Journal Of Clinical And Diagnostic Research[JOURNAL]
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200 papers
Diagnostic Approach to Viral Acute Encephalitis Syndrome (AES) in Paediatric Age Group: A Study from New Delhi.
Goel S, Chakravarti A, Mantan M … +2 more , Kumar S, Ashraf MA
J Clin Diagn Res · 2017 Sep · PMID 29207707 · Full text
INTRODUCTION: Acute Encephalitis Syndrome has heralded the emergence of multiple virulent pathogens, which may result in severe morbidity and mortality. In India, encephalitis is not notified and there has been a dearth...
INTRODUCTION: Acute Encephalitis Syndrome has heralded the emergence of multiple virulent pathogens, which may result in severe morbidity and mortality. In India, encephalitis is not notified and there has been a dearth of analysis for trends in encephalitis death rates and causation. A downward trend has been observed in encephalitis deaths, due to 'known' causes, which can be largely explained by improvement in diagnostic, treatment, and prevention methods. There is still a very high proportion of encephalitis deaths in developing countries, where the aetiological diagnosis of the pathogen is not established and thus, lies the importance of monitoring encephalitis morbidity and mortality with a view to improve pathogen diagnosis and identify emerging infectious diseases. AIM: To formulate a diagnostic approach to viral acute encephalitis syndrome in paediatric age group. MATERIALS AND METHODS: A cross-sectional study including 50 paediatric patients, clinically diagnosed with acute encephalitis syndrome using WHO criteria was conducted. The CSF of all the patients was evaluated to diagnose the aetiology for viral pathogens. ELISA was used for diagnosing Japanese encephalitis and dengue encephalitis; and multiplex real time PCR was used for detecting HSV-1, HSV-2, Varicella zoster virus, Mumps virus, Enterovirus and Parechovirus. RESULTS: Confirmed diagnosis was established in 11 (22%) of 50 cases. A confirmed or probable viral agent of encephalitis was found in 7 (14%), bacterial agent was found in 2 (4%), non-infectious aetiology was found in 2 (4%). Fatal outcome was independently associated with patient age. CONCLUSION: Despite extensive testing, the aetiologies of more than three fourth of the cases remains elusive. Nevertheless the result from the present study may be useful for future design of early diagnosis and treatment of the disease. New strategies for pathogen identification and continued analysis of clinical features and case histories should help us improve our ability to diagnose, treat and prevent encephalitis.
Detection of Extended Spectrum Beta-lactamase Producing Serotype Typhi in a Tertiary Care Centre.
Ramachandran A, Shanthi M, Sekar U
J Clin Diagn Res · 2017 Sep · PMID 29207706 · Full text
INTRODUCTION: Infections caused by are an important public health threat in tropical and subtropical countries. Due to the emergence of resistance to ampicillin, chloramphenicol and trimethoprim/sulfamethoxazole (multid...
INTRODUCTION: Infections caused by are an important public health threat in tropical and subtropical countries. Due to the emergence of resistance to ampicillin, chloramphenicol and trimethoprim/sulfamethoxazole (multidrug resistant salmonellae) in the late 1980s, fluoroquinolones and extended spectrum cephalosporins became the drugs of choice. Resistance to cefotaxime and ceftriaxone due to the production of Extended Spectrum Beta-Lactamase (ESBL) and reduced susceptibility to ciprofloxacin have emerged resulting in treatment failure. The Cefotaximase (CTX-M) type ESBLs are the most widespread beta lactamase among Enterobacteriaceae including salmonellae. AIM: To detect the presence of in salmonellae causing human infections. Detection of genes to identify the coexistence of and gene MATERIALS AND METHODS: The study included 103 consecutive, non-repetitive salmonellae isolated from clinical specimens obtained from July 2015- June 2016 which were identified up to species level by conventional/automated methods. Susceptibility to various classes of antimicrobial agents was determined by disc diffusion method. Minimum Inhibitory Concentration (MIC) to cefotaxime and ceftriaxone was determined by agar dilution method. The results were interpreted in accordance with Clinical & Laboratory Standard Institute (CLSI) (guidelines 2015. Detection of the ESBL phenotype was performed by the combined disk method. Polymerase Chain Reaction (PCR) amplification of all isolates was performed using group specific primers to characterize the presence of and . RESULT: Of the 103 study isolates two isolates of were resistant to cefotaxime and ceftriaxone and had a MIC of 128μg/ml. PCR amplification and sequencing detected the presence of in these two isolates. These two isolates exhibited resistance to ciprofloxacin in vitro but gene was not detected in these isolates. CONCLUSION: Resistance to third generation cephalosporins among salmonellae is a cause for concern as it may lead to treatment failure. It is imperative to continuously monitor the susceptibility pattern as enteric fever is endemic in India.
Serum Vitamin D Level as a Risk Factor for Female Genital Tuberculosis (FGTB).
Gautam S, Jain A, Akhtar S … +2 more , Priyadarshini A, Jaiswar SP
J Clin Diagn Res · 2017 Sep · PMID 29207705 · Full text
INTRODUCTION: Vitamin D is now known to be essential to containment and killing through activation of 25-hydroxyvitamin-D receptors (VDRs) present on all immune cells or obtained from dietary food stuffs as either vitam...
