Background/Aims: Acute exacerbations of chronic hepatitis B (CHB-AEs) are common in endemic areas and are often presumed to be acute hepatitis B (AHB) due to their similarities in clinical and serological pictures, presenting a major diagnostic dilemma. This study aimed to identify laboratory markers for differentiating between the two groups, and to establish the cut-off value for significant markers. Methods: A retrospective analysis of records was conducted for patients who presented with clinical features of acute hepatitis along with hepatitis B surface antigen (HBsAg) and IgM antibody to hepatitis B core antigen (IgM anti-HBc) positivity from May 2015 to May 2017. A total of 172 patients were enrolled and grouped as AHB (n=89) and CHB-AE (n=83) based on their history of hepatitis B virus infection and duration of HBsAg persistence. Virological and biochemical parameters were analyzed and compared. Cut-off values, sensitivity, and specificity of the variables were calculated. Results: The median value of signal by cut-off (S/Co) ratio for IgM anti-HBc was significantly higher in AHB group (30.44) compared to CHB-AE group (8.63) with a sensitivity and specificity of 97% and 84%, respectively, at a cut-off of 20.5 (P<0.01). The mean international normalized ratio (INR) was significantly greater in CHB-AE (1.88±1.24) group compared to AHB group (1.62±0.17) with a sensitivity and specificity of 57.9% and 45.1%, respectively, at a cut-off value of 1.27. Conclusions A value of 20.5 S/Co of IgM anti-HBc and 1.27 INR could be helpful in differentiating between AHB and CHB-AE.

The complex architecture of the papillary muscles (PMs) of the ventricles plays a crucial role in cardiac function and pathology. This comparative study aimed to examine the differences in PMs morphology between the right and left ventricles, focusing on their number, location, and shape. A total of 38 grossly normal hearts from donated bodies were dissected, and the number, location, and shape of PMs in both ventricles were observed. In this study, the left ventricle predominantly exhibited a single PM with 71.05% on the sternocostal surface and 57.89% on the diaphragmatic surface.The right ventricle showed a higher prevalence of single PM, at 89.47% on the sternocostal surface and 63.16% on the diaphragmatic surface. Broad-based shape of the PM emerged as the predominant variant, constituting 55.26% and 44.73% on the sternocostal and diaphragmatic surfaces of the left ventricle, respectively. In contrast, conical-shaped PM predominated in the right ventricle. Unique findings included “H” and “b” shaped muscles, conjoint PMs were observed exclusively in the left ventricle, and small papillary projections with direct tendinous cord attachment in the right ventricle. A distinct webbed shaped configuration of PM was exclusively observed in the right ventricle in only one specimen. No significant difference (P=0.84) was noted in muscle bellies between ventricular surfaces. This study emphasizes the complexity and variability in PM morphology, highlighting the importance of a thorough understanding of these structures for cardiothoracic surgeons, radiologists, and cardiologists to enhance interventional techniques.

The complex architecture of the papillary muscles (PMs) of the ventricles plays a crucial role in cardiac function and pathology. This comparative study aimed to examine the differences in PMs morphology between the right and left ventricles, focusing on their number, location, and shape. A total of 38 grossly normal hearts from donated bodies were dissected, and the number, location, and shape of PMs in both ventricles were observed. In this study, the left ventricle predominantly exhibited a single PM with 71.05% on the sternocostal surface and 57.89% on the diaphragmatic surface.The right ventricle showed a higher prevalence of single PM, at 89.47% on the sternocostal surface and 63.16% on the diaphragmatic surface. Broad-based shape of the PM emerged as the predominant variant, constituting 55.26% and 44.73% on the sternocostal and diaphragmatic surfaces of the left ventricle, respectively. In contrast, conical-shaped PM predominated in the right ventricle. Unique findings included “H” and “b” shaped muscles, conjoint PMs were observed exclusively in the left ventricle, and small papillary projections with direct tendinous cord attachment in the right ventricle. A distinct webbed shaped configuration of PM was exclusively observed in the right ventricle in only one specimen. No significant difference (P=0.84) was noted in muscle bellies between ventricular surfaces. This study emphasizes the complexity and variability in PM morphology, highlighting the importance of a thorough understanding of these structures for cardiothoracic surgeons, radiologists, and cardiologists to enhance interventional techniques.

