scholarly journals A mini review on the Lactic Acidosis in goats and its remedial approaches

2020 ◽  
Vol 5 (2) ◽  
pp. 98-103
Author(s):  
Asad Ali Khaskheli ◽  
Muhammad Ibrahim Khaskheli ◽  
Allah Jurio Khaskheli ◽  
Arshad Ali Khaskheli
Keyword(s):  
Alkaline Phosphatase ◽  
Lactic Acidosis ◽  
Sodium Bicarbonate ◽  
Glucose Level ◽  
Magnesium Hydroxide ◽  
Total Bilirubin ◽  
Direct Bilirubin ◽  
Cassia Fistula ◽  
Indirect Bilirubin ◽  
Rumen Ph

The current study was performed in order to investigate the threat of lactic acidosis in goats worldwide and explore the curative strategies. In this regards a detailed review was performed, however obtained facts were found to be much interesting and valuable. It was indicated by researchers that lactic acidosis is the most common problem in goats throughout the worlds. It represents significant economic loss due to direct and indirect effects. It was further stated that goats with lactic acidosis show decreased body temperature up to 98.1±0.89 °F, rumen and intestinal movement 0.23±0.48/m, rumen pH 4.8±0.07, blood pH 7.1±0.08, increased respiration rate 56.14±7.15/m and heart rate, 136.28±4.71/m. Affected goats also show signs of dyspnea, anorexia, inactivity, incoordination and recumbancy. The glucose level remains 190.14±36.49 mg/dl, total bilirubin 0.75±0.04 mg/dl, direct bilirubin 0.27±0.03mg/dl, indirect bilirubin 0.40±0.03 mg/dl, alanine aminotransferase ALT 36.42±3.04 U/l and alkaline phosphatase 420±3.65 U/l. Furthermore, Glucose level, total bilirubin, direct bilirubin, indirect bilirubin, ALT (SGPT) and alkaline phosphatase increase with treatment of Cassia Fistula, serum biochemical changes rapidly return to normal compared to treatment with Sodium bicarbonate or Magnesium hydroxide. The ruminal juices changes are also significantly improved with the treatment. The changes in the ingesta color, odor and consistency and rumen pH return to normal with the use of Cassia Fistula, Sodium bicarbonate and Magnesium hydroxide. In conclusion, Cassia fistula, Sodium bicarbonate and Magnesium hydroxide could be used as valuable strategies against lactic acidosis in goats. These therapies have been proved to be effective for treating the acidosis in goats. 

In Vitro Effects of Light on Serum Bilirubin Subfractions Measured by High-Performance Liquid Chromatography: Comparison with Four Routine Methods

1992 ◽  
Vol 38 (10) ◽  
pp. 2124-2129 ◽  
Author(s):  
H Ihara ◽  
H Nakamura ◽  
Y Aoki ◽  
T Aoki ◽  
M Yoshida
Keyword(s):  
High Performance ◽  
Total Bilirubin ◽  
Serum Bilirubin ◽  
Accurate Determination ◽  
Hplc Method ◽  
Direct Bilirubin ◽  
Spectrometric Method ◽  
Indirect Bilirubin ◽  
In Vitro Effects

Abstract The effects of light on serum bilirubin subfractions in vitro were investigated by HPLC and four routine methods for bilirubin analysis. By HPLC, the rate of photodegradation of unconjugated bilirubin (Bu) was nearly twice that of monoconjugated bilirubin (mBc) and threefold that of diconjugated bilirubin (dBc); delta bilirubin (Bd) was most stable against photoirradiation. In the diazo method, the rate of photodegradation of direct bilirubin was almost the same as that of the sum of mBc, dBc, and Bd determined by the HPLC method. However, the rate of photodegradation of indirect bilirubin was significantly lower (P < 0.001) than that obtained by HPLC, because approximately 30% of the bilirubin photoproducts reacted with the diazo reagent as indirect bilirubin. The rate of photodegradation of total bilirubin determined by the direct spectrometric method was lower than that determined by the diazo method, but equal to that of the total peak areas of HPLC. In the Ektachem method, bilirubin photoproducts affected total bilirubin negligibly, and Bc and Bu positively, so that the value of Bd decreased. In the bilirubin oxidase method, bilirubin photoproducts were oxidized enzymatically by both the total and direct bilirubin reagents. We re-emphasize the importance of shielding serum from light to avoid generating bilirubin photoproducts that interfere with the accurate determination of serum bilirubin subfractions. We also recommend HPLC analysis as a standard method for bilirubin measurement.

