International journal of Clinical Biochemistry and Research

7-9

Authors: Anita Sharma*,Ashish Sharma

Aim: To find the difference in the levels of homocysteine and lipid-peroxidation in male and female patients of coronary artery disease. Materials and Methods: 71 subjects were included in this study over a period of 12 months out of which 12 female patient of CAD, 29 male patient of CAD and 30 were normal healthy subjects as controls. Estimation of plasma malondialdehyde (MDA) was done by colorimetric technique on RA 50 semi-automated chemistry analyzer. The homocysteine level in the plasma was estimated using the Hcy enzymatic assay on SYNCHRON CX5, Automated Chemistry Analyzer of Beckman Coulter Ltd. Results: We found significant increased levels of Hcy and MDA in male CAD patients than in female CAD patients. Conclusion: In female CAD patients, decreased levels of Hcy and MDA areindication of low oxidative stress that may be due to female sex hormones.

15-19

Authors: Gajendra Singh Dhakad,Ashish Kumar Sharma*,Gulab Kanwar,Ajay Kumar Singh,Shrikant Sharma

Introduction: Iron profile is one of the most important indexes for good health. Altered iron profile is a risk factor for many diseases. Excessive iron accumulation in body causes damages of many cellular structures and leads to oxidative damage and causes many complications. So, Iron profile must be studied in many diseases like diabetes mellitus. Materials and Methods: 100 subjects were taken in this study, out of which 50 were type 2 diabetes and 50 were normal healthy controls. BMI was calculated by dividing body weight (Kg) to square of height (meters). The waist / hip circumference ratio was calculated by dividing the waist circumference (cm) to hip circumference (cm). Sphygmomanometer was used for blood pressure measurement. The serum iron, TIBC, UIBC, plasma glucose and HbA1c were measured by semiautoanalyzer. The serum ferritin was estimated by chemiluminescence method. The % transferrin saturation was calculated by formula serum iron (?g/dl) x 100/ TIBC (?g/dl). Result: The anthropometric parameters like weight, BMI, waist circumference, hip circumference, waist hip circumference ratio, systolic and diastolic blood pressure was statistically extremely significantly (p<0> increased in type 2 diabetes mellitus subjects as compared to healthy control subjects. The plasma fasting glucose, HbA1C, serum iron, % saturation and serum ferritin were statistically extremely significantly (p<0> increased and UIBC was statistically extremely significantly (p<0> decreased while TIBC and hemoglobin were statistically significantly (p<0> Conclusion: Elevated iron and ferritin is a risk factor for diabetes and produce many complications. Proper management must be taken to remove the excess iron that can be very harmful to the body.

25-28

Authors: Anita M. Raut,Dhananjay V. Andure*,Ramchandra K. Padalkar,Sangita M. Patil,Sonali S. Bhagat

The cigarette smoke contains more than 4000 chemical including 43 cancer causing carcinogens and more than 400 toxins these includes nicotine, tar, carbon monoxide, ammonia, hydrogen cyanide, arsenic, nitric oxide and many others. Cigarette smoke oxidants cause oxidative damage and increases the protein oxidation by rapid proteolytic degradation of the oxidized proteins, as there is loss of thiol groups. The present study was planned to study interaction of thiol (-SH) of sulfhydryl proteins as well as lipid peroxidation by studying MDA, total antioxidant capacity and level of vitamin C. 30 smokers of smoking history 10 to 20 cigarettes per day were included in the study whereas 40 healthy non-smokers who never had smoked were served as healthy controls. The base line clinical investigations malondialdehyde (MDA), Sulfhydryl proteins (-SH), total antioxidant capacity (TAC) & vitamin C were measured. The results indicate that the total antioxidant capacity (TAC), vitamin C and sulfhydryl proteins (-SH) were low (p<0>

32-35

Authors: Mamatha B.V*,Chandrakanth K.H,Kashinath R.T,Rakshitha M.N

One of the important functions of thyroid hormones is homeostasis of mineral metabolism. So thyroid disorders usually lead to disturbances in mineral metabolism. Objective: To analyze serum levels of minerals like calcium, phosphorus and magnesium in patients of subclinical hypothyroidism and to correlate these parameters with TSH levels in cases. Materials and Methods: The study group included 70 patients who are diagnosed with subclinical hypothyroidism and 70 healthy controls who are age and sex matched with cases. Thyroid profile which includes estimation of serum T3, T4, TSH was done. Serum calcium, phosphorus and magnesium were also estimated in both cases and controls. Results: The study showed that in subclinical hypothyroidism patients serum calcium levels were significantly low with mean values of 8.9±0.62 and p<0> Conclusion: The serum levels of minerals like calcium, phosphorus and magnesium levels are significantly altered in subclinical hypothyroidism. Frequent follow up and checking the levels of these minerals in SCH patients should be done. Along with the treatment of the disease, it is necessary to give mineral supplements to prevent bone complications.

41-44

Authors: Lingraj Patil,Naga Mrudula*

Introduction: Tuberculosis is mainly associated with diarrhea, vomiting and profuse sweating leading to dehydration, electrolyte imbalance and acid base derangements. Treatment with anti tubercular drugs reduces the symptoms and balances the electrolytes. Hence, this study was carried out to assess the electrolyte imbalance among tuberculosis patients and to know the effect of anti tubercular treatment. This study was carried out to study the electrolyte imbalance among newly diagnosed tuberculosis patients and to know the effect of treatment with anti tubercular drugs in improving the electrolyte balance at BRIMS teaching Hospital Bidar. Materials and Methods: This was observational study conducted in pulmonary Medicine OPD of Bidar Institute of Medical Sciences teaching hospital Bidar. 50 participants were enrolled in our study and assessed for demographic data, serum electrolytes and bicarbonate levels and compared with Tuberculosis patients before and after treatment. Results: The electrolyte imbalance in terms of decrease in sodium, potassium chloride and bicarbonate values was significantly associate (p<0> Conclusion: In our study, after treatment with antitubercular drugs, electrolyte levels returned to normal. Because of the high incidence of the electrolyte disturbances in tuberculosis patients, close monitoring and aggressive management are mandatory.

48-52

Authors: Geetha Bhaktha*,Shivananda Nayak,Manjula Shantaram,Shreemathi Mayya

Objective: Diabetes is a disorder and prevention has become a global priority. Significance of hereditary factor in the advancement of Diabetes mellitus is really convincing. Sensitive factor for developing Type 2 diabetes (T2DM) is identified as adiponectin and hence the need of the study. Materials and Methods: This is a cross-sectional study. Subjects with self-reported history of T2DM in both parents were selected and biochemical parameters with anthropometric were recorded. They were grouped as diabetic and non-diabetics. Result: A greater level of difference of 9.45 units was seen in adiponectin levels between presence and absence of family history of diabetes (FHD). Further adiponectin continued to witness a significant difference even in diabetics and normal group with respect to family history. Hence when linear regression was made to asses relationship between adiponectin and other variables, it was found that diabetic status (P =0.000), leptin (P =0.001), and FH (P =0.000) had reached statistical significance among others parameters. Moreover adiponectin was positively correlated with diabetic status (B=4.655) and negatively correlated with leptin (B= -0.125) and Family History (B= -9.034). Conclusion: The comprehensive relation between Family History and adiponectin is true and are inversely related. Hence the impact of familial predisposition is advocated due to genetic load and diabetic status.

56-60

Authors: Manasa D.R,Chandru M.C*

Introduction and Objective: Chronic inflammation & lipid peroxidation plays a pivotal role in the etiopathogenesis of cardiovascular risks in many clinical conditions. Whereas, Lichen planus (LP), is a chronic skin inflammatory disorder which disturbs lipid metabolism& increases the lipid peroxides. However, there are limited data about the correlation between oxidative stress & hypertriglyceridemia in LP, hence the study was undertaken to 1) Estimate the levels of TG (triglycerides) & MDA (malondialdehyde) levels & 2) to correlate between the MDA & TG levels in LP patients. Materials and Methods: A case control study was done at KIMS hospital, Hubli, which included 50 LP patients and 50 healthy individuals. Serum levels of TG (GPO-PAP method) and MDA (TBA method) was done. Result: Patients with LP presented higher significant TG values (182.93 vs. 113 mg? dl), MDA values (4.81 vs. 3.99 nmol/ml) vs. controls.Also,our study showed positive correlation between TAG & MDA levels which is statistically significant (0.012). Interpretation and Conclusion: Thus,the present study showed increased levels of TG & MDA, indicating that hypertriglyceridemia & lipid peroxidation may have domino effect with each other due to chronic inflammation & thereby may increase the cardiovascular complications in LP patients.

64-66

Authors: S K Bhargavi,Shiva Kumar*,M Prasad

Introduction: The thyroid gland produces two hormones, Thyroxin (T4) and Triiodothyronine (T3). These hormones play a critical role in cell differentiation during development and help maintain thermogenic and metabolic homeostasis in the adult. Hypothyroidism is a clinical condition in which the thyroid hormones production is below normal. It affects approximately 2% of the population. Materials and Methods: This study was conducted over a period of one year among subjects having hypothyroidism at Sri Siddhartha Medical College and Hospital, Tumkur, Karnataka. Ethics committee approval obtained prior to the study. Both female and male subjects were included in the study and all of them in the age group of 20-60 years. Patients (N = 120) who were diagnosed clinically and biochemically as hypothyroid for the first time who were attending OPD or admitted were enrolled for the study. 60 normal healthy individuals working in Sri Siddartha Medical College were included as control group. Results: Serum uric acid levels were significantly increased in hypothyroid subjects when compared to controls (p value = 0.0001). Conclusion: It is important to evaluate serum uric acid levels routinely in hypothyroidism patients, to correct the possible altered purine nucleotide metabolism and to prevent the onset of gout. It may also help to observe set in myopathic changes in advanced hypothyroidism.

74-78

Authors: Alpna Goyal,Rashmi Gupta*,Chitra Upadhyay,Indu Gautam

Introduction: Adiponectin has been implicated in the physiology of insulin resistance during pregnancy. Insulin resistance is developed in the last half of pregnancy. Insulin has a direct influence on fetal growth and proven in past studies. Hence we can state that the adiponectin also has a effect on fetal development and growth and since it is a key regulator in the insulin sensitivity. The aim of the present study is to increase the knowledge of role of adiponectin, especially in a physiologically demanding state of pregnancy, and study its effect on development of a fetus by virtue of its birth weight and gestational age during a normal pregnancy. Materials and Methods: This open-ended non-comparative prospective study was conducted at the outpatient and inpatient department of Obstetrics and Gynecology as well as in the department of Biochemistry, Sawai Man Singh Medical College, Jaipur on 50 normal pregnant subjects and their neonates attending Obstetrics and Gynecology, department for routine checkups during the period of August 2014 to July 2015. Levels of adiponectin in maternal serum during mid-trimester and pre-labor stage of pregnancy were evaluated and compared. The evaluation of maternal and fetal adiponectin levels were also done in relation to birth weight and gender. Results: Adiponectin is detectable in pregnant subjects, with significantly higher levels seen in newborns; however, there was no relationship seen between maternal and fetal adiponectin levels at any stage of gestation (Midterm p=0.604, Full-term p=0.589). Mean Birth weight of newborns was noted at 2.95 (± 0.445) kg with slightly lower values in male babies. Statistically significant positive correlation was seen between fetal birth weights and fetal adiponectin levels (p<0> Conclusion: Adiponectin is a plausible candidate for illuminating some physiologic and pathophysiologic conditions associated with pregnancy and fetal growth. Our study concludes with the hope of further breakthrough studies in the clinical application of this very interesting molecule in the management of various metabolic diseases of newborns and adults.

82-86

Authors: A Khadeja BI,V Santhosh*,S Suganya

Introduction: Magnesium which is present in the extra-cellular compartment is very vital for antagonising calcium physiology. Hypomagnesemia is sensed as a stressor by our body suggesting that magnesium metabolism plays an essential role in the evolving of metabolic syndrome. Statistical data on the association of hypomagnesemia with metabolic syndrome would help the clinicians to overcome therapeutic compliance of the patients, so our study was designed to estimate the levels of serum magnesium in patients with metabolic syndrome and healthy controls and to correlate it with the components of metabolic syndrome. Materials and Methods: The present case-control study was conducted in patients with metabolic syndrome attending a tertiary care hospital in Kanchipuram District during the period from April to December 2017. 65 patients of metabolic syndrome & 65 controls who attended the various out-patient departments of the hospital were selected for the study. Waist circumference, blood pressure, fasting plasma glucose, serum triglycerides, HDL-cholesterol and serum magnesium was estimated, compared and analyzed. Results: This study has proven that the mean serum magnesium level in patients with metabolic syndrome was 1.3±0.07mg/dL while in controls it was 2.06±0.26mg/dL. A highly significant difference (p <0> Conclusion: The study has made the association of hypomagnesemia and metabolic syndrome evident. Further studies with larger sample size will help in providing data to implement supplementation of oral magnesium for effective correction of metabolic derangements observed in metabolic syndrome.

90-94

Authors: Meghal Mehta,Prerana Deokar*,Abhay Nagdeote

Introduction: Hypertensive disorders of pregnancy (HDP) represents a group of condition with high blood pressure (BP) during pregnancy, proteinuria and in some cases convulsions. It complicates 5-10% of all pregnancy. Hyperuricemia due to oxidative stress is associated with deleterious effects on endothelial function, oxidative metabolism, platelet adhesion and aggregation. Calcium plays a critical role in the function of the cardiac and vascular smooth muscle. Patients with hypertension in pregnancy have benefitted from dietary calcium supplements. Lactate Dehydrogenase (LDH), an intracellular enzyme, is elevated in cell leakiness, hemolysis and cell death. Aim and Objectives: To study serum Uric acid, LDH and Calcium in HDP and to compare with control. To study its correlation with systolic and diastolic BP in cases. Materials and Methods: A study conducted on 50 cases and 50 controls selected according to inclusion and exclusion criteria. 3ml of venous blood was drawn to estimate the serum uric acid, LDH and Calcium levels in each subject. Unpaired‘t’-test was used to study changes in the serum levels of uric acid, LDH and calcium in two groups. Pearson’s correlation coefficient was applied to correlate serum uric acid, LDH and calcium levels with systolic and diastolic BP in cases. Results: There was statistically significant increase in the levels of serum uric Acid, LDH and statistically decreased levels of serum calcium in cases as compared to controls. Conclusion: Serum uric acid, LDH and calcium could be considered as a supportive diagnostic tool in HDP.

