Elevated Serum Glutamic Oxaloacetic Transaminase Research Articles

Study of platelet activation, hypercoagulable state, and pulmonary hypertension in patients with transfusion-dependent beta-thalassemia

Abstract: BACKGROUND: Thalassemic patients require lifelong blood transfusions, which can lead to complications such as pulmonary arterial hypertension. The pathogenesis involves hypercoagulability, in which researches on coagulation abnormalities in this regard are limited. OBJECTIVES: The aims of the study was to investigate the mechanism of hypercoagulability and pulmonary hypertension in transfusion-dependent thalassemic patients and compare it with healthy controls. PATIENTS MATERIALS AND METHODS: This case–control analysis enrolled 50 transfusion-dependent thalassemia patients and 50 healthy controls. Complete blood counts, liver function tests, coagulation markers (P-selectin, protein C, antithrombin III, and fibrinogen), serum ferritin, and transthoracic echocardiography were performed, and blood transfusion/chelation history and splenectomy status were recorded. RESULTS: Thalassemia patients revealed severe anemia, leukocytosis, thrombocytosis, significantly elevated serum ferritin (1957.50 ± 2455.05 g/L), elevated liver enzymes serum glutamic oxaloacetic transaminase (22.01 ± 9.89 U/L), serum glutamic pyruvic transaminase (22.70 ± 9.78 U/L) in comparison to controls, and mean serum P-selectin was significantly higher in thalassemic patients (100.48 ± 53.29 ng/mL). Mean serum antithrombin-III and protein C were significantly lower in thalassemic patients (89.27 ± 16.08 units/h, 86.04 ± 25.21 μg/mL) in comparison to controls. CONCLUSIONS: Transfusion-dependent thalassemia is characterized by severe anemia and splenomegaly, leading to complex hemodynamic changes with evidence of platelet activation, hypercoagulable state, liver injury, and increased atherosclerosis. It induces pulmonary artery thrombosis contributing to the development of pulmonary artery hypertension.

Influence of elevated liver enzyme level on 30-day mortality rates in patients undergoing nonemergency orthopedic surgery

BackgroundThe effect of elevated preoperative liver enzyme levels on postoperative outcomes is a topic of concern to clinicians. This study explored the association between elevated preoperative liver enzyme levels and surgical outcomes in patients undergoing orthopedic surgery.MethodsUsing the American College of Surgeons National Surgical Quality Improvement Program database, we obtained data on adult patients who received nonemergency orthopedic surgery under general anesthesia between 2011 and 2021.ResultsWe evaluated the data of 477,524 patients, of whom 6.1% (24 197 patients) had elevated preoperative serum glutamic oxaloacetic transaminase (SGOT) levels. An elevated SGOT level was significantly associated with 30-day postoperative mortality (adjusted hazard ratio, 1.62; 95% confidence interval, 1.39 to 1.90). We determined that the mortality rate rose with SGOT levels. The results remained unchanged after propensity score matching.ConclusionElevated preoperative SGOT levels constitute an independent risk factor for 30-day postoperative mortality and are proportionately associated with the risk of 30-day postoperative mortality.

IJCM_299A: Clinical profile of patients with dengue: a cross-sectional study from a tertiary care hospital, Karnataka

Background: Dengue fever (DF) are among the most important mosquito- borne diseases of the Indian subcontinent and have become a major global public health concern. Its clinical manifestations of which vary from influenza- like illness (DF) to life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The purpose of the study was to find out the mode of presentation, biochemical profile and complications of Dengue cases in an apical level. Objectives: 1. To identify socio-demographic characteristics and clinical features; 2. To document the disease specific management and outcomes Methodology: A cross-sectional study of admitted patients was conducted in the department of medicine and Infectious Diseases over a period of 9 months (15/2/2023 -15/11/2023). Patients aged above 18 years with serology proven (nonstructural protein 1 [NS1]/dengue immunoglobulin M [IgM]) DF were included in this study. Their Socio demographic Details, clinical and laboratory data was recorded and analyzed. Results: Preliminary Results: Out of 125 cases, - 89 (71.2 %) patients were males and 36 (28.8%) were females. - The most common presentations were fever (96%) followed by Nausea/vomiting (40%), Headache (35%) and myalgia (31%). - Dengue NS1 and IgM antibodies were positive in 87.3% and 88.12% of the patients, respectively. - the incidence of DF, DHF, and DSS was 87.2, 11.2, and 1.6% respectively. - Shock, bleeding, and elevated serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase levels predicted adverse outcome. Conclusion: DF can present with a spectrum of clinical manifestations ranging from mild self-limiting illness to severe fatal disease. It can have varied and multi-systemic manifestations which can go unrecognized. Continuous seroepidemiological surveillance is essential to control outbreak and minimize morbidity and mortality.