scholarly journals Ginseng-Related Drug-Induced Liver Injury

2018 ◽  
Vol 12 (2) ◽  
pp. 439-446 ◽  
Author(s):  
Kyawzaw Lin ◽  
Aung Naing Lin ◽  
Sandar Linn ◽  
Pwint Phyu Hlaing ◽  
Viswanath Vasudevan ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Liver Injury ◽  
Total Bilirubin ◽  
Fatty Infiltration ◽  
Well Being ◽  
The United States ◽  
Medicinal Herb ◽  
Direct Bilirubin ◽  
Drug Induced ◽  
Drug Induced Liver Injury

Ginseng is commonly used as a medicinal herb for memory and concentration and general well-being. Drug-induced liver injury (DILI) is one of the most challenging disorders and trending events in the United States which are related to body building and weight loss supplements. Currently, herbal and dietary supplementation is the second most common cause of DILI. Here, we report on a 45-year-old healthy Chinese woman who presented with dull intermittent left upper quadrant abdomen pain for a month. Upon thorough history taking, she had been taking ginseng tea and supplementation for her menopausal symptoms for almost 3 months. Physical examination was unremarkable except mild tenderness in left upper quadrant of the abdomen. Liver function test showed aspartate transaminase (AST) 717 U/L, alanine transaminase (ALT) 343 U/L, total bilirubin 5 mg/dL, direct bilirubin 3.3 mg/dL, alkaline phosphatase 182 U/L, with international normalized ratio (INR) 1.2. Prior liver enzymes (6 months earlier) showed AST 21 U/L, ALT 18 U/L, total bilirubin 0.8 mg/dL, direct bilirubin 0.3 mg/dL, alkaline phosphatase 34 U/L, with INR 0.7. Viral serology for acute hepatitis B, C, E, cytomegalovirus, Epstein-Barr virus, and varicella zoster virus was negative. She was immune to hepatitis A. Her antinuclear antibody was positive. Her anti-Smith antibody, anti-smooth muscle antibody, HFE gene mutation, ceruloplasmin, alpha-1 antitrypsin serologies were within normal references. An abdomen sonogram showed fatty infiltration. Liver biopsy showed moderate to severe portal inflammation and marked lobular disarray. Portal and lobular inflammatory infiltrates consisted of a mixture of histiocytes, lymphocytes, plasma cells, eosinophils, and neutrophils with centrilobular necrosis and focal bridging necrosis, and necro-inflammation. After 6 weeks of follow-up, the patient improved physically, and the abdomen pain resolved. Ginseng has been widely used in the Chinese community as medicinal herb for a variety of conditions for decades. However, proper research has never been done regarding its pharmacokinetics, efficacy, and safety issues. In our case report, the idiosyncratic DILI resulted from ingestion of ginseng as herbal supplementation for premenopausal symptoms. Physicians should be aware of and suspect DILI in any patient with acute liver injury, and patients should be reminded that all medications and supplements have a potential to cause DILI.

scholarly journals Protective effect of Echinochrome against intrahepatic cholestasis induced by alpha-naphthylisothiocyanate in rats

2020 ◽  
Vol 80 (1) ◽  
pp. 102-111
Author(s):  
Sohair R Fahmy ◽  
Dawlat A Sayed ◽  
Amel M Soliman ◽  
Nesreen Y Almortada ◽  
Wafaa E Abd-El Aal
Keyword(s):  
Alkaline Phosphatase ◽  
Body Weight ◽  
Bile Duct ◽  
Protective Effect ◽  
Intrahepatic Cholestasis ◽  
Total Bilirubin ◽  
Protective Effects ◽  
Indirect Bilirubin ◽  
Albumin Content ◽  
Gst Activity

