Disturbed Liver Function Research Articles

Hepatic Osteodystrophy-Molecular Mechanisms Proposed to Favor Its Development.

Almost all patients with chronic liver diseases (CLD) show altered bone metabolism. Depending on the etiology, this manifests in a severe osteoporosis in up to 75% of the affected patients. Due to high prevalence, the generic term hepatic osteodystrophy (HOD) evolved, describing altered bone metabolism, decreased bone mineral density, and deterioration of bone structure in patients with CLD. Once developed, HOD is difficult to treat and increases the risk of fragility fractures. Existing fractures affect the quality of life and, more importantly, long-term prognosis of these patients, which presents with increased mortality. Thus, special care is required to support the healing process. However, for early diagnosis (reduce fracture risk) and development of adequate treatment strategies (support healing of existing fractures), it is essential to understand the underlying mechanisms that link disturbed liver function with this bone phenotype. In the present review, we summarize proposed molecular mechanisms favoring the development of HOD and compromising the healing of associated fractures, including alterations in vitamin D metabolism and action, disbalances in transforming growth factor beta (TGF-β) and bone morphogenetic protein (BMP) signaling with histone deacetylases (HDACs) as secondary regulators, as well as alterations in the receptor activator of nuclear factor kappa B ligand (RANKL)–osteoprotegerin (OPG) system mediated by sclerostin. Based on these mechanisms, we give an overview on the limitations of early diagnosis of HOD with established serum markers.

ОСОБЕННОСТИ ИЗМЕНЕНИЙ НЕКОТОРЫХ БИОХИМИЧЕСКИХ ПОКАЗАТЕЛЕЙ КРОВИ У БОЛЬНЫХ С ПОСЛЕОПЕРАЦИОННЫМ СТЕРНОМЕДИАСТИНИТОМ


 
 
 There was found out an expression of alterations of figure of liver function at patients with postoperative sternomediastenitis. There were revealed hupoproteinemia and dysproteinemia. Their degree was connected with disturb has of liver function. There data shows necessary of conduction of complex treatment of postoperative sternomediastenitis in consideration of disturbances of liver function.
 
 

Antioxidative properties of Thymus vulgaris on liver rats induced by paclitaxel

Background: Thymus vulgaris (Thym) is a species of flowering plant in the mint family Lamiaceae with potent antioxidant, and it has been beneficial effects during short-term administration. Paclitaxel sold under the brand name Tax (Tax) is chemotherapy drug which capable to produce free radicals. Objective: This study was designed to evaluate the effects of Thym against toxic effects of Tax to the liver of rats. Materials and Methods: Sixty-four male rats were assigned to eight groups: Control normal and Tax control groups (20 mg/kg); Thym groups (4.5, 9, 18 mg/kg), and Tax + Thym-treated groups (4.5, 9, 18 mg/kg). Treatments were administered intraperitoneally daily for 2 weeks. Griess technique was assessed for determined serum nitrite oxide (NO) level. Aspartate aminotransferase, ALANINE aminotransferase, and alkaline phosphatase concentrations were determined for liver functional disturbances. In addition, liver malondialdehyde (MDA), total antioxidant capacity (TAC), the diameter of hepatocytes, and the central hepatic vein (CHV) were investigated. Results: Tax administration significantly improved liver MDA and NO level, the mean diameter of CHV and hepatocyte, liver enzymes, and decreased TAC level compared to the normal control group (P

Hepatoprotective activity of royal jelly on mercuric chloride–induced damage model in rats

