The study of association of serum ischemia-modified albumin and prediabetes in women: A case–control study

Background: Prediabetes, diabetes, and their associated complications adversely affect women’s health worldwide. Women in the reproductive age group are more prone for developing diabetes and its associated complications such as gestational diabetes and infertility. Hence, it is the need of the hour to diagnose women at risk of pre-diabetes. Oxidative stress, ischemia, and hypoxia have been suggested as important factors in developing prediabetes and its sequels. Aims and Objectives: The present study aimed to study the association of serum ischemia-modified albumin (IMA), namely, a marker of oxidative stress, ischemia, and hypoxia with prediabetes in the women of reproductive age group. Materials and Methods: The present study was carried out in 50 females in the reproductive age group of 19–45 years. The study population was further sub-divided into two groups: Group I consisted of 25 prediabetic patients and Group II consisted of 25 healthy controls. Serum samples of the subjects were analyzed for serum IMA, blood sugar profile, and other routine biochemistry tests. Results: The present study showed that mean serum IMA was raised in prediabetic group as compared to healthy controls. The serum IMA also positively correlated with blood sugar profile. Conclusion: Increased serum IMA could be used as a biomarker for predicting prediabetes in females of reproductive age group. This, in turn, would be helpful in preventing the burden of various complications known to occur in the natural course of prediabetes and diabetes.

The study of serum hsCRP, ferritin, IL-6 and plasma D-dimer in COVID-19: a retrospective study

OBJECTIVES

The cut off values for serum high sensitivity C-reactive protein (hsCRP), ferritin, interleukin 6 (IL-6) and plasma D-dimer could be of profound help in detecting COVID-19 patients at risk of adverse outcomes. Therefore, the aim of the present study is to determine the cut off values of the serum hsCRP, ferritin, IL-6 and plasma D-dimer in predicting mortality in COVID-19 patients.

METHODS

Four hundred RT-PCR confirmed cases of COVID-19 were sub divided into two groups based on their outcome during hospitalisation. Group I consisted of survivors and Group II consisted of non-survivors. The survivors were further divided into three sub-groups: mild, moderate and severe based on the severity of infection. The laboratory data of serum hsCRP, ferritin, IL-6 and plasma D-dimer for all these patients was retrieved from the Medical Record Section of the Hospital.

RESULTS

Mean serum hsCRP, ferritin, IL-6 and plasma D-dimer levels were significantly higher in non-survivors as compared to survivors of COVID-19. The levels of these biomarkers correlated with the severity of COVID-19 illness. ROC curve analysis revealed that plasma D-dimer is having a better predictive value as compared to other parameters in predicting mortality in COVID-19.

CONCLUSIONS

The serum hsCRP, ferritin, IL-6 and plasma D-dimer levels could be used in risk stratification of COVID-19 patients. The optimum cut off given by the current study could be considered in predicting adverse outcome in these patients. Amongst the many studied biomarkers, plasma D-dimer might be the best early biomarker to predict mortality in COVID-19 patients.

Does serum TSH level act as a surrogate marker for psychological stress and cardio-metabolic risk among adolescent and young people?

OBJECTIVES

The incidence of metabolic syndrome is increasing even at younger ages. Metabolic syndrome constitutes a group of cardiovascular risk factors that include high cholesterol, triacylglycerol, hyperglycemia, central obesity, etc., which increases the risk of cardiovascular disease, diabetes mellitus, may be even cancer. Indian students enter colleges just after crossing their adolescent age and will be exposed to greater academic stress. Psychological stress or depression is associated with transient change in thyroid hormones level or dysfunction. To explore an association among serum Thyroid Stimulating Hormone (TSH) levels, fT3:fT4 ratio, psychological stress scores, and selected known cardio-metabolic risk markers.

METHODS

Forty first year MBBS students were included. Their demographic, anthropometric variables, and the blood pressure were documented. Serum TSH, fT3, fT4, and salivary cortisol level was quantified. The stress level was assessed using Cohen Perceived Stress Scale Scoring. Data were expressed in mean ± standard deviation. Data (parametric/non-parametric) were compared by Independent unpaired ANOVA or Kruskal Wallis test whichever is appropriate. Spearmen correlation analysis was performed.

RESULTS

Serum TSH and Cohen stress score are negatively correlated (r=-0.152), but serum cortisol showed (r=0.763) a positive correlation. TSH levels and the marks obtained in the summative assessments were negatively correlated and the correlation was not statistically significant.

CONCLUSIONS

The psychological stress is associated with low serum TSH, high cortisol, and poor academic performance in first year MBBS students. Blood pressure, plasma glucose, and anthropometric measures were not associated with the psychological stress.

COVID-19 transmission: a positive perspective

OBJECTIVES

To understand the dynamics of infectivity of COVID-19 and allay the fear and anxiety associated with it in healthcare workers and the society.

CASE PRESENTATION

Three individuals accompanied their pediatric patients in the COVID ward but did not develop infection. Information about their knowledge and perspective about the disease and the protective measures undertaken by them during their stay in the hospital was gathered by administering a questionnaire 14 days after discharge.

