International journal of Clinical Biochemistry and Research

164-167

Authors: Sucharita Mohanty

Errors in It's our profession to know all the details of testing and instrumentation and quality control. It's our profession to assure that test results are correct. Improvements need not be only at "pre" or "post" or "analytical" - it should be at all three stages, as the consequence of error in any of the stage is the same: poor patient care. No error is worse than the other. We must make efforts on all fronts. Even if this means making small improvements in each area, a unified improvement effort will achieve better test results and better patient care than narrow efforts in either the pre-, post- or analytical area. To have a uniform consensus, the laboratories should have certain quality indicators to have control over the procedures that tend to generate errors

172-174

Authors: Karthik G, Shantha kumari N., Nataraj B

Introduction: Tuberculosis (TB) is an important global health problem. It has more impact on developing and underdeveloped countries. The impact of tuberculosis can be seen by the fact that in 1993, the world Health Organization (WHO) declared tuberculosis a Global Emergency. WHO estimated that tuberculosis infects about one-third of world’s population. Every year, 8 million people contract tuberculosis, of which 95% are in the developing world.1 Aims and Objectives: To estimate and compare serum Copper, Zinc levels, and Cu/Zn ratio in newly detected pulmonary tuberculosis patients with healthy volunteers. To estimate Total Protein and Albumin levels to rule out hypoproteinemia. Materials and Methods: The study included 40 newly detected sputum positive pulmonary tuberculosis patients and 40 healthy volunteers. Serum copper and zinc was estimated by colorimetric method using RA-50 semi autoanalyser. Total protein was estimated by biuret method and Albumin, by bromocresol green method using automated analyser. Results and Conclusions: There was a significant increase in serum copper levels in pulmonary tuberculosis patients when compared to control group (P<0>)

180-184

Authors: Namrata Chhabra, Amandeep Kaur, Sarah Chhabra, Sahiba Kukreja

Introduction: The prevalence of diabetes mellitus has reached epidemic levels globally. Depression as a comorbidity in patients with Diabetes Mellitus has been reported by many studies. The coexistence of diabetes and depression is associated with significant morbidity, mortality, and increased healthcare cost. The reports of studies are conflicting and the exact mechanisms linking depression and diabetes are unclear. Aim and Objective: The aim of the study was to determine the prevalence as well as the correlation of depression with socio demographic profile, duration of disease state, presence of complications and effect of therapeutic intervention in patients with Diabetes mellitus. Materials and Methods: A cross sectional survey was conducted with an aim of assessing depression as a comorbidity in patients with diabetes mellitus. Depression was assessed using the patient health questionairre-9 (PHQ-9). Results: Depression as defined by PHQ score ?5 was present in 45% of the individuals. Severe depression (PHQ score ?15) was present in 8% subjects, moderate depression (PHQ score ?10) in 14% subjects, and mild depression was present in 23% of subjects. Coexisting depression in patients with diabetes was associated with decreased adherence to treatment, poor metabolic control, higher complication rates, decreased quality of life and increased disability. Depression was significantly more prevalent in rural subjects (59%) as compared to urban ones (26%). Conclusion: Coordinated strategies for clinical care are necessary to improve clinical outcomes and reduce the burden of illness. Currently, recognition of depression among individuals with diabetes is suboptimal, therefore global approaches to establish coordinated, multifaceted interventions to improve early recognition of depression and early initiation of treatment for depression are required to reduce the worldwide burden of depression among individuals with diabetes.

191-195

Authors: M. C. Archana, Minu Meenakshi Devi K. R.

