International journal of Clinical Biochemistry and Research

198-202

Authors: Mishra B. P, MPS Marwaha, Bhupinder Kaur Anand, Lingidi Jhansi Lakshmi, Badade Z. G

Introduction: Owing to their easy availability and accessibility, organophosphate and carbamates are the most commonly used pesticides worldwide in the pest control of crops. Acute toxicity and clinical manifestations of organophosphate pesticide are caused by excessive synaptic accumulation of acetylcholine (AChE). Objective: To analyze the biochemical parameters of serum cholesterol and hematological parameter of absolute erythrocyte count in fish Channa Punctatus exposed under organophosphate pesticide sumithion. Materials and Methods: This research study has been done in fish Channa Punctatus, which was exposed 24 to 96 hours to four different concentration of sumithion pesticide. Serum cholesterol was determined as biochemical biomarkers while absolute erythrocyte counts as hematological biomarker. Serum cholesterol was determined by zlatkis method (Zlatkis A; Zak B. and Boyale A. J. 1953)15. Absolute erythrocyte count was determined by electrical conductivity method of cell counting. Result: There was significant increase in serum cholesterol in Sumithion pesticide exposed, fish Channa Punctatus, comparative to normal control subject. The maximum rise of 18.93% (80.74 ± 78.56) in serum cholesterol was observed after exposure of 96 hrs at 0.40mg/l Sumithion pesticide. Toxicity of Sumithion resulted in decrease of absolute erythrocyte counts at all concentration of time intervals. Decrease was more pronounced with increasing time of exposures. The lowest erythrocyte count was 57.24% below control at the highest concentration of 0.73mg/L within 24hrs. Conclusion: Results of our study indicates that hypercholesterolemia & decreased level of erythrocyte count in fish channa punctatus exposed under sumithion pesticide are biochemical & hematological biomarker for human beings also. Therefore it is advised to pesticide workers to take all precautions regarding protection from pesticide exposure and proper use of prophylactic supplementation for their healthy life.

210-215

Authors: Pushpa Sarkar, Mahadeva SK, Raghunath H, Kruthi BN

Background & Objective: Overweight and obesity are becoming major problems in the developed as well as developing countries. In India about 30-65 % of adult urban Indians are reported to be either overweight or obese. Therefore the objectives of the study was to assess the prevalence of overweight, obesity and metabolic syndrome and determine the correlation between overweight, obesity and parameters of metabolic syndrome among medical students of Mandya Institute of Medical Sciences (MIMS), Mandya. Methods: The data of the cross-sectional study includes physical measurements like height, weight, Waist Circumference (WC) and biochemical investigation like Fasting Blood Glucose (FBS), serum Triglyceride (TG) and High Density Lipoprotein-Cholesterol (HDL-C). Results: Out of 304 students, 144 were male students (47.37%) and 160 (52.63%) were female students. The prevalence of underweight in the present study was found to be 16.5%, overweight 15.2%, obese 0.9% and metabolic syndrome was 6.25%. It was found that higher percentage (9.72%) of male students had metabolic syndrome as compared to 5 (3.13%) females. Conclusion: Overweight and obese students had increased values of biochemical parameters as compared to students with normal BMI. Metabolic syndrome was more prevalent in males than in female students of MIMS, Mandya. Early detection of the individual components of metabolic syndrome would help in early treatment and prevention of progression to metabolic syndrome.

223-225

Authors: Sucharita Mohanty, Alpana Mishra

Background: During the summer it has been observed, a rise in incidence of hypokalemia in paediatric patients. The phenomenon of seasonal pseudohypokalaemia has been reported previously. High ambient temperature may be a spurious cause of hypokalemia.1, 2 Method: The study was undertaken to observe the effect of temperature on the level of serum potassium in children. The children in the age group of 1- 14 years, admitted to SVPPGIP, Cuttack, Odisha, were selected for the study. A retrospective record based study was conducted from December 2014 to August 2015. Results: The mean potassium concentration during winter (December2014 to February 2015) was 4.53 ± 0.89 mmol/L and during summer (March 2015 to August 2015) was 4.36 ± 1.19 mmol/L. The mean temperature in summer and winter were 36.18 ± 3.14°C and 29.79 ± 3.16°C respectively. There was a negative correlation (r =-0.118) between serum potassium and ambient temperature (p<0.0001). The proportion of hypokalemic samples was significantly higher in summer than winter with odds ratio 1.507. Conclusion: The high ambient temperature in tropical climate may be the cause of seasonal pseudohypokalemia in paediatric patients. In vitro changes in potassium are more complex than is usually stated in textbooks.8 The exact timing and temperature are clearly critical in determining the result that is actually reported by the laboratory.

