Therapeutic potential of policosanol in the concurrent management of dyslipidemia and non-alcoholic fatty liver disease

Background High-fat diet (HFD) possesses a major cause of cardiovascular disease, and hepatosteatosis. Unfortunately, long-term use of statins has a theoretical possibility of worsening of hepatic histology in the patients with non-alcoholic fatty liver disease (NAFLD). The objective of the study was to explore hepatoprotective potential of policosanol as an alternative to statins in experimental NAFLD. For the same, young male Wistar rats were fed with HFD for 8 weeks to induce NAFLD. 48 adult Wistar rats were distributed into six investigational groups: normal control, HFD control, and four treatment groups, receiving policosanol (50 and 100 mg/kg/day), atorvastatin (30 mg/kg/day), and silymarin (100 mg/kg/day) for 8 weeks along with HFD. Result HFD consumption caused profound hepatotoxicity evident by hepatic oxidative stress, increased Serum glutamic oxaloacetic transaminase (SGOT), Serum glutamic pyruvic transaminase (SGPT), Alkaline phosphatase (ALP), and bilirubin content. Treatment with policosanol (100 mg/kg) markedly reduced the elevated SGOT, SGPT, and ALP levels in HFD-fed rats. Moreover, policosanol significantly reduced hepatic oxidative stress manifest by reduced malondialdehyde (MDA) and increased glutathione (GSH) level. The treatment with policosanol (100 mg/kg) was found to be more active in attenuating the HFD-induced hepatotoxicity as compared to policosanol (50 mg/kg) and atorvastatin (30 mg/kg). Moreover, we observed that the hepatoprotective potential of policosanol was comparable to the silymarin. Conclusions The results of the study clearly indicated that the policosanol could be considered an intriguing approach for the treatment of NAFLD.

Outcomes of COVID-19 infection in patients with chronic kidney disease on maintenance hemodialysis at a COVID hospital in India

Background: Patients with chronic kidney disease (CKD) on hemodialysis are highly vulnerable to COVID-19 infection with a mortality rate higher than the rest of the population. There are several clinical and laboratory parameters that can predict the course and the outcomes in this group of population. Methods: We retrospectively collected the baseline demographic, clinical, in-hospital, and laboratory data of the patients with CKD on maintenance hemodialysis who were admitted to our COVID-19 hospital during the first and the second wave. Results: We obtained data for 35 patients from the first and 5 patients from the second wave. The analysis of the data for 35 patients from the first wave revealed shortness of breath (62.9%), and fever (54.3%) being the most common presenting symptoms, and the majority of the patients (57.2 %) presented with moderate to severe disease at admission with 57 % had bilateral lung infiltrates, and required oxygen support (65.7%) at admission. The comparison of clinical and laboratory markers between survivors (27 patients, 77.1%) and non-survivors (8 patients, 22.9%) revealed an older age, severe disease at presentation, invasive mechanical ventilation, baseline severe lymphocytopenia, high serum glutamic oxaloacetic transaminase, blood urea, and inflammatory markers like Interleukin-6 and procalcitonin, fibrinogen and low albumin in non survivors. Conclusions: The older age, severe disease at presentation, the requirement of invasive mechanical ventilation, raised baseline Interleukin-6, procalcitonin, serum glutamic oxaloacetic transaminase, blood urea and a low albumin level could be valuable predictors of poor outcomes.

Optimization and Evaluation of Piperine Loaded Herbosomes for their Antioxidant and Hepatoprotective Potential