Look Out for Fever: Clinical Profile of Dengue in Young Adults in a Tertiary Care Center in North India.

Background Dengue fever (DF) is a common viral disease, clinical manifestations of which vary from influenza-like illness (DF) to life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The aim of this article was to study the clinical profile of DF in young adults. Material and Methods This was an observational study conducted in the department of medicine over a period of 2 years (January 1, 2013-December 31, 2014). Patients aged between 18 and 30 years with serology proven (nonstructural protein 1 [NS1]/dengue immunoglobulin M [IgM]) DF were included in this study. The clinical and laboratory data was recorded and analyzed. Results Out of 418 cases, the incidence of DF, DHF, and DSS was 87.32, 7.66, and 5.02%, respectively. The most common presentations were fever (99.76%) followed by vomiting (29.43%), pain abdomen (17.94%), myalgias (13.16%), petechial rash (12.92%), and bleeding (10.29%). Dengue NS1 and IgM antibodies were positive in 87.3% and 88.12% of the patients, respectively. Ascites, splenomegaly, hepatomegaly, pleural effusion, gall bladder wall edema, and pericardial effusion were present in 8.13, 6.94, 6.70, 5.98, 2.63, and 0.72% of the patients, respectively. Complications included bleeding (10.29%), acute respiratory distress syndrome (1.67%), myocarditis (1.44%), seizures (1.44%), hemarthrosis (0.24%), and encephalopathy (0.24%). The mortality rate was 3.35% with death of 14 patients. Shock, bleeding, and elevated serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase levels predicted adverse outcome. Conclusion DF can present with a plethora of clinical manifestations in endemic areas. Adverse outcome is more likely if patients have elevated SGOT levels, shock, and bleeding. Continuous seroepidemiological surveillance is essential to control outbreak and minimize morbidity and mortality.

A Combination of Virgin Coconut Oil and Extra Virgin Olive Oil Elicits Superior Protection Against Doxorubicin Cardiotoxicity in Rats

The use of the chemotherapy agent doxorubicin (DOX) is associated with free radical formation that may lead to cardiotoxicity. Virgin coconut oil (VCO) and extra virgin olive oil (EVOO) are plant-based oil that is rich in antioxidants. This study examined the protective effects of VCO and EVOO combination to reduce DOX acute cardiotoxicity in rats. Twenty-five male rats (180-200 g) were divided into the following groups: Group I as a control, group II was given DOX i.p. injection of 25 mg/kg body weight (b.w.), group III to V received peroral administration of either VCO, EVOO or VCO-EVOO (1:1) combination at a dose of 10 mL/kg b.w. for 6 days before receiving DOX i.p. injection. After 24 hours from DOX injection, blood samples and organs were collected. Cardiac biomarkers, such as serum glutamic-oxaloacetic transaminase (SGOT), lactate dehydrogenase (LDH), and creatine kinase-MB (CKMB) were analyzed followed by histopathological examination. The administration of EVOO alone was found to reduce the marked elevation of SGOT, LDH, and CKMB levels in DOX-treated rats (p<0.05), while VCO administration only significantly reduced LDH and CKMB levels. However, when both oils were used in combination, the protective effect was shown to be more powerful since all cardiac biomarker levels were maintained at near-normal levels (p<0.05). Histopathological analysis showed a significant improvement in the myocardial tissue structures after pre-treatment with VCO-EVOO combination. The administration of VCO and EVOO in combination was superior to elicit protection against DOX-induced cardiotoxicity compared to their individual application in rats.

Therapeutic potential of policosanol in the concurrent management of dyslipidemia and non-alcoholic fatty liver disease

BackgroundHigh-fat diet (HFD) possesses a major cause of cardiovascular disease, and hepatosteatosis. Unfortunately, long-term use of statins has a theoretical possibility of worsening of hepatic histology in the patients with non-alcoholic fatty liver disease (NAFLD). The objective of the study was to explore hepatoprotective potential of policosanol as an alternative to statins in experimental NAFLD. For the same, young male Wistar rats were fed with HFD for 8 weeks to induce NAFLD. 48 adult Wistar rats were distributed into six investigational groups: normal control, HFD control, and four treatment groups, receiving policosanol (50 and 100 mg/kg/day), atorvastatin (30 mg/kg/day), and silymarin (100 mg/kg/day) for 8 weeks along with HFD.ResultHFD consumption caused profound hepatotoxicity evident by hepatic oxidative stress, increased Serum glutamic oxaloacetic transaminase (SGOT), Serum glutamic pyruvic transaminase (SGPT), Alkaline phosphatase (ALP), and bilirubin content. Treatment with policosanol (100 mg/kg) markedly reduced the elevated SGOT, SGPT, and ALP levels in HFD-fed rats. Moreover, policosanol significantly reduced hepatic oxidative stress manifest by reduced malondialdehyde (MDA) and increased glutathione (GSH) level. The treatment with policosanol (100 mg/kg) was found to be more active in attenuating the HFD-induced hepatotoxicity as compared to policosanol (50 mg/kg) and atorvastatin (30 mg/kg). Moreover, we observed that the hepatoprotective potential of policosanol was comparable to the silymarin.ConclusionsThe results of the study clearly indicated that the policosanol could be considered an intriguing approach for the treatment of NAFLD.

