Aspartate Aminotransferase Values Research Articles

Metabolic Profile of Holstein Cows: Reference Values in Herds of Rio Grande do Sul - Brazil

Background: Assessing data from metabolic profile is a complex task depending on individual factors such as breed, age, sex and physiological status and environmental factors such as climate and management. Therefore, reference intervals produced in herds from different geographic regions are not always precise in the local reality. The aim of this study is to compile results of values of the most used parameters in the metabolic profile of healthy Holstein cows, grouped by lactation stage, obtained from studies in Rio Grande do Sul, Brazil, as an effort for the elaboration of regional reference intervals for dairy cattle in this geographic area.Materials, Methods & Results: The research was defined through the PICO strategy, considering multiparous Holstein cows from scientific studies carried out in Rio Grande do Sul, during the period 1996-2021, in which the nitrogen, glycidic, lipidic, enzymatic or mineral metabolic profile was determined. Google Scholar, Scientific Electronic Library and PubMed were the electronic databases selected for the search, using the following descriptors: "profile" and "metabolic" and "metabolic profile" and "dairy" or "cattle" or "cow" and "Brazil" and "southern" or "Rio Grande do Sul". Studies in Portuguese, English and Spanish languages were considered. The references of the articles initially selected were also verified, through ResearchGate and Google Scholar, in addition to unpublished data, unfinished studies or data in the so called "gray literature". It was possible to identify a total of 34 publications, which were tabulated to assess the scientific quality and bias risk. Studies were evaluated by a pair of independent reviewers, in order to compare results. Eligibility confirmation was given after the complete reading of the articles, evaluating the presence of all the inclusion selection criteria, such as adequate population and the intervention made. Examples of exclusion criteria for studies were studies or data duplication and methodological flaws that could compromise reliability. Thus, of the 34 studies selected in the initial screening, 14 remained. Thereafter, observational studies were preferably sought for data extraction. In the case of clinical trials, only data from control groups were used, in order to avoid disturbances due to interventions or treatments that could be applied. The reference intervals or means of the evaluated metabolites extracted from these studies were grouped in tables, in order to facilitate the comparison with research results obtained in different regions or even for comparison with future studies in the region of interest.Discussion: This retrospective study obtained mean values and standard deviation of the most used parameters in the metabolic profile of Holstein cows, grouped by lactation stage, obtained from studies performed in the state of Rio Grande do Sul, Brazil. Divergences were observed in several evaluations, especially in values of albumin, beta-hydroxybutyrate, aspartate transaminase and calcium, in spite of all data represented healthy animals from research trials with adequate environment and diet. It is important to consider the risk of time bias in this study, as within this 25-year period there was a very large evolution in dairy farming and some values may not be fully representative of current management systems in Holstein herds. Nevertheless, the results reinforce the importance of using regional reference values for the proper interpretation of metabolic profile results in dairy cows. In addition, the proposing of database index for regional averages or reference intervals, is useful for comparing results of metabolic profiles carried out in different geographic regions, in future studies to be performed in this particular region, or even to be utilized by field practitioners of this particular region.Keywords: biochemical blood profile, regional reference, healthy cows.Título: Perfil metabólico de vacas da raça Holandesa:valores de referência em rebanhos do Rio Grande do Sul - BrasilDescritores: perfil bioquímico sanguíneo, referência regional, vacas sadias.

The hepato-renal protective potential of walnut seed skin extract against acute renal ischemia/reperfusion damage

