TO STUDY THE EFFICACY OF POLY HERBO-MINERAL COMPOUND IN THE MANAGEMENT OF GRADE I & GRADE II FATTY LIVER (HEPATIC STEATOSIS)

Hepatic Steatosis is a common predicament in society due to changes in lifestyle and food practices. Depending upon the cause and amount of accumulation, fatty change may be mild and reversible, or severe producing irreversible cell injury and cell death. Disturbances of lipid metabolism in the liver due to various etiological factors lead to Fatty Liver. Ayurveda has immense potential in the management of Non-Communicable Diseases, and Fatty liver is one among them. In Ayurveda, a direct correlation of Fatty liver is not found but it can be considered under Yakrit roga and Medo roga, as a Santarpanjanya Vyadhi. Hepatic steatosis patients are treated with Triphaladi yoga and Yashtimadhu churna for 3 months, in the Department of Kayachikitsa, Govt. Ayurvedic College and Hospital, Guwahati. This trial aims to formulate a practical Ayurvedic protocol for the management of Grade I and Grade II Fatty liver. However, further research studies are needed to fulfil the aims and objectives. Keywords: Yakrit Roga, Hepatic steatosis, Santarpanjanya Vyadhi, poly-herbo mineral compound, clinical trial.

TO STUDY THE EFFICACY OF POLY HERBO-MINERAL COMPOUND IN THE MANAGEMENT OF GRADE I & GRADE II FATTY LIVER (HEPATIC STEATOSIS)

Hepatic Steatosis is a common predicament in society due to changes in lifestyle and food practices. Depending upon the cause and amount of accumulation, fatty change may be mild and reversible, or severe producing irreversible cell injury and cell death. Disturbances of lipid metabolism in the liver due to various etiological factors lead to Fatty Liver. Ayurveda has immense potential in the management of Non-Communicable Diseases, and Fatty liver is one among them. In Ayurveda, a direct correlation of Fatty liver is not found but it can be considered under Yakrit roga and Medo roga, as a Santarpanjanya Vyadhi. Hepatic steatosis patients are treated with Triphaladi yoga and Yashtimadhu churna for 3 months, in the Department of Kayachikitsa, Govt. Ayurvedic College and Hospital, Guwahati. This trial aims to formulate a practical Ayurvedic protocol for the management of Grade I and Grade II Fatty liver. However, further research studies are needed to fulfil the aims and objectives. Keywords: Yakrit roga, Hepatic steatosis, Santarpanjanya Vyadhi, poly-herbo mineral compound, clinical trial.

Neonatal calve Colisepticemia: Bacteriological and Pathological Findings

A-3-days old calf, freshly dead, with a history of sudden deaths among neonate calves in the farm, was referred to the pathology and diagnosis department at the Veterinary Research Institute. Postmortem examination revealed a diffuse redding of the carcass particularly of the lungs, liver and intestine. Histopathologically thickening of alveolar septa by mononuclear cells, fibrinous thrombi and effusion of fibrinous exudates into alveoli were observed in the lung. Intestine showed complete loss of lining epithelium. In the liver there were loss of lobulation, fatty change and fibrinous thrombi. Bacteriologically, Pure culture of Eshericia coli was isolated from lung, liver and intestine using different methods. All findings confirmed the diagnosis of colisepticemia.

Abstract 13084: Epsilon Waves on Electrocardiograms in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy: Relationship to Left Ventricular Invasion or Heart Compression Due to an Enlarged Right Ventricle

