Serum and amniotic fluid mucoproteins in normal and toxaemic pregnancy

Serum and amniotic fluid mucoprotein concentrations were estimated in normal and toxaemic pregnant women. The levels were found to be higher in preeclampsia and eclampsia than the normal controls. Comparatively higher concentrations were observed in amniotic fluid than serum. Data suggest that the estimation of serum and amniotic fluid mucoproteins may be useful in assessing the severity of toxaemia of pregnancy and fetal well being.     

Effect of l-Arginine on Nitric Oxide Levels in Intrauterine Growth Restriction and its Correlation with Fetal Outcome

The current management of intrauterine growth restriction (IUGR) being empirical and aimed at selecting a safe time for delivery. Acknowledging the beneficial effects of l-arginine on endothelial vasculature the present study was designed to evaluate efficacy of l-arginine on bioavailability of nitric oxide (NO) with respect to fetal outcome. With l-arginine supplementation, mean NO levels were significantly increased and a significant mild reduction in systolic/end-diastolic velocity ratio (S/D ratio) was observed on doppler blood flow study, also neonatal outcome improved and incidences of complications were lowered. A deficiency in NO may play an important role in the causation of asymmetric fetal growth restriction. l-Arginine can be used to increase maternal NO levels, enhancing birth weight and decreasing neonatal morbidity. The ideal candidate for arginine therapy according to our study would be IUGR cases with S/D ratio less than 4.96 ± 0.49 and NO levels below 33 μmol/L with minimum of 3 weeks duration of arginine supplementation.     

Further studies on serum arginase as indicator of hepatocellular damage

Studies on serum arginase have shown that it is having the least unexplained variation and its activity is closely related with the severity of jaundice. Arginase is thus stable, consistent, efficient, specific and sensitive to changes. It is a better indicator of hepatocellular damage.     

Dyslipidemia in pregnancy may contribute to increased risk of neural tube defects -a pilot study in north Indian population

Neural tube defects are congenital structural abnormalities of the brain and vertebral column resulting from improper or non-timely closure of the neural tube. Prevalence of neural tube defects is reported to be higher among women with diabetes mellitus and obesity. This study was designed to investigate the relation between the presence of dyslipidemia in antenatal patients and the risk of fetal neural tube defects. The present study was an observational, cross-sectional study involving 129 pregnant women in 16 to 18 weeks gestation period. Of these, 80 women had normal pregnancies and 49 were clinically high-risk cases for neural tube defects. Fasting blood samples were analyzed for blood sugar and lipid profile by enzymatic assay and alpha-fetoprotein levels using Enzyme Immunoassay. Alpha-fetoprotein (AFP) values were converted to Multiples of Median (MoM) appropriate for the gestational age. Based on AFP values, women were labeled as screen negative (AFP <2 MoM, n= 102) and screen positive (AFP > 2 MoM, n =27). Screen positive women were further evaluated by ultrasound and 21 women were found to carry a neural tube defects positive pregnancy. Statistical analysis was done on SPSS software. Body weight of the women showed a significant positive correlation with serum triglycerides, plasma sugar and AFP MoM values. A significant difference was observed in serum cholesterol levels (p= 0.038), triglycerides (p=0.001) and plasma sugar levels (p=0.002) between normal women and those with neural tube defects positive pregnancy. The Odds ratio for neural tube defects risk in dyslipidemic cases was 24.23 (CI 4.73 − 148.60) with a relative risk of 12.12. Dyslipidemia especially hypertriglyceridemia was found to be significantly associated with fetal neural tube defects.     