Acute kidney damage is defined as a sudden change in kidney functions that prevents the removal of nitrogenous wastes from the body, thus disrupting the body's fluid and electrolyte balance. When acute kidney injury occurs, the kidneys and liver are most affected in the body. Agents used in the treatment of acute kidney injury often have nonsteroidal anti-inflammatory properties that can produce toxic effects on the gastrointestinal tract and kidneys. Natural antioxidants can be recommended as an alternative to existing treatment or in combination to protect tissues against these toxic effects. Therefore, we conducted our current study on whether walnut seed skin (WSS) extract might have hepato-renal protective effects in kidney-damaged Sprague-Dawley rats. This study is the first to use walnut seed skin extract in liver and kidney tissues in renal ischemia/reperfusion (IR) injury. Female Sprague-Dawley rats were randomly divided into three groups: Healty control (HC), renal IR (50 min ischemia – 3 h reperfusion), and renal IR + 450 mg/kg/p.o. WSS extract (the rats were treated with WSS extract orally once 1 h before the IR procedure). For this purpose, blood, liver and kidney tissues of rats were used. In serum samples, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), urea and creatinine values were determined separately for the administration groups. We also performed histopathological studies on liver and kidney tissues. Finally, gene markers (endothelial nitric oxide synthase (eNOS), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), Caspase-4 and Caspase-9) determined to evaluate the anti-oxidant, anti-inflammatory and apoptotic effect of walnut seed skin were measured by q-RT PCR method. As a result of the study it was determined that pre-application of WSS extract improved the deteriorated serum parameters in rats with renal ischemia. In the histopathological analysis results, it was observed that WSS had a protective effect on kidney and liver tissue. In studies on gene expression, although there were different and contradictory results for liver and kidney tissue, we determined that WSS was more protective on liver tissue. In conclusion, the healing potential of WSS in renal and hepatic tissues seems to act by inhibiting the inflammatory response, oxidative stress and apoptosis. Therefore, the potential of this extract is remarkable and may serve as a potential therapeutic that may protect against acute organ damages due to renal IR.

The prognostic impact of preoperative mean corpuscular volume in colorectal cancer.

The relationship between preoperative mean corpuscular volume and postoperative prognosis has been reported in some cancers recently, but no certain consensus has been reached, especially for colorectal cancer. We evaluated the usefulness of mean corpuscular volume as a prognostic factor in colorectal cancer patients. This study included 1003 patients with colorectal cancer who underwent curative surgery in a single institution. The relationship between mean corpuscular volume values and postoperative recurrence was evaluated by fractional polynomial model. Based on the result, patients were divided into groups according to mean corpuscular volume values. Clinicopathological factors and long-term outcomes were compared between the groups. The risk of postoperative recurrence according to mean corpuscular volume value showed a J-shaped curve, suggesting that both low and high mean corpuscular volume have high risk. Low mean corpuscular volume (≤84fl) group was oncologically advanced in terms of pathological tumor stage, histological grade and lymphatic invasion with higher inflammation markers. High mean corpuscular volume (>95fl) group had higher frequency of drinking habit with higher values of aspartate aminotransferase, alanine aminotransferase and γ-glutamyl transpeptidase. Abnormal mean corpuscular volume group including these two groups showed significantly worse disease-free survival than the other (P < 0.001). Multivariate analysis suggested that abnormal mean corpuscular volume was an independent risk factor for postoperative recurrence (hazard ratio, 1.344; 95% confidence interval, 1.005-1.796; P = 0.046). Furthermore, its prognostic impact was more significant in pStage III than in other stages. Preoperative low and high mean corpuscular volume is a poor prognostic factor in colorectal cancer patients. It could be a predictive marker to estimate worse survival outcome after surgery.

Stress, Metabolic and Serum Muscle-Derived Enzymes Response of Horses Employed in Wooded Area and Field Trekking Courses

Horse trekking is a non-competitive sport that, as other kinds of exercise, involves skeletal muscle effort and may implicate significant energy expenditure leading to stress. The aim of the current study was to assess the effect of trekking on metabolic and stress response as well as muscle damage markers in clinically healthy horses. Thirty horses were equally divided in 3 groups according to trekking course: Group A (trekking course 15 km long), Group B (trekking course 35 km long starting;), Group C (three trekking courses for three consecutive days; during the first day the trekking course was 25 km long, Group C1; during the second day the trekking course was 40 km long, Group C2; during the third day the trekking course was 25 km long, Group C3). Blood samples were collected from each horse before trekking (TPRE), after 5 min (TPOST) and 1 h from the trekking end to assess lactate, glucose, total proteins, non-esterified fatty acids (NEFAs), creatinine, aspartate aminotransferase (AST), creatine phosphokinase (CPK), lactate dehydrogenase (LDH) and cortisol concentration. Higher cortisol, lactate, glucose, NEFAs, creatinine, CPK, LDH and AST values were found after trekking than rest (P < .001). Horses of Groups C2 and C3 showed higher values of the investigated haematochemical parameters and muscle enzymes than Groups A and B. The findings suggest that trekking induces a metabolic reaction accompanied by an acute stress response in horses and underline that this recreational exercise, if not associated with the adequate recovery period, can increase the probability of muscle damage.