Toxicological evaluations of betulinic acid and ursolic acid; common constituents of Houttuynia cordata used as an anthelmintic by the Naga tribes in North-east India

BackgroundBetulinic acid (BA) and ursolic acid (UA) are two major phytoconstituents of Houttuynia cordata Thunb., (Saururaceae) which is used as an anthelmintic in the traditional medicine system of the Nagas in Nagaland, India. This study evaluates their toxic potentials using rodent models (Swiss albino mice and Wistar rats) according to the OECD (Organization for Economic Cooperation and Development) guidelines. Acute and 28-day sub-acute oral toxicity studies were conducted, and evaluations were made based on biochemical, hematological, and histopathological observations.ResultsAcute oral toxicity study revealed the oral LD50 of both the test compounds to be > 2000 mg/kg in mice. Sub-acute administration of BA at 10 mg/kg body weight (b.w.) revealed a significant increase in serum glutamic oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP), urea concentrations and eosinophil and lymphocyte counts in rats. Animals administered with 10 mg/kg b.w. UA revealed elevated neutrophil count, SGOT, ALP, and urea concentrations, whereas white blood cells (WBC), lymphocyte, and platelet counts were found to be low. Histopathological examinations of body organs revealed alterations in the architecture of the liver, kidney, and spleen tissues. Notably, all these alterations were recoverable as evident in the satellite group, indicating a recovering pattern from the toxic effects caused by the oral administration of these phytocompounds.ConclusionAlthough UA and BA possess several therapeutic properties, their long-term usage can cause mild toxicity in their users. This study also paves way for evaluating the optimum effective and safe dose of these phytocompounds.

Risk and Protective Factors Associated with Daytime Sleepiness in Patients Diagnosed with Hepatitis B or Hepatitis C Infection

Background: Poor sleep quality and daytime fatigue are common features of chronic hepatitis. Objectives: To evaluate the association between daytime sleepiness and hepatitis and to identify factors that contribute to daytime sleepiness in patients with hepatitis B and those with hepatitis C. Methods: In this prospective cross-sectional pilot study, outpatients with fatigue who did not receive any treatment for hepatitis were recruited from the Department of Gastroenterology and Hepatology and were classified into 5 groups of hepatitis B, hepatitis C, hepatitis B + C, other hepatitis types, and without hepatitis (controls). Gastroesophageal reflux and daytime sleepiness were determined based on two self-reported questionnaires, and linear and logistic regression analyses were performed. Results: In total 42 subjects had hepatitis B, 62 had hepatitis C, 9 had hepatitis B + C, 4 had other hepatitis types, and 14 had no hepatitis. Of them, 38 (29.01%) had gastroesophageal reflux (GERDQ score ≥ 12), and 13 (9.92%) had daytime sleepiness (ESS score ≥ 8). Hepatitis B patients with gastroesophageal reflux had significantly higher odds of daytime sleepiness [odds ratio (OR) = 12.44, 95% confidence interval (CI) = 1.59 - 261.02]. In hepatitis C patients, hypertension was significantly associated with daytime sleepiness (OR = 15.6, 95% CI = 2.13 - 143.21), while those with taller body height and elevated serum glutamic-oxaloacetic transaminase (GOT) levels had significantly lower odds of daytime sleepiness (body height: OR = 0.81, 95% CI = 0.65 - 0.93; GOT: OR = 0.76, 95% CI = 0.55 - 0.95). Conclusions: Gastroesophageal reflux is a risk factor for daytime sleepiness in hepatitis B patients. In hepatitis C patients, hypertension is a risk factor, while taller body height and elevated serum GOT are protective factors for daytime sleepiness.