229-232

Authors: Rahul M. H, Deepa K, Varun Reddy, Sudhir, Shubha Jayaram

Introduction: Obesity is the leading cause for cardiovascular disease in the world. Cystatin C is a novel marker of cardiovascular disease and atherogenic indices which is used as an index for cardiac risk stratification. The objective of the study was to estimate the Cystatin C levels in non-obese and obese individuals aged between 18-39 years and to compare the levels of Cystatin C among these individuals. The study was also done with an objective to know the association of Cystatin C with atherogenic indices. Methodology: The subjects were selected from healthy volunteers of Mysore aged between 18-39 years of either sex. They were grouped into two groups based on their BMI. Each group had sample size of 60. Sample were collected in fasting state and analyzed for Total Cholesterol, Triglyceride, LDL-Cholesterol & HDL cholesterol by enzymatic method and Cystatin-C by immune-turbidimetric method using Randox auto-analyzer. Results and Interpretation: The mean serum Cystatin C level in non obese group was 0.7±0.03 mg/L, and in Obese group 1.15±0.09 mg/L (p value<0.001). Serum Cystatin C showed a positive correlation with serum triglycerides (r=0.7), Atherogenic index of plasma (AIP) (r=0.80), TCHOL: HDL (Castelli’s Risk Index I) (r=0.71), HDL: LDL (Castelli’s Risk Index II) (r=0.70) and Atherogenic coefficient (AC) {(Non HDLc)/HDLc} (r=0.60) respectively and negative correlation with serum HDL (r=-0.52). Conclusion: Several indices have been derived from lipid profiles to establish an index for predicting the risk of having coronary event. Cystatin C, was strongly correlated with the Atherogenic index of plasma (AIP), hence AIP can be used as a better index for screening the preclinical Cardiovascular event in obese individuals as estimation of Cystatin C is cost effective.

236-241

Authors: Shailaja A Katti, Anuradha Katti Suravanshi, S S Bangar, Dipti Sanakal, Sudarshan Surendran

Osteoarthritis (OA), a joint disease, is progressive and also degenerative. This has been one of the primary causes of morbidity in elderly population, affecting their social functioning and mental health due to the pain associated with degeneration. An increase in the levels of oxidative stress is associated with the degeneration of articular cartilage and promotes the progression of the disease. Objective: Our study was designed to evaluate the amount of oxidative stress in osteoarthritis, by quantifying the levels of Malondialdehyde (MDA) and antioxidant (enzymatic – Superoxide dismutase (SOD) and non-enzymatic – Vitamin C and Vitamin E) levels. Correlation between lipid peroxidation levels and antioxidants was also done along with the above said. Materials and Methods: A total of 100 subjects were included in the study and were divided into two groups. The first group comprised of 50 patients who had been confirmed with osteoarthritis after clinical and radiological examinations. Another 50 subjects who were age and sex matched controls, formed the other group. Statistical analysis was done using Student’s t test and Pearson’s correlation coefficient was used for correlations. Results: A significant (p<0.001) increase in the serum MDA levels and a significant (p<0.001) decrease in the enzymatic and nonenzymatic antioxidants was observed when compared with the normal controls. Conclusion: There is an increased level of oxidative stress observed in patients with osteoarthritis, which is indicated by the increased MDA levels and the decreased antioxidant levels. Thus, these findings cite the biochemical rationale for performing clinical trials of antioxidants, in an attempt prevent and treat osteoarthritis.