99-104

Authors: Kruthi BN,Pushpa Sarkar,Raghunath H*

Introduction and Objectives: Hypertension (HTN) is one of the major public health problems of adult population. HTN and renal functions are closely related and it is a predisposing factor for renal abnormalities. The objectives of the study were to estimate and compare the levels of Microalbuminuria (MAU), serum creatinine and estimated Glomerular Filtration Rate (eGFR) in essential hypertensives and to correlate their levels with duration of HTN. Materials and Methods: The data of the cross sectional study includes physical measurements, blood pressure and biochemical investigations like serum creatinine, MAU [measured using Albumin Creatinine Ratio (ACR)] & eGFR. Result: Out of 220 subjects, 112 (48.21% male and 51.78% female) were essential hypertensives and 112 (47.32% male and 52.68% female) were non-hypertensives. Mean value of serum creatinine was within the normal range in both the study groups. 62.5% hypertensives had MAU as compared to 4.46% non-hypertensives. The difference in eGFR was not statistically significant among the study groups. Receiver Operative Characteristic curve (ROC) for duration of HTN showed that area under the curve for MAU was more as compared to serum creatinine and eGFR. Conclusion: HTN is a non-communicable disease (NCD) that still remains inadequately treated. The kidney is considered as a prime target for hypertensive damage. Our study suggests that MAU is prevalent in essential hypertensive subjects and has a positive correlation with the duration of HTN. MAU can be used as a better predictor of renal impairment in essential hypertensive patients as compared to serum creatinine and eGFR. More extensive screening for MAU should be performed to facilitate better stratification of renal disease in hypertensive patients.

111-117

Authors: Ahmed M.A. Akabawy,Heba Hamed,Wafaa S. Hegab,Hewaida Fadel,Sahar A. Ali*

Objective: Investigate serum levels of chemerin, apelin, betatrophin and leptin adipokines and HsCRP in obese and non-obese patients either prediabetic or diabetic and correlate their levels with other biochemical parameters of IR. Additionally, studying the effect of their combinations on the sensitivity of investigation for the development and/or progression of T2DM. Subjects: serum levels of adipokines were analyzed using ELISA technique in 160 subjects. Results: Serum Chemerin, Apelin and HsCRP levels were significantly higher in all obese groups compared to non-obese of the same group.Serum levels of both betatrophin & HsCRP were positively correlated with glycemic indices (FPG, A1c, HOMA-IR). Serum levels of chemerin were positively correlated with FPG, A1c. Serum Chemerin, betatrophin, HsCRP all showed negative correlation with HOMA-? level. The combination of different markers improved their sensitivity of detection, with the highest level of sensitivity shown between betatrophin with HsCRP. Conclusion: these results indicate crucial roles played by the studied adipokines and HsCRP in IR caused by obesity and consequently T2DM development. Combination of Betatrophin and HsCRP can be an early sensitive predictor for IR occurrence in obese patients. These adipokines may be targets for the development of therapies to treat or inhibit IR associated to obesity.

121-125

Authors: H L. Vishwanath,Shwetha N*,Leelambika C

Introduction: Diabetes mellitus is a metabolic disease characterized by abnormally high blood glucose levels. Caused by a derangement in the secretion and function of the endocrinal portion of the pancreas as there is a interrelation between the functional and the anatomical portion of the pancreas. Objectives: To evaluate serum amylase and serum lipase in diabetic patients and its association. Materials and Methods: 30 age and sex matched diagnosed cases of type 2 DM between 40-80yr were included in the study and 30 healthy individuals as controls. All samples were analyzed by auto analyser. Data analysis was done by means of two tailed and independent ‘t’ test. Results: There was a considerable decline in serum amylase (p<0 p=0.00661) r=0.1086) r=0.0155).> Conclusion: The current study shows an pancreatic exocrine destruction in type 2 DM. Serum pancreatic enzymes can be used as an extra explanatory parameter for the evaluation of progression of the disease and response to treatment.

129-134

Authors: Veena Bhaskar S Gowda*,Prashant Vishwanath,Bhaskar H Nagaiah,Bharathi Sengodan,Parveen Doddamani

Introduction: Problem-based learning has been proposed as an alternative to learning by the traditional lecture method with advantages of assisting medical students to acquire and retain relevant information through integration of basic and clinical sciences. It is also proposed to motivate and improve students’ ability to integrate theory and practice in clinical practice. Acquisition of diagnostic reasoning skills in Problem based learning curriculum is proposed to be better than in a conventional medical education. Materials and Methods: Seventy students from AIMST University, Malaysia following an integrated hybrid PBL curriculum (hPBL) and seventy students from JSS medical college, India following a traditional curriculum (TC) were considered for the study. Twenty-five case scenarios in multiple choice formats were administered to both groups. Results: Students from the hPBL curriculum showed a better performance with respect to all questions compared to students from TC. Statistically significant difference was found between the mean percentage score at AIMST (72.11%) compared to that at JSSMC (56.53%) (P<0.002). Conclusion: Students studying in an hPBL curriculum developed better diagnostic competence to answer questions with respect to all major organ systems in the body compared to students from the TC. This is presumed to be because they are better able to integrate knowledge acquired from all of the basic sciences. Since most of the qualifying exams around the globe are objective oriented, training students to acquire medical knowledge in an integrated way and prepare them to develop a better diagnostic competence is the need of the hour.

505-508

Authors: M. Girija Menon,Amrut Arvindrao Dambal*,D Sridevi,Harika Kolli,G Lakshmi Chaitanya

Introduction: Diabetes mellitus characterized by high glycemic levels is routinely associated with many mineral abnormalities. The purpose of this study was to evaluate the levels of serum magnesium among subjects with diabetes mellitus and to compare and analyze the same in normal non diabetics. Materials and Methods: In this case control study conducted at Malla Reddy Hospital, 50 subjects known to be diabetics were considered as cases and 50 apparently normal non- diabetics were the controls. Serum magnesium was estimated, compared and analyzed. Results: Serum magnesium levels were 1.89 ± 0.32 among cases and 2.26 ± 0.27 among controls. Extreme statistical significance was observed between both the groups. Conclusion: Serum magnesium levels were found to be decreased in subjects with diabetes mellitus. We conclude that diabetes mellitus could influence magnesium homeostasis.

513-516

Authors: B Jyotchna Devi*,V Uma Lakshmi,Naazia Arifuddin,J Rama Rao,Ch Kiranmai

Serum Paraoxonase is an esterase, along with Apolipoprotein A1 and Clusterin (Apolipoprotein J), PON 1 is associated with HDL. This study was done to assess the significance of serum Paraoxonase as an biomarker along with standard liver function tests in evaluating alcoholic cirrhosis. Serum Paraoxonase levels was estimated in 30 patients diagnosed with alcoholic cirrhosis and 30 healthy blood donors. Paraoxonase levels were significantly lower in cases as compared with controls (P<0> Conclusion : Serum Paraoxonase is sensitive marker for patients with alcoholic liver disease and oxidative stress and should be included as an additional parameter along with the other parameters in liver function tests.

521-525

Authors: Anita M. Raut,Dhananjay V Andure*,Ramchandra K. Padalka,Sangita M. Patil,Sonali S. Bhagat

Lungs are the only organs which are continuously exposed to external environment through the process of breathing. The cigarette smoking is main leading cause of various morbidities related to lungs. Adenosine deaminase (ADA) and alpha-1 antitrypsin (A1AT) are the two very important parameters of which ADA is required for maintaining proper immunity and A1AT is required for resolving oxidant stress on lungs by various mechanism. In the present study we evaluated the level of these parameters in active cigarette smokers without lung disease and COPD patients, and found that ADA level was significantly high in healthy smokers and COPD patients as compared to healthy controls (P<0>

533-536

Authors: Ajay Kumar Singh,Raj Kumar*,Ashish Sharma,Dharambeer Sharma,Saurabha Srivastava

Thyroid hormones (TH) are essential for an adequate development and kidney maturity. The dysfunction of thyroid causes striking changes in glomerular and tubular capacities and electrolyte and water homeostasis. Hypothyroidism is affiliated with a decline in glomerular filtration, hyponatremia, and a modification of the capacity for water extraction. Since various renal function derangements occur in hypothyroidism, therefore, present study has been intended to determine the various parameters (urea, creatinine and uric acid) related to renal function in hypothyroid patients and correlation of these parameters with thyroid hormones (T3, T4, TSH). The study was conducted on 200 hypothyroidisms. Age and sex matched healthy euthyroids were selected for the study. Serum was taken from each patient and control and was analyzed for T3 by competitive analog-based immunoassay, T4 by competitive analog-based immunoassay, TSH by 2 site chemiluminescent immunometric assay, creatinine by modified Jaffe’s method, urea by urease method and uric acid by uricase method respectively. A total number of 300 cases that includes 200 hypothyroid patients (25% males and 75% females) and 100 controls (42% males and 58% females) were examined. The mean level of serum T3 (1.968 ± 0.1195 pg/ml), serum T4 (1.0152 ± 0.1235 pg/ml), serum urea (33 ± 5.570mg/dl) of hypothyroids were significantly lower as compared to mean level of serum T3 (3.704 ± 0.1699 pg/ml), serum T4 (1.5764 ± 0.16230 pg/ml) and serum urea (35.12 ± 3.710mg/dl) of euthyroids. The mean level of serum TSH (8.928 ± 0.9589µIU/ml) serum Creatinine (2.192 ± 0.2566mg/dl) and serum uric acid (4.224 ± 0.6554mg/dl) of hypothyroids were significantly higher as compared to mean level of serum TSH (3.06 ± 0.4110 µIU/ml), serum Creatinine (0.852 ± 0.1396 mg/dl) and serum uric acid (3.772 ± 0.2975 mg/dl) of euthyroids. Hypothyroids serum T3 significantly correlated with positive person serum uric acid (r = 0.343). Hypothyroids serum T4 indicate noteworthy negative Pearson relationship with serum urea (r = - 0.367) and creatinine (r = - 0.267) Hypothyroids serum TSH indicate huge negative Pearson connection with serum uric acid (r = - 0.190) and creatinine (r = - 0.344). Elevated serum creatinine, serum urea and serum uric acid demonstrates renal capacity disturbances in hypothyroidism.

541-546

Authors: Bijoya P. Chatterjee,Sandip Sendhav*,Amit Kakaiya,Prasanta Chatterjee Biswas

Introduction: Among the various risk factors for the development of Ischemic heart diseases (IHD) as well as stroke is elevated low density lipoprotein cholesterol (LDL-C) levels. This makes accurate reporting of LDL-C crucial in the management of IHD. On one hand estimation of LDL-C by direct method is available, but it is expensive and on the other hand the Friedewald’s formula is most commonly employed but a method with limitations. Aim: Therefore the aim of this study is to evaluate the correlation between calculated LDL-C with direct LDL-C method and analyse their appropriateness. Materials and Methods: This study was a hospital based cross-sectional study. LDL-C was measured by both Friedewald’s formula (FF) and direct LDL method in 501 participants between the age group of 30–70 years. Paired t-test was used to test the difference in LDL concentration obtained by a direct method and Friedewald’s formula. The level of significance was taken as P < 0> Results: The mean and standard deviation (SD) of LDL-C estimated by both direct assay and FF showed a significant difference (p<0>0.05) at TG range >400 mg/dL. There was a discrepancy of 37 out of 501participants (7.38%) classified as cardiac risk groups by the two methods used. A significant correlation between LDL-C levels obtained by FF and direct methods, (p value <0 xss=removed xss=removed> Conclusion: The study concludes that both methods can be employed depending on TG levels. Direct LDL estimation appears to be unreliable at TG concentrations >400 mg/dL but useful when sample is collected from a non-fasting participants.

551-554

Authors: Asfia Afreen*,Dinesh Javarappa,Itagappa M

Diabetes mellitus is a chronic endocrine disorder associated with a multitude of microvascular and macrovascular complications. The imbalance between the productions of free radicals plays a prominent role in the development of these complications. Different markers of oxidative stress on erythrocyte membrane like Malondialdehyde (MDA), Protein carbonyl, Protein thiols and protein content of the membrane show variations which can be estimated to know the effect of oxidative stress. Similar effect is seen on erythrocyte membranes when these are subjected to proxidants like Ascorbic acid with Iron or Copper in Vitro. In our study the effect of oxidative stress on RBC membrane in diabetes was estimated and the same was validated by subjecting Erythrocyte membranes of controls to oxidative stress in vitro by using Ascorbic acid with Iron. A case control comparative study was done with type 2 DM patient blood samples and normal controls at BMCH & RC, Chitradurga. The maximum number were of the age group of 41- 45 i.e. 32%. The mean FBS levels among cases and controls 197.50 mg/dl and 93.48 mg/dl respectively. There was similarity in the results between levels of protein content (4.56±0.19), protein carbonyl (1.20±0.08), protein thiol levels (1.42±0.10) and MDA (4.23±0.21) among diabetics in comparison to protein content (4.28±0.14), protein carbonyl (1.39±.0.097), protein thiols (1.04±0.05) and MDA (4.75±0.81) in controls treated with Iron Ascorbate a pro-oxidant mixture.

