Liver Function Tests Research Articles

Causality and Severity of Adverse Reactions and Biochemical Changes to Benznidazole Treatment in Patients with Chronic Chagas Disease.

Chagas disease (CD) is a serious public health problem in Latin America. Benznidazole (BNZ) is used for the treatment of CD and, despite its wide use, little information is available about its toxicity and mechanisms of adverse drug reactions (ADR). To identify and classify clinical and laboratory adverse reactions caused by BNZ in terms of causality and severity. Prospective cohort study from January 2018 to December 2021. Treatment follow-up included visits and biochemical tests (complete blood count, liver and kidney function tests) before, during and after treatment. ADR were classified according to causality and severity. In the statistical analysis, the significance level was set at p<0.05. Forty patients with chronic CD were included. A high prevalence of ADR was observed 161 ADR in 30 patients [90%]; of these, 104 (64.6%) were classified as possible and 57 (35.4%) as probable. The ADR were classified as moderate and mild. Of the 40 patients, nine (22.5%) discontinued treatment. ADR associated with treatment discontinuation and interventions were those that affected the dermatological system, central and peripheral nervous system and sense organs such as ageusia. Mild hematological and biochemical changes such as lymphopenia were observed after 30 days of treatment. Many patients were able to complete the treatment even with ADR, which can be attributed to the successful follow-up strategy with symptomatic treatment and counseling, leading to patient's awareness of symptoms and treatment adherence.

Norethindrone-Associated Transaminitis in Endometriosis Patients: A Case Series and Literature Review.

In this case series, we discuss 10 cases of norethindrone-induced transaminitis and conduct a literature review of this rare adverse event. A retrospective chart review was conducted on 10 patients (median age: 33 years) with diverse endometriosis phenotypes who received norethindroneand subsequently developed transaminitis, which is defined aselevated alanine transaminase (ALT) and aspartate transaminase (AST) levels. This condition was diagnosed in both asymptomatic and symptomatic patients, either during the work-up of acute symptoms or incidentally through routine lab tests. Our objective was to assess and characterize a case series of transaminitis associated with norethindrone use in endometriosis patients, detailing clinical presentations, management strategies, and outcomes. All cases exhibited normalization of liver function tests after discontinuation, occurring within one to 12 months with varying intervals of liver function testing. Patients receiving higher dosages (10 mg daily) demonstrated quicker resolution (average: four months). The reported adverse effects included nausea, vomiting, headache, rash, polyarthralgia, and abnormal uterine bleeding. Vigilant management, including prompt discontinuation, consistently resulted in the resolution of transaminitis. This study underscores the importance of continuous monitoring of liver function, even in asymptomatic patients on norethindrone therapy. Further investigations are imperative to identify specific groups susceptible to this adverse event.

Prognostic significance of liver function tests in predicting maternal and fetal outcomes in Hypertensive Disorders of Pregnancy

Prognostic significance of liver function tests in predicting maternal and fetal outcomes in Hypertensive Disorders of Pregnancy

Liver dysfunction in adults with COVID-19 infection: A longitudinal study with transient elastography evaluation.

Abnormal liver biochemistry (ALB) is common among patients with COVID-19 infection due to various factors. It is uncertain if it persists after the acute infection. We aimed to investigate this. A multicenter study of adult patients hospitalized for COVID-19 infection, with at least a single abnormal liver function test, was conducted. Detailed laboratory and imaging tests, including transabdominal ultrasound and FibroScan, were performed at assessment and at 6-month follow-up after hospital discharge. From an initial cohort of 1246 patients who were hospitalized, 731 (58.7%) had ALB. A total of 174/731 patients fulfilled the inclusion criteria with the following characteristics: 48.9% patients had severe COVID-19; 62.1% had chronic liver disease (CLD); and 56.9% had metabolic-associated fatty liver disease (MAFLD). ALB was predominantly of a mixed pattern (67.8%). Among those (55.2%) who had liver injury (aspartate aminotransferase/alanine aminotransferase >3 times the upper limit of normal, or alkaline phosphatase/γ-glutamyl transferase/bilirubin >2 times the upper limit of normal), a mixed pattern was similarly predominant. Approximately 52.3% had normalization of the liver lunction test in the 6-month period post discharge. Patients with persistent ALB had significantly higher mean body mass index (BMI) and serum low-density lipoprotein (LDL), higher rates of MAFLD and CLD, higher mean liver stiffness measurement and continuous attenuated parameter score on FibroScan, and higher rates of liver injury on univariate analysis. Multivariate analysis was not statistically significant. Approximately 47.7% of COVID-19 patients were found to have persistent ALB up to 6 months following the acute infection, and it was associated with raised BMI, elevated serum LDL, increased rates of MAFLD and CLD, and higher rates of liver injury on univariate analysis, but not on multivariate analysis.