Introduction: Diabetes mellitus is the most important cause for vascular diseases of heart and brain. The major factor in the development of diabetic complications is oxidative stress. Superoxide dismutases (SODs) are the enzymes which play a primary role against oxidative stress. A polymorphism C/T substitution producing TT genotype in superoxide dismutase 2 gene causes impaired targeting of the SOD 2 enzyme, resulting in reduced activity of the enzyme inside mitochondria. This can lead to increased oxidative stress in these patients making them susceptible to cardiovascular complications Aim:Our study is performed to analyse if there is increased susceptibility of diabetics with SOD2 gene polymorphism to cardiovascular complications and to assess if this SOD2 polymorphism causes reduced SOD activity. Materials and Methods: 30 cases of diabetics with cardiovascular disease, 30 cases of diabetics without cardiovascular disease and 30 healthy controls are included in the study. Genotype analysis by PCR and RFLP and serum superoxide dismutase activity is measured by spectrophotometer. Results:TT genotype is more frequently distributed and Serum SOD activity is reduced among diabetics with CVD compared to diabetics without CVD and controls ,which shows an increased risk of cardiovascular complications among diabetics with SOD2(GCT/GTT) gene polymorphism. Conclusion: TT genotype is an independent risk factor for the development of cardiovascular complications in diabetes. Patients with TT genotype have reduced level of serum superoxide dismutase that may cause increased oxidative stress, the main mechanism for development of cardiovascular complications in diabetes.

201-205

Authors: Bindu Pavani.CH, Shruti Mohanty, Archana A. Dharwadkar

Introduction: Some previous studies and our recent study had shown low serum uric acid (UA) in Diabetic patients compared to Non diabetics and it was suggested that low serum UA levels in Diabetics are probably due to uricosuric effect of urinary Glucose. This study was conducted to have an insight regarding the pathophysiology of low serum UA levels in Diabetics. Materials And Methods:Fasting blood glucose(FBG) , Post lunch blood glucose(PLBG), serum UA and 24 hr urinary excretion were estimated in Type 2 Diabetics without nephropathy (Cases) and in Nondiabetic inpatients(Controls) who got admitted into various Departments of KIMS hospital. The comparison of serum UA and 24hr urinary excretion between cases and controls and correlation between 24 hr urinary excretion, FBG and serum UA in cases was tested using SPSS 19 version. Result: Serum UA Mean is low in Diabetics compared to Non diabetics and this difference is significant whereas 24 hr urinary excretion is significantly higher in Diabetics compared to Nondiabetics. Significant negative association between FBG and serum UA and positive association between 24hr urinary UA and FBG and negative association of 24 hr urinary excretion with serum UA in Diabetics which is nonsignificant. Summary and Conclusions:At high concentrations of FBG there is increase in 24 hr urinary excretion providing an objective evidence to hypothesis that low UA levels in diabetics are probably due to inhibition of UA reabsorption in the proximal convoluted tubule of kidney by glucose

209-211

Authors: Ranjith Kumar C., Laxmikanth B, Srinivas Nagaram

Introduction and Objectives: Thyroid dysfunction and autoimmunity are related to adverse impact on fertility in reproductive aged women. Anti-Mullerian hormone (AMH), biomarker of ‘ovarian age’ may be affected by impaired thyroid function, but the relationship between AMH and thyroid hormone is unclear. The aim of this study was to determine the impact of thyroid stimulating hormone (TSH) on AMH levels. Materials and Methods: In this case–control study, to identify the impact of thyroid hormone on ovarian reserve, we recruited 30 consecutive Indian infertile patients and 30 normal fertile women aged 19 –39 years without impact factors on thyroid and ovarian functions between April 2017 and September 2017. We assessed patient age, AMH, and TSH levels of all study participants as independent variables. We also evaluated the correlations between AMH and TSH in our study groups. In addition, independent variables were subjected to multiple regression analysis. Results: Our results showed significant changes in AMH and TSH between groups. The increased TSH status in the subfertile cases was inversely correlated with the TSH levels (r=-0.44, p<0 xss=removed xss=removed> Conclusion:AMH levels were inversely correlated with TSH levels in infertile women of reproductive age. Further studies with large sample size are warranted in future