INTRODUCTION: Vitamin D is now known to be essential to containment and killing through activation of 25-hydroxyvitamin-D receptors (VDRs) present on all immune cells or obtained from dietary food stuffs as either vitamin D3 or vegetable vitamin D2 (also known as ergocalciferol). AIM: To evaluate the association of serum vitamin D level between the Female Genital Tuberculosis (FGTB) cases and healthy controls. MATERIALS AND METHODS: Total 120 cases and 120 controls enrolled for the study following inclusion and exclusion criteria. Detailed clinical history was taken from each subjects. Total of 3 ml of the blood was collected in EDTA vial from each subject (case and control). Quantification of serum vitamin D level was measured by active human vitamin D ELISA kit using an ELISA reader. Statistical analysis was done using Statistical Package for Social Science (SPSS) version 21.0. A p-value <0.05 was considered as significant. RESULTS: A total of 120 confirmed FGTB cases and 120 healthy control enrolled for study. Out of 120 women 97.5%, 10.0%, 3.3%, 3.3% were detected positive for respectively. Comparing the mean demographic value of age and BMI were (29.03±3.127, 28.03±3.00) and (22.92±3.33, 24.15±3.97) respectively with the p=0.012* and p=0.010* found to be significant among cases and controls. The mean serum vitamin D level was 14.96±8.81 in cases and 23.00±8.83 in controls with p-value<0.001. There was a significant positive association found in low serum vitamin D level among FGTB cases than controls. CONCLUSION: Vitamin D is important for normal immune cell function, as well as regression of FGTB disease. FGTB may be controlled by regulating the serum vitamin D level concentration. This study suggests that, vitamin D deficiency and BMI is strongly associated with the progression of active FGTB disease which alters the expression of antimicrobial peptide and lead to the persistence of TB infection. Therefore, serum vitamin D level may play an important role in treatment of FGTB.
Opportunistic Microorganisms in Oral Cavity According to Treatment Status in Head and Neck Cancer Patients.
Soni P, Parihar RS, Soni LK
J Clin Diagn Res · 2017 Sep · PMID 29207704 · Full text
INTRODUCTION: Cancer patients receiving chemotherapy and/or radiation therapy are prone to many predisposing factors like immunosuppression, imbalance in the oral flora, hypo-salivation and local tissue damage. Therefore...
INTRODUCTION: Cancer patients receiving chemotherapy and/or radiation therapy are prone to many predisposing factors like immunosuppression, imbalance in the oral flora, hypo-salivation and local tissue damage. Therefore, considered to be at higher risk for oral bacterial and fungal infection than the general population. AIM: To study oropharyngeal flora in head and neck cancer patients under treatment and to correlate their incidence according with Chemotherapy cycles and Radiochemotherapy. MATERIALS AND METHODS: Total 110 patients were selected for study, those were further divided into two groups, group I under Chemotherapy (CT) - 55 patients and group II under Radiochemotherapy (RCT) - 55 patients and 50 healthy individuals were taken as control. Saliva sample was collected from control and study group and inoculated on Blood agar, MacConkey agar and Sabouraud's Dextrose Agar (SDA). The identification of bacterial and fungal isolates was done by standard microbiological methods and result was calculated according to cycles of Chemotherapy and Radiochemotherapy combined. Significant differences between patients were tested using the Chi-square test or Fisher's exact test. A p-value less than 0.05 was considered as statistically significant. RESULT: There were 149 culture isolates from 110 patient in which Gram Negative Bacilli (GNB) found in 63.6%, spp. in 50%, in 8% and Normal commensal of oral cavity in 13.6% patients in study group and this was higher than control group and this difference was statistically significant in relation to all isolates individually. Relatively more microorganism were isolated during RCT (56%) in compare to CT alone (44%), among GNB- (27.7%,32.3%) and (25%,29.4%) were most frequently isolated during CT, RCT respectively. spp. were more commonly isolated from patient on RCT (63.6%) than CT (36.3%) when compared to control group (20%) among which was more prevalent species. Both GNB & spp. were more commonly isolated in later chemotherapy cycles (CT4, CT5 CT6). CONCLUSION: Colonisation of Gram negative bacilli & spp. is directly related to number of chemotherapy cycles and combined cancer therapy. Hence, prophylactic medication for these two organisms should be incorporated along with cancer therapy.
Diagnosis of Acute Q Fever by Detection of DNA using Real-Time PCR, Employing a Commercial Genesig Easy Kit.
Pradeep J, Stephen S, Ambroise S … +1 more , Gunasekaran D
J Clin Diagn Res · 2017 Sep · PMID 29207703 · Full text
INTRODUCTION: Query (Q) fever is an important zoonosis and a cause of concern for humans, due to the potential bioterrorism threat posed by the causative agent, . Because of the danger of contracting the illness, isolati...
