Serum super oxide dismutase (SOD), malondialdehyde (MDA) levels in urinary disorders

Evaluation of serum SOD and MDA level was done in 21 first episode renal stone formers, 9 recurrent stone formers, 20 patients with obstructive uropathy other than urolithiasis and 12 patients with urinary infection. Twenty-two healthy volunteers were taken as controls. The level of SOD in respective groups was 2.12±0.84, 2.78±0.85, 1.42±0.31, 1.98±0.70 and 2.32±0.62 units/ml and of MDA was 2.61±1.07, 2.69±1.15, 1.65±0.33, 1.33±0.34 and 1.55±0.48 n mol/ml respectively. The results indicate increased peroxidative stressin nephrolithiasis only. Since SOD level was normal in all groups, this increased peroxidative stress in nephrolithiasis should be due to factors other than this one.     

Alkaptonuric ochronosis: Report of a case and brief review

Alkaptonuria, a metabolic disorder characterized by a triad of homogentisic aciduria, arthritis and ochronosis is one of the first conditions in the charter of group of inborn errors of metabolism proposed to have Mendelian recessive inheritance. It is due to the deficiency of the enzyme homogentisic acid oxidase which catalyzes the conversion of homogentisic acid to maleylacetoacetic acid in the catabolism of tyrosine. Homogentisic acid thus accumulates in cells and body fluids and its oxidized polymers bind to collagen, leading to progressive deposition of grey to bluish black pigment resulting in degenerative changes in cartilage, intervertebral disc and other connective tissues, leading to arthritis which is the only disabling effect in an affected older individual. However the diagnosis can be made in neonates when blackish stain is noticed in an unwashed diaper. Alkaptonuria is treated symptomatically, surgical intervention necessitates in advanced stages, treatment with ascorbic acid (Vitamin C) and dietary restrictions of food containing phenylalanine and tyrosine have proved to be successful in alleviating the symptoms.     

Serum adenosine deaminase, 5′ nucleotidase and malondialdehyde in acute infective hepatitis

Serum adenosine deaminase (ADA), 5′ nucleotidase (5′NT) and malondialdehyde (MDA) were estimated in patients with acute infective hepatitis (AIH) along with the routine parameters of liver disease. Present study is done to evaluate these special parameters in patients with clinical history of AIH and to assess the utility of these parameters as diagnostic/ prognostic indices of liver function and to correlate special parameters with routine live function tests (LFT). ADA, 5′NT and MDA along with routine LFT was estimated in 25 patients with AIH and 25 samples from healthy voluntary blood donars served as the control group. Routine LFT was estimated by standard clinical chemistry procedures on dade behring analyser and ADA, 5′NT and MDA were estimated by berthlot reaction, fiske and subbarao method and thiobarbituric acid method respectively. Statistical analysis showed that serum ADA, 5′NT and MDA were significantly higher in patients as compared with the controls. There was a significant positive correlation between ADA and total bilirubin and MDA and total bilirubin. Hence we can conclude that these tests would be more sensitive to diagnose the patients with AIH and that the raised bilirubin levels could be looked upon, as a protective mechanism which the liver has evolved in order to combat oxidative stress.     

Evaluation of ovulisa: An indigenous ELISA kit for detection of ovulation

Aprototype kit for the detection of occurrence of ovulation based on urinary pregnanediol glucuronide estimations by ELISA was developed in our laboratory. This kit was sent for evaluation at 4 centres in Bombay and Pune, India. The diagnosis of ovulation/anovulation based on the results of the kit is comparable with that based on reference parameters commonly used (ultrasonography of ovarian follicles and serum progesterone estimations). The accuracy of the test was 93.5%, specificity was 87.5% and sensitivity was 95.7%. This rapid indigenous test can be very useful in assessing ovulatory status of the woman by the clinicians in their offices.     

Effect of obesity and insulin resistance on diabetic control

Diabetes Mellitus in obese and non-obese Indian individuals.AIMS: Effect of Obesity and insulin resistance on diabetic control.SETTINGS AND DESIGN: 50 each groups Diabetic individuals obese and non-obese.METHODS AND MATERIAL: On selected 50 each group diabetic patient and normal, following blood investigations has been performed—Plasma Glucose, Glycohemoglobin and Serum Insulin.STATISTICAL ANALYSIS USED: Individuals patient’s results were analyzed and compared with the normal controls.RESULTS AND CONCLUSION: The changes in glycosylated haemoglobin are mainly proportional to the post lunch glucose level (r=0.773) (p<0.01) and not correlated to circulating insulin or the body mass index. However the levels were higher in obese diabetes (Type I and II both) than in non-obese. Mechanism of resistance in insulin receptor interactions due to obesity is well known. However, obesity does not seem to affect directly glycosylated haemoglobin. Under such circumstances, the reduction of weight for a diabetic person can improve sugar control by minimizing insulin resistance and thereby can improve glycosylated haemoglobin levels.     