Background: Mercuric chloride (MC) is the chemical composition of mercury and chlorine with many side effects such as oxidative stress referring to mercury toxicity. Royal jelly (RJ) as a honey bee secretion has antioxidant activities. This study was designed to evaluate the effects of RJ against the parameters of hepatic damage in male rats induced by MC toxicity. Materials and Methods: In this study, 48 male rats were randomly assigned into six groups: sham (saline) and MC control (50 mg/kg) groups; RJ groups (200 mg/kg RJ for 1 day and 200 mg/kg RJ for 7 days, orally) and MC + RJ groups (200 mg/kg RJ orally + 50 mg/kg MC intraperitoneally for 1 day, and 200 mg/kg RJ orally and 50 mg/kg MC intraperitoneally for 7 days). Griess technique was used for the determination of serum nitric oxide (NO) level. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) concentrations were determined for liver functional disturbances value. In addition, thiobarbituric acid reactive species, antioxidant capacity, the diameter of hepatocytes, and the central hepatic vein (CHV) were investigated. Results: MC administration significantly increased the liver malondialdehyde (MDA) and NO levels, the mean diameter of CHV and hepatocyte, hepatic enzymes, and decreased tissue Ferric reducing antioxidant power (FRAP) level compared to the sham group (P < 0.01). The RJ and RJ + MC in all treatments significantly reduced the mean diameter of hepatocyte and CHV, hepatic enzymes, renal MDA and NO levels, and increased tissue FRAP level compared to the MC control group (P < 0.01). It seems that RJ administration recovers the hepatic injury induced by MC in rats.

STUDY OF SOME HEALTH HAZARDS AMONG OPERATING THEATER PERSONNEL DUE TO EXPOSURE TO ANESTHETIC GASES (PART I)

Introduction: Anesthetics are essential materials used in hospitals to induce unconsciousness in patients prior to surgical procedures. The most commonly used agents are isoflurane , sevoflurane and halothane. Aim of work: To assess the health effects of exposure to anesthetic gazes focusing on hepatic and renal manifestations among operating room (OR) personnel. Materials and methods: Operating room (OR) personnel (184: 68 males and 116 females) were included in the study and compared with 192 (63 males and 129 females) from other departments staff of the same hospital mainly from internal medicine hospital and outpatient clinics. The studied groups filled a questionnaire including personnel, family, past and present histories. Liver and kidney function tests were examined. Plain urine samples were collected at the end of shift to test for β2 microglobulin. Operating theaters were evaluated regarding the type of breathing circuits used whether open or closed, the type of anesthetic gases used, presence of air conditioning, and scavenging system. Isoflurane air level was measured using the organic method 103 by OSHA. Results: OR personnel experienced symptoms namely headache, tiredness, drowsiness, and decreased memory compared with their controls, without having statistical significance except for headache. There was a statistically significant increase in the level of ALP (Alkaline phosphatase), total bilirubin, urea, creatinine and B2 microglobulin among exposed when compared to the control group. Also AST (Aspartate transaminase), ALP, direct bilirubin, B2 microglobulin, urea and creatinine were higher among personnel using both open and closed circuits than in those using closed circuits only. The mean values of AST, ALP, total bilirubin, B2 microglibulin urea and creatinine were higher among personnel using isoflurane, sevoflurane and halothane (3 types of anesthetic gazes) more than those using isoflurane and sevoflurane or those using isoflurane only. The mean levels of urea and creatinine were statistically higher among surgeons when compared to other groups. Conclusion: Personnel working in operating theaters are more at risk to develop disturbances in liver and kidney functions compared to the controls especially surgeons. Recommendations: Implementation of adequate and working scavenging system, air conditioning, use of closed circuits whenever possible, periodic checking of anesthetic air levels, periodic biochemical analysis for OR personnel, and replacement of any malfunctioning parts of anesthesia machine.

Somatostatin analogue, Octreotide, improves restraint stress-induced liver injury by ameliorating oxidative stress, inflammatory response, and activation of hepatic stellate cells.