Plasma proteinase inhibitory activity in ectopic and molar pregnancy

Antitryptic, antichymotryptic and alpha 2- macroglobulin activities were measured in sera of normal nonpregnant and normal pregnant women and women with tubal ectopic pregnancy and molar pregnancies in the first 5 to 7 weeks of pregnancy calculated from the last menstrual period. While alpha 2-macroglobulin decreased in early normal pregnancy compared to nonpregnant state (p<0.001), in ectopic and molar pregnancies there was an increase in alpha 2- macroglobulin activity (p < 0.001), as compared to nonpregnant and normal pregnant women. Antitryptic activity did not increase in normal and ectopic pregnancy, however was increased in molar pregnancy (p < 0.01). Antichymotryptic activities did not show a change either in normal pregnancy or in cases of ectopic and molar pregnancy. Drop in alpha 2- macroglobulin activity to near normal levels in ectopic, 6 weeks post surgery, correlated well with the decrease in β-hCG. However, in molar pregnancy, alpha 2- macroglobulin remained elevated even when the β-hCG levels in serum returned to zero 10 weeks after surgery. The studies suggest a major role for circulating proteinase inhibitors especially alpha 2-macroglobulin in regulating proteinase activity in normal, ectopic and molar pregnancy.     

Paraoxonase 1 activity and phenotype distribution in premenopausal and postmenopausal women

Introduction

Postmenopausal women have higher risk of cardiovascular disease. One of the contributing factors could be reduced activity of anti-atherogenic enzyme paraoxonase 1 (PON1). The aim of this study was to examine differences in the lipid status, paraoxonase and arylesterase PON1 activities and PON1 phenotype in women with regular menstrual cycle and in postmenopausal women.

Materials and methods:

The study included 51 women in reproductive age (25 in follicular and 26 in luteal phase of the menstrual cycle) and 23 women in postmenopause. Lipid parameters in sera were determined using original reagents and according to manufacturer protocol. PON1 activity in serum was assessed by spectrophotometric method with substrates: paraoxon and phenylacetate. PON1 phenotype was determined by double substrate method.

Results:

Compared to the women in follicular and luteal phase, postmenopausal women have significantly higher concentration of triglyceride [0.9 (0.7–1.3), 0.7 (0.6–1.0) vs. 1.5 (0.9–1.7) mmol/L; P = 0.002], cholesterol [5.10 (4.78–6.10), 5.05 (4.70–5.40) vs. 6.30 (5.73–7.23) mmol/L; P < 0.001], LDL [3.00 (2.56–3.63), 3.00 (2.70–3.70) vs. 3.90 (3.23–4.50) mmol/L; P < 0.001], and apolipoprotein B [0.88 (0.75–1.00), 0.79 (0.68–1.00) vs. 1.07 (0.90–1.24) mmol/L; P = 0.002]. PON1 basal [104 (66–260), 106 (63–250) vs. 93 (71–165) U/L; P = 0.847] and salt-stimulated paraoxonase activity [210 (131–462), 211 (120–442) vs. 180 (139–296) U/L; P = 0.857] as well as arylesterase activity [74 (63–82), 70 (54–91) vs. 70 (60–81) kU/L; P = 0.906] and PON1 phenotype (P = 0.810) were not different in the study groups.

Conclusion:

There are no differences in PON1 activity and PON1 phenotype between women with regular menstrual cycle and postmenopausal women.     

Study of serum lipid profile in pregnancy induced hypertension

Four groups of subjects: normal healthy normotensive nonpregnant women (Group A), normal normotensive pregnant women (Group B), women with preeclamptic toxaemia (Group C) and eclamptic women (Group D): with fifty subjects in each group, were investigated for serum lipid profile in the third trimester of pregnancy. There was significant increase in serum triglyceride and VLDL cholesterol leve as well as decrease in LDL cholesterol in normal pregnancy, while total cholesterol and HDL cholesterol levels did not show any statistically significant alteration. The preeclampsia (Group C) was associated with a significant rise in triglyceride and VLDL cholesterol and fall in HDL cholesterol concentration, while eclamptic women showed significant fall in HDL cholesterol and rise in LDL cholesterol as compared to normal pregnant women. However, interestingly, elevation of the ratios of total cholesterol: HDL cholesterol and triglyceride: HDL cholesterol as well as diminuition of the ratio of HDL cholesterol: VLDL cholesterol showed statistical significance in pregnancy induced hypertension in both Groups C and D, while eclamptic women showed significant elevation of LDL cholesterol: HDL cholesterol ratio in addition.     