Piperine is classified as a class II drug in the biopharmaceutical classification system due to its low aqueous solubility. As a result, piperine herbosomes were created to improve the dissolution rate and in vivo liver protecting activity of piperine and physico-chemical characteristics were used to confirm herbosome formation. The piperine-herbosome formulation revealed spherical particle size of all formulations from P1-P10 and found142.4 ± 0.98 nm for best piperine-herbosome formulation (P2) and a PDI value of 0.237, indicating a homogeneous population of piperine loaded vesicles. In vitro drug release rate and percent entrapment efficiency were determined for all formulations P1-P25 and found to be 95.306 ± 0.21 and 97.306 ± 0.65 in 12 h, respectively for best piperine-herbosome formulation (P2). It exemplifies the complex’s long-term releasing capability. This information suggests that it may have a longer retention time inside the body, extending the duration of effect. The antioxidant potential of pure piperine was determined using the DPPH scavenging method, with an IC50 value of 107.59 ± 0.11 g/mL compared to a formulation with an IC50 value of 93.926 ± 0.03 g/mL. Swiss albino mice of either sex were utilized for the evaluation of hepatoprotective activity. On the 8th day, the hepatotoxicity was caused by giving a single oral dosage of CCl4 (0.5 mL) and the parameters were evaluated on the 9th day. This formulation has the best optimized based on drug content and drug entrapment. Serum glutamic oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), alkaline phosphatase (ALP) and total bilirubin were among the biochemical markers measured. In comparison to normal control (161 ± 0.31 IU/L, 52.78 ± 0.28 IU/L, 121.12 ± 0.14 IU/L and 0.633 ± 1.44 IU/L) and P2 formulation (163.23 ± 0.49 IU/L, 66.9 ± 0.05 IU/L, 128.3 ± 1.15 IU/L and 0.645 ± 0.67 IU/L respectively).

Usefulness of the modified hemophagocytic syndrome diagnostic score as a prognostic factor in lung transplantation patients

Background: Lung transplantation (LTX) is an established treatment for end-stage lung disease; however, the post-LTX mortality rate remains high. This study aimed to evaluate the prognostic value of the modified reactive hemophagocytic syndrome diagnostic score (mHScore) and its individual components on mortality after LTX.Methods: We retrospectively analyzed 294 patients who underwent LTX at Severance Hospital, Yonsei University, Korea, from January 2012 and December 2020, and classified them into high (n=114, mHScore > 104.0) and low mHScore (n=180, mHScore ≤ 104.0) groups. Triglyceride, ferritin, serum glutamic oxaloacetic transaminase, fibrinogen, and cytopenia were used to calculate the mHScore. We compared baseline characteristics and mortality rates as LTX prognostic factors.Results: The high mHScore group had significantly more cytopenia and higher ferritin, triglyceride, lactate dehydrogenase, and C-reactive protein levels than the low mHScore group. The mortality rate was significantly higher in the high than in the low mHScore group (hazard ratio, 4.429, p < 0.001). Multivariate regression analysis revealed that a high mHScore was significantly associated with postoperative mortality, even after adjusting for other confounding factors. A high mHScore was also associated with postoperative complications.Conclusions: The mHScore can be used to estimate post-LTX prognosis and predict postoperative mortality.

Efficacy of hepatoprotector jamu formula (combination of Curcuma longa, Curcuma xanthorrhiza, and Taraxacum officinale) compared to Fructus schizandrae extract in mild liver injury: a randomized controlled trial

The prevalence of impaired liver function in developing countries is increasing. Indonesia has several traditional medicines that can be used as alternative treatments for liver dysfunction. The aim of this study was to determine the efficacy of hepatoprotector jamu formula (combination of Curcuma longa, Curcuma xanthorrhiza, and Taraxacum officinale) compared to Fructus schizandrae fruit extract for treating mild liver injury. This study was a RCT using parallel open label design which involved 60 subjects for 42 days of intervention. The parameters used to evaluate efficacy were Serum Glutamic Pyruvic Transaminase (SGPT) and Serum Glutamic Oxaloacetic Transaminase (SGOT). There was a significant difference of average SGPT levels on day 21 and day 42 compared to day 0 in both hepatoprotector jamu group and Fructus Schizandrae extract group (p < 0.001). Compared to the baseline, there were a significant difference of average SGOT levels on the follow up days in hepatoprotector jamu group (p=0.023 on day 21; p=0.003 on day 42) as well as Fructus Schizandrae extract group (p=0.028 on day 21; p=0.042 on day 42. The efficacy of hepatoprotector jamu formula was comparable to Fructus schizandrae extract in improving mild liver injury.