CONCLUSIONS

It was observed that use of proper precautionary measures like wearing a mask and regular hand sanitization helped in prevention from COVID-19 infection even after having close contact with confirmed cases. Such facts/observation will help in sensitizing the public about COVID-19 and eliminate panic in the society.

Lipid profile of population of central region of Nepal

This study was conducted to know the status of Lipid profile in people of central region of Nepal. This study was conducted in College of Medical Sciences & Teaching Hospital, Bharatpur, Nepal from February 2009 to March 2010 which is situated in central region of Nepal. A total of 870 cases, out of which 512(58.85%) male and 358(41.14%) female were included and study was carried out using data retrieved from the register maintained in the Department of Biochemistry. The variables collected were age, sex, lipid profile which includes total cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C) & low density lipoprotein-cholesterol (LDL-C). The data was analyzed using excel 2007 and Statistical Package for the Social Sciences (SPSS) 16.0. The total mean±SD of TC, TG, HDL-C, LDL-C were found to be 164.87±49.49, 157.56±79.78, 33.59±11.10, 97.79±40.68 respectively. Total Cholesterol, HDL-C & LDL-C were found to be statistically significant whereas TG was statistically insignificant between male and female. In both male and female, TG & LDL-C were higher in the age group of 21-40 years whereas HDL-C was higher in the age group of >61 years in both the group. Total cholesterol (TC) level was higher in the age group of 21-40 years in male while in female in the age group of 41-60 years. Desirable level of TC was observed in 78.50% of the total subjects while the normal TG, LDL-C were observed in 56.55%, 81.49%, respectively. Very high levels of TC, TG, LDL-C were observed in 4.94%, 0.34% & 1.6% of the total population studied, respectively. More percentage of female (27.65%) had higher HDL-C level than in male (15.62%). High triglycerides (TG) level is the commonest lipid abnormality in our study. HDL-C level was increase with increasing in age. Clinical evaluation can be made according to this study.

Liver dysfunction in alcoholics in Western Nepal

To estimate liver function tests in patients with alcoholic fatty liver disease, alcoholic hepatitis and alcoholic cirrhosis and to compare the levels of enzymes between the groups. A hospital based case control study was carried out at Nepalgunj Medical College, Nepal from January 2013 to June 2013. A total of 150 alcoholic associated liver disorders patients aged between 20-70 years and 50 sex age matched normal healthy controls were taken to assess liver function tests (LFTs) by measuring Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatase (ALP), Gamma glutamyltranspeptidase (GGT) & Albumin. The mean±SD of liver function tests (LFTs) of patients of alcoholic fatty liver disease is highest followed by alcoholic hepatitis patients. All the 3 groups of alcoholic associated liver disorders patients when compared to normal healthy control subjects showed statistically significant increase in the levels of AST (p<0.000), ALT (p<0.000), ALP (p<0.006), GGT (p<0.000), & Albumin (p<0.000). Liver function tests values for alcoholic associated liver disorders patients when compared to the healthy control subjects was significantly altered.

Prevalence of hyperuricemia in Chitwan District of Nepal

The prevalence of hyperuricemia has been increasing in both developed and developing countries. The purpose of present study was to know the prevalence of hyperuricemia in the population of Chitwan district as well as to compare the prevalence of hyperuricemia between Mongolian and non-Mongolian races of Chitwan district, who had attended the College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal during the period of January 1999 to December 2003. In this study 3794 subjects were investigated for serum uric acid level (SUA). Hyperuricemia is defined as SUA more than 7mg/dl for males and menopausal women and 6mg/dl for pre-menopausal females. SUA was estimated by Caraway method in digital colorimeter. Overall prevalence was 21.42%; the condition was more common in men than women (26.78% vs. 16.82%; p<0.001). The prevalence was higher in Mongolian than non Mongolian both in males and females (24.50 % Vs 21.06%; p>0.05). Key words: Hyperuricemia; SUA; digital colorimeter DOI: 10.3126/jcmsn.v6i2.3612   Journal of college of Medical Sciences-Nepal, 2010, Vol.6, No-2, 18-23

Study of effect of ethanol on antioxidant - vitamin A and C in rat liver

Objective: To see the effect of consumption of locally distilled alcohol (country liquor) continuously for few months on hepatic vitamin A and C status in albino rats. Materials and methods: The study was conducted in 36 male wistar strain albino rats for 3-4 months old consisting six groups of six animals each. Results: The first observation was weight gain among the series of alcoholic animals when compared to the control and alcoholic fed animals supplemented with vitamin A and C, p-value by T-test between the mean values of the initial weight and final weight was < 0.01 (0.006), significant. Conclusion: It was found that the major effect on hepatic vitamin A and C contents were observed more distinctly in mitochondrial fractions when compared with the rest fractions. Supplementation of vitamins helped to protect loss of the vitamins which delayed the aging process at age 9-10 months in our study. Key words: Albino rats; alcoholic; hepatic; vitamin A DOI: 10.3126/jcmsn.v6i1.3599 Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 1, 29-34