International journal of Clinical Biochemistry and Research

262-266

Authors: Arun Kumar, Vishal Kalasker, K. Pratibha, K. Srinivas Rao, Harish Bhat

Introduction: Acute ischemic stroke (AIS) is one of the leading cause of death worldwide and the main causes of long-term disability. Brain CT shows no abnormality in the early event of AIS and the infarct may not be seen reliably for 24-48 hours. Oxidative stress is proposed as a fundamental mechanism of brain damage in ischemic stroke. Earlier it was reported that free radicals alters the N-terminus of the albumin which decreases its binding capacity for metals and is termed as Ischemia Modified Albumin (IMA). Recently it was found that IMA is increased in cerebrovascular diseases and may serve as biomarker for early identification of acute stroke. There is little information regarding the use of IMA for the prognosis of AIS. There is growing evidence of the importance of high sensitive C-reactive protein (hs-CRP) in Acute Ischemic Stroke. Therefore, the current study aims to determine the prognostic evaluation of time course of serum level of IMA and hs-CRP in Acute ischemic Stroke patients. Material and Method: 56 AIS patients diagnosed (clinically/ radiologically) of either sex and >18 years of age were taken as cases. 56 age and sex matched healthy subjects were taken as controls. Serum IMA levels were estimated by spectrophotometric method and hs-CRP levels were estimated by Auto-analyzer. Results: There was a significant increase in IMA levels in AIS patients at the time of admission (488.82±24.84) and on 3rd day (397.17±32.44) when compared to control (324.27±36.45) group. It was found to be statistically significant (P < 0.001). There was a significant increase in Hs-CRP levels in AIS patients at the time of admission (9.55±1.63) than in control (0.95±0.40) group. It was found to be statistically significant (P < 0.001). Conclusion: Estimation of serum IMA in AIS patients has both diagnostic and prognostic application. Routine hs-CRP measurement will be a useful tool for identifying AIS patients, in order to plan aggressive diagnostic protocols and prevention therapies. Diagnosis of AIS can be made very early then the available routine investigation & the cost of the test is less, can be used in Primary health care & remote places where CT & MRI are far from their reach.

272-276

Authors: Dhanunjay Kalvakuri, Srinivasa Rao K, Manjunath G.A

Objective: This study is to evaluate significance of serum ferritin in differentiating between different hematological conditions. Methods: This is a prospective study conducted on children aged between 1 to 12 years attending Pediatric OP and IP of Navodaya Medical College, Raichur for period of one year. 200 children who fulfilled WHO criteria for anemia were taken as cases and 200 normal healthy children of same demographic data were taken as controls. Serum ferritin levels were compared between the normal healthy children and children with different types of anemias. Results: The mean value of serum ferritin in normal controls (106.8 ± 38.0ng/ml), in IDA (5.1 ± 2.3ng/ml), in Dimorphic anemia (330±40ng/ml), in Sickle cell anemia (430±83ng/ml), in Thalassemia major (1520±230 ng/ml), and in leukemias (1550±140ng/ml) Conclusion: Serum ferritin is moderately raised in dimorphic anemia, in Sickle cell anemia, Thalassemia and leukemias it is significantly raised. And we found that serum ferritin is the most sensitive and reliable parameter compared to other parameters in iron profile in evaluating both iron deficient and iron overload conditions.

280-284

Authors: Anita M Raut, D.V. Andure, Dilip Mhaisekar, Smita Mhaisekar, R.K. Padalkar

Introduction: The primary abnormality in respiratory acidosis is retention of CO2 (increased H2CO3) due to impaired alveolar ventilation resulting in a rise in pCO2 causing acidemia. However, respiratory alkalosis occurs when there is decrease in H2CO3 concentration. A fall in pCO2, reduces the ratio of carbonic acid to bicarbonate resulting in alkalemia. Aim: To study variations in biochemical parameters in respect to respiratory acidosis and alkalosis. Material and Methods: The biochemical parameters of respiratory acidosis and alkalosis like blood pH, concentration of CO2, pO2, pCO2, level of HCO3 - . Results: The studied components of respiratory acidosis and alkalosis were found to be highly significant in chronic conditions of respiratory acidosis and alkalosis (p<0.01) than acute condition of respiratory failure when compared with the healthy controls. Conclusion: In this study, we observed that there is marked increase in product of metabolism in acute and chronic phase of respiratory syndrome when compared with the healthy controls.