Potential Biochemical Markers for Preterm Labor: A Pilot Study in North India

Preterm delivery is a major contributor for neonatal mortality. Intensive research is underway to establish a reliable biomarker that can ascertain the risk of preterm delivery in pregnant women. The aim of our study was to evaluate the role of various biochemical parameters as potential biomarker for risk assessment for preterm labor. Forty women presenting with preterm labor and 40 women who delivered at term were included in the study. Parameters that were evaluated include corticotrophin (ACTH), prolactin, thyroid stimulating hormone (TSH), ferritin and Alkaline Phosphatase (ALP). Serum ACTH, ferritin, ALP and Ferritin/Iron ratio were significantly higher in the subjects who delivered prematurely as compared to the controls. Comparison of sensitivity, specificity, likelihood ratio, positive and negative predictive values for different cut offs for ACTH, ferritin, ALP and ferritin/iron ratio was carried out. Ferritin emerged as the best marker with area under curve of 0.96 as compared to 0.88 for ACTH, 0.825 for ALP and 0.735 for ferritin/iron ratio. Our study establishes the superiority of ferritin as a predictive biomarker for preterm labor as compared to the rest of the parameters evaluated.     

用C/S和B/S模型构建高校科研管理信息系统的网络平台

对传统的C／S模型和新兴的B／S模型的构建进行了描述，C／S和B／S体系为科研管理的网络平台的铺设提供了良好的开发模式。对其的优劣进行比较，并认为这两种模式将会长期协调发展。正确、合理地结合二者的优势，可发挥其最大效益，实现科研管理系统的高效运行。     

Women in sports: the applicability of common national reference intervals for inflammatory and coagulation biomarkers (HemSter Study)

IntroductionIntensive physical activity causes functional and metabolic changes in the athlete’s organism. The study aimed to verify the common national available reference intervals (RIs) for common inflammatory and screening coagulation tests in a population of healthy young female athletes.Materials and methodsOne hundred and twenty-one female athletes (age range: 16–34), from various sports disciplines (water polo, handball, volleyball, football, basketball), were included in the study. All participants completed the international physical activity short-form questionnaire. Blood samples were collected between 8–10 am, after an overnight fast, before any physical activity. Reference intervals were determined according to Clinical & Laboratory Standards Institute EP28-A3C Guidelines.ResultsCalculated RIs for white blood cell count (WBC), prothrombin time (PT), and activated partial thromboplastin time (APTT) ratio were in accordance with the common national RIs. Calculated RI for C-reactive protein (CRP) was lower (< 2.9 mg/L) than the proposed cut-off for a healthy population (< 5.0 mg/L). Reference interval for fibrinogen was higher (1.9–4.4 g/L), than the available RIs (1.8–3.5 g/L). D-dimer cut-off value was set at 852 µg/L fibrinogen equivalent units (FEU), higher than the proposed 500 µg/L FEU for venous thromboembolism (VTE) exclusion.ConclusionsThe applicability of the available RIs for WBC count, PT, and APTT-ratio was confirmed. However, RIs for CRP and fibrinogen differed significantly than the available common national RIs for the healthy non-athletes’ population. A higher cut-off for D-dimers should be extensively verified before implementation for VTE diagnosis exclusion in a group of healthy young female athletes.     

Impact of iodine deficiency on thyroid function in pregnant African women — A possible factor in the genesis of ‘small for dates’ babies