Basal Values of Biochemical and Hematological Parameters in Elite Athletes.

The purpose of this study was to show how continuous exercise affects the basal values of biochemical and hematological parameters in elite athletes. A total of 14,010 samples (male = 8452 and female = 5558 (March 2011–March 2020)) from 3588 elite athletes (male = 2258 and female = 1330, mean age 24.9 ± 6.9 vs. 24.1 ± 5.5 years, respectively) from 32 sport modalities, were studied over 9 years to check the variation of basal biochemical and hematological parameter values. There were differences seen in the basal values of creatine kinase (CK), urea, creatinine, aspartate transaminase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), potassium, total bilirubin, and eosinophil percentage compared to reference population data. However, other analytes showed narrow ranges of variation like glucose, total protein, albumin, sodium, hemoglobin, mean cell volume (MCV), and platelet count. Exercise produces changes in biochemical and hematological basal values of athletes compared to the general population, with the greatest variation in CK, but AST, ALT, LDH, potassium, and total bilirubin (TBil) show high values in serum, only with a wider distribution of values. The data here reflects the effect of exercise on biochemical and hematological parameter baseline ranges in elite athletes. As clinical laboratories use reference intervals to validate clinical reports, these “pseudo” reference intervals should be used when validating laboratory reports.

Organ function biomarker abnormalities, associated factors and disease outcome among hospitalized patients with COVID-19.

Background: The aim of this study was to determine the magnitude of abnormal organ function tests and biomarkers in hospitalized patients with confirmed COVID-19 and to define the association among markers of organ failure, disease severity and its outcome in hospitalized COVID-19 patients in Ethiopia. Methods: A prospective cohort study was conducted among COVID-19 patients admitted to Millennium COVID-19 Treatment Center from December 2020 to June 2021. Results: The median age of the 440 study participants was 60.3 ± 1.3 years, and from these 71.3% of patients were male. Disease severity: p-value: 0.032; adjusted odds ratio (AOR) (95% CI): 4.4 (0.022–0.085); and the presence of any co-morbidity; p-value: 0.012; AOR (95% CI): 0.80 (0.47–0.83) was significantly associated with mortality. Aspartate transaminase, alanine transaminase and alkaline phosphatase parameter values of patients overall, were elevated – mainly among critical patients (56.9 ± 57.7, 58.5 ± 63 and 114.6 ± 60, respectively).

Asprosin, visfatin and subfatin as new biomarkers of obesity and metabolic syndrome.

Metabolic syndrome (MetS) and obesity are important public health problems associated with adipose tissue mass. Asprosin, visfatin, and subfatin are new members of which fate in MetS and obesity has not been fully revealed yet. Thus, this study was to investigate the association between asprosin, visfatin, subfatin, and biochemical values, demographic data, and body composition measurement values in MetS patients with and without obesity. Blood samples were taken from a total of 90 people, including 31 MetS patients with obesity, 29 MetS patients without obesity, and 30 healthy (control). Asprosin, visfatin, and subfatin were studied by the ELISA method. There was a negative correlation between asprosin and Body Mass Index (BMI) in the MetS + Obese group. The correlations between asprosin and urea and fasting insulin (FI) levels in the MetS group were positive and statistically significant (p < 0.05). While there was a statistically significant negative correlation (p < 0.05) between visfatin and BMI in the MetS + Obese group, the correlation with waist circumference in the MetS + Obese and MetS groups was statistically significant and negative (p < 0.05). There was a statistically significant negative relationship (p < 0.05) between aspartate aminotransferase value and visfatin. The results between visfatin values and asprosin and subfatin in all groups were significant (p < 0.05). There is a direct relationship between circulating amounts of asprosin, visfatin, and subfatin hormones and age, weight, height, diastolic blood pressure, high-density lipoprotein-cholesterol, aspartate aminotransferase, alanine transaminase, and creatinine. Therefore, asprosin, visfatin, and subfatin hormones are the new biomarkers of metabolic turbulence.

Effects of age and sex on some hematological and biochemical parameters in Hair goats.