INTRODUCTION: Query (Q) fever is an important zoonosis and a cause of concern for humans, due to the potential bioterrorism threat posed by the causative agent, . Because of the danger of contracting the illness, isolation attempts are seldom made. Serological and molecular diagnostic tests are the main option. AIM: To study the prevalence of acute Q fever in Puducherry and surrounding districts of Tamil Nadu, India, employing a new commercial Real-Time Polymerase Chain Reaction (RT-PCR) kit and confirming it by the gold standard Immunofluorescence Assay (IFA). MATERIALS AND METHODS: Acute phase blood samples from 72 consecutive febrile patients and 24 healthy individuals were included in this prospective study. DNA was extracted from the buffy coats and preserved at -80°C. Detection of was carried out employing a commercial Real-Time PCR kit. Serum samples were tested for IgM (Phase I+II) and IgG (Phase I+II) by QM-120 and QG-120, IFA Fuller Laboratories, California, USA. Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were calculated keeping IFA as the reference. RESULTS: Presumptive diagnosis of acute Q fever was made in two febrile patients by the Genesig Easy kit (2.78%). In addition to these two PCR positive cases, one more patient was positive for both Phase II IgM and Phase II IgG antibodies by the gold standard IFA. All 24 healthy controls were negative for Q fever by both PCR and IFA. The sensitivity, specificity, NPV and PPV for Genesig Easy kit PCR were: 66.67%, 100%, 100% and 98.57 % respectively against IFA as the reference. CONCLUSION: The true prevalence of Q fever in India and other developing countries is poorly understood, owing to the difficulties in the diagnosis of this infection. Since molecular diagnostic tests have good specificity and are mandated for confirmation of single acute samples, validation of commercial Q fever PCR kits is the need of the hour. Genesig Easy kit in our hands was found to be reliable with the moderate sensitivity and high specificity. Performing both PCR (with acute specimens) and IFA (with paired sera) would be ideal for Q fever diagnosis.
Nagging Presence of Associated Diarrhoea in North India.
Chaudhry R, Sharma N, Gupta N … +5 more , Kant K, Bahadur T, Shende TM, Kumar L, Kabra SK
J Clin Diagn Res · 2017 Sep · PMID 29207702 · Full text
INTRODUCTION: Associated Diarrhoea (CDAD) is a significant cause of morbidity in hospitalised patients worldwide. The data on clinical epidemiology of this disease in Indian subcontinent is scarce. AIM: To evaluate the...
INTRODUCTION: Associated Diarrhoea (CDAD) is a significant cause of morbidity in hospitalised patients worldwide. The data on clinical epidemiology of this disease in Indian subcontinent is scarce. AIM: To evaluate the risk factors and clinical course of patients with CDAD. MATERIALS AND METHODS: A cross-sectional study was planned at our tertiary care centre, All India Institute of Medical Sciences, whereby, all patients who had nosocomial diarrhea between 2010 and 2014 were included in the study. Their clinical and laboratory profile were recorded using structured questionnaire and their stool samples were subjected to ELISA for detection of toxins A and B (Premier toxins A and B). Those patients who had toxins A and B in their stool samples were diagnosed as CDAD. The clinical and laboratory profile of CDAD patients were further analysed. RESULTS: A total of 791 patients with nosocomial diarrhea were included in this study. CDAD was diagnosed in a total of 48(6%) patients. The year wise breakdown of the positive patients is as follows: 7/135 (5.2%), 4/156 (2.6%), 5/141 (3.5%), 9/193 (4.7%) and 23/166 (13.8%), respectively. A total of 16/48 (33.3%) of CDAD cases belonged to the age group of 51-60 years. Malignancy (n=15, 31.25%) was the most common underlying pathological condition. All the patients had a history of antibiotic intake. Most common antibiotic used in the patients of CDAD was third generation cephalosporins (n=27, 56.25%). The use of clindamycin, carbapenems and colistin increased in the year 2014. Mean duration of hospital stay was 9.8 days. Diarrhoea was associated with fever in 50% of the patients while abdominal pain was seen in 39.6% of the patients. CONCLUSION: The control of infection suffers from the rampant use of higher antibiotics. There is a need for proper implementation of antimicrobial stewardship programmes and better hospital infection control to stop the transmission of this nagging bug.
Characterization of Vancomycin Resistant Enterococci in Hospitalized Patients and Role of Gut Colonization.
Purohit G, Gaind R, Dawar R … +4 more , Verma PK, Aggarwal KC, Sardana R, Deb M
J Clin Diagn Res · 2017 Sep · PMID 29207701 · Full text
INTRODUCTION: Enterococci are part of the normal intestinal flora and have been recognized as important human pathogens. Vancomycin Resistant Enterococci (VRE) are global threat as this resistance is transmissible and al...
INTRODUCTION: Enterococci are part of the normal intestinal flora and have been recognized as important human pathogens. Vancomycin Resistant Enterococci (VRE) are global threat as this resistance is transmissible and also poses a challenge for infection control. AIM: This study was undertaken to study phenotypic and genotypic characteristics of VRE from clinically significant infections among hospitalized patients and their association with gut colonization. MATERIALS AND METHODS: Clinically significant isolates of enterococci (n=250) were studied. Species confirmation was done by Polymerase Chain Reaction (PCR). Minimum Inhibitory Concentration (MIC) for vancomycin was determined by E-test. PCR for and gene was done for genotypic characterization. MIC for teicoplanin, linezolid, tigecycline, daptomycin and quinupristin-dalfopristin was determined by E test. Patients with VRE infection were screened for gut colonization using vancomycin screen agar (6 μg/mL). Continuous data was analysed using the Student's t-test. Categorical data was assessed using Pearson's Chi-square test. A value of p ≤ 0.05 was considered statistically significant. RESULTS: There was good correlation between the phenotypic and genotypic methods used for species identification and detection of vancomycin resistance. (162, 64.8%) was most common followed by (82, 32.84%) and (6, 2.4%). Overall higher resistance was observed among Vancomycin MIC ≥ 2 μg/mL was noted in 63 (25.2%) isolates. Fifty seven isolates showed presence of and was detected in six isolates of . Isolates with genotype was not detected in the present study. MIC (μg/mL) for teicoplanin, linezolid, tigecycline, daptomycin and quinupristin-dalfopristrin was 24, 0.75, 0.064, 2 and 0.064 respectively. Resistance to linezolid (1, 1.6%) and tigecycline (2, 3.2%) was rare. Majority (33/47, 70.2%) patients with clinically significant VRE infection showed gut colonization. CONCLUSION: Vancomycin resistance among enterococci is emerging. Emergence of tigecycline and linezolid resistance is also posing a challenge for clinicians. Thus, further investigations are warranted to control vancomycin resistance among pathogens.
