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

role of prostaglanidin E2 [PGE2] in refractory ascites in patients with hepatic cirrhosis

To determine the effect of the prostaglandin E2 in the pathogenesis of refractory ascites in liver cirrhosis. The study is consisted of three groups. Group I: consisted of twenty patients having liver cirrhosis with refractory ascites. Group II: comprised ten patients having liver cirrhosis with ascites. Group III: included ten normal subjects as controls. All the groups were subjected to thorough history taking and physical examination, routine blood examination, liver function tests, renal function tests including serum urea. creatinine, creatinine clearance, serum sodium and potassium, 24hs urinary sodium and potassium, 24hs urinary volume, estimation of PGE2 in the urine using ELISA technique. liver function tests showed a significant affection in group I, II particularly serum albumin, AIG ratio and prothrombin activity. Renal functions showed deterioration in glomerular filtration rate as shown by creatinine clearance values in group I, II, III. Other parameters, save 24hs urinary potassium levels were found to be statistically significant affected on comparing the three groups. Urinary PGE2 levels showed a statistically significant difference on comparing the three groups. renal prostaglandins play an important role in the preservation of renal function in all situations with known elevation of vasconstriction mediators, as occurs in decompensated liver disease

Antithrombin III in relation to other coagulation disorders in cases of diabetic ketoacidosis before and after treatment

This work was done on 20 patients with diabetic ketoacidosis. Coagulation studies were done to every patient before and after treatment including prothrombin time, partial thromboplastin time, antithrombin III, fibrin degradation products. It was found that the partial thromboplastin increased significantly after control of the ketotic state, the antithrombin III decreased significantly after treatment, no change was found in prothrombin time and platelet count