Alanine Aminotransferase Values Research Articles

Evaluation of Oxidative Stress, Thyroid Hormones, Trace Elements and Some Biochemical Markers in Goats Naturally Infected with Theileria ovis.

Theileriosis is a tick-borne disease caused by protozoon species in the Theileria genus of the Theileriidae family. The biochemical changes induced by infection are considered to be an important understanding of the pathophysiology of caprine theileriosis. In this study, it was aimed to determine oxidative stress, thyroid hormones, trace elements, and biochemical parameters in theileriosis infection. A sample of 14 goat was used for this purpose, of which 7 were healthy and 7 were infected with Theileria ovis. Theileria infection was diagnosed from the polymerase chain reaction (PCR). Sera from blood samples was tested for total antioxidant capacity (TAC), total oxidant capacity (TOC), oxidative stress index (OSI), alanine aminotransferase (ALT), aspartate transaminase (AST), gamma glutamyl transferase (GGT), total protein, albumin, triglyceride, cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), urea, blood urea nitrogen (BUN), creatinine, triiodothyronine (T3), thyroxine (T4), copper (Cu), zinc (Zn), cobalt (Co), manganese (Mn), selenium (Se), iron (Fe). TOC, OSI, AST, ALT and GGT values were higher in the patient group than in the healthy group (P < 0.05). On the other hand, there were decreases in TAC, T3, T4, total protein, albumin, creatinine, Cu, Zn, Se, and Co values (P < 0.05). However, there was not found to be a statistical difference between the healthy and patient groups in terms of triglyceride, cholesterol, HDL, LDL, urea, BUN, Mn, and Fe values (P > 0.05). It can be stated that oxidative stress is a complication of caprine theileriosis and it may be accompanied with hypothyroidism and deficits in trace minerals.

Effects of Agro-based Adsorbents on the Biochemical Profiles of Wistar Rats Exposed to Cyanide

Background: Cyanide is a very toxic chemical that reacts with the ferric cytochrome oxidase in the mitochondrial system to form a stable complex. This complex inhibits the process of oxidative phosphorylation, thereby interrupting aerobic respiration in the organism. It is postulated that activated charcoal (AC) intercepts the ingested cyanide in the gastrointestinal tract before it is absorbed into the system. Methods: A single dose of 3 mg/kg body weight of potassium cyanide (KCN) was orally administered to the rats in each of the five groups, each consisting of 6 rats. After 15 minutes, all rats in each group were given AC from different agro-based materials. The control group (group 1) received standard commercial AC orally at 1 g/kg. group 2 received AC from plantain peels, group 3 received AC from castor oil seed shell, group 4 received AC from coconut shell and group 5 received a combination of AC from plantain peels, castor oil seed shell, and coconut shell. Blood samples were collected sequentially from rats in each group for biochemical assays using standard procedures. Results: The control group, which received KCN and standard commercial AC, exhibited the highest alanine transaminase (ALT) value (60.09±0.10 U/L) on day seven. Similarly, the highest aspartate transaminase (AST) value (196.28±0.72 U/L) was observed in the control group. Alkaline phosphate (ALP) levels followed a similar pattern. On day seven, the serum creatinine levels were 3.81±0.11 mg/dL for group 1 and 3.45±0.05 mg/dL for group 5. Subsequently, all biochemical parameters decreased after day 7, with the lowest levels recorded in rats that received AC derived from coconut shells. Conclusion: The administration of locally prepared agro-based adsorbents to Wistar rats after exposure to sublethal doses of cyanide significantly mitigated the effects of the cyanide on the liver, kidneys, and heart, as indicated by the biochemical parameters of the albino Wistar rats in the study.

A double‐blind, randomized control trial to investigate the therapeutic potential of garlic scapes for high apoprotein E levels in a high‐Fat diet‐induced hypercholesteremic rat model

AbstractHypercholesteremia is the main contributor to metabolic diseases, including obesity, hypertension, and diabetes, which are the primary global sources of morbidity and death rates. Garlic scapes, a member of the Allium sativum family and a rich source of antioxidants, are utilized in various cuisine preparations due to their unique flavors and tastes. The current study examined garlic scape powder's effect on apoprotein E and its ability to decrease cholesterol. In an in vivo experiment, normal, healthy Wistar albino rats (weeks) were divided into a negative control group (NC, n = 10) and a high‐fat diet‐raised group (n = 50) until they achieved cholesterol ≥250 mg/dL. Hypercholesteremic rats were further divided randomly into five groups: positive control (PC), standard group (fenofibrate 20 mg/kg bwt), and treatment groups G1, G2, and G3 that were administered with garlic scape powder 400 mg, 800 mg, and 1200 mg/kg bwt orally, respectively, for 3 months. The blood samples were examined for cholesterol, triglycerides, high‐density lipoproteins (HDLs), low‐density lipoproteins, apoprotein E, albumin levels, alanine aminotransferase (ALT), and aspartate aminotransferase (AST). The liver tissues of the rats were subjected to histopathology. The lipid profile was assessed using serum kit techniques, whereas an ELISA kit was used to evaluate apoprotein E, and a serum kit was used to estimate ALT and AST. In comparison to all other groups except NC, the highest dose of 1200 mg/kg bwt of garlic scapes significantly (p ≤ .05) increased serum insulin (13.66 ± 0.72 μU/mL), apoprotein E levels (6.08 ± 0.10 mg/dL), HDL (42.1 ± 1.81 mg/dL), and reduce TG (88.7 ± 1.64 mg/dL) and decreased overall cholesterol levels (67.9 ± 1.17 mg/dL). Except for NC, all treatment groups had significantly (p ≤ .05) lower ALT and AST values than PC. To sum up, powdered garlic scapes may be a great way to avoid hyperlipidemia, which raises the risk of cardiovascular illnesses. ALT and AST levels were significantly (p ≤ .05) reduced in all treatment groups compared to PC, except for NC. In conclusion, garlic scape powder may be an excellent source to prevent hyperlipidemia, a risk factor for cardiovascular diseases. In addition, powdered garlic scapes supplementation at high doses may be used as an alternative natural source in functional foods to halt hyperlipidemia without liver toxicity in the long term.

