Background: Occult hepatitis C virus (HCV) infection is defined as the presence of HCVRNA in LIVER or peripheral blood mononuclear cells (PBMCs) in the absence of detectable hepatitis C antibody (anti-HCV) or HCV-RNA in the serum. Although occult HCV infection is less aggressive than classic chronic HCV infection, nevertheless it is important in management of hemodialysis (HD) patients. Occult HCV infection has been described in two different clinical settings: in patients with normal LIVER ENZYMES or in patients with abnormal values of LIVER ENZYMES. The aim of this study was to detect the occult HCV infection in hemodialysis patients with ELEVATED LIVER ENZYMES.Patients& Methods: This cross sectional study was performed in hemodialysis patients referring to 3 dialysis units in Tehran. In 30 anti-HCV negative HD patients with ELEVATED LIVER ENZYMES, presence of HCV-RNA in plasma samples was tested by Reverse Transcriptase-Nested Polymerase Chain Reaction (RT-nested PCR). In cases with negative anti-HCV and plasma HCVRNA, HCV-RNA was checked in PBMC specimens by RT-nested PCR.Results: A total of 30 HD patients with mean age 54.4 ± 14.1years and mean dialysis duration 81.2 ±64.4 months were enrolled in the study. All HD subjects were negative for HCV-RNA in plasma and occult HCV infection with RT-nested PCR method.Conclusion: Occult HCV infection was rare in HD patients with ELEVATED levels of LIVER ENZYMES.

Background: Diabetes mellitus (DM) is highly consequential to global health among chronic diseases. Due to a limited researches that have examined relationships between LIVER ENZYMES and DM, this study aimed to investigate the link between ELEVATED LIVER ENZYMES and diabetes among Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan cohort study (PGCS) population. Methods: This cross-sectional study was conducted on 10519 individuals. The demographic and clinical information of the participants was recorded. The changes in alanine aminotransferases (ALT) and aspartate aminotransferases (AST), alkaline phosphatase (ALP), and γ-glutamyltransferase (GGT) were evaluated. IBM SPSS Version 21 was used to analyze the data, with a significance level < 0.05. Results: The frequency of diabetes was 24.1% and was more prevalent in women than men (27.4% vs. 20.2%, p< 0.001). After removing all confederates, patients with ELEVATED ALT, AST, GGT, and ALP levels were 1.27, 1.27, 1.52, and 1.46 times more likely to have diabetes, respectively. The likelihood of developing diabetes rose in correlation with the number of ELEVATED LIVER ENZYMES, up to almost 1.77-fold among subjects with three or four increased LIVER ENZYMES. Conclusion: Patients diagnosed with diabetes exhibited significantly increased levels of LIVER ENZYMES compared to those without diabetes. Also, impairment of three or four LIVER ENZYMES demonstrated a positive correlation with an ELEVATED likelihood of DM. This indicates the importance of considering the LIVER status in the management of the DM population.

Background & aim: Hemolysis, ELEVATED LIVER ENZYMES, and low platelets syndrome (HELLP) was mimicked by several infectious conditions. It is critically important to distinguish these two, since their management and course differs, substantially. Case report: The case was a 27-year-old gravid patient with gestational age of 30 weeks who initially presented with headache and lower limb pain as well as leukopenia (and lymphopenia), normochromic normocytic anemia, thrombocytopenia, abnormal LIVER ENZYMES, increased lactate dehydrogenase enzyme and C-reactive protein. The patient was initially managed for HELLP syndrome, but due to the atypical presentation (low blood pressure and an episode of delirium when admitted), the novel coronavirus disease 2019 (COVID-19), realtime reverse transcription polymerase chain reaction (rRT-PCR) was requested for the patient that was positive. The spiral lung high-resolution computed tomography scan revealed changes compatible with COVID-19 diagnosis. Finally, the patient underwent uncomplicated normal vaginal deLIVERy at 39th gestational week. Conclusion: It is important to consider the COVID-19 in differential diagnosis of patients suspected to HELLP syndrome, as the isolation and treatment of the patient is different and time-sensitive.