Enhanced antihyperlipidemic potential of gemfibrozil under co-administration with piperine

Gemfibrozil is a well-known potent antihyperlipidemic drug with the capacity to lower triglyceride and cholesterol levels, which are responsible for most cardiovascular and cerebrovascular diseases. In addition, gemfibrozil has a potent activity at elevating the high density lipoprotein levels. However, this drug has a very short half-life of about 2 ​h and toxicity is observed in the liver as the dose increases. The drug piperine has the capacity to enhance the bioavailability of other drugs without altering their basic properties as well as improving their activity. In this study, we aimed to enhance the bioavailability of gemfibrozil as well as making it more potent and less toxic by applying piperine as a bio-enhancer. Thus, piperine was co-administered to rats with gemfibrozil and the antihyperlipidemic activity was tested when fed on a high fat diet. The results showed that co-administration of gemfibrozil with piperine decreased the elevated triglyceride and cholesterol levels to normal, and they performed significantly better than the individual drugs. Weight gain was controlled effectively by drug administration together with piperine compared with other groups. Hepatic function analyses demonstrated that the potentiation of gemfibrozil did not alter the hepatic function but instead it improved significantly by normalizing the elevated serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, and alkaline phosphatase levels. The plasma drug concentration of gemfibrozil was studied over time, where the enhanced activity of the drug reached its Cmax within 1 ​h of administration and the activated drug level was observed in the blood for 4 ​h.

Liver function in dengue and its correlation with disease severity: a retrospective cross-sectional observational study in a tertiary care center in Coastal India.

Introductiondengue, the most important arthropod- borne disease is transmitted to humans by mosquitos of the Aedes family. Liver dysfunction in dengue varies from mild injury with elevation of transaminases to severe hepatocyte injury. The aim of our study was to assess the prevalence of hepatic dysfunction in patients with dengue and to correlate between the severity of the disease with the extent of hepatic dysfunction.Methodsretrospective cross-sectional observational study including 120 patients with confirmed dengue serology admitted in Medicine Department of Father Muller Medical College during November 2018-December 2019. Patient demographics, presenting symptoms, clinical signs, laboratory parameters such as complete blood count, serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), alkaline Phosphatase (ALP), total and direct bilirubin; serum albumin and globulin levels were collected. Patients were categorized based on the modified WHO classification of 2009 into dengue with or without the warning signs and severe dengue. Comparison of multiple means across disease severity was performed using One Way-ANOVA with post hoc analysis using least significant difference. Pearson's correlation coefficient test was used to calculate the correlation between transaminases and platelet count. P-value <0.05 and CI 95% were considered in all analyses.Resultsserum glutamic-oxaloacetic transaminase was elevated in 66.7%, 78.6% and 91.7% patients of dengue without warning signs, warning signs and severe dengue respectively. Serum glutamic-pyruvic transaminase was elevated in 42.4%, 52.4% and 91.7% patients of dengue without warning signs, warning signs and severe dengue respectively. Patients with elevated SGOT (93.8%) and SGPT (81.2%) had a higher incidence of bleeding manifestations. Hypoalbuminemia (50.8%) and A: G ratio reversal (27.3%) was significantly more in severe dengue (p<0.0001). Serum glutamic-oxaloacetic transaminase and serum glutamic-pyruvic transaminase levels negatively correlated with platelet count (p<0.0001).Conclusionliver involvement in the form of elevated transaminases was found in 74.2% dengue patients. Serum glutamic-oxaloacetic transaminase and serum glutamic-pyruvic transaminase level increases with increase in dengue severity which is indicated by fall in platelet count as they are negatively correlated with each other. Liver damage is one of the common complications of dengue and transaminitis, hypoalbuminemia and reversal of A: G ratio should be used as biochemical markers in dengue patients to detect and monitor hepatic dysfunction.

A Retrospective Study in Dengue Positive Cases - Hematological and Biochemical Parameters (Liver Function Tests, Renal Function Tests) Correlation

Dengue fever is the most common arboviral infection in the world, and it is a disease with a broad clinical spectrum and a wide variety of presentations, ranging from asymptomatic to an undifferentiated fever (viral syndrome) to the more severe forms such as severe dengue (SD) or Dengue hemorrhagic fever (DHF). The diagnosis of dengue fever is carried out based on clinical, epidemiological and laboratory data. Among laboratory tests, both non-specific [blood count, platelet count, tourniquet test, prothrombin time (PT), activated partial thromboplastin time (APTT), liver function tests and serum albumin concentration] and specific tests (viral isolation tests and serology for antibody examination) are used. The principle aim of our study is to assess and compare the biochemical and haematological parameters of patients with dengue. In our study population, the peak frequency of the patients who were dengue positive was on the age group between 21 and 30 years (44%), and it was more common among males. The most common serological indicator of dengue fever was the presence of NS1 antibody. High haematocrit (56%) was found in most of the patients, and the next common finding was thrombocytopenia (51%). Elevated Serum glutamic oxaloacetic transaminase seen in 53% of cases and Elevated Serum glutamic pyruvic transaminase, Alkaline Phosphatase, Serum Bilirubin, Serum creatinine and Serum urea were found in 41%, 11%,7%, 4%, 3%of cases respectively. The knowledge about these parameters helps the clinician in early diagnosis of the cases and initiation of the management measures before the drastic clinical features of the disease sets.

