Mean Aspartate Aminotransferase Research Articles

Hepatotoxic Effects of Gaseous Sulfur Dioxide (SO₂), Nitrogen Dioxide (NO₂), and Their Mixture on Sea Bass (Centropristis striata): Hematological, Biochemical and Genotoxic Studies

This study meticulously explores the intricate hepatotoxic effects stemming from acute exposure to gaseous sulfur dioxide (SO2), nitrogen dioxide (NO2), and their amalgamation on sea bass (Centropristis striata). Employing a comprehensive approach involving hematological, cytotoxic, and histochemical analyses, the research provides crucial insights into the potential adverse impacts of these pollutants on fish health. The examination specifically focuses on the effects of SO2+NO2 on hematological, histochemical, and serum biochemical parameters in Centropristis striata. Treatment groups, subjected to LC30, LC50, and LC90 acute exposure of gaseous SO2, NO2, and SO2+NO2, alongside a control group, underwent evaluation of parameters such as red and white blood cells, hemoglobin, hematocrit, mean corpuscular hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin concentration, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, acid phosphatase, lactate dehydrogenase, total protein, albumin, serum creatinine, and blood urea. At the 96th hour, RBC values decreased, and WBC values increased in all experimental conditions compared to the control group (p>0.05). MCV and MCH increased with the concentration of gaseous pollutants and exposure time (p>0.05). Hematological parameter variations underscore disruptions in blood composition and immune responses. Simultaneously, alterations in serum biochemical parameters suggest potential impairments in liver and kidney functions, along with disturbances in lipid metabolism. Significant declines in albumin levels, indicating potential liver dysfunction or inflammation due to SO2 and NO2 exposures, were observed at all experimental conditions, while decreased globulin levels suggest immunosuppressive effects from combined pollutants. A substantial increase in the albumin/globulin ratio further signals an imbalance indicative of potential liver dysfunction or inflammation. Varied responses in liver enzyme levels (SGPT/ALT, SGOT/AST, ALP) underscore potential liver damage or injury (p< 0.05). These findings deepen our understanding of environmental impacts on aquatic ecosystems, emphasizing the need for ongoing efforts to ensure the health and sustainability of fish populations in polluted environments.

The Causes of Thyrotoxicosis, Clinical Features, and Treatment Strategies in a Former Iodine Deficient Area

Thyrotoxicosis is a hypermetabolic condition caused by excess thyroid hormones in the circulation with/without increased production from the thyroid gland. In this prospective study, we aimed to investigate the causes of thyrotoxicosis, clinical features, and treatment strategies in a former iodine-deficient area. Thyroid function tests, antithyroid and antithyroid receptor antibodies, and routine thyroid ultrasonography was obtained, and a thyroid scintigraphy/radioactive iodine uptake test was performed on need. A statistically significant difference was found between toxic multinodular goiter (TMNG) and Graves’ disease (GD) groups when mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) values were analyzed. TSH levels were significantly lower in GD patients compared to those in TMNG and TNG patients, but free triiodothyronine (FT3) and free thyroxine (FT4) values were higher. A high level of TSH receptor antibody (TRAb) was observed in patients with normal antithyroid peroxidase (Anti-TPO). TRAb levels were found to be high. Anti-TPO and anti-thyroglobulin (Anti-Tg) levels were observed to be positively correlated with sT3 and sT4 levels. TMNG is the leading cause of thyrotoxicosis; despite sufficient iodide intake in our former iodine-deficient region, TMNG is characteristically seen in older patients with much lower thyroid hormone levels than GD. According to the study results, the diagnosis of patients with thyrotoxicosis, their clinical presentation, the treatment they will receive, early detection of postoperative complications were predicted

Antianemic Activity of Allolobophora caliginosa Extract against Phenylhydrazine-induced Anemia in Rats

Background:: Anemia is a global hematological disorder. Earthworms have antimicrobial, antispasmodic, antihypertensive, antiallergic, anti-inflammatory, and anticoagulant properties. Objective:: Our study aimed to investigate the anti-anemic activity of the earthworm Allolobophora caliginosa extract (AcE) on phenylhydrazine-induced hemolytic anemia in rats. Methods:: Eighteen adult male albino rats were randomly divided into 3 groups (n = 6 per group) as follows: Control, PHZ, and AcE-treated groups. Induction of anemia was done by intraperitoneal administration of phenylhydrazine (40 mg/kg) for 2 consecutive days. Treatment of AcE by intraperitoneal injection (45 mg/kg) for six successive days. Results:: Treatment of anemic rats with AcE extract caused significant increases in red blood cells (RBCs), hemoglobin (HB), hematocrit (HCT), total protein (TP), albumin, glutathione reduced (GSH), catalase (CAT), and glutathione-S-transferase (GST), as compared to the PHZ group. While, mean corpuscular haemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), malondialdehyde (MDA), and nitric oxide (NO) levels significantly decreased after intraperitoneal administration of AcE, when compared to the PHZ group. Liver sections from the AcEtreated group restored the normal micromorphological features of the liver. The expression of caspase- 3 was weak and/or there was no expression in the liver sections from AcE groups. AcE caused a significant reduction in the incidence of DNA damage, which appeared as less DNA in the tails. Conclusion:: The present research sheds light on the antianemic efficacy of AcE in rats. This study reveals that AcE has antianemic activity, which can be linked to its iron and branched-chain amino acid content, as well as antioxidant and anti-apoptotic properties.