Comparison of Blood Biochemical Markers and Anthropometric Parameters in Different Fatty Liver Grades

Background and Aims: Obesity and hyperlipidemia, diabetes, and malnutrition are among the causes of fatty liver disease. This study compares blood biochemical markers and anthropometric parameters in different grades of fatty liver. Materials and Methods: In this descriptive cross-sectional study, 73 fatty liver patients were studied. The degree of fatty liver disease was divided into three grades on ultrasonography. Anthropometric parameters BMI, waist circumstance, height, weight in the fasting state were evaluated according to the standard protocols. The blood samples were taken and biochemical variables fasting blood sugar, serum glutamic-oxaloacetic transaminase (SGOT), Serum glutamic-pyruvic transaminase (SGPT), calcium, phosphorus, low density lipoprotein (LDL), cholesterol, triglyceride, and others were examined with photometric and HPLC methods. Results: Statistical analysis was significant between grades 1 and 3 of fatty liver (p = 0.006) and body mass index between grades 1 and 3 of fatty liver (p = 0.003). Comparing SGOT between different grades did not show any significant differences. However, comparing Bili Total indicated a significant difference between grades 1 and 2 and 1 and 3. Moreover, statistical analysis of qualitative variables, such as gender, hypertension, smoking, drug, alcohol, heart disease, stomach disease, and kidney disease, was not statistically significant between the three fatty liver groups. Median ± IQR had a significant difference for SGOT and Bili Total (p < 0.05). Conclusion: This study showed the significance of BMI, waist circumstance, and bilirubin factors in different grades of fatty liver. Monitoring BMI, waist circumstance, and bilirubin factors will be useful for susceptible people to non-alcoholic fatty liver disease.

Hepatoprotective Activity of Ethanol Extract of Figs Leaves (Ficus carica L.) with SGOT & SGPT Parameters in Sprague Dawley Female Rats Induced by Paracetamol

Background: Long-term usage of paracetamol damages liver cells characterized by the increasing levels of Serum Glutamic Pyruvic Transaminase (SGPT) and Serum Glutamic Oxaloacetic Transaminase (SGOT). Figs (Ficus carica L.) leaves contain high flavonoid compounds that able to act as hepatoprotector agents which inhibited the process of liver damage. Objectives: This study aims to determine the dose characteristics and hepatoprotective activity of figs (Ficus carica L.) leaves extract. Material and Methods: The hepatoprotective activity of figs extract (Ficus carica L.) was determined by measuring SGPT & SGOT levels in rat blood. 42 rats were prepared, divided into 7 groups: normal control group, negative control given paracetamol with a dose 40 mg/200 g BW, positive control given hepamax®, base control given Na CMC, and 3 test dose groups given figs leaves extract with a dose of 40 mg/200 g BW, 80 mg BW/200 g BW and 160 mg/200 g BW. The treatment was carried out for 14 consecutive days. Paracetamol was given for 14 days, while positive control, 3 test dose groups and base control were given on day 7 to day 14. Rats blood samples were taken through the orbital sinuses on day 1, day 5, day 10 and day 14 after treatment began. SGPT & SGOT levels were determined using spectrophotometry with analytical methods using specific SGPT & SGOT reagent kits. Results: The results showed that the leaves extract of figs (Ficus carica L.) proved to be able to reduce the levels of SGPT & SGOT with the most potent dosage was 40 mg/200 g BW. However, the reduction of SGPT & SGOT levels were not significantly different from other treatments. Conclusions: Figs (Ficus carica L.) leaves extract showed activity as a hepatoprotective agent, based on the reduction of SGPT & SGOT levels in rat after 14 days of treatment.

