZ in draft horses. Our findings also suggest that estimation of these biochemical variables might help predict the outcomes of PBZ toxicity in Egyptian draft horses

Factors affecting the occurrence of hydrothorax in Egyptian patients with decompensated liver disease

It is well known that in cirrhotic patients, a large volume of ascetic fluid is generally well tolerated due to the capacitance of the peritoneal cavity. On the other hand, even modest volumes of pleural fluid can cause significant respiratory symptoms, including dyspnea and chest pain. Therefore, although infrequent, hepatic hydrothorax may represent a major clinical problem in the management of patients with portal hypertension. This work search for factors affecting the occurrence of hepatic hydrothorax in Egyptian patients with decompensated liver disease A total of 40 patients selected from Al Azhar University Hospitals with decompensated liver disease and ascites were included in this study divided into two groups 20 patients have ascites without pleural effusion were selected to be included in the study as a group [I], another a 20 patients have ascites with pleural effusion were selected also, to be included in the study as a group [II].All patients were subjected to the following:-Careful history taking, Careful clinical examination, laboratory investigations, including, complete urine and stool analysis, complete blood picture and, Liver function tests, Renal function tests, ascitic fluid and pleural fluid analysis for, physical, chemical, Cytological examinations. Abdominal Ultrasonography, Chest X ray, Results showed that the mean of BMI and ascitic fluid LDH are higher in patients with pleural effusion than in patients without pleural effusion. In contrast, the mean of alkaline phosphatase, ascitic fluid glucose and ascitic fluid RBCs are lower in patients with pleural effusion than in patients without pleural effusion but these findings are not enough to explain the occurrence of hepatic hydrothorax in those patients and these factors still obscure so more studies are needed to detect these factors

Study of natural killer and natural killer T cells in chronic hepatitis C infection

Natural killer [NK] and natural killer T [NKT] cells are components of the innate immune system, and participate in the inflammatory processes during hepatic diseases. Impaired activity of these cells is suggested to contribute to viral persistence and chronic infection in hepatitis C virus [HCV] infection. However, the exact mechanisms are not yet fully understood. To investigate the frequency of peripheral NK and NKT cells in patients with chronic HCV infection, as compared to healthy controls. 30 patients with chronic hepatitis due to HCV infection were included. Patients with liver cirrhosis, HCV and HBV co-infection, diabetes mellitus, or who received interferon therapy were excluded. In addition, 20 normal healthy subjects were included as controls. Assessment of the frequency of peripheral NK and NKT cells by flow cytometry was carried out for all subjects. Compared to controls, HCV patients had significantly lower percentages of NK and NKT cells in peripheral blood. Among HCV patients, NK and NKT cell percentages did not correlate significantly with serum transaminase levels. Defective innate immunity, as evidenced by reduced peripheral NK and NKT cell frequency, is observed in patients with chronic hepatitis C infection

Diagnostic role of resistin in nonalchoholic fatty liver disease

Nonalcoholic fatty liver disease [NAFLD] is a major cause of liver-related morbidity and mortality. Insulin resistance is believed to be a key factor in the development of fatty liver. Moreover, insulin resistance states characterized by elevated expression and production of several cytokines have been implicated in the pathogenesis and progression of NAFLD but direct evidence of the role of resistin in NAFLD is lacking. To determine the circulating resistin level in patients affected by NAFLD and to correlate resistin level with insulin sensitivity, liver functions and histological features. This study included 100 subjects divided into: forty patients with NAFLD, forty obese persons with BMI >30 having normal transaminases and normal liver ultrasound and twenty controls with BMI < 20. For all subjects serum resistin was measured. Homeostasis model assessment [HOMA] was calculated and liver profile was assessed. Liver biopsy was done in NAFLD patients. Serum resistin was higher in patients with NAFLD [16.2 +/- 4 ng/ml] compared to obese and control groups [6.8 +/- 4.1 and 3.4 +/- 1.1 [ng/ml]] respectively [p <0.01]. Serum resistin was higher in histologically advanced cases of NAFLD compared to simple steatosis [19.2 +/- 3.6 vs. 13.5 +/- 2.7] respectively [p < 0.01]. Moreover serum resistin correlated positively with 8M I, HOMA, highly sensitive CRP, AST and ALT. Resistin has a role in pathogenesis of NAFLD. Its level is a predictive of histology in NAFLD. So The use or serum resistin assay as a simple diagnostic biomarker for NAFLD is recommended

Acute hydrogen cyanamide [Dormex] toxicity: an outbreak in El-Minia governorate; a prospective study

