scholarly journals Alanine Aminotransferase is a Predictor of NAFLD Activity Score for Diagnosing Non-alcoholic Steatoehpatitis

2019 ◽  
Vol 48 (2) ◽  
pp. 1-6
Author(s):  
Dulal Chandra Das ◽  
Sheikh Mohammad Noor E Alam ◽  
Ripon Das ◽  
Masuda Mohsena ◽  
Mamun Al Mahtab

Nonalcoholic fatty liver disease (NAFLD) is a metabolic disorder characterized by excessive triglyceride- accumulation in hepatocytes. NAFLD has a multifactorial etiology and a combination of environmental, genetic and metabolic factors play a role in the development of advanced disease. NAFLD consists of a wide spectrum of conditions, ranging from simple steatosis to nonalcoholic steatohepatitis (NASH) which can progress to cirrhosis and hepatocellular carcinoma (HCC). Despite the high prevalence and severity of hepatic illness, NAFLD remains under diagnosed, because of few symptoms, lack of accurate laboratory markers. The accurate diagnosis of NASH remains dependent on specific histological parameters in liver biopsy. Although liver biopsy remains the ‘gold standard’, there are practical limitations, including costs and risks. There is an increasing requirement for simple, less invasive, highly accurate and affordable screening tools. Alanine aminotransferase (ALT) has been proposed as a noninvasive and available marker for assessment of NASH. A hospital based observational study was carried out for a period of two years in the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Data were analyzed by SPSS version 16. Statistical inference were done by estimating distribution, Chi-square test and student’s t-test respectively. Fifty (50) patients were analysed.Twenty five were NASH and twenty five were simple steatosis. ALT in NASH group  were 97.0±51.5IU/L and insimple steatosis group were 55.5±28.6 IU/L. In NASH group 64%  of raised ALT had NASH . In Non-NASH group 16% of raised ALT had no NASH.There was significant difference in the NAFLD activity score for diagnosing NASH between elevated and normal ALT( P  value 0.001). Bangladesh Med J. 2019 May; 48 (2): 1-6

2019 ◽  
Vol 48 (1) ◽  
pp. 44-49
Author(s):  
Sheikh Mohammad Noor E Alam ◽  
Dulal Chandra Das ◽  
Md Shahinul Alam ◽  
Masuda Mohsena ◽  
Mamun Al Mahtab

Nonalcoholic fatty liver disease (NAFLD) is a metabolic disorder characterized by excessive triglyceride accumulation in hepatocytes. NAFLD has a multifactorial etiology and a combination of environmental, genetic and metabolic factors play a role in the development of advanced disease. NAFLD consists of a wide spectrum of conditions, ranging from simple steatosis to nonalcoholic steatohepatitis (NASH) which can progress to cirrhosis and hepatocellular carcinoma (HCC). Despite the high prevalence and severity of hepatic illness, NAFLD remains underdiagnosed, because of few symptoms, lack of accurate laboratory markers. The accurate diagnosis of NASH remains dependent on specific histological parameters in liver biopsy. Although liver biopsy remains the ‘gold standard’, there are practical limitations, including costs and risks. There is an increasing requirement for simple, less invasive, highly accurate and affordable screening tools. Aspartate aminotransferase (AST) has been proposed as a noninvasive and available marker for assessment of NASH. A hospital based observational study was carried out for a period of two years in the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Data were analyzed by SPSS version 16. Qualitative and quantitative data were analyzed by Chi-square test and student’s t-test respectively. Fifty (50) patients were analysed. Twenty five were NASH and twenty five were non- NASH. AST in NASH group were 55.2 ± 30.1 IU/L and in Non-NASH group were 33.6± 20 IU/L. In NASH group significantly higher percentage of raised AST had NASH compared with normal AST (68% vs.32%).There was significant difference in the NAFLD activity score for diagnosing NASH between elevated and normal AST (P value 0.004). Higher AST values correlated with higher specificity. By multivariate analysis AST were found to be significant. Thus Aspartate aminotransferase (AST) is a good predictor for diagnosing non- alcoholic steatohepatitis (NASH). Bangladesh Med J. 2019 Jan; 48 (1): 44-49


2020 ◽  
Vol 16 (4) ◽  
pp. 222-229
Author(s):  
Surakchhya Gautam ◽  
Sangita Thapa ◽  
Anju Khapung