The aim of this study is to investigate the effect of somatostatin (SST) analogue, Octreotide, on some features of liver injury induced by immobilization stress (IS) in adult male albino rats. Eighteen adult male albino rats were randomly divided into three equal groups: control, IS, and Octreotide-treated stressed groups. Octreotide (40μg/kg body weight, subcutaneously) was administrated twice daily for 8days during the exposure to IS. Octreotide was found to reduce the IS significantly and induce elevations in the plasma level of corticosterone, liver transaminases, and tumor necrosis factor α (TNF-α) as compared with IS group. Furthermore, Octreotide administration has significantly elevated the decline in the total antioxidant capacities (TAC) and lowered the elevated malondialdehyde (MDA) levels observed with IS in the hepatic tissue. Additionally, Octreotide treatment provided protection against the histopathological changes in the stressed liver in the form of significant reduction in the mean number of degenerated hepatocytes, the area % of collagen fibers, and glial fibrillary acid protein (GFAP) immunostaining with a significant increase in the mean number of normal hepatocytes. In conclusion, stressed rats showed disturbed liver functions and its oxidant-antioxidant status with highly expression hepatic stellate cells (HSCs), which were all improved by Octreotide administration, SST analogue.

Repeated oral dose toxicity study on hydrolysable tannin rich fraction isolated from fruit pericarps of Terminalia chebula Retz in Wistar albino rats

Terminalia chebula fruits are one of the richest sources of hydrolysable tannins and it is well known medicinal agent in traditional systems of medicine for treatment of various chronic ailments. In the present study, hydrolysable tannin rich fraction (HTF) was isolated from 80% hydroalcoholic extract of Terminalia chebula fruit pericarps and it was studied for acute and repeated dose oral toxicity in Wistar albino rats. HTF did not show any toxic symptoms or mortality at single dose administration of 5000 mg/kg/p.o followed by observation for 14 days. On repeated dose 28 days oral toxicity study, administration of HTF at 1000 mg/kg showed marked reduction in body weight, food intake and water intake when compared with vehicle control. It was also observed that HTF could increase serum urea, glucose and AST level significantly when compared with vehicle control indicating mild disturbances in liver and kidney functions. On histopathological screening, HTF treatment showed a mild granulomatous inflammation in the liver and all other organs remained normal. It was concluded that following 28 days repeated dose oral administration, HTF caused mild disturbances in liver and kidney function which was indicated by reduced body weight, food and water intake, serum parameters and histological observations.

Budd-Chiari syndrome secondary to polycythemia vera with inferior vena cava thrombosis

A middle aged male presented with abdominal distension since one month. Further workup showed plasma hemoglobin of 18.1 g/dL with a high pack cell volume (PCV), raised urea, creatinine and disturbed liver function tests. Abdominal ultrasonography showed an enlarged caudate lobe with thrombi in the inferior vena cava while CT scan of abdomen confirmed the same findings and was suggestive of Budd-Chiari syndrome. Further workup was conducted to rule out other causes and to find out the possible cause of Budd-Chiari syndrome. A peripheral film was requested, which showed hyper-segmented neutrophils. Later on JAK2 mutation and thrombophilia profile was ordered, which was positive for JAK2 mutation. Even though the patient was started on low molecular weight heparin but he eventually passed away. Key point Budd-Chiari syndrome is due to the obstruction of the hepatic efferent outflow tract from either the hepatic veins to where the inferior vena cava meets the right atrium. Its pathogenesis is due to the decreased outflow of the liver, leading to increase in pressure, stasis and later on damage induced by hypoxia and thrombus in the portal veins. Citation: Majid Z, Tasneem AA, Luck NH, Ul Haque MM, Mandhwani RK, Laeeq SM, et al. Budd-Chiari syndrome secondary to polycythemia vera with inferior vena cava thrombosis Immunopathol Persa. 2018;4(1):e04. DOI: 10.15171/ipp.2018.04.

