International journal of Clinical Biochemistry and Research

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.