AN OBSERVATIONAL STUDY OF DENGUE INDUCED HEPATIC DYSFUNCTION INA TERTIARY CARE HOSPITAL OF GKGH BHUJ

INTRODUCTION: Dengue infection is a major health problem worldwide including our country.Globally the incidence of Dengue has grown dramatically in the recent years. Every year during themonsoon months and later, many parts of the country witness outbreak of dengue infection. 2020was no exception and we experienced an outbreak of this vector borne disease in Bhuj. An analysisof these patients revealed that in addition to the classical features of fever, body ache, rash andthrombocytopenia and bleeding tendency, there were other features such as liver dysfunctionincluding a preferential rise of SGOT, hepatomegaly, splenomegaly, ascites, gallbladder wall edemaand pericholecystic fluid collection.OBJECTIVE: To study clinical, biochemical and radiological changes in the liver of patients withDengue fever.METHOD:observational and cross-sectional study was conducted on a 50 suspected cases of Dengue feveradmitted and diagnosed at GKGH hospital Bhuj in October 2020. Detailed history, clinicalexamination, biochemical parameters, radiological investigation for liver function was done in allpatients. All patients were treated as per NVBDCP guidelines.RESULTS: all patients in our study had hepatic dysfunction in the form of elevated SGOT abovenormal limits.CONCLUSIONS: Our study shows that there are certain features of Dengue that are not known tobe usually associated with it. The presence of raised liver enzymes in all patients (SGOT > SGPT),ascites, hepatomegaly, splenomegaly, and gallbladder edema and pericholecystic fluid collection.

Perfil metabólico de vacas Holandês e mestiças Holandês x Jersey no periparto / Metabolic profile of Holstein and crossbred Holstein x Jersey cows in the peripartum

O objetivo do presente trabalho foi determinar e comparar o perfil metabólico de vacas Holandês (H) e mestiças Holandês x Jersey (HxJ) no periparto. Avaliaram-se 24 vacas, sendo 11 vacas Holandês e 13 mestiças Holandês x Jersey. Semanalmente, coletou-se sangue para a determinação das concentrações séricas de glicose, beta-hidroxibutirato (BHB), proteína total, albumina, aspartato aminotransferase (AST), creatinoquinase (CK), cálcio total, cálcio iônico, magnésio, fósforo inorgânico e colesterol. Avaliou-se também o peso vivo e o escore de condição corporal (ECC). Os dados foram submetidos à análise de variância com medidas repetidas no tempo. As vacas Holandês apresentaram maior peso vivo. Não houve diferença entre os grupamentos genéticos para ECC. Foi observada tendência de maiores concentrações séricas de BHB, AST e maior concentração de cálcio iônico em vacas mestiças Holandês x Jersey. Vacas mestiças Holandês x Jersey e Holandês apresentaram perfil energético similar durante o período de transição pré e pós-parto na maioria dos indicadores, com exceção do cálcio, que foi maior nas vacas mestiças, e do fósforo, que foi superior nas vacas Holandês.(AU)

The aim of this study was to determine and compare the metabolic profile of Holstein (H) and crossbred Holstein x Jersey (HxJ) on peripartum. For this, 24 cows were evaluated, 11 Holstein and 13 crossbreeds Holstein x Jersey. Weekly, venous blood sample were collected to determine concentration of glucose, beta-hydroxybutyrate (BHBA), total protein, albumin, aspartate aminotransferase (AST), creatine kinase (CK), total calcium, ionic calcium, magnesium, inorganic phosphorus and cholesterol. Body weight (BW) and body condition score (BCS) were also evaluated. The data were submitted to analysis of variance with repeated measures in time. Holstein cows presented higher BW, however, there was no difference for BCS in compare to crossbreed Holstein x Jersey cows. Tendency for higher serum concentrations of BHBA, AST and higher concentration of ionic calcium was observed in crossbreed cows in comparison to the Holstein. The energetic profile during the pre and postpartum transition period is similar for both genetic groups with higher concentrations of BHBA on the first week of lactation, however, with a tendency of higher serum concentrations of BHBA for crossbreed cows. Higher concentrations of ionic calcium were observed in crossbreed cows and higher concentrations of phosphorus in Holstein cows on peripartum. Holstein and Holtein x Jersey crossbreed cows have a similar energy profile during the pre and postpartum transition period in most of the indicators, except for calcium that was higher in crossbred cows and higher phosphorus in Holstein cows.(AU)