A study in early neonatal period for the outcome based on the hepatic involvement following severe birth asphyxia in full term neonates

Background: The current study is focused on assessing the liver involvement of severely birth asphyxiated newborns, by measuring liver enzymes like Serum glutamic oxaloacetic transaminase (SGOT) and Serum glutamic pyruvic transaminase (SGPT) to predict the outcome of those babies. Methods: Total 111 severely birth asphyxiated newborns were assessed in a hospital based prospective analytical study. Liver enzymes were measured for all babies included in the study. Study subject details were obtained through a pre-structured questionnaire and also morbidity and mortality were noted. Analysis of the research data was done through appropriate statistical methods using SPSS version 20.Results: It was observed that incidence of hypoxic ischemic hepatitis, among entire study population was 34.2% (38 cases) based on SGPT (&gt;100 U/l) values. Current study findings indicated that incidence of hypoxic ischemic hepatitis had a positive correlation with hypoxic ischemic encephalopathy (HIE) staging. Mean SGOT, SGPT values were observed to increase as the HIE staging progressed. Based on Spearman’s correlation coefficient evaluation, it was determined that the elevated SGOT and SGPT values had moderate positive correlation with HIE, seizure, ventilator support and death in the study population. It was found from the present study findings that statistically significant mortality (77.4%) was observed among the HIE stage III babies, with elevated SGPT values.Conclusions: Current study findings revealed that elevated SGOT and SGPT values (more than twice the normal) has high sensitivity to predict the outcome in severely birth asphyxiated newborns. The stated parameters can prove to be effective in counselling parents regarding morbidity and mortality of neonates due to birth asphyxia.

Pumpkin (Cucurbita maxima) seeds protect against formaldehyde-induced major organ damages

Exposures to hazardous chemicals including formaldehyde are harmful to human health. In this study, the authors investigate the protective effects of pumpkin seed oil (PSO) extract against formaldehyde-induced major organ damages in mice. Administration of formaldehyde (FA) caused significant elevation of serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), serum creatinine, etc. Histopathological examinations of liver, kidney, and brain tissues showed the degenerations of those organs. Mice pretreated with PSO extract significantly attenuated the FA-induced elevation of SGOT (39.0 ± 1.30 vs 20.5 ± 0.65 IU/L; FA-group vs PSO treatment group), SGPT (91.8 ± 1.65 vs 51.0 ± 1.29 IU/L), serum creatinine (1.05 ± 0.07 vs 0.65 ± 0.07 IU/L), and preserved the normal histology of organ tissues. The FA-induced elevation of malondialdehyde (MDA) in the brain, liver, and kidneys was suppressed by pretreatment with PSO extract. The extract also attenuated the FA-induced reduction of endogenous antioxidant pools. In vitro phytochemical analyses showed that PSO extract possesses free radical scavenging and total antioxidant activities due to the presence of phenolic and flavonoid compounds. Thus, PSO extract has significant protective effects against FA-induced organ toxicities by scavenging oxidative stress and inhibiting lipid peroxidation.

Minimally invasive surgery for left ventricular assist device implantation is safe and associated with a decreased risk of right ventricular failure

BackgroundRight ventricular failure (RVF) after left ventricular assist device (LVAD) implantation is associated with significant mortality and morbidity. The objective of this study was to determine pre- and postoperative risk factors associated with the occurrence of RVF after LVAD implantation.MethodsThis retrospective study included 68 patients who received LVADs between 2010 and 2018 either for bridge to transplant (40 patients, 58.8%) or bridge to destination therapy (28 patients, 41.2%). RVF after LVAD implantation was defined according to the INTERMACS classification. The primary endpoint was the occurrence of RVF. The secondary endpoints were hospital mortality and morbidity and long-term survival.ResultsThe majority of patients (61.8%) had an INTERMACS profile 1 (36.8%) or 2 (25.0%). The LVAD was implanted either by sternotomy (37 patients, 54.4%) or thoracotomy (31 patients, 45.6%). RVF after LVAD implantation was observed in 32 patients (47.1%). In univariate analysis, an elevated serum glutamic oxaloacetic transaminase (SGOT) (P=0.028) and a high preoperative vasoactive inotropic score (VIS) (P=0.028) were significantly associated with an increased risk of RVF, whereas the implantation of LVAD through a thoracotomy approach was associated with a significant reduction in this risk (P=0.006). The multivariate analysis demonstrated that only the thoracotomy approach was significantly associated with decreased risk of RVF (odds ratio =0.33, 95% confidence interval: 0.17–0.96; P=0.042). Hospital mortality was 53.1% and 5.6% in the RVF and control groups, respectively (P<0.0001). The incidence of stroke and postoperative acute renal failure were significantly increased in the RVF group compared with the control group. The survival after LVAD implantation was 33.5%±9.0% and 85.4%±6.0% at 1 year in the RVF and control groups, respectively (P<0.0001).ConclusionsLVAD implantation by thoracotomy significantly reduced the risk of postoperative RVF. This surgical approach should, therefore, be favored.