DIMETHOATE HEPATOTOXICITY IN MICE EXPOSED TO CHRONIC INTOXICATION

Background: Because pesticides play an important role in agriculture field, and their use has increased, the evaluation of their toxic effects is of major concern to public health. Aim: The aim of this work was to study the propensity of dimethoate (DM) to cause hepatic function disturbance in mice. Material and Methods: Dimethoate was administered orally at doses of (20mg/kg body weight) dissolved in 1 ml corn oil [1/20 of the LD50 (380mg/kg)] once daily for 14 weeks. Biochemical parameters in serum were studied: aminotransferases (ALT and AST), alkaline phosphatase (ALP), total proteins and albumin. Liver will be examined by light and electron microscope to evaluate histopathological changes. Results: Our results indicated that: the levels of the ALT and AST, ALP as well as bilirubin, in the serum of treated rabbits showed highly significant (P<0.0001) increase compared to control animals, whereas either, total protein, and albumin were highly significantly decreased (P<0.0001).Light microscopic examination of the hepatic tissue in dimethoate treated group showed congested portal vein, dilated bile duct , hepatocytes with vacuolated cytoplasm and deeply stained shrunken nuclei and hemorrhage. While electron microscope of the same group showed areas of hemorrhage, apoptotic nucleus and necrotic areas. In conclusion: Our study demonstrated that administration of DM orally at doses of (20mg/kg body weight) [1/20 of the LD50] for 14 weeks induced disturbance in the liver function .It is recommended to do Further investigations to prove the implication of oxidative stress in liver function disturbance and study the role of antioxidant in its limitation

Metabolic profiling of the hepatotoxicity and nephrotoxicity of Ginkgolic acids in rats using ultra-performance liquid chromatography-high-definition mass spectrometry

Ginkgolic acids (GAs) are thought to be the potentially hazardous constituents corresponding to the toxic side effects of Ginkgo products. In this study, toxicological and metabolomics studies of GAs were carried out by ultra-performance liquid chromatography-high-definition mass spectrometry (UPLC-HDMS). Significant changes in serum clinical chemistry were observed in the both low (100 mg/kg) and high (900 mg/kg) doses. Especially the serum enzyme of ALT, AST, LDH, and CK decreased in treated groups. The histopathological observation demonstrated hepatic steatosis in liver and tubular vacuolar degeneration in kidney. These results demonstrated the hepatotoxicity and nephrotoxicity of GAs. Functional disorders are more likely to be toxic induced by GAs. Metabolic profiling within seven days revealed the change of the body status after oral administration. The results indicated the body function was significantly influenced at the 3rd day and could recover in seven days. Metabolomic analysis showed alterations in 14 metabolites from plasma such as LysoPC(18:0), LysoPC(18:2) and other lipids. The results suggested that exposure to GAs could cause disturbances in liver and kidney function associated with the metabolisms of lipids, glucose and the enzyme activity.

Діагностика цитолітичного синдрому у хворих на туберкульоз легень

Introduction. The liver is one of the most important organs of the human body, performing a number of important functions. Among the common liver diseases, infiltrative pathologies we distinguished: fatty degeneration, lymphomas, amyloidosis, sarcoidosis and tuberculosis. Characterizing liver disease, the manifestations of disorders are divided into syndromes that help to diagnose a particular disease of the liver and determine its causes. In particular – the cytolytic syndrome (CS).The aim of the study – to examine the CS markers in the case of liver dysfunction in patients with newly diagnosed lung tuberculosis prior to treatment and after two months of therapy with first-line anti-tuberculosis drugs.Methods of the research. Two groups of people were examined: the 1st control group of practically healthy donors – 34 people; and the 2nd – patients with newly diagnosed pulmonary tuberculosis prior to treatment and after two months of therapy with first-line anti-tuberculosis drugs (31 people). All patients underwent standard biochemical blood tests, ultrasound of the liver in dynamics. The spectrum of biochemical blood test parameters included determination of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and γ-glutamyltranspeptidase (GGTP).Results and Discussion. The obtained data testifying to occurrence of CS in newly diagnosed tuberculosis patients before the start of treatment are confirmed by the tendency to increase the levels of AST and GGTP. Especially such changes are observed after intensive therapy with antituberculous drugs. There are likely changes in such markers as ALT, LDH and GGTP.Conclusions. It is established that tuberculous intoxication can affect the functional state of the liver. After prolonged treatment of patients with pulmonary tuberculosis, an increase in the indices of such markers of cytolysis as ALT, LDH and GGTP is observed. Disturbance of liver function during therapy may be due to the hepatotoxic effect of anti-tuberculosis drugs, which necessitates the appointment for patients hepatoprotectors.