Alterations of liver enzymes in T2DM: a case control study

Background: Liver plays an important role in regulation of blood glucose in fed state as well as in fasting. Diabetes mellitus can result as a consequence of liver disorder and vice versa. Objective of the present study is to compare the liver enzymes in type 2 diabetic patients as compared to non-diabetic patients.Methods: A case- control study was conducted in Clinical Biochemistry Laboratory, Adarsha Super speciality Hospital, Udupi from April 2018 to August 2018. The data of 174 diabetic patients and 118 healthy people as controls was collected. Fasting blood glucose, aspartate aminotransferase (AST), alanine amino transferase (ALT) and alkaline phosphatase (ALP) were estimated in the study subjects.Results: It was found that AST levels (47.55±4.69U/L) in diabetics extremely significantly high as compared to controls (33.51±2.33U/L). ALT levels were insignificantly high in diabetics compared to controls. ALP was significantly elevated (p=0.0002) in diabetics. Correlation study showed a weak positive correlation between AST, ALT and blood glucose. Odds ratio showed a higher risk of liver enzyme elevation in diabetics. Risk of elevation of AST was found to be 1.65 times high and ALT was 1.25 times high in diabetics compared to non-diabetics.Conclusions: Diabetics had high liver enzymes as compared to non-diabetics. An association was found between type 2 diabetes mellitus and liver enzymes. For better characterization of cause and effect, further studies need to be done on alterations in liver function tests along with the histopathological analysis of liver biopsy samples.

Effects of Arctium lappa aqueous extract on lipid profile and hepatic enzyme levels of sucrose-induced metabolic syndrome in female rats

ABSTRACT Arctium lappa is known to have antioxidant and antidiabetic effects in traditional medicine. Objectives: The aim of this paper was to study the effects of A. lappa root extract (AE) on lipid profile and hepatic enzyme levels in sucrose-induced metabolic syndrome (MS) in female rats. The study used 40 adult female Wistar rats weighing 150 g-250 g randomly divided into five groups: control, metabolic syndrome (MS), metabolic syndrome+AE at 50,100, 200 mg/kg. MS was induced by administering 50% sucrose in drinking water for 6 weeks. AE was intra-peritoneally administered daily at doses of 50,100, and 200 mg/kg for two sequential weeks at the end of the fourth week in metabolic syndrome rats. Twenty-four hours after the last administration of AE, blood was collected and centrifuged, and then the serum was used for the measurement of lipid profile and hepatic enzyme. Serum glucose, insulin, fasting insulin resistance index, body weight, water intake, lipid profile, and hepatic enzymes were significantly increased although food intake was decreased in MS rats compared to the control rats. The lipids and liver enzymes were reduced by AE extracts in the MS group. This study showed that the A. lappa root aqueous extract exhibits a hypolipidemic activity of hyperlipidemic rats. This activity is practically that of a triple-impact antioxidant, hypolipidemic, and hepatoprotective.

Avaliação hepática em ratos Wistar expostos ao chá de Ayahuasca / Hepatic evaluation in Wistar rats exposed to Ayahuasca tea

