Online ISSN: 2515-8260

Keywords : bilirubin

Prospective Analysis Of Pre-Operative Role Of Rise In Bilirubin In Acute Appendicitis

Dr. Ritesh Kumar Agarwal; Dr. Jagdish Mutreja; Dr. Shashank Rai; Dr. Anshul Sharma .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 8, Pages 2038-2050

Aim: To study the diagnostic role of rise in bilirubin in Acute appendicitis.
Materials and method: Prospective analytical study of Pre-operative Role of Rise in Bilirubin in acute appendicitis was carried out in December 2019 – April 2021. All cases coming with uncomplicated acute appendicitis admitted during study period in Sharda Hospital, Gr. Noida, UP. were included in study. Patients withPre-operative diagnosed case of acute appendicitis with age above 18 years were included. The patients with Complicated appendicitis, Negative proved specimen on Histopathalogy Examination, Patients suffering from Positive HBs Ag, Previous history of Jaundice, Chronic Alcoholism (daily intake of >40 ml for male &>20 ml for female),Patients suffering from Hemolytic Disease, Congenital biliary disease, Hepato-biliary malignancy, Recent history of liver trauma, Cholelithiasis, Females with history of oral contraceptive pill, Patients with history of Statins, Pregnancy were excluded from the study. A detailed history, complete physical examination and routine & appropriate investigations were done for all patients.
Results: The mean age of the study population was 29.46±9.81 (18-70) years with majority of the study population belonging to 18-30 years (62.7%) followed by 31-40 years (22.7%) and above 39 years (14.5%). The study population consisted of 78 (70.9%) males and 32 (29.1%) females. The mean Total Sr. Bilirubin (mg/dL), Direct (mg/dL) and Indirect (mg/dL) among study population was 0.98±0.37 (0.29-2.11), 0.77±0.33 (0.28-1.72) and 0.20±0.21 (0.00-1.73). The mean Alvarado Score of the study population was 7.40±0.59 (7-9). The mean Total Sr. Bilirubin (mg/dL) was significantly more among subjects with Alvarado score≥ 7 compared to subjects with Alvarado score7. Frequency Percent Paracaecal 18 16.4% Pelvic 1 0.9% Retrocaecal 89 80.9% Subcaecal 2 1.8% Total 110 100.0% The Pre-operative findings showed that appendicitis was Paracaecal, among 18 (16.4%), Pelvic, among 1 (0.9%), Retrocaecal, among 89 (80.9%) and Subcaecal, among 2 (1.8%) subjects. There was no significant difference in mean TLC (/mm3) between subjects with Abnormal and Normal Bilirubin level. The mean C-Reactive Protein (mg/dL) was significantly more among subjects with Abnormal Bilirubin level compared to Normal Bilirubin level.


Dr Ramaswami B,Dr Natarajkumar, Dr Rakesh Shaganti

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 331-335

To study the incident of gallstone stone in different age and sex.
Cross-sectional observational study,
Place and duration of study:
Mamata Medical College and General Hospital, Khammam from October 2018 to September 2020.
RESULTS: In the present study, among 50 cases, 41 (82%) were females and 9 (18%) were males
with male to female ratio of 1:4.5. Representing the majority of the study population were females.
Out of these 3 cases two were pigmented, one was cholesterol stone. But Chi-square statistic at 0.866
with P value of 0.64. Out of 41 female patients in the present study, 10 had a history of OCP use at
some point in their life. Among them 5, 4, 1 patients had pigment, cholesterol and mixed stones.
Mean serum bilirubin value was more among pigmented stone group (1.069 mg/dl) as compared to
mixed (0.850 mg/dl) and cholesterol group (0.6 mg/dl). Mean serum cholesterol group (3.382 mg/dl).
CONCLUSION: On the basis of the above observations, it is possible to say that pigment gallstone
patients have high serum bilirubin, calcium and phosphate levels and the type of gallstone doesn’t
depend on age, sex, BMI status and OCP usage.

Cord blood albumin as a predictor of significant neonatal hyperbilirubinemia in normal term healthy newborn

Dr. Dharmagadda Sai Krishna, Dr. Hemant Gupta, Dr. Neelam Grover, Dr. Bharti Kawatra, Dr. Kiranjeet Kaur

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 18-24

Introduction: Hyperbilirubinemia is the most common morbidity in normal term healthy
newborn. There is evidence that cord blood albumin (CBA) level can act as a potential marker
for the prediction of hyperbilirubinemia in neonates. The present study was therefore designed
to establish a correlation between the level of cord blood albumin (CBA) and total serum
bilirubin (TSB) so that albumin level could be standardized as a prediction marker for the
neonatal hyperbilirubinemia.
Methods: CBA and TSB levels were analysed in 500 normal term healthy newborns with birth
weight ≥2500 grams and APGAR score ≥ 7/10 at 1 min and 5 mins, after obtaining consent
from their parents. Albumin levels were analysed from the cord blood at the time of birth and
TSB levels were analysed from venous blood. Pearson’s correlation coefficient was used to
analyse the correlation between CBA and TSB levels.
Results: The mean CBA was 2.94 ± 0.34 g/dl and mean TSB was 11.17 ± 2.52 mg/dl. The
relationship between CBA and TSB values was statistically significant on further analysis of
CBA with the modality of treatment, the results were again statistically significant. The
correlation between CBA and TSB was also observed with negative correlation of r = - 0.43
with p value of <0.0001 which was highly significant.
Conclusion: Newborns with high CBA levels have low risk of developing neonatal
hyperbilirubinemia and can be discharged early from hospital. Whereas low CBA is an
indicator for developing neonatal hyperbilirubinemia in the first week of life.


Brungi Asha Jyothi, Madupathi Anil Babu

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11780-11786

Background:Preeclampsia is a multisystem disorder, which occurs only in pregnant women during the second and third trimesters of pregnancy and is associated with raised blood pressure and proteinuria. It rarely presents before 20 weeks of gestation like in hydatidformmole.Eclampsia is a syndrome with one or more episodes of convulsions in association with preeclampsia. In India, the national incidence of hypertensive disorders   is 15.2%,with incidence in nulliparous women being four times greater than in multipara.Liver Function Test (LFT) abnormalities occur in 3% of the pregnancies, and preeclampsia is the most frequent cause6.In HELLP syndrome, an elevation in liver function test results is noted7. Periportal hemorrhagic necrosis in the periphery of the liver lobule is probably the lesion that causes elevated serum liver enzymes.AIM: To Study and compare liver function tests in Pre-eclampsia and Eclampsia with normal healthy pregnant women and assess the ante-partum severity in both the diseases.
Materials and Methods: Study was conducted on 70 pregnant women admitted with pre-eclampsia and eclampsia and 35 normal pregnancy patients in between 19-26 yrs of age in third trimester of pregnancy.
Results: There is an increase in Diastolic blood pressure in mild pre-eclampsia and significant increase in severe pre-eclampsia and eclampsiapatientswhen compared to controlsThere is an increase in AST, ALT, LDH parameters in mild pre-eclampsia and significant increase in severe pre-eclampsia and eclampsia patientswhen compared to controls except for bilirubin.
Conclusion: There is a derangement of parameters of LFT in severe preeclampsia and eclampsia. But there was no significant elevation in mild pre-eclampsia.Persistant liver parameter that  increased was ALT (as it is more specific to the liver damage). These can be taken as a predictor of the disease.