560-564

Authors: Ovono Abessolo Félix*,Mbang Bengone Aude Syntia,Ndong Atome Guy Roger,Batou Alvine Sybille,Ngou Milama Edouard

Objective: The aim of this study was to investigate the relationship between the sweat function and parameters of the metabolic syndrome in type 2 diabetes patients. Materials and Methods: This was a cross-sectional study, which took place from July 2016 to December 2016. It was carried out on type 2 diabetes patients who were under treatment. The sweat function, levels of glucose, triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol were determined, as the parameters of the metabolic syndrome. Univariate and multivariate analyzes were used to determine the relationship between these parameters and the neuropathy score determined by the sudoscan. Results: Of the 244 patients, aged 32 to 88 years, the average conductance of hands was 59.0±0.8 mS and that of the feet 70.5±11.8mS. The neuropathy score obtained was 39.5±16.2%, with no significant difference between men and women (p = 0.289). By univariate analysis, age (p = 0.0355), blood glucose (p = 0.015), waist circumference (p = 0.0006), the glycated hemoglobin (p = 0.0378), the duration of diabetes (p = 0.0006), systolic blood pressure (p = 0.0378) and size (p = 0.0062) were associated with neuropathy score. In multivariate analysis, there was an association between neuropathy score and the body mass index, weight, duration of diabetes, glycated hemoglobin and glycemia. Conclusion: The conductance of the feet and hands as well as neuropathy score obtained by the sudoscan are associated with other parameters of the metabolic syndrome. The sudoscan can therefore provide information regarding to the glycemic control of diabetics.

570-573

Authors: Anuj Modi*,Nita Sahi

Introduction: Calcium and phosphorous are the two important minerals whose abnormalities are most ignored in the developing countries. The impact of calcium abnormalities ranges from abdominal pain, muscle spasms, psychiatric disorders to cardiac arrest. Other than the known regulators of calcium and phosphorous, thyroid hormones may affect the levels of calcium and phosphorous. The aim of our study is to estimate serum calcium, phosphorous and thyroid profile and to see the effect of thyroid hormones on serum calcium and phosphorous. Materials and Methods: 40 hyperthyroid and 40 hypothyroid patients were taken as cases. 40 healthy individuals were taken as controls. Thyroid profile, serum calcium and phosphorous were estimated in cases and controls. Serum calcium and phosphorous levels were compared with thyroid hormones among cases and controls. Correlation of thyroid hormones with serum calcium and phosphorous were done. Result: The mean serum calcium and phosphorous levels in hyperthyroid patients are 12.7±0.89 mg/dl and 5.1±0.68 mg/dl respectively which are increased (p value < 0> Conclusion: Hyperthyroidism and hypothyroidism may lead to hypercalcemia and hypocalcemia respectively, which are the cause of may disorders and disabilities. The concentration of serum calcium and phosphorous should be checked regularly in those patients.

578-582

Authors: Palem Siva Prasad,Veluri Ganesh*

ntroduction: Endothelial dysfunction (ED) is a well known initial stage of atherosclerosis and cardiovascular disease (CVD) in general population. Recently studies shown increased HbA1c is a marker for cardiovascular risk in subjects with diabetes and without diabetes. Atherogenic index of plasma (AIP) is another risk factor for cardiovascular events. Hence, the study has been designed to assess the correlation of HbA1c with AIP and ED in type-2 diabetic subjects to forecast risk of cardiovascular events. Materials and Methods: Hundred subjects are enrolled into study with the age of 38 to 58 years, among these 50 were type 2 diabetic subjects and 50 were healthy controls. HbA1c was estimated by immuno-turbidimetric method. Nitric oxide (NO) was measured by kinetic cadmium reduction method and AIP was calculated by standard formula Log (triglyceride/HDL-c). ‘Kruskal Wallis’ test was used to perform statistical variables between the study groups. The association between the variables was executed by “Pearson correlation test”. Result: HbA1c level was shown to be significantly higher in type-2 diabetic subjects than healthy controls. Significant lower level of NO was observed in type-2 diabetic subjects than healthy controls. AIP level was significantly higher in type-2 diabetic subjects than healthy controls. The present study also observed significant correlation of HbA1c with NO and AIP. Conclusion: We have found that HbA1c has significant correlation with NO and AIP. Therefore, estimation of HbA1c may be a predictable marker for cardiovascular events in type-2 diabetic subjects.

588-593

Authors: Susanna Theophilus Yesupatham*,Munilakshmi Uppalamethi,Shashidhar Krupad Nagaraj,Lakshmaiah Venkataswami

Objective: To evaluate Gender specific alterations in the levels of serum lipid profile parameters Total Cholesterol (TC), Triglycerides (TG), Low density lipoprotein Cholesterol (LDL-C), High density lipoprotein Cholesterol (HDL-C), non-HDL-C (TC-HDL-C), lipid ratios [TC/HDL, TG/HDL, LDL/HDL, non HDL/HDL, LDL/non HDL], hs-CRP and uric acid in male and female Diabetic patients with Acute Myocardial Infarction(AMI) compared to male and female Diabetic patient controls, and to correlate the serum lipid ratios with serum hs-CRP and uric acid levels among male and female Type 2 DM patients with AMI. Materials and Methods: Blood samples collected after admission from thirty male and thirty female Type 2 DM with AMI, and from thirty male and thirty female Type 2 DM patients with no previous history of coronary heart disease as controls, the samples were analyzed for levels of serum lipid profile, hs CRP and uric acid. Results: There was a significantly high TG/HDL ratio in males diabetic patients p<0> Conclusion: A higher level of dyslipidemia in female diabetic patients with AMI compared to male diabetic patients with AMI necessitates the need to initiate a more aggressive lipid management strategy for women with diabetes. Estimating the serum hs CRP levels as independent parameter may serve as predictor of risk of AMI irrespective of their gender during routine follow up of diabetic patients.

599-603

Authors: Archana A*,Brindha G,Ursula Sampson

Introduction: To study the concentration of serum soluble endoglin during second trimester pregnancy and monitor for the development of preeclampsia. Materials and Methods: Seventy-five healthy singleton pregnant women in second trimester was evaluated in this study. ELISA technique was used for measuring the concentration of Serum soluble endoglin. Patients with increased level of serum endoglin were monitored for signs and symptoms of preeclampsia. Result: Thirty five pregnant women developed preeclampsia among 75 pregnant women. The mean value for sENG in cases was 8.7 ± 1.4 and control 5.9 ± 0.6. The normal value of serum sENG varies from 2.54 to 7.06 ng/ml. Hence, it is higher than the normal limit in cases. Conclusions: The concentration of sENG was studied and women were monitored for development of preeclampsia. The present study showed that women with increased serum soluble endoglin levels developed preeclampsia later. Hence, it is suggested that soluble endoglin will be useful in predicting pre eclampsia.

608-612

Authors: Baviskar P. A,Guha Niyogi NI*,V W Patil,Bagle T. R

Introduction: Diabetic nephropathy is one of the leading complications of longstanding diabetes mellitus. With the background of inflammation, there is need for laboratory tests for early diagnosis and prevention of diabetic nephropathy. Materials and Methods: A cross sectional study done after screening, patients satisfying the inclusion and exclusion criteria 50 patients of type II diabetic patients with nephropathy (Group I) and 50 type II diabetic patients without nephropathy(Group II) were included in the study. Serum uric acid was estimated by standard enzymatic uricase method on autoanalyser ADVIA 1800. Serum urea was estimated by urease method and serum creatinine was estimated by Jaffe’s method and Sr.Uric Acid by uricase method using fully autoanalyzer ADVIA 1800. Results: The mean age in group I was 59 + 9.28 years and group II was 56.2 + 11.47 years. The serum Uric Acid was 9.51 +2.46 (mg/dl) in group I and statistically significant (p<0>+ 1.68 mg/dl. The Serum creatinine in group I (6.68 + 2.94 mg/dl) and statistically significant p<0>+ 0.77 mg/dl). There was positive correlation between Sr.Uric Acid and Sr. Creatinine (r=0.625, p<0 r=0.542, r=0.841,> Conclusion: Regular detection can help the clinician to take appropriate action to delay complications which in turn may help preserve renal function in DN patients.

617-621

Authors: Bhavesh R,Boinapalli Sudhakar*

Introduction: Quality failures in clinical biochemistry laboratory have an adverse impact on patient care. Identification and correction of the quality failures are essential to decrease risk and improve patient safety in hospital. Materials and Methods: This study was assessed over 14 months from January 2017 to February 2018. A designed ‘Quality enquiry forms’ were introduced to report quality failures which prioritize corrective action. Quality failures were categorized in three phases: preanalytical, analytical and postanalytical with subcategories in each phase. Quality failures were graded on the basis of actual (‘A’ score) and potential (‘P’ score) adverse outcome on patient care using 5 point scoring system. Results: The numbers of quality failures reported were 453 (0.53%) out of 84,569 requisites received by the clinical biochemistry laboratory, during this entire study period. Quality failures were reported as 50.3%, 5.1% and 44.6% in preanalytical, analytical and postanalytical phases respectively. Quality failure severity ‘A’ score was tilted towards lower side: 58.5% allocated an ‘A’ score of 1 (least severe grade), while for the ‘P’ score towards higher side: 45.5% allocated a ‘P’ score of 5 (most severe grade). Conclusion: Quality enquiry reporting system is an effective method for recognition of quality failures in clinical biochemistry laboratory. Systematic approach in this study encompasses a multifaceted strategy for error analysis based on error detection and prevention.

627-630

Authors: Sandeep Kumar Sharma,Niranjan Singh*,K V. Thimmaraju,Mona Tilak

Introduction: Chronic obstructive pulmonary disease (COPD) which includes chronic bronchitis and emphysema is considered as a progressive type of respiratory tract disease and is characterized by structural changes such as emphysema, airflow limitation, dynamic hyperinflation, air trapping, and peribronchial fibrotic remodeling of the lungs with significant systemic inflammatory components, induced by chronic exposures to smoking and/or occupational or environmental sources. Materials and Methods: This case control study was conducted on 60 subjects in which 30 were healthy controls and 30 were cases of COPD. Patients with history of respiratory disease other than COPD, cardiac diseases and neuromuscular disease were excluded. 30 healthy age and gender matched non-smoker adults were selected as control group. Results: Unpaired t test was performed and it was observed that Total Cholesterol, Triglyceride, Low Density Lipoprotein, Lactate dehydrogenase levels were significantly higher and serum concentrations of High Density Lipoprotein was decreased significantly in cases as compared to controls. Conclusion: Serum LDH levels are altered in many respiratory diseases but it has not been studied in depth in COPD patients. In view of this we conducted the study and our results shows that patients with COPD have raised serum LDH levels.

638-641

Authors: Hemantha Kumara D. S,Muralidhara Krishna C.S*,H L. Vishwanath

Introduction: Excessive consumption of alcohol and alcoholism are widely observed risk factors for damage to health and social problems. Early identification of alcoholic liver disease could improve the possibility of early treatment and reduce damage to health and health costs. Our present study was anticipated to establish the association between the liver enzyme gamma-glutamyl transpeptidase and an haematocrit parameter mean corpuscular volume in alcohol liver disease patients. Materials and Methods: Our study includes 100 subjects, with 50 cases and 50 controls. Serum was collected for the analyses of GGT, liver enzymes ALP, AST, ALT, total protein, albumin, bilirubin. Haemoglobin, Mean corpuscular volume, PCV and RBC were also analyzed. The statistical relationship between AST and ALT has been calculated. Statistical data analysis was performed by SPSS 20 software. Results: The values of the GGT and MCV levels were significantly increased in patients compared to controls (p <0>Conclusion: The Overall verdict of this study shows that the increase in ?GT and MCV levels in ALD patients can be used for added diagnostic markers for the diagnosis of alcoholic liver disease.

646-650

Authors: Leela P*,C.R. Mallikarjuna,Shreedhar A. M

Cardiovascular diseases are the major cause of death globally. Hyperlipidemias and hyperlipoproteinemias are the most important risk factors for atherosclerosis. Inflammation plays a major role in atherothrombosis, and measurement of inflammatory biomarkers like High Sensitive C- reactive protein (hsCRP) can provide detection of high risk for Ischemic Heart Disease (IHD). Lipoprotein (a) [Lp (a)] is a low density lipoprotein like particle synthesized by the liver. There is a strong association between circulating Lp(a) levels and IHD. Objectives: To estimate the serum levels of lipoprotein (a) and lipid profile in ischemic heart disease patients and healthy subjects and to show that serum hsCRP as a better predictor of ischemic heart disease than low density lipoprotein cholesterol. Materials and Methods: A total number of 100 subjects were studied comprising of 50 controls and 50 IHD subjects. Total cholesterol (TC), triglycerides (TGL) and HDL-C, were estimated by enzymatic methods, LDL-C and VLDL-C were estimated by calculation, Lp(a) was estimated by immunoturbidimetric methods and hsCRP was estimated by chemiluminiscence method. Appropriate statistical analysis was done. Results: TC, TGL, LDL-C, VLDL-C, Lp(a) and hsCRP were increased whereas HDL-C was decreased in IHD subjects when compared to controls. Diagnostic validity test revealed that hsCRP to be a better discriminator of IHD than LDL-C. Conclusion: The results of the current study support the concept that the levels of Lp(a), and hsCRP are strongly related to ischemic heart disease in addition to the levels of serum lipids.

