Serum Urea:Albumin Ratio as a Prognostic Marker in Critical Patients With Non-Chronic Kidney Disease

Routine laboratory investigations play an important role in estimating the risk of mortality in intensive care unit (ICU) patients. The significance of urea:albumin ratio (UAR) in predicting the stay and mortality of ICU patients is not known. It is a retrospective study of patients admitted to ICU (n = 412) with non-chronic kidney disease (non-CKD). Receiver-operating characteristics (ROC) analysis for predicting mortality was carried out to find area under curve (AUC) and threshold levels. Analysis of survival probability was carried out by Kaplan–Meier method and Log-rank test. The AUC to predict mortality were 0.695, 0.767 and 0.791 for serum albumin, urea and UAR, respectively. The threshold levels for albumin, urea and UAR were 2.8 g/dL, 53 mg/dL, and 23.44 mg/g, respectively. The highest odds ratio (OR) of 9.75 to predict mortality at threshold level was observed for UAR, while OR were 7.0 and 3.62 for serum urea and albumin, respectively. The serum urea above and albumin below threshold level were associated with increase in ICU stay of >3 days but the highest OR of 4.73 to predict stay of >3 days was observed for UAR. Kaplan–Meier survival analysis shows significant (p < 0.001) difference at the threshold value of UAR. Serum urea and albumin are found to be an independent predictor for the mortality and stay; however an increased UAR value is the best parameter in predicting mortality and stay in ICU patients with non-CKD illness.     

Comparative Study of Serum Amylase and Lipase in Acute Pancreatitis Patients

To establish utility of single enzymatic marker for the diagnosis of acute pancreatitis. This is a cohort study. Tertiary care centre proven cases of acute pancreatitis (n = 50) admitted in surgery ward between December 2011 and May 2013 were included in the study. Serum amylase and lipase were performed along with many analytes. All relevant data including serum lab values and imaging were collected. All 50 patients included in the study had raised serum lipase, 42 patients had both amylase and lipase raised, 8 patients had amylase normal but lipase raised. In smaller hospitals where limited lab and radiological facilities are available, estimation of serum lipase will be a better choice over serum amylase in diagnosis of acute pancreatitis.     

Microwave-assisted rapid synthesis of alumina nanoparticles using tea,coffee and triphala extracts

Alumina nanoparticles （A1NP） were synthe- sized from aluminium nitrate using extracts of tea, coffee and triphala--a well known herbal plant as well as a non- toxic and eco--friendly green material. The synthesis was carried out taking 1：4 ratio of metal salt and these extracts under microwave irradiations at 540 W, which gave better yield of nanoparticles. Water was taken as solvent medium. The formations of A1NP were initially monitored by the colour changes occurring in the reaction mixture during the incubation period. As synthesized nanoparticles were characterized by scanning electron microscope （SEM）, UV-Visible （UV-Vis） spectroscopy and Fourier transform infrared spectroscopy （FTIR）. The A1NP were found to be spherical in shape in case of tea and coffee extracts with a size of 50-200 nm and to be oval shaped in case of triphala extract with an average size of 200-400 nm. The formation of A1NP with the microwave-assistance using these plant extracts has proved to be very faster than any other methods. In addition, excellent reproducibility of these nanoparticles, without the use of any additional capping agent or stabilizer will have great advantages in compari- son with microbial synthesis, avoiding all the tedious and hygienic complications.     

“That which we call a rose by any other name would smell as sweet”: How the nose knows!

Richard Axel and Linda B Buck received the Nobel Prize for their discoveries leading to an understanding of how odors are perceived. A large family of receptors present in the nasal epithelium are activated by specific odorants and relay information on the signal to the brain, allowing us to have the sense of smell.     

Post prandial plasma glucose level less than the fasting level in otherwise healthy individuals during routine screening

During routine screening, some otherwise healthy individuals who showed remarkably lower post prandial (at 2 hour) plasma glucose without any symptom were subjected to extended glucose tolerance test and a few of them to extended post meal tolerance test as well. It was observed that post prandial (at 2 hour) plasma glucose after glucose administration was significantly lower than the fasting level (p<0.05−p<0.001). However, post prandial plasma glucose at 2 hour after their usual meal exhibited a significantly higher level than the fasting and post glucose level (p<0.05−p<0.001). Glucose appears to be a stronger agent than the more natural mixed meal in these individuals in causing post prandial lowering of plasma glucose. Hence, these individuals are to be evaluated with their usual meals before considering further investigations. Like upper limit, there is the need to have a consensus lower limit of reference interval of blood glucose level.     

A closer look at the Mulliken-Barker test

Qualitative analysis of unknown organic compounds is an essential part of the core curriculum for BSc and MSc students in chemistry. The functional group detection is a significant component of qualitative analysis. The present work describes the reason for the failure of Mulliken-Barker test for nitro compounds having carboxylic acid functionality and suggests a possible remedy.     

The major players in adaptive immunity

Our immune system, by and large, does a fine job in protecting us from opportunistic and infectious microbes, potential carcinogens and allergens. It is therefore crucial to understand the organization of the immune network. This article focuses on some important features and key players involved in adaptive immune response. The first part of the article dealt with the humoral immune response mediated mainly by immunoglobulins produced by the B cells. The second part deals with T cells, the Major Histocompatibility Complex (MHC)-encoded molecules, and Recombination Activating Genes (RAG) responsible for generating diverse B-cell receptors (BCR) and T-cell receptors (TCR). With the advent of newer and smarter infectious agents, it is important to understand the working of the immune network as more research in this area may facilitate the development of better protective strategies.