Hepatic Injury in Neonates with Perinatal Asphyxia

Background: Perinatal asphyxia (PA) is a major cause of morbidity and mortality in which dramatic transient impairment in liver functions occurs in some patients. Objectives: We aimed to evaluate the state of the liver in cases of Perinatal asphyxia and to assess the severity of hepatic impairment in relation to different grades of HIE. Patients and Methods: This case-control study was conducted on 100 full-term newborns with perinatal asphyxia (Group I) and 50 healthy neonates served as controls (Group II). All biochemical parameters of liver function were measured on the 1st, 3rd, and 10th day after birth. These parameters include serum alanine transferase (ALT), aspartate transferase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), total protein, serum albumin, serum bilirubin (total and direct), and international normalized ratio (INR), in both cases and controls. Results: Among babies with PA, 25 (25%) had an Apgar score of 0 to 3 (severe PA), 43 (43%) had an Apgar score of 4 to 5 (moderate PA) and 32 (32%) had an Apgar score of 6 to 7 (mild PA) at 5 minutes of life. HIE was found in 39% among cases of PA and the remaining 61% were normal. Among babies with PA and HIE; 25.7% had stage I, 41% had stage II and 33.3% had stage III. Impaired liver function was reported in 48% of asphyxiated babies. On the first day of life, ALT, AST, ALP, LDH, PT, and INR were significantly higher in Group I compared to Group II. However, total protein and serum albumin were significantly lower in Group I compared to Group II. ALT and AST showed a positive correlation with the severity of HIE. On the third day of life, LDH rises as the stage of HIE progressed from stage 0 to stage 3. The difference in LDH among most stages of HIE was statistically significant. Conclusion: Liver enzymes can be used as an easy early diagnostic marker to differentiate between babies with asphyxia and those without asphyxia. Also, liver enzymes can be used for the detection of the severity of PA.

Download Full-text

Hepatic Dysfunction in Asphyxiated Neonates: Prospective Case-Controlled Study

Clinical Medicine Insights Pediatrics ◽

10.4137/cmped.s21426 ◽

2015 ◽

Vol 9 ◽

pp. CMPed.S21426 ◽

Cited By ~ 22

Author(s):

Mukesh Choudhary ◽

Deepak Sharma ◽

Dhanraj Dabi ◽

Mamta Lamba ◽

Aakash Pandita ◽

...

Keyword(s):

Liver Function ◽

Serum Albumin ◽

Apgar Score ◽

Total Protein ◽

Perinatal Asphyxia ◽

Birth Asphyxia ◽

Stage Iii ◽

Controlled Study ◽

Group A ◽

Group B

Objective This study was performed to determine the occurrence of hypoxic hepatitis in full-term neonates after perinatal asphyxia and to correlate between the rise in enzymes and severity of asphyxia with Apgar score and hypoxic ischemic encephalopathy (HIE) grading of the neonates. Method and Material This prospective case-controlled study was conducted in a tertiary-level hospital in India for a period of 12 months. The study group A comprised 70 newborns suffering from birth asphyxia, while 30 healthy neonates were included in group B (control). All biochemical parameters of liver function, ie, serum alanine transferase (ALT), aspartate transferase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), total protein, serum albumin, bilirubin (total and direct), and international normalized ratio (INR), were measured on postnatal days 1, 3, and 10 in both study and control groups. Results In group A, 22.8% newborns had severe (Apgar score 0–3), 47.1% had moderate (Apgar score 4–5), and 30% had mild (Apgar score 6–7) birth asphyxia at five minutes. In all, 14.28% babies were in HIE stage I, 25.73% babies were in HIE stage II, and 11.42% babies were in HIE stage III. The rest of the newborns, 48.57%, were normal. The prevalence of liver function impairment was seen in 42.85% of asphyxiated neonates. On day 1, ALT, AST, ALP, LDH, PT, and INR were significantly higher, and total protein and serum albumin were significantly lower in group A than in group B. However, ALT and AST correlated well with increasing severity of HIE score. On day 3, there was a rising trend observed in the concentration of mean LDH as HIE staging of neonates progressed from stage 0 to stage III, and among various HIE stages, the difference in LDH was statistically significant. Conclusion We concluded that AST, ALT at 24 hours, and LDH at 72 hours of animation can be a utilitarian diagnostic tool to differentiate asphyxiated neonates from non-asphyxiated neonates and to discover the severity of perinatal asphyxia because of easy accessibility and feasibility of tests. The outcomes of this survey would be useful for physicians who receive neonates for whom birth details are not easily documented as most of the time the referred newborn infants lack asphyxia history either because the attendants do not know clearly the whole birth history or it was an unattended delivery, or the referring healthcare professional has not been observant because of legal threats. The neurological assessment also becomes difficult and inconclusive as ventilator treatment, sedative drugs, and anticonvulsant therapy would produce an evaluation of severity of hypoxic ischemic brain disease and neurological insult difficult.