2-6

Authors: Amruta Bakshi*,Jayshree Bavikar,Shilpa Asegaonkar

Introduction: Rising prevalence of obesity represents rapidly growing threat for Indian subcontinent. Dyslipidemia in obesity accelerates the process of atherogenesis; though its occurrence can’t be underestimated in apparently normal individual lipids. This warrants need of precise measures to predict dyslipidemia beyond routine lipid parameters. Atherogenic Index of Plasma, Atherogenic Coefficient & Lipid Accumulation Product have gained attention in this regard. Aims and Objectives: This cross sectional study aimed at assessing usefulness of calculated lipid indices over individual lipids as potential predictors of atherosclerosis in obesity. Materials and Methods: The study enrolled 100 apparently healthy overweight & obese cases and 100 healthy controls. Fasting blood sample was collected for lipid profile parameters. Statistical analysis was done by SPSS software. Results: The levels of TC(211.4+ 36.2/173.9+21.4), TAG (162.9+41.5/124.6+26.3), AIP (0.23+0.11/0.08+0.03), AC (4.3+1.4/2.7+1.1) & LAP (31.3+8.6/24.3+6.2) were elevated while HDL (41.7+9.2/ 52.2+8.3) levels were founder to be low in cases compared to controls (p<0>Cases having raised AIP and LAP outnumbered than those with atherogenic dyslipidemia. Conclusion: Calculated lipid indices proved to be better than conventional lipid parameters as simple, sensitive & independent tools to screen high risk individuals for atherogenesis in obesity especially in Indian scenario with limited resources.

10-14

Authors: Arshiya Fatima,Arshia Zeib*,V Umalakshmi

Introduction and Objectives: Chronic kidney disease is the pathophysiologic process with different etiologies, resulting in exorable attrition of nephrons and their function. The most frequent cause of CKD is diabetic nephropathy, caused by type 2 diabetes mellitus. Kidney disease worsens over time by transitioning through a defined sequence of stages. Thus it should be possible to detect CKD prior to kidney failure. Insulin levels, change with CKD as a result of reduced excretion, decreased degradation, or a defect in regulation. Insulin resistance is associated with CKD as an antecedent or as a consequence of CKD is not yet known. The prevalance of higher IR in CKD cases is due to the decrease in glomerular filtration rate and a disturbance in insulin metabolism. The presence of insulin resistance and hyperinsulinemia was observed in CKD patients both with and without diabetes. The aim is to evaluate their role in both diabetic and non diabetic CKD patients. Materials and Methods: A case control study was done. Around 90 individuals were taken for the study and divided into 3 groups (healthy controls, CKD non diabetic patients and CKD diabetic patients).After taking informed consent blood samples were collected in individual’s fasting condition. Fasting plasma glucose, serum insulin measured and insulin resistance calculated by HOMA-IR. Multiple comparisons between different groups were done using ANOVA test. Results: The present study showed that the mean±S.D of IR in controls was 1.7±1.5, in CKD without DM cases was 4.2±4.8 and in CKD with DM cases 11.1±11.8. Fasting Plasma Glucose, Fasting Insulin, IR were significantly increased (P<0> Interpretation and Conclusion: Insulin resistance was found to be associated with CKD in both diabetic and non diabetic patients. Increased insulin resistance causes more worsening of renal function. Thus, by introducing measures that can reduce insulin resistance like glycemic therapy and early detection of metabolic syndrome might delay the progression of renal dysfunction and cardiovascular mortality in chronic kidney disease cases.

20-24

Authors: Sunita Meena,Anju Jain,Kiran Agarwal,Ekta Debnath,Atul Kumar Meena*

Introduction: The prevalence of Gestational diabetes mellitus (GDM) is increasing world wide. It has been said that plasma levels of TNF-? is regulated by single nucleotide polymorphism in promoter region of TNF-? gene in development of GDM. The study was done to determine Tumor Necrosis Factor-? (TNF) levels and its gene Polymorphism in GDM cases and controls and to correlate them with each other. Materials and Methods: A total of 60 patients were selected comprising 30 diagnosed GDM cases and 30 apparently healthy pregnant women from ANC matched for age and gestation. OGTT was conducted and glucose estimated by GOD-POD method (Beckman AU-480 auto-analyzer) and serum TNF-? levels using sandwich ELISA. TNF-? 308(G/A) gene polymorphism was analyzed by extracting DNA from whole blood (using QIAGEN DNA mini kit) followed by DNA amplification by PCR and RFLP using restriction enzyme Nco1. Results: TNF-? levels were significantly increased in GDM cases (28.93±20.96 pg/ml) as compared to controls (19.4±11.6 pg/ml). TNF-? polymorphism revealed GG genotype in 87% cases and 93% controls; AA 3% of cases and 7% of controls and GA 10% of cases and absent in controls. However, the difference was statistically insignificant. TNF-? levels did not significantly correlate with the polymorphism. ROC analysis showed area under the curve of 0.613 for prediction of GDM. Conclusion: In GDM significant increase of TNF- ? levels signifies the role of inflammation in the etio-pathogenesis. The TNF-? G308A gene Polymorphism in particular is however not significantly associated with GDM.

25-28

Authors: Anita M. Raut,Dhananjay V. Andure*,Ramchandra K. Padalkar,Sangita M. Patil,Sonali S. Bhagat

The cigarette smoke contains more than 4000 chemical including 43 cancer causing carcinogens and more than 400 toxins these includes nicotine, tar, carbon monoxide, ammonia, hydrogen cyanide, arsenic, nitric oxide and many others. Cigarette smoke oxidants cause oxidative damage and increases the protein oxidation by rapid proteolytic degradation of the oxidized proteins, as there is loss of thiol groups. The present study was planned to study interaction of thiol (-SH) of sulfhydryl proteins as well as lipid peroxidation by studying MDA, total antioxidant capacity and level of vitamin C. 30 smokers of smoking history 10 to 20 cigarettes per day were included in the study whereas 40 healthy non-smokers who never had smoked were served as healthy controls. The base line clinical investigations malondialdehyde (MDA), Sulfhydryl proteins (-SH), total antioxidant capacity (TAC) & vitamin C were measured. The results indicate that the total antioxidant capacity (TAC), vitamin C and sulfhydryl proteins (-SH) were low (p<0>

32-35

Authors: Mamatha B.V*,Chandrakanth K.H,Kashinath R.T,Rakshitha M.N

One of the important functions of thyroid hormones is homeostasis of mineral metabolism. So thyroid disorders usually lead to disturbances in mineral metabolism. Objective: To analyze serum levels of minerals like calcium, phosphorus and magnesium in patients of subclinical hypothyroidism and to correlate these parameters with TSH levels in cases. Materials and Methods: The study group included 70 patients who are diagnosed with subclinical hypothyroidism and 70 healthy controls who are age and sex matched with cases. Thyroid profile which includes estimation of serum T3, T4, TSH was done. Serum calcium, phosphorus and magnesium were also estimated in both cases and controls. Results: The study showed that in subclinical hypothyroidism patients serum calcium levels were significantly low with mean values of 8.9±0.62 and p<0> Conclusion: The serum levels of minerals like calcium, phosphorus and magnesium levels are significantly altered in subclinical hypothyroidism. Frequent follow up and checking the levels of these minerals in SCH patients should be done. Along with the treatment of the disease, it is necessary to give mineral supplements to prevent bone complications.

41-44

Authors: Lingraj Patil,Naga Mrudula*

Introduction: Tuberculosis is mainly associated with diarrhea, vomiting and profuse sweating leading to dehydration, electrolyte imbalance and acid base derangements. Treatment with anti tubercular drugs reduces the symptoms and balances the electrolytes. Hence, this study was carried out to assess the electrolyte imbalance among tuberculosis patients and to know the effect of anti tubercular treatment. This study was carried out to study the electrolyte imbalance among newly diagnosed tuberculosis patients and to know the effect of treatment with anti tubercular drugs in improving the electrolyte balance at BRIMS teaching Hospital Bidar. Materials and Methods: This was observational study conducted in pulmonary Medicine OPD of Bidar Institute of Medical Sciences teaching hospital Bidar. 50 participants were enrolled in our study and assessed for demographic data, serum electrolytes and bicarbonate levels and compared with Tuberculosis patients before and after treatment. Results: The electrolyte imbalance in terms of decrease in sodium, potassium chloride and bicarbonate values was significantly associate (p<0> Conclusion: In our study, after treatment with antitubercular drugs, electrolyte levels returned to normal. Because of the high incidence of the electrolyte disturbances in tuberculosis patients, close monitoring and aggressive management are mandatory.

48-52

Authors: Geetha Bhaktha*,Shivananda Nayak,Manjula Shantaram,Shreemathi Mayya

Objective: Diabetes is a disorder and prevention has become a global priority. Significance of hereditary factor in the advancement of Diabetes mellitus is really convincing. Sensitive factor for developing Type 2 diabetes (T2DM) is identified as adiponectin and hence the need of the study. Materials and Methods: This is a cross-sectional study. Subjects with self-reported history of T2DM in both parents were selected and biochemical parameters with anthropometric were recorded. They were grouped as diabetic and non-diabetics. Result: A greater level of difference of 9.45 units was seen in adiponectin levels between presence and absence of family history of diabetes (FHD). Further adiponectin continued to witness a significant difference even in diabetics and normal group with respect to family history. Hence when linear regression was made to asses relationship between adiponectin and other variables, it was found that diabetic status (P =0.000), leptin (P =0.001), and FH (P =0.000) had reached statistical significance among others parameters. Moreover adiponectin was positively correlated with diabetic status (B=4.655) and negatively correlated with leptin (B= -0.125) and Family History (B= -9.034). Conclusion: The comprehensive relation between Family History and adiponectin is true and are inversely related. Hence the impact of familial predisposition is advocated due to genetic load and diabetic status.

61-63

Authors: N Ashakiran*,V A.R Satyanarayana,M Ravikanth,P S Girish Kumar

Introduction: Liver disease is considered as one of the main health concern in Human Immunodeficiency Virus (HIV) patients. Diseases of the liver in HIV patients encompass spectrum of liver abnormalities. Elevated levels of liver enzymes like aspartate transaminase (AST), alanine transaminase (ALT) and alkaline Phosphatase (ALP) are markers of hepatocyte injury. The aim of the present study was to evaluate the clinical significance of liver enzymes such as AST, ALT and ALP in HIV patients on antiretroviral therapy. Materials and Methods: In this cross sectional case-control study, a total of 180 subjects were included in this study. Among them 90 HIV positive patients were included as cases and 90 normal subjects were included as controls. Seropositivity of all 90 HIV patients was confirmed by HIV TRI-DOT test. Estimation of serum AST, ALT and ALP was done by using automated chemistry analyzer. P value <0> Results: In this study, there is a significant elevation in liver enzymes such as AST, ALT and ALP (p<0> Conclusion: In this study, we conclude that, significantly elevated levels of liver enzymes is observed in HIV positive patients under the treatment. Therefore, the elevated levels of liver enzymes should be analyzed and monitored in HIV patients to prevent further progression of disease.

67-73

Authors: Hasit Dalpatbhai LAD,Neeta Maheshchandra Rana*,Umesh Manoj Kathiria,DVSS Ramavataram

Introduction and Objective: In laboratory, the errors related to the total testing process, affecting clinical decision making, may occur in all the phases. Quality Indicators are fundamental tool to assess the laboratory performance. The aim of this study is to observe the error types and rates for analytical and post analytical phase inorder to assess laboratory performance and rectify them. In addition to acrreditate laboratory as per international standards, it would also help to improve patient care and safety. Materials and Methods: For a period of one year, errors were observed, recorded and analyzed at clinical Biochemistry laboratory, SMIMER, Surat by this retrospective study. Data analysis of total 907611 tests carried out on 317212 samples was done. Analytical and post analytical errors were identified; recorded and analysed taking into consideration certain related Quality Indicators. Results: For analytical phase and post analytical phase error rates recorded were 7.51% and 8.57% of total samples respectively while it was observed to be as high as 46.71% and 53.28% respectively against total errors encountered for the phases. Highest (45.9%) error rate of analytical phase error was due to tests not in conformance with External Quality Assurance - Proficiency Testing scheme in a previously treated cause. 17.52% of post analytical phase error was due to low rate of critical call outs to clinicians. No records were maintained pertaining to (1) delayed delivery of reports due to insufficient reagents, (2) critical values call out time (min) and (3) staff training events. Also the laboratory was not equipped with Laboratory Informatics System. Conclusion: Quality Indicators based high error rates warrant active intervention and strict supervision of both the phases of TTP under study. Strategic measures should be initiated to minimize the risk of errors. Ultimately it would be useful for betterment of patient care and safety.

79-81

Authors: Jyothi R. S*,Basavaraj B,Gurupadappa K

Introduction and Aim: Community Acquired Pneumonia (CAP) is one of the most important causes of death in pneumonia patients. Most of the CAP patients hospitalized end up with severe complications. So the requirement of ICU in CAP patients is the most challenging decision to be taken on the part of physicians. This study was carried out to evaluate the necessity of serum albumin level and Blood Urea Nitrogen (BUN)/Albumin ratio in the assessment of ICU need and death within one month of admission in CAP patients. Materials and Methods: Patients who were suffering and hospitalized for CAP were taken into the study. Venous blood samples were collected to determine albumin levels and to calculate BUN/Alb ratio. The levels of these parameters were correlated with the need of ICU and death within one month in these patients. Results: 63 patients diagnosed and hospitalized with community acquired pneumonia were taken into the in the study. Patients who had lower serum albumin and higher BUN/Albumin ratio, had the necessity of ICU treatment. The level of BUN/Albumin ratio in determining ICU necessity was found to be ?12.94. The sensitivity was 91.30% and the specificity 65.79%. Decreased albumin level was an independent risk factor for the necessity of ICU management (OR: 4.152, 95% CI: 0.814 to 0.971, p<0> Conclusion: Patients who had decreased serum albumin and increased BUN/Albumin ratio had the necessity of ICU management. Decreased level of albumin is an self-determining biochemical parameter for determining ICU requirement and assessing prognosis in CAP.