Tadalafil as New Treatment in Erectile Dysfunction: A Review

Erectile dysfunction is disability to achieve or sustain erection to do satisfying intercourse, that occur at lest for three month. Erectile dysfunction patients are significantly increasing every year, especially in male age 40-70 years old. Tadalafil inhibit PDE5 enzyme 10.000 time more potent than PDE1, PDE2, PDE4 and PDE7; 700 time more potent than PDE6; 900 time more potent than PDE8, PDE9, PDE10, and also 14 time more potent than PDE11A1.In elderly erectile dysfunction commonly is caused by aging process, hence in young adult can caused by physiologic factor or stress. Some studies report there is no significant difference of the tadalafil’s pharmacokinetic in young adult and elderly, and in patient with and without diabetes mellitus. The dose of tadalafil does not need to be reguleted in patient who have liver function disturbance, DM, elderly, renal function disturbance, patient who take medicine like erythromycin, ketoconazole, itraconazole, protease inhibitor, and medicine that inhibit the CYP3A4 system. Clinical study report that tadalafil can increase erection significantly and the patient able to do sex intercourse successfully.Tadalafil does not affect the blood pressure or heart rate, neither affect the concentration motility and morphology of the sperm and neither cause eye disturbance. There is no evidence of teratogenicity, embryotoxicity and foetotoxicity in rat that were given tadalafil 1000 mg/kg/day.

Evaluation of Wilson Disease With 18F-FDG PET/CT

Wilson disease is an autosomal-recessive disorder with copper accumulation and deposition in different organs. Disturbances in liver function and basal ganglia lead to hepatic and extrapyramidal motor symptoms. Age of onset ranges from 5 to 40 years of age. Wilson disease should be ruled out by measuring serum ceruloplasmin levels, and 24-hour urinary copper levels. We report a case of a 30 year-old female who had experienced progressive dystonia for a year. A decreased uptake of glucose metabolism using 18F-Fluoro-desoxyglucose-Positron-Emission- Tomography/Computed-Tomography (18F-FDG PET/CT) in the striatal area has been reported in the literature. With low levels of ceruloplasmin, elevation of aminotransferase activity and 24-hour urinary copper levels, associated with PET results using 18F FDG led to the diagnosis of Wilson disease. This study shows the feasibility of using in vivo imaging FDG PET/CT for identification of Wilson disease when there is a high clinical suspicion.

Clinical, Biochemical and Histopathlogical Alteration in Broiler Chickens Experimentally Infected with H9N2 Avian Influenza Virus During Aflatoxicosis

The present study reveal the role of aflatoxicosis in affecting the performance traits of broiler chickens which appear in the adverse effect on the lower weight gain and disturbed liver function and its pathological effect on liver and kidney tissues. On other hand the infection with H9N2 influenza virus during aflatoxicosis can lead to increase the severity of signs, lesions and histopathological effect leading to higher mortalities than H9N2 virus infection alone.

Acute Renal and Hepatic Failure and Abnormal Blood Cell Count in Acute Leukemia: A Report of Four Cases and Review of the Literature

Leukemia is white blood cells cancer, which characterized with production of immature blood cells. Overcrowding of bone marrow with this abnormal immature cells, which interference with normal blood cells production, this may be lead to hyperleukocytosis, cytopenias, liver and kidney failure. In this study reports a case series of four patients with acute leukemia were studied. From this study, we concluded that hyperleukocytosis and cytopenias, disturbance in liver and kidney function were correlated with ALL than in AML.