Statistical Significance is Prerequisite in Study.
Mondal H, Mondal S
J Clin Diagn Res · 2017 Sep · PMID 29207700 · Full text
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Effect of 12 Weeks of Yoga Therapy on Quality of Life and Indian Diabetes Risk Score in Normotensive Indian Young Adult Prediabetics and Diabetics: Randomized Control Trial.
Keerthi GS, Pal P, Pal GK … +3 more , Sahoo JP, Sridhar MG, Balachander J
J Clin Diagn Res · 2017 Sep · PMID 29207699 · Full text
INTRODUCTION: India has become the epicentre for diabetes, a stress-related disorder affecting the working skills and day-to-day lifestyle management of younger population. Most of the studies have reported the effect of...
INTRODUCTION: India has become the epicentre for diabetes, a stress-related disorder affecting the working skills and day-to-day lifestyle management of younger population. Most of the studies have reported the effect of yoga on improving Quality of Life (QoL) in diabetic patients with other comorbidities. Till date, no randomized control trial reports are available to show the effect of yoga therapy on QoL and Indian Diabetes Risk Score (IDRS) in normotensive prediabetic and diabetic young individuals. AIM: To determine the effect of 12 weeks of yoga therapy on QoL and IDRS among normotensive prediabetic and diabetic young Indian adults. MATERIALS AND METHODS: A randomized control trial was conducted in Endocrinology Outpatient Department (OPD). Normotensive participants (n=310) aged 18-45 years were divided into healthy controls (n=62), prediabetics (n=124) and diabetics (n=124). Study group subjects were randomly assigned to Group II (n=62, prediabetes-standard treatment), Group III (n=62, prediabetes-standard treatment + yoga therapy), Group IV (n=62, diabetes-standard treatment) and Group V (n=62, diabetes-standard treatment + yoga therapy). Flanagan QoL scale, IDRS questionnaire, Fasting Plasma Glucose (FPG) and insulin were assessed pre and post 12 weeks of intervention. Statistical analysis was done using Student's paired t-test and one-way ANOVA. RESULTS: Pre-post intervention analysis showed significant improvement in QoL scale with p<0.01 in Group II and Group IV; p<0.001 in Group III and Group V respectively. There was significant reduction in IDRS in Group II (p<0.05); p<0.001 in Group III, Group IV and Group V respectively. Significant difference (p<0.001) in QoL scale and IDRS were found when study groups with standard treatment along with yoga therapy were compared to standard treatment alone. CONCLUSION: Yoga therapy along with standard treatment for 12 weeks improved QoL and attenuated the diabetes risk among Indian prediabetics and diabetics compared to standard treatment alone.
Protective effects of Ethanolic Extract of (amla) on Cardiovascular Pathophysiology of Rats, Fed with High Fat Diet.
Kanthe PS, Patil BS, Bagali SC … +3 more , Reddy RC, Aithala MR, Das KK
J Clin Diagn Res · 2017 Sep · PMID 29207698 · Full text
INTRODUCTION: Dietary high fat alters lipid profile and possibly induce sympatho-vagal imbalance. is found to be potential antioxidant and possibly counteract hyperlipidemia induced lipid peroxidation. AIM: To assess Et...
INTRODUCTION: Dietary high fat alters lipid profile and possibly induce sympatho-vagal imbalance. is found to be potential antioxidant and possibly counteract hyperlipidemia induced lipid peroxidation. AIM: To assess Ethanolic extract of (EEO) as lipid lowering and cardiovascular protective agent against high dietary fat supplemented to experimental rats. Further to study a comparative analysis between EEO and atorvastatin on hyperlipidemia and cardiovascular integrity. MATERIALS AND METHODS: EEO was prepared and phytochemical analysis was done. Rats were divided into five groups, having six rats in each group as following; Group I-control (20% fat); Group II (+ EEO 100 mg/kg body wt); Group III (fed with high fat diet; 30% fat); Group IV (fed with high fat diet; 30% fat + EEO 100 mg/kg body wt) and Group V (fed with high fat diet; 30% fat + atorvastatin 4 mg/kg body wt). The treatments were continued for 21 days. Gravimetric parameters and electrophysiological parameters {Heart Rate (HR), sympatho-vagal balance} were recorded and lipid profiles of all the groups were measured. ANOVA, correlation and multiple regressions were done for analysis of data. RESULTS: Significant alteration in serum lipid profile was observed in rats fed with high dietary fat but supplementation of EEO was found to be reversible. Electrophysiological evaluation revealed altered HR and sympatho-vagal balance in high dietary fat fed rats (Group III) which indicate cardiac autonomic malfunctions which were found to be improved in supplemented group of rats (Group IV). Further, analysis has shown significant negative correlation between HDL/LDL and sympatho-vagal balance in all groups of rats which clearly indicate a role of dietary fat on sympatho-vagal balance. These results further corroborated with findings of histopathological study on myocardium and elastic artery. CONCLUSION: Observations from the study indicate a beneficial role of ethanolic extract of (amla) on dyslipidemia and cardiac autonomic functions in rats treated with high fat diet.