Download Full-text

The Effect of Parenteral Infusion of Amino Acids in Burn Patient

Medicine Today ◽

10.3329/medtoday.v24i1.14107 ◽

2013 ◽

Vol 24 (1) ◽

pp. 12-15

Author(s):

Kamrun Nahar ◽

Zeba-un Naher ◽

Matira Khanam ◽

Shaheen Akhter ◽

Tahmina Bashar ◽

...

Keyword(s):

Amino Acid ◽

Serum Albumin ◽

Total Protein ◽

Burn Injury ◽

Burn Patients ◽

Serum Total Protein ◽

Female Ratio ◽

Group I ◽

The Mean ◽

Group Ii

Adequate nutritional support may prevent weight loss following severe burn injury. However, persistently low levels of serum albumin, transferring and serum total protein in burn patients have suggested that a protein deficiency may continue to exist which is out of proportion to energy requirements. This interventional study cross sectional study was done in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during January 2008 to December 2008. A total of 40 acute burn injury (within 24 hours of burn) patients of 20-45 years age with 15%-30% burn were selected for this study as case. The study subjects were divided into two groups: Group I represent superficial burn & Group II represents deep burn. The mean age of 28.35±6.81 years and 30.85±7.32 years in group I and group II respectively. The number of male in Group-I was 08 and Group-II was 08 and male female ratio was 2:3. The mean serum total protein before infusion of amino acid in Group-I was 55.31±3.58 g/L and in Group-II was 52.01±2.26 g/L (p<0.001). The mean serum total protein after infusion of amino acid in Group-I was 68.02±2.04 g/L and in Group-II was 61.86±2.49g/L (p<0.001). The mean serum albumin before infusion of amino acid in Group-I was 27.6±2.88 g/L and in Group-II was 25.57±1.89 g/L (p<0.001). The mean serum albumin after infusion of amino acid in Group-I was 22.29±3.50 g/L and in Group-II was 19.83±2.86 g/L (p<0.001). In group-I, serum total protein was increased by 22.98% after infusion and in group-II, that was increased by 18.94% (p<0.01). In group-I, serum albumin was decreased by 19.24% after infusion and in group-II, that was decreased by 22.45% (p<0.05). Serum total protein significantly increased after infusion of amino acid but serum albumin significantly decreased after infusion of amino acid. DOI: http://dx.doi.org/10.3329/medtoday.v24i1.14107 Medicine TODAY Vol.24(1) 2012 pp.12-15

Download Full-text

Comparison of Serum Total Protein and Serum Albumin after Infusion of Amino Acid of the 15%-30% Burn Patients

Journal of Science Foundation ◽

10.3329/jsf.v9i1-2.14653 ◽

2013 ◽

Vol 9 (1-2) ◽

pp. 109-113

Author(s):

N Kamrun ◽

Zeba Un-Naher ◽

M Ali ◽

T Bashar ◽

MI Arslan

Keyword(s):

Amino Acid ◽

Serum Albumin ◽

Total Protein ◽

Burn Injury ◽

Burn Patients ◽

Amino Acid Supplementation ◽

Serum Total Protein ◽

Cross Sectional ◽

Group I ◽

Group Ii

The aim of the study to find out the ratio of raise of serum total protein and serum albumin during amino acid supplementation in burn patients. This interventional study cross sectional study was done in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during January 2008 to December 2008. A total of 40 acute burn injury (within 24 hours of burn) patients of 20-45 years age with 15%-30% burn were selected for this study as case. The study subjects were divided into two groups: Group I represent superficial burn & Group II represents deep burn. In group-I, serum albumin was decreased by 19.24% after infusion and in group-II, that was decreased by 22.45% (p<0.05). Serum total protein significantly increased after infusion of amino acid but serum albumin significantly decreased after infusion of amino acid. DOI: http://dx.doi.org/10.3329/jsf.v9i1-2.14653 J. Sci. Foundation, 9(1&2): 109-113, June-December 2011

Download Full-text

Preoperative Low Serum Albumin Levels Increase the Requirement of Renal Replacement Therapy after Cardiac Surgery

The Heart Surgery Forum ◽

10.1532/hsf.1577 ◽

2016 ◽

Vol 19 (3) ◽

pp. 123 ◽

Cited By ~ 7

Author(s):

Orhan Findik ◽

Ufuk Aydin ◽

Ozgur Baris ◽

Hakan Parlar ◽

Gokcen Atilboz Alagoz ◽

...