The effect of iodine deficiency (ID) on thyroid function in African women during pregnancy and postnatal period was examined, for which very limited information is available. Serum T₄, T₃, TSH, TBG, thyroxine binding capacity (TBK), free thyroxine index (FT₄I=T₄/TBK) and T₄/TBG were determined by ELISA technique in 32 pregnant women (resident of Plateau state, Nigeria- an ID zone) through pregnancy upto term delivery, and in 5 women up to 6 weeks post delivery. Urinary iodide level was measured at delivery to determine the degree of iodine deficiency. Results were matched with a non pregnant control comprising 44 subjects. 5555 birth weights (BW) of term babies in the region were analysed to determine the prevalence of ‘small for dates’ (SFD) babies in the population. Results show that the level of serum FT₄I was elevated very significantly at late gestation (P<.001) but the women were not hyperthyroid, suggesting a marked disturbance in binding of T₄ with TBG during pregnancy. Five women with SFD babies were found in ‘compensated hypothyroid state’ and showed a significant depression (p<.01) in serum T₄/TBG, T₄, FT₄I and T₃ levels to a low normal range, with a concurrent significant rise (p.<.001) in TSH level (above normal range) throughout pregnancy. Incidence of SFD babies was higher (p.<.001) in ID zone (Bassa 15.2%) compared to control zone (Jos 9.8%). It is concluded that a state of maternal ‘subclinical (compensated) hypothyroidism’ during pregnancy possibly plays an important role in the aetiopathogenesis of SFD babies in Africans. A normal reference range for thyroid parameters at various stages of pregnancy in healthy African women is established for the first time.     

Studies on serum amylases in carcinoma of liver,biliary tract and pancreas

Total amylase activity, its isoenzymes and pancreatic to salivary ratio were studied in 33 healthy subjects and 52 patients with hepatobiliary and pancreatic malignancies of which 12 were with hepatocellular carcinoma, 12 with liver metastases, 9 with carcinoma of gall bladder, 6 with obstructive jaundice, 7 with periampullary carcinoma and 6 cases with carcinoma of pancreas. Total amylase was found to be elevated in carcinoma of pancreas and periampullary carcinoma compared to normal whereas in obstructive jaundice the values were decreased significantly (p<0.001). P (Pancreatic) fraction was found to be elevated significantly in all except in carcinoma of pancreas and obstructive jaundice. S (Salivary) fraction was decreased significantly in all except in carcinoma of pancreas. P/S ratio was elevated in hepatocellular carcinoma, obstructive jaundice, metastatic liver disease, gall bladder carcinoma and periampullary carcinoma (p<0.001) but in carcinoma of pancreas P/S ratio was low as compared to normal. This simple test of total serum amylase, P fraction and S fraction, P/S ratio can be utilised in differentiating various hepatobiliary and pancreatic malignancies.     

Thyroid hormones status during pregnancy in normal Iranian women

Pregnancy is associated with significant, but reversible changes in thyroid function studies, which are among the most profound seen as a result of a normal physiologic state. The present study was carried out to find out alterations in thyroid function tests in each trimester in normal pregnant women as compared to non-pregnant women in Tabriz-Iran. A case-control study designed with 229 normal pregnant women that randomly selected from the first (64 samples), the second (92 samples), and the third (73 samples) trimesters and 250 randomly selected non-pregnant healthy female controls. Age range in both groups was 16–40 years. Thyroid function tests carried out by measuring serum levels of thyroid stimulating hormone (TSH), free and total thyroxin (FT₄, TT₄), and free and total triiodothyronine (FT₃, TT₃) by commercially available radio immunoassay kits. We found that mean TT₄ increased progressively during pregnancy. Our study showed increasing in serum levels of TT₃ in the second trimester and then declining during the third trimester compared with non-pregnant women. We showed that FT₄ strongly decreased during the third trimester. Free T₃ showed declining in the second and third trimesters. Mean TSH did not show significant difference in each trimester compared with non-pregnant women. The thyroid function tests in pregnancy should be interpreted against gestational age-related reference intervals to avoid mis-interpretation of thyroid function during pregnancy.     

