Serum alkaline phosphatase isoenzymes as a marker for liver disease

The activity of total alkaline phosphatase [total ALP] and its isoenzymes were examined in 10 healthy control subjects, 7 patients with chronic hepatitis, 11 patients with bilharzial hepatic fibrosis [BHF], 6 patients with obstructive jaundice, 7patients with primary liver cancer and 9 patients with liver metastasis by the methods of heat inactivation and cellulose acetate electrophoresis. Results showed a significantly higher mean values of total ALP and liver ALP in all patients in comparison to the control subjects, in obstructive jaundice in comparison to patients with chronic hepatitis BHF and in liver malignancy. Biliary ALP was not detected in healthy control subjects nor in patients with chronic hepatitis while it was present in 9% of patients with BHF, in 100% of patients with obstructive jaundice, in 57% of patients with hepatoma and in 89% of patients with liver metastasis. Intestinal ALP was not detected in patients with primary hepatic carcinoma while it was present in 20% of healthy control subjects, in 28% of patients with chronic hepatitis, in 36% of patients with BHF, in 50% of patients with obstructive jaundice and in 11.1% of patients with liver metastasis. In cases of obstructive jaundice and liver malignancy, there was a positive correlation between total ALP and both biliary ALP and GGT also between biliary ALP and GGT. These results demonstrated that ALP isoenzyme analysis are highly helpful in the characterization of hepatic disorders, and the biliary ALP isoenzyme is a good marker for the detection of liver malignancy and obstructive jaundice as well as it correlates significantly and positively with GGT in these patients

Potentiation of action of sodium nitroprusside by adding alpha-2 adrenergic agonists clonidine in induced hypotension

This study was conducted on 30 patients of ASA class I or II, they were divided into two groups. The first group consisted of 15 patients receiving sodium nitroprusside alone as hypotensive drug during general anesthesia, the second group consisted of 15 patients receiving a mixture of sodium nitroprusside and clonidine as hypotensive drug during general anesthesia. Clinical and laboratory results showed that clonidine nitroprusside mixture [CNP] is as effective as sodium nitroprusside [SNP] for induction of hypotension during general anesthesia. In addition, the mixture of clonidine- sodium nitroprusside has the advantage of decreasing the dose requirement of SNP with more hemodynamic stability during and after infusion together with reduced potential of cyanide toxicity