Keyword(s):

Acute Kidney Injury ◽

Regression Analysis ◽

Cardiac Surgery ◽

Renal Replacement Therapy ◽

Serum Albumin ◽

Replacement Therapy ◽

Kidney Injury ◽

Preoperative Serum ◽

Group I ◽

Group Ii

Background: Acute kidney injury is a common complication of cardiac surgery that increases morbidity and mortality. The aim of the present study is to analyze the association of preoperative serum albumin levels with acute kidney injury and the requirement of renal replacement therapy after isolated coronary artery bypass graft surgery (CABG). Methods: We retrospectively reviewed the prospectively collected data of 530 adult patients who underwent isolated CABG surgery with normal renal function. The perioperative clinical data of the patients included demographic data, laboratory data, length of stay, in-hospital complications and mortality. The patient population was divided into two groups: group I patients with preoperative serum albumin levels <3.5 mg/dL; and group II pateints with preoperative serum albumin levels ≥3.5 mg/dL. Results: There were 413 patients in group I and 117 patients in group II. Postoperative acute kidney injury (AKI) occured in 33 patients (28.2%) in group I and in 79 patients (19.1%) in group II. Renal replacement therapy was required in 17 patients (3.2%) (8 patients from group I; 9 patients from group II; P = .018). 30-day mortality occurred in 18 patients (3.4%) (10 patients from group I; 8 patients from group II; P = .037). Fourteen of these patients required renal replacement therapy. Logistic regression analysis revealing the presence of lower serum albumin levels preoperatively was shown to be associated with increased incidence of postoperative AKI (OR: 1.661; 95% CI: 1.037-2.661; P = .035). Logistic regression analysis also revealed that DM (OR: 3.325; 95% CI: 2.162-5.114; P = .000) was another independent risk factor for AKI after isolated CABG. Conclusion: Low preoperative serum albumin levels result in severe acute kidney injury and increase the rate of renal replacement therapy and mortality after isolated CABG.

Download Full-text

Irisin levels in relation to metabolic and liver functions in Egyptian patients with metabolic syndrome

Canadian Journal of Physiology and Pharmacology ◽

10.1139/cjpp-2015-0371 ◽

2016 ◽

Vol 94 (4) ◽

pp. 359-362 ◽

Cited By ~ 7

Author(s):

Fatma H. Rizk ◽

Samah A. Elshweikh ◽

Amira Y. Abd El-Naby

Keyword(s):

Metabolic Syndrome ◽

Liver Enzymes ◽

Resistance Index ◽

Control Group ◽

Model Assessment ◽

Group Iii ◽

Group I ◽

Elevated Liver Enzymes ◽

Liver Functions ◽

Group Ii

Irisin is a new myokine that is suspected to influence metabolic syndrome (MetS). However, there is a great controversy with respect to its level in cases of MetS and its correlation with different metabolic parameters. The present study assesses irisin levels in MetS patients and studies its relationship to metabolic and liver functions to evaluate the possible role of the liver in regulation of this level. Sixty subjects were included in this experiment, who were divided into 3 groups: group I (normal control), group II (MetS patients with normal liver enzymes), and group III (MetS with elevated liver enzymes and fatty liver disease). Serum irisin levels showed significant increases in groups II and III compared with group I, and significant increases in group III compared with group II. Also, irisin levels were positively correlated with body mass index, serum triglycerides, homeostatic model assessment of insulin resistance index (HOMA-IR), and liver enzymes. We concluded that serum irisin levels increased in patients with MetS, especially those with elevated liver enzymes, and had a positive correlation with parameters of lipid metabolism and glucose homeostasis with the possibility of hepatic clearance to irisin.