Introduction: Epsilon waves on V1-3 leads are known as one of the specific lead ECG findings in patients with arrhythmogenic right ventricular (RV) cardiomyopathy (ARVC) that suggests the presence of RV conduction delay. Four dimensional (4D) cardiac CT visualizes ARVC characteristics, such as fat and fibrotic invasion in RV (RVM) and left ventricular (LV) myocardium (LVM), an enlarged RV, reduced RV motion, and bulging. Hypothesis: If epsilon waves are observed in V4-6 leads, this finding suggests the occurrence of LV invasion in ARVC. Another hypothesis exists in which extreme RV enlargement may compress the LV and cause clockwise rotation; an enlarged RV itself may cause epsilon waves in V4-6 leads. Methods: This is a retrospective analysis of 17 patients (11 males, 57 ± 17 years) with suspected ARVC who underwent cardiac CT. On 4D CT, nine met 2010 ARVC task force criteria. Results: All nine patients had epsilon waves on ECG. Five had fat and fibrotic invasion in the LVM but four did not. We divided nine into the following five groups by CT findings. On CT, a markedly enlarged RV compressed the LV to the left side and a fibro fatty change were observed exclusively in RVM (gp 1, N=1) or were observed in both RVM and LVM (gp 2, N=2). A moderately enlarged RV without compression of the LV to the left side and a fibro fatty change were observed exclusively in RVM (gp 3, N=3), or observed in both RVM and LVM (gp 4, N=2). The complications of severe mitral valve regurgitation, a markedly enlarged LV, and a fibro fatty change were observed in both RVM and LVM (gp 5, N=1). A patient in gp 1 showed epsilon waves in V1-6 leads. Patients in gp 2 showed epsilon waves in V1-6 (N=1), and V3-5 (N=1) leads, respectively. Patients in gp 3 showed epsilon waves in V1-4 (N=2), and V1-3 (N=1) leads, respectively. Patients in gp 4 showed epsilon waves in V1-3 (N=1), and V1, 2 (N=1) leads, respectively. A patient in gp 5 showed epsilon waves in V4-6 leads. Conclusions: The distribution of epsilon waves on ECG in patients with confirmed ARVC by cardiac CT was highly influenced by the degree of LV compression due to a markedly enlarged RV on CT rather than the presence of LV invasion. Also, structural change due to complicated heart diseases, such as valvular diseases, may also influence the distribution of epsilon waves in ARVC.

Pathology and prevalence of hepatic lesions of Azeri buffaloes (bubalus bubalis) slaughtered at Urmia Abattoir, Northwest Iran

This study was carried out for the evaluation of the prevalence rate and the pathology of various lesions in the confiscated livers of slaughtered Azeri buffaloes at Urmia Abattoir, Northwest Iran. Livers of 306 Azeri buffaloes were inspected grossly during five months according to their color and consistency changes in Urmia Abattoir. Among the inspected carcasses, livers of 28 buffaloes had various lesions. The collected tissue samples of confiscated livers were placed in 10% buffered formalin as a fixative solution in order to prepare pathologic sections with a thickness of 6 μm. The sections were stained by haematoxylin and eosin (H&E) and periodic acid schiff (PAS) methods. The most common pathologic changes in the confiscated buffalo livers were fatty change (46.4%), hepatitis and cholangitis (42.9%), and bile duct hyperplasia (39.3%) respectively. The results of this study have shown that there was a significant difference (p<0.05) between hepatic congestion and sex. In addition, there was no significant difference (p>0.05) between hepatic lesions and age. The results of this study have revealed that fascioliasis has an important role in the creation of some hepatic lesions such as bile duct hyperplasia, fatty change, and hepatitis in buffaloes. Since various hepatic lesions can reduce buffalo productions and has negative influence on animal reproduction, it is necessary to pay more attention to accurate performing of antiparasitic program and the evaluation of possible role of poisonous plants, heavy metals, and mycotoxins in the generation of hepatic lesions of buffaloes.