Association of Liver Function Tests With the Severity and Outcome of Dengue Fever in Children.

Background Dengue is one of the most common vector-borne diseases in India, and it is transmitted by Aedes family mosquitoes. Hepatic injury is known to occur from dengue infection. Direct hepatotoxicity and deranged host immune responses to the virus are responsible for this hepatic dysfunction. Hence, the study was undertaken to understand the deranged hepatic enzymes using liver function tests (LFTs)and the severity and outcome of dengue fever in children. Methods This study is an observational-descriptive study conducted between June 2022 and May 2024. The study population includes children between the ages of one month and 16 years who have been diagnosed with dengue fever andadmitted to pediatric wards and pediatric intensive care units (PICUs), with a sample size of 151. Informed consent from guardians and institutional ethical clearance were obtained. Results A total of 4.8% (N = 7) mortality was seen in this study with dengue patients. Hepatomegaly was seen in34% (N = 49)of cases. There is a clear statistical significance that is seen among the non-survived and survived dengue patients with a 10-fold increase in serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) levels, respectively, along with total bilirubin, activated partial thromboplastin time(APTT), and prothrombin time (PT). Conclusions The current study shows that deranged LFTs are associated with more severe disease with more PICUadmissions and mortality of the disease. The evidence clearly indicates the inclusion of LFTs as a routine investigation to understand the severity of the disease and the prognosis of the outcome.

Cardiac surgery and acute hepatitis B - Use of the Seraph™ 100 hemofilter.

We present a case of a 55-year-old male, presenting with angina symptoms with electrocardiographic changes and a panfocal systolic murmur radiating to the carotids. He had a primary HBV infection 8 months ago, without antiviral treatment. Echocardiography showed critical aortic valve stenosis (area: 0.53 cm2/m2). No coronary lesions were found on coronary angiography. Blood analysis revealed AST/GOT of 96 U/L and ALT/GPT 150 U/L. The serological profile revealed positive IgM anti-HBc, anti-HBc, anti-HBs and anti-HBe antibodies, with an increasing viral load (VL). The abdominal ultrasound identified mild hepatic fibrosis (F3) with minimal steatosis. Mechanical aortic prosthetic valve replacement was performed under CPB. The Seraph™ 100 filter was incorporated into the CPB circuit to reduce the risk of HBV contamination, infection and liver failure. The postoperative VL was monitored (Table 1). Liver function tests showed peak levels of bilirubin 0.66 mg/dL, AST/GOT 58 U/L, ALT/GPT 74 U/L at 6 hours post-surgery, with recovery of normal ranges at 48 hours post-surgery.

A Retrospective Analysis of Micafungin Prophylaxis in Children Under 12 Years Undergoing Chemotherapy or Hematopoietic Stem Cell Transplantation.

Literature is limited regarding ideal micafungin dosing in pediatric patients with hematologic malignancies receiving chemotherapy or hematopoietic stem cell transplantation. Micafungin is an intravenous echinocandin with activity against Candida and Aspergillus species and has a favorable safety profile compared with other antifungal classes. Our objective was to evaluate the breakthrough invasive fungal infection (IFI) rate in pediatric patients who received a prophylactic micafungin course at our institution. A single-center, retrospective study was conducted between January 1, 2011, and July 31, 2017, to determine the IFI rate in patients receiving micafungin prophylaxis. Patients with suspected IFI were evaluated for probable or proven infection based on European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group Consensus Group invasive fungal disease definitions. Statistical analyses were descriptive. A total of 170 prophylactic micafungin courses from 129 unique patients ages <12 years at a median dose of 3 mg/kg daily were identified. The rate of probable or proven breakthrough IFIs was 2.4% as determined by clinical, radiologic, microbiologic, and histopathologic criteria. A low rate of breakthrough IFI was seen with micafungin prophylaxis that is consistent with prior published adult hematopoietic stem cell transplantation studies. Micafungin was well tolerated, with liver function test elevations being transient in most cases and thought to be related to alternative factors.