292-294

Authors: Laxman Siddha, Ghanshyam Singh Sengar, Sikha Khandelwal, Niranjan Nagaraj, Pramod Kumar Berwal

Background: various researchers have shown association of celiac disease with altered lipid profile. We studied serum cholesterol levels in patient with celiac disease and effect of gluten free diet on it. This study aims to compare the serum cholesterol levels in celiac disease patient with general population and to study effect of gluten free diet on serum cholesterol in them. Methods: 50 children with celiac disease (either newly diagnosed or having poor dietary compliance for gluten free diet) and 50 healthy children were enrolled. Their serum cholesterol levels were collected and compared. After 6 months of strict gluten free diet, serum cholesterol levels for celiac patients were measured and compared with the previous levels. Result: mean serum cholesterol in patients with celiac disease was significantly lower (16.78%) than the healthy children (p<0.001). Boys with celiac disease had 13.07% and girls with celiac disease had 21.34 % lower mean serum cholesterol when compared to their healthy peers. The difference between both sexes was significant. After 6 months of strict gluten free diet, celiac patients showed 22.87% increase in their serum cholesterol. Boys had 15.03% and girls had 24.81% increase in their serum cholesterol. These levels were significantly higher than those measured at the start of therapy and comparable to their healthy peers. Conclusion: hypocholesterolemia is significantly associated with celiac disease. Gluten free diet significantly increases serum cholesterol levels in the range comparable to healthy population. The serum cholesterol levels were not found to be abnormally high suggesting that gluten free diet should not adversely affect cardiovascular health in long term.

299-303

Authors: Sangappa Virupaxappa Kashinakunti, Pampareddy B. Kollur, Manjula Rangappa, Gurupadappa Shantappa Kal

Background: Serum gamma glutamyl transferase (GGT) which is a simple and reliable marker of liver fat deposition leads to hepatic insulin resistance and long term hepatic insulin resistance may lead to type 2diabetes mellitus (DM). In this context, the present study was under taken to study the serum GGT levels and its possible associations with serum triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C) and high density lipoprotein cholesterol (HDL-D) in type 2 DM. Material and methods: The study was conducted at HSK hospital, Bagalkot from Jan 2016 to Jun 2016. The diagnosis of DM was based on WHO criteria. Sixty subjects participated in each group (DM and Controls). Fasting sample was collected and fasting blood sugar (FBS), HbA1c, urea, creatinine, GGT, and lipid parameters were estimated. Data was analysed using SPSS software. Student’s t test and Pearson correlation was applied for quantitative data. Results: The serum levels of FBS, PPBS, HbA1c, creatinine, urea, TG and VLDL were raised significantly in cases compared to controls, whereas serum HDL was significantly decreased in cases compared to controls (p=0.000). There was statistically significant (p=0.001) positive correlation between the TGL and GGT. HDL-C was significantly, negatively correlated with GGT. Conclusion: There was positive correlation between GGT and TG, TC, LDL-C and VLDL-C, only TGL was significant, and there was significant negative correlation between HDL and GGT. Hence serum GGT can be used as marker of cardiovascular diseases in type 2 DM patients.

308-311

Authors: Shimi Mahesh Sundharan, Kavita Anil Dipnaik, Pramod Waman Ingale, Sudarshan Nandkumar Shelke, Pooja