This study was performed to determine the blood reference values of hematological and biochemical parameters in Hair goats at different ages. For this aim, clinically healthy Hair goats (n = 180, ages of six month and 1-3 years male and female) were used to collect blood samples. In whole blood, white blood cell (WBC), red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC)and red cell distribution width (RDW) were evaluated. The levels of, albumin, total protein, globulin, glucose, total bilirubin, urea, creatinine, phosphorus, magnesium, calcium, aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), creatine kinase (CK), alanine aminotransferase (ALT) and iron levels were investigated in sera. Age and sex had no effect on the cell structures of blood. In the either sex (male or female), age had no effect. However, sex had a significant effect on the blood cell structures except for WBC, HGB, and HCT. Albumin, protein, calcium, AST, ALT, ALP and magnesium values were not different among groups. Both the age and sex of the goats had significant effects on blood levels of glucose, phosphorus, urea, cholesterol, creatinine, GGT, CK and total bilirubin. In conclusion, this was the first study reporting the hematologic and biochemical parameters in blood of the Hair goats. The results indicated that these parameters could show variations under physiological conditions due to age and gender.

Effect of heat stress on vital and hematobiochemical parameters of healthy dogs.

Background and Aim:Heat stress is a major challenge for animals, impairing their welfare and performance. This study aimed to determine the effect of heat stress on the vital and hematobiochemical parameters of healthy dogs.Materials and Methods:The experimental subjects comprised 10 dogs, encompassing seven males and three non-pregnant females between 2 and 3 years of age. Ambient temperature (AT) and relative humidity (RH) were recorded 2 hourly during the day and the temperature humidity index was calculated. Vital parameters [i.e., rectal temperature (RT), respiratory rate, and heart rate (HR)] were assessed and blood was collected from each dog daily for hematobiochemical analysis.Results:The RT (38.5±0.2°C) of dogs exposed to high AT and high RH (HA/HR) conditions was significantly (p<0.05) higher than that of dogs exposed to HA and low RH (LR) conditions (37.2±0.11°C). Under HA/HR conditions, packed cell volume, hemoglobin concentrations, and white blood cell counts were significantly lower than those of the same dogs exposed to HA/LR conditions. Conversely, under HA/HR conditions, the lymphocyte, monocyte, eosinophil, alanine aminotransferase, aspartate aminotransferase, and cortisol values were significantly higher (p<0.05) than the values obtained in dogs exposed to HA/LR conditions. Meanwhile, the alkaline phosphatase, urea, and glucose levels were significantly lower (p<0.05) in dogs exposed to HA/HR conditions.Conclusion:The exposure of healthy dogs to HA/HR conditions induced heat stress, which may have an adverse effect on their immune status, thereby affecting their health and welfare.

Assessment of Fibrotic Liver Regeneration After Partial Hepatectomy With Intravoxel Incoherent Motion Diffusion-Weighted Imaging: An Experimental Study in a Rat Model With Carbon Tetrachloride Induced Liver Injury

PurposeTo determine whether intravoxel incoherent motion (IVIM) parameters correlate with liver regeneration and function recovery after partial hepatectomy (PH) in rats with carbon tetrachloride (CCl4)-induced liver fibrosis.MethodsSixty-two adult Sprague-Dawley rats were divided into the control group and the fibrosis group with CCl4 injection for 8 weeks. At the end of the 8th week, all rats received left lateral lobe liver resection. Within each group, IVIM imaging (n = 10/group) and histologic and biochemical analyses (n = 3/group/time point) were performed pre- and post-PH (on days 1, 2, 3, 5, 7, 14, and 21). Differences in liver IVIM parameters and correlation between IVIM parameters and Ki-67 indices, hepatocyte diameter, alanine transaminase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil) values were analyzed.ResultsPost-PH, liver true diffusion coefficient (D) values decreased and pseudodiffusion coefficient (D*) and perfusion fraction (PF) values increased, then recovered to pre-PH levels gradually in both fibrosis and control rats. PF in fibrosis group were significantly higher than in controls from 3 to 21 days (P < 0.05). In fibrosis rats, both Ki-67 indices and hepatocyte diameters increased, and a strong correlation was found between PF and Ki-67 indices (r = −0.756; P = 0.03), D* and PF values and ALT, AST, and TBil values (r = −0.762 to −0.905; P < 0.05). In control rats, only hepatocyte diameters increased, and all IVIM parameters correlated well with hepatocyte diameters, ALT, AST and TBil values (r = 0.810 to −1.000; P < 0.05).ConclusionThe regeneration pattern in fibrotic liver tissue was different compared with control livers. IVIM parameters can monitor liver regeneration and functional recovery non-invasively after PH.