Prevalence and clinical profile of glycogen storage diseases in children from Western India.

Aim of the studyTo determine the prevalence and clinical profile of glycogen storage diseases (GSD) in children in western India.Material and methodsThis retrospective analysis was conducted over a period of 7 years from 2006 to 2012. All children diagnosed with GSD on liver biopsy were included in the study. Their clinical history, examination, biochemical profile and outcome were noted.ResultsOf 751 children, 18 (2.4%) were clinically diagnosed with GSD. Mean age at presentation was 2.3 ±1.3 years. Male : female ratio was 1 : 1. The main presenting features were abdominal distension in 15 (83.3%) patients, hepatomegaly in all 18 (100%), splenomegaly in 11 (61.1%) and jaundice in 2 (11.1%) patients. Four (22.2%) patients had delayed development. Four (22.2%) patients were siblings to an older affected child. Only 1 (5.6%) patient had portal hypertension and 2 (11.1%) had ascites. Only 1 (5.6%) patient had elevated bilirubin levels, 17 (94.4%) had elevated serum glutamic-oxaloacetic transaminase (SGOT) and all 18 (100%) patients had elevated serum glutamic-pyruvic transaminase (SGPT) levels. Nine (69.3%) patients of the 13 tested had acidosis, 1 (9.1%) had elevated uric acid, 2 (11.1%) had neutropenia, 8 (44.4%) experienced hypoglycemia, 4 (22.2%) patients had nephromegaly and only 1 patient showed evidence of cirrhosis in the liver biopsy. Fifteen (83.3%) patients were short. Three out of 6 patients tested had hypertriglyceridemia (50%). One (5.6%) patient died, 9 (50%) patients were lost to followup and the remaining 8 (44.4%) patients continued regular follow-up.ConclusionsMetabolic acidosis, hypertriglyceridemia, short stature, and hypoglycemia are major problems in children with GSD. Most of the patients are referred late at the time of presentation.

Effect of sitagliptin, a DPP-4 inhibitor, against DENA-induced liver cancer in rats mediated via NF-κB activation and inflammatory cytokines.

The target of the current research was to investigate the anticancer activity of sitagliptin on diethylnitrosamine (DENA)-induced cancer in the liver. Wistar rats were treated with or without sitagliptin before DENA treatment. We detected liver weight, blood glucose, and histopathology of the liver. Serum biochemical markers like serum glutamate pyruvate transaminase (SGPT), serum glutamate oxaloacetate transaminase (SGOT), serum alkaline phosphatase (SALP), gamma-glutamyl transpeptidase (GGTP), total bilirubin (TBR), total protein (TPR), and albumin (ALB) were also evaluated. In addition, lipid profile parameters comprising total cholesterol (TC), triglycerides, and high-density lipoprotein were also measured. Inflammatory mediators like interleukin-6 (IL-6), interleukin-1beta (IL-1β), and tumor necrosis factor-alpha (TNF-α) were determined in liver homogenate. Furthermore, the activity of nuclear factor (NF-κB) was also measured. Our results showed that sitagliptin (10 and 20 mg/kg) in a dose-dependent manner expressively decreased the DENA-induced elevation of SGPT, SGOT, SALP, and GGTP. Whereas sitagliptin (10 and 20 mg/kg) in a dose-dependent mode reduced the level of TBR and increased the TPR and ALB as well as improved the liver histopathology alterations in DENA-exposed rats. Lipid profile was also restored by the sitagliptin (10 and 20 mg/kg) in a DENA-treated rats. The level of IL-1β, IL-6, and TNF-α were suggestively suppressed. Moreover, pretreatment with sitagliptin (10 and 20 mg/kg) prevented the activation of NF-κB. In conclusion, sitagliptin (10 and 20 mg/kg) has a potential protective effect against DENA-induced liver cancer by inhibition of inflammation and NF-κB activation.