ABSTRACT Background Serum uric acid (UA) is associated with many health conditions, including renal, cardiovascular and metabolic disorders. Diagnosis and monitoring often require painful invasive procedures which will add undue stress to the patients. The aim of this study was to correlate salivary and serum UA, so that, salivary sampling will help to bypass these measures and evaluate the condition of both healthy and the diseased. Methods This hospital based descriptive cross sectional study was conducted in 100 participants between age groups 21 to 82 years. Demographic data including height, weight and blood pressure were recorded. Serum and salivary samples were collected and UA level in both type of samples were estimated and correlation statistics was carried out. Results Total participants are categorized in three groups, 20-40, 41-60 and more than 60 years, among which maximum participants 43% are between 41-60 years of age. Average of body mass index (BMI) was found to be 24.46, where 50% were within normal range. Mean serum and salivary UA(mg/dl) was 4.15 and 1.90 respectively, exhibiting moderate positive correlation. They were correlated with significant “p-value” according to gender, age groups and disease conditions. Paired t- test was done between the measured and calculated salivary UA and no statistically significant difference in mean of these two values was obtained. Conclusions Salivary and serum UA are associated in our study so salivary UA can be used as a biomarker. Salivary UA was found to be more gender specific and specific among adults. Salivary UA can also be used as a screening tools for young and adult population.


2021 ◽  
Vol 7 (2) ◽  
pp. 86-91
Author(s):  
Rayvita AN Meagratia ◽  
Ferdy Kurniawan Cayami ◽  
Udin Bahrudin ◽  
Wiwik Lestari ◽  
Nani Maharani ◽  
...  

BackgroundVariants of adiponutrin (PNPLA3) and adiponectin (ADIPOQ) genes were considered to be associated with non-alcoholic fatty liver disease (NAFLD). Although the prevalence of NAFLD is increasing, there are limited numbers of studies about the association in Indonesian population.ObjectiveTo confirm whether specific variants of adiponutrin (PNPLA3) and adiponectin (ADIPOQ) genes are associated with NAFLD in Indonesian patients.MethodsData and DNA of 152 participants were obtained from a previous study in Dr. Kariadi Hospital, Semarang, Indonesia. PCR-RFLP analysis was performed for detection of PNPLA3 rs738409 and ADIPOQ rs2241767 variants. The diagnosis and severity of NAFLD were assessed according to NAFLD activity score (NAS) based on histopathology assessment of liverbiopsy.ResultsAllele G of PNPLA3rs738409 was associated with NAFLD in both bivariate (p=0.009, OR 2.52, CI 95% 1.25–5.07) and multivariate (p=0.008, OR 2.62, CI 95% 1.29%–5.32%) analysis, while ADIPOQ rs2241767 had no significant association. In NAFLD participants, both genotypes showed allele G was higher in the group of possible non-alcoholic steatohepatitis (NASH) – NASH (NAS >2) than in the simple steatosis group (NAS <2) i.e. 40.0% vs. 3.75% for the rs2241767 variant and 23.75% vs. 1.25% for the rs738409 variant, without significant association.ConclusionVariant PNPLA3 rs738409 was associated with NAFLD incidence in studied population. Among NAFLD participants, the frequency of both variants were found higher in the possible NASH – NASH group, yet needs to be confirmed with more participants and a multicenter study.Data and DNA of 152 participants were obtained from a previous study in Dr. Kariadi Hospital, Semarang, Indonesia. PCR-RFLP analysis was performed for detection of PNPLA3 rs738409 and ADIPOQ rs2241767 variants. The diagnosis and severity of NAFLD were assessed according to NAFLD activity score (NAS) based on histopathology assessment of liverbiopsy.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Gamal Zaki ◽  
Ahmad Mohamed El Yasaky ◽  
Rana Ahmed El Hilaly ◽  
Mayada Taha Mostafa

Abstract Background Rheumatoid arthritis (RA) is a progressive, systemic autoimmune disorder characterized by articular and extra-articular manifestations. The lung is commonly a site of extra-articular disease. The lung manifestations of RA vary and may include airways, parenchymal, vascular, and pleural disease. Manifestations of lung disease in RA typically follow the development of articular disease. Methotrexate (MTX)has shown efficacy for the treatment of several diseases, especially RA. Methotrexate has also been implicated as a causative agent in interstitial lung disease. Objective to find any association between MTX intake and lung abnormalities in RA patients. Patients and Methods This study included sixty adult RA patients, recruited from Ain Shams University Hospitals. Patients were divided into thirty patients on MTX therapy, and another thirty patients on non-methotrexate therapy. All underwent history, clinical examination, chest examination, evaluation of RA by modified disease activity score 28 (DAS 28) and pulmonary function tests(PFT). Results The age of patients receiving MTX ranged from 35-65 years and the non-MTX group was 35-57 years with a mean ±SD of 47.733±5.265 and 40.700 ±5.187, respectively. Male to female ratio of MTX group was about 1:3, while Non MTX group was about 1:9.There was no significant difference regarding age and sex. There was no difference between both group regarding modified DAS score and chest manifestations. There was no difference in PFT findings between patients on high or low dose of MTX therapy .Similarly, no association was found between disease activity score and PFT findings in both groups. On the other hand, a significant association between chest symptoms and PFT, P value&lt;0.05 . Also a strong significant association was found between anticitrullinated protein antibodies (ACPA) status and PFT in both group, p value &lt;0.05. Conclusion MTX treatment was not associated with an increased risk of RA-ILD diagnosis. On the contrary, evidence showed that MTX may delay the onset of ILD. There seems no reason to confuse the association of MTX and hypersensitivity pneumonitis with the onset of RAILD.ACPA antibody is considered a major risk factor in RA-ILD, ACPA titers constitute an independent factor associated not only with the presence but also with the severity of RA-ILD