Effect of gervital in attenuating hepatotoxicity caused by methotrexate or azathioprine in adult albino rats.

Methotrexate (MTX) and azathioprine (AZA) are chemotherapeutic, antimetabolic, and immunosuppressive agents with substantial risks such as oxidative lesions to the liver. This study examined the effect of grape seed extract (GSE; gervital) in attenuating hepatotoxicity caused by MTX or AZA treatment. Rats were divided into six groups (six rats per group): Group I, normal control group; Group II, GSE (150mg/kg/day); Group III, MTX (8mg/kg/week); Group IV, AZA (15mg/kg/day); Group V, GSE (150mg/kg/day) + MTX (8mg/kg/week); and Group VI, GSE (150mg/kg/day) + AZA (15mg/kg/day). After 35-day experimental period, all rats were sacrificed and blood was collected for biochemical study and hemoglobin (Hb) assessment. The liver was weighed and triaged for histological, ultrastructural, and biochemical studies. MTX and AZA treatment decreased Hb levels, increased relative liver weight, increased the activity of glutamate pyruvate transaminase (ALT) and glutamate oxaloacetate transaminase (AST) aminotransferase (ALT) and aspartate aminotransferase (AST) values, and displayed histopathological and ultrastructural alterations. These changes included the disorganization of hepatocytes, pyknosis, karyolysis of some nuclei, and mononuclear leukocytic infiltration. The liver with significant oxidative stress (OS) showed decreased reduced glutathione (GSH), catalase (CAT), and superoxide dismutase (SOD) and increased malondialdehyde (MDA) levels. In contrast, GSE administration ameliorated ALT, AST, and all histopathological and ultrastructural changes. GSE treatment also reduced MDA levels but increased the antioxidant parameters. In conclusion, it was concluded that GSE supplementation could be considered as a promising antioxidant in reducing OS, histopathological and ultrastructural alterations induced by MTX and AZA.

Analysis of the clinical characteristics of the liver injury induced by levetiracetam.

Levetiracetam (LEV) has a low risk of hepatotoxicity due to low liver metabolism. Knowledge regarding the association between LEV exposure and liver injury is based mainly on case reports. The purpose of this study is to summarize the clinical features of LEV-induced liver injury. We collected literature on liver injury induced by LEV for retrospective analysis from 1999 to April 2021 in Chinese and English. The median age of 21 patients (13 males and 8 females) was 31 years (range 0.13-76). The median time for liver injury was 19 days (range 3-120). The clinical manifestations of patients ranged from asymptomatic elevated liver enzymes in 5 patients (23.8%) to fever, digestive system symptoms and skin rash in 16 patients (76.2%). The median values of alanine aminotransferase and aspartate aminotransferase were 773 IU/L (range 60-4800) and 667.5 IU/L (range 53-10 387), respectively. Liver biopsy demonstrated hepatocellular necrosis. The liver function returned to normal at a median time of 9 days (range 2-270) after discontinuation of LEV. LEV-induced liver injury is a rare adverse reaction, ranging from asymptomatic elevated transaminases to fulminant liver failure. Patients receiving long-term treatment with LEV should consider monitoring liver function.

The importance of urotensin II level in the diagnosis of acute mesenteric ischemia

Aim: This study was conducted to investigate the diagnostic importance of Urotensin II (UT-II) levels, which cause vasodilation as a compensation mechanism in the early phase of Acute Mesenteric Ischemia (AMI). For this purpose, human plasma urotensin was studied for the first time in the literature for the early diagnosis of mesenteric ischemia.&#x0D; Material and Method: The study consisted of 60 patients. The patients were divided into three groups: Group 1: group with mesenteric ischemia (n: 20); Group 2: group with abdominal pain and with no mesenteric ischemia (n: 20); Group 3: control group with no complaints (n: 20). The blood samples were taken from the patients through peripheral venous access, and Urotensin II (UT-II), Aspartate Aminotransferase (AST), Alkaline phosphatase (ALP), Lactate, and D-dimer levels were measured.&#x0D; Results: While a significant increase was found between Group1 and Group 2 and between Group1 and Group3 in terms of UT-II values (p0.05). A significant increase was found between Group1 and Group2 and between Group1 and Group3 regarding AST values (p0.05). There was a significant increase between Group1 and Group3 in terms of D-dimer values (p0.05). There was no significant difference between the groups concerning ALP and Lactate values (P&gt;0.05).&#x0D; Conclusion: It was concluded that UT-II could be used in the diagnosis of AMI but that there was a need for comprehensive studies investigating the changes in ischemia time-related UT-II serum levels.