Effect of probiotics on hematology and histopathology of organs associated with immune system in male and female Wistar rats

In the present study, potential probiotics were isolated from dairy products and characterized on a molecular basis. Male and female (16 + 16, n = 4) Wistar rats were randomly assigned to 5 groups to revise the effects of isolated potential probiotics on the gut immune system: 0-day, negative control, positive control (commercial product Lactobacillus acidophilus-14), laboratory isolated strains Pro-3 (Weissella confusa MZ735961), and Pro-4 (Lactiplantibacillus plantarum MZ727611). Aspartate-aminotransferase, Interleukin-6, bilirubin, and Alanine-transaminase values in both genders were expected but AST and creatinine values had a minor increase in the female group compared to the male probiotic-treated group. Cellular blood count level of mean corpuscular hemoglobin in male groups showed no considerable differences (p = 0.95), while there were decreased differences (p = 0.00) in female groups. The level of mean corpuscular hemoglobin concentration (MCHC) showed distinct variations (p = 0.02) in male groups, while these values were insignificant changes (p > 0.05) among female groups. No damage to the liver, thymus, or colon was ascertained based on morphological findings. The colon wall thickness, external muscle, crypt depth, and mucosa were significantly (p = 0.03) improved in rats given potential probiotics. In conclusion, probiotic supplementation stimulates the immune system. It may protect the intestinal mucosa by strengthening the gut’s immune system and promoting intestinal efficiency (nutrient absorption and number of goblet cells). L. plantarum can therefore offer a reliable, affordable, and safe treatment for functional gastrointestinal illnesses.

Inflammation patterns in early post-operative cholangitis predict long-term outcomes in biliary atresia: a potential role of non-suppurative cholangitis.

Frequent post-operative cholangitis in biliary atresia (BA) affects the long-term native liver survival. This study assessed the characteristics of early cholangitis and their influence on the prognosis. Forty-three patients with BA who underwent surgery between 2000 and 2020 were analyzed for routine inflammatory markers. Early cholangitis characteristics were compared between native liver survivor (NLS) and living donor liver transplant (LDLT) patients. Among the 43 patients, 30 (69.8%) experienced 130 episodes of cholangitis. In the area under the receiver operating characteristics curve (AUROC) analysis, the cutoff value of the total cholangitis episodes was 3, with an area under the AUROC curve of 0.695 (95% confidence interval 0.522-0.868). Before 3years old, 113 episodes (86.9%) of cholangitis were observed. The white blood cell, C-reactive protein, and alanine aminotransferase values at cholangitis onset did not markedly differ between the LDLT and NLS groups. Conversely, the neutrophil-to-lymphocyte ratio in the NLS group was significantly lower than in the LDLT group (0.85 vs. 1.63, p < 0.001). Cholangitis in the NLS group was lymphocyte-dominant and atypical in its pathogenesis. Lymphocyte-dominant cholangitis is non-suppurative, and future research should clarify its pathogenesis to improve the treatment and prognosis of BA.

Evaluation of interferon gamma release assay to measure t-cell response in COVID-19 patients from intensive care units and inpatient departments.