Evaluation of oxidative stress in pregnancy induced hypertension

This work was undertaken to investigate correlation between oxidative stress and initiation of pathogenesis of pregnancy induced hypertension (PIH). Fifty primigravidae in age group of 20–35 years and gestational age 28–42 weeks with PIH were taken as cases. Twenty healthy primigravidae with no medical and surgical complications of pregnancy and with blood pressure ≤140/90 mm Hg served as controls. The cases were again subgrouped as severe preeclampsia (12 in number) and mild pre-eclampsia (38 in number). All of them were evaluated for serum malondialdehyde (MDA), Serum vitamin E and plasma vitamin C levels. The serum MDA levels were raised significantly in women with mild preeclampsia (P<0.01) and in women with severe preeclampsia (P<0.01) in comparison to normal primi gravida. The serum vitamin E levels were decreased in primi gravida with mild preeclampsia (p<0.1) and in primi with severe pre eclampsia (P<0.1) in comparison to normal primi gravida but the fall was not statistically significant. There was a significant fall (P<0.05) in the vitamin C levels in primi with mild preeclampsia than in the normal primi. The vitamin C levels in severe preeclamptic patients were lower than the normal primi but the fall was not statistically significant (P=0.10). The serum MDA and vitamin E showed a negative correlation in all the cases. The serum MDA and plasma vitamin C also showed a negative correlation in the control and study group. This observation suggests that in hypertensive disorders of pregnancy there is an imbalance between lipid peroxidation and antioxidant vitamin status because of oxidative stress. The decreased serum concentrations of the antioxidant vitamins supports the hypothesis that lipid peroxidation is an important causative factor in the pathogenesis of preeclampsia. The rise in antioxidants is probably to compensate the increased peroxide load in severe preeclampsia.     

Effect of anti-epileptic drugs in pregnancy and teratogenesis

Epilepsy raises special concern in women during pregnancy. Antiepileptic drugs are known to induce major and minor malformations in the foetus. Aim of the study was to find an association between maternal serum alpha fetoprotein levels, foetal abnormalities and antiepileptic drugs mediated teratogenicity. Maternal serum alpha feto protein levels, kidney and liver function tests in age matched normal pregnant women and seizure free epileptic pregnant women during 12–14 weeks of gestation were estimated. Cases were subjected to ultrasonography at 11^th–14^th week of pregnancy and again at 20^th week of pregnancy. maternal serum alfa feto protein was assayed by a specific Electro Chemiluminescence Immuno Assay test. There was no significant difference in kidney and liver function tests in cases as compared to controls. There were elevated levels of alpha feto protein in cases as compared to controls but this was not statistically significant. No anomalies were detected in ultrasound reports. Most women had normal full term delivery with healthy children but of low birth weight. No correlation was seen between maternal serum alfa feto protein levels and antiepileptic drug leading to teratogenesis.     

Biochemical profile and outcome in normal and high risk subjects

The present study was carried out to assess the biochemical profile and outcome of pregnancy and study the adverse consequences if any, among normal and high risk pregnant women. The study group included 182 normal and 168 high risk cases attending to private and Government Hospitals in Bangalore. The high risk groups were: Pregnancy induced hypertension (PIH), gestational diabetes mellitus (GDM), Adolescents and anemic cases. Lipid peroxidation was enhanced in PIH and GDM groups (5.56 nmol/ml and 3.98 nmol/ml) MDA values as compared to other groups. Vitamin E levels were significantly (p< 0.05) lower in PIH group (0.38 mg/dl) as compared to other groups. Caesarean as a mode of delivery indicating more number of complications were higher among GDM (61.9%) followed by PIH group. Incidences of low birth weight were observed more in PIH group. The study revealed occurrence of oxidative stress and adverse outcome among high risk pregnancy groups.     

Effects of short-term hormone replacement on atherogenic indices in Indian postmenopausal women