Impact of one-anastomosis gastric bypass and laparoscopic sleeve gastrectomy on metabolic parameters in morbidly obese patients: A comparative review.

Objective: To compare one-anastomosis gastric bypass and laparoscopic sleeve gastrectomy in morbidly obese patients in terms of frequency of dyslipidemia, mean AST, mean ALT, mean HbA1C and mean FPG. Study Design: Randomized Controlled Trial Setting: Department of General Surgery, Allied Hospital, Faisalabad. Period: October 20, 2022, to June 20, 2023, Methods: Morbidly obese individuals were randomly assigned to either undergo laparoscopic sleeve gastrectomy (Group A) or one-anastomosis gastric bypass (Group B). The study, led by a consultant with 3 years of post-fellowship experience, conducted comprehensive patient assessments, including BMI calculations and metabolic profiling. Monthly follow-ups continued until the 6th month, after which lipid profiles, alanine transaminase (ALT), aspartate transaminase (AST), hemoglobin A1C (HbA1C) and fasting plasma glucose (FPG), results were obtained from the hospital pathology lab. The comparative analysis revealed superior outcomes in Group B, the one-anastomosis gastric bypass cohort, as compared to Group A (laparoscopic sleeve gastrectomy), spanning multiple parameters. Results: The mean FPG in Group A was 5.52±0.26, compared to 5.56±0.25 in Group B. Mean HbA1c was 6.65±0.24 in Group A and 6.26±0.19 in Group B. AST levels were comparable, with 24.13±3.31 in Group A and 24.23±3.48 in Group B, yielding a p-value of 0.896. Similarly, ALT levels showed no significant difference between the groups (24.55±3.46 in Group A and 23.92±3.35 in Group B, p-value=0.414). Conclusion: One-anastomosis gastric bypass demonstrated superior efficacy over laparoscopic sleeve gastrectomy in morbidly obese patients, showcasing favorable outcomes in terms of dyslipidemia, AST, ALT, HbA1C, and FPG.

Foot-and-mouth disease-associated myocarditis is age dependent in suckling calves

Myocarditis is considered a fatal form of foot-and-mouth disease (FMD) in suckling calves. In the present study, a total of 17 calves under 4 months of age and suspected clinically for FMD were examined for clinical lesions, respiratory rate, heart rate, and heart rhythm. Lesion samples, saliva, nasal swabs, and whole blood were collected from suspected calves and subjected to Sandwich ELISA and reverse transcription multiplex polymerase chain reaction (RT-mPCR) for detection and serotyping of FMD virus (FMDV). The samples were found to be positive for FMDV serotype “O”. Myocarditis was suspected in 6 calves based on tachypnoea, tachycardia, and gallop rhythm. Serum aspartate aminotransferase (AST), creatinine kinase myocardial band (CK-MB) and lactate dehydrogenase (LDH), and cardiac troponins (cTnI) were measured. Mean serum AST, cTn-I and LDH were significantly higher (P < 0.001) in < 2 months old FMD-infected calves showing clinical signs suggestive of myocarditis (264.833 ± 4.16; 11.650 ± 0.34 and 1213.33 ± 29.06) than those without myocarditis (< 2 months old: 110.00 ± 0.00, 0.06 ± 0.00, 1050.00 ± 0.00; > 2 months < 4 months: 83.00 ± 3.00, 0.05 ± 0.02, 1159.00 ± 27.63) and healthy control groups (< 2 months old: 67.50 ± 3.10, 0.047 ± 0.01, 1120.00 ± 31.62; > 2 months < 4 months: 72.83 ± 2.09, 0.47 ± 0.00, 1160.00 ± 18.44). However, mean serum CK-MB did not differ significantly amongst the groups. Four calves under 2 months old died and a necropsy revealed the presence of a pathognomic gross lesion of the myocardial form of FMD known as “tigroid heart”. Histopathology confirmed myocarditis. This study also reports the relevance of clinical and histopathological findings and biochemical markers in diagnosing FMD-related myocarditis in suckling calves.

The effects of two dietary synbiotics on growth performance, hematological parameters, and nonspecific immune responses in Japanese Eel.