246-249

Authors: Swetha Singaravelu, Shantha Kumari

Background: Alcoholism is a serious social threat in our country leading to morbidity and mortality in various aspects. It causes damage to almost all the systems of the body including central nervous system, cardiovascular system, liver and kidneys out of which liver being the most commonly affected. However renal dysfunction is usually noticed during the terminal stages by then the other systems have already damaged. Aims and Objectives: This study is to measure the parameters of renal functions like serum urea, creatinine, creatinine clearance, sodium, potassium, calcium and phosphorus in chronic alcoholic men without dependence features and to show the need to assay simple renal function tests periodically as damage to the kidneys are usually missed. Materials and Methodology: The study was conducted in 60 middle aged men of age 30-50 yrs in Dr. B. R. A. M. C. H from outpatient and inpatient departments. Among them 30 were controls and 30 were chronic alcoholics. Informed consent obtained from all subjects. A detailed history was obtained by questionnaire and serum collected from fasting sample was measured for the following analytes urea, creatinine, creatinine clearance, sodium, potassium, calcium and phosphorus. Results and Conclusion: The serum urea and creatinine values are significantly raised in cases of chronic alcoholic with p value of <0.01. The creatinine clearance is significantly lowered in cases of chronic alcoholic intake with p value of 0.006. The levels of serum sodium, potassium, calcium and phosphorous are significantly lowered when compared to the controls with a p value of <0.01. This strongly suggests chronic alcohol consumption is associated with renal dysfunction.

130-139

Authors: Gajraj Singh Yadav, Gora Dadheech Acharya, Meenu Rai, Archana Shrivastava

Background: Diabetic glomerulopathy in hyper glycemic state impaired kidney filtrations. Micro albuminuriais primary urinary marker simply indicating kidney dysfunction. IgG and transferrins are authenticating urinary markers of kidney dysfunction. High urine creatinine (Crt)) is waste product of unusual high protein metabolism. Materials and Methods: The present study was conducted over 400 diabetes mellitus type –II (DMT-II) complicated patients; they were randomly selected on micro albuminuria using dipstic method. Urinary markers: Albumin (Alb), Immunoglobulin G (IgG), Transferrin (Trf), and Urine Crt were analyzed using enzyme linked immunosorvant assay (ELISA) kit method and Jaffe’s reaction respectively. Statistical analysis was performed using IBM, SPSS version 20.0 (Illinois). Data was expressed as mean ± S.D., Correlation between parameters was assessed using Pearson’s correlation coefficients (r) by linear regression analysis. Result: 276 patients were reported as hyperalbuminic (More than normoalbuminuria 30mg/day) cases among 400 DM type-II complications. 55.15%hyperimmunoglobulinic-G(more than normal level of IgG) and 67.88 % hyper transferrinic cases were reported and found positive correlation between Crt & Alb (r2 = 0.561, P-0.01), Crt & Trf (r2 = 0.142, P-0.01), Crt & IgG (r2 = 0.205, P-0.01).

143-147

Authors: Mario Leesha Fernando, Santhi Silambanan, Jothi Malar

Background and Objectives: Cardiovascular disease is the leading cause of death in type 2 Diabetes mellitus (DM). Type 2 DM is a significant risk factor of atherosclerotic coronary artery disease. Neutrophil to Lymphocyte ratio (NLR), an indicator of systemic inflammation has been shown to provide a reliable inflammatory index to be used in prognostic stratification of CAD. The objective of this study is to investigate the relationship between neutrophil to lymphocyte ratio (NLR) and coronary artery disease (CAD) in diabetic patients. Methods: 100 diabetic patients who had coronary lesion with diameter stenosis of at least 50% and 50 diabetic patients with normal coronary anatomy matched with age and sex were retrospectively selected and classified as CAD(+) and CAD(-) group respectively. Diabetics with chronic infections and inflammation were excluded. NLR in two groups were compared. Results: NLR was higher in CAD (+) group compared to CAD (-) group (p = 0.000). ROC curve analysis revealed that NLR value of ≥ 2.26 identified the presence of CAD in diabetic patients with 100% specificity and 92% sensitivity. Conclusion: NLR was higher in diabetic patients with angiographically proven CAD compared to those without CAD. NLR may serve as a useful marker to predict the presence of CAD in type 2 diabetic patients.

154-161

Authors: Anuradha Katti-Suryawanshi, Shailaja Avinash Katti, D.S. Jayaprakash Murthy, Abdul Kayum Shaikh

Diabetes Mellitus (DM) is an important cause of morbidity and mortality through its various complications. A decrease in Paraoxonase 1 (PON1) activity in diabetes is associated with occurrence of vascular complications. Our objectives were to estimate PON1 activity, Catalase (CAT) activity and Malondialdehyde (MDA) levels in Non-Insulin Dependent Diabetes Mellitus (NIDDM) cases and controls. We also had an objective to establish possible relationship between PON1, High Density Lipoprotein-Cholesterol (HDL- Cholesterol), CAT, MDA levels and to correlate CAT/PON1 ratio with Glycosylated Hemoglobin (HbA1c) levels.

