Characteristics of Hepatic Complications In Pf Malaria: A Study In A Tertiary Health Center

Abstract

Introduction: Malaria significantly impedes economic growth. It is brought on by Plasmodium infection and spread to people through the bite of a female anopheles mosquito. About 20% of the nation's malaria infections come from Orissa, and 85% of those cases are P. falciparum. The state accounts for 40% of malaria-related fatalities nationwide. Out of 39,556 positive cases and 9 fatalities in Odisha in 2019. Materials and Mathod:  Out of 450 hospitalised patients with acute severe malaria, 60 complex malaria cases presenting with jaundice were studied in this prospective case series research to better understand their clinical characteristics.  For a total of seven days, quinine dihydrochloride, 600 mg administered intravenously every eight hours, was administered to all patients.Results: The male to female ratio in the current study was 3:1, with 45 cases being men and 15 cases being women. Most instances—around 39 in total—belong to the 15–35 age bracket, or 65% of all cases. In every patient in our investigation, fever was the initial complaint.  The temperature was between 100 and 103 °F. Furthermore, the presence of cerebral symptoms in 24 (40%) of the patients would logically support a clinical diagnosis of Falciparum infection. On the other hand, liver enlargement was seen in 12 (20%) instances.39(65%) instances The spleen requires extended exposure to malarial infection. In the current investigation, 39 instances (65%) had elevated S.G.O.T, whereas 42 cases (70%) had elevated S.G.P.T. valves greater than 100 U/L. showing clear hepatocellular damage.In 30 cases (or 50% of the total), the SGOT was above 100U/L, and in 27 cases (or 45% of the total), the SGPT was over 100U/L (Table 9). SGPT and 145 u/1 for SGPT had the greatest value at 200. Only 15 people (or 25%) experienced a little rise in serum alkaline phosphatase. 79.2 U/L was the highest figure ever observed. Histopathology of the liver revealed evidence of swollen hepatocytes in 100% of cases, malarial pigment deposition (also known as "Hemozoin") in 75% of cases, inflammatory infiltrates in 60% of cases, congestion of hepatocytes in 50% of cases, and associated centrizonal necrosis in 25% of cases. Conclusion: Sever In malaria, concurrent viral hepatitis or underlying chronic liver disease are frequently linked to hepatic dysfunction. Patients who have malarial hepatopathy also run a higher risk of complications. Malarial Hepatopathy should be identified early on and vigorously treated since people who have it may do better than those who have the condition from other sources.