Effects of Organophosphorus Pesticides on Cardiorespiratory Parameters among the Farmers.
Priyadharshini UK, Latha R, Kavitha U … +1 more , Nirmala N
J Clin Diagn Res · 2017 Sep · PMID 29207697 · Full text
INTRODUCTION: Indiscriminate use and improper handling of synthetic pesticides in agriculture have resulted in serious problems such as asthma, wheeze and chronic bronchitis among the farmers. Though number of studies ha...
INTRODUCTION: Indiscriminate use and improper handling of synthetic pesticides in agriculture have resulted in serious problems such as asthma, wheeze and chronic bronchitis among the farmers. Though number of studies have been done on pesticide exposure and its effect on cardiorespiratory parameters in Northern India, only few studies were done in Southern India, thus this study was chosen. AIM: To find the cardiorespiratory changes in farm workers exposed to organophosphorus pesticides. MATERIALS AND METHODS: Peak Expiratory Flow Rate (PEFR), blood pressure, pulse rate were measured among 35 farm workers of Palayam and Naduveerpattu village of Cuddalore district and 35 age, sex, BMI matched controls were taken from urban area and the same parameters were measured in both groups from 10 am-12 am in the morning. History of use of personal protective equipments like face mask, eye mask, special clothes, shoes, hat, history of respiratory symptoms and hygienic work practices was also obtained from the farmers. Chi-square test was used to analyse the qualitative data. All values were expressed as Mean±SD. Students unpaired t-test was used to compare PEFR between two groups and to compare the duration of exposure and PEFR using GRAPH PAD PRISM. The p<0.05 was considered to be statistically significant. RESULTS: There was a significant decrease in PEFR among the farmers (p<0.001) compared to the controls. On comparing the duration of exposure of pesticide and the PEFR values by unpaired Students t-test, there was a significant difference with p-value of 0.03. Blood Pressure did not show any significant difference between the two groups. But the pulse rate was significantly decreased among the farmers (p<0.001) which could be due to their regular physical activity. About 71% of the farmers used personal protective equipments. CONCLUSION: Thus, chronic exposure to organophosphorus pesticides has an impact on PEFR among the farmers.
Correlation of Pregnancy Associated Plasma Protein A and Zinc with Calculated Risk Ratio of Dual Test.
Ghoshal I, Varashree BS, Belle VS … +1 more , Prabhu K
J Clin Diagn Res · 2017 Sep · PMID 29207696 · Full text
INTRODUCTION: First trimester screening by dual test is the most preferred method of antenatal screening. The detection rate of foetal aneuploidy using dual test is 95%. This test uses maternal serum free β human Chorion...
INTRODUCTION: First trimester screening by dual test is the most preferred method of antenatal screening. The detection rate of foetal aneuploidy using dual test is 95%. This test uses maternal serum free β human Chorionic Gonadotropin (free β hCG) and Pregnancy Associated Plasma Protein A (PAPP-A) along with maternal demographic and foetal sonographic indices to calculate risk for foetal aneuploidy. PAPP-A is a zinc binding metalloproteinase which is also responsible for placental development and foetal growth. So, zinc might also have some role in first trimester screening. No studies are available substantiating the role of zinc in first trimester screening. AIM: To measure and correlate maternal serum zinc with PAPP-A and calculated risk ratio of first trimester screening. MATERIALS AND METHODS: PAPP-A and zinc were measured from the serum of 84 pregnant women aged 20-40 years in 11-13 weeks+6 days of gestation who underwent dual test during their antenatal check-up. Risk calculation was done using Screening Software for Downs Windows Lab (SSDWL). RESULTS: Maternal serum PAPP-A showed a significant positive correlation with maternal serum zinc (p-value <0.001). Maternal serum PAPP-A and zinc both showed a significant positive correlation with calculated risk ratio (p-value<0.01). CONCLUSION: As PAPP-A is a zinc binding metalloproteinase, zinc showed significant pattern of correlation with aneuploidy risk as shown by PAPP-A. So there could be a possible role for serum zinc in first trimester of screening.
Association of Glycated Haemoglobin and Serum Apolipoproteins with Diabetic Retinopathy: An Indian Overview.
Mukherjee B, Shankar S, Ahmed R … +2 more , Singh K, Bhatia K
J Clin Diagn Res · 2017 Sep · PMID 29207695 · Full text
INTRODUCTION: India is presently facing an epidemic of diabetes mellitus and the risks of chronic complications from the disease are associated with the duration of the disease as well as the degree of hyperglycaemia. Di...