Interferon gamma release assay (IGRA) is an in vitro blood test to measure interferon gamma (IFN-γ) released from antigen-specific Tcells after stimulation with pathogen-specific peptides. In this study, it was aimed to investigate the T-cell response using IGRA and to compare various laboratory values in Coronavirus Disease (COVID-19) patients hospitalized either in hospital inpatient departments or in intensive care units. Atotal of 100 patients (50+50) who were identified as positive for COVID-19 through the molecular method in Selcuk University Faculty of Medicine Infectious Diseases Service and Reanimation Intensive Care Unit were included in the study. IFN-γ levels in blood samples collected from patients were determined using the QuantiFERON Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) (QIAGEN, Germany) kit. The patients' gender, age, c-reactive protein (CRP), aspartate aminotransferase (AST), alanine transaminase (ALT), interleukin (IL)-6, lymphocyte count, procalcitonin, and D-dimer results were obtained from the hospital automation system. Thirty-eight of the IGRA test results were negative, 44 were positive and 18 were inconclusive. The age of patients with negative IGRA test results was significantly higher (p<0.001) compared to patients with positive results. There were no significant differences between patients' IGRA test results and gender, prognosis, IL-6, lymphocyte counts, CRP, AST, and ALT values.Age, death rates, D-dimer, CRP, procalcitonin, AST and ALT values of patients hospitalized in the intensive care unit were significantly higher (p<0.001) compared to the those hospitalized in the inpatient department, while conversely, the lymphocyte values were lower (p<0.001). The relatively higher IGRA negative results in the elderly, negative and intermediate results in intensive-care patients, and low lymphocyte levels in intensive-care patients indicate that the cellular immune response is diminished and/or absent. The death rates, D-dimer, CRP, procalcitonin, AST and ALT values of the patients hospitalized in the intensive care unit were higher compared to those from the in-patient department, indicating the severity of inflammation and signaling the development of organ failure. In the light of these findings, we suggest that IGRA tests may serve as aguide in immunomodulatory therapy (Tab. 2, Fig. 2, Ref.27). Text in PDF www.elis.sk Keywords: COVID-19, interferon gamma release assay test, Tcell response.

Seroreactivity against Leptospira spp. differs between community cats and privately-owned cats in Hong Kong

Leptospirosis is a bacterial zoonotic disease of major One Health significance and public health impact globally, with a wide host range including mammals, cetaceans and herpetofauna. This study aimed to determine Leptospira seroprevalence, risk factors for seroreactivity and prevalence of urinary Leptospira shedding among domestic cats in Hong Kong.Microagglutination testing of 22 Leptospira serovars from 20 serogroups was performed on 738 sera from outdoor free-roaming “community” cats (n = 391) and privately-owned (n = 347) cats. Urine from 268 community cats was tested for pathogenic Leptospira DNA by qPCR targeting lipL32. Potential risk factors associated with exposure were assessed using logistic regression.Overall Leptospira seroprevalence was 9.35%. Of 14 serogroups detected, Javanica (4.3%), Djasiman (2.3%) and Australis (1.5%) were most common. Seroreactivity was significantly higher among community (13.3%) than privately-owned cats (4.9%; OR 2.98 [95% CI 1.68–5.25], P < 0.001), especially to Javanica (7.65% of community cats versus 0.58% of privately-owned cats (P < 0.001). Antibody titres to all serogroups ranged from 1:100 to 1:6400 (median 1:200) and were highest for Javanica (median 1:800).Leptospira DNA was detected in urine from 12/268 community cats (4.48%; median load 6.42 × 102 copies/mL urine; range 1.40 × 101–9.63 × 104). One in three seroreactive community cats with paired urine and blood samples had leptospiruria. After adjusting for source, none of breed, sex, neuter status, age, district rodent infestation rate, serum alanine transaminase or creatinine values were associated with seroreactivity.Cats in Hong Kong are exposed to a diversity of Leptospira serogroups and can shed Leptospira silently in urine. The higher seroprevalence among outdoor free-roaming community cats highlights the importance of environmental drivers in leptospirosis transmission and risks of exposure for sympatric human populations. Gloves should be worn when handling feline urine to minimise the risk of zoonotic transmission from subclinically infected cats.

A Retrospective Comparison of Clinical and Laboratory Aspects of Patients With COVID-19-Related Acute Respiratory Distress Syndrome (ARDS) and Non-COVID-19-Related ARDS.

This study investigated demographic characteristics, hemodynamic values, respiratory datas, laboratory values ​​such as biochemistry and blood gas, and treatment approaches of coronavirus disease 2019 (COVID-19)-related and non-COVID-19-related acute respiratory distress syndrome (ARDS) patients hospitalized in the intensive care unit (ICU). Determining the differences and similarities between COVID-19-related ARDS (CARDS) patients and non-COVID-19-related ARDS (NCARDS) patients will be useful to better understand these two diseases. A total of 32 NCARDS patients who were followed and treated in the ICU for various reasons between January 2015 and December 2020 and 32 CARDS patients who were followed and treated in the ICU for various reasons between March 2020 and December 2020 were examined retrospectively. Age, gender, comorbidities, Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation (APACHE) II Score, blood pressure, heart rate, saturation, laboratory results, arterial blood gas (ABG) values, length of stay in the ICU, intubation, the number of days till the patient was extubated, the treatments applied, admission to the service, and mortality were evaluated. In the comparison between the two groups, the demographic data of the patients, the number of days intubated and extubated, APACHE II scores, and ICU length of stay were not statistically different. Values of positive end-expiratory pressure (PEEP), first hospitalization GCS, first hospitalization hemoglobin (Hgb), albumin at first admission, alanine aminotransferase (ALT) at first admission, and steroid use were found to be significantly different in patients with CARDS (p < 0.001). The median of PEEP values (p = 0.04), first admission GCS values (p = 0.04), first admission Hgb values (p = 0.005), albumin values at the first admission (p = 0.03), ALT values (p = 0.03), and the rate of steroid use (p = 0.001) of CARDS patients were significantly higher than those of NCARDS patients. The median of the first hospitalization heart rate values (p = 0.009), first hospitalization saturation values (p = 0.001), and first admission neutrophil values (p = 0.03) in NCARDS patients were significantly higher than that of CARDS patients. There was no significant difference between the two groups in terms of mortality, sedation use, inotropic support, C-reactive protein (CRP), and procalcitonin values. CARDS and NCARDS have clinical and laboratory similarities and differences. Therefore, there should be differences in our follow-up and treatment approach to these two disease groups.