Feed additives have attracted increased attention in aquaculture due to their ability to modulate fish gut microbiota, resulting in improved fish growth and immunity. This study assessed the effects of two synbiotics in Japanese Eel Anguilla japonica: Bacillus subtilis with mannooligosaccharides (MOS) and Enterococcus faecium with fructooligosaccharides (FOS). Six diets, including a control (CON) diet, oxytetracycline (OTC) diet, and four synbiotic diets (B. subtilis at 1 × 106 or 1 × 107 colony-forming units [CFU]/g with MOS at 5 g/kg [BS6MO and BS7MO; collectively, BSMOS diets] and E. faecium at 1 × 106 or 1 × 107 CFU/g with FOS at 5 g/kg [EF6FO and EF7FO; collectively, EFFOS diets]), were fed to triplicate groups of 20 fish (average weight ± SD = 6.00 ± 0.07 g) for 8 weeks. Fish fed the BSMOS diets showed significantly higher weight gain, specific growth rate (SGR), and feed efficiency compared to fish fed the CON and OTC diets, but the values were not significantly different from those of fish fed the EFFOS diets. Weight gain and SGR of fish that were given EFFOS diets were not significantly different from those of fish fed all other diets. Fish fed the OTC diet showed a higher mean aspartate aminotransferase level, although the difference was not statistically significant. The myeloperoxidase activity of fish fed the BS7MO diet was significantly higher than those of fish receiving all other diets, and the superoxide dismutase activity of fish fed the BS7MO diet was also significantly higher than that of fish fed the EF7FO diet. Overall, the BSMOS synbiotic diets were significantly more effective than the CON diet in enhancing fish survival against a Vibrio anguillarum challenge. Our findings suggest that synbiotics can be a preferable alternative to antibiotics in aquaculture.

Liver enzymes as a predictor of mortality in patients with COVID-19? A cross-sectional study

Liver injury in patients with COVID-19 infection may directly result from viral infection of liver cells, immune-mediated inflammation such as cytokine storm, and hypoxia resulting from pneumonia. Additionally, liver injury may occur due to drug toxicity and may lead to liver failure in critically ill COVID-19 patients. Given the significance of the liver and its vulnerability in COVID-19 patients, this study aimed to investigate the correlation of serum liver enzymes with the prognosis of hospitalized COVID-19 patients at Imam Khomeini Hospital in Urmia. This descriptive-analytical study involved hospitalized COVID-19 patients at Imam Khomeini Hospital in Urmia. Patient data were extracted from medical records and recorded in checklists, including demographic characteristics (age and gender), serum levels of Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST), and patient outcomes (recovery and mortality). Subsequently, the serum levels of AST and ALT in recovered and discharged patients were compared with those of deceased patients. The mean AST level was higher in deceased patients compared to recovered and discharged patients, and this difference was statistically significant (P <0.033). Therefore, overall, higher AST levels in COVID-19 patients may indicate a worse prognosis. Similarly, the mean ALT level was higher in deceased patients compared to recovered and discharged patients, and this difference was statistically significant (P <0.015). Thus, higher ALT levels in COVID-19 patients may generally indicate a worse prognosis. Continuous monitoring of liver enzymes in patients with a poor prognosis can lead to early identification and, to the extent possible, prevention of complications and mortality through enhanced care.

Pharmakokinetics of Mistletoe Lectins after Intravenous Application of a Mistletoe Product in Healthy Subjects.

Mistletoe lectins (ML) have cytotoxic and immunomodulating properties, and subcutaneously applied mistletoe products (MP) containing ML have approval for supportive cancer treatment. MP are also given off-label intravenously, but data about pharmacokinetics are widely lacking. Therefore, the aim of our phase I trial was to evaluate the pharmacokinetics and safety of intravenously applied natural ML. Initially, 12 healthy male volunteers were planned to receive a single infusion of 2000 mg Helixor® P. We had to terminate the study prematurely after the inclusion of eight subjects due to elevation of all subjects' liver enzymes. ML was detected in all subjects after infusion. The mean half-life of serum ML was 7.02 ± 2.01 h. Mean alanine transaminase increased from 23 ± 6 to a maximum of 445 ± 260 U/L, and mean aspartate aminotransferase increased from 24 ± 3 to a maximum of 318 ± 33 U/L 72 h after infusion. Severity grading for drug-induced liver injury was mild. Participants did not suffer from any liver-specific symptoms and recovered completely. As a conclusion, the dose of 2000 mg Helixor® P caused transient liver injury in healthy subjects and should, therefore, not be used for initial patient treatment. Liver enzymes should be monitored in patients receiving intravenous treatment with Helixor® P.

Development of reference intervals for serum biochemistry and haematology of juvenile green sea turtles (Chelonia mydas) in a Thai rehabilitation centre.