87-89

Authors: Yellesh Pothula*,Yousef Mohammed Al-Marzooq,Ramzi AL Salem,Wasel AL-Jasem,Abdulhadi Al-Hajji

Introduction: A state and local Public clinical diagnostic laboratory quality improvement usually monitored by laboratory improvement strategies. The Institute of Medicine (IOM) in 1999 delivered a report on medical errors, which later focus on patient safety. Aim: The study was undertaken to find out the effect of quality improvement programme for the prevention of laboratory diagnostic errors. Materials and Methods: Diagnostic bias is called as any error from placing order of tests to analysis of results. The diagnostic process in the laboratory mainly divided in to three stages such as, pre-analytical, analytical and post analytical phase. Results: Out of 14,047 specimens, 14.01% requisition form found without any signature of clinicians and 6.88% with no brief clinical history and provisional diagnosis. Conclusion: The concluded quality improvement implementation program for deficient of out of TAT in clinical chemistry laboratory is mandatory to achieve the patient safety goal. The last step of the PDCA cycle “ACT” to maintain constant continuous improvement as ever ending program is the responsibility of the unit team work.

95-98

Authors: Neha Uppal*,Vibha Uppal,Sahiba Kukreja,Anju Sharma

Introduction: Patients’ evaluation of care is a realistic tool to provide opportunity for improvement, enhance strategic decision making, reduce cost, meet patients' expectations, frame strategies for effective management, monitor healthcare performance of health plans and provide benchmarking across the healthcare institutions. Surveys have become a tool to quantify the consumer experience. To the best of our knowledge, there is till date very little data reviewing the patient satisfaction for clinical biochemistry laboratory. Thus, this study is planned to find out the perception of patients for laboratory services for its improvement. Materials and Methods: Using the patient perception for laboratory services as a surrogate marker for quality and value of health care delivery, we reviewed the experience of 100 patients through well designed pre-validated questionnaires, having 11 closed ended and two open ended questions and evaluating the association between quality and patient reported experience for discussing the future opportunities and methods of improvement in Clinical Biochemistry Laboratory, SGRDIMSAR, and Amritsar. Results: The overall satisfaction level for laboratory services was very high being 100% for cleanliness and referring the laboratory services to others. It was 97.3% indicating excellent staff behaviour whereas the least was for locating the laboratory i.e. 89.19%. Conclusion: The overall degree of patient satisfaction was very high especially regarding the cleanliness of toilets & behaviour and guidance of the laboratory staff. This would really help in boosting their morale and future willingness to work harder and serve patients in a better manner.

105-110

Authors: Basavaraj Patil,Amareshwar M*,Sreekantha ,Avinash S S

Introduction: The liver is a major organ of the body playing an important role in the maintenance of metabolic homeostasis especially lipid metabolism. As viral hepatitis is an inflammatory condition of the liver, it might interfere with the lipid and lipoprotein metabolism and cause a disturbance in their regulation in vivo and thereby cause change in normal levels of lipids and lipoproteins. Materials and Methods: It is a case control study was designed to carry out the work with a total of 30 cases of acute viral hepatitis and 30 healthy controls were taken belonging to the age group 19-35 years. A detailed history, clinical examination, liver function test, lipid profile, viral markers and other relevant laboratory investigations were done. Appropriate statistical methods were applied to analyze the results. Results: The study shows that there is a statistically significant increase in the triglycerides, LDL, VLDL and a decrease in HDL. The follow up analysis showed that serum bilirubin, SGOT, SGPT and triglycerides were decreased and total cholesterol and HDL were increased. Comparison of serum bilirubin with lipid parameters shows no correlation with total cholesterol and inverse correlation with TGL which is statistically insignificant. Comparison of SGOT and SGPT with lipid parameters shows inverse correlation with triglycerides which is statistically significant. Conclusion: From the study it can be concluded that acute viral hepatitis does affect the lipid profile and HDL levels might be used as a prognostic marker to assess severity of liver disease.

118-120

Authors: Shilpashree M.K*,Krishnamurthy N,K P. Raju,B N. Sharath

Introduction: In India, chronic low back pain is normally seen in adults. Studies suggests that serum vitamin D levels is directly or indirectly related to low back pain. We determined the serum vitamin D levels among patients with chronic low back pain. Materials and Methods: A cross-sectional study was conducted during 2015-16 at a tertiary hospital in Bangalore. Patients were enrolled for the study based on a standard criteria. Serum vitamin D levels were estimated by using mass spectrometry. Results: A total of 39 patients with low back pain were enrolled. The proportion of severe, moderate and mild vitamin D deficiency were found to be 11(28%), 8 (20%) and 20 (52%) respectively. Conclusion: Majority of patients had some degree of vitamin D deficiency. Supplementation of vitamin D can be considered for all patients with chronic low back pain.

126-128

Authors: P Srilakshmi*,Rama Krishna Reddy Y. V,Prathibha Bharathi K,K Rambabu

Introduction: The present study was carried out to assess the influence of advanced glycosylation end products, microalbuminuria, and hypertension in development of nephropathy in diabetic-hypertensive individuals. Microalbuminuria has been shown to be a risk factor for nephropathy in patients with type 2 diabetes with uncontrolled glycemic index. In this study, we aimed to explore the association advanced glycosylated end products between microalbuminuria and other risk factors in the development of diabetic nephropathy in diabetic-hypertensive individuals. Materials and Methods: A total of 131 individuals were randomly recruited in the study and were segregated into three groups. Group-1 is normal (n=50) and group-II contains control DM (n=22) and group-III contains uncontrolled DM (n=59). Medical records were used to collect data of age, SBP, DBP and history of diabetes, hypertension. Blood samples were collected to estimate FBS, PPBS, glycosylated hemoglobin (HbA1C), and urine for estimation the urinary albumin. Result: The FBS, PPBS, SBP has shown a significant rise between the controls and uncontrolled diabetes, where as DBP has show significant rise in the controlled diabetes in caparison to control group. Microalbuminuria and HbA1c has shown a significant rise in control diabetes and uncontrolled diabetes group when compared with control group. Microalbuminuria has shown a significant correlation with SBP, FBS, PPBS and HbA1c. ROC analysis indicates HbA1c and microalbuminuria are good markers for diabetic nephropathy. Conclusion: Increased levels of microalbuminuria and advanced glycosylated end products will increase the compliance of diabetic-hypertensive individuals for developing the nephropathy.

135-137

Authors: Naazia Arifuddin,B Jyotchna Devi*,N V. Lakshmi,Kiranmai

Introduction: Quality in laboratory medicine refers to satisfaction of the needs and expectations of users or customers which can be achieved by providing a guarantee in each and every step like the whole testing process which in turn includes the physician ordering the test, pre – analytical, analytical, post – analytical phases and finally the results for interpretation. The aim of this study is to highlight human dependent errors that affects biochemical tests, through cases which we encountered in our lab. Conclusion: To prevent these errors, a symbiotic and synergistic participation should be there amongst the lab personnel and the health care team. This goal can be achieved with proper education and training of individuals involved in this process. Thus, prevention of these errors will help in better and effective patient management.

168-171

Authors: Suchitra Kumari

Prenatal diagnosis is offered to patients at risk of chromosome anomalies with Abnormal ultrasound scan, Carrier of a chromosomal structural rearrangement and Elevated risk of aneuploidy indicated by biochemical and/or ultrasound screening. It is usually carried out using samples like Amniotic fluid (AF), Chorionic Villus Samples (CVS) or Foetal blood. Prenatal diagnosis involves both invasive and non -invasive techniques. Non-invasive tests are getting acceptance by the patients & obstetricians worldwide but still they are used as screening tool not as diagnostic measure. Genetic diagnosis guide in making decisions about maintaining or ending a pregnancy. So many ethical issues must be considered before screening or testing pregnancies for underlying genetic disorders. There must be compliance with legal requirements and constraints applicable to the communication of confidential information

175-179

Authors: M. Manonmani, V. Kuzhandai Velu, Manimekalai K

Introduction: Coronary heart disease is an impairment of heart function due to inadequate blood flow to the heart. It is the most common cause of death worldwide. Serum sCD40L is an inflammatory marker. It is released from the platelets as soon as the onset of the chest pain. It is a strong predictor of cardio vascular risk factor. Objectives: To estimate Serum sCD40Ligand, Serum CK-MB, Serum Lipid Parameters, Serum LDH, and Serum AST levels in patients with ACS. Materials and Methods:Study group comprised of 50 subjects were admitted in ICCU with ACS. 50 healthy sex and age matched subjects were taken as control groups. Venous blood samples were collected. Serum Soluble CD40Ligand was estimated by ELISA technique, Serum CK-MB estimated by Immunoinhibition method, Serum Lipid profile by enzymatic assay methods. Serum LDH by DKGC method, Serum AST by Modified IFCC method. Results:There was significant increase in Serum sCD40L(p<0>significant decrease in the Sr. HDL-C levels in the ACS patients compared to control group. There was no significant change in Sr. LDH levels and Sr. AST levels in ACS patients compared to control group. There was a significant positive correlation between Serum sCD40L and Serum CK-MB, Serum TC, Serum TGL, Serum LDL-C, Serum VLDL and a negative correlation between Serum sCD40L and Serum HDL-C while no significant correlation was found between Serum sCD40L with Serum LDH and Serum AST levels. Conclusion:Serum sCD40L can be used as a marker in individuals with Acute Coronary Artery disease

185-190

Authors: Rama Mani Gorle, Munta Anil Kumar, Santa Ayyagari

Introduction: The awareness on vitamin D related metabolic activities have drawn attention in the recent times. The studies reported vitamin D deficiency may result in the progression of malignancies.1,2 Being a tropical country, 80% of the Indians are found to be vitamin D deficient and thus the evaluation of serum vitamin D deficiency helps in understanding its risk association in haematological malignancies.3,4 Materials and Methods: The study comprised of 250 haematological malignancy cases and 250 age and sex matched healthy controls. The diagnosis was confirmed by blood, bone marrow or lymph node biopsies. Serum vitamin D levels were analysed by Electrochemiluminescence Immunoassay (ECLIA) method and statistical analysis was done by using Medcalc 11.6. The data were expressed as mean ± SD and the risk association of vitamin D deficiency and comparison in the experimental groups was done by using the odds ratio (OR) and odds relative risk ratio (RR). Results:Among the 250 haematological cases, 185(74.0%) showed low serum vitamin D levels, whereas controls had comparatively lesser deficiency rate (60%). Despite significant vitamin D deficiency of control group, haematological malignancies showed highly significant risk association towards the disease occurrence (OR=1.90; t-test =0.0026). Conclusion: Low serum vitamin D levels were significantly associated with haematological malignancies. Additional population based studies are required to evolve therapeutic strategies and treatment protocols for the risk reduction and management of malignancies

196-200

Authors: Basavaraj Savadi, Nagalakshmi C. S., PrashanthG., Ganashree C. P., Rashmi B. M

Arterial blood gas (ABG) analysis is a challenging but clinically very important diagnostic test in intensive care unit patients but combined acid base disorders either due to compensatory mechanisms or mixed disorders are often difficult and sometimes confusing. The aim of the current research study is to find out the clinical significance of two newer ratios derived using standard bicarbonate, bicarbonate and carbonic acid values. The study included 176 arterial blood gas samples collected from I.C.U patients and ABG analysis were done which classified them into various acid base disorder groups. Bicarbonate/carbonic acid ratio and standard bicarbonate/carbonic acid ratio values were calculated for all the samples. These two values were divided to form a newer ratio 1 (HCO3 /H2CO3)/(Std HCO3 /H2CO3) and the difference between the two values form an another newer ratio 2 (HCO3 - Std HCO3)/H2CO3. The relation between pH, pCO2and the two newer ratios were graphically analysed. Mean ± standard deviation was calculated for both the ratios 1 and 2 in various acid-base disorder groups. One way ANOVA statistical test was applied and the two ratios are found to be statistically significant at p<0>pCO2 values. The study concluded that the two newer ratios derived may provide some clues regarding the disturbances affecting the acid-base homeostasis which may be used as a discriminator between various acid-base disorders

206-208

Authors: Manisha G. Audi

Oxygen free radicals generated during radiation injury damage human erythrocyte membrane proteins including spectrin and band 3 protein. Results show an appreciable degree of spectrin and band 3 protein loss of about 55-65% due to crosslinking, and proteolysis when sodium dodecyl sulphate polyacrylamide gel electrophoresis carried out on erythrocyte ghosts. Oxidative damage to membrane proteins lead to degradation of its cytoskeletal components

212-216

Authors: Ranjith Kumar C, B Laxmikanth

Introduction and Objectives: The main circulating form of vitamin D in blood is 25-hydroxy vitamin D (25[OH] D) has been known to be associated with the pathogenesis of acute coronary syndromes (ACS). Deficiency of 25[OH] D has been associated with cardiovascular risk and coronary artery disease. Therefore, it is of high importance to assess for 25(OH) D deficiency in acute myocardial infarction (AMI) to initiate treatment at the earliest. The serum levels of 25(OH) D in AMI patients across different seasons are unclear. Materials and Methods:The serum levels of 25(OH) D were assessed in 50 subjects presented with first time myocardial infarction to Cardiology departments of SVS Medical College& Hospital. Patients were enrolled throughout the year of 2017 and their serum samples were analyzed using the TOSOH AIA 360. Group 1 consisted study period from February to May. Group 2 consisted study period from June to September. From October to December including January of 2017 considered as winter, named Group 3. Based on the vitamin D status, subjects were classified as normal (? 30 ng/ml), insufficient (20-30 ng/ml) and deficient (? 20 ng/ml) groups. Results:Of the 50 enrolled patients, 60% were 25(OH) deficient and 18% were insufficient, for a total of 78% of patients with abnormally low 25 (OH)D levels. Vitamin D levels are statistically highly significant variation across the groups. (p = 0.0000533). Conclusions: Our results suggested that the prevalence of Vitamin D deficiency was high in AMI patients presented in winter and summer seasons as compared to that of rainy season

222-225

Authors: Reshma D. C., Anuradha Patil

In a developing country like India, screening the population of remote areas for Non Communicable Diseases is difficult because of less availability of infrastructure and technical staff. It is ideal to carry out the analysis in a good quality central laboratory, but the transportation of samples in cold chain is of concern. Dried serum spot technology has various advantages compared to conventional serum analysis, it helps in convenient shipment of samples at low cost without the requirement of cold chain. Problems with leaking and spilling of liquid serum samples will not happen. Stability of analytes will be improved. Serum spot analysis is therefore a convenient method for screening the population presenting with health risks. This study was undertaken to look for stability of triglycerides in serum dried on filter paper at room temperature for different time intervals.100 Samples of Patients coming to the laboratory of KLE Hospital Belgaum were analysed for Triglyceride levels. The remaining serum was spotted onto 3M Whattman filter paper and left at room temperature for an hour for drying. Subsequently dried serum spots were analysed for Triglyceride levels on 0, 7, 14, 21, 28 and 35 days in a Erba semi autoanalyser using commercially available kit.The comparable values obtained from dried serum spots makes it a reliable and convenient method for screening modifiable risk factors like Triglyceride levels.