2021 ◽  
Vol 75 (2) ◽  
pp. 143-148
Author(s):  
Seyed Mohsen Dehghani ◽  
Sadegh Mohammadi ◽  
Iraj Shahramian ◽  
Fateme Parooie ◽  
Hadi Mirzaie ◽  
...  

Introduction: Liver function test is a part of safe and aff ordable routine blood biochemical tests and provides useful information for the diagnosis and management of liver dysfunction. In this study we evaluated the value of the R factor in distinguishing between intrahepatic and extrahepatic causes of infant cholestasis. Methods: Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic value of the R factor in each group in comparison with liver biopsy as the gold standard of diagnosis. The data were analyzed using SPSS statistical software and P < 0.05 indicated a significant difference. Results: The study included 37 neonatal hepatitis patients (group A) and 25 biliary atresia patients (group B). The R factor was calculated using the (ALT patient/ULN)/(ALP patient/ULN) formula; ROC analysis revealed that if the R factor was ≤ 0.09 the patient diagnosis would be biliary atresia with high sensitivity (92%) (p-value = 0.001). The corresponding specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy and area under the ROC curve (AUC) were 75.7%, 72%, 93%, 82% and 0.87, respectively. Conclusion: The study revealed that the R factor is a good diagnostic marker for differentiating between the most common intrahepatic and extrahepatic causes of infant cholestasis and has good diagnostic accuracy, sensitivity, specificity, PPV and NPV, in comparison with liver biopsy as the gold standard of diagnosis.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Bakht Roshan ◽  
Grace Guzman

Patients with chronic hepatitis C virus (HCV) infection and persistently normal alanine aminotransferase (PNALT) are generally described to have mild liver disease. The aim of this study was to compare clinical and histological features in HCV-infected patients with PNALT and elevated ALT. Patients presenting to the University of Illinois Medical Center, Chicago, who had biopsy proven HCV, an ALT measurement at the time of liver biopsy, at least one additional ALT measurement over the next 12 months, and liver biopsy slides available for review were identified. PNALT was defined as ALT ≤ 30 on at least 2 different occasions over 12 months. Of 1200 patients with HCV, 243 met the study criteria. 13% (32/243) of patients had PNALT while 87% (211/243) had elevated ALT. Significantly more patients with PNALT had advanced fibrosis (F3 and F4) compared to those with elevated ALT (P=0.007). There was no significant difference in the histology activity index score as well as mean inflammatory score between the two groups. In conclusion, in a well-characterized cohort of patients at a tertiary medical center, PNALT did not distinguish patients with mild liver disease.


2021 ◽  
Vol 9 (01) ◽  
pp. 479-485
Author(s):  
Manisha a ◽  
◽  
Madhavi Verma ◽  
Tarika Sharma ◽  
◽  
...  

Background: Providing information to the patients before liver biopsy level of patient during procedure.To reduce the anxiety level, coping used as an procedure may decrease the level of anxiety and can improve tolerance alternatives. There are two types of coping present: Monitoring coping style- Individuals who seek information in response to stressful situation and Blunting coping style- Individuals who avoids informationin response to stressful situation. Methods: Convenient sampling was used to enroll 80 patients, randomly assigned to Experimental and Comparison group based on Randomized days using Hospital Anxiety and Depression-sub scale and Miller-Behavioral Style Scale. Results:Out of 40 subjects 24 were monitors and 16 were blunters in the Experimental group and in the Comparison group 25 were monitors and 15 were blunters. There was significant difference found between mean anxiety score of experimental group (6.9) and comparison group (9.03) at t value = 7.557 and p = 0.01. Anxiety of Monitors was significantly less in Experimental group as compared to Comparison group (p value 0.041) at 0.041. Conclusion:Information Pamphlet was found to be effective in decreasing the anxiety of patients undergoing Liver Biopsy.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A80-A80
Author(s):  
Victoria J Shi ◽  
Suban Burale ◽  
Tamorah Lewis ◽  
Neerupma Silswal ◽  
Paula Monaghan-Nichols