No reference intervals for serum biochemistry and haematology of sea turtles in Thailand exists to assist veterinarians who are responsible for sea turtle health management and treatment. This study determined serum biochemistry and basic haematology of healthy juvenile green sea turtles (n = 92) in captivity in Thailand following the American Society for Veterinary Clinical Pathology (ASVCP), Quality Assurance and Laboratory Standards Committee (QALS) guidelines for the determination of reference intervals in veterinary species. Biochemistry tests, including blood urea nitrogen, creatinine, uric acid, alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase were analysed using an IDEXX VetTest Chemistry Analyzer. Haematology parameters were measured manually using a microhaematocrit for packed cell volume (PCV), Neubauer counting chamber for red blood cell count and cyanmethemoglobin method for haemoglobin concentration. mean corpuscular volume and mean corpuscular haemoglobin concentration were calculated using the PCV, red blood cell count and haemoglobin. Turtles in this study were found to have higher mean values for PCV (28.70%), haemoglobin (92.13 g/L), mean corpuscular haemoglobin concentration (327.03 g/L), uric acid (247.15 μmol/L), alanine aminotransferase (16.53 IU/L), aspartate aminotransferase (209.44 IU/L), and alkaline phosphatase (245.08 IU/L) compared to sea turtles in Brazil. The reference intervals established using high numbers of healthy turtles in this study will assist veterinarians with diagnostic and treatment decisions when evaluating laboratory results for juvenile green sea turtles.

Tea and coffee consumption impact on the non-alcoholic fatty liver disease: a systematic review and meta-analysis

Introduction: Non-alcoholic fatty liver disease (NAFLD) is diagnosed when≥5–10% of hepatocytes display macroscopic steatosis in the absence of other etiologies of liver disease. Consumption of coffee or tea or both may decrease the risk of NAFLD, as recommended by studies of liver enzymes. Methods: The required data was collected from different databases such as EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Web of Science as well as the database inception to July 2021. In addition, pooled mean difference and 95% confidence intervals (CIs) were considered in the random effects model. Results: Of the total collected 218 articles, 8 met our inclusion criteria to be involved in the meta-analysis. Four studies assessed green tea and one study assessed sour tea consumption in NAFLD patients. Three studies assessed coffee use. All studies have shown an inverse correlation of coffee intake with elevated serum enzyme levels. Based on the meta-analysis outcome, the mean alanine aminotransferase (ALT) in the intervention group was measured as 12.50 points less than that of the control group. The mean aspartate aminotransferase (AST) of the intervention group was 9.23 points lower than that of the control group (P value&lt;0.001). Conclusion: There is increasing evidence that steadily revealed an opposite relationship between the consumption amount of green tea and coffee and the risk of liver diseases. This meta-analysis supports the protective role of the mentioned beverages in patients suffering from NAFLD.

Effects of Gardenia Ternifolia Leaf Extract on antioxidant and hepatic enzymes in sniper-induced toxicity in Albino rats

Aim: This study evaluates the effects of Gardenia ternifolia leaf extract on antioxidant and hepatic enzymes in sniper-induced toxicity in albino rats. Methodology: A total of 42 male albino rats weighing 120g to 150g, grouped into 6 groups of 7rats each. Group 1 (Negative control), Group 2 (Positive control), Group 3 (Therapeutic Low Dose), Group 4 (Therapeutic High Dose), Group 5 (Prophylactic Low Dose) and Group 6 (Prophylactic High Dose). After 4 weeks of treatment, the rats were anaesthetized, sacrificed and blood samples collected. The Liver was also harvested for histological analysis. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) were estimated using a rat-specific sandwich-enzyme linked immunosorbent assay (ELISA) method. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were carried out using Reitman Frankel method. Alkaline phosphatase (ALP) was carried out using colorimetric phenolphthalein method. The liver tissue was prepared and stained using standard Haematoxylin and Eosin (H &amp; E) staining technique and captured using scope TekTM device. Results: The mean SOD and GPx values for the therapeutic and prophylactic groups were significantly higher (P &lt;.05) when compared with the positive control. The mean SOD and GPx values in the therapeutic groups were not significantly different (P &gt;.05) from the negative control. The mean ALT, AST and ALP values for the therapeutic and prophylactic groups were significantly lower (P &lt;.05) than the positive control but significantly higher (P &lt;.05) than the negative control. Histology analysis of liver indicated normal histoarchitecture in the negative control while in the positive control, there were severe cell degeneration, distortion, necrosis and death of the hepatocytes. The Therapeutic Low Dose and Prophylactic Low Dose groups indicated severe degeneration and hypertrophy of hepatocytes. The Therapeutic High Dose and Prophylactic High Dose groups showed less deposit, well delineated radiating hepatocytes and near normal cytoarchitecture. Conclusion: Administration of Sniper® (dichlorvos) led to an increase in oxidative stress; depletion of antioxidant enzyme levels. It elevated liver enzymes levels, caused histopathological changes and death of cells in the liver. The treatment with leaf extract of Gardenia ternifolia ameliorated the effect of dichlorvos toxicity, restored the anti-oxidant and liver enzyme levels especially the high dose extract.