Indian ethnicity by itself is a strong risk factor for development of CAD in Indian postmenopausal women due to lower HDL levels as compared to Whites and women of oriental origin. We evaluated and compared the short-term effects of menopause, estrogen replacement therapy and combined estrogen and progestin replacement therapy on various atherogenic indices. 40 postmenopausal women, both surgical and natural (20 each) were selected. 10 surgical postmenopausal women were given 0.625 mg conjugated estrogens daily for 6 months and 10 natural postmenopausal women were given 0.625 mg conjugated estrogen with 2.5 mg medroxyprogesterone acetate daily. 20 women were included in the control group and given placebo. Fasting venous blood samples were analyzed for extended lipid profile and calculated atherogenic indices before starting the therapy and after 1,3 and 6 months. LDL and Apolipoprotein B increased (p<0.05) and those of Apolipoprotein A1 and HDL decreased in the control groups. In both the study groups levels of serum cholesterol and LDL decreased (p<0.05) and those of HDL and Apolipoprotein A1 increased (p<0.01). LDL/HDL, Apo B/ApoA1, Total Cholesterol/HDL decreased significantly (p<0.05) in both the study groups compared to the control groups. The effect of estrogen alone was more significant as compared to combination therapy. Log Triglycerides (TG)/HDL ratio showed a decrease in women on estrogen alone but the difference was not significant. Our study confirms that short term HRT has a favorable effect on atherogenic indices in Indian postmenopausal women.     

Estimation of Upper Limit of Normal for Serum Alanine Transaminase in Healthy South Indian Population

Alanine aminotransferase (ALT) is the most common and cost effective screening test for asymptomatic liver disease. There is paucity of data on normal ALT among healthy individuals in India. An observational cross sectional study was conducted from January to July 2013 to estimate the upper limit of normal for ALT in healthy south Indian population. Adults undergoing voluntary or pre-employment health screening were included. Those with current and past alcoholism or smoking, acute illness or hospitalization during preceding 12 months, non-steroidal anti-inflammatory or over the counter medication use within a month, current or past intake of herbal medications, any chronic medical illness, abnormal body mass index (BMI), fatty liver in ultrasound, abnormality in haemoglobin, platelet count, blood sugar, creatinine, lipid profile and thyroid function test and positive serology (Hepatitis B, C or HIV) were excluded. A total of 2600 subjects were screened. 344 were included for analysis. Mean age was 35 years in men and 34.83 years in women, with a mean BMI of 22.2 kg/m² in men and 21.8 kg/m² in women. The mean ALT in men and women were 21.87 ± 2.9 (97.5th percentile 28 U/L) and 19.35 ± 3.3 (97.5th percentile 24 U/L) respectively. In conclusion, mean and upper limit of ALT (97.5th percentile) in south Indian men was 21.87 and 28 IU/L and women were 19.35 and 24 IU/L respectively. There is a need to re-consider ALT levels in our population for better detection of individuals at risk for liver disease.     

Maternal Leptin,Adiponectin, Resistin,Visfatin and Tumor Necrosis Factor-Alpha in Normal and Gestational Diabetes

Gestational diabetes mellitus (GDM) is a common medical complication associated with pregnancy. The present study evaluates the changes in maternal adipocytokines (leptin, adiponectin, resistin, visfatin and tumor necrosis factor-alpha; TNF-α) in pregnancy complicated with GDM compared to normal pregnancy at 2nd and 3rd trimesters. The study included total number of 142 pregnant women classified into 4 groups: normal pregnancy (n = 33) and pregnancy with GDM (n = 24) both at 2nd trimester and normal pregnancy (n = 38) and GDM (n = 47) at 3rd trimester. Both GDM groups were significantly presented with elevated body mass index, fasting blood sugar and abnormal oral glucose tolerance test compared to their matched control. Results indicated reduction in maternal serum leptin and adiponectin in GDM compared to normal pregnancy at 3rd trimester. Elevated resistin and TNF-α were evident among pregnancy complicated with GDM at both tested trimesters. On the other hand, significant elevation in maternal visfatin was noted between GDM and matched control at 2nd trimester only. Significant increase in maternal leptin and visfatin and resistin was noted by advances in gestational period in healthy pregnancy. On the other hand, reduced adiponectin and elevated visfatin mean values were noticed in GDM at 3rd compared to 2nd trimester. It could be concluded that increased insulin resistance accompanies GDM is associated with suppressed leptin and adiponectin and increased resistin and TNF-α which might suggest their involvement in the development of GDM.     

C／S与B／S的结构比较及Web数据库的访问方式

本文对Client/Server结构与Browser/Server结构进行了比较，指出B／S模式是未来数据开发的方向，并简要介绍了访问Web数据库的ASP方式。