INTRODUCTION: India is presently facing an epidemic of diabetes mellitus and the risks of chronic complications from the disease are associated with the duration of the disease as well as the degree of hyperglycaemia. Diabetic retinopathy is a known microvascular complication of diabetes mellitus and is the most common cause of blindness in the western countries.Apolipoproteins are the protein component of lipoproteins. Apart from acting as structural proteins, they also act as cofactors to various enzymes. AIM: To measure the levels of serum apolipoproteins and glycated haemoglobin in cases of diabetic retinopathy and to assess their association with the stages of diabetic retinopathy. MATERIAL AND METHODS: The 135 diabetic cases [with (110) and without (125) retinopathy] attending the Ophthalmology OPD of this tertiary care hospital were included in the present study. Following retinoscopy, the patients were classified as Non-Proliferative Diabetic Retinopathy (NPDR) (n=75) and Proliferative Diabetic Retinopathy (PDR) (n=35). The controls (n=100) were age and sex matched patients who did not have diabetes. The cases and controls were assessed for HbA1c, total cholesterol, triglycerides, HDL cholesterol, Apo A-I and Apo B-100. RESULTS: The HbA1c was found to be higher in diabetics without retinopathy (7.02%) as compared to controls (5.58%) (p<0.05) and the highest value was seen in the mild NPDR group (8.82%). The mean value of Apo A-I was found to be lowest in the diabetics without retinopathy at 88 mg/dl and the highest in severe NPDR at 167 mg/dL. The mean value of Apo B-100 was found to be highest in severe NPDR at 114 mg/dL. The mean value of HDL cholesterol was lowest in moderate NPDR at 36.6 mg/dl. Total cholesterol was highest in severe NPDR at 280.88mg/dl while triglyceride was highest in severe NPDR at 286.4mg/dl. CONCLUSION: In our study, the level of HbA1c was found to range from 5.58% in non-diabetic to 8.82% in mild NPDR. There was a clear association between Apo B-100 and total cholesterol, triglycerides with the highest value of each parameter seen in the severe NPDR group. There was a discordance noted in the levels of HDL and Apo A-I in various groups. Apo B-100 values may be of value in prognosis of diabetic retinopathy as higher values may result in progression of the disease. Further studies involving Lp(a) and homocysteine may be required in cases of diabetic retinopathy.
The Effect of Ramadan Fasting on Biochemical Parameters in Healthy Thai Subjects.
Ongsara S, Boonpol S, Prompalad N … +1 more , Jeenduang N
J Clin Diagn Res · 2017 Sep · PMID 29207694 · Full text
INTRODUCTION: Although, the effect of Ramadan fasting on the risks for Cardiovascular Disease (CVD) has been reported in several studies, the results were inconsistent. In addition, the effect of Ramadan fasting on bioch...
INTRODUCTION: Although, the effect of Ramadan fasting on the risks for Cardiovascular Disease (CVD) has been reported in several studies, the results were inconsistent. In addition, the effect of Ramadan fasting on biochemical parameters in Thai subjects has not been evaluated. AIM: The aim of this study was to investigate the effect of Ramadan fasting on anthropometry, blood pressure, Fasting Blood Glucose (FBG), lipid profiles, and body composition in healthy Thai subjects. MATERIALS AND METHODS: A total of 65 healthy subjects (21 men and 44 women) aged between 19-24 years were randomly recruited. Anthropometry, blood pressure, FBG, Total Cholesterol (TC), Triglyceride (TG), High Density Lipoprotein-Cholesterol (HDL-C), Low Density Lipoprotein-Cholesterol (LDL-C), and body composition were measured before Ramadan, end of Ramadan and after one month of Ramadan. RESULTS: There were no changes in anthropometry, blood pressure, lipid profiles and body composition in both genders before Ramadan, end of Ramadan and after one month of Ramadan. Nevertheless, FBG levels were significantly increased after one month of Ramadan compared with baseline (5.09±0.50 versus 4.83±0.38 mmol/L, p=0.016, respectively) in women. CONCLUSION: The Ramadan fasting did not affect the lipid, anthropometric and body composition in healthy Thai subjects. However, the increased FBG levels after one month of Ramadan were observed in women. To improve the favourable biochemical parameters after Ramadan fasting, the lifestyle modifications such as, increased intake of healthy diets and increased physical activity should be recommended.
Serum Uric Acid in Chronic Obstructive Pulmonary Disease: A Hospital Based Case Control Study.
Sarangi R, Varadhan N, Bahinipati J … +3 more , Dhinakaran A, Anandaraj, Ravichandran K
J Clin Diagn Res · 2017 Sep · PMID 29207693 · Full text
INTRODUCTION: Airway inflammation and imbalance between oxidant/anti-oxidant mechanisms are postulated to play a major role in the pathogenesis and exacerbation of Chronic Obstructive Pulmonary Disease (COPD). Previous s...
INTRODUCTION: Airway inflammation and imbalance between oxidant/anti-oxidant mechanisms are postulated to play a major role in the pathogenesis and exacerbation of Chronic Obstructive Pulmonary Disease (COPD). Previous studies on the role of serum Uric Acid (UA) in COPD subjects have been both confounding and inconclusive. AIM: To measure the serum UA levels among COPD subjects and to correlate with different stages of the disease. MATERIALS AND METHODS: The study included 39 stable COPD subjects (21 males, 18 females; 13 smokers, 26 nonsmokers; age group; 40 to 60 years) and compared with 46 control subjects from the general population. Serum UA levels were measured by enzymatic colorimetric assay in fully automated analyser (Cobas Integra 400+, Roche, Germany) using commercially available kits from Roche. This was further correlated with duration and severity of COPD {determined as per Global Initiative for Obstructive Lung Disease (GOLD) criteria}. RESULTS: The mean age of COPD and control subjects was 62.97±11.30 and 48.76±12.71 years, respectively (p<0.001). COPD cases had significantly higher level of UA compared to control subjects (4.85±1.67 vs. 2.32±0.93 mg/dl, respectively, p<0.001). Female subjects with COPD had higher levels of UA compared to their male counterparts (5.15±1.89 vs. 4.59±1.45 mg/dl, respectively, p=0.3). Similar insignificant (p=0.56) trend was also observed among control subjects. Hyperuricaemia correlated significantly (p< 0.05) with advance duration (≥ 10 years) of COPD; whereas, statistically insignificant trend was observed for GOLD stage 3/4 versus stage 1/2 disease. Nonsmokers were having higher uric acid level than smokers. Alcohol intake did not affect the level of uric acid in COPD cases (p=0.79). CONCLUSION: Serum uric acid is a simple, cost effective biochemical test which may be useful in risk stratification of subjects with newly diagnosed chronic obstructive pulmonary disease. Hyperuricaemia is associated with advance duration and stage of COPD.