Developing an AI-predictive model for predicting the likelihood of post-operative infection in surgical patients

Abstract Introduction Antimicrobial resistance was listed among the top ten global health issues by the World Health Organization in 2019.1 By 2050, it is projected to have caused 10 million deaths, surpassing cancer, diabetes, and road traffic accidents.2 The rise in resistant bacterial strains and reduced availability of novel antibiotics makes tackling antimicrobial resistance even more challenging. Preventing infections is the most effective approach, and Artificial Intelligence (AI) has the potential to help predict the likelihood of a patient experiencing a post-operative infection.3 This can help clinicians identify those who might be at higher risk and implement clinical interventions to potentially reduce this risk, during the pre-operative stage. Aim To develop and internally validate an AI-predictive model for predicting the likelihood of post-operative infection in surgical patients. Methods A secondary care dataset from the Pioneer Research Hub was used to develop the predictive model, which included a range of data such as demographic information, vital signs, microbiological culture results, lab investigations, comorbidities, surgical details, and infection diagnoses. Machine learning techniques and clinician input were used to select predictors, both modifiable (e.g. blood glucose) and non-modifiable (e.g. age). Recursive feature elimination with cross-validation was performed, and the dataset was split into training (80%) and internal validation (20%) sets. Missing data was managed through complete case analysis and multiple imputation. Various supervised machine learning classifier algorithms were trained, and an ensemble model was created. Ethical approval was obtained (20/EM/0183, IRAS 280077). Results Data on 2,716 patients who underwent elective abdominal surgery were included in the model training and validation. The infection incidence in this cohort was 38%. Out of 74 initial predictors, 19 were selected. These predictors included demographic data (gender), comorbidities (diabetes, COPD, cardiac conditions, obesity, anaemia), microbiology data (positive cultures within 90 days before surgery, multi-drug resistance), and laboratory investigations within 90 days before surgery: WBCs, lymphocytes, blood glucose, platelets, haematocrit, mean cell haemoglobin, haemoglobin, total bilirubin, aspartate aminotransferase, alanine transaminase, and C-reactive protein. The gradient boosting classifier performed the best among the supervised machine learning algorithms. The ensemble model showed high performance in training (sensitivity: 85.3%, specificity: 74.6%, AUROC: 88.6%) and internal validation (sensitivity: 96.9%, specificity: 74.1%, AUROC: 85.5%). The PROBAST checklist was used to address bias before predictor selection. Discussion/Conclusion The developed AI-predictive model has the potential to predict the likelihood of an elective abdominal surgery patient experiencing a post-operative infection. Identifying patients at high risk of post-surgical infections can guide clinical decision making and help implement interventions during the pre-operative stage, (i.e. as part of nutritional prehabilitation screening), to reduce infection risk. However, it is important to acknowledge the limitations of this model. One limitation is the presence of missing data in the training dataset, which may introduce biases and affect the accuracy of the model. Additionally, potential inaccuracies in data entry could impact the reliability of the model's predictions. Furthermore, it is crucial to consider any historical biases that might have influenced data collection, as these biases could have adverse effects on the developed model.

Analysis of Influencing Factors of Positive Antiplatelet Antibody in Patients with Diffuse Large B-Cell Lymphoma