Abstract The present study was designed to evaluate the protective effects of echinochrome (Ech) on intrahepatic cholestasis in rats induced by a single (i.p.) injection of alpha-naphthylisothiocyanate (ANIT) (75 mg/kg body weight). The rats were pre-treated orally for 48hr (one dose / 24hr) with Ech (1, 5 and 10 mg/kg body weight) or ursodeoxycholic acid (UDCA) 80 mg/kg body weight drug then, injected with ANIT. ANIT markedly increased serum activities of alanine amino transaminase (ALT), aspartate amino transaminase (AST) and alkaline phosphatase (ALP), which was accompanied by a massive inflammation of epithelial cells on bile duct at 24h after ANIT injection. ANIT also increased the levels of total protein (TP), total bilirubin (TB), direct bilirubin (DB), indirect bilirubin (IB), however decrease albumin content (ALB). In addition ANIT increased hepatic MDA and NO level and decreased GSH level and GST activity. The Ech exerted hepatoprotective and anticholestatic effects as assessed by a significant decrease in the activities of serum AST, ALT and ALP, and the levels of TP, TB, DB and IB as well as liver MDA level and NO level. In conclusion, Ech was found to possess hepatoprotective effect against intrahepatic cholestasis induced by hepatotoxin such as ANIT.

scholarly journals Magnesium Hydroxide as Curative Strategy against Lactic Acidosis in Goat

2020 ◽  
Author(s):  
A. A. Khaskheli ◽  
M. Q. Koondhar ◽  
A. A. Jariko
Keyword(s):  
Lactic Acidosis ◽  
Magnesium Hydroxide ◽  
Clinical Signs ◽  
Economic Loss ◽  
Normal Diet ◽  
Indirect Bilirubin ◽  
Ruminal Ph ◽  
Group A ◽  
Serum Biochemical ◽  
Group B

Lactic acidosis is a metabolic disorder caused by feeding errors. It represents a significant economic loss due to direct as well as indirect effects. In present study a total of twenty four goats were focused in order to observe the efficacy of Magnesium hydroxide against induced lactic acidosis. Goats were divided into two groups viz., A and B. Goats in group A were induced lactic acidosis by offering over feeding of grains, while group B was kept as control and normal diet was provided to the goats. After appearance of clinical signs, goat in group A were treated with Magnesium hydroxide at the dose rate of 1g/Kg body weight on the interval of 24, 48 and 72 hours. Results indicated body temperature, ruminal pH, blood pH, respiration rate and heart rate attained normal level after the treatment with Magnesium hydroxide. Serum biochemical examinations of liver function after induction of lactic acidosis revealed that glucose level (190.14±36.49mg/dl), total bilirubin (0.75±0.04mg/dl), direct bilirubin (0.27±0.03mg/dl), indirect bilirubin (0.40±0.03mg/dl), alanine aminotransferase (36.42±3.04 U/L) and alkaline phosphatase (420±3.65 U/L) were significantly (P less than 0.05) increased. Magnesium Hydroxide helped in improving the normal physiological parameters but did not improved the rumen and intestinal motility. The hematological examination after the induction of lactic acidosis revealed hemo-concentration and increased Hb% (15.02±1.30) which significantly (P less than 0.05) became normal within 72hrs after Magnesium hydroxide therapy. Present study concludes that the Magnesium hydroxide is very helpful in minimizing the complications of lactic acidosis in goat, thus may be used as therapy of choice.

scholarly journals Effects of Yinzhihuang Granules on Serum Liver Enzymes in Jaundice Patients: A Real-World Study Based on HIS Data

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Cheng Zhang ◽  
Lidan Zhang ◽  
Jian Lyu ◽  
Yanming Xie ◽  
Yuting Xie
Keyword(s):  
Alkaline Phosphatase ◽  
Electronic Medical Records ◽  
Real World ◽  
Medical Records ◽  
Total Bilirubin ◽  
Liver Enzymes ◽  
Serum Levels ◽  
Indirect Bilirubin ◽  
Average Serum ◽  
Glutamyl Transpeptidase

