Online ISSN: 2515-8260

Keywords : Liver function test

A study on hepatic dysfunction in Covid 19 patients

Priyadarshini V, Sanjay Surya GS, Gowtham H, Jagadeesan M, Prasanna Karthik S, Kannan R

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 573-578

Background and Objectives - Covid -19 is a pandemic, which is known to be a multi organ disease with complex clinical manifestations. Covid 19 virus has predilection for lung involvement but can also cause hepatic dysfunction. This study aims to analyze the significance of abnormal liver function tests in SARS- COV2 positive patients.
METHOD- This retrospective study, involved 150 patients (75 MALES, 75 FEMALES) who tested positive for SARS COV2. After obtaining clearance from the ethical committee, clinical and biochemical data were collected retrospectively from patient records, for a period of six months. They were segregated into severe  and non severe SARS COV2 infected individuals.  liver function test  were compared among patients between these 2 groups.
Of the 150 covid- 19 positive patients, 75 were males and 75 were females. The mean age was 50±5 years. 95 patients belonged to the non severe covid-19 category (22 hypoxic and 73 non hypoxic patients), who were admitted in the ward. 55 patients belonged to the severe covid -19 category (hypoxic patients who required NIV/ ventilator support), admitted in the ICU.
Severe hypoalbuminemia 63% , was observed in the severe category, compared to 6.32%  in the non- severe category. Raised transaminases were observed in 60%  in the severe category, compared to 23.15% in the non severe category.
The incidence of death observed in the ICU in our study was 25.45%, of which 35% were female patients and 64.28%  were male patients.
CONCLUSION- Hypoalbuminemia, raised transaminases and bilirubin were observed in covid-19 patients admitted in the ICU, indicating, they could be considered as a poor prognostic factor.

An Observational Study of the Effect of Laparoscopic Cholecystectomy on Liver Function Test

Hari Om Dhaker, Shyam Bhutra, Yogendra Singh Chundawat, Naresh Kumar, Nani Dhaker, Saranshi Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2308-2314

Background: Cholecystectomy is a common treatment of symptomatic gallstones and other gallbladder conditions. As it gained worldwide popularity, it has become one of the most common operations performed in general surgical practice. In this study we aimed to investigate to determine changes in liver function tests after laparoscopic cholecystectomy.
Material & Methods: A prospective observational study done on 100 patients who underwent elective laparoscopic cholecystectomy were taken up for the study in the department of General surgery at JLN medical college and hospital, Ajmer, Rajasthan, India during period between January 2020 to December 2021. All patients who gave consent for the study underwent a standard clinical and laboratory evaluation including USG. Pre-operative investigations included liver function tests i.e. prothrombin time, bilirubin (total and direct), alanine transaminase, aspartate transaminase, alkaline phosphatase, total proteins, serum albumin, GGT, and LDH. The subjects under inclusion criteria have taken up for the study. The liver function tests have repeated 24 hours, 3rd day, 7th days, 10th days after the operation and compared.
Result: The mean age of the study population was 43.3 years with a standard deviation of 13.35 yrs. A negative t-STAT shows that the value of serum total protein, serum albumin was falling after the laparoscopic procedure. A statistically significant increase in the bilirubin(total and direct), SGOT, SGPT, GGT, LDH, and serum alkaline phosphatase levels were noted after laparoscopic cholecystectomy and no statistical significance in prothrombin time.
Conclusion: We concluded that statistically significant increase in the bilirubin (total and direct), SGOT, SGPT, GGT, LDH, and serum alkaline phosphatase levels after Laparoscopic cholecystectomy. There was a decrease in total protein and albumin and no change for prothrombin time. However, further studies with larger sample sizes and multi-center trials would yield more definite results, along with meta-analyses. We strongly suggest the consideration of confounding factors such ascomorbidities, duration of surgery, CO2 pressure, utilized anesthetic agents, and also longer period follow-ups. 

Serum ferritin and liver function test response to oral versus subcutaneous iron chelating agent

Aymen Abd. Albakaa; Faris M. Al- Haris; Alaa Jumaah Mnaji Nasrawi; Jassim Mohammed Al Musawi; Talib Abdul Jalil Al Madany

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 130-135

Thalassemias are group of inherited autosomal recessive blood disorder. The genetic defect, which could be either mutation or deletion, results in complete absence or reduction synthesis of one of the globin chain that make up hemoglobin. This cause reduction of haemoglobin molecules production ,resulting in decreased of oxygen carrying capacity of the circulation thus causing anemia, the characteristic presenting symptom of the thalassemia. Good chelation therapy and regular blood transfusion protocol have increased the life expectancy.
Objectives : is to compare serum ferritin level and liver function test in a group of patients with beta thalassemia major in response to subcutaneous and oral chelating agent .
Patients and Methods: Prospective analytic study design done on group of 60 patients with beta thalassemia major diagnosed by hemoglobin electrophoresis registered in thalassemia center in AL – Zahra Teaching Hospital for Maternity and Children in AL- Najaf AL- Ashraf , during a period from
1st of February 2019 to 1st of February 2020, aged 2.5 to 17.9 years with serum ferritin levels above 1000 ng/ml and liver transaminases below 5 folds the normal upper limit .
The patients divided into 2 groups, 30 patients were on Deferasirox {Exjade} therapy and 30 patients were on Deferoxamine {Desferal} therapy .
Base line S. Ferritin value as well as LFT (S. GOT , S. GPT , ALP and TSB) value, were taken as base line level and then every (8-12) weeks and were used to assess the changes that occurred in response to subcutaneous and oral chelating agent .
Results : Our study show significant decline in SF (P value <0.05) in both groups after 1 year of treatment with oral or subcutaneous chelating agent. Patients on Exjade show more rate of decrement of serum ferritin (11%) compared to patients taken Desferal who a rate of decrement (6%). Patients on Exjade and Desferal therapy show increment in liver enzymes after 1 year of treatment with statistically significant results, p-value < 0.05 .
We found superiority in oral iron chelating agents (Exjade) to subcutaneous iron chelating agents (Desferal). Serum ferritin level is suitable for long term monitoring as an indicator of efficacy than liver biopsy .