The Role of 25-Hydroxy Vitamin D Deficiency in Iron Deficient Children of North India

Extensive data from animal and human studies indicate a role of vitamin D in erythropoiesis. Iron and vitamin D deficiencies are implicated with adverse health effects in children even if they are asymptomatic. The potential relationship between the two remains poorly understood. A cross-sectional study was performed in the period from 1st May 2012 through 30th April 2013 and subjects were classified into vitamin D deficiency (VDD), vitamin D insufficiency (VDI) and vitamin D sufficiency (VDS) groups according to their 25(OH) D levels. A total of 263 children were included in the analysis. Anaemia was present in 66 % of 25(OH) D deficient subjects compared with 35 % in vitamin D sufficient individuals (p < 0.0001). The association of breast feeding and development of VDD was also significant (p < 0.05). Serum levels of 25(OH) D were found lower in female sex and if the analysis was performed in the winter/spring season. Physicians should therefore assess vitamin D levels in all anaemic children and ensure adequate supplementation to prevent deficiencies.     

Studies on the age dependent changes in serum adenosine deaminase activity and its changes in hepatitis

Serum Adenosine deaminase (ADA) activity in normal healthy control subjects increases upto 30 years, remains steady between 31–60 years of age and shows a steep increase in the age group of 61–70 years. This was compared with serum aspartate transaminase (AST) and alanine transaminase (ALT) activity which also showed a gradual increase upto 40 years of age and decreased thereafter. The activities of serum ADA, AST and ALT increased in patients with hepatitis of all age groups compared to their respective controls. The degree of increase in the activities of the above enzymes in hepatitis, decreased with age. The present study also shows that while studying serum ADA activity in hepatitis for diagnostic purposes, the value obtained in a particular age group should be compared with normal range of values for the respective age group only.     

Methylenetetrahydrofolate Reductase C677T Polymorphism and Risk for Male Infertility in Asian Population

Methylenetetrahydrofolate reductase (MTHFR) is a critical enzyme of folate pathway and required for DNA synthesis and methylation. MTHFE C677T polymorphisms is reported as risk factors for various diseases and disorders like birth defects, metabolic, neurological, psychiatric disorders, and cancers. Several studies have investigated association between the MTHFR C677T polymorphism and male infertility. To assess the risk associated with MTHFR C677T polymorphism in Asian population, a meta-analysis was performed. Included articles were collected from the following electronic databases: PubMed, Google Scholar, and Science direct up to March 2015. Risk was estimated as pooled odds ratios (ORs) with confidence intervals (CIs) for assessment. Seventeen case–control studies involving 4392 breast infertile males and 3667 fertile males were found suitable for the inclusion in the present meta-analysis. Results showed that the C677T polymorphism was significantly associated with male infertility in Asian population using all the five genetic models (OR_{T vs. C} (allele contrast model) = 1.86, 95% CI 1.7–2.0; OR_{TT vs. CC} (homozygote model) = 1.96, 95% CI 1.67–2.30; OR_{CT vs. CC} (co-dominant model) = 1.40, 95% CI 1.18–1.62; OR_{TT+CT vs. CC} (dominant model) = 1.53, 95% CI 1.30–1.77; OR_{TT vs. CT+CC} (recessive model) = 1.67, 95% CI 1.44–1.92). In conclusion, results of present meta-analysis strongly supported an association between C677T polymorphism and male infertility in Asians.     

Acute Renal Failure in Liver Transplant Patients: Indian Study

The acute renal failure is the frequent medical complication observed in liver transplant patients. The objective of this study was to determine the cause of acute renal failure in post liver transplant patients. A total of 70 patients who underwent (cadaveric 52, live 18) liver transplantation were categorized based on clinical presentation into two groups, namely hepatorenal failure (HRF, n = 29), and Hepatic failure (HF, n = 41). All the patients after the liver transplant had received tacrolimus, mycophenolate and steroids. We analyzed the modification of diet in renal disease, (MDRD) serum urea, creatinine and albumin before and after 5th and 30th day of liver transplant and data was categorized into survivors and non-survivors group. In HRF survivor group, serum creatinine, and urea levels were high and, albumin, MDRD were low in pre- transplant and reached to normal levels on 30th day of post transplant, and 79.3 % of patients in this group showed resumption of normal kidney function. On the contrary in HRF nonsurvivor group, we did not observed any significant difference and 20.7 % of patients showed irreversible changes after the liver transplant. In HF survivor group, 82.9 % of liver failure patients did not show any deviation in serum creatinine, urea, albumin and MDRD, whereas in HF non survivor group, 17.1 % of liver failure patients who had HCV positive before the transplant developed acute renal failure. The levels of creatinine, urea, albumin and MDRD were normal before the transplant and on day 30th, the levels of albumin and MDRD were significantly low whereas serum urea, creatinine levels were high. In conclusion, based on these observations, an diagnosis and treatment of Acute renal failure is important among the liver transplantation cases in the early postoperative period.     