O chá de Ayahuasca é empregado no xamanismo, na terapia antidrogas e indevidamente em recreações alucinógenas. O estudo teve como objetivo avaliar o fígado, tanto histológica como bioquimicamente, por se tratar do órgão responsável pela metabolização desse chá. Foram utilizados ratos Wistar (n=24), machos, adultos, divididos em dois grupos (controle e tratado). Foi administrada uma dose diária quatro vezes superior à utilizada no contexto religioso, por quatro dias consecutivos. Não houve alteração morfológica pela análise qualitativa, porém, na análise quantitativa do grupo tratado ocorreu redução do volume do hepatócito e de seu núcleo. Na análise bioquímica observou-se uma redução da Gama-Glutamil-Transferase e da Fosfatase Alcalina. De acordo com a dose e o tempo de exposição não foram encontradas alterações morfológicas nesse estudo. O estudo morfométrico mostrou alterações significativas no volume do hepatócito e de seu núcleo, onde ocorreu diminuição do volume do grupo tratado em relação ao grupo controle. Observou-se uma redução estatisticamente significativa nos parâmetros da Gama-Glutamil-Transferase e Fosfatase Alcalina. Nesse experimento foi observada uma redução do volume dos hepatócitos, sem ocorrer, entretanto, alterações na função e na estrutura hepática.

Ayahuasca tea is employed in Xamanism, in anti-drug therapy and illicitly in hallucinogenic recreations. Current study assesses the liver histologically and biochemically since it is an organ involved in the metabolism of the tea. Twenty-four male adult Wistar rats were divided into two groups (control and treated). A daily dose four times higher than that used within a religious context was given, during four consecutive days. There was no qualitative morphological change but a reduction of hepatocyte volume and its nucleus occurred when the quantitative analysis of the treated group was performed. Biochemical analysis showed a decrease in gamma-glutamyltransferasis and Alkaline Phosphatase. There were no morphological alterations for dose and exposure time in current study. Morphometric analysis showed significant alterations in hepatocyte volume and its nucleus where a decrease in volume of the treated group occurred when compared to that of control. A significant statistical decrease was detected in the gamma-glutamyl-transferasis and alkaline phosphatase parameters. Current analysis also detected a decrease in hepatocyte volume without alterations in hepatic functions and structure.

Evaluación del potencial hepatoprotector de la Mentha piperita L previo a la inducción de hepatotoxicidad con acetaminofen / Evaluation of hepatoprotective potential of Mentha piperita L before induction of hepatotoxicity with acetaminophen

A preclinical pharmacological study was conducted to evaluate the hepatoprotective effect of Mentha piperita L. against paracetamol induced toxicity. Adult male NMRI mice who were administered orally soft plant extracts in doses of 200mg/kg and 400mg/kg, three consecutive days prior to the induction of hepatotoxicity were used. Clinical signs of toxicity, hepatic biochemical parameters and morphological analysis of the liver was evaluated. The biochemical parameters analyzed showed significant differences, but none of the two groups showed a similar untreated control group behavior. No macroscopic changes in the liver were confirmed. Microscopically, the study groups with Mentha piperita L. showed mild to moderate damage with significant differences from the untreated control group. The evaluation of hepatoprotective potential on the M. piperita L. extract at doses studied did not behave as hepatoprotective agent...

Se realizó un estudio farmacológico preclínico para evaluar el efecto hepatoprotector de Mentha piperita L. frente a la toxicidad inducida por el paracetamol. Se emplearon ratones adultos machos NMRI a los que se administró por vía oral extractos blandos de la planta a dosis de 200 mg/kg y 400 mg/kg, tres días consecutivos previos a la inducción de la hepatotoxicidad. Se evaluaron los signos clínicos de toxicidad, parámetros bioquímicos hepáticos y el análisis morfológico del hígado. Los parámetros bioquímicos analizados mostraron diferencias altamente significativas, pero ninguno de los dos grupos presentaron un comportamiento similar al grupo control no tratado. No se confirmaron alteraciones macroscópicas del hígado. A nivel Microscópico, los grupos en estudio con Mentha piperita L. presentaron daños de leves a moderados con diferencias significativas respecto al grupo control no tratado. Se puede afirmar que según la evaluación del potencial hepatoprotector del extracto de M. piperita L. a las dosis estudiadas no se comportó como agente hepatoprotector...

Correlation between serum ferritin level and liver function tests in thalassemic patients receiving multiple blood transfusions.