HEPATO-NEPHROPROTECTIVE ACTIVITY OF NIGELLA SATIVA OIL ON PARACETAMOL-INDUCED NEW ZEALAND RABBITS (ORYCTOLAGUS CUNICULUS)

Objective: The objective of this work was to investigate the hepato-nephroprotective activity of Nigella sativa (Ranunculaceae) oil on paracetamol-induced New Zealand rabbits (Oryctolagus cuniculus).Methods: Hepato-nephroprotective activity of Nigella sativa oil was demonstrated on six groups of paracetamol-induced New Zealand rabbits (Oryctolagus cuniculus) aged 3-4 mo, three in each group (2 males, 1 female). Group I was normal control (water 1.0 ml/kg of body weight per oral), group II was negative control (water 1.0 ml/kg of body weight per oral), group III was positive control (silymarin 100 mg/kg of body weight per oral), group IV-VI were treated with Nigella sativa oil (NSO) dose of 0.5 mg/kg of body weight, 1.0 mg/kg of body weight, and 2.0 mg/kg of body weight per oral, respectively, for 15 d. At the 16th day, rabbits in group II-VI were induced with paracetamol at a dose of 600 mg/kg of body weight per oral. At the 23rd day the animals were measured for their clinical biochemistry parameters and histological examination.Results: Paracetamol administration dose of 600 mg/kg of BW resulted in the elevation of serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), and ureum-N levels of the animals, particularly in group II which was treated only with paracetamol. Normal histology of the liver defines the clear shape of the terminal hepatic venule (THV)/central vein (CV) and sinusoids, whereas that of the kidney defines clear shape of the Bowman capsule and glomerulus shape. Qualitative histological examination of the liver showed that the THV/CV in all groups was normal, however in the paracetamol-treated group, the sinusoids were dilated, necrosis and mass apoptosis were detected. Dilated sinusoids were observed in the silymarin group and in the lower and medium doses of NSO groups. In the highest dose of NSO group the THV/CV and sinusoids were normal, but a local apoptosis and fat degeneration were detected. Qualitative histological examination of the kidney indicated that there was no abnormality of the glomerulus shape, however, mass apoptosis and local necrosis of the kidney were found in the paracetamol-treated group and the silymarin-treated group. The lowest dose of the NSO-treated group showed a normal shape of glomerulus and Bowman capsule, normal apoptosis. No necrosis was observed in the rabbit’s kidney. Higher doses of NSO groups indicated a normal glomerulus shape and Bowman capsule, mass apoptosis and local necrosis.Conclusion: In this study, Nigella sativa oil could maintain the normality of the THV/CV and sinusoids in the liver of paracetamol-induced New Zealand rabbits (Oryctolagus cuniculus). Normal glomerulus shape and Bowman capsule were also confirmed in the kidney of paracetamol-induced animals.

The Potency of Red Seaweed (Eucheuma cottonii) Extracts as Hepatoprotector on Lead Acetate-induced Hepatotoxicity in Mice.

Background:Lead is one of the most toxic metals, producing severe organ damage in animals and humans. Oxidative stress is reported to play an important role in lead acetate-induced liver injury.Aim:This study was carried out to investigate the role of ethanol extract of Eucheuma cottonii in protecting against lead acetate-induced hepatotoxicity in male mice.Materials and Methods:The sample used fifty male mice which were divided into five groups: negative control (mice were given daily with Aquadest); positive control (mice were given daily with lead acetate 20 mg/kg body weight (BW) orally once in a day for 21 days); and the treatment group (mice were given E. cottonii extracts 200 mg, 400 mg, and 800 mg/kg BW orally once in a day for 25 days, and on the 4th day, were given lead acetate 20 mg/kg BW 1 h after E. cottonii extract administration for 21 days). On day 25, the levels of serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvate transaminase (SGPT), alkaline phosphatase (ALP), malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GPx) were measured. The data of SGOT, SGPT, ALP, MDA, SOD, and GPx were analyzed with one-way ANOVA, followed by least significant difference test.Results:The results showed that oral administration of lead acetate 20 mg/kg BW for 21 days resulted in a significant increase in SGOT, SGPT, ALP, and MDA levels. Moreover, there was a significant decrease in SOD and GPx levels. Treatment with E. cottonii extracts of 800 mg/kg BW but not with 200 mg/kg BW and 400 mg/kg BW significantly (P < 0.05) decreased the elevated SGPT, SGOT, ALP, and MDA levels as compared to positive control group. Treatment with E. cottonii extracts of 800 mg/kg BW also showed a significant increase in SOD and GPx levels as compared to positive control group. Treating mice with lead acetate showed different histopathological changes such as loss of the normal structure of hepatic cells, blood congestion, and fatty degeneration whereas animals treated with lead acetate and E. cottonii extracts showed an improvement in these changes and the tissue appeared with normal structures.Conclusion:It can be concluded that E. cottonii extracts could be a potent natural product and can provide a promising hepatoprotective effect against lead acetate-induced hepatotoxicity in mice.SUMMARY In summary, Oxidative stress reported to play an important role in lead acetate induced liver injury. The lead acetate treatment significantly increased the SGOT, SGPT, ALP, MDA, and decreased the antioxidant enzymes (SOD and GPx) in liver. The inhibition of antioxidant enzymes will increase free radicals in liver tissues and might induce liver injury in mice. The presence of ethanol extract of Eucheuma cottonii with lead acetate showed protective effects as attenuating lead acetate against its liver toxicity, and this may be due to the activity of ethanol extract of Eucheuma cottonii as antioxidant. The antioxidant enzymes (SOD and GPx) were increased, and MDA, SGOT, SGPT, ALP were decreased after ethanol extract of Eucheuma cottonii administration. The enzymatic activities (SOD and GPx) and MDA in mice can be used as biomarkers of heavy metal toxicity such as lead acetate. Histopathological view of liver sections in the lead acetate treated group showed the liver damage, as compared to the negative control group. However, administration of ethanol extract of Eucheuma cottonii significantly improved the histopathological in liver of lead acetate-treated mice. From the results of this study we concluded that the ethanol extract of Eucheuma cottonii could be a potent natural product provide a promising protective effect against lead acetate induced liver toxicity in mice. Abbreviations Used: SGOT: Serum Glutamic Oxaloacetic Transaminase, SGPT: Serum Glutamic Pyruvate Transaminase, ALP: Alkaline Phosphatase, MDA: Malondialdehyde, SOD: Superoxide Dismutase, GPx: Glutathione Peroxidase.