166-171

Authors: Jaskiran Kaur Sandhu, Anju Sharma, Sahiba Kukreja, Neha, Amandeep Kaur

Objective: To study the serum levels of Thyroid Stimulating Hormone (TSH) in neonates. Also to assess the sex differences in thyroid function and to compare our results to previously published reference data. TSH was estimated in 91 neonates using enhanced Chemiluminescence technique using vitros ECi-Ortho Clinical Diagnostics. Results: Although the mean serum levels of TSH were higher in females, no significant differences were observed in serum TSH between males and females. Conclusion: The study underlines the importance of new born screening for thyroid dysfunction. Due to high reported prevalence of congenital Hypothyroidism (CH) in our country and the lack of international standardization, performing multi-central studies with more population helps in making a more precise evaluation of thyroid status in neonates. Frequent laboratory monitoring in infancy is essential to ensure optimal neurocognitive outcome. Serum TSH and free T4 should be measured every 1- 2 months in the first 6 months of life and every 3-4 months thereafter. In general, the prognosis of infants detected by screening and started on treatment early is excellent.

177-181

Authors: Sonu Yeldose, Avinash S S, Sreekantha, Arun Kumar K, Malathi M, Shivashankara A R

Background: Women who undergo hysterectomy alone are known to attain menopause 3.7 years earlier than those who attain natural menopause due to altered blood supply to ovaries1. Very few studies are conducted to know the effect of earlier onset of endocrinological changes associated with hysterectomy on the serum and urinary levels of calcium, magnesium and phosphate. Hence the present study was conducted to compare the levels of calcium, magnesium and phosphate in serum and urine of hysterectomised vs. natural postmenopausal women. Methods: The case control study included 26 healthy premenopausal, 22 early surgical menopausal (who were hysterectomised before the age of 50 years) and 21 natural post menopausal women aged above 50 years. Women suffering from endocrine disorders (hypo/hyper parathyroidism, hypo/ hyperpituitarism, ovarian disorders, diabetes), renal failure and malignancy were excluded. Calcium, magnesium and phosphate levels were estimated in serum using calcium-cresoptholone complex, magnesium-calmagite complex and Ammonium phosphomolybdate method respectively. Creatinine was estimated in random urine by kinetic jaffe's method. Calcium/creatinine, magnesium/creatinine and phosphate/creatinine ratio were estimated in random urine using same methods. Estimations were done spectrophotometrically in a fully automated Cobas c311 analyser after appropriate quality control check. Statistical analysis for significance of difference between means was done using ANOVA and kruskal Wallis test by SPSS 13 software. Results: Natural post-menopausal(serum calcium:9.12±0.46 mg/dl; magnesium:2.1±0.23 mg/dl) (urine calcium/creatinine: 0.18±0.13; magnesium/creatinine: 0.09±0.05) and hysterectomised women (serum calcium: 8.83±0.63 mg/dl; magnesium: 2.0±0.16 mg/dl) (urine calcium/creatinine: 0.16±0.1; magnesium/creatinine: 0.07±0.04) have decreased levels of serum calcium and increased serum magnesium, urine calcium/creatinine, magnesium/creatinine compared to normal premenopausal women (serum calcium:9.38±0.46 mg/dl; magnesium:1.96±0.14 mg/dl)(urine calcium/creatinine:0.07±0.05; magnesium/creatinine: 0.06 ± 0.03). Conclusions: Natural post-menopausal and hysterectomies women have decreased levels of serum calcium and increased serum magnesium, urine calcium/creatinine, magnesium/creatinine compared to normal premenopausal women. Large population based study with dietary details can establish the above findings and find the relationship with oestrogen for diet and hormone supplementation. Abbreviations: ER-E Strogen receptor; CBD-Calbindin; TRPV-Transient receptor potential cation channel; NCX-Sodium cation exchange channel.