Cordyline fruticosa leaf powder supplemented in the diet of weaned pigs: effect on growth performance, heamatological and serum biochemical indices

In Sumitra Research Institute, Gujarat, a total of 50 cross-bred male piglets (Yorkshire × Landrace) with an initial body weight of 9.77 ± 0.06 kg weaned at 28 days were randomly distributed 5 treatments of 10 replicates containing 1 animal each in 60 days’ trial. According to the Nutritional Research Council’s recommendation in 2012, a basal diet was adequate in all nutrients. Pigs in treatment 1 were fed a basal diet without C. fruticosa leaf powder while treatments 2, 3, 4, and 5 were fed the same diet supplemented with C. fruticosa leaf powder at 20 g, 40 g, 60 g, and 80 g respectively. Animals were given unrestricted access to fresh clean water and a completely randomized design was adopted. The experimental result showed that average daily weight gains and average daily feed intake which took the form of 0.29-0.46 kg and 0.68-0.77 kg were higher in the C. fruticosa leaf powder-supplemented group relative to the control (p &lt; 0.05). The treatments significantly influenced the best feed conversion ratio and mortality rate from 1.73-2.34 to 1.0-3.0% (p &lt; 0.05). Haemoglobin, red blood cell, pack cell volume, total platelet count, mean platelet volume, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, white blood cell, lymphocytes, and monocytes count follow a similar trend as values were greater in treatment 3, 4 and 5, an intermediary in treatment 2 and lower in treatment 1 (p &lt; 0.05). The treatment significantly influenced total protein, glucose, cholesterol, Calcium, and Phosphorus values (p &lt; 0.05). In contrast, bilirubin, urea, creatinine, sodium, chloride, alanine transaminase, aspartate aminotransferase, and alkaline phosphatase values were similar among the treatments (p &gt; 0.05). In conclusion, Cordyline fruticosa leaf powder can be supplemented in the diet of weaned pigs without causing any negative effect on the growth and health status of weaned pigs.

Biopsy-Proven Gastric Pathological Findings in Mechanically Ventilated Intensive Care Unit Patients.

Objectives Helicobacter pylori (H. pylori) is known to affect a large proportion of the world population. It plays a role in the pathogenesis of peptic ulcer (PU) and increases the likelihood of bleeding. In critically ill patients in intensive care units (ICUs), the risk of bleeding may be much higher due to many concomitant factors. The study aimed to determine the activation of H. pylori in mechanically ventilated (MV) intensive care patients and compare this with the general population. Methods This study was performed retrospectively by screening patients who underwent esophagogastroduodenoscopy and histopathological sampling in our hospital between January and June 2023. The study included 79 patients aged between 18 and 85 years. The patients were categorized into two groups: 35 patients in the ICU with mechanical ventilation (MV) support (EMV) and 44 patients who presented to the gastroenterology department due to dyspeptic symptoms and underwent endoscopy (ED). Age; sex characteristics; laboratory parameters such as hemoglobin (Hb), hematocrit (Htc), mean cellular volume (MCV), white blood cell (WBC), neutrophil, platelet, glucose, urea, creatinine, aspartate transaminase (AST), alanine transaminase (ALT), C-reactive protein (CRP), albumin, ferritin, thyroid-stimulating hormone (TSH), anti-hepatitis C virus (HCV), hepatitis B surface antigen (HBsAg), anti-HIV; and biopsy results (H. pylori positivity, intestinal metaplasia, and atrophy) were recorded. Results A total of 79 patients who underwent gastric biopsy were assessed. There were 35 patients in the EMV group and 44 patients in the ED group. There was no difference in gender and age distribution between the groups. Hb and Htc were significantly lower in EMV compared to ED (p=0.001). Hb was 9.4±1.7 g/dL in EMV and 10.8±2.1 g/dL in ED. Htc was 29.6±5.1 in EMV and 33.5±5.7 in ED. MCV, WBC, glucose, urea, AST, ALT, CRP, and ferritin values were statistically significantly higher in EMV (p<0.05). Albumin and creatinine levels were statistically significantly lower in EMV (p<0.05). There was no significant difference between the groups in terms of neutrophils, platelets, and TSH. In the EMV group, H. pylori activity was negative in 31 (88.6%) patients and positive in four (11.4%) patients. In the ED group, H. pylori activity was negative in 30 (68.2%) patients and positive in 14 (31.8%) patients. There was a statistically significant difference between the groups in terms of H. pylori positivity (p=0.032). Conclusions The prevalence of H. pylori in MV patients in the ICU is low compared to the average population. The incidence of atrophic gastritis and intestinal metaplasia is the same. The present study supports that ICU cases do not have a higher risk of gastric premalignant lesions compared to the average population.