Download Full-text

Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

Bangladesh Journal of Child Health ◽

10.3329/bjch.v41i3.36951 ◽

2018 ◽

Vol 41 (3) ◽

pp. 159-164 ◽

Cited By ~ 1

Author(s):

Madhabi Baidya ◽

Mahfuza Shirin ◽

Liton Chandra Saha

Keyword(s):

Perinatal Asphyxia ◽

Care Center ◽

Tertiary Care ◽

Preterm Neonates ◽

P Value ◽

Care Hospital ◽

Cross Sectional ◽

Neonatal Transport ◽

Group I ◽

Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

Download Full-text

EFFECT OF ALCOHOLISM ON LIVER FUNCTION TEST IN RURAL POPULATION IN INDIA

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i8.1347 ◽

2020 ◽

Vol 4 (8) ◽

Author(s):

Richa K Lath ◽

Aniruddha Jibhkate

Keyword(s):

Liver Function ◽

Liver Function Test ◽

Liver Damage ◽

Total Protein ◽

Liver Enzymes ◽

Normal Individual ◽

Public Health Problem ◽

Albumin Level ◽

Study Group ◽

Function Test

Background: alcoholism is one of the major socioeconomic as well as public health problem in India. The problem is occurring equally in urban as well as in rural India. This study was carried out in essence of liver damage in alcoholics and alteration in the biochemical enzymes in the serum with respect to liver damage. Method: 100 alcoholics and 100 non alcoholic patients were selected from the hospital OPD. Liver function test was performed in both the study group. Liver enzymes ALT,AST,ALP and the total protein and albumin level were compared in the study group and controls. Results: The results showed there is significant increase in the liver enzymes ALT,AST,ALP in the alcoholic patients as compared to normal individual and significant fall in concentration of the total protein and albumin level in the alcoholics. Keywords: Alcoholics, liver function test

Download Full-text

Outcome of babies admitted with hypoxic-ischemic encephalopathy in Neonatal Unit of Services Hospital, Lahore

Annals of King Edward Medical University ◽

10.21649/akemu.v12i2.889 ◽

2016 ◽

Vol 12 (2) ◽

Author(s):

Muhammad Nasir Rana ◽

Muhammad Yakoob Kazi ◽

Ambreen Nasir ◽

Muhammad Abbas

Keyword(s):

Congenital Anomaly ◽

Apgar Score ◽

Descriptive Study ◽

Neonatal Unit ◽

Advanced Technology ◽

Medical Sciences ◽

Group Iii ◽

Group I ◽

Group Ii ◽

Ischemic Encephalopathy

Objectives: To determine the outcome of newborns, admitted with different stages of HIE in Neonatal Unit, Services Hospital, Lahore. Study design: Descriptive Study. Place and duration of study: Neonatology Section, Pediatrics Department, Services Institute of Medical Sciences (SIMS) / Services Hospital, Lahore. Over a period of Six months, from 1st August 2005 to 31st January 2006. Material & methods: A total of 170 newborns having Apgar score less than 7 were included in the study. Babies with any congenital anomaly were excluded. Results: 80% were males. 17.64% had weight less than 1.5 Kg, 37.06% weight between 1.5 Kg to 2.5 Kg and 45.29% had weight more than 2.5 Kg. 90.5% of our babies were delivered in Services Hospital, Lahore. 77.64% babies were full term. Babies were divided into three groups; Group-I had Apgar score 0-3, Group-II between 4 & 5 and Group-III had Apgar score 6-7. In Group-I, 65% babies died, whereas 100% had any one of the complications, in Group-II, there were 22% deaths and no baby died from Group-III. Conclusions: Despite advanced technology, a high number of babies have HIE and its complications. It is better to prevent babies from HIE, because once HIE occur, you cannot save babies completely from its complications.

