Postoperative Hepatic Dysfunction After Frozen Elephant Trunk for Type A Aortic Dissection

Background: This study was aimed to investigate the incidence, risk factors, and outcomes of patients with postoperative hepatic dysfunction (PHD) after frozen elephant trunk (FET) for type A aortic dissection (TAAD).Method: A retrospective study was performed with 492 patients who underwent FET for TAAD between 2015 and 2019. Independent risk factors for PHD were determined by multivariate mixed-effect logistic analysis with surgeon-specific factor as a random effect.Results: The incidence of PHD was 25.4% (n = 125) in our cohort. Patients with PHD presented higher early mortality (10.4 vs. 1.1%, p < 0.001), rates of acute kidney injury (42.4 vs. 12.8%, p < 0.001), and newly required dialysis (23.2 vs. 3.0%, p < 0.001) compared with those without PHD. Moreover, with the median follow-up period of 41.3 months, the survival curve was worse in patients with PHD compared with no PHD group (log-rank p < 0.001), whereas it was similar after excluding patients who died within 30 days (log-rank p = 0.761). Multivariable analyses suggested that PHD was predicted by preoperative aspartate transferase [odds ratio (OR), 1.057; 95% confidence intervals (CI), 1.036–1.079; p < 0.001], celiac trunk malperfusion (OR, 3.121; 95% CI, 1.008–9.662; p = 0.048), and cardiopulmonary bypass time (OR, 1.014; 95% CI, 1.005–1.023; p = 0.003). Retrograde perfusion (OR, 0.474; 95% CI, 0.268–0.837; p = 0.010) was associated with a reduced risk of PHD. Celiac trunk malperfusion was an independent predictor for PHD but not associated with early mortality and midterm survival.Conclusions: PHD was associated with increased early mortality and morbidity, but not with late death in midterm survival. PHD was predicted by preoperative aspartate transferase, celiac trunk malperfusion, and cardiopulmonary bypass (CPB) time, and retrograde perfusion was associated with a reduced risk of PHD.

Changes in Liver, Kidney and Atherogenic Indices of Women in Ebocha, Niger-Delta, Nigeria due to Gas Flaring

Gas flaring causes pollution to the environment and also affects the human organs such as the liver and kidneys. The present study seeks to investigate changes in liver, kidney function and atherogenic predictor indices of native women of Ebocha, Niger Delta, Nigeria who have over the years been chronically exposed to the persistent gas flaring in the area. Two hundred (200) healthy and freely consented women aged between 30 to 50 years were recruited; one hundred (100) from Ebocha and one hundred (100) from Uturu the control station. Results revealed that the values of serum activities of alanine aminotransferase (ALT), aspartate transferase (AST) alkaline phosphatase (ALP), and the concentrations of albumin and total protein were significantly (p<0.05) higher in Ebocha women when compared to values of women from Uturu. The pollution caused as a result of gas flaring did not affect the concentrations of bilirubin in women from both sites. However, serum creatinine, urea, K+, Na+, Cl- and HCO3-concentrations were significantly (p<0.05) higher in Ebocha women when compared to values for women from the control station. Ebocha women had significantly (p<0.05) reduced concentrations of serum triglyceride, total cholesterol and HDL cholesterol but significantly (p<0.05) increased LDL-cholesterol and atherogenic predictor indices in comparison with those from Uturu indicating that chronic gas flaring has negative effects on the liver, renal function, lipid profile and atherogenic predictor indices of women resident in Ebocha. Liver, kidney, atherogenic indices, gas flaring, women, Niger Delta.

Impact of one-rod levonorgestrel implant on the blood chemistry profile

The aim of this study was to investigate the effect of a one-rod levonorgestrel implant on the blood chemistry profile, including random blood glucose (RBG), haemoglobin (Hb), alanine transferase (ALT), aspartate transferase (AST), and the lipid profile, including total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides. This prospective cohort study was conducted at Raden Saleh Clinic, Jakarta, from 2010 to 2012. The implants were inserted subdermally in 30 patients. The subjects were evaluated every 6 month up to 2 years. Bivariate analysis using t-test or Wilcoxon signed rank test was performed for all variables. p < 0.05 was considered a significant value. The Hb, RBG, AST, and lipid profile levels were significantly different before and 6 months after one-rod implant insertion (p < 0.05). However, for 24 months, all of the parameters were still within normal limits and did not differ clinically. One-rod levonorgestrel implant insertion has a minimal effect on all blood chemistry profiles.