Evaluating initial screening practices for calcium dysregulation after acute traumatic spinal cord injury: a retrospective review

ObjectivesThe purpose of this study was to determine the frequency of which calcium homeostasis markers are obtained in the acute setting after an initial traumatic spinal cord injury (TSCI).DesignRetrospective chart review of a limited data set linking ICD 10 codes designating TSCI to corresponding calcium homeostasis markers for patients with an initial chart encounter for TSCI.SettingA level 1 trauma center in Virginia, United StatesMethodsThe statistical software SPSS was used to calculate summary statistics including frequency, mean, and standard deviation for calcium homeostasis markers (basic metabolic panel, magnesium, spot urine calcium, testosterone panel, liver function tests, Vitamin D level, C-telopeptide, parathyroid hormone, celiac panel, DXA imaging report) as well as the mean and standard deviation for time to first check of the marker.ResultsMost markers were not obtained besides calcium. Only 10 of 80 (12.5%) of subjects had a Vitamin D level (mean 28, SD 23) checked during acute admission (mean days to check 1.5, SD 1.6), with most other markers checked much less frequently.ConclusionsMost calcium homeostasis markers were not checked on acute admission after TSCI. Future studies on implementing a standardized calcium homeostasis marker protocol for monitoring and potential medical intervention should be explored.

Hepatic Hydatid cyst in children: An experience from East of Turkey

İntoduction: Hydatid cyst is a parasitic disease caused by the infection of Echinococcus granulosus and rarely Echinococcus alveolaris eggs, which are endemic in our country. Current treatment options for liver hydatid cysts; They can be listed as medical treatment, surgical treatment, percutaneous drainage and clinical follow-up only. In this study, the effectiveness of the WHO-IWGE protocol in terms of diagnosis and treatment strategies in our pediatric cases of liver hydatid cyst in a health institution in eastern Turkey was evaluated in the light of the literature. Material Method: Pediatric patients between the ages of 0-16 who were diagnosed with KcKH and followed up and treated were evaluated retrospectively. In pre-operative evaluation, lung radiography, abdominal ultrasonography, serological tests, hemogram and liver function tests were routinely performed. Results: 250 child patients between the ages of 0 and 16, whose data were fully available, were included in the study. 118 of the cases were girls and 132 were boys. The average age was 11.2 years. Most of the KcKH patients were admitted to the hospital for another reason and the cyst was detected incidentally. Of the 65 patients requiring surgery, 17 were patients who initially underwent primary intervention with PAIR. Patients who underwent PAIR were observed for one night and discharged in an average of 18 hours. Patients with free drainage were discharged in 2-4 days. The average length of stay for patients who underwent open surgery was found to be 9 days. In conclusion; The Gharbi classification updated by WHO is effective and reliable in determining the KcKH treatment strategy. In cases who are receiving chemotherapy and an intervention decision is made, a final USG is performed just before the procedure; It can provide both a change in treatment management and more patients benefiting from medical treatment.

Association of Adiponectin and Oxidized HDL with ABO Blood Groups in Fatty Liver Patients

Non-Alcoholic Fatty Liver Disease (NAFLD) is a group of liver diseases that are not brought on by alcohol usage and are defined by an excessive buildup of fat in the liver cells. Objective: To identify the relationship between the Body Mass Index (BMI) and liver function markers in the study group, as well as Oxidized High-Density Lipoprotein (oxHDL) levels. Methods: This study was conducted at the University of Lahore, for the duration of six months from January 2022 to June 2022. For determining the role of adiponectin and oxHDL, (n=200) patients and divided into two group, healthy group (n=100) and disease group (n=100) participants. Biochemical identification, liver function test, lipid profile test and ELISA was done for analyzing the association with NAFLD. SPSS software was used for statistical analysis. Results: In this study different parameters were used that’s values of parameters mean of cases according to blood group system were varied than normal range, such as adiponectin level, BMI, oxLDL, oxHDL, ALT, AST, ALP, Cholesterol level, d-LDL, Calculated LDL, sdLDL, V-LDL, Triglyceride level, Apolipoprotein-B level was significantly higher and AST/ALT Ratio values, albumin, HDL were slightly less than normal values. O Blood groups was reported very low risk of fatty liver patients due to high adiponectin. Conclusions: From analysis it was concluded, that adiponectin and oxHDL associated with high risk of non-alcoholic fatty liver disorder.

