Spurious Hyperphosphatemia in a Case of Multiple Myeloma

A 50 year old male was admitted in our hospital with anemia and impaired renal function. He was subsequently found to have extremely elevated serum phosphate level (24 mg/dL, reference interval: 2.5–4.5 mg/dL) with normal serum calcium when assayed on a Beckman Coulter AU 480^® analyser. Clinico-biochemical discrepancy led to the suspicion of spurious hyperphosphatemia. Serum total protein was grossly elevated with gross reversal of albumin to globulin ratio. Serum electrophoresis revealed a large M band and was confirmed as Ig G-Kappa type on immunofixation. Subsequently a bone marrow aspiration biopsy confirmed the diagnosis of multiple myeloma. The patient serum was then reassayed for phosphate on a Vitros^® 250 Dry Chemistry platform and the result was within normal reference interval. Paraproteinemias are a common cause of analytical interference in clinical biochemistry laboratories and as multilayered film technology platforms like Vitros^® assay most routine analytes on a protein free filtrate they are unaffected by paraprotein interference. Clinically discordant patient results should always be interpreted keeping such interferences in mind.     

An approach to assign individual marks from a team mark: the case of Australian grading system at universities

This study uses a new approach to assign individual marks from a team mark using individual contributions to a teamwork product. A team member’s contribution to a teamwork product, in the form of an individual weighting factor, is calculated using team members’ co‐assessment. A comparison of the proposed approach with existing methods has been discussed with the help of a typical teamwork example. The approach has been refined to make it applicable for the Australian grading system at universities. It has been implemented in a large undergraduate engineering course to observe its effectiveness in practice. The results show that the method encourages teamwork, penalises below‐average contributions and rewards above‐average contributions. An analysis of a students’ perception survey shows that students prefer the approach over alternative approaches.     

沉积物-水界面通量测定中热脉冲信号分析(英文)

分析了热脉冲传感器脉冲信号与沉积物-水界面通量之间的传热问题,并通过优化程序,提出了用热脉冲测定计算界面通量J的新方法.此分析方法只需3个实验参数,即x0,λ和(pc)l就可利用热脉冲测定数据计算出沉积物-水界面通量J.数据分析结果表明:热脉冲顶点温度到达时间与水流速度呈曲线关系;沉积物-水界面通量和热源上下游温升比值的自然对数之间存在一种简单的线性关系.这种简单的线性关系,有利于热脉冲型传感器在土壤-水界面通量测定中的广泛应用.     

Protective effect of<Emphasis Type="Italic">Bacopa monniera L.</Emphasis> on cytarabine induced biochemical changes in chick embryo

Bacopa monniera, a medicinal plant distributed throughout India. Cytosine arabinoside (1-β-arabinofuranosylcytosine; Ara-C) is the most important antimetabolite chemotherapeutic drug used for acute leukemia. In this study we examined the chemoprotective property of an ethanolic extract of Bacopa monniera on biochemical changes in chick embryo. CA caused biochemical changes in a concentration and time dependent manner in amniotic fluid, liver and heart tissues. Ethanolic extract of BM given to chick embryo at doses of 2, 4, 6 mg per egg. There is significant decrease in biochemical levels of glucose, protein, urea, uric acid, creatinine and inorganic phosphorus. Enzymatic activities of alkaline phosphatase, lactate dehydrogenase, serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase and malatedehydrogenase were also decreased with dose dependent manner in amniotic fluid, liver and heart tissues.     

Global and regional cardiac function in lifelong endurance athletes with and without myocardial fibrosis

The aim of the present study was to compare cardiac structure as well as global and regional cardiac function in athletes with and without myocardial fibrosis (MF). Cardiac magnetic resonance imaging with late gadolinium enhancement was used to detect MF and global cardiac structure in nine lifelong veteran endurance athletes (58?±?5 years, 43?±?5 years of training). Transthoracic echocardiography using tissue-Doppler and myocardial strain imaging assessed global and regional (18 segments) longitudinal left ventricular function. MF was present in four athletes (range 1–8?g) and not present in five athletes. MF was located near the insertion points of the right ventricular free wall on the left ventricle in three athletes and in the epicardial lateral wall in one athlete. Athletes with MF demonstrated a larger end diastolic volume (205?±?24 vs 173?±?18?ml) and posterior wall thickness (11?±?1 vs 9?±?1?mm) compared to those without MF. The presence of MF did not mediate global tissue velocities or global longitudinal strain and strain rate; however, regional analysis of longitudinal strain demonstrated reduced function in some fibrotic regions. Furthermore, base to apex gradient was affected in three out of four athletes with MF. Lifelong veteran endurance athletes with MF demonstrate larger cardiac dimensions and normal global cardiac function. Fibrotic areas may demonstrate some co-localised regional cardiac dysfunction, evidenced by an affected cardiac strain and base to apex gradient. These data emphasize the heterogeneous phenotype of MF in athletes.     

The effect of culture and belief systems on students’ academic buoyancy

Increasingly, learner motivation is implicated in student failure at universities. This has led to intense research into internal or external variables that might buoy resilience to failure. This research investigates the impact of strong cultural connectedness and strong belief systems on the academic buoyancy of international students studying at an Australian University. For this purpose, we surveyed 102 tertiary students at a Sydney university. Results demonstrate that, in the event of academic failure, students’ academic buoyancy remains high if they have support through strong cultural connections and from their belief systems. We further endeavored to identify if academic buoyancy was fed by intrinsic or extrinsic motivation. This research contributes to the understanding of the sources of strengths available to international students from primarily collective cultures studying overseas. There are implications for educational practice in terms of identifying students ‘at high risk’ if they are unable to draw strengths from cultural connections and belief systems.     