185-189

Authors: Deepa K, Prithvi Naveen, Meera S, Shubha Jayaram Sudhir

Background & Objectives: Gestational Diabetes Mellitus (GDM) is one of the most common medical complications of pregnancy. Complement 3(C3) is the central component of the complement system which induce inflammatory, immunomodulatory and metabolic responses. This passive immunity acquired by the fetus is crucial for the adaptation of the newborn to the extra uterine environment, providing protection against infections. The Objectives of the present study was to estimate the serum levels of complement3 (C3) & Immunoglobin (Ig) G in Gestational Diabetic and their newborns, and to compare the above parameters with normal pregnant females and their newborns. Material & Methods: Total 90 pregnant females aged between 20-40yrs with regular antenatal care at Cheluvamba Hospital & Mission Hospital, Mysore, were included in the study. Out of 90, 45 were diagnosed with gestational diabetes. About 4ml of blood sample was collected from the mother during the time of labour and 4ml of cord blood was collected from their newborns and serum was analysed for complement C3 and Immunoglobin (Ig) G by immunoturbidimetric method. Results & Interpretation: The study showed significant increase in complement C3 levels in Gestational Diabetes, when compared with normal pregnancy with mean and standard deviation of 190+14.4 and 105+11.2 respectively. There was significant decrease in Immunoglobulin G levels in cord blood of newborns of gestational diabetes when compared with cord blood of newborns of normal pregnancy with mean and standard deviation of 790.4+138.7 and 974.0+144.3 respectively with p value <0.05. Conclusion: Complement C3 estimation in GDM could help to understand the underlying chronic inflammation which in turn affects the growing fetus innate immune system and predisposes the individual for future Diabetes and its complications.

73-76

Authors: Seema Verma, Arunima Karkun, Huma Naz Siddiqui

The present study was carried out to evaluate the antimicrobial activity of clove oil extracted from clove. Screening for antibacterial and antifungal of clove oil was done using agar well diffusion. Four Bacterial and ten fungal species were taken. According to the result clove oil was more effective against Bacteria as compared to Fungi. We can conclude by this study that clove oil works better as antibacterial. It was also observed that by increasing concentration of clove oil the growth of fungi was decreased.

83-88

Authors: Radhika Krishnaswamy, Soniya Lukose

Background: The Glomerular filtration rate (GFR) is considered to be the most reliable measure of the functional capacity of the kidneys and is it has proved to be the most sensitive and specific marker of changes in overall renal function. The accurate measurement of the GFR is time consuming, expensive, and not practical for routine clinical use.1 Though Inulin clearance is considered to be the gold standard test, it has not been used widely because it time consuming, expensive, requires continuous infusion, and constraining for the patient. 2, 3, 4 Creatinine clearance is most commonly used for the estimation of GFR. The need to collect a urine sample remains a major limitation of the creatinine clearance test.5 Many formulae have been developed to transform serum creatinine so that it may accurately reflect, GFR.6 Variations in creatinine production owing to age and sex related differences in muscle mass have been measured and incorporated into the formulas to improve the GFR.7 In adults, the most commonly used formulae are those derived from the Modification of Diet in Renal Disease (MDRD) and the Cockcroft-Gault (CG), which have not been validated in Indian population. 8 This study was aimed to compare the diagnostic performance of the MDRD Cockcroft-Gault formulae, and Measured Creatinine Clearance in Indian population. Materials and Methods: In 370 subjects Creatinine Clearance was calculated by Routine Creatinine Clearance test using serum and urine Creatinine and also through MDRD and the Cockcroft-Gault formulae. Subjects were divided into two groups based on the Measured Creatinine Clearance values. Group A consisted of subjects with Measured Creatinine Clearance >60 ml/min. Group B consisted of subjects with Measured Creatinine Clearance <60 ml/min Statistical analysis: Correlation (Pearsons correlation) between the values of Clearance obtained through the three methods in the above two groups was analyzed using SPSS-16 version. Results: Group A (Measured Creatinine Clearance >60 ml/min) The Cockcroft-Gault formula showed strong positive correlation (r value 0.756, p value <0.001) with the Measured Creatinine Clearance than the MDRD formula. (r value 0.684,p value <0. 001) Group B (Measured Creatinine Clearance <60 ml/min) both Cockcroft and MDRD showed weak positive correlation with Measured Creatinine Clearance. Cockcroft ((r value 0.617, p value <0.001) MDRD (r value 0.613, p value <0.001) Conclusion: The present study shows weak positive correlation between the Measured Creatinine Clearance, MDRD and Cockcroft formulae at Clearance values<60 ml/min and strong positive correlation between Measured Creatinine Clearance and Cockcroft formula at Clearance values >60 ml/min. Since MDRD formula includes age, gender, and race and developed for the western population with chronic renal insufficiency, further research is needed in our population, to establish and incorporate adjustment& Correction factors in the formula, so that it can be used for a wider range of renal function, in our population to give reliable results and therefore can replace the traditional Measured Creatinine Clearance test.