The complex architecture of the papillary muscles (PMs) of the ventricles plays a crucial role in cardiac function and pathology. This comparative study aimed to examine the differences in PMs morphology between the right and left ventricles, focusing on their number, location, and shape. A total of 38 grossly normal hearts from donated bodies were dissected, and the number, location, and shape of PMs in both ventricles were observed. In this study, the left ventricle predominantly exhibited a single PM with 71.05% on the sternocostal surface and 57.89% on the diaphragmatic surface.The right ventricle showed a higher prevalence of single PM, at 89.47% on the sternocostal surface and 63.16% on the diaphragmatic surface. Broad-based shape of the PM emerged as the predominant variant, constituting 55.26% and 44.73% on the sternocostal and diaphragmatic surfaces of the left ventricle, respectively. In contrast, conical-shaped PM predominated in the right ventricle. Unique findings included “H” and “b” shaped muscles, conjoint PMs were observed exclusively in the left ventricle, and small papillary projections with direct tendinous cord attachment in the right ventricle. A distinct webbed shaped configuration of PM was exclusively observed in the right ventricle in only one specimen. No significant difference (P=0.84) was noted in muscle bellies between ventricular surfaces. This study emphasizes the complexity and variability in PM morphology, highlighting the importance of a thorough understanding of these structures for cardiothoracic surgeons, radiologists, and cardiologists to enhance interventional techniques.

The complex architecture of the papillary muscles (PMs) of the ventricles plays a crucial role in cardiac function and pathology. This comparative study aimed to examine the differences in PMs morphology between the right and left ventricles, focusing on their number, location, and shape. A total of 38 grossly normal hearts from donated bodies were dissected, and the number, location, and shape of PMs in both ventricles were observed. In this study, the left ventricle predominantly exhibited a single PM with 71.05% on the sternocostal surface and 57.89% on the diaphragmatic surface.The right ventricle showed a higher prevalence of single PM, at 89.47% on the sternocostal surface and 63.16% on the diaphragmatic surface. Broad-based shape of the PM emerged as the predominant variant, constituting 55.26% and 44.73% on the sternocostal and diaphragmatic surfaces of the left ventricle, respectively. In contrast, conical-shaped PM predominated in the right ventricle. Unique findings included “H” and “b” shaped muscles, conjoint PMs were observed exclusively in the left ventricle, and small papillary projections with direct tendinous cord attachment in the right ventricle. A distinct webbed shaped configuration of PM was exclusively observed in the right ventricle in only one specimen. No significant difference (P=0.84) was noted in muscle bellies between ventricular surfaces. This study emphasizes the complexity and variability in PM morphology, highlighting the importance of a thorough understanding of these structures for cardiothoracic surgeons, radiologists, and cardiologists to enhance interventional techniques.

The complex architecture of the papillary muscles (PMs) of the ventricles plays a crucial role in cardiac function and pathology. This comparative study aimed to examine the differences in PMs morphology between the right and left ventricles, focusing on their number, location, and shape. A total of 38 grossly normal hearts from donated bodies were dissected, and the number, location, and shape of PMs in both ventricles were observed. In this study, the left ventricle predominantly exhibited a single PM with 71.05% on the sternocostal surface and 57.89% on the diaphragmatic surface.The right ventricle showed a higher prevalence of single PM, at 89.47% on the sternocostal surface and 63.16% on the diaphragmatic surface. Broad-based shape of the PM emerged as the predominant variant, constituting 55.26% and 44.73% on the sternocostal and diaphragmatic surfaces of the left ventricle, respectively. In contrast, conical-shaped PM predominated in the right ventricle. Unique findings included “H” and “b” shaped muscles, conjoint PMs were observed exclusively in the left ventricle, and small papillary projections with direct tendinous cord attachment in the right ventricle. A distinct webbed shaped configuration of PM was exclusively observed in the right ventricle in only one specimen. No significant difference (P=0.84) was noted in muscle bellies between ventricular surfaces. This study emphasizes the complexity and variability in PM morphology, highlighting the importance of a thorough understanding of these structures for cardiothoracic surgeons, radiologists, and cardiologists to enhance interventional techniques.