Background: Multiple blood transfusions are the mainstay of thalassemic patients in order to combat the severe anemia. These frequent blood transfusions result in the excessive iron deposition, leading to multiple injuries to a variety of organs in the body. In response to these injuries, the levels of various enzymes are disturbed. The whole phenomena usually involve the interrelation of one parameter with some other. The present study aimed to estimate the levels of serum ferritin and hepatic enzymes and to find out any possible correlation between them in thalassemic patients receiving multiple blood transfusions. Methods: A total number of 90 thalassemic patients of both sexes ranging from 10-15 years, receiving multiple blood transfusions were included in the present study. Blood samples from all the patients were withdrawn and analyzed for the values of serum ferritin, hemoglobin and hepatic enzymes (serum alanine transaminase, serum aspartate transaminase, serum alkaline phosphatase). Pearson correlation coefficient was applied to observe correlation between serum ferritin level and hepatic enzymes. A P value of ≤0.05 was considered statistically significant. Results: The overall values of serum ferritin, and hepatic enzymes (serum Alanine Transaminase, serum Aspartate Transaminase, serum Alkaline Phosphatase) were remarkably increased than their normal values. However, hemoglobin level was considerably decreased in thalassemic patients. A weak positive insignificant correlation was observed between serum ferritin with hepatic enzymes and hemoglobin in thalassemic patients. Conclusion: Multiple blood transfusions cause iron overload in the body, which in turn, lead to increased serum ferritin levels in thalassemic patients. High levels of hepatic enzymes are somewhat correlated to serum ferritin concentration. However, the exact reason of elevated levels is still unclear. Further detailed studies should be conducted in order to identify the exact mechanism behind this and to search for the promising correlations of various parameters in thalassemic patients receiving multiple blood transfusions.

Evaluation and comparison of automated analysers on hepatic enzymes.

Background: Clinical Biochemistry tests comprise over one third of all hospital laboratory investigation. The laboratory accreditation requirement has become an important aspect in selecting the analysers for analysing and evaluating the samples. Recently accrediting bodies are focusing on the importance of total quality management and assessment of trueness of laboratory measurements. The present study aimed to evaluate the hepatic enzymes using a single analytical methodology in 2 different automated analysers (semi autoanalyser and fully automated analyser) to understand the reliability of instrumentation on analytical methodology that would fit the laboratory performance standard. Methods: A total number of 50 serum samples from adult patients requested for liver function tests at Shri Sathya Sai medical college and research institute were analysed. The samples were evaluated for hepatic enzymes on (Cobasmira) Autoanalyser and (Biosystems) Semi Autoanalyser using the same analytical methodology and the values were compared between the 2 automated analysers. Data analysis was done by appropriate statistical methods. Results: No large differences were obtained in the values between the 2 automated analysers. Mean ± SD of each of the hepatic enzyme analysed by automated analysers were very close to each other indicating a minimum bias. Pearson’s correlation and scattered diagram showed significant positive correlation at 95% confidence interval between 2 automated analysers. Conclusion: The findings of this study confirm that both the automated analysers were reliable for evaluation of hepatic enzymes.

Efeito da pimenta rosa associada a diversas dosagens de antibióticos em frangos de corte / Effect of Brazilian red pepper meal associated with different levels of antibiotics on broilers chickens