Correlation of Serum Vitamin D Levels to Vascular Access Dysfunction in Prevalent Hemodialysis

Vascular access dysfunction in hemodialysis patients has been correlated to low serum vitamin D level in previous studies. Vitamin D deficiency and hepatitis C virus infection have been linked to endothelial cell dysfunction, promoting inflammatory cascade.30 negative - & 30 positive - hepatitis C virus patients on prevalent hemodialysis in Ain Shams University Hospitals, were enrolled in the study. All patients had access blood flow &lt; 800 ml/min. For all patients we performed: complete physical examination, complete blood count, serum ferritin, ESR 1st and 2nd hours, CRP, blood urea, serum creatinine, serum albumin, total and direct bilirubin, alanine transferase, aspartate transferase, prothrombin time, International Normalized Ratio, serum calcium and phosphorus, and serum intact parathyroid hormone. Previous laboratory tests were performed using conventional methods within our hospitals laboratories. Serum vitamin Dlevel was measured by Enzyme Linked Immunosorbent Assay. Access blood flow was measured by Duplex Ultrasound. Vitamin D serum level was &lt; 20 ng/ml within negative and positive groups with no significant difference between them. Vascular access flow was significantly lower within positive patients. Parathyroid hormone, Phosphorus, Prothrombin time, International Normalized Ratio, Alanine - and Aspartate - transferase were significantly higher within positive patients. We deduced that Vitamin D level &lt; 20ng/ml was associated with reduced vascular access blood flow &lt; 800 ml/min, with much more reduced access flow within hepatitis C virus positive patients. [Mona Hosny Abdel Salam, Reem Jan Farid, Mostafa Abdelnassier Abdelgawad and Marwa Salim Youssef Ismail. Correlation of Serum Vitamin D Levels to Vascular Access Dysfunction in Prevalent Hemodialysis.

A medicinal liver injury with an immunomodulatory drug of natural origin. Case report

As practice shows, there are many alternative drugs that cause drug damage to the liver. A case of medicinal damage to the liver with an immunomodulatory herbal preparation Immunostimulating collection, which included St. John's wort, Elecampane, Kopeichnik, Echinacea, Licorice, Rosehip, is presented. A 39-year-old patient came to the clinic with complaints of yellowing of the skin, whites of the eyes, heaviness in the epigastrium after eating, lightening of feces, dark urine, sour taste in the mouth, bloating, pruritus, decreased appetite, pronounced general weakness, drowsiness 10 days after you start taking herbal immunostimulant. The diagnosis of drug damage to the liver was made taking into account the history and laboratory parameters, since the patient had negative markers of viral hepatitis and increasing of biochemical blood tests: alanine transferase up to 2800 U/l (norm up to 32 U/L), aspartate transferase up to 1776 U/l (norm up to 31 U/l), total bilirubin up to 577 U/l (norm up to 21 U/l), direct bilirubin up to 116 U/l (norm up to 4.3 U/l), alkaline phosphatase up to 112 U/l (norm up to 98 U/l). After the withdrawal of the immunomodulator and the appointment of therapy, including diet, enzyme replacement therapy, drugs clinical and laboratory manifestations of liver drug damage completely disappeared. This confirms the leading role of the immunoactive drug, which the patient took in the toxic effect on the liver.

Impact of One-Rod Levonorgestrel Implant on Blood Chemistry Profile

Objective: The aim of this study is to investigate the effect of one-rod levonorgestrel implant on the blood chemistry profile which include random blood glucose (RBG), hemoglobin (Hb), alanine transferase (ALT), aspartate transferase (AST), and lipid profile such as total cholesterol, High-density lipoprotein (HDL), Low-density lipoprotein (LDL), and triglycerideMethods: This prospective cohort study was conducted at Raden Saleh Clinic, Jakarta from 2010 to 2012. The implants were inserted subdermally in 30 patients. The subjects were evaluated for 6 months and the blood chemistry profile was followed up to 2 years. Bivariate analysis using t-test or Wilcoxon signed rank test was performed for all variables. The p <0.05 was considered as a significant value. Results: The level of Hb, RBG, AST, and lipid profile was different significantly before and after 6-months one-rod implant insertion (p<0.05). However, in 24 months, all of parameters were still on normal limit and not different clinically. Conclusion: One-rod levonorgestrel implant insertion shows minimal effect to all blood chemistry profiles.

Effects of omega-3 fatty acid supplementation on serum Alanine Transferase and Aspartate Transferase levels in middle-aged patients with type 2 diabetes mellitus

Background: People with type2 diabetes mellitus (DM) are at amplified chance of non-alcoholic fatty liver disease. Objective: To observe the effects of omega-3 fatty acid supplementation Alanine Transferase (ALT) and Aspartate Transferase (AST) in middle age patients with type 2 DM. Methods: A prospective interventional study in 2017, recruited 52 type 2 diabetic patients of both sexes aged 40 to 50 years. Among them, 27 patients were given fish oil capsule orally (omega 3 fatty acid 2g/day) for consecutive 12 weeks and 25 patients without supplementation were selected as control also studied after 12 weeks. Serum ALT and AST of all patients were estimated by enzymatic colorimetric method at baseline and after 12 weeks. For statistical analysis, Paired Student’s ‘t’ test and Unpaired Student’s ‘t’ test were performed. Results: In this study ALT and AST significantly decreased in patients supplemented with omega-3 fatty acid after 12 weeks, ALT (alanine aminotransferase) and AST (aspartate transaminase) were decreased in diabetic patients after supplementation with omega- 3 fatty acid in comparison to control group. Conclusion: It can be concluded that omega-3 fatty acid supplementation was effective to reduce ALT and AST levels in diabetic patients and it may be helpful to minimize the risk of fatty liver in type-2 DM. J Bngladesh Soc Physiol 2021;16(1): 39-43