Background: Acute LIVER failure (ALF) is caused by massive hepatocyte death and accompanied by severe coagulation disorder and encephalopathy. It often leads to multiple organ failure and subsequently death. However, the association between ALF and other organ failure remains unclear. Objectives: Here, we evaluated patients with acute LIVER injury (ALI) and ELEVATED pancreatic ENZYMES to demonstrate the association between ALI and pancreatic disorder. Methods: We conducted a single-center retrospective study to analyze patients with ALI. Between 2012 and 2017, 163 patients with ALI were treated in our hospital. We stratified patients based on whether serum amylase and lipase were ELEVATED above 1. 5 times the upper limit of normal. We compared the baseline characteristics, severity, prognosis, and serum cytokine levels between the two groups. Results: Of the 163 patients, 75 (54. 0%) presented ELEVATED pancreatic ENZYMES above 1. 5 times the upper limit of normal. Computed tomography imaging findings associated with pancreatitis were observed in 29 patients (17. 8%). The elevation of pancreatic ENZYMES was associated with ALI severity. High level of serum tumor necrosis factor-alpha (TNF-, ) was associated with the elevation of pancreatic ENZYMES (elevation group Vs. no elevation group: 134. 0, 177. 2 pg/mL Vs. 89. 4, 159. 8 pg/mL). Conclusions: The elevation of pancreatic ENZYMES was often accompanied by ALI and associated with ALI severity. TNF-,signaling was involved in the elevation of pancreatic ENZYMES. It is possible that the pancreatic disorder reflected ALI severity, consequently correlated with mortality, and did not directly aggravate ALI pathogenesis. These findings provide novel insights into the pathogenesis of ALF.

Background: Regular physical activity promotes health that can affect LIVER health, particularly modulating LIVER ENZYMES. The objective of this study was to assess the association between physical activities and ELEVATED LIVER enzyme levels in the population of the Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan cohort study (PGCS). Methods: This cross-sectional study was conducted on 10,519 individuals from the PGCS population. The demographical and clinical data of participants were collected. The study involved measuring the levels of physical activity and LIVER ENZYMES, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and γ-glutamyl transferase (GGT). The study assessed physical activity intensity using standardized classification based on the energy costs of different activities, which was calculated through questionnaires administered in three tertiles. The relationship between physical activity and ELEVATED LIVER ENZYMES was examined using the Cochran–Armitage test for trend and logistic regression. Results: The average age of individuals was 51.52±8.90 years, and 53.6% were women. The prevalence of ELEVATED ALT, AST, and GGT decreased with increasing physical activity (p<0.001, 0.010, and <0.001, respectively). According to fully adjusted model, participants with low physical activity levels had higher odds for ELEVATED ALT and GGT compared to the participants with high physical activity levels (OR=1.15, 95% CI: 1.04–1.31 and OR=1.37, 95% CI: 1.16–1.61, respectively) (p<0.05). Conclusion: Higher physical activity levels were associated with a lower prevalence of ELEVATED LIVER ENZYMES, suggesting that regular physical activity may positively affect LIVER health.

Background Type-2 diabetes is a risk factor for progressive non-alcoholic fatty LIVER disease and the majority of diabetic patients have blood lipid disorders, so they take statin drugs. Statins have the adverse effects such as LIVER dysfunction and increase in LIVER ENZYMES. The purpose of this study was to compare the LIVER ENZYMES in type 2 diabetic patients who are user and non-user of statin. Materials and Methods In a case-control study, increased LIVER ENZYMES (ALT and AST > 40 U/L) were measured in blood samples of 200 type II diabetic patients (with and without statin consumption) who referred to Mashhad Diabetes Clinic in Mashhad city (Iran), during May to November 2017. Levels of LIVER ENZYMES and anthropometric indices were measured for both groups. LIVER ENZYMES were assessed at the baseline of two groups. The SPSS 20th software was used for data analysis. Results The mean of Body mass index in two groups of diabetic patients with and without statin consumption had a significant difference (p <0. 05). The mean of ALP in both groups was not statistically significant, but the mean of LDL, ALT, AST and cholesterol levels in two groups of patients was statistically significant (p<0. 05). Conclusion Based on the results, cholesterol level in diabetic patients with statin consumption was higher than non-consuming group.