Este trabalho objetivou avaliar o efeito da adição de níveis crescentes de antibióticos associado ao farelo de pimenta rosa (FPR) sobre a função hepática e desempenho de frangos de corte. Utilizou-se 528 pintos, machos, da linhagem Cobb de um dia de idade distribuídos num delineamento inteiramente casualizado com seis tratamentos, quatro repetições com 22 aves cada: T1: Controle Negativo (CN): Dieta Basal; T2: Controle Positivo (CP): Dieta Basal com 1,2% FPR; T3: CP+11ppm bacitracina Zn e 17ppm salinomicina; T4: CP+22ppm bacitracina Zn e 34ppm salinomicina; T5: CP+33ppm bacitracina Zn e 51ppm salinomicina; T6: CP + 45ppm bacitracina Zn e 67ppm salinomicina. Por conter taninos, o uso de pimenta rosa na alimentação animal requer avaliação da função hepática, sendo a dosagem das enzimas ALT (alanina aminotransferase), AST (aspartato aminotransferase) e GGT (gama glutamiltransferase) ferramenta auxiliar no diagnóstico de lesões hepáticas. Portanto, aos 21 e 41 dias de idade, 10 animais por tratamento foram escolhidos aleatoriamente e coletadas amostras de sangue. Aos 21 dias de idade, verificou-se efeito significativo (P<0,05) dos tratamentos sobre os valores da AST e ALT, sendo que as aves alimentadas com FPR associado com maiores doses de antibióticos tiveram valores elevados de AST e reduzidos de ALT, comparada aos demais tratamentos. Entretanto, as concentrações séricas das enzimas AST, ALT e GGT nos frangos alimentados com 1,2% de FPR não diferiram (P>0,05) do CN aos 21 e 41 dias de idade. Não houve efeito (P>0,05) dos tratamentos sobre o peso das aves e do peso relativo do fígado aos 43 dias. A adição do farelo de pimenta rosa com ou sem promotor de produção melhorou a conversão alimentar aos 43 dias de idade. Concluiu-se que a adição de 1,2% FPR não comprometeu a função hepática e que a inclusão de doses mais altas de antibióticos, associado ao FPR na dieta, resultou em alteração das enzimas hepáticas.

The aim of this research was to evaluate the effects of the increase levels of antibiotics associated with the Brazilian red pepper meal (BRPM) on liver function and performance of broilers. A total of 528 day-old male chicks, Cobb, distributed in a randomized design of six treatments and four replicates of 22 birds each: T1: Negative Control (NC): basal diet; T2: Positive Control (PC): basal diet with 1,2% BRPM; T3: PC+11ppm zinc bacitracin and 17ppm salinomycin, T4: PC + 22ppm zinc bacitracin and 34ppm salinomycin; T5: PC+33ppm zinc bacitracin and 51ppm salinomycin; T6: PC+45ppm zinc bacitracin and 67ppm salinomycin. BRPM contains tannins thus its use in animal feed needs to evaluate by liver function and animal performance. The dosage of the enzymes ALT (alanine aminotransferase), AST (aspartate aminotransferase) and GGT (gamma glutamyltransferase) is a tool in the diagnosis of liver damage. For this, were randomly collected blood samples from 10 animals per treatment between 21 and 41 days age. At 21 days of age it was observed elevated values of AST and decreased of ALT in broilers fed diet BRPM associated with higher levels of antibiotics compared to the others (P<0.05). However, it was observed that the serum concentrations of AST, ALT and GGT in broiler chickens fed diet with 1.2% of BRPM did not differ from NC at 21 and 41 days (P>0.05). There was no effect (P>0.05) of treatments on broilers weight and relative liver weight at 43 days of age. The supplementation of Brazilian red pepper with or without antibiotics improved feed conversion at 43 days of age. It was concluded that the inclusion of 1.2% BRPM did not affect liver function but the addition of high levels of antibiotics associated with the BRPM resulted in alteration of hepatic enzymes.

Evaluation of Serum Levels of Hepatic Enzymes and Plasma Proteins between Different Types of Acute Viral Hepatitis.

This cross-sectional study was carried out in 80 serologically diagnosed cases of acute viral hepatitis to assess and compare the serum hepatic enzymes & plasma proteins between four different types (A,B,C,E), 20 in each group. Hepatitis E, hepatitis B and hepatitis C were more prevalent in males than that in females. The study showed that geometric mean of S.AST of all the four types differed significantly (F= 274.94, p<0.001). Geometric mean of S.ALT, S.AST and S.ALP in cases of HCV were significantly lower than others (p<0.001). Geometric mean of S.ALT & S.AST in cases of HEV were significantly increased than others (p<0.001). But the geometric mean of S.ALP of HBV was significantly higher than others (p<0.001). On the other hand though S.ALP of HAV and HEV was lower than HBV but significantly higher than HCV (p<0.001). The mean±SD of serum albumin of HCV was decreased significantly in contrast to those of HAV and HBV (p<0.001). A:G ratio of HCV was also significantly lower than other three (p<0.001). It was revealed through the study that hepatic enzymes were most affected in cases of HEV but least affected in cases of HCV.