Early combination with mycophenolate mofetil for immune-related hepatitis in patients with solid tumors treated with immune checkpoint inhibitors.

12133 Background: Hepatitis, as an immune-related adverse event (irAE), occurs in 2%-10% of patients treated with immune checkpoint inhibitors (ICIs). Although guidelines recommend the use of mycophenolate mofetil (MMF) for steroid-refractory and steroid-resistant ir-hepatitis, there has been no evidence on the efficacy of MMF. Methods: We retrospectively reviewed consecutive patients with solid tumors who developed grade 2 or higher ir-hepatitis requiring systemic steroids after ICIs (nivolumab, pembrolizumab, atezolizumab, avelumab, durvalumab and ipilimumab) between January 2015 and August 2023. The changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin level, according to the CTCAE version 5.0, were used to assess ir-hepatitis. ALT improvement was calculated as the ratio of the change in ALT values from onset to day 7, normalized by the ALT values at onset. Results: Among 4405 patients treated with ICI during the study period, 130 patients (3%) developed grade 2 or higher ir-hepatitis requiring systemic steroids. The median age was 62 (range: 19-85) years-old, and 122 patients (94%) had an ECOG performance status (PS) 0/1. These patients included 67 (52%) with melanoma, 35 (27%) with lung cancer, 7 (5%) with esophageal cancer, and 21 (16%) with other cancers. Among 123 evaluable patients, 46 patients (46/123, 37%) received MMF including 20 patients experiencing steroid-refractory and 26 steroid-resistant. The median duration from the start of systemic steroids to MMF was 11 days (range: 0-113 days). Improvement of hepatitis to grade 1 with MMF was observed in 40 patients (40/46, 87%) with a median time of 18 (range: 3-176) days. Of the patients evaluated for the impact of the timing of MMF on the improvement of ir-hepatitis (n=38), ALT improvement at day 7 after ir-hepatitis onset in patients who initiated MMF within 3 days of ir-hepatitis onset (early combination group, n=8) was significantly higher compared with the patients who initiated MMF after 3 days of ir-hepatitis onset (late combination group, n=30) (72.3% vs. 41.7%, p=0.02). Additionally, among patients evaluable for systemic steroid dosage (n=45), the total systemic steroid dosage in patients in the early combination group (n=8) was significantly less than in the late combination group (n=37) (median: 2120mg vs 4005 mg, p=0.02). Conclusions: MMF was effective for both steroid-refractory and steroid -resistant ir-hepatitis. Early combination with MMF in addition to systemic steroids can lead to a more rapid improvement of ir-hepatitis compared to late combination with MMF consequently reducing the total systemic steroid dosage. [Table: see text]

Risk factors for liver enzyme elevation with remdesivir use in the treatment of paediatric COVID-19.

Remdesivir (RDV) causes liver enzyme elevation in adults; however, the frequency of this elevation in children and the associated risk factors are largely unknown. Therefore, we aimed to examine risk factors for liver enzyme elevation in hospitalised paediatric patients who received RDV. This was a retrospective case-control study of all patients aged <18 years who were diagnosed with coronavirus disease 2019 and received RDV at a tertiary care hospital between February 2022 and September 2023. Demographic and clinical data were retrieved from the medical records and analysed. Patients with liver enzyme elevation were defined as cases, while those with no liver enzyme elevation were defined as controls. The two groups were compared and analysed for possible risk factors for liver enzyme elevation with RDV use. Sixty-six patients were treated with RDV, 12 (18.2%) of whom developed liver enzyme elevation. Liver enzyme elevation was associated with the median duration of RDV administration (7.5 days vs. 3 days, P = 0.012), median total RDV dose (17.7 mg/kg vs. 10.3 mg/kg, P = 0.017) and acetaminophen use (67% vs. 22%) (odds ratio = 4.34; 95% confidence interval, 1.05-19.97, P = 0.023). All patients showed improvement, except three who had no liver enzyme measurements after having the highest aspartate aminotransferase and alanine aminotransferase values during the observation period. Liver enzyme elevation was reversible after discontinuing RDV use. Overall, RDV can be considered safe in children with careful monitoring.

Clinical and biochemical characteristics, and outcome in 33 patients with ceftriaxone-induced liver injury.