PUB096 Enhanced Delivery of Anticancer Drug to the Lungs via Liposomal Aerosols

Lung cancer tends to spread very early, and is a very life threatening cancer and one of the most difficult cancers to treat. Non-small cell lung cancer (NSCLC) usually grows and spreads more slowly than small cell lung cancer. There are three forms of NSCLC: Adenocarcinomas are found in an outer area of the lung. Squamous cell carcinomas are usually found in the center of the lung by an air tube (bronchus). Large cell carcinomas can occur in any part of the lung. Liposomes were used as Effective encapsulation of both hydrophobic & hydrophilic molecules. Due to their ability to solubilize poorly water soluble drugs, facilitate their nebulization, minimizing clinical drug dose and reducing toxicity, prolonging and targeting release of therapeutic agents by modification of liposome surface. The failures of the present delivery systems are – Oral administration of etoposide at varying dosage for the treatment of lung cancer causes GI toxicity and disturbances of liver function. The parenteral administration of etoposide for lung cancer treatment has been reported to cause severe hepatic impairment and Hypotension. Moreover, intravenously injected ligands mediated liposomes have been limited due to - Leakage of their contents before they reach the target tissue, Rapid clearance from the blood stream, uptake by the macrophages of liver and spleen. Liposomes were prepared by lipid cast film method, optimized and then coupled with Mannose. Drug loaded Liposomes were characterized in-vitro for shape, size, and stability in various body fluids. The Air-jet nebulizer system was used for aerosol and was characterized for Appearance, Leak Test, Internal Pressure, Amount discharge/ actuation, Spray Pattern area and Penetration Efficiency. The in-vivo study comprised of estimation of serum and tissue distribution of drug and fluorescence microscopy. Liposomes formed were multilamellar and were found to be stable in gastric and intestinal fluids.Fluorescence microscopy suggested that liposomes were taken up by the gut associated lymphoid tissues and therapeutic level of drug can be achieved at desired site. Thus, from the results obtained it can be concluded that the Aerosolized mannose liposomes can deliver drug to the cancerous cells in an effective way and hold great potential for lung targeting. Through mannosylated liposomes, therapeutic level of drug can be achieved at desired site. The system carried dual function, firstly retention of drug and secondly selective delivery of etoposide to lungs.

Paracetamol induced hepatic toxicity and amelioration by cinnamon in rats

The study was designed to evaluate the hepato-protective activity of aqueous extract of cinnamon in acute experimental liver injury induced by paracetamol. Twenty four male albino rats were randomly divided into four groups (six rats in each). Group I rats received distilled water for 15 days and served as a vehicle control. The animals in the group II were given single oral administration of paracetamol (1 g/kg), 1 h after last distilled water administration and acts as paracetamol toxic control group. Groups III and IV received aqueous extract of cinnamon (200 and 400 mg/kg bwt), respectively, once daily for 15 consecutive days followed by a single oral administration of paracetamol (1 g/kg), 1 h after the last cinnamon dose administration. The degree of hepatoprotection was measured using liver enzymes (Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), bilirubin, albumin, and lipid profile levels. Also, histopathological examinations of liver were done. The significantly disturbed liver functions by paracetamol toxicity were restored to nearly normal values by administration of cinnamon. Also, the change in biochemical parameters in groups received paracetamol alone was modified towards the normal values in groups given paracetamol and cinnamon. Histopathological effect of paracetamol on liver was also markedly decreased by co-administration of cinnamon. Our findings concluded that cinnamon aqueous extracts possessed hepato-protective activity against paracetamol induced hepatic toxicity in rats.

Pharmacokinetics and safety/tolerability of higher oral and intravenous doses of rifampicin in adult tuberculous meningitis patients

