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.