Background Diffuse large B-cell lymphoma (DLBCL) is a common malignant tumor of the hematological system. Chemotherapy is the main treatment. As a cytotoxic drug, chemotherapeutic drugs can lead to thrombocytopenia, increase the risk of bleeding and require platelet transfusion if necessary. Since platelet antibody is the main cause of ineffective platelet transfusion, the detection of platelet antibody is of great significance to prevent the inefficacy of platelet transfusion in patients with diffuse large B-cell lymphoma. Objective To analyze the screening results of antiplatelet antibodies in patients with diffuse large B-cell lymphoma and to explore the main factors affecting the production of antiplatelet antibodies so as to provide basis for safe blood transfusion. Methods Patients with diffuse large B-cell lymphoma treated in our department from August 2022 to May 2023 were selected as subjects. Antiplatelet antibodies (GP IX, GP Ⅰ b, GPIIb, GPIIa, GMP140) were detected by flow cytometry. The factors affecting the positive antiplatelet antibodies were analyzed from the aspects of clinical characteristics and laboratory indexes. Results In 155 patients with diffuse large B-cell lymphoma, the positive rate of antiplatelet antibody was 63.23% (98/155). Among them, the positive rate of antiplatelet antibody in male patients was 63.75% (51/80), higher than that in female patients was 62.67%(47/75), and the difference was statistically significant (P&amp;lt;0.05). The positive rate of antiplatelet antibody in patients over 60 years old was 65.18% (43/67), higher than that in patients aged ≤ 60 years old was 62.5%(55/88). The difference was statistically significant (P&amp;lt;0.05). In addition, the positive detection of antiplatelet antibody was related to the abnormal results of large platelet ratio, mean platelet volume, D-dimer and aspartate aminotransferase. In the positive distribution of antiplatelet antibodies, the positive rates of GP IX, GP Ⅰ b, GPIIb, GPIIa and GMP140 autoantibodies were 1.29% (2/155), 29.03% (45/155), 37.42% (58/155), 1.29% (2/155), 49.68% (77/155), respectively. The positive number of antiplatelet antibodies was related to the abnormal results of partial prothrombin time, prothrombin time, prothrombin activity, international standardized ratio, thrombin time, fibrin (prothrombin) degradation products, globulin, alanine aminotransferase and aspartate aminotransferase. Conclusion Patients with diffuse large B-cell lymphoma with abnormal results of large platelet ratio, mean platelet volume, D-dimer and aspartate aminotransferase should pay attention to the detection of antiplatelet antibodies before platelet transfusion to prevent transfusion failure.

Comparison of clinical and laboratory parameters of primary vs secondary dengue fever in travellers.

Dengue fever (DF), caused by the dengue virus (DENV), is the most common arboviral disease in travellers worldwide. It is hypothesized that compared with primary DF, secondary DF may result in antibody-dependent enhancement of the immune response, resulting in more severe disease. We aimed to compare clinical and laboratory parameters in travellers with primary and secondary DF to determine whether secondary DF is associated with markers of severe disease. We conducted a retrospective cohort study, which included all patients diagnosed with DF at the Central Virology Laboratory of the Israeli Ministry of Health during 2008-19. Clinical, laboratory and virological data were extracted from laboratory and patient records. A diagnosis of DENV infection was based on a positive nonstructural protein 1 (NS1) test, polymerase chain reaction or serology testing for immunoglobulin M (IgM) and immunoglobulin G (IgG). Primary and secondary infections were classified based on travel history, NS1 result and IgM/IgG ratio. Severe DF was defined according to WHO classification. We identified 245 DF cases: 210 (86%) primary and 35 (14%) secondary. Whilst fever duration was significantly longer in secondary compared with primary infections (6.4 vs 5.3days, P = 0.027), mean Aspartate aminotransferase levels were significantly higher in primary compared with secondary cases (146 vs 65U/L, P < 0.001), and no other clinical or laboratory parameter differed significantly between the groups. Of note, only four patients had severe DF, all had primary infections and none died. In a cohort of returning travellers with DF, secondary infection, compared with primary infection, was not associated with a consistent trend towards greater severity of the clinical and laboratory markers examined in this study.

Comparative Analysis of Hepatocellular Carcinoma Patients with and Without Type 2 Diabetes Mellitus

Purpose of the Study: To evaluate the clinical impact of Type 2 Diabetes Mellitus (T2DM) in patients with Hepatocellular Carcinoma (HCC) in comparison to those without T2DM. Methods: Retrospective study, HCC data obtained from public domain (kaggle.com). Summary of Results Obtained: Mean age in the diabetic and non-diabetic groups were 70.4 and 62.08 years respectively. There was a female preponderance seen in both groups. Mean aspartate aminotransferase and alanine aminotransferase (AST/ALT) values in diabetic group were 81.42/54.8 U/L and in non-diabetic group were 116.72/77.4 U/L (p=0.19). Mean International Normalized Ratio (INR) in diabetic and non-diabetic groups were 1.51 and 1.34 respectively (p=0.32). Mean total bilirubin values in diabetic and non-diabetic groups were 2.39 and 1.95 mg/dL respectively (p=0.63). Total number of patients with varices were 33 in the diabetic and 32 in the non-diabetic group (p=0.59). Total number of patients with portal hypertension were 33 in the diabetic and 34 in the non-diabetic group (p=0.32). Portal venous thrombosis was found in 9 patients in the diabetic and 12 patients in the non-diabetic group (p=0.67). Metastatic disease was seen in 10 patients in the diabetic and 12 patients in the non-diabetic group (p=0.74).