97-109

Authors: Sanjay D Gabhale, Pallavi Taparia, Dharamveer Yadav, S.P. Agnihotri

Background: Pleural effusion is an abnormal collection of fluid in pleural space resulting from excess production or disruptions of homeostatic forces that regulate the flow of fluid in and out of the area. It is a frequent manifestation of serious thoracic disease whose specific diagnosis is a challenging task. Pleural effusion can be due to Infectious, malignant, parapneumonic disease and tubercular or other causes. Diagnosis of PE is not straight forward due to associated heart disease, malignancy or infection. A specific biomarker is therefore required for differential diagnosis of pleural effusion. C- Reactive Protein is an acute phase protein synthesized by hepatocytes and widely used to assess severity of infection and is directly associated to degree of inflammation in diseased state. The aim of this study is to assess specificity and sensitivity of Pleural Fluid CRP and other routine biochemical indices in diagnosis of exudative Pleural effusion arising due to varying etiologies. Material and Method: The study involved 187 adult patients diagnosed with exudative pleural effusionand classified into 5 groups as follows: 1. malignant pleural effusion (MPE), 2. Chronic non-specific inflammation (CNI), 3. Parapneumonic pleural effusion (PPE), 4.Tubercular pleural effusion (TBPE) and 5. Others. After complete clinical evaluation, routine Pleural fluid analysis and CRP was analysed. Reciever Operating Characterstics (ROC) analysis established the cutoffs of CRP for discriminating between groups. Result and Discussion: Pleural Fluid CRP level was significantly higher in infectious parapneumonic group, followed by Chronic non specific inflammatory group and Tubercular cases with lowest value in malignant group. ROC analysis of Pleural fluid CRP provided good sensitivity (97.05%), specificity (71.76%), NPV of 95.31% and PPV of 80.48 %for the differentiation of tubercular vs. non tubercular effusions. In ROC analysis of CRP for differentiation of Parapneumonic from non Parapneumonic pleural effusion (tubercular, chronic non-specific inflammation, malignant and others), sensitivity of 100%, specificity 98.88%, NPV of 100% and PPV of 81.82% was seen at cut off level of 90.8 mg/l. It provides largest Area under Curve I.e 1.000. CONCLUSION: Pleural fluid CRP can be used as a diagnostic aid specially differentiating between acute and chronic inflammation and also between infectious and non infectious inflammation with CRP value more than 30 mg/l almost excludes malignancy. Pleural fluid CRP can be used as specific biomarker for differential diagnosis of Parapneumonic pleural effusion with excellent sensitivity and acceptable specificity.

120-122

Authors: Ramesh Chandra Thanna, Rekha Choudhary, Swati Pathak, Amrita Vamne, Shreya Nigoskar

Background: Uric acid is the final product of the purine metabolism in humans. The 2 final reactions in its production which catalyze the conver-sion of hypoxanthine to xanthine and the latter to uric acid are catalyzed by the enzyme xanthine oxidoreductase. The role of uric acid in the progression of prediabetes to diabetes has been known. Serum uric acid has been shown to be associated with cardiovascular disease, hypertension, and chronic kidney disease. Aims & objectives: The present study was done to see the level of uric acid in preeclampsia and regnancy induced hypertension (PIH) patients. Material and Methods: The study involves 50 cases of preeclamsia of age group between 20-35 year and 50 controls with similar age group.Srum uric acid was done from all subjects by uricase method in semi-automated biochemistry analyser after centrifugation of samples. Results: The observed mean serum uric acid levels in preeclampsia was 7.48±0.59 mg/dl as compare to 4.12±0.59 in control group. The difference between them is highly significant because p-value is less than 0.05. Conclusion: High serum uric acid level could be a useful indicator of the maternal and fetal complication.

5-12

Authors: Sunaiba M, Avinash S.S, Arunkumar K, Malathi M, Shivashankara A. R, Ashwini K