The aim of this study is to assess the acute toxic effects of Hydrogen Cyanamide, the active ingredient in Donnex which is a plant growth regulator, in human and to estimate the magnitude of hydrogen cyanamide-related illnesses in our locality [El-Minia govemorate- Upper Egypt]. Symptomatic cases involving acute Dormex exposure during the outbreak period [From January 2009 to March 2009] that were presented to the Poison Control Centre [PCC], El-Minia University Hospital and El-Minia general hospitals were included in this study. In each patient, a detailed history regarding age, sex, residence, route and mode of exposure, symptoms, signs and complications were taken at the time of presentation. A thorough clinical examination was then carried out. Laboratory investigations were done for random blood sugar [R.B.S], serum sodium and potassium levels, liver enzymes aspartate aminotransferase, and alanine aminotransferase [AST and ALT respectively], blood urea nitrogen [BUN], and serum creatinine. Chest X ray was also done for every case of this work. The study was conducted on 43 patients of both sexes with acute Donnex toxicity in addition to 10 healthy individuals of both sexes, representing the basic profile for the studied laboratory parameters. The majority of cases were below 20 years. Gender distribution revealed that a male to female ratio was about 2.6: 1. Patients from rural areas represent [83.7%] while [16.3%] were from urban areas. Exposures were either occupational [67.0%] or as a result of unintentional ingestion [30.2%]; and only one case were related to suicide attempt. All cases occurred from early January through March of the year 2009, which is the period when Dormex [CH2N2] was being applied to the grape trees in our district. The routes of exposure to Dormex CH2N2 were skin contact [60.5%], oral ingestion [32.6%], and inhalation [6.9%]. Most of the cases involved workplace exposure [67.5%]. Dermatological manifestations were evident in the vast majority of cases [67.4%], while ocular manifestations were noted in [39.5%] of the patients. [67.4%] of patients had systemic signs and/or symptoms, including GIT manifestations, CNS manifestations, pulmonary manifestations, and cardiovascular manifestations. Five deaths from the 43 cases were identified. Statistically significant hyperglycemia and elevation in hepatic enzymes profile were noted on admission in all patient groups in comparison to control group, while there were no statistically significant changes observed in serum electrolytes and renal function tests in all patients at time of admission in comparison with control subjects. Based on the current study, acute exposure to Dormex, either dermally in the workplace or by ingestion in those using this product, pose a major threat to human health in the form of hepatic dysfunction, prolonged coma, and severe respiratory and gastrointestinal affections. The study recommended that all efforts should be directed towards studying the possible acute and chronic toxic effects of Dormex on human health in more expanded, large scale clinical and experimental studies

Biochemical and cellular changes due to trihexphenidyl [parkinol] dependence in albino rats

Trihexphenidyl [Parkinol] is one of anticholinergics which is an important member of hallucinogens. It may be abused for its euphoriant and hallucinogenic effects, and it may be combined with street drugs for enhanced effect. To investigate the effect of trihexphenidyl [parkinol] dependence on biochemical parameter [liver functions tests] and histopathological examination of the liver and brain of albino rat. Twenty adult male albino rats of an average weight [150-200 grams] were divided into two equal groups as follow: Group I: [Control group]: Formed of 10 rats. Group II: [Dependent group]: Consisted of 10 rats that was given trihexphenidyl orally in gradually increasing doses until they reached the dependent dose in one month. Blood samples were collected. Biochemical parameter [liver functions tests] was done on the sera of the rats. Liver and brain tissues were taken for histological examination. Biochemical study, it was found that serum liver function tests, ALT and AST showed highly significant increased, P was <0.001, while serum albumin was significantly decreased P was<0.05 in dependent group than in control group. Histopathological examination of the liver, it showed small foci of hepatic cell necrosis with moderate periportal mononuclear cell infiltration, with subcapsular fatty degeneration and chronic venous congestion. On the other hand the brain of trihexphenidyl dependent group showed congestion, edema and degenerative changes in some neurons. From the present results, it can be concluded that trihexphenidyl [parkinol] abuse can lead to hepatotoxicity, as it affects liver function tests and the histological picture of the liver. Also trihexphenidyl abuse causes histopathological changes in the brain. So health educational programs should be held to pay attention about trihexphenidyl dependence and its deleterious effects on health and the relation between trihexphenidyl and other types of drug dependence. Neurologists and psychiatrists should be aware about the potential trihexphenidyl [parkinol] toxicity over the long term medical use by the patients, and its capability of being addicted. Also media and press should explain the deleterious effects of trihexphenidyl use for prolonged time

Biochemical markers in blood can predict the cirrhotic evolution of chronic hepatitis

Approximately one-fifth of chronically infected patients develop significant chronic liver inflammation that progressively can lead to cirrhosis and HCC. The course and outcome of chronic liver disease may be difficult to predict. There is an urgent need to develop and validate noninvasive tests that can accurately reflect the full spectrum of hepatic inflammation and fibrosis. Serum fibronectin can differentiate HCV infected patients with liver fibrosis from patients with non fibrosis. Serum pseudocholinesterase activity might be a more specific indicator of liver dysfunction than the traditional liver function tests while prothrombin time is a measurement of synthetic liver function. To study the ability of three serum biochemical markers when combined in specific equation can differentiate between chronic active hepatitis and cirrhotic patients. Patients were 29 with chronic active hepatitis [CAR] and 28 with liver cirrhosis. These were compared with 10 healthy controls. Liver function tests were done to all subjects. Three biochemical parameters were also measured and combined in a certain equation. Fibronectin was measured using ELISA, pseudocholinesterase using colorimetric method while prothrombin activity was done using calcium thromboplastin. It was found that the equation significantly discriminated between fibrosis and cirrhosis at cut off value of 243.28, with sensitivity 100% and specificity 60% and area under the curve 80%, p=0.000. The three biochemical inexpensive parameters when combined can contribute to the differentiation between liver cirrhosis and chronic hepatitis