Effects of feeding graded levels of whole cottonseed on haemato-biochemical parameters of red Sokoto bucks

Whole cottonseed (WCS) is an important source of protein for ruminants, however, it contains a polyphenolic secondary metabolite gossypol which may reduce its palatability and cause pathophysiological effects. The study was aimed at evaluating the effects of feeding graded levels of WCS on the haemato-biochemical parameters of Red Sokoto bucks (RSB). After a 14-day pre-treatment period, 20 bucks (n = 5) were assigned for 90 days to one of four isonitrogeneous treatments: control (A); 0 % (B); 15 % (C); 30 % and (D); 45 %. Blood was collected for Packed Cell Volume (PCV) and serum analyses at days 0, 45 and 90 of the experimental period for concentrations of urea, creatinine, total protein, albumin, globulin and activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP). The PCV was decreased in groups fed above 15 % of WCS on days 45. There were no significant (P > 0.05) differences in globulin concentration, alanine aminotransferase and alkaline phosphatase activities but aspartate transferase activity was higher (p < 0.05) in group D (45% WCS) compared to the various treatment groups. The urea concentration was higher (p < 0.05) in groups B and D at day 45 compared to the control group. The creatinine concentration was higher (p < 0.05) in group D at days 45 and 90 compared to the control group. The serum total protein and albumin concentration were higher (p < 0.05) in groups C and D at day 45 compared to the control group. Our finding revealed that prolonged feeding of bucks above 30 % WCS for more than 60 days exerted considerable deleterious and adverse effects on blood constituents leading to aneamia, hyper-cretenaemia, ureamia, increased levels of total protein, albumin, aspartate transferase activity and death. Keywords: Biochemical parameters, Bucks, Gossypol, Serum, Whole cotton seed

NAT8L mRNA oxidation is linked to neurodegeneration in multiple sclerosis

RNA oxidation has been implicated in neurodegeneration, but the underlying mechanism for such effects is unclear. Recently, we demonstrated extensive RNA oxidation within the neurons in multiple sclerosis (MS) brain. In this report we identified selectively oxidized mRNAs in neuronal cells that pertained to neuropathological pathways. N-acetyl aspartate transferase 8 like (NAT8L) mRNA is one such transcript, whose translated product enzymatically synthesizes N-acetyl aspartic acid (NAA), a neuronal metabolite important for myelin synthesis. We reasoned that impediment of translation of an oxidized NAT8L mRNA will result in reduction in its cognate protein, thus lowering NAA level. This assertion is directly supported by our studies on a model cellular system, an MS animal model and postmortem human MS brain. Reduced NAA level in the brain hampers myelin integrity making neuronal axons more susceptible to damage, which contributes in MS neurodegeneration. Overall, this work provides a framework for mechanistic understanding of the link between RNA oxidation and neurodegenerative diseases.

The Level of FGF 21 as a New Risk Factor for the Occurrence of Cardiometabolic Disorders amongst the Psoriatic Patients

Fibroblast growth factors 21 and 23 are used as markers of cardiometabolic disorders which are common comorbidities in psoriasis. The study aimed to evaluate the serum level of these factors in psoriatic patients and elucidate the possible interplay between disease activity, metabolic or inflammatory parameters, and systemic treatment. A total of 33 patients with active plaque-type psoriasis and 11 healthy controls were enrolled in the study. Patients were divided into subgroups based on their BMI, disease severity, and treatment. Blood samples were collected at the beginning of the study and after 3 months of systemic treatment with acitretin or methotrexate. Serum FGF21 levels in psoriatic patients were higher versus control group (p < 0.05). FGF21 levels regarding psoriasis activity were significantly increased in all three subgroups compared to the controls (p < 0.05). Regarding FGF23, no significant changes were found beside positive correlation with aspartate transferase (p < 0.05). No significant effect of systemic treatment on FGF21 and FGF23 levels was found. Interestingly, a nearly threefold decrease in FGF21 concentration after acitretin-based treatment was observed (p < 0.05). After methotrexate therapy, FGF21 levels remained unchanged. FGF21 levels might be helpful in prediction of the risk of cardiometabolic comorbidities development especially in patients with severe psoriasis and obesity.