INSECTICIDAL AND TOXICOLOGICAL STUDY OF Dennettia tripetala (G. Baker) FRUIT OIL EXTRACT USED AS COWPEA GRAINS PROTECTANT AGAINST Callosobruchus maculatus (Fab) (COLEOPTERA: CHRYSOMELIDAE) INFESTATION

Dennettia tripetala fruit ethanolic oil extract was investigated for its insecticidal property. Bioassay was conducted at 0.2, 0.4, 0.6, 0.8 and 1.0ml/20 g of susceptible cowpea. Results indicated that 1.0 ml dosage was the most effective as it evoked 100% beetle mortality within 24 h of application and its effect was significantly (p&lt;0.05) different from other treatments except the positive control that recorded up to 94% mortality of the beetles. All dosages displayed significant lethal effects on the insect as compared with the untreated check. Insect mortality was dosage dependent. Probit analysis showed that, fruit oil extract required 2.46 and 6.66ul to achieve 50 and 95% highest insect mortality within 24 hours. Treated seeds with highest dose of 1.0 ml D. tripetala extract prevented oviposition, adult emergence as well as ability of the insect to cause damage and weight loss, hence reduced infestation and subsequent damage of treated cowpea seeds. Thus, Dennettia tripetala extract could be a potential toxicant and of great importance in storage protection of stored cowpea against the bruchids. The bilirubin, GGT and Uric acid were high as the dosages increased. Positive control showed significantly higher concentration of Bilirubin - 69.11g/dl, GGT - 38.02g/dl Uric acid - 50.25g/dl while Total protein was at its least (0.06g/dl) when compared to other groups. The low values of AST (Aspartate Aminotransferase), ALP (Alkaline Phosphate), ALT (Alanine Aminotransferase) and Creatine concentrations recorded at 1.0ml of 2% concentration of D. tripetala oil extract has no hepatotoxic effect on animals.

Correlation between Liver Ultrasonography with AST and ALT Value in Suspect Hepatitis

BACKGROUND: Liver ultrasonography is frequently recommended in Hepatitis patients. Hepatitis is liver inflammation caused by infection with microorganisms, drugs, and alcohol. Hepatitis causes liver cell damage and sometimes can change the echostructure of ultrasonography. These changes have affected the value of Aspartate Aminotransferase (AST) or Alanine Aminotransferase (ALT).&#x0D; AIM: The study aimed was to identify the correlation of liver ultrasonography with liver function (AST / ALT) in patients with suspected Hepatitis.&#x0D; METHOD OLOGY: The method was a Cross-Sectional approach to identify the relationship of liver ultrasonography, including echostructure, size, edge or surface, portal vein, gall bladder with AST and ALT in patients with suspected Hepatitis. The subjects were from PKU Muhammadiyah Hospital Yogyakarta, 2015-2018, 18-60 years old. They were identified using ALT and AST and proposed ultrasonography of the liver and gallbladder. The samples size consisted of 68 men and 32 women. Liver enzyme and ultrasonography did not know the results of this examination (blind). The relationship between the two variables was analyzed through the Chi-Square.&#x0D; RESULTS: The result was showed a significant relationship between liver ultrasonography, including the echostructure, size, portal vein dilatation with AST and ALT, and p-value for echo structure to AST 0.05 and ALT 0.02. The p-value of liver size revealed an AST of 0.03 and a p-value of a portal venous wall with AST 0.06 and with ALT of 0.02.&#x0D; CONCLUSIONS: There was a significant relationship between echostructure, liver size, and portal vein wall with AST and ALT. The liver surface edge and gallbladder had no significant relationship with AST and ALT.

Role of Ayurveda treatment in the management of hepatitis B (Ubhayapatha Ashrita Swatantra Kamala)- A case report.