Introduction: AOPP (Advanced oxidation protein products) are the dityrosine containing protein cross linking products indicating the oxidised tyrosine residues of the plasma protein albumin, fibrinogen and lipoproteins. AOPP are elevated in oxidative stress and inflammation. Unlike AOPP the mAOPP estimation is not interfered by triglyeride levels. Objective: Analytical method comparison of AOPP with mAOPP. Materials and Methods: Measurement of AOPP involves the principle of spectrophotometric determination of oxidation of I- plasma AOPP under acidic condition by Witko Sarsat method. To remove the interference by the triglycerides especially seen in hypertriglyceridemia, the plasma was treated with lipid precipitating agent and the mAOPP were measured. In this study using pooled serum samples we compared the performance characteristics like precision, accuracy, linearity limit and reference range of AOPP assay with the mAOPP assay under our laboratory conditions as per CLIA guidelines of method validation. Results and Discussion: The intrarun, intraday, interday and overall precision of AOPP (4.25%, 5.18%, 3.89%, 5%) was better than that of mAOPP (5.76%, 5.5%, 5.8%, and 5.8%). But on linear regression, mAOPP = 0.5×AOPP + 9.8 chloramine T equivalents (r2-0.62; p < 0.001) and the AOPP was 18% higher than mAOPP. In eutriglyceridemia however, mAOPP = 0.7xAOPP + 4.8 chloramine T equivalents (r2 = 0.75; p < 0.001) and the AOPP was only 14.5% higher. Also the correlation (r = 0.74) of AOPP – mAOPP levels with TG showed that the difference was significantly higher (p < 0.001) in the persons with higher TG levels clearly establishing the overestimation of AOPP. Conclusion: Hence mAOPP may prove to be a better estimate of protein oxidation status and a better diagnostic and prognostic indicator compared to AOPP especially in hypertriglyceridemic patients.

18-21

Authors: Dinesh Kumar Sharma

Background: The present study concentrate to get significant association of serum uric acid levels with pre-eclampsia and PIH and also between serum uric acid and severity of disease. Material and Methods: 80 Patients diagnosed as having Pre-eclampsia and 80 controls with similar age group were studied after taking their consent. Blood samples were collected under aseptic precautions in plain vacutainer for serum uric acid estimations. Uric acid estimation was done by Uricase Peroxidase Method on Fully Automated Biochemistry Analyzer Miura 300. Results: The observed mean serum uric acid levels in preeclampsia was 7.52±0.77 mg/dl as compared to 3.70±0.94 mg/dl in controls.

27-32

Authors: Nishtha Saral, Mamta Rathore, V. D. Bohra, Madhuri Gupta

Background: β-Thalassemia results from a defect in β-globin chain production and ranges from clinically silent heterogeneous thalassemia minor to severe transfusion dependent homozygous thalassemia major. After approximately one year of transfusion, iron begins to deposit in parenchymal tissues, which might cause damage to the parenchyma and organ function impairment. So, iron overload may be develop liver, kidney, heart and endocrine abnormalities. Objectives: The aim of study was to correlate the early hepatic and renal complications in condition of β-thalassemia with serum iron and total iron binding capacity (TIBC) levels. Method: In study 50 β-thalassemia major patients were compared with 50 normal healthy subjects as controls. Fasting serum iron, TIBC, LFT and RFT were estimated using standard kit methods. Data were statistically evaluated by Student’s t-test and Pearson’s correlation coefficient (r). Result: A significant increase in the levels of serum iron and a significant decrease in TIBC in β-thalassemia patients were observed. Serum levels of liver enzymes (Aspartate transaminase, Alanine transaminase and alkaline phosphatase) were significantly higher in β-thalassemia patients as compared to controls. A significant decrease in total proteins and increase in serum bilirubin level was found in β-thalassemia patients. Serum urea and creatinine levels were significantly higher, but no change in levels of serum uric acid was found in β-thalassemia patients when compared to controls. There was significant negative correlation between serum iron and TIBC, total protein among patient group. Conclusion: Iron overload due to frequent transfusions in β-thalassemia results in abnormal organ function tests. Proper and timely screening of these parameters can help in early diagnosis & prevention of iron overload.