230-231

Authors: Anuja Adarsh, Vikas K Vaghela, Nayan mali

Introduction: Type-II diabetes is one of the most common non-communicable chronic disease and Vitamin D deficiency is also considered a public health problem around the world. As Vitamin D deficiency influence the insulin levels so this study is conducted. Objectives:This study aims to evaluate serum level of Vitamin D in patients with type II diabetes mellitus. Materials and Methods:50 patients with type II diabetes is taken as cases and 50 healthy person taken as control. Study is conducted from june 2017 to sept. 2017 in Civil Hospital, Ahmedabad. Result:In present study mean serum vitamin D level of case is significantly lower than controls. P value is < 0> Conclusion:It suggests that alterations in vitamin D status may affect insulin sensitivity, ?-cell function or both. So monitoring of Fasting plasma sugar & Post prandial plasma sugar levels in patients along with serum Vitamin D plays an important role in prevention & treatment of the Type II Diabetes Mellitus

238-243

Authors: G. S. R. Kedari, Guru Pawan Kumar G., H. Ashwin Raj, Ratnashree Biswas

Introduction: Several studies were conducted worldwide to estimate various endogenous hormone levels in endometrial cancer patients of post-menopausal women and very few studies were done in premenopausal women. In India, our study is the first study conducted to estimate the endogenous hormones in endometrial cancer patients of premenopausal age group. Materials and Methods: 25 number of endometrial cancer patients were taken as cases and 50 number of age matched healthy subjects were selected as controls for this study. Total testosterone, follicular estrogen, mid luteal estrogen, luteal estrogen, and follicular progesterone, mid luteal progesterone, luteal progesterone and fasting insulin were estimated for all the subjects. Results: Statistical significant increase were observed in the levels of testosterone, follicular progesterone, mid luteal progesterone and luteal progesterone in cases when compared to controls. No statistical significant difference were observed in follicular estrogen, mid luteal estrogen, luteal estrogen and fasting insulin levels between cases and controls. Conclusion: From our study we conclude that endogenous hormones play a major role in the development of endometrial cancer in pre menopausal women as Testosterone is increased and progesterone is decreased in cases when compared to controls. Extensive studies are required to diagnose endometrial cancer in early stages for better prognosis

249-253

Authors: Hiren Sanghani, Vijaysinh Parmar, Asha Khubchandani

Introduction: Type 2 diabetes mellitus (DM) is supposed to be associated with alteration in the serum levels of trace elements. Conversely, research also suggests that imbalances of specific elements associated with the complications of diabetes mellitus. Copper plays important role in oxidative stress and it’s one of the important factor contributes to aetiology of DM. And zinc involved with synthesis & secretion of insulin. So, we have choose copper and zinc to find association in diabetics patients. Materials and Methods: In this cross sectional observational study total of one hundred and twenty (120) subjects were included and categorized into 3 groups. On the basis of screening, 80 patients were divided into two study groups: Group I (40 patients with micro- or macrovascular complications) and Group II (40 diabetic patients without complications). Group III include the 40 age and sex matched non-diabetic healthy control subjects selected for comparison. Serum zinc, copper concentration and HbA1c% (glycated haemoglobin) were estimated in all three study groups. Result: Serum copper concentration and HbA1c% were significantly (p<0> Conclusion: Alteration in levels of trace elements (like, Zn and Cu) are found to be important influencing factors for diabetic patients for developing complications. From the present study, it may be determined that altered levels of trace elements (like zinc and copper) may have contributory a role in the pathogenesis and progression of type 2 DM

257-262

Authors: Simbita Marwah, Mihir Mehta, Charmi Raval, Amit Trivedi, N. Haridas

Aim: The central role of the laboratory is to aid the clinician, in interpreting observed values, by providing relevant reference values. To prevent ambiguities inherent in the term normal values, a laboratory should establish its own reference limits. Therefore, the current study was aimed at establishing the reference range of Thyroid function test in healthy population. Study design: This was a retrospective cross sectional study on 1000 healthy individuals above 18 years of age, attending the routine health check-up. Materials and Methods: Partitioning was done according to age and sex, inclusion and exclusion criteria were applied and T3, T4 and TSH levels were estimated on the study group. Results: The values of T3 and T4 obtained were (mean and reference interval in nmol/L) 1.85 (1.15-2.55) and 100.58(57.35-143.81)respectively for males and 1.87(1.07-2.55) and 110.49(62.46-158.52) respectively for females. Similarly, TSH values were 1.23 (0.37-5.19) mIU/L and 1.37(0.27-5.63) mIU/L in males and females respectively. Conclusion: We found that the value of serum Total T3 & serum Total T4 was higher as compared to the international values while that serum TSH was similar

268-270

Authors: Ranjeet U. Jadhav, G. J. Belwarkar, P. E. Jagtap, S. P. Dhonde, N. S. Nagane

Introduction: Percutaneous transluminal coronary angioplasty (PTCA) has become a common intervention in coronary artery disease (CAD), relieving symptoms such as angina and improving myocardial function. There is short term injury to the heart after PTCA; which can take in the form of reperfusion arrhythmias or myocardial stunning or both. Production of oxygen derived free radical potentially cytotoxic species which can be formed may be controlled by naturally occurring antioxidant defence. In this study we investigated the alterations in oxidative and antioxidative status after PTCA by estimating Malondialdehyde (MDA) as marker of oxidative stress, Superoxide Dismutase (SOD) and vitamin C for antioxidant status and myocardial cell damage by Creatine Phosphokinase total (Cpk-total) and Creatine Phosphokinase-MB (Cpk-MB). Materials and Methods: 120 patients of CAD, subjected to PTCA were included in the study. MDA, SOD, Vitamin C, Cpk total and Cpk-MB levels were measured after PTCA in patents. Result: There were increased levels of SOD & Cpk-total, 4.94 ± 0. Units / ml & 119.46 ± 40.51 U/L, (p < 0 style="color:black">mg/dl & 13.62 ± 6.17 U/L (p > 0.05), borderline increased. They are statistically insignificant. Conclusion: These findings suggest that cardial lipo peroxidation may be common event following brief episodes of myocardial ischemia and support a role for antioxidant therapy in patients after PTCA

277-283

Authors: Lekha Tejaswi Y, Preethi BP

Introduction: The present study was aimed at evaluating serum uric acid, urinary calcium to creatinine ratio and microalbuminuria as predictors of pre-eclampsia in asymptomatic pregnant females. Materials and Methods: 100 asymptomatic pregnant females were screened for uric acid, urinary calcium to creatinine ratio and microalbuminuria between 20-24weeks of their gestation and were followed up till delivery. BP was recorded and proteinuria evaluated by dipstick method. Our observations were subjected to statistical analysis by evaluating diagnostic accuracy and Receiver Operating Characteristic curve of uric acid, urinary calcium to creatinine ratio and microalbuminuria. Results:Calcium creatinine ratio (94%) and microalbuminuria (89%) turned out to have good specificity, negative predictive value remained high for calcium creatinine ratio (97%), microalbuminuria (95%) and serum uric acid (91%). Area under the curve for calcium creatinine ratio is highest when compared to microalbuminuria and serum uric acid, making it an excellent predictor. Conclusion: Our study findings suggest that calcium creatinine ratio was an excellent predictor of preeclampsia followed by microalbuminuria which was a good test for preeclampsia and serum uric acid which turned out to be a fair predictor of preeclampsia. We conclude that calcium creatinine ratio and microalbuminuria as early predictors of preeclampsia and can be used for screening purpose.

288-291

Authors: Shivakumar, K. Prathibha Bharathi, P. Aruna, J. N. Naidu, M. Prasad

The prevalence of diabetes mellitus is increasing worldwide. Recent studies showed that India has got large number of diabetic patients. Diabetic nephropathy (DN) develops in 30% to 40% of patients with type 1 diabetes mellitus and in 10% to 20% of patients with type 2 diabetes mellitus. Diabetic nephropathy is the leading cause of end-stage renal disease (ESRD) worldwide. An early sign of impending nephropathy is microalbuminuria. A total number of 90 samples were analyzed to study the microalbumin levels in 30 diabetic nephropathy patients, 30 diabetic patients without nephropathy and 30 healthy controls. The mean and standard deviation were calculated for all the parameters. The significance between the groups were determined using Student - test for Equality of means. The results show increase in mean concentration of microalbumin in diabetic nephropathy cases when compared to controls and was statistically highly significant (p< 0>

296-300

Authors: P. Aruna, M. Krishnamma, K. Ramalingam, J. N. Naidu, M. Prasad

Introduction: Preeclampsia is a serious complication of the second half of pregnancy and is an important cause of maternal and perinatal morbidity and mortality. Measurement of circulatory inflammatory markers of endothelial cell dysfunction and inflammation may provide an alternative method of detecting women at high risk of delivery. Women with a history of pre-eclampsia have an increased succeptibiliy to lipoprotein oxidation when compared to women who had normal pregnancy. Aims and objectives: The present study was designed to study hsCRP in association with blood pressure, proteinuria and lipid profile as markers of inflammation and endothelial dysfunction in preeclampsia. Materials and Methods: The present study was carried out for one year on diagnosed patients of Preeclampsia attending the outpatient and inpatient departments of obstetrics and Gynecology department of Narayana Medical College and Hospital, Nellore. The study was undertaken on 50 Preeclampsia cases and 50 normal pregnant women as controls. Results: In our study hs-CRP levels were significantly elevated in cases when compared to control subjects. Total cholesterol, triacylglycerol and LDL values were elevated in total cases when compared to controls. However the decrease in HDL cholesterol was not significant when compared to controls. Conclusion: Elevated levels of LDL undergo oxidation to form oxidized LDL, which is involved in inflammation and free radical generation. Increased inflammation leads to increased levels of hsCRP, which is further associated with dyslipidemia, an important cardiovascular risk factor in preeclampsia

306-309

Authors: Pallavi Ashrit, Arun Kumar, Gundumalla Pradeep Reddy, Vishal Kalasker, Harish Bhat

Introduction: Diabetes Mellitus is one of the most common metabolic disorders, resulting in hyperglycemia and is associated with micro and macro vascular complications. Diabetic retinopathy (DR) is a widely accepted cause of blindness in adults. The duration of diabetes, glycemic control and microalbuminuria (MA) have been implicated in the onset and progression of DR. Materials and Methods: The aim of our study is to correlate FBS, PPBS, HbA1c and microalbuminuria with diabetic retinopathy and to find out MA as the predictor of DR in T2DM patients. Our study included, 50 T2DM patients with DR, 50 T2DM patients without DR and 50 controls of both sex in the age group of 40 – 60 years. Fasting blood sugar (FBS) and post prandial blood sugar (PPBS) were estimated by Glucose Oxidase method, glycated hemoglobin (HbA1c) by Ion Exchange Resin Method and urine samples were assayed for Microalbumin by Immunoturbidimetric assay and DR was diagnosed using Fundoscopy. Results: In our study, levels of urinary microalbumin, FBS, PPBS and HbA1c in T2DM patients with DR is increased than T2DM patients without DR than the control group, which is highly significant (p <0>and microalbuminuria) in group A cases are positively correlated with grades of Diabetic Retinopathy. Conclusion: Microalbuminuria and diabetic retinopathy are closely associated in T2DM patients and is a reliable marker which can predict the risk for the development of DR. All patients with MA should undergo regular retinal evaluation.

314-320

Authors: T. Rajini Samuel

Arterial blood gas (ABG) analysis is a challenging but clinically very important diagnostic test in intensive care unit patients but combined acid base disorders either due to compensatory mechanisms or mixed disorders are often difficult and sometimes confusing. The aim of the current research study is to find out the clinical significance of two newer ratios derived using standard bicarbonate, bicarbonate and carbonic acid values. The study included 176 arterial blood gas samples collected from I.C.U patients and ABG analysis were done which classified them into various acid base disorder groups. Bicarbonate/carbonic acid ratio and standard bicarbonate/carbonic acid ratio values were calculated for all the samples. These two values were divided to form a newer ratio 1 (HCO3 /H2CO3)/(Std HCO3 /H2CO3) and the difference between the two values form an another newer ratio 2 (HCO3 - Std HCO3)/H2CO3. The relation between pH, pCO2and the two newer ratios were graphically analysed. Mean ± standard deviation was calculated for both the ratios 1 and 2 in various acid-base disorder groups. One way ANOVA statistical test was applied and the two ratios are found to be statistically significant at p<0>2 values. The study concluded that the two newer ratios derived may provide some clues regarding the disturbances affecting the acid-base homeostasis which may be used as a discriminator between various acid-base disorders

324-327

Authors: Rohini Bhadri, Shobha Kini

A good dietary regime is important for health. But to follow a particular regime is hurricane task. It is known from previous studies that there is an association between vegetarian diet and low total serum cholesterol as well as LDL-cholesterol. Fruits and vegetables being rich sources of fiber and antioxidants have been the focus in our interventional study. Our current study focused on the difficulty of a change in the dietary habits, hence with a minor change in the daily diet for 90 days, we assessed the effect on the BMI, lipid profile and blood sugar Materials and Methods: 30 Teaching and Non teaching faculty of our college were included in the study. The age group was between 25 and 60 yrs of age with no metabolic disorders. Their BMI was calculated, Biochemical parameters were measured which included Lipid profile and Blood sugar before and after intervention. A slight modification in the diet was suggested with addition of raw vegetables and sprouts for a period of 90 days. Result: BMI was decreased from 26.8 kg/mt2 to 25.8 kg/mt2 .Mean Lipid profile values in mg/dl for Total cholesterol pre and post were 205 ±36.83 and 196.4± 32.95, HDL cholesterol pre and post were 46.0 ± 6.9 and 44.8 ±7.38, LDL cholesterol pre and post were 130.1 ± 28.51 and 126.0 ± 27.33, TG pre and post were 144.3 ± 89.75 and 126.32 ± 48.93 and the CRI was 4.5 ± 0.8 and 4.4 ±0 .6. Blood glucose pre and post 94.33 to 89.2 mg/dl. Most of the results were statistically not significant. Conclusion: Even a minor change in the diet can definitely have a good effect in lowering the BMI, lipid profile and Blood sugar.