217-221

Authors: Mohd. Azam Hyder, Marghoob Hasan, Abdel Marouf Moheildien

Introduction: Interference substances can be significance source of error in the clinical laboratory measurements. Such errors may, in some cases represents hazards in patients. Hemolysis interferes with the Clinical Chemistry Analysis, which influence results of analytes and its leads to erroneous clinical interpretations. Hemolysis of Red cells is inevitable during the collection and handling of blood samples. In usual practice it is very difficult task to perform the rigorous analysis to evaluate interference in routine laboratories. Our objective was to assess effect of Hemolysis on routine biochemistry analysis Materials and Methods: The study followed the CLSI EP7-A2 protocol, sample were collected from 5 male subjects, aged 25-35 years, [0% (normal pool serum), serial dilution of different hemolysis grades [25% (1+coulter analyzer. The data was analyzed and ±5% difference from interferent free sample was taken as acceptable criteria.) ,50%(2+), 75%(3+) and 100%(4+)] of sample were prepared by spiking pooled serum with red cell lysate. The interference was studied up to concentrations of 0.5gm/dl for hemoglobin. Hemolysis indices graded on the basis of the appearance of the sample qualitatively ranked from “no visible hemolysis” to “4+ hemolysis. Aliquots were analyzed in triplicates using Beckman Results: The experimental design for laboratory method validation for hemolysis showed that Hemolysed samples starting from 1+ of hemolysis grade will be rejected for laboratory analysis for clinical chemistry parameters like Total bilirubin, Aspartate amino transferase, Alkaline Phosphatase, Gamaglutamyle transferase, Uric acid and serum potassium. While serum Creatinine hemolysed sample with 4+ hemolysis will not be accepted. Conclusions:Study results are useful for rejecting / to comment about the potentially misleading results in clinical chemistry parameters of clinical laboratory

226-229

Authors: Vijaysinh Parmar, Hiren Sanghani, Asha Khubchandani

Introduction: Serum creatinine is a useful diagnostic parameter of kidney function. Its concentration reflects glomerular filtration rate. Because of negative interference of bilirubin over creatinine level, may mislead the clinician. The most common and serious problems in the determination of serum creatinine concentration by the kinetic Jaffe method is the negative interference by bilirubin. Materials and Methods: This cross sectional study was done on 160 patients which have high bilirubin level, taken from B. J. Medical College, Civil hospital, Ahmedabad from August 2013 to December 2013. These samples were studied for interference of total bilirubin on measurement of Serum creatinine level before and after treating with deproteinizer (trichloroacetic acid 0.55 mmol/ltr). Serum bilirubin and serum creatinine level were measured by modified Jendrassik & Groff’s method and kinetic Jaffe’s reaction respectively by using Erba XL-640 fully auto analyzer. Results: In this study significant difference was found in Serum Creatinine level with the samples of high bilirubin content before and after treating with deproteinizer (trichloroacetic acid) (p<0>Preprecipitation of albumin along with bilirubin by trichloroacetic acid beforehand is suggested as an approach to correct the bilirubin interference. Conclusion: From this study it is concluded that bilirubin have negative interference on serum creatinine level. And this is corrected by using deproteinizer trichloroacetic acid

232-237

Authors: Suryapriya Rajendran, Manju M., Sasmita Mishra, Rakesh Kumar

Introduction: Diabetic nephropathy develops due to oxidative stress and inflammation resulting from chronic hyperglycemia. Bilirubin, a product of heme catabolism is found to have antioxidant and anti-inflammatory properties. Though previous studies have examined the relationship between total bilirubin and diabetic nephropathy, very few studies have focused on indirect and direct bilirubin levels. Hence, the present study aimed to compare serum bilirubin (total, indirect and direct) levels between non-diabetics, type 2 diabetics and diabetic nephropathy subjects and also to correlate albuminuria with serum bilirubin in type 2 diabetics and diabetic nephropathy subjects. Materials and Methods: 50 non-diabetics, 50 type 2 diabetics and 50 diabetic nephropathy subjects were included in the study. Fasting blood glucose, HbA1C, serum bilirubin (total, indirect and direct), serum creatinine, urine microalbumin and urine creatinine were measured. Estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (ACR) was calculated. Results: Total bilirubin, direct and indirect bilirubin were significantly decreased in type 2 diabetics and diabetic nephropathy subjects compared to non-diabetics. Total bilirubin and indirect bilirubin were also significantly decreased in diabetic nephropathy subjects compared to type 2 diabetics. Total bilirubin, direct and indirect bilirubin showed significant negative correlation with albuminuria (Urine ACR) in type 2 diabetics and diabetic nephropathy subjects. Conclusion: Our study suggests that low bilirubin levels might be a risk factor for the development of type 2 diabetes and diabetic nephropathy. Bilirubin can be used as a marker to predict the risk of developing type 2 diabetes among general population and diabetic nephropathy among type 2 diabetes patients