Oxidative Stress in the Development of Genetic Generalised Epilepsy: An Observational Study in Southern Indian Population.
Prasad DKV, Satyanarayana U, Shaheen U … +2 more , Prabha TS, Munshi A
J Clin Diagn Res · 2017 Sep · PMID 29207692 · Full text
INTRODUCTION: Oxidative stress resulting from excessive generation of Reactive Oxygen Species (ROS) plays a significant role in neurodegeneration associated with seizures/epilepsy. AIM: To evaluate oxidative stress marke...
INTRODUCTION: Oxidative stress resulting from excessive generation of Reactive Oxygen Species (ROS) plays a significant role in neurodegeneration associated with seizures/epilepsy. AIM: To evaluate oxidative stress markers and antioxidant enzymes in Genetic Generalised Epilepsy (GGE) and to know the extent of oxidative stress induced by Anti-Epileptic Drugs (AEDs) with the time duration of treatment. MATERIALS AND METHODS: In this case-control study, 310 GGE patients (male:female=203:107), who were on AED treatment (n=235) and 75 untreated patients (male:female=49:26) along with 310 age and sex matched healthy controls were recruited. Oxidative stress markers such as Nitric Oxide (NO), Malondialdehyde (MDA) and antioxidant enzyme activities namely Superoxide Dismutase (SOD), Glutathione Peroxidase (GPx) and Catalase (CAT) were measured spectrophotometrically. RESULTS: Significantly higher levels of serum NO, MDA and low levels of plasma Total Antioxidant Capacity (TAC) were found in patients as compared to controls (p<0.001) whereas erythrocyte SOD, CAT and GPx activities were found to be significantly low in patients when compared to the control group (p<0.001). Statistically significant higher levels of NO, MDA and lower levels of SOD, CAT and TAC were observed in patients subgroup, who were on AEDs for more than >5 years compared to other groups (≤ 1 year and 1-≤ 5 years) (p=0.02, p=0.01, p=0.001, p=0.01 and p=0.05 respectively). Further, significant increase in the levels of NO, MDA and decreased activities of SOD, CAT were found in treated patients compared to untreated patients (p<0.05) denoting that additional oxidative stress induced by AEDs which results in seizure recurrence and drug intractability. CONCLUSION: Our study demonstrated that GGE patients have additional oxidative stress due to AEDs and decreased antioxidant enzyme activities causing an imbalance between oxidant and antioxidant status, which might contribute to the pathogenesis of GGE.
A Comparative Study of High Sensitivity C-Reactive Protein and Metabolic Variables in Type 2 Diabetes Mellitus with and without Nephropathy.
Shaheer AK, Tharayil JK, Krishna PW
J Clin Diagn Res · 2017 Sep · PMID 29207691 · Full text
INTRODUCTION: Diabetic nephropathy is a serious chronic complication of Type 2 Diabetes Mellitus (T2DM) which impairs the quality of life, leading to increased morbidity and mortality. The high sensitivity C-reactive pro...
INTRODUCTION: Diabetic nephropathy is a serious chronic complication of Type 2 Diabetes Mellitus (T2DM) which impairs the quality of life, leading to increased morbidity and mortality. The high sensitivity C-reactive protein (hs-CRP) is an acute phase reactant which acts as a non-specific systemic marker of inflammation. AIM: To find out the relationship between serum hs-CRP and metabolic variables in Type 2 diabetic patients with and without nephropathy. MATERIALS AND METHODS: The study group consists of 96 subjects that include non-diabetic healthy controls, Type 2 diabetic patients without any complications and patients with diabetic nephropathy. The study group was composed of both genders, aged 31-70 years, who reported after 10-12 hours overnight fasting; then, venous blood and fresh urine samples were collected, in the morning from all the study subjects. Data were analysed using Statistical Package for the Social Sciences (SPSS). Independent t-test was used to compare between the groups and Chi square test was used to find out the relationship between serum hs-CRP and metabolic variables. RESULTS: The results showed a significantly (p<0.05) increasing trend of serum hs-CRP with the degree of microalbumin excretion and the severity of nephropathy in Type 2 diabetic patients. The result showed a significant (p<0.05) relationship between hs-CRP and the metabolic variables like Fasting Blood Glucose (FBG), Post Prandial Blood Glucose (PPBG), Total Cholesterol (TC), Triglycerides (TG), LDL-Cholesterol (LDL-C), TC:HDL-Cholesterol (HDL-C) ratio and estimated Glomerular Filtration Rate (eGFR) and no significance (p>0.05) between hs-CRP and HDL-Cholesterol in both diabetic and diabetic nephropathy subjects. CONCLUSION: Hs-CRP was strongly associated with the metabolic variables and predictors of cardiovascular risk in Type 2 diabetes mellitus with and without nephropathy. The hs-CRP might be considered as a predictor or illness indicator for the development of nephropathy and cardiovascular risk in Type 2 diabetic patients.
Morphological and Morphometric Study of Coronary Sinus in North Indian Population.