Hepatitis B is one of the most common causes of liver disease, and due to unawareness of the safety measures, more prone to spread. As per the World Health Organization, for the South East Asia region, its prevalence is 2%. Yellowish discoloration of the eyes, body, and urine, abdominal discomfort, and vomiting is its cardinal symptoms. In Ayurveda, this set of symptoms is known as Kamala. This case report illustrates the effectiveness of the Ayurveda treatment modality in a patient with a viral load of 3705.71 IU/ml, and the values of AST (aspartate aminotransferase) and alanine transaminase (ALT) were 140 IU/ml and 173 IU/ml, respectively. A 40-year-old female patient with a complaint of yellowish discoloration of urine, eyes, and skin with fatigue and irritability was diagnosed with Ubhayapatha Ashrita Swatantra Kamala. The patient was treated with Ayurveda drugs and Virechana Karma (therapeutic purgation). After the treatment for 13 months, the disease was cured. Improvement was observed based on hepatitis B virus deoxyribonucleic acid (DNA) polymerase chain reaction (PCR) (hepatitis B DNA PCR) (decreased from 3705.71 IU/ml to <50.0 IU/ml) and the values of AST (decreased from 140 IU/ml to 19.0 IU/ml) and ALT (decreased from 173 IU/ml to 28 IU/ml). The patient was stable and asymptomatic during the follow-up period of 4 months.

Prevalence of abnormal liver biochemistry and its impact on COVID-19 patients' outcomes: a single-center Greek study.

BackgroundAbnormalities in aminotransferases are frequently observed in hospitalized COVID-19 patients, but their clinical impact is poorly characterized.MethodsA total of 1046 patients hospitalized to the non-intensive care unit ward with documented COVID-19 were included retrospectively. Demographic, clinical and laboratory characteristics on admission and during hospital stay, including the presence of liver injury (LI), defined as aspartate aminotransferase (AST) >200 IU/L, were recorded.ResultsOn admission, 363 (34.7%) and 269 (25.7%) patients had abnormal AST and ALT values (i.e., >40 IU/L), respectively, while during hospitalization 53 (5%) patients fulfilled the criteria for LI. In multivariate logistic regression analysis, AST (odds ratio [OR] 1.023, 95% confidence interval [CI] 1.016-1.029; P<0.001), and ferritin (OR 1.01, 95%CI 1.001-1.02; P<0.001) were the baseline factors independently associated with the development of LI during hospital stay. One hundred twenty-three (11.7%) patients died during hospitalization. The independent variables associated with mortality were: age (hazard ratio [HR] 1.043, 95%CI 1.029-1.056; P<0.001), ferritin (HR 1.1, 95%CI 1.05-1.2; P<0.001), platelets (HR 0.996, 95%CI 0.994-0.999; P=0.003), and administration of remdesivir (HR 0.50, 95%CI 0.30-0.85; P=0.009). The patients with abnormal baseline AST (i.e., >40 IU/L), compared to those with normal AST values, had worse outcomes (log rank test: 8.8, P=0.003).ConclusionsElevated aminotransferases are commonly seen in COVID-19 patients. They possibly reflect disease severity and may be associated with in-hospital mortality.

Assessment of Potential Risk Factors, Characteristics, and Outcome of Pneumothorax and Pneumomediastinum in Patients with COVID-19: A Retrospective Case-control Study

Introduction: Pneumothorax (PTX) and/or pneumomediastinum (PMD) are rare complications of Coronavirus Disease-2019 (COVID-19) and are linked to high mortality. Incidence rates vary between 0.56-2.01% in the reported literature. With clinical examination being hampered in the current pandemic setting, there is a delay in the diagnosis. There is a need to identify and establish potential predictive factors, that may aid in identifying patients with a high-risk of developing PTX and/or PMD. Aim: To identify potential risk factors and thus, explore their association with PTX and/or PMD among patients with COVID-19. Materials and Methods: A retrospective case-control study was conducted at MS Ramaiah Medical College and Hospital, Bangalore, South India over a six-month period. A total of 130 patients diagnosed with COVID-19 were recruited in a 1:3 ratio as cases and controls respectively. Cases were patients, diagnosed radiologically with PTX and/or PMD, and controls were, matched individuals without PTX and/or PMD. Patient’s clinical and laboratory parameters (complete blood count, renal and liver function tests, serum levels of inflammatory markers such as C-reactive protein (CRP), lactate dehydrogenase (LDH), and D-Dimer were tested for potential association with PTX and/or PMD. Student’s t-test, Chi-square test, multivariate and univariate logistic regression analysis were performed. Results: During the study period, there was a total of 3,251 COVID-19 admissions at the centre with 976 patients requiring Intensive Care Unit (ICU) admission. The overall incidence of PTX and/or PMD during the study period was (31/3251) 0.95%. The previous history of COVID-19, non vaccination with COVID-19 vaccine, cough as a predominant symptom, high values of baseline CRP, total bilirubin, Aspartate Transaminase (AST), and total leukocyte counts had a positive association. In-hospital mortality (54.8% vs 33.30%) and mortality 28 days (35.7% vs 7.6%) following discharge, were higher among those with PTX and/or PMD. Conclusion: Patients with a history of previous infection with COVID-19, non vaccination /incomplete-vaccination with COVID-19 vaccines, and patients with increasing total leukocyte counts and AST levels, high baseline total serum bilirubin were at increased risk of a detrimental clinical course and may indicate, the possibility of development of PTX and/or PMD in COVID-19 disease.