Increasing Glucose Concentrations Interfere with Estimation of Electrolytes by Indirect Ion Selective Electrode Method

The estimation of electrolytes like sodium (Na⁺), potassium (K⁺) and chloride (Cl⁻) using direct and indirect ion-selective electrodes (ISE) is a routine laboratory practice. Interferents like proteins, triglycerides, drugs etc. are known to affect the results. The present study was designed to look into the effect of increasing glucose concentrations on estimation of Na⁺, K⁺ and Cl⁻ by direct and indirect ISE. Pooled sera was mixed with glucose stock solution (20 g/dL) prepared in normal saline to obtain glucose concentrations ranging from ~100 to ~5000 mg/dL. Na⁺, K⁺ and Cl⁻ levels were estimated by direct and indirect ISE analyzers and results were statistically analysed using ANOVA and Pearson’s correlation. Similar experiment was also performed in 24 h urine sample from healthy subjects. Significant difference was observed between Na⁺ and Cl⁻ measurements by direct and indirect ISE, with indirect ISE values being consistently higher than direct ISE. Besides this, significant difference was observed amongst Na⁺ and Cl⁻ values from baseline values obtained by indirect ISE at glucose concentrations ≥2486 mg/dL. However, no such difference was observed with direct ISE. Na⁺ and Cl⁻ estimation by indirect ISE showed significant negative correlation with glucose concentration, more so, above ~2000 mg/dL. K⁺, however, showed no significant difference with varying glucose. Similar results were observed in 24 h urine samples with a significant difference observed amongst Na⁺ and Cl⁻ values at ≥2104 mg/dL glucose. Thus we conclude that high glucose concentrations interfere significantly in estimation of Na⁺ and Cl⁻ by indirect ISE in serum as well as urine.

Electronic supplementary material

The online version of this article (doi:10.1007/s12291-015-0522-0) contains supplementary material, which is available to authorized users.     

Hepcidin and Ferritin: Important Mediators in Inflammation Associated Anemia in Systemic Lupus Erythematosus Patients

Systemic Lupus Erythematosus is an autoimmune disease with female preponderance. Anemia is found in 50% of Systemic Lupus Erythematosus patients. This is a cross sectional case control study with 30 female Systemic Lupus Erythematosus patients having inflammation associated anemia (Hemoglobin < 10.0 gm/dl) and 30 age matched controls with the aim to measure serum hepcidin and ferritin levels, correlate and study their role as homeostatic regulators of iron metabolism and utility as markers. Serum transferrin, ferritin, iron, total iron binding capacity, hsCRP, liver enzymes and renal parameters were analyzed by using automated analyser. Hepcidin levels were estimated by Sandwich-ELISA method. There was significant decrease in Iron (p < 0.0001), Iron Binding capacity (p < 0.0001), Transferrin (p < 0.0001) in patients, and a significant increase in inflammatory markers: hs-CRP (p < 0.0001), ESR (p < 0.0001) compared to controls. Significant increase in both Hepcidin (p < 0.0001) and Ferritin (p < 0.0001) was observed in patients with significant positive correlation (r = 0.711) with each other. Additionally, ferritin and hepcidin significantly positively correlated with hs-CRP and ESR (r = 0.526, 0.735); (r = 0.427, 0.742) respectively. Negative correlation with hemoglobin, iron, total iron binding capacity and transferrin with hepcidin (r = ? 0.80, ? 0.307, ? 0.553, ? 0.584) and ferritin (r = ?0.722, ? 0.22, ? 0.654, ? 0.728) was observed respectively. On ROC analysis both hepcidin and ferritin has sensitivity of 96.7%, specificity of 100% at cut-off values of 110 and 49 respectively. AUC of hepcidin was 0.993 and ferritin was 0.978. We have established a positive linear correlation between Hepcidin and Ferritin levels in disease activity and the changes correlated with the inflammatory state and anemia in patients, making them important mediators and potential markers of inflammation associated anemia.     

Counting subspaces of a finite vector space — 1

This is the first of a two-part series where we discuss the relation between the Gaussian binomial and multinomial coefficients and ordinary binomial and multinomial coefficients from a combinatorial viewpoint, based on expositions by Knuth, Stanley and Butler.     

Comparative Study of Two ELISA Kits for Estimation of Antibodies to Hepatitis B Virus in Human Normal Immunoglobulin and Specific Immunoglobulin Intended for Intravenous or Intramuscular Use

Current study is conducted to evaluate method verification of two locally available kits manufactured by DSI & BIORAD for quantitative estimation of Hepatitis B virus antibodies in human normal immunoglobulin by using International standard of National Institute of Biological Standards and Control. Four analyst perform five sets of test in duplicate analysing accuracy, precision, and limit of detection, sensitivity and specificity. Our results suggest that both DSI and BIORAD kits fulfil the validation criteria and are sensitive to detect up to 10 mIU concentration precisely and accurately. DSI kit is more precise at concentration 100 mIU and economically 4–5 times cheaper in local market; on the other hand, BIORAD kits provide larger detection range up to 1000 mIU.