To summarize the clinical and biochemical characteristics of patients with ceftriaxone-induced liver injury and guide the selection of safe medication. Retrieved domestic and foreign databases from inception to October 2023, collected case data conforming to ceftriaxone-induced liver injury, and statistically analyzed the data. A total of 617 articles were retrieved, and 16 articles with 33 cases (10 children, 23 adults) were included. Males represented 60% (18/30), with a male-to-female ratio of 1.5:1. The age of onset ranged from 2 days to 96 years, with 15 of 23 adults (65%) over 55 years old. The time from ceftriaxone use to liver injury fluctuated between 0.5 and 47 days. Only 9 patients (27.3%, 9/33) had clinical symptoms, and the clinical classification was dominated by cholestatic injury (46.2%, 12/26). There was a significant difference in the clinical classification of ceftriaxone-induced liver injury between children and adults (P = 0.0126), with hepatocellular injury predominating in children and cholestatic injury predominating in adults. The severity of liver injury was mainly mild (66.7%, 12/18). Peak values of alanine aminotransferase ranging from 228.5 to 8098 U/L, aspartate aminotransferase ranging from 86.7 to 21575 U/L, alkaline phosphatase ranging from 143 to 2434 U/L, and total bilirubin ranging from 3.35 to 66.1mg/dL. There was a significant difference in peak values of alkaline phosphatase between children and adults (P = 0.027), with a higher peak value of alkaline phosphatase in adults (1039 ± 716.4 U/L vs. 257 ± 134.9 U/L). Patients with normal imaging examinations accounted for the majority (61.5%, 7/13). The prognosis of 32 patients (97%, 32/33) was good, and one child with sickle cell anemia who developed immune hemolysis, progressive renal failure, and acute liver injury after using ceftriaxone died in the end. Ceftriaxone-induced liver injury can occur at any age, with a higher risk in the elderly, and age may be related to the clinical classification. Although the clinical manifestations are not specific, close monitoring of liver biochemical indicators during the use can detect liver injury early. Most cases have a good prognosis, but for people with concomitant sickle cell anemia, it is necessary to be vigilant about the occurrence of severe hemolytic anemia.

Effect of coconut shell extract on the growth performance and some haemato-biochemical parameters of broiler chicken

This experiment was carried out at Sumitra Research Institute, Gujarat, India to evaluate the effect of coconut shell extract on the growth performance and some haemato-biochemical parameters of broiler chicken. 240 – 1 day old Hubbard broiler chicks of mixed sex were randomly distributed to six treatments with six replicates containing ten birds each in a completely randomized design. Birds in treatment 1(T1) was fed standard diet with no coconut shell extract; T2: standard diet with 1.0 mL coconut shell extract per liter of water; T3: standard diet with 2.0 mL coconut shell extract per liter of water and T4: standard diet with 3.0 mL coconut shell extract per liter of water. Standard diet was formulated according to the nutritional needs of broilers. The study lasted for fifty-six day and birds were offered fresh clean water and feed ad libitum. Phenols (410.3 mg/g-1), tannins (98.21 mg/g-1), alkaloids (100.6 mg/g-1), flavonoids (309.5 mg/g-1), saponins (71.4 mg/g-1) and steroids (28.7 mg/g-1) were identified coconut shell extract. Overall weight gains of birds fed T3 (2506.3 g) and T4 (2527.6 g) had a numerical and a remarkable significant improvement if feed conversion ratio from 1.92 to 1.59 compared to T2 (2210.0 g) and T1 (1996.1 g). Mortality was only recorded among birds in T1 (2.00 %) (p &lt; 0.05). Pack cell volume, red blood cell, white blood cell, haemoglobin, mean corpuscular volume, mean corpuscular haemoglobin and mean corpuscular haemoglobin concentrations were influenced (p &lt; 0.05) by the treatments. However, values were within the normal range for healthy birds. Total protein, albumin and globulin values were higher in T2, T3 and T4 except for alanine phosphatase, aspartate transaminase and alanine transaminase values which were not significantly (p &gt; 0.05) different among the treatment. Total cholesterol was higher (p &lt; 0.05) in T1 relative to the other treatments. It was concluded that coconut shell extract can be fed to broilers up to 3.0 mL without causing any negative effect on the health status of animals.

Haemato-biochemical indices and immune response of grower pigs fed enzyme supplemented dried cassava peel and maize cob composite meal

This study was carried out to examine the haemato-biochemical and immune response of grower pigs fed enzyme supplemented dried cassava peel and maize cob composite meal (CPMCM). A total of 36 crossbreed male grower pigs (Large white) of about 16 weeks old were randomly distributed into four groups of nine animals per treatment. Each treatment was further divided into three replicates consisting of three pigs in a completely randomized design. Pigs in treatment 1 were fed 0% CPMCM while CPMCM was used to replace maize at 40% (T2), 50% (T3) and 60% in T4. Examination of phyto-constituents in CPMCM showed that it contains alkaloids, tannins, saponins, cyanide, phenols and flavonoids at 20.05 mg/kg-1, 9.06 mg/kg-1, 10.04 mg/kg-1, 15.03 mg/kg-1, 8.92 mg/kg-1 and 14.11 mg/kg-1 respectively. Haematological results revealed that red blood cell, pack cell volume, haemoglobin, mean corpuscular haemoglobin, mean corpuscular volume, mean corpuscular haemoglobin concentration, white blood cell, monocytes and lymphocytes were significantly (p &lt; 0.05) influenced by the treatment except for basophils count (p &gt; 0.05). Total protein, total bilirubin, glucose, creatinine, alkaline phosphatase, alanine transaminase and aspartate transaminase values were significantly different among the treatment (p &lt; 0.05) except for cholesterol and urea levels. It was concluded that all the blood parameters evaluated were within the established range for healthy pigs and dietary replacement of cassava peel and maize cob composite meal (CPMCM) with maize up to 60% pose no deleterious effect on the health of the animals.