Alteraciones bioquímicas en individuos expuestos al arsénico en el agua de bebida en Tucumán, Argentina / Biochemical alterations in individuals consuming high levels of arsenic in drinking water in Tucuman, Argentina

El objetivo de esta investigación fue evaluar los niveles del ácido siálico (S) y enzimas hepáticas en individuos que consumieron agua con arsénico (As) relacionándolos con la presencia ("I con H") o no de hepatomegalia ("I sin H"). Se incluyeron 200 individuos, 85 correspondieron al Grupo Control (GC), 32 "I con H" y 83 "I sin H" quienes habían consumido agua con niveles mayores a 0,01 mg/L. Se les tomó una muestra de sangre venosa y se les realizó el dosaje del S y de las enzimas alaninaninotransferasa (ALT), aspartatoaminotransferasa (AST), fosfatasa alcalina (FAL), gamma glutamil transferasa (GGT), bilirrubina directa (BD) y total (BT), lactato deshidrogenasa (LDH) y 5' nucleotidasa (5'Nu). En los individuos que consumieron agua contaminada se encontró un aumento de los niveles del S. En el grupo "I con H", la FAL, la GGT y la LDH se encontraron aumentadas. En el grupo "I sin H", la GGT y la LDH tuvieron niveles elevados. En los individuos expuestos al As, no se encontraron alteraciones en los otros parámetros bioquímicos estudiados y la prevalencia de hepatomegalia no fue significativa. Los cambios bioquímicos encontrados fueron compatibles con la presencia de un patrón colestásico. Estos datos muestran que la concentración del S sérico podría servir como un indicador de exposición al arsénico que podría ser utilizado en forma conjunta con otros marcadores.

The aim of this study was to investígate the relationship between the levels of serum sialic acid (S) and hepatic enzymes in individuáis who drink As contaminated water. Two hundred individuáis were selected: 85 were the control group, 32 presented hepatomegaly (I with H) and 83 did not present hepatomegaly (I without H) who had consumed drinking water containing As levels higher than O.Ol mg/L. Blood samples were collected for the determination of S and hepatic enzymes in serum: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (FAL), gamma glutamil transpeptidase (GGT), direct (BD) and total bilirrubin (BT), lactate deshydrogenase (LDH) and 5'nucleotldase (5'Nu). The populatlon exposed to As in drinking water presented high levels of S, FAL, GGT, LDH and GGT, LDH were increased in I with H and I without H respectively. No significant changes were observed in the other parameters studied. Prevalence of hepatomegaly was not significantly higher and the hepatic biochemical changes were related with the presence of cholestasis in As-exposed people. These data show that people with high As level intake would have an increased sialoprotein replacement which could be an marker with other one of the alterations caused by arsenic.

Esporotricose experimental sistêmica em ratos Wistar: avaliação hematológica e perfil hepático / Systemic experimental sporotrichosis in Wistar rats: hematological evaluation and hepatic profile

Alanine aminotransferase (ALT) and alkaline phosphatase (AP) hepatic enzymes, hematological values, and total plasmatic proteins (TPP) of 12 Wistar rats with systemic experimental sporotrichosis were evaluated. Inoculation was performed at 2x10³ cells of S. schenckii/ml. The values ranged from 35 to 48UI/l for ALT and 67 to 251.3UI/l for AP. Fifty percent of the AP values were above the physiological limits. TPP was elevated in 66.7 percent (8/12) of the rats with values varying from 7.9 to 8.5g percent. In 75 percent (9/12) of the animals, it was observed that hemoglobin and red blood cells count were below the physiologic limits, and 8.3 percent (1/12) of the animals showed anemia masked by dehydration. At the necropsy, it was observed local and/or disseminated nodular lesions. At the histological analysis, cells compatible to S. schenckii were found. The observed alterations are aggravating factors for the recurrence and treatment of the mycosis.