Systematic Differences Between Total and Free Prostate-Specific Antigen Immunoassays: Comparison Using Passing and Bablok Regression

Recent studies have shown that there are systematic differences among total and free prostate-specificantigen (PSA) immunoassays. In this study we analyzedintermethod differences in total PSA (tPSA) and free PSA(fPSA) measurement using ARCHITECT i2000SR (Abbott Diagnostics) and COBAS E601 (Roche Diagnostics). A number of 160 blood samples were tested for tPSA and 50 samples for fPSA (selecting only sampleswith tPSA: 4.1–10.0 μg/L). Passing–Bablok regression analysis was used to compare the two analytical methods fortPSA, fPSA and percentage of fPSA (%fPSA). A strong correlation was noticed between ARCHITECT i2000SR and COBAS E601 for tPSA, fPSA and %fPSA (r between 0.94 and 0.99). Concentrations of tPSA and fPSA measured by COBAS E601 were higher thanthose measured by ARCHITECT i2000SR with a bias of 0.8 μg/L for tPSA and 0.14 μg/L for fPSA. Analyzing therelative difference between methods for fPSA and %fPSA, COBAS E601 exceed a 10% relative difference limit. Our study confirms that there are differences in measured concentrations of tPSA and fPSA byvarious commercial methods. Because clinical judgment on subsequent diagnostic procedures, such as prostatebiopsy, is based on tPSA and fPSA results, tests harmonization should be a priority.     

A Single Centre Prospective Study of Liver Function Tests in Post Liver Transplant Patients

Liver transplantation means surgical replacement of a diseased liver with a healthy liver. The survival rate used to be 30 % after 1 year and LTx was considered to be the last procedure when all medical or surgical intervention failed. Advances in donor organ preservation, surgical techniques, patient selection, immunosuppressive regimens and treatments for opportunistic infections all have contributed to substantially improve the survival rates. Despite substantial technological, medical and surgical advances, liver transplantation remains a complex procedure that is accompanied by significant morbidity and mortality. The post-operative outcome of each patient varies greatly depending on the patient’s pre- operative state, quality of the donated organ and the complexity of the surgery. Complications occur both immediately post transplant and in the long term. Most of the problems can be satisfactorily assessed with a panel of routine LFTs results of which are generated quickly, cheaply on the analyzer which operates 24 h. Liver Function Test identifies the presence of problem but not problem itself. Abnormal results can be meaningful only when used with clinical data, radiological findings. The study includes 75 post LTx patients in three groups adults (non ACR), Pediatrics and ACR. All recipients were on immunosuppressive therapy (tacrolimus, mycophenolate and methylprednisolone), antiviral (ganciclovir), antiprotozoal, antibacterial and antifungal (fluconazole). 5 mL of blood was drawn in plain vacutainer from the post LTx patients every day for 15 days and LFT and GGT was done. Routinely performed liver function tests correlates well with clinical complications involving liver in the transplant patients. Instead of daily testing, may be alternate day analysis of LFT should be sufficient for effective monitoring of patients. The total protein and albumin and the transaminases offer little help in monitoring LFT post LTx. The elevated levels of serum GGT and ALP may be related to chronic immune damage to the transplanted liver. Serum GGT and ALP can be used as early markers for diagnosing biliary complications and can be used to asses adequacy of endoscopic treatment in the group of patients presenting early. Thus, most of the problems can be satisfactorily assed with a panel of routine LFTs generated quickly, cheaply on analyzer which operates 24 h each day. However, it must be emphasized that LFTs may identify the presence of problems but not the problem itself and the abnormal results are meaningful only when correlated with other clinical information.     

Correlation between chemical components of billary calculi and bile & sera and bile of gallstone patients

Total cholesterol, total bilirubin, calcium, oxalate, inorganic phosphate, magnesium, iron, copper, sodium and potassium were analyzed quantitatively in gallstones, bile of gall bladder and sera of 200 patients of cholelithiasis (52 cholesterol, 76 mixed and 72 pigment stone patients) and their contents were correlated between calculi and bile and sera and bile in these three type of stone patients. A significant positive correlation was observed between total cholesterol, total bilirubin of calculi and bile, copper of bile and sera of cholesterol stone patients, copper of calculi and bile, total bilirubin, oxalate, magnesium, potassium of sera and bile of pigment stone patients and oxalate and iron of stone and bile, total bilirubin, oxalate, sodium of sera and bile of mixed stone patients. A significant negative correlation was found between magnesium of serum and bile of cholesterol stone patients, oxalate of calculi and bile of pigment stone patients and magnesium of serum and bile of mixed stone patients.     

Immunomodulation of excretory secretory materials from the filarial parasite<Emphasis Type="Italic">Setaria digitata</Emphasis>

ES materials released along with the release of mf showed immunosuppression as evidenced by a decrease in T lymphocyte levels in the immunised animals. Lipid fractions of the mf associated ES materials and protein fractions of the detergent soluble materials were found to cause suppression of immune response in the host. Further study revealed that the suppression associated with the lipid fractions is actually the end result and that mf associated ES materials is actually a mixture of immunosuppressive and immunopotentiating components and the release of the components is most likely regulated.     

Fetal lead exposure: Encephalopathy in a child

It is well known that lead exposure in the early period of pre pregnancy and antenatal life leads to serious health complications. In this case report, a five month old child who was suffering from encephalopathy was finally confirmed a victim of lead exposure, the source being the environment and the family. We report this case with complete clinical investigation including blood lead analysis. This case report highlights the various ways in which lead may accumulate in the body. It is also aimed at increasing awareness regarding the pathogenesis and clinical manifestations of lead toxicity. The literature survey done reveals that this is the youngest age at which lead toxicity has been documented in India.