Zabina B, Singla RK, Sharma RK … +1 more , Bala N
J Clin Diagn Res · 2017 Sep · PMID 29207690 · Full text
INTRODUCTION: Coronary sinus (CS) is the largest vein draining the blood from heart. It is a muscular tube of about 2 cm to 3 cm length and 1 cm in caliber. It has become a clinically important structure through its role...
INTRODUCTION: Coronary sinus (CS) is the largest vein draining the blood from heart. It is a muscular tube of about 2 cm to 3 cm length and 1 cm in caliber. It has become a clinically important structure through its role in providing access for different cardiac procedures viz., biventricular pacing, arrhythmia ablation and for deployment of an array of cardiac devices. AIM: To study the location, shape, length and width of CS including its left atrial muscular coverage in 50 cadaveric hearts. MATERIALS AND METHODS: The present study comprised of 50 adult human apparently normal formalin fixed cadaveric hearts belonging to either sex obtained from the Department of Anatomy, Government Medical College, Amritsar, India. Location and shape of CS were noted, external and internal lengths of the CS were measured with the help of a thread and Vernier caliper. Width of CS was measured at three levels; at the beginning, at the point of entry of Middle Cardiac Vein (MCV) and at termination in right atrium. The walls of CS were examined to note whether they were covered by the muscles of left atrium or not. Descriptive analysis was done to calculate range, mean and Standard Deviation (SD) by using Statistical Package for Social Science (SPSS) 17.0. RESULTS: CS was located in the posterior atrioventricular sulcus in 98%. Two shapes; funnel in 82% and tubular/cylindrical in 18% were observed. External length of coronary sinus ranged from 20.5 mm to 58.78 mm (mean 38.22±8.6 mm) and internal length ranged from 16.28 mm to 49.6 mm (mean 34.48±8.9 mm). Maximum width of coronary sinus was at its termination (9.61±2.6 mm) and it was covered by muscles of left atrium in 96% of hearts. CONCLUSION: CS is a constant structure in cardiac venous anatomy but its location, shape, length and width are variable. Knowing these variations can help cardiac surgeons especially during cardiac resynchronization therapy, ablation and defibrillation.
Students' Perception and Attitude on Methods of Anatomy Teaching in a Medical College of West Bengal, India.
Bandyopadhyay R, Biswas R
J Clin Diagn Res · 2017 Sep · PMID 29207689 · Full text
INTRODUCTION: Incorporating newer teaching aids over traditional one in Anatomy has been challenging both for the teachers and the learners. Different educational strategies are being used for teaching of Anatomy. AIM: T...
INTRODUCTION: Incorporating newer teaching aids over traditional one in Anatomy has been challenging both for the teachers and the learners. Different educational strategies are being used for teaching of Anatomy. AIM: To elicit the perception and attitude toward teaching approaches in the Anatomy curriculum among first year medical students. MATERIALS AND METHODS: A cross-sectional, descriptive study was undertaken with the help of predesigned, pre-tested questionnaire to elicit knowledge in four domains of classroom teaching which were: a) gross anatomical structure; b) organ identification; c) topography; and d) radiological anatomy and self-assessment of acquired skills in respective fields among 114 first year students. RESULTS: A total of 57% of students opined good in gross structure of anatomy. A 60.5% of students preferred chalk and board method and 33.3% with LCD projector. Regarding acquiring knowledge, 72.8% of medical students gathered knowledge in gross anatomical structure domain whereas 58.8% in radiological anatomy. The overall mean score of attitude of the students regarding incorporating newer techniques in Anatomy teaching is 14.17±2.26. CONCLUSION: The perception of Anatomy teaching and attitude among medicos have been studied and opinion from them had thrown light for incorporation of newer techniques in their teaching curriculum.
Radiological Biometric Study of Metatarsals and Phalanges.
Patil S, Hanumantharaya GH, Desai SP … +1 more , Nidoni M
J Clin Diagn Res · 2017 Sep · PMID 29207688 · Full text
INTRODUCTION: Several diseases affect the forefoot bones. Relative dimensions of the forefoot bones are important considerations for preoperative and postoperative assessment of surgeries. The choice of a particular surg...
INTRODUCTION: Several diseases affect the forefoot bones. Relative dimensions of the forefoot bones are important considerations for preoperative and postoperative assessment of surgeries. The choice of a particular surgery over another can also be made if the surgeon knows the length to which a bone needs to be lengthened or shortened in comparison to other bones of the forefoot. AIM: To measure the dimensions of the metatarsals and phalanges on standardized radiographs and to determine possible correlations amongst them. MATERIALS AND METHODS: A cross-sectional prospective study was conducted on 60 volunteer participants of either sex. The dimensions of metatarsals and phalanges were measured on standardized radiographs of both feet in 60 healthy adults. The mean, range and standard deviation were calculated. Correlation analysis was done to assess the association between the variables. RESULTS: The first metatarsal was the shortest (56.42±4.41 mm in males and 50.09±3.06 mm in females) and widest of all metatarsals (13.7±1.00 mm in males and 11.7±0.91 mm in females). The first proximal phalanx was the longest (28.0±2.40 mm in males and 25.8±2.21 mm in females) and the fifth distal phalanx (5.2±1.33 mm in males and 4.4±1.03 mm in females) was the shortest of all phalanges. A strong correlation (p<0.001) exists amongst the lengths of metatarsals, proximal phalanges and middle phalanges, within their own groups. CONCLUSION: Correlation of the lengths and widths of the forefoot bones amongst themselves and between types can be calculated mathematically utilising standardized radiographs. This helps in assessment of forefoot disorders, choose an appropriate surgical technique and postoperative evaluation.
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