Troponin T and Heart Type Fatty Acid Binding Protein (h-Fabp) as Biomarkers in Patients Presenting with Chest Pain

Acute coronary syndrome (ACS) is a term for a range of clinical signs and symptoms suggestive of myocardial ischemia. It results in functional and structural changes and ultimately releasing protein from injured cardiomyocytes. These cardiac markers play a major role in diagnosis and prognosis of ACS. This study aims to assess the efficacy of heart type fatty acid binding protein (h-FABP) as a marker for ACS along with the routinely used hs-TropT. In our observational study, plasma h-FABP (cut-off 6.32 ng/ml) and routinely done hs-Trop T (cutoff 0.1 and 0.014 ng/ml) were estimated by immunometric laboratory assays in 88 patients with acute chest pain. Based on the clinical and laboratory test findings the patients were grouped into ACS (n = 41) and non-ACS (n = 47). The diagnostic sensitivity, specificity, NPV, PPV and ROC curve at 95 % CI were determined. Sensitivity of hs-TropT (0.1 ng/ml), hs-TropT (0.014 ng/ml) and h-FABP were 53, 86 and 78 % respectively and specificity for the same were 98, 73 and 70 % respectively. Sensitivity, specificity and NPV calculated for a cut-off combination of hs-TropT 0.014 ng/ml and h-FABP was 100, 51 and 100 % respectively. These results were substantiated by ROC analysis. Measurement of plasma h-FABP and hs-TropT together on admission appears to be more precise predictor of ACS rather than either hs-Trop T or h-FABP.     

Urinary iodine levels in three ecological zones of Bangladesh

Urinary iodine levels in children (5–11 years) and in adult males and females (15–44 years) of three ecological zones (hilly, flood-prone and plains) of Bangladesh were analyzed to determine the status of biochemical iodine deficiency in the country. Data indicated that a large majority of the population all over Bangladesh have biochemical iodine deficiency urinary iodine excretion (UIE) less than the accepted cut-off level of 10 μg/dl. Adults were deficient to comparable degrees, 31.3% severely iodine deficient. The flood-prone zone was less affected: 71.7% children had iodine deficiency and 25% were severely deficient. Adults of this zone were less affected than the children. Iodine deficiency was least severe in the plain zone: 59.8% children were biochemically iodine deficient and of them 23.4% had UIE less than 2.0 μg/dl. In the case of the adults of this zone, 60.8% were biochemically iodine deficient and 20.6% had severe iodine deficiency. The results indicate that Bangladesh as a whole is an iodine deficient region, with the hilly zone being the most severely affected. Children were slightly more affected than the adults, and females were more affected than the males.     

The effect of extremely high glucose concentrations on 21 routine chemistry and thyroid Abbott assays: interference study

Introduction

Extremely high glucose concentrations have been shown to interfere with creatinine assays especially with Jaffe method in peritoneal dialysate. Because diabetes is the fastest growing chronic disease in the world, laboratories study with varying glucose concentrations. We investigated whether different levels of glucose spiked in serum interfere with 21 routine chemistry and thyroid assays at glucose concentrations between 17-51 mmol/L.

Materials and methods

Baseline (group I) serum pool with glucose concentration of 5.55 (5.44-5.61) mmol/L was prepared from patient sera. Spiking with 20% dextrose solution, sample groups were obtained with glucose concentrations: 17.09, 34.52, and 50.95 mmol/L (group II, III, IV, respectively). Total of 21 biochemistry analytes and thyroid tests were studied on Abbott c8000 and i2000sr with commercial reagents. Bias from baseline value was checked statistically and clinically.

Results

Creatinine increased significantly by 8.74%, 31.66%, 55.31% at groups II, III, IV, respectively with P values of < 0.001. At the median glucose concentration of 50.95 mmol/L, calcium, albumin, chloride and FT4 biased significantly clinically (-0.85%, 1.63%, 0.65%, 7.4% with P values 0.138, 0.214, 0.004, < 0.001, respectively). Remaining assays were free of interference.

Conclusion

Among the numerous biochemical parameters studied, only a few parameters are affected by dramatically increased glucose concentration. The creatinine measurements obtained in human sera with the Jaffe alkaline method at high glucose concentrations should be interpreted with caution. Other tests that were affected with extremely high glucose concentrations were calcium, albumin, chloride and FT4, hence results should be taken into consideration in patients with poor diabetic control.Key words: assay interference, glucose interference, preanalytical phase, creatinine, Jaffe kinetic assay, thyroid function tests