Four-Year Report of Iatrogenic Bile Duct Injury Repair from a Referral Hepatobiliary Center.

Iatrogenic bile duct injury (BDI) is one of the most common complications that challenge surgeons performing laparoscopic cholecystectomy (LC). As the number of LC surgeries increases, a pattern of BDI is emerging, but little is known about this matter. The purpose of this study was to assess the pattern of post-LC BDIs directed in a referral center in Iran. Post-BDI patients referred to a hepatobiliary center were studied. Demographic data, clinical status, diagnostic examinations, referral time, post-referral management, and morbidity were analyzed. Nine out of 68 patients had Charcot's cholangitis triad featuring right upper quadrant abdominal pain, fever, and icter. Fever, icter, and itching were the most frequent symptoms. Increased bilirubin, leukocytosis, and abnormal liver function test (LFT) were the most common laboratory abnormalities. 30 patients experienced hepatic artery injury. Out of them, six patients experienced hepatectomy due to hepatic ischemia. Two patients were re-admitted and re-operated, and four patients died. Early and correct treatment by a hepatobiliary surgeon experienced in the management of these types of injuries prevents further complications in patients suffering from iatrogenic BDI. Postoperative complications of bile duct repair, such as anastomosis stricture, are possible; thus, patients need long-term and thorough postoperative observation.

Simultaneous choledochal cyst excision and pancreaticojejunostomy (Puestow’s technique) for type IA cyst with associated chronic pancreatitis: a case report

Introduction and importanceCholedochal cysts are congenital conditions that affect the biliary tree, typically identified during childhood. These cysts present as dilations in the biliary system, occurring either in the extrahepatic or intrahepatic regions or in some cases, in both areas. Occasionally, it may have associated chronic pancreatitis posing a challenge to the management of both conditions.In the case reported, a female child was diagnosed with a choledochal cyst along with chronic pancreatitis. She had an excision of cyst and lateral pancreaticojejunostomy simultaneously for both conditions resulting in favorable outcomes.Case presentationAn 8-year-old child visited the clinic with a complaint of upper abdominal pain accompanied by intermittent vomiting. An ultrasound was performed which showed a dilated common bile duct. To confirm the diagnosis, an MRCP and baseline labs including liver function tests were ordered. The findings were suggestive of a type IA choledochal cyst with concomitant chronic pancreatitis. Subsequently, she had choledochal cyst excision with Roux-en-Y hepaticojejunostomy reconstruction plus lateral pancreaticojejunostomy using the classical Puestow’s technique. The patient’s recovery post-surgery was uneventful, resulting in discharge on the fifth post-operative day for routine outpatient follow-up.Clinical discussionPatients afflicted with choledochal cysts are prone to recurrent pancreatitis, though the precise underlying mechanism is unknown. Certain studies propose an association between abnormal pancreatico-biliary junction and recurrent pancreatitis, often defined as a common channel surpassing 15 mm in length. However, this aberration could not be definitively established in the current case. Diagnosis of choledochal cysts can be confirmed through either ERCP or MRCP, with the latter preferred due to its non-invasive nature. The optimal management strategy for choledochal cysts necessitates cyst resection and Roux-en-Y hepaticojejunostomy reconstruction Moreover, in cases associated with chronic pancreatitis, longitudinal pancreatojejunostomy may be undertaken.ConclusionThus, it is concluded that although rare choledochal cysts may have associated chronic pancreatitis. Surgical excision of the cyst and lateral pancreaticojejunostomy can be performed simultaneously resulting in favorable post-operative outcomes.

