Faecal fat content in healthy adults by the ‘acid steatocrit method’

Malabsorption syndromes causing steatorrhoea are quite common in India. Estimation of faecal fat is an important non-invasive investigation, which provides vital information regarding the occurrence of malabsorption. The aim of this study was to estimate the fat excretion per day in stools of apparently healthy adults on an unrestricted diet in random spot stool samples using the Acid Steatocrit Method, which provides an alternate, simpler and yet reliable method of stool fat estimation. Several studies have proved the correlation of the acid steatocrit method with the conventional methods. In India, however, there has been no published data regarding the normal levels of fat in the stools, by the acid steatocrit method. We follow the normal range values, as set by the United States and the European countries, not having a range for the Indian population. Hence, we took up a preliminary study, to estimate stool fat in a section of normal and healthy Indian population. The result obtained after screening 600 healthy and normal adults, showed the mean of stool fat to be 8.72 gms/24 hours, which is much higher than that, defined by Western literature (7 gms/24 hours). This can be accounted for, by the cultural and ethnic variations in dietary and food habits. Further studies are required in the same direction, involving larger population groups, and in different malabsorptive conditions.     

Three Cases of Lead Toxicity Associated with Consumption of Ayurvedic Medicines

Ayurveda is a traditional form of medicine used by majority of the Indians. Here we report three cases of lead toxicity, following intake of Ayurvedic medicines. Three patients presented with blood lead levels (BLLs) of 122.4, 115 and 42.8 μg/dl respectively at the time of hospitalization. The first case was chelated with D- penicillamine, the second with calcium disodium ethylene diamino tetra acetate (EDTA) and the third with environmental intervention and education. Associated Ayurvedic products were collected from patients and analyzed for metallic concentration. Cessation of Ayurvedic medication along with chelation, nutritional intervention and education, reduced the BLL to 27.4 μg/dl in the first case after 1 year, 21.1 μg/dl after 9 months in the second and 18.2 μg/dl after 6 months in the third case.     

Situated Learning: Conceptualization and Measurement

A focus on the interaction between cognitive schemas and context in situ has been suggested as fundamental in organizational decision making and information interpretation. Past research suggests that the situation and the social interaction that occur during learning at the cognitive level consist of factors that affect the process, but the research lacks a coherent explanation for how those factors affect it. We propose a conceptualization of learning, termed situated learning, which accounts for these factors. By drawing on situated cognition theory, social learning theory, and the theory of mental models, we identify and measure four components of situated learning, that is, thematic focus, cognitive absorption, social structure, and participation. Among the most important lessons for researchers and practitioners is the need to consider learning as a constellation of the four components instead of an indivisible phenomenon. This perspective can enhance our understanding of cognitive processes, such as information interpretation and decision making.     

Effect of Vitamin B<Subscript>12</Subscript> and Folate on Homocysteine levels in colorectal cancer

Folate and cobalamin (Vitamin B₁₂) are two essential micronutrients involved in one-carbon metabolism, which affects heart disease, neural tube defects and cancer. Methylenetetrahydrofolate reductase, the key enzyme involved in one carbon metabolism produces methyl tetrahydrofolate from methylene tetrahydrofolate, which in turn donates methyl group to homocysteine to generate methionine. There exist two common low function polymorphic variants of the methylenetetrahydrofolate reductase gene involving nucleotides 677 C→T and 1298 A→C, which are associated with hyperhomocysteinemia. These polymorphisms are also linked with increased risk for certain cancers such as breast cancer and at the same time providing a protective effect on colorectal cancer. In this case control study, we have evaluated levels of folic acid, vitamin B₁₂ and homocysteine in patients with colorectal cancer. Folate and homocysteine levels did not differ significantly between the two groups; however an increasing trend was noticed with increase in homocysteine levels. Vitamin B₁₂ levels were increased in cases compared to control group.     

Evaluation of immunohistochemistry and enzyme linked immunosorbent assay for HER-2/neu expression in breast carcinoma

HER-2 is overexpressed in approximately 20–30% of invasive Breast Cancer. ECD of the HER-2 protein is frequently cleaved and released into the circulation, where it can be detected by ELISA in up to 45% of patients with metastatic breast cancer. The objective of our study was to compare the current methods for the detection of HER-2 protein. Tissue HER-2 levels were studied in 100 breast cancer patients by IHC and compared with serum HER-2 levels by ELISA. IHC frequency was 29%. Serum HER-2 ECD was positive in 42% of patients. A statistically significant correlation was observed. HER-2 detected by IHC correlates significantly with serum HER-2 levels detected by ELISA. Thus, ELISA is a reliable and economical tool to assess the HER-2 status in tumors, when breast tissue sample is not available.     

Lead toxicity as a result of herbal medication

Awareness about the toxic effects of non-essential metals is still lacking in developing countries. Lead is one among them, which ranks second in the Agency for Toxic Substances and Disease Registry’ s top 20 lists of toxic metals. Some of the herbal medicines prepared from certain roots and leaves are known to contain this toxic metal at alarming levels. We have a case of a person who suffered from the toxic effects of lead such as vomiting and colicky abdominal pain after consuming a herbal remedy for Jaundice treatment. This went unrecognized initially because of the presence of multiple problems like Malaria and Renal calculi. Lead poisoning as causative factor for anemia, vomiting and colic were confirmed only when blood lead concentration was estimated. A combination of chelation therapy and nutritional supplementation was found to be useful in reducing the body lead burden.     

Diagnosis of alpha-1-antitrypsin deficiency by serum protein electrophoresis

Alpha-1-antitrypsin deficiency is a hereditary disease leading to hepatitis and cirrhosis. It is the most common genetic cause of liver disease in children which must inherit the tendency from both parents to develop. It acquires the highest priority in the differential diagnosis in a child with chronic liver disease. In this case report we substantiate the role of serum protein electrophoresis, in diagnosing alpha-1-antitrypsin deficiency.     

Serum markers for early diagnosis of non-‘Q’ wave and ‘Q’ wave myocardial infarction

The present study conducted on twenty-five uncomplicated cases of acute myocardial infarction diagnosed by clinical and electrocardiographic findings indicated significantly increased level of cardiac Troponin-T and increased activities of the enzymes total creatine kinase, creatine kinase-MB, aspartate transaminase and lactate dehydrogenase as compared to the twenty-five healthy control subjects. The level of cardiac Troponin-T and the activities of the enzymes total creatine kinase, creatine kinase-MB, aspartate transaminase and lactate dehydrogenase was found to be higher in “Q” wave myocardial infarction patients as compared to the non-“Q” wave and the controls. Since cardiac Troponin-T has been shown to increase in unstable angina and renal failure without cardiac disease and creatine kinase-MB activity has been found to be normal in patients with unstable angina and increase very slightly in patients with renal failure, it was concluded that a combination of cardiac Troponin-T and creatine kinase-MB activity was sufficient for the early diagnosis of acute myocardial infarction.