title: Ischaemic Markers in Acute Hepatic Injury.
abstract: BACKGROUND
  Hepatic injury of varied aetiology may progress to Acute Liver Failure (ALF). Compromised microcirculation is thought to be a deciding factor of hepatic hypoxia may be involved in disease progression that needs early detection. Ischaemia markers like serum Ischaemia- modified albumin (IMA), ALT-LDH ratio and ALT-LDH index have been suggested for its detection at early stage.
  
  
  OBJECTIVE
  To find out the association of Ischaemia markers like serum IMA, ALT-LDH ratio and ALT-LDH index in acute hepatic injury cases.
  
  
  METHODS
  Forty one diagnosed acute liver injury cases of varied aetiology admitted in Department of Medicine, and Gastroenterology of SCB Medical College, Cuttack were enrolled in the study along with 30 age and sex matched healthy controls. Blood collected at time of admission and at time of discharge (1(st) day and 7(th) day) were evaluated for FPG, RFT, LFT, Serum Albumin along with serum LDH, IMA, PT-INR and platelet count.
  
  
  RESULTS
  Serum bilirubin, hepatic enzymes, IMA, PT-INR was more markedly raised in cases than controls on the 1(st) day of admission. ALT-LDH ratio and index were significantly low in complicated cases. However, on responding to treatment the ALT-LDH index on 7(th) day registered a rise in comparison to the 1(st) day, while serum IMA revealed an insignificant decline showing improvement in hepatic hypoxia. ALT-LDH ratio remains more or less same on response to treatment.
  
  
  CONCLUSIONS
  Serum IMA and ALT-LDH Index reveals association with disease process in Acute Hepatic Injury cases both clinically and biochemically and can be used as supportive parameters for the diagnosis of disease process.
authors.affiliation: Assistant Professor, Department of Biochemistry, SCB Medical College , Cuttack, Odisha, India .
authors.forename: Suchismita
authors.initials: S
authors.lastname: Panda
authors.affiliation: Assistant Professor, Department of Gastroenterology, SCB Medical College , Cuttack, Odisha, India .
authors.forename: Sushanta Kumar
authors.initials: SK
authors.lastname: Jena
authors.affiliation: Associate Professor, Department of Biochemistry, AIIMS , Raipur, Chattisgarh, India .
authors.forename: Rachita
authors.initials: R
authors.lastname: Nanda
authors.affiliation: Additional Professor, Department of Biochemistry, AIIMS , Bhubaneswar, Odisha, India .
authors.forename: Manaswini
authors.initials: M
authors.lastname: Mangaraj
authors.affiliation: Senior Resident, Department of Biochemistry, SCB Medical College , Cuttack, Odisha, india .
authors.forename: Parsuram
authors.initials: P
authors.lastname: Nayak
keywords: ALT-LDH Index; Acute liver failure; IMA