Lung transplant list withdrawal in a liver transplant patient thanks to elexacaftor-tezacaftor-ivacaftor: a case report

BackgroundElexacaftor-tezacaftor-ivacaftor (ETI) is a transmembrane conductance regulator modulator that significantly improves lung function in patients affected by cystic fibrosis (CF). This triple drug is currently not indicated in liver transplant patients, as clinical trials including subjects with previous solid organ transplantation are lacking.Case presentationWe report on a liver transplant girl with CF-related advanced pulmonary disease meeting clinical criteria for lung transplant, who started the triple modulator because she could not get on the lung transplant waiting list due to psycho-social motivations. Since initiation of ETI therapy, she has experienced a significant improvement in respiratory function and quality of life, without adverse effects.ConclusionsThis case shows that ETI therapy can represent a lifesaving drug for individuals without alternatives, even in liver transplant patients. The clinical benefits of the modulator overcome risks, which may be limited with a close drug monitoring of immunosuppressants serum levels and functional liver tests.

Anti-diarrheal effects of ethanol leaf extract of Eleusine Indica in Castor Oil induced diarrhea using mice model

Ancient civilizations employed medicinal herbs to treat ailments. Medicinal herbs are essential for treating chronic disorders. Different medicinal plants can treat comparable ailments, depending on the country. In many rural communities in developing countries, particularly in Africa, therapeutic medicines and remedies derived from indigenous plants are almost invariably the only readily available and cost-effective alternatives to traditional diarrhea medicines. The study aims to evaluate the anti-diarrheal activity of the Eleusine indica ethanol extract in mice. The study used fresh Eleusine indica leaves. The extracts were administered at concentrations of 250, 500, and 1000 mg/kg for 28 days. On the 29th, the rats were induced with diarrhea, and blood samples were collected through the retro-orbital plexus before being sacrificed. The serum from the collected blood was used to run hematological and electrolyte tests. The liver and kidney function tests were analyzed using standard methods. The determination of antidiarrheal activity was done using the following models: Castor oil (CO) induced diarrhea, CO induced enteropooling activity, and CO induced gastrointestinal motility. The 80% ethanol extract produced significant (p&lt;0.001) antidiarrheal activity in all three models tested. The hematological, renal, hepatic, and electrolyte parameters of extract-treated mice were not significantly (p &gt; 0.05) different from those of the control group. There was no statistically significant difference (p &gt; 0.05) in the chloride, sodium, potassium, calcium, and bicarbonate levels of the extract-treated groups when compared to the control group. The findings of the studies demonstrated the antidiarrheal activities of Eleusine indica leaves, which could be a therapeutic option against diarrhea.

Liver involvement with Langerhans cell histiocytosis in adults.

Liver involvement portends poor prognosis in adults. We aimed to characterize the clinical features, liver function tests, radiologic findings, molecular profiles, therapeutic approaches and outcomes of adults patients with Langerhans cell histiocytosis (LCH) with liver involvement. We conducted a retrospective analysis of all adults with LCH (≥ 18 years) seen at Peking Union Medical College Hospital (Beijing, China) between January 2001 and December 2022. Among the 445 newly diagnosed adults with LCH, 90 patients had liver involvement at diagnosis and 22 patients at relapse. The median age was 32 years (range, 18-66 years). Of 112 evaluable patients, 108 had full liver function testing, including alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT), and total bilirubin and albumin. Elevated ALP was seen in 63.0% and GGT in 86.1%; 14.8% had elevated bilirubin. Next-generation sequencing of 54 patients revealed frequent BRAFN486_P490 (29.6%), BRAFV600E (18.5%), and MAP2K1 (14.8%). After a median 40 months' follow-up (range 1-168 months), 3-year progression-free survival (PFS) and overall survival were 49.7% and 86.6% respectively. In multivariable analyses, ≥3 abnormal liver function tests (HR 3.384, 95% CI 1.550-7.388, P = .002) associated with inferior PFS; immunomodulatory drug therapy (HR 0.073, 95% CI, 0.010-0.541, P = .010) correlated with superior PFS versus chemotherapy. In summary, elevated GGT and ALP were common in adults with LCH liver involvement. Greater than equal to 3 abnormal liver function tests predicted poor outcomes. Immunomodulatory drug therapy was associated with favorable progression-free survival compared to chemotherapy.