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age group with a worldwide prevalence of about 4 to12%1,2 . PCOS is seen in up to 25% of the Caucasians and 50% of the South Asian women respectively3,4 . It is a heterogeneous disorder of unknown aetiology with a strong genetic element5 . PCOS does not exclusively involve the reproductive apparatus; it has a complex number of systemic relevancy symptoms. It leads to Metabolic Syndrome with severe consequences on the cardiovascular system6 . The precise cardiovascular disease (CVD) risk in women with PCOS remains unclear because there are no longitudinal studies pertaining to cardiovascular events. There is a paucity of data in regard to cardiovascular event rates and mortality in PCOS hence the present study was aimed to assess cardiovascular disease risk in women with PCOS. Aim: To evaluate cardiovascular disease risk in women with Polycystic ovary syndrome. Materials and Methods: 50 diagnosed cases of PCOS and 50 age matched healthy females were included in this study. Cases were diagnosed based on new Rotterdam criteria formulated by the American Society for Reproductive Medicine (ASRM) and the European Society for Human Reproduction and Embryology (ESHRE). Blood samples were collected after overnight fasting. Serum High sensitivity-C Reactive Protein (hs-CRP), Total Cholesterol(TC), Triglycerides(TG), HDL Cholesterol(HDL-C), VLDL Cholesterol(VLDL-C), LDL Cholesterol (LDL-C) were estimated. Body Mass Index (BMI) was calculated for women in both the groups. Statistical analysis: Results were analyzed using unpaired t-test and p-value was calculated. BMI was correlated with hs-CRP using one way ANOVA test. Statistically non-significant increased levels of serum total cholesterol, Triglycerides, HDL cholesterol, LDL cholesterol, VLDL cholesterol and hs-CRP in PCOS cases as compared with control were observed. BMI was found to be significantly increased in cases as compared to control. Conclusion: hs-CRP is a known cardiovascular risk marker. In this study though hs-CRP was increased in the case group compared to controls but it was not statistically significant. hs-CRP levels vary with age, sex and BMI. Therefore, age, sex and BMI should be considered when interpreting hs-CRP. Women with PCOS who participated in our study were quite young (15- 35years) and majority of them had a normal BMI and this may be the reason for a relatively smaller risk of CVD compared with other studies

316-319

Authors: Anurag Yadav, Arun Kumar K, James Gonsalves, Avinash SS, Sudarshan Surendran

Ischemia modified albumin (IMA), a recently developed marker for myocardial ischemia is measured by using albumin cobalt binding (ACB) assay. The correlation between the formation of IMA and alterations in the pH levels are of considerable importance and the same was not clear in the available literature. Based on our literature search, the study was designed to check and compare the levels of IMA and the pH in acidosis and alkalosis patients with those in normal patients. The mean of IMA in patient with acidosis (0.832±0.16) was higher when compared with the normal pH patients (mean 0.71±0.21). The IMA levels in patients of alkalosis were also found higher (mean 0.804±0.19) compared to that of the normal control. It was also observed that the mean of IMA was lower in the patients with alkalosis than the patients with acidosis. When the IMA levels and the pH levels in acidosis and alkalosis patients were correlated, there was a weak negative correlation between pH levels in acidosis and IMA levels. In alkalosis, the correlation was positive but there was no significance in these changes. In conditions of acidosis and alkalosis, where the pH levels are altered which could be one of the factors responsible for increase in the IMA levels. However, the correlation was weak and an increase in the sample size could provide us with a better relation between the levels of pH and IMA

325-329

Authors: Nagalakshmi CS, Ganashree CP, Krishnamurthy N, Chethana Chethan, Shilpashree MK

Background & Objectives: Psychosomatic disturbances faced by women approaching their fifth decade have been a matter of concern since many years. Many approaches have been tried to help them, including nutritional, pharmacologic and hormone replacement therapies. However, the importance of regular yoga practice is not much debated though it is believed to improve blood glucose levels & serum lipid concentrations and also to combat oxidative stress. The current study was designed to broadly analyze the clinico-biochemical challenges encountered by such women and to suggest better measures to face them. Methods: A total of 90 women aged around 40-60 years were grouped into perimenopausal, postmenopausal and healthy control groups and were checked for anthoropometric and biochemical parameters like FBS, HbA1c, lipid profile, calcium, magnesium, copper, ceruloplasmin, TSH, uric acid, alkaline phosphatase (ALP) and total proteins. Results: Age of the subjects, their BMI, blood pressure and waist hip ratio (WHR) together with levels of glycated Hb, LDL cholesterol, TGs, calcium, magnesium, copper, ceruloplasmin and uric acid levels exhibited significant variation among the groups. Conclusions: Several psychosomatic changes encountered in and around menopause and few biochemical changes can be better handled by persistent yoga practice, either alone or in combination with conventional treatment, as it can effectively bring down the oxidative stress levels, chances of developing metabolic syndrome, risk of CVD events and improve the quality of life in such women