Objective. Our aim was to analyze the influence of Yinzhihuang granules on serum liver enzymes in jaundice patients and to provide real-world evidence for the efficacy evaluation of Yinzhihuang granules in treating jaundice. Methods. We constructed a data warehouse which integrates real-world electronic medical records from the hospital information system of multiple 3A hospitals in China and used a descriptive statistical method to analyze the changes in the serum liver enzymes of the jaundice patients treated with Yinzhihuang granules and then used Wilcoxon signed-rank to test the changes in the indicators caused by the treatment. Results. After being treated with Yinzhihuang granules, the jaundice patients had a decrease in the average serum levels of total bilirubin, indirect bilirubin, aspartate aminotransferase, glutamyl transpeptidase, and alkaline phosphatase, and the differences were statistically significant ( P < 0.05 ) but had no significant changes in the average serum levels of direct bilirubin and alanine aminotransferase ( P > 0.05 ). Conclusion. The data analysis on the real-world electronic medical records demonstrate that Yinzhihuang granules help to reduce jaundice patients’ serum levels of total bilirubin, indirect bilirubin, aspartate aminotransferase, glutamyl transpeptidase, and alkaline phosphatase, but there is no evidence that Yinzhihuang granules help to reduce the jaundice patients’ serum levels of direct bilirubin and alanine aminotransferase.

scholarly journals Gambaran Hiperbilirubinemia pada Bayi Aterm dan Prematur di RSUP Prof Dr. R. D. Kandou Manado

e-CliniC ◽  
2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Yulke R. Y. Rompis ◽  
Jeanette I. Ch. Manoppo ◽  
Rocky Wilar
Keyword(s):  
Medical Record ◽  
Bilirubin Level ◽  
Total Bilirubin ◽  
Neonatal Hyperbilirubinemia ◽  
Direct Bilirubin ◽  
Unconjugated Bilirubin ◽  
Medical Record Data ◽  
Premature Neonates ◽  
Indirect Bilirubin ◽  
Record Data

Abstract: Hyperbilirubinemia is an increase of blood bilirubin level due to physiological or non-physiologic factors, which is clinically characterized by jaundice. In neonates, their livers have not worked optimally, therefore, the process of glucuronidation of bilirubin does not occur optimally. This situation causes the predominance of unconjugated bilirubin in the blood. This study was aimed to obtain the profile of neonatal hyperbilirubinemia cases in the Pediatrics Department of Prof. Dr. R. D. Kandou Hospital Manado. We used medical record data of neonatal hiperbilirubinemia in aterm and premature neonates at the Pediatrics Department of Prof. Dr. R. D. Kandou Hospital di Bagian Ilmu Kesehatan Anak RSUP Prof. Dr. R. D. Kandou Hospital during 2014-2015. The results showed that there were 54 cases, consisted of 32 males (59.3%) and 22 females (40.7%). Among aterm neonates, mean direct bilirubin was 3.97 mg/dL; mean indirect bilirubin was 11.76 mg/dL; and mean total bilirubin was 15.69 mg/dL. Meanwhile, among premature neonates, mean direct bilirubin was 0.87 mg/dL; mean indirect bilirubin was 12.48 mg/dL; and mean total bilirubin was 13.35 mg/dL. In conclusion, at the Pediatrics Department of Prof. Dr. R. D. Kandou Hospital Manado neonatal hyperbilirubinemia was more common in aterm neonates compared to premature neonates. Moreover, it is more common in males than in females.Keywords: hyperbilirubinemia, bilirubin, aterm meonates, premature neonates Abstrak: Hiperbilirubinemia ialah terjadinya peningkatan kadar bilirubin dalam darah, baik oleh faktor fisiologi maupun non-fisiologi, yang secara klinis ditandai dengan ikterus. Pada neonatus, hati belum berfungsi secara optimal sehingga proses glukuronidasi bilirubin tidak terjadi secara maksimal yang menyebabkan dominasi bilirubin tak terkonjugasi dalam darah. Penelitian in bertujuan untuk mendapatkan gambaran hiperbilirubinemia pada bayi aterm dan prematur di RSUP Prof. Dr. R. D. Kandou Manado. Data penelitian diperoleh dari rekam medik kejadian hiperbilirubinemia pada bayi aterm dan prematur di Bagian Ilmu Kesehatan Anak RSUP Prof. Dr. R. D. Kandou periode 2014-2015. Hasil penelitian mendapatkan 54 kasus dengan diagnosis hiperbilirubinemia yang memenuhi kriteria inklusi penelitian, terdiri dari 32 pasien berjenis kelamin laki-laki (59,3%) dan 22 berjenis kelamin perempuan (40,7%). Pada bayi aterm, rerata bilirubin direk sebesar 3,97 mg/dL; rerata bilirubin indirek 11,76 mg/dL; dan rerata bilirubin total 15,69 mg/dL. Pada bayi prematur, rerata bilirubin direk sebesar 0,87 mg/dL; rerata bilirubin indirek 12,48 mg/dL; dan rerata bilirubin total 13,35 mg/dL. Simpulan penelitian ini ialah kasus hiperbilirubinemia di Bagian Ilmu Kesehatan Anak RSUP Prof Dr. R. D. Kandou Manado lebih sering pada bayi aterm dibandingkan bayi prematur, dan lebih sering pada jenis kelamin laki-laki.Kata kunci: hiperbilirubinemia, bilirubin, bayi aterm, bayi prematur