Abstract Bronchopulmonary Dysplasia (BPD) is a common heterogeneous lung disease that can result from preterm birth at less than 28-weeks gestation, prenatal and postnatal inflammatory insults, ventilator associated lung injury, and oxygen-related injury. Synthetic glucocorticoids (sGCs) are commonly used pre- and postnatally to treat inflammation and improve lung physiology. Clinical responses to sGC therapy for BPD vary in patients. We hypothesize that genetic background differences in transcriptional response to sGC therapy dictate the efficacy in infants with BPD. Identifying pathways and genes that mediate these differences will allow prospective determination of which infants would respond to sGC treatment. 26 preterm infants that received sGC treatment for BPD were identified. Respiratory Severity Score (RSS), an indication of BPD severity, was measured at diagnosis, 4 days, and 7 days post-sGC treatment. Patients were stratified into Responders versus Non-Responders by improvement in respiratory function after treatment. Changes in RSS were used to discriminate Responders (R &gt;3 decrease in RSS) to treatment from Non-Responders (NR &lt;3 decrease). 13 Responders and 13 Non-Responders were selected. They included 7 females and 19 males with an average gestational age of 24.3 weeks, and were 46% Caucasian, 31% African American, 19% Hispanic, and 4% other. 100µL of blood was collected before and after seven days of a dexamethasone treatment course. To examine differences in transcription response between Responders (n = 13) and Non-Responders (n= 13), RNA was isolated and analyzed using the Clariom S Human Transcriptome Affymetrix array. 21,500 expressed genes were profiled. Results: were imported into the Transcriptome Analysis Console (TAC) software, and genes with a significant difference (fold change &gt;1.48 or &lt; -1.48 and p-value &lt;0.05) in Responders and Non-Responders were identified. Of those, 133 genes were upregulated and 74 downregulated. Ingenuity Pathway Analysis (IPA) was used to identify signaling pathways and disease processes that were uniquely altered in Responders versus Non-Responders. Non-Responders showed significant activation of neuroinflammatory signaling pathways, degranulation pathways, and lymphocyte activation disease pathways. Target genes in the top dysregulated pathways were evaluated using quantitative Polymerase Chain Reaction (qPCR). Expression changes in Matrix Metalloproteinase-25, Interleukin-12 Receptor beta, and Microsomal Glutathione Transferase-1, key mediators of inflammation, were validated in independent studies using qPCR. While response to systemic glucocorticoids in neonates with BPD is variable, these studies identified pathways that are altered in Responders versus Non-Responders and are a step towards developing pre-screening tools to stratify infants for response to sGC BPD therapy.


2019 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Dini Kesuma

Synthesis of the 4-chlorobenzoylthiourea compound was carried out by acylating thiourea with 4-chlorobenzoyl chloride. The 4-chlorobenzoylthiourea compound  will increase the lipophilic and the electronic properties other than the lead compounds of benzoylthiourea in order to, by expectation, raise the central nervous system depressant as well. The lipophilic would affect the ability of the compounds in penetrating biological membranes, which is highly dependent on the solubility of the drug within lipid/water. Log P is the most common method used in determining the parameter value. This experiment was to mix two dissolvents (octanol and water) which are immissible. The both levels of the compounds were carefully observed by a spectrophotometer UV-Vis. From the test, the result of log P value of the 4-chlorobenzoylthiourea compound was 2.32, while the theoretical log P value of the compounds, by using the π Hansch-Fujita method is 1.62 and the f Rekker-Mannhold method is 2.225. Consequently, the result of the test shows that there is a significant difference between the progress experiment and both theoretical log P methods. Moreover, in the test of the central nervous system depressant through the potentiation test to thiopental using mice indicates that the 4-chlorobenzoylthiourea compound have potentiation effects to thiopental compared to the lead compounds of benzoylthiourea.


Author(s):  
Eliyas Sulaiman Mohandas ◽  
Nik Mastura Nik Ismail Azlan ◽  
Salwa Othman ◽  
Muhammad Aizat Azhari

This study aims to investigate whether the use of six selected short stories throughout the duration of a 14-week course could enhance students’ reading comprehension achievement at the end of the semester. Out of the six short stories read, three were chosen as in-class assignments known as ‘Personal Reading Logs’ (hereafter, PRLs). One group of semester two Diploma students taking a reading skills course was selected through a convenience sampling method. A pre-test was conducted by having the students answer a past semester reading quiz of which the results would then be compared to their post-test (final reading exam) results. A paired samples t-test revealed no significant difference in the reading scores of the pre-test and the post-test, t (17) = -.265, p > .05. Since the p-value was bigger than 0.05, this indicated that the mean reading score of the post-test (M = 50.556) was not significantly higher than the mean reading score of the pre-test (M = 49.722). Therefore, the null hypothesis which stated that there was no difference in the mean score of the pre-test and post-test was retained. Overall, the result refuted the findings of other studies promoting the effectiveness of using short stories to enhance L2 reading comprehension achievement.


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