Comparison of the effects of hesperidin over 30 and 60-day intervals on rainbow trout: a potential biostimulant to promote growth, immunological and antioxidant responses, and disease resistance

Abstract The current research evaluated the effects of dietary hesperidin (HSP) on growth parameters, digestive enzyme activities, innate immune markers, and antioxidant responses in rainbow trout, Oncorhynchus mykiss after the 30- and 60-day feeding trial. Then, specimens were subjected to Yersinia ruckeri infection for 14 days. For this, six hundred rainbow trout juveniles (initial weight; 25.49±0.40 g) were fed with different levels of HSP including 0 (HSP0; control), 50 (HSP50), 100 (HSP100), 150 (HSP150), and 200 (HSP200) mg/kg feed. After 60 days, dietary HSP100 supplementation significantly improved growth and feed efficiency indices. The optimal dose of HSP based on the regression test for WG and FCR detected 122 and 131mg/kg, respectively. At the end of the 30th day, dietary HSP150 supplementation markedly boosted serum lysozyme (LYZ), myeloperoxidase (MPO), complement component C3, and immunoglobulin (Ig) levels, as decreased malondialdehyde (MDA) content. In the same period, dietary administration of HSP at the different concentrations markedly increased complement component C4 (HSP150 and HSP200), superoxide dismutase (SOD), skin mucus alkaline phosphatase (ALP) (HSP100- HSP200), skin mucus LYZ and catalase (CAT) (HSP100 and HSP 150), and skin mucus Ig level (HSP50- HSP200). After 60 days, all dietary HSP supplementation significantly improved lipase, serum C3, glutathione peroxidase (GPX), and skin mucus ALP, LYZ, and Ig levels, but decreased MDA, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) values. After 60 days, dietary administration of HSP150 induced a significant discrepancy in the activity of serum LYZ, MPO, respiratory burst (RB), and lactate dehydrogenase (LDH) compared to the control group. In the same period, dietary HSP supplementation at different levels induced a remarkable increase in digestive protease activity (HSP100), serum ACH50 and CAT activities (HSP100 and HSP150), skin mucus peroxidase and serum SOD levels (HSP100-HSP200), and serum C4 value (HSP50, HSP150, and HSP200), but markedly decreased ALP activity (HSP150 and HSP200). In addition, dietary HSP supplementation, especially HSP150, markedly boosted disease resistance against Y. ruckeri infection. The current data demonstrated that the oral administration of 100 - 150 mg/kg HSP has a high potential to promote growth performance, disease resistance, and faster induction of immune and antioxidant responses.

The Insidious Enemy of the Liver: The Situation in Childhood Acetaminophen Poisoning and Early N-AC Treatment.

This study was designed as a cross-sectional, observational, retrospective study. The variables of the study were paracetamol overdose, demographic information, poisoning mechanisms, clinical, laboratory findings, and clinical progression of the cases. The cases compared in whom treatment was initiated within the first 8 hours after poisoning and those in whom it was not. χ2, t test, and logistic regression analyses were conducted at appropriate facilities. Three hundred forty-eight cases were included in the study. N-AC treatment was initiated within the first 8 hours after poisoning in 322 cases (92.5%), and 26 cases received N-AC treatment after 8 hours after poisoning. Liver toxicity developed in 6 cases (1.7%), and indications for liver transplantation were met in 36 cases (10.3%). Among the 26 cases for which treatment was not initiated within the first 8 hours, 18 cases (69.2%) had indications for liver transplantation (P < 0.01). It was found that N-AC within the first 8 hours reduced the risk by 43 times (P = 0.02) and being older than 6 years, being admitted to the intensive care unit, and having alanine aminotransferase values above 1000 U/L increased the risk significantly (P = 0.009, P = 0.005, P < 0.001). When a receiver operating characteristic curve was plotted for the 4th-hour blood acetaminophen level to predict liver transplantation, a value of 684.5 μg/mL emerged with 89% sensitivity and 93% specificity (area under the curve, 0.951). As a result, this study demonstrates the protective effect of early-initiated N-AC therapy on liver toxicity in pediatric acetaminophen poisoning cases. It also highlights a significant impact of gastrointestinal decontamination methods.