Download Full-text

NORMALAND ABNORMAL LIQUOR VOLUME AND ITS CORRELATION WITH PERINATAL OUTCOME

10.36106/ijsr/7938740 ◽

2021 ◽

pp. 4-6

Author(s):

Kumari Nisha ◽

Renu Jha ◽

Kumudini Jha ◽

Debarshi Jana

Keyword(s):

Apgar Score ◽

Perinatal Outcome ◽

Neonatal Intensive Care ◽

Fetal Distress ◽

Special Unit ◽

Group I ◽

Group Ii ◽

The Difference ◽

One Year ◽

Four Quadrant

Aim:To assess and compare the perinatal outcome among mothers with normal and abnormal amniotic uid volume. Method: A prospective comparative study was conducted for a period of one year from January 2020 to December 2020. Group I consist of 50 patients with normal amniotic uid and group II consists of 50 patients with either oligohydramnios or polyhydramnios. Amniotic uid index (AFI) was calculated using Phalen's four quadrant technique using ultrasound. The perinatal outcome was judged by assessing the fetal distress predicted by abnormal fetal heart rate (FHR) or meconium stained liquor, one minute and 5 minute Apgar score, frequency of admission to neonatal intensive care unit (NICU), baby weight of less than 10th percentile for gestation age and perinatal mortality. Results: Induction of labour, caesarean section and meconium stained liquor was found to be most common among the patients in group II (abnormal AFI) in comparison with normal AFI subjects and similarly the perinatal outcome measures like low birth weight, increased frequency of admission to NICU due to respiratory distress and a low APGAR score was more commonly found in abnormal AFI group and the difference was found to be statistically signicant. Conclusion: AFI measurement in antepartum or intrapartum period can help to identify women who need increased antepartum surveillance for pregnancy complications and such women should be managed in a special unit to combat the complications effectively.

Download Full-text

AMELIORATION OF GENTAMICIN-INDUCED RENAL DAMAGE IN RATS BY ETHANOL EXTRACT OF THE WHOLE PLANT BIOPHYTUM SENSITIVUM (LINN.) DC

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2018v10i5.25514 ◽

2018 ◽

Vol 10 (5) ◽

pp. 130

Author(s):

Abhirama B. R. ◽

Shanmuga Sundaram R ◽

Raju A

Keyword(s):

Body Weight ◽

Water Intake ◽

Total Protein ◽

Urine Volume ◽

Ethanol Extract ◽

Group Iv ◽

Control Group ◽

Group I ◽

Whole Plant ◽

Group Ii

Objective: Present study was undertaken to investigate the nephroprotective activity of whole plant ethanol extract of Biophytum sensitivum Linn. DC (B. sensitivum; EEBS) on gentamicin induced-nephrotoxicity in Wistar albino rats.Methods: Animals were divided into five groups, containing six animals in each. Gentamicin (GM) 100 mg/kg/d; i. p., was given to all groups except normal control to induce nephrotoxicity for a period of 8 d in rats. Animals in Group I served as control and Group II as GM-treated or nephrotoxic control. Group III received standard quercetin (50 mg/kg; p. o.); group IV received EEBS (250 mg/kg; p. o.) and group V received EEBS (500 mg/kg; p. o.), for 8 d. Several renal functional tests and injury markers such as a change in body weight, water intake, urine volume and pH, urinary levels of total protein, albumin, sodium, potassium, calcium and magnesium were measured. Different hematological parameters including, red blood cells (RBC), hemoglobin (Hb), packed cell volume (PCV), mean corpuscular haemoglobin (MCH), white blood corpuscles (WBC), lymphocyte, monocyte, polymorphs and eosinophil were also analyzed.Results: The results revealed that co-administration of EEBS at 250 and 500 mg/kg significantly reduced the urinary excretion of total protein (4.05±0.04, 3.53±0.05 g/dl), albumin (0.81±0.08, 0.71±0.00 g/dl), calcium (8.05±0.05, 7.81±0.06 mg/dl) and magnesium (0.79±0.05, 0.77±0.06 mg/dl) respectively. EEBS treatment in group IV and V animals produced a significant increase in body weight (2.58±0.17, 2.52±0.22 g), water intake (17.35±0.82, 17.87±0.86 ml/24 h) urine output (7.24±0.15, 7.88±0.08 ml/24 h), compared to animals in group II. Co-therapy with both doses of extracts also showed significant increase in RBC (6.85±0.31, 7.10±0.43 million/mm3) Hb (13.96±0.21, 13.83±0.31 g/dl), MCH (20.45±0.49, 20.67±0.51 pg) and PCV (38.29±0.42, 38.53±0.20%) levels, whereas WBC (8.24±0.21, 8.15±0.10 1X103/mm3) and polymorphs (14.19±0.20, 14.05±0.11%) levels were found to be significantly reduced respectively in animals than those in toxic control group.Conclusion: This study substantiated and confirmed the ethnomedical usefulness of B. sensitivum as a nephroprotective and antioxidant agent.

Download Full-text