335-339

Authors: Suchitra Kumari, Ipsita Dash, Manaswini Mangaraj

Introduction: Decompensated diabetes mellitus with impaired renal function, acid-base disorders are often associated with electrolyte imbalance. Analysis of electrolytes is often advised without a true indication in Diabetes Mellitus. So our objective was to analyze serum electrolyte profile in diabetes mellitus to determine whether routine measurement of electrolytes can be safely avoided in diabetes. Study Design: This was a retrospective study of hospital records of all Diabetes Mellitus cases who were advised kidney function test during the period January 2014 - August 2015. Medical records and laboratory results of 190 Diabetes Mellitus cases could be retrieved and retrospectively viewed for clinical diagnosis, result of Laboratory investigation i.e. Fasting blood sugar, serum urea, creatinine, Na+ , K+ , Cl- , Ca2+, PO4- .One hundred ninety Diabetes Mellitus cases were divided into 3 groups based on their serum creatinine levels i.e. Group-I (n=98) serum creatinine <1.5 mg/dl, Group-II (n=74) serum creatinine 1.5-3 mg/dl and Group- III (n=18) serum creatinine >3 mg/dl. Results: Out of 190 patients 114 had electrolyte disorder. Serum sodium levels were altered in 45% of Group-I patients, more evident in Group-II (64%) and Group III (89%). Approximately 51% Diabetes Mellitus cases had deranged Serum K+ levels in Group I. Hyperkalemia and hypochloremia were common electrolyte disorders both in Group-II and Group III. Group- I had hypercalcemia and hyperphosphatemia whereas hypocalcemia and hypophosphatemia were more commonly registered in GroupII (40%, 37% respectively) and Group-III (68%, 61% respectively). Conclusion: So it is concluded that in diabetes mellitus electrolyte derangements occur even with normal renal function. So routine measurement of serum electrolyte could not be avoided in Diabetes Mellitus. However, the frequency of electrolyte derangement is more with deterioration of the renal function in Diabetes Mellitus.

343-347

Authors: Vikas Kumar Gupta, Prashant Nigam, S.K.B. Patil

Background: Thyroid diseases are common worldwide. In India too, there is a significant burden of thyroid diseases. According to a projection from various studies on thyroid disease, it has been estimated that about 42 million people in India suffer from thyroid diseases. Thyroid dysfunction has varied impact on pregnancy outcome. Thyroid disorders are amongst the most common endocrine diseases in India. The prevalence and pattern of thyroid disorders depends on sex, age, ethnic and geographical factors and especially on iodine intake. A high iodine intake is associated with lower prevalence of goitre and higher prevalence of hypothyroidism. This study was designed to address this question. We undertook this study to provide reference data for TSH, T4 and T3 in women of this region and evaluate their status of thyroid function. Material and Methods: The study was carried out at Department of Biochemistry, Chhattishgarh Institute of medical sciences, Bilaspur (C.G.). The study was conducted on 1100 subjects of age group 15- 65. The thyrotropin, TSH levels of serum samples were analysed using kits (Diagnostic Product Corporation (DPC), LosAngeles, USA) on the I25 GAMA Counter. Serum T3 and T4 were performed using competitive RIA technique and serum TSH was performed using IRMA technique. Result and Discussion: Of the 1100 total subjects in the age range 15–65 years, 24.1% had thyroid dysfunction and 75.9% were euthyroid. The prevalence of thyroid dysfunction in group I, 19% hypothyroid, 5% hyperthyroidism 75.9% euthyroid and in group II, 16% hypothyroidism, 4% hyperthyroid and 79.5 were euthyroid. The finding that a large number of women unknowingly have laboratory evidence of thyroid dysfunction supports the usefulness of screening for early detection. We hope to extend the study to a larger cross section of men and women in this region keeping in mind environmental and etiopathological factors like auto immunity, drugs, Iodine and non-thyroidal illness.