THU0492 MAGNETIC RESONANCE IMAGING OF THE SACROILIAC JOINTS IN PATIENTS WITH HYPERMOBILITY: A RETROSPECTIVE COHORT STUDY

Background:The incidence of inflammatory and structural lesions on magnetic resonance imaging of sacroiliac joints (MRI SIJs) in patients with hypermobility related disorders has not been fully investigated. Hypermobile patients are more susceptible to pelvic instability and biomechanical stress of the SIJs, leading to MRI SIJ changes similar to those occurring in spondyloarthritis (SpA). Patients with hypermobility and suspected SpA pose a unique challenge owing to the high prevalence of back pain in the hypermobility cohort and the absence of spinal restriction on clinical examination.Objectives:In this study, we aim to investigate the incidence of MRI SIJ lesions in patients with hypermobility.Methods:We performed a retrospective study of all patients with a confirmed diagnosis of hypermobility related disorders (including hypermobility syndrome, hypermobility spectrum disorders and Ehlers-Danlos Syndromes) referred for an MRI lumbar spine and SIJ between 2011 and 2019 to investigate long-standing back pain. MRIs were examined by a musculoskeletal (MSK) radiologist with more than 25 years of experience, who was blinded to the clinical outcome of the patients. MRI SIJs were assessed for the presence of bone marrow oedema, subchondral sclerosis, erosion, fatty change, enthesitis, ankylosis, joint fluid and capsulitis.Results:51 patients with confirmed hypermobility related disorders were referred for MRI SIJ and lumbar spine between 2011 and 2019. 3 patients demonstrated clinical features in keeping with a diagnosis of SpA and were excluded from the study. 15/48 (31.3%) of patients with hypermobility and back pain (but no clinical picture of SpA) were found to have inflammatory and/or structural lesions on MRI SIJ. The most frequent lesions were small foci of bone marrow oedema (16.6%) followed by subchondral sclerosis (12.5%) and fatty change (10.4%). The incidence of erosions was 4.2%.Conclusion:There is a relatively high incidence of inflammatory and structural lesions on MRI SIJ of patients with hypermobility. The presence of hypermobility should be taken into consideration when interpreting MRI changes in patients with suspected SpA. Further research into long-term outcomes of MRI SIJs in patients with hypermobility and back pain is required to establish the clinical significance of these findings.Disclosure of Interests: :Alexis Jones: None declared, Coziana Ciurtin Grant/research support from: Pfizer, Consultant of: Roche, Modern Biosciences, Hanadi Kazkaz: None declared, Margaret Hall-Craggs: None declared

Nitrosative Stress and Lipid Homeostasis as a Mechanism for Zileuton Hepatotoxicity and Resistance in Genetically Sensitive Mice

Zileuton is an orally active inhibitor of leukotriene synthesis for maintenance treatment of asthma, for which clinical usage has been associated with idiosyncratic liver injury. Mechanistic understanding of zileuton toxicity is hampered by the rarity of the cases and lack of an animal model. A promising model for mechanistic study of rare liver injury is the Diversity Outbred (J:DO) mouse population, with genetic variation similar to that found in humans. In this study, female DO mice were administered zileuton or vehicle daily for 7 days (i.g.). Serum liver enzymes were elevated in the zileuton group, with marked interindividual variability in response. Zileuton exposure-induced findings in susceptible DO mice included microvesicular fatty change, hepatocellular mitosis, and hepatocellular necrosis. Inducible nitric oxide synthase and nitrotyrosine abundance were increased in livers of animals with necrosis and those with fatty change, implicating nitrosative stress as a possible injury mechanism. Conversely, DO mice lacking adverse liver pathology following zileuton exposure experienced decreased hepatic concentrations of resistin and increased concentrations of insulin and leptin, providing potential clues into mechanisms of toxicity resistance. Transcriptome pathway analysis highlighted mitochondrial dysfunction and altered fatty acid oxidation as key molecular perturbations associated with zileuton exposure, and suggested that interindividual differences in cytochrome P450 metabolism, glutathione-mediated detoxification, and farnesoid X receptor signaling may contribute to zileuton-induced liver injury (ZILI). Taken together, DO mice provided a platform for investigating mechanisms of toxicity and resistance in context of ZILI which may lead to targeted therapeutic interventions.

Comparative study of pathological lesions of liver in autopsy cases

Background: Liver is a site for plethora of diseases among which many become symptomatic while others usually either go undiagnosed or are concealed by other prominent diseases. As said about liver to be the custodian of milieu interior most of the silent liver diseases are diagnosed only on autopsy examination. Aims and objectives was to study various pathological lesions of liver in medicolegal and clinical autopsy cases and to corelate liver diseases with age and sex. Retrospective cross-sectional observational study of 649 medicolegal and clinical autopsies conducted within 2 years of duration (January 2017 to December 2018).Methods: Out of all 649 autopsies conducted in our hospital all liver specimens along with other organs viscera were collected and formalin fixed. After gross examination sections from the liver were submitted for tissue processing and then stained with haematoxylin and eosin stain.Results: The most common pathology found in our study was fatty change (11.1%) followed by venous congestion (4.3%), hepatitis (3.5%), cirrhosis (2.2%), tuberculosis/ granulomatous hepatitis (0.6%), chronic hepatitis (0.3%), malignancy (1%), miscellaneous (2%) and normal (72.4%). Maximum cases were in 21-30 years of age group with male preponderance.Conclusions: Autopsy examination of liver is an effective tool to identify silent liver diseases. Use of autopsy findings along with other investigative techniques.