244-248

Authors: Arun Mathew Chacko, Geetha A, Beena Kumari, Deepti G. N., Sumina Cherian

Introduction: The goal of the present study was to find out the effect of coexisting hypothyroidism on the biochemical and anthropometric measurements in PCOS patients. Materials and Methods:The study consisted of 90 subjects already diagnosed as PCOS and thirty age matched controls .Biochemical parameters like fasting blood sugar and lipid profile and the anthropometric measurements like BMI and waist circumference were compared between the two groups. The 90 PCOS subjects were further divided in to two depending on their thyroid status as euthyroid and hypothyroid and the biochemical and anthropometric parameters were compared between these two groups. Result:In our study there was no statistically significant difference in the biochemical parameters between the PCOS subjects and the control group but the anthropometric parameters BMI and waist circumference were markedly increased in PCOS subjects as compared to the control group. The fasting blood sugar, total cholesterol (TC), LDL cholesterol and TG (triglyceride) levels were increased in hypothyroid PCOS subjects as compared to the euthyroid PCOS subjects. The waist circumference was also markedly increased in hypothyroid PCOS subjects as compared to the euthyroid group. Conclusion:Fasting blood sugar, Total cholesterol, LDL cholesterol and triglycerides were significantly increased in hypothyroid PCOS patients as compared to euthyroid PCOS patients. This may increase the risk of developing diabetes and cardiovascular events in PCOS patients suffering form hypothyroidis

254-256

Authors: K. N. Pujari, S. P. Jadkar, C. G. Patil, Aruna Kulkarni, V. B. Tuljapurkar

Leukemias are malignant neoplasms of hematopoietic stem cells characterized by diffuse infiltration of the blood and bone marrow by neoplastic cells. Leukemias are classified as acute and chronic according to clinical course and myeloid and lymphoid according to the cell predominantly involved in leukemic process. Free radicals are implicated in the pathogenesis of leukemia. Oxidative destruction of polyunsaturated fatty acid is called as lipid peroxidation. In this study, we determined serum malonyldialdehyde (MDA) level as a lipid peroxidation product in patients with leukemia. The mean serum MDA levels were significantly increased in leukemic patients (p<0>significant difference in serum MDA levels with respect to sex only in patients with chronic myeloid leukemia. Whereas in age groups, we found significant trend in serum MDA levels in patients with CML, AML and ALL patients. There was no significant difference in serum MDA level in patients with CLL with respect to age. Our finding of the high levels of serum malondialdehyde in leukemic patients as compared to healthy control may be due to increased oxidative stress in patients with leukemia

263-267

Authors: Bibifatima Bawakhan, Chandru M. C., Venkatesh Moger

Introduction: In recent years the burden of chronic kidney disease has increased worldwide. End Stage Renal Disease (ESRD) needs Hemodialysis as a common renal replacement therapy to reduce its morbidity and mortality. Hemodialysis adequacy must be maintained for effective treatment and is measured either by Urea Kinetic Model (Kt/V), Urea Reduction Ratio (URR), natural log Kt/V or Daugirdas 2nd generation formula. Though Kt/V is accurate, URR is commonly used in clinical practice because of its simplicity and clear concept. Objective: To estimate and compare URR with single pool Kt/V in assessing hemodialysis adequacy. Materials and Methods: An experimental prospective study consisting of 100 ESRD patients of either sex between 18-70 years, who were on hemodialysis maintenance. Blood urea was estimated by GLDH- urease method and serum creatinine by Jaffe’s method. Values were substituted in URR and Kt/V formula. Results and Conclusion: There was a significant difference in serum Urea levels after dialysis treatment (P< 0>positive correlation with Kt/V. Since the URR and Kt/V are closely related, their predictive power in terms of patient outcome is similar. However, use of Kt/V and urea modelling allows for comparing expected with predicted dialysis dose that can be used to analyse dialysis treatment and dialyzer clearance