41-47

Authors: Viyatprajna Acharya, B D Toora

Background: Obesity is now occurring in pandemic proportions and has earned a new name as “Globesity” for it. Unlike earlier times developing countries too are facing the challenge of obesity and the modern epidemics have a common root cause tapering to obesity. Obesity during adolescent and young adulthood usually persists to adulthood in almost 50% cases and gives rise to early onset of type 2 diabetes mellitus, cardiovascular disorders and metabolic syndrome for which insulin resistance being the common link to all. Objective: The present study was taken up to study the prevalence of insulin resistance in apparently healthy young adult obese population and study its correlation with different cardiovascular risk factors like lipid profile and sdLDL-C. Material and Methods: In a randomized control study 106 apparently healthy young adults in the age group of 21-34 years were chosen from the community out of which 45 were obese and 61were age and gender matched non-obese controls. They were divided in obese and non-obese groups based on cut-off BMI of 25Kg/m2. Along with physical parameters fasting plasma glucose, lipid profile and routine biochemical parameters were assayed by standard kit methods and plasma insulin was measured by sandwich ELISA method. Different lipid ratios, atherogenic index and insulin resistance were calculated. Atherogenic index was calculated and insulin resistance was measured by HOMA-IR model and QUICKI index. Small dense LDL-C (sdLDL-C) was quantified by modified Tsutomu –Hirano method. Results: In the obese group BMI, waist circumference (WC) and waist-hip ratio (WHR) elevated significantly (p=0.0001) and TG, VLDL-C and sdLDL-C as well as atherogenic index elevated significantly (p<0.001).Significant Hyperinsulinaemia (p<0.0001) was found in the obese group and 50% of obese cases had hyperinsulinaemia. Insulin resistance calculated by HOMA-IR and QUICKI index was statistically significant (p<0.0001) in obese. Linear regression analysis showed sdLDL-C (R2=0.08, p=0.05 at 95% C.I.), hyperinsulinaemia (R2=0.089, p=0.054 at 95% C.I.) and insulin resistance (R2=0.099, p=0.03 at 95% C.I.) significantly dependent on WC and atherogenic index was significantly dependent on TG (R2=0.0036, p=0.05 at 95% C.I.) rather than any other lipid factors. On ROC analysis either method of insulin resistance showed equal efficacy (AUC for HOMA-IR= 80.3% and QUICKI = 80.14%; C.I. 95%) and atherogenic index turned out to be a better predictor than sdLDL-C (AUC for Atherogenic index= 76.14% and QUICKI = 71.46%). Conclusions: For Indian subpopulation WC and WHR should also be evaluated along with BMI. Insulin resistance should be identified early and interventional measures should be taken in terms of low carbohydrate protein-rich diet, physical exercise and insulin receptor sensitizers for a short-term. sdLDL-C rises earlier than total cholesterol and hence can be accepted as CVS risk predictor. Not many studies have been done in India on young adult health which is the group that can be targeted for early prevention of the modern epidemics like DM, Metabolic syndrome, CVS disorders and cancers.

54-58

Authors: Smita S. Swami, Sanjay C. Swami, Vinayak W. Patil, Anuradha M. Kanhere

Hypertension (HT) Type 2 diabetes mellitus (DM) are among the most common chronic non-communicable diseases and multifactorial disorders affecting both developed and developing countries, including India. Although DM and HT are not among the top leading causes of death, such as cancer and stroke, these two diseases draw attention from the public due to their increasing trends. The presence of hypertension in diabetic patients substantially increases the risks of coronary heart disease, stroke, nephropathy and retinopathy. When HT coexists with DM, the risk of CVD is increased by 75%, which further contributes to the overall morbidity and mortality of already high risk population. India contributes a lion’s share in the diabetic and hypertensive population. This needs to be tackled with proper awareness and proper government policies. The current review article throws light on comorbidity of HT and DM and its current scenario in India.

61-64

Authors: Dhiraj Trivedi, K Sankara Narayana

Background: Estimating the time since death is one of the prime objectives of conducting Medico-legal autopsies. The exact time of death can be known from hospital records, police investigation report etc. But at times, it is difficult to predict when such records are not available. Various methods have been experimented using biological fluids like blood, vitreous humor, synovial fluid, urine etc. to determine time lapse with varying degree of success. After somatic death, blood components undergo biochemical changes at every tissue. This principle can be utilized effectively to predict time since death in routine forensic practice where time of death is uncertain. Study purpose/Objectives: The present study was conducted to evaluate the relationship of postmortem blood glucose level with time elapsed from death on thirty-nine postmortem blood samples of time registered deaths of an adult occurred at our hospital. Methods: The 10 ml of jugular venous blood was collected from each autopsy case. Blood glucose level was estimated by glucometer. The results were correlated with time since death. Results and Mean Findings: Significant difference between blood glucose level before death (125.32 ± 489.29) and after death (56.73 ± 42.00) was observed. When the time interval since death (884.11 ± 489.29 min)were compared with difference in blood glucose level (68.59 ± 57.76mg/dl) shows high significance (p<0.0001). Similar significance (p<0.0001) were noted when the time interval since death were compared with rate of fall (0.103 ± 0.093 mg/dl min) of glucose level. Conclusions: Estimation of postmortem blood glucose level doesn’t provide any specific pattern of fall. Hence, it cannot be recommended for estimation of time since death as individual parameter.