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.     

Screening for lead poisoning in urban school children of southern India using capillary and venous blood samples

Our study aimed at comparing lead and zinc protoporphyrin (ZPP) levels in capillary and venous blood samples in a small population and to employ an easier method of sample collection for a major screening program in school children in major Indian cities. An awareness program on lead and its effects was conducted in two different schools. A total of thirty urban school children from South India, with an age group between 4–12 years consented for dual blood sampling and reported for the study. Venous and capillary blood samples were obtained simultaneously. Blood lead and zinc protoporphyrin (ZPP) levels were estimated using ESA Lead Analyzer and Haematofluorometer respectively. A significant correlation between capillary and venous ZPP (r=0.98) and lead (r=0.99) was observed. Rank sum test showed that there is no statistically significant difference between capillary and venous ZPP (P=0.891) and lead (P=0.672) values. This pilot study recommends that screening for lead may be done using capillary blood samples since significant correlation is observed between capillary and venous blood measurements. Obtaining samples using this mode is a non-invasive, less expensive, quick and easy method in children. Appropriately performed capillary sampling may be considered as an acceptable alternative to venipuncture for screening of blood for lead poisoning both in children and adults.     

Implementation of instructional innovations in K-8 science classes: perspectives of inservice teachers

The Iowa Chautauqua Programme (ICP) was disseminated through the National Diffusion Network (NDN) of the US Department of Education as an exemplary model of professional development for inservice science teachers. As a result, several new professional development programmes, emulating the Iowa Chautauqua model, were initiated in diverse settings across the USA. Adhering closely to the principal features of the ICP, the Collier Chautauqua Programme (CCP) was developed in Collier County, Florida. Teacher concerns associated with classroom implementation of instructional innovations promoted by the programme were studied qualitatively during the first year of programme implementation. Data were collected through individual and focus group interviews, workshop and classroom observations, and pre-formatted teacher journals. These data were analysed using the stages of concern (SoC) of the concerns based adoption model (CBAM) as the conceptual framework. Results reveal intricate relationships between classroom implementation by teachers and programme implementation by the school district.     

Distribution of Methionine Synthase Reductase (MTRR) Gene A66G Polymorphism in Indian Population

Methionine synthase reductase (MTRR) is an important enzyme of the folate/homocysteine pathway. It is responsible for regulation of methionine enzyme by reductive methylation. A common variant A66G is reported in the FMN-binding domain of the MTRR gene, which leads to substitution of isoleucine by methionine (I22M) in MTRR enzyme with reduced activity. Reduced catalytic activity of enzyme leads to high homocysteine concentration in blood and increases risk for numerous diseases. The frequency of A66G polymorphism varies in different ethnic groups. The present study has been designed to evaluate the frequency of MTRR A66G gene polymorphism in the Eastern UP population by PCR–RFLP method. Along with this we also performed a meta-analysis to evaluate the global prevalence of this polymorphism. Databases were screened to identified the eligible studies. The prevalence of the G allele and GG genotype was determined by the use of prevalence proportion with 95% CI. Open meta-analyst software was used for the meta-analysis. Total 1000 blood samples were analyzed, the frequencies of A and G alleles were 0.35 and 0.65 respectively. Meta-analysis results revealed that the prevalence of G allele and GG genotype were 49.4% (95% CI 40.6–58.1, p ≤ 0.001) and 24.3% (95% CI 17.8–30.9, p ≤ 0.001) respectively. In sub-group meta-analysis, the lowest frequency of G allele was found in South America (32.7%; 95% CI 14.1–51.3, p ≤ 0.001), and highest in Asia (56.4%; 95% CI 39.5–73.3, p ≤ 0.001). The results of the meta-analysis showed that the Asian population has the highest frequency of G allele and highest frequency of the GG genotype was found in the European population.     

Estimation of reference values in liver function test in health plan individuals of an urban south Indian population

Reference intervals in clinical chemistry are commonly based on results of measurements in reference western population or are taken from the western literature. Reference Values are thought to aid physicians to interpret results of measurements and, should be representative of a defined group of individuals. This group should be as similar as possible to the patients under investigation. The reference population in this, study has been recruited from the individuals attending the Health Plan Clinic who fulfill the defined inclusion and exclusion criteria as well as defined partition criteria. The samples were sorted based on the decision by the physician. The emerging group of individuals was considered as a reference population for the hospital patients and the results of measurements in this study was evaluated statistically, to stress on the urgent need to establish the in-house reference values. The reference limits are defined as the central 95 percentile of the population after eliminating the outliers. The lower, reference limit is the 2.5 percentile while the upper reference limit constituted the 97.5 percentile for the population.     

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.     

Association of Inflammatory Biomarker C-Reactive Protein, Lipid Peroxidation and Antioxidant Capacity Marker with HbF Level in Sickle Cell Disease Patients from Chattisgarh

This study was undertaken to determine the association of inflammatory biomarker, oxidative stress and antioxidant capacity marker with fetal haemoglobin (HbF) level among sickle cell trait and sickle cell disease (SCD) patients in Chattisgarh. The study group consisted of 51 SCD (SS) patients with painful episode, 49 SCD (SS) patients with steady state, 50 sickle cell trait (AS) and 50 controls. Malondialdehyde (MDA), CRP, total antioxidant power (FARP), total thiol and HbF levels were quantified. We found a significant positive (p < 0.0001) association between CRP and MDA levels and its inverse association with HbF level in SS patients. We also observed that antioxidant capacity had significantly positively (p < 0.0001) associated with HbF level. The protective effect of HbF was found, because the increase in HbF levels resulted in decrease in lipid peroxidation and inflammation in SCD patients. A decrease in the HbF level and its antioxidant capacity has been associated with the pathogenesis of SCD. These finding may explain the high level of HbF is ameliorating oxidative stress and inflammation in SCD patients.