scholarly journals Gambaran Hiperbilirubinemia pada Bayi Aterm dan Prematur di RSUP Prof Dr. R. D. Kandou Manado

e-CliniC ◽  
2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Yulke R. Y. Rompis ◽  
Jeanette I. Ch. Manoppo ◽  
Rocky Wilar
Keyword(s):  
Medical Record ◽  
Bilirubin Level ◽  
Total Bilirubin ◽  
Neonatal Hyperbilirubinemia ◽  
Direct Bilirubin ◽  
Unconjugated Bilirubin ◽  
Medical Record Data ◽  
Premature Neonates ◽  
Indirect Bilirubin ◽  
Record Data

Abstract: Hyperbilirubinemia is an increase of blood bilirubin level due to physiological or non-physiologic factors, which is clinically characterized by jaundice. In neonates, their livers have not worked optimally, therefore, the process of glucuronidation of bilirubin does not occur optimally. This situation causes the predominance of unconjugated bilirubin in the blood. This study was aimed to obtain the profile of neonatal hyperbilirubinemia cases in the Pediatrics Department of Prof. Dr. R. D. Kandou Hospital Manado. We used medical record data of neonatal hiperbilirubinemia in aterm and premature neonates at the Pediatrics Department of Prof. Dr. R. D. Kandou Hospital di Bagian Ilmu Kesehatan Anak RSUP Prof. Dr. R. D. Kandou Hospital during 2014-2015. The results showed that there were 54 cases, consisted of 32 males (59.3%) and 22 females (40.7%). Among aterm neonates, mean direct bilirubin was 3.97 mg/dL; mean indirect bilirubin was 11.76 mg/dL; and mean total bilirubin was 15.69 mg/dL. Meanwhile, among premature neonates, mean direct bilirubin was 0.87 mg/dL; mean indirect bilirubin was 12.48 mg/dL; and mean total bilirubin was 13.35 mg/dL. In conclusion, at the Pediatrics Department of Prof. Dr. R. D. Kandou Hospital Manado neonatal hyperbilirubinemia was more common in aterm neonates compared to premature neonates. Moreover, it is more common in males than in females.Keywords: hyperbilirubinemia, bilirubin, aterm meonates, premature neonates Abstrak: Hiperbilirubinemia ialah terjadinya peningkatan kadar bilirubin dalam darah, baik oleh faktor fisiologi maupun non-fisiologi, yang secara klinis ditandai dengan ikterus. Pada neonatus, hati belum berfungsi secara optimal sehingga proses glukuronidasi bilirubin tidak terjadi secara maksimal yang menyebabkan dominasi bilirubin tak terkonjugasi dalam darah. Penelitian in bertujuan untuk mendapatkan gambaran hiperbilirubinemia pada bayi aterm dan prematur di RSUP Prof. Dr. R. D. Kandou Manado. Data penelitian diperoleh dari rekam medik kejadian hiperbilirubinemia pada bayi aterm dan prematur di Bagian Ilmu Kesehatan Anak RSUP Prof. Dr. R. D. Kandou periode 2014-2015. Hasil penelitian mendapatkan 54 kasus dengan diagnosis hiperbilirubinemia yang memenuhi kriteria inklusi penelitian, terdiri dari 32 pasien berjenis kelamin laki-laki (59,3%) dan 22 berjenis kelamin perempuan (40,7%). Pada bayi aterm, rerata bilirubin direk sebesar 3,97 mg/dL; rerata bilirubin indirek 11,76 mg/dL; dan rerata bilirubin total 15,69 mg/dL. Pada bayi prematur, rerata bilirubin direk sebesar 0,87 mg/dL; rerata bilirubin indirek 12,48 mg/dL; dan rerata bilirubin total 13,35 mg/dL. Simpulan penelitian ini ialah kasus hiperbilirubinemia di Bagian Ilmu Kesehatan Anak RSUP Prof Dr. R. D. Kandou Manado lebih sering pada bayi aterm dibandingkan bayi prematur, dan lebih sering pada jenis kelamin laki-laki.Kata kunci: hiperbilirubinemia, bilirubin, bayi aterm, bayi prematur

scholarly journals The Predictivity of Serum Biochemical Markers in Acute Biliary Pancreatitis