Genetic issues in ICP.

Intrahepatic cholestasis of pregnancy (ICP) is the commonest gestational liver disorder with variable global incidence. Genetic susceptibility, combined with hormonal and environmental influences, contributes to ICP aetiology. Adverse pregnancy outcomes linked to elevated serum bile acids highlight the importance of comprehensive risk assessment. ABCB4 and ABCB11 gene variants play a significant role in about 20% of severe ICP cases. Several other genes including ATP8B1, NR1H4, ABCC2, TJP2, SERPINA1, GCKR and HNF4A have also been implicated with ICP. Additionally, ABCB4 variants elevate the risk of drug-induced intrahepatic cholestasis, gallstone disease, gallbladder and bile duct carcinoma, liver cirrhosis and abnormal liver function tests. Genetic variations, both rare and common, intricately contribute to ICP susceptibility. Leveraging genetic insights holds promise for personalised management and intervention strategies. Further research is needed to elucidate variant-specific phenotypic expressions and therapeutic implications, advancing precision medicine in ICP management.

Probing liver function test patterns in COVID-19 pneumonia: Implications for disease severity assessment.

To explore the incidence of liver function test derangement, the precise patterns of derangement, and their relationship with coronavirus disease-2019 pneumonia severity. The retrospective study was conducted at the Dow University Hospital and the Ojha Institute of Chest Diseases, Karachi, and comprised consecutive data from December 16, 2020, to March 16, 2021, of adults of either gender who had nasal swabs positive for coronavirus disease-2019 on real-time reverse transcriptase-polymerase chain reaction. Data regarding patients' demographics, co-morbidities, addictions, laboratory results, and standard information was retrieved from electronic and manual records. The severity of the disease was determined based on World Health Organisation protocols. Data was analysed using SPSS 23. Of the 344 patients, 235(68.3%) were males and 109(31.7%) were females. The overall mean age was 54.58±14.75 years, 187(54.4%) had severe coronavirus disease-2019 pneumonia and 157(45.6%) had non-severe disease at the time of admission. There was a significant prevalence of both mixed and cholestatic patterns of liver function test abnormality among the cases (p=0.046). The presence of a mixed pattern was linked to the disease severity (p<0.05). Advanced age and hypertension were significant risk factors for the development of severe coronavirus disease-2019 pneumonia (p<0.001 and p=0.002). Liver function test abnormality and coronavirus disease-2019 pneumonia severity were fund to have a significant relationship.

Improvement of skin condition and intestinal microbiota via Heyndrickxia coagulans SANK70258 intake: A placebo-controlled, randomized, double-blind, parallel-group comparative study

ObjectiveHeyndrickxia coagulans SANK70258, a representative probiotic, is known for alleviating inflammation caused by cedar pollen, improving the intestinal environment and bowel movements. A previous study on consuming H. coagulans SANK70258 together with galactooligosaccharides showed a trend toward improvement in skin scaliness scores and subjective assessments of skin roughness. However, the effect of H. coagulans SANK70258 alone on the skin remains unclear. Thus, we aimed to re-evaluate the effects of the intake of H. coagulans SANK70258 alone on skin conditions and the intestinal environment through a clinical trial. MethodsThis placebo-controlled, double-blind clinical trial involved 80 Japanese women aged 30 to 65 with perceived skin roughness. Participants were divided into placebo and test groups. Over eight weeks, the test group consumed H. coagulans SANK70258, and its effects on skin condition and intestinal health were examined. ResultsThe probiotic group showed significant intestinal improvements, with reduced fecal phenol levels (p = 0.044) and pH (p = 0.022), as well as enhanced skin lightness (L* value) (p = 0.040) and liver function tests. Metabolic analyses revealed decreases in fecal Nε-(carboxymethyl)lysine and plasma hydroxyproline, suggesting skin health benefits. There were also significant improvements in skin scaliness (p = 0.015) and bowel movement frequency (p = 0.032) in subgroup analysis. ConclusionsH. coagulans SANK70258 can improve skin health by improving the intestinal lining. This probiotic reduces the levels of intestinal putrefactive products and advanced glycation end-product levels in feces, suggesting that it may affect not only skin health but also systemic tissues such as the liver.