Acute Toxicity Study of Porang (Amorphophallus oncophyllus) Flour Macerated with Strobilanthes crispus in Wistar Rats

BACKGROUND: Porang (Amorphophallus oncophyllus) is a local tuber food that high in bioactive compound glucomannan. It uses are limited due to oxalate acid content which poses health risks. Strobilanthes crispus leaves could reduce the level of calcium oxalate in porang. However, there is still no study to prove its safety. AIM: This study aimed to investigate the acute oral toxicity study of porang (A. oncophyllus) macerated with S. crispus based on observation of mortality rate (LD50), the changes in behavior during 72 h, renal and hepatic function such as urinary protein, serum glutamic oxaloacetic transaminase (SGOT), and serum glutamic pyruvic transaminase (SGPT) levels of Wistar rat (Rattus norvegicus) METHODS: An acute toxicity test was conducted based on the Organization of Economic Co-Operation and Development 420 Fixed-Dose Procedure Guideline that consists of preliminary and main studies. For the preliminary study, rats were divided into control and five treatment groups with the dosage of 50, 300, 2000, and 5000 mg/kg body weight (BW) for each natural porang flour (NPF) and S. crispus-macerated porang flour (SPF). For the main study, rats were divided into four groups, those were NPF and SPF with the dosage of 2000 and 5000 mg/kg BW. Levels of urinary protein and blood serum SGOT and SGPT levels were measured at 0, 24, and 72 after treatment. RESULTS: The acute toxicity study showed that porang and porang macerated with S. crispus were not toxic until the highest dose of 5000 mg/kg BW. It was proved by the absence of LD50, no change in behavior, no weight losses, and also the results of biochemical tests, such as urinary protein, SGOT, and SGPT which were still in the normal range. CONCLUSIONS: Porang flour and SPF were concluded as non-toxic food based on acute toxicity study.

The antihyperlipidaemic and hepatoprotective effect of Ipomoea batatas L. leaves extract in high-fat diet rats

The administration of high-fat diets can increase the body's lipid level and damage the organs. Purple sweet potato leaf (Ipomoea batatas L.) was reported as an antioxidant against free radicals. This study aimed to observe the sweet potato leaf extract's activity on decreasing lipid profile and hepatoprotective effect in high-fat diet fed rats. The treatment animals were divided into five groups, namely normal control, high-fat diet (HFD) control, the treatment group of purple sweet potato leaf extract (SPLE) doses 100 mg/kg BW, 200 mg/kg BW and 400 mg/kg BW which fed with high-fat diet for 14 days and SPLE for 28 days. After treatment was completed, the blood was collected for the detection of cholesterol, triglyceride, serum glutamic oxaloacetic transaminase (SGOT), and serum glutamic pyruvate transaminase (SGPT). After that, the animals were sacrificed, and a liver histopathology observation was conducted using Haematoxylien and Eosin staining. The result showed a significant decrease in cholesterol and triglyceride levels (p≤0.05) compared to the negative group in all treated groups. The SGOT and SGPT enzymes in all of treatment groups were also found to decrease compared with HFD control. The result was confirmed by the histopathological observations. The finding suggested the potency of SPLE for antihyperlipidaemic and hepatoprotective agent.

Device Diagnosing Health of Bovine

The research problem taken into consideration for study dealt with the design of a low cost hand-held ZnO based sensing device for testing blood serum of bovine (cow), to diagnose their health of liver and kidney by detecting four biological parameters in-situ. Zinc oxide nanoparticles were synthesised by chemical bath deposition method. Using transmission electron microscopy (TEM) and X-ray diffraction (XRD), the size of ZnO nanoparticles were determined. It shows a hexagonal wurtzite structure with an orientation along the direction (101). TEM images show various morphological changes of nanostructured ZnO. The average crystallite sizes of ZnO molecule is found to be 0.004 nm from XRD. The constituents of nano sized ZnO are found to be of Zn (57.27%), Cl (33.01%), C (8.04%) and O (1.68%) as obtained from EDS. The samples of blood serum of bovine, avian and caprine are characterised by transmission electron microscopy (TEM) and Benesphera Avantor Performance (Biochemistry Analyser). ZnO based sensing device is designed with the help of Arduino and Microsoft visual basic 6.0 version software. The resistance of blood serum is taken into consideration for carrying out the experiment. It has been measured after adding ZnO (1 μl) to blood serum of (1 ml) to detect four biological parameters – Serum glutamate pyruvate transaminase (SGPT), Serum glutamic-oxaloacetic transaminase (SGOT), Blood urea nitrogen (BUN) and creatinine of bovine more precisely. The device can indicate whether the blood serum of bovine have normal/diseased parameters. This device will also help the veterinarians in the field.