334-337

Authors: Shalini L., Santhi Silambanan

Introduction: Increasing diabetic burden in India has shifted our health care focus towards its prevention and management of diabetes mellitus. Often multiple investigations are requested by the physicians to assess diabetic status. Conventionally fluoride tubes (glycolytic inhibitor) have been used for glucose analysis in clinical laboratories. Preservatives used here make it unsuitable to measure other key clinical chemistry analytes, for which serum separator gel tubes(SST) are being employed. On centrifugation of SST tubes, a thick gel barrier is formed separating the serum from the cells. This gel barrier prevents utilization of glucose by the cells, hence researchers have considered using it for glucose measurement. This study has been done to assess the integrity of serum samples obtained from SST tubes for analysis of glucose. Materials and Methods: A single centre cross-sectional study was done, with 140 paired samples collected in fluoride and SST tubes from patients attending Sri Ramachandra Laboratory Services. Samples were analyzed by glucose oxidase-peroxidase method in Siemens ADVIA 1800 Clinical Chemistry at 1 hr, 6 hrs and 24 hrs of sample collection. Results:Statistical analysis showed no significant change in glucose concentrations measured in fluoride against serum samples. Paired t-test results showed no statistical significance between the tubes, irrespective of time. Bland Altman plot analysis revealed that serum values were not significantly different from fluoride samples throughout the study period. Intraclass correlation (ICC) showed correlation of 0.999 between serum and plasma at 1 hr, 6 hrs and 24 hrs from time of collection Conclusions: Serum from SST tubes can be used to measure blood glucose instead of standard accepted fluoride plasma samples

343-347

Authors: Suresh Pichandi, Janakiraraman P., Ramadevi K.

Objective: Aim of the present study is to analyse the nutritional status of iodine among pregnant women by measuring urinary excretion and do the correlation with thyroid hormone and auto antibodies Materials and Methods:one hundred pregnant women with third trimester gestation and one hundred age-matched non-pregnant were included in study. Results:Urinary Iodine excretion and serum TSH, fT4, fT3, AMA and ATG were estimated were estimated for case and control groups. The mean urinary iodine excretion concentration (UIC) in pregnant women was 290.17±91.71 µg/L. Excess urinary iodine excretion was found in 69%. There were elevated serum AMA levels in 36 pregnant women and that positive correlated with excess iodine. Conclusion:The pregnant women had no iodine deficiency, rather had high urinary iodine concentrations indicating more than adequate iodine intake. The excess urinary iodine level may tiger the thyroid auto antibody.

5-11

Authors: Jayshri Sadashiv Jankar, Kumud Namdeorao Harley, Kanchan Manoharrao Mohod.

Introduction: Nitric oxide (NO) is known as a mediator in a broad cluster of biological systems. NO is the endothelium-derived relaxing factor, which causes vasodilation by relaxing vascular smooth muscle. This role of NO plays an important role of diabetic nephropathy in Type 2 Diabetes Mellitus (DM) Aims: To assess serum nitric oxide levels among type 2 diabetes mellitus patients having normoalbuminuria and microalbuminuria. Setting and Design: This cross sectional study was carried out at Department of Biochemistry in a tertiary care rural hospital in Central India with 200 diagnosed patients of type 2 diabetes mellitus. Materials and Methods: 24 hr urine albumin was done in all the patients. Based on the concentration of albumin in urine, patients were categorised in two groups, group 1 had normoalbuminuria (i.e. Urine Albumin <20 mg/ 24 hr) and group 2 had microalbuminuria (i.e. Urine Albumin >20 to <300 mg/24 hr). Then, serum NO was assessed and compared in these groups. Results: Serum NO levels were significantly raised (p <0.05) in Group 2 as compared to Group 1. Conclusion: Our observations suggest that serum NO levels measurement has a good detection potential for early stages of diabetic nephropathy manifested in the form of microalbuminuria in Type 2 DM.

17-22

Authors: Pragati Khanorkar, B. K. Agrawal, Kiran Kumar B. Sodavadiya.

Introduction: Aim of the study was to identify the role of selective serum lipids and serum creatinine in the development of type 2 DM microvascular complications like cataract and retinopathy which are potential cause of blindness in these patients. Materials and Methods: It is a cross sectional study of 100 patients, 50 each of cataract and retinopathy, compared with 50 healthy patients for lipid profile and serum creatinine by Erba 360 automated analyser. The study was carried out from Jan. 2016 to Jun.2017. Result: In type 2 DM patients there is dyslipidemia i.e. raised levels of serum total cholesterol, triglycerides, low density and very low density lipoproteins and low levels of high density lipoproteins, when compared with the healthy subjects. When compared between cataract and retinopathy patients, serum total cholesterol, low density lipoproteins and LDL/HDL were significantly raised (p < 0.001) in cataract patients whereas serum triglycerides (p< 0.001) and serum creatinine (p< 0.05) levels were significantly raised in retinopathy patients. Conclusion: cataract and retinopathy are the preventable causes of blindness among the diabetic patients. Timely assessment of lipid profile and serum creatinine may help to detect these complications early and thus prevent the morbidity caused thereby.

26-30

Authors: Vikas K Vaghela, Bhavika K Vaghela, Jaivik K Vaghela

Introduction: Malaria is a major protozoal disease in developing countries responsible for 2-3 million deaths per year. Zinc (Zn) and copper (Cu) are involved in numerous aspects of cellular metabolism. They are required for the catalytic function of several enzymes, play essential roles in immune function and act as antioxidants. So this study will give us a proper view whether there is a need for a more study on zinc supplementation in these patients. Material and Method: Fifty children with Malaria are included in the study as cases and equal number of age and sex matched healthy children formed the control group. Study is conducted during the period of August 2014 to October 2016. Result: In the present study mean Zinc level was significantly lower in cases as compared to controls (P value is 0.0426 which is less than 0.05) and mean Copper levels was significantly higher in cases as compared to controls (p<0.001). Conclusion: Children having malaria has low serum zinc levels as compare to healthy controls is due to excessive production of free radicals. They having malaria has high copper levels as compare to healthy controls is due to competitive absorption of zinc and copper. So the zinc supplementation is necessary for the immunity against plasmodial infection and to decrease the toxicity of copper in our body.

35-40

Authors: JB Honnamurthy, Shivashankara AR, Avinash SS, John P Mathai, Malathi M.

Alcohol deaddiction improves the liver function markers in blood as well as saliva in both smokers and non-smokers. The study was conducted to observe the changes in liver function markers after deaddiction in both blood as well as saliva. The study included 83 alcohol dependent subjects, among whom 45 were smokers and 38 were non-smokers. They were followed up after deaddiction for 19-21 days. The liver function markers GGT- γ glutamyl transferase, AST- Aspartate transaminase, ALT- Alanine transaminase, TP- Total protein, and Alb-Albumin were measured spectrophotometrically before and after deaddiction in saliva as well as blood. Paired‘t’ test was done to analyse the significance of their changes in before and after deaddiction. There was no difference in NR (normalization rate) of GGT, AST and ALT between alcohol dependent smokers and non-smokers in saliva as well as blood. NR of TP and Alb was better in non-smokers compared to smokers. GGT (p<.001), AST (p<.001) and ALT (p<.001) have decreased and SFR has increased significantly in all groups after withdrawal. Elevation after withdrawal of TP and Alb were not significant. Elevation of Alb after withdrawal was not significant. In both alcohol dependent smokers as well as non-smokers, salivary GGT (p<.001), AST (p<.001) and ALT (p<.001) levels can be used instead of blood levels to monitor the prognosis of deaddiction, but TP and Alb cannot be used for the same.

46-48

Authors: Arun N., Pushpalatha M., Mohanan P. K..

Introduction: The aim of this study was to evaluate the prevalence of hypothyroidism in diagnosed cases of cholelithiasis using the patient’s ultrasonography data and to find the prevalence of obesity in gallstone disease. Materials and Methods: This study was conducted in Govt. medical college, Thrissur. Two hundred and sixty five study subjects were selected from the patients who were attending wards and outpatient department (OPD) of General Surgery with diagnosed cases of cholelithiasis by ultrasound of abdomen. All the participants were subjected to clinical examination and lab investigations. Serum thyroid-stimulating hormone (TSH) was used to assess thyroid function and thereby hypothyroidism. Body Mass Index (BMI) was used to assess obesity. Results: High prevalence of hypothyroidism (23%) was observed in gallstone disease. In this study only 6% gallstone disease subjects were obese. We also found that 73% of the study subjects with hypothyroidism were obese. Conclusion: Hypothyroidism may be suggested as a risk factor for developing gallstone disease. Gallstone patients should be checked for serum TSH because of high incidence of hypothyroidism.

54-60

Authors: Jagruti Dholakia, Hariom Sharma, Smita N Vasava, Subhankar Kayal.

Introduction: Lifestyle related risk factors are prone to increase the burden of cardiovascular diseases. Thus, the study was carried out in the medical students who are more prone to develop lifestyle diseases because of their busy schedule and less time for extracurricular activities. Objective: To study correlation of anthropometric and biochemical parameters in first year medical students. Materials and Methods: Total 150 students of first year MBBS (Batch 2014-2015) Government Medical College (GMC), Bhavnagar were enrolled in the study. Anthropometric measurements were carried out to measure body weight (BW), body height (BH), Waist circumference (WC) and hip circumference (HC), while Body mass index (BMI) was calculated. Blood samples were collected for estimation of fasting blood glucose (FBS), Lipid profile, Total protein and Albumin. The investigations were performed on fully auto analyzer I-Lab 650, in Clinical Biochemistry Laboratory, Sir T. Hospital, Bhavanagar. Results: Results concluded that 1) Overweight and obesity among the students were 17.3% and 4% respectively; 2) When the abnormal serum cholesterol (≥200 mg%)was compared between male and female students it was statistically significant with p 0.003; 3) In the present study 03 (2.0%) students had FBS >126 mg/dl, high risk of developing Type 2 diabetes mellitus. 4) In the present study WC showed positive correlation with blood pressure, r: -0.28 and p: 0.0005 and negative correlation with HDL-Cholesterol, r: -0.21 and p: 0.008. Whereas, BMI showed positive correlation with triglyceride with r: -0.27and p: 0.0008 and negative correlation with HDL-Cholesterol with r: -0.34 and p< 0.0008 considered highly significant. Conclusion: High prevalence of cardiovascular risk factors like overweight, high blood pressure and high triglyceride were common among the medical students. So, it can be concluded that healthy lifestyles should be adopted from young adulthood since medical students are the future health providers.

66-71

Authors: Bhaktavachalam Prudhvi, Aparna Pottepalem.

Introduction: Obesity is a nutritional disorder and associated with excess fat deposition due to altered balance between energy intake and consumption. Obesity and obesity related hypertension are identified as risk factors in development of diabetes and chronic kidney disease. Obesity alters the hemodynamic functions of organs and is a threat for development of cardiovascular diseases, renal failure and peripheral arterial disease. Objectives: The objective of the present study was to compare the renal profile among healthy individuals, obese individuals, obese with preexisting hypertension and obese individuals without hypertension. Materials and Methods: A prospective cross sectional observational study was conducted at ACSR government medical college and hospital, a tertiary care hospital for a period of two years from October 2014 to September 2016. 120 subjects were divided into 4 groups with 30 in each group, healthy, obese, non obese hypertensive and obese hypertensives. Results: All the measured variables in all the four groups of the study were expressed as mean ± standard deviation. BMI of 32.1 ± 2.1 was observed in obese group whereas 22.1 ± 3.1 was observed in healthy group. Statistically significant correlation was found with BMI, S. urea, S. creatinine, S. uricacid and estimated Glomerular filtration rate (‘p’ value <0.005). Discussion: To conclude, obesity related metabolic abnormalities and impairment of renal function may present even at a young age and may progress asymptomatically before the development of clinical manifestations. Hence there is a need to develop global strategy for maintaining the increased number of overweight and obese patients in the community.

78-84

Authors: K. Prathibha Bharathi, Shivakumar, M. Krishnamma, J.N. Naidu, M. Prasad.