Management of Anesthesia in Pre-Eclamptic Patients with Covid 19 Infection

Background: Pregnant women with immunological and cardiopulmonary system abnormalities may experience more severe symptoms from respiratory virus infections. Objectives: The aim of this study was to assess the management of anesthesia in pre eclamptic patients with covid 19 infection. Methods: This cross-sectional descriptive study was carried out in the Department of Anaesthesia, Uttara Adhunik Medical College Hospital, during October 2020 to September 2021. A total of 50 pregnant women with pre-eclampsia and had positive polymerase chain reaction (PCR) test for COVID-19 with nasopharyngeal swabs were included in the study irrespective of age and patients who were not willing to participate were and who were clinically suspected (such as a clinical situation or travel history) but tested negative for COVID-19 excluded from this study. Statistical analyses of the results were be obtained by using window based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-22), where required. Results: The mean age of the patients was 26± 2.0 years. 36% patients were within 26-31 weeks of gestational age, 40% patients were within 32-36 weeks of gestational age, 20% patients were within 37-42 weeks of gestational age, and only 4% had more than 42 weeks of gestational age. About 60% patients had mild pre-eclampsia and 40% had severe pre-eclampsia. 98% patients had given spinal anesthesia and 2% had given epidural type of anesthesia. The indication for caesarian section was 50% for severe pre-eclampsia, 25% for uterine rupture in pre-eclampsia and 25% for previous caesarean section. The mean Hemoglobin was 12.17 ± 1.70, mean Aspartate aminotransferase was 28.05 ± 21.11, mean Alanine aminotransferase, was 17.06 ± 12.98, mean Creatine was 0.68 ± 0.71, mean C-reactive protein was 2.10 ± 2.33 and mean D-Dimer was 3.00 ± 2.26. About 60% of the patients were fit to discharge within 4 days and 40% within 5 days. Conclusion: Preeclampsia as one of pregnancy related complications is a notable burden of adverse health. Regional anaesthesia is not considered to be prohibited by the diagnosis of COVID-19 alone. In conclusion, COVID-19-infected pregnant women should be managed by specialised teams in a multidisciplinary facility, and all medical personnel involved in the caesarean section should be careful to use Level-3 PPE equipment. Due to the increased risk of infection and morbidity in general anaesthesia in pregnant women with COVID-19, regional anaesthesia becomes more prevalent. We also noted that there is no umbilical chord transmission from mother to child.

A STUDY ON BIOCHEMICAL PARAMETERS IN ASSESSING THE SEVERITY OF ACUTE ORGANOPHOSPHORUS POISONING

Objectives: Organophosphorus (OP) poisoning is an important global health issue with increasing mortality rate for every year particularly in developing countries since its overuse in agricultural activity. The present study was performed to analyze the clinical profile and biochemical parameters such as serum cholinesterase, serum creatinine phosphokinase (CPK), liver enzymes, serum amylase, lipase, serum k+, troponin, serum urea, and creatinine on day 1 for correlation with clinical severity of poisoning. Methods: A observational study was performed on 100 cases with OP poisoning at a tertiary care center. Peradeniya OP Poisoning Scale was applied to all cases at the time of admission and the severity was designated as mild, moderate, and severe taking into account 5 vital parameters such as miosis, fasciculations, respiration rate, bradycardia, and level of consciousness and data were statistically analyzed by SPSS. Results: Rise in clinical severity of poisoning and substantial reduction in the level of serum cholinesterase was observed. The mean serum CPK, troponin T (Trop T), amylase, lipase, bilirubin, aspartate aminotransferase, and alanine aminotransferase showed marked elevation according to the severity of OP poisoning. In addition, serum potassium levels showed decreased level as per the severity level. Conclusion: Initial serum cholinesterase and serum Trop T are strong predictors of the clinical severity of OP poisoning.

Pattern of Liver Function Test in Scrub Typhus Cases: A Hospital Based Observational Study in a Tertiary Care Center in Nepal

Background and Aim: Scrub typhus, a potentially severe but treatable infection is a major cause of acute non-malarial febrile illness in children in the rural tropics. The present study aims to explore the association between the liver function tests in the cases of scrub typhus and correlate the levels of these parameters with the severity of the scrub typhus infections, their clinical risk characteristics that may be used to forecast disease severity under routine clinical practice.&#x0D; Methodology: This prospective observational study, conducted at National Medical College Teaching Hospital, a tertiary care referral teaching hospital situated in province two of Nepal over a period of 7 months (November, 2021- May 2022) enrolled 75 scrub typhus cases and their liver function tests were done following standard guidelines.&#x0D; Results:There were deranged liver function tests in the participants. The mean Aspartate Transaminase, Alanine Transaminase, Total Bilirubin and Albumin were425.48 ± 505.56 U/L, 368.54 ± 402.22 U/L, 3.8 ± 3.1 mg/dL and 3.10 ± 0.8 g/dL, respectively. Most of the cases presented with hypoalbuminemia (66.7%), cardiac dysfunction (64%), acute kidney injury (61%) and hepatitis (60%). About 9 % of the subjects presented as multiorgan dysfunction syndrome (MODS).&#x0D; Conclusion: Scrub typhus cases presents with deranged liver function tests results and the values can be helpful in assessment of the disease severity and outcome.