271-276

Authors: Roshan Alam, Mohd Arif, Saba Khan, Mohammad Mustufa Khan

Introduction: Microalbuminuria has recently emerged as an early marker of hypertension induced target organ damage. Microalbuminuria in hypertensive patients may act as a potential risk factor for cardiovascular and kidney diseases. Objective:The aim of the study is to evaluate the levels of microalbuminuria in hypertensive (HT) patients and normotensive (NT) control subjects. Materials and Methods:In this case-control study, 42 HT patients and 42 age and gender matched NT controls were enrolled. Body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP) was measured by standard protocol. Urinary microalbumin and creatinine were estimated in spot urine sample of all subjects using commercially available kit. Chi-square test, unpaired t test and Pearson correlation coefficient were used for Statistical analysis. The p-value<0> Results:In this study, results showed that more than half of the HT patients have smoking habits (59.3%), alcoholic habits (71.4%) and family history of HT (73.8%), which is significantly higher as compared to NT controls (p=0.02, p=0.004, p=0.02, respectively). Anthropometric parameters height, weight and BMI were found significantly higher in HT patients as compared to NT controls (p=0.01, p=0.007, p=0.001, respectively). Mean of SBP and DBP were also found significantly higher in HT patients than NT controls (p=0.001, p=0.001, respectively). Urinary microalbumin, urinary creatinine and albumin creatinine ratio (ACR) were found significantly higher in HT patients as compared to NT controls (p=0.02, p=0.01, p=0.02, respectively). Correlation of various anthropometric and clinical parameters showed that ACR have significantly positive correlation with age in HT patients (r=0.364, p<0>negative correlation with age in HT patients, but not significant (r= -0.027). Similarly, ACR also have negative correlation with BMI, SBP and DBP in HT patients (r= -0.068, r= -0.145, r= -0.219, respectively), but these are not significant. Conclusions:Interestingly, more than half of the hypertensive cases have family history of HT in this study population. Urinary microalbumin, urinary creatinine and ACR were found significantly higher in HT patients than NT controls. ACR has significantly positive correlation with age in HT patients

284-287

Authors: C. Suvarna Devi, R. Ramya, H. R. Suma, J. N. Naidu, M. Prasad Naidu

Chronic kidney disease (CKD) is a global health issue rising in alarming rate. Diseases of mineral and bone metabolism are more common in chronic kidney disease. This study was aimed to evaluate comparison between ionized calcium and albumin corrected calcium in Subjects with CKD with dialysis treatment, to assess their calcium levels. Subjects with CKD on dialysis treatment, who presented to the Department of Medicine, PESIMSR, Kuppam were included into the study. Sample (n=40) was collected from all patients from AV fistula. This was used to analyze total calcium, serum albumin, pH and also ionized calcium values. Albumin corrected calcium is calculated using equation. The preliminary data analyses reporting a significant variation among ionized calcium and total calcium besides albumin corrected calcium in patients with CKD (p< 0>.There is a significant variation among ionized calcium and total as well as albumin corrected calcium in subjects with CKD (P < 0>

292-295

Authors: Nineetha Muraleedharan, M. Saboora Beegum, Jessy S. J.

Introduction: Preeclampsia is a common disease of vascular dysfunction in pregnancy. Previous studies have suggested that nitric oxide, a vasodilator decreases in preeclampsia. This could lead to a decrease in thyroid capillary flow as suggested by few studies, thereby causing a decrease in thyroid hormones. Present study aims to investigate nitric oxide in preeclampsia and also seeks to find any correlation between nitric oxide and thyroid profile in preeclampsia. Materials and Methods: In this Case-Control study, 40 preeclampsia subjects as cases and 40 pregnant women as controls at 30-38 weeks of gestation were involved. 5 ml of venous blood was collected to assay serum nitric oxide using chemical method (Griess assay) and thyroid profile (T3, T4, TSH, FT3 and FT4) using ELISA. Analysis and Results: Mean, median, standard deviation for quantitative variables was compared by student t test. Percentage values were compared using Chisquare test. ANOVA tests and Post Hoc analysis was done. Nitric Oxide was significantly decreased in preeclampsia (20.5±3.03 µmol/L) than in normal pregnant (26.25±5.09 µmol/L). It was significantly decreased even in mild preeclampsia (p<0> Conclusion:Preeclampsia is associated with a significant decrease in serum nitric oxide and thyroid hormone levels. In this study, we found correlation between decreased thyroid hormones (T3 and fT4) and nitric oxide levels, which was not significant. However preeclamptic women should be screened for hypothyroidism both during pregnancy and in post-natal period.