Haematochemical Profile of Healthy Dogs Seropositive for Single or Multiple Vector-Borne Pathogens.

the present study aimed to investigate the immunological response to common vector-borne pathogens and to evaluate their impact on haematochemical parameters in owned dogs. Blood samples were collected from 400 clinically healthy dogs living in an endemic area (Sardinia Island, Italy). All dogs were serologically tested for VBDs and divided into groups based on their negative (Neg) or positive response towards Ehrlichia (Ehrl), Rickettsia (Rick), Leishmania (Leish), Borrelia (Borr), Anaplasma (Anapl), and Bartonella (Barto). A Kruskall-Wallis's test, followed by Dunn's post hoc comparison test, was applied to determine the statistical effect of negativity and single or multiple positivity on the studied parameters. the group of dogs simultaneously presenting antibodies towards Leishmania, Ehrlichia, and Rickettsia showed higher values of total proteins, globulins, creatine phosphokinase, aspartate aminotransferase, alanine aminotransferase, and amylase than dogs that tested negative or dogs with antibodies toward a single pathogen investigated herein. Our results seem to suggest that exposure to more vector-borne pathogens could lead to greater liver function impairment and a greater inflammatory state. Further investigations are needed in order to better clarify how co-infections affect haematochemical patterns in dogs living in endemic areas of VBDs.

Predictors of Choledocholithiasis in Cholecystectomy Patients and Their Cutoff Values and Prediction Model in Korea in Comparison with the 2019 ASGE Guidelines.

: In 2019, the American Society for Gastrointestinal Endoscopy (ASGE) established clinical predictors for choledocholithiasis. Our study was designed to evaluate these predictors within the Korean clinical context, establish cutoff values, and develop a predictive model. : This retrospective study analyzed patients who underwent laparoscopic cholecystectomy. The relationships between choledocholithiasis and predictors including age, blood tests, and imaging findings were assessed through univariate and multivariate logistic regression analyses. We established Korean cutoff values for these predictors and developed a scoring system for choledocholithiasis using a multivariate logistic regression. The performance of this scoring system was then compared with that of the 2019 ASGE guidelines through a receiver operating characteristic curve. : We established Korean cutoff values for age (>70 years), alanine aminotransferase (>26.5 U/L), aspartate aminotransferase (>28.5 U/L), gamma-glutamyl transferase (GGT; >82.5 U/L), alkaline phosphatase (ALP; >77.5 U/L), and total bilirubin (>0.95 mg/dL). In the multivariate analysis, only age >70 years, GGT >77.5 U/L, ALP >77.5 U/L, and common bile duct dilatation remained significant. We then developed a new Korean risk stratification model from the multivariate analysis, with an area under the curve of 0.777 (95% confidence interval, 0.75 to 0.81). Our model was stratified into the low-risk, intermediate-risk, and high-risk groups with the scores being <1.0, 1.0-5.5, and >5.5, respectively. : Predictors of choledocholithiasis in cholecystectomy patients and their cutoff values in Korean should be adjusted and further studies are needed to develop appropriate guidelines.

Evaluation of Silybin Nanoparticles against Liver Damage in Murine Schistosomiasis mansoni Infection.

Silybin (SIB) is a hepatoprotective drug known for its poor oral bioavailability, attributed to its classification as a class IV drug with significant metabolism during the first-pass effect. This study explored the potential of solid lipid nanoparticles with (SLN-SIB-U) or without (SLN-SIB) ursodeoxycholic acid and polymeric nanoparticles (PN-SIB) as delivery systems for SIB. The efficacy of these nanosystems was assessed through in vitro studies using the GRX and Caco-2 cell lines for permeability and proliferation assays, respectively, as well as in vivo experiments employing a murine model of Schistosomiasis mansoni infection in BALB/c mice. The mean diameter and encapsulation efficiency of the nanosystems were as follows: SLN-SIB (252.8 ± 4.4 nm, 90.28 ± 2.2%), SLN-SIB-U (252.9 ± 14.4 nm, 77.05 ± 2.8%), and PN-SIB (241.8 ± 4.1 nm, 98.0 ± 0.2%). In the proliferation assay with the GRX cell line, SLN-SIB and SLN-SIB-U exhibited inhibitory effects of 43.09 ± 5.74% and 38.78 ± 3.78%, respectively, compared to PN-SIB, which showed no inhibitory effect. Moreover, SLN-SIB-U demonstrated a greater apparent permeability coefficient (25.82 ± 2.2) than PN-SIB (20.76 ± 0.1), which was twice as high as that of SLN-SIB (11.32 ± 4.6) and pure SIB (11.28 ± 0.2). These findings suggest that solid lipid nanosystems hold promise for further in vivo investigations. In the murine model of acute-phase Schistosomiasis mansoni infection, both SLN-SIB and SLN-SIB-U displayed hepatoprotective effects, as evidenced by lower alanine amino transferase values (22.89 ± 1.6 and 23.93 ± 2.4 U/L, respectively) than those in control groups I (29.55 ± 0.7 U/L) and I+SIB (34.29 ± 0.3 U/L). Among the prepared nanosystems, SLN-SIB-U emerges as a promising candidate for enhancing the pharmacokinetic properties of SIB.