Gut-derived lymphocyte recruitment to liver and induce liver injury in non-alcoholic fatty liver disease mouse model.

Most studies focus on gut-derived factors like microbiota and its products and how they contribute to non-alcoholic fatty liver disease (NAFLD) progression. This study investigated whether the gut-derived lymphocytes could migrate to the liver and induce liver injury in NAFLD. A high-fat diet induced an NAFLD mouse model, and lymphocytes were labeled with 1,1-dioctadecyl-3,3,3,3 tetramethylindotricarbocyanine iodide and carboxy-fluorescein succinimidyl ester, respectively, and intravenously injected to mice to monitor lymphocyte migration. Adoptive transfer model results indicated that compared with lymphocytes from the spleen, bone marrow and thymus of NAFLD donor mice, mesenteric lymph nodes (MLN) cells from NAFLD donor mice predominately accumulated in the livers of NAFLD recipient mice. The frequencies of central memory CD4(+) T and CD8(+) T cells in livers of NAFLD mice were significantly increased; however, the activated T cells were not significantly altered. After adoptively transferred MLN cells, the frequencies of the activated CD4(+) T and CD8(+) T cells increased in livers of NAFLD recipient mice. By contrast, the frequencies of central memory and naïve CD4(+) T and CD8(+) T cells decreased. MLN cells also induced liver injury in NAFLD recipient mice, as reflected by elevated serum alanine aminotransferase and glutamic oxaloacetic transaminase serums. Moreover, the chemotaxis assay showed that CCL5 mediated the MLN cell migration to the liver. Also, blocking the CCL5 inhibited MLN cell migration to the liver in vitro. Gut-derived lymphocytes from NAFLD mice could migrate to the liver and induce liver injury and hepatic CD4(+) T and CD8(+) T cells activation. The migration was associated with the upregulation of CCL5 in the liver.

Oral Lichen Planus in Relation to Transaminase Levels and Hepatitis C Viral Antibodies Detection: A Clinical Study

ABSTRACTBackgroundLichen planus (LP) is a common long term inflammatory disorder that affects skin and mucous membranes. Though mostly asymptomatic in oral mucosa it may cause severe morbidity in erosive cases. The relation between LP and liver diseases especially hepatitis C have been proposed by many authors with varied results. Alteration in liver function tests reflected by increased levels of transaminase levels, i.e., serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT) with or without the presence of antibodies against hepatitis C virus (HCV) has been observed in oral lichen planus (OLP) patients in many studies. So this study was undertaken with the intent to further evaluate any alliance between OLP and liver disease principally hepatitis C.Materials and methodsThe study consisted of 30 histopathologically confirmed patients of OLP and 30 age and sex matched healthy volunteers visiting the outpatient department of a dental hospital over a period of 1 year. All subjects in both groups were subjected to SGOT, SGPT and HCV antibodies detection.ResultsThe percentage of patients with elevated SGOT and SGPT values was higher among the OLP patients in the study group (40%) in comparison to subjects in the control group (7%). The mean values of SGOT and SGPT were also higher in the study group in comparison to the control group. No HCV antibodies were found in the serum of subjects in both the study group and control group.ConclusionLiver disease or hepatitis C can be considered a risk factor for LP and may lead to diagnosis, early treatment and possibly a better prognosis in asymptomatic OLP patients. Further studies with large samples are recommended to prove the current hypothesis regarding the association between LP and chronic liver disease and/or HCV infection.How to cite this articleSobti G, Manjunath M, Deepak TA, Krishna S, Annaji AG. Oral Lichen Planus in Relation to Transaminase Levels and Hepatitis C Viral Antibodies Detection: A Clinical Study. World J Dent 2016;7(2):64-68.