Clinical Characteristics Predicting Mortality Risk in Hospitalized Geriatric Patients with COVID-19 Pneumonia: a Retrospective Study

Coronavirus disease 2019 (COVID-19) is a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Geriatric patients with COVID-19 are more likely to progress to severe disease, and they are at increased risk of hospitalization and mortality. In this study we aimed to investigate the risk factors for predicting mortality in geriatric patients with COVID 19 by reviewing the clinical data of survivors and non-survivors. This was a retrospective study of 189 geriatric patients with COVID- 19 pneumonia who were hospitalized in pulmonology clinic, in Duzce University, Medical Faculty Hospital between March 2020 and January 2021 in Turkey. In the study, 60.3% (n = 114) of the patients were male and the median age was 75. 80.4% (n = 152) of the patients were discharged. The presence of cardiovascular disease, chronic renal failure, malignancy, increased number of comorbidities, complaints of anorexia, no fever, decreased oxygen saturation value, increased pulse rate, high values of maximum (max) D-dimer, aspartate aminotransferase, urea, creatinine, troponin, lactate dehydrogenase (LDH), max LDH, ferritin and max ferritin, C-reactive protein (CRP), max CRP, procalcitonin, max procalcitonin, potassium values and low albumin values, complications as bacterial infection, cardiac disease, acute respiratory distress syndrome, liver function tests failure, arrhythmia and shock, the need for corticosteroid and pulse corticosteroid therapy increased the mortality. According to multiple logistic regression model, the de-velopment of cardiac disease, acute respiratory distress syndrome, bacterial infection, the need for pulse steroids, and the max ferritin value increased the risk of mortality by between 1.001 and 28.715 times. Both clinical and laboratory parameters predicting mortality in geriatric patients with COVID-19 pneumonia should be monitored very carefully. Complications that develop should be evaluated and multidisciplinary and necessary treatments should be initiated without delay.

The role of hematological parameters in differentiating Plasmodium falciparum and others – a study from Somalia

Introduction and aim. Accurate identification of Plasmodium species is important because of the differences in their treatment. We aimed to investigate the role of hematological and biochemical parameters in the differentiation of Plasmodium falciparum and other plasmodium species. Material and methods. This is a retrospective study. Patients admitted to the emergency department with signs and symptoms of malaria were included into the study. Patients with malaria were grouped as P. falciparum and others. Hematological parameters of two groups were compared by univariate and multivariate analysis. Statistical analysis was performed using the Jamovi. Results. A total of 107 patients were included in the study. According to univariant and multivariant analysis there was no difference in between two groups in the terms of blood urea nitrogen, aspartate aminotransferase, total bilirubin, hemoglobin, hematocrit, white blood cell count, platelet count, and mean platelet volume (in univariate analysis p values were 0.029, 0.011, 0.019, 0.171, 0.870, 0.307, 0.042, and 0.276, respectively and in multivariate analysis p values for blood urea nitrogen, aspartate aminotransferase, total bilirubin, hemoglobin, and platelet count were 0.100, 0.535, 0.328, and 0.213, respectively). Conclusion. The investigated hematological and biochemical parameters were found to be not valuable in predicting type of malaria. On the other hand, we recommend confirming the results of our study with larger samples and multicenter studies.