Hemato-Serological Findings as Early signals in Nile Tilapia Oreochromis niloticus Treated with Benzalkonium Chloride

To evaluate the toxicity of benzalkonium chloride in aquaculture, the hemato-serological indices of Nile tilapia Oreochromis niloticus are used as biomarkers. Following exposure to three concentrations of benzalkonium chloride BAC 0.1, 0.25, 0.50, and 1 mg/l (BAC1,2,3 and 4) in aquaria for two durations 21 and 42 days, the microbiological assay in fish aquaria, in addition to blood parameters were assessed. Except for the mean difference between BAC2 and BAC3 (P &gt; 0.05) at 42 days, the mean values of the bacterial counts revealed a significant difference between all compared groups (0.05 ≥ P ≤ 0.01). Following exposure to the lower concentrations of BAC (1, 2 and 3), the main blood parameters of Oreochromis niloticus namely red blood cells RBCs, and hemoglobin Hb decreased in fluctuated pattern when compared to control treatment (0.05 &gt; P&lt; 0.01), but interestingly peaked at the higher concentration (BAC4), despite there were no significant differences when compared to control (except hemoglobin at 42 days, P&lt; 0.01). Contrarily, the white blood cells WBCs rapidly rose at the first concentration BAC1 (P&lt; 0.01), particularly at the second duration, compared to the control treatments. The counted WBCs changed after exposure to the following two concentrations BAC2, BAC3, before peaking at the higher experimental concentration BAC4 (P&lt; 0.01). The mean cells volume MCV, mean cells haemoglobin MCH and MCHC mean cells haemoglobin concentration exhibited a narrow fluctuation between control and BAC treated fish. Regarding biochemical findings, the average levels of cholesterol and triglycerides showed erratic behavior depending on BAC levels in treatment. The mean alanine transaminase ALT and aspartate aminotransferase AST levels fluctuated between the control and BAC1,2,3 before abruptly increasing at the higher BAC4, with significant differences (0.05 &gt; P&lt; 0.01) when control, BAC1,2,3, compared to BAC4, except AST between BAC3 and BAC4 (insignificant- 42 days). Following BAC exposure, other parameters, including protein and urea remained the same as in control fish. The alteration in some hemato-serological markers demonstrated how a compensatory mechanism is generated in response to the stress caused by exposure to biocides.

Synergetic Influence of Some Tropical Leaf Meals and Garlic on the Haemato-biochemical Parameters and Antioxidant Activities of Weaner Pigs

Aim: This experiment was designed to study the effects of using garlic-composite leaf meals produced from four (4) different leaves and garlic: bitter leaf (Vernonia amygdalina), scent leaf (Ocimum gatissimum), Neem leaf (Azadirachta indica), Moringa leaf (Moringa oleifera) and Garlic (Allium sativum) as a premix in the diets of growing pigs. The leaves and garlic were air dried, milled and sieved separately. Thereafter the leaves and garlic were mixed in the ratio of 4 (Vernonia amygdalina): 3 (Moringa oleifera): 1 (Ocimum gatissimum): 1 (Azadirachta indica) and 1 (Allium sativum) to produce the garlic-composite tropical leaf meals. Individual leaves and their composite mix were analyzed for proximate, mineral, antioxidant and the phytochemical components of the leaves were determined using GCMS and other standard methods.&#x0D; Methodology: Eighteen large white weaner-pigs of eight weeks were allocated in a completely randomized design for this experiment comprising three treatments and three replicates with two pigs per replicate. The average weight of the pigs were 13 kg. Basal diet were formulated and subdivided into three portions in which garlic-composite leaf meals were fed at 0g/kg, 10g/kg, and 20g/kg were used as an additives to the diets of weaner pigs and the diets were designated as I, II and III respectively. The pigs were then assigned to these 3 dietary treatments which were fed to the pigs at 5% of their body weight for 12 weeks experimental period. Water was supplied ad libitum throughout the experimental period. All data were subjected to analysis of variance.&#x0D; Results: Dietary inclusion of GCLM on haematology, serum biochemistry indices and antioxidants significantly (P&lt;0.05) affected the Packed Cell Volume (%), Mean Corpuscular Volume (fl) Lymphocytes (%), Granulocytes (%), Alanine aminotransferase (IU/L), Aspartate aminotransferase (IU/L), Total Protein (g/l) and catalase (Ku) of the experimental pigs.&#x0D; Conclusions: It could be concluded within the limit of this study, that garlic-composite leaf meals had high nutrient potentials for pigs and could completely help growing pigs to improve in body weight as the composite leaf meals increases in pig diets.