A Comparative Study of Serum Alt &Ast Level And Ast/Alt Ratio In Alcoholic And Non-Alcoholic Acute Uncomplicated Falciparum Malaria Without Clinical Jaundice

Serum alanine aminotransferase (ALT) and aspartate aminotransfarese levels and AST/ALT ratio in 28 alcoholic and 26 nonalcoholic cases suffering from acute uncomplicated anicteric plasmodium falciparum malaria, age ranging from 18-70 years of both sexes. No. Of males and females were 18 and 10 in alcoholic uncomplicated falciparum malaria and 14 & 12 in non-alcoholic uncomplicated falciparum malaria cases respectively. Cases for study were selected by random sampling among the patients suffering from fever admitted in department of medicine,rajendra institute of medical sciences, ranchi,who were subsequently proved by clinical and laboratory assessment to be cases of acute uncomplicated anicteric falciparum malaria and not associated with any other systemic and organic involvements. Cases were divided in two groups comprising both males and female, alcoholics and non alcoholics on the basis of history of alcohol intake. Serum ALT &AST levels in all the cases selected for study were estimated once at admission. The mean serum ALT&AST levels were found to increase significantly in both groups but ALT&AST levels were greater in alcoholic patients than in non alcoholic patients. The mean AST/ALT ratio was found to be more than one in both groups but it was marginally more in alcoholic patients and the AST/ALT ratio found in both the studygroups would have been more than the commonly encountered chronic liver diseases like non-alcoholic steatohepatitis, chronic hepatitis c and chronic hepatitis b as per the review of previous reports and the ratio was less than the patients of denovo alcoholic liver disease. So the conclusion drawn was mean serum ALT&AST level and AST/ALT ratio were higher in alcoholic patients in comparison to nonalcoholic patient emphasizing the predictive value for the future hepatic dysfunction and to start the adequate and aggressive management at the earliest to prevent the further complication. The AST/ALT ratio>1 reported previously to be highly specific for the diagnosis of alcoholic liver disease only but the present study confirms that the AST/ALT ratio as noninvasive means of assessing liver disease must be done with caution in tropical area where falciparum malaria fever have been amongst the leading causes of hospitalisation.