Introduction: The Diabetes mellitus was characterized by chronic hyperglycemia with disturbances of carbohydrate, fat, and protein metabolism resulting from defects in insulin secretion, insulin action, or both. The two broad categories of diabetes are type 1 and type 2. Type 2 Diabetes Mellitus (T2DM) is the most common form of diabetes. The role of elevated high sensitivity C-reactive protein (hs-CRP) as a risk marker for cardiovascular diseases, including coronary heart disease, stroke and peripheral arterial disease is well established through consistent results from a number of prospective studies. More recent data suggest that hs-CRP is superior to other markers of inflammation for risk evaluation. Materials and Methods: The present study was conducted over a period of one year on outpatients attending the General Medicine Department at Narayana General Hospital, Nellore. The study was undertaken on 50 type 2 Diabetes mellitus and 50 normal healthy controls. Both male and females in the age group of 35 – 70 years were included. Results: Fasting blood glucose, post prandial blood glucose, and hs-CRP levels was measured in 50 T2DM cases and 50 age matched healthy controls. The mean and standard deviation were calculated for all the Biochemical parameters. The significance between the groups were determined using Student t- test for Equality of means. The p-value of < 0.05 was considered significant. Conclusion: This study concludes that there is increase in hs-CRP levels in T2DM cases compared with controls. hs-CRP is an inflammatory marker and has role in atherosclerosis. From this study it is observed that there is moderate correlation between hs-CRP levels and it increases the risk of atherosclerosis.

91-96

Authors: Manju. M, Sasmita Mishra, B.D.Toora, S. Vithiyavathy.

Introduction: Pre-diabetes is an important risk factor for the development of overt diabetes as well as cardiovascular disease. Pre-diabetes is frequently associated with obesity which in turn is commonly associated with hypovitaminosis-D. Low Vitamin D levels impair synthesis & secretion of insulin and through many other mechanisms is attributed in the pathogenesis of diabetes. Pre-diabetes is a stage where prevention efforts have been shown to be effective in delaying or preventing the onset of diabetes. However, there are not many studies that have examined the association between low serum 25(OH) Vit D levels and prediabetes. The aim of this study was to compare Vit D levels between the normals, pre-diabetics & diabetics and study the relationship between insulin resistance and vitamin-D status among individuals with pre-diabetes and diabetes. Materials and Methods: 50 non diabetic, 50 pre-diabetic and 50 type 2 diabetics were included in the study. Waist hip ratio and Body mass index calculated. Fasting blood sugar, insulin, lipid profile, calcium, alkaline phosphatase and serum 25 hydroxy vitamin D were estimated. Insulin resistance (HOMA2-IR) and beta cell function (HOMA2-β) was calculated using HOMA 2 calculator. Result: Vitamin-D deficiency (<20 ng/ml) was seen in 20% normals, 36% of prediabetics and 48% of diabetics. BMI, WHR, Total cholesterol, triglycerides, LDL & VLDL were significantly increased & HDL decreased in prediabetic and diabetic groups when compared to normals (p<0.001).25 OH Vit D levels were significantly decreased (p<0.0001) in diabetics as compared to normals and pre diabetics (p<0.0001). There was a strong negative correlation between Vit D and HOMA 2-IR in diabetics (r= - 0.63) and prediabetic (r= - 0.77). Conclusion: Vit D deficiency is common in prediabetic state and subjects having severe vitamin D deficiency (<10 ng/ml), had the worst insulin resistance. Our study results help in proposing vitamin D levels as an early marker for diabetes and help in recommending vitamin D to be prescribed in the pre diabetic stage itself.

101-105

Authors: Mohammad Ibrahim Shaik, Mohammad Siddique Ahmed Khan.

Introduction: Insulin resistance and secretion are highly dependent on variable influencing factors, in the developmental process of Diabetes mellitus. Growing incidence of diabetes prompt us to study the various contributing factors in the development of Diabetes mellitus in healthy individuals. Objective: To study the relationship associated between anthropometric measurements, plasma lipids, glycemic indices, thyroid stimulating hormone with Insulin resistance and secretion in healthy individuals. Materials and Methods: A cross-sectional study was conducted in normal healthy individuals, from general population.(n=142).Body mass index, body fat, were measured, Glycemic indices, fasting glucose, post prondial glucose, Glycated hemoglobin, fasting insulin levels, Thyroid stimulating hormone, fasting lipid profile were analysed. Result: Insulin resistance (HOMA IR) is positively correlated with Glycemic indices (FBS, PPBG, HbA1C) P<0.05, Body mass index P<0.05, Body fat P<0.05, and Cholesterol/HDL ratio. Serum Thyroid Stimulating Hormone (TSH) P<0.05 is negatively associated with Insulin Secretion. Glycemic Indices, Triacylglycerol, cholesterol, LDL are negatively correlated with Insulin Secretion. Conclusions: Glycemic indices, body mass index, body fat and lipid profile are intrinsically related to Insulin resistance and Insulin secretion. Increased TSH is associated with decreased insulin secretion leading to increase blood glucose levels, which indicates that thyroid hormone is important for pro insulin expression and translation, providing the evidence that, effects of thyroid hormones on carbohydrate metabolism also include the control of proinsulin gene expression, the possible role of thyroid hormones on insulin secretion.

112-115

Authors: Jigar G Shaherawala, Prashant M Jadav.

Introduction: Polycystic ovarian disease (PCOS) is one of the most common female endocrine disorders. PCOD produces symptoms in approximately 5% to 10% of women of reproductive age (12–45 years old). It is thought to be one of the leading causes of female subfertility. Objectives: To establish correlation among LH, FSH, fasting blood sugar and lipid profile among the women with polycystic ovary syndrome (PCOS), in order to evaluate their diagnostic and prognostic significance. Materials and Methods: This study includes total 500 female participants of age Group between 18-40 year of age. They were divided in to two groups. Group 1(n=300) includes women having PCOD (Cases Group) and Group 2(n=200) is controls Group. Fasting Blood samples were obtained from all participants to measure Blood sugar, Lipid Profile FSH and LH. Results: The Mean level of Fasting Blood sugar, Serum cholesterol, Serum Triglyceride, Serum FSH and Serum LH is found to be higher in Cases group as compared to controls group and difference among them found to be statistically significant. Conclusion: PCOD is a very complicated endocrine disorder. Blood tests to measure hormone levels, an ultrasound to look at your reproductive organs and thorough personal and family histories should be completed before a PCOD diagnosis is confirmed. Assessing hormone levels serves two major purposes. First of all, it helps to rule out any other problems that might be causing the symptoms. Secondly, together with an ultrasound and personal and family histories, it helps gynecologist to diagnose the cases of PCOD.

120-123

Authors: Santosh B. Jagtap, Sanjyoti S. Bandebuche, Mamata V. Hegde.

Introduction: Creatinine enzymatic method is more accurate but its own higher cost is the main reason why the use of Jaffe assays is still in practice. The verification step is performed because assay procedure confirms to the manufacturer’s claims in the end users’ setup. Desirable specification based on biological variation gives Allowable Total Error (ATE) and Sigma metrics provides summative evaluation of method performance. Objectives: Verification of manufacturer’s precision claims. Calculation of bias, Total Analytical Error (TAE) and sigma metrics. Materials and Methods: Modified Jaffe’s (No deproteinization) and enzymatic creatinine Erba XL liquid pack on Erba EM360 fully auto analyser were used. Intra assay and inter assay imprecision done on 20 replicates each. The estimates of bias uses data from precision experiment. Results & Discussion: The performance of jaffe’s and enzymatic serum creatinine is comparable to manufacturer's stated claimed value and are within desirable specification based on biological variation. The bias calculated in both assays is less than allowable bias. Total Analytical Error (TAE) is less than Allowable Total Error (ATE). Both the methods overall showed ATE ≥ bias + 4 SD. Within-run showed ATE ≥ bias + 5 SD complying Six Sigma concepts. Conclusion: Both Jaffe’s and enzymatic creatinine assays gives good performance and better sigma metrics. This makes enzymatic method a better choice due to inherent advantages such as increased accuracy and less interference if cost is neglected.

128-133

Authors: Shylaja.T.V, Amit Sonagra, Asmabi Makandar, Patnaik, Shanthinaidu.

Introduction: Detecting AKI in a timely fashion with the current AKIN staging criteria is a challenge because the diagnosis of AKI is usually based on changes in serum creatinine (SCr) which is a poor marker of early renal dysfunction. Aim: To study the role of Serum Neutrophil Gelatinase-Associated Lipocalcin (NGAL) as early biomarker for the detection of Contrast induced acute kidney injury (CIAKI) in subjects undergoing Percutaneous transluminal coronary angiogram (PTCA) with normal eGFR. Materials and Methods: Prospective cohort study was conducted, where SCr and serum NGAL were serially measured in a heterogeneous group of subjects (n=60) presenting to cardiology department. Results: The study population consisted of 60 subjects. All subjects were divided into 2 groups “CIAKI group” and “no-CIAKI group” according to predefined definition. The serum NGAL increased and reached its peak at 4 hours after contrast media (CM) administration and did not returned to baseline by 24 hours while the SCr increased at 24 hours and reached peak at 48 hours respectively (P<0.001).Thus, 4 hours after CM administration were considered to be appropriate time point for NGAL measurement and there was no significant correlation between serum NGAL with SCr at 0 hours, 4hours, 24 hours and 48hours. Conclusion: In our study, we found that serum NGAL promises to be a simple, safe, non-invasive and reliable early biomarker for predicting possible onset of CIAKI following contrast administration.

138-142

Authors: Sridevi V., Chandrakanth, Vinit Anand.

Introduction & Objectives: Rheumatoid arthritis (RA) is a prototypical inflammatory joint disease. The degree of inflammation is reflected in the extent of joint damage, which further has influence on the quality of life of patients with RA. Serum adenosine deaminase (ADA) has been previously proposed to predict disease activity in patients with RA. The aim of this study was to investigate the level of serum ADA, CRP & ALP in Rheumatoid arthritis patients and compare it with healthy subjects. Materials and Methods: Fifty four RA patients and fifty four age matched healthy controls between 35-65 years were included in the study. ADA &ALP activity and CRP levels in serum were measured in all the subjects and correlated. Results: Serum ADA level was found significantly higher among RA subjects with respect to controls (31.37±4.16 versus 11.19±1.802 U/L; P < 0.0001). Serum ALP levels were also increased in RA cases as compared to controls and were statistically significant (145.17±15.86 versus 83.19±17.55 U/L; P < 0.0001). Serum CRP levels were also increased among RA subjects when compared to controls (2.60±1.16 versus 0.283±0.1161). Conclusion: ADA assay can be a reliable, sensitive and specific test. CRP is an important inflammatory marker for rapid diagnosis of rheumatoid arthritis. Increase in ALP in RA patients when compared to healthy controls suggests the role of serum ALP as a marker of disease activity in RA. However, larger and well controlled studies are needed to establish its role as inflammatory marker.

148-153

Authors: Tirthal Rai, Srinidhi Rai, Janice, P. Kathyayani.

As we live in a country with abundant sunshine the prevalence of this sunshine vitamin deficiency is around 70-100%. Minimum thirty minutes of UV B ray exposure causes the production of 600-1000IU of vitamin D in our body. The cut off values for 25-OH vitamin D deficiency is<20ng/ml. The exact cut off value for ‘deficiency’ and ‘insufficiency’ and its vitamin D therapy in India remains controversial. Despite the controversy the Clinicians often prescribe high dose vitamin D to treat the deficiency. Objectives of the study: To compare the vitamin D levels in apparently healthy office workers and manual laborers. Methods and Materials: This study was conducted on 50 apparently healthy office workers, working indoors from 9am to 5 pm and 50 apparently healthy manual labourers working outdoors, during the month of January and February in Mangalore, India. Results: The mean vitamin D levels were significantly higher (p <0.001) in manual labourers than the office workers (18.14 ± 6.98 and 11.16 ± 7.48). The vitamin D status among the office workers showed 2% having a normal vitamin D level(>30 ng/ml),12% having insufficiency(20 -30ng/ml), 28% having deficiency (<20ng/ml) and 58% having severe deficiency(<10ng/ml) similarly in the manual labourers 4% had normal vitamin D level,28% insufficiency,58% deficiency and 10% having severe deficiency. The hours of exposure and vitamin D concentration had significant correlation (p<0.001). Conclusion: Though there was a positive correlation between the vitamin D levels and the hours of exposure, even then only 4% of the manual labourers were having a normal vitamin D level, hence we conclude by saying that either the hours of exposure to sunlight should be more than 5hrs or a new reference range of vitamin D must be established in our Indian population as majority of our study population were asymptomatic, which could also curb the unnecessary intake of the vitamin D drug.

158-163

Authors: Kirankumar P. Chauhan, Jatin D. Patel, Sonali Prajapati, Amit Trivedi.

Introduction: The blood sample is collected and transported to the laboratory for analysis, during this time the samples bares many extra-analytical factors prior to analysis. Contact time of plasma or serum with the blood cells is one of these factors because of ongoing cell metabolism as well as active and passive movement of analytes in cellular compartments. Aim and Objective: The aim of our study is to determine the stability of different seventeen biochemical parameters in primary collection (without separation of serum/plasma) and Secondary collection (with separation of serum/plasma) tube. Materials and Methods: Hundred patients’ venous blood sample were collected in plain vacutainer and fluoride vacutainer (primary tube), set of the seventeen biochemical analytes like sodium, potassium, ionized calcium, chloride, glucose, creatinine, urea, uric acid, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, total protein, albumin, bilirubin, triglyceride, total cholesterol and HDL-cholesterol tests were analysed. Once the tests were carried out from primary tube, approximately half serum was separated into two aliquots (secondary collection tube). All tubes were stored at 2 to 8° C. After 24 hr and 48 hr again same sate of tests were performed on the same equipment. Statistical analysis was done after that. Results: Out of seventeen analytes most analytes remained stable in both primary and secondary tubes up to 48 hr at 2 to 8° C, these includes chloride, creatinine, urea, uric acid, total bilirubin, total protein, albumin. alkaline phosphatase (ALP), aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Plasma glucose decreased in both primary and secondary collection tube but concentration is within significant change limit (SCL). While serum potassium is increase 28.84% at 24 hr and 75.58% at 48 hr; concentration is also out of SCL range in primary collection tube even though samples stored at 2 - 8⁰ C. Conclusion: Most biochemical analytes will remain stable for 48 hr at 2 - 8⁰ C, only few analytes like plasma glucose and serum potassium requires stringent control before serum-clot separation.