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Bülent Güngör ◽  
Kasım Çağlayan ◽  
Cafer Polat ◽  
Deniz Şeren ◽  
Kenan Erzurumlu ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Biochemical Markers ◽  
Total Bilirubin ◽  
Direct Bilirubin ◽  
Gamma Glutamyl Transferase ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Glutamyl Transferase

Background and Aim. There are no accurate methods of differentiating acute biliary pancreatitis. Obstructions of biliary ducts, idiopathic pancreatitis may be related with biliary origin which needs identification for acute treatment. We searched for the predictivity of biochemical markers in early acute biliary pancreatitis. Patients and Methods. Serum levels of AST (Aspartate Transaminase),ALT (Alanine Transaminase), ALP (Alkaline Phosphatase), GGT (Gamma Glutamyl Transferase), total bilirubin, direct bilirubin, LDH (Lactate Dehydrogenase), amylase, lipase, CRP (C-Reactive Protein) and WBC (White Blood Cell) were measured in 157 patients with acute pancreatitis. Biliary and nonbiliary pancreatitis were differentiated by Magnetic Resonance Cholangiopancreatography (MRCP), Endoscopic Retrograde Cholangiopancreatography (ERCP), Intraoperative Cholangiopancreatography (IOC). Cut-off points of admission biochemical markers with sensitivity, specifity, positive predictive value and negative predictive value were determined after identification of significant variables. Receiver Operator Curves were plotted for each biochemical marker. Results. Serum Alkaline Phosphatase, total bilirubin, direct bilirubin, amylase and lipase levels were significantly higher in biliary pancreatitis with a positive predictive value of 80.8%, 83.9%, 81.6%, 78.8%, 79.7%. Conclusion. Increased Alkaline Phosphatase,total bilirubin, direct bilirubin, amylase and lipase levels may be used in prediction of biliary pancreatitis.

scholarly journals Prediction of Early Liver Failure in Pediatric Patients Admitted to Intensive Care Unit

2019 ◽  
Vol 11 (3) ◽  
pp. 141-146
Author(s):  
Mozhgan Zahmatkeshan ◽  
Zahra Serati ◽  
Shole Freydooni ◽  
Ali Reza Safarpour ◽  
Atefeh Esmailnejad ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Alkaline Phosphatase ◽  
Logistic Regression ◽  
Intensive Care ◽  
Length Of Stay ◽  
Critically Ill ◽  
Significant Relationship ◽  
Pediatric Patients ◽  
Total Bilirubin ◽  
Direct Bilirubin

BACKGROUND Hepatic dysfunction has been associated with poor prognosis in critically ill patients. We aimed to investigate the incidence of early liver dysfunction and its association with probable predictive variables in a group of Iranian patients. METHODS The study was conducted on 149 pediatric patients referred to the pediatric intensive care unit (PICU), Shiraz University of Medical Sciences, Shiraz, Iran between April and October 2016. Serum levels of liver aminotransferase, alkaline phosphatase, total bilirubin, direct bilirubin, and international normalized ratio (INR) were recorded in 24, 48, and 96 hours after admission. RESULTS On the first day of admission, direct bilirubin was the least (9.1%) and abnormal alkaline phosphatase level was the most (66.9%) common abnormalities. Abnormal levels of all tests except alkaline phosphatase were predictive of increased rate of mortality. In univariable logistic regression, abnormal aminotransferases (ALT and AST), INR, total bilirubin, and direct bilirubin had significant relationship with patients’ mortality after 24, 48, and 96 hours. In multivariable logistic regression only ALT and INR in the first 24 hours had significant relationship with mortality in final model. Although univariate logistic regression revealed a significant relationship between AST and ALT levels with PICU length of stay, no significant relationship was observed between these variables and PICU length of stay (except AST in the first 24 hours) in multivariable analysis. CONCLUSION Increase in liver enzymes may predict mortality and increased PICU length of stay in critically ill children.

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