High-dose intravenous (i.v.) rifampicin improved the outcome of tuberculous meningitis (TBM) in a previous study. Unfortunately, i.v. rifampicin is not available in many high-endemic settings. This study examined exposures to and safety of higher oral rifampicin doses compared with i.v. rifampicin. Thirty adult Indonesian TBM patients were randomised to rifampicin 750 mg (ca. 17 mg/kg) orally, 900 mg (ca. 20 mg/kg) orally or 600 mg (ca. 13 mg/kg, as used previously) i.v. over 1.5 h for 14 days, combined with other TB drugs. The pharmacokinetics of rifampicin was assessed in the critical phase of TBM treatment (≤3 days after treatment initiation) and at ≥9 days. In the first days of treatment, the geometric mean (range) plasma AUC0–24 values following rifampicin 750 mg orally, 900 mg orally and 600 mg i.v. were 131.4 (38.1–275.1), 164.8 (66.9–291.2) and 145.7 (77.7–430.2) mg⋅h/L, respectively; Cmax values were 14.3 (6.1–22.2), 16.2 (5.7–28.3) and 24.7 (13.9–37.8) mg/L. CSF concentrations correlated with plasma exposures. After ≥9 days, AUC0–24 values had decreased to 100.1, 101.2 and 94.9 mg⋅h/L. Transient grade 3 ALT increases (8/30 patients) and one grade 4 ALT increase occurred, not related to rifampicin exposure. Higher oral rifampicin doses resulted in approximately similar plasma AUC0–24 but lower plasma Cmax values compared with 600 mg i.v. over 1.5 h. Exposures to rifampicin varied substantially and decreased due to autoinduction. Liver function disturbances occurred in this severely ill population. Future studies should examine even higher rifampicin doses in TBM treatment.

Liver enzymes Alterations after Laparoscopic Cholecystectomy: A Prospective Study

Background: In laparoscopic cholecystectomy, carbon dioxide gas is used for insufflation into peritoneum. The carboxy peritoneum which is used to create space in laparoscopic cholecystectomy is kept at pressure of 10-15mm of Hg. This high carboxy peritoneum pressure is likely to cause impedance in splanchnic perfusion and decrease the hepatic perfusion. This can lead to disturbances in liver functions. Material and Methods: This study was done on a total of fifty patients presenting with symptomatic gall stone disease. Liver function tests were done in all the patients in pre operative and post operative period after laparoscopic cholecystectomy. Results: Total serum bilirubin measured pre operative and post operative were compared, there was no significant change in the serum bilirubin levels. The serum AST levels were compared in preoperative and postoperative period and there was significant increase in level of serum AST. The serum ALT levels comparison between preoperative and postoperative values has shown significant change. The difference in serum alkaline phosphatase levels is also non significant. Conclusion: This study concludes that transient elevation of liver enzymes does occur after laparoscopic cholecystectomy.

Lipid-Liver Crosstalk in Health and Disease

The liver is a major metabolic organ, essentially controlling glucose and fat metabolism. Because lipids are water-insoluble, they need to be transported in the circulation in association with proteins in the form of lipoproteins. These lipoproteins play a key role in the absorption and transport of dietary lipids by the small intestine, in the transport of lipids from the liver to peripheral tissues, and in the transport of lipids from peripheral tissues to the liver and intestine. Upon feeding, energy is provided by glycolysis and the unused glucose is stored as glycogen in the liver. Excess glucose is used to synthesize fatty acids through de novo lipogenesis. Fatty acids are incorporated into triacylglycerol, phospholipids, or cholesterol esters in hepatocytes. These complex lipids are stored in lipid droplets or secreted into the circulation as very low-density lipoprotein particles. Upon fasting, after consumption of stored glycogen, the liver secretes glucose through gluconeogenesis. Fasting also promotes lipolysis in adipose tissue, resulting in release of free fatty acids which are metabolized in hepatic mitochondria though beta-oxidation for energy production, while excess fatty acids are stored by the liver leading to hepatic steatosis. Disturbances in lipid metabolism, as in alcoholic and non-alcoholic steatohepatitis, obesity and diabetes, will affect liver performance and function. Likewise, disturbed liver functions by acute or chronic liver disease, as in viral hepatitis, will affect lipid homeostasis. This may carry an increased risk of atherosclerosis and ischemic heart disease which may endanger life. Dietary restriction or fasting was found to have a positive impact on restoring lipid homeostasis leading to improved quality of life.