A Correlation of Cerebral Malaria with Different Changes in Hepatitis: A Hospital Based Study

  • Pratap Singh Principal Specialist (General Medicine), Haridev Joshi Hospital, Dungarpur, Rajasthan, India.
Keywords: Ventilator associated pneumonia, Intensive care unit, Multi drug resistant, Endotracheal aspirates

Abstract

Background: Ventilator associated pneumonia (VAP) is a type of nosocomial pneumonia occurring in patients who are mechanically ventilated for more than 48 hours. VAP is the most common nosocomial infection occurring in the intensive care units and its incidence varies from 8% to 28%.

AIMS & OBJECTIVES- This study was done to determine the bacteriological profile and antibiotic sensitivity pattern of the isolates obtained from the endotracheal aspirates of the clinically suspected patients of VAP in ICU.  Materials & Methods: The study was conducted in the department of general medicine of the Haridev Joshi Hospital, Dungarpur, Rajasthan, India. The present study included 52 patients who had serum bilirubin > 3 mg%. So, after excluded patient the study group included 45 patients. All patients were underwent a set of investigations, including conjugated and unconjugated bilirubin, and serum AST and ALT levels. All the patients with cerebral malaria underwent detailed ultrasonography to check the size and echo-texture of the liver. Results: A total of 45 patients with malaria were included in the study. The mean serum bilirubin level was 11.23+6.8 mg %, mean AST levels was 298.42+242.21 IU/l and mean ALT levels was 382.21+298.12 IU/l. 17 patients were diagnosed having cerebral malaria. The patients with cerebral malaria were directed to undergo USG abdomen. Enlarged size if liver was seen 14 patients.  Conclusion: Within the limitations of our study we conclude that significant hepatitis findings are seen in patients with cerebral malaria. Required supportive and anti-malarial treatment should be provided to the patients with specially taking care of the hepatic health.

 

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References

1. World Health Organization. Communicable diseases. WHO Malaria facts and figures. World Health Organization, Europe. 2011.
2. Casals PC and Roberts D.et al Malaria and the red cell. Vox Songuinis 2004; 87(2): 115‐119.
3. I Mueller, PA Zimmerman, JC Reeder, Trends Parasitol. 2007, 23 (6) 278 – 283.
4. Onyesom and N. Onyemakonor, Levels of Parasitaemia and Changes in Some Liver Enzymes among Malarial Infected Patients in EdoDelta Region of Nigeria. Current Research Journal of Biological Sciences 2011; 3(2): 78-81.
5. Whitten R, Milner DA, Yeh MM, Kamiza S, Molyneux ME, Taylor TE: Liver pathology in Malawian children with fatal encephalopathy. Hum Pathol. 2011, 42: 1230-1239. 10.1016/j.humpath.2010.11.019.
6. Prommano O, Chaisri U, Turner GD, Wilairatana P, Ferguson DJ, Viriyavejakul P, White NJ, Pongponratn E: A quantitative ultrastructural study of the liver and the spleen in fatal falciparum malaria. Southeast Asian J Trop Med Public Health. 2005, 36: 1359-1370.
7. Molyneux ME, Looareesuwan S, Menzies IS, Grainger SL, Phillips RE, Wattanagoon Y, et al. Reduced hepatic blood flow and intestinal malabsorption in severe falciparum malaria. Am J Trop Med Hyg 1989;40:470-6. 27.
8. Abro AH, Ustadi AM, Abro HA, Abdou AS, Younis NJ, Akaila SI. Jaundice with hepatic dysfunction in P. falciparum malaria. J Coll Physicians Surg Pak 2009;19:363-6.
9. Viriyavejakul P, Khachonsaksumet V, Punsawad C. Liver changes in severe Plasmodium falciparum malaria: histopathology, apoptosis and nuclear factor kappa B expression. Malaria Journal. 2014;13:106. doi:10.1186/1475-2875-13-106.
10. Kochar DK, Agarwal P, Kochar SK, Jain R, Rawat N, Pokharna RK, Kachhawa S, Srivastava T. Hepatocyte dysfunction and hepatic encephalopathy in Plasmodium falciparum malaria. An International Journal of Medicine, Volume 96, Issue 7, 1 July 2003, Pages 505–512.
11. Andrade BB, Santos CJN, Camargo LM, Souza-Neto SM, Reis-Filho A, Clarêncio J, et al. (2011) Hepatitis B Infection Is Associated with Asymptomatic Malaria in the Brazilian Amazon. PLoS ONE 6(5): e19841.
12. Enemchukwu BN, Ibe CC, Udedi SC, Iroha A, Ubaoji KI, Ogundapo SS. Liver function assessment in malaria, typhoid and malaria-typhoid co-infection in Aba, Abia State, Nigeria. Pak J Biol Sci. 2014 Jun;17(6):860-3.
Published
2018-03-21
How to Cite
1.
Singh P. A Correlation of Cerebral Malaria with Different Changes in Hepatitis: A Hospital Based Study. International Archives of BioMedical and Clinical Research [Internet]. 21Mar.2018 [cited 26Apr.2018];4(1):72-4. Available from: https://iabcr.org/index.php/iabcr/article/view/271