Non-invasive parameters for the detection of variceal bleed in patients of liver cirrhosis, an experience of a tertiary care hospital in Pakistan

Objective: Cirrhotic patients commonly undergo screening endoscopy for the existence of esophageal varices. The use of this invasive procedure which is expensive, poorly tolerable and generally not acceptable for the patients is increasing due to increasing number of patients with chronic liver disease and their enriched survival. In this study, our aim is to identify clinical, biochemical, and ultrasonography parameters which might noninvasively predict the presence of esophageal varices and risk of bleeding in patients with liver cirrhosis. Material and Methods: Total 150 Patientsof chronic liver disease admitted in ward-5, JPMC(Sep 2011-Feb 2012) with a complaint of hematemesis or melena were included in the study. Platelet counts of 75,000 to 150,000/µL was defined as grade 1 thrombocytopenia, 50,000 to \u3c75,000/µL as grade II, 25,000 to \u3e\u3c50,000/µL as grade III and below 25,000/µL as grade IV. The normal range for the INR is 0.8–1.2. Portal vein size of 1.2 cm or above was taken as dilated. Spleen of \u3e13 cm was considered as enlarged in our study. Results: Out of 72 patients of variceal bleed 69 (46%) were males and 81(54%) were females. Thrombocytopenia was present in 64 (88%) patients with mean platelet count of 85.86/µL (±69.79). Deranged coagulation profile was present in 56 (77%) cases with mean INR of 1.63 (±0.5). Portal vein diameter (PVD) of \u3e1.2 cm was found in 46(63.8%) of patients with mean PVD of 1.22(±0.3023) and splenic size of \u3e13 cm was reported in 54 (75%) cases with mean splenic diameter of 14.5 cm (±2.39). Conclusion: Thrombocytopenia, deranged coagulation profile, large splenic size, and dilated portal vein strongly predict the risk of variceal bleeding

Antioxidant Enzymes and Germination Pattern: Upshot of High Salinity on Soluble Protein and Average Weight of Spinacia oleracea (Spinach) Seedlings

Spinach (Spinacia oleracea L.) is widely considered as a functional food mainly due to its various beneficial components including vitamins, minerals, phytochemicals, bioactive and antioxidant compounds that stimulate health beyond basic nutrition. The overwhelming agricultural crop at salinity conditions faced several abiotic and biotic stresses that unfortunately reduced the potential applicability of highly nutritious plants. Therefore, in this study the response of antioxidant enzymes were studied at different germination stages of the seedlings and results suggested that all antioxidant enzymes play a crucial role during oxidative stress. Spinach (Spinacia oleracea L.) seedlings had the potential to germinate remarkably well up to 800 mM NaCl concentration and the average weight of seedlings and soluble protein content was efficiently increased at high salinity. During oxidative stress, catalase, ascorbate peroxidase, guaiacol peroxidase, superoxide dismutase, and glutathione reductase significantly showed tolerances to salinity stress conditions. Among them, Ascorbate Peroxidase presented significant activity even at 600 mM of NaCl in germination stage 1. The antioxidant defense mechanism of Spinacia oleracea is activated at the very early stage of germination which perhaps helps the plant to survive under harsh conditions thus maintaining the nutritional components of the plant