Peripartum outcomes and immune responses after SARS-CoV-2 infection in the third trimester of pregnancy

BackgroundSARS-CoV-2 infection in pregnant women during the third trimester resulted in overall adverse pregnancy outcomes compared to non-infected controls and a unique humoral and cellular response at delivery. In this study we aimed to assess the impact of SARS-CoV-2 infection on maternal/neonatal peripartum outcomes andimmunological profiles.MethodIn this study, we recruited 304 SARS-CoV-2 infected pregnant women and 910 SARS-CoV-2 non-infected pregnant women who were admitted for delivery. Peripartum and neonates’ outcomes response to SARS-CoV-2 infection were analyzed. Furthermore, we characterized the antibody and cytokines profile in SARS-CoV-2 infected maternal blood (MB) and cord blood (CB). We also assessed routine laboratory tests and liver function tests in MB before labor. Unpaired T test, Mann-Whitney test and Spearman test were used to analyze the data.ResultsSARS-CoV-2 infected pregnant women were significantly associated with increased risk of adverse pregnancy outcomes, including preterm labor (13.8% vs. 9.5%, p = 0.033) and meconium-stained amniotic fluid (8.9% vs. 5.5%, p = 0.039). The risk of low birth weight (< 2500 g) (10.5% vs. 6.5%, p = 0.021) and Apgar score < 8 at 1-minute (9.2% vs. 5.8%, p = 0.049) significantly increased in newborns from COVID-19 positive mothers than their counterparts. Our results showed that antibodies were increased in adverse-outcome SARS-CoV-2 infected mothers and their neonates, and abnormal proportion of immune cells were detected in SARS-CoV-2 infected mothers. While the immune response showed no difference between adverse-outcome infected pregnant women and normal-outcome infected pregnant women. Thus, SARS-CoV-2 infection during the third trimester of pregnancy induced a unique humoral and cellular response at delivery.ConclusionSARS-CoV-2 infection closer to delivery could incline to adverse pregnancy outcomes. Therefore, the utmost care is required for SARS-CoV-2 infected pregnant women and their newborns.Trial registrationThe study protocol was approved by the Institutional Review Board of the First Hospital of Jilin University with the approval code number 23K170-001, and informed consent was obtained from all enrolled patients prior to sample collection.

Real-world study on the effect of nab-paclitaxel treatment on clinical outcomes and laboratory parameters in patients across metastatic tumor sites

Objectives: PacliALLTM is the first and only indigenously developed brand of nab-paclitaxel in India that has shown bioequivalence to the global reference (Abraxane®). However, real-world Evidence is scarce about the use of it in different tumor sites beyond approved indications. This study assessed the effects of nab-paclitaxel (PacliALLTM) on clinical outcomes in patients diagnosed with different metastatic cancers in a tertiary care hospital in India. Material and Methods: In this retrospective study, data on demographics, medical history, and laboratory investigations were collected from medical records of patients with metastatic cancer. Patients on nab-paclitaxel were included, and data on laboratory findings, including hematological, liver, and kidney function tests and prognostic outcomes, were evaluated. Results: The study population consisted of 73 patients with metastatic cancer (mean age- 54.6 years). Primary sites of cancer in most patients were the oral cavity (40.8%), followed by breast and ovary (15.3%, each). The Eastern Cooperative Oncology Group score was 0 in 84.3% and 1 in 14.3% of patients. Weekly analyses showed no significant differences in hemoglobin, neutrophil, creatinine, random blood glucose (RBG), and serum glutamic-oxaloacetic transaminase levels. A significant proportion of patients reported anemia and RBG &gt;125 mg/dL at baseline (97.1% and 63.4%, respectively) and week 17 (85.1% and 88.1%, respectively). Most patients had a partial response at week 17 (76.8%), respectively. No serious adverse reactions were reported, requiring a change in treatment. Conclusion: Nab-paclitaxel showed manageable tolerability and favorable response rates in metastatic cancer patients. It is widely used beyond approved indications in a significant proportion of patients across various tumor sites.