301-305

Authors: Jagannadha Phaneendra D.S, Sujatha Pasula, V. Sunanda, D. N. Apparow, Vennela kodali

Introduction: Hypertension is a major public health problem. Uric acid is emerging as one of the strongest risk factors for hypertension. Alteration in lipid profile has been identified as independent risk factor for hypertension. Aim:The aim of our present study was to determine the association of uric acid and lipid profile with hypertension of recent onset. Materials and Methods: 45 subjects with age group between 20-50 yrs with recent onset essential hypertension were taken as test group. Control group comprised of 45 healthy, age and sex matched controls satisfying the exclusion criteria. Serum Uric acid, TC, HDL-C,LDL-C, TG’S were determined by enzymatic methods using commercially available kits on a fully automated analyzer. VLDL was a calculated parameter. Results:In the test group the mean uric acid levels in males and females were 6.1 ± 0.78 mg/dl and 5.5 ± 0.93 mg/dl respectively. The mean uric acid levels among males and females in the control population was 4.2 ± 0.81 and 4.1± 0.56 mg/dl respectively. A significant difference in uric acid levels between the test group and control group both among males (p= 0.039) and females (p= 0.041) was observed. Among the lipid profile parameters. The mean Total cholesterol and Triglycerides were high in cases as compared to controls with p-values of 0.046 and 0.038 respectively. In test group higher mean values for HDL – C, LDL-C, VLDL were found as compared to controls but the increase was not statistically significant. Conclusion: A significant association of UA with Hypertension both among males and females was observed in our study. Among the lipid profile parameters a significant association was found between Total cholesterol, Triglycerides and hypertension.

310-313

Authors: Poonam Agrawal, Niket Verma, Binita, Sumita Sethi, Pratima

Introduction: Aim of this study was to assess the level of ischemia modified albumin(IMA) in newly diagnosed untreated hypothyroid subjects. Materials and Methods:Serum IMA assessment was done by Barr et al method 30 newly diagnosed patients of hypothyroidism For the control group 50 normal healthy euthyroid adults were selected. TSH was done by one-step sandwich ELISA, and fT3, fT4 was done by one-step competitive ELISA method. Data were presented as mean ± standard deviation (SD). Results: Serum IMA was not found to be statistically different between hypothyroid and euthyroid control group. Conclusion:Contrary to the findings of majority of studies done on this subject, our study has not shown any significant elevation of IMA in hypothyroid subjects as compared to euthyroid subjects. IMA level in subjects of hypothyroidism has been a controversial issue since long. Assessment of cIMA should be done in association with other oxidative stress marker, and their correlation if any should be studied in a large cohort.

321-323

Authors: Rajeswari Devi V. , Jothi Malar R, Santhi Silambanan, Sungdirenla Jamir

Introduction: Congenital adrenal hyperplasia (CAH) is an adrenal disorder, most commonly caused by 21- hydroxylase enzyme deficiency. Newborn screening for CAH is done by the measurement of 17-hydroxyprogesterone (17-OHP). Aim: To establish the reference limits of 17-OHP in newborns. Materials and Methods: The study was conducted at Sri Ramachandra Medical College and Research Institute (SRMC& RI), Chennai. The clinical data of 360 neonates delivered over a period of two years from January 2015 to December 2016 were retrospectively analyzed. The newborns were grouped according to birth-weight: G1: < 1>2250 g. Based on birth weights 17-OHP cut-off values were determined for each group by rank number. Results: The reference limits for the three group, < 1>2250 g are 2.23 - 59.3, 1.9 - 29.7 and 1.9 - 15.1 nmol/L respectively. The upper reference limits of all the groups are less than the values showed in the kit literature. Conclusion: CAH can be diagnosed by measuring 17-OHP at birth as a part of neonatal screening. Population specific and birth weight specific cut off values of 17-OHP will reduce the false positives.

328-333

Authors: Roopa Rani Bhandary, Sukanya Shetty, Ashalatha Rao, Srikrishna U

Introduction: The prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) is rising continuously. Cardiovascular disease is one among the leading causes of morbidity and premature mortality in patients with NAFLD. Aims and Objectives: To determine the risk of atherosclerosis in NAFLD subjects diagnosed by USG at K.S.Hegde Charitable hospital. Materials and Methods:A cross-sectional study involving 203 persons diagnosed with NAFLD were included in the study. Subjects with alcoholic liver disease, renal failure, tuberculosis, hepatitis B and/or C and those on lipid lowering drug were excluded from the study. Lipid profile was measured and Atherogenic Index of Plasma (AIP) was calculated as log (TG/HDL-c). Categorization of the subjects with respect to risk of atherosclerosis was done based on serum LDL-c, non HDL-c and AIP. Statistical analysis was done using Chi Square test and p value < 0> Results: More than normal values were observed for serum total cholesterol, LDL-c, triglyceride and non HDL-c in high percentage of NAFLD subjects (76.8%, 84.7%, 70.4% and 72.4% respectively). Serum HDL-c level was low in 53.2% subjects. 51.2% of subjects had high AIP and 23.6% had moderately high AIP. Conclusion: Results of categorization of the subjects with respect to risk of atherosclerosis based on serum LDL-c, non HDL-c and AIP showed that high percentages of subjects were in moderate and high risk categories. AIP is probably a better marker to determine the risk of atherosclerosis.

338-342

Authors: Jyothi S., Sridevi V.

Introduction and Objectives: Several studies have hypothesized the relation of Blood Urea Nitrogen (BUN) and serum Creatinine level with the severity of coronary artery disease. The basis of this study is to show the prognostic significance of BUN and serum Creatinine levels at admission for assessing the risk of mortality in patients with acute coronary syndromes (ACS). This study also undertakes the comparative prognostic significance of BUN over serum creatinine as an indicator of risk of mortality in patients with ACS. Materials and Methods & Results:This was a prospective study of all patients admitted with suspected (n=1019) and retrospectively confirmed (n=65) Myocardial Infarction (MI) or Unstable Angina. The Receiver-operating characteristic curve analysis established that the area under the curve for BUN was higher than that of Creatinine 0.71 (95% CL 0.65 to 0.78) and 0.63 (95% CL 0.59 to 0.66), respectively (p=0.005). The threshold level was 8.6mmol/L for BUN and 110µmol/L for Creatinine. Sensitivity was 61% and 56% for threshold levels of BUN and Creatinine, and specificity was 84% and 78%, respectively. It is seen only an increase of BUN and a combination of increased BUN and Creatinine levels, as risk factors of mortality with ACS.Isolated increase in creatinine levels was not found to be significant. Separate inclusion of BUN and Creatinine as continuous variables in the regression model showed that both were associated with the risk of mortality. Odds Ratio (OR) 1.18 (95% CL 1.12 to 1.25) and 1.08 (95% CL 1.011 to 1.019) per unit increase (R2 =12.5 and 8.1% respectively). When both were simultaneously included, only the increased BUN level was persistent with the prognosis of ACS: OR after multivariate adjustment 1.14 (95% CL 1.04 to 1.18). Conclusion: An increased level of BUN is a more significant prognostic marker of mortality assessment at admission in ACS than that of serum Creatinine

348-352

Authors: J. Visalasree, Phlips Abraham

Introduction: Pregnancy induced hypertension is considered as the major cause of maternal and perinatal mortality. Even though occurrence of PIH is due to abnormal placentation, endothelial dysfunction (ED) plays a pivotal role in the genesis of the multisystem disorder that develops in pre eclampsia and eclampsia. Excessive inflammation might lead to ED. So, a study has been designed to analyse some inflammatory markers (TNF-?, HsCRP, IL-6) and their association with endothelial dysfunction (NO) in PIH women. Materials and Methods:Study group consisted of Normotensive pregnant women (N) preclamptic women (PE) and eclamptic women (E) with 100 subjects in each group in the 3rd trimester of pregnancy. They were investigated for TNF-?, IL-6, HsCRP & NO. Statistical analysis was done using ANOVA Results:When compared to controls TNF-?, IL-6, HsCRP levels were found to be significantly high & NO levels were significantly low in PE, E group. Eclamptic women showed a significantly high level of TNF-?, and low levels of NO when compared to PE group. Conclusion:Early careful monitoring of TNF-? along with NO might be helpful to predict the origination and advancement of the disease. It may